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Giannini N, Gadducci G, Fuentes T, Gonnelli A, Di Martino F, Puccini P, Naso M, Pasqualetti F, Capaccioli S, Paiar F. Electron FLASH radiotherapy in vivo studies. A systematic review. Front Oncol 2024; 14:1373453. [PMID: 38655137 PMCID: PMC11035725 DOI: 10.3389/fonc.2024.1373453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/15/2024] [Indexed: 04/26/2024] Open
Abstract
FLASH-radiotherapy delivers a radiation beam a thousand times faster compared to conventional radiotherapy, reducing radiation damage in healthy tissues with an equivalent tumor response. Although not completely understood, this radiobiological phenomenon has been proved in several animal models with a spectrum of all kinds of particles currently used in contemporary radiotherapy, especially electrons. However, all the research teams have performed FLASH preclinical studies using industrial linear accelerator or LINAC commonly employed in conventional radiotherapy and modified for the delivery of ultra-high-dose-rate (UHDRs). Unfortunately, the delivering and measuring of UHDR beams have been proved not to be completely reliable with such devices. Concerns arise regarding the accuracy of beam monitoring and dosimetry systems. Additionally, this LINAC totally lacks an integrated and dedicated Treatment Planning System (TPS) able to evaluate the internal dose distribution in the case of in vivo experiments. Finally, these devices cannot modify dose-time parameters of the beam relevant to the flash effect, such as average dose rate; dose per pulse; and instantaneous dose rate. This aspect also precludes the exploration of the quantitative relationship with biological phenomena. The dependence on these parameters need to be further investigated. A promising advancement is represented by a new generation of electron LINAC that has successfully overcome some of these technological challenges. In this review, we aim to provide a comprehensive summary of the existing literature on in vivo experiments using electron FLASH radiotherapy and explore the promising clinical perspectives associated with this technology.
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Affiliation(s)
- Noemi Giannini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy
- Centro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy
| | - Giovanni Gadducci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy
- Centro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy
| | - Taiusha Fuentes
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy
- Centro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy
| | - Alessandra Gonnelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy
- Centro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy
| | - Fabio Di Martino
- Centro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy
- Unit of Medical Physics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Tuscany, Italy
- National Institute of Nuclear Physics (INFN)-section of Pisa, Pisa, Tuscany, Italy
| | - Paola Puccini
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Tuscany, Italy
| | - Monica Naso
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Tuscany, Italy
| | - Francesco Pasqualetti
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Tuscany, Italy
| | - Simone Capaccioli
- Centro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy
- Department of Physics, University of Pisa, Pisa, Tuscany, Italy
| | - Fabiola Paiar
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy
- Centro Pisano Multidisciplinare Sulla Ricerca e Implementazione Clinica Della Flash Radiotherapy (CPFR), University of Pisa, Pisa, Italy
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Tuscany, Italy
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Ius T, Montemurro N, Lombardi G, Berardinelli J, Romano A, Barresi V, Cerretti G, Guarnera A, Tel A, Cavallo LM, Pasqualetti F, Feletti A. Decoding the puzzle: A multidisciplinary systematic review of adult brainstem glioma. Crit Rev Oncol Hematol 2024; 196:104261. [PMID: 38395241 DOI: 10.1016/j.critrevonc.2024.104261] [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: 08/06/2023] [Revised: 12/26/2023] [Accepted: 01/04/2024] [Indexed: 02/25/2024] Open
Abstract
Adult brainstem gliomas (BSGs) are a group of rare central nervous system tumors with varying prognoses and controversial standard treatment strategies. To provide an overview of current trends, a systematic review using the PRISMA guidelines, Class of evidence (CE) and strength of recommendation (SR), was conducted. The review identified 27 studies. Surgery was found to have a positive impact on survival, particularly for focal lesions with CE II SR C. Stereotactic image-guided biopsy was recommended when resective surgery was not feasible with CE II and SR B. The role of systemic treatments remains unclear. Eight studies provided molecular biology data. This review gathers crucial literature on diagnosis and management of adult BSGs. It provides evidence-based guidance with updated recommendations for diagnosing and treating, taking into account recent molecular and genetic advancements. The importance of brain biopsy is emphasized to optimize treatment using emerging genetic-molecular findings and explore potential targeted therapies.
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Affiliation(s)
- Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department University Hospital of Udine, Italy.
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Jacopo Berardinelli
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Andrea Romano
- Department of Neuroradiology, NESMOS S. Andrea Hospital, University Sapienza, Rome, Italy
| | - Valeria Barresi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giulia Cerretti
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Alessia Guarnera
- Department of Neuroradiology, NESMOS S. Andrea Hospital, University Sapienza, Rome, Italy
| | - Alessandro Tel
- Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department University Hospital of Udine, Italy
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Francesco Pasqualetti
- Division of Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Alberto Feletti
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, Italy
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Morelli M, Lessi F, Franceschi S, Ferri G, Giacomarra M, Menicagli M, Gambacciani C, Pieri F, Pasqualetti F, Montemurro N, Aretini P, Santonocito OS, Di Stefano AL, Mazzanti CM. Exploring Regorafenib Responsiveness and Uncovering Molecular Mechanisms in Recurrent Glioblastoma Tumors through Longitudinal In Vitro Sampling. Cells 2024; 13:487. [PMID: 38534332 PMCID: PMC10968984 DOI: 10.3390/cells13060487] [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: 02/07/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
Glioblastoma, a deadly brain tumor, shows limited response to standard therapies like temozolomide (TMZ). Recent findings from the REGOMA trial underscore a significant survival improvement offered by Regorafenib (REGO) in recurrent glioblastoma. Our study aimed to propose a 3D ex vivo drug response precision medicine approach to investigate recurrent glioblastoma sensitivity to REGO and elucidate the underlying molecular mechanisms involved in tumor resistance or responsiveness to treatment. Three-dimensional glioblastoma organoids (GB-EXPs) obtained from 18 patients' resected recurrent glioblastoma tumors were treated with TMZ and REGO. Drug responses were evaluated using NAD(P)H FLIM, stratifying tumors as responders (Resp) or non-responders (NRs). Whole-exome sequencing was performed on 16 tissue samples, and whole-transcriptome analysis on 13 GB-EXPs treated and untreated. We found 35% (n = 9) and 77% (n = 20) of tumors responded to TMZ and REGO, respectively, with no instances of TMZ-Resp being REGO-NRs. Exome analysis revealed a unique mutational profile in REGO-Resp tumors compared to NR tumors. Transcriptome analysis identified distinct expression patterns in Resp and NR tumors, impacting Rho GTPase and NOTCH signaling, known to be involved in drug response. In conclusion, recurrent glioblastoma tumors were more responsive to REGO compared to TMZ treatment. Importantly, our approach enables a comprehensive longitudinal exploration of the molecular changes induced by treatment, unveiling promising biomarkers indicative of drug response.
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Affiliation(s)
- Mariangela Morelli
- Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy; (F.L.); (S.F.); (M.G.); (C.M.M.)
| | - Francesca Lessi
- Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy; (F.L.); (S.F.); (M.G.); (C.M.M.)
| | - Sara Franceschi
- Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy; (F.L.); (S.F.); (M.G.); (C.M.M.)
| | - Gianmarco Ferri
- Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy; (F.L.); (S.F.); (M.G.); (C.M.M.)
| | - Manuel Giacomarra
- Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy; (F.L.); (S.F.); (M.G.); (C.M.M.)
| | - Michele Menicagli
- Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy; (F.L.); (S.F.); (M.G.); (C.M.M.)
| | - Carlo Gambacciani
- Neurosurgical Department of Spedali Riuniti di Livorno, 57124 Livorno, Italy (O.S.S.)
| | - Francesco Pieri
- Neurosurgical Department of Spedali Riuniti di Livorno, 57124 Livorno, Italy (O.S.S.)
| | - Francesco Pasqualetti
- Radiotherapy Department, Azienda Ospedaliera Universitaria Pisana, 56126 Pisa, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana, 56126 Pisa, Italy;
| | - Paolo Aretini
- Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy; (F.L.); (S.F.); (M.G.); (C.M.M.)
| | | | - Anna Luisa Di Stefano
- Neurosurgical Department of Spedali Riuniti di Livorno, 57124 Livorno, Italy (O.S.S.)
| | - Chiara Maria Mazzanti
- Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy; (F.L.); (S.F.); (M.G.); (C.M.M.)
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Pasqualetti F, Gabelloni M, Faggioni L, Aquaro GD, De Vietro F, Mendola V, Spina N, Frey J, Montemurro N, Cantarella M, Caccese M, Gadducci G, Giannini N, Valenti S, Morganti R, Ius T, Caffo M, Vergaro G, Cosottini M, Naccarato AG, Lombardi G, Bocci G, Neri E, Paiar F. Glioblastoma and Internal Carotid Artery Calcium Score: A Possible Novel Prognostic Partnership? J Clin Med 2024; 13:1512. [PMID: 38592330 PMCID: PMC10933913 DOI: 10.3390/jcm13051512] [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: 01/23/2024] [Revised: 02/24/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose: Clinical evidence suggests an association between comorbidities and outcome in patients with glioblastoma (GBM). We hypothesised that the internal carotid artery (ICA) calcium score could represent a promising prognostic biomarker in a competing risk analysis in patients diagnosed with GBM. Methods: We validated the use of the ICA calcium score as a surrogate marker of the coronary calcium score in 32 patients with lung cancer. Subsequently, we assessed the impact of the ICA calcium score on overall survival in GBM patients treated with radio-chemotherapy. Results: We analysed 50 GBM patients. At the univariate analysis, methyl-guanine-methyltransferase gene (MGMT) promoter methylation (p = 0.048), gross total tumour resection (p = 0.017), and calcium score (p = 0.011) were significant prognostic predictors in patients with GBM. These three variables also maintained statistical significance in the multivariate analysis. Conclusions: the ICA calcium score could be a promising prognostic biomarker in GBM patients.
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Affiliation(s)
- Francesco Pasqualetti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Michela Gabelloni
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Giovanni Donato Aquaro
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Fabrizio De Vietro
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Vincenzo Mendola
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Nicola Spina
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Jessica Frey
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy;
| | - Martina Cantarella
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Mario Caccese
- Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (M.C.); (G.L.)
| | - Giovanni Gadducci
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Noemi Giannini
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Silvia Valenti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, 56124 Pisa, Italy;
| | - Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, 33100 Udine, Italy;
| | - Maria Caffo
- Department of Neurosurgery, University of Messina, 98122 Messina, Italy;
| | - Giuseppe Vergaro
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy;
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
| | - Mirco Cosottini
- Department of Neuroradiology, University of Pisa, 56126 Pisa, Italy;
| | - Antonio Giuseppe Naccarato
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Giuseppe Lombardi
- Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (M.C.); (G.L.)
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, Clinical Pharmacology, University of Pisa, 56126 Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Fabiola Paiar
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
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Crucitta S, Pasqualetti F, Gonnelli A, Ruglioni M, Luculli GI, Cantarella M, Ortenzi V, Scatena C, Paiar F, Naccarato AG, Danesi R, Del Re M. IDH1 mutation is detectable in plasma cell-free DNA and is associated with survival outcome in glioma patients. BMC Cancer 2024; 24:31. [PMID: 38172718 PMCID: PMC10763009 DOI: 10.1186/s12885-023-11726-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Circulating cell-free DNA (cfDNA, liquid biopsy) is a powerful tool to detect molecular alterations. However, depending on tumor characteristics, biology and anatomic localization, cfDNA detection and analysis may be challenging. Gliomas are enclosed into an anatomic sanctuary, which obstacles the release of cfDNA into the peripheral blood. Therefore, the advantages of using liquid biopsy for brain tumors is still to be confirmed. The present study evaluates the ability of liquid biopsy to detect IDH1 mutations and its correlation with survival and clinical characteristics of glioma patients. METHODS Blood samples obtained from glioma patients were collected after surgery prior to the adjuvant therapy. cfDNA was extracted from plasma and IDH1 p.R132H mutation analysis was performed on a digital droplet PCR. χ2-test and Cohen k were used to assess the correlation between plasma and tissue IDH1 status, while Kaplan Meier curve and Cox regression analysis were applied to survival analysis. Statistical calculations were performed by MedCalc and GraphPad Prism software. RESULTS A total of 67 samples were collected. A concordance between IDH1 status in tissue and in plasma was found (p = 0.0024), and the presence of the IDH1 mutation both in tissue (138.8 months vs 24.4, p < 0.0001) and cfDNA (116.3 months vs 35.8, p = 0.016) was associated with longer median OS. A significant association between IDH1 mutation both in tissue and cfDNA, age, tumor grade and OS was demonstrated by univariate Cox regression analysis. No statistically significant association between IDH1 mutation and tumor grade was found (p = 0.10). CONCLUSIONS The present study demonstrates that liquid biopsy may be used in brain tumors to detect IDH1 mutation which represents an important prognostic biomarker in patients with different types of gliomas, being associated to OS.
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Affiliation(s)
- Stefania Crucitta
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesco Pasqualetti
- Radiation Oncology, Department of Medicine and Oncology, University of Pisa, Pisa, Italy
- Department of Oncology, University of Oxford, Oxford, UK
| | - Alessandra Gonnelli
- Radiation Oncology, Department of Medicine and Oncology, University of Pisa, Pisa, Italy
| | - Martina Ruglioni
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanna Irene Luculli
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Martina Cantarella
- Radiation Oncology, Department of Medicine and Oncology, University of Pisa, Pisa, Italy
| | - Valerio Ortenzi
- Division of Pathology, Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Cristian Scatena
- Division of Pathology, Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Fabiola Paiar
- Radiation Oncology, Department of Medicine and Oncology, University of Pisa, Pisa, Italy
| | - Antonio Giuseppe Naccarato
- Division of Pathology, Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Pisa, Italy
| | - Romano Danesi
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
- Department of Oncology and Hemato-Oncology, University of Milano, Via Festa del Perdono, 7, Milano, 20122, Italy.
| | - Marzia Del Re
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Santonocito OS, Grimod G, DI Stefano AL, Pieri F, Nizzola M, Mazzuca N, Pasqualetti F, Morganti R, Zucchi V, Gambacciani C. O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) PET as a potential selection tool for second surgery in glioblastoma patients. J Neurosurg Sci 2023:S0390-5616.23.06019-8. [PMID: 38127301 DOI: 10.23736/s0390-5616.23.06019-8] [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: 12/23/2023]
Abstract
BACKGROUND Treatment-related changes still represent a diagnostic challenge in the management of patients with suspect of recurrent glioblastoma. The specificity of conventional MRI in detecting recurrence remains limited. Brain PET imaging provides information on tumor metabolism and can contribute to improving the diagnostic accuracy of cerebral neoplasms. We performed a retrospective analysis to evaluate the clinical value of O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) PET in the diagnosis of glioblastoma recurrence. METHODS A retrospective analysis on patients considered suitable for salvage surgery for recurrence glioblastoma was performed. 18F-FET-PET was performed to investigate gadolinium enhancement suspected for recurrence. Static and kinetic 18F-FET parameters were analyzed and related to O-6-methylguanine-DNA methyltransferase (MGMT) status. RESULTS Forty-two of the 51 patients who underwent 18F-FET-PET were re-operated. In each case, neuropathological diagnosis of tumor recurrence was confirmed. pMGMT hypermethylation was detected in 21 patients. Mean tumor-to-brain ratios (TBR) max was 3.87 (range 2.6-6.0). Static and kinetic 18F-FET parameters were similar according to MGMT status. CONCLUSIONS 18FET-PET can be a reliable tool to improve the selection of patients suitable for salvage surgery for glioblastoma recurrence.
