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Roberto M, Barchiesi G, Resuli B, Verrico M, Speranza I, Cristofani L, Pediconi F, Tomao F, Botticelli A, Santini D. Sarcopenia in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:596. [PMID: 38339347 PMCID: PMC10854936 DOI: 10.3390/cancers16030596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: We estimated the prevalence and clinical outcomes of sarcopenia among breast cancer patients. (2) Methods: A systematic literature search was carried out for the period between July 2023 and October 2023. Studies with breast cancer patients evaluated for sarcopenia in relation to overall survival (OS), progression-free survival (PFS), relapse of disease (DFS), pathological complete response (pCR), or toxicity to chemotherapy were included. (3) Results: Out of 359 screened studies, 16 were eligible for meta-analysis, including 6130 patients, of whom 5284 with non-MBC. Sarcopenia was evaluated with the computed tomography (CT) scan skeletal muscle index and, in two studies, with the dual-energy x-ray absorptiometry (DEXA) appendicular lean mass index. Using different classifications and cut-off points, overall, there were 2007 sarcopenic patients (33%), of whom 1901 (95%) presented with non-MBC. Sarcopenia was associated with a 33% and 29% higher risk of mortality and progression/relapse of disease, respectively. Sarcopenic patients were more likely to develop grade 3-4 toxicity (OR 3.58, 95% CI 2.11-6.06, p < 0.0001). In the neoadjuvant setting, a higher rate of pCR was observed among sarcopenic patients (49%) (OR 2.74, 95% CI 0.92-8.22). (4) Conclusions: Our meta-analysis confirms the correlation between sarcopenia and negative outcomes, especially in terms of higher toxicity.
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Affiliation(s)
- Michela Roberto
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Giacomo Barchiesi
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Blerina Resuli
- Department of Medicine V, University Hospital Munich, Ziemssenstraße 5, 80336 Munich, Germany
| | - Monica Verrico
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Iolanda Speranza
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Leonardo Cristofani
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Federica Pediconi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy;
| | - Federica Tomao
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy;
| | - Andrea Botticelli
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Daniele Santini
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
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Tufman A, Schneiderbauer S, Walter J, Resuli B, Kauffmann-Guerrero D, Mümmler C, Mertsch P, Götschke J, Kovács J, Manapov F, Schneider C, Sellmer L, Arnold P, Heinemann V, Behr J, Nasseh D. Early mortality in German patients with lung cancer: risk factors associated with 30-and 60-day mortality. Clin Exp Med 2023; 23:5183-5190. [PMID: 37700112 PMCID: PMC10725334 DOI: 10.1007/s10238-023-01187-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023]
Abstract
Despite therapeutic advances, early mortality in lung cancer is still prevalent. In this study, we aimed to assess risk factors for 30- and 60-day mortality in German lung cancer patients. In this retrospective cross-sectional analysis, we used data of lung cancer patients treated at LMU Hospital Munich between 2015 and 2019. We categorized patients into 30-day mortality, 60 day-mortality, and longer survival. We used Student's t-test and ANOVA to compare means and Chi2-test to compare frequencies. We used logistic regression analysis to identify factors associated with a risk for early mortality. Of the 2454 lung cancer patients, 2.0% (n = 50) died within 30 and 1.7% (n = 41) within 30 to 60 days of diagnosis. Older age and advanced stage at diagnosis were significantly associated with early mortality in the univariate and the multivariate analysis. Patients in the 30-day mortality group significantly more often did not receive tumor-directed therapy. They were also more likely to die in an acute care setting compared to the 60-day mortality group. The group of patients who died unexpectedly (12.0%) was dominantly female, with a high proportion of patients with unintentional weight loss at the time of diagnosis. Our results suggest that in the treatment of patients with lung cancer there is a need for a greater focus on older patients. Moreover, physicians should pay special attention to females with recent weight loss and patients with a comorbidity of diabetes mellitus or renal impairment. Engaging a case manager focused on detecting patients with the above characteristics could help improve overall care.
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Affiliation(s)
- Amanda Tufman
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | | | - Julia Walter
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany.
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany.
