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Aricò D, Giacoppo G, Bambaci M, Marino L, Girlando A, Sortino G, Leone G, Fernandes B, Alì M, Evangelista L, Romano A. 18 F-FET PET/CT in Calcifying Pseudoneoplasm of the Neuraxis : First Case. Clin Nucl Med 2024; 49:e272-e273. [PMID: 38537205 DOI: 10.1097/rlu.0000000000005197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
ABSTRACT A 66-year-old man has been treated in a psychiatric department for 4-5 years for a depressive syndrome, which is associated with poor motor initiative, confusional state, and dysosmia. Dynamic 18 F-FET PET/CT showed only faint uptake of radiotracer just above the background on the left frontal calcific lesion. The time-activity curve of the neoplasms showed a descending pattern. After a left fronto-orbitary minicraniotomy surgery, histology examination concluded for a rare calcifying pseudoneoplasm of the neuraxis (CAPNON). To our knowledge, no data are available on the metabolic behavior of CAPNON in 18 F-FET PET/CT. This case highlighted that a faint uptake and descending pattern on dynamic 18 F-FET PET/CT may be helpful in suspected CAPNON before surgery.
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Affiliation(s)
| | | | | | | | | | | | - Giorgia Leone
- Pathology Section, Humanitas Istituto Clinico Catanese, Misterbianco
| | | | - Marco Alì
- Medical Oncology Unit, Humanitas Istituto Clinico Catanese, Catania
| | | | - Alberto Romano
- Neurosurgery Unit, Humanitas Istituto Clinico Catanese, Misterbianco, Italy
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2
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Licata L, De Sanctis R, Vingiani A, Cosentini D, Iorfida M, Caremoli ER, Sassi I, Fernandes B, Gianatti A, Guerini-Rocco E, Zambelli C, Munzone E, Simoncini EL, Tondini C, Gentilini OD, Zambelli A, Pruneri G, Bianchini G. Real-world use of multigene signatures in early breast cancer: differences to clinical trials. Breast Cancer Res Treat 2024; 205:39-48. [PMID: 38265569 PMCID: PMC11062950 DOI: 10.1007/s10549-023-07227-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/11/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE In Italy, Lombardy was the first region to reimburse multigene assays (MGAs) for patients otherwise candidates for chemotherapy. This is a real-world experience of MGAs usage in six referral cancer centers in Lombardy. METHODS Among MGAs, Oncotype DX (RS) was used in 97% of cases. Consecutive patients tested with Oncotype DX from July 2020 to July 2022 were selected. The distribution of clinicopathologic features by RS groups (low RS: 0-25, high RS: 26-100) was assessed using chi-square and compared with those of the TAILORx and RxPONDER trials. RESULTS Out of 1,098 patients identified, 73% had low RS. Grade and Ki67 were associated with RS (p < 0.001). In patients with both G3 and Ki67 > 30%, 39% had low RS, while in patients with both G1 and Ki67 < 20%, 7% had high RS. The proportion of low RS in node-positive patients was similar to that in RxPONDER (82% vs 83%), while node-negative patients with low RS were significantly less than in TAILORx (66% vs 86%, p < 0.001). The distribution of Grade was different from registration trials, with more G3 and fewer G1 (38% and 3%) than in TAILORx (18% and 27%) and RxPONDER (10% and 24%) (p < 0.001). Patients ≤ 50 years were overrepresented in this series (41%) than in TAILORx and RxPONDER (31% and 24%, respectively) (p < 0.001) and, among them, 42% were node positive. CONCLUSIONS In this real-world series, Oncotype DX was the test almost exclusively used. Despite reimbursement being linked to pre-test chemotherapy recommendation, almost 3/4 patients resulted in the low-RS group. The significant proportion of node-positive patients ≤ 50 years tested indicates that oncologists considered Oncotype DX informative also in this population.
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Affiliation(s)
- Luca Licata
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
- School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.
| | - Rita De Sanctis
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Medical Oncology and Hematology Unit, IRCCS - Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Andrea Vingiani
- Deparment of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
- School of Medicine, University of Milan, Milan, Italy
| | - Deborah Cosentini
- Medical Oncology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Monica Iorfida
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Isabella Sassi
- Pathology Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS - Humanitas Research Hospital, Rozzano - Milan, Italy
| | - Andrea Gianatti
- Department of Pathology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Elena Guerini-Rocco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Elisabetta Munzone
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Oreste Davide Gentilini
- School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
- Breast Surgery Unit, San Raffaele Hospital, Milan, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Medical Oncology and Hematology Unit, IRCCS - Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giancarlo Pruneri
- Deparment of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
- School of Medicine, University of Milan, Milan, Italy
| | - Giampaolo Bianchini
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
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Torrisi R, Vaira V, Giordano L, Fernandes B, Saltalamacchia G, Palumbo R, Carnaghi C, Basilico V, Gentile F, Masci G, De Sanctis R, Santoro A. Identification of a Panel of miRNAs Associated with Resistance to Palbociclib and Endocrine Therapy. Int J Mol Sci 2024; 25:1498. [PMID: 38338777 PMCID: PMC10855102 DOI: 10.3390/ijms25031498] [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: 12/06/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
We investigated whether we could identify a panel of miRNAs associated with response to treatment in tumor tissues of patients with Hormone Receptor-positive/HER2-negative metastatic breast cancer treated with endocrine therapy (ET) and the CDK4/6 inhibitor (CDK4/6i)i palbociclib. In total, 52 patients were evaluated, with 41 receiving treatment as the first line. The overall median PFS was 20.8 months (range 2.5-66.6). In total, 23% of patients experienced early progression (<6 months). Seven miRNAs (miR-378e, miR-1233, miR-99b-5p, miR-1260b, miR-448, -miR-1252-5p, miR-324-3p, miR-1233-3p) showed a statistically significant negative association with PFS. When we considered PFS < 6 months, miR-378e, miR-99b-5p, miR-877-5p, miR-1297, miR-455-5p, and miR-4536-5p were statistically associated with a poor outcome. In the multivariate analysis, the first three miRNAs confirmed a significant and independent impact on PFS. The literature data and bioinformatic tools provide an underlying molecular rationale for most of these miRNAs, mainly involving the PI3K/AKT/mTOR pathway and cell-cycle machinery as cyclin D1, CDKN1B, and protein p27Kip1 and autophagy. Our findings propose a novel panel of miRNAs associated with a higher likelihood of early progression in patients treated with ET and Palbociclib and may contribute to shed some light on the mechanisms of de novo resistance to CDK4/6i, but this should be considered exploratory and evaluated in larger cohorts.
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Affiliation(s)
- Rosalba Torrisi
- Medical Oncology and Hematology Unit, Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milano, Italy; (G.S.); (G.M.); (R.D.S.); (A.S.)
| | - Valentina Vaira
- Division of Pathology, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milano, Italy; (V.V.); (F.G.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milano, Italy
| | - Laura Giordano
- Biostatistic Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milano, Italy;
| | - Bethania Fernandes
- Pathology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milano, Italy;
| | - Giuseppe Saltalamacchia
- Medical Oncology and Hematology Unit, Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milano, Italy; (G.S.); (G.M.); (R.D.S.); (A.S.)
| | | | - Carlo Carnaghi
- Clinical Trials Unit, Istituto Clinico Humanitas, Centro Catanese di Oncologia, 20072 Catania, Italy;
| | - Vera Basilico
- Medical Oncology Unit, Istituto Clinico Mater Domini Humanitas, Castellanza, 21100 Varese, Italy;
| | - Francesco Gentile
- Division of Pathology, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milano, Italy; (V.V.); (F.G.)
| | - Giovanna Masci
- Medical Oncology and Hematology Unit, Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milano, Italy; (G.S.); (G.M.); (R.D.S.); (A.S.)
| | - Rita De Sanctis
- Medical Oncology and Hematology Unit, Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milano, Italy; (G.S.); (G.M.); (R.D.S.); (A.S.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Armando Santoro
- Medical Oncology and Hematology Unit, Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milano, Italy; (G.S.); (G.M.); (R.D.S.); (A.S.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
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4
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Tinterri C, Fernandes B, Zambelli A, Sagona A, Barbieri E, Di Maria Grimaldi S, Darwish SS, Jacobs F, De Carlo C, Iuzzolino M, Gentile D. The Impact of Different Patterns of Residual Disease on Long-Term Oncological Outcomes in Breast Cancer Patients Treated with Neo-Adjuvant Chemotherapy. Cancers (Basel) 2024; 16:376. [PMID: 38254865 PMCID: PMC10814808 DOI: 10.3390/cancers16020376] [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: 12/19/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUNDS The majority of breast cancer (BC) patients treated with neo-adjuvant chemotherapy (NAC) achieves a pathologic partial response with different patterns of residual disease. No clear correlation between these patterns and oncological results was described. Our aims were to define the predictive factors for different patterns of residual disease and compare the outcomes between the scattered versus the circumscribed pattern. METHODS We reviewed 219 postoperative surgical specimens. Patients were divided into two groups: scattered versus circumscribed. Disease-free survival (DFS), distant DFS (DDFS), and overall survival (OS) were analyzed. RESULTS The scattered and circumscribed patterns were assessed in 111 (50.7%) and 108 (49.3%) patients. Two independent predictive factors for the circumscribed pattern were identified: discontinuation of NAC cycles (p = 0.011), and tumor size post-NAC >18 mm (p = 0.022). No difference was observed in terms of DFS and DDFS. Patients with the scattered pattern exhibited a statistically significant better OS. Discontinuation of NAC cycles, tumor size >18 mm, triple-negative BC, and ypN+ were associated with increased recurrence and poorer survival. CONCLUSIONS Discontinuation of NAC cycles and tumor size are independent factors associated with patterns of residual disease. The scattered pattern presents better survival. Understanding the relationship between NAC, the residual pattern, and differences in survival outcomes offers the potential to optimize the therapeutic approaches.
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Affiliation(s)
- Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; (A.Z.); (M.I.)
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (B.F.); (C.D.C.)
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; (A.Z.); (M.I.)
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy;
| | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
| | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
| | - Simone Di Maria Grimaldi
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
| | - Shadya Sara Darwish
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
| | - Flavia Jacobs
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy;
| | - Camilla De Carlo
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (B.F.); (C.D.C.)
| | - Martina Iuzzolino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; (A.Z.); (M.I.)
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (B.F.); (C.D.C.)
| | - Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; (A.Z.); (M.I.)
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5
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Fernandes MGO, Vilariça AS, Fernandes B, Camacho C, Saraiva C, Estevinho F, Novais E Bastos H, Lopes JM, Fidalgo P, Garrido P, Alves S, Silva S, Sequeira T, Barata F. Improving non-small-cell lung cancer survival through molecular characterization: Perspective of a multidisciplinary expert panel. Pulmonology 2024; 30:4-7. [PMID: 37210340 DOI: 10.1016/j.pulmoe.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 05/22/2023] Open
Affiliation(s)
- M G O Fernandes
- Pulmonology Department, Centro Hospitalar e Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; IBMC/i3S - Instituto de Biologia Molecular e Celular/Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal Pulmonology Department, Centro Hospitalar e Universitário de São João, EPE, Porto, Portugal.
| | - A S Vilariça
- Pulmonology Department, Centro Hospitalar e Universitário de Lisboa Norte, EPE - Hospital Pulido Valente, Lisboa, Portugal
| | - B Fernandes
- Pulmonology Department, Hospital de Braga, Braga, Portugal
| | - C Camacho
- Oncology Department, Serviço de Saúde da Região Autónoma da Madeira, Funchal, Portugal
| | - C Saraiva
- Pulmonology Department, Centro Hospitalar e Universitário do Algarve, EPE - Hospital de Portimão, Portugal
| | - F Estevinho
- Oncology Department, Unidade Local de Saúde de Matosinhos, EPE - Hospital Pedro Hispano, Matosinhos, Portugal
| | - H Novais E Bastos
- Pulmonology Department, Centro Hospitalar e Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; IBMC/i3S - Instituto de Biologia Molecular e Celular/Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal Pulmonology Department, Centro Hospitalar e Universitário de São João, EPE, Porto, Portugal
| | - J M Lopes
- Pulmonology Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - P Fidalgo
- Oncology Department, Centro Hospitalar e Universitário do Porto, EPE - Hospital de Santo António, Porto, Portugal
| | - P Garrido
- Pulmonology Department, Fundação Champalimaud, Lisboa, Portugal
| | - S Alves
- Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - S Silva
- Pulmonology Department, Centro Hospital de Leiria, EPE - Hospital de Santo André, Leiria, Portugal
| | - T Sequeira
- Oncology Department, Centro Hospitalar e Universitário de Lisboa Central, EPE - Hospital Santo António dos Capuchos, Lisboa, Portugal
| | - F Barata
- Pulmonology Department; Centro Hospitalar e Universitário de Coimbra, EPE - Hospitais da Universidade de Coimbra, Coimbra, Portugal
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6
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Fusco N, Ivanova M, Frascarelli C, Criscitiello C, Cerbelli B, Pignataro MG, Pernazza A, Sajjadi E, Venetis K, Cursano G, Pagni F, Di Bella C, Accardo M, Amato M, Amico P, Bartoli C, Bogina G, Bortesi L, Boldorini R, Bruno S, Cabibi D, Caruana P, Dainese E, De Camilli E, Dell'Anna V, Duda L, Emmanuele C, Fanelli GN, Fernandes B, Ferrara G, Gnetti L, Gurrera A, Leone G, Lucci R, Mancini C, Marangi G, Mastropasqua MG, Nibid L, Orrù S, Pastena M, Peresi M, Perracchio L, Santoro A, Vezzosi V, Zambelli C, Zuccalà V, Rizzo A, Costarelli L, Pietribiasi F, Santinelli A, Scatena C, Curigliano G, Guerini-Rocco E, Martini M, Graziano P, Castellano I, d'Amati G. Advancing the PD-L1 CPS test in metastatic TNBC: Insights from pathologists and findings from a nationwide survey. Crit Rev Oncol Hematol 2023; 190:104103. [PMID: 37595344 DOI: 10.1016/j.critrevonc.2023.104103] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/20/2023] Open
Abstract
Pembrolizumab has received approval as a first-line treatment for unresectable/metastatic triple-negative breast cancer (mTNBC) with a PD-L1 combined positive score (CPS) of ≥ 10. However, assessing CPS in mTNBC poses challenges. Firstly, it represents a novel analysis for breast pathologists. Secondly, the heterogeneity of PD-L1 expression in mTNBC further complicates the assessment. Lastly, the lack of standardized assays and staining platforms adds to the complexity. In KEYNOTE trials, PD-L1 expression was evaluated using the IHC 22C3 pharmDx kit as a companion diagnostic test. However, both the 22C3 pharmDx and VENTANA PD-L1 (SP263) assays are validated for CPS assessment. Consequently, assay-platform choice, staining conditions, and scoring methods can significantly impact the testing outcomes. This consensus paper aims to discuss the intricacies of PD-L1 CPS testing in mTNBC and provide practical recommendations for pathologists. Additionally, we present findings from a nationwide Italian survey elucidating the state-of-the-art in PD-L1 CPS testing in mTNBC.
