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Faoro L, Salizzato V, Coppola M, Carpanese D, Fabozzi A, Tondulli L, Marconcini R, Spagnolo F, Del Bianco P, Chiarion-Sileni V, Piccin L. Real-world multicentre observational study of effectiveness and toxicity in patients with advanced cutaneous squamous cell carcinoma treated with cemiplimab. J Eur Acad Dermatol Venereol 2024. [PMID: 38712988 DOI: 10.1111/jdv.20066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 04/18/2024] [Indexed: 05/08/2024]
Affiliation(s)
- L Faoro
- Specialization School in Hospital Pharmacy, University of Pisa, Pisa, Italy
- Pharmacy, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - V Salizzato
- Melanoma Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - M Coppola
- Pharmacy, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - D Carpanese
- Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - A Fabozzi
- Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, Castelfranco Veneto, Italy
| | - L Tondulli
- Oncology Department, Integrated University Hospital of Verona, Verona, Italy
| | - R Marconcini
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - F Spagnolo
- Skin Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - P Del Bianco
- Clinical Research Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - V Chiarion-Sileni
- Melanoma Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - L Piccin
- Melanoma Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
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2
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Scaini MC, Catoni C, Poggiana C, Pigozzo J, Piccin L, Leone K, Scarabello I, Facchinetti A, Menin C, Elefanti L, Pellegrini S, Aleotti V, Vidotto R, Schiavi F, Fabozzi A, Chiarion-Sileni V, Rosato A. A multiparameter liquid biopsy approach allows to track melanoma dynamics and identify early treatment resistance. NPJ Precis Oncol 2024; 8:78. [PMID: 38548846 PMCID: PMC10978909 DOI: 10.1038/s41698-024-00567-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 03/14/2024] [Indexed: 04/01/2024] Open
Abstract
Melanoma heterogeneity is a hurdle in metastatic disease management. Although the advent of targeted therapy has significantly improved patient outcomes, the occurrence of resistance makes monitoring of the tumor genetic landscape mandatory. Liquid biopsy could represent an important biomarker for the real-time tracing of disease evolution. Thus, we aimed to correlate liquid biopsy dynamics with treatment response and progression by devising a multiplatform approach applied to longitudinal melanoma patient monitoring. We conceived an approach that exploits Next Generation Sequencing (NGS) and droplet digital PCR, as well as the FDA-cleared platform CellSearch, to analyze circulating tumor DNA (ctDNA) trend and circulating melanoma cell (CMC) count, together with their customized genetic and copy number variation analysis. The approach was applied to 17 stage IV melanoma patients treated with BRAF/MEK inhibitors, followed for up to 28 months. BRAF mutations were detected in the plasma of 82% of patients. Single nucleotide variants known or suspected to confer resistance were identified in 70% of patients. Moreover, the amount of ctDNA, both at baseline and during response, correlated with the type and duration of the response itself, and the CMC count was confirmed to be a prognostic biomarker. This work provides proof of principle of the power of this approach and paves the way for a validation study aimed at evaluating early ctDNA-guided treatment decisions in stage IV melanoma. The NGS-based molecular profile complemented the analysis of ctDNA trend and, together with CMC analysis, revealed to be useful in capturing tumor evolution.
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Affiliation(s)
- Maria Chiara Scaini
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy.
| | - Cristina Catoni
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Cristina Poggiana
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy.
| | - Jacopo Pigozzo
- Medical Oncology 2, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Luisa Piccin
- Medical Oncology 2, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Kevin Leone
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Ilaria Scarabello
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Antonella Facchinetti
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology (DiSCOG), Oncology Section, University of Padua, Padua, Italy
| | - Chiara Menin
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Lisa Elefanti
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Stefania Pellegrini
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Valentina Aleotti
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Riccardo Vidotto
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Francesca Schiavi
- Familial Cancer Clinic, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Alessio Fabozzi
- Oncology Unit 3, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | | | - Antonio Rosato
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology (DiSCOG), Oncology Section, University of Padua, Padua, Italy
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3
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Pasello G, Fabricio ASC, Del Bianco P, Salizzato V, Favaretto A, Piccin L, Zustovich F, Fabozzi A, De Rossi C, Pigozzo J, De Nuzzo M, Cappelletto E, Bonanno L, Palleschi D, De Salvo GL, Guarneri V, Gion M, Chiarion-Sileni V. Sex-related differences in serum biomarker levels predict the activity and efficacy of immune checkpoint inhibitors in advanced melanoma and non-small cell lung cancer patients. J Transl Med 2024; 22:242. [PMID: 38443899 PMCID: PMC10916307 DOI: 10.1186/s12967-024-04920-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/20/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Immune Checkpoint Inhibitors (ICIs) lead to durable response and a significant increase in long-term survival in patients with advanced malignant melanoma (MM) and Non-Small Cell Lung Cancer (NSCLC). The identification of serum cytokines that can predict their activity and efficacy, and their sex interaction, could improve treatment personalization. METHODS In this prospective study, we enrolled immunotherapy-naïve patients affected by advanced MM and NSCLC treated with ICIs. The primary endpoint was to dissect the potential sex correlations between serum cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, GM-CSF, MCP-1, TNF-ɑ, IP-10, VEGF, sPD-L1) and the objective response rate (ORR). Secondly, we analyzed biomarker changes during treatment related to ORR, disease control rate (DCR), progression free survival (PFS) and overall survival (OS). Blood samples, collected at baseline and during treatment until disease progression (PD) or up to 2 years, were analyzed using Luminex xMAP or ELLA technologies. RESULTS Serum samples from 161 patients (98 males/63 females; 92 MM/69 NSCLC) were analyzed for treatment response. At baseline, IL-6 was significantly lower in females (F) versus males (M); lower levels of IL-4 in F and of IL-6 in both sexes significantly correlated with a better ORR, while higher IL-4 and TNF-ɑ values were predictive of a lower ORR in F versus M. One hundred and sixty-five patients were evaluable for survival analysis: at multiple Cox regression, an increased risk of PD was observed in F with higher baseline values of IL-4, sPD-L1 and IL-10, while higher IL-6 was a negative predictor in males. In males, higher levels of GM-CSF predict a longer survival, whereas higher IL-1β predicts a shorter survival. Regardless of sex, high baseline IL-8 values were associated with an increased risk of both PD and death, and high IL-6 levels only with shorter OS. CONCLUSIONS Serum IL-1β, IL-4, IL-6, IL-10, GM-CSF, TNF-ɑ, and sPD-L1 had a significant sex-related predictive impact on ORR, PFS and OS in melanoma and NSCLC patients treated with ICIs. These results will potentially pave the way for new ICI combinations, designed according to baseline and early changes of these cytokines and stratified by sex.
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Affiliation(s)
- Giulia Pasello
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy.
| | - Aline S C Fabricio
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Paola Del Bianco
- Clinical Research Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - Adolfo Favaretto
- Medical Oncology Unit, Ca' Foncello Hospital, AULSS 2, Treviso, Italy
| | - Luisa Piccin
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - Alessio Fabozzi
- Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - Jacopo Pigozzo
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Mattia De Nuzzo
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy
| | - Elia Cappelletto
- Regional Center for Biomarkers, Department of Clinical Pathology, AULSS3 Serenissima, Venice, Italy
| | - Laura Bonanno
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Dario Palleschi
- Medical Oncology Unit, Ca' Foncello Hospital, AULSS 2, Treviso, Italy
| | - Gian Luca De Salvo
- Clinical Research Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Valentina Guarneri
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy
| | - Massimo Gion
- Regional Center for Biomarkers, Department of Clinical Pathology, AULSS3 Serenissima, Venice, Italy
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4
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Cappelletto E, Fasiolo LT, Salizzato V, Piccin L, Fabozzi A, Contato A, Bianco PD, Pasello G, Chiarion-Sileni V, Gion M, Fabricio ASC. Cytokine and soluble programmed death-ligand 1 levels in serum and plasma of cancer patients treated with immunotherapy: Preanalytical and analytical considerations. Int J Biol Markers 2024; 39:9-22. [PMID: 38407953 DOI: 10.1177/03936155231226234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
AIM To evaluate cytokine and soluble programmed death ligand-1 (sPD-L1) levels in the serum and plasma of cancer patients treated with immunotherapy, and to test different assays. METHODS Three Luminex xMAP assays and two ELLA microfluidic cartridges were used to screen 28 immune-related biomarkers in 38 paired serum and citrate-theophylline-adenosine-dipyridamole (CTAD) plasma samples collected from 10 advanced melanoma or non-small cell lung cancer (NSCLC) patients at different time points during immunotherapy. RESULTS Twenty-three of 28 biomarkers were detected both in serum and plasma by at least one of the assays, including IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, GM-CSF, IFN-γ, TNF-α, VEGF, IP-10, MCP-1, eotaxin, fractalkine, G-CSF, IFN-α, IL-1RA, IL-13, IL-17A, MIP-1β and sPD-L1. Conversely, FGF-2 and IL-1α were not detected in both matrices; GRO-α factor and EGF were detected only in serum and MIP-1α only in plasma. sPD-L1, MCP-1, IFN-γ, IL-8, MIP-1β and VEGF were, respectively, 1.15-, 1.44-, 1.83-, 2.43-, 2.82-, 6.72-fold higher in serum, whereas IL-10, IL-4, IL-2 and IL-5 were 1.05-, 1.19-, 1.92- and 2.17-fold higher, respectively, in plasma. IP-10 levels were higher in plasma but, as well as for VEGF, the bias serum versus plasma varied depending on the assay used (IP-10: -5.7% to -145%; VEGF: 115% to 165%). No significant differences were found for the remaining nine analyzed cytokines. CONCLUSION The cytokine and sPD-L1 levels may differ between serum and plasma samples collected from cancer patients treated with immunotherapy, and the results obtained can be influenced by the different characteristics of the tested assays. The standardization of pre-analytical and analytical procedures is therefore needed for the future implementation of these circulating biomarkers in clinical practice.
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Affiliation(s)
- Elia Cappelletto
- Regional Center for Biomarkers, Department of Clinical Pathology, AULSS3 Serenissima, Venice, Italy
| | | | | | - Luisa Piccin
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Alessio Fabozzi
- Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Anna Contato
- Regional Center for Biomarkers, Department of Clinical Pathology, AULSS3 Serenissima, Venice, Italy
| | - Paola Del Bianco
- Clinical Research Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Giulia Pasello
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | | | - Massimo Gion
- Regional Center for Biomarkers, Department of Clinical Pathology, AULSS3 Serenissima, Venice, Italy
| | - Aline S C Fabricio
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
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5
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Pasello G, Fabricio ASC, Del Bianco P, Favaretto A, Salizzato V, Piccin L, Zustovich F, De Rossi C, Pigozzo J, Fabozzi A, Benetti B, Tiozzo Fasiolo L, Bonanno L, Guarneri V, De Salvo GL, Palleschi D, Gion M, Chiarion-Sileni V. Circulating cytokines as predictors of response to immune checkpoint inhibitors (ICIs) in patients (pts) with melanoma (Mel) and non–small cell lung cancer (NSCLC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2549] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2549 Background: ICIs lead to durable response and a significant survival improvement in a limited number of advanced stage Mel and NSCLC pts. The identification of predictive circulating biomarkers could be a promising tool to optimize pts’ selection and outcome for ICIs treatment. Methods: This is a prospective real-world study enrolling advanced stage Mel and NSCLC pts referred to four Italian Centers and treated with ICIs. The primary endpoint is to verify the presence of an association between circulating cytokines (IL-1b, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, TNFα, GM-CSF) and disease control rate (DCR), progression free survival (PFS) and overall survival (OS). Pts undergo a blood collection, before every cycle for 6 cycles (T1-T6) and at tumor assessment till disease progression (PD) or for 2 years. Biomarker levels were assessed by Luminex xMAP based technology using R&D High Sensitivity kits. Each marker was categorized according to high and low levels by maximizing its discriminative ability, and the association with the outcome was tested in univariate and multiple analyses. Results: We report preliminary results on the T1-T2 blood samples from the first 78 enrolled pts (32 females/46 males; 43 Mel/35 NSCLC; median age 69 years). Serum IL-6, IL-8 and IL-10 were significantly higher at T1 and T2 in pts with PD (Kruskal-Wallis test). The median relative increase (RI) of IL-8 was 32% and 2% in pts with PD and disease control (DC), respectively (p = 0.0001). At multiple logistic analysis, IL-6 and IL-8 at T2 and the RI of IL-8 were independent factors predicting the probability of DC, with an overall accuracy of 83.8%. High levels of IL-6 and IL-8 at T2 were significantly associated with a low probability of DC (OR = 0.13, 95%CI: 0.03-0.52 and OR = 0.09, 95%CI: 0.02-0.37, respectively), and the RI showed a significantly lower probability of DC (OR = 0.14, 95%CI: 0.02-0.58). With a median follow-up of 10.6 months (m), mPFS and mOS were 5.8 m, 95%CI: 2.3-7.4 and 8.3 m, 95%CI: 4.0-13.8 for NSCLC; 6.9 m, 95%CI: 2.8-15.9 and 12.6 m, 95%CI: 4.7-NE for Mel pts, respectively. In the multiple Cox model, elevated IL-6 and IL-8 at T1 (HR = 3.03, 95%CI: 1.55-6.37, HR = 2.86, 95%CI: 1.46-5.63), elevated IL-10 at T2 (HR = 2.86, 95%CI: 1.39-5.94), and a RI of IL-8 (HR = 4.22, 95%CI: 1.85-11.21) remained significantly associated with a worse PFS. Higher levels of IL-6 (HR = 3.85, 95%CI: 1.13-20.0) and IL-8 (HR = 4.29, 95%CI: 1.98-9.83) at T2 and a RI of IL-8 (HR = 3.06, 95%CI: 1.43-6.72) remained significantly associated with a worse OS. Conclusions: High serum levels of IL-8 and IL-6 at T2 of ICI, combined with an increase of IL-8 from baseline, are strong predictors of PD, PFS, OS, in pts with advanced Mel and NSCLC. The role of the other cytokines tested, their time fluctuations and associations with clinical prognostic factors, gender, and immuno-related adverse events will be presented at the meeting.
