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Borzillo V, Scipilliti E, Pezzulla D, Serra M, Ametrano G, Quarto G, Perdonà S, Rossetti S, Pignata S, Crispo A, Di Gennaro P, D’Alesio V, Arrichiello C, Buonanno F, Mercogliano S, Russo A, Tufano A, Di Franco R, Muto P. Stereotactic body radiotherapy with CyberKnife ® System for low- and intermediate-risk prostate cancer: clinical outcomes and toxicities of CyPro Trial. Front Oncol 2023; 13:1270498. [PMID: 38023175 PMCID: PMC10660677 DOI: 10.3389/fonc.2023.1270498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/11/2023] [Indexed: 12/01/2023] Open
Abstract
Simple summary Stereotactic body radiotherapy (SBRT) of 35-36.25 Gy in five fractions with the CyberKnife System yields excellent control with low toxicity in low-intermediate-risk prostate cancer patients. We found no differences in biochemical control and overall survival in relation to dose. There were no significant differences in toxicity or quality of life between the two groups. Aims Stereotactic body radiotherapy (SBRT) is an emerging therapeutic approach for low- and intermediate-risk prostate cancer. We present retrospective data on biochemical control, toxicity, and quality of life of CyPro Trial. Materials and methods A total of 122 patients with low- and intermediate-risk prostate cancer were treated with the CyberKnife System at a dose of 35 Gy or 36.25 Gy in five fractions. Biochemical failure (BF)/biochemical disease-free survival (bDFS) was defined using the Phoenix method (nadir + 2 ng/ml). Acute/late rectal and urinary toxicities were assessed by the Radiation Therapy Oncology Group (RTOG) toxicity scale. Quality of life (QoL) was assessed by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and PR25. International Erectile Function Index-5 (IIEF5) and International Prostate Symptom Score (IPSS) questionnaires were administered at baseline, every 3 months after treatment during the first years, and then at 24 months and 36 months. Results The 1-, 2-, and 5-year DFS rates were 92.9%, 92.9%, and 92.3%, respectively, while the 1-, 2-, and 5-year bDFS rates were 100%, 100%, and 95.7%, respectively. With regard to risk groups or doses, no statistically significant differences were found in terms of DFS or bDFS. Grade 2 urinary toxicity was acute in 10% and delayed in 2% of patients. No Grade 3 acute and late urinary toxicity was observed. Grade 2 rectal toxicity was acute in 8% and late in 1% of patients. No Grade 3-4 acute and late rectal toxicity was observed. Grade 2 acute toxicity appeared higher in the high-dose group (20% in the 36.25-Gy group versus 3% in the 35-Gy group) but was not statistically significant. Conclusion Our study confirms that SBRT of 35-36.25 Gy in five fractions with the CyberKnife System produces excellent control with low toxicity in patients with low-intermediate-risk prostate cancer. We found no dose-related differences in biochemical control and overall survival. Further confirmation of these results is awaited through the prospective phase of this study, which is still ongoing.
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Affiliation(s)
- Valentina Borzillo
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Esmeralda Scipilliti
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Donato Pezzulla
- Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy
| | - Marcello Serra
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Gianluca Ametrano
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Giuseppe Quarto
- Department of Uro-Gynecological, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Sisto Perdonà
- Department of Uro-Gynecological, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Sabrina Rossetti
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Sandro Pignata
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Piergiacomo Di Gennaro
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Valentina D’Alesio
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Cecilia Arrichiello
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | | | - Simona Mercogliano
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Antonio Russo
- Department of Diagnostic Imaging and Radiation Oncology, University “Federico II” of Naples, Napoli, Italy
| | - Antonio Tufano
- Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Rossella Di Franco
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
| | - Paolo Muto
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, Napoli, Italy
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2
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Franzese D, Tufano A, Izzo A, Muscariello R, Grimaldi G, Quarto G, Castaldo L, Rossetti S, Pandolfo SD, Desicato S, Del Prete P, Ferro M, Pignata S, Perdonà S. Unilateral post-chemotherapy robot-assisted retroperitoneal lymph node dissection in Stage II non-seminomatous germ cell tumor: A tertiary care experience. Asian J Urol 2023; 10:440-445. [PMID: 38024429 PMCID: PMC10659970 DOI: 10.1016/j.ajur.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) represents an integral component of the management of patients with non-seminomatous germ cell tumor (NSGCT). Modified templates have been proposed to minimize the surgical morbidity of the procedure. Moreover, the implementation of robotic surgery in this setting has been explored. We report our experience with unilateral post-chemotherapy robot-assisted retroperitoneal lymph node dissection (PC-rRPLND) for clinical Stages IIA and IIB NSGCTs. Methods A retrospective single institution review was performed including 33 patients undergoing PC-rRPLND for Stages IIA and IIB NSGCTs between January 2015 and February 2019. Following orchiectomy, patients were scheduled for chemotherapy with three cycles of bleomycin-etoposide-cisplatin. Patients with a residual tumor of <5 cm and an ipsilateral metastatic disease on pre- and post-chemotherapy CT scans were eligible for a unilateral template in absence of rising tumor markers. Descriptive statistics were provided for demographics, clinical characteristics, intraoperative and postoperative parameters. Perioperative, oncological, and functional outcomes were recorded. Results Overall, 7 (21.2%) patients exhibited necrosis or fibrosis; 14 (42.4%) had mature teratoma; and 12 (36.4%) had viable tumor at final histology. The median lymph node size at surgery was 25 (interquartile range [IQR] 21-36) mm. Median operative time was 180 (IQR 165-215) min and no major postoperative complications were observed. Anterograde ejaculation was preserved in 75.8% of patients. Median follow-up was 26 (IQR 19-30) months and a total of three recurrences were recorded. Conclusion PC-rRPLND is a reliable and technically reproducible procedure with safe oncological outcomes and acceptable postoperative ejaculatory function in well selected patients with NSGCTs.
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Affiliation(s)
- Dario Franzese
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Antonio Tufano
- Urology Unit, Department of Maternal-Child and Urological Sciences, “Sapienza” University, Rome, Italy
| | - Alessandro Izzo
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Raffaele Muscariello
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Giovanni Grimaldi
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Giuseppe Quarto
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Luigi Castaldo
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Sabrina Rossetti
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Sonia Desicato
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Paola Del Prete
- Scientific Directorate, Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Naples, Italy
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Sandro Pignata
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori “Fondazione G. Pascale”, IRCCS, Naples, Italy
| | - Sisto Perdonà
- Department of Urology, National Cancer Institute, Pascale Foundation, Naples, Italy
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3
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Tralongo P, Bordonaro S, Di Lorenzo G, De Giorgi U, Borsellino N, Facchini G, Rossetti S, Fornarini G, Longo V, Tralongo AC, Caspani F, Spada M, Calvani N, Carlini P. Feasibility of cabazitaxel in octogenarian prostate cancer patients. Curr Urol 2023; 17:153-158. [PMID: 37448615 PMCID: PMC10337820 DOI: 10.1097/cu9.0000000000000081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 09/17/2020] [Indexed: 11/26/2022] Open
Abstract
Background To evaluate the effectiveness and safety of cabazitaxel in castration-resistant prostate cancer patients aged ≥80 years, we performed a retrospective study on a sample of patients from 11 Italian cancer centers. Materials and methods Fifty-seven patients aged ≥80 years were treated with cabazitaxel after previous failure with docetaxel; 39 completed a comprehensive geriatric assessment questionnaire (34 fit and 5 vulnerable) and 8 patients (14%) had an Eastern Cooperative Oncology Group performance status (PS) ≥2, while most had a PS of 0-1 (86%). Cabazitaxel was administered at a dose of 25 mg/m2 in 30 (52%) patients and 20 mg/m2 or adapted schedules in 27 (48%) patients. These schedules were adopted mainly in patients ≥85 years (75%), with a PS ≥2 (87.5%), and those classified as vulnerable (100%). Results The duration of treatment was 4.8 months and was comparable in all subgroups; disease control rate was reported in 36 patients (63%); prostate-specific antigen response was recorded in 18 patients (31.5%). Median overall survival was 13.1 months regardless of age (<85/≥85 years), but overall survival was reduced in vulnerable (7.2 months) and PS ≥ 2 patients (6.8 months). The most frequently documented grade 3-4 toxicities were neutropenia (14%) and diarrhea (10.5%). Six patients (10.5%) dropped out due to severe toxicity. Conclusions Octogenarian patients can be treated with cabazitaxel with reduced doses or alternative schedules that are associated with less toxicity and fewer treatment interruptions. Comprehensive geriatric assessment could facilitate more appropriate patient selection.
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Affiliation(s)
- Paolo Tralongo
- Medical Oncology Unit, RAO - Umberto I Hospital, Siracusa, Italy
| | | | - Giuseppe Di Lorenzo
- Department of Medicine and Health Sciences ‘Vincenzo Tiberio’, University of Molise, Campobasso, Italy
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Nicolò Borsellino
- Medical Oncology Unit, Ospedale Buccheri La Ferla, Fatebenefratelli, Palermo, Italy
| | - Gaetano Facchini
- Medical Oncology Unit, Santa Maria delle Grazie di Pozzuoli, Napoli, Italy
| | - Sabrina Rossetti
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - Giuseppe Fornarini
- Medical Oncology 1, IRCCS, Ospedale Policlinico San Martino, Genova, Italy
| | - Vito Longo
- Istituto Tumori Giovanni Paolo II I.R.C.C.S., Ba, Ospedale di Circolo, Varese, Italy
| | | | - Francesca Caspani
- Medical Oncology Unit, ASST SETTE LAGHI, Ospedale di Circolo, Varese, Italy
| | - Massimiliano Spada
- Medical Oncology Unit, Fondazione Istituto G. Giglio di Cefalù, Palermo, Italy
| | - Nicola Calvani
- Medical Oncology Division & Breast Unit, Sen. A. Perrino Hospital, Brindisi, Italy
| | - Paolo Carlini
- Medical Oncology 1, Istituto Nazionale Tumori Regina Elena, Roma, Italy
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Ventriglia J, Passarelli A, Pisano C, Cecere SC, Rossetti S, Feroce F, Forte M, Casartelli C, Tambaro R, Pignata S, Perversi F, Di Napoli M. The role of immunotherapy treatment in non-clear cell renal cell carcinoma: an analysis of the literature. Crit Rev Oncol Hematol 2023:104036. [PMID: 37263397 DOI: 10.1016/j.critrevonc.2023.104036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023] Open
Abstract
Non-clear cell renal cell carcinoma (nccRCC) is a heterogeneous group representing 15-30% of renal tumors. They are mostly excluded from immunotherapy trials due to their rarity and worse prognosis. This, alongside nccRCC misdiagnosis/misclassification, lack of immune-biomarker expression rate data, lack of homogeneous data reporting, the retrospective nature of many studies, small sample sizes, and the fact that high-grade evidence only stems from trials mostly addressing the clear cell subtype, result in poorly defined treatments. We thus reviewed available data from several clinical trials, retrospective studies, and meta-analyses on immunotherapy responses and their correlation with histological subtypes and prognostic biomarkers. The papillary and unclassified subtypes are the best candidate for immunotherapy, showing response rates up to ~35%. Chromophobe cancers, on the other end, have mostly null response rates. Cancers with sarcomatoid features respond very well to immunotherapy, regardless of their histology. Available data for translocation, medullary, collecting duct, and other nccRCCs are inconclusive. Regarding PD-L1, its expression correlates with better responses, but its prognostic value remains to be determined due to small sample sizes hindering direct statistical comparisons. It is necessary to involve a larger number of nccRCC patients and centers in clinical trials and report tumor response rates and PD-(L)1 and other markers' expression rates divided by nccRCC subtypes and not just for the whole cohorts. This will allow us to collect more robust data to best identify patients who can benefit from immunotherapy and ultimately define the standard of treatment. AVAILABILITY OF DATA AND MATERIAL: N/A.
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Affiliation(s)
- Jole Ventriglia
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80138 Naples, Italy.
| | - Anna Passarelli
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80138 Naples, Italy.
| | - Carmela Pisano
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80138 Naples, Italy.
| | - Sabrina Chiara Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80138 Naples, Italy.
| | - Sabrina Rossetti
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80138 Naples, Italy.
| | - Florinda Feroce
- Pathology Unit, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy.
| | - Miriam Forte
- Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Campania(,) Italy.
| | - Chiara Casartelli
- Medical oncology Unit, University Hospital of Parma, Parma 43126, Italy.
| | - Rosa Tambaro
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80138 Naples, Italy.
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80138 Naples, Italy.
| | | | - Marilena Di Napoli
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80138 Naples, Italy.
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5
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Nuzzo PV, Ravera F, Saieva C, Zanardi E, Fotia G, Malgeri A, Rossetti S, Valença LB, Oliveira TM, Vauchier C, Pereira Mestre R, Modesti M, Patrikidou A, Pignata S, Procopio G, Fornarini G, De Giorgi U, Russo A, Francini E. Clinical outcomes of volume of disease on patients receiving enzalutamide versus abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer. Ther Adv Med Oncol 2023; 15:17588359231156147. [PMID: 36895852 PMCID: PMC9989439 DOI: 10.1177/17588359231156147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/21/2023] [Indexed: 03/06/2023] Open
Abstract
Background Androgen receptor signaling inhibitors (ARSis) abiraterone acetate (AA) plus prednisone and enzalutamide (Enza), are currently the most administered first-line treatments for metastatic castration-resistant prostate cancer (mCRPC). AA and Enza have shown similar overall survival (OS) benefits and there is no consensus upon the best option for mCRPC first-line treatment. Volume of disease may represent a useful biomarker to predict response to therapy in such patients. Objectives In this study, we seek to evaluate the impact of volume of disease on patients treated with first-line AA versus Enza for mCRPC. Design and methods We retrospectively evaluated a cohort of consecutive patients with mCRPC categorized by volume of disease [high volume (HV) or low volume (LV) per E3805 criteria] at ARSi onset and treatment type (AA or Enza), assessing OS and radiographic progression-free survival (rPFS), from therapy start, as co-primary endpoints. Results Of the 420 patients selected, 170 (40.5%) had LV and received AA (LV/AA), 76 (18.1%) LV and had Enza (LV/Enza), 124 (29.5%) HV and were given AA (HV/AA), and 50 (11.9%) HV and received Enza (HV/Enza). Among patients with LV, OS was significantly longer when treated with Enza [57.2 months; 95% confidence interval (CI): 52.1-62.2 months] versus AA (51.6 months; 95% CI, 42.6-60.6 months; p = 0.003). Consistently, those with LV receiving Enza showed increased rPFS (40.3 months; 95 CI, 25.0-55.7 months) than those having AA (22.0 months; 95% CI, 18.1-26.0 months; p = 0.004). No significant difference in OS or rPFS was observed in those with HV treated with AA versus Enza (p = 0.51 and p = 0.73, respectively). In multivariate analysis of patients with LV, treatment with Enza was independently associated with better prognosis than AA. Conclusion Within the intrinsic limitations of a retrospective design and small population, our report suggests that volume of disease could be a useful predictive biomarker for patients starting first-line ARSi for mCRPC.