| | - Blerina Resuli
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
| | - Diego Kauffmann-Guerrero
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Carlo Mümmler
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
| | - Pontus Mertsch
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Jeremias Götschke
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
| | - Julia Kovács
- Department of Thoracic Surgery Munich, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Farkhad Manapov
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Christian Schneider
- Department of Thoracic Surgery Munich, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Laura Sellmer
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Paola Arnold
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Volker Heinemann
- Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany
| | - Jürgen Behr
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Daniel Nasseh
- Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany
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3
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Walter J, Moeller C, Resuli B, Kauffmann-Guerrero D, Manapov F, Dinkel J, Neumann J, Kovacs J, Schneider C, Huber RM, Tufman A. Guideline adherence of tumor board recommendations in lung cancer and transfer into clinical practice. J Cancer Res Clin Oncol 2023; 149:11679-11688. [PMID: 37402967 PMCID: PMC10465379 DOI: 10.1007/s00432-023-05025-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/26/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE Evaluating patients and treatment decisions in a multidisciplinary tumor board has led to better quality of care and longer survival in cancer patients. The aim of this study was to evaluate tumor board recommendations for thoracic oncology patients regarding guideline adherence and transferal of recommendations into clinical practice. METHODS We evaluated tumor board recommendations of the thoracic oncology tumor board at Ludwig-Maximilians University (LMU) Hospital Munich between 2014 and 2016. We compared patient characteristics between guideline-adherent and non-guideline-adherent recommendations, as well as between transferred and non-transferred recommendations. We used multivariate logistic regression models to evaluate factors associated with guideline adherence. RESULTS Over 90% of recommendations by the tumor board were either adherent to the guidelines (75.5%) or over fulfilling guidelines (15.6%). Almost 90% of recommendations were transferred to clinical practice. If a recommendation was not according to the guidelines, the reason was mostly associated with the general condition (age, Charlson comorbidity index, ECOG) of the patient or due to the patients' request. Surprisingly, sex also had a significant influence on the guideline adherence of recommendations, with females being more likely to get recommendations not according to the guidelines. CONCLUSION In conclusion, the results of this study are promising, as the guideline adherence of recommendations as well as the transferal of recommendations into clinical practice were high. In the future, a special focus should be put on fragile patients as well as female patients.
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Affiliation(s)
- Julia Walter
- Department of Medicine V-Pneumology, University Hospital, Ludwig-Maximilians-University Hospital (LMU) Munich, Munich, Germany.
- German Center for Lung Research (DZL), Giessen, Germany.
| | - Caroline Moeller
- Department of Medicine V-Pneumology, University Hospital, Ludwig-Maximilians-University Hospital (LMU) Munich, Munich, Germany
| | - Blerina Resuli
- Department of Medicine V-Pneumology, University Hospital, Ludwig-Maximilians-University Hospital (LMU) Munich, Munich, Germany
| | - Diego Kauffmann-Guerrero
- Department of Medicine V-Pneumology, University Hospital, Ludwig-Maximilians-University Hospital (LMU) Munich, Munich, Germany
- German Center for Lung Research (DZL), Giessen, Germany
| | - Farkhad Manapov
- German Center for Lung Research (DZL), Giessen, Germany
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Julien Dinkel
- German Center for Lung Research (DZL), Giessen, Germany
- Department of Radiology, Asklepios Clinic Gauting, Gauting, Germany
| | - Jens Neumann
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Julia Kovacs
- German Center for Lung Research (DZL), Giessen, Germany
- Department of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Christian Schneider
- German Center for Lung Research (DZL), Giessen, Germany
- Department of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Rudolf M Huber
- Department of Medicine V-Pneumology, University Hospital, Ludwig-Maximilians-University Hospital (LMU) Munich, Munich, Germany
- German Center for Lung Research (DZL), Giessen, Germany
| | - Amanda Tufman
- Department of Medicine V-Pneumology, University Hospital, Ludwig-Maximilians-University Hospital (LMU) Munich, Munich, Germany
- German Center for Lung Research (DZL), Giessen, Germany
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4
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Orciuolo C, Cappuzzo F, Landi L, Resuli B, Carpano S, Vidiri A, Buglioni S, Mandoj C, Ciliberto G, Minuti G. Pretreated EGFRdel19/ BRAFV600E Lung Adenocarcinoma With Leptomeningeal Disease Achieving Long-Lasting Disease Control on Osimertinib, Dabrafenib, and Trametinib: A Case Report. JTO Clin Res Rep 2023; 4:100545. [PMID: 37533438 PMCID: PMC10392131 DOI: 10.1016/j.jtocrr.2023.100545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/14/2023] [Accepted: 06/24/2023] [Indexed: 08/04/2023] Open
Abstract
Oncogene-addicted NSCLC inevitably becomes resistant to targeted therapy by developing acquired resistance through on- or off-target mechanisms, potentially detectable by liquid biopsy. We present the first reported case of a patient with pretreated EGFRdel19/BRAFV600E lung adenocarcinoma and symptomatic leptomeningeal metastasis obtaining durable clinical benefit on osimertinib, dabrafenib, and trametinib treatment.