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Affiliation(s)
- Giulia Pasello
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy
| | | | - Paola Del Bianco
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | | | - Luisa Piccin
- Melanoma Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - Fable Zustovich
- UOC Oncologia di Belluno, Dipartimento di Oncologia Clinica, AULSS 1 Dolomiti, Ospedale S. Martino,, Belluno, Italy
| | - Costanza De Rossi
- Medical Oncology Department, ULSS 3, Serenissima, Mestre-Venezia Italy, Venice, Italy
| | - Jacopo Pigozzo
- Melanoma Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - Alessio Fabozzi
- Medical Oncology 3, Istituto Oncologico Veneto IOV-IRCCS, Castelfranco Veneto, Italy
| | | | | | - Laura Bonanno
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, and Oncology 2, Veneto Insittute of Oncology IOV-IRCCS, Padua, Italy
| | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Dario Palleschi
- Oncology Unit, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy
| | - Massimo Gion
- Regional Center for Biomarkers, SS Giovanni & Paolo Hospital, Venice, Italy
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6
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Rastrelli M, Del Fiore P, Russo I, Tartaglia J, Dal Monico A, Cappellesso R, Nicolè L, Piccin L, Fabozzi A, Biffoli B, Di Prata C, Ferrazzi B, Dall'Olmo L, Vecchiato A, Spina R, Russano F, Bezzon E, Cingarlini S, Mazzarotto R, Parisi A, Scarzello G, Pigozzo J, Brambullo T, Tropea S, Vindigni V, Bassetto F, Bertin D, Gregianin M, Dei Tos AP, Cavallin F, Alaibac M, Chiarion-Sileni V, Mocellin S. Merkel Cell Carcinoma: Evaluation of the Clinico-Pathological Characteristics, Treatment Strategies and Prognostic Factors in a Monocentric Retrospective Series (n=143). Front Oncol 2022; 11:737842. [PMID: 34976795 PMCID: PMC8718393 DOI: 10.3389/fonc.2021.737842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/02/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin. The incidence of the disease has undergone a significant increase in recent years, which is caused by an increase in the average age of the population and in the use of immunosuppressive therapies. MCC is an aggressive pathology, which metastasizes early to the lymph nodes. These characteristics impose an accurate diagnostic analysis of the regional lymph node district with radiography, clinical examination and sentinel node biopsy. In recent years, there has been a breakthrough in the treatment of the advanced pathology thanks to the introduction of monoclonal antibodies acting on the PD-1/PD-L1 axis. This study aimed to describe the clinico-pathological characteristics, treatment strategies and prognostic factors of MCC. METHODS A retrospective cohort study was conducted involving 143 consecutive patients who were diagnosed and/or treated for MCC. These patients were referred to the Veneto Institute of Oncology IOV-IRCCS and to the University Hospital of Padua (a third-level center) in the period between December 1991 and January 2020. In the majority of cases, diagnosis took place at the IOV. However, some patients were diagnosed elsewhere and subsequently referred to the IOV for a review of the diagnosis or to begin specific therapeutic regimens. RESULTS 143 patients, with an average age of 71 years, were affected mainly with autoimmune and neoplastic comorbidities. Our analysis has shown that age, autoimmune comorbidities and the use of therapy with immunomodulating drugs (which include corticosteroids, statins and beta-blockers) are associated with a negative prognosis. In this sense, male sex is also a negative prognostic factor. CONCLUSIONS Autoimmune and neoplastic comorbidities were frequent in the studied population. The use of drugs with immunomodulatory effects was also found to be a common feature of the population under examination. The use of this type of medication is considered a negative prognostic factor. The relevance of a multidisciplinary approach to the patient with MCC is confirmed, with the aim of assessing the risks and benefits related to the use of immunomodulating therapy in the individual patient.
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Affiliation(s)
- Marco Rastrelli
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy.,Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Irene Russo
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy.,Division of Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Tartaglia
- Division of Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Alessandro Dal Monico
- Division of Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Rocco Cappellesso
- Pathological Anatomy Unit, University Hospital of Padua, Padua, Italy
| | - Lorenzo Nicolè
- Department of Medicine, University of Padua School of Medicine and Surgery, Padua, Italy.,Unit of Surgical Pathology & Cytopathology, Ospedale dell'Angelo, Mestre, Italy
| | - Luisa Piccin
- Melanoma Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Alessio Fabozzi
- Oncology Unit 3, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Bernardo Biffoli
- Clinic of Plastic Surgery, Department of Neuroscience, Padua University Hospital, University of Padua, Padua, Italy
| | - Claudia Di Prata
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Beatrice Ferrazzi
- Postgraduate School of Occupational Medicine, University of Verona, Verona, Italy
| | - Luigi Dall'Olmo
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy.,Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy
| | - Antonella Vecchiato
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Romina Spina
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Francesco Russano
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Elisabetta Bezzon
- Radiology Unit, Department of Imaging and Medical Physics, Istituto Oncologico Veneto (IOV) IRCSS, Padua, Italy
| | - Sara Cingarlini
- Oncology Section, Department of Oncology, Verona University and Hospital Trust, Verona, Italy
| | - Renzo Mazzarotto
- Department of Radiotherapy, Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Alessandro Parisi
- Radiotherapy Unit, Veneto Institute of Oncology, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Giovanni Scarzello
- Radiotherapy Unit, Veneto Institute of Oncology, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Jacopo Pigozzo
- Melanoma Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Tito Brambullo
- Clinic of Plastic Surgery, Department of Neuroscience, Padua University Hospital, University of Padua, Padua, Italy
| | - Saveria Tropea
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Vincenzo Vindigni
- Clinic of Plastic Surgery, Department of Neuroscience, Padua University Hospital, University of Padua, Padua, Italy
| | - Franco Bassetto
- Clinic of Plastic Surgery, Department of Neuroscience, Padua University Hospital, University of Padua, Padua, Italy
| | - Daniele Bertin
- Radiotherapy and Nuclear Medicine Unit, Oncological Institute of Veneto IOV-IRCCS, Padua, Italy
| | - Michele Gregianin
- Radiotherapy and Nuclear Medicine Unit, Oncological Institute of Veneto IOV-IRCCS, Padua, Italy
| | - Angelo Paolo Dei Tos
- Pathological Anatomy Unit, University Hospital of Padua, Padua, Italy.,Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
| | | | - Mauro Alaibac
- Division of Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Simone Mocellin
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy.,Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy
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7
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Tosi A, Cappellesso R, Dei Tos AP, Rossi V, Aliberti C, Pigozzo J, Fabozzi A, Sbaraglia M, Blandamura S, Del Bianco P, Chiarion-Sileni V, Rosato A. The immune cell landscape of metastatic uveal melanoma correlates with overall survival. J Exp Clin Cancer Res 2021; 40:154. [PMID: 33947438 PMCID: PMC8097926 DOI: 10.1186/s13046-021-01947-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/13/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Uveal melanoma (UM) represents the most common primary intra-ocular malignancy in adults. Up to 50% of the patients develop distant metastases within 10 years from diagnosis, with the liver as the most common site. Upon metastatization, life expectancy strongly reduces and immune checkpoint inhibitors that prove effective in cutaneous melanoma do not modify clinical outcome. To date, few studies have focused on deciphering the immunomodulatory features of metastatic UM microenvironment, and there are no prognostic models for clinical use. This highlights the urgent need to understand the delicate interplay between tumor and immune cells acting at the site of metastasis. METHODS We collected a patient cohort comprising 21 metastatic UM patients. Hepatic and extra-hepatic UM metastasis samples were studied by multiplex immunofluorescence to assess the tumor immune cell composition. Quantitative analyses were performed to correlate immune cell densities with treatment response, metastasis site and patient survival. RESULTS Compared to patients with progressive disease, those with controlled disease had a higher intra-tumoral/peritumoral ratio of CD8 + Granzyme B+ cells, higher density of intra-tumoral CD8+ cytotoxic T lymphocytes (CTL) and an increased percentage of UM cells in close proximity to T lymphocytes, reflecting a role of tumor-killing T cells in the disease. In liver metastases (LM), the intra-tumoral densities of CD163+ tumor-associated macrophages (TAM) and of total CD8+ T cells were higher than in extra-hepatic UM metastases, but the percentage of Granzyme B+ CTL was lower. Moreover, LM displayed more UM cells adjacent to both CTL and TAM, and also more T cells in proximity to TAM, all signs of an impaired immune response. The percentage of activated CTL within the tumor represented a prognostic indicator, as patients with a higher intra-tumoral percentage of CD8 + Granzyme B+ cells had the better outcome. A temptative Immunoscore was generated and proved capable to stratify patients with improved survival. Finally, CD4 + FoxP3+ T cells appeared a crucial population for response to immunotherapy. CONCLUSION The results of this study underly the clinical relevance and functional importance of composition and localization of antitumor effector cells for the progression of UM metastasis.
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Affiliation(s)
- Anna Tosi
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Rocco Cappellesso
- Pathological Anatomy Unit, Padova University Hospital, Padova, Italy
| | - Angelo Paolo Dei Tos
- Pathological Anatomy Unit, Padova University Hospital, Padova, Italy
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padova, Padova, Italy
| | - Valentina Rossi
- Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128, Padova, Italy
| | - Camillo Aliberti
- Departement of Diagnostic & Interventive Radiology-Pederzoli Hospital, Peschiera, VR, Italy
| | - Jacopo Pigozzo
- Melanoma Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Alessio Fabozzi
- Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Marta Sbaraglia
- Pathological Anatomy Unit, Padova University Hospital, Padova, Italy
| | - Stella Blandamura
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padova, Padova, Italy
| | - Paola Del Bianco
- Clinical Research Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | | | - Antonio Rosato
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
- Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128, Padova, Italy.
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8
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Elefanti L, Zamuner C, Del Fiore P, Stagni C, Pellegrini S, Dall’Olmo L, Fabozzi A, Senetta R, Ribero S, Salmaso R, Mocellin S, Bassetto F, Cavallin F, Tosi AL, Galuppini F, Dei Tos AP, Menin C, Cappellesso R. The Molecular Landscape of Primary Acral Melanoma: A Multicenter Study of the Italian Melanoma Intergroup (IMI). Int J Mol Sci 2021; 22:3826. [PMID: 33917086 PMCID: PMC8067752 DOI: 10.3390/ijms22083826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 12/19/2022] Open
Abstract
Acral melanoma (AM) is a rare and aggressive subtype of melanoma affecting the palms, soles, and nail apparatus with similar incidence among different ethnicities. AM is unrelated to ultraviolet radiation and has a low mutation burden but frequent chromosomal rearrangements and gene amplifications. Next generation sequencing of 33 genes and somatic copy number variation (CNV) analysis with genome-wide single nucleotide polymorphism arrays were performed in order to molecularly characterize 48 primary AMs of Italian patients in association with clinicopathological and prognostic features. BRAF was the most commonly mutated gene, followed by NRAS and TP53, whereas TERT promoter, KIT, and ARID1A were less frequently mutated. Gains and losses were recurrently found in the 1q, 6p, 7, 8q, 20 and 22 chromosomes involving PREX2, RAC1, KMT2C, BRAF, CCND1, TERT, and AKT3 genes, and in the 6q, 9, 10, 11q and 16q chromosomes including CDKN2A, PTEN, and ADAMTS18 genes, respectively. This study confirmed the variety of gene mutations and the high load of CNV in primary AM. Some genomic alterations were associated with histologic prognostic features. BRAF mutations, found with a higher rate than previously reported, correlated with a low Breslow thickness, low mitotic count, low CNV of the AMs, and with early-stage of disease.