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Affiliation(s)
- Pier Vitale Nuzzo
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Francesco Ravera
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
- Department of Internal Medicine, University of Genoa, Genova, Italy
| | - Calogero Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit–ISPRO, Florence, Italy
| | - Elisa Zanardi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Giuseppe Fotia
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Andrea Malgeri
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Sabrina Rossetti
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Loana Bueno Valença
- Instituto D’Or de Pesquisa e Ensino (IDOR), Salvador, Brazil
- Hospital Sao Rafael, Salvador, Brazil
| | - Thiago Martins Oliveira
- Instituto D’Or de Pesquisa e Ensino (IDOR), Salvador, Brazil
- Hospital Sao Rafael, Salvador, Brazil
| | - Charles Vauchier
- Thoracic Oncology Unit, Bichat-Claude Bernard Hospital, Paris, France
| | | | - Mikol Modesti
- Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Anna Patrikidou
- Department of Medical Oncology, Gustave Roussy Institute, Villejuif, France
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | | | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST), Meldola, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Edoardo Francini
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, Florence 50134, Italy
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Caffo O, Basso U, Cavasin N, Facchini G, Catalano F, Nicodemo M, Sorarù M, Ermacora P, Galli L, Cattrini C, Borsellino N, Sirotova Z, Rossetti S, Grillone F, Zucali PA, Ortega C, Ricotta R, Valcamonico F, Vittimberga I, Buttigliero C. Real-world outcomes of docetaxel (DOC) in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC): First analysis from an Italian multicenter observational study (ECHOS trial). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
167 Background: Although CHAARTED trial suggested a survival advantage in de novo (DN) high volume (HV) mCSPC pts, the use of DOC is still debated according to the timing of either metastatic onset [relapsed (REL) vs DN] or disease burden [low volume (LV) vs HV]. In this view, it could be of interest to describe the real-world use of DOC. From 2014, ECHOS multicenter study is collecting real world data from mCSPC pts in Italy, where DOC was the only reimbursed agent until recently. Here, we present study results after first data lock at the end of 2021. Methods: We reviewed the clinical records of the mCSPC pts treated with DOC in 34 Italian Institutions. For each pt we recorded pre and post-DOC clinical history, baseline characteristics, treatment details and clinical outcomes. Results: We identified 568 pts [median age 66.5 yrs (range 43-85)]. Most of them were classified as having a DN/HV disease (78%): the remaining had a REL/LV (2.5%), a REL/HV (8.1%), and a DN/LV disease (11.5%). After a median follow-up of 22 mos, 389 pts experienced disease progression and 227 died. The survival outcomes according to the metastases timing and disease volume is reported in the table. Conclusions: Our real-world experience shows that DOC is proposed not only in DN/HV pts, but also in the other pts regardless of metastases timing and disease volume. The prognosis of DN/HV pts treated with DOC appears to be worse than in CHAARTED trial. These findings need to be confirmed by further analyses made on larger number of pts enrolled in the ECHOS trial. [Table: see text]
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Affiliation(s)
| | - Umberto Basso
- Oncology Unit 1, Department of Oncolgoy, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Nicolò Cavasin
- Oncology Unit 1, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Gaetano Facchini
- ASLNapoli 2 Nord Ospedale delle Grazie di Pozzuoli, Pozzuoli, Italy
| | - Fabio Catalano
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Maurizio Nicodemo
- Medical Oncology Department - Ospedale "Santa Maria del Prato", Feltre, Italy
| | - Mariella Sorarù
- U.O. Oncologia, Ospedale di Camposampiero (PD), Camposampiero (PD), Italy
| | | | - Luca Galli
- Department of Surgical, Medical and Molecular Pathology and Critical Area Medicine, University of Pisa, Pisa, Italy
| | - Carlo Cattrini
- "Maggiore della Carità" University Hospital, Novara, Italy
| | - Nicolo Borsellino
- Medical Oncology Unit - Buccheri La Ferla Fatebenefratelli Hospital, Palermo, PA, Italy
| | | | - Sabrina Rossetti
- Fondazione Pascale, IRCCS, Istituto Nazionale dei Tumori, Napoli, Italy
| | - Francesco Grillone
- Azienda Ospedaliero-Universitario "Mater Domini", Policlinico of Catanzaro, Catanzaro, Italy
| | - Paolo Andrea Zucali
- Department of Biomedical Sciences, Humanitas University - Department of Oncology, IRCCS Humanitas Research Hospital, Pieve Emanuele, Italy
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7
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Lee-Ying RM, Saieva C, Nuzzo PV, Malgeri A, Fotia G, Zanardi E, Rossetti S, Valenca LB, Patrikidou A, Modesti M, Martins Oliveira T, Pignata S, Fornarini G, Procopio G, Santini D, Sweeney C, Heng DYC, De Giorgi U, Russo A, Francini E. Clinical outcomes of abiraterone acetate (AA) or enzalutamide (E) as first-line therapy (Rx) for men aged ≥75 with metastatic castration-resistant prostate cancer (mCRPC) according to previous use of docetaxel (D) for metastatic castration-sensitive prostate cancer (mCSPC) in a multicenter international registry: A SPARTACUSS – Meet-URO 26 study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
107 Background: The optimal management of mCRPC in men aged ≥75 is challenging, and there is a paucity of clinical data in the literature. Although AA and E are commonly used as 1st line Rx for mCRPC, it is unclear whether use of upfront D for mCSPC may impact their clinical efficacy or safety in this elderly population. Methods: Patients aged ≥75 who started AA or E as 1st line Rx for mCRPC within January 2015 - April 2019 were identified from the IRB approved databases of 10 institutions in Europe, South and North America. Demographic and clinicopathological data were collected from available medical records, including Gleason, prior local therapy, newly diagnosed metastatic disease, disease volume, ECOG, PSA and sites of metastases. Patients were classified by use of upfront D for mCSPC. The primary endpoints were overall survival (OS) from AA/E onset and OS from ADT start and safety of AA/E. The endpoints distributions including median (95% CI) were estimated by Kaplan-Meier method. Results: Of the 337 patients selected, 24 (7.1%) received ADT+D and 313 (92.9%) ADT alone for mCSPC. Patients with ADT+D tended to be younger (78 vs 81, p=0.022) and, albeit not statistically significant, had higher rates of Gleason score >8 (81.0% vs 62.6%, p=0.10), newly diagnosed (83.3% vs 65.6%, p=0.08) and high volume disease (45.8% vs 34.6%, p=0.28), compared to those with ADT alone. Median follow-up was 18.8 months. No significant difference of OS from ADT start or from AA/E onset was observed between the 2 cohorts (see table). Despite OS from ADT start being longer in those having ADT+D, OS from AA/E start was approximately 2 years in both cohorts. Rates of adverse events (AEs) of any grade (58.3% vs 52.1%, p=0.67) and grade ≥3 (12.5% vs 15.7%, p=1.0) did not significantly differ between the 2 cohorts. Conclusions: While limited by small sample size for ADT+D and retrospective study design, patients aged ≥75 having AA/E as 1st line mCRPC Rx showed similar survival outcomes and tolerability regardless of previous use of D for mCSPC. [Table: see text]
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Affiliation(s)
| | | | | | | | - Giuseppe Fotia
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elisa Zanardi
- UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Sabrina Rossetti
- Fondazione Pascale, IRCCS, Istituto Nazionale dei Tumori, Napoli, Italy
| | | | | | - Mikol Modesti
- EOC Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | | | - Sandro Pignata
- Department Uro-Ginecologico, Istituto Nazionale Tumori-Fondazione “G. Pascale”, Naples, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giuseppe Procopio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, MI, Italy
| | - Daniele Santini
- UOC Oncologia Medica Territoriale, La Sapienza University, Polo Pontino, Roma, Italy, Roma, Italy
| | | | | | - Ugo De Giorgi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Antonio Russo
- Unit of Medical Oncology-Department of Oncology-AOUP, Palermo, Italy
| | - Edoardo Francini
- Sapienza University of Rome, Medical Oncology Department, Policlinico Umberto I, Firenze, Italy
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8
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Gennusa V, Saieva C, Lee-Ying RM, Nuzzo PV, Spinelli GP, Zanardi E, Fotia G, Rossetti S, Valenca LB, Patrikidou A, Andrade L, Pereira Mestre R, Fornarini G, Procopio G, Santini D, Sweeney C, Heng DYC, De Giorgi U, Russo A, Francini E. Efficacy and safety of docetaxel (D) vs androgen-receptor signaling inhibitors (ARSi) as second-line therapy (Rx) after progression on alternative ARSi as first-line Rx for patients who are elderly (≥75 years old) with metastatic castration-resistant prostate cancer (mCRPC) in a multicenter international database: A SPARTACUSS–Meet-URO 26 study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
166 Background: About 2/3 of all prostate cancer (PCa) deaths occur in patients aged ≥75, who are frequently diagnosed with advanced PCa. ARSi abiraterone acetate (AA) and enzalutamide (E) are the most common 1st line Rx for patients with mCRPC. Yet, the optimal treatment sequence for the elderly ≥75 after ARSi failure is still unclear. Methods: Using available medical records, patients aged ≥75 who started ARSi as 1st line Rx for mCRPC within January 2015 - April 2019 and, upon progression, 2nd line alternative ARSi or D were identified from the IRB approved hospital registries of 10 centers in Europe, North and South America. Patients were categorized by type of 2nd line Rx for mCRPC into cohorts AA/E and D. Primary endpoints were overall survival (OS) from 1st line AA/E start, OS and radiographic progression-free survival (rPFS) from 2nd line Rx start, and safety. The Kaplan Meier method was used to calculate endpoint distributions and medians (95% CI). Results: Of the 122 patients identified, 57 (46.7%) had AA/E and 65 (53.3%) D, as 2nd line Rx for mCRPC. Median follow-up was 26.3 months (95% CI, 23.1-27.9 months). Cohort AA/E tended to be older (81 vs 78 years; p=0.001) and with high-volume disease (45.5% vs 25.0%; p=0.022) compared to cohort D. No significant difference in OS from 1st line ARSi onset and OS or rPFS from 2nd line Rx start was found between the 2 cohorts. Cohort AA/E had longer rPFS than cohort D, albeit not significant (18.5 vs 12.0 months; p=0.13). Rates of adverse events (AEs) of any grade (42.1 vs 53.8; p=0.21) and AEs of grade ≥3 (19.3% vs 18.5%; p=1.0) did not show significant differences between the 2 cohorts. Conclusions: Within the limitations of small cohorts and retrospective design, treatment sequences with 2nd line AA/E or D after failure of 1st line alternative ARSi for mCRPC showed similar efficacy and safety in the elderly ≥75 years old.
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Affiliation(s)
| | - Calogero Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit – ISPRO, Firenze, Italy
| | | | | | - Gian Paolo Spinelli
- Department of Medico-Surgical Sciences and Biotechnologies, Oncology Unit, Santa Latina, Italy
| | - Elisa Zanardi
- UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Giuseppe Fotia
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabrina Rossetti
- Fondazione Pascale, IRCCS, Istituto Nazionale dei Tumori, Napoli, Italy
| | | | | | - Livia Andrade
- Instituto D'Or de Pesquisa e Ensino, Salvador, Brazil
| | | | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giuseppe Procopio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, MI, Italy
| | | | | | | | - Ugo De Giorgi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Antonio Russo
- Department of Surgical, Oncological, and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Edoardo Francini
- Department of Experimental and Clinical Medicine, Firenze, Italy
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9
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Nuzzo PV, Pederzoli F, Saieva C, Zanardi E, Fotia G, Malgeri A, Rossetti S, Valenca Bueno L, Andrade LMQS, Patrikidou A, Mestre RP, Modesti M, Pignata S, Procopio G, Fornarini G, De Giorgi U, Russo A, Francini E. Clinical impact of volume of disease and time of metastatic disease presentation on patients receiving enzalutamide or abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer. J Transl Med 2023; 21:75. [PMID: 36737752 PMCID: PMC9896712 DOI: 10.1186/s12967-022-03861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/28/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Metastatic castration-resistant prostate cancer remains a challenging condition to treat. Among the available therapeutic options, the androgen receptor signaling inhibitors abiraterone acetate plus prednisone (AA) and enzalutamide (Enza), are currently the most used first-line therapies in clinical practice. However, validated clinical indicators of prognosis in this setting are still lacking. In this study, we aimed to evaluate a prognostic model based on the time of metastatic disease presentation (after prior local therapy [PLT] or de-novo [DN]) and disease burden (low volume [LV] or high-volume [HV]) at AA/Enza onset for mCRPC patients receiving either AA or Enza as first-line. METHODS A cohort of consecutive patients who started AA or Enza as first-line treatment for mCRPC between January 1st, 2015, and April 1st, 2019 was identified from the clinical and electronic registries of the 9 American and European participating centers. Patients were classified into 4 cohorts by the time of metastatic disease presentation (PLT or DN) and volume of disease (LV or HV; per the E3805 trial, HV was defined as the presence of visceral metastases and/or at least 4 bone metastases of which at least 1 out the axial/pelvic skeleton) at AA/Enza onset. The endpoint was overall survival defined as the time from AA or Enza initiation, respectively, to death from any cause or censored at the last follow-up visit, whichever occurred first. RESULTS Of the 417 eligible patients identified, 157 (37.6%) had LV/PLT, 87 (20.9%) LV/DN, 64 (15.3%) HV/PLT, and 109 (26.1%) HV/DN. LV cohorts showed improved median overall survival (59.0 months; 95% CI, 51.0-66.9 months) vs. HV cohorts (27.5 months; 95% CI, 22.8-32.2 months; P = 0.0001), regardless of the time of metastatic presentation. In multivariate analysis, HV cohorts were confirmed associated with worse prognosis compared to those with LV (HV/PLT, HR = 1.87; p = 0.029; HV/DN, HR = 2.19; P = 0.002). CONCLUSION Our analysis suggests that the volume of disease could be a prognostic factor for patients starting AA or Enza as first-line treatment for metastatic castration-resistant prostate cancer, pending prospective clinical trial validation.
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Affiliation(s)
- Pier Vitale Nuzzo
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Filippo Pederzoli
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Calogero Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit-ISPRO, Florence, Italy
| | - Elisa Zanardi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giuseppe Fotia
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Malgeri
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Sabrina Rossetti
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Loana Valenca Bueno
- Instituto D'Or de Pesquisa e Ensino, Salvador, State of Bahia, Brazil
- Hospital São Rafael, Salvador, State of Bahia, Brazil
| | - Livia Maria Q S Andrade
- Instituto D'Or de Pesquisa e Ensino, Salvador, State of Bahia, Brazil
- Hospital São Rafael, Salvador, State of Bahia, Brazil
| | - Anna Patrikidou
- Department of Medical Oncology, Gustave Roussy Institute, Villejuif, France
| | | | - Mikol Modesti
- Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | | | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST), Meldola, Italy
| | - Antonio Russo
- Department of Surgical, Oncological, and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Edoardo Francini
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
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10
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Passarelli A, Ventriglia J, Pisano C, Cecere SC, Napoli MD, Rossetti S, Tambaro R, Tarotto L, Fiore F, Farolfi A, Bartoletti M, Pignata S. The way to precision medicine in gynecologic cancers: The first case report of an exceptional response to alpelisib in a PIK3CA-mutated endometrial cancer. Front Oncol 2023; 12:1088962. [PMID: 36713525 PMCID: PMC9880853 DOI: 10.3389/fonc.2022.1088962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/12/2022] [Indexed: 01/15/2023] Open
Abstract
Endometrial cancer (EC) is the most common gynecologic cancer in Europe and its prevalence is increasing. EC includes a biological and clinical heterogeneous group of tumors, usually classified as type I (endometrioid) or type II (non-endometrioid) based on the histopathological characteristics. In 2013, a new molecular classification was proposed by The Cancer Genome Atlas (TCGA) based on the comprehensive molecular profiling of EC. Several molecular somatic alterations have been described in development and progression of EC. Using these molecular features, EC was reclassified into four subgroups: POLE ultra-mutated, MSI hypermutated, copy-number low, and copy-number high that correlate with the prognosis. To this regard, it is widely reported that EC has more frequent mutations in the phosphatidylinositol 3-kinase (PI3K) pathway signaling than any other tumor. PIK3CA is the main significant mutated gene after PTEN alterations. Overall, over 90% of endometrioid tumors have activating PI3K molecular alterations that suggests its critical role in the EC pathogenesis. Thus, the dysregulation of PI3K pathway represents an attractive target in EC treatment. Herein, we report a radiological and clinically meaningful response to a selective PIK3 inhibitor in a patient with extensively pre-treated advanced endometrioid EC harboring a somatic activating PIK3CA hotspot mutation. These evidences provide the rational for translational strategies of the PI3K inhibition and could support the clinical usefulness of PIK3CA genotyping in advanced EC. To our knowledge, this is the first clinical case of PIK3CA-mutated EC successfully treated with alpelisib.
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Affiliation(s)
- Anna Passarelli
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy,*Correspondence: Anna Passarelli, ,
| | - Jole Ventriglia
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Carmela Pisano
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Sabrina Chiara Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Marilena Di Napoli
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Sabrina Rossetti
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Rosa Tambaro
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Luca Tarotto
- Interventional Radiology Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Francesco Fiore
- Interventional Radiology Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Alberto Farolfi
- Department of Medical Oncology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Emilia-Romagna, Italy
| | - Michele Bartoletti
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), Aviano, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
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11
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Avona A, Capodici M, Di Trapani D, Giustra MG, Greco Lucchina P, Lumia L, Di Bella G, Rossetti S, Tonanzi B, Viviani G. Hydrocarbons removal from real marine sediments: Analysis of degradation pathways and microbial community development during bioslurry treatment. Sci Total Environ 2022; 838:156458. [PMID: 35660624 DOI: 10.1016/j.scitotenv.2022.156458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
In this study, real marine sediments polluted by petroleum compounds were treated by means of a bioslurry pilot scale reactor. The treatment performance was evaluated by measuring the removal of total petroleum hydrocarbon (TPH), coupled to further analyses required to understand the mechanisms involved in the biodegradation process. The maximum TPH-removal efficiency reached 86 % at the end of experiments. Moreover, high throughput 16S RNA gene sequencing was used to describe the microbiome composition in sediment prior to, and after, bioslurry treatment, in order to identify the taxa mostly entailed in the TPH removal process. The raw sediment was mostly colonized by members of Sulfurimonas genus; after bioslurry treatment, it was noticed a shift in the microbial community composition, with Proteobacteria phylum dominating the remediation environment (high increase in terms of growth for Hydrogenophaga and Sphingorhabdus genera) along with the Phaeodactylibacter genus (Bacteroidetes). Furthermore, the assessment of gaseous emissions from the system allowed to quantify the volatile hydrocarbon component and, consequently, to obtain a more accurate evaluation of TPH-removal pathway by the bioslurry system. Finally, phytotoxicity tests on sediment samples highlighted an increase of the treated sample quality status compared to the untreated one.