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Affiliation(s)
- Nicola Fusco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
| | - Mariia Ivanova
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Frascarelli
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Carmen Criscitiello
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Division of New Drugs and Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Bruna Cerbelli
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Maria Gemma Pignataro
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Angelina Pernazza
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Elham Sajjadi
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Giulia Cursano
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Fabio Pagni
- Department of Medicine and Surgery, University Milan Bicocca, Monza (MB), Italy; Department of Pathology, IRCCS San Gerardo Hospital, Monza (MB), Italy
| | - Camillo Di Bella
- Department of Pathology, IRCCS San Gerardo Hospital, Monza (MB), Italy
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania "L. Vanvitelli", Naples, Italy
| | - Michelina Amato
- Department of Pathology, San Giovanni-Addolorata Hospital, Rome Italy
| | - Paolo Amico
- Department of Pathology, Ospedale Maria Paternò Arezzo, Ragusa, Italy
| | - Caterina Bartoli
- Morphological Diagnostic and Biomolecular Characterization Area, Complex Unit of Pathological Anatomy Empoli-Prato, Oncological Department Azienda USL Toscana Centro, Italy
| | - Giuseppe Bogina
- Pathology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Laura Bortesi
- Pathology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Renzo Boldorini
- Pathology Unit, University of Eastern Piedmont, Novara, Italy
| | - Sara Bruno
- Division of Pathology, ASL2 Savona, Liguria, Italy
| | - Daniela Cabibi
- Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy
| | - Pietro Caruana
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Emanuele Dainese
- Surgical Pathology Division, Department of Oncology, ASST Lecco, "A. Manzoni" Hospital, Lecco, Italy
| | - Elisa De Camilli
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Loren Duda
- Department of Clinical and Experimental Medicine, Pathology Unit, University of Foggia, Foggia, Italy
| | - Carmela Emmanuele
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | - Giuseppe Nicolò Fanelli
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Gerardo Ferrara
- Department of Anatomic Pathology and Cytopathology, G. Pascale National Cancer Institute Foundation (IRCCS) Naples, Italy
| | - Letizia Gnetti
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | | | - Giorgia Leone
- Division of Pathology, Clinical Institute Humanitas Catania Cubba, Misterbianco (Catania), Italy
| | - Raffaella Lucci
- Pathology Unit, Monaldi Hospital, A.O. dei Colli of Naples, Naples, Italy
| | - Cristina Mancini
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | - Grazia Marangi
- Anatomic Pathology Unit, SS. Annunziata Hospital, Taranto, Italy
| | - Mauro G Mastropasqua
- Department of Precision and Regenerative Medicine and Jonian Area, School of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Lorenzo Nibid
- Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Sandra Orrù
- Businco Oncologic Hospital, ARNAS Brotzu, Cagliari, Italy
| | - Maria Pastena
- IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Monica Peresi
- Pathology and Cytopathology Diagnostic Unit, Ospedale Villa Scassi di Genova, Genoa, Italy
| | - Letizia Perracchio
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Angela Santoro
- General Pathology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Vania Vezzosi
- Histopathology and Molecular Diagnostics Unit, Careggi Hospital, Firenze, Italy
| | | | - Valeria Zuccalà
- Pathology Unit, Pugliese-Ciaccio Hospital Catanzaro, Catanzaro, Italy
| | - Antonio Rizzo
- Division of Pathology, Clinical Institute Humanitas Catania Cubba, Misterbianco (Catania), Italy
| | | | | | - Alfredo Santinelli
- Anatomic Pathology, Azienda Sanitaria Territoriale di Pesaro-Urbino, Pesaro, Italy
| | - Cristian Scatena
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Division of New Drugs and Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elena Guerini-Rocco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Maurizio Martini
- Department of Human and Developmental Pathology, University of Messina, Messina, Italy
| | - Paolo Graziano
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | | | - Giulia d'Amati
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
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Cannizzaro D, Zaed I, Olei S, Fernandes B, Peschillo S, Milani D, Cardia A. Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68. Front Surg 2023; 10:1228955. [PMID: 37744724 PMCID: PMC10511771 DOI: 10.3389/fsurg.2023.1228955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Intracranial aneurysms occur in 3%-5% of the general population. While the precise biological mechanisms underlying the formation, growth, and sudden rupture of intracranial aneurysms remain partially unknown, recent research has shed light on the potential role of inflammation in aneurysm development and rupture. In addition, there are ongoing investigations exploring the feasibility of employing new drug therapies for controlling the risk factors associated with aneurysms. CD68, a glycosylated glycoprotein and the human homolog of macrosialin, is prominently expressed in monocyte/macrophages within inflamed tissues and has shown potential application in oncology. An observational study was conducted with the aim of comparing the histological characteristics of aneurysm walls with preoperative MRI scans, specifically focusing on CD68 activity. Method An observational pilot study was conducted to investigate the histological characteristics of the aneurysm wall that could be potentially associated with aneurysm growth and rupture. A total of 22 patients diagnosed with ruptured and unruptured intracranial aneurysms who had undergone conventional clipping between January 2017 and December 2022 were included in the study. Results A histopathological analysis of the aneurysm wall was performed in all patients, particularly focusing on the presence of CD68. A preoperative MRI with gadolinium was conducted in 10 patients with unruptured aneurysms and six patients with ruptured aneurysms. An emergency clipping was performed in the remaining six patients. The results showed that CD68 positivity and wall enhancement were significantly associated with intracranial aneurysm wall degeneration, growth, and rupture. Conclusion The histological and radiological inflammatory findings observed in the wall of cerebral aneurysms, as well as the CD68 positivity, are significantly associated with the risk of intracranial aneurysm growth and rupture. This study highlights the crucial importance of considering clinical and medical data when making treatment decisions for intracranial aneurysms. Furthermore, it emphasizes the relevance of evaluating wall enhancement in MRI scans as part of the diagnostic and prognostic process.
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Affiliation(s)
- Delia Cannizzaro
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ismail Zaed
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Simone Olei
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Simone Peschillo
- Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Davide Milani
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Andrea Cardia
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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8
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Ninatti G, Pini C, Bono BC, Gelardi F, Antunovic L, Fernandes B, Sollini M, Landoni C, Chiti A, Pessina F. The prognostic power of [ 11C]methionine PET in IDH-wildtype diffuse gliomas with lower-grade histological features: venturing beyond WHO classification. J Neurooncol 2023; 164:473-481. [PMID: 37695488 DOI: 10.1007/s11060-023-04438-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE IDH-wildtype (IDH-wt) diffuse gliomas with histological features of lower-grade gliomas (LGGs) are rare and heterogeneous primary brain tumours. [11C]Methionine (MET) positron emission tomography (PET) is commonly used to evaluate glial neoplasms at diagnosis. The present study aimed to assess the prognostic value of MET PET in newly diagnosed, treatment naïve IDH-wt gliomas with histological features of LGGs. METHODS Patients with a histological diagnosis of IDH-wt LGG who underwent preoperative (< 100 days) MET PET/CT and surgery were retrospectively included. Qualitative and semi-quantitative analyses of MET PET images were performed. Progression-free survival (PFS) and overall survival (OS) were analysed by Kaplan-Meier curves. Cox proportional-hazards regression was used to test the association of imaging and clinical data to PFS and OS. RESULTS We included 48 patients (M:F = 25:23; median age 55). 39 lesions were positive and 9 negative at MET PET. Positive MET PET was significantly associated with shorter median PFS (15.7 months vs. not reached, p = 0.0146) and OS time (32.6 months vs. not reached, p = 0.0253). Incomplete surgical resection and higher TBRmean values were independent predictors of shorter PFS on multivariate analysis (p < 0.001 for both). Higher tumour grade and incomplete surgical resection were independent predictors of OS at multivariate analysis (p = 0.027 and p = 0.01, respectively). CONCLUSION MET PET is useful for the prognostic stratification of patients with IDH-wt glial neoplasms with histological LGGs features. Considering their huge biological heterogeneity, the combination of MET PET and molecular analyses may help to improve the prognostic accuracy in these diffuse gliomas subset and influence therapeutic choices accordingly.
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Affiliation(s)
- Gaia Ninatti
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristiano Pini
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Beatrice Claudia Bono
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Fabrizia Gelardi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Lidija Antunovic
- Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Martina Sollini
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.
- Nuclear Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
| | - Claudio Landoni
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Nuclear Medicine Department, IRCCS Monza, San Gerardo Hospital, Monza, Italy
| | - Arturo Chiti
- Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Federico Pessina
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Miglietta F, Ragazzi M, Fernandes B, Griguolo G, Massa D, Girardi F, Bottosso M, Bisagni A, Zarrilli G, Porra F, Iannaccone D, Dore L, Gaudio M, Santandrea G, Fassan M, Lo Mele M, De Sanctis R, Zambelli A, Bisagni G, Guarneri V, Dieci MV. A Prognostic Model Based on Residual Cancer Burden and Tumor-Infiltrating Lymphocytes on Residual Disease after Neoadjuvant Therapy in HER2+ Breast Cancer. Clin Cancer Res 2023; 29:3429-3437. [PMID: 37417941 PMCID: PMC10472099 DOI: 10.1158/1078-0432.ccr-23-0480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/26/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE We aim to evaluate the prognostic significance of tumor-infiltrating lymphocyte on residual disease (RD-TIL) in HER2+ patients with breast cancer who failed to achieve pathologic complete response (pCR) after anti-HER2+ chemotherapy (CT)-based neoadjuvant treatment (NAT). We assessed the feasibility of combining the prognostic information provided by residual cancer burden (RCB) and RD-TILs into a composite score (RCB+TIL). EXPERIMENTAL DESIGN HER2+ patients with breast cancer treated with CT+anti-HER2-based NAT at three institutions were retrospectively included. RCB and TIL levels were evaluated on hematoxylin and eosin-stained slides from surgical samples according to available recommendations. Overall survival (OS) was used as an outcome measure. RESULTS A total of 295 patients were included, of whom 195 had RD. RCB was significantly associated with OS. Higher RD-TILs were significantly associated with poorer OS as compared with lower RD-TILs (15% cutoff). In multivariate analysis, both RCB and RD-TIL maintained their independent prognostic value. A combined score, RCB+TIL, was calculated from the estimated coefficient of RD-TILs and the RCB index in a bivariate logistic model for OS. The RCB+TIL score was significantly associated with OS. The C-index for OS of the RCB+TIL score was numerically higher than that of RCB and significantly higher than that of RD-TILs. CONCLUSIONS We have reported an independent prognostic impact of RD-TILs after anti-HER2+CT NAT, which might underlie an imbalance of the RD microenvironment towards immunosuppressive features. We provided a new composite prognostic score based on RCB+TIL, which was significantly associated with OS and proved to be more informative than the isolated evaluation of RCB and RD-TILs.
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Affiliation(s)
- Federica Miglietta
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
| | - Moira Ragazzi
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
| | - Davide Massa
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
| | - Fabio Girardi
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
| | - Michele Bottosso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
| | - Alessandra Bisagni
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Zarrilli
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padova, Padova, Italy
| | - Francesca Porra
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
| | - Daniela Iannaccone
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
| | - Leocadia Dore
- Humanitas Clinical and Research Center – IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Mariangela Gaudio
- Humanitas Clinical and Research Center – IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Giacomo Santandrea
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Matteo Fassan
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padova, Padova, Italy
| | - Marcello Lo Mele
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padova, Padova, Italy
| | - Rita De Sanctis
- Humanitas Clinical and Research Center – IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Alberto Zambelli
- Humanitas Clinical and Research Center – IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Giancarlo Bisagni
- Oncology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Istituto Oncologico Veneto – IOV IRCCS, Padova, Italy
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Tinterri C, Canavese G, Gatzemeier W, Barbieri E, Bottini A, Sagona A, Caraceni G, Testori A, Di Maria Grimaldi S, Dani C, Boni L, Bruzzi P, Fernandes B, Scorsetti M, Zambelli A, Gentile D. Sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer patients undergoing mastectomy with one to two metastatic sentinel lymph nodes: sub-analysis of the SINODAR-ONE multicentre randomized clinical trial and reopening of enrolment. Br J Surg 2023; 110:1143-1152. [PMID: 37471574 PMCID: PMC10492188 DOI: 10.1093/bjs/znad215] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 04/05/2023] [Revised: 05/15/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND The initial results of the SINODAR-ONE randomized clinical trial reported that patients with T1-2 breast cancer and one to two macrometastatic sentinel lymph nodes treated with breast-conserving surgery, sentinel lymph node biopsy only, and adjuvant therapy did not present worse 3-year survival, regional recurrence, or distant recurrence rates compared with those treated with axillary lymph node dissection. To extend the recommendation of axillary lymph node dissection omission even in patients treated with mastectomy, a sub-analysis of the SINODAR-ONE trial is presented here. METHODS Patients with T1-2 breast cancer and no more than two metastatic sentinel lymph nodes undergoing mastectomy were analysed. After sentinel lymph node biopsy, patients were randomly assigned to receive either axillary lymph node dissection followed by adjuvant treatment (standard arm) or adjuvant treatment alone (experimental arm). The primary endpoint was overall survival. The secondary endpoint was recurrence-free survival. RESULTS A total of 218 patients were treated with mastectomy; 111 were randomly assigned to the axillary lymph node dissection group and 107 to the sentinel lymph node biopsy-only group. At a median follow-up of 33.0 months, there were three deaths (two deaths in the axillary lymph node dissection group and one death in the sentinel lymph node biopsy-only group). There were five recurrences in each treatment arm. No axillary lymph node recurrence was observed. The 5-year overall survival rates were 97.8 and 98.7 per cent in the axillary lymph node dissection treatment arm and the sentinel lymph node biopsy-only treatment arm, respectively (P = 0.597). The 5-year recurrence-free survival rates were 95.7 and 94.1 per cent in the axillary lymph node dissection treatment arm and the sentinel lymph node biopsy treatment arm, respectively (P = 0.821). CONCLUSION In patients with T1-2 breast cancer and one to two macrometastatic sentinel lymph nodes treated with mastectomy, the overall survival and recurrence-free survival rates of patients treated with sentinel lymph node biopsy only were not inferior to those treated with axillary lymph node dissection. To strengthen the conclusion of the trial, the enrolment of patients treated with mastectomy was reopened as a single-arm experimental study. REGISTRATION NUMBER NCT05160324 (http://www.clinicaltrials.gov).