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Affiliation(s)
| | - Gianluca Grimod
- Department of Neurosurgery, Hospital of Livorno, Livorno, Italy
| | | | - Francesco Pieri
- Department of Neurosurgery, Hospital of Livorno, Livorno, Italy
| | | | - Nicola Mazzuca
- Department of Nuclear Medicine, Hospital of Livorno, Livorno, Italy
| | | | - Riccardo Morganti
- Department of Clinical and Experimental Medicine, Section of Statistics, University of Pisa, Pisa, Italy
| | - Vanna Zucchi
- Department of Pathology, Hospital of Livorno, Livorno, Italy
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Ius T, Lombardi G, Baiano C, Berardinelli J, Romano A, Montemurro N, Cavallo LM, Pasqualetti F, Feletti A. Surgical Management of Adult Brainstem Gliomas: A Systematic Review and Meta-Analysis. Curr Oncol 2023; 30:9772-9785. [PMID: 37999129 PMCID: PMC10670486 DOI: 10.3390/curroncol30110709] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023] Open
Abstract
The present review aims to investigate the survival and functional outcomes in adult high-grade brainstem gliomas (BGSs) by comparing data from resective surgery and biopsy. MEDLINE, EMBASE and Cochrane Library were screened to conduct a systematic review of the literature, according to the PRISMA statement. Analysis was limited to articles including patients older than 18 years of age and those published from 1990 to September 2022. Case reports, review articles, meta-analyses, abstracts, reports of aggregated data, and reports on multimodal therapy where surgery was not the primary treatment were excluded. The ROBINS-I tool was applied to evaluate the risk of bias. Six studies were ultimately considered for the meta-analysis. The resective group was composed of 213 subjects and the bioptic group comprised 125. The analysis demonstrated a survival benefit in those patients in which an extensive resection was possible (STR HR 0.59 (95% CI 0.42, 0.82)) (GTR HR 0.63 (95% CI 0.43, 0.92)). Although surgical resection is associated with increased survival, the significantly higher complication rate makes it difficult to recommend surgery instead of biopsy for BSGs. Future investigations combining volumetric data and molecular profiles could add important data to better define the proper indication between resection and biopsy.
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Affiliation(s)
- Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, 33100 Udine, Italy;
| | - Giuseppe Lombardi
- Department of Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Cinzia Baiano
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, 80131 Naples, Italy; (C.B.); (L.M.C.)
| | - Jacopo Berardinelli
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, 80131 Naples, Italy; (C.B.); (L.M.C.)
| | - Andrea Romano
- Department of Neuroradiology, NESMOS S.Andrea Hospital, University Sapienza, 00189 Rome, Italy;
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy;
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, 80131 Naples, Italy; (C.B.); (L.M.C.)
| | | | - Alberto Feletti
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, 37129 Verona, Italy;
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8
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Pasqualetti F, Zanotti S. Nonrandomised controlled trial in recurrent glioblastoma patients: the promise of autologous tumour lysate-loaded dendritic cell vaccination. Br J Cancer 2023; 129:895-896. [PMID: 36792723 PMCID: PMC10491746 DOI: 10.1038/s41416-023-02194-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
Recently, Liau et al. reported the results of Phase 3 clinical trial testing DCVax-L vaccines on patients with glioblastoma. Despite the promising and significant results obtained, the study design and the long-lasting period of recruitment of this work deserve some reflection.
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Affiliation(s)
- Francesco Pasqualetti
- Department of Oncology, University of Oxford, OX3 7DQ, Oxford, UK.
- Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
| | - Sofia Zanotti
- Anatomic Pathology Unit, IRCCS Humanitas University Research Hospital, Milan, Italy.
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9
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Pasqualetti F, Miniati M, Gonnelli A, Gadducci G, Giannini N, Palagini L, Mancino M, Fuentes T, Paiar F. Cancer Stem Cells and Glioblastoma: Time for Innovative Biomarkers of Radio-Resistance? Biology (Basel) 2023; 12:1295. [PMID: 37887005 PMCID: PMC10604498 DOI: 10.3390/biology12101295] [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] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/28/2023]
Abstract
Despite countless papers in the field of radioresistance, researchers are still far from clearly understanding the mechanisms triggered in glioblastoma. Cancer stem cells (CSC) are important to the growth and spread of cancer, according to many studies. In addition, more recently, it has been suggested that CSCs have an impact on glioblastoma patients' prognosis, tumor aggressiveness, and treatment outcomes. In reviewing this new area of biology, we will provide a summary of the most recent research on CSCs and their role in the response to radio-chemotherapy in GB. In this review, we will examine the radiosensitivity of stem cells. Moreover, we summarize the current knowledge of the biomarkers of stemness and evaluate their potential function in the study of radiosensitivity.
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Affiliation(s)
- Francesco Pasqualetti
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56100 Pisa, Italy; (F.P.); (A.G.); (G.G.); (N.G.); (M.M.); (T.F.); (F.P.)
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, University of Pisa, Italy, Via Roma 67, 56100 Pisa, Italy;
| | - Alessandra Gonnelli
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56100 Pisa, Italy; (F.P.); (A.G.); (G.G.); (N.G.); (M.M.); (T.F.); (F.P.)
| | - Giovanni Gadducci
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56100 Pisa, Italy; (F.P.); (A.G.); (G.G.); (N.G.); (M.M.); (T.F.); (F.P.)
| | - Noemi Giannini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56100 Pisa, Italy; (F.P.); (A.G.); (G.G.); (N.G.); (M.M.); (T.F.); (F.P.)
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, University of Pisa, Italy, Via Roma 67, 56100 Pisa, Italy;
| | - Maricia Mancino
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56100 Pisa, Italy; (F.P.); (A.G.); (G.G.); (N.G.); (M.M.); (T.F.); (F.P.)
| | - Taiusha Fuentes
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56100 Pisa, Italy; (F.P.); (A.G.); (G.G.); (N.G.); (M.M.); (T.F.); (F.P.)
| | - Fabiola Paiar
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56100 Pisa, Italy; (F.P.); (A.G.); (G.G.); (N.G.); (M.M.); (T.F.); (F.P.)
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10
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Caruso G, Ferrarotto R, Curcio A, Metro L, Pasqualetti F, Gaviani P, Barresi V, Angileri FF, Caffo M. Novel Advances in Treatment of Meningiomas: Prognostic and Therapeutic Implications. Cancers (Basel) 2023; 15:4521. [PMID: 37760490 PMCID: PMC10526192 DOI: 10.3390/cancers15184521] [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: 08/03/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Meningiomas are the most frequent histotypes of tumors of the central nervous system. Their incidence is approximately 35% of all primary brain tumors. Although they have the status of benign lesions, meningiomas are often associated with a decreased quality of life due to focal neurological deficits that may be related. The optimal treatment is total resection. Histological grading is the most important prognostic factor. Recently, molecular alterations have been identified that are specifically related to particular phenotypes and, probably, are also responsible for grading, site, and prognostic trend. Meningiomas recur in 10-25% of cases. In these cases, and in patients with atypical or anaplastic meningiomas, the methods of approach are relatively insufficient. To date, data on the molecular biology, genetics, and epigenetics of meningiomas are insufficient. To achieve an optimal treatment strategy, it is necessary to identify the mechanisms that regulate tumor formation and progression. Combination therapies affecting multiple molecular targets are currently opening up and have significant promise as adjuvant therapeutic options. We review the most recent literature to identify studies investigating recent therapeutic treatments recently used for meningiomas.
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Affiliation(s)
- Gerardo Caruso
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | - Rosamaria Ferrarotto
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | - Antonello Curcio
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | - Luisa Metro
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | | | - Paola Gaviani
- Neuro Oncology Unit, IRCCS Foundation Carlo Besta Neurological Institute, 20133 Milan, Italy;
| | - Valeria Barresi
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy;
| | - Filippo Flavio Angileri
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | - Maria Caffo
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
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11
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Pasqualetti F, Barberis A, Zanotti S, Montemurro N, De Salvo GL, Soffietti R, Mazzanti CM, Ius T, Caffo M, Paiar F, Bocci G, Lombardi G, Harris AL, Buffa FM. The impact of survivorship bias in glioblastoma research. Crit Rev Oncol Hematol 2023; 188:104065. [PMID: 37392899 DOI: 10.1016/j.critrevonc.2023.104065] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 02/14/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/03/2023] Open
Abstract
Despite advances in the therapy of Central Nervous System (CNS) malignancies, treatment of glioblastoma (GB) poses significant challenges due to GB resistance and high recurrence rates following post-operative radio-chemotherapy. The majority of prognostic and predictive GB biomarkers are currently developed using tumour samples obtained through surgical interventions. However, the selection criteria adopted by different neurosurgeons to determine which cases are suitable for surgery make operated patients not representative of all GB cases. Particularly, geriatric and frail individuals are excluded from surgical consideration in some cancer centers. Such selection generates a survival (or selection) bias that introduces limitations, rendering the patients or data chosen for downstream analyses not representative of the entire community. In this review, we discuss the implication of survivorship bias on current and novel biomarkers for patient selection, stratification, therapy, and outcome analyses.
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Affiliation(s)
- Francesco Pasqualetti
- Department of Oncology, University of Oxford, Oxford, UK; Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
| | | | - Sofia Zanotti
- Anatomic Pathology Unit, IRCCS Humanitas University Research Hospital, Milan, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy
| | | | - Riccardo Soffietti
- Division of Neuro-Oncology, Department of Neuroscience, University and City of Health and Science University Hospital, Turin, Italy
| | | | - Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Maria Caffo
- Unit of Neurosurgery, Department of Biomorphology and Dental Sciences and Morfophunctional Imaging, University Hospital "G. Martino", Messina, Italy
| | - Fabiola Paiar
- Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126 Pisa, Italy
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | | | - Francesca M Buffa
- Department of Oncology, University of Oxford, Oxford, UK; Department of Computing Sciences, Bocconi University, Milan, Italy; Institute for Data Science and Analytics, Bocconi University, Milano, Italy
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12
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Lessi F, Morelli M, Franceschi S, Aretini P, Menicagli M, Marranci A, Pasqualetti F, Gambacciani C, Pieri F, Grimod G, Zucchi V, Cupini S, Di Stefano AL, Santonocito OS, Mazzanti CM. Innovative Approach to Isolate and Characterize Glioblastoma Circulating Tumor Cells and Correlation with Tumor Mutational Status. Int J Mol Sci 2023; 24:10147. [PMID: 37373295 DOI: 10.3390/ijms241210147] [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: 05/15/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Circulating tumor cells (CTCs) are one of the most important causes of tumor recurrence and distant metastases. Glioblastoma (GBM) has been considered restricted to the brain for many years. Nevertheless, in the past years, several pieces of evidence indicate that hematogenous dissemination is a reality, and this is also in the caseof GBM. Our aim was to optimize CTCs' detection in GBM and define the genetic background of single CTCs compared to the primary GBM tumor and its recurrence to demonstrate that CTCs are indeed derived from the parental tumor. We collected blood samples from a recurrent IDH wt GBM patient. We genotyped the parental recurrent tumor tissue and the respective primary GBM tissue. CTCs were analyzed using the DEPArray system. CTCs Copy Number Alterations (CNAs) and sequencing analyses were performed to compare CTCs' genetic background with the same patient's primary and recurrent GBM tissues. We identified 210 common mutations in the primary and recurrent tumors. Among these, three somatic high-frequency mutations (in PRKCB, TBX1, and COG5 genes) were selected to investigate their presence in CTCs. Almost all sorted CTCs (9/13) had at least one of the mutations tested. The presence of TERT promoter mutations was also investigated and C228T variation was found in parental tumors and CTCs (C228T heterozygous and homozygous, respectively). We were able to isolate and genotype CTCs from a patient with GBM. We found common mutations but also exclusive molecular characteristics.
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Affiliation(s)
- Francesca Lessi
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy
| | - Mariangela Morelli
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy
| | - Sara Franceschi
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy
| | - Paolo Aretini
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy
| | - Michele Menicagli
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy
| | - Andrea Marranci
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy
| | - Francesco Pasqualetti
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56122 Pisa, Italy
| | - Carlo Gambacciani
- Division of Neurosurgery, Spedali Riuniti di Livorno-USL Toscana Nord-Ovest, 57124 Livorno, Italy
| | - Francesco Pieri
- Division of Neurosurgery, Spedali Riuniti di Livorno-USL Toscana Nord-Ovest, 57124 Livorno, Italy
| | - Gianluca Grimod
- Division of Neurosurgery, Spedali Riuniti di Livorno-USL Toscana Nord-Ovest, 57124 Livorno, Italy
| | - Vanna Zucchi
- Division of Pathology, Spedali Riuniti di Livorno-USL Toscana Nord-Ovest, 57124 Livorno, Italy
| | - Samanta Cupini
- Division of Oncology, Spedali Riuniti di Livorno-USL Toscana Nord-Ovest, 57124 Livorno, Italy
| | - Anna Luisa Di Stefano
- Division of Neurosurgery, Spedali Riuniti di Livorno-USL Toscana Nord-Ovest, 57124 Livorno, Italy
- Neurology Department, Foch Hospital, 92150 Suresnes, France
| | - Orazio Santo Santonocito
- Division of Neurosurgery, Spedali Riuniti di Livorno-USL Toscana Nord-Ovest, 57124 Livorno, Italy
| | - Chiara Maria Mazzanti
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, 56017 Pisa, Italy
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13
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Agosti E, Panciani PP, Zeppieri M, De Maria L, Pasqualetti F, Tel A, Zanin L, Fontanella MM, Ius T. Tumor Microenvironment and Glioblastoma Cell Interplay as Promoters of Therapeutic Resistance. Biology (Basel) 2023; 12:biology12050736. [PMID: 37237548 DOI: 10.3390/biology12050736] [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] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
The invasive nature of glioblastoma is problematic in a radical surgery approach and can be responsible for tumor recurrence. In order to create new therapeutic strategies, it is imperative to have a better understanding of the mechanisms behind tumor growth and invasion. The continuous cross-talk between glioma stem cells (GSCs) and the tumor microenvironment (TME) contributes to disease progression, which renders research in this field difficult and challenging. The main aim of the review was to assess the different possible mechanisms that could explain resistance to treatment promoted by TME and GSCs in glioblastoma, including the role of M2 macrophages, micro RNAs (miRNAs), and long non-coding RNAs (lncRNAs) from exosomes from the TME. A systematic review of the literature on the role of the TME in developing and promoting radioresistance and chemoresistance of GBM was performed according to PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. A dedicated literature review search was also performed on the immunotherapeutic agents against the immune TME. We identified 367 papers using the reported keywords. The final qualitative analysis was conducted on 25 studies. A growing amount of evidence in the current literature supports the role of M2 macrophages and non-coding RNAs in promoting the mechanisms of chemo and radioresistance. A better insight into how GBM cells interact with TME is an essential step towards comprehending the mechanisms that give rise to resistance to standard treatment, which can help to pave the way for the development of novel therapeutic strategies for GBM patients.
