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Berardi R, Mastroianni C, Lo Russo G, Buosi R, Santini D, Montanino A, Carnaghi C, Tiseo M, Chiari R, Camerini A, Barni S, De Marino V, Ferrari D, Cristofano A, Doni L, Freddari F, Fumagalli D, Portalone L, Sarmiento R, Schinzari G, Sperandi F, Tucci M, Inno A, Ciuffreda L, Mariotti M, Mariani C, Caramanti M, Torniai M, Gallucci R, Bennati C, Bordi P, Buffoni L, Galeassi A, Ghidini M, Grossi E, Morabito A, Vincenzi B, Arvat E. Syndrome of inappropriate anti-diuretic hormone secretion in cancer patients: results of the first multicenter Italian study. Ther Adv Med Oncol 2019; 11:1758835919877725. [PMID: 31632468 PMCID: PMC6767731 DOI: 10.1177/1758835919877725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 08/30/2019] [Indexed: 11/22/2022] Open
Abstract
Background: Hyponatremia in cancer patients is often caused by the syndrome of
inappropriate antidiuretic hormone secretion (SIADH). The aim of this
observational multicenter study was to analyze the medical and economic
implications of SIADH in this setting. Methods: This study included 90 oncological patients from 28 Italian institutions that
developed SIADH between January 2010 and September 2015. Data on
clinical–pathological characteristics, anticancer therapies, hyponatremia,
and related treatments were statistically analyzed. Results: The majority were lung cancer patients (73%) with metastatic disease at the
onset of hyponatremia (83%). A total of 76 patients (84%) were hospitalized
because of SIADH and less than half (41%) received tolvaptan for SIADH
treatment. The duration of hospitalization was significantly longer in
patients who did not receive tolvaptan and in those who do not reach sodium
normalization during hospitalization. Patients who experienced a second
episode of hyponatremia following tolvaptan dose
modification/discontinuation presented a significantly lower serum sodium
value at the time of hospitalization and minimum sodium value during
hospitalization compared with patients who had not experienced another
episode. The severity of hyponatremia, defined as minimum sodium value
during hospitalization with a cut-off value of 110 mmol/l, and not obtaining
sodium correction during hospitalization significantly correlated with
overall survival rate. Conclusions: Hyponatremia due to SIADH could result in longer hospitalization and in a
decreased overall survival when not adequately treated, and tolvaptan
represents an effective treatment with a potential effect of both improving
overall survival and decreasing duration of hospitalization.
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Affiliation(s)
| | | | - Giuseppe Lo Russo
- Thoracic Oncology Fondazione IRCCS Istituto dei
Tumori, Milano, Italy
| | - Roberta Buosi
- Oncology Unit- S. Spirito Hospital - Casale M.to
– Alessandria, Italy
| | - Daniele Santini
- Medical Oncology Unit, Campus Bio-Medico
University of Rome, Rome, Italy
| | - Agnese Montanino
- Thoracic Medical Oncology, Istituto Nazionale
Tumori ‘Fondazione G Pascale’, IRCCS, Napoli, Italy
| | | | - Marcello Tiseo
- U.O. Oncologia Medica Azienda
Ospedaliero-Universitaria di Parma, Italy
| | - Rita Chiari
- Medical Oncology, Santa Maria della Misericordia
Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Andrea Camerini
- Medical Oncology, Azienda USL Toscana
nord-ovest, Ospedale Versilia, Italy
| | - Sandro Barni
- Oncology Unit, ASST Bergamo Ovest, Treviglio,
Italy
| | - Valeria De Marino
- U.O. Pneumologia ad indirizzo Oncologico.