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Affiliation(s)
- A Avona
- Dipartimento di Ingegneria, Università degli Studi di Palermo, Viale delle Scienze ed.8, 90128 Palermo, Italy
| | - M Capodici
- Dipartimento di Ingegneria, Università degli Studi di Palermo, Viale delle Scienze ed.8, 90128 Palermo, Italy
| | - D Di Trapani
- Dipartimento di Ingegneria, Università degli Studi di Palermo, Viale delle Scienze ed.8, 90128 Palermo, Italy.
| | - M G Giustra
- Facoltà di Ingegneria e Architettura, Università Kore di Enna, Cittadella Universitaria, 94100 Enna, Italy
| | - P Greco Lucchina
- Dipartimento di Ingegneria, Università degli Studi di Palermo, Viale delle Scienze ed.8, 90128 Palermo, Italy
| | - L Lumia
- Facoltà di Ingegneria e Architettura, Università Kore di Enna, Cittadella Universitaria, 94100 Enna, Italy
| | - G Di Bella
- Facoltà di Ingegneria e Architettura, Università Kore di Enna, Cittadella Universitaria, 94100 Enna, Italy
| | - S Rossetti
- Istituto di Ricerca sulle Acque (IRSA), Consiglio Nazionale delle Ricerche (CNR), Via Salaria km 29.300, Monterotondo, 00015, Roma, Italy
| | - B Tonanzi
- Istituto di Ricerca sulle Acque (IRSA), Consiglio Nazionale delle Ricerche (CNR), Via Salaria km 29.300, Monterotondo, 00015, Roma, Italy
| | - G Viviani
- Dipartimento di Ingegneria, Università degli Studi di Palermo, Viale delle Scienze ed.8, 90128 Palermo, Italy
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12
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Passarelli A, Pisano C, Cecere SC, Di Napoli M, Rossetti S, Tambaro R, Ventriglia J, Gherardi F, Iannacone E, Venanzio SS, Fiore F, Bartoletti M, Scognamiglio G, Califano D, Pignata S. Targeting immunometabolism mediated by the IDO1 Pathway: A new mechanism of immune resistance in endometrial cancer. Front Immunol 2022; 13:953115. [PMID: 36119020 PMCID: PMC9479093 DOI: 10.3389/fimmu.2022.953115] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Immunotherapy is acquiring a primary role in treating endometrial cancer (EC) with a relevant benefit for many patients. Regardless, patients progressing during immunotherapy or those who are resistant represent an unmet need. The mechanisms of immune resistance and escape need to be better investigated. Here, we review the major mechanisms of immune escape activated by the indolamine 2,3-dioxygenase 1 (IDO1) pathway in EC and focus on potential therapeutic strategies based on IDO1 signaling pathway control. IDO1 catalyzes the first rate-limiting step of the so-called “kynurenine (Kyn) pathway”, which converts the essential amino acid l-tryptophan into the immunosuppressive metabolite l-kynurenine. Functionally, IDO1 has played a pivotal role in cancer immune escape by catalyzing the initial step of the Kyn pathway. The overexpression of IDO1 is also associated with poor prognosis in EC. These findings can lead to advantages in immunotherapy-based approaches as a rationale for overcoming the immune escape. Indeed, besides immune checkpoints, other mechanisms, including the IDO enzymes, contribute to the EC progression due to the immunosuppression induced by the tumor milieu. On the other hand, the IDO1 enzyme has recently emerged as both a promising therapeutic target and an unfavorable prognostic biomarker. This evidence provides the basis for translational strategies of immune combination, whereas IDO1 expression would serve as a potential prognostic biomarker in metastatic EC.
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Affiliation(s)
- Anna Passarelli
- Department of Urology and Gynecology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
- *Correspondence: Anna Passarelli,
| | - Carmela Pisano
- Department of Urology and Gynecology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Sabrina Chiara Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Marilena Di Napoli
- Department of Urology and Gynecology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Sabrina Rossetti
- Department of Urology and Gynecology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Rosa Tambaro
- Department of Urology and Gynecology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Jole Ventriglia
- Department of Urology and Gynecology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Federica Gherardi
- Radiation Oncology Unit, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Eva Iannacone
- Radiation Oncology Unit, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | | | - Francesco Fiore
- Interventional Radiology Unit, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Michele Bartoletti
- Medical Oncology and Cancer Prevention Unit, Department of Medical Oncology, Oncology Referral Center, Aviano, Italy
| | - Giosuè Scognamiglio
- Surgical Pathology Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Daniela Califano
- Functional Genomic Unit, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
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Di Franco R, Borzillo V, Scipilliti E, Ametrano G, Serra M, Arrichiello C, Savino F, De Martino F, D’Alesio V, Cammarota F, Crispo A, Pignata S, Rossetti S, Quarto G, Muto P. Reirradiation of Locally Recurrent Prostate Cancer with Cyberknife® System or Volumetric Modulated Arc Therapy (VMAT) and IGRT-Clarity®: Outcomes, Toxicities and Dosimetric Evaluation. Cancers (Basel) 2022; 14:cancers14133187. [PMID: 35804958 PMCID: PMC9264827 DOI: 10.3390/cancers14133187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
The management of prostate cancer recurrence following external beam radiotherapy is not defined yet. Stereotaxic body reirradiation therapy showed encouraging results for local and biochemical control. From April 2017 to December 2020, 29 patients with prostate cancer recurrence were collected, joining the retrospective studies CyPro (prot. 46/19 OSS) and CLARO (Prot. 19/20 OSS) trials. Patients received Cyberknife® treatment (17 pts) or alternatively VMAT (Volumetric Modulated Arc Technique) therapy by IGRT (Image-Guided Radiation Therapy)/Clarity® (12 pts). By comparing the reirradiation of two groups, urinary (GU), rectal (GI) toxicities, and biochemical control were investigated. Further, the two techniques were dosimetrically compared by rival plans. The VMAT-IGRT Clarity® treatments were replanned with an optimized template developed for prostate VMAT-SBRT in FFF mode keeping the same dose and fractionation scheduled for Cyberknife Group (30 Gy in 5 fx, at 80% isodose). In the CK group, 23% of patients experienced grade 2 acute GU, while 6% grade 2 acute GI. In the VMAT-Clarity® group, acute GU toxicity was recorded in 17%, while for 8% grade 2 late toxicity was recorded. The dosimetric analysis shows that the VMAT-FFF allows to deliver a biological equivalent dose to CK, with the advantage of reducing the likelihood of toxicities arising.
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Affiliation(s)
- Rossella Di Franco
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (V.B.); (E.S.); (G.A.); (M.S.); (C.A.); (V.D.); (P.M.)
- Correspondence: ; Tel.: +39-08159031764; Fax: +39-0815903809
| | - Valentina Borzillo
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (V.B.); (E.S.); (G.A.); (M.S.); (C.A.); (V.D.); (P.M.)
| | - Esmeralda Scipilliti
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (V.B.); (E.S.); (G.A.); (M.S.); (C.A.); (V.D.); (P.M.)
| | - Gianluca Ametrano
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (V.B.); (E.S.); (G.A.); (M.S.); (C.A.); (V.D.); (P.M.)
| | - Marcello Serra
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (V.B.); (E.S.); (G.A.); (M.S.); (C.A.); (V.D.); (P.M.)
| | - Cecilia Arrichiello
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (V.B.); (E.S.); (G.A.); (M.S.); (C.A.); (V.D.); (P.M.)
| | | | - Fortuna De Martino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy;
| | - Valentina D’Alesio
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (V.B.); (E.S.); (G.A.); (M.S.); (C.A.); (V.D.); (P.M.)
| | | | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (A.C.); (S.R.)
| | - Sandro Pignata
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy;
| | - Sabrina Rossetti
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (A.C.); (S.R.)
| | - Giuseppe Quarto
- Department of Uro-Gynecological, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy;
| | - Paolo Muto
- Department of Radiation Oncology, Istituto Nazionale Tumori—IRCCS—Fondazione G. Pascale, 80131 Napoli, Italy; (V.B.); (E.S.); (G.A.); (M.S.); (C.A.); (V.D.); (P.M.)
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14
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Glinge C, Rossetti S, Bruun Oestergaard L, Stampe NK, Ravn Jacobsen M, Koeber L, Engstroem T, Torp-Pedersen C, Gislason G, Jabbari R, Tfelt-Hansen J. Familial clustering of unexplained heart failure - A Danish nationwide cohort study. Europace 2022. [DOI: 10.1093/europace/euac053.008] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This project has received funding from the European Union’s Horizon 2020 research and innovation programme under acronym ESCAPE-NET, registered under grant agreement No 733381, and the European Union’s COST programme under acronym PARQ, registered under grant agreement No CA19137.
Background
Although family history of heart failure (HF) is associated with increased risk of HF, the extent to which a family history contributes to the risk of HF needs further investigation.
Purpose
To determine whether a family history of unexplained HF in first-degree relatives (children or sibling) increases the rate of unexplained HF.
Methods
Using Danish nationwide registry data (1978-2017), we identified patients (probands) diagnosed with first unexplained HF (HF without any known comorbidities) in Denmark, and their first-degree relatives. All first-degree relatives were followed from the HF date of the proband and until an event of unexplained HF, exclusion diagnosis, death, emigration, or study end, whichever occurred first. Using the general population as a reference, we calculated adjusted standardized incidence ratios (SIR) of unexplained HF in the three groups of relatives using Poisson regression models.
Results
We identified 57,845 first-degree relatives to individuals previously diagnosed with unexplained HF. Having a family history was associated with a significantly increased unexplained HF rate of 2.08 (95% CI 1.82-2.38) (Figure 1). The estimate was higher among siblings (SIR 4.82 [95% CI 3.17-7.32]). Noteworthy, the rate of HF increased for all first-degree relatives when the proband was diagnosed with HF in a young age (≤50 years, SIR of 3.60 [95% CI 2.37-5.47]) and having >1 proband (SIR of 2.73 [95% CI 1.14-6.56]). The highest estimate of HF was observed if the proband was ≤40 years at diagnosis (6.12 [95% CI 3.39-11.05]) (Figure 2).
Conclusion
A family history of unexplained HF was associated with a two-fold increased rate of unexplained HF among first-degree relatives. If the proband age was ≤40 years, the risk was six-folded. These findings suggest that screening families of unexplained HF with onset below 50 years is indicated.
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Affiliation(s)
- C Glinge
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - S Rossetti
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - L Bruun Oestergaard
- Aalborg University, Department of Health, Science and Technology, Aalborg, Denmark
| | - NK Stampe
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - M Ravn Jacobsen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - T Engstroem
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - C Torp-Pedersen
- Aalborg University, Department of Health, Science and Technology, Aalborg, Denmark
| | - G Gislason
- Gentofte University Hospital, Cardiology, Gentofte, Denmark
| | - R Jabbari
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - J Tfelt-Hansen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
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15
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Galli L, Chiuri VE, Di Lorenzo G, Pisconti S, Rossetti S, Sirotova Z, Muto A, Petrioli R, De Tursi M, Sbrana A, Francolini G, Ardizzoia A, Scavelli C, Satta F, Quadrini S, Airoldi M, D'Aniello C, Bonetti A, Conforti S, Aieta M, Beccaglia P, Maestri A, Fratino L. First-line treatment of metastatic castration-resistant prostate cancer: the real-world Italian cohort of the Prostate Cancer Registry. Tumori 2022; 109:224-232. [PMID: 35400269 PMCID: PMC10070548 DOI: 10.1177/03008916221079662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND With the availability of multiple treatment options for metastatic castration-resistant prostate cancer (mCRPC), new real-world data on disease management and drugs' performance are needed. METHODS We described characteristics, management and clinical outcomes of patients receiving first-line mCRPC treatment within the Italian cohort of the real-world, prospective, international Prostate Cancer Registry. Patients were enrolled consecutively (2013-2016) in 32 Italian sites and followed for 3 years. RESULTS 238 patients were included: 157 received first-line abiraterone acetate plus prednisone ("abiraterone" thereafter) and 70 first-line docetaxel; 11 patients receiving other treatments were not considered. Compared with docetaxel-treated patients, those receiving abiraterone were significantly older (age ⩾75: 63.7% vs 38.6%), less frequently had a Gleason score >8 (48.2% vs 67.6%, p<0.005) at initial diagnosis, and more frequently an ECOG score ⩾1 (52.7% vs 36.2%, p<0.05) and comorbidities (76.4% vs 57.1%, p<0.05) at baseline; they reported a lower analgesic use (15.3% vs 30%, p<0.005). In the abiraterone group (median follow-up 22.1 months), median time to progression (TTP) and progression-free survival (PFS) were, respectively, 14.4 months (95% confidence interval, CI, 10.6-18.0) and 13.0 months (95% CI, 9.1-16.8); median overall survival (OS) was not reached, and 3-year OS was 59.1%. In the docetaxel treatment group (median follow-up 25.3 months), median TTP, PFS and OS were, respectively, 8.2 months (95% CI, 6.1-10.3), 8.2 months (95% CI, 5.8-10.3) and 33.2 months (95% CI, 19.2-not estimable). CONCLUSION This investigation provided valuable information on the overall mCRPC treatment pattern and the effectiveness of first-line abiraterone and docetaxel in a population representative of everyday practice.
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Affiliation(s)
- Luca Galli
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | | | | | - Sabrina Rossetti
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Zuzana Sirotova
- Unit of Medical Oncology, Aosta Regional Hospital, Aosta, Italy
| | - Andrea Muto
- Division of Medical Oncology, "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - Roberto Petrioli
- Oncology Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences and Center for Advanced Studies and Technology (CAST), G. D'Annunzio University, Chieti, Italy
| | - Andrea Sbrana
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.,Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Giulio Francolini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Antonio Ardizzoia
- Oncology Department, Ospedale Alessandro Manzoni-ASST Lecco, Lecco, Italy
| | - Claudio Scavelli
- Medical Oncology Unit, S. Cuore di Gesù Hospital, Gallipoli (LE), Italy
| | - Francesco Satta
- Unit of Medical Oncology, Ospedale San Pietro, Fatebenefratelli, Rome, Italy
| | - Silvia Quadrini
- Unit of Medical Oncology, Ospedale "SS Trinità" - ASL Frosinone, Sora, Italy
| | - Mario Airoldi
- Oncology Unit 2, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Carmine D'Aniello
- Division of Medical Oncology, AORN Azienda dei Colli, Monaldi Hospital, Naples, Italy
| | - Andrea Bonetti
- Department of Oncology, Mater Salutis Hospital - Az. ULSS 9 Scaligera, Legnago, Italy
| | | | - Michele Aieta
- Department of Onco-Hematology, Division of Medical Oncology, Centro di Riferimento Oncologico della Basilicata IRCCS, Rionero in Vulture, Italy
| | | | - Antonio Maestri
- Medical Oncology Department, Santa Maria della Scaletta Hospital, Imola, Italy
| | - Lucia Fratino
- Medical Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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16
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Procopio G, Chiuri V, Giordano M, Alitto A, Maisano R, Bordonaro R, Cinieri S, Rossetti S, De Placido S, Airoldi M, Galli L, Gasparro D, Ludovico G, Guglielmini P, Carella C, Nova P, Aglietta M, Schips L, Beccaglia P, Sciarra A, Livi L, Santini D, Procopio G, Chiuri V, Mantini G, Roberto Bordonaro RM, Cinieri S, Rossetti S, De Placido S, Airoldi M, Galli L, Gasparro D, Ludovico GM, Guglielmini PF, Santini D, Naglieri E, Fagnani D, Aglietta M, Livi L, Schips L, Passalacqua R, Fiore M, D'Angelillo RM, Ceresoli GL, Magrini S, Rondonotti D, Mirone V, Ferriero MC, Sciarra A, Acquati M, Boccardo F, Scagliotti GV, Mencoboni M, De Giorgi U, Micheletti G, Lanzetta G, Sartori D, Carlini P, Soto Parra HJ, Battaglia M, Uricchio F, Bernardo A, De Lisa A, Carrieri G, Ardizzoia A, Aieta M, Pisconti S, Marchetti P, Paiar F. Real-world experience of abiraterone acetate plus prednisone in chemotherapy-naive patients with metastatic castration-resistant prostate cancer: long-term results of the prospective ABItude study. ESMO Open 2022; 7:100431. [PMID: 35405438 PMCID: PMC9058899 DOI: 10.1016/j.esmoop.2022.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/14/2022] [Accepted: 02/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Limited real-world data exist on the effectiveness and safety of abiraterone acetate plus prednisone (abiraterone hereafter) in the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) naive to chemotherapy. Most of the few available studies had a retrospective design and included a small number of patients. In the interim analysis of the ABItude study, abiraterone showed good clinical effectiveness and safety profile in the chemotherapy-naive setting over a median follow-up of 18 months. Patients and methods We evaluated clinical and patient-reported outcomes (PROs) of chemotherapy-naive mCRPC patients treated with abiraterone as for clinical practice in the Italian, observational, prospective, multicentric ABItude study. mCRPC patients were enrolled at abiraterone start (February 2016-June 2017) and followed up for 3 years; clinical endpoints and PROs, including quality of life (QoL) and pain, were prospectively collected. Kaplan–Meier curves were estimated. Results Of the 481 patients enrolled, 454 were assessable for final study analyses. At abiraterone start, the median age was 77 years, with 58.6% elderly patients and 69% having at least one comorbidity (57.5% cardiovascular diseases). Visceral metastases were present in 8.4% of patients. Over a median follow-up of 24.8 months, median progression-free survival (any progression reported by the investigators), time to abiraterone discontinuation, and overall survival were, respectively, 17.3 months [95% confidence interval (CI) 14.1-19.4 months], 16.0 months (95% CI 13.1-18.2 months), and 37.3 months (95% CI 36.5 months-not estimable); 64.2% of patients achieved ≥50% reduction in prostate-specific antigen. QoL assessed by Functional Assessment of Cancer Therapy—Prostate, the European Quality of Life 5 Dimensions 3 Level, and European Quality of Life Visual Analog Scale remained stable during treatment. Median time to pain progression according to Brief Pain Inventory data was 31.1 months (95% CI 24.8 months-not estimable). Sixty-two patients (13.1%) had at least one adverse drug reaction (ADR) and 8 (1.7%) one serious ADR. Conclusion With longer follow-up, abiraterone therapy remains safe, well tolerated, and active in a large unselected population. A prospective real-life study of abiraterone acetate in mCRPC patients. In 481 chemotherapy-naive mCRPC patients (median follow-up: 25 months), abiraterone plus prednisone was effective and safe. QoL, measured with various tools, remained stable during treatment with abiraterone plus prednisone. The median time to pain progression was 31.1 months.
