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Pilkay S, Nolasco M, Nunes S, Riffer A, Femia D, Halevy D, Veerman T, Heiland S, Suwannimit N, Trexler N, Gump B. SLC6A4 gene variants moderate associations between childhood food insecurity and adolescent mental health. Brain Behav 2024; 14:e3426. [PMID: 38361316 PMCID: PMC10869890 DOI: 10.1002/brb3.3426] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 11/10/2023] [Accepted: 01/27/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Food insecurity is a persistent concern in the United States and has been shown to affect child mental health and behavior. The SLC6A4 gene has been indicated as a moderator of the effects of chronic stress on anxiety in adolescents aged 14-21. However, it is unclear if SLC6A4 may also play a role in the effects of childhood food insecurity, a form of chronic stress, on adolescent mental health. This study aimed to identify effects of food insecurity on adolescents' mental health and delinquent behavior when both mom and child go hungry in the child's early years, and the potential interaction with SLC6A4 variants (SS/LL). METHODS The data and sample for this research are from the Future of Families and Child Wellbeing Study. The cohort consists of 4898 children (age 1-15 years, male = 47%, African American = 50%) and their respective caregivers sampled from large cities in the United States from 1998 to 2000. RESULTS The SLC6A4 serotonin transporter short/short allele emerged statistically significant as a moderator of childhood food insecurity and adolescent mental health. Specifically, the presence of the short/short allele increased anxiety symptoms in adolescents with exposure to food insecurity in childhood. CONCLUSION The SLC6A4 short/short allele amplifies risk of anxiety-related mental illness when children experience food insecurity. The gene-environment interaction provides insight into the mechanistic pathway of the effects of poverty-related adversity, such as food insecurity, on developmental trajectories of mental health.
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Affiliation(s)
- S. Pilkay
- David B. Falk College of Sport and Human Dynamics, School of Social WorkSyracuse UniversitySyracuseNew YorkUSA
| | - M. Nolasco
- David B. Falk College of Sport and Human Dynamics, School of Social WorkSyracuse UniversitySyracuseNew YorkUSA
| | - S. Nunes
- David B. Falk College of Sport and Human Dynamics, School of Social WorkSyracuse UniversitySyracuseNew YorkUSA
| | - A. Riffer
- Jane Addams College of Social WorkUniversity of Illinois ChicagoChicagoIllinoisUSA
| | - D. Femia
- David B. Falk College of Sport and Human Dynamics, School of Social WorkSyracuse UniversitySyracuseNew YorkUSA
| | - D. Halevy
- Wurzweiler School of Social WorkYeshiva UniversityNew YorkNew YorkUSA
| | - T. Veerman
- School of Natural Health, Social and Behavioral Sciences, Social WorkCentenary UniversityHackettstownNew JerseyUSA
| | - S. Heiland
- David B. Falk College of Sport and Human Dynamics, School of Social WorkSyracuse UniversitySyracuseNew YorkUSA
| | - N. Suwannimit
- David B. Falk College of Sport and Human Dynamics, School of Social WorkSyracuse UniversitySyracuseNew YorkUSA
| | - N. Trexler
- David B. Falk College of Sport and Human Dynamics, School of Social WorkSyracuse UniversitySyracuseNew YorkUSA
| | - B. Gump
- David B. Falk College of Sport and Human Dynamics, Department of Public HealthSyracuse UniversitySyracuseNew YorkUSA
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Panzuto F, Pusceddu S, Faggiano A, Rinzivillo M, Brighi N, Prinzi N, Riccardi F, Iannicelli E, Maggio I, Femia D, Tafuto S, Manuzzi L, Di Sarno A, Annibale B, de Braud F, Campana D. Prognostic impact of tumour burden in stage IV neuroendocrine neoplasia: A comparison between pancreatic and gastrointestinal localizations. Pancreatology 2019; 19:1067-1073. [PMID: 31587962 DOI: 10.1016/j.pan.2019.09.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Although prognosis of NENs is affected by several features including tumour burden, the specific role of this factor in pancreatic NENs (PanNENs) and gastrointestinal NENs (GI NENs) is not well established. AIM To compare the prognostic role of tumour burden in PanNENs and GI NENs. PATIENTS AND METHODS This study was a retrospective analysis of stage IV PanNENs and GI NENs. Tumours were classified based on liver tumour volume (<25% or >25%). Overall survival as assessed by Kaplan-Meier curves, and Cox proportional hazards method was used to perform risk factor analysis. RESULTS The analysis included 300 patients, including 166 panNENs (55.3%) and 134 GI NENs (44.7%). A total of 158 patients (52.7%) had G2 tumours, 107 had G1 tumours (35.7%), and 35 had G3 tumours (11.6%). Tumour liver involvement >25% was observed in 187 patients (62.3%): 106 PanNENs (56.7%), and 81 GI NENs (43.3%) (p = 0.551). Bone metastases were present in 45 patients (15%): 22 PanNENs (13.2%) and 23 GI NENs (17.1%) (p = 0.416). Characteristics of the PanNENs, including: grading (G2 vs G1, HR = 3.7; G3 vs G1, HR = 16.40), liver involvement > 25% (HR = 3.09), and bone metastases (HR = 2.27) were independent predictors for poor survival, whereas the only significant risk factor in GI NENs was grading (G2 vs G1, HR = 4.36; G3 vs G1, HR = 8.60). CONCLUSIONS PanNENs and GI NENs have different risk profiles. Liver tumour volume and the presence of bone metastases significantly affect survival in patients with PanNENs but has no impact on the clinical outcomes of GI NENs.