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Affiliation(s)
- Corrado Orciuolo
- Division of Medical Oncology 2, IRCCS National Cancer Institute Regina Elena, Rome, Italy
| | - Federico Cappuzzo
- Division of Medical Oncology 2, IRCCS National Cancer Institute Regina Elena, Rome, Italy
| | - Lorenza Landi
- Clinical Trials Center: Phase 1 and Precision Medicine, IRCCS National Cancer Institute Regina Elena, Rome, Italy
| | - Blerina Resuli
- Division of Medical Oncology 2, IRCCS National Cancer Institute Regina Elena, Rome, Italy
| | - Silvia Carpano
- Division of Medical Oncology 2, IRCCS National Cancer Institute Regina Elena, Rome, Italy
| | | | | | - Chiara Mandoj
- IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Gabriele Minuti
- Clinical Trials Center: Phase 1 and Precision Medicine, IRCCS National Cancer Institute Regina Elena, Rome, Italy
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5
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Negrao MV, Araujo HA, Lamberti G, Cooper AJ, Akhave NS, Zhou T, Delasos L, Hicks JK, Aldea M, Minuti G, Hines J, Aredo JV, Dennis MJ, Chakrabarti T, Scott SC, Bironzo P, Scheffler M, Christopoulos P, Stenzinger A, Riess JW, Kim SY, Goldberg SB, Li M, Wang Q, Qing Y, Ni Y, Do MT, Lee R, Ricciuti B, Alessi JV, Wang J, Resuli B, Landi L, Tseng SC, Nishino M, Digumarthy SR, Rinsurongkawong W, kawong VR, Vaporciyan AA, Blumenschein GR, Zhang J, Owen DH, Blakely CM, Mountzios G, Shu CA, Bestvina CM, Garassino MC, Marrone KA, Gray JE, Patel SP, Cummings AL, Wakelee HA, Wolf J, Scagliotti GV, Cappuzzo F, Barlesi F, Patil PD, Drusbosky L, Gibbons DL, Meric-Bernstam F, Lee JJ, Heymach JV, Hong DS, Heist RS, Awad MM, Skoulidis F. Comutations and KRASG12C Inhibitor Efficacy in Advanced NSCLC. Cancer Discov 2023; 13:1556-1571. [PMID: 37068173 PMCID: PMC11024958 DOI: 10.1158/2159-8290.cd-22-1420] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [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: 12/20/2022] [Revised: 03/08/2023] [Accepted: 03/29/2023] [Indexed: 04/19/2023]
Abstract
Molecular modifiers of KRASG12C inhibitor (KRASG12Ci) efficacy in advanced KRASG12C-mutant NSCLC are poorly defined. In a large unbiased clinicogenomic analysis of 424 patients with non-small cell lung cancer (NSCLC), we identified and validated coalterations in KEAP1, SMARCA4, and CDKN2A as major independent determinants of inferior clinical outcomes with KRASG12Ci monotherapy. Collectively, comutations in these three tumor suppressor genes segregated patients into distinct prognostic subgroups and captured ∼50% of those with early disease progression (progression-free survival ≤3 months) with KRASG12Ci. Pathway-level integration of less prevalent coalterations in functionally related genes nominated PI3K/AKT/MTOR pathway and additional baseline RAS gene alterations, including amplifications, as candidate drivers of inferior outcomes with KRASG12Ci, and revealed a possible association between defective DNA damage response/repair and improved KRASG12Ci efficacy. Our findings propose a framework for patient stratification and clinical outcome prediction in KRASG12C-mutant NSCLC that can inform rational selection and appropriate tailoring of emerging combination therapies. SIGNIFICANCE In this work, we identify co-occurring genomic alterations in KEAP1, SMARCA4, and CDKN2A as independent determinants of poor clinical outcomes with KRASG12Ci monotherapy in advanced NSCLC, and we propose a framework for patient stratification and treatment personalization based on the comutational status of individual tumors. See related commentary by Heng et al., p. 1513. This article is highlighted in the In This Issue feature, p. 1501.
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Affiliation(s)
- Marcelo V. Negrao
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Haniel A. Araujo
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Neal S. Akhave
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Teng Zhou
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Lukas Delasos
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - J. Kevin Hicks
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Mihaela Aldea
- Institut Gustave Roussy, Villejuif, France
- Paris-Saclay University, Paris, France
| | | | - Jacobi Hines
- University of Chicago Medical Center, Chicago, Illinois, USA
| | | | - Michael J. Dennis
- Moores Cancer Center, University of California San Diego, San Diego, California, USA
| | - Turja Chakrabarti
- Department of Medicine, Division of Hematology and Oncology, University of California San Francisco, San Francisco, California, USA
| | - Susan C. Scott
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Paolo Bironzo
- Department of Oncology, University of Turin, Turin, Italy
| | - Matthias Scheffler
- Department for Internal Medicine, Center for Integrated Oncology Köln-Bonn, University Hospital Cologne, Germany
| | - Petros Christopoulos
- Department of Thoracic Oncology, Thoraxklinik and National Center for Tumor Diseases at Heidelberg University Hospital
| | | | - Jonathan W. Riess
- University of California Davis Comprehensive Cancer Center, Sacramento, California, USA
| | - So Yeon Kim
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Mingjia Li
- Division of Medical Oncology, The Ohio State University - James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Qi Wang
- Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yun Qing
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ying Ni
- Center for Immunotherapy & Precision Immuno-Oncology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Minh Truong Do
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Richard Lee
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Joao Victor Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jing Wang
- Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Blerina Resuli
- Istituto Nazionale Tumori IRCCS “Regina Elena”, Rome, Italy
| | - Lorenza Landi
- Istituto Nazionale Tumori IRCCS “Regina Elena”, Rome, Italy