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17
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Di Franco R, Cascella M, Fusco M, Borzillo V, Scipilliti E, Ferraioli P, Iannacone E, De Palma G, Silvestro G, Gherardi F, Buonopane S, Alberti D, Totaro G, Manzo R, Guida G, Cuomo A, Pignata S, Di Napoli M, Rossetti S, Celentano E, Crispo A, Grimaldi M, Ravo V, Muto P. Management of Metastatic Disease in Campania (MAMETIC): An Observational Multicenter Retrospective and Prospective Trial on Palliative Radiotherapy in an Italian Region. Study Protocol. J Pain Res 2022; 15:1003-1010. [PMID: 35422656 PMCID: PMC9005129 DOI: 10.2147/jpr.s336357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background Methods Conclusion
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Affiliation(s)
- Rossella Di Franco
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
- Correspondence: Rossella Di Franco, Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia, Email
| | - Marco Cascella
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Napoli, Italia
| | - Mario Fusco
- Cancer Registry Unit, ASL Napoli 3 SUD, Napoli, Italia
| | - Valentina Borzillo
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Esmeralda Scipilliti
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Piera Ferraioli
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Eva Iannacone
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Giampaolo De Palma
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Giustino Silvestro
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Federica Gherardi
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Sergio Buonopane
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Domingo Alberti
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Giuseppe Totaro
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Roberto Manzo
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Giovanna Guida
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Arturo Cuomo
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Napoli, Italia
| | - Sandro Pignata
- Department of Uro-Gynecological, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Marilena Di Napoli
- Department of Uro-Gynecological, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Sabrina Rossetti
- Department of Uro-Gynecological, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Vincenzo Ravo
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
| | - Paolo Muto
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia
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18
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Rossetti S, Di Napoli M, Pisano C, C Cecere S, Tambaro R, Ventriglia J, Passarelli A, Iovane G, Feroce F, Lastoria S, Di Gennaro F, Muto P, Borzillo V, Di Franco R, Perdonà S, Quarto G, Pignata S. Oligometastatic prostate cancer treatment. Future Oncol 2021; 17:3893-3899. [PMID: 34296622 DOI: 10.2217/fon-2021-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Oligometastatic prostate cancer is an intermediate state between localized disease and widespread metastasis. Its biological and clinical peculiarities are still to be elucidated. New imaging techniques contribute to the detection of patients with oligometastatic disease. PET/CT scanning with prostate-specific membrane antigen can improve the selection of men with true early, low-volume oligometastatic disease, who are candidates for metastasis-directed therapy. Clinical studies demonstrated that androgen deprivation therapy can be delayed in oligometastatic patients with a low tumor burden, although no survival benefit has been demonstrated at present. This article presents available evidence on the treatment strategies for oligometastatic prostate cancer.
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Affiliation(s)
- Sabrina Rossetti
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
| | - Marilena Di Napoli
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
| | - Carmela Pisano
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
| | - Sabrina C Cecere
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
| | - Rosa Tambaro
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
| | - Jole Ventriglia
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
| | - Anna Passarelli
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
| | - Gelsomina Iovane
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
| | - Florinda Feroce
- Pathology Unit, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy
| | - Secondo Lastoria
- Nuclear Medicine, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy
| | - Francesca Di Gennaro
- Nuclear Medicine, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy
| | - Paolo Muto
- Radiotherapy, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy
| | - Valentina Borzillo
- Radiotherapy, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy
| | - Rossella Di Franco
- Radiotherapy, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy
| | - Sisto Perdonà
- Urology Unit, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy
| | - Giuseppe Quarto
- Urology Unit, Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Naples, 80131, Italy
| | - Sandro Pignata
- Department of Urology & Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale Napoli, 80131, Italy
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19
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Matturro B, Majone M, Aulenta F, Rossetti S. Correlations between maximum reductive dechlorination rates and specific biomass parameters in Dehalococcoides mccartyi consortia enriched on chloroethenes PCE, TCE and cis-1,2-DCE. FEMS Microbiol Ecol 2021; 97:6253249. [PMID: 33899920 DOI: 10.1093/femsec/fiab064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/23/2021] [Accepted: 04/23/2021] [Indexed: 01/04/2023] Open
Abstract
One of the challenges to implementing the modeling of the biological reductive dechlorination (RD) process is the evaluation of biological parameters that represent the abundance/activity levels of the microorganisms involved in the biodegradation of chloroethenes. Here we report a combined analysis of kinetic and specific biomass parameters conducted on three dechlorinating consortia enriched on PCE, TCE and cis-1,2-DCE. In these consortia, Dehalococcoides mccartyi (Dhc) represented ≥70% of the bacterial population identified via 16S rRNA gene amplicon sequencing. Quantitative biomolecular methods were used to generate specific biomass parameters targeting either the Dhc population (16S rRNA genes or cells) or specific genes encoding RD process-involved reductive dehalogenases. The correlation factor between the abundance of active Dhc cells or tceA gene copies and maximum RD rates allowed to predict an increment of 7E+09 of active Dhc cells or 5E+09 tceA gene copies/L under controlled conditions. Diversely, the utilization of gene transcripts as biomass parameters for RD modeling did not provide reliable correlations with kinetic performances. This study provides valuable insights for further modeling of the RD process through the utilization of specific biomass parameters.
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Affiliation(s)
- B Matturro
- Water Research Institute, IRSA-CNR, Via Salaria km 29.300, Monterotondo (RM) 00015, Italy
| | - M Majone
- Department of Chemistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - F Aulenta
- Water Research Institute, IRSA-CNR, Via Salaria km 29.300, Monterotondo (RM) 00015, Italy
| | - S Rossetti
- Water Research Institute, IRSA-CNR, Via Salaria km 29.300, Monterotondo (RM) 00015, Italy
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20
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DI Franco R, Borzillo V, Alberti D, Ametrano G, Petito A, Coppolaro A, Tarantino I, Rossetti S, Pignata S, Iovane G, Perdonà S, Quarto G, Grimaldi G, Izzo A, Castaldo L, Muscariello R, Serra M, Facchini G, Muto P. Acute Toxicity in Hypofractionated/Stereotactic Prostate Radiotherapy of Elderly Patients: Use of the Image-guided Radio Therapy (IGRT) Clarity System. In Vivo 2021; 35:1849-1856. [PMID: 33910872 DOI: 10.21873/invivo.12447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/17/2021] [Accepted: 03/25/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of intra-fractional monitoring and correction of prostate position with the Image Guided Radio Therapy (IGRT) system can increase the spatial accuracy of dose delivery. Clarity is a system used for intrafraction prostate-motion management, it provides a real-time visualization of prostate with a transperineal ultrasound. The aim of this study was to evaluate the use of Clarity-IGRT on proper intrafraction alignment and monitoring, its impact on Planning Tumor Volume margin and on urinary and rectal toxicity in elderly patients not eligible for surgery. PATIENTS AND METHODS Twenty-five elderly prostate cancer patients, median age=75 years (range=75-90 years) were treated with Volumetric Radiotherapy and Clarity-IGRT using 3 different schemes: A) 64.5/72 Gray (Gy) in 30 fractions on prostate and seminal vesicles (6 patients); B) 35 Gy in 5 fractions on prostate and seminal vesicles (12 patients); C): 35 Gy in 5 fractions on prostate (7 patients). Ultrasound identification of the overlapped structures to the detected ones during simulation has been used in each session. A specific software calculates direction and entity of necessary shift to obtain the perfect match. The average misalignment in the three-dimensional space has been determined and shown in a box-plot. RESULTS All patients completed treatment with mild-moderate toxicity. During treatment, genitourinary toxicity was 32% Grade 1; 4% Grade 2, rectal was 4% Grade 1. At follow-up of 3 months, genitourinary toxicity was 20% Grade 1; 4% Grade 2, rectal toxicity was 4% Grade 2. At follow-up of 6 months, genitourinary toxicity was 4% Grade 1; 4% Grade 2. Rectal toxicity was 4% Grade 2. CONCLUSION Radiotherapy with the Clarity System allows a reduction of PTV margins, the amount of fractions can be reduced increasing the total dose, not exacerbating urinary and rectal toxicity with greater patient's compliance.
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Affiliation(s)
- Rossella DI Franco
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy;
| | - Valentina Borzillo
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Domingo Alberti
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Gianluca Ametrano
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Angela Petito
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Andrea Coppolaro
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Ilaria Tarantino
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Sabrina Rossetti
- Departmental Unit Of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Sandro Pignata
- Departmental Unit Of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Gelsomina Iovane
- Departmental Unit Of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Sisto Perdonà
- Uro-Gynecological Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Giuseppe Quarto
- Uro-Gynecological Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Giovanni Grimaldi
- Uro-Gynecological Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Alessandro Izzo
- Uro-Gynecological Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Luigi Castaldo
- Uro-Gynecological Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Raffaele Muscariello
- Uro-Gynecological Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Marcello Serra
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Gaetano Facchini
- Department of Hospital Medicine, Unit of Medical Oncology, ASL Napoli 2 Nord, "S.M. delle Grazie" Hospital, Pozzuoli, Italy
| | - Paolo Muto
- Department of Radiation Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
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21
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Denaro R, Aulenta F, Crisafi F, Di Pippo F, Cruz Viggi C, Matturro B, Tomei P, Smedile F, Martinelli A, Di Lisio V, Venezia C, Rossetti S. Marine hydrocarbon-degrading bacteria breakdown poly(ethylene terephthalate) (PET). Sci Total Environ 2020; 749:141608. [PMID: 32836129 DOI: 10.1016/j.scitotenv.2020.141608] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 05/09/2023]
Abstract
Pollution of aquatic ecosystems by plastic wastes poses severe environmental and health problems and has prompted scientific investigations on the fate and factors contributing to the modification of plastics in the marine environment. Here, we investigated, by means of microcosm studies, the role of hydrocarbon-degrading bacteria in the degradation of poly(ethylene terephthalate) (PET), the main constituents of plastic bottles, in the marine environment. To this aim, different bacterial consortia, previously acclimated to representative hydrocarbons fractions namely, tetradecane (aliphatic fraction), diesel (mixture of hydrocarbons), and naphthalene/phenantrene (aromatic fraction), were used as inocula of microcosm experiments, in order to identify peculiar specialization in poly(ethylene terephthalate) degradation. Upon formation of a mature biofilm on the surface of poly(ethylene terephthalate) films, the bacterial biodiversity and degradation efficiency of each selected consortium was analyzed. Notably, significant differences on biofilm biodiversity were observed with distinctive hydrocarbons-degraders being enriched on poly(ethylene terephthalate) surface, such as Alcanivorax, Hyphomonas, and Cycloclasticus species. Interestingly, ATR-FTIR analyses, supported by SEM and water contact angle measurements, revealed major alterations of the surface chemistry and morphology of PET films, mainly driven by the bacterial consortia enriched on tetradecane and diesel. Distinctive signatures of microbial activity were the alteration of the FTIR spectra as a consequence of PET chain scission through the hydrolysis of the ester bond, the increased sample hydrophobicity as well as the formation of small cracks and cavities on the surface of the film. In conclusion, our study demonstrates for the first time that hydrocarbons-degrading marine bacteria have the potential to degrade poly(ethylene terephthalate), although their degradative activity could potentially trigger the formation of harmful microplastics in the marine environment.
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Affiliation(s)
- R Denaro
- Water Research Institute (IRSA) (CNR), Via Salaria km 29, 300, 00015 Monterotondo, Rome, Italy.
| | - F Aulenta
- Water Research Institute (IRSA) (CNR), Via Salaria km 29, 300, 00015 Monterotondo, Rome, Italy
| | - F Crisafi
- Institute for Biological Resources and Marine Biotechnology (IRBIM) (CNR), Spianata San Raineri, 86, 98121 Messina, Italy
| | - F Di Pippo
- Water Research Institute (IRSA) (CNR), Via Salaria km 29, 300, 00015 Monterotondo, Rome, Italy
| | - C Cruz Viggi
- Water Research Institute (IRSA) (CNR), Via Salaria km 29, 300, 00015 Monterotondo, Rome, Italy
| | - B Matturro
- Water Research Institute (IRSA) (CNR), Via Salaria km 29, 300, 00015 Monterotondo, Rome, Italy
| | - P Tomei
- Water Research Institute (IRSA) (CNR), Via Salaria km 29, 300, 00015 Monterotondo, Rome, Italy
| | - F Smedile
- Institute for Biological Resources and Marine Biotechnology (IRBIM) (CNR), Spianata San Raineri, 86, 98121 Messina, Italy
| | - A Martinelli
- Department of Chemistry, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - V Di Lisio
- Department of Chemistry, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - C Venezia
- Water Research Institute (IRSA) (CNR), Via Salaria km 29, 300, 00015 Monterotondo, Rome, Italy
| | - S Rossetti
- Water Research Institute (IRSA) (CNR), Via Salaria km 29, 300, 00015 Monterotondo, Rome, Italy
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22
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Bersanelli M, Buti S, Banna GL, De Giorgi U, Cortellini A, Rebuzzi SE, Tiseo M, Fornarini G, Mazzoni F, Panni S, Tursi MD, Marino PD, Rossetti S, Rossi E, Tomao S, Luca ED, Sorarù M, Mucciarini C, Atzori F, Torre LL, Vitale MG, Martelli V, Sepe P, Mollica V, Vaccaro V, Schinzari G, Ficorella C, Massari F, Maestri A, Sabbatini R, Sava T, Maio MD, Verzoni E, Procopio G, Giannarelli D. Impact of influenza syndrome and flu vaccine on survival of cancer patients during immunotherapy in the INVIDIa study. Immunotherapy 2020; 12:151-159. [PMID: 32089035 DOI: 10.2217/imt-2019-0180] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aim: INVIDIa was a retrospective, multicenter study, exploring the clinical efficacy of influenza vaccine in 300 cancer patients undergoing immunotherapy. Overall survival (OS) was immature at the initial report. Methods: We reported the final OS analysis from the original study population and within subgroups. Results: Both at the univariate and multivariate analysis, the occurrence of influenza syndrome (IS) was significantly related to better OS in the overall population (OR: 0.53 [95% CI: 0.32-0.88]; p = 0.01). In the lung cancer subgroup, receiving flu vaccine and/or developing IS was related to better OS (p = 0.04). Within elderly patients, the flu vaccine was the main variable for the relative OS advantage (p = 0.05). Conclusion: Receiving the flu vaccine and/or developing IS was related to better OS within the INVIDIa population.
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Affiliation(s)
- Melissa Bersanelli
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.,Department of Medicine & Surgery, University of Parma, Parma, Italy
| | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | | | - Ugo De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alessio Cortellini
- Medical Oncology Unit, St Salvatore Hospital, L'Aquila, Italy.,Department of Biotechnological & Applied Clinical Sciences, St Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Sara Elena Rebuzzi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.,Medical Oncology Unit 1, IRCCS Policlinico San Martino Hospital, Genova, Italy
| | - Marcello Tiseo
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.,Department of Medicine & Surgery, University of Parma, Parma, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Policlinico San Martino Hospital, Genova, Italy
| | | | - Stefano Panni
- Medical Oncology Unit, ASST - Istituti Ospitalieri Cremona Hospital, Cremona, Italy
| | - Michele De Tursi
- Department of Medical, Oral & Biotechnological Sciences & CeSI-MeT, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Pietro Di Marino
- Department of Medical, Oral & Biotechnological Sciences & CeSI-MeT, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Sabrina Rossetti
- Dipartimento Corp-S Assistenziale dei Percorsi Oncologici Uro-Genitale, S.S.D Oncologia Clinica Sperimentale Uro-Andrologica, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | - Ernesto Rossi
- Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silverio Tomao
- Department of Medical & Surgical Sciences & Biotechnology, University "La Sapienza", Latina, Italy
| | - Emmanuele De Luca
- Medical Oncology, Ordine Mauriziano Hospital, University of Turin, Torino, Italy
| | | | | | - Francesco Atzori
- Medical Oncology, Department of Medical Sciences "M. Aresu", University Hospital & University of Cagliari, Cagliari, Italy
| | - Leonardo La Torre
- Medical Oncology Department, Santa Maria della Scaletta Hospital, Imola, Italy
| | | | - Valentino Martelli
- Medical Oncology Unit 1, IRCCS Policlinico San Martino Hospital, Genova, Italy
| | - Pierangela Sepe
- Genito-Urinary Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori of Milan, Milano, Italy
| | - Veronica Mollica
- Division of Oncology, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Vanja Vaccaro
- Oncology Unit 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Giovanni Schinzari
- Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Corrado Ficorella
- Department of Biotechnological & Applied Clinical Sciences, St Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,Medical Oncology Unit 1, IRCCS Policlinico San Martino Hospital, Genova, Italy
| | | | - Antonio Maestri
- Medical Oncology Department, Santa Maria della Scaletta Hospital, Imola, Italy
| | | | - Teodoro Sava
- Medical Oncology, Camposampiero Hospital, Padova, Italy
| | - Massimo Di Maio
- Medical Oncology, Ordine Mauriziano Hospital, University of Turin, Torino, Italy
| | - Elena Verzoni
- Genito-Urinary Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori of Milan, Milano, Italy
| | - Giuseppe Procopio
- Genito-Urinary Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori of Milan, Milano, Italy
| | - Diana Giannarelli
- Biostatistical Unit, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
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23
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Tambaro R, Napoli MD, Pisano C, Cecere SC, Attademo L, Rossetti S, Feroce F, Setola S, Califano D, Russo D, Spina A, Perdonà S, Izzo A, Pignata S. From clinical trials to clinical use of checkpoint inhibitors for patients with metastatic urothelial cancer. Immunotherapy 2020; 13:67-77. [PMID: 33045887 DOI: 10.2217/imt-2020-0128] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Monoclonal antibodies targeting the checkpoint inhibitors (CPIs), programmed cell death protein-1 or programmed cell death ligand-1, are changing the landscape of urothelial carcinoma therapeutics. Overall, clinical studies in metastatic or advanced urothelial cancer showed that CPIs provided a slight improvement in survival and a relevant advantage in safety, compared with chemotherapy. After reviewing published and ongoing trials, the authors discuss expected answers to unmet needs, with a special attention to the research of biological markers for patients with urothelial cancer eligible for treatment with CPIs in this article.