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Affiliation(s)
- Francesco Panzuto
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy.
| | - Sara Pusceddu
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENET Center of Excellence, Milan, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Dept. of Experimental Medicine, Sapienza University of Rome, Italy
| | - Maria Rinzivillo
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy
| | - Nicole Brighi
- NET Team Bologna ENETS Center of Excellence, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy
| | - Natalie Prinzi
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENET Center of Excellence, Milan, Italy
| | - Ferdinando Riccardi
- Naples ENETS Center of Excellence, Oncology, Cardarelli Hospital, Naples, Italy
| | - Elsa Iannicelli
- Radiology, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy
| | - Ilaria Maggio
- NET Team Bologna ENETS Center of Excellence, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy
| | - Daniela Femia
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENET Center of Excellence, Milan, Italy
| | - Salvatore Tafuto
- Naples ENETS Center of Excellence, Department of Abdominal Oncology, Istituto Nazionale, Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy
| | - Lisa Manuzzi
- NET Team Bologna ENETS Center of Excellence, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy
| | - Antonella Di Sarno
- Naples ENETS Center of Excellence, Oncology Unit, AO dei Colli, Monaldi Unit, Naples, Italy
| | - Bruno Annibale
- Digestive Disease Unit, Sant'Andrea University Hospital, Dept. of Medical-Surgical Sciences and Translatioal Medicine, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENET Center of Excellence, Milan, Italy
| | - Davide Campana
- NET Team Bologna ENETS Center of Excellence, Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy
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Femia D, Prinzi N, Anichini A, Mortarini R, Nichetti F, Corti F, Torchio M, Peverelli G, Pagani F, Maurichi A, Mattavelli I, Milione M, Bedini N, Corti A, Di Bartolomeo M, de Braud F, Pusceddu S. Treatment of Advanced Merkel Cell Carcinoma: Current Therapeutic Options and Novel Immunotherapy Approaches. Target Oncol 2019; 13:567-582. [PMID: 30073632 DOI: 10.1007/s11523-018-0585-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Advanced Merkel cell carcinoma (MCC) is a very aggressive, rare neuroendocrine tumor of the skin with a high frequency of locoregional recurrence and metastasis, and a high mortality rate. Surgical resection, sentinel lymph node biopsy, and radiotherapy represent the gold standard of treatment in patients with localized disease, while chemotherapy has a significant role in the treatment of advanced disease. However, no definitive evidence on the survival impact of radiotherapy in the advanced stages has been provided to date, and response to chemotherapy remains brief in the majority of cases, indicating an urgent need for alternative approaches. Biological and genome sequencing studies have implicated multiple molecular pathways in MCC, thus leading to the development of new agents that target angiogenic factors, anti-apoptosis molecules, poly-ADP ribose polymerase, intracellular signal proteins such as the PI3K/AKT/mTOR pathway, and peptide receptors such as somatostatin receptors. More recently, immunotherapy agents such as avelumab, pembrolizumab, and nivolumab, which act by blocking the programmed cell-death (PD)-1/PD-L1 immune checkpoint, have shown promising results, especially in the advanced setting, and should now be considered standard of care for metastatic MCC. Current research is focusing on developing new immunotherapeutic strategies, identifying predictive biomarker to aid in the selection of patients responsive to immunotherapy, and defining combination approaches to increase efficacy in refractory patients.
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Affiliation(s)
- Daniela Femia
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy
| | - Natalie Prinzi
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy
| | - Andrea Anichini
- Department of Research, Human Tumors Immunobiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano and ENETS Center of Excellence, Milan, Italy
| | - Roberta Mortarini
- Department of Research, Human Tumors Immunobiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano and ENETS Center of Excellence, Milan, Italy
| | - Federico Nichetti
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy
| | - Francesca Corti
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy
| | - Martina Torchio
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy
| | - Giorgia Peverelli
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy
| | - Filippo Pagani
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy
| | - Andrea Maurichi
- Melanoma and Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, ENETS Center of Excellence, Milan, Italy
| | - Ilaria Mattavelli
- Melanoma and Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, ENETS Center of Excellence, Milan, Italy
| | - Massimo Milione
- 1st Pathology Division, Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori and ENETS Center of Excellence, Milan, Italy
| | - Nice Bedini
- Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano and ENETS Center of Excellence, Milan, Italy
| | | | - Maria Di Bartolomeo
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy
| | - Filippo de Braud
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy.,University of Milan, Milan, Italy
| | - Sara Pusceddu
- Department of Medical Oncology Unit-1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano and ENETS Center of Excellence, Via Venezian 1, 20133, Milan, Italy.