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Affiliation(s)
- Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | | | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Alberto Bottini
- Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Giulia Caraceni
- Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Alberto Testori
- Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | | | - Carla Dani
- Department of Epidemiology, Biostatistics and Clinical Trials, IRCCS S. Martino, IST, Genoa, Italy
| | - Luca Boni
- Department of Epidemiology, Biostatistics and Clinical Trials, IRCCS S. Martino, IST, Genoa, Italy
| | - Paolo Bruzzi
- Department of Epidemiology, Biostatistics and Clinical Trials, IRCCS S. Martino, IST, Genoa, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Marta Scorsetti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Medical Oncology and Haematology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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11
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Gentile D, Sagona A, De Carlo C, Fernandes B, Barbieri E, Di Maria Grimaldi S, Jacobs F, Vatteroni G, Scardina L, Biondi E, Vinci V, Trimboli RM, Bernardi D, Tinterri C. Pathologic response and residual tumor cellularity after neo-adjuvant chemotherapy predict prognosis in breast cancer patients. Breast 2023; 69:323-329. [PMID: 37001289 PMCID: PMC10070173 DOI: 10.1016/j.breast.2023.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Residual tumor cellularity (RTC) and pathologic complete response (pCR) after neo-adjuvant chemotherapy (NAC) are prognostic factors associated with improved outcomes in breast cancer (BC). However, the majority of patients achieve partial pathologic response (pPR) and no clear correlation between RTC patterns and outcomes was described. Our aims were to define predictive factors for pCR and compare different outcomes of patients with pCR or pPR and with different RTC patterns. MATERIALS AND METHODS Baseline and post-NAC demographics, clinicopathological characteristics, post-operative data, survival and recurrence status were recorded from our institutional database. A multivariable analysis was performed using a logistic regression model to identify independent predictors of pCR. Disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS) analyses were performed using the Kaplan-Meier method. RESULTS Overall, of the 495 patients analyzed, 148 (29.9%) achieved pCR, 347 (70.1%) had pPR, and the median RTC was 40%. Multivariable analysis identified 3 independent factors predictive of pCR: tumor stage before NAC (cT1-2 84.5% versus cT3-4 15.5%), BC sub-type (HER2-positive 54.7% versus triple-negative 29.8% versus luminal-like 15.5%), and vascular invasion (absence 98.0% versus presence 2.0%). We found statistically significant longer DFS, DDFS, and OS in patients with pCR and with RTC <40%; no difference was observed in terms of OS between RTC <40% and RTC ≥40% groups. CONCLUSIONS Tumor stage before NAC, BC sub-type, and vascular invasion are significant and independent factors associated with pCR. Patients with pCR and with RTC <40% have longer DFS, DDFS, and OS compared with patients with pPR.
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Affiliation(s)
- Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Camilla De Carlo
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | | | - Flavia Jacobs
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy; Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Giulia Vatteroni
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Lorenzo Scardina
- Division of Breast Surgery, Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Ersilia Biondi
- Division of Breast Surgery, Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Valeriano Vinci
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Rubina Manuela Trimboli
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Daniela Bernardi
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Corrado Tinterri
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
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12
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Gentile D, Sagona A, De Carlo C, Fernandes B, Grimaldi SDM, Barbieri E, Gatzemeier W, Scardina L, Biondi E, Jacobs F, Vatteroni G, Tinterri C. Abstract P6-01-32: Evaluation of pathologic response and residual tumor cellularity following neo-adjuvant chemotherapy predict prognosis in breast cancer patients. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p6-01-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Introduction: Treatment of early-stage beast cancer (BC) has changed since recent evidence showed that neoadjuvant chemotherapy (NAC) can reduce residual tumor cellularity (RTC) and improve patient outcomes. Achieving a pathologic complete response (pCR) has been associated with significantly improved disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS). However, among patients treated with NAC, few experience pCR, while approximately 60-80% of them achieve a pathologic partial response (pPR). In previous studies, BC patients with different grades of pPR have been usually grouped and analyzed together, with inconsistent results and unclear prognostic significance. Objectives: The primary aims of this study were to describe the clinical and treatment characteristics of BC patients treated with NAC, to identify independent predictive factors of pCR, and to compare the oncologic outcomes between patients achieving pCR or pPR. The secondary aim of this study was to measure the RTC of BC patients with pPR and to compare the outcomes of patients with different RTC in order to improve prognostic information. Methods: All the consecutive BC patients undergoing NAC at the Breast Unit of IRCCS Humanitas Research Hospital (Milan, Italy) between October 2006 and April 2020 and their corresponding post-operative pathology slides were reviewed. The following exclusion criteria were used: excisional biopsy or debulking surgery as first BC operation, patients with a previous BC diagnosis or other prior or synchronous malignancies, male patients, unknown NAC regimen, disease progression during NAC, and follow-up ≤12 months. Results: A total of 495 BC patients received NAC. Overall, 148 (29.9%) patients achieved pCR, while 347 (70.1%) had pPR, and median RTC was 40%. At multivariable analysis, 3 independent factors predicting pCR were identified. Tumor stage pre-NAC (cT1-2 84.5% versus cT3-4 15.5%, odds ratio (OR)=0.119, 95% confidence interval (95%CI)=0.048-0.189, p=0.001), BC sub-type (HER2-enriched 54.7% versus triple-negative 29.8% versus luminal-like 15.5%, OR=2.178, 95%CI=2.055-2.301, p=0.001), and vascular invasion (absence 98.0% versus presence 2.0%, OR=0.022, 95%CI=0.004-0.090, p=0.001). Patients with BC undergoing NAC and achieving pCR presented statistically significant longer DFS, DDFS, and OS (p = < 0.001). Patients with RTC < 40% presented statistically significant better DFS and DDFS (p = 0.033, p = 0.015, respectively). However, no statistically significant difference in terms of OS was observed between RTC < 40% and RTC ≥40% groups (p = 0.148). Conclusions: Tumor stage pre-NAC, BC sub-type, and vascular invasion are significantly and independently associated with pCR. Patients with pCR present a better prognosis compared to patients with pPR in terms of DFS, DDFS, and OS. Measurement of RTC in BC patients with pPR improves the prognostic information that can be obtained from the assessment of the pathologic response. Different patterns of residual disease play an important role in predicting the risk of subsequent loco-regional and distant recurrence, and patients with RTC < 40% present significantly better DFS and DDFS.
Citation Format: Damiano Gentile, Andrea Sagona, Camilla De Carlo, Bethania Fernandes, Simone Di Maria Grimaldi, Erika Barbieri, Wolfgang Gatzemeier, Lorenzo Scardina, Ersilia Biondi, Flavia Jacobs, Giulia Vatteroni, Corrado Tinterri. Evaluation of pathologic response and residual tumor cellularity following neo-adjuvant chemotherapy predict prognosis in breast cancer patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-01-32.
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Gentile D, Gatzemeier W, Sagona A, Barbieri E, Testori A, Errico V, Bottini A, Di Maria Grimaldi S, Caraceni G, Boni L, Bruzzi P, Fernandes B, Franceschini D, Spoto R, Torrisi R, Zambelli A, Scorsetti M, Santoro A, Canavese G, Tinterri C. The current status and future perspectives of the multicenter randomized clinical trial SINODAR-ONE. European Journal of Surgical Oncology 2023. [DOI: 10.1016/j.ejso.2022.11.107] [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: 02/23/2023]
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Miglietta F, Ragazzi M, Fernandes B, Griguolo G, Massa D, Bisagni A, Bottosso M, Porra F, Gaudio M, Iannaccone D, Fassan M, Lo Mele M, Gasparini E, Zarrilli G, Coiro S, Dore L, Zambelli A, Bisagni G, Guarneri V, Dieci M. A composite prognostic model for overall survival (OS) based on residual cancer burden (RCB) and tumor-infiltrating lymphocytes (TILs) on residual disease (RCB+TIL) in HER2+ breast cancer patients treated with neoadjuvant therapy: a multicenter study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01354-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Conti Nibali M, Rossi M, Sciortino T, Gay L, Lopci E, Fernandes B, Rudà R, Bello L. P03.08.B Proton Therapy and recurrent Lower Grade Glioma: clinical and radiological aspects, intraoperative findings and histo-pathological features. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.112] [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: 11/12/2022] Open
Abstract
Abstract
Background
Radiation therapy (RT) plays a central role in management of central nervous system disease, in particular in the multimodality management of low(er) and high-grade CNS gliomas. New strategy that involved Proton Therapy (PT) have been experienced in the last years. No data are available about re-surgery of lesion irradiated with protons.
Material and Methods
We reviewed our single Unit experience of re-surgery of Lower-Grade Glioma patients that received, in their neuro-oncological history, a treatment with PT. We collect clinical data, intra-operative findings, histopathological features and oncological and clinical outcome after surgery.
Results
We collected three cases of young with an IDH1-mutated tumor that underwent to Proton Therapy (PT). In two cases PT was performed due to progression of disease, in one case as adjuvant therapy after first surgical treatment. In all cases we performed surgery within three years after PT. All patients complained drug resistant epilepsy after PT with symptom relief after surgery and one patient complained a spine fracture due to corticosteroids intake to control radionecrosis’s symptoms after PT. In the pre-operative work-up all patient performed a 11-C-Methionin PET scan that revealed an increase of tracer uptake in the suspected area of tumor progression. In one case advanced MRI protocol with PWI was performed to further distinguish and sample area of pseudoprogression and tumor progression. In two patients area of gliosis and necrosis was find at the histological examination.
Conclusion
Our experience, although limited to three case, provided a clinical and radiological example of the small cohort of patients that performed surgery after a Prothon Radiotherapy. Clinical presentation was heterogenous except a poor seizure control. Despite time elapsed since PT, areas of radionecrosis were found in the histopathological samples of 2/3 of patients. Moreover, we need to collect more data to draw a complete picture in this complex field.