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Affiliation(s)
- Rosa Tambaro
- Department of Urology & Gynecology, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Napoli, Italy
| | - Marilena Di Napoli
- Department of Urology & Gynecology, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Napoli, Italy
| | - Carmela Pisano
- Department of Urology & Gynecology, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Napoli, Italy
| | - Sabrina Chiara Cecere
- Department of Urology & Gynecology, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Napoli, Italy
| | - Laura Attademo
- Department of Urology & Gynecology, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Napoli, Italy
| | - Sabrina Rossetti
- Department of Urology & Gynecology, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Napoli, Italy
| | - Florinda Feroce
- Pathology Unit, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Naples, Italy
| | - Sergio Setola
- Radiology Unit, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Naples, Italy
| | - Daniela Califano
- Functional Genomic Unit, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Naples, Italy
| | - Daniela Russo
- Functional Genomic Unit, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Naples, Italy
| | - Anna Spina
- Functional Genomic Unit, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Naples, Italy
| | - Sisto Perdonà
- Urology Unit, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Naples, Italy
| | - Alessandro Izzo
- Urology Unit, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Naples, Italy
| | - Sandro Pignata
- Department of Urology & Gynecology, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Napoli, Italy
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24
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Luo X, Li JX, Liu YT, Zou G, Yao WX, Qing GQ, Yang RL, Ye XY, Facchini G, Rossetti S. Influence of lymph node dissection in patients undergoing radical nephrectomy for non-metastatic renal cell carcinoma: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2020; 23:6079-6090. [PMID: 31364109 DOI: 10.26355/eurrev_201907_18422] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Whether lymph node dissection (LND) should be performed concomitantly with radical nephrectomy (RN) for non-metastatic renal carcinoma has still been controversial recently. We conducted a meta-analysis assessing oncologic outcomes of radical nephrectomy with lymph node dissection (LND) and without lymph node dissection (non-LND) in non-metastatic renal cell carcinoma (NMRCC). PATIENTS AND METHODS A systematic review was performed until April 2018 using a comprehensive search in PubMed, EMBASE, and Cochrane Library databases to identify eligible comparative studies. A formal meta-analysis was performed for studies comparing radical nephrectomy with LND and radical nephrectomy with non-LND for cT1-T4NxM0 tumors. Furthermore, a subgroup analysis for locally advanced renal cell carcinoma (cT3-T4NxM0) was conducted. RESULTS Thirteen studies on patients with LND and non- LND were identified and included in the analysis. LND group did not have a significantly better survival than non-LND group for cT1-T4NxM0 tumors (HR 0.93, 95% CI 0.78-1.11, p=0.45), However, in the subgroup of locally advanced renal cell carcinoma (cT3-T4NxM0), it showed a significantly better OS rate in patients who had undergone LND compared to those without LND (HR 0.73, 95% CI 0.60-0.90; p=0.003). CONCLUSIONS LND offers better cancer control and better long-term survival in locally advanced renal cell carcinomas (cT3-T4NxM0). This conclusion should be confirmed by a prospective randomized clinical trial.
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Affiliation(s)
- X Luo
- Department of Urology, Guangzhou Panyu Central Hospital, Guangzhou, China.
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25
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Facchini G, Rossetti S, Berretta M, Cavaliere C, D'Aniello C, Iovane G, Mollo G, Capasso M, Della Pepa C, Pesce L, Facchini S, Imbimbo C, Pisconti S. Prognostic and predictive factors in testicular cancer. Eur Rev Med Pharmacol Sci 2020; 23:3885-3891. [PMID: 31115016 DOI: 10.26355/eurrev_201905_17816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Testicular cancer is a relatively rare neoplasia, with an incidence of about 1,5% among male malignancies, usually in the third and fourth decade of life. Although several histological variants are known, with some histotypes affecting older patients (e.g., spermatocytic seminoma), there is a clear predominance (90-95%) of germ cell tumors among young adults patients1. Testicular Germ Cell Tumor (TGCT), undoubtedly the seminoma histological variant more than non-seminoma one, is definitely a highly curable disease, with a distinctive sensitivity to cisplatin-based therapy (and for seminomas to radiotherapy) and an outstanding cure rate of nearly 80% even for patients with advanced disease. So far, clinical and pathohistological features supported our efforts to choose the best treatment option for patients suffering from this malignancy, but we don't clearly enough know molecular and pathological features underlying different clinical behaviors, mostly in early-stage disease: by improving this knowledge, we should better "shape" therapeutic or surveillance programs for each patient, also in order to avoid unnecessary, if not harmful, treatments.
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Affiliation(s)
- G Facchini
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy.
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26
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Iacovelli R, Ciccarese C, Facchini G, Milella M, Urbano F, Basso U, De Giorgi U, Sabbatini R, Santini D, Berardi R, Santoni M, Bracarda S, Massari F, Masini C, De Tursi M, Ricotta R, Buti S, Zustovich F, Sepe P, Rossetti S, Maruzzo M, Cortesi E, Tortora G, Procopio G. Correction to: Cabozantinib After a Previous Immune Checkpoint Inhibitor in Metastatic Renal Cell Carcinoma: A Retrospective Multi-Institutional Analysis. Target Oncol 2020; 15:691. [PMID: 32857328 DOI: 10.1007/s11523-020-00746-6] [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: 10/23/2022]
Abstract
While typesetting the article the Table 3 column/row entries are interchanged. Please find below the updated Table.
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Affiliation(s)
- Roberto Iacovelli
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00158, Rome, Italy.
| | - Chiara Ciccarese
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00158, Rome, Italy.,Oncologia Medica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gaetano Facchini
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Michele Milella
- Oncologia Medica, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Federica Urbano
- Oncology Unit, Department of Radiology, Oncology and Human Pathology, Sapienza University of Rome, Rome, Italy
| | - Umberto Basso
- Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Roberto Sabbatini
- Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Santini
- Oncologia Medica, Campus Bio-Medico University of Rome, Rome, Italy
| | - Rossana Berardi
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, Ancona, Italy
| | - Matteo Santoni
- Oncologia Medica, Ospedale di Macerata, Via Santa Lucia 2, 62100, Macerata, Italy
| | - Sergio Bracarda
- S.C. Medical Oncology, Azienda Ospedaliera S. Maria, Terni, Italy
| | - Francesco Massari
- Dipartimento di Oncologia Medica, Ospedale Sant'Orsola-Malpighi, Bologna, Italy
| | - Cristina Masini
- Medical Oncology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michele De Tursi
- Dipartimento di Scienze Orali e Mediche, Sezione di Oncologia, Università G. D'Annunzio, Chieti, Italy
| | - Riccardo Ricotta
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Sebastiano Buti
- Unità Operativa di Oncologia Medica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | | | - Pierangela Sepe
- Genitourinary Cancer Unit, Dipartimento di Oncologia Medica, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Sabrina Rossetti
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Marco Maruzzo
- Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Enrico Cortesi
- Oncology Unit, Department of Radiology, Oncology and Human Pathology, Sapienza University of Rome, Rome, Italy
| | - Giampaolo Tortora
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00158, Rome, Italy.,Oncologia Medica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Procopio
- Genitourinary Cancer Unit, Dipartimento di Oncologia Medica, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Santagata S, Trotta AM, Rea G, Napolitano M, Capiluongo A, D'Alterio C, Napoli MD, Rossetti S, Pignata S, Scala S. Abstract 6675: Basal NK activity and early Tregs inhibition predicts nivolumab responsiveness in metastatic renal cancer patients (REVOLUTION) trial. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-6675] [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: Regulatory T cells (Tregs) are responsible for maintaining self-tolerance, and inhibit antitumor immune responses. PD-1 blockade was reported to increase resistance of effector T cells to Tregs suppression and directly reduces in vitro Tregs suppressive function. Natural killer cells (NKs) expressed PD-1 and engagement of PD-1 reduces their cytolytic potential. To identify biomarkers informative and predictive of Nivolumab efficacy Tregs and NKs phenotype and function was determined in Nivolumab treated metastatic renal cancer (mRCC) patients (REV). Effect of CXCR4 antagonism are evaluated on ex vivo Tregs and NKs.
Methods: 48 REV, 26 other than ICI treated-mRCC (CTR) and 23 Healthy Donors (HD) were enrolled. To date, the clinical evaluation is available for 42 REV [14 with objective response (OR) and 28 in progression (PD)] and 18 CTR (11 OR and 7 PD). 31 patients (pts) underwent first clinical evaluation at 3 months resulting in 25 pts with OR and 6 in PD. Tregs (CD4+CD25+CD127lowFOXP3+) and NKs (CD3-CD56+CD107a+) phenotype and function were evaluated at day 0, 14, 28, 90, and 180. CFSE-T-effector proliferation-Tregs dependent and CD107a externalization toward K562 as NKs function were evaluated.
Results: Higher NKG2D was reported on CD3-CD56dim cells from OR as compared to PD pts (p=0.0054). Statistically significant low NKs basal activity was detected at T0 in 3 months PD- Nivolumab treated pts (p=0.032). CD107a+/CD53+CD56+ is higher in OR compared to PD pts over time. Percent Tregs CD4+CD25+CD127lowFOXP3+ and CD8/Tregs ratio were respectively low (p<0.001) and high (p<0.001) in 71 mRCC as compared to 23 HD. Significant lower PD-1 was observed in Tregs at 3 months of treatment in OR pts (p= 0.048). Moreover, higher % of CD4+CD25+CD127lowFoxp3+ Tregs were observed in PD compared to OR pts over time (p<0.001) with higher CTLA4 expression in PD group. Tregs function, as evaluated at 2 weeks post treatment, was inhibited in responder and potentiated in PD patients. Moreover, CXCR4 antagonism dramatically reversed Tregs function ex vivo as early as at day 14 of treatment in OR pts (p=0.0024). A statistically significant reduction in peripheral Tregs (Effector/Naïve and nonTregs) was revealed in 14 Long Responder compared to 23 PD pts (> 12 months) (p<0.05; p<0.01 and p<0.05, respectively). In 18 CTR no modification in Treg phenotype and function were detected but a common decrease in NK activity unrelated to the clinical outcome.
Conclusions: Basal NK activity and 2 weeks Tregs evaluation discriminates mRCC Nivolumab responding patients. Ex vivo CXCR4 antagonism inhibits Tregs function in responding patients at early treatment time point (2 weeks). These evidence are not detected in non-immune treated mRCC patients.
Citation Format: Sara Santagata, Anna Maria Trotta, Giuseppina Rea, Maria Napolitano, Anna Capiluongo, Crescenzo D'Alterio, Marilena Di Napoli, Sabrina Rossetti, Sandro Pignata, Stefania Scala. Basal NK activity and early Tregs inhibition predicts nivolumab responsiveness in metastatic renal cancer patients (REVOLUTION) trial [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6675.
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Caffo O, Frantellizzi V, Tucci M, Galli L, Monari F, Baldari S, Masini C, Bortolus R, Facchini G, Alongi P, Zichi C, Biasco E, Fanti S, Pignata S, Filice A, Borsatti E, Rossetti S, Spada M, Cortesi E, De Vincentis G. Fracture risk and survival outcomes in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) sequentially treated with abiraterone acetate (AA) and radium-223 (RA223). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e17593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17593 Background: The increased incidence of bone fractures found in pts who received the AA-RA223 combination compared to those treated with AA alone in the ERA223 trial led to restrictive recommendations by the European Medicines Agency which limited the use of RA223 to pts who have received at least two previous treatments for mCRPC or who cannot receive any other treatment. Moreover, clinicians started to debate the risk of RA223-related fractures associated with the sequential administration of AA and RA223. The aim of this retrospective study was to assess the safety of administering RA223 to pts who have progressed during AA treatment mainly in terms of the rate of skeletal fractures. Methods: We retrospectively reviewed the records of mCRPC pts who received RA223 after progressing during an AA treatment line in everyday clinical practice in ten Italian Hospitals. Results: We reviewed data of a consecutive series of 94 mCRPC pts. Most of the pts (85.1%) received RA223 as second- or third-line treatment and had a Soloway score 2 or 3 (90%). RA223 treatment was well-tolerated: there were only four cases of grade 3 anemia, two case of grade 3 leukopenia, and one case of grade 3 neutropenia. The overall fracture rate of 2.1%: one fracture was recorded during the course of RA223 treatment, and one was recorded one month after its end. The fractures both occurred at metastatic sites in pts who were not treated with antiresorptive agents. Median overall survival (OS) from RA223 start was more than 14 mos and the pts who received Ra223 in second line (which is not allowed today in Europe) had the same median OS as those who received this agent in later lines. Conclusions: The findings of this study showed that the treatment with RA223 as subsequent treatment line after AA was active and safe with a very low risk of a fracture. The OS outcomes indicated that the administration of RA223 in early treatment lines is not detrimental, even after AA. Thus the present observational report makes a valuable contribution to the current debate concerning the risks and benefits of including RA223 in the therapeutic algorithm.
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Affiliation(s)
| | | | | | - Luca Galli
- Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | | | | | | | | | | | | | | | - Elisa Biasco
- Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | | | | | | | | | - Sabrina Rossetti
- Clinical and Experimental Uro-Andrologic Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione “G. Pascale”-IRCCS, Naples, Italy
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29
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Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, Madeddu G, Magistri P, Bimonte S, Trovò M, Gnagnarella P, Cuomo A, Cascella M, Lleshi A, Nasti G, Facchini S, Fiorica F, Di Francia R, Nunnari G, Pellicanò GF, Guglielmino A, Danova M, Rossetti S, Amore A, Crispo A, Facchini G. Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study. Front Oncol 2020; 10:594. [PMID: 32411599 PMCID: PMC7202223 DOI: 10.3389/fonc.2020.00594] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 08/05/2019] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose: Complementary and Alternative Medicine (CAM) interventions are widely used by patients with chronic disorders, including cancer, and may interact with cancer treatment. Physicians are often unaware of this, probably due to poor patient-physician communication on CAM. The purpose of this study was to evaluate physicians' knowledge, attitudes and practice patterns regarding CAM in a survey conducted in Italy. Methods: A questionnaire was administered to 438 physicians (11 Italian hospitals) who predominantly treat patients with chronic disease, to collect personal and professional data and information on attitudes toward CAM and its possible role in Conventional Medicine (CM). Results: Of the 438 participants, most were specialists in oncology (18%), internal medicine (17%), surgery (15%), and radiotherapy (11%). Most worked at university (44%) or research hospitals (31%). Forty-two percent of participants believed that CAM could have an integrative role within CM. Oncologists were the physicians who were best informed on CAM (58%). Physicians working at research institutes or university hospitals had a greater knowledge of CAM than those employed at general hospitals (p < 0.0001), and those who were also involved in research activity had a greater knowledge of CAM than those who were not (p < 0.003). Length of work experience was significantly related to CAM knowledge. Moreover, 55% of participants suggest CAM interventions to their patients and 44% discuss CAM with them. The best-known interventions were acupuncture, Aloe vera and high-dose vitamin C. Conclusion: CAM use by patients with chronic disease and/or cancer has become a topical issue for the scientific community and for physicians. Knowing the reasons that prompt these patients to use CAM and guiding them in their decisions would improve treatment and outcomes and also benefit healthcare systems. Our findings contribute to a greater understanding of CAM knowledge, attitudes, and practice among Italian physicians. Further research is needed to identify the more effective CAM treatments and to work toward an integrated healthcare model.