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Cavalcoli F, Pusceddu S, Zilli A, Tamagno G, Femia D, Prinzi N, Travers J, Consonni D, Ciafardini C, Conte D, Massironi S. Effects of low-dose aspirin on clinical outcome and disease progression in patients with gastroenteropancreatic neuroendocrine neoplasm. Scand J Gastroenterol 2019; 54:1111-1117. [PMID: 31454281 DOI: 10.1080/00365521.2019.1656773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: The chemopreventive effect of aspirin (ASA) has been observed in the setting of colorectal cancer and other solid neoplasms. Recently, ASA has demonstrated a promising anti-proliferative effect on GEP-NENs in vitro. However, the direct anti-neoplastic impact of ASA on GEP-NEN clinical outcome is yet to be clarified. Materials and methods: All the GEP-NEN patients followed up in three European Centers from January 2005 to September 2016 were retrospectively enrolled. Patients taking ASA in doses of 75-100 mg daily for cardiovascular prevention for at least six months were evaluated. The possible association between ASA and disease grading, staging, primary site, OS and PFS were evaluated. Results: Two hundred fifty one patients were included (117 males, median age 63 years). Of these, 64 patients were prescribed with ASA. No clear impact on OS or PFS was observed in GEP-NEN patients taking ASA compared to those not taking it. ASA intake was related with the patients' older age. At Cox multivariate analysis, stage IV and Ki-67 resulted independent predictors for OS and PFS. In the setting of intestinal NENs, a suggestive, but not statistically significant, protective role of ASA on PFS was observed [HR 0.41 (95% CI: 0.13-1.29)]. Conclusions: Despite ASA showed promising anti-proliferative effects in vitro and a chemopreventive action in NENs has been reported, a clear impact of ASA on survival in NENs has not emerged from the present study. However, in the subgroup of patients with small-intestine NENs, ASA showed a trend toward a protective role.
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Affiliation(s)
- Federica Cavalcoli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università Degli Studi di Milano , Milan , Italy
| | - Sara Pusceddu
- Medical Oncology, Unit 1, ENETS Center of Excellence, Fondazione IRCCS Istituto Tumori Milano , Milan , Italy
| | - Alessandra Zilli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università Degli Studi di Milano , Milan , Italy
| | - Gianluca Tamagno
- Department of Endocrinology/Diabetes, Mater Misericordiae University Hospital , Dublin , Ireland
| | - Daniela Femia
- Medical Oncology, Unit 1, ENETS Center of Excellence, Fondazione IRCCS Istituto Tumori Milano , Milan , Italy
| | - Natalie Prinzi
- Medical Oncology, Unit 1, ENETS Center of Excellence, Fondazione IRCCS Istituto Tumori Milano , Milan , Italy
| | - John Travers
- Department of Endocrinology/Diabetes, Mater Misericordiae University Hospital , Dublin , Ireland
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Clorinda Ciafardini
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università Degli Studi di Milano , Milan , Italy
| | - Dario Conte
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università Degli Studi di Milano , Milan , Italy
| | - Sara Massironi
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università Degli Studi di Milano , Milan , Italy
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5
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Pusceddu S, Vernieri C, Di Maio M, Marconcini R, Spada F, Massironi S, Ibrahim T, Brizzi MP, Campana D, Faggiano A, Giuffrida D, Rinzivillo M, Cingarlini S, Aroldi F, Antonuzzo L, Berardi R, Catena L, De Divitiis C, Ermacora P, Perfetti V, Fontana A, Razzore P, Carnaghi C, Davì MV, Cauchi C, Duro M, Ricci S, Fazio N, Cavalcoli F, Bongiovanni A, La Salvia A, Brighi N, Colao A, Puliafito I, Panzuto F, Ortolani S, Zaniboni A, Di Costanzo F, Torniai M, Bajetta E, Tafuto S, Garattini SK, Femia D, Prinzi N, Concas L, Lo Russo G, Milione M, Giacomelli L, Buzzoni R, Delle Fave G, Mazzaferro V, de Braud F. Metformin Use Is Associated With Longer Progression-Free Survival of Patients With Diabetes and Pancreatic Neuroendocrine Tumors Receiving Everolimus and/or Somatostatin Analogues. Gastroenterology 2018; 155:479-489.e7. [PMID: 29655834 DOI: 10.1053/j.gastro.2018.04.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 03/21/2018] [Accepted: 04/06/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Metformin seems to have anticancer effects. However, it is not clear whether use of glycemia and metformin affect outcomes of patients with advanced pancreatic neuroendocrine tumors (pNETs). We investigated the association between glycemia and progression-free survival (PFS) of patients with pNETs treated with everolimus and/or somatostatin analogues, as well as the association between metformin use and PFS time. METHODS We performed a retrospective analysis of 445 patients with advanced pNET treated at 24 medical centers in Italy from 1999 through 2015. Data on levels of glycemia were collected at time of diagnosis of pNET, before treatment initiation, and during treatment with everolimus (with or without somatostatin analogues), octreotide, or lanreotide. Diabetes was defined as prior or current use of glycemia control medication and/or fasting plasma glucose level ≥ 126 mg/dL, hemoglobin A1c ≥ 6.5% (48 mmol/L), or a random sample of plasma glucose ≥ 200 mg/dL (11.1 mmol/L), with reported classic symptoms of hyperglycemia or hyperglycemic crisis. Patients were assigned to groups based on diagnosis of diabetes before or during antitumor therapy. PFS was compared between patients with vs without diabetes. Among patients with diabetes, the association between metformin use and PFS was assessed. We performed sensitivity and landmark analyses to exclude patients who developed diabetes while receiving cancer treatment and to exclude a potential immortal time bias related to metformin intake. RESULTS PFS was significantly longer in patients with diabetes (median, 32.0 months) than without diabetes (median, 15.1 months) (hazard ratio for patients with vs without diabetes, 0.63; 95% confidence interval, 0.50-0.80; P = .0002). PFS of patients treated with metformin was significantly longer (median PFS, 44.2 months) than for patients without diabetes (hazard ratio for survival of patients with diabetes receiving metformin vs without diabetes, 0.45; 95% confidence interval, 0.32-0.62; P < .00001) and longer than for patients with diabetes receiving other treatments (median PFS, 20.8 months; hazard ratio, 0.49; 95% confidence interval, 0.34-0.69; P < .0001). In multivariable analysis, adjusted for other factors associated with outcomes, metformin was associated with longer PFS but level of glycemia was not. Metformin was associated with increased PFS of patients receiving somatostatin analogues and in those receiving everolimus, with or without somatostatin analogues. Sensitivity and landmark analyses produced similar results. CONCLUSIONS In a retrospective study of patients with pNETs, we found a significant association between metformin use and longer PFS.