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Affiliation(s)
| | - M Rossi
- Università degli Studi di Milano , Milano , Italy
| | | | - L Gay
- Università degli Studi di Milano , Milano , Italy
| | - E Lopci
- Humanitas Research Hospital , Milano , Italy
| | - B Fernandes
- Humanitas Research Hospital , Milano , Italy
| | - R Rudà
- Ospedale CastelFranco Veneto , Treviso , Italy
| | - L Bello
- Università degli Studi di Milano , Milano , Italy
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Bono B, Olei S, Rossini Z, Fernandes B, Valeri M, Pessina F. Primary brain necrotizing granulomas caused by. Infect Dis Now 2022; 52:381-383. [DOI: 10.1016/j.idnow.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/07/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
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Tinterri C, Gentile D, Gatzemeier W, Sagona A, Barbieri E, Testori A, Errico V, Bottini A, Marrazzo E, Dani C, Dozin B, Boni L, Bruzzi P, Fernandes B, Franceschini D, Spoto R, Torrisi R, Scorsetti M, Santoro A, Canavese G, Custodero O, Troilo VL, Taffurelli M, Cucchi MC, Galluzzo V, Cabula C, Cabula R, Lazzaretti MG, Caruso F, Castiglione G, Grossi S, Tavoletta MS, Rossi C, Curcio A, Friedman D, Fregatti P, Magni C, Tazzioli G, Papi S, Giovanazzi R, Chifu C, Bettini R, Pezzella M, Michieletto S, Saibene T, Roncella M, Ghilli M, Sibilio A, Cariello A, Coiro S, Falco G, Meli EZ, Fortunato L, Ciuffreda L, Murgo R, Battaglia C, Rubino L, Biglia N, Bounous V, Rovera FA, Chiappa C, Pollini G, Mirandola S, Meneghini G, Di Bartolo F. ASO Visual Abstract: Preservation of Axillary Lymph Nodes Compared with Complete Dissection in T1-2 Breast Cancer Patients Presenting 1-2 Metastatic Sentinel Lymph Nodes: The Multicenter Randomized Clinical Trial SINODAR-ONE. Ann Surg Oncol 2022. [DOI: 10.1245/s10434-022-11908-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Bruce A, Menzies A, Long G, Fernandes B, Joshua F. AB1426 PREDICTORS OF RHEUMATIC TOXICITIES OF IMMUNE CHECKPOINT INHIBITORS AND CANCER OUTCOMES IN PATIENTS WITH ADVANCED MELANOMA. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundImmune checkpoint inhibitors (ICIs) including monoclonal antibodies to PD-1 and CTLA-4 have activity across various cancers. Dedicated cohort studies have examined the epidemiology and clinical course of rheumatic toxicities (1–3) and the effect of pre-existing autoimmune disease has been explored (4), with limited assessment of the effect of non-immune mediated rheumatic disease (3). A positive association between ICI-induced rheumatic disease and favourable cancer outcomes has been suggested (1,2), although derived from heterogenous cancer populations.ObjectivesTo identify risk factors for the development of ICI-induced rheumatic disease and predictors of cancer outcomes in patients with advanced melanoma.MethodsA single-centre observational study of patients with stage III or IV melanoma receiving all available ICI therapies, who completed a for-purpose questionnaire to capture rheumatic symptoms and risk factors upon recruitment and at 12-months. Symptom severity was assessed according to patient reported measures such as visual analogue scale (VAS) scores for pain. Clinical details were extracted from patients’ medical records. Predictors of rheumatic toxicities and cancer outcomes were identified through regression analysis.ResultsAmongst 147 eligible patients, the prevalence of new or worsening rheumatic symptoms was 32.5% at recruitment and 21% at 12 months. The incidence of documented arthralgia, inflammatory arthritis and PMR-like syndrome was 39.5%, 5.4% and 3.4% respectively. Binary logistic regression identified pre-existing symptomatic rheumatic disease, including non-immune mediated rheumatic disease, as the primary risk factor for developing rheumatic toxicities (OR 3.161). Continuation of ICI therapy (OR 16.52), followed by rheumatic toxicities (OR = 4.368) were predictors of favourable tumour response.ConclusionRheumatic toxicities of ICI therapy commonly affect patients with melanoma and are more likely to occur in patients with pre-existing autoimmune and non-immune mediated rheumatic disease. Continuation of ICI therapy improves cancer outcomes and can be facilitated by early detection of rheumatic symptoms using patient reported outcome measures.Table 1.Bivariate logistic regression of predictors of patient-reported rheumatic toxicity. Sig., Significance; OR, Odds ratio; CI, confidence interval; BRAF/MEK, BRAF and MEK inhibitors; PD-1, Programmed Cell Death protein – 1; CTLA-4, Cytotoxic T-lymphocyte-associated protein.Figure 1.A) Receiver-operator curve for accuracy of binary logistic regression model clinician-recorded rheumatic disease. (B) Area under receiver-operator curve. Test result variable(s): predicted probability. AUROC, Area Under Receiver-Operator Curve; Std. Error, Standard Error; Sig., Significance.(a) Under the nonparametric assumption(b) Null hypothesis: true area = 0.5References[1]Kostine M, Rouxel L, Barnetche T, Veillon R, Martin F, Dutriaux C, et al. Rheumatic disorders associated with immune checkpoint inhibitors in patients with cancer-clinical aspects and relationship with tumour response: a single-centre prospective cohort study. Ann Rheum Dis. 2018;77(3):393–8.[2]Braaten TJ, Brahmer JR, Forde PM, Le D, Lipson EJ, Naidoo J, et al. Immune checkpoint inhibitor-induced inflammatory arthritis persists after immunotherapy cessation. Ann Rheum Dis. 2019;332–8.[3]Buder-Bakhaya K, Benesova K, Schulz C, Anwar H, Dimitrakopoulou-Strauss A, Weber TF, et al. Characterization of arthralgia induced by PD-1 antibody treatment in patients with metastasized cutaneous malignancies. Cancer Immunol Immunother. 2018;67(2):175–82.[4]Menzies AM, Johnson DB, Ramanujam S, Atkinson VG, Wong ANM, Park JJ, et al. Anti-PD-1 therapy in patients with advanced melanoma and preexisting autoimmune disorders or major toxicity with ipilimumab. Ann Oncol. 2017;28(2):368–76.Disclosure of InterestsAlana Bruce: None declared, Alexander Menzies Consultant of: A.M.M. has participated in advisory boards for BMS, MSD, Novartis, Roche, Pierre-Fabre, Georgina Long Consultant of: GVL is consultant advisor for Aduro Biotech Inc, Agenus Inc, Amgen Inc, Array Biopharma inc, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb, Evaxion Biotech A/S, Hexel AG, Highlight Therapeutics S.L., Merck Sharpe & Dohme, Novartis Pharma AG, OncoSec, Pierre Fabre, QBiotics Group Limited, Regeneron Pharmaceuticals Inc, Specialised Therapeutics Australia Pty Ltd., Brian Fernandes: None declared, Fredrick Joshua Consultant of: F.J. has performed clinical trials and participated in advisory boards for Abbvie, Pfizer, Novartis, Sanofi, Eli Lily and Roche
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Tinterri C, Gentile D, Gatzemeier W, Sagona A, Barbieri E, Testori A, Errico V, Bottini A, Marrazzo E, Dani C, Dozin B, Boni L, Bruzzi P, Fernandes B, Franceschini D, Spoto R, Torrisi R, Scorsetti M, Santoro A, Canavese G. Preservation of Axillary Lymph Nodes Compared with Complete Dissection in T1-2 Breast Cancer Patients Presenting One or Two Metastatic Sentinel Lymph Nodes: The SINODAR-ONE Multicenter Randomized Clinical Trial. Ann Surg Oncol 2022; 29:5732-5744. [PMID: 35552930 DOI: 10.1245/s10434-022-11866-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/20/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The SINODAR-ONE trial is a prospective noninferiority multicenter randomized study aimed at assessing the role of axillary lymph node dissection (ALND) in patients undergoing either breast-conserving surgery or mastectomy for T1-2 breast cancer (BC) and presenting one or two macrometastatic sentinel lymph nodes (SLNs). The endpoints were to evaluate whether SLN biopsy (SLNB) only was associated with worsening of the prognosis compared with ALND in terms of overall survival (OS) and relapse. METHODS Patients were randomly assigned (1:1 ratio) to either removal of ≥ 10 axillary level I/II non-SLNs followed by adjuvant therapy (standard arm) or no further axillary treatment (experimental arm). RESULTS The trial started in April 2015 and ceased in April 2020, involving 889 patients. Median follow-up was 34.0 months. There were eight deaths (ALND, 4; SNLB only, 4), with 5-year cumulative mortality of 5.8% and 2.1% in the standard and experimental arm, respectively (p = 0.984). There were 26 recurrences (ALND 11; SNLB only, 15), with 5-year cumulative incidence of recurrence of 6.9% and 3.3% in the standard and experimental arm, respectively (p = 0.444). Only one axillary lymph node recurrence was observed in each arm. The 5-year OS rates were 98.9% and 98.8%, in the ALND and SNLB-only arm, respectively (p = 0.936). CONCLUSIONS The 3-year survival and relapse rates of T1-2 BC patients with one or two macrometastatic SLNs treated with SLNB only, and adjuvant therapy, were not inferior to those of patients treated with ALND. These results do not support the use of routine ALND.
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Affiliation(s)
- Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
| | | | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alberto Testori
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Valentina Errico
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alberto Bottini
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Carla Dani
- Department of Epidemiology, Biostatistics and Clinical Trials, IRCCS S. Martino, IST, Genoa, Italy
| | - Beatrice Dozin
- Department of Epidemiology, Biostatistics and Clinical Trials, IRCCS S. Martino, IST, Genoa, Italy
| | - Luca Boni
- Department of Epidemiology, Biostatistics and Clinical Trials, IRCCS S. Martino, IST, Genoa, Italy
| | - Paolo Bruzzi
- Department of Epidemiology, Biostatistics and Clinical Trials, IRCCS S. Martino, IST, Genoa, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Davide Franceschini
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ruggero Spoto
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Rosalba Torrisi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marta Scorsetti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giuseppe Canavese
- Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Barbieri E, Gentile D, Bottini A, Sagona A, Gatzemeier W, Losurdo A, Fernandes B, Tinterri C. Neo-Adjuvant Chemotherapy in Luminal, Node Positive Breast Cancer: Characteristics, Treatment and Oncological Outcomes: A Single Center's Experience. Eur J Breast Health 2021; 17:356-362. [PMID: 34651115 DOI: 10.4274/ejbh.galenos.2021.2021-4-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/26/2021] [Indexed: 12/31/2022]
Abstract
Objective Neo-adjuvant chemotherapy (NAC) is the treatment of choice for patients with locally advanced breast cancer (BC). In luminal-like BC, the decision to administer NAC remains controversial. The purpose of this study was to describe the clinical characteristics, treatment, and oncological outcomes of luminal-like, node positive, BC patients treated with NAC, and to identify independent predictive factors for treatment. Materials and Methods All consecutive patients with luminal-like, node positive BC who underwent NAC were retrospectively reviewed. Pathologic complete response (pCR) was defined as no invasive or in situ residual tumor in both breast and axillary nodes (ypT0N0). Results A total of 205 luminal-like, node positive BC patients underwent NAC. Overall, 34 (16.6%) patients showed pCR, 86 (42.0%) patients underwent breast-conserving surgery (BCS), 119 (58.0%) patients underwent mastectomy, 130 (63.4%) patients underwent axillary lymph node dissection (ALND) without prior sentinel lymph node biopsy (SLNB), and 75 (36.6%) patients underwent breast surgery plus SLNB. Pathologic CR to NAC (29.1% vs 7.6% if no pCR, odds ratio = 2.866, 95% confidence interval = 1.296-6.341, p = 0.009) was found to significantly increase the probability to receive BCS. There was no significant difference in terms of disease-free and overall survival between patients with luminal-like, node positive BC receiving BCS or mastectomy (p = 0.596, p = 0.134, respectively), and ALND or SLNB only (p = 0.661, p = 0.856, respectively). Conclusion Luminal-like, node positive BC presents low pCR rates after NAC. Pre-operative chemotherapy increases the rate of BCS. Pathologic CR has emerged as an independent predictive factor for BCS. In patients with axillary pCR, SLNB is an acceptable procedure not associated with worse oncological outcomes.
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Affiliation(s)
- Erika Barbieri
- Breast Unit, Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Damiano Gentile
- Breast Unit, Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alberto Bottini
- Breast Unit, Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Andrea Sagona
- Breast Unit, Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Wolfgang Gatzemeier
- Breast Unit, Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Agnese Losurdo
- Medical Oncology and Hematology Unit, Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Corrado Tinterri
- Breast Unit, Institute for Research, Hospitalization and Healthcare (IRCCS) Humanitas Research Hospital, Milan, Italy
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Gentile D, Sagona A, Barbieri E, Antunovic L, Franceschini D, Losurdo A, Fernandes B, Tinterri C. Breast conserving surgery versus salvage mastectomy for ipsilateral breast cancer recurrence: a propensity score matching analysis. Updates Surg 2021; 74:479-489. [PMID: 34181187 DOI: 10.1007/s13304-021-01122-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/21/2021] [Indexed: 01/01/2023]
Abstract
Salvage mastectomy is regarded as the treatment of first choice for ipsilateral breast cancer recurrence (IBCR), even if a second breast conserving surgery (BCS) is feasible. The purpose of this study was to compare the long-term oncological outcomes of IBCR patients who had undergone either mastectomy or second BCS, performing a propensity score matching (PSM) analysis to reduce the selection bias. All the consecutive patients with IBCR were retrospectively reviewed and divided into two different groups of treatment: repeat BCS versus salvage mastectomy. The propensity score predicting the probability of surgical treatment was determined for each patient and a 1:1 matching was performed. Disease-free survival (DFS), distant disease-free survival (DDFS), overall survival (OS), and breast cancer-specific survival (BCSS) were analyzed and compared between the two groups. A total of 309 patients underwent surgical treatment for IBCR. After PSM, 108 patients treated with repeat BCS and 108 patients treated with salvage mastectomy were included in the analysis. There was no significant difference in terms of DFS between patients with IBCR receiving repeat BCS or salvage mastectomy (p = 0.167). However, patients with IBCR undergoing second BCS had significantly better DDFS, OS, and BCSS compared to salvage mastectomy (p < 0.001). Salvage mastectomy should not be considered the optimal treatment for IBCR and it does not seem to improve prognosis compared to repeat conserving surgery. Second BCS for IBCR is a safe option with encouraging long-term oncological outcomes and should be proposed to all patients, when technically feasible.
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Affiliation(s)
- Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy. .,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, , Milan, Italy.
| | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Lidija Antunovic
- Department of Nuclear Medicine, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Davide Franceschini
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Agnese Losurdo
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, , Milan, Italy
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Pessina F, Navarria P, Clerici E, Bellu L, Franzini A, Milani D, Simonelli M, Persico P, Politi LS, Casarotti A, Fernandes B, Olei S, Sollini M, Chiti A, Scorsetti M. Role of 11C Methionine Positron Emission Tomography (11CMETPET) for Surgery and Radiation Therapy Planning in Newly Diagnosed Glioblastoma Patients Enrolled into a Phase II Clinical Study. J Clin Med 2021; 10:jcm10112313. [PMID: 34070698 PMCID: PMC8198980 DOI: 10.3390/jcm10112313] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: We investigated the role of [11C]-methionine PET in a cohort of newly diagnosed glioblastoma multiforme (GBM) patients to evaluate whether it could modify the extent of surgical resection and improve radiation therapy volume delineation. (2) Methods: Newly diagnosed GBM patients, ages 18-70, with a Karnofsky performance scale (KPS) ≥ 70 with available MRI and [11C]-methionine PET were included. Patients were treated with different amounts of surgical resection followed by radio-chemotherapy. The role of [11C]-methionine PET in surgical and RT planning was analyzed. A threshold of SUVmax was searched. (3) Results: From August 2013 to April 2016, 93 patients were treated and included in this analysis. Residual tumor volume was detected in 63 cases on MRI and in 78 on [11C]-methionine PET, including 15 receiving gross total resection. The location of uptake was mainly observed in FLAIR abnormalities. [11C]-methionine uptake changed RT volume in 11% of patients. The presence of [11C]-methionine uptake in patients receiving GTR proved to influence survival (p = 0.029). The threshold of the SUVmax conditioning outcome was five. (4) Conclusions: [11C]-methionine PET allowed to detect areas at higher risk of recurrence located in FLAIR abnormalities in patients affected by GBM. A challenging issue is represented by integrating morphological and functional imaging to better define the extent of surgical resection to perform.
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Affiliation(s)
- Federico Pessina
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
| | - Pierina Navarria
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (E.C.); (L.B.)
- Correspondence: ; Tel.: +390-282-247-458
| | - Elena Clerici
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (E.C.); (L.B.)
| | - Luisa Bellu
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (E.C.); (L.B.)
| | - Andrea Franzini
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
| | - Davide Milani
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
| | - Matteo Simonelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
- Oncology and Hematology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Pasquale Persico
- Oncology and Hematology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Letterio S. Politi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
- Neuroradiology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Alessandra Casarotti
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
| | - Bethania Fernandes
- Pathology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Simone Olei
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
| | - Martina Sollini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
- Diagnostic Imaging Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Arturo Chiti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (L.S.P.); (A.C.)