Azienda dei colli-Monaldi, Napoli, Italy
| | - Daris Ferrari
- U.O. Oncologia Medica ASST Santi Paolo e Carlo,
Presidio Ospedaliero San Paolo, Milano, Italy
| | | | | | | | | | - Luigi Portalone
- Pneumologia Oncologica 2, Az. Osp. S. Camillo
Forlanini, Roma, Italy
| | | | - Giovanni Schinzari
- Polo Scienze Oncologiche ed Ematologiche, UOC
di Oncologia Medica, Università Cattolica del Sacro Cuore, Fondazione
Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Francesca Sperandi
- U.O. Oncologia Medica, Azienda
Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Marcello Tucci
- Division of Medical Oncology, Department of
Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin,
Italy
| | - Alessandro Inno
- Medical Oncology, Ospedale Sacro Cuore Don
Calabria, Negrar, Verona, Italy
| | - Libero Ciuffreda
- Azienda Ospedaliero Universitaria Città della
Salute e della Scienza, Torino, Italy
| | - Marita Mariotti
- Istituto Scientifico Romagnolo per lo Studio e
la Cura dei Tumori, Meldola, Italy
| | | | - Miriam Caramanti
- Clinica Oncologica, Università Politecnica
delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I,
GM Lancisi, G Salesi, Ancona, Italy Current address: UOC Oncologia, Ospedale
E.Profili di Fabriano Asur, Marche Area Vasta 2, Italy
| | - Mariangela Torniai
- Clinica Oncologica, Università Politecnica
delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I,
GM Lancisi, G Salesi, Ancona, Italy
| | - Rosaria Gallucci
- Thoracic Oncology Fondazione IRCCS Istituto dei
Tumori, Milano, Italy
| | - Chiara Bennati
- Dipartimento di Oncologia-Ematologia, AUSL
della Romagna, Ravenna, Italy
| | - Paola Bordi
- U.O. Oncologia Medica Azienda
Ospedaliero-Universitaria di Parma, Italy
| | - Lucio Buffoni
- Azienda Ospedaliero Universitaria Città della
Salute e della Scienza, Torino, Italy
| | | | - Michele Ghidini
- Medical Oncology and Hematology Unit, Humanitas
Cancer Center, Humanitas Clinical and Research Center-IRCCS, Rozzano
(Milan), Italy
| | - Emidio Grossi
- Division of Oncological Endocrinology,
Department of Medical Sciences, University of Turin, Italy
| | - Alessandro Morabito
- Thoracic Medical Oncology, Istituto Nazionale
Tumori ‘Fondazione G Pascale’, IRCCS, Napoli, Italy
| | - Bruno Vincenzi
- Medical Oncology Unit, Campus Bio-Medico
University of Rome, Rome, Italy
| | - Emanuela Arvat
- Division of Oncological Endocrinology,
Department of Medical Sciences, University of Turin, Italy
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Berardi R, Torniai M, Pusceddu S, Spada F, Ibrahim T, Brizzi MP, Antonuzzo L, Ferolla P, Panzuto F, Silvestris N, Partelli S, Ferretti B, Freddari F, Gucciardino C, Testa E, Concas L, Murgioni S, Bongiovanni A, Zichi C, Riva N, Rinzivillo M, Brunetti O, Giustini L, Di Costanzo F, Delle Fave G, Fazio N, De Braud F, Falconi M, Cascinu S. Prognostic impact of the cumulative dose and dose intensity of everolimus in patients with pancreatic neuroendocrine tumors. Cancer Med 2017; 6:1493-1499. [PMID: 28547856 PMCID: PMC5504331 DOI: 10.1002/cam4.1028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/18/2016] [Accepted: 12/30/2016] [Indexed: 12/19/2022] Open
Abstract
The aim of this work is to assess if cumulative dose (CD) and dose intensity (DI) of everolimus may affect survival of advanced pancreatic neuroendocrine tumors (PNETs) patients. One hundred and sixteen patients (62 males and 54 females, median age 55 years) with advanced PNETs were treated with everolimus for ≥3 months. According to a Receiver operating characteristics (ROC) analysis, patients were stratified into two groups, with CD ≤ 3000 mg (Group A; n = 68) and CD > 3000 mg (Group B; n = 48). The response rate and toxicity were comparable in the two groups. However, patients in group A experienced more dose modifications than patients in group B. Median OS was 24 months in Group A while in Group B it was not reached (HR: 26.9; 95% CI: 11.0-76.7; P < 0.0001). Patients who maintained a DI higher than 9 mg/day experienced a significantly longer OS and experienced a trend to higher response rate. Overall, our study results showed that both CD and DI of everolimus play a prognostic role for patients with advanced PNETs treated with everolimus. This should prompt efforts to continue everolimus administration in responsive patients up to at least 3000 mg despite delays or temporary interruptions.