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Affiliation(s)
- Sara Pusceddu
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy.
| | - Claudio Vernieri
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Fondazione Istituto FIRC di Oncologia Molecolare (IFOM), Milan, Italy
| | - Massimo Di Maio
- Dipartimento di Oncologia, Università degli Studi di Torino, A. O. Ordine Mauriziano, Turin, Italy
| | - Riccardo Marconcini
- Dipartimento di Oncologia, Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Francesca Spada
- IEO - Istituto Europeo di Oncologia, ENETS Center of Excellence, Milan, Italy
| | - Sara Massironi
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Toni Ibrahim
- Centro di Osteoncologia e Tumori Rari, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Maria Pia Brizzi
- Azienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano, Italy
| | | | - Antongiulio Faggiano
- Unità di chirurgia tiroidea e paratiroidea, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | | | - Maria Rinzivillo
- Azienda Ospedaliera Universitaria Sant'Andrea, ENETS Center of Excellence, Rome, Italy
| | | | | | | | - Rossana Berardi
- Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | | | | | - Paola Ermacora
- Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy
| | | | | | - Paola Razzore
- Unit of Endocrinology, Ospedale Mauriziano, Torino, Italy
| | - Carlo Carnaghi
- Istituto Clinico Humanitas, Rozzano, ENETS Center of Excellence, Italy
| | | | | | | | - Sergio Ricci
- Dipartimento di Oncologia, Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Nicola Fazio
- IEO - Istituto Europeo di Oncologia, ENETS Center of Excellence, Milan, Italy
| | - Federica Cavalcoli
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Alberto Bongiovanni
- Centro di Osteoncologia e Tumori Rari, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Anna La Salvia
- Azienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano, Italy
| | | | - Annamaria Colao
- Endocrinology Section, Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Italy
| | | | - Francesco Panzuto
- Azienda Ospedaliera Universitaria Sant'Andrea, ENETS Center of Excellence, Rome, Italy
| | | | | | | | | | | | - Salvatore Tafuto
- IRCCS Fondazione Pascale, ENETS Center of Excellence, Naples, Italy
| | | | - Daniela Femia
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy
| | - Natalie Prinzi
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy
| | - Laura Concas
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy
| | - Giuseppe Lo Russo
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Medical-Surgical Science and Traslational Medicine Departement, Sapienza University, Rome, Italy
| | - Massimo Milione
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy
| | - Luca Giacomelli
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy
| | - Roberto Buzzoni
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy
| | - Gianfranco Delle Fave
- Azienda Ospedaliera Universitaria Sant'Andrea, ENETS Center of Excellence, Rome, Italy
| | - Vincenzo Mazzaferro
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Universita' degli Studi di Milano, Milan, Italy
| | - Filippo de Braud
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Universita' degli Studi di Milano, Milan, Italy
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6
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Pusceddu S, Barretta F, Trama A, Botta L, Milione M, Buzzoni R, De Braud F, Mazzaferro V, Pastorino U, Seregni E, Mariani L, Gatta G, Di Bartolomeo M, Femia D, Prinzi N, Coppa J, Panzuto F, Antonuzzo L, Bajetta E, Brizzi MP, Campana D, Catena L, Comber H, Dwane F, Fazio N, Faggiano A, Giuffrida D, Henau K, Ibrahim T, Marconcini R, Massironi S, Žakelj MP, Spada F, Tafuto S, Van Eycken E, Van der Zwan JM, Žagar T, Giacomelli L, Miceli R. A classification prognostic score to predict OS in stage IV well-differentiated neuroendocrine tumors. Endocr Relat Cancer 2018; 25:607-618. [PMID: 29559553 PMCID: PMC5920017 DOI: 10.1530/erc-17-0489] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/20/2018] [Indexed: 02/05/2023]
Abstract
No validated prognostic tool is available for predicting overall survival (OS) of patients with well-differentiated neuroendocrine tumors (WDNETs). This study, conducted in three independent cohorts of patients from five different European countries, aimed to develop and validate a classification prognostic score for OS in patients with stage IV WDNETs. We retrospectively collected data on 1387 patients: (i) patients treated at the Istituto Nazionale Tumori (Milan, Italy; n = 515); (ii) European cohort of rare NET patients included in the European RARECAREnet database (n = 457); (iii) Italian multicentric cohort of pancreatic NET (pNETs) patients treated at 24 Italian institutions (n = 415). The score was developed using data from patients included in cohort (i) (training set); external validation was performed by applying the score to the data of the two independent cohorts (ii) and (iii) evaluating both calibration and discriminative ability (Harrell C statistic). We used data on age, primary tumor site, metastasis (synchronous vs metachronous), Ki-67, functional status and primary surgery to build the score, which was developed for classifying patients into three groups with differential 10-year OS: (I) favorable risk group: 10-year OS ≥70%; (II) intermediate risk group: 30% ≤ 10-year OS < 70%; (III) poor risk group: 10-year OS <30%. The Harrell C statistic was 0.661 in the training set, and 0.626 and 0.601 in the RARECAREnet and Italian multicentric validation sets, respectively. In conclusion, based on the analysis of three 'field-practice' cohorts collected in different settings, we defined and validated a prognostic score to classify patients into three groups with different long-term prognoses.