| | - Shu-Chi Tseng
- Department of Radiology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Mizuki Nishino
- Department of Radiology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Subba R. Digumarthy
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Waree Rinsurongkawong
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Vadeerat Rinsurong kawong
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Ara A. Vaporciyan
- Department Thoracic & Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - George R. Blumenschein
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Jianjun Zhang
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Dwight H. Owen
- Division of Medical Oncology, The Ohio State University - James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Collin M. Blakely
- Department of Medicine, Division of Hematology and Oncology, University of California San Francisco, San Francisco, California, USA
| | - Giannis Mountzios
- Fourth Department of Medical Oncology and Clinical Trials Unit, Henry Dunant Hospital Center, Greece
| | - Catherine A. Shu
- Department of Medicine, Columbia University, New York, New York, USA
| | | | | | - Kristen A. Marrone
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jhanelle E. Gray
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Sandip Pravin Patel
- Moores Cancer Center, University of California San Diego, San Diego, California, USA
| | - Amy L. Cummings
- University of California Los Angeles, Los Angeles, California, USA
| | | | - Juergen Wolf
- Department for Internal Medicine, Center for Integrated Oncology Köln-Bonn, University Hospital Cologne, Germany
| | | | | | - Fabrice Barlesi
- Institut Gustave Roussy, Villejuif, France
- Paris-Saclay University, Paris, France
| | | | | | - Don L. Gibbons
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J. Jack Lee
- Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - John V. Heymach
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - David S. Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Mark M. Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ferdinandos Skoulidis
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
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6
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Negrao MV, Araujo HA, Lamberti G, Cooper AJ, Zhou T, Akhave N, Delasos L, Hicks JK, Aldea M, Minuti G, Hines J, Aredo JV, Dennis MJ, Chakrabarti T, Scott S, Bironzo P, Scheffler M, Christopoulos P, Kim SY, Goldberg S, Ni Y, Resuli B, Landi L, Tseng SC, Nishino M, Owen D, Blakely C, Mountzios G, Shu CA, Bestvina C, Garassino M, Marrone K, Gray J, Patel SP, Cummings AL, Wakelee HA, Wolf J, Scagliotti GV, Cappuzzo F, Barlesi F, Patil P, Gibbons DL, Meric-Bernstam F, Lee JJ, Heymach JV, Hong DS, Heist RS, Awad MM, Skoulidis F. Abstract 3431: Molecular determinants of KRAS p.G12C inhibitor efficacy in advanced NSCLC. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3431] [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: 04/07/2023]
Abstract
Abstract
Background: Irreversible allosteric KRAS p.G12C inhibitors (KG12Ci) such as sotorasib and adagrasib have revolutionized the therapeutic landscape of advanced KG12C-mutant NSCLC, however individual responses are heterogeneous and curtailed by innate and adaptive/acquired resistance. Molecular determinants of KG12Ci efficacy in NSCLC are poorly defined. We dissected the impact of major KG12C co-mutations and explored the effects of less prevalent co-alterations on the clinical activity of KG12Ci in the largest treated cohort to date of patients (pts) with advanced NSCLC. Key findings were validated in preclinical KG12C NSCLC models.
Methods: Baseline clinico-genomic features and clinical outcome data from pts with stage IV KG12C NSCLC (ECOG PS 0-2) treated with single-agent KG12Ci were collected retrospectively from 20 centers in the US and Europe. The Kaplan-Meier method was used to estimate PFS and OS and differences were assessed with the log-rank test. Hazard ratios (HR) and their 95% CI were estimated using a Cox proportional hazards model stratified for clinical co-variates. The impact of selected co-alterations on sotorasib efficacy was assessed in syngeneic (C57BL/6) KG12C NSCLC models.
Results: 411 eligible pts were included in the study. Median age was 68 years, 77% of pts had received both platinum-based chemotherapy and PD-(L)1 inhibitors and 35% had brain metastases. 83% of pts received sotorasib. ORR with KG12Ci was 32.4% (95% CI, 27.9-37.1), PFS was 5.1m (95% CI, 4.5-5.6) and OS was 10.2m (95% CI, 8.4-12.1). Co-alterations in KEAP1, SMARCA4 and CDKN2A/B were each associated with significantly shorter PFS (KEAP1: 2.8m vs 5.5m, HR 2.50, P<0.001; SMARCA4: 1.7m vs 5.5m, HR 2.64, P=0.001; CDKN2A/B: 2.3m vs 5.3m, HR 2.57, P<0.001) and OS with KG12Ci even after adjustment for clinical covariates. STK11 co-mutations without concurrent KEAP1 alterations did not impact clinical outcomes with KG12Ci. In an exploratory analysis, co-mutations in DNA damage repair (DDR) genes and genes encoding components of the ATRX/DAXX/EZH2 pathway were associated with improved KG12Ci efficacy, whereas PI3K/AKT/MTOR/PTEN alterations and missense ROS1/ALK/BRAF/NTRK1-3 mutations resulted in inferior outcomes. The impact of SMARCA4 and DDR gene inactivation was validated in isogenic syngeneic KG12CNSCLC models; additional co-alterations are under evaluation. Integration of KEAP1/SMARCA4/CDKN2A/B co-mutations identified a subgroup (KSCMUT, 37.6% of all pts) with significantly shorter PFS (2.7m vs 6.2m, P<0.001) and OS (6.3m vs 14.6m, P<0.001) that accounted for 57.3% of pts with primary refractory (PFS≤3m) disease.
Conclusions: Co-mutations in KEAP1, SMARCA4 and CDKN2A/2B define subgroups of KG12C NSCLC pts with markedly distinct outcomes with KG12Ci monotherapy. Tailoring of KG12C inhibitor-anchored therapeutic strategies and patient stratification should take into account the co-mutation status of individual tumors.