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Affiliation(s)
- Edoardo Agosti
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Pier Paolo Panciani
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Lucio De Maria
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Francesco Pasqualetti
- Division of Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, 56100 Pisa, Italy
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - Alessandro Tel
- Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Luca Zanin
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Marco Maria Fontanella
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy
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14
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Nicosia L, Franceschini D, Perrone-Congedi F, Molinari A, Gerardi MA, Rigo M, Mazzola R, Perna M, Scotti V, Fodor A, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo RM, Bruni A, Cappelli A, D'Angelo E, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti FM, Lunardi G, Valdagni R, Fazio I, Scarzello G, Vavassori V, Maranzano E, Maria Magrini S, Arcangeli S, Gambacorta MA, Valentini V, Paiar F, Ramella S, Di Muzio NG, Loi M, Jereczek-Fossa BA, Casamassima F, Osti MF, Scorsetti M, Alongi F. A predictive model of polymetastatic disease from a multicenter large retrospectIve database on colorectal lung metastases treated with stereotactic ablative radiotherapy: The RED LaIT-SABR study. Clin Transl Radiat Oncol 2023; 39:100568. [PMID: 36935855 PMCID: PMC10014322 DOI: 10.1016/j.ctro.2022.100568] [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: 09/25/2022] [Revised: 12/02/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Aim Stereotactic ablative radiotherapy (SABR) showed increasing survival in oligometastatic patients. Few studies actually depicted oligometastatic disease (OMD) evolution and which patient will remain disease-free and which will rapidly develop a polymetastatic disease (PMD) after SABR. Therefore, apart from the number of active metastases, there are no clues on which proven factor should be considered for prescribing local treatment in OMD. The study aims to identify predictive factors of polymetastatic evolution in lung oligometastatic colorectal cancer patients. Methods This international Ethical Committee approved trial (Prot. Negrar 2019-ZT) involved 23 Centers and 450 lung oligometastatic patients. Primary end-point was time to the polymetastatic conversion (tPMC). Additionally, oligometastases number and cumulative gross tumor volume (cumGTV) were used as combined predictive factors of tPMC. Oligometastases number was stratified as 1, 2-3, and 4-5; cumGTV was dichotomized to the value of 10 cc. Results The median tPMC in the overall population was 26 months. Population was classified in the following tPMC risk classes: low-risk (1-3 oligometastases and cumGTV ≤ 10 cc) with median tPMC of 35.1 months; intermediate-risk (1-3 oligometastases and cumGTV > 10 cc), with median tPMC of 13.9 months, and high-risk (4-5 oligometastases, any cumGTV) with median tPMC of 9.4 months (p = 0.000). Conclusion The present study identified predictive factors of polymetastatic evolution after SABR in lung oligometastatic colorectal cancer. The results demonstrated that the sole metastases number is not sufficient to define the OMD since patients defined oligometastatic from a numerical point of view might rapidly progress to PMD when the cumulative tumor volume is high. A tailored approach in SABR prescription should be pursued considering the expected disease evolution after SABR, with the aim to avoid unnecessary treatment and toxicity in those at high risk of polymetastatic spread, and maximize local treatment in those with a favorable disease evolution.
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Affiliation(s)
- Luca Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
- Corresponding author at: Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034 Verona, Negrar, Italy.
| | - Davide Franceschini
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Francesca Perrone-Congedi
- Department of Radiation Oncology, “Sapienza” University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | | | | | - Michele Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
| | - Rosario Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
| | - Marco Perna
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Vieri Scotti
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Andrei Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Aurelia Iurato
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128 Rome, Italy
| | - Francesco Pasqualetti
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
- Department of Oncology, University of Oxford, Oxford, UK
| | - Giovanni Gadducci
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
| | - Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Alessio Bruni
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Anna Cappelli
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Elisa D'Angelo
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili di Brescia – Brescia University, Brescia, Italy
| | | | | | - Berardino De Bari
- Radiation Oncology Department, Neuchâtel Hospital Network, la Chaux-de-Fonds, Switzerland
| | - Matteo Sepulcri
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Dario Aiello
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
| | | | - Claudia Sangalli
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marzia Franceschini
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Gianluigi Lunardi
- Clinical Analysis Laboratory and Transfusional Medicine, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Riccardo Valdagni
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
| | - Ivan Fazio
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
| | - Giovanni Scarzello
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | | | - Stefano Maria Magrini
- Radiation Oncology Department, ASST Spedali Civili di Brescia – Brescia University, Brescia, Italy
| | - Stefano Arcangeli
- Department of Radiation Oncology, University of Milan Bicocca, Italy
| | - Maria Antonietta Gambacorta
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabiola Paiar
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
| | - Sara Ramella
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128 Rome, Italy
| | - Nadia Gisella Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Mauro Loi
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
| | | | - Mattia Falchetto Osti
- Department of Radiation Oncology, “Sapienza” University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Marta Scorsetti
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University Pieve Emanuele – Milan, Italy
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
- University of Brescia, Brescia, Italy
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15
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Innocenti L, Ortenzi V, Scarpitta R, Montemurro N, Pasqualetti F, Asseri R, Lazzi S, Szumera-Cieckiewicz A, De Ieso K, Perrini P, Naccarato AG, Scatena C, Fanelli GN. The Prognostic Impact of Gender, Therapeutic Strategies, Molecular Background, and Tumor-Infiltrating Lymphocytes in Glioblastoma: A Still Unsolved Jigsaw. Genes (Basel) 2023; 14:501. [PMID: 36833428 PMCID: PMC9956148 DOI: 10.3390/genes14020501] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/21/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
Despite the adoption of novel therapeutical approaches, the outcomes for glioblastoma (GBM) patients remain poor. In the present study, we investigated the prognostic impact of several clinico-pathological and molecular features as well as the role of the cellular immune response in a series of 59 GBM. CD4+ and CD8+ tumor-infiltrating lymphocytes (TILs) were digitally assessed on tissue microarray cores and their prognostic role was investigated. Moreover, the impact of other clinico-pathological features was evaluated. The number of CD4+ and CD8+ is higher in GBM tissue compared to normal brain tissue (p < 0.0001 and p = 0.0005 respectively). A positive correlation between CD4+ and CD8+ in GBM is present (rs = 0.417-p = 0.001). CD4+ TILs are inversely related to overall survival (OS) (HR = 1.79, 95% CI 1.1-3.1, p = 0.035). The presence of low CD4+ TILs combined with low CD8+ TILs is an independent predictor of longer OS (HR 0.38, 95% CI 0.18-0.79, p = 0.014). Female sex is independently related to longer OS (HR 0.42, 95% CI 0.22-0.77, p = 0.006). Adjuvant treatment, methylguanine methyltransferase (MGMT) promoter methylation, and age remain important prognostic factors but are influenced by other features. Adaptive cell-mediated immunity can affect the outcomes of GBM patients. Further studies are needed to elucidate the commitment of the CD4+ cells and the effects of different TILs subpopulations in GBM.
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Affiliation(s)
- Lorenzo Innocenti
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Valerio Ortenzi
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
| | - Rosa Scarpitta
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Pisa University Hospital, 56126 Pisa, Italy
| | - Francesco Pasqualetti
- Department of Radiation Oncology, Pisa University Hospital, 56126 Pisa, Italy
- Department of Oncology, Oxford University, Oxford OX1 4BH, UK
| | - Roberta Asseri
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Stefano Lazzi
- Anatomic Pathology Unit, Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy
| | - Anna Szumera-Cieckiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Katia De Ieso
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
| | - Paolo Perrini
- Department of Neurosurgery, Pisa University Hospital, 56126 Pisa, Italy
| | - Antonio Giuseppe Naccarato
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
| | - Cristian Scatena
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
| | - Giuseppe Nicolò Fanelli
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10021, USA
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16
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Paiar F, Gabelloni M, Pasqualetti F, Cocuzza P, Montrone S, Arena C, Faggioni L, Falaschi Z, Del Secco L, Alberich-Bayarri A, Bonmati LM, Neri E. Correlation of Pre- and Post-radio-chemotherapy MRI Texture Features With Tumor Response in Rectal Cancer. Anticancer Res 2023; 43:781-788. [PMID: 36697103 DOI: 10.21873/anticanres.16218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND/AIM The present study aimed to investigate radiomics features derived from magnetic resonance imaging (MRI) in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy (CRT). PATIENTS AND METHODS We retrospectively evaluated data of 53 patients (32 males, 21 females) with T3/T4 or N+ rectal cancer who underwent MRI before and after CRT. Twenty-seven texture radiomics features were extracted from regions of interest, delimiting the tumor on T2-weighted images. RESULTS All 27 radiomics features extracted before CRT showed a statistically significant association with the tumor regression grade (TRG) (p<0.05), whereas, after CRT, only the Cluster Prominence value was the only variable to predict TRG (p=0.037, r=0.291). CONCLUSION All 27 features extracted before CRT were able to predict response to CRT and Cluster Prominence continued to be statistically significant even after CRT. The impact of radiomics features derived from MRI could be further investigated in patients with locally advanced rectal cancer.
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Affiliation(s)
- Fabiola Paiar
- Radiation Oncology, Department of Translational Research, University of Pisa, Pisa, Italy.,Radiation Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Michela Gabelloni
- Academic Radiology, Department of Translational Research, University of Pisa, Pisa, Italy
| | | | - Paola Cocuzza
- Radiation Oncology, Area Vasta NordOvest, Lucca, Italy
| | - Sabrina Montrone
- Radiation Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Chiara Arena
- Academic Radiology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Zeno Falaschi
- Academic Radiology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Lorenzo Del Secco
- Academic Radiology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Angel Alberich-Bayarri
- QUIBIM SL, Quantitative Imaging Biomarkers in Medicine, GIBI230, Biomedical Imaging Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Luis Marti Bonmati
- Department of Radiology, Quirón Hospital, Valencia, Spain.,Biomedical Imaging Research Group (GIBI2^30), Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, Pisa, Italy
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17
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Morelli M, Stefano ALD, Picca A, Lessi F, Santonocito O, Menicagli M, Pasqualetti F, Franceschi S, Aretini P, Sanson M, Mazzanti CM. BIOM-35. A NEW PRECISION-MEDICINE APPROACH TO PREDICT TUMOR TREATMENT RESPONSE IDENTIFIES IN GLIOBLASTOMA A 17 GENE SIGNATURE PROGNOSTIC OF TMZ RESPONSE AND SURVIVAL WITH ROBUST PREDICTIVE VALUE. Neuro Oncol 2022. [PMCID: PMC9660525 DOI: 10.1093/neuonc/noac209.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
The Glioblastoma (GB) field has been experiencing a therapeutic standstill since 2005, primarily due to ineffective preclinical approaches to test anti-cancer treatments. Therefore, better treatment screening approaches are required. We developed a NADH FLIM-based functional precision medicine approach, that within one week after surgery identified two groups of TMZ Responder and Non-Responder tumors. A 17 gene molecular signature able to classify with 100% precision the TMZ responder and non-responder samples was discovered and identified by Kaplan Meier analysis, a Low-Risk and a High-Risk survival group, interrogating the TCGA GB database (Hazard Ratio = 1.87 p=0.00098,n=148) and TCGA LGG database (Hazard Ratio = 7.66 p=1.197e−35, n=660). Same results were obtained in the CCGA datasets. The 17 gene signature power for independently predicting prognosis (Hazard Ratio = 1.9, p=0.002) was then confirmed by direct RNAseq analysis of a separate clinically characterized cohort of 235 GB patients. Then, we combined the methylation status of the MGMT promoter to analyze the survival status of patients. The survival analysis based on the 17 gene risk signature and MGMT promoter methylation status demonstrated remarkable stratification of the clinical courses into four subgroups. Patients with MGMT promoter unmethylation and 17 gene High-Risk score had the worst prognosis, while patients with MGMT promoter methylation and 17 gene Low-Risk score had the best prognosis. In the latter group, a significant 24-month increase in survival was observed with 10% of 100 months Long Survivors with a difference of 35 months compared to the other groups. Our data indicate a new statistically strong RNAseq-based prognostic survival and TMZ response tool for patients with malignant glioma. The accuracy of this functional precision medicine approach allowed the development of a new prognostic gene signature that can improve the clinical management of GB patients. The approach could be implemented on other cancers as well.
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Affiliation(s)
| | | | - Alberto Picca
- Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière , Paris , France
| | | | - Orazio Santonocito
- Neurosurgical Department of Spedali Riuniti di Livorno , Livorno , Italy
| | | | | | | | | | - Marc Sanson
- Sorbonne Université, Paris Brain Institute , Paris , France
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18
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Abstract
PURPOSE OF REVIEW Gliomas are the most common primary tumors of the central nervous system. They are characterized by a disappointing prognosis and ineffective therapy that has shown no substantial improvements in the past 20 years. The lack of progress in treating gliomas is linked with the inadequacy of suitable tumor samples to plan translational studies and support laboratory developments. To overcome the use of tumor tissue, this commentary review aims to highlight the potential for the clinical application of liquid biopsy (intended as the study of circulating biomarkers in the blood), focusing on circulating tumor cells, circulating DNA and circulating noncoding RNA. RECENT FINDINGS Thanks to the increasing sensitivity of sequencing techniques, it is now possible to analyze circulating nucleic acids and tumor cells (liquid biopsy). SUMMARY Although studies on the use of liquid biopsy are still at an early stage, the potential clinical applications of liquid biopsy in the study of primary brain cancer are many and have the potential to revolutionize the approach to neuro-oncology, and importantly, they offer the possibility of gathering information on the disease at any time during its history.