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Affiliation(s)
- Sara Pusceddu
- Department of Medical Oncology ENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Francesco Barretta
- Unit of Clinical Epidemiology and Trial OrganizationFondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy
| | - Annalisa Trama
- Department of Preventive and Predictive MedicineFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Evaluative Epidemiology Unit, ENETS Center of Excellence, Milan, Italy
| | - Laura Botta
- Department of Preventive and Predictive MedicineFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Evaluative Epidemiology Unit, ENETS Center of Excellence, Milan, Italy
| | - Massimo Milione
- Department of PathologyFondazione IRCCS Istituto Nazionale dei Tumori, Milano, ENETS Center of Excellence, Milan, Italy
| | - Roberto Buzzoni
- Department of Medical Oncology ENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Filippo De Braud
- Department of Medical Oncology ENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
- University of MilanMilan, Italy
| | - Vincenzo Mazzaferro
- University of MilanMilan, Italy
- Liver SurgeryTransplantation and Gastroenterology, University of Milan and Istituto Nazionale Tumori Fondazione IRCCS, ENETS Center of Excellence, Milano, Milan, Italy
| | - Ugo Pastorino
- Department of Thoracic Surgical OncologyFondazione IRCCS Istituto Nazionale dei Tumori, Milano, ENETS Center of Excellence, Milan, Italy
| | - Ettore Seregni
- Department of Nuclear Medicine ENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale dei Tumori, Milano, Milan, Italy
| | - Luigi Mariani
- Unit of Clinical Epidemiology and Trial OrganizationFondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy
| | - Gemma Gatta
- Department of Preventive and Predictive MedicineFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Evaluative Epidemiology Unit, ENETS Center of Excellence, Milan, Italy
| | - Maria Di Bartolomeo
- Department of Medical Oncology ENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Daniela Femia
- Department of Medical Oncology ENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Natalie Prinzi
- Department of Medical Oncology ENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Jorgelina Coppa
- Liver SurgeryTransplantation and Gastroenterology, University of Milan and Istituto Nazionale Tumori Fondazione IRCCS, ENETS Center of Excellence, Milano, Milan, Italy
| | - Francesco Panzuto
- Department of Medical GastroenterologyAzienda Ospedaliera Sant'Andrea, Roma ENETS Center of Excellence, Rome, Italy
| | - Lorenzo Antonuzzo
- Department of Medical OncologyAzienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Emilio Bajetta
- Department of Medical OncologyPoliclinico di Monza, Monza, Italy
| | - Maria Pia Brizzi
- Department of Medical OncologyAzienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano, Italy
| | - Davide Campana
- Department of Medical OncologyPoliclinico Sant'Orsola Malpighi, Bologna, Italy
| | - Laura Catena
- Department of Medical OncologyPoliclinico di Monza, Monza, Italy
| | | | - Fiona Dwane
- Ireland National Cancer RegistryCork, Ireland
| | - Nicola Fazio
- Department of Medical OncologyIEO - Istituto Europeo di Oncologia, Milano, ENETS Center of Excellence, Milan, Italy
| | - Antongiulio Faggiano
- Department of Thyroid and Parathyroid Surgery UnitAzienda Ospedaliera Universitaria Federico II, ENETS Center of Excellence, Naples, Italy
| | - Dario Giuffrida
- Department of Medical OncologyIOM - Istituto Oncologico del Mediterraneo, Catania, Italy
| | - Kris Henau
- Belgian Cancer RegistryBrussels, Belgium
| | - Toni Ibrahim
- Osteoncology and Rare Tumors CenterIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRST, IRCCS, Meldola, Italy
| | | | - Sara Massironi
- Gastroenterology and Endoscopy UnitFondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Maja Primic Žakelj
- Institute of Oncology LjubljanaEpidemiology and Cancer Registry, Ljubljana, Slovenia
| | - Francesca Spada
- Department of Medical OncologyIEO - Istituto Europeo di Oncologia, Milano, ENETS Center of Excellence, Milan, Italy
| | - Salvatore Tafuto
- Department of Medical OncologyFondazione IRCCS Pascale, ENETS Center of Excellence, Naples, Italy
| | | | - Jan Maaten Van der Zwan
- Department of ResearchNetherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Tina Žagar
- Institute of Oncology LjubljanaEpidemiology and Cancer Registry, Ljubljana, Slovenia
| | - Luca Giacomelli
- Department of Surgical Sciences and Integrated DiagnosticsUniversity of Genoa, Genoa, Italy
| | - Rosalba Miceli
- Unit of Clinical Epidemiology and Trial OrganizationFondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy