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Affiliation(s)
- Lisa Elefanti
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (L.E.); (S.P.)
| | - Carolina Zamuner
- Anatomy and Histology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (P.D.F.); (L.D.); (S.M.)
| | - Camilla Stagni
- Department of Molecular Medicine, University of Padua, 35128 Padua, Italy;
| | - Stefania Pellegrini
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (L.E.); (S.P.)
| | - Luigi Dall’Olmo
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (P.D.F.); (L.D.); (S.M.)
| | - Alessio Fabozzi
- Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Rebecca Senetta
- Pathology Unit, Department of Oncology, University of Turin, 10124 Turin, Italy;
| | - Simone Ribero
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10124 Turin, Italy;
| | - Roberto Salmaso
- Pathological Anatomy Unit, Padua University Hospital, 35128 Padua, Italy; (R.S.); (A.P.D.T.); (R.C.)
| | - Simone Mocellin
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (P.D.F.); (L.D.); (S.M.)
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, 35128 Padua, Italy
| | - Franco Bassetto
- Plastic Surgery Unit, Padua University Hospital, 35128 Padua, Italy;
- Department of Neurosciences (DNS), University of Padua, 35128 Padua, Italy
| | | | - Anna Lisa Tosi
- Pathological Anatomy Unit, AULSS5, Santa Maria della Misericordia Hospital, 45100 Rovigo, Italy;
| | - Francesca Galuppini
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, 35128 Padua, Italy;
| | - Angelo Paolo Dei Tos
- Pathological Anatomy Unit, Padua University Hospital, 35128 Padua, Italy; (R.S.); (A.P.D.T.); (R.C.)
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, 35128 Padua, Italy;
| | - Chiara Menin
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (L.E.); (S.P.)
| | - Rocco Cappellesso
- Pathological Anatomy Unit, Padua University Hospital, 35128 Padua, Italy; (R.S.); (A.P.D.T.); (R.C.)
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9
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Pavan A, Calvetti L, Dal Maso A, Fabozzi A, Piccin L, Chiarion-Sileni V, Pasello G, Aprile G, Guarneri V, Conte P, Bonanno L. Circulating biomarkers and risk of immune-related adverse events (irAEs) in patients (pts) with advanced non-small cell lung cancer (aNSCLC) and metastatic melanoma (mMel). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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10
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Rastrelli M, Ferrazzi B, Cavallin F, Chiarion Sileni V, Pigozzo J, Fabozzi A, Tropea S, Vecchiato A, Costa A, Parisi A, Rossi CR, Del Fiore P, Alaibac M. Prognostic Factors in Merkel Cell Carcinoma: A Retrospective Single-Center Study in 90 Patients. Cancers (Basel) 2018; 10:cancers10100350. [PMID: 30249978 PMCID: PMC6210570 DOI: 10.3390/cancers10100350] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022] Open
Abstract
Merkel Cell Carcinoma (MCC) is a rare but highly aggressive neuroendocrine neoplasm of the skin. This study aimed at describing characteristics, treatment, and prognosis of a series of consecutive cases of MCC patients, in order to contribute to the investigation of this rare malignancy and provide better patient care. This is a retrospective cohort study including all 90 patients diagnosed and/or treated for MCC between 1991 and 2018 at the Veneto Institute of Oncology in Padua (Italy). Patient and tumor characteristics, treatment, and immunohistochemical data were extracted from a prospectively collected local database. There were 68 primary (76%) and 22 non-primary (15 occult primary, three metastatic, four recurrence) tumors (24%). CK20 expression was associated with reduced overall (HR 2.92, 95% CI 1.04–8.16) and disease-specific (HR 4.62, 95% CI 1.31–16.28) survival. Immunomodulatory regimens for treatment of other comorbidities were associated with reduced disease-specific ((HR 2.15, 95% CI 1.06–4.36) and recurrence-free (HR 3.08, 95% CI 1.44–6.57) survival. Iatrogenic immunomodulation resulted as the main factor associated with impaired prognosis. Lack of CK20 expression was associated with better survival.
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Affiliation(s)
- Marco Rastrelli
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Beatrice Ferrazzi
- Dermatology Unit and Pathology Unit, Department of Medicine (DIMED), University of Padua, 35121 Padua, Italy.
| | | | - Vanna Chiarion Sileni
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35121 Padua, Italy.
| | - Jacopo Pigozzo
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35121 Padua, Italy.
| | - Alessio Fabozzi
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35121 Padua, Italy.
| | - Saveria Tropea
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Antonella Vecchiato
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Alessandra Costa
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Alessandro Parisi
- Radiotherapy Unit, Veneto Institute of Oncology, IOV⁻IRCCS, 35121 Padua, Italy.
| | - Carlo Riccardo Rossi
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35121 Padua, Italy.
| | - Paolo Del Fiore
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Mauro Alaibac
- Dermatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padua, Italy.
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11
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Stagni C, Zamuner C, Elefanti L, Zanin T, Bianco PD, Sommariva A, Fabozzi A, Pigozzo J, Mocellin S, Montesco MC, Chiarion-Sileni V, De Nicolo A, Menin C. BRAF Gene Copy Number and Mutant Allele Frequency Correlate with Time to Progression in Metastatic Melanoma Patients Treated with MAPK Inhibitors. Mol Cancer Ther 2018; 17:1332-1340. [PMID: 29626128 DOI: 10.1158/1535-7163.mct-17-1124] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/07/2018] [Accepted: 03/27/2018] [Indexed: 11/16/2022]
Abstract
Metastatic melanoma is characterized by complex genomic alterations, including a high rate of mutations in driver genes and widespread deletions and amplifications encompassing various chromosome regions. Among them, chromosome 7 is frequently gained in BRAF-mutant melanoma, inducing a mutant allele-specific imbalance. Although BRAF amplification is a known mechanism of acquired resistance to therapy with MAPK inhibitors, it is still unclear if BRAF copy-number variation and BRAF mutant allele imbalance at baseline can be associated with response to treatment. In this study, we used a multimodal approach to assess BRAF copy number and mutant allele frequency in pretreatment melanoma samples from 46 patients who received MAPK inhibitor-based therapy, and we analyzed the association with progression-free survival. We found that 65% patients displayed BRAF gains, often supported by chromosome 7 polysomy. In addition, we observed that 64% patients had a balanced BRAF-mutant/wild-type allele ratio, whereas 14% and 23% patients had low and high BRAF mutant allele frequency, respectively. Notably, a significantly higher risk of progression was observed in patients with a diploid BRAF status versus those with BRAF gains [HR, 2.86; 95% confidence interval (CI), 1.29-6.35; P = 0.01] and in patients with low percentage versus those with a balanced BRAF mutant allele percentage (HR, 4.54; 95% CI, 1.33-15.53; P = 0.016). Our data suggest that quantitative analysis of the BRAF gene could be useful to select the melanoma patients who are most likely to benefit from therapy with MAPK inhibitors. Mol Cancer Ther; 17(6); 1332-40. ©2018 AACR.
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Affiliation(s)
- Camilla Stagni
- Oncology and Immunology Section, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Carolina Zamuner
- Anatomy and Histology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Lisa Elefanti
- Diagnostic Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Tiziana Zanin
- Anatomy and Histology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Paola Del Bianco
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Antonio Sommariva
- Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Alessio Fabozzi
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Jacopo Pigozzo
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Simone Mocellin
- Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Vanna Chiarion-Sileni
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Arcangela De Nicolo
- Cancer Genomics Program, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Chiara Menin
- Diagnostic Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
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12
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De Vita F, Giordano G, Fabozzi A, Guerrera B, Fabozzi T, Fasano M, Ferrara M, Fascione A, Di Benedetto G. Metastatic Melanoma: An Unusual Presentation. Tumori 2018; 97:130-2. [DOI: 10.1177/030089161109700124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this report we describe a case of a malignant cutaneous melanoma metastasizing to the pleural surface and peritoneal cavity 5 years after surgical resection of the primary lesion. Malignant cutaneous melanoma is a very aggressive cancer able to metastasize anywhere in the body. Pleural secondary lesions represent a rare event described only in a small number of patients and the association with peritoneal localizations may suggestan uncommon pattern of spread that we discuss. Free full text available at www.tumorionline.it
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Affiliation(s)
- Ferdinando De Vita
- Division of Medical Oncology, F. Magrassi-A. Lanzara Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, II Policlinico, Naples
| | - Guido Giordano
- Division of Medical Oncology, F. Magrassi-A. Lanzara Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, II Policlinico, Naples
| | - Alessio Fabozzi
- Division of Medical Oncology, F. Magrassi-A. Lanzara Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, II Policlinico, Naples
| | - Barbara Guerrera
- Division of Medicine, Second University of Naples School of Medicine, Clinical Hospital, Marcianise
| | - Teresa Fabozzi
- Division of Medical Oncology, F. Magrassi-A. Lanzara Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, II Policlinico, Naples
| | - Morena Fasano
- Division of Medical Oncology, F. Magrassi-A. Lanzara Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, II Policlinico, Naples
| | - Marianna Ferrara
- Division of Medicine, Second University of Naples School of Medicine, Clinical Hospital, Marcianise
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13
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Orditura M, Gravina A, Riccardi F, Diana A, Mocerino C, Leopaldi L, Fabozzi A, Giordano G, Nettuno R, Incoronato P, Barzelloni ML, Caputo R, Pisano A, Grimaldi G, Genua G, Montesarchio V, Barbato E, Iodice G, Lieto E, Procaccini E, Mabilia R, Febbraro A, Laurentiis MD, Ciardiello F. Eribulin for metastatic breast cancer (MBC) treatment: a retrospective, multicenter study based in Campania, south Italy (Eri-001 trial). ESMO Open 2017; 2:e000176. [PMID: 28761747 PMCID: PMC5519815 DOI: 10.1136/esmoopen-2017-000176] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 03/06/2017] [Accepted: 03/09/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND On the basis of the results of two pivotal phase III clinical trials, eribulin mesylate is currently approved in EU for the treatment of advanced breast cancer (aBC) in patients who have previously received an anthracycline and a taxane in either the adjuvant or the metastatic setting, and at least one chemotherapeutic regimen for metastatic disease. METHODS In our study, we investigated the efficacy and tolerability of eribulin as second or further line chemotherapy in 137 women affected by aBC. RESULTS Eribulin as monotherapy provided benefit in terms of progression-free survival (PFS), response rate (RR) and disease control rate (DCR) independently of its use as second or late-line therapy. The overall RR and DCR were 17.5% and 64%, respectively. In particular, DCR and overall RR were 50% and 13.6%, 65.4% and 21.1%, 70.4% and 14.8% and 66.7% and 16.7% in second, third, fourth and further lines of treatment, respectively. Median PFS (mPFS) according to the line of therapy was 5.7, 6.3, 4.5 and 4.0 months in patients treated with eribulin in second, third, fourth and over the fourth line, respectively. No significant difference in terms of mPFS was found between the various BC subtypes. Overall, eribulin resulted safe and most adverse events were of grade 1 or 2 and easily manageable. Grades 3-4 toxicities were neutropaenia and neurotoxicity. CONCLUSIONS With the limitations due to the observational nature of our findings, eribulin was shown to be an effective and safe therapeutic option in heavily pretreated patients with aBC.