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Affiliation(s)
- Francesco Pasqualetti
- Department of Oncology, University of Oxford, Oxford, UK
- Radiation Oncology Unit, Pisa University Hospital
| | - Milena Rizzo
- Noncoding RNA group, Functional Genetics and Genomics Lab, Institute of Clinical Physiology (IFC), CNR, Pisa
| | | | | | | | - Francesca M Buffa
- Department of Oncology, University of Oxford, Oxford, UK
- Department of Computing Sciences, Bocconi University, Milan, Italy
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19
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Morelli M, Lessi F, Di Stefano A, Santonocito O, Gambacciani C, Pieri F, Aquila F, Ferri G, Snuderl M, Mulholland P, Ottaviani D, Aretini P, Pasqualetti F, Franceschi S, Mazzanti C. P15.01.A Metabolic-imaging of human glioblastoma explants: a new precision-medicine model to predict treatment response early. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Glioblastoma (GB) is the most severe form of brain cancer, with a 12-15 month median survival. Although cell therapies for GB are on the near horizon, surgical resection, temozolomide (TMZ) and radiotherapy (RT) remain the primary therapeutic options for GB, and no new small-molecule therapies have been introduced in recent years. This therapeutic standstill is partially because preclinical models of GB do not reflect the complexities of GB cell biology. Furthermore, the aggressive progression of GB makes it critical to identify patient-tailored therapeutic strategies early.
Material and Methods
We developed a novel in-vitro 3D glioblastoma explants (GB-EXPs) model derived from patients’ resected tumors maintaining cytoarchitecture seen in the tumors. We then performed metabolic-imaging by fluorescence lifetime imaging microscopy (FLIM) on live GB-EXPs to predict drug response, using TMZ as test drug.
Results
The entire process was successfully completed within 1 week since surgery. A unique drug response sample stratification emerged that was well reflected at the molecular level, highlighting new targets associated with TMZ treatment and identifying a molecular signature associated with survival.
Conclusion
To the best of our knowledge, this is the first time that FLIM-based metabolic imaging is used on live glioblastoma explants to test anti-neoplastic drugs. FLIM-based readouts of drug response in GB explants could accelerate precision treatment of patients with GB and the identification of new anti-GB drugs.
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Affiliation(s)
- M Morelli
- Fondazione Pisana per la Scienza , S. Giuliano Terme , Italy
| | - F Lessi
- Fondazione Pisana per la Scienza , S. Giuliano Terme , Italy
| | | | | | | | - F Pieri
- Spedali Riuniti Livorno , Livorno , Italy
| | - F Aquila
- Spedali Riuniti Livorno , Livorno , Italy
| | - G Ferri
- Fondazione Pisana per la Scienza , S. Giuliano Terme , Italy
| | - M Snuderl
- LAngone Medical Center NYU , New York, NY , United States
| | | | | | - P Aretini
- Fondazione Pisana per la Scienza , S. Giuliano Terme , Italy
| | - F Pasqualetti
- Department of Oncology University of Oxford , Oxford , United Kingdom
| | - S Franceschi
- Fondazione Pisana per la Scienza , S. Giuliano Terme , Italy
| | - C Mazzanti
- Fondazione Pisana per la Scienza , S. Giuliano Terme , Italy
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20
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Lessi F, Morelli M, Aretini P, Menicagli M, Franceschi S, Pasqualetti F, Gambacciani C, Di Stefano A, Santonocito O, Mazzanti CM. P14.01.B Isolation and characterization of circulating tumor cells in a glioblastoma case with recurrence at distance and correlation with tumor mutational status. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Circulating Tumor Cells (CTCs) are considered to be one of the important causes of tumor recurrence and distant metastasis. For many years, glioblastoma (GB) was thought to be restricted to the brain. Nevertheless, a growing body of evidence indicates that, like many other cancers, hematogenic dissemination is a reality. The absence of a procedural uniformity in literature prompted us to develop an innovative and sensitive method to obtain CTCs in GB. Our aim is to define the genetic background of single CTCs compared with the primary GB tumor and its recurrence to assess whether or not their presence in the peripheral circulation correlates with GB migration and dissemination.
Material and Methods
CTCs were enriched from whole blood of one patient with recurrent GB with Parsortix Cell Separation System and analysed on DEPArray system. After that, CTCs Copy Number Aberrations (CNAs) and sequencing analysis was performed to compare CTCs genetic background with the same patient’s primary and recurrence tissues, analysed by NextSeq 500 (whole exome sequencing).
Results
We obtained 211 mutations in common between primary and recurrence tumor. Among these, three somatic mutations (c.430 G>A in PRKCB gene, c.815 C>T in TBX1 gene and c.1554 T>G in COG5 gene) were selected to investigate their presence in recurrence CTCs. Almost all of the sorted CTCs (9/13) had at least one of the mutations tested.
Conclusion
In confirmation of the hypothesis, the CTCs detected in the patient's blood were actually cancer cells deriving from GB tumor.
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Affiliation(s)
- F Lessi
- Fondazione Pisana per la Scienza , San Giuliano Terme , Italy
| | - M Morelli
- Fondazione Pisana per la Scienza , San Giuliano Terme , Italy
| | - P Aretini
- Fondazione Pisana per la Scienza , San Giuliano Terme , Italy
| | - M Menicagli
- Fondazione Pisana per la Scienza , San Giuliano Terme , Italy
| | - S Franceschi
- Fondazione Pisana per la Scienza , San Giuliano Terme , Italy
| | - F Pasqualetti
- Azienda Ospedaliera Universitaria Pisana , Pisa , Italy
- University of Oxford , Oxford , United Kingdom
| | - C Gambacciani
- Spedali Riuniti di Livorno—USL Toscana Nord-Ovest , Livorno , Italy
| | - A Di Stefano
- Spedali Riuniti di Livorno—USL Toscana Nord-Ovest , Livorno , Italy
| | - O Santonocito
- Spedali Riuniti di Livorno—USL Toscana Nord-Ovest , Livorno , Italy
| | - C M Mazzanti
- Fondazione Pisana per la Scienza , San Giuliano Terme , Italy
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21
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Morelli M, Lessi F, Barachini S, Liotti R, Montemurro N, Perrini P, Santonocito OS, Gambacciani C, Snuderl M, Pieri F, Aquila F, Farnesi A, Naccarato AG, Viacava P, Cardarelli F, Ferri G, Mulholland P, Ottaviani D, Paiar F, Liberti G, Pasqualetti F, Menicagli M, Aretini P, Signore G, Franceschi S, Mazzanti CM. Metabolic-imaging of human glioblastoma live tumors: A new precision-medicine approach to predict tumor treatment response early. Front Oncol 2022; 12:969812. [PMID: 36132155 PMCID: PMC9483168 DOI: 10.3389/fonc.2022.969812] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Glioblastoma (GB) is the most severe form of brain cancer, with a 12-15 month median survival. Surgical resection, temozolomide (TMZ) treatment, and radiotherapy remain the primary therapeutic options for GB, and no new therapies have been introduced in recent years. This therapeutic standstill is primarily due to preclinical approaches that do not fully respect the complexity of GB cell biology and fail to test efficiently anti-cancer treatments. Therefore, better treatment screening approaches are needed. In this study, we have developed a novel functional precision medicine approach to test the response to anticancer treatments in organoids derived from the resected tumors of glioblastoma patients. Methods GB organoids were grown for a short period of time to prevent any genetic and morphological evolution and divergence from the tumor of origin. We chose metabolic imaging by NAD(P)H fluorescence lifetime imaging microscopy (FLIM) to predict early and non-invasively ex-vivo anti-cancer treatment responses of GB organoids. TMZ was used as the benchmark drug to validate the approach. Whole-transcriptome and whole-exome analyses were performed to characterize tumor cases stratification. Results Our functional precision medicine approach was completed within one week after surgery and two groups of TMZ Responder and Non-Responder tumors were identified. FLIM-based metabolic tumor stratification was well reflected at the molecular level, confirming the validity of our approach, highlighting also new target genes associated with TMZ treatment and identifying a new 17-gene molecular signature associated with survival. The number of MGMT gene promoter methylated tumors was higher in the responsive group, as expected, however, some non-methylated tumor cases turned out to be nevertheless responsive to TMZ, suggesting that our procedure could be synergistic with the classical MGMT methylation biomarker. Conclusions For the first time, FLIM-based metabolic imaging was used on live glioblastoma organoids. Unlike other approaches, ex-vivo patient-tailored drug response is performed at an early stage of tumor culturing with no animal involvement and with minimal tampering with the original tumor cytoarchitecture. This functional precision medicine approach can be exploited in a range of clinical and laboratory settings to improve the clinical management of GB patients and implemented on other cancers as well.
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Affiliation(s)
- Mariangela Morelli
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
- *Correspondence: Chiara Maria Mazzanti, ; Mariangela Morelli,
| | - Francesca Lessi
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
| | - Serena Barachini
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Romano Liotti
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
- Department of Biology, University of Pisa, Pisa, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Paolo Perrini
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | - Carlo Gambacciani
- Neurosurgical Department of Spedali Riuniti di Livorno, Livorno, Italy
| | - Matija Snuderl
- Department of Pathology, New York University (NYU) Langone Medical Center, New York City, NY, United States
| | - Francesco Pieri
- Neurosurgical Department of Spedali Riuniti di Livorno, Livorno, Italy
| | - Filippo Aquila
- Neurosurgical Department of Spedali Riuniti di Livorno, Livorno, Italy
| | - Azzurra Farnesi
- Neurosurgical Department of Spedali Riuniti di Livorno, Livorno, Italy
| | - Antonio Giuseppe Naccarato
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Paolo Viacava
- Anatomical Pathology Department, Azienda Ospedaliera Toscana Nord-ovest, Livorno, Italy
| | - Francesco Cardarelli
- National Enterprise for nanoScience and nanoTechnology (NEST), Scuola Normale Superiore and Istituto Nanoscienze-CNR, Pisa, Italy
| | - Gianmarco Ferri
- National Enterprise for nanoScience and nanoTechnology (NEST), Scuola Normale Superiore and Istituto Nanoscienze-CNR, Pisa, Italy
- Section of Nanomedicine, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
| | - Paul Mulholland
- Department of Oncology, University College London Hospitals, London, United Kingdom
| | - Diego Ottaviani
- Department of Oncology, University College London Hospitals, London, United Kingdom
| | - Fabiola Paiar
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Gaetano Liberti
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Francesco Pasqualetti
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Michele Menicagli
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
| | - Paolo Aretini
- Section of Bioinformatics, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
| | - Giovanni Signore
- Section of Nanomedicine, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
| | - Sara Franceschi
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
| | - Chiara Maria Mazzanti
- Section of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, San Giuliano Terme, Pisa, Italy
- *Correspondence: Chiara Maria Mazzanti, ; Mariangela Morelli,
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22
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Pasqualetti F, Giampietro C, Montemurro N, Giannini N, Gadducci G, Orlandi P, Natali E, Chiarugi P, Gonnelli A, Cantarella M, Scatena C, Fanelli GN, Naccarato AG, Perrini P, Liberti G, Morganti R, Franzini M, Paolicchi A, Pellegrini G, Bocci G, Paiar F. Old and New Systemic Immune-Inflammation Indexes Are Associated with Overall Survival of Glioblastoma Patients Treated with Radio-Chemotherapy. Genes (Basel) 2022; 13:genes13061054. [PMID: 35741816 PMCID: PMC9223226 DOI: 10.3390/genes13061054] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Background. Systemic immunity and inflammation indexes (SI) derived from blood cells have gained increasing attention in clinical oncology as potential biomarkers that are associated with survival. Materials and methods. We tested 12 different SI using blood tests from patients with isocitrate dehydrogenase 1 and 2 wild-type glioblastomas, treated with radio-chemotherapy. The primary endpoint was their overall survival. Results. A total of 77 patients, comprising 43 males and 34 females, with a median age of 64 years (age range 26-84), who were treated between October 2010 and July 2020, were included in the present analysis (approved by a local ethics committee). In the univariate Cox regression analysis, all the indexes except two showed a statistically significant impact on OS. In the multivariate Cox regression analysis, neutrophil × platelet × leukocyte/(lymphocyte × monocyte) (NPW/LM) and neutrophil × platelet × monocyte/lymphocyte (NPM/L) maintained their statistically significant impact value. Conclusions. This univariate analysis confirms the potential of systemic inflammation indexes in patients with glioblastoma, while the multivariate analysis verifies the prognostic value of NPW/LM and NPM/L.
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Affiliation(s)
- Francesco Pasqualetti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.G.); (G.G.); (A.G.); (M.C.); (F.P.)
- Department of Oncology, University of Oxford, Oxford OX1 4BH, UK
- Correspondence: or
| | - Celeste Giampietro
- UO Laboratorio Analisi Chimico Cliniche, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (C.G.); (E.N.); (P.C.); (G.P.)
| | - Nicola Montemurro
- Neurosurgery Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.M.); (P.P.); (G.L.)
| | - Noemi Giannini
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.G.); (G.G.); (A.G.); (M.C.); (F.P.)
| | - Giovanni Gadducci
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.G.); (G.G.); (A.G.); (M.C.); (F.P.)
| | - Paola Orlandi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (P.O.); (G.B.)
| | - Eleonora Natali
- UO Laboratorio Analisi Chimico Cliniche, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (C.G.); (E.N.); (P.C.); (G.P.)
| | - Paolo Chiarugi
- UO Laboratorio Analisi Chimico Cliniche, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (C.G.); (E.N.); (P.C.); (G.P.)
| | - Alessandra Gonnelli
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.G.); (G.G.); (A.G.); (M.C.); (F.P.)
| | - Martina Cantarella
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.G.); (G.G.); (A.G.); (M.C.); (F.P.)
| | - Cristian Scatena
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (C.S.); (G.N.F.); (A.G.N.); (M.F.); (A.P.)
| | - Giuseppe Nicolò Fanelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (C.S.); (G.N.F.); (A.G.N.); (M.F.); (A.P.)
| | - Antonio Giuseppe Naccarato
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (C.S.); (G.N.F.); (A.G.N.); (M.F.); (A.P.)
| | - Paolo Perrini
- Neurosurgery Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.M.); (P.P.); (G.L.)
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (C.S.); (G.N.F.); (A.G.N.); (M.F.); (A.P.)
| | - Gaetano Liberti
- Neurosurgery Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.M.); (P.P.); (G.L.)
| | | | - Maria Franzini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (C.S.); (G.N.F.); (A.G.N.); (M.F.); (A.P.)
| | - Aldo Paolicchi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (C.S.); (G.N.F.); (A.G.N.); (M.F.); (A.P.)
| | - Giovanni Pellegrini
- UO Laboratorio Analisi Chimico Cliniche, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (C.G.); (E.N.); (P.C.); (G.P.)
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (P.O.); (G.B.)
| | - Fabiola Paiar
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (N.G.); (G.G.); (A.G.); (M.C.); (F.P.)
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (C.S.); (G.N.F.); (A.G.N.); (M.F.); (A.P.)