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Rinzivillo M, Fazio N, Pusceddu S, Spallanzani A, Ibrahim T, Campana D, Marconcini R, Partelli S, Badalamenti G, Brizzi MP, Catena L, Schinzari G, Carnaghi C, Berardi R, Faggiano A, Antonuzzo L, Spada F, Gritti S, Femia D, Gelsomino F, Bongiovanni A, Ricci S, Brighi N, Falconi M, Delle Fave G, Panzuto F. Sunitinib in patients with pre-treated pancreatic neuroendocrine tumors: A real-world study. Pancreatology 2018; 18:198-203. [PMID: 29361429 DOI: 10.1016/j.pan.2018.01.005] [Citation(s) in RCA: 17] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/19/2017] [Accepted: 01/11/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Besides data reported in a Phase-III trial, data on sunitinib in pancreatic Neuroendocrine Tumors (panNETs) are scanty. AIM To evaluate sunitinib efficacy and tolerability in panNETs patients treated in a real-world setting. PATIENTS AND METHODS Retrospective analysis of progressive panNETs treated with sunitinib. Efficacy was assessed by evaluating progression-free survival, overall survival, and disease control (DC) rate (stable disease (SD) + partial response + complete response). Data are reported as median (25th-75th IQR). RESULTS Eighty patients were included. Overall, 71.1% had NET G2, 26.3% had NET G1, and 2.6% had NET G3 neoplasms. A total of 53 patients (66.3%) had received three or more therapeutic regimens before sunitinib, with 24 patients (30%) having been treated with four previous treatments. Median PFS was 10 months. Similar risk of progression was observed between NET G1 and NET G2 tumors (median PFS 11 months and 8 months, respectively), and between patients who had received ≥ 3 vs ≤ 2 therapeutic approaches before sunitinib (median PFS 9 months and 10 months, respectively). DC rate was 71.3% and SD was the most frequent observed response, occurring in 43 pts (53.8%). Overall, 59 pts (73.8%) experienced AEs, which were grade 1-2 in 43 of them (72.9%), grade 3 in 15 pts (25.4%), and grade 4 in one patient (1.7%). Six pts (7.5%) stopped treatment due to toxicity. CONCLUSIONS The present real-world experience shows that sunitinib is a safe and effective treatment for panNETs, even in the clinical setting of heavily pre-treated, progressive diseases.
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Affiliation(s)
- Maria Rinzivillo
- Digestive and Liver Disease, ENETS Center of Excellence Sant'Andrea Hospital - Sapienza University of Rome, Italy
| | - Nicola Fazio
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, ENETS Center of Excellence IEO, Milan, Italy
| | - Sara Pusceddu
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENETS Center of Excellence, Milan, Italy
| | - Andrea Spallanzani
- Division of Oncology, Department of Oncology and Haematology, University Hospital of Modena, Modena, Italy
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Davide Campana
- Department of Medical and Surgical Sciences, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Riccardo Marconcini
- Department of Oncology, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Istituto Toscano Tumori, Santa Chiara Hospital, Pisa, Italy
| | - Stefano Partelli
- Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita e Salute University, Milan, Italy
| | - Giuseppe Badalamenti
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - Maria Pia Brizzi
- Medical Oncology, AOU S. Luigi Gonzaga Regione Gonzole 10, Orbassano, Italy
| | - Laura Catena
- Struttura di Oncologia Policlinico di Monza, Monza, MB, Italy
| | | | - Carlo Carnaghi
- Oncology Unit, Humanitas Clinical and Research Centre, Rozzano, Italy
| | - Rossana Berardi
- Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, Ancona, Italy
| | - Antongiulio Faggiano
- Divisione di Endocrinologia, Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, ENETS Center of Excellence Naples, Italy
| | | | - Francesca Spada
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, ENETS Center of Excellence IEO, Milan, Italy
| | - Sara Gritti
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, ENETS Center of Excellence IEO, Milan, Italy
| | - Daniela Femia
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENETS Center of Excellence, Milan, Italy
| | - Fabio Gelsomino
- Division of Oncology, Department of Oncology and Haematology, University Hospital of Modena, Modena, Italy
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sergio Ricci
- Department of Oncology, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Istituto Toscano Tumori, Santa Chiara Hospital, Pisa, Italy
| | - Nicole Brighi
- Department of Experimental, Diagnostic and Specialty Medicine, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Massimo Falconi
- Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita e Salute University, Milan, Italy
| | - Gianfranco Delle Fave
- Digestive and Liver Disease, ENETS Center of Excellence Sant'Andrea Hospital - Sapienza University of Rome, Italy
| | - Francesco Panzuto
- Digestive and Liver Disease, ENETS Center of Excellence Sant'Andrea Hospital - Sapienza University of Rome, Italy.