- Pathology Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Marta Scorsetti
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (F.P.); (A.F.); (D.M.); (A.C.); (S.O.); (M.S.)
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (E.C.); (L.B.)
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Roque Marcal I, Amaral VT, Fernandes B, Abreu RM, Guimaraes GV, Ciolac EG. High-intensity interval vs moderate-intensity continuous exercise in heated water-based on acute hemodynamic, vascular, and cardiac autonomic responses in older individuals with hypertension. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.196] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP #2017/25648-4 #2018/09695-5) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES – Finance Code 001).
OnBehalf
Exercise and Chronic Disease Research Laboratory (ECDR)
Introduction
Post-exercise hypotension is an important tool in the treatment and control of hypertension. In recent years, high-intensity interval exercise (HIIE) has gained significant popularity in exercise-based prevention and rehabilitation of clinical populations. However, to date, it is not clarifying the acute responses of exercise performed in heated water-based in older individuals with hypertension.
Purpose
To assess hemodynamic, vascular, and cardiac autonomic responses to heated water-based HIIE versus moderate-intensity continuous exercise (MICE) in older individuals with hypertension.
Methods
Twenty older individuals (67 ± 7 y) under treatment for hypertension were randomly assigned to perform HIIE (25 min), MICE (30 min) and control (CON; 30 min) sessions in a heated swimming pool (30-32ºC). Blood pressure (BP), arterial stiffness, endothelial reactivity, and heart rate variability (HRV) were measured before (PRE), immediately after (POST), and after 45 min (REC). 24-h ambulatory BP monitoring and ambulatory HRV were also performed after each intervention. HRV were analyzed in ms² (ms²) or normalized units (nu) and then converted into natural logarithms (ln). Time domain markers as mean of intervals R-R (µi-RR), and frequency domain such as high frequency band (HF) and low frequency band (LF).
Results
Systolic BP increased at POST (p < 0.05) in all interventions, with higher increases in CON (29 ± 3 mmHg) and MICE (19 ± 3 mmHg) than HIIE (9 ± 4 mmHg). Although systolic BP reduced at REC in all interventions, it returned to levels similar to PRE in HIIE, and continue at higher levels than PRE in MICE and CON. HIIE promoted a higher response on markers of parasympathetic modulation at REC compared to MICE (HFln,nu 0.14 ± 0.06, p = 0.02) and CON (µi-RR: 0.02 ± 0.01, p = 0.05). By contrast, during night-time, HIIE demonstrated a lower parasympathetic modulation than CON (HFln,nu: -0.06 ± 0.03, p = 0.05). In addition, CON showed a higher HRV during 24-h compared to HIIE and MICE.
Conclusion
Despite differences between interventions in BP and cardiac autonomic responses, heated water-based HIIE or MICE were not effective to improve hemodynamic and vascular responses. These results may have important implications in the management of older individuals with hypertension in heated water-based.
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Affiliation(s)
| | - VT Amaral
- Sao Paulo State University, Bauru, Brazil
| | | | - RM Abreu
- Sao Paulo State University, Bauru, Brazil
| | | | - EG Ciolac
- Sao Paulo State University, Bauru, Brazil
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Giaretto S, Renne SL, Rahal D, Bossi P, Colombo P, Spaggiari P, Manara S, Sollai M, Fiamengo B, Brambilla T, Fernandes B, Rao S, Elamin A, Valeri M, De Carlo C, Belsito V, Lancellotti C, Cieri M, Cagini A, Terracciano L, Roncalli M, Di Tommaso L. Digital Pathology During the COVID-19 Outbreak in Italy: Survey Study. J Med Internet Res 2021; 23:e24266. [PMID: 33503002 PMCID: PMC7901595 DOI: 10.2196/24266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Transition to digital pathology usually takes months or years to be completed. We were familiarizing ourselves with digital pathology solutions at the time when the COVID-19 outbreak forced us to embark on an abrupt transition to digital pathology. OBJECTIVE The aim of this study was to quantitatively describe how the abrupt transition to digital pathology might affect the quality of diagnoses, model possible causes by probabilistic modeling, and qualitatively gauge the perception of this abrupt transition. METHODS A total of 17 pathologists and residents participated in this study; these participants reviewed 25 additional test cases from the archives and completed a final psychologic survey. For each case, participants performed several different diagnostic tasks, and their results were recorded and compared with the original diagnoses performed using the gold standard method (ie, conventional microscopy). We performed Bayesian data analysis with probabilistic modeling. RESULTS The overall analysis, comprising 1345 different items, resulted in a 9% (117/1345) error rate in using digital slides. The task of differentiating a neoplastic process from a nonneoplastic one accounted for an error rate of 10.7% (42/392), whereas the distinction of a malignant process from a benign one accounted for an error rate of 4.2% (11/258). Apart from residents, senior pathologists generated most discrepancies (7.9%, 13/164). Our model showed that these differences among career levels persisted even after adjusting for other factors. CONCLUSIONS Our findings are in line with previous findings, emphasizing that the duration of transition (ie, lengthy or abrupt) might not influence the diagnostic performance. Moreover, our findings highlight that senior pathologists may be limited by a digital gap, which may negatively affect their performance with digital pathology. These results can guide the process of digital transition in the field of pathology.
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Affiliation(s)
- Simone Giaretto
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Salvatore Lorenzo Renne
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Daoud Rahal
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Paola Bossi
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Piergiuseppe Colombo
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Paola Spaggiari
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Sofia Manara
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Mauro Sollai
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Barbara Fiamengo
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Tatiana Brambilla
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Bethania Fernandes
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Stefania Rao
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Abubaker Elamin
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Marina Valeri
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Camilla De Carlo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Vincenzo Belsito
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Cesare Lancellotti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Miriam Cieri
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Angelo Cagini
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Luigi Terracciano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Massimo Roncalli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Luca Di Tommaso
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
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25
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Aguiar F, Rolo R, Rodrigues AP, Fernandes B, Ferreira L. The golden bronchus. Respir Med Res 2021; 80:100812. [PMID: 34224956 DOI: 10.1016/j.resmer.2021.100812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/29/2020] [Accepted: 01/02/2021] [Indexed: 11/24/2022]
Affiliation(s)
- F Aguiar
- Pneumology department, Hospital de Braga, Braga, Portugal.
| | - R Rolo
- Pneumology department, Hospital de Braga, Braga, Portugal
| | - A P Rodrigues
- Pathology department, Hospital de Braga, Braga, Portugal
| | - B Fernandes
- Pneumology department, Hospital de Braga, Braga, Portugal
| | - L Ferreira
- Pneumology department, Hospital de Braga, Braga, Portugal
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26
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Losurdo A, De Sanctis R, Fernandes B, Torrisi R, Masci G, Agostinetto E, Gatzemeier W, Errico V, Testori A, Tinterri C, Roncalli M, Santoro A. Insights for the application of TILs and AR in the treatment of TNBC in routine clinical practice. Sci Rep 2020; 10:20100. [PMID: 33208857 PMCID: PMC7674426 DOI: 10.1038/s41598-020-77043-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/27/2020] [Indexed: 12/20/2022] Open
Abstract
Triple negative breast cancer (TNBC), usually presenting with a very aggressive phenotype, is a heterogeneous entity. We aim to discuss new biomarkers, suitable for prognostic and predictive purposes. We retrospectively collected clinical variables and immunohistochemical characteristics of early TNBCs, specifically focusing on the prognostic and predictive significance of tumor infiltrating lymphocytes (TILs) and androgen receptor (AR) expression, assessing their correlation with clinical variables. Among 159 patients, TILs were significantly higher in younger patients and with lower BMI, and in tumors with higher ki-67 and greater nodal involvement; conversely, AR was significantly higher in older patients and in tumors with lower ki-67. Interestingly and in line with literature, both TILs level and ARs expression were lower within metastatic sites, in patients who developed distant metastases, compared to those found in the primary site. Small (pT1) and node negative tumors were highly represented and no correlation of either TILs or AR with prognosis could be observed. Our findings support the use of stromal TILs to identify a more aggressive, but chemo-sensitive phenotype, mostly represented in younger women, while AR may identify a less aggressive, slow-growing luminal TNBC subtype, more common among older patients. TILs and AR are worth implementing in routine clinical practice to refine prognosis even if, in our case series, we couldn't identify a significant correlation of the two variables with either disease-free and overall survival.
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Affiliation(s)
- Agnese Losurdo
- Department of Medical Oncology and Hematology, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Rita De Sanctis
- Department of Medical Oncology and Hematology, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Rosalba Torrisi
- Department of Medical Oncology and Hematology, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giovanna Masci
- Department of Medical Oncology and Hematology, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Elisa Agostinetto
- Department of Medical Oncology and Hematology, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Wolfgang Gatzemeier
- Department of Breast Surgery, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Valentina Errico
- Department of Breast Surgery, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Alberto Testori
- Department of Breast Surgery, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Corrado Tinterri
- Department of Breast Surgery, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Massimo Roncalli
- Department of Pathology, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Armando Santoro
- Department of Medical Oncology and Hematology, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
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27
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Correia D, Fernandes B, Ponte A, Marques M, Couto-Gonçalves S, Rolim L, Nobre-Góis I, Carvalho C, Casalta-Lopes J, Borrego M. PO-0977: Hypofractionated external beam radiation therapy for breast cancer: real-life outcomes. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00995-6] [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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28
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Franceschini D, Loi M, Chiola I, Arculeo S, Marzo M, Fernandes B, Masci G, Torrisi R, Tinterri C, Testori A, Santoro A, Scorsetti M. Preliminary Results of a Randomized Study on Postmenopausal Women With Early Stage Breast Cancer: Adjuvant Hypofractionated Whole Breast Irradiation Versus Accelerated Partial Breast Irradiation (HYPAB Trial). Clin Breast Cancer 2020; 21:231-238. [PMID: 33121891 DOI: 10.1016/j.clbc.2020.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The purpose of this study was to report preliminary data of a randomized phase III trial comparing hypofractionated whole breast irradiation (HWBI) and accelerated partial breast irradiation (APBI) using volumetric modulated arc therapy (VMAT). MATERIAL AND METHODS The HYPAB trial enrolled postmenopausal women with biopsy-proven infiltrating breast cancer, clinically negative axilla, single T1 to T2 tumors, who were treated with breast-conserving surgery. Patients were randomized 1:1 after surgery to HWBI (40.5 Gy whole breast, 48.0 Gy to surgical bed, 15 fractions over 3 weeks) or APBI (30 Gy delivered in 5 fractions of 6 Gy given on alternate days on the surgical bed). Cosmetic outcome was the primary end point of the study. RESULTS A total of 172 patients were enrolled. After a median follow-up of 36 months, 5 local failures and 3 locoregional failures were recorded, with no difference between the 2 treatment arms. Use of HWBI as compared with APBI was significantly correlated with increased incidence of overall (62% vs. 14%; P < .001) and grade 2 (18% vs. 1%; P < .001) acute skin toxicity. APBI was correlated with a lower incidence of overall late toxicity as compared with HWBI (18% vs. 41%; P = .001), but no significant difference was found in term of occurrence of grade 2 events (1% vs. 4%; P = NS). At comparative assessment between baseline and post-radiotherapy evaluation, impairment in cosmetic outcome was reported in 19 (11%) patients. Owing to premature closure of the study, no per-protocol comparison between the treatment arms was performed. CONCLUSION APBI with the VMAT technique is safe and feasible, with lower acute toxicity when compared with HWBI.
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Affiliation(s)
- Davide Franceschini
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy.
| | - Mauro Loi
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Ilaria Chiola
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Simona Arculeo
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Marco Marzo
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Bethania Fernandes
- Pathology Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Giovanna Masci
- Medical Oncology Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Rosalba Torrisi
- Medical Oncology Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Corrado Tinterri
- Breast Surgery Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Alberto Testori
- Breast Surgery Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Armando Santoro
- Medical Oncology Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy; Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - Marta Scorsetti
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy; Humanitas University, Department of Biomedical Sciences, Milan, Italy
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29
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Kakogiannos N, Ferrari L, Giampietro C, Scalise AA, Maderna C, Ravà M, Taddei A, Lampugnani MG, Pisati F, Malinverno M, Martini E, Costa I, Lupia M, Cavallaro U, Beznoussenko GV, Mironov AA, Fernandes B, Rudini N, Dejana E, Giannotta M. JAM-A Acts via C/EBP-α to Promote Claudin-5 Expression and Enhance Endothelial Barrier Function. Circ Res 2020; 127:1056-1073. [PMID: 32673519 PMCID: PMC7508279 DOI: 10.1161/circresaha.120.316742] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
RATIONALE Intercellular tight junctions are crucial for correct regulation of the endothelial barrier. Their composition and integrity are affected in pathological contexts, such as inflammation and tumor growth. JAM-A (junctional adhesion molecule A) is a transmembrane component of tight junctions with a role in maintenance of endothelial barrier function, although how this is accomplished remains elusive. OBJECTIVE We aimed to understand the molecular mechanisms through which JAM-A expression regulates tight junction organization to control endothelial permeability, with potential implications under pathological conditions. METHODS AND RESULTS Genetic deletion of JAM-A in mice significantly increased vascular permeability. This was associated with significantly decreased expression of claudin-5 in the vasculature of various tissues, including brain and lung. We observed that C/EBP-α (CCAAT/enhancer-binding protein-α) can act as a transcription factor to trigger the expression of claudin-5 downstream of JAM-A, to thus enhance vascular barrier function. Accordingly, gain-of-function for C/EBP-α increased claudin-5 expression and decreased endothelial permeability, as measured by the passage of fluorescein isothiocyanate (FITC)-dextran through endothelial monolayers. Conversely, C/EBP-α loss-of-function showed the opposite effects of decreased claudin-5 levels and increased endothelial permeability. Mechanistically, JAM-A promoted C/EBP-α expression through suppression of β-catenin transcriptional activity, and also through activation of EPAC (exchange protein directly activated by cAMP). C/EBP-α then directly binds the promoter of claudin-5 to thereby promote its transcription. Finally, JAM-A-C/EBP-α-mediated regulation of claudin-5 was lost in blood vessels from tissue biopsies from patients with glioblastoma and ovarian cancer. CONCLUSIONS We describe here a novel role for the transcription factor C/EBP-α that is positively modulated by JAM-A, a component of tight junctions that acts through EPAC to up-regulate the expression of claudin-5, to thus decrease endothelial permeability. Overall, these data unravel a regulatory molecular pathway through which tight junctions limit vascular permeability. This will help in the identification of further therapeutic targets for diseases associated with endothelial barrier dysfunction. Graphic Abstract: An graphic abstract is available for this article.