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Affiliation(s)
- Michele Orditura
- Dipartimento di Internistica Clinica e Sperimentale Flaviano Magrassi, Università degli Studi della Campania"Luigi Vanvitelli", Naples, Italy
| | - Adriano Gravina
- Department of Breast Oncology, National Cancer Institute ‘Fondazione Pascale’, Naples, Italy
| | | | - Anna Diana
- Dipartimento di Internistica Clinica e Sperimentale Flaviano Magrassi, Università degli Studi della Campania"Luigi Vanvitelli", Naples, Italy
| | | | - Luigi Leopaldi
- U.O. Oncologia Medica ASL NA1, Ospedale San Gennaro, Naples, Italy
| | - Alessio Fabozzi
- U.O. Oncologia Ospedale Sacro Cuore di Gesú, Fatebenefratelli, Benevento, Italy
- SSD oncologia del melanoma e dell'esofago, ISTITUTO ONCOLOGICO VENETO IRCCS, Padova, Italy
| | - Guido Giordano
- U.O. Oncologia Ospedale Sacro Cuore di Gesú, Fatebenefratelli, Benevento, Italy
| | - Raffaele Nettuno
- U.O.S. di Oncologia ASL Caserta—PO AGP, di Piedimonte Matese (CE), Italy
| | | | | | - Roberta Caputo
- Department of Breast Oncology, National Cancer Institute ‘Fondazione Pascale’, Naples, Italy
| | - Agata Pisano
- U.O.C. Oncoematologia Ospedale Santa Maria Delle Grazie, Pozzuoli (NA), Italy
| | - Giuseppe Grimaldi
- U.O. Medicina—Oncoematologia Ospedale Umberto I, Nocera Inferiore (SA), Italy
| | - Geppino Genua
- U.O. Oncologia Ospedale Civile ASL AV/1, Ariano Irpino (AV), Italy
| | | | - Enrico Barbato
- U.O.S.D. Oncologia Medica Ospedale ‘Moscati’, Aversa (CE), Italy
| | - Giovanni Iodice
- Department of Breast Oncology, National Cancer Institute ‘Fondazione Pascale’, Naples, Italy
| | - Eva Lieto
- IX Divisione di Chirurgia Generale Dipartimento di Scienze Cardiotoraciche e Respiratorie Seconda, Università degli Studi di Napoli, Naples, Italy
| | - Eugenio Procaccini
- Breast Unit Second University of Naples School of Medicine, Naples, Italy
| | | | - Antonio Febbraro
- U.O. Oncologia Ospedale Sacro Cuore di Gesú, Fatebenefratelli, Benevento, Italy
| | - Michelino De Laurentiis
- Department of Breast Oncology, National Cancer Institute ‘Fondazione Pascale’, Naples, Italy
| | - Fortunato Ciardiello
- Dipartimento di Internistica Clinica e Sperimentale Flaviano Magrassi, Università degli Studi della Campania"Luigi Vanvitelli", Naples, Italy
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14
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Federico A, Brancaccio G, Dallio M, Iodice P, Fabozzi A, Del Prete S, Ciardiello F, Loguercio C, Gaeta GB. Reactivation of hepatitis B virus in cancer patients treated with chemotherapy for solid tumors. Is the prophylaxis really required? Dig Liver Dis 2017; 49:197-201. [PMID: 27899262 DOI: 10.1016/j.dld.2016.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 11/05/2016] [Accepted: 11/08/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Reactivation of hepatitis B virus during cancer chemotherapy for non-hematological tumors is not fully clear. AIM To evaluate the risk of hepatitis B virus reactivation in carriers of hepatitis B virus cancer patients treated with chemotherapy for solid tumors. METHODS Two hundred sixty-seven patients with solid tumors were consecutively enrolled: 13 (4.8%) were hepatitis B s-antigen positive, of whom 6 were documented inactive carriers and 7 had chronic liver disease. Thirty-two patients (12%) were hepatitis B s-antigen negative/hepatitis B c-antibody positive. Hepatitis B virus inactive carriers were followed every 3 months by alanine aminotransferases, hepatitis B virus-DNA; whereas hepatitis B virus occult carriers were followed every 3 months by alanine aminotransferases and hepatitis B s-antigen. RESULTS None of the 38 total patients with inactive or occult B infection who did not receive prophylaxis presented hepatitis B virus reactivation during the follow-up period. CONCLUSION This study suggests that, in hepatitis B s-antigen negative patients who undergo chemotherapy for solid tumors, hepatitis B and c-antibody screening results are not relevant to clinical decision and can be avoided. Larger studies are needed to establish whether the risk of reactivation of HBV during chemotherapy is negligible in this subset of patients and they could not be monitored for HBV reactivation.
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Affiliation(s)
- Alessandro Federico
- Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
| | | | - Marcello Dallio
- Division of Hepatogastroenterology, Second University of Naples, Naples, Italy
| | - Patrizia Iodice
- Division of Oncology, S. Giovanni di Dio Hospital, Frattamaggiore, Italy
| | - Alessio Fabozzi
- Division of Oncology, Second University of Naples, Naples, Italy
| | | | | | - Carmela Loguercio
- Division of Hepatogastroenterology, Second University of Naples, Naples, Italy
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Fasano M, Fabozzi A, Giordano G, Venturini F, Aurilio G, Cantile F, Fabozzi T, Ricci V, Santabarbara G, Morgillo F, Ciardiello F, De Vita F. Complete response to capecitabine in a frail, elderly patient with metastatic colorectal cancer: A case report. Oncol Lett 2017; 13:979-983. [PMID: 28356988 PMCID: PMC5351201 DOI: 10.3892/ol.2016.5523] [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: 03/17/2015] [Accepted: 04/08/2016] [Indexed: 02/05/2023] Open
Abstract
The clinical management of frail, elderly patients affected by colorectal cancer (CRC) remains a subject of debate. The present study reports the case of an elderly man with metastatic CRC (mCRC) who was successfully treated with capecitabine. The patient survived for 29 months, thus highlighting its potential activity in terms of obtaining a complete response and high efficacy. A 77-year-old man presented with adenocarcinoma of the rectum with multiple and synchronous liver metastases, in addition to several comorbidities. The patient received single-agent capecitabine chemotherapy (825 mg/mq twice a day) on days 1-14 of a 21-day cycle. Following 12 cycles of well-tolerated therapy, a computed tomography scan revealed a complete response with no evidence of liver metastases. An overall survival of 29 months was documented, and the patient eventually succumbed to a diabetes-related complication. In compromised patients with mCRC, reduced-dose capecitabine is an excellent therapeutic option due to its positive safety profile, activity and efficacy.
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Affiliation(s)
- Morena Fasano
- Department of Clinical and Experimental Medicine‘F. Magrassi-A. Lanzara’, Division of Medical Oncology, Second University of Naples School of Medicine, I-80131 Naples, Italy
| | - Alessio Fabozzi
- Department of Clinical and Experimental Medicine‘F. Magrassi-A. Lanzara’, Division of Medical Oncology, Second University of Naples School of Medicine, I-80131 Naples, Italy
- Correspondence to: Dr Alessio Fabozzi, Department of Clinical and Experimental Medicine‘F. Magrassi-A. Lanzara’, Division of Medical Oncology, Second University of Naples School of Medicine, II Policlinico, 5 Pansini Street, I-80131 Naples, Italy, E-mail:
| | - Guido Giordano
- Medical Oncology Unit, San Filippo Neri Hospital, I-00135 Rome, Italy
| | - Filippo Venturini
- Department of Clinical and Experimental Medicine‘F. Magrassi-A. Lanzara’, Division of Medical Oncology, Second University of Naples School of Medicine, I-80131 Naples, Italy
| | - Gaetano Aurilio
- Urogenital and Head and Neck Cancer Division, European Institute of Oncology, I-20141 Milan, Italy
| | - Flavia Cantile
- Department of Oncology and Hematology, Division of Medical Oncology, University Hospital ‘Policlinico di Modena’, I-41124 Modena, Italy
| | - Teresa Fabozzi
- Department of Solvent Oncology, IRCSS San Raffaele, I-20132 Milano, Italy
| | - Vincenzo Ricci
- Department of Oncology, S. Croce and Carle Teaching Hospital, I-12100 Cuneo, Italy
| | - Giuseppe Santabarbara
- Division of Medical Oncology, ‘San Giuseppe Moscati’ Hospital, I-83100 Avellino, Italy
| | - Floriana Morgillo
- Department of Clinical and Experimental Medicine‘F. Magrassi-A. Lanzara’, Division of Medical Oncology, Second University of Naples School of Medicine, I-80131 Naples, Italy
| | - Fortunato Ciardiello
- Department of Clinical and Experimental Medicine‘F. Magrassi-A. Lanzara’, Division of Medical Oncology, Second University of Naples School of Medicine, I-80131 Naples, Italy
| | - Ferdinando De Vita
- Department of Clinical and Experimental Medicine‘F. Magrassi-A. Lanzara’, Division of Medical Oncology, Second University of Naples School of Medicine, I-80131 Naples, Italy
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Marano L, Petrillo M, Pezzella M, Patriti A, Braccio B, Esposito G, Grassia M, Romano A, Torelli F, De Luca R, Fabozzi A, Falco G, Di Martino N. Applicability of the Proposed Japanese Model for the Classification of Gastric Cancer Location: The "PROTRADIST" Retrospective Study. J INVEST SURG 2016; 30:210-216. [PMID: 27690693 DOI: 10.1080/08941939.2016.1230248] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The extension of lymphadenectomy for surgical treatment of gastric cancer remains discordant among European and Japanese surgeons. Kinami et al. (Kinami S, Fujimura T, Ojima E, et al. PTD classification: proposal for a new classification of gastric cancer location based on physiological lymphatic flow. Int. J. Clin. Oncol. 2008;13:320-329) proposed a new experimental classification, the "Proximal zone, Transitional zone, Distal zone" (PTD) classification, based on the physiological lymphatic flow of gastric cancer site. The aim of the present retrospective study is to assess the applicability of PTD Japanese model in gastric cancer patients of our Western surgical department. METHODS Two groups of patients with histologically documented adenocarcinoma of the stomach were retrospectively obtained: In the first group were categorized 89 patients with T1a-T1b tumor invasion; and in the second group were 157 patients with T2-T3 category. The data collected were then categorized according to the PTD classification. RESULTS In the T1a-T1b group there were no lymph node metastases within the r-GA or r-GEA compartments for tumors located in the P portion, and similarly there were no lymphatic metastases within the l-GEA or p-GA compartments for tumors located in the D portion. On the contrary, in the T2-T3 group the lymph node metastases presented a diffused spreading with no statistical significance between the two classification models. CONCLUSIONS Our results show that the PTD classification based on physiological lymphatic flow of the gastric cancer site is a more physiological and clinical version than the Upper, Medium And Lower classification. It represents a valuable and applicable model of cancer location that could be a guide to a tailored surgical approach in Italian patients with neoplasm confined to submucosa. Nevertheless, in order to confirm our findings, larger and prospective studies are needed.
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Affiliation(s)
- Luigi Marano
- a Division of Multidisciplinary Robotic Surgery , Department of Surgery , "San Matteo degli Infermi" Hospital - ASL Umbria 2 , Via Loreto 3, Spoleto (PG) , Italy
| | - Marianna Petrillo
- b 8th General and Gastrointestinal Surgery - Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine , Second University of Naples , Piazza Miraglia 2, Naples , Italy
| | - Modestino Pezzella
- b 8th General and Gastrointestinal Surgery - Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine , Second University of Naples , Piazza Miraglia 2, Naples , Italy
| | - Alberto Patriti
- a Division of Multidisciplinary Robotic Surgery , Department of Surgery , "San Matteo degli Infermi" Hospital - ASL Umbria 2 , Via Loreto 3, Spoleto (PG) , Italy
| | - Bartolomeo Braccio
- b 8th General and Gastrointestinal Surgery - Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine , Second University of Naples , Piazza Miraglia 2, Naples , Italy
| | - Giuseppe Esposito
- b 8th General and Gastrointestinal Surgery - Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine , Second University of Naples , Piazza Miraglia 2, Naples , Italy
| | - Michele Grassia
- b 8th General and Gastrointestinal Surgery - Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine , Second University of Naples , Piazza Miraglia 2, Naples , Italy
| | - Angela Romano
- b 8th General and Gastrointestinal Surgery - Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine , Second University of Naples , Piazza Miraglia 2, Naples , Italy
| | - Francesco Torelli
- b 8th General and Gastrointestinal Surgery - Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine , Second University of Naples , Piazza Miraglia 2, Naples , Italy
| | - Raffaele De Luca
- c Department of Surgical Oncology , National Cancer Research Centre, Istituto Tumori "G. Paolo II ," Bari , Italy
| | - Alessio Fabozzi
- d Department of Clinical Pathology , Fatebenefratelli Hospital , Benevento , Italy
| | - Giuseppe Falco
- e Breast Surgery Unit , IRCCS-Arcispedale Santa Maria Nuova , Viale Risorgimento 80, Reggio Emilia , Italy
| | - Natale Di Martino
- b 8th General and Gastrointestinal Surgery - Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine , Second University of Naples , Piazza Miraglia 2, Naples , Italy
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De Vita F, Ventriglia J, Febbraro A, Laterza MM, Fabozzi A, Savastano B, Petrillo A, Diana A, Giordano G, Troiani T, Conzo G, Galizia G, Ciardiello F, Orditura M. NAB-paclitaxel and gemcitabine in metastatic pancreatic ductal adenocarcinoma (PDAC): from clinical trials to clinical practice. BMC Cancer 2016; 16:709. [PMID: 27590845 PMCID: PMC5010686 DOI: 10.1186/s12885-016-2671-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 07/04/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Pancreatic adenocarcinoma is an aggressive disease with poor prognosis. In a randomized phase III trial, combination of Nab-paclitaxel (Nab-P) plus gemcitabine showed superior activity and efficacy in first-line treatment compared with gemcitabine alone. METHODS Nab-P is not dispensed in Italy; however, we obtained this drug from our Ethics Committee for compassionate use. The aim of this study was to evaluate the efficacy and safety profile of this Nab-P and gemcitabine combination in a cohort of patients treated outside clinical trials. From January 2012 to May 2014, we included 41 patients with advanced pancreatic adenocarcinoma receiving combination of 125 mg/m(2) Nab-P and 1 g/m(2) gemcitabine on days 1, 8 and 15 of a 28-day cycle, as first-line treatment. Median age of patients was 67 (range 41-77) years, and 11 patients were aged ≥70 years. RESULTS Eastern Co-operative Oncology Group performance status was 0 or 1 in 32 patients (78 %) and 2 in nine patients (22 %). Primary tumor was located in the pancreatic head or body/tail in 24 (58.5 %) and 17 (41.5 %) patients, respectively, and nine patients had received biliary stent implantation before starting chemotherapy. Median carbohydrate antigen 19-9 level was 469 U/l (range 17.4-61546 U/l) and 29 patients (70.7 %) had referred pain at the time of diagnosis. Patients received a median six cycles (range 1-14) of treatment. Overall response rate was 36.6 %; median progression-free survival was 6.7 months [(95 % confidence interval (CI) 5.966-8.034), and median overall survival was 10 months (95 % CI 7.864-12.136). Treatment was well tolerated. No grade 4 toxicity was reported. Grade 3 toxicity included neutropenia in 10 patients (24.3 %), thrombocytopenia in five (12 %), anemia in three (7.3 %), diarrhea in four (9.7 %), nausea and vomiting in two (4.9 %), and fatigue in six (14.6 %). Finally, pain control was achieved in 24 of 29 patients (82.3 %) with a performance status improvement of 10 % according to the Karnofsky scale. CONCLUSIONS Our results confirm that combination of gemcitabine plus Nab-P is effective both in terms of overall response rate, progression-free survival and overall survival, with a good safety profile.