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Affiliation(s)
- Massimiliano Berretta
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rosaria Taibi
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Paolo Tralongo
- Division of Medical Oncology, "Umberto I" Hospital, Siracusa, Italy
| | - Alberto Fulvi
- Division of Medical Oncology, "Gemelli" Hospital, Roman, Italy
| | | | - Giordano Madeddu
- Division of Infectious Diseases, University of Sassari, Sassari, Italy
| | - Paolo Magistri
- Department of Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | - Sabrina Bimonte
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Marco Trovò
- Division of Radiotherapy, "Santa Maria della Misericordia" Hospital, Udine, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Arturo Cuomo
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Marco Cascella
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Arben Lleshi
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Guglielmo Nasti
- Division of Medical Oncology B, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Sergio Facchini
- Department of Urology, University of Naples "Federico II", Naples, Italy
| | | | | | - Giuseppe Nunnari
- Division of Infectious Disease, University of Messina, Messina, Italy
| | | | - Aurelio Guglielmino
- Division of Anaesthesia, Policlinico Universitario, University of Catania, Catania, Italy
| | - Marco Danova
- Department of Internal Medicine and Medical Oncology, Vigevano Civic Hospital, ASST of Pavia, Vigevano, Italy
| | - Sabrina Rossetti
- Medical Oncology, Department of Uro-Gynaecological Oncology 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Alfonso Amore
- Division of Surgery Melanoma and Skin Cancer, 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Anna Crispo
- Unit of Epidemiology, 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Gaetano Facchini
- Medical Oncology, Department of Uro-Gynaecological Oncology 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
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Caffo O, Aieta M, Palesandro E, Macerelli M, Mucciarini C, Nicodemo M, De Giorgi U, Sartori D, Fratino L, Iacovelli R, Rossetti S, Scapoli D, Morelli F, Carrozza F, Nole F, Zagonel V, Messina C, Gasparro D. Enzalutamide (E) re-challenge as second-line in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with first-line enzalutamide + docetaxel (D): Preliminary results of a post-progression analysis of CHEIRON trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
123 Background: CHEIRON trial was a phase II study which randomized previously untreated mCRPC pts to receive D 75 mg/m2 IV d1 q3w for 8 courses alone or plus E 160 mg PO daily. As per protocol, E was administered in experimental arm for only 24 wks until D conclusion. The study met its primary endpoint since the rate of pts without disease progression at 6 mos was significantly higher in DE arm compared to D arm (89.1% vs 72.8%; p = 0.002). The clinicians were asked to consider an E re-challenge as first post-progression treatment for those pts without disease progression at the chemotherapy end in the experimental arm. We presented the preliminary analysis of E activity in post-progression setting of CHEIRON DE arm. Methods: We evaluated all patients enrolled in the experimental arm, focusing on pts who received E as first post-progression treatment. We collected data concerning the treatment duration and disease control and compared the outcomes of pts treated with E re-challenge with those of pts who received other treatments at the time of first progression after experimental therapy. Results: Among the 120 pts who received DE experimental arm, 101 did not show a disease progression and 82 received a second-line active treatment: 54 (66%) were treated with E, the other received abiraterone (10 pts), cabazitaxel (13 pts), and radium 223 (5 pts). The median interval between the end of DE and the start of E re-challenge was 7.6 mos (range 0.9-18.4 mos). At a median follow-up of 15.5 mos, the median duration of E re-challenge was 9.8 mos (range 1.9-30.9) with 22 pts still on treatment. Pts who received E rechallenge showed a median progression free survival of 11.4 mos which was significantly longer compared to 4.5 mos showed in pts who received other treatments (p < 0.0001). The median overall survival was 20.4 mos and 12.3 mos, respectively (p = NS). Conclusions: In pts who received first-line DE in the CHEIRON trial, the reintroduction of E after a per-protocol discontinuation demonstrated to be feasible, with a prolonged disease control compared to the other post-progression therapeutic options. Clinical trial information: NCT02453009.
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Affiliation(s)
| | | | | | | | - Claudia Mucciarini
- U.O. Medicina Oncologica, Ospedale Ramazzini, Carpi-AUSL Modena, Carpi, Italy
| | | | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | | | - Roberto Iacovelli
- Medicenda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Sabrina Rossetti
- Clinical and Experimental Uro-Andrologic Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione “G. Pascale”-IRCCS, Naples, Italy
| | | | - Franco Morelli
- IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Franco Nole
- IEO, Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Vittorina Zagonel
- Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
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D'Aniello C, Berretta M, Cavaliere C, Rossetti S, Facchini BA, Iovane G, Mollo G, Capasso M, Pepa CD, Pesce L, D'Errico D, Buonerba C, Di Lorenzo G, Pisconti S, De Vita F, Facchini G. Biomarkers of Prognosis and Efficacy of Anti-angiogenic Therapy in Metastatic Clear Cell Renal Cancer. Front Oncol 2019; 9:1400. [PMID: 31921657 PMCID: PMC6917607 DOI: 10.3389/fonc.2019.01400] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 11/27/2019] [Indexed: 12/30/2022] Open
Abstract
In the last decades, the prognosis of metastatic renal cell carcinoma (mRCC) has remarkably improved following the advent of the "targeted therapy" era. The expanding knowledge on the prominent role played by angiogenesis in RCC pathogenesis has led to approval of multiple anti-angiogenic agents such as sunitinib, pazopanib, axitinib, cabozantinib, sorafenib, and bevacizumab. These agents can induce radiological responses and delay cancer progression for months or years before onset of resistance, with a clinically meaningful activity. The need for markers of prognosis and efficacy of anti-angiogenic agents has become more compelling as novel systemic immunotherapy agents have also been approved in RCC and can be administered as an alternative to angiogenesis inhibitors. Anti PD-1 monoclonal antibody nivolumab has been approved in the second-line setting after tyrosine kinase inhibitors failure, while combination of nivolumab plus anti CTLA-4 monoclonal antibody ipilimumab has been approved as first-line therapy of RCC patients at intermediate or poor prognosis. In this review article, biomarkers of prognosis and efficacy of antiangiogenic therapies are summarized with a focus on those that have the potential to affect treatment decision-making in RCC. Biomarkers predictive of toxicity of anti-angiogenic agents have also been discussed.
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Affiliation(s)
- Carmine D'Aniello
- Division of Medical Oncology, A.O.R.N. dei COLLI “Ospedali Monaldi-Cotugno-CTO,”Naples, Italy
| | - Massimiliano Berretta
- Division of Medical Oncology, Istituto Nazionale Tumori, IRCCS CRO Aviano (PN), Milan, Italy
| | - Carla Cavaliere
- UOC of Medical Oncology, ASL NA 3 SUD, Ospedali Riuniti Area Nolana, Nola, Italy
| | - Sabrina Rossetti
- Departmental Unit of Experimental Uro-Andrologic Clinical Oncology, Istituto Nazionale Tumori Fondazione G. Pascale—IRCCS, Naples, Italy
| | - Bianca Arianna Facchini
- Division of Medical Oncology, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Gelsomina Iovane
- Departmental Unit of Experimental Uro-Andrologic Clinical Oncology, Istituto Nazionale Tumori Fondazione G. Pascale—IRCCS, Naples, Italy
| | - Giovanna Mollo
- Departmental Unit of Experimental Uro-Andrologic Clinical Oncology, Istituto Nazionale Tumori Fondazione G. Pascale—IRCCS, Naples, Italy
| | - Mariagrazia Capasso
- Departmental Unit of Experimental Uro-Andrologic Clinical Oncology, Istituto Nazionale Tumori Fondazione G. Pascale—IRCCS, Naples, Italy
| | | | - Laura Pesce
- Oncology Unit, San Luca Hospital, Vallo Della Lucania, Italy
| | - Davide D'Errico
- Departmental Unit of Experimental Uro-Andrologic Clinical Oncology, Istituto Nazionale Tumori Fondazione G. Pascale—IRCCS, Naples, Italy
| | - Carlo Buonerba
- CRTR Rare Tumors Reference Center, AOU Federico II, Naples, Italy
- Environment & Health Operational Unit, Zoo-Prophylactic Institute of Southern Italy, Portici, Italy
| | - Giuseppe Di Lorenzo
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Medicine, University of Molise, Campobasso, Italy
| | - Salvatore Pisconti
- Department of Onco-Hematology, Medical Oncology, S.G. Moscati Hospital, Taranto, Italy
| | - Ferdinando De Vita
- Division of Medical Oncology, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Gaetano Facchini
- Departmental Unit of Experimental Uro-Andrologic Clinical Oncology, Istituto Nazionale Tumori Fondazione G. Pascale—IRCCS, Naples, Italy
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Cappuccio F, Rossetti S, Cavaliere C, Iovane G, Taibi R, D'Aniello C, Imbimbo C, Facchini S, Abate V, Barberio D, Facchini G. Health-related quality of life and psychosocial implications in testicular cancer survivors. A literature review. Eur Rev Med Pharmacol Sci 2019; 22:645-661. [PMID: 29461592 DOI: 10.26355/eurrev_201802_14290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In this review, we focused our attention on Quality of Life (QoL) of testicular cancer survivors (TCSs), in general and in the most relevant areas. Several key findings have been highlighted in our review. MATERIALS AND METHODS PubMed, MEDLINE and PsycINFO databases were consulted to find published studies, from 1980 to May 2017, that met our inclusion criteria. RESULTS The majority of studies investigated older adult TCSs, while few studies on adolescent and young adult patients were available. Many studies indicate that health-related QoL (HRQoL) is similar among the TCSs and the general population. Even if QoL deteriorates so clear at the time of diagnosis and throughout treatment, afterward returns to normal levels, as defined by the matched controls. However, there are numerous chronic conditions consequent to diagnosis and treatment of testicular cancer that plague survivors and affect QoL, like Raynaud-like phenomena, peripheral neuropathy, fatigue, anxiety, sexual, fertility and body image problems. Even if these problems can have no effects on the measures of global QoL, they have an impact on the quality of life. Differences between TCSs with and without a partner bring to different outcomes in the adjustments to cancer. CONCLUSIONS It is necessary to identify TCSs with higher risks of poorer QoL outcomes, to focus interventions on the areas with the greatest impairments. Further researches should consider the effects of testicular cancer on the impaired areas, collecting more data to better identify survivor's needs and consequent interventions, with a special focus on adolescent and young adult TCSs. Other works are requested on therapies, preventive and ameliorative, to reduce chronic side effects of testicular cancer treatment.
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Affiliation(s)
- F Cappuccio
- Progetto ONCONET2.0 - Linea progettuale 14 per l'implementazione della prevenzione e diagnosi precoce del tumore alla prostata e testicolo - Regione Campania, Italy.
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Caffo O, Palesandro E, Nole F, Gasparro D, Mucciarini C, Aieta M, Zagonel V, Iacovelli R, De Giorgi U, Rossetti S, Fratino L, Ermacora P, Nicodemo M, Giordano M, Sartori D, Scapoli D, Verri E, Maines F, Pappagallo G, Aglietta M. Updated survival analyses of a multicentric phase II randomized trial of docetaxel (D) plus enzalutamide (E) versus docetaxel (D) as first-line chemotherapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) (CHEIRON study). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Santagata S, Trotta A, Rea G, Napolitano M, D’Alterio C, Napoli MD, Rossetti S, Pignata S, Scala S. Basal NK activity and early Treg function inhibition predicts Nivolumab responsiveness in metastatic renal cancer patients (REVOLUTION) trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tralongo P, Bordonaro S, Lorenzo GD, Borsellino N, Facchini G, Rossetti S, Martelli V, Longo V, Tralongo A, Caspani F, Tuzi A, Spada M, Calvani N, Carlini P, De Giorgi U. Cabazitaxel for octogenarian patients with metastatic castration-resistant prostate cancer (MCRPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ronchi A, Cozzolino I, Montella M, Panarese I, Zito Marino F, Rossetti S, Chieffi P, Accardo M, Facchini G, Franco R. Extragonadal germ cell tumors: Not just a matter of location. A review about clinical, molecular and pathological features. Cancer Med 2019; 8:6832-6840. [PMID: 31568647 PMCID: PMC6853824 DOI: 10.1002/cam4.2195] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 03/25/2019] [Accepted: 04/10/2019] [Indexed: 12/25/2022] Open
Abstract
Extragonadal germ cell tumors (EGGCTs) are uncommon neoplasms, which arise in anatomical locations other than gonads. The pathogenesis of these neoplasms is still poorly understood and it is a matter of debate if they really represent extragondal primary neoplasms or rather extragondal metastasis from occult gonadal neoplasms. The actual observations suggest that EGGCTs represent a unique entity, so their biology and behavior are substantially different from gonadal counterparts. The diagnosis of EGGCTs is often challenging, and differential diagnosis is particularly wide. Nevertheless, a correct diagnosis is essential for the correct management of the patient. We summarize the state of art about EGGCTs, with particular emphasis on diagnosis and prognosis.
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Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Iacopo Panarese
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Sabrina Rossetti
- Uro-Andrologic Oncology Unit, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Paolo Chieffi
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaetano Facchini
- Uro-Andrologic Oncology Unit, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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Facchini G, Rossetti S, Berretta M, Cavaliere C, Scagliarini S, Vitale MG, Ciccarese C, Di Lorenzo G, Palesandro E, Conteduca V, Basso U, Naglieri E, Farnesi A, Aieta M, Borsellino N, La Torre L, Iovane G, Bonomi L, Gasparro D, Ricevuto E, De Tursi M, De Vivo R, Lo Re G, Grillone F, Marchetti P, De Vita F, Scavelli C, Sini C, Pisconti S, Crispo A, Gebbia V, Maestri A, Galli L, De Giorgi U, Iacovelli R, Buonerba C, Cartenì G, D'Aniello C. Second line therapy with axitinib after only prior sunitinib in metastatic renal cell cancer: Italian multicenter real world SAX study final results. J Transl Med 2019; 17:296. [PMID: 31464635 PMCID: PMC6716812 DOI: 10.1186/s12967-019-2047-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This multi-institutional retrospective real life study was conducted in 22 Italian Oncology Centers and evaluated the role of Axitinib in second line treatment in not selected mRCC patients. METHODS 148 mRCC patients were evaluated. According to Heng score 15.5%, 60.1% and 24.4% of patients were at poor risk, intermediate and favorable risk, respectively. RESULTS PFS, OS, DCR and ORR were 7.14 months, 15.5 months, 70.6% and 16.6%, respectively. The duration of prior sunitinib treatment correlated with a longer significant mPFS, 8.8 vs 6.3 months, respectively. Axitinib therapy was safe, without grade 4 adverse events. The most frequent toxicities of all grades were: fatigue (50%), hypertension (26%), and hypothyroidism (18%). G3 blood pressure elevation significantly correlated with longer mPFS and mOS compared to G1-G2 or no toxicity. Dose titration (DT) to 7 mg and 10 mg bid was feasible in 24% with no statistically significant differences in mPFS and mOS. The sunitinib-axitinib sequence was safe and effective, the mOS was 41.15 months. At multivariate analysis, gender, DCR to axitinib and to previous sunitinib correlated significantly with PFS; whereas DCR to axitinib, nephrectomy and Heng score independently affected overall survival. CONCLUSIONS Axitinib was effective and safe in a not selected real life mRCC population. Trial registration INT - Napoli - 11/16 oss. Registered 20 April 2016. http://www.istitutotumori.na.it.
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Affiliation(s)
- Gaetano Facchini
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 80131, Napoli, Italy.
| | - Sabrina Rossetti
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 80131, Napoli, Italy
| | - Massimiliano Berretta
- Department of Medical Oncology, Centro di Riferimento Oncologico, Istituto Nazionale Tumori CRO, Aviano, PN, Italy
| | - Carla Cavaliere
- UOC of Medical Oncology ASL NA 3 SUD Ospedali Riuniti Area Nolana, Naples, Italy
| | - Sarah Scagliarini
- Division of Oncology, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Naples, Italy
| | - Maria Giuseppa Vitale
- Division of Medical Oncology, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
| | - Chiara Ciccarese
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Giuseppe Di Lorenzo
- Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Erica Palesandro
- Division of Medical Oncology, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Vincenza Conteduca
- Department of Oncology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy
| | - Umberto Basso
- Medical Oncology Unit 1, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Emanuele Naglieri
- Division of Medical Oncology, Istituto Oncologico Giovanni Paolo II, Bari, Italy
| | - Azzurra Farnesi
- University Hospital of Pisa, Oncology Unit 2, Pisa, Pisa, Italy
| | - Michele Aieta
- Medical Oncology Department, National Institute of Cancer, Rionero in Vulture, Italy
| | | | - Leonardo La Torre
- Medical Oncology Department, "Santa Maria della Scaletta" Hospital AUSL, Imola, Italy
| | - Gelsomina Iovane
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 80131, Napoli, Italy
| | - Lucia Bonomi
- Oncology Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | - Enrico Ricevuto
- S. Salvatore Hospital, ASL1 Abruzzo, University of L'Aquila, L'Aquila, Italy
| | - Michele De Tursi
- Oncology and Experimental Medicine, "G. D'Annunzio" University, Chieti, Italy
| | | | | | - Francesco Grillone
- Medical Oncology Unit Azienda Ospedaliera "Mater Domini", Catanzaro, Italy
| | | | - Ferdinando De Vita
- Division of Medical Oncology, University of Campania "L. Vanvitelli", Napoli, Italy
| | - Claudio Scavelli
- Medical Oncology Unit, "S. Cuore di Gesù" Hospital, Gallipoli, Italy
| | | | | | - Anna Crispo
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 80131, Napoli, Italy
| | - Vittorio Gebbia
- Medical Oncology Unit, La Maddalena Clinic for Cancer, University of Palermo, Palermo, Italy
| | - Antonio Maestri
- Medical Oncology Department, "Santa Maria della Scaletta" Hospital AUSL, Imola, Italy
| | - Luca Galli
- University Hospital of Pisa, Oncology Unit 2, Pisa, Pisa, Italy
| | - Ugo De Giorgi
- Department of Oncology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy
| | - Roberto Iacovelli
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Carlo Buonerba
- Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Giacomo Cartenì
- Division of Oncology, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Naples, Italy
| | - Carmine D'Aniello
- Division of Medical Oncology, AORN Dei Colli "Ospedali Monaldi-Cotugno-CTO", Napoli, Italy
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Bersanelli M, Giannarelli D, Castrignanò P, Fornarini G, Panni S, Mazzoni F, Tiseo M, Rossetti S, Gambale E, Rossi E, Papa A, Cortellini A, Lolli C, Ratta R, Michiara M, Milella M, De Luca E, Sorarù M, Mucciarini C, Atzori F, Banna GL, La Torre L, Vitale MG, Massari F, Rebuzzi SE, Facchini G, Schinzari G, Tomao S, Bui S, Vaccaro V, Procopio G, De Giorgi U, Santoni M, Ficorella C, Sabbatini R, Maestri A, Natoli C, De Tursi M, Di Maio M, Rapacchi E, Pireddu A, Sava T, Lipari H, Comito F, Verzoni E, Leonardi F, Buti S. INfluenza Vaccine Indication During therapy with Immune checkpoint inhibitors: a transversal challenge. The INVIDIa study. Immunotherapy 2019; 10:1229-1239. [PMID: 30326787 DOI: 10.2217/imt-2018-0080] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
AIM Considering the unmet need for the counseling of cancer patients treated with immune checkpoint inhibitors (CKI) about influenza vaccination, an explorative study was planned to assess flu vaccine efficacy in this population. METHODS INVIDIa was a retrospective, multicenter study, enrolling consecutive advanced cancer outpatients receiving CKI during the influenza season 2016-2017. RESULTS Of 300 patients, 79 received flu vaccine. The incidence of influenza syndrome was 24.1% among vaccinated, versus 11.8% of controls; odds ratio: 2.4; 95% CI: 1.23-4.59; p = 0.009. The clinical ineffectiveness of vaccine was more pronounced among elderly: 37.8% among vaccinated patients, versus 6.1% of unvaccinated, odds ratio: 9.28; 95% CI: 2.77-31.14; p < 0.0001. CONCLUSION Although influenza vaccine may be clinically ineffective in advanced cancer patients receiving CKI, it seems not to negatively impact the efficacy of anticancer therapy.