Citation Format: Marcelo V. Negrao, Haniel A. Araujo, Giuseppe Lamberti, Alissa J. Cooper, Teng Zhou, Neal Akhave, Lukas Delasos, J Kevin Hicks, Mihaela Aldea, Gabriele Minuti, Jacobi Hines, Jacqueline V. Aredo, Michael J. Dennis, Turja Chakrabarti, Susan Scott, Paolo Bironzo, Matthias Scheffler, Petros Christopoulos, So Yeon Kim, Sarah Goldberg, Ying Ni, Blerina Resuli, Lorenza Landi, Shu-Chi Tseng, Mizuki Nishino, Dwight Owen, Collin Blakely, Giannis Mountzios, Catherine A. Shu, Christine Bestvina, Marina Garassino, Kristen Marrone, Jhanelle Gray, Sandip Pravin Patel, Amy L. Cummings, Heather A. Wakelee, Jurgen Wolf, Giorgio V. Scagliotti, Federico Cappuzzo, Fabrice Barlesi, Pradnya Patil, Don L. Gibbons, Funda Meric-Bernstam, J Jack Lee, John V. Heymach, David S. Hong, Rebecca S. Heist, Mark M. Awad, Ferdinandos Skoulidis. Molecular determinants of KRAS p.G12C inhibitor efficacy in advanced NSCLC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3431.
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Affiliation(s)
| | | | - Giuseppe Lamberti
- 2Lowe Center for Thoracic Oncology del Dana-Farber Cancer Institute - Harvard Medical School Cancer Center of Boston, Boston, MA
| | - Alissa J. Cooper
- 3Harvard Medical School - Massachusetts General Hospital, Boston, MA
| | - Teng Zhou
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | | | | | | | - Susan Scott
- 12Johns Hopkins University School of Medicine, Baltimore, MD
| | - Paolo Bironzo
- 13University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | | | | | | | | | - Ying Ni
- 4Cleveland Clinic Cancer Center, Cleveland, OH
| | | | - Lorenza Landi
- 7IRCCS Instituti Fisioterapici Ospitalieri, Rome, Italy
| | | | | | - Dwight Owen
- 19Ohio State University - Wexher Medical Center, Columbus, OH
| | - Collin Blakely
- 11University of California San Francisco, San Francisco, CA
| | | | | | | | | | - Kristen Marrone
- 22Johns Hopkins University School of Medicine - Bayview, Baltimore, MD
| | | | | | | | | | - Jurgen Wolf
- 14University Hospital of Cologne, Cologne, Germany
| | | | | | | | | | | | | | - J Jack Lee
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | | | - Rebecca S. Heist
- 3Harvard Medical School - Massachusetts General Hospital, Boston, MA
| | - Mark M. Awad
- 2Lowe Center for Thoracic Oncology del Dana-Farber Cancer Institute - Harvard Medical School Cancer Center of Boston, Boston, MA
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Orciuolo C, Sorrentino R, Colarusso C, Ceddia S, Minuti G, Conti L, Mandoj C, Carpano S, Canali L, Fucci C, Brandi M, Fusco F, Giammaruco M, Resuli B, Landi L, Cappuzzo F. PP01.54 ImmunoBlood: A Prospective Study Evaluating the Development of Anti-Checkpoint Inhibitor Antibodies in Patients with Advanced Non-Small Cell Lung Cancer Treated with Immunotherapy. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.080] [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: 01/30/2023]
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Landi L, Delmonte A, Bonetti A, Pasello G, Metro G, Mazzoni F, Borra G, Giannarelli D, Andrikou K, Mangiola D, Gori S, D'Andrea MR, Minuti G, Resuli B, Laudisi A, Vidiri A, Conti L, Cappuzzo F. Combi-TED: a new trial testing Tedopi ® with docetaxel or nivolumab in metastatic non-small-cell lung cancer progressing after first line. Future Oncol 2022; 18:4457-4464. [PMID: 36946237 DOI: 10.2217/fon-2022-0913] [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] [Indexed: 03/23/2023] Open
Abstract
Despite the positive results obtained by first-line chemoimmunotherapy in patients with metastatic non-small-cell lung cancer (NSCLC), only a few second-line options are available after disease progression. Combi-TED is a phase II international study that will assess the efficacy of Tedopi®, a cancer vaccine, combined with either docetaxel or nivolumab and compared with docetaxel monotherapy in patients with metastatic NSCLC after chemoimmunotherapy. The study, currently in the recruitment phase, will assess 1-year overall survival (primary end point), patient's progression-free survival and overall response rate, as well as the correlation of efficacy with several tumor or blood biomarkers. The results will hopefully provide more information on Tedopi combinational treatment compared with current standard of care in NSCLC patients who fail first-line chemoimmunotherapy. Clinical Trial Registration: NCT04884282 (ClinicalTrials.gov).