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Affiliation(s)
- Nikolaos Kakogiannos
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Laura Ferrari
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Costanza Giampietro
- EMPA, Swiss Federal Laboratories for Material Science and Technologies, Experimental Continuum Mechanics, Dübendorf, Switzerland (C.G.)
| | - Anna Agata Scalise
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Claudio Maderna
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Micol Ravà
- Experimental Oncology (M.R.), European Institute of Oncology IRCSS, Milan
| | | | - Maria Grazia Lampugnani
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.).,Mario Negri Institute for Pharmacological Research, Milan (M.G.L.)
| | | | - Matteo Malinverno
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Emanuele Martini
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Ilaria Costa
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Michela Lupia
- Unit of Gynaecological Oncology Research (M.L., U.C.), European Institute of Oncology IRCSS, Milan
| | - Ugo Cavallaro
- Unit of Gynaecological Oncology Research (M.L., U.C.), European Institute of Oncology IRCSS, Milan
| | - Galina V Beznoussenko
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Alexander A Mironov
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
| | - Bethania Fernandes
- Pathology Unit, Humanitas Clinical and Research Centre, Rozzano, Milan (B.F., N.R.)
| | - Noemi Rudini
- Pathology Unit, Humanitas Clinical and Research Centre, Rozzano, Milan (B.F., N.R.)
| | - Elisabetta Dejana
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.).,Oncology and Haemato-Oncology, School of Medicine, University of Milan (E.D.).,Immunology, Genetics and Pathology, Uppsala University, Sweden (E.D.)
| | - Monica Giannotta
- From the FIRC Institute of Molecular Oncology, Milan, Italy (N.K., L.F., A.A.S., C.M., M.G.L., M.M., E.M., I.C., G.V.B., A.A.M., E.D., M.G.)
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30
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Roncaroli F, Chatterjee D, Giannini C, Pereira M, La Rosa S, Brouland JP, Gnanalingham K, Galli C, Fernandes B, Lania A, Radotra B. Primary papillary epithelial tumour of the sella: expanding the spectrum of TTF-1-positive sellar lesions. Neuropathol Appl Neurobiol 2020; 46:493-505. [PMID: 32311761 DOI: 10.1111/nan.12622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/30/2020] [Accepted: 04/09/2020] [Indexed: 12/11/2022]
Abstract
AIM To describe four novel primary epithelial tumours of the sella with papillary architecture and Thyroid Transcription Factor 1 (TTF-1) expression. METHODS Paraffin-embedded tissue from the four cases and recurrence of patient 1 was investigated with haematoxylin-eosin, special histochemical stains, immunohistochemistry with a broad panel of antibodies and next-generation sequencing. The ultrastructure of one tumour was studied in tissue retrieved from paraffin. RESULTS The lesions occurred in three females aged 20, 26 and 42 years and a male aged 49 years. They presented with signs and symptoms secondary to pituitary stalk compression. Preoperative neuroimaging documented mixed solid and cystic, enhancing sellar masses with suprasellar extension. Histologically, the tumours showed thin papillae lined by a single layer of cytokeratin and TTF-1-positive cuboidal and cylindrical cells with mildly atypical nucleus. Next-generation sequencing performed in three cases did not identify any mutations. The main differential diagnosis included metastasis from lung or thyroid carcinoma, extraventricular choroid plexus papilloma and sellar ependymoma. CONCLUSION We suggest the descriptive term of primary papillary epithelial tumour of the sella (PPETS) for this entity and propose that it could represent the intracranial equivalent of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma. The cell of origin of PPETS remains undetermined although the intense and ubiquitous expression of TTF-1 may suggest a derivation from the infundibulum or ventricular recess. Our study expands the spectrum of sellar TTF-1-positive tumour and challenges the view that they all derive from pituicytes.
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Affiliation(s)
- F Roncaroli
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biology, University of Manchester, Manchester, UK
| | - D Chatterjee
- Deparment of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - C Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA.,Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - M Pereira
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Division of Evolution and Genomic Science, University of Manchester, Manchester, UK
| | - S La Rosa
- Institute of Pathology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - J P Brouland
- Institute of Pathology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - K Gnanalingham
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal Foundation Trust, Salford, Manchester, UK
| | - C Galli
- Department of Histopathology, Humanitas University, Milan, Italy
| | - B Fernandes
- Department of Histopathology, Humanitas University, Milan, Italy
| | - A Lania
- Department of Endocrinology, Humanitas University, Milan, Italy
| | - B Radotra
- Deparment of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Agostinetto E, Giordano L, Torrisi R, De Sanctis R, Masci G, Losurdo A, Zuradelli M, Tinterri C, Gatzemeier W, Testori A, Alloisio M, De Rose F, Fernandes B, Santoro A. Biological Characteristics and Long-term Outcomes in Node-negative Breast Cancer. Clin Breast Cancer 2020; 20:e481-e489. [PMID: 32279915 DOI: 10.1016/j.clbc.2020.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/10/2020] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Because the risk of relapse of node-negative breast cancer (BC) is varying, we evaluated the prognosis of patients with this disease and the factors associated with increased risk of relapse. PATIENTS AND METHODS The clinical charts of patients with BC with evidence of negative nodes and with a potential ≥ 5-year follow-up were retrospectively reviewed. RESULTS We analyzed 1276 patients. Over a median follow-up of 71.6 months (range, 1-227.2 months), we observed 159 events of relapse or death. The median RFS was 170 months. The median overall survival (OS) was 192 months. At univariate analysis, older age, negative hormonal receptors, larger tumor size and higher proliferation index (Ki67) were associated with worse recurrence-free survival (RFS) and OS (P < .05); higher grading was associated with worse RFS (P = .01). At multivariate analysis for RFS, age, Ki67 and tumor size confirmed their independent prognostic role. At multivariate analysis for OS, age and positive hormonal receptors showed an independent prognostic role. We observed no differences in prognosis between human epidermal growth factor receptor 2 (HER2) positive and triple-negative (TN) BC, but TNBC showed a worse OS compared with luminal-like BC. CONCLUSIONS In node-negative BC, age, hormone receptor status, tumor size and Ki67 were prognostic factors. The TNBC subtype was not associated with poorer prognosis compared with the HER2-positive subtype, but showed a worse OS compared with luminal-like BC.
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Affiliation(s)
- Elisa Agostinetto
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Laura Giordano
- Biostatistic Unit, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Rosalba Torrisi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Rita De Sanctis
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, Rozzano (Milan), Italy
| | - Giovanna Masci
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Agnese Losurdo
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Monica Zuradelli
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Corrado Tinterri
- Breast Unit, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | | | - Alberto Testori
- General and Thoracic Surgery, Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Marco Alloisio
- General and Thoracic Surgery, Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Fiorenza De Rose
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Bethania Fernandes
- Department of Pathology, Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Armando Santoro
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, Rozzano (Milan), Italy.
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Losurdo A, Scirgolea C, Mazza E, Errico V, Fernandes B, Tommaso LD, Sagona A, Pilipow K, Torrisi R, Masci G, De Sanctis R, Agostinetto E, Testori A, Tinterri C, Roncalli M, Santoro A, Lugli E. Abstract P5-04-07: Defining T cell dysfunctionality in breast cancer by single cell analysis: Implications for immunotherapy. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-04-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Despite the well-known association between extensive lymphocytic infiltration in breast cancer (BC), good prognosis, and high response rates to neoadjuvant chemotherapy (CT), pathologic evaluation of tumor infiltrating lymphocytes (TILs) is currently not routine and a deep understanding of the properties of TILs, remain largely unfilled. So far, only in triple-negative (TN), PD-L1 positive BCs it has been possible to demonstrate a survival benefit with immunotherapy plus CT, thereby making the definition of possible immunotherapeutic targets across all biological subtypes a fundamental requirement. Material and methods Single-cell RNA-sequencing (scRNAseq) data from 8 BCs were downloaded from Gene Expression Omnibus dataset (GSE114725), obtaining CD45+ single cells only from the tumoral compartment. scRNAseq-guided high-dimensional profiling by 27-parameter FACS was then applied to a large cohort (n=54, including luminal-like, TN and HER2+ BCs) of early BC patients surgically treated at our Institution. We simultaneously profiled the peripheral blood, the normal and tumoral tissue from each patient and acquired using FACS Symphony A5 flow cytometer (BD Biosciences). Flow Cytometry Standard (FCS) 3.0 files were imported into FlowJo software v9, and analyzed by standard gating to remove aggregates and dead cells, and subsequently imported in FlowJo v10, biexponentially transformed, and exported for further analysis in R by a custom-made script, using an ad-hoc pipeline. Data were analyzed using the Phenograph unbiased algorithm coded in the cytofkit package. Data were further analyzed in FlowJo to determine the frequency of positive cells for each marker and the corresponding median fluorescence intensity (MFI). These values were multiplied to derive the integrated MFI; hierarchical metaclustering of all samples, based on the frequency of Phenograph clusters, was performed in R based on the Euclidean distance and Ward-linkage. Pearson correlation analysis was used to investigate the relationship between CD8+ and CD4+ clusters. Results Our scRNA-guided informative 27-colors flow cytometry panel included antibodies to define not only different lymphocyte subpopulations, but also different stages of T lymphocytes: differentiation and memory maturation (CCR7, CD45RA), activation status (HLA-DR), cytotoxicity (GZMK, GZMB), exhaustion (PD-1, TIGIT) and tissue residency (CD69, CD103). Focusing on CD8+ T cells, we observed, as expected, bona fide naïve T cells to be virtually absent at the tumor site and enriched in peripheral blood, while cytotoxic and effector memory cells were enriched in the tumor compartment. Of note, we identified a population of tissue resident memory T cells (Trm) CD69+ CD103+, CD39+, specifically enriched in the tumor, that could be further subdivided into a HLA-DR+ CD127- and a HLA-DR- CD127+ subpopulation. Interestingly, the HLA-DR+ subset exhibited more exhaustion markers (PD-1hi, TIGIT+, NKG2A+) and was significantly positively correlated with CD4+ regulatory T cells. We speculated, and deeply investigated by bulk RNA-seq, that these two subsets of Trm might represent different maturation states and that they could be reinvigorated targeting highly expressed inhibitory molecules using approved (e.g., PD-1) together with newly identified (e.g., NKG2A) immunotherapeutics. Moreover, as no difference was observed in the relative distribution of Phenograph clusters, our data may be applied to revert acquired immune escape mechanisms in all different BC biological subtypes. Conclusions We identified, among Trm CD69+ CD103+, tumor-specific CD39+, PD1+ exhausted population, novel dysfunctional NKG2A+ T cells previously not characterized in BC. This population is of extreme interest to characterize a novel potential immunotherapeutic target.
Citation Format: Agnese Losurdo, Caterina Scirgolea, Emilia Mazza, Valentina Errico, Bethania Fernandes, Luca Di Tommaso, Andrea Sagona, Karolina Pilipow, Rosalba Torrisi, Giovanna Masci, Rita De Sanctis, Elisa Agostinetto, Alberto Testori, Corrado Tinterri, Massimo Roncalli, Armando Santoro, Enrico Lugli. Defining T cell dysfunctionality in breast cancer by single cell analysis: Implications for immunotherapy [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-04-07.
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Affiliation(s)
- Agnese Losurdo
- 1Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Caterina Scirgolea
- 2Laboratory of Translational Immunology, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Emilia Mazza
- 2Laboratory of Translational Immunology, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Valentina Errico
- 3Breast Surgery Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Bethania Fernandes
- 4Department of Pathology, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Luca Di Tommaso
- 4Department of Pathology, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Andrea Sagona
- 3Breast Surgery Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Karolina Pilipow
- 2Laboratory of Translational Immunology, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Rosalba Torrisi
- 1Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Giovanna Masci
- 1Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Rita De Sanctis
- 1Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Elisa Agostinetto
- 1Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Alberto Testori
- 3Breast Surgery Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Corrado Tinterri
- 3Breast Surgery Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Massimo Roncalli
- 4Department of Pathology, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Armando Santoro
- 1Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Enrico Lugli
- 2Laboratory of Translational Immunology, Humanitas Cancer Center, Humanitas Research Hospital, Rozzano (MI), Italy
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Guedes TP, Fernandes B, Pedroto I. Hepatobiliary and Pancreatic: Symptomatic hepatic splenosis. J Gastroenterol Hepatol 2019; 34:2061. [PMID: 31317571 DOI: 10.1111/jgh.14743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/26/2019] [Indexed: 12/14/2022]
Affiliation(s)
- T P Guedes
- Gastroenterology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - B Fernandes
- Pathology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - I Pedroto
- Gastroenterology Department, Centro Hospitalar do Porto, Porto, Portugal
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Gil F, Elvas L, Raposo S, Carvalho T, Gil J, Cardoso JC, Fernandes B. Keratoacanthoma-like nodules as first manifestation of metastatic epithelioid trophoblastic tumor. Dermatol Online J 2019; 25:13030/qt9xx6p2tt. [PMID: 31735008] [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] [Received: 11/08/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023] Open
Abstract
Cutaneous metastases are rarely the initial manifestation of a previously undiagnosed malignancy and keratoacanthoma-like lesions are a notoriously unusual presentation pattern of cutaneous dissemination of a primary tumor. Herein, we report a 40-year-old woman presenting to our dermatology department with multiple keratoacanthoma-like scalp nodules. Subsequent investigation determined it to be the first manifestation of a disseminated endometrial epithelioid trophoblastic tumor, eventually causing the patient's death. Epithelioid trophoblastic tumor, a rare form of gestational trophoblastic disease, is a recently described neoplasm whose cutaneous metastasis has not been previously reported in the literature.