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Affiliation(s)
| | - Diana Giannarelli
- Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Policlinico San Martino Hospital, Genova, Italy
| | - Stefano Panni
- Medical Oncology Unit, ASST - Istituti Ospitalieri Cremona Hospital, Cremona, Italy
| | | | - Marcello Tiseo
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Sabrina Rossetti
- SSD Oncologia Clinica Sperimentale Uro-Andrologica, Dipartimento Corp-S Assistenziale dei Percorsi Oncologici Uro-Genitale, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | - Elisabetta Gambale
- Department of Medical, Oral & Biotechnological Sciences & CeSI-MeT, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Ernesto Rossi
- Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Anselmo Papa
- Department of Medical & Surgical Sciences & Biotechnology, University "La Sapienza", Latina, Italy
| | - Alessio Cortellini
- Department of Biotechnological & Applied Clinical Sciences, St Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Cristian Lolli
- Medical Oncology, Scientific Institute of Romagna for the Study & Treatment of Tumors (IRST) IRCCS, Meldola, Italy
| | - Raffaele Ratta
- Genito-Urinary Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori of Milan, Milano, Italy
| | - Maria Michiara
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Michele Milella
- Oncology Unit 1, Regina Elena National Cancer Institute, Rome, Italy
| | - Emmanuele De Luca
- Medical Oncology, Ordine Mauriziano Hospital, University of Turin, Torino, Italy
| | | | | | - Francesco Atzori
- Department of Medical Sciences "M. Aresu", Medical Oncology, University Hospital & University of Cagliari, Cagliari, Italy
| | | | - Leonardo La Torre
- Medical Oncology Department, Santa Maria della Scaletta Hospital, Imola, Italy
| | | | | | - Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Policlinico San Martino Hospital, Genova, Italy
| | - Gaetano Facchini
- SSD Oncologia Clinica Sperimentale Uro-Andrologica, Dipartimento Corp-S Assistenziale dei Percorsi Oncologici Uro-Genitale, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | | | - Silverio Tomao
- Department of Medical & Surgical Sciences & Biotechnology, University "La Sapienza", Latina, Italy
| | - Simona Bui
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Vanja Vaccaro
- Oncology Unit 1, Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Procopio
- Genito-Urinary Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori of Milan, Milano, Italy
| | - Ugo De Giorgi
- Medical Oncology, Scientific Institute of Romagna for the Study & Treatment of Tumors (IRST) IRCCS, Meldola, Italy
| | | | - Corrado Ficorella
- Department of Biotechnological & Applied Clinical Sciences, St Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | | | - Antonio Maestri
- Medical Oncology Department, Santa Maria della Scaletta Hospital, Imola, Italy
| | - Clara Natoli
- Department of Medical, Oral & Biotechnological Sciences & CeSI-MeT, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Michele De Tursi
- Department of Medical, Oral & Biotechnological Sciences & CeSI-MeT, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Massimo Di Maio
- Medical Oncology, Ordine Mauriziano Hospital, University of Turin, Torino, Italy
| | - Elena Rapacchi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Annagrazia Pireddu
- Department of Medical Sciences "M. Aresu", Medical Oncology, University Hospital & University of Cagliari, Cagliari, Italy
| | - Teodoro Sava
- Medical Oncology, Camposampiero Hospital, Padova, Italy
| | - Helga Lipari
- Medical Oncology, Cannizzaro Hospital, Catania, Italy
| | - Francesca Comito
- Division of Oncology, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Elena Verzoni
- Genito-Urinary Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori of Milan, Milano, Italy
| | | | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
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Cappello S, Cruz Viggi C, Yakimov M, Rossetti S, Matturro B, Molina L, Segura A, Marqués S, Yuste L, Sevilla E, Rojo F, Sherry A, Mejeha OK, Head IM, Malmquist L, Christensen JH, Kalogerakis N, Aulenta F. Combining electrokinetic transport and bioremediation for enhanced removal of crude oil from contaminated marine sediments: Results of a long-term, mesocosm-scale experiment. Water Res 2019; 157:381-395. [PMID: 30974287 DOI: 10.1016/j.watres.2019.03.094] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 03/27/2019] [Accepted: 03/30/2019] [Indexed: 05/23/2023]
Abstract
Marine sediments represent an important sink of harmful petroleum hydrocarbons after an accidental oil spill. Electrobioremediation techniques, which combine electrokinetic transport and biodegradation processes, represent an emerging technological platform for a sustainable remediation of contaminated sediments. Here, we describe the results of a long-term mesocosm-scale electrobioremediation experiment for the treatment of marine sediments contaminated by crude oil. A dimensionally stable anode and a stainless-steel mesh cathode were employed to drive seawater electrolysis at a fixed current density of 11 A/m2. This approach allowed establishing conditions conducive to contaminants biodegradation, as confirmed by the enrichment of Alcanivorax borkumensis cells harboring the alkB-gene and other aerobic hydrocarbonoclastic bacteria. Oil chemistry analyses indicated that aromatic hydrocarbons were primarily removed from the sediment via electroosmosis and low molecular weight alkanes (nC6 to nC10) via biodegradation.
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Affiliation(s)
- S Cappello
- Institute for Coastal Marine Environment (IAMC), National Research Council (CNR), Messina, Italy
| | - C Cruz Viggi
- Water Research Institute (IRSA), National Research Council (CNR), Monterotondo, RM, Italy
| | - M Yakimov
- Institute for Coastal Marine Environment (IAMC), National Research Council (CNR), Messina, Italy
| | - S Rossetti
- Water Research Institute (IRSA), National Research Council (CNR), Monterotondo, RM, Italy
| | - B Matturro
- Water Research Institute (IRSA), National Research Council (CNR), Monterotondo, RM, Italy
| | - L Molina
- Environmental Protection Department, Estación Experimental Del Zaidín, Consejo Superior de Investigaciones Científicas (CSIC), Granada, Spain
| | - A Segura
- Environmental Protection Department, Estación Experimental Del Zaidín, Consejo Superior de Investigaciones Científicas (CSIC), Granada, Spain
| | - S Marqués
- Environmental Protection Department, Estación Experimental Del Zaidín, Consejo Superior de Investigaciones Científicas (CSIC), Granada, Spain
| | - L Yuste
- Departamento de Biotecnología Microbiana, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - E Sevilla
- Departamento de Biotecnología Microbiana, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - F Rojo
- Departamento de Biotecnología Microbiana, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - A Sherry
- School of Civil Engineering and Geosciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - O K Mejeha
- School of Civil Engineering and Geosciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - I M Head
- School of Civil Engineering and Geosciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - L Malmquist
- Department of Plant and Environmental Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J H Christensen
- Department of Plant and Environmental Sciences, University of Copenhagen, Copenhagen, Denmark
| | - N Kalogerakis
- School of Environmental Engineering, Technical University of Crete, Chania, Greece
| | - F Aulenta
- Water Research Institute (IRSA), National Research Council (CNR), Monterotondo, RM, Italy.
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40
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Antonello G, Belgeri M, Ferrara P, Fontana R, Gasparet D, Monaco CL, Molino C, Napoli P, Nigra M, Panero C, Pezzati L, Rossetti S, Scavuzzo M, Sfriso A, Solimando D. HbS/Hb Nouakchott: Double heterozygosity, observed for the first time in Italy, visible only in capillary electrophoresis. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Caffo O, Palesandro E, Nole F, Gasparro D, Mucciarini C, Aieta M, Iacovelli R, De Giorgi U, Rossetti S, Maruzzo M, Fratino L, Sacco C, Nicodemo M, Giordano M, Sartori D, Scapoli D, Verri E, Veccia A, Pappagallo GL, Aglietta M. A multicentric phase II randomized trial of docetaxel (D) plus enzalutamide (E) versus docetaxel (D) as first-line chemotherapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): CHEIRON study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5050 Background: D and E demonstrated to be efficacious in the treatment of mCRPC pts. Due to different antitumor mechanism of action of these agents, it could be postulated that their combination can improve disease control. CHEIRON study tried to demonstrate the candidate efficacy of chemo-hormonal combination D+E versus D in mCRPC first-line. Methods: Eligibility criteria included mCRPC diagnosis, ECOG PS ≤ 2, adequate renal, hepatic and hematological functions, no prior treatment for mCRPC. Pts were randomized to receive D 75 mg/m2 IV d1 q3w plus prednisone 5 mg PO BID for 8 courses alone or plus E 160 mg PO daily for 24 weeks. Stratification criteria were presence of pain and visceral metastases. The primary endpoint of the study was the rate of pts without disease progression (according to PCWG2) at 6 mos after randomization. Results: Between 09/2014 and 10/2017, 246 pts (median age 70 years, range 44-88, pain reported by 54 pts, visceral metastases present in 50 pts) were randomized to DE (120) or D (126). The rate of pts without disease progression at 6 mos was significantly higher in DE arm compared to D arm (89.1% vs 72.8%; p = 0.002). Similarly, a higher proportion of DE pts achieved a PSA reduction ≥ 50% compared to the baseline values compared to the D pts (92% vs 69%; p < 0.0001). No differences were observed in terms of objective response rate. Major haematological toxicities consisted of grade 3-4 neutropenia (13 pts DE – 11 pts D); febrile neutropenia was observed in 10 DE pts and in 6 D pts. At a median follow-up of 24 mos, the median progression free survival was 10.1 mos and 9.1 mos in DE and D arm, respectively (p = 0.01). In DE arm the median overall survival was 33.7 mos compared to 29.6 mos of the standard arm (p NS). Conclusions: The present study was the first phase II randomized trial, which tested the addition of a new generation hormone agent to D compared to D alone. From this data, DE improved the 6-mo disease control with a prolongation of PFS compared to the standard chemotherapy. Clinical trial information: NCT02453009.
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Affiliation(s)
| | | | - Franco Nole
- Medical Oncology Division of Urogenital and Head and Neck Tumors, European Institute of Oncology, Milan, Italy
| | | | - Claudia Mucciarini
- Department of Oncology and Haematology, Ramazzini Hospital, Carpi, Italy
| | - Michele Aieta
- IRCCS Referall Cancer Center of Basilicata, Department of Onco-Hematology, Rionero in Vulture, Italy
| | - Roberto Iacovelli
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Sabrina Rossetti
- Clinical and Experimental Uro-Andrologic Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione “G. Pascale”-IRCCS, Naples, Italy
| | - Marco Maruzzo
- Oncologia 1 - Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | | | - Cosimo Sacco
- Dipartimento di Oncologia, Azienda Ospedaliero-Universitaria S. M. della Misericordia, Udine, Italy
| | | | | | | | | | - Elena Verri
- Medical Oncology Division of Urogenital and Head and Neck Tumors. European Institute of Oncology, Milan, Italy
| | | | | | - Massimo Aglietta
- Division of Medical Oncology, Candiolo Cance rInstitute, FPO-IRCCS, Candiolo, Italy
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Di Pippo F, Di Gregorio L, Congestri R, Tandoi V, Rossetti S. Biofilm growth and control in cooling water industrial systems. FEMS Microbiol Ecol 2019; 94:4935158. [PMID: 29596620 DOI: 10.1093/femsec/fiy044] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/13/2018] [Indexed: 12/18/2022] Open
Abstract
Matrix-embedded, surface-attached microbial communities, known as biofilms, profusely colonise industrial cooling water systems, where the availability of nutrients and organic matter favours rapid microbial proliferation and their adhesion to surfaces in the evaporative fill material, heat exchangers, water reservoir and cooling water sections and pipelines. The extensive growth of biofilms can promote micro-biofouling and microbially induced corrosion (MIC) as well as pose health problems associated with the presence of pathogens like Legionella pneumophila. This review examines critically biofilm occurrence in cooling water systems and the main factors potentially affecting biofilm growth, biodiversity and structure. A broad evaluation of the most relevant biofilm monitoring and control strategies currently used or potentially useful in cooling water systems is also provided.
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Affiliation(s)
- F Di Pippo
- CNR-IRSA, National Research Council, Water Research Institute, Via Salaria Km 29.300, Monterotondo 00015, Rome, Italy.,CNR-IAMC, National Research Council, Institute for Coastal Marine Environment, Località Sa Mardini, Torregrande, 09170 Oristano, Italy
| | - L Di Gregorio
- CNR-IRSA, National Research Council, Water Research Institute, Via Salaria Km 29.300, Monterotondo 00015, Rome, Italy.,University of Rome Tor Vergata, Department of Biology, Via Cracovia 1, 00133 Rome, Italy
| | - R Congestri
- University of Rome Tor Vergata, Department of Biology, Via Cracovia 1, 00133 Rome, Italy
| | - V Tandoi
- CNR-IRSA, National Research Council, Water Research Institute, Via Salaria Km 29.300, Monterotondo 00015, Rome, Italy
| | - S Rossetti
- CNR-IRSA, National Research Council, Water Research Institute, Via Salaria Km 29.300, Monterotondo 00015, Rome, Italy
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Verzoni E, Cartenì G, Cortesi E, Giannarelli D, De Giglio A, Sabbatini R, Buti S, Rossetti S, Cognetti F, Rastelli F, Sobrero A, Turci D, Sternberg CN, Porta C, Cappuzzo F, Tortora G, Tassinari D, Panni S, Pazzola A, Surico G, Raimondi A, De Giorgi U, Procopio G. Real-world efficacy and safety of nivolumab in previously-treated metastatic renal cell carcinoma, and association between immune-related adverse events and survival: the Italian expanded access program. J Immunother Cancer 2019; 7:99. [PMID: 30944023 PMCID: PMC6448290 DOI: 10.1186/s40425-019-0579-z] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [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: 11/14/2018] [Accepted: 03/26/2019] [Indexed: 12/17/2022] Open
Abstract
Background The Italian Renal Cell Cancer Early Access Program was an expanded access program that allowed access to nivolumab, for patients (pts) with metastatic renal cell carcinoma (mRCC) prior to regulatory approval. Methods Pts with previously treated advanced or mRCC were eligible to receive nivolumab 3 mg/kg every 2 weeks. Pts included in the analysis had received ≥1 dose of nivolumab and were monitored for drug-related adverse events (drAEs) using CTCAE v.4.0. Immune-related (ir) AEs were defined as AEs displaying a certain, likely or possible correlation with immunotherapy (cutaneous, endocrine, hepatic, gastro-intestinal and pulmonary). The association between overall survival (OS) and irAEs was assessed, and associations between variables were evaluated with a logistic regression model. Results A total of 389 pts were enrolled between July 2015 and April 2016. Overall, the objective response rate was 23.1%. At a median follow-up of 12 months, the median progression-free survival was 4.5 months (95% CI 3.7–6.2) and the 12-month overall survival rate was 63%. Any grade and grade 3–4 drAEs were reported in 124 (32%) and 27 (7%) of pts, respectively, and there were no treatment-related deaths. Any grade irAEs occurred in 76 (20%) of patients, 8% cutaneous, 4% endocrine, 2% hepatic, 5% gastro-intestinal and 1% pulmonary. Of the 22 drAEs inducing treatment discontinuation, 10 (45%) were irAEs. Pts with drAEs had a significantly longer survival than those without drAEs (median OS 22.5 versus 16.4 months, p = 0.01). Pts with irAEs versus without irAEs had a more significant survival benefit (median OS not reached versus 16.8 months, p = 0.002), confirmed at the landmark analysis at 6 weeks. The occurrence of irAEs displayed a strong association with OS in univariable (HR 0.48, p = 0.003) and multivariable (HR 0.57, p = 0.02) analysis. Conclusions The appearance of irAEs strongly correlates with survival benefit in a real-life population of mRCC pts treated with nivolumab. Electronic supplementary material The online version of this article (10.1186/s40425-019-0579-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elena Verzoni
- Medical Oncology-Genitourinary Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy.
| | | | - Enrico Cortesi
- Radiology, Oncology and Pathology, Policlinico Umberto I, Rome, Italy
| | - Diana Giannarelli
- Biostatistical Unit, Regina Elena National Cancer Institute - IRCCS, Rome, Italy
| | | | - Roberto Sabbatini
- Oncology and Hematology Department, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy
| | - Sebastiano Buti
- Medical Oncology, Azienda Ospedaliera di Parma, Parma, Italy
| | - Sabrina Rossetti
- Urology and Gynecology, Istituto Nazionale Tumori - IRCCS - Fondazione Pascale, Naples, Italy
| | - Francesco Cognetti
- Medical Oncology, Regina Elena National Cancer Institute - IRCCS, Rome, Italy
| | | | | | - Daniele Turci
- Medical Oncology, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Cora N Sternberg
- Medical Oncology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy
| | - Camillo Porta
- Department of Internal Medicine, University of Pavia and Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | | | | | | | - Stefano Panni
- Medical Oncology, Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Antonio Pazzola
- Medical Oncology, Ospedale Civile SS Annunziata, Sassari, Italy
| | | | - Alessandra Raimondi
- Medical Oncology-Genitourinary Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy
| | - Ugo De Giorgi
- Urologic-Gynecologic Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy
| | - Giuseppe Procopio
- Medical Oncology-Genitourinary Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy
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Caffo O, Facchini G, Biasco E, Ferraù F, Morelli F, Donini M, Buttigliero C, Calvani N, Guida A, Chiuri VE, Basso U, Mucciarini C, Conteduca V, Rossetti S, Veccia A, Maines F, Kinspergher S, De Giorgi U. Activity and safety of metronomic cyclophosphamide in the modern era of metastatic castration-resistant prostate cancer. Future Oncol 2019; 15:1115-1123. [DOI: 10.2217/fon-2018-0715] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Aim: To evaluate activity of metronomic cyclophosphamide (mCTX) in heavily pretreated metastatic castration-resistant prostate cancer (mCRPC) patients. Patients & methods: We retrospectively evaluated a consecutive series of 74 mCRPC patients treated with at least one new agent after docetaxel failure, who received once-daily oral mCTX treatment at a fixed dose of 50 mg. Results: The treatment was well tolerated. Sixteen percent of the patients experienced a major biochemical response. Median progression-free survival was 4.0 months, and median overall survival was 8.1 months. Conclusions: In the modern context of mCRPC, mCTX may represent a valuable and inexpensive alternative to new agents, which have shown similar activity in heavily pretreated patients.