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Affiliation(s)
- Rossana Berardi
- Clinica di Oncologia Medica, Università Politecnica delle Marche, AOU Ospedali Riuniti di, Ancona, Italy
| | - Mariangela Torniai
- Clinica di Oncologia Medica, Università Politecnica delle Marche, AOU Ospedali Riuniti di, Ancona, Italy
| | - Sara Pusceddu
- Medicina Oncologica 1, ENETS Center of excellence, Fondazione IRCCS Istituto Tumori, Milano, Italy
| | - Francesca Spada
- Unità di Oncologia Medica Gastrointestinale e Tumori Neuroendocrini (Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors), IEO Istituto Europeo di Oncologia, Milano, Italy
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Lorenzo Antonuzzo
- SC di Oncologia Medica, Azienda Opedaliero-Universitaria Careggi, Firenze, Italy.,Doctorate Course in Genetics, Oncology and Clinical Medicine, University of Siena, Siena, Italy
| | - Piero Ferolla
- Multidisciplinary NET Group, Umbria Regional Cancer Network, Perugia, Italy
| | - Francesco Panzuto
- Digestive and Liver Disease, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, National Cancer Institute Giovanni Paolo II, Bari, Italy
| | - Stefano Partelli
- Chirurgia del Pancreas, Università Politecnica delle Marche, AOU Ospedali Riuniti di, Ancona, Italy.,Chirurgia del Pancreas, Ospedale San Raffaele IRCCS, Università Vita e Salute, Milano, Italy
| | - Benedetta Ferretti
- Oncologia Medica, Ospedale di San Severino, San Severino Marche (MC), Italy
| | | | | | - Enrica Testa
- Oncologia Medica, Ospedale di Urbino, Urbino, Italy
| | - Laura Concas
- Medicina Oncologica 1, ENETS Center of excellence, Fondazione IRCCS Istituto Tumori, Milano, Italy
| | - Sabina Murgioni
- Unità di Oncologia Medica Gastrointestinale e Tumori Neuroendocrini (Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors), IEO Istituto Europeo di Oncologia, Milano, Italy
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Clizia Zichi
- Oncologia Medica, A.O.U. San Luigi, Orbassano (TO), Italy
| | - Nada Riva
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Maria Rinzivillo
- Digestive and Liver Disease, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Oronzo Brunetti
- Medical Oncology Unit, National Cancer Institute Giovanni Paolo II, Bari, Italy
| | | | | | - Gianfranco Delle Fave
- Digestive and Liver Disease, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Nicola Fazio
- Unità di Oncologia Medica Gastrointestinale e Tumori Neuroendocrini (Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors), IEO Istituto Europeo di Oncologia, Milano, Italy
| | - Filippo De Braud
- Medicina Oncologica 1, ENETS Center of excellence, Fondazione IRCCS Istituto Tumori, Milano, Italy
| | - Massimo Falconi
- Chirurgia del Pancreas, Università Politecnica delle Marche, AOU Ospedali Riuniti di, Ancona, Italy.,Chirurgia del Pancreas, Ospedale San Raffaele IRCCS, Università Vita e Salute, Milano, Italy
| | - Stefano Cascinu
- Clinica di Oncologia Medica, Università Politecnica delle Marche, AOU Ospedali Riuniti di, Ancona, Italy.,Oncologia Medica, Università di Modena e Reggio Emilia, Modena, Italy
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Berardi R, Pusceddu S, Spada F, Ibrahim T, Brizzi M, Antonuzzo L, Ferolla P, Rinzivillo M, Silvestris N, Freddari F, Testa E, Bongiovanni A, Zichi C, Di Costanzo F, Delle Fave G, Fazio N, de Braud F, Falconi M, Cascinu S. Prognostic impact of the cumulative dose and dose intensity of everolimus in patients with pancreatic neuroendocrine tumors (PNETs). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.17] [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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Berardi R, Scartozzi M, Freddari F, Squadroni M, Santinelli A, Bearzi I, Fabris G, Cascinu S. “Biliary tract cancers: Molecular profiling as a tool for treatment decisions. A literature review” [Cancer Treatment Reviews 32(5) (2006) 333–347]. Cancer Treat Rev 2007. [DOI: 10.1016/j.ctrv.2006.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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5
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Berardi R, Rossana B, Scartozzi M, Mario S, Freddari F, Federica F, Squadroni M, Michela S, Santinelli A, Alfredo S, Bearzi I, Italo B, Fabris G, Guidalberto F, Cascinu S, Stefano C. Biliary tract cancers: molecular profiling as a tool for treatment decisions. A literature review. Cancer Treat Rev 2006; 32:333-47. [PMID: 16762510 DOI: 10.1016/j.ctrv.2006.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Revised: 01/20/2006] [Accepted: 03/14/2006] [Indexed: 02/01/2023]
Abstract
Biliary tract cancer is a quite rare disease; despite recent significant advances in imaging modalities, most of the patients have advanced disease at presentation thus making radical surgery not feasible. Many different chemotherapeutic regimens have been investigated in small uncontrolled studies, with generally disappointing results. We extensively reviewed the literature on this topic trying to give an explanation to chemoresistance in this setting of patients and considering the molecular profiling as a tool for treatment decision. This review is divided in two parts, in the first one we illustrated chemotherapy results and possible mechanisms of resistance. In the second part we analysed the new molecular targets developing an hypothesis about the future therapeutics perspectives.