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Affiliation(s)
- F Gil
- Department of Dermatology, Hospital de Santarém EPE, Santarém.
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Chrysanthaki T, Fernandes B, Smith S, Black N. Can Memory Assessment Services (MAS) in England be categorized? A national survey. J Public Health (Oxf) 2019; 39:828-840. [PMID: 28334926 DOI: 10.1093/pubmed/fdx018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 02/01/2017] [Indexed: 11/13/2022] Open
Abstract
Background The effectiveness and efficiency of memory assessment services (MASs) is unknown. Our aim was to determine if a typology can be constructed, based on shared structural and process characteristics, as a basis for a non-randomized evaluation of their effectiveness and cost-effectiveness. Methods Survey of random sample of 73 MASs in 2015; comparison of characteristics and investigation of inter-correlation. Results It was not possible to group characteristics to form the basis of a typology of MASs. However, there was considerable variation in staff numbers (20-fold), new patients per whole-time equivalent (WTE) staff (20-fold), skill mix and the nurse:doctor ratio (1-10). The operational performance also varied: first appointments (50-120 minutes); time for first follow-up (2-12 weeks); frequency of follow-up in first year (1-5). These differences were not associated with the number of new patients per WTE staff or the accreditation status of the MAS. Post diagnosis, all MASs provided pharmacological treatment but the availability of non-pharmacological support varied, with half providing none or only one intervention while others providing four or more. Conclusions In the absence of any clear typology, evaluation of MASs will need to focus on the impact of individual structural and process characteristics on outcomes.
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Affiliation(s)
- T Chrysanthaki
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - B Fernandes
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - S Smith
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - N Black
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
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Sciortino T, Fernandes B, Conti Nibali M, Gay LG, Rossi M, Lopci E, Colombo AE, Elefante MG, Pessina F, Bello L, Riva M. Frameless stereotactic biopsy for precision neurosurgery: diagnostic value, safety, and accuracy. Acta Neurochir (Wien) 2019; 161:967-974. [PMID: 30895395 DOI: 10.1007/s00701-019-03873-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 03/06/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Stereotactic biopsy is consistently employed to characterize cerebral lesions in patients who are not suitable for microsurgical resection. In the past years, technical improvement and neuroimaging advancements contributed to increase the diagnostic yield, the safety, and the application of this procedure. Currently, in addition to histological diagnosis, the molecular analysis is considered essential in the diagnostic process to properly select therapeutic and prognostic algorithms in a personalized approach. The present study reports our experience with frameless stereotactic brain biopsy in this molecular era. METHODS One hundred forty consecutive patients treated from January 2013 to September 2018 were analyzed. Biopsies were performed using the Brainlab Varioguide® frameless stereotactic system. Patients' clinical and demographic data, the time of occupation of the operating room, the surgical time, the morbidity, and the diagnostic yield in providing a histological and molecular diagnosis were recorded and evaluated. RESULTS The overall diagnostic yield was 93.6% with nine procedures resulting non-diagnostic. Among 110 patients with glioma, the IDH-1 mutational status was characterized in 108 cases (98.2%), resulting wild-type in all subjects but 3; MGMT methylation was characterized in 96 cases (87.3%), resulting present in 60 patients, and 1p/19q codeletion was founded in 6 of the 20 cases of grade II-III gliomas analyzed. All the specimens were apt for molecular analysis when performed. Bleeding requiring surgical drainage occurred in 2.1% of the cases; 8 (5.7%) asymptomatic hemorrhages requiring no treatment were observed. No biopsy-related mortality was recorded. Median length of hospital stay was 5 days (IQR 4-8) with mean surgical time of 60.77 min (± 23.12) and 137.44 ± 24.1 min of total occupation time of the operative room. CONCLUSIONS Stereotactic frameless biopsy is a safe, feasible, and fast procedure to obtain a histological and molecular diagnosis.
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Affiliation(s)
- Tommaso Sciortino
- Università degli Studi di Milano, Milan, Italy
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Bethania Fernandes
- Unit of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Marco Conti Nibali
- Università degli Studi di Milano, Milan, Italy
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Lorenzo G Gay
- Università degli Studi di Milano, Milan, Italy
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Marco Rossi
- Università degli Studi di Milano, Milan, Italy
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Egesta Lopci
- Unit of Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Anna E Colombo
- Unit of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Maria G Elefante
- Unit of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
| | - Federico Pessina
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Rozzano (MI), Italy
| | - Lorenzo Bello
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Marco Riva
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano (MI), Italy.
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy.
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Riva M, Lopci E, Castellano A, Olivari L, Gallucci M, Pessina F, Fernandes B, Simonelli M, Navarria P, Grimaldi M, Rudà R, Castello A, Rossi M, Alfiero T, Soffietti R, Chiti A, Bello L. Lower Grade Gliomas: Relationships Between Metabolic and Structural Imaging with Grading and Molecular Factors. World Neurosurg 2019; 126:e270-e280. [PMID: 30797926 DOI: 10.1016/j.wneu.2019.02.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Positron emission tomography (PET) is a valuable tool for the characterization of brain tumors in vivo. However, few studies have investigated the correlation between carbon-11-methionine (11C-METH) PET metrics and the clinical, radiological, histological, and molecular features of patients affected by lower grade gliomas (LGGs). The present observational study evaluated the relationships between 11C-METH PET metrics and structural magnetic resonance imaging (MRI) findings with the histomolecular biomarkers in patients with LGGs who were candidates for surgery. METHODS We enrolled 96 patients with pathologically proven LGG (51 men, 45 women; age 44.1 ± 13.7 years; 45 with grade II, 51 with grade III), who had been referred from March 2012 to January 2015 for tumor resection and had undergone preoperative 11C-METH PET. The semiquantitative metrics for 11C-METH PET included maximum standardized uptake value (SUVmax), SUV ratio to normal brain, and metabolic tumor burden (MTB). The PET semiquantitative metrics were analyzed and compared with the MRI features, histological diagnosis, isocitrate dehydrogenase-1/2 status, and 1p/19q codeletion. RESULTS Histological grade was associated with SUVmax (P = 0.002), SUV ratio (P = 0.011), and MTB (P = 0.001), with grade III lesions showing higher values. Among the nonenhancing lesions on MRI, SUVmax (P = 0.001), SUV ratio (P = 0.003) and MTB (P < 0.001) were significantly different statistically for grade II versus grade III. The MRI lesion volume correlated poorly with MTB (r2 = 0.13). The SUVmax and SUV ratio were greater (P < 0.05) in isocitrate dehydrogenase-1/2 wild-type lesions, and the SUV ratio was associated with the presence of the 1p19q codeletion. CONCLUSIONS The 11C-METH PET metrics correlated significantly with histological grade and the molecular profile. Semiquantitative PET metrics can improve the preoperative evaluation of LGGs and thus support clinical decision-making.
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Affiliation(s)
- Marco Riva
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy; Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.
| | - Egesta Lopci
- Unit of Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Antonella Castellano
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Olivari
- Unit of Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | | | - Federico Pessina
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Bethania Fernandes
- Unit of Pathology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Matteo Simonelli
- Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Pierina Navarria
- Unit of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Marco Grimaldi
- Unit of Neuroradiology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Roberta Rudà
- Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | - Angelo Castello
- Unit of Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Marco Rossi
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Tommaso Alfiero
- Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Riccardo Soffietti
- Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | - Arturo Chiti
- Unit of Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Unit of Nuclear Medicine, Humanitas Clinical and Research Center -IRCCS, Rozzano, Milan, Italy
| | - Lorenzo Bello
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy; Unit of Oncological Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
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Gil F, Elvas L, Raposo S, Carvalho T, Gil J, Cardoso JC, Fernandes B. Keratoacanthoma-like nodules as first manifestation of metastatic epithelioid trophoblastic tumor. Dermatol Online J 2019. [DOI: 10.5070/d32510045819] [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: 11/08/2022] Open
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Figini M, Riva M, Graham M, Castelli GM, Fernandes B, Grimaldi M, Baselli G, Pessina F, Bello L, Zhang H, Bizzi A. Prediction of Isocitrate Dehydrogenase Genotype in Brain Gliomas with MRI: Single-Shell versus Multishell Diffusion Models. Radiology 2018; 289:788-796. [PMID: 30277427 DOI: 10.1148/radiol.2018180054] [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] [Indexed: 01/05/2023]
Abstract
Purpose The primary aim of this prospective observational study was to assess whether diffusion MRI metrics correlate with isocitrate dehydrogenase (IDH) status in grade II and III gliomas. A secondary aim was to investigate whether multishell acquisitions with advanced models such as neurite orientation dispersion and density imaging (NODDI) and diffusion kurtosis imaging offer greater diagnostic accuracy than diffusion-tensor imaging (DTI). Materials and Methods Diffusion MRI (b = 700 and 2000 sec/mm2) was performed preoperatively in 192 consecutive participants (113 male and 79 female participants; mean age, 46.18 years; age range, 14-77 years) with grade II (n = 62), grade III (n = 58), or grade IV (n = 72) gliomas. DTI, diffusion kurtosis imaging, and NODDI metrics were measured in regions with or without hyperintensity on diffusion MR images and compared among groups defined according to IDH genotype, 1p/19q codeletion status, and tumor grade by using Mann-Whitney tests. Results In grade II and III IDH wild-type gliomas, the maximum fractional anisotropy, kurtosis anisotropy, and restriction fraction were significantly higher and the minimum mean diffusivity was significantly lower than in IDH-mutant gliomas (P = .011, P = .002, P = .044, and P = .027, respectively); areas under the receiver operating characteristic curve ranged from 0.72 to 0.76. In IDH wild-type gliomas, no difference among grades II, III, and IV was found. In IDH-mutant gliomas, no difference between those with and those without 1p/19q loss was found. Conclusion Diffusion MRI metrics showed correlation with isocitrate dehydrogenase status in grade II and III gliomas. Advanced diffusion MRI models did not add diagnostic accuracy, supporting the inclusion of a single-shell diffusion-tensor imaging acquisition in brain tumor imaging protocols. Published under a CC BY 4.0 license. Online supplemental material is available for this article.
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Affiliation(s)
- Matteo Figini
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Marco Riva
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Mark Graham
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Gian Marco Castelli
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Bethania Fernandes
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Marco Grimaldi
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Giuseppe Baselli
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Federico Pessina
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Lorenzo Bello
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Hui Zhang
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
| | - Alberto Bizzi
- From the Departments of Scientific Direction (M.F.) and Neuroradiology (G.M.C., A.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy; Department of Medical Biotechnology and Translational Medicine (M.R.) and Department of Oncology and Hemato-Oncology (L.B.), Università degli Studi di Milano, Milan, Italy; Unit of Surgical Neuro-Oncology (M.R., F.P., L.B.), Department of Pathology (B.F.), and Department of Radiology (M. Grimaldi), Humanitas Research Hospital, Milan, Italy; Centre for Medical Image Computing & Department of Computer Science, University College London, London, England (M. Graham, H.Z.); and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (G.B.)
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Losurdo A, De Sanctis R, Fernandes B, Errico V, Sagona A, Masci G, Zuradelli M, Agostinetto E, Torrisi R, Gatzemeier W, Testori A, Roncalli M, Alloisio M, Tinterri C, Santoro A. TNBC universe: A monocentric retrospective analyses of TILs and AR as prognostic markers. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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41
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De Rose F, Fogliata A, Franceschini D, Iftode C, Navarria P, Comito T, Franzese C, Fernandes B, Masci G, Torrisi R, Tinterri C, Testori A, Santoro A, Scorsetti M. Hypofractionation with simultaneous boost in breast cancer patients receiving adjuvant chemotherapy: A prospective evaluation of a case series and review of the literature. Breast 2018; 42:31-37. [PMID: 30149235 DOI: 10.1016/j.breast.2018.08.098] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/16/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION To evaluate acute toxicity and cosmetic outcomes of hypofractionated simultaneous integrated boost (SIB) as adjuvant treatment after breast-conserving surgery and adjuvant chemotherapy and to review the association of chemotherapy and short fractionation with boost. MATERIALS AND METHODS Patients presenting early-stage breast cancer were enrolled in a phase II trial. All patients received VMAT-SIB technique to the whole breast and tumor bed in 15 fractions, for a total dose of 40.5 and 48 Gy. Acute and late skin toxicities and breast pain were recorded. Cosmetic outcomes were also assessed as excellent/good or fair/poor. RESULTS Between August 2010 and December 2015, 787 consecutive patients were treated and had at least 2 year follow-up. A subset of 175 patients underwent adjuvant chemotherapy (median age of 55 years) and was analysed. The median follow up was 39 months (range 24-80). At the end of RT treatment, skin toxicity was G1 in 51.1% of patients, G2 in 9.7%. At 2 years of follow up, it was G1 in 13.5% of patients, no cases ≥ G2; cosmetic outcome was excellent in 63.5% and good in 36.5% of the patients. No significant difference compared to the patients without systemic therapy was observed. CONCLUSION Hypofractionated VMAT-SIB in patients who had undergone adjuvant systemic therapy was safe and well tolerated in terms of acute and early late settings and cosmesis. Our data confirmed the results of other studies published on the association of hypofractionation and chemotherapy or concomitant boost.