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Affiliation(s)
- Lorenza Landi
- Istituto Nazionale Tumori 'Regina Elena' - Via Elio Chianesi n. 53, Roma (RM), 00144, Italy
| | - Angelo Delmonte
- Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST) - Via Piero Maroncelli n. 40, Meldola (FC), 47014, Italy
| | - Andrea Bonetti
- Azienda ULSS 9 Scaligera - Ospedale Mater Salutis Legnago - Via Gianella n.1, Legnago (VR), 37045, Italy
| | - Giulia Pasello
- Department of Surgery, Oncology, & Gastroenterology, University of Padova - Via Giustiniani n. 2 - Padova (PD), 35124, Italy
- Istituto Oncologico Veneto, Via Gattamelata n. 64, Padova (PD), 35128, Italy
| | - Giulio Metro
- Ospedale Santa Maria della Misericordia - Azienda Ospedaliera di Perugia - Via Dottori n. 1, Perugia (PG), 06132, Italy
| | - Francesca Mazzoni
- Azienda Ospedaliero-Universitaria Careggi - Largo G.A. Brambilla n. 3, Firenze (FI), 50134, Italy
| | - Gloria Borra
- Azienda Ospedaliera Universitaria 'Maggiore della Carità' - C.so Mazzini n. 18, Novara (NO), 28100, Italy
| | - Diana Giannarelli
- Biostatistics, Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli, IRCCS - Largo Agostino Gemelli n. 8, Roma (RM) 00168, Italy
| | - Kalliopi Andrikou
- Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST) - Via Piero Maroncelli n. 40, Meldola (FC), 47014, Italy
| | - Daniela Mangiola
- Azienda ULSS 9 Scaligera - Ospedale Mater Salutis Legnago - Via Gianella n.1, Legnago (VR), 37045, Italy
| | - Stefania Gori
- IRCCS Ospedale Sacro Cuore Don Calabria - Via Don A. Sempreboni n. 5, Negrar di Valpolicella (VR), 37024, Italy
| | | | - Gabriele Minuti
- Istituto Nazionale Tumori 'Regina Elena' - Via Elio Chianesi n. 53, Roma (RM), 00144, Italy
| | - Blerina Resuli
- Istituto Nazionale Tumori 'Regina Elena' - Via Elio Chianesi n. 53, Roma (RM), 00144, Italy
| | - Anastasia Laudisi
- Istituto Nazionale Tumori 'Regina Elena' - Via Elio Chianesi n. 53, Roma (RM), 00144, Italy
| | - Antonello Vidiri
- Istituto Nazionale Tumori 'Regina Elena' - Via Elio Chianesi n. 53, Roma (RM), 00144, Italy
| | - Laura Conti
- Istituto Nazionale Tumori 'Regina Elena' - Via Elio Chianesi n. 53, Roma (RM), 00144, Italy
| | - Federico Cappuzzo
- Istituto Nazionale Tumori 'Regina Elena' - Via Elio Chianesi n. 53, Roma (RM), 00144, Italy
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Takanen S, Bangrazi C, Graziano V, Parisi A, Resuli B, Simione L, Caiazzo R, Raffetto N, Tombolini V. Number of mediastinal lymph nodes as a prognostic factor in PN2 non small cell lung cancer: a single centre experience and review of the literature. Asian Pac J Cancer Prev 2015; 15:7559-62. [PMID: 25292028 DOI: 10.7314/apjcp.2014.15.18.7559] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Currently the most important prognostic factor in lung cancer is the stage. In the current lung TNM classification system, N category is defined exclusively by anatomic nodal location though, in other type of tumours, number of lymph nodes is confirmed to be a fundamental prognostic factor. Therefore we evaluated the number of mediastinal lymph nodes as a prognostic factor in locally advanced NSCLC after multimodality treatment, observing a significant effect of the number of lymph nodes in terms of OS (p<0.01) and DFS (p<0.001): patients with a low number of positive mediastinal nodes have a better prognosis.
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Affiliation(s)
- Silvia Takanen
- Department of Radiation Oncology, Azienda Policlinico Umberto I, "Sapienza" University of Rome. Viale del Policlinico Italy E-mail :
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Cuko L, Bilaj F, Bega B, Barbullushi A, Resuli B. Eosinophilic ascites, as a rare presentation of eosinophilic gastroenteritis. Hippokratia 2014; 18:275-277. [PMID: 25694765 PMCID: PMC4309151] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Eosinophilic ascites is the most unusual presentation of eosinophilic gastroenteritis (EGE), caused by edema and eosinophilic inflammation of the small bowel wall's serosal layer. CASE REPORT We report the case of a 37-year-old woman, who presented with diffuse abdominal pain, nausea, abdominal distension, moderate ascites and diarrhea of two weeks duration. The rest of physical and clinical examination was unremarkable, and her past medical history was uneventful. Magnetic Resonance Imaging showed the presence of ascites and diffuse thickening of small bowel wall, but did not detect a primary malignancy in the abdominal cavity; and no signs of portal hypertension or liver damage. Laboratory test results revealed essential peripheral blood eosinophilia, elevated serum IgE and marked increase of eosinophils in the abdominal fluid. Treatment with corticosteroids normalized laboratory tests results, and the ascites resolved immediately. CONCLUSIONS EGE is a rare entity and it should be kept in mind in patients of unexplained ascites. The absence of primary malignancy on imaging, coupled with marked increase of fluid esinophilia and immediate response to treatment with steroids, confirm indirectly the diagnosis of EGE. Hippokratia 2014; 18 (3): 275-277.