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Pasqualetti F, Calistri E, Fuentes T, Sainato A, Manfredi B, Morganti R, Galli L, Mercinelli C, Sammarco E, Baldaccini D, Coraggio G, Panichi M, Erba PA, Paiar F. Early Versus Late Postoperative Radiotherapy in Patients With Prostate Cancer: Results of a Single-centre Retrospective Study. Anticancer Res 2022; 42:2997-3001. [PMID: 35641255 DOI: 10.21873/anticanres.15783] [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: 04/07/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM A much-debated topic relating to patients at risk of local prostate cancer recurrence, but with post-operative leveIs of prostate-specific antigen (PSA) lower than 0.2 ng/ml, concerns the best timing of postoperative radiotherapy (RT), adjuvant or salvage? The present monocentric, retrospective study aimed to investigate the best PSA value at which to plan salvage RT for patients with recurrent prostate cancer. PATIENTS AND METHODS From January 2011 to December 2019, 158 patients were treated with adjuvant RT at Pisa University Hospital, whilst 91 patients underwent salvage RT. We grouped the patients treated with salvage RT using their PSA values at the time of salvage RT: PSA >0.5 ng/ml, PSA between 0 and 0.5 ng/ml, and PSA ≤0.2 ng/ml. The median follow-up was 63 months. Biochemical recurrence-free survival (BFS) measured from surgery was the primary endpoint. RESULTS Salvage RT led to shorter BFS compared to adjuvant RT considering the whole cohort of patients, with a hazard ratio of 3.195 (95% confidence interval=1.534-6.655, p=0.002). However, analysing only the group of patients with PSA ≤0.2 ng/ml at the time of salvage RT, salvage RT led to BFS similar to that achieved with adjuvant RT (p=0.35). CONCLUSION Our results suggest that when scheduled for patients with a PSA ≤0.2 ng/ml, salvage RT results in equivalent biochemical control to that with adjuvant RT.
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Affiliation(s)
| | - Elisa Calistri
- Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | | | - Aldo Sainato
- Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | - Bruno Manfredi
- Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | | | - Luca Galli
- Oncology Unit 2, University Hospital of Pisa, Pisa, Italy
| | | | | | - Davide Baldaccini
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | | | - Marco Panichi
- Institute of Advanced Oncology (IOA), Atrys-Sanitas, Barcelona, Spain
| | - Paola Anna Erba
- Nuclear Medicine, Department of Translational Research and Advanced Technology in Medicine and Surgery, University of Pisa, Pisa University Hospital, Pisa, Italy
| | - Fabiola Paiar
- Radiation Oncology, Pisa University Hospital, Pisa, Italy
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24
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Cucchiara F, Luci G, Giannini N, Giorgi FS, Orlandi P, Banchi M, Di Paolo A, Pasqualetti F, Danesi R, Bocci G. Association of plasma levetiracetam concentration, MGMT methylation and sex with survival of chemoradiotherapy-treated glioblastoma patients. Pharmacol Res 2022; 181:106290. [DOI: 10.1016/j.phrs.2022.106290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/18/2022] [Accepted: 06/02/2022] [Indexed: 12/27/2022]
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25
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Franceschi S, Lessi F, Morelli M, Menicagli M, Pasqualetti F, Aretini P, Mazzanti CM. Sedoheptulose Kinase SHPK Expression in Glioblastoma: Emerging Role of the Nonoxidative Pentose Phosphate Pathway in Tumor Proliferation. Int J Mol Sci 2022; 23:ijms23115978. [PMID: 35682658 PMCID: PMC9180619 DOI: 10.3390/ijms23115978] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/26/2022] Open
Abstract
Glioblastoma (GBM) is the most common form of malignant brain cancer and is considered the deadliest human cancer. Because of poor outcomes in this disease, there is an urgent need for progress in understanding the molecular mechanisms of GBM therapeutic resistance, as well as novel and innovative therapies for cancer prevention and treatment. The pentose phosphate pathway (PPP) is a metabolic pathway complementary to glycolysis, and several PPP enzymes have already been demonstrated as potential targets in cancer therapy. In this work, we aimed to evaluate the role of sedoheptulose kinase (SHPK), a key regulator of carbon flux that catalyzes the phosphorylation of sedoheptulose in the nonoxidative arm of the PPP. SHPK expression was investigated in patients with GBM using microarray data. SHPK was also overexpressed in GBM cells, and functional studies were conducted. SHPK expression in GBM shows a significant correlation with histology, prognosis, and survival. In particular, its increased expression is associated with a worse prognosis. Furthermore, its overexpression in GBM cells confirms an increase in cell proliferation. This work highlights for the first time the importance of SHPK in GBM for tumor progression and proposes this enzyme and the nonoxidative PPP as possible therapeutic targets.
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Affiliation(s)
- Sara Franceschi
- Fondazione Pisana per la Scienza, 56017 Pisa, Italy; (F.L.); (M.M.); (M.M.); (P.A.); (C.M.M.)
- Correspondence:
| | - Francesca Lessi
- Fondazione Pisana per la Scienza, 56017 Pisa, Italy; (F.L.); (M.M.); (M.M.); (P.A.); (C.M.M.)
| | - Mariangela Morelli
- Fondazione Pisana per la Scienza, 56017 Pisa, Italy; (F.L.); (M.M.); (M.M.); (P.A.); (C.M.M.)
| | - Michele Menicagli
- Fondazione Pisana per la Scienza, 56017 Pisa, Italy; (F.L.); (M.M.); (M.M.); (P.A.); (C.M.M.)
| | - Francesco Pasqualetti
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy;
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK
| | - Paolo Aretini
- Fondazione Pisana per la Scienza, 56017 Pisa, Italy; (F.L.); (M.M.); (M.M.); (P.A.); (C.M.M.)
| | - Chiara Maria Mazzanti
- Fondazione Pisana per la Scienza, 56017 Pisa, Italy; (F.L.); (M.M.); (M.M.); (P.A.); (C.M.M.)
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Palumbo I, Pasqualetti F, Delishaj D, Gonnelli A, Aristei C, Borghesi S, Pirtoli L, Belgioia L, Arcangeli S. Integrating stereotactic radiotherapy and systemic therapies. Rep Pract Oncol Radiother 2022; 27:310-317. [PMID: 36299395 PMCID: PMC9591045 DOI: 10.5603/rpor.a2022.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/16/2022] [Indexed: 12/03/2022] Open
Abstract
This paper focuses on stereotactic radiotherapy (SRT ) interactions with targeted therapies and immune system modulating agents because SRT inevitably interacts with them in the treatment of oligometastatic patients. Radiation oncologists need to be aware of the advantages and risks of these interactions which can, on one hand, enhance the effect of therapy or, on the other, potentiate reciprocal toxicities. To date, few prospective studies have evaluated the interactions of SRT with new-generation drugs and data are mainly based on retrospective experiences, which are often related to small sample sizes.
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Caccese M, Simonelli M, Villani V, Rizzato S, Ius T, Pasqualetti F, Russo M, Rudà R, Amoroso R, Bellu L, Bertorelle R, Cavallin F, Dipasquale A, Carosi M, Pizzolitto S, Cesselli D, Persico P, Casini B, Fassan M, Zagonel V, Lombardi G. Definition of the Prognostic Role of MGMT Promoter Methylation Value by Pyrosequencing in Newly Diagnosed IDH Wild-Type Glioblastoma Patients Treated with Radiochemotherapy: A Large Multicenter Study. Cancers (Basel) 2022; 14:cancers14102425. [PMID: 35626029 PMCID: PMC9139569 DOI: 10.3390/cancers14102425] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background. O6-methylguanine (O6-MeG)-DNA methyltransferase (MGMT) methylation status is a predictive factor for alkylating treatment efficacy in glioblastoma patients, but its prognostic role is still unclear. We performed a large, multicenter study to evaluate the association between MGMT methylation value and survival. Methods. We evaluated glioblastoma patients with an assessment of MGMT methylation status by pyrosequencing from nine Italian centers. The inclusion criteria were histological diagnosis of IDH wild-type glioblastoma, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≤2, and radio-chemotherapy treatment with temozolomide. The relationship between OS and MGMT was investigated with a time-dependent Receiver Operating Characteristics (ROC) curve and Cox regression models. Results. In total, 591 newly diagnosed glioblastoma patients were analyzed. The median OS was 16.2 months. The ROC analysis suggested a cut-off of 15% for MGMT methylation. The 2-year Overall Survival (OS) was 18.3% and 51.8% for MGMT methylation <15% and ≥15% (p < 0.0001). In the multivariable analysis, MGMT methylation <15% was associated with impaired survival (p < 0.00001). However, we also found a non-linear association between MGMT methylation and OS (p = 0.002): median OS was 14.8 months for MGMT in 0−4%, 18.9 months for MGMT in 4−40%, and 29.9 months for MGMT in 40−100%. Conclusions. Our findings suggested a non-linear relationship between OS and MGMT promoter methylation, which implies a varying magnitude of prognostic effect across values of MGMT promoter methylation by pyrosequencing in newly diagnosed IDH wild-type glioblastoma patients treated with chemoradiotherapy.
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Affiliation(s)
- Mario Caccese
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (V.Z.); (G.L.)
- Correspondence: ; Tel.: +39-(0)4-9821-5888
| | - Matteo Simonelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (A.D.); (P.P.)
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Veronica Villani
- Neuro-Oncology Unit, Regina Elena National Cancer Institute, 00161 Rome, Italy;
| | - Simona Rizzato
- Department of Oncology, Central Friuli University Health Authority, 33100 Udine, Italy;
| | - Tamara Ius
- Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
| | - Francesco Pasqualetti
- Radiation Oncology Unit, Pisa University Hospital, 56121 Pisa, Italy;
- Department of Oncology, University of Oxford, Oxford OX1 4BH, UK
| | - Marco Russo
- Neurology Unit, Neuromotor Department, Azienda USL-IRCCS Reggio Emilia, 42121 Emilia, Italy;
| | - Roberta Rudà
- Department of Neuro-Oncology, University of Turin and City of Health and Science Hospital, 10094 Torino, Italy;
- Neurology Unit, Hospital of Castelfranco Veneto, 31033 Castelfranco Veneto, Italy
| | - Rosina Amoroso
- Neurosurgery Unit, Department of Surgery, Hospital of Livorno, Azienda Asl Toscana Nord Ovest, 57100 Livorno, Italy;
| | - Luisa Bellu
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy;
| | - Roberta Bertorelle
- Immunology and Molecular Oncology Unit, Department of Oncology, Veneto Institute of Oncology IOV IRCCS, 35128 Padua, Italy;
| | | | - Angelo Dipasquale
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (A.D.); (P.P.)
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Mariantonia Carosi
- Pathology Unit, Regina Elena National Cancer Institute, 00161 Rome, Italy; (M.C.); (B.C.)
| | - Stefano Pizzolitto
- Department of Surgical Pathology, Central Friuli University Health Authority, 33100 Udine, Italy;
| | - Daniela Cesselli
- Department of Laboratory Medicine, Institute of Pathology, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
- Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Pasquale Persico
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; (M.S.); (A.D.); (P.P.)
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Beatrice Casini
- Pathology Unit, Regina Elena National Cancer Institute, 00161 Rome, Italy; (M.C.); (B.C.)
| | - Matteo Fassan
- Department of Oncology, Veneto Institute of Oncology, IOV-IRCCS, 35128 Padua, Italy;
- Cytopathology Unit, Department of Medicine (DIMED), Surgical Pathology & AMP, University of Padua, 35128 Padua, Italy
| | - Vittorina Zagonel
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (V.Z.); (G.L.)
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (V.Z.); (G.L.)
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Calistri E, Fuentes T, Morganti R, Sainato A, Manfredi B, Matteucci F, Pasqualetti F, Paiar F. PO-1383 Adjuvant versus salvage radiotherapy in patiens with prostate cancer: a monocentric experience. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03347-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nicosia L, Franceschini D, Perrone Congedi F, Casamassima F, Gerardi M, Rigo M, Mazzola R, Perna M, Scotti V, Fodor A, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo R, Bruni A, Alicino G, Frassinelli L, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti F, Lunardi G, Valdagni R, Fazio I, Corti L, Vavassori V, Maranzano E, Magrini S, Arcangeli S, Valentini V, Paiar F, Ramella S, Di Muzio N, Livi L, Jereczek- Fossa B, Osti M, Scorsetti M, Alongi F. OC-0602 A pREDictive model of polymetastatic disease on oligometastatic colorectal cancer: the RED LaIT-SABR. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02624-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fuentes T, Calistri E, Sainato A, Manfredi B, Matteucci F, Morganti R, Pasqualetti F, Paiar F. PO-1368 Prophylactic pelvic nodal RT vs only prostate bed irradiation in patients with prostatic cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03332-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pasqualetti F, Trippa F, Aristei C, Borghesi S, Colosimo C, Cantarella M, Mazzola R, Ingrosso G. Stereotactic radiotherapy for oligometastases in the lymph nodes. Rep Pract Oncol Radiother 2022; 27:46-51. [PMID: 35402021 PMCID: PMC8989441 DOI: 10.5603/rpor.a2022.0007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022] Open
Abstract
Even though systemic therapy is standard treatment for lymph node metastases, metastasis-directed stereotactic radiotherapy (SRT ) seems to be a valid option in oligometastatic patients with a low disease burden. Positron emission tomography-computed tomography (PET-CT ) is the gold standard for assessing metastases to the lymph nodes; co-registration of PET-CT images and planning CT images are the basis for gross tumor volume (GTV ) delineation. Appropriate techniques are needed to overcome target motion. SRT schedules depend on the irradiation site, target volume and dose constraints to the organs at risk (OARs) of toxicity. Although several fractionation schemes were reported, total doses of 48–60 Gy in 4–8 fractions were proposed for mediastinal lymph node SRT, with the spinal cord, esophagus, heart and proximal bronchial tree being the dose limiting OAR s. Total doses ranged from 30 to 45 Gy, with daily fractions of 7–12 Gy for abdominal lymph nodes, with dose limiting OARs being the liver, kidneys, bowel and bladder. SRT on lymph node metastases is safe; late side effects, particularly severe, are rare.