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8
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Pusceddu S, Prinzi N, Lo Russo G, Femia D, Milione M, Perrone F, Tamborini E, Concas L, Pulice I, Vernieri C, Corti F, Buzzoni R, de Braud F. Rationale and protocol of MetNET-2 trial: Lanreotide Autogel plus metformin in advanced gastrointestinal or lung neuroendocrine tumors. Future Oncol 2017; 13:1677-1683. [PMID: 28580793 DOI: 10.2217/fon-2017-0132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Metformin (MET) has recently emerged as a potentially active agent in cancer prevention and treatment. MET is thought to exert its antitumor effects either via modification of systemic metabolism or through cell-autonomous effects (e.g., activation of AMPK and inhibition of the mTOR pathway). Preliminary findings of the PRIME-NET study suggest that the addition of MET to treatment with everolimus (EVE) and/or somatostatin analogs (SSAs) can provide clinical benefit in diabetic neuroendocrine tumor (NET) patients. In light of this and other retrospective evidence of MET's anticancer activity in NETs, prospective studies are needed. A pilot, single-arm, open-label, prospective study (MetNET-2 trial, NCT02823691) was designed to evaluate the safety of MET in combination with lanreotide in well-differentiated gastrointestinal (WD GI) and lung NETs.
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Affiliation(s)
- Sara Pusceddu
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Natalie Prinzi
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Giuseppe Lo Russo
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Daniela Femia
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Massimo Milione
- Department of Pathology, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Federica Perrone
- Department of Pathology, Laboratory of Experimental Molecular Pathology, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Elena Tamborini
- Department of of Diagnostic Pathology & Laboratory Medicine ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Laura Concas
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Iolanda Pulice
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Claudio Vernieri
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Francesca Corti
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Roberto Buzzoni
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Unit 1, ENET Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
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9
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Pusceddu S, Verzoni E, Prinzi N, Mennitto A, Femia D, Grassi P, Concas L, Vernieri C, Lo Russo G, Procopio G. Everolimus treatment for neuroendocrine tumors: latest results and clinical potential. Ther Adv Med Oncol 2017; 9:183-188. [PMID: 28344663 PMCID: PMC5349426 DOI: 10.1177/1758834016683905] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Neuroendocrine tumors (NETs) are a heterogeneous class of diseases characterized by challenging management. Preclinical evidence shows that the PI3K/AKT/mTOR signaling pathway plays a central role in the pathogenesis and progression of NETs. Everolimus is a direct inhibitor of this pathway, and therefore this molecule appears to be a well-grounded strategy for the treatment of NETs, capable of changing clinical practice. The efficacy and safety of everolimus was demonstrated in the RADIANT trials. In this work, we comment on the results of the RADIANT trials, and other recent key evidence from fully published clinical trials on everolimus, and we discuss the current role of everolimus in the treatment of NETs.
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Affiliation(s)
- Sara Pusceddu
- Medical Oncology, Istituto Nazionale Tumori, Milan, Italy
| | - Elena Verzoni
- Medical Oncology, Istituto Nazionale Tumori, Milan, Italy
| | | | | | - Daniela Femia
- Medical Oncology, Istituto Nazionale Tumori, Milan, Italy
| | - Paolo Grassi
- Medical Oncology, Istituto Nazionale Tumori, Milan, Italy
| | - Laura Concas
- Medical Oncology, Istituto Nazionale Tumori, Milan, Italy
| | | | | | - Giuseppe Procopio
- Medical Oncology, Istituto Nazionale Tumori, Via Venezian 1, 20100, Milan, Italy
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Vernieri C, Femia D, Pusceddu S, Capella C, Rosai J, Calareso G, Concas L, Prinzi N, Lo Russo G, de Braud F, Buzzoni R. Primary Cerebellar Neuroendocrine Tumors: Chimeras or Real Entities? A Case Report with a 6-Year Follow-Up. Case Rep Oncol 2016; 9:432-439. [PMID: 27721764 PMCID: PMC5043191 DOI: 10.1159/000447771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 06/22/2016] [Indexed: 11/19/2022] Open
Abstract
We report the case of a 38-year-old patient who was diagnosed with a cerebellar well-differentiated neuroendocrine tumor (WDNET) in 2009. At first glance, we believed that it was a metastasis from an unrecognized WDNET arising outside the cerebellum. However, despite a prolonged follow-up of 6 years, an extracranial WDNET has never been found. During this time, the tumor recurred locally twice, and the patient was treated with surgery and radiotherapy. At the moment, he enjoys good general conditions and his tumor is under control. Due to the histopathological characteristics and clinical behavior of the tumor, we believe that this is the first report to date of a primary cerebellar WDNET.