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Affiliation(s)
- L Cuko
- Department of Gastro-Hepatology, Radiology, Laboratory, University Hospital Center "Mother Teresa", Tirana, Albania
| | - F Bilaj
- Department of Gastro-Hepatology, Radiology, Laboratory, University Hospital Center "Mother Teresa", Tirana, Albania
| | - B Bega
- Department of Gastro-Hepatology, Radiology, Laboratory, University Hospital Center "Mother Teresa", Tirana, Albania
| | - A Barbullushi
- Department of Gastro-Hepatology, Radiology, Laboratory, University Hospital Center "Mother Teresa", Tirana, Albania
| | - B Resuli
- Department of Gastro-Hepatology, Radiology, Laboratory, University Hospital Center "Mother Teresa", Tirana, Albania
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Kodhelaj K, Resuli B, Petrela E, Malaj V, Jaze H. Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in Albanian overweight children. Minerva Pediatr 2014; 66:23-30. [PMID: 24608579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Overweight and obesity has emerged as a significant global health problem in the pediatric population. Childhood non-alcoholic fatty liver disease (NAFLD) has become a common and important liver disease. Although mostly benign, some children with NAFLD develop fibrosis and in some case cirrhosis. The aims of this study were to determine the prevalence of NAFLD/non-alcoholic steatohepatitis (NASH) in overweight Albanian children, to evaluate the demographic and biochemical details and to assess the association between the severity of fatty liver changes and demographic and biochemical abnormalities. METHODS A total of 80 school aged children, 24 overweight (85th≤BMI≤94th percentile) and 55 obese (BMI≥94th percentile), aged 10.43±2.2 years (M±SD) were included in the current study, in January-December 2010. Their age was in the range of 7-15 years. Their sex distribution was 36 female and 44 male. The children were enrolled to the Tirana schools and none of them were part of any weight or diet programmer. Children who were found to have TBC, evidence of HBV or HCV, infections, drug toxicity, autoimmune hepatitis, inborn error of metabolism or concomitant cortisteroid therapy were excluded. Laboratory parameters were measured at the time of bioclinical examinations. Fatty liver was diagnosed by ultrasonography detection of the most characteristic features of fatty infiltration. The scoring system was used in order to graduate the severity of the disease. The child was considered to have mild, moderate and severe fatty liver changes if the overall score was 1-3, 4-6 and 7-9, respectively. Multivariate regression analysis was used to assess the association between the different variables and the severity of NAFLD. RESULTS NAFLD was present in 55/80 (68.7%) of the overweight children, 34 (61.8%) boys and 21 (38.2%) girls. Mild, moderate and severe degree of fatty liver were found in 35 (43.7%), 19 (23.7%) and 1 (1.3%), respectively. Nash was seen in 13 (23.7%) of the children's with NAFLD. Univariate analysis revealed that weight, BMI, waist, fasting blood insulinemia, triglycerides, total cholesterol and HOMA-IR were significantly associated with the presence of NAFLD (P<0.001). Multivariate analysis revealed a consistent and strong positive association between severity of fatty liver and weight, BMI, waist, fasting blood Insulinemia, cholesterolemia, triglyceridemia and HOMA-IR (P<0.001). CONCLUSION NAFLD/NASH was frequent among our cohort of overweight children (68.7% and 23.7%). Weight, waist, BM, hypercholesterolemia, hypertriglyceridemia, fasting serum Insulinemia and HOMA-IR are independent predictors of liver steatosis in overweight children. Hyperinsulinemia and insulin resistance, especially when are associated with elevate values of ALT level, are strong independent risk factors in developing NAFLD/NASH.
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Affiliation(s)
- K Kodhelaj
- Speciality Polyclinic of Tirana, Albania -
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12
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Resuli B. 82P COMBINED MODALITY THERAPY OF ADVANCED NON-SMALL-CELL LUNG CANCER: A SINGLE INSTITUTION EXPERIENCE. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Takanen S, Resuli B, Graziano V, Parisi A, Lisi R, Raffetto N, Tombolini V. Complete response and long-term survival in malignant pleural mesothelioma: case report. Anticancer Res 2012; 32:1485-1487. [PMID: 22493390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Malignant pleural mesothelioma is a rare tumour. A three-modal strategy, comprising of surgery, radiotherapy and chemotherapy has been shown to be essential for appropriate management. Current literature evidences the importance of radiation therapy in the adjuvant setting for local control of the disease, as part of a multidisciplinary treatment, with increment of progression-free survival rate, but also of disease-free survival. CASE REPORT At the beginning of 2007, a 26-year-old Peruvian woman was admitted to the hospital referring breathlessness and other non-specific symptoms such as fever and weight loss. After the diagnosis of pleural mesothelioma by thoracoscopic talc insufflation, combined with pleural biopsy, and total body computed tomographic scan, the patient underwent two cycles of neoadjuvant chemotherapy with pemetrexed (500 mg/m(2)) and cisplatin (75 mg/m(2)), followed by an extra-pleural pneumonectomy. After 6 months, the patient was treated with three-dimensional external beam radiation therapy to the left hemithorax. Computed tomographic scans, performed after the ending of the radiotherapy, integrated with positron-emission tomography, were all negative for neoplastic pathology. The patient remains in good health and free from recurrence at four years. CONCLUSION This clinical case shows a disease-free survival interval of 4 years for malignant pleural mesothelioma. A good staging system and a combined treatment, involving surgery, neoadjuvant chemotherapy and adjuvant radiation therapy, represent a useful strategy not only to contain local disease progression, but even to increase disease-free survival in pleural mesothelioma.