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Affiliation(s)
- Ferdinando De Vita
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Jole Ventriglia
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Antonio Febbraro
- Division of Medical Oncology, Fatebenefratelli Hospital, Viale Principe di Napoli 14/a, 82100 Benevento, Italy
| | - Maria Maddalena Laterza
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Alessio Fabozzi
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Beatrice Savastano
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Angelica Petrillo
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Anna Diana
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Guido Giordano
- Division of Medical Oncology, Fatebenefratelli Hospital, Viale Principe di Napoli 14/a, 82100 Benevento, Italy
| | - Teresa Troiani
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Giovanni Conzo
- Divisions of Surgical Oncology, Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Gennaro Galizia
- Divisions of Surgical Oncology, Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Fortunato Ciardiello
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
| | - Michele Orditura
- Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, Second University of Naples - School of Medicine, c/o II Policlinico, Via Pansini, 5, 80131 Naples, Italy
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Santangelo G, Accardo M, De Vita F, Del Giudice S, Gallucci F, Fabozzi A, De Falco M. Malignant transformation in non-recurrent peritoneal cystic mesothelioma Our experience and review of the literature. Ann Ital Chir 2016; 87:S2239253X16023343. [PMID: 27031307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM Cystic peritoneal mesothelioma is commonly regarded as a benign neoplasm at its first manifestation. It can only seldom show malignant transformation, and only after repeated postoperative recurrences. MATERIAL OF STUDY We hereby represent a unique case of peritoneal cystic mesothelioma, malignant since its first presentation. We observed a 73 year-old man presenting with intermittent abdominal pain and periumbilical swelling. At surgery, we found an extensive, oval-shaped, multi-lobed cystic formation that was surgically removed. RESULTS Histopathology was consistent with a malignant peritoneal cystic mesothelioma. In agreement with oncologists, we decided not to give any further therapy because of the few possibilities offered by systemic chemotherapy and the paucity of published data from the literature. We planned periodical follow-up including US scan every six and CTscan every 12 months. DISCUSSION Several cases of malignant transformation occurring after repeated recurrences of peritoneal mesothelioma have been reported. To our knowledge, this is the first case showing "ab initio" histological features of malignancy, typical of an active, proliferating and infiltrating lesion. In addition, advanced age and male gender of our patient are extremely peculiar CONCLUSION Our observation suggests the possibility, although very rare, that peritoneal cystic mesothelioma may present as malignant since its first manifestation. KEY WORDS Peritoneal cystic mesothelioma.
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Savastano B, Ventriglia J, Laterza M, Petrillo A, Tirino G, Diana A, Fabozzi A, Giordano G, Orditura M, Ciardiello F, De Vita F. Prognostic value of blood neutrophil-to-lymphocyte ratio (NLR)in advanced pancreatic cancer patients treated with Nab-paclitaxel and Gemcitabine: our experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Laterza M, Petrillo A, Ventriglia J, Fabozzi A, Savastano B, Diana A, Martinelli E, Morgillo F, Ciardiello F, De Vita F. Baseline neutrophil-lymphocyte ratio as a prognostic factor for patients with resectable gastric cancer undergoing adjuvant chemotherapy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Giordano G, Febbraro A, Tomaselli E, Sarnicola ML, Parcesepe P, Parente D, Forte N, Fabozzi A, Remo A, Bonetti A, Manfrin E, Ghasemi S, Ceccarelli M, Cerulo L, Bazzoni F, Pancione M. Cancer-related CD15/FUT4 overexpression decreases benefit to agents targeting EGFR or VEGF acting as a novel RAF-MEK-ERK kinase downstream regulator in metastatic colorectal cancer. J Exp Clin Cancer Res 2015; 34:108. [PMID: 26427914 PMCID: PMC4590269 DOI: 10.1186/s13046-015-0225-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/24/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cancer-related immune antigens in the tumor microenvironment could represent an obstacle to agents targeting EGFR "cetuximab" or VEGF "bevacizumab" in metastatic colorectal cancer (mCRC) patients. METHODS Infiltrating immune cells into tumor tissues, cancer-related expression of immune antigens (CD3, CD8, CD68, CD73, MPO, CD15/FUT4) from 102 mCRC patients receiving first-line Cetuximab or Bevacizumab plus chemotherapy were assessed by immunohistochemistry and validated in an independent tissue microarrays of 140 patients. Genome-wide expression profiles from 436 patients and 60 colon cancer cell lines were investigated using bioinformatics analysis. In vitro kinase assays of target genes activated by chemokines or growth factors were performed. RESULTS Here, we report that cancer-related CD15/FUT4 is overexpressed in most of mCRCs patients (43 %) and associates with lower intratumoral CD3+ and CD8+ T cells, higher systemic inflammation (NLR at diagnosis >5) and poorer outcomes, in terms of response and progression-free survival than those CD15/FUT4-low or negative ones (adjusted hazard ratio (HR) = 2.92; 95 % CI = 1.86-4.41; P < 0.001). Overexpression of CD15/FUT4 is induced through RAF-MEK-ERK kinase cascade, suppressed by MEK inhibitors and exhibits a close connection with constitutive oncogenic signalling pathways that respond to ERBB3 or FGFR4 activation (P < 0.001). CD15/FUT4-high expressing colon cancer cells with primary resistance to cetuximab or bevacizumab are significantly more sensitive to MEK inhibitors than CD15/FUT4-low counterparts. CONCLUSION Cancer-related CD15/FUT4 overexpression participates in cetuximab or bevacizumab mechanisms of resistance in mCRC patients. CD15/FUT4 as a potential target of the antitumor immune response requires further evaluation in clinical studies.
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Affiliation(s)
- Guido Giordano
- Medical Oncology Unit, Fatebenefratelli Hospital, 82100, Benevento, Italy
| | - Antonio Febbraro
- Medical Oncology Unit, Fatebenefratelli Hospital, 82100, Benevento, Italy
| | - Eugenio Tomaselli
- Department of Clinical Pathology, Fatebenefratelli Hospital, 82100, Benevento, Italy
| | - Maria Lucia Sarnicola
- National Institute of Molecular Genetics "Romeo and Enrica Invernizzi", Milan, Italy
| | - Pietro Parcesepe
- Department of Pathology and Diagnostics, University of Verona, 31134, Verona, Italy
| | - Domenico Parente
- Department of Clinical Pathology, Fatebenefratelli Hospital, 82100, Benevento, Italy
| | - Nicola Forte
- Department of Clinical Pathology, Fatebenefratelli Hospital, 82100, Benevento, Italy
| | - Alessio Fabozzi
- Medical Oncology Unit, Fatebenefratelli Hospital, 82100, Benevento, Italy
| | - Andrea Remo
- Department of Pathology and Oncology, "Mater Salutis" Hospital, 37045, Legnago, Verona, Italy
| | - Andrea Bonetti
- Department of Pathology and Oncology, "Mater Salutis" Hospital, 37045, Legnago, Verona, Italy
| | - Erminia Manfrin
- Department of Pathology and Diagnostics, University of Verona, 31134, Verona, Italy
| | - Somayehsadat Ghasemi
- Department of Pathology and Diagnostics, University of Verona, 31134, Verona, Italy
| | - Michele Ceccarelli
- Bioinformatics Laboratory, BIOGEM scrl, Ariano Irpino, Avellino, Italy
- Department of Sciences and Technologies, University of Sannio, Via Port'Arsa, 1182100, Benevento, Italy
| | - Luigi Cerulo
- Bioinformatics Laboratory, BIOGEM scrl, Ariano Irpino, Avellino, Italy
- Department of Sciences and Technologies, University of Sannio, Via Port'Arsa, 1182100, Benevento, Italy
| | - Flavia Bazzoni
- Department of Pathology and Diagnostics, University of Verona, 31134, Verona, Italy
| | - Massimo Pancione
- Department of Sciences and Technologies, University of Sannio, Via Port'Arsa, 1182100, Benevento, Italy.
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Laterza M, Petrillo A, Ventriglia J, Fabozzi A, Savastano B, Tirino G, Orditura M, Diana A, Ciardiello F, De Vita F. 2392 Baseline neutrophil-lymphocyte ratio as a prognostic factor for patients with resectable gastric cancer undergoing adjuvant chemotherapy. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31308-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Della Corte CM, Bellevicine C, Vicidomini G, Vitagliano D, Malapelle U, Accardo M, Fabozzi A, Fiorelli A, Fasano M, Papaccio F, Martinelli E, Troiani T, Troncone G, Santini M, Bianco R, Ciardiello F, Morgillo F. SMO Gene Amplification and Activation of the Hedgehog Pathway as Novel Mechanisms of Resistance to Anti-Epidermal Growth Factor Receptor Drugs in Human Lung Cancer. Clin Cancer Res 2015; 21:4686-97. [PMID: 26124204 DOI: 10.1158/1078-0432.ccr-14-3319] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 06/13/2015] [Indexed: 02/06/2023]
Abstract
PURPOSE Resistance to tyrosine kinase inhibitors (TKI) of EGF receptor (EGFR) is often related to activation of other signaling pathways and evolution through a mesenchymal phenotype. EXPERIMENTAL DESIGN Because the Hedgehog (Hh) pathway has emerged as an important mediator of epithelial-to-mesenchymal transition (EMT), we studied the activation of Hh signaling in models of EGFR-TKIs intrinsic or acquired resistance from both EGFR-mutated and wild-type (WT) non-small cell lung cancer (NSCLC) cell lines. RESULTS Activation of the Hh pathway was found in both models of EGFR-mutated and EGFR-WT NSCLC cell line resistant to EGFR-TKIs. In EGFR-mutated HCC827-GR cells, we found SMO (the Hh receptor) gene amplification, MET activation, and the functional interaction of these two signaling pathways. In HCC827-GR cells, inhibition of SMO or downregulation of GLI1 (the most important Hh-induced transcription factor) expression in combination with MET inhibition exerted significant antitumor activity.In EGFR-WT NSCLC cell lines resistant to EGFR inhibitors, the combined inhibition of SMO and EGFR exerted a strong antiproliferative activity with a complete inhibition of PI3K/Akt and MAPK phosphorylation. In addition, the inhibition of SMO by the use of LDE225 sensitizes EGFR-WT NSCLC cells to standard chemotherapy. CONCLUSIONS This result supports the role of the Hh pathway in mediating resistance to anti-EGFR-TKIs through the induction of EMT and suggests new opportunities to design new treatment strategies in lung cancer.