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Affiliation(s)
- Claudio Vernieri
- Istituto Nazionale Tumori, Milan, Italy; IFOM - Istituto FIRC di oncologia molecolare, Milan, Italy
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De Braud F, Buzzoni R, Concas L, Femia D, Prinzi N, Milione M, Tamborini E, Perrone F, Russo G, Vernieri C, Pulice I, Piras F, Dinoi G, Pusceddu S. Safety of lanreotide 120 mg ATG in combination with metformin in patients with advanced well-differentiated gastro-intestinal (GI) or lung carcinoids. A pilot, one-arm, open-label, prospective study: The MetNET-2 trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw369.35] [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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12
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Femia D, Prinzi N, Pusceddu S, Concas L, Lo Russo G, Claudio V, Milione M, Dinoi G, Raimondi A, Michele P, Filippo D, Buzzoni R. Complete response to avelumab in Merkel Cell Carcinoma, and potential correlation with toxicity: a case report. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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13
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Pusceddu S, Marconcini R, Spada F, Cavalcoli F, Ibrahim T, Brizzi M, Brighi N, Faggiano A, Puliafito I, Delle Fave G, Perfetti V, Luppi G, Carnaghi C, Razzore P, Davì M, Cauchi C, Duro M, Di Maio M, Buzzoni R, Femia D, De Braud F. Metformin impact on progression-free survival in diabetic patients with advanced pancreatic neuroendocrine tumors (pNET) receiving everolimus and/or somatostatin analogues. The PRIME-NET (Pancreatic multicentric, Retrospective, Italian MEtformin) study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.06] [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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14
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Buzzoni R, Filippo D, Femia D, Prinzi N, Concas L, Milione M, Tamborini E, Perrone F, Lo Russo G, Vernieri C, Pulice I, Piras F, Dinoi G, Pusceddu S. Safety of Lanreotide 120 mg ATG in combination with metformin in patients with progressive advanced well-differentiated gastro-intestinal (GI) or lung carcinoids. A pilot, one-arm, open-label, prospective study: the MetNET-2 trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.28] [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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15
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Pusceddu S, Femia D, Lo Russo G, Ortolani S, Milione M, Maccauro M, Vernieri C, Prinzi N, Concas L, Leuzzi L, De Braud F, Buzzoni R. Update on medical treatment of small intestinal neuroendocrine tumors. Expert Rev Anticancer Ther 2016; 16:969-76. [PMID: 27353232 DOI: 10.1080/14737140.2016.1207534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Small intestinal (SI) neuroendocrine tumors (NETs) are relatively rare tumors. Due to the lack of symptom or specific symptoms, SI-NETs are often diagnosed at an advanced stage, making therapy challenging. The management of patients with advanced stage SI-NETS requires a multidisciplinary approach that combines surgical and medical treatment including novel targeted molecular therapies. AREAS COVERED This article summarizes current strategies for the medical treatment of SI-NETS. Expert commentary: The treatment plan of advanced-stage SI-NETs should be tailored in a case-by-case manner with the adoption of a multidisciplinary approach that combines different treatment options, including biological targeted therapies. In particular, we believe that the identification of the optimal treatment sequence(s), correct treatment timing and the selection of patients eligible to different treatments need specific investigation in controlled clinical trials.
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Affiliation(s)
- Sara Pusceddu
- a Department of Medical Oncology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Daniela Femia
- a Department of Medical Oncology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Giuseppe Lo Russo
- a Department of Medical Oncology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Silvia Ortolani
- b Department of Medical Oncology , Azienda Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy
| | - Massimo Milione
- c Department of Phatology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Marco Maccauro
- d Department of Nuclear Medicine , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Claudio Vernieri
- a Department of Medical Oncology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Natalie Prinzi
- e Department of Experimental Medicine , 'Sapienza' University of Rome , Rome , Italy
| | - Laura Concas
- a Department of Medical Oncology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Livia Leuzzi
- a Department of Medical Oncology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Filippo De Braud
- a Department of Medical Oncology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
| | - Roberto Buzzoni
- a Department of Medical Oncology , Fondazione IRCCS 'Istituto Nazionale dei Tumori' , Milan , Italy
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Pusceddu S, Buzzoni R, Vernieri C, Concas L, Marceglia S, Giacomelli L, Milione M, Leuzzi L, Femia D, Formisano B, Mazzaferro V, de Braud F. Metformin with everolimus and octreotide in pancreatic neuroendocrine tumor patients with diabetes. Future Oncol 2016; 12:1251-60. [PMID: 26890290 DOI: 10.2217/fon-2015-0077] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A bidirectional relationship seems to exist between diabetes mellitus and development of pancreatic tumors. Metformin, the most widely used drug in the treatment of Type 2 diabetes mellitus, has recently emerged as a potentially active agent in cancer chemoprevention and treatment. In this article, we discuss the potential correlation between glycemic status, administration of antiglycemic treatments, such as metformin or insulin, and prognosis of pancreatic neuroendocrine tumors patients treated with everolimus and octreotide, on the basis of existing evidence and our experience.
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Affiliation(s)
- Sara Pusceddu
- Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Buzzoni
- Day Hospital/Outpatient Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudio Vernieri
- Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,IFOM, FIRC Institute of Molecular Oncology, 20139 Milan, Italy
| | - Laura Concas
- Day Hospital/Outpatient Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Marceglia
- Department of Information & Bioengineering, Politecnico University, Milan, Italy
| | - Luca Giacomelli
- Department of Surgical Sciences & Integrated Diagnostics, School of Medicine, Genova University, Genoa, Italy
| | - Massimo Milione
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Livia Leuzzi
- Day Hospital/Outpatient Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniela Femia
- Day Hospital/Outpatient Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Barbara Formisano
- Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Vincenzo Mazzaferro
- Gastro-Intestinal Surgery, Liver Transplantation & Hepatology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Filippo de Braud
- Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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