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Affiliation(s)
- Silvia Takanen
- Department of Radiation Oncology, Polyclinic Umberto I, Sapienza University of Rome, Rome, Italy.
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Kondili LA, Brunetto MR, Maina AM, Argentini C, Chionne P, La Sorsa V, Resuli B, Mele A, Rapicetta M. Clinical and molecular characterization of chronic hepatitis B in Albania: a country that is still highly endemic for HBV infection. J Med Virol 2005; 75:20-6. [PMID: 15543588 DOI: 10.1002/jmv.20231] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [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: 02/03/2023]
Abstract
Albania is a Mediterranean country, still with a high endemicity level of hepatitis B virus (HBV) infection. The chronic hepatitis B profile was characterized in this geographical area and used as a model to investigate the impact of endemicity level on the prevalence of the two major forms of chronic hepatitis B (HBeAg-positive and HBeAg-negative chronic hepatitis B). A cross-sectional study was conducted among 62 chronic hepatitis B patients consecutively admitted to the most important tertiary health care center for the diagnosis and treatment of liver disease in Albania. HBV-DNA was measured with an in-house PCR with a sensitivity of 10(4) copies/ml which uses primers encompassing the pre-core/core region. PCR products were subjected to sequencing and oligohybridization assay. Of the 62 patients, 75.8% had HBeAg-negative chronic hepatitis B. Genotype D was found in all 39 patients with detectable HBV viremia, for whom the heterogeneity of the region modulating HBeAg expression was assessed. Basic core promoter (BCP) mutations (1762/1764) were observed more often in anti-HBe-positive and older patients. In more than 90% of the HBeAg-negative chronic hepatitis B patients with detectable viremia, HBV that carries the G to A pre-core mutation at nucleotide 1896 was found. Patients with HBeAg-positive chronic hepatitis B were younger than HBeAg-negative chronic hepatitis B patients, and for symptomatic and asymptomatic liver-disease patients, the age of peak prevalence was at least 10 years lower for HBeAg-positive chronic hepatitis B patients. In conclusion, the virological and clinical pattern of chronic hepatitis B in Albania is similar to that observed in other Mediterranean countries; it seems to be independent of the HBV endemicity level.
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Affiliation(s)
- L A Kondili
- Department of Infectious, Parasitic, and Immunomediated Diseases, Viral Hepatitis Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Barbullushi M, Ldrizi A, Rroji A, Molla M, Seferi S, Dasho K, Basho J, Resuli B. Tuberous sclerosis complex diagnosed firstly in an elderly patient. Clin Nephrol 2002; 57:251-2. [PMID: 11924758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
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Resuli B, Prifti S, Guma S, Stone M. Prevalence of Helicobacter pylori infection in an Albanian population. Postgrad Med J 1999; 75:318. [PMID: 10533652 PMCID: PMC1741229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Kondili LA, Tosti ME, Szklo M, Costantino A, Cotichini R, Resuli B, Rapicetta M, Mele A. The relationships of chronic hepatitis and cirrhosis to alcohol intake, hepatitis B and C, and delta virus infection: a case-control study in Albania. Epidemiol Infect 1998; 121:391-5. [PMID: 9825791 PMCID: PMC2809537 DOI: 10.1017/s0950268898001216] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [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: 11/07/2022] Open
Abstract
The present study examined the effect of hepatitis B virus (HBV) and alcohol intake, and the role of hepatitis delta virus (HDV) and hepatitis C virus (HCV) in the aetiology of chronic liver disease in Albania. A total of 106 cases of liver cirrhosis or chronic hepatitis were compared to 195 control patients without these or other liver diseases. Adjusted odds ratios were 52.7 (95% CI 22.7-122) for HBV surface antigen, 26.9 (95% CI 4.9-147) for anti-HCV, 26.2 (95% CI 3-1-221) for anti-HDV, 2.4 (95% CI 1.3-4.4) for lifetime alcohol intake and 2.3 (95% CI 1-5.5) for duration of alcohol intake. Although not significant, an interaction was suggested between HBsAg and anti-HCV and between HBsAg and alcohol intake. Our study underlines the role of hepatitis viruses in the development of chronic liver diseases. Additionally, it suggests that heavy alcohol intake may magnify the effect of HBV on these diseases. HBV vaccination and alcohol abstention appear to be important strategies to reduce the risk of liver cirrhosis and chronic hepatitis in Albania.
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Affiliation(s)
- L A Kondili
- Laboratorio di Virologia, Istituto Superiore di Sanità, Roma, Italia
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