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Affiliation(s)
- Carminia Maria Della Corte
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy
| | - Claudio Bellevicine
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy. Università degli Studi di Napoli Federico II, Naples, Italy
| | - Giovanni Vicidomini
- Chirurgia Toracica, Dipartimento di Scienze Cardio-Toraciche e Respiratorie, Seconda Università degli Studi di Napoli, Naples, Italy
| | - Donata Vitagliano
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy
| | - Umberto Malapelle
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy. Università degli Studi di Napoli Federico II, Naples, Italy
| | - Marina Accardo
- Anatomia Patologica, Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Seconda Università degli Studi di Napoli, Naples, Italy
| | - Alessio Fabozzi
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy
| | - Alfonso Fiorelli
- Chirurgia Toracica, Dipartimento di Scienze Cardio-Toraciche e Respiratorie, Seconda Università degli Studi di Napoli, Naples, Italy
| | - Morena Fasano
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy
| | - Federica Papaccio
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy
| | - Erika Martinelli
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy
| | - Teresa Troiani
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy
| | - Giancarlo Troncone
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy. Università degli Studi di Napoli Federico II, Naples, Italy
| | - Mario Santini
- Chirurgia Toracica, Dipartimento di Scienze Cardio-Toraciche e Respiratorie, Seconda Università degli Studi di Napoli, Naples, Italy
| | - Roberto Bianco
- Oncologia Medica, Dipartimento di Medicina clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Fortunato Ciardiello
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy
| | - Floriana Morgillo
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara," Seconda Università degli Studi di Napoli, Naples, Italy.
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Laterza MM, Petrillo A, Ventriglia J, Fabozzi A, Savastano B, Tirino G, Diana A, Martinelli E, Morgillo F, Orditura M, Ciardiello F, De Vita F. Baseline neutrophil-lymphocyte ratio as a prognostic factor for patients with resectable gastric cancer undergoing adjuvant chemotherapy. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e15018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Jole Ventriglia
- Medical Oncology, Second University of Naples, Naples, Italy
| | - Alessio Fabozzi
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | - Giuseppe Tirino
- Oncologia medica Seconda Università Di Napoli, Naples, Italy
| | - Anna Diana
- Medical Oncology, Dept. of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
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Ventriglia J, Giordano G, Petrillo A, Laterza MM, Fabozzi A, Savastano B, Tirino G, Troiani T, Orditura M, Febbraro A, Ciardiello F, De Vita F. The pretreatment neutrophil-lymphocyte ratio (NLR) as a predictor of outcome in a cohort of metastatic pancreatic cancer patients treated with nab-paclitaxel and gemcitabine. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e15224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jole Ventriglia
- Medical Oncology, Second University of Naples, Naples, Italy
| | - Guido Giordano
- Medical Oncology Unit, Ospedale Sacro Cuore di Gesù, Fatebenefratelli,, Benevento, Italy
| | | | | | - Alessio Fabozzi
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | - Giuseppe Tirino
- Oncologia medica Seconda Università Di Napoli, Naples, Italy
| | - Teresa Troiani
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | - Antonio Febbraro
- Oncologia Medica, Ospedale Sacro Cuore di Gesù Fatebenefratelli, Benevento, Italy
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Federico A, Orditura M, Cotticelli G, DE Sio I, Romano M, Gravina AG, Dallio M, Fabozzi A, Ciardiello F, Loguercio C, DE Vita F. Safety and efficacy of sorafenib in patients with advanced hepatocellular carcinoma and Child-Pugh A or B cirrhosis. Oncol Lett 2015; 9:1628-1632. [PMID: 25789012 PMCID: PMC4356395 DOI: 10.3892/ol.2015.2960] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 12/12/2014] [Indexed: 02/06/2023] Open
Abstract
Sorafenib confers a survival benefit for patients with advanced hepatocellular carcinoma (HCC) and Child-Pugh (CP) A liver cirrhosis. At present, limited data exists with regard to the safety and efficacy of sorafenib in treating CP-B HCC patients. The present study describes the use of sorafenib in patients with HCC and CP-A or -B cirrhosis. Clinical data was obtained from patients with HCC who were treated with sorafenib at the Department of Clinical and Experimental Medicine, Second University of Naples (Naples, Italy) and were analyzed retrospectively in terms of tumor response, tolerance and survival. The treatment outcomes were analyzed according to the respective CP status. The adverse events (AEs) were graded using the Common Terminology Criteria for Adverse Events, version 3.0, and the tumor response was assessed according to the Response Evaluation Criteria in Solid Tumors, version 1.2. In total, 26 patients received sorafenib at 400 mg twice daily. The median age was 69 years (range, 58–81 years) and the ratio of males to females was 18:8. Overall, 15 patients were infected with the hepatitis C virus (HCV), eight with HBV and three were co-infected with HCV/HBV. In total, 20 (77%) patients presented with an underlying CP-A (CP-A5 and CP-A6) cirrhosis and six (23%) with CP-B (CP-B7). Previous treatments included surgery (n=4), transarterial chemoembolization (n=5) and percutaneous ethanol injection or radiofrequency interstitial thermal ablation (n=12). A partial response was observed in three patients (12%), a stable disease lasting at least 12 weeks in 13 patients (50%) and a progression of disease in 10 patients (38%). The median overall survival (OS) time was 7.4 months [95% confidence interval (CI), 3.2–11.6) and the median progression-free survival (PFS) time was 3.7 months (95% CI, 1.9–5.5). The median OS and PFS times differed between patients with CP-A and CP-B, with a trend (P=0.06) toward a worse outcome in those with CP-B, although this was not statistically significant. The CP-A and CP-B groups experienced a similar incidence in the majority of AEs. A reduction in dose was required in 59% of the patients. The CP-A5, CP-A6 and CP-B7 patients tolerated sorafenib similarly, and derived comparable clinical and survival benefits.
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Affiliation(s)
- Alessandro Federico
- Division of Hepatogastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Michele Orditura
- Division of Oncology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Gaetano Cotticelli
- Division of Hepatogastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Ilario DE Sio
- Division of Hepatogastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Marco Romano
- Division of Hepatogastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Antonietta Gerarda Gravina
- Division of Hepatogastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Marcello Dallio
- Division of Hepatogastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Alessio Fabozzi
- Division of Oncology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Fortunato Ciardiello
- Division of Oncology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Carmela Loguercio
- Division of Hepatogastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
| | - Ferdinando DE Vita
- Division of Oncology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples 80131, Italy
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Di Carlo C, Savoia F, Fabozzi A, Gargano V, Nappi C. A case of ovarian torsion in a patient carrier of a FSH receptor gene mutation previously affected by spontaneous ovarian hyperstimulation syndrome. Gynecol Endocrinol 2015; 31:105-8. [PMID: 25495063 DOI: 10.3109/09513590.2014.987229] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We here report a case of ovarian torsion in a patient with an history of two previous episodes of spontaneous ovarian hyperstimulation syndrome during her two pregnancies. A mutation of follicle-stimulating hormone receptor (FSHr) gene was identified in this patient and in other members of the family. Two years after her successful second pregnancy, the patient showed signs of severe thyroiditis during administration of oral contraceptive, with suppressed TSH and increased thyreoglobulin, in the absence of any abnormalities of the auto-antibodies. In few days, she developed severe pelvic pain and ultrasonographic evidence of increased ovarian volume. She underwent laparoscopy with unilateral adnexectomy for ovarian ischemic necrosis due to adnexal torsion. Our experience suggests that patients' carrier of a mutation of FSHr gene are at risk of ovarian pathologies also when non-pregnant and in the presence of low TSH levels. Further investigations are needed for an appropriate knowledge of typical and atypical manifestations of spontaneous ovarian hyperstimulation syndrome.
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Affiliation(s)
- C Di Carlo
- Dipartimento di Neuroscienze e Scienze della Riproduzione, Università degli Studi di Napoli Federico II , Naples , Italy and
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Iovino F, Orditura M, Auriemma PP, Ciorra FR, Giordano G, Orabona C, Bara F, Sergio R, Savastano B, Fabozzi A, Laterza MM, Ventriglia J, Petrillo A, Della Corte CM, DE Vita F. Vertebral carcinomatosis eleven years after advanced gastric cancer resection: A case report. Oncol Lett 2014; 9:1403-1405. [PMID: 25663920 PMCID: PMC4315078 DOI: 10.3892/ol.2014.2822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 10/29/2014] [Indexed: 01/16/2023] Open
Abstract
Bone metastasis is an uncommon event in advanced gastric cancer patients and bone metastases are rarely detected as isolated lesions. However, eleven years after treatment for locally advanced gastric cancer, including total gastrectomy followed by adjuvant chemotherapy, a 49-year-old female was admitted to the IX Division of General Surgery of the Second University of Naples (Naples, Italy) exhibiting severe progressive neurological symptoms. Magnetic resonance imaging indicated vertebral abnormalities, with evidence of marrow infiltration in several vertebral bodies; however, a contrast-enhanced computed tomography scan did not detect disease progression to other sites. Biopsy of the soft tissue at the level of the second lumbar vertebra (L2) revealed a metastatic lesion derived from gastric mucinous adenocarcinoma. The patient was initially treated with radiotherapy directed to the L2–L4 vertebral bodies to control the pain. Subsequently, systemic chemotherapy according to a FOLFOX-4 (leucovorin, fluorouracil and oxaliplatin) regimen commenced. However, after eight cycles, pulmonary progression of the disease occurred. Thus, palliative care was administered and the patient succumbed one month later. The late relapse of gastric cancer in the current patient may be associated with the theory of tumour dormancy.
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Affiliation(s)
- Francesco Iovino
- IX Division of General Surgery, Department of Anaesthetic, Surgical and Emergency Sciences, Second University of Naples, Naples I-80131, Italy
| | - Michele Orditura
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples I-80131, Italy
| | - Pasquale Pio Auriemma
- IX Division of General Surgery, Department of Anaesthetic, Surgical and Emergency Sciences, Second University of Naples, Naples I-80131, Italy
| | - Francesca Romana Ciorra
- IX Division of General Surgery, Department of Anaesthetic, Surgical and Emergency Sciences, Second University of Naples, Naples I-80131, Italy
| | - Giovanni Giordano
- IX Division of General Surgery, Department of Anaesthetic, Surgical and Emergency Sciences, Second University of Naples, Naples I-80131, Italy
| | - Consiglia Orabona
- IX Division of General Surgery, Department of Anaesthetic, Surgical and Emergency Sciences, Second University of Naples, Naples I-80131, Italy
| | - Francesco Bara
- IX Division of General Surgery, Department of Anaesthetic, Surgical and Emergency Sciences, Second University of Naples, Naples I-80131, Italy
| | - Renato Sergio
- IX Division of General Surgery, Department of Anaesthetic, Surgical and Emergency Sciences, Second University of Naples, Naples I-80131, Italy
| | - Beatrice Savastano
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples I-80131, Italy
| | - Alessio Fabozzi
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples I-80131, Italy
| | - Maria Maddalena Laterza
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples I-80131, Italy
| | - Jole Ventriglia
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples I-80131, Italy
| | - Angelica Petrillo
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples I-80131, Italy
| | - Carminia Maria Della Corte
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples I-80131, Italy
| | - Ferdinando DE Vita
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples I-80131, Italy
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Vita FD, Martino ND, Fabozzi A, Laterza MM, Ventriglia J, Savastano B, Petrillo A, Gambardella V, Sforza V, Marano L, Auricchio A, Galizia G, Ciardiello F, Orditura M. Clinical management of advanced gastric cancer: the role of new molecular drugs. World J Gastroenterol 2014; 20:14537-58. [PMID: 25356019 PMCID: PMC4209522 DOI: 10.3748/wjg.v20.i40.14537] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 02/19/2014] [Accepted: 06/02/2014] [Indexed: 02/06/2023] Open
Abstract
Gastric cancer is the fourth most common malignant neoplasm and the second leading cause of death for cancer in Western countries with more than 20000 new cases yearly diagnosed in the United States. Surgery represents the main approach for this disease but, notwithstanding the advances in surgical techniques, we observed a minimal improvement in terms of overall survival with a significant increasing of relapsing disease rates. Despite the development of new drugs has significantly improved the effectiveness of chemotherapy, the prognosis of patients with unresectable or metastatic gastric adenocarcinoma remains poor. Recently, several molecular target agents have been investigated; in particular, trastuzumab represents the first target molecule showing improvements in overall survival in human epithelial growth factor 2-positive gastric cancer patients. New molecules targeting vascular epithelial growth factor, mammalian target of rapamycin, and anti hepatocyte growth factor-c-Met pathway are also under investigation, with interesting results. Anyway, it seems necessary to select more accurately the population to treat with new agents by the identification of new biomarkers in order to optimize the results. In this paper we review the actual "scenario" of targeted treatments, also focusing on the new agents in development for gastric cancer and gastro-esophageal carcinoma, discussing their efficacy and potential applications in clinical practice.