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Affiliation(s)
- Francesco Pasqualetti
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - Fabio Trippa
- Radiation Oncology Centre, S. Maria Hospital, Terni, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Italy
| | - Simona Borghesi
- Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana Sud Est, Italy
| | - Caterina Colosimo
- Operative Unit of Radiotherapy, Department of Oncology, San Luca Hospital, Lucca, Italy
| | | | - Rosario Mazzola
- Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy
| | - Gianluca Ingrosso
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Italy
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Colosimo C, Pasqualetti F, Aristei C, Borghesi S, Forte L, Mignogna M, Badii D, Bosio M, Paiar F, Nanni S, Bertocci S, Lastrucci L, Parisi S, Ingrosso G. Stereotactic radiotherapy for bone oligometastases. Rep Pract Oncol Radiother 2022; 27:40-45. [PMID: 35402030 PMCID: PMC8989454 DOI: 10.5603/rpor.a2022.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/20/2021] [Indexed: 12/25/2022] Open
Abstract
About 60–90% of cancer patients are estimated to develop bone metastases, particularly in the spine. Bone scintigraphy, computed tomography (CT ) and magnetic resonance imaging (MRI ) are currently used to assess metastatic bone disease; positron emission tomography/computed tomography (PET-CT ) has become more widespread in clinical practice because of its high sensitivity and specificity with about 95% diagnostic accuracy. The most common and well-known radiotracer is 18F-fluorodeoxyglucose (18FDG); several other PET-radiotracers are currently under investigation for different solid tumors, such as 11C or 18FDG-choline and prostate specific membrane antigen (PSMA)-PET/CT for prostate cancer. In treatment planning, standard and investigational imaging modalities should be registered with the planning CT so as to best define the bone target volume. For target volume delineation of spine metastases, the International Spine Radiosurgery Consortium (ISRC ) of North American experts provided consensus guidelines. Single fraction stereotactic radiotherapy (SRT ) doses ranged from 12 to 24 Gy; fractionated SRT administered 21–27 Gy in 3 fractions or 20–35 Gy in 5 fractions. After spine SRT, less than 5% of patients experienced grade ≥ 3 acute toxicity. Late toxicity included the extremely rare radiation-induced myelopathy and a 14% risk of de novo vertebral compression fractures.
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Affiliation(s)
- Caterina Colosimo
- Operative Unit of Radiotherapy, Department of Oncology, San Luca Hospital, Lucca, Italy
| | - Francesco Pasqualetti
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Italy
| | - Simona Borghesi
- Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana Sud Est, Italy
| | - Letizia Forte
- Department of Radiotherapy, Livorno Hospital, ATNO, Italy
| | - Marcello Mignogna
- Operative Unit of Radiotherapy, Department of Oncology, San Luca Hospital, Lucca, Italy
| | | | - Manrico Bosio
- Department of Radiotherapy, Livorno Hospital, ATNO, Italy
| | - Fabiola Paiar
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - Sara Nanni
- Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana Sud Est, Italy
| | - Silvia Bertocci
- Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana Sud Est, Italy
| | | | - Silvana Parisi
- Radiation Oncology Unit - Department of Biomedical, Dental Science, and Morphological and Functional Images, University of Messina, Italy
| | - Gianluca Ingrosso
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Italy
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Pasqualetti F, Montemurro N, Desideri I, Loi M, Giannini N, Gadducci G, Malfatti G, Cantarella M, Gonnelli A, Montrone S, Visani L, Scatena C, Naccarato AG, Perrini P, Gambacciani C, Santonocito O, Morganti R, Paiar F. Impact of recurrence pattern in patients undergoing a second surgery for recurrent glioblastoma. Acta Neurol Belg 2022; 122:441-446. [PMID: 34396487 DOI: 10.1007/s13760-021-01765-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/26/2021] [Indexed: 12/19/2022]
Abstract
The impact of different patterns of glioblastoma (GBM) recurrence has not yet been fully established in patients suitable for a second surgery. Through the present observational study carried out at Pisa University Hospital, we aimed to investigate how different patterns of GBM failure influence second surgery outcomes. Overall survival (OS) and post-recurrence survival (PRS) were assessed according to clinical characteristics, including pattern of recurrence, in a prospective cohort of recurrent GBM patients. Survival curves were calculated using the Kaplan-Meier method and the log-rank test was applied to evaluate the differences between curves. Patients with local recurrence had better OS than patients with non-local one, 24.1 versus 18.2 months, respectively [P = 0.015, HR = 1.856 (1.130-3.050)]. The second surgery conferred an advantage in OS respect to non-operated patients, however, this advantage was more evident in patients with local recurrence [P = 0.002 with HR 0.212 (95% CI 0.081-0.552) and P = 0.029 with HR = 0.522 (95% CI 0.291-0.936), respectively]. The recurrence pattern can influence the outcome of patients with recurrent GBM suitable for a second surgery.
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Sollini M, Bartoli F, Cavinato L, Ieva F, Ragni A, Marciano A, Zanca R, Galli L, Paiar F, Pasqualetti F, Erba PA. [ 18F]FMCH PET/CT biomarkers and similarity analysis to refine the definition of oligometastatic prostate cancer. EJNMMI Res 2021; 11:119. [PMID: 34837532 PMCID: PMC8627538 DOI: 10.1186/s13550-021-00858-8] [Citation(s) in RCA: 1] [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: 06/27/2021] [Accepted: 11/04/2021] [Indexed: 01/06/2023] Open
Abstract
Background The role of image-derived biomarkers in recurrent oligometastatic Prostate Cancer (PCa) is unexplored. This paper aimed to evaluate [18F]FMCH PET/CT radiomic analysis in patients with recurrent PCa after primary radical therapy. Specifically, we tested intra-patient lesions similarity in oligometastatic and plurimetastatic PCa, comparing the two most used definitions of oligometastatic disease. Methods PCa patients eligible for [18F]FMCH PET/CT presenting biochemical failure after first-line curative treatments were invited to participate in this prospective observational trial. PET/CT images of 92 patients were visually and quantitatively analyzed. Each patient was classified as oligometastatic or plurimetastatic according to the total number of detected lesions (up to 3 and up to 5 or > 3 and > 5, respectively). Univariate and intra-patient lesions' similarity analysis were performed. Results [18F]FMCH PET/CT identified 370 lesions, anatomically classified as regional lymph nodes and distant metastases. Thirty-eight and 54 patients were designed oligometastatic and plurimetastatic, respectively, using a 3-lesion threshold. The number of oligometastic scaled up to 60 patients (thus 32 plurimetastatic patients) with a 5-lesion threshold. Similarity analysis showed high lesions' heterogeneity. Grouping patients according to the number of metastases, patients with oligometastatic PCa defined with a 5-lesion threshold presented lesions heterogeneity comparable to plurimetastic patients. Lesions within patients having a limited tumor burden as defined by three lesions were characterized by less heterogeneity. Conclusions We found a comparable heterogeneity between patients with up to five lesions and plurimetastic patients, while patients with up to three lesions were less heterogeneous than plurimetastatic patients, featuring different cells phenotypes in the two groups. Our results supported the use of a 3-lesion threshold to define oligometastatic PCa. Supplementary Information The online version contains supplementary material available at 10.1186/s13550-021-00858-8.
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Affiliation(s)
- Martina Sollini
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Francesco Bartoli
- Nuclear Medicine, Department of Translational Research and Advanced Technology in Medicine and Surgery University of Pisa, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Lara Cavinato
- MOX - Modeling and Scientific Computing, Department of Mathematics, Politecnico di Milano, p.zza Leonardo da Vinci 32, 20133, Milan, Italy
| | - Francesca Ieva
- MOX - Modeling and Scientific Computing, Department of Mathematics, Politecnico di Milano, p.zza Leonardo da Vinci 32, 20133, Milan, Italy.,CADS - Center for Analysis, Decision and Society, Human Technopole, Milan, Italy
| | - Alessandra Ragni
- MOX - Modeling and Scientific Computing, Department of Mathematics, Politecnico di Milano, p.zza Leonardo da Vinci 32, 20133, Milan, Italy
| | - Andrea Marciano
- Nuclear Medicine, Department of Translational Research and Advanced Technology in Medicine and Surgery University of Pisa, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Roberta Zanca
- Nuclear Medicine, Department of Translational Research and Advanced Technology in Medicine and Surgery University of Pisa, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Luca Galli
- Medical Oncology, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Fabiola Paiar
- Radiation Oncology, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | | | - Paola Anna Erba
- Nuclear Medicine, Department of Translational Research and Advanced Technology in Medicine and Surgery University of Pisa, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy. .,University Medical Center Groningen, Medical Imaging Center, University of Groningen, Groningen, The Netherlands. .,Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
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Nicosia L, Franceschini D, Perrone-Congedi F, Casamassima F, Gerardi MA, Rigo M, Mazzola R, Perna M, Scotti V, Fodor A, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo RM, Bruni A, Alicino G, Frassinelli L, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti FM, Lunardi G, Valdagni R, Fazio I, Corti L, Vavassori V, Maranzano E, Magrini SM, Arcangeli S, Valentini V, Paiar F, Ramella S, Di Muzio NG, Livi L, Jereczek-Fossa BA, Osti MF, Scorsetti M, Alongi F. A multicenter LArge retrospectIve daTabase on the personalization of Stereotactic ABlative Radiotherapy use in lung metastases from colon-rectal cancer: the LaIT-SABR study. Radiother Oncol 2021; 166:92-99. [PMID: 34748855 DOI: 10.1016/j.radonc.2021.10.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/14/2021] [Accepted: 10/31/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION stereotactic ablative radiotherapy (SABR) has been shown to increase survival in oligometastatic disease, but local control of colorectal metastases remains poor. We aimed to identify potential predictive factors of SBRT response through a multicenter large retrospective database and to investigate the progression to the polymetastatic disease (PMD). MATERIAL AND METHODS the study involved 23 centers, and was approved by the Ethical Committee (Prot. Negrar 2019-ZT). 1033 lung metastases were reported. Clinical and biological parameters were evaluated as predictive for local progression-free survival (FLP). Secondary end-point was the time to the polymetastatic conversion (tPMC). RESULTS Two-year FLP was 75.4%. Two-year FLP for lesions treated with a BED <100 Gy, 100-124 Gy, and ≥125 Gy was 76.1%, 70.6%, and 94% (p=0.000). Two-year FLP for lesion measuring ≤10 mm, 10-20 mm, and >20 mm was 79.7%, 77.1%, and 66.6% (p=0.027). At the multivariate analysis a BED ≥125 Gy significantly reduced the risk of local progression (HR 0.24, 95%CI 0.11-0.51; p=0.000). Median tPMC was 26.8 months. Lesions treated with BED ≥125 Gy reported a significantly longer tPMC as compared to lower BED. The median tPMC for patients treated to 1, 2-3 or 4-5 simultaneous oligometastases was 28.5, 25.4, and 9.8 months (p=0.035). CONCLUSION The present is the largest series of lung colorectal metastases treated with SABR. The results support the use of SBRT in lung oligometastatic colorectal cancer patients as it might delay the transition to PMD or offer relatively long disease-free period in selected cases. Predictive factors were identified for treatment personalization.
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Affiliation(s)
- L Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center.
| | - D Franceschini
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - F Perrone-Congedi
- Department of Radiation Oncology, "Sapienza" University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | | | - M A Gerardi
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - M Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center
| | - R Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center
| | - M Perna
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - V Scotti
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - A Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Iurato
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128, Rome, Italy
| | - F Pasqualetti
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - G Gadducci
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - S Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - R M Niespolo
- Department of Radiation Oncology, Azienda Ospedaliera S. Gerardo, Monza, Italy
| | - A Bruni
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - G Alicino
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - L Frassinelli
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - P Borghetti
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - A Di Marzo
- Radiation Oncology Centre, S. Maria Hospital, Terni, Italy
| | - A Ravasio
- Radiotherapy Unit, Humanitas Gavazzeni, Bergamo
| | - B De Bari
- Radiation Oncology Department, University Hospital of Besançon, Besançon, France; Radiation Oncology Department, Neuchâtel Hospital Network, la Chaux-de-Fonds, Switzerland
| | - M Sepulcri
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - D Aiello
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
| | - G Mortellaro
- Department of Radiation Oncology, ARNAS Ospedale Civico, Palermo, Italy
| | - C Sangalli
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Franceschini
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Montesi
- Radiotherapy Unit ULSS5, Rovigo, Italy
| | - F M Aquilanti
- Radiotherapy Marrelli Hospital, Marrelli Hospital, Crotone, Italy
| | - G Lunardi
- Medical Analysis Laboratory, IRCCS Sacro Cuore Don Calabria Hospital
| | - R Valdagni
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Haematology-Oncology, University of Milan
| | - I Fazio
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
| | - L Corti
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - V Vavassori
- Radiotherapy Unit, Humanitas Gavazzeni, Bergamo
| | - E Maranzano
- Radiation Oncology Centre, S. Maria Hospital, Terni, Italy
| | - S M Magrini
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - S Arcangeli
- Department of Radiation Oncology, Azienda Ospedaliera S. Gerardo, Monza, Italy
| | - V Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Paiar
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - S Ramella
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128, Rome, Italy
| | - N G Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - L Livi
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - B A Jereczek-Fossa
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - M F Osti
- Department of Radiation Oncology, "Sapienza" University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - M Scorsetti
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University Pieve Emanuele, Milan, Italy
| | - F Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center; University of Brescia, Brescia, Italy
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Pasqualetti F, Sainato A, Morganti R, Laliscia C, Vasile E, Gonnelli A, Montrone S, Gadducci G, Giannini N, Coccia N, Fuentes T, Zanotti S, Falconi M, Paiar F. Adjuvant Radiotherapy in Patients With Pancreatic Adenocarcinoma. Is It Still Appealing in Clinical Trials? A Meta-analysis and Review of the Literature. Anticancer Res 2021; 41:4697-4704. [PMID: 34593417 DOI: 10.21873/anticanres.15283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/08/2021] [Revised: 08/06/2021] [Accepted: 09/02/2021] [Indexed: 11/10/2022]
Abstract
AIM Pancreatic adenocarcinoma is a life-threatening disease with a rising frequency and the fourth leading cause of cancer death. This review aimed to assess the impact of postoperative radiotherapy through a meta-analysis of prospective randomized studies. MATERIALS AND METHODS Six studies met the inclusion criteria and were analyzed to calculate the cumulative risk of death (hazard ratio) in patients affected by pancreatic cancer treated with or without radiotherapy. Higgins' index was used to determine heterogeneity in between-study variability and, subsequently, the random-effects model was applied according to DerSimonian and Laird. RESULTS Eight hundred and thirty-seven patients were analyzed (418 in the control arm and 419 in the treatment one), the hazard ratio for death after randomization was 0.92 (p=0.560, 95% confidence interval=0.70-1.22). When scrutinizing these studies, only one out of six showed a statistically significant benefit due to the addition of radiotherapy in the postoperative setting. CONCLUSION We conclude that the use of adjuvant radiotherapy is not beneficial in treating all patients affected by pancreatic cancer but only for a subset of cases with potential residual local disease.