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Affiliation(s)
- Fiorenza De Rose
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy
| | - Antonella Fogliata
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy.
| | - Davide Franceschini
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy
| | - Cristina Iftode
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy
| | - Pierina Navarria
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy
| | - Tiziana Comito
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy
| | - Ciro Franzese
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy
| | - Bethania Fernandes
- Humanitas Research Hospital and Cancer Center, Pathology Dept, Milan, Rozzano, Italy
| | - Giovanna Masci
- Humanitas Research Hospital and Cancer Center, Medical Oncology Dept, Milan, Rozzano, Italy
| | - Rosalba Torrisi
- Humanitas Research Hospital and Cancer Center, Medical Oncology Dept, Milan, Rozzano, Italy
| | - Corrado Tinterri
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Alberto Testori
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Armando Santoro
- Humanitas Research Hospital and Cancer Center, Medical Oncology Dept, Milan, Rozzano, Italy
| | - Marta Scorsetti
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy; Humanitas University, Biomedical Science Faculty, Milan, Rozzano, Italy
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Cannizzaro D, Mancarella C, Milani D, Fernandes B, Rossi M, Fornari M, Cardia A. Intraventricular liponeurocytoma: The role of surgery and adjuvant therapy. Interdisciplinary Neurosurgery 2018. [DOI: 10.1016/j.inat.2017.11.001] [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: 10/18/2022] Open
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43
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Losurdo A, De Sanctis R, Fernandes B, Errico V, Sagona A, Masci G, Zuradelli M, Agostinetto E, Torrisi R, Gatzemeier W, Testori A, Roncalli M, Alloisio M, Tinterri C, Santoro A. A monocentric retrospective analysis of TILs and AR as hints for prognosis definition in TNBC. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e12580] [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)
- Agnese Losurdo
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Rozzano (Milano), Italy
| | - Rita De Sanctis
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Rozzano (Milano), Italy
| | - Bethania Fernandes
- Department of Pathology, Humanitas Cancer Center, Rozzano (Milano), Italy
| | | | - Andrea Sagona
- Breast Center, Humanitas Cancer Center, Rozzano (Milano), Italy
| | - Giovanna Masci
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Rozzano (Milano), Italy
| | - Monica Zuradelli
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Rozzano (Milano), Italy
| | - Elisa Agostinetto
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Rozzano (Milano), Italy
| | - Rosalba Torrisi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Rozzano (Milano), Italy
| | | | - Alberto Testori
- Breast Center, Humanitas Cancer Center, Rozzano (Milano), Italy
| | - Massimo Roncalli
- Department of Pathology, Humanitas Cancer Center, Rozzano (Milano), Italy
| | - Marco Alloisio
- Thoracic Surgery Department, Humanitas Cancer Center, Rozzano (Milano), Italy
| | | | - Armando Santoro
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Rozzano (Milano), Italy
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De Rose F, Fogliata A, Franceschini D, Iftode C, Torrisi R, Masci G, Sagona A, Tinterri C, Testori A, Gatzemeier W, Fernandes B, Rahal D, Cozzi L, Santoro A, Scorsetti M. Hypofractionated volumetric modulated arc therapy in ductal carcinoma in situ: toxicity and cosmetic outcome from a prospective series. Br J Radiol 2018; 91:20170634. [PMID: 29322827 DOI: 10.1259/bjr.20170634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Hypofractionated radiotherapy in early stage breast cancer is an effective adjuvant treatment, but there is a lack of randomized data for patients with ductal carcinoma in situ (DCIS). The aim of this study is the evaluation of skin toxicity and cosmesis, and early clinical outcome of DCIS patients enrolled in an institutional Phase II trial of hypofractionated breast irradiation. METHODS 137 DCIS patients were enrolled in the trial. All patients underwent volumetric modulated arc therapy (VMAT) to the whole breast with a total dose of 40.5 Gy in 15 fractions over 3 weeks, without tumour bed boost. Acute and late skin toxicities were recorded. Cosmetic outcomes were assessed as excellent/good or fair/poor. Early clinical outcome was reported. RESULTS Median age was 58 y.o. (range 30-86). The median follow-up time was 22 months (range 6-45). At the end of the radiotherapy, skin toxicity was grade G1 in 56% of the patients, G2 in 15%, no patients presented G3 toxicity. In the range of 3-9 months of follow-up, the skin toxicity was G1 in 28% of patients, no G2-G3 cases; cosmetic outcome was good/excellent in 95% of patients. In the follow-up interval of 9-24 months, the skin toxicity was G1 in 12% of patients, no G2-G3 toxicity; cosmetic outcome was good/excellent in 96% of patients. After an early evaluation of clinical outcomes, 5 patients (3.6%) presented an in-breast recurrence. CONCLUSION Hypofractionated radiotherapy using VMAT is a viable option for DCIS. A longer follow-up is needed to assess clinical outcomes and late toxicity. Advances in knowledge: The use of hypofractionated VMAT is dosimetrically feasible for treating breast DCIS.
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Affiliation(s)
- Fiorenza De Rose
- 1 Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Antonella Fogliata
- 1 Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Davide Franceschini
- 1 Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Cristina Iftode
- 1 Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Rosalba Torrisi
- 2 Department of Medical Oncology, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Giovanna Masci
- 2 Department of Medical Oncology, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Andrea Sagona
- 3 Department of Breast Surgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Corrado Tinterri
- 3 Department of Breast Surgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Alberto Testori
- 3 Department of Breast Surgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Wolfgang Gatzemeier
- 3 Department of Breast Surgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Bethania Fernandes
- 4 Department of Pathology, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Daoud Rahal
- 4 Department of Pathology, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Luca Cozzi
- 1 Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy.,5 Department of Biomedical Sciences, Humanitas University , Milan, Rozzano , Italy
| | - Armando Santoro
- 2 Department of Medical Oncology, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy
| | - Marta Scorsetti
- 1 Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital and Cancer Center , Milan, Rozzano , Italy.,5 Department of Biomedical Sciences, Humanitas University , Milan, Rozzano , Italy
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Lopci E, Riva M, Olivari L, Raneri F, Soffietti R, Piccardo A, Bizzi A, Navarria P, Ascolese AM, Rudà R, Fernandes B, Pessina F, Grimaldi M, Simonelli M, Rossi M, Alfieri T, Zucali PA, Scorsetti M, Bello L, Chiti A. Prognostic value of molecular and imaging biomarkers in patients with supratentorial glioma. Eur J Nucl Med Mol Imaging 2017; 44:1155-1164. [PMID: 28110346 DOI: 10.1007/s00259-017-3618-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/03/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE We evaluated the relationship between 11C-methionine PET (11C-METH PET) findings and molecular biomarkers in patients with supratentorial glioma who underwent surgery. METHODS A consecutive series of 109 patients with pathologically proven glioma (64 men, 45 women; median age 43 years) referred to our Institution from March 2012 to January 2015 for tumour resection and who underwent preoperative 11C-METH PET were analysed. Semiquantitative evaluation of the 11C-METH PET images included SUVmax, region of interest-to-normal brain SUV ratio (SUVratio) and metabolic tumour volume (MTV). Imaging findings were correlated with disease outcome in terms of progression-free survival (PFS), and compared with other clinical biological data, including IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation. The patients were monitored for a mean period of 16.7 months (median 13 months). RESULTS In all patients, the tumour was identified on 11C-METH PET. Significant differences in SUVmax, SUVratio and MTV were observed in relation to tumour grade (p < 0.001). IDH1 mutation was found in 49 patients, 1p/19q codeletion in 58 patients and MGMT promoter methylation in 74 patients. SUVmax and SUVratio were significantly inversely correlated with the presence of IDH1 mutation (p < 0.001). Using the 2016 WHO classification, SUVmax and SUVratio were significantly higher in patients with primary glioblastoma (IDH1-negative) than in those with other diffuse gliomas (p < 0.001). Relapse or progression was documented in 48 patients (median PFS 8.7 months). Cox regression analysis showed that SUVmax and SUVratio, tumour grade, tumour type on 2016 WHO classification, IDH1 mutation status, 1p/19q codeletion and MGMT promoter methylation were significantly associated with PFS. None of these factors was found to be an independent prognostic factor in multivariate analysis. CONCLUSION 11C-METH PET parameters are significantly correlated with histological grade and IDH1 mutation status in patients with glioma. Grade, pathological classification, molecular biomarkers, SUVmax and SUVratio were prognostic factors for PFS in this cohort of patients. The trial was registered with ClinicalTrials.gov (registration: NCT02518061).
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine, Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy.
| | - Marco Riva
- Neurosurgery, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | | | - Fabio Raneri
- Neurosurgery, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Riccardo Soffietti
- Neuro-Oncology, University & City of Health and Science Hospital, Turin, Italy
| | | | - Alberto Bizzi
- Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Pierina Navarria
- Radiosurgery and Radiotherapy, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Anna Maria Ascolese
- Radiosurgery and Radiotherapy, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Roberta Rudà
- Neuro-Oncology, University & City of Health and Science Hospital, Turin, Italy
| | - Bethania Fernandes
- Pathology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Federico Pessina
- Neurosurgery, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Marco Grimaldi
- Medical Oncology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Matteo Simonelli
- Radiology Department, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Marco Rossi
- Università degli Studi di Milano, Milan, Italy
| | | | - Paolo Andrea Zucali
- Radiology Department, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Marta Scorsetti
- Pathology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
- Humanitas University, Rozzano, Milan, Italy
| | - Lorenzo Bello
- Neurosurgery, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
- Università degli Studi di Milano, Milan, Italy
| | - Arturo Chiti
- Nuclear Medicine, Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy
- Humanitas University, Rozzano, Milan, Italy
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Rossi M, Conti Nibali M, Riva M, Fernandes B, Pessina F, Soffietti R, Navarria P, Bikfalvi A, Bello L. P09.08 Clinical validation of integrated diagnosis in low-grade glioma (LGG). Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.217] [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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Lopci E, Riva M, Olivari L, Raneri F, Fernandes B, Pessina F, Roncalli M, Bello L, Chiti A. P07.14 Correlation of molecular and imaging biomarkers in primary brain tumours. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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48
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Riva M, Rodriguez Y Baena R, Pessina F, Lopci E, Fernandes B, Galli C, Rossi M, Bello L. The diffusion-weighted imaging and 11-C-methionine positron emission tomography depiction of an endodermal cyst at the cervico-medullary junction. Br J Neurosurg 2015; 29:739-41. [PMID: 25812023 DOI: 10.3109/02688697.2015.1023780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A case of a 52-year-old male with left-sided neck pain, vertigo and gait instability is reported. A MRI scan revealed an intra-dural mass at the cervico-medullary junction, further characterised by diffusion-weighted imaging and 11-C-methionine positron emission tomography. Pathological diagnosis was endodermal cyst. The clinico-surgical relevance of the imaging findings is discussed.
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Affiliation(s)
- Marco Riva
- a Università degli Studi di Milano , Rozzano , Italy
| | | | - Federico Pessina
- b Unit of Surgical Neuro-Oncology, Humanitas Research Hospital , Rozzano , Italy
| | - Egesta Lopci
- c Unit of Nuclear Medicine, Humanitas Research Hospital , Rozzano , Italy
| | - Bethania Fernandes
- d Unit of Pathological Anatomy, Humanitas Research Hospital , Rozzano , Italy
| | - Carlo Galli
- e Azienda Ospedaliera della Provincia di Lodi , Lodi , Italy
| | - Marco Rossi
- a Università degli Studi di Milano , Rozzano , Italy
| | - Lorenzo Bello
- b Unit of Surgical Neuro-Oncology, Humanitas Research Hospital , Rozzano , Italy.,f Department of Biomedical Technology and Translational Medicine , Università degli Studi di Milano , Milan , Italy
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Veerasingam S, Vethamony P, Mani Murali R, Fernandes B. Depositional record of trace metals and degree of contamination in core sediments from the Mandovi estuarine mangrove ecosystem, west coast of India. Mar Pollut Bull 2015; 91:362-367. [PMID: 25510546 DOI: 10.1016/j.marpolbul.2014.11.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 11/20/2014] [Accepted: 11/30/2014] [Indexed: 06/04/2023]
Abstract
The concentrations of seven trace metals (Fe, Mn, Cu, Cr, Co, Pb and Zn) in three sediment cores were analysed to assess the depositional trends of metals and their contamination level in the Mandovi estuary, west coast of India. All sediment cores showed enrichment of trace metals in the upper part of core sediments and decrease in concentration with depth, suggesting excess of anthropogenic loading (including mining activities) occurred during the recent past. Scanning electron microscope (SEM) images distinguished the shape, size and structure of particles derived from lithogenic and anthropogenic sources in core sediments. The geo-accumulation index (I(geo)) values indicate that Mandovi estuary is 'moderately polluted' with Pb, whereas 'unpolluted to moderately polluted' with Fe, Mn, Cu, Cr, Co and Zn. The comparative analysis of trace metals revealed that Fe and Mn were highly enriched in the Mandovi estuary compared to all other Indian estuaries.
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Affiliation(s)
- S Veerasingam
- CSIR - National Institute of Oceanography, Dona Paula, Goa 403 004, India
| | - P Vethamony
- CSIR - National Institute of Oceanography, Dona Paula, Goa 403 004, India.
| | - R Mani Murali
- CSIR - National Institute of Oceanography, Dona Paula, Goa 403 004, India
| | - B Fernandes
- CSIR - National Institute of Oceanography, Dona Paula, Goa 403 004, India
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Fernandes B, Silva R, Ribeiro A, Matamá T, Gomes AC, Cavaco-Paulo AM. Improved Poly (D,L-lactide) nanoparticles-based formulation for hair follicle targeting. Int J Cosmet Sci 2015; 37:282-90. [DOI: 10.1111/ics.12197] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/25/2014] [Indexed: 11/27/2022]
Affiliation(s)
- B. Fernandes
- Centre of Biological Engineering (CEB); University of Minho; Campus of Gualtar 4710-057 Braga Portugal
| | - R. Silva
- Centre of Biological Engineering (CEB); University of Minho; Campus of Gualtar 4710-057 Braga Portugal
| | - A. Ribeiro
- Centre of Biological Engineering (CEB); University of Minho; Campus of Gualtar 4710-057 Braga Portugal
- Centre of Molecular and Environmental Biology (CBMA); University of Minho; Campus of Gualtar 4710-057 Braga Portugal
| | - T. Matamá
- Centre of Biological Engineering (CEB); University of Minho; Campus of Gualtar 4710-057 Braga Portugal
- Centre of Molecular and Environmental Biology (CBMA); University of Minho; Campus of Gualtar 4710-057 Braga Portugal
| | - A. C. Gomes
- Centre of Molecular and Environmental Biology (CBMA); University of Minho; Campus of Gualtar 4710-057 Braga Portugal
| | - A. M. Cavaco-Paulo
- Centre of Biological Engineering (CEB); University of Minho; Campus of Gualtar 4710-057 Braga Portugal
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