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Laterza M, Orditura M, Fabozzi A, Ventriglia J, Savastano B, Petrillo A, Giordano G, Martinelli E, Gambardella V, Ciardiello F, De Vita F. Increased Vegf-C Serum Levels are Predictive of a Poor Outcome in Patients with Resectable Gastric Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Laterza M, Orditura M, Fabozzi A, Ventriglia J, Savastano B, Petrillo A, Giordano G, Martinelli E, Gambardella V, Ciardiello F, De Vita F. Increased Vegf-C Serum Levels are Predictive of a Poor Outcome in Patients with Resectable Gastric Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Orditura M, Galizia G, Di Martino N, Ancona E, Castoro C, Pacelli R, Morgillo F, Rossetti S, Gambardella V, Farella A, Laterza MM, Ruol A, Fabozzi A, Napolitano V, Iovino F, Lieto E, Fei L, Conzo G, Ciardiello F, De Vita F. Effect of preoperative chemoradiotherapy on outcome of patients with locally advanced esophagogastric junction adenocarcinoma-a pilot study. ACTA ACUST UNITED AC 2014; 21:125-33. [PMID: 24940093 DOI: 10.3747/co.21.1570] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND To date, few studies of preoperative chemotherapy or chemoradiotherapy (crt) in gastroesophageal junction (gej) cancer have been statistically powered; indeed, gej tumours have thus far been grouped with esophageal or gastric cancer in phase iii trials, thereby generating conflicting results. METHODS We studied 41 patients affected by locally advanced Siewert type i and ii gej adenocarcinoma who were treated with a neoadjuvant crt regimen [folfox4 (leucovorin-5-fluorouracil-oxaliplatin) for 4 cycles, and concurrent computed tomography-based three-dimensional conformal radiotherapy delivered using 5 daily fractions of 1.8 Gy per week for a total dose of 45 Gy], followed by surgery. Completeness of tumour resection (performed approximately 6 weeks after completion of crt), clinical and pathologic response rates, and safety and outcome of the treatment were the main endpoints of the study. RESULTS All 41 patients completed preoperative treatment. Combined therapy was well tolerated, with no treatment-related deaths. Dose reduction was necessary in 8 patients (19.5%). After crt, 78% of the patients showed a partial clinical response, 17% were stable, and 5% experienced disease progression. Pathology examination of surgical specimens demonstrated a 10% complete response rate. The median and mean survival times were 26 and 36 months respectively (95% confidence interval: 14 to 37 months and 30 to 41 months respectively). On multivariate analysis, TNM staging and clinical response were demonstrated to be the only independent variables related to long-term survival. CONCLUSIONS In our experience, preoperative chemoradiotherapy with folfox4 is feasible in locally advanced gej adenocarcinoma, but shows mild efficacy, as suggested by the low rate of pathologic complete response.
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Affiliation(s)
- M Orditura
- Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
| | - G Galizia
- Divisions of Surgical Oncology, Department of Anesthesiologic, Surgical, and Emergency Sciences, Second University of Naples School of Medicine, Naples, Italy
| | - N Di Martino
- Divisions of Surgical Oncology, Department of Anesthesiologic, Surgical, and Emergency Sciences, Second University of Naples School of Medicine, Naples, Italy
| | - E Ancona
- Division of General Surgery 1, University of Padua, School of Medicine, Padua, Italy
| | - C Castoro
- Division of General Surgery 1, University of Padua, School of Medicine, Padua, Italy
| | - R Pacelli
- Division of Radiotherapy, Federico ii University of Naples School of Medicine, Naples, Italy
| | - F Morgillo
- Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
| | - S Rossetti
- Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
| | - V Gambardella
- Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
| | - A Farella
- Division of Radiotherapy, Federico ii University of Naples School of Medicine, Naples, Italy
| | - M M Laterza
- Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
| | - A Ruol
- Division of General Surgery 1, University of Padua, School of Medicine, Padua, Italy
| | - A Fabozzi
- Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
| | - V Napolitano
- Divisions of Surgical Oncology, Department of Anesthesiologic, Surgical, and Emergency Sciences, Second University of Naples School of Medicine, Naples, Italy
| | - F Iovino
- Divisions of Surgical Oncology, Department of Anesthesiologic, Surgical, and Emergency Sciences, Second University of Naples School of Medicine, Naples, Italy
| | - E Lieto
- Divisions of Surgical Oncology, Department of Anesthesiologic, Surgical, and Emergency Sciences, Second University of Naples School of Medicine, Naples, Italy
| | - L Fei
- Divisions of Surgical Oncology, Department of Anesthesiologic, Surgical, and Emergency Sciences, Second University of Naples School of Medicine, Naples, Italy
| | - G Conzo
- Divisions of Surgical Oncology, Department of Anesthesiologic, Surgical, and Emergency Sciences, Second University of Naples School of Medicine, Naples, Italy
| | - F Ciardiello
- Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
| | - F De Vita
- Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy
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De Vita F, Orditura M, Laterza MM, Fabozzi A, Ventriglia J, Savastano B, Petrillo A, Giordano G, Gambardella V, Martinelli E, Ciardiello F. Increased circulating levels of VEGF-C to predict outcome in resectable gastric cancer patients. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.4080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Fernando De Vita
- Medical Oncology Division, Second University of Naples, Naples, Italy
| | | | | | - Alessio Fabozzi
- Medical Oncology, Second University of Naples, Naples, Italy
| | - Jole Ventriglia
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | | | - Guido Giordano
- Medical Oncology, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Benevento, Italy
| | - Valentina Gambardella
- Division of Medical Oncology, F.Magrassi-A.Lanzara. Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples, Italy
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34
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Giordano G, Febbraro A, Orditura M, Troiani T, Laterza MM, Fabozzi A, Ventriglia J, Savastano B, Petrillo A, Ciardiello F, De Vita F. Correlation of 12-weeks decrease of CA19.9 with overall response rate (ORR) and progression-free survival (PFS) in advanced pancreatic cancer (APC) patients (pts) treated with first-line nab-paclitaxel (Nab-P) and gemcitabine (G). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Guido Giordano
- Medical Oncology, Second University of Naples, Naples, Italy
| | - Antonio Febbraro
- Medical Oncology Unit, Ospedale Sacro cuore di Gesù, Fatebenefratelli, Benevento, Italy, Benevento, Italy
| | | | - Teresa Troiani
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | - Alessio Fabozzi
- Medical Oncology, Second University of Naples, Naples, Italy
| | - Jole Ventriglia
- Medical Oncology, Second University of Naples, Naples, Italy
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35
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De Vita F, Orditura M, Febbraro A, Morgillo F, Laterza MM, Fabozzi A, Giordano G, Savastano B, Petrillo A, Ventriglia J, Ciardiello F. Combination nab-paclitaxel (Nab-P) plus gemcitabine (G) as first-line treatment in advanced pancreatic cancer (APC): Our experience. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Fernando De Vita
- Medical Oncology Division, Second University of Naples, Naples, Italy
| | | | - Antonio Febbraro
- Medical Oncology Unit, Ospedale Sacro cuore di Gesù, Fatebenefratelli, Benevento, Italy, Benevento, Italy
| | | | | | - Alessio Fabozzi
- Medical Oncology, Second University of Naples, Naples, Italy
| | - Guido Giordano
- Medical Oncology, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Benevento, Italy
| | | | | | - Jole Ventriglia
- Medical Oncology, Second University of Naples, Naples, Italy
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36
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Orditura M, Galizia G, Sforza V, Gambardella V, Fabozzi A, Laterza MM, Andreozzi F, Ventriglia J, Savastano B, Mabilia A, Lieto E, Ciardiello F, De Vita F. Treatment of gastric cancer. World J Gastroenterol 2014; 20:1635-1649. [PMID: 24587643 PMCID: PMC3930964 DOI: 10.3748/wjg.v20.i7.1635] [Citation(s) in RCA: 451] [Impact Index Per Article: 45.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 10/29/2013] [Accepted: 11/13/2013] [Indexed: 02/06/2023] Open
Abstract
The authors focused on the current surgical treatment of resectable gastric cancer, and significance of peri- and post-operative chemo or chemoradiation. Gastric cancer is the 4th most commonly diagnosed cancer and the second leading cause of cancer death worldwide. Surgery remains the only curative therapy, while perioperative and adjuvant chemotherapy, as well as chemoradiation, can improve outcome of resectable gastric cancer with extended lymph node dissection. More than half of radically resected gastric cancer patients relapse locally or with distant metastases, or receive the diagnosis of gastric cancer when tumor is disseminated; therefore, median survival rarely exceeds 12 mo, and 5-years survival is less than 10%. Cisplatin and fluoropyrimidine-based chemotherapy, with addition of trastuzumab in human epidermal growth factor receptor 2 positive patients, is the widely used treatment in stage IV patients fit for chemotherapy. Recent evidence supports the use of second-line chemotherapy after progression in patients with good performance status
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37
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De Vita F, Orditura M, Laterza MM, Fabozzi A, Savastano B, Ventriglia J, Marano L, Giordano G, Petrillo A, Martinelli E, Troiani T, Morgillo F, Di Martino N, Ciardiello F. Postoperative chemoradiation FOLFOX 4-based for R1 resected gastric cancer: A retrospective mono-institutional study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.3_suppl.143] [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
143 Background: Improved DFS and OS were seen in curatively resected patients (pts.) with gastric and gastroesophageal adenocarcinoma treated with the Int0116 protocol of postoperative adjuvant chemoradiotherapy compared to surgery alone. However, there are very limited data about the efficacy of this approach in pts. with R1 resection. To evaluate the efficacy of a combined chemoradiation regimen in this setting, we reviewed our case records from 43 pts. with R1 resection treated between May 2008 and July 2012. Methods: 43 pts. with histologically confirmed gastric adenocarcinoma, received combined adjuvant chemotherapy with FOLFOX-4 for 8 cycles and concomitant radiotherapy (45 Gy in 25 daily fractions over 5 weeks). Radiotherapy was begun after 2 cycles of CT, (reduced by 20% during the period of concomitant radiotherapy). Pts. were followed at 3-month intervals for 2 years, at 6-month intervals for the next 3 years and yearly thereafter. Results: The median age was 62 years (range, 22-74) and the majority of pts. (76.7%) were males. Tumor location was equally distributed in the stomach. Most of the patients had locally advanced disease: 93% had T3-4 tumors and 74.4% had lymph node involvement. There was no treatment related death. Gastrointestinal G3 toxicity was observed in 11.6% of pts., while haematologic G3-4 toxicity was observed in 9.3%. Experienced toxicities led to chemotherapy dose reductions in 9 pts. and dose delay in 11 patients; 7 pts. had a delay in radiotherapy. With a median follow-up of 36 months (range 2-49) for the 43 R1 pts., 74.4% died of gastric cancer, 11.6% are alive with no evidence of recurrence and 13.9% are alive with disease. 66.6% of the relapses in this group occurred at distant sites and 33.3% were locoregional. The estimated 3-year OS was 19%. The median DFS was 14.5 months and the median OS was 16 months. Conclusions: These results seem to imply some benefit for the postoperative treatment, as nearly 19% of the R1 pts. in our study remained free of recurrence at 3 years from surgery. In the absence of phase III data and consequently lack of clear guidelines in this setting, our results support the common practice of adding postoperative chemoradiation after R1 gastrectomy.
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Affiliation(s)
| | | | | | - Alessio Fabozzi
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | - Jole Ventriglia
- Medical Oncology, Second University of Naples, Naples, Italy
| | - Luigi Marano
- VIII Division of Surgery, Second University of Naples, Naples, Italy
| | - Guido Giordano
- Medical Oncology, Second University of Naples, Naples, Italy
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De Vita F, Orditura M, Fabozzi A, Laterza MM, Ventriglia J, Savastano B, Giordano G, Petrillo A, Marano L, Di Martino N, Morgillo F, Martinelli E, Troiani T, Ciardiello F. Incidence and prognostic significance of HER2 overexpression in gastric cancer (GC): A monoinstitutional retrospective analysis. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.3_suppl.160] [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
160 Background: HER2 overexpression in GC is reported in 20% of cases; it is considered a negative prognostic factor with a positive predictive value of response to trastuzumab. We reviewed our case records analyzing its clinical significance. Methods: We retrospectively collected the data for patients (pts.) with histologically confirmed GC and tumor specimens. Results: From June 2011 to December 2012 we analyzed HER2 status in 76 pts with metastatic GC. (M/F 50/26, median age 64 years, ECOG performance status 0/1/2 = 59/12/5, G1/G2/G3 = 6.6%/22.4%/71%). In 36.8% of pts. gastric body was the primary tumor site. HER-2 overexpression was observed in 13 pts (17.1%). HER2-positive group had the following characteristics: M/F = 10/3, median age 63 years; Lauren’s histotype: 75% intestinal and 25% diffuse; G1/G2/G3 = 15.4%/30.8%/53.8%; T3-T4 tumors and N+ disease were observed in 46.1% respectively; the primary tumor site was: proximal 38.4%, distal 61.6%. 46.1% of pts with metastatic disease received a first line CT with a median progression free survival (mPFS) of 5 months (range, 3-7) and a median overall survival (mOS) of 9 months (range, 3-23). In HER2-negative group, (N= 63, M/F = 40/23, median age 64 years), 92.1% of pts. Lauren’s histotype: 45.5% intestinal and 54.5% diffuse; G1/G2/G3 = 4.8%/20.6%/74.6%; metastatic disease: 55.5%. T3-T4 tumors were assessed in 65.1% of pts and N+ disease in 61.9%. The primary tumor location was: proximal 38.1%, distal 61.9%. 57.1% with advanced disease received a first line CT with a mPFS of 5.5 months (range, 2-30) and a mOS of 10 months (range, 2-67). No statistically significant differences for mPFS (p: 0.08) and mOS (p: 0.06) were observed between HER2 positive and HER2 negative metastatic patients. Conclusions: According to our experience, HER2 overexpression doesn’t seem to correlate with a worse prognosis. In particular, it is not correlated with a worse histology and higher stage at diagnosis. Furthermore, no differences in terms of mPFS and mOS were observed between HER2 positive and HER2 negative metastatic pts.