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Affiliation(s)
- Francesco Pasqualetti
- Department of Oncology, University of Oxford, Oxford, U.K.;
- Unit of Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | - Aldo Sainato
- Unit of Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | - Riccardo Morganti
- Unit of Section of Statistics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Enrico Vasile
- Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
| | | | - Sabrina Montrone
- Unit of Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | | | - Noemi Giannini
- Unit of Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | - Natalina Coccia
- Unit of Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | - Taiusha Fuentes
- Unit of Radiation Oncology, Pisa University Hospital, Pisa, Italy
| | - Sofia Zanotti
- Anatomic Pathology Unit, IRCCS Humanitas University Research Hospital, Milan, Italy
| | - Massimo Falconi
- Division of Pancreatic Surgery, Department of Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabiola Paiar
- Unit of Radiation Oncology, Pisa University Hospital, Pisa, Italy
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Nicosia L, Franceschini D, Perrone Congedi F, Casamassima F, Gerardi M, Perna M, Scotti V, Fodor A, Mazzola R, Rigo M, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo R, Bruni A, Frassinelli L, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti F, Valdagni R, Fazio I, Corti L, Vavassori L, Maranzano E, Magrini S, Lohr F, Arcangeli S, Valentini V, Paiar F, Ramella S, Di Muzio N, Livi L, Jereczek-Fossa B, Osti M, Scorsetti M, Alongi F. PH-0112 Multicenter large retrospectIve database on SBRT for colorectal lung metastases: the LaIT-SABR study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07246-7] [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: 11/30/2022]
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Gonnelli A, Pasqualetti F, Molinari A, Gadducci G, Giannini N, Malfatti G, Fabiola P. OC-0404 Role of single nucleotide polymorphisms (SNPs) in high-grade gliomas treated with concomitant RTCT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06891-2] [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: 11/29/2022]
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Giannini N, Gonnelli A, Gadducci G, Montrone S, Sainato A, Manfredi B, Pasqualetti F, Laliscia C, Malfatti G, Calistri E, Morganti R, Paiar F. PO-1247 Radiochemotherapy in anal cancer, what is the optimal dose? A single istitutional experience. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07698-2] [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: 10/20/2022]
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Gadducci G, Pasqualetti F, Gonnelli A, Giannini N, Gabelloni M, Morganti R, Neri E, Malfatti G, Paiar F. PO-1156 Temporal muscle thickness as a potential biomarker of OS in NSCLC patients with BM treated with SRT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07607-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Montemurro N, Fanelli GN, Scatena C, Ortenzi V, Pasqualetti F, Mazzanti CM, Morganti R, Paiar F, Naccarato AG, Perrini P. Surgical outcome and molecular pattern characterization of recurrent glioblastoma multiforme: A single-center retrospective series. Clin Neurol Neurosurg 2021; 207:106735. [PMID: 34119900 DOI: 10.1016/j.clineuro.2021.106735] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/21/2021] [Accepted: 05/24/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Despite recent advances in diagnosis and treatment of the disease, the prognosis of patients with glioblastoma multiforme (GBM) remains poor. While the value of molecular pattern profiles at first diagnosis has been demonstrated, only few studies have examined these biomarkers at the time of recurrence. The aim of this study was to explore the impact of extent of resection at repeated craniotomy on overall survival (OS) of patients with recurrent GBM. In addition, we investigated the molecular pattern profiles at first and second surgery to evaluate possible temporal evolution of these patterns and to assess the effect of these modifications on OS. METHODS We conducted a retrospective cohort study of 63 patients (mean age 59.2 years) surgically treated at least two times for recurrent GBM between 2006 and 2020. RESULTS Median OS and progression-free survival (PFS) were 22 months (range 2-168 months) and 10 months (range 1-96 months), respectively. The OS following gross-total resection (GTR) at recurrence for patients with initial GTR (GTR/GTR) was significantly increased (42.6 months) compared with sub-total resection (STR) at reoperation after initial GTR (GTR/STR) (19 months) and with GTR at reoperation after initial STR (STR/GTR) (17 months) (p = 0.0004). Overall surgical morbidity resulted 12.7% and 11.1% at first and at second surgery, respectively. Changes in genetic profiles between first and second surgery of 1p/19q co-deletion, MGMT promoter methylation and p53 mutations occurred in 5.6%, 1.9% and 9.3% of cases, respectively. MGMT promoter methylation appeared to affect OS in univariate analysis at first (p = 0.038) and second surgery (p = 0.107), whereas p53 mutation appeared to affect OS only at second surgery (p = 0.01). In a multivariate analysis female sex (HR = 0.322, 95% CI 0.147-0.705; p = 0.005), PFS (HR = 0.959, 95% CI 0.934-0.986; p = 0.003), GTR at first and second surgery (HR = 0.195, 95% CI 0.091-0.419; p < 0.0001) and adjuvant chemotherapy at recurrence (HR = 0.407, 95% CI 0.206-0.809; p = 0.01) were associated with longer OS. CONCLUSIONS This study confirmed the role of extent of resection (EOR) at first and at recurrence as a significant predictor of outcome in patients with recurrent GBM. In addition, this study highlighted the concept of a dynamic evolution of GBM genome after initial surgical resection, supporting the need of further studies to investigate the clinical and therapeutic implications of the changes in genetic profiles after initial surgery.
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.
| | - Giuseppe Nicolò Fanelli
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy; Division of Surgical Pathology, Pisa University Hospital, Pisa, Italy
| | - Cristian Scatena
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy; Division of Surgical Pathology, Pisa University Hospital, Pisa, Italy
| | - Valerio Ortenzi
- Division of Surgical Pathology, Pisa University Hospital, Pisa, Italy
| | - Francesco Pasqualetti
- Department of Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | - Riccardo Morganti
- Clinical Trial Statistical Support, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Fabiola Paiar
- Department of Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Antonio Giuseppe Naccarato
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy; Division of Surgical Pathology, Pisa University Hospital, Pisa, Italy
| | - Paolo Perrini
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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Berzero G, Bellu L, Baldini C, Ducray F, Guyon D, Eoli M, Silvani A, Dehais C, Idbaih A, Younan N, Nguyen-Them L, Gaillard S, Pasqualetti F, Lepage-Seydoux C, Sekkate S, Tresca P, Kas A, Gratieux J, Ammari S, Saragoussi E, Savatovsky J, Delattre JY, Hoang-Xuan K, Meyronet D, Villa C, Bielle F, Sanson M, Touat M, Di Stefano AL. Sustained Tumor Control With MAPK Inhibition in BRAF V600-Mutant Adult Glial and Glioneuronal Tumors. Neurology 2021; 97:e673-e683. [PMID: 34088874 DOI: 10.1212/wnl.0000000000012330] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/11/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To assess whether RAF and MEK inhibitors (RAFi/MEKi) can provide long-term clinical benefit in adult patients with BRAF V600-mutant glial and glioneuronal tumors (GGNTs), we analyzed tumor response and long-term outcome in a retrospective cohort. METHODS We performed a retrospective search in the institutional databases of 6 neuro-oncology departments for adult patients with recurrent or disseminated BRAF V600-mutant GGNTs treated with RAFi/MEKi. RESULTS Twenty-eight adults with recurrent or disseminated BRAF V600-mutant gangliogliomas (n = 9), pleomorphic xanthoastrocytomas (n = 9), and diffuse gliomas (n = 10) were included in the study. At the time that treatment with RAFi/MEKi was started, all tumors displayed radiologic features of high-grade neoplasms. Thirteen patients received RAFi as single agents (vemurafenib [n = 11], dabrafenib [n = 2]), and 15 received combinations of RAFi/MEKi (vemurafenib + cobimetinib [n = 5], dabrafenib + trametinib [n = 10]). Eleven patients achieved a partial or complete response (11 of 28, 39%), with a median reduction of -78% in their tumor burden. Responders experienced a median increase of 10 points in their Karnofsky Performance Status (KPS) score and a median progression-free survival of 18 months, which was longer than achieved with first-line treatment (i.e., 7 months, p = 0.047). Responders had better KPS score (p = 0.018) and tended to be younger (p = 0.061) and to be treated earlier (p = 0.099) compared to nonresponders. Five patients were rechallenged with RAFi/MEKi at progression, with novel tumor responses in 2. On univariate and multivariate analyses, response to RAFi/MEKi was an independent predictor of overall survival. CONCLUSIONS Our study highlights the long-term clinical benefits of RAFi/MEKi in adult patients with BRAF V600-mutant GGNTs and encourages rechallenge in responders. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that, for adult patients with BRAF V600-mutant GGNT, RAFi/MEKi can reduce tumor burden and provide clinical benefit.
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Affiliation(s)
- Giulia Berzero
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Luisa Bellu
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Capucine Baldini
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - François Ducray
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - David Guyon
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Marica Eoli
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Antonio Silvani
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Caroline Dehais
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Ahmed Idbaih
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Nadia Younan
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Ludovic Nguyen-Them
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Stephan Gaillard
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Francesco Pasqualetti
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Coralie Lepage-Seydoux
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Sakina Sekkate
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Patricia Tresca
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Aurélie Kas
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Julie Gratieux
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Samy Ammari
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Edouard Saragoussi
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Julien Savatovsky
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Jean-Yves Delattre
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Khê Hoang-Xuan
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - David Meyronet
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Chiara Villa
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Franck Bielle
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Marc Sanson
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Mehdi Touat
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris
| | - Anna Luisa Di Stefano
- From Sorbonne Université (G.B., L.B., C.D., A.I., J.-Y.D., K.H.-X., F.B., M.S., M.T., A.L.D.S.), Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle Épinière, and AP-HP Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France; Radiation Therapy Unit (L.B.), Imaging and Medical Physics Department, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; Drug Development Department (C.B.), Institut Gustave Roussy and Université Paris-Saclay, Villejuif; Department of Neuroncology (F.D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurology (D.G., N.Y., A.L.D.S.), Department of Neurosurgery (S.G.), Service de Pharmacie (C.L.-S.), Department of Oncology (S.S.), Department of Neuroradiology (J.G.), and Department of Pathology (C.V.), Hôpital Foch, Suresnes, France; Neuro-oncology Unit (M.E., A.S.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Service de Neurologie (L.N.T.), Centre Hospitalier Perpignan, France; Radiation Oncology (F.P.), Department of Medicine and Oncology, University Hospital, Pisa, Italy; Clinical Research Unit (P.T.), Institut Curie, Paris; Department of Nuclear Medicine (A.K.), AP-HP GH Pitié-Salpêtrière, Paris; Department of Diagnostic Radiology (S.A.), Institut Gustave Roussy, Villejuif, France; Neuroradiology Unit (E.S., J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris; Department of Pathology (D.M.), Eastern Hospital Group, Lyon Civil Hospices; Department of Neuropathology (F.B.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Onconeurotek Tumor Bank (F.B., M.S.), Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France. Dr. Berzero is currently at Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; and Dr. Gaillard is currently at the Department of Neurosurgery, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris.
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Scoccianti S, Olmetto E, Pinzi V, Osti MF, Di Franco R, Caini S, Anselmo P, Matteucci P, Franceschini D, Mantovani C, Beltramo G, Pasqualetti F, Bruni A, Tini P, Giudice E, Ciammella P, Merlotti A, Pedretti S, Trignani M, Krengli M, Giaj-Levra N, Desideri I, Pecchioli G, Muto P, Maranzano E, Fariselli L, Navarria P, Ricardi U, Scotti V, Livi L. Immunotherapy in association with stereotactic radiotherapy for Non-Small Cell Lung Cancer brain metastases: results from a multicentric retrospective study on behalf of AIRO. Neuro Oncol 2021; 23:1750-1764. [PMID: 34050669 DOI: 10.1093/neuonc/noab129] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To define efficacy and toxicity of Immunotherapy (IT) with stereotactic radiotherapy (SRT) including radiosurgery (RS) or hypofractionated SRT (HFSRT) for brain metastases (BM) from Non-Small Cell Lung Cancer (NSCLC) in a multicentric retrospective study from AIRO (Italian Association of Radiotherapy and Clinical Oncology). METHODS NSCLC patients with BM receiving SRT+IT and treated in 19 Italian centers were analysed and compared with a control group of patients treated with exclusive SRT. RESULTS One hundred patients treated with SRT+IT and 50 patients treated with SRT-alone were included. Patients receiving SRT+IT had a longer intracranial Local Progression Free Survival (iLPFS) (propensity score-adjusted p=0.007). Among patients who, at the diagnosis of BM, received IT and had also extracranial progression (n=24), IT administration after SRT was shown to be related to a better overall survival (OS) (p=0.037). At multivariate analysis, non-adenocarcinoma histology, KPS =70 and use of HFSRT were associated with a significantly worse survival (p=0.019, p=0.017 and p=0.007 respectively). Time interval between SRT and IT ≤7 days (n=90) was shown to be related to a longer OS if compared to SRT-IT interval >7 days (n=10) (propensity score-adjusted p=0.008). The combined treatment was well tolerated. No significant difference in terms of radionecrosis between SRT+IT patients and SRT-alone patients was observed. Time interval between SRT and IT had no impact on toxicity rate. CONCLUSIONS Combined SRT+IT was a safe approach, associated with a better iLPFS if compared to exclusive SRT.