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Affiliation(s)
- Rossana Berardi
- Clinica di Oncologia Medica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi di Ancona, via Conca 71, 60020 Ancona, Italy.
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6
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Berardi R, Grilli G, Romagnoli E, Saladino T, Freddari F, Tamburrano T, Galizia E, Carbonari G, Mariani C, Braconi C, Pierantoni C, Battelli N, Scartozzi M, Cascinu S. [Paraneoplastic syndromes: a review]. Clin Ter 2005; 156:281-8. [PMID: 16463565] [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] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Modern oncology often obtains good results against earlier neoplasms, whilst it's still in difficulties against the advanced ones. The knowledge of paraneoplastic syndromes is crucial both to cure patients and to do an earlier diagnosis. When we recognize a paraneoplastic syndrome that comes before the clinic beginning of a neoplasm, perhaps we save a life. This review discusses all the main paraneoplastic syndromes, focusing mainly on their clinical aspect and reminding the most commonly associated cancers.
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Affiliation(s)
- R Berardi
- Clinica di Oncologia Medica, Azienda Ospedaliero, Università Politecnica delle Marche, Ancona, Italia.
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Scartozzi M, Galizia E, Freddari F, Berardi R, Cellerino R, Cascinu S. Molecular biology of sporadic gastric cancer: prognostic indicators and novel therapeutic approaches. Cancer Treat Rev 2004; 30:451-9. [PMID: 15245777 DOI: 10.1016/j.ctrv.2004.01.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [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: 02/07/2023]
Abstract
Both the availability of multiple treatment modalities and novel therapeutic targets make the correct prognostic stratification and the identification of truly predictive factors an issue of major debate in gastric cancer. Along with "classic" prognostic factors such as those related to the diffusion of the tumour at diagnosis (i.e., depth of gastric wall infiltration, locoregional lymph nodes or distant metastases) or those concerning the pathologic characteristics of the tumour, other, innovative, factors should be considered if a better definition of the characteristics of the tumour is to be given. These biological factors are often derived from the genetic process, which is thought to represent a crucial step to gastric cancer (DNA copy number changes, microsatellite instability, thymidilate synthase, E-cadherin, beta-catenin, mucin antigen, p53, c-erb B-2, COX-2, matrix metalloproteinases, VEGFR and EGFR). Some of those putative prognostic indicators can also be considered predictive of response to therapy as they are a molecular target either to chemotherapeutics (i.e., thymidilate synthase that is targeted by 5FU) or to a new class of antineoplastic molecules (i.e., c-erb B-2 targeted by trastuzumab, COX-2 by NSAIDs, matrix metalloproteinases, EGFR and VEGFR by specific inhibitors).
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Affiliation(s)
- Mario Scartozzi
- Clinica di Oncologia Medica, Università Politecnica delle Marche-Azienda Ospedaliera Umberto I, Ancona, Italy
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Freddari F, Berardi R, Scartozzi M, Cascinu S. [Non-small cell lung carcinoma: pathology, biology and prognosis]. Suppl Tumori 2004; 3:S3-4. [PMID: 15067954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- Federica Freddari
- Clinica di Oncologia Medica, Università Politecnica delle Marche, Ancona
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