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Affiliation(s)
| | | | - Alessio Fabozzi
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | - Jole Ventriglia
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | - Guido Giordano
- Medical Oncology, Second University of Naples, Naples, Italy
| | | | - Luigi Marano
- VIII Division of Surgery, Second University of Naples, Naples, Italy
| | | | | | | | - Teresa Troiani
- Medical Oncology, Second University of Naples, Naples, Italy
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Marano L, Izzo G, Esposito G, Petrillo M, Cosenza A, Marano M, Fabozzi A, Boccardi V, De Vita F, Di Martino N. Peripherally Inserted Central Catheter Tip Position: A Novel Empirical-Ultrasonographical Index in a Modern Surgical Oncology Department. Ann Surg Oncol 2013; 21:656-61. [DOI: 10.1245/s10434-013-3391-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Indexed: 12/20/2022]
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Orditura M, Galizia G, Fabozzi A, Lieto E, Gambardella V, Morgillo F, Del Genio GM, Fei L, Di Martino N, Renda A, Ciardiello F, De Vita F. Preoperative treatment of locally advanced esophageal carcinoma (Review). Int J Oncol 2013; 43:1745-53. [PMID: 24100679 DOI: 10.3892/ijo.2013.2118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 07/30/2013] [Indexed: 11/06/2022] Open
Abstract
Esophageal cancer (EC) is an aggressive malignancy with increasing incidence worldwide. Surgery is still the most effective treatment, however, both the high rate of local and distant recurrences and surgery-related complications led us to investigate new preoperative strategies. In this review, we discuss the role of neoadjuvant therapy for locally advanced EC with a focus on preoperative chemoradiation (trimodality treatment). Furthermore, the last fifteen years of published literature and our experience have been also reviewed. In the preoperative setting, few trials have reported a significant benefit with fluoropyrimidine and platinum compound-based neoadjuvant chemotherapy, compared to surgery alone. A large number of phase III trials and meta-analyses have demonstrated improved outcomes with preoperative chemoradiation vs. neoadjuvant chemotherapy or surgery alone. Therefore, trimodality therapy can be considered the most effective option in the management of locally advanced EC. Addition of drugs targeting VEGF or HER2 to standard chemotherapy appears to be feasible but needs to be explored more accurately. FDG-PET may predict both response to neoadjuvant treatments and prognosis.
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Affiliation(s)
- Michele Orditura
- Division of Medical Oncology, 'F. Magrassi - A. Lanzara' Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, School of Medicine, Naples, Italy
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41
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Morgillo F, De Vita F, Antoniol G, Orditura M, Auriemma PP, Diadema MR, Lieto E, Savastano B, Festino L, Laterza MM, Fabozzi A, Ventriglia J, Petrillo A, Ciardiello F, Barbarisi A, Iovino F. Serum insulin-like growth factor 1 correlates with the risk of nodal metastasis in endocrine-positive breast cancer. ACTA ACUST UNITED AC 2013; 20:e283-8. [PMID: 23904766 DOI: 10.3747/co.20.1380] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Increased insulin-like growth factor (igf) signalling has been observed in breast cancer, including endocrine-responsive cancers, and has been linked to disease progression and recurrence. In particular, igf-1 has the ability to induce and promote lymphangiogenesis through the induction of vascular endothelial growth factor C (vegfc). In the present study, we analyzed serum and tumour samples from 60 patients with endocrine-positive breast cancer to determine the expression and the possible relationship of circulating igf-1, igf binding protein 3 (igfbp3), and vegfc with the presence of lymphatic metastasis and other immunohistochemical parameters. The analysis revealed a clear and significant correlation between high basal levels of igf-1, igfbp3, and vegfc and lymph node metastasis in endocrine-responsive breast cancer. In addition, expression of those molecules was significantly higher in breast cancer patients than in healthy control subjects. Those findings may enable more accurate prediction of prognosis in patients with breast cancer.
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Affiliation(s)
- F Morgillo
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi e A. Lanzara", Seconda Università degli Studi di Napoli, Napoli, Italy
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Festino L, Fabozzi A, Manzo A, Gambardella V, Martinelli E, Troiani T, De Vita F, Orditura M, Ciardiello F, Morgillo F. Critical appraisal of the use of regorafenib in the management of colorectal cancer. Cancer Manag Res 2013; 5:49-55. [PMID: 23610528 PMCID: PMC3628528 DOI: 10.2147/cmar.s34281] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The lack of valid clinical management options for patients affected by metastatic colorectal cancer, which has progressed after all approved standard treatments, has lead to research into new active molecules. Regorafenib is an oral small-molecule multi kinase inhibitor, binding to several intracellular kinases, with powerful inhibitory activity against vascular endothelial growth factor receptors (VEGFR-1,VEGFR-2, and VEGFR-3), platelet-derived growth factor receptor, fibroblast growth factor receptor 1, Raf, TIE-2, and the kinases KIT, RET, and BRAF. The antitumor activity of regorafenib has been tested in vitro and in vivo, and inhibition of tumor growth has been observed in several cancer models, particularly colorectal cancer and gastrointestinal stromal tumors. The most frequent adverse events of grade 3 or higher related to regorafenib were hand-foot skin reaction, fatigue, diarrhea, hypertension, and rash or desquamation. Only a few Phase I–II trials, and most recently a Phase III trial in pretreated colorectal cancer, have been carried out to date. Several ongoing trials are testing the efficacy of regorafenib in combination with chemotherapy. At this point in time, regorafenib is the first small-molecule tyrosine kinase inhibitor to gain approval by the US Food and Drug Administration for pretreated metastatic colorectal cancer patients.
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Affiliation(s)
- Lucia Festino
- Division of Medical Oncology, Department of clinical and experimental medicine and surgery "F. Magrassi e A. Lanzara", Second University of Naples, Napoli, Italy
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Di Benedetto G, Fabozzi A, Rinaldi C. Clinical management of thyroid nodules with indeterminate cytology: our institutional experience using SIAPEC cytological criteria and V600-BRAF test. Pathologica 2013; 105:1-4. [PMID: 23858942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND We evaluated the diagnostic accuracy of thyroid FNAC, integrated with V600E - BRAF mutational study. Herein, we report our experience using the SIAPEC cytological morphological criteria. METHODS From September 2009 to December 2010, we performed ultrasound-guided fine needle aspiration cytology (FNAC) on 124 patients with clinical evidence of a thyroid nodule, classifying the results in five cytological categories, according to Italian Society of Pathology and Cytology (SIAPEC) consensus conference morphological criteria. In patients with indeterminate (Tir3), suggestive of malignancy (Tir4) or positive for malignancy specimens (Tir5), we obtained a new biopsy in order to study V600E BRAF status. Patients with a diagnosis of Tir2 were assessed every six months with follow-up in the subsequent years. Patients with cytological diagnosis of Tir3, Tir4 and Tir5 underwent thyroid surgical resection with histological assessment of the lesion. Cyto-histological correlation was evaluated. RESULTS We obtained the following results: Tir2 = 103 (83.1%), Tir3 = 14 (11.3%), Tir4 = 2 (1.6%); Tir5 = 5 (4%). B-RAF mutation was found on 1 Tir3, 1 Tir4 and 2 Tir5. Thyroidectomy was performed on 17 patients classified as Tir3, Tir4 and Tir5. The diagnostic specificity of FNB was of 94.5%, a sensitivity of 100%, a predictive value positive for neoplasia of 77.7 % and a predictive value of malignancy of 61.7%. CONCLUSIONS Diagnostic accuracy of cytology can be improved through the study of mutational status of BRAF gene. These additional evaluations are well studied, easy to perform and could enter in the current diagnostic procedures to optimize clinical management of thyroid nodular disease.
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Affiliation(s)
- G Di Benedetto
- Cytopathology Service, ASL Caserta, Department of Clinical Pathology, University Hospital Marcianise (CE), Italy.
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Di Benedetto G, Fabozzi A, Rinaldi C, Rinaldi CR. BRAF test and cytological diagnosis with a single fine needle cytology sample. Acta Cytol 2013; 57:337-40. [PMID: 23860494 DOI: 10.1159/000350618] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 03/12/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Recently, fine needle cytology (FNC) of the thyroid has been combined with biomolecular analysis. In particular, there has been detailed study of the V600E-BRAF mutation. The aim of our study is to demonstrate that with a single thyroid sample it is possible to obtain enough cellular material for both cytological diagnosis and a V600E-BRAF molecular test. STUDY DESIGN FNC was carried out under ultrasound guidance aided by an echographist and cytopathologist. We acquired one biopsy for each nodule with a 23-gauge needle without suction. The preparations were smeared by the pathologist onto one glass slide, air dried and stained with Diff-Quick. Cell adequacy was evaluated for each patient. The needle was washed by aspirating 2 ml of physiologic solution which was collected into a tube. The material was collected for molecular testing. RESULTS The following cytological diagnoses were made: not neoplastic, Tir2 (n = 227); indeterminate, Tir3 (n = 15); suspicious, Tir4 (n = 4), and malignancy, Tir5 (n = 12). The V600E-BRAF mutation was found in 0 of 227 Tir2 specimens, 2 of 15 (13.3%) Tir3 specimens, 2 of 4 (50%) Tir4 specimens and 9 of 12 (75%) Tir5 specimens. CONCLUSIONS Our data showed that, in a routine clinical setting, FNC specimens can be handled properly to provide both morphological and molecular information. In fact, our tests show that with a single specimen it is possible to set up a slide for the cytological diagnosis and to obtain enough residual cellular material for DNA extraction (>70 ng) and for the identification of the V600E-BRAF mutation.
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Affiliation(s)
- Giuseppe Di Benedetto
- Cytopathology Service, Department of Clinical Pathology, ASL Caserta, Caserta, Italy
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Tommaselli G, D'Afiero A, Formisano C, Fabozzi A, Di Carlo C, Nappi C. O692 COMPARISON OF TVT-O AND TVT-ABBREVO FOR THE SURGICAL MANAGEMENT OF FEMALE STRESS URINARY INCONTINENCE: A 12-MONTHS PRELIMINARY STUDY. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61122-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tommaselli G, D'Afiero A, Formisano C, Fabozzi A, Di Carlo C, Nappi C. O691 EFFICACY AND SAFETY OF TVT-O AND TVT-SECUR IN THE TREATMENT OF FEMALE STRESS URINARY INCONTINENCE: THREE YEARS FOLLOW-UP. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61121-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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47
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De Vita F, Giordano G, Fabozzi A, Guerrera B, Fabozzi T, Fasano M, Ferrara M, Fascione A, Di Benedetto G. Metastatic melanoma: an unusual presentation. Tumori 2011. [PMID: 21528678 DOI: 10.1700/611.7152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this report we describe a case of a malignant cutaneous melanoma metastasizing to the pleural surface and peritoneal cavity 5 years after surgical resection of the primary lesion. Malignant cutaneous melanoma is a very aggressive cancer able to metastasize anywhere in the body. Pleural secondary lesions represent a rare event described only in a small number of patients and the association with peritoneal localizations may suggest an uncommon pattern of spread that we discuss.
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Affiliation(s)
- Ferdinando De Vita
- Division of Medical Oncology, F. Magrassi-A. Lanzara Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, II Policlinico, Naples
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Caroli GC, Fabozzi A, Borghi B. [Is the prevention of pulmonary embolism in orthopedics really possible?]. Chir Organi Mov 1987; 72:351-3. [PMID: 3447824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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