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Affiliation(s)
- Silvia Scoccianti
- Radiation Oncology Unit, Ospedale Santa Maria Annunziata, Department of Oncology, Bagno a Ripoli, Florence, Italy
| | - Emanuela Olmetto
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Florence, Italy
| | - Valentina Pinzi
- U.O Radioterapia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Neurosurgery, Milan, Italy
| | - Mattia Falchetto Osti
- U.O.C Radioterapia, A.O.U Sant'Andrea Facoltà Medicina e Psicologia Università Sapienza, Department of Medicine,Surgery and Translational Medicine,Rome, Italy
| | - Rossella Di Franco
- Istituto Nazionale Tumori IRCCS, Fondazione G. Pascale, Department of Radiotherapy, Naples, Italy
| | - Saverio Caini
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Cancer Risk Factors and Life-Style Epidemiology Unit, Florence, Italy
| | - Paola Anselmo
- Radiotherapy Oncology Center, S. Maria Hospital, Department of Oncology, Terni, Italy
| | - Paolo Matteucci
- Radioterapia Oncologica, Campus Biomedico, Department of Radiation Oncology, Rome, Italy
| | - Davide Franceschini
- Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, Rozzano, Italy
| | | | - Giancarlo Beltramo
- Cyberknife Centro Diagnostico Italiano, Department of Radiology, Milan, Italy
| | - Francesco Pasqualetti
- Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Department of Translational Medicine, Pisa, Italy
| | - Alessio Bruni
- Radiotherapy Unit, University Hospital of Modena, Department of Oncology and Hematology, Modena, Italy
| | - Paolo Tini
- Radiotherapy Unit, University of Siena, Department of Radiotherapy and Oncology, Siena, Italy
| | - Emilia Giudice
- UOC di Radioterapia, Policlinico Universitario Tor Vergata, Department of Onco-Haematology, Rome, Italy
| | - Patrizia Ciammella
- Radioterapia Oncologica "G. Prodi", AO-IRCCS Arcispedale S. Maria Nuova, Department of Oncology and Advanced Technology, Reggio Emilia, Italy
| | - Anna Merlotti
- Radiation Oncology A.S.O. S.Croce e Carle, Department of Radiation Oncology, Cuneo, Italy
| | - Sara Pedretti
- U.O. Radioterapia oncologica, Department of Radiation Oncology, ASST Spedali Civili di Brescia e Università degli studi di Brescia, Brescia, Italy
| | - Marianna Trignani
- U.O.C. Radioterapia Oncologica, Ospedale Clinicizzato SS Annunziata- Università Chieti G. D'Annunzio, Department of Radiation Oncology, Chieti, Italy
| | - Marco Krengli
- Radiation Oncology, University Hospital Maggiore della Carità, Department of Translational Medicine, Novara, Italy
| | - Niccolò Giaj-Levra
- IRCCS Ospedale Sacro Cuore Don Calabria, Department of Advanced Radiation Oncology, Verona, Italy
| | - Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Florence, Italy
| | - Guido Pecchioli
- Neurosurgery Unit, Azienda Ospedaliero Universitaria Careggi, Department of Neurosurgery, Florence, Italy
| | - Paolo Muto
- Istituto Nazionale Tumori IRCCS, Fondazione G. Pascale, Department of Radiotherapy, Naples, Italy
| | - Ernesto Maranzano
- Radiotherapy Oncology Center, S. Maria Hospital, Department of Oncology, Terni, Italy
| | - Laura Fariselli
- U.O Radioterapia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Neurosurgery, Milan, Italy
| | - Piera Navarria
- Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, Rozzano, Italy
| | | | - Vieri Scotti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Florence, Italy
| | - Lorenzo Livi
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Florence, Italy
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Pasqualetti F, Gonnelli A, Orlandi P, Palladino E, Giannini N, Gadducci G, Mattioni R, Montrone S, Calistri E, Mazzanti CM, Franceschi S, Ortenzi V, Scatena C, Zavaglia K, Fanelli GN, Morganti R, Santonocito O, Bocci G, Naccarato AG, Paiar F. Correction to: Association of XRCC3 rs1799794 polymorphism with survival of glioblastoma multiforme patients treated with combined radio-chemotherapy. Invest New Drugs 2021; 39:1166. [PMID: 33704622 DOI: 10.1007/s10637-021-01097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - Alessandra Gonnelli
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Paola Orlandi
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126, Pisa, Italy
| | - Eleonora Palladino
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Noemi Giannini
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Giovanni Gadducci
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Roberto Mattioni
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Sabrina Montrone
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Elisa Calistri
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Chiara Maria Mazzanti
- Laboratory of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, Pisa, Italy
| | - Sara Franceschi
- Laboratory of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, Pisa, Italy
| | - Valerio Ortenzi
- Department of Translational Research and new technologies in Medicine and Surgery, University of Pisa, 56100, Pisa, Italy
| | - Cristian Scatena
- Department of Translational Research and new technologies in Medicine and Surgery, University of Pisa, 56100, Pisa, Italy
| | - Katia Zavaglia
- Division of Molecular Genetics, Department of Laboratory Medicine, Pisa University Hospital, Pisa, Italy
| | - Giuseppe Nicolo Fanelli
- Department of Translational Research and new technologies in Medicine and Surgery, University of Pisa, 56100, Pisa, Italy
| | - Riccardo Morganti
- Section of Statistics, Azienda Ospedaliero-Universitaria Pisana, Pisa University Hospital, Pisa, Italy
| | - Orazio Santonocito
- Nurosurgery Unit, Area Vasta-NordOvest, Livorno General Hospital, Livorno, Italy
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126, Pisa, Italy
| | - Antonio Giuseppe Naccarato
- Department of Translational Research and new technologies in Medicine and Surgery, University of Pisa, 56100, Pisa, Italy
| | - Fabiola Paiar
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
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Pasqualetti F, Gonnelli A, Orlandi P, Palladino E, Giannini N, Gadducci G, Mattioni R, Montrone S, Calistri E, Mazzanti CM, Franceschi S, Ortenzi V, Scatena C, Zavaglia K, Fanelli GN, Morganti R, Santonocito O, Bocci G, Naccarato GA, Paiar F. Association of XRCC3 rs1799794 polymorphism with survival of glioblastoma multiforme patients treated with combined radio-chemotherapy. Invest New Drugs 2021; 39:1159-1165. [PMID: 33558989 DOI: 10.1007/s10637-021-01075-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/25/2021] [Indexed: 11/29/2022]
Abstract
This study reports the results of a monocentric prospective analysis conducted with the aim of evaluating the impact of XRCC1 rs25487, XRCC3 rs861539, XRCC3 rs1799794, RAD51 rs1801320 and GSTP-1 rs1695 single nucleotide polymorphisms (SNP) on patients with high-grade glioma treated with concomitant radio-chemotherapy. From October 2010 to August 2019, a total of 75 patients aged ≥18 years, with histological diagnosis of high-grade glioma, isocitrate dehydrogenase (IDH) 1/2 wild type and treated with radio-chemotherapy and sequential chemotherapy with temozolomide (TMZ) were prospectively recruited. The local ethic committee approved this study (Comitato Etico di Area Vasta Nord Ovest [CEAVNO]; protocol 3304/2011). After a median follow up of 25 months (range: 7-98 months), median progression-free survival (PFS) and overall survival (OS) were 11 months (CI95%: 8-14 months) and 18 months (CI95%: 15-21 months), respectively. In univariate and multivariate Cox regression analysis, a statistically significant association with PFS and OS was found with XRCC3 rs1799794 SNP. The study suggests that XRCC3 rs1799794 SNP can be associated with different PFS and OS in glioblastoma patients treated with radio-chemotherapy.
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Affiliation(s)
| | - Alessandra Gonnelli
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Paola Orlandi
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126, Pisa, Italy
| | - Eleonora Palladino
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Noemi Giannini
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Giovanni Gadducci
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Roberto Mattioni
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Sabrina Montrone
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Elisa Calistri
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - Chiara Maria Mazzanti
- Laboratory of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, Pisa, Italy
| | - Sara Franceschi
- Laboratory of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, Pisa, Italy
| | - Valerio Ortenzi
- Department of Translational Research and new technologies in Medicine and Surgery, University of Pisa, 56100, Pisa, Italy
| | - Cristian Scatena
- Laboratory of Genomics and Transcriptomics, Fondazione Pisana per la Scienza, Pisa, Italy
| | - Katia Zavaglia
- Division of Molecular Genetics, Department of Laboratory Medicine, Pisa University Hospital, Pisa, Italy
| | - Giuseppe Nicolo Fanelli
- Department of Translational Research and new technologies in Medicine and Surgery, University of Pisa, 56100, Pisa, Italy
| | - Riccardo Morganti
- Section of Statistics, Azienda Ospedaliero-Universitaria Pisana, Pisa University Hospital, Pisa, Italy
| | - Orazio Santonocito
- Nurosurgery Unit, Area Vasta-NordOvest, Livorno General Hospital, Livorno, Italy
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126, Pisa, Italy
| | - Giuseppe Antonio Naccarato
- Department of Translational Research and new technologies in Medicine and Surgery, University of Pisa, 56100, Pisa, Italy
| | - Fabiola Paiar
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
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Olmetto E, Scoccianti S, Di Franco R, Anselmo P, Beltramo G, Mantovani C, Osti M, Pinzi V, Giaj-Levra N, Bruni A, Matteucci P, Pedretti S, Giudice E, Tini P, Krengli M, Ciammella P, Pasqualetti F, Trignani M, Merlotti A, Borzillo V, Franceschini D, Maranzano E, Umberto R, Pierina N, Scotti V. PD-0175: TTIRS trial:a retrospective analysis of the association between TT or IT and RS for BM from NSCLC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00199-7] [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: 11/29/2022]
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Gonnelli A, Montrone S, Molinari A, Pasqualetti F, Paiar F. PO-0858: Stereotactic Radiotherapy for Treatment of Brain Metastases: a monocentric experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00875-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Navarria P, Minniti G, Clerici E, Comito T, Cozzi S, Pinzi V, Fariselli L, Ciammella P, Scoccianti S, Borzillo V, Anselmo P, Maranzano E, Dell'acqua V, Jereczek-Fossa B, Giaj Levra N, Podlesko AM, Giudice E, Buglione di Monale E Bastia M, Pedretti S, Bruni A, Bossi Zanetti I, Borghesi S, Busato F, Pasqualetti F, Paiar F, Scorsetti M. Brain metastases from primary colorectal cancer: is radiosurgery an effective treatment approach? Results of a multicenter study of the radiation and clinical oncology Italian association (AIRO). Br J Radiol 2020; 93:20200951. [PMID: 33035077 DOI: 10.1259/bjr.20200951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES The prognosis of brain metastatic colorectal cancer patients (BMCRC) is poor. Several local treatments have been used, but the optimal treatment choice remains an unresolved issue. We evaluated the clinical outcomes of a large series of BMCRC patients treated in several Italian centers using stereotactic radiosurgery (SRS). METHODS 185 BMCRC patients for a total of 262 lesions treated were evaluated. Treatments included surgery followed by post-operative SRS to the resection cavity, and SRS, either single-fraction, then hypofractionated SRS (HSRS). Outcomes was measured in terms of local control (LC), toxicities, brain distant failure (BDF), and overall survival (OS). Prognostic factors influencing survival were assed too. RESULTS The median follow-up time was 33 months (range 3-183 months). Surgery plus SRS have been performed in 28 (10.7%) cases, SRS in 141 (53.8%), and HSRS in 93 (35.5%). 77 (41.6%) patients received systemic therapy. The main total dose and fractionation used were 24 Gy in single fraction or 24 Gy in three daily fractions. Local recurrence occurred in 32 (17.3%) patients. Median, 6 months,1-year-LC were 86 months (95%CI 36-86), 87.2% ± 2.8, 77.8% ± 4.1. Median,6 months,1-year-BDF were 23 months (95%CI 9-44), 66.4% ± 3.9, 55.3% ± 4.5. Median,6 months,1-year-OS were 7 months (95% CI 6-9), 52.7% ± 3.6, 33% ± 3.5. No severe neurological toxicity occurred. Stage at diagnosis, Karnofsky Performance Status (KPS), presence and number of extracranial metastases, and disease-specific-graded-prognostic-assessment (DS-GPA) score were observed as conditioning survival. CONCLUSION SRS/HSRS have proven to be an effective local treatment for BMCRC. A careful evaluation of prognostic factors as well as a multidisciplinary evaluation is a valid aid to manage the optimal therapeutic strategy for CTC patients with BMs. ADVANCES IN KNOWLEDGE The prognosis of BMCRC is poor. Several local treatments was used, but optimal treatment choice remains undefined. Radiosurgery has proven to be an effective local treatment for BMCRC. A careful evaluation of prognostic factors and a multidisciplinary evaluation needed.
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Affiliation(s)
- Pierina Navarria
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
| | | | - Elena Clerici
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
| | - Tiziana Comito
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
| | - Salvatore Cozzi
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy
| | - Valentina Pinzi
- Radiotherapy Unit, Istituto Neurologico Fondazione "Carlo Besta", Milan, Italy
| | - Laura Fariselli
- Radiotherapy Unit, Istituto Neurologico Fondazione "Carlo Besta", Milan, Italy
| | - Patrizia Ciammella
- Radiation Therapy Unit, Department of Oncology and Advanced Technology, Azienda Ospedaliera Arcispedale S Maria Nuova, Reggio Emilia, Italy
| | - Silvia Scoccianti
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Valentina Borzillo
- UOC Radiation Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione "Giovanni Pascale", Milan, Italy
| | - Paola Anselmo
- Radiotherapy Oncology Centre, "S. Maria" Hospital, Terni, Italy
| | | | - Veronica Dell'acqua
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Barbara Jereczek-Fossa
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Niccolò Giaj Levra
- Radiation Oncology, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy
| | | | - Emilia Giudice
- Radiation Therapy unit, Policlinico Universitario Tor Vergata, Roma, Italy
| | | | - Sara Pedretti
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | | | | | | | | | - Francesco Pasqualetti
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Fabiola Paiar
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Marta Scorsetti
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Hospital-IRCCS, Rozzano (MI), Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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Lombardi G, Barresi V, Castellano A, Tabouret E, Pasqualetti F, Salvalaggio A, Cerretti G, Caccese M, Padovan M, Zagonel V, Ius T. Clinical Management of Diffuse Low-Grade Gliomas. Cancers (Basel) 2020; 12:E3008. [PMID: 33081358 PMCID: PMC7603014 DOI: 10.3390/cancers12103008] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 09/11/2020] [Revised: 10/06/2020] [Accepted: 10/14/2020] [Indexed: 12/21/2022] Open
Abstract
Diffuse low-grade gliomas (LGG) represent a heterogeneous group of primary brain tumors arising from supporting glial cells and usually affecting young adults. Advances in the knowledge of molecular profile of these tumors, including mutations in the isocitrate dehydrogenase genes, or 1p/19q codeletion, and in neuroradiological techniques have contributed to the diagnosis, prognostic stratification, and follow-up of these tumors. Optimal post-operative management of LGG is still controversial, though radiation therapy and chemotherapy remain the optimal treatments after surgical resection in selected patients. In this review, we report the most important and recent research on clinical and molecular features, new neuroradiological techniques, the different therapeutic modalities, and new opportunities for personalized targeted therapy and supportive care.
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Affiliation(s)
- Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of oncology-IRCCS, 35128 Padova, Italy; (G.C.); (M.C.); (M.P.); (V.Z.)
| | - Valeria Barresi
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37129 Verona, Italy;
| | - Antonella Castellano
- Neuroradiology Unit, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Emeline Tabouret
- Team 8 GlioMe, CNRS, INP, Inst Neurophysiopathol, Aix-Marseille University, 13005 Marseille, France;
| | | | - Alessandro Salvalaggio
- Department of Neuroscience, University of Padova, 35128 Padova, Italy;
- Padova Neuroscience Center (PNC), University of Padova, 35128 Padova, Italy
| | - Giulia Cerretti
- Department of Oncology, Oncology 1, Veneto Institute of oncology-IRCCS, 35128 Padova, Italy; (G.C.); (M.C.); (M.P.); (V.Z.)
| | - Mario Caccese
- Department of Oncology, Oncology 1, Veneto Institute of oncology-IRCCS, 35128 Padova, Italy; (G.C.); (M.C.); (M.P.); (V.Z.)
| | - Marta Padovan
- Department of Oncology, Oncology 1, Veneto Institute of oncology-IRCCS, 35128 Padova, Italy; (G.C.); (M.C.); (M.P.); (V.Z.)
| | - Vittorina Zagonel
- Department of Oncology, Oncology 1, Veneto Institute of oncology-IRCCS, 35128 Padova, Italy; (G.C.); (M.C.); (M.P.); (V.Z.)
| | - Tamara Ius
- Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
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Sbrana A, Paolieri F, Bloise F, Nuzzo A, Manacorda S, Sammarco E, Manfredi F, Mercinelli C, Gadducci G, Giannini N, Antonuzzo A, Paiar F, Falcone A, Pasqualetti F, Galli L. 1711P SARS-CoV-2 infection in prostate cancer patients: Data from a high-incidence area in Italy. Ann Oncol 2020. [PMCID: PMC7506440 DOI: 10.1016/j.annonc.2020.08.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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