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Affiliation(s)
- Orazio Caffo
- Medical Oncology Department, Santa Chiara Hospital, Largo Medaglie d’Oro, 38122 Trento, Italy
| | - Gaetano Facchini
- Departmental Unit of Clinical & Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G Pascale, Via Mariano Semmola 52, 80131 Naples, Italy
| | - Elisa Biasco
- Oncology Unit 2, University Hospital, Via Paradisa 2, 56124 Pisa, Italy
| | - Francesco Ferraù
- Medical Oncology Department, San Vincenzo Hospital, Via Sirina, 98039 Taormina, Italy
| | - Franco Morelli
- Medical Oncology Department, Casa Sollievo della Sofferenza, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Italy
| | - Maddalena Donini
- Medical Oncology Department, General Hospital, Viale Concordia, 26100 Cremona, Italy
| | - Consuelo Buttigliero
- Medical Oncology Department, University of Torino, San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Italy
| | - Nicola Calvani
- Medical Oncology Division & Breast Unit, Antonio Perrino Hospital, 72100 Brindisi, Italy
| | - Annalisa Guida
- Medical Oncology Division, Azienda Ospedaliero Universitaria, Policlinico di Modena, 41100 Modena, Italy
| | | | - Umberto Basso
- Medical Oncology Unit 1, Istituto Oncologico Veneto IOV, IRCCS, 35128 Padua, Italy
| | | | - Vincenza Conteduca
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy
| | - Sabrina Rossetti
- Departmental Unit of Clinical & Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G Pascale, Via Mariano Semmola 52, 80131 Naples, Italy
| | - Antonello Veccia
- Medical Oncology Department, Santa Chiara Hospital, Largo Medaglie d'Oro, 38122 Trento, Italy
| | - Francesca Maines
- Medical Oncology Department, Santa Chiara Hospital, Largo Medaglie d'Oro, 38122 Trento, Italy
| | - Stefania Kinspergher
- Medical Oncology Department, Santa Chiara Hospital, Largo Medaglie d'Oro, 38122 Trento, Italy
| | - Ugo De Giorgi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy
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Buonerba C, Grillone F, Rossetti S, Livi L, Scartozzi M, Tagliaferri P, Bruzzese D, Scafuri L, Riccio V, Costabile F, Bosso D, Iaccarino S, Facchini G, Carrano S, Izzo M, Caraglia M, De Placido S, di Lorenzo G. A randomized phase II study comparing cabazitaxel/prednisone to cabazitaxel alone in docetaxel-pretreated men with metastatic castration resistant prostate cancer (mCRPC): The CABACARE trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.tps345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS345 Background: In the TROPIC trial, cabazitaxel (CAB) plus daily prednisone (PDN) was associated with a significant advantage in OS and PFS in docetaxel (DOC)-pretreated patients (Pts). Whether daily PDN may significantly contribute to CAB efficacy or improve its safety profile is unknown. In the CHARTEED trial, DOC was administered without daily PDN with no concerns about the lack of efficacy or greater toxicity. Safety data about CAB without PDN are scarce. Corticosteroids present multiple biological effects, which may potentially be either positive, such as those mediated by adrenal androgen and cytokine suppression, or detrimental, such as those associated with the activation of the glucocorticoid receptor (GR) and of the androgen receptor (AR). Furthermore, PDN is a CYP3A4 inducer and can potentially negatively affect CAB clearance. Finally, AR-V7 positivity in circulating tumor cells and retinoblastoma (RB) loss/inactivation have been identified as potential mechanisms of resistance to hormonal and chemotherapy treatments in prostate cancer. For this reason, we also aim to evaluate if CAB activity is related to such biomarkers. Methods: CABACARE (EudraCT 2016-005251-25) is a randomized, phase II, open label, multi-center study comparing CAB at 25 mg/m2 q21 plus daily PDN (10 mg) vs CAB at 25 mg/m2 q21 alone in mCRPC pts progressed during or after DOC treatment. The study is designed to test non inferiority in terms of PFS, according PCWG-2, of CAB alone vs CAB plus PDN assuming that the two arms are equally effective (non-inferiority HR = 1.4). Main secondary objectives are: safety, QoL, pain assessment, overall response rate (ORR), PSA response, time to PSA progression, Time to radiological progression; OS; time to skeletal related events . The influence of AR-V7 and RB status measured in circulating epithelial cells at baseline on CAB activity will also be evaluated. A total of 35 Italian centers have started / will start recruiting pts in the CABACARE trial. Of the 220 pts required by the trial design, 43 pts have been enrolled since 30th Nov , 2017 until 2nd Oct, 2018 in 10 different Italian Institutions. Clinical trial information: 2016-005251-25.
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Affiliation(s)
| | | | - Sabrina Rossetti
- Istituto Nazionale Tumori Fondazione G. Pascale - IRCCS, Naples, Italy
| | | | - Mario Scartozzi
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | | | | | | | | | | | | | | | - Gaetano Facchini
- Istituto Nazionale Tumori Fondazione G. Pascale - IRCCS, Naples, Italy
| | | | - Michela Izzo
- Medical Oncology, University of Naples Federico II, Naples, Italy
| | - Michele Caraglia
- Department of Biochemistry, Biophisics and General Pathology, University of Campania "L.Vanvitelli", Caserta, Italy
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Caffo O, Palesandro E, Nole F, Gasparro D, Mucciarini C, Aieta M, Zagonel V, Iacovelli R, De Giorgi U, Rossetti S, Fratino L, Sacco C, Nicodemo M, Giordano M, Sartori D, Scapoli D, Verri E, Kinspergher S, Pappagallo GL, Aglietta M. A multicentric phase II randomized trial of docetaxel (D) plus enzalutamide (E) versus docetaxel (D) as first-line chemotherapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): CHEIRON study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
148 Background: D and E demonstrated to be efficacious in the treatment of mCRPC pts. Due to different antitumor mechanism of action of these agents, it could be postulated that their combination can improve disease control. CHEIRON study tried to demonstrate the candidate efficacy of chemo-hormonal combination D+E versus D in mCRPC first-line. Methods: Eligibility criteria included untreated mCRPC diagnosis, ECOG PS ≤ 2, adequate renal, hepatic and hematological functions. Pts were randomized to receive D 75 mg/m2 IV d1 q3w plus prednisone 5 mg PO BID for 8 courses alone or plus E 160 mg PO daily for 24 weeks. Stratification criteria were presence of pain and visceral metastases. The primary endpoint of the study was the rate of pts without disease progression (according to PCWG2) at 6 mos after randomization. Results: Between 09/2014 and 10/2017, 246 pts (median age 70 years, range 44-88, pain reported by 54 pts, visceral metastases present in 50 pts) were randomized to DE (120) or D (126). The rate of pts without disease progression at 6 mos was significantly higher in DE arm compared to D arm [87.3% (CI95% 64-80) vs 72.6% (CI95% 80-92); p = 0.006). Similarly, a higher proportion of DE pts achieved a PSA reduction ≥ 50% compared to the baseline values compared to the D pts [92.2%(CI95% 61-77) vs 70.0%(CI95% 86-96); p < 0.0001). No differences were observed in terms of objective response rate. Major haematological toxicities consisted of grade 3-4 anemia (3 pts DE – 1 pt D) and grade 3-4 neutropenia (23 pts DE – 19 pts D); febrile neutropenia was observed in 10 DE pts and in 5 D pts. At a median follow-up of 20 mos, the median progression free survival was 11.3 mos (CI95% 10.0-12.7) and 9.1 mos (CI95% 8.9-9.2) in DE and D arm, respectively (p = 0.004). In D arm the median overall survival was 30.5 mos (CI95% 24.1-36.8) compared to 28.7 mos (CI95% 20.7-36.6) of the experimental arm (p NS). Conclusions: From the present study, the first phase II randomized trial testing the addition of a new generation hormone agent to D, DE improved the 6-mo disease control with a prolongation of PFS compared to the standard chemotherapy. Clinical trial information: NCT02453009.
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Affiliation(s)
| | | | - Franco Nole
- Medical Oncology Division of Urogenital and Head and Neck Tumors, European Institute of Oncology, Milan, Italy
| | | | - Claudia Mucciarini
- Department of Oncology and Haematology, Ramazzini Hospital, Carpi, Italy
| | - Michele Aieta
- Centro Di Riferimento Oncologico DI Basilicata, Rionero in Vulture, Italy
| | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Roberto Iacovelli
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Sabrina Rossetti
- Istituto Nazionale Tumori Fondazione G. Pascale - IRCCS, Naples, Italy
| | | | - Cosimo Sacco
- Dipartimento di Oncologia, Azienda Ospedaliero-Universitaria S. M. della Misericordia, Udine, Italy
| | | | | | | | | | - Elena Verri
- Medical Oncology Division of Urogenital and Head and Neck Tumors. European Institute of Oncology, Milan, Italy
| | | | | | - Massimo Aglietta
- Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia, IRCCS, Candiolo, Italy
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47
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Di Lorenzo G, Sonpavde G, Pond G, Lucarelli G, Rossetti S, Facchini G, Scagliarini S, Cartenì G, Federico P, Daniele B, Morelli F, Bellelli T, Ferro M, De Placido S, Buonerba C. Statin Use and Survival in Patients with Metastatic Castration-resistant Prostate Cancer Treated with Abiraterone Acetate. Eur Urol Focus 2018; 4:874-879. [DOI: 10.1016/j.euf.2017.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/09/2017] [Accepted: 03/21/2017] [Indexed: 11/24/2022]
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Di Gregorio L, Congestri R, Tandoi V, Neu TR, Rossetti S, Di Pippo F. Biofilm diversity, structure and matrix seasonality in a full-scale cooling tower. Biofouling 2018; 34:1093-1109. [PMID: 30663885 DOI: 10.1080/08927014.2018.1541454] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 06/09/2023]
Abstract
Biofilms commonly colonise cooling water systems, causing equipment damage and interference with the operational requirements of the systems. In this study, next-generation sequencing (NGS), catalysed reporter deposition fluorescence in situ hybridisation (CARD-FISH), lectin staining and microscopy were used to evaluate temporal dynamics in the diversity and structure of biofilms collected seasonally over one year from an open full-scale cooling tower. Water samples were analysed to evaluate the contribution of the suspended microorganisms to the biofilm composition and structure. Alphaproteobacteria dominated the biofilm communities along with Beta- and Gammaproteobacteria. The phototrophic components were mainly cyanobacteria, diatoms and green algae. Bacterial biodiversity decreased from winter to autumn, concurrently with an increase in cyanobacterial and microalgal richness. Differences in structure, spatial organisation and glycoconjugates were observed among assemblages during the year. Overall, microbial variation appeared to be mostly affected by irradiance and water temperature rather than the source of the communities. Variations in biofilms over seasons should be evaluated to develop specific control strategies.
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Affiliation(s)
- L Di Gregorio
- a CNR-IRSA , Water Research Institute , Rome , Italy
- b Department of Biology , University of Rome Tor Vergata , Rome , Italy
| | - R Congestri
- b Department of Biology , University of Rome Tor Vergata , Rome , Italy
| | - V Tandoi
- a CNR-IRSA , Water Research Institute , Rome , Italy
| | - T R Neu
- c Department of River Ecology , Helmholtz Centre for Environmental Research - UFZ , Magdeburg , Germany
| | - S Rossetti
- a CNR-IRSA , Water Research Institute , Rome , Italy
| | - F Di Pippo
- a CNR-IRSA , Water Research Institute , Rome , Italy
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49
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Masini C, Vitale MG, Maruzzo M, Procopio G, de Giorgi U, Buti S, Rossetti S, Iacovelli R, Atzori F, Cosmai L, Vignani F, Prati G, Scagliarini S, Guida A, Berselli A, Pinto C. Safety and Efficacy of Pazopanib in First-Line Metastatic Renal-Cell Carcinoma With or Without Renal Failure: CORE-URO-01 Study. Clin Genitourin Cancer 2018; 17:e150-e155. [PMID: 30396828 DOI: 10.1016/j.clgc.2018.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 09/26/2018] [Accepted: 10/01/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Pazopanib has been approved for first-line treatment of patients with metastatic renal-cell carcinoma on the basis of clinical trials that enrolled only patients with adequate renal function. Few data are available on the safety and efficacy of pazopanib in patients with renal insufficiency. This study investigated the effect of kidney function on treatment outcomes in such patients. PATIENTS AND METHODS We retrospectively analyzed data of metastatic renal-cell carcinoma patients treated with pazopanib from January 2010 to June 2016 with respect to renal function. Patients with Modification of Diet in Renal Disease ≤ 60 mL/min/1.73 m2 (group A) were compared to patients with Modification of Diet in Renal Disease > 60 mL/min/1.73 m2 (group B) in terms of progression-free survival, toxicities, response rates, and overall survival. RESULTS A total of 229 patients were included: 128 in group A and 101 in group B. Median progression-free survival was 14 months (95% confidence interval [CI], 9.4-18.5) and 17 months (95% CI, 11.4-22.8), and overall survival was 30.5 months (95% CI, 8-53) and 41.4 months (95% CI, 21-62) for group A and group B, respectively, with no significant difference (P = .6). No significant difference between the 2 groups was reported in the incidence of adverse events. Dose reductions were more frequent in group A patients (66% vs. 36%; P = .04). CONCLUSION Although the dose of pazopanib was reduced more frequently in patients with renal impairment, kidney function at therapy initiation does not adversely affect the safety and efficacy of pazopanib.
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Affiliation(s)
- Cristina Masini
- Medical Oncology Unit, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy.
| | | | | | - Giuseppe Procopio
- Medical Oncology Unit, Istituto Nazionale Tumori Milano, Milan, Italy
| | - Ugo de Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Sabrina Rossetti
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, INT Fondazione G. Pascale (IRCCS), Naples, Italy
| | - Roberto Iacovelli
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata (AOUI), University of Verona, Verona, Italy
| | - Francesco Atzori
- Medical Oncology Unit, Department of Medical Sciences "M. Aresu," University of Cagliari, Cagliari, Italy
| | - Laura Cosmai
- Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona, Italy
| | | | - Giuseppe Prati
- Day Hospital Oncology, Ospedale Civile di Guastalla, Reggio Emilia, Reggio Emilia, Italy
| | | | - Annalisa Guida
- University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
| | - Annalisa Berselli
- Medical Oncology Unit, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Carmine Pinto
- Medical Oncology Unit, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
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50
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Vitale M, Pipitone S, Scagliarini S, Zucali P, Galli L, Rossetti S, Caserta C, Iacovelli R, Masini C, Ficorella C, Di Girolamo S, Buti S, Benedetti B, Santoni M, Porta C, Bracarda S, Baldessari C, Giaquinta S, Cascinu S, Sabbatini R. Correlation between immuno-related adverse events (IRAEs) occurrence and clinical outcome in metastatic renal cell carcinoma (mRCC) patients treated with nivolumab: IRAENE trial, an Italian multi-institutional retrospective study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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