1
|
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]
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Mantovani A, Lunardi G, Bonapace S, Dugo C, Altomari A, Molon G, Conti A, Bovo C, Laaksonen R, Byrne CD, Bonnet F, Targher G. Association between increased plasma ceramides and chronic kidney disease in patients with and without ischemic heart disease. Diabetes Metab 2020; 47:101152. [PMID: 32283179 DOI: 10.1016/j.diabet.2020.03.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/21/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
AIM Plasma levels of certain ceramides are increased in patients with ischemic heart disease (IHD). Many risk factors for IHD are also risk factors for chronic kidney disease (CKD), but it is currently uncertain whether plasma ceramide levels are increased in patients with CKD. METHODS We measured six previously identified high-risk plasma ceramide concentrations [Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/20:0), Cer(d18:1/22:0), Cer(d18:1/24:0) and Cer(d18:1/24:1)] in 415 middle-aged individuals who attended our clinical Cardiology and Diabetes services over a period of 9 months. RESULTS A total of 97 patients had CKD (defined as e-GFRCKD-EPI<60ml/min/1.73m2 and/or urinary albumin-to-creatinine ratio≥30mg/g), 117 had established IHD and 242 had type 2 diabetes. Patients with CKD had significantly (P=0.005 or less) higher levels of plasma Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/20:0), Cer(d18:1/22:0), Cer(d18:1/24:0), and Cer(d18:1/24:1) compared to those without CKD. The presence of CKD remained significantly associated with higher levels of plasma ceramides (standardized beta coefficients ranging from 0.124 to 0.227, P<0.001) even after adjustment for body mass index, smoking, hypertension, diabetes, prior IHD, plasma LDL-cholesterol, hs-C-reactive protein levels and use of any lipid-lowering medications. Notably, more advanced stages of CKD and abnormal albuminuria were both associated (independently of each other) with increased levels of plasma ceramides. These results were consistent in all subgroups considered, including patients with and without established IHD or those with and without diabetes. CONCLUSION Increased levels of plasma ceramides are associated with CKD independently of pre-existing IHD, diabetes and other established cardiovascular risk factors.
Collapse
Affiliation(s)
- A Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy
| | - G Lunardi
- Medical Analysis Laboratory, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - S Bonapace
- Division of Cardiology, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - C Dugo
- Division of Cardiology, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - A Altomari
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy
| | - G Molon
- Division of Cardiology, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - A Conti
- Medical Analysis Laboratory, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - C Bovo
- Medical Direction, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - R Laaksonen
- Zora Biosciences Oy, Espoo, Finland; Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere University Hospital, Tampere, Finland
| | - C D Byrne
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Southampton, UK; Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK
| | - F Bonnet
- University Hospital of Rennes, University of Rennes 1, CHU, Rennes, France
| | - G Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy.
| |
Collapse
|
4
|
Mantovani A, Altomari A, Lunardi G, Bonapace S, Lippi G, Bonnet F, Targher G. Association between specific plasma ceramides and high-sensitivity C-reactive protein levels in postmenopausal women with type 2 diabetes. Diabetes Metab 2019; 46:326-330. [PMID: 31185304 DOI: 10.1016/j.diabet.2019.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 05/26/2019] [Indexed: 12/27/2022]
Abstract
AIM Emerging evidence suggests that specific plasma ceramides are involved in the pathophysiology of cardiovascular disease (CVD) and other inflammation-associated diseases. However, scarce information is currently available on the association between distinct plasma ceramides (that have been associated with increased cardiovascular morbidity and mortality) and plasma high-sensitivity C-reactive protein (hs-CRP) concentrations in patients with type 2 diabetes mellitus (T2DM), a group of individuals at high risk of developing CVD and other chronic inflammation-related conditions. METHODS We measured six previously identified high-risk plasma ceramide species [Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/20:0), Cer(d18:1/22:0), Cer(d18:1/24:0), Cer(d18:1/24:1)] in 92 postmenopausal women with T2DM attending the diabetes outpatient service over a 3-month period. Plasma ceramide levels were measured using targeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay. RESULTS Plasma hs-CRP levels were positively associated with all measured ceramides in univariable linear regression analyses. However, only plasma Cer(d18:1/16:0) (standard β coefficient: 0.27, P=0.015), Cer(d18:1/22:0) (standard β coefficient: 0.25, P=0.032) and Cer(d18:1/24:1) (standard β coefficient: 0.30, P=0.007) remained significantly associated with increased plasma hs-CRP levels after adjusting for age, adiposity measures, diabetes duration, HbA1c, insulin resistance, smoking, hypertension, plasma LDL cholesterol, estimated glomerular filtration rate, preexisting ischaemic heart disease and use of lipid-lowering, antihypertensive, antiplatelet or hypoglycaemic drugs. CONCLUSION In postmenopausal women with T2DM, elevated levels of specific plasma ceramides are associated with higher plasma hs-CRP levels independent of established cardiovascular risk factors, diabetes-related variables and other potential confounding factors.
Collapse
Affiliation(s)
- A Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
| | - A Altomari
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - G Lunardi
- Laboratory of Clinical Pharmacology, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar VR, Italy
| | - S Bonapace
- Division of Cardiology, IRCCS Sacro Cuore-Don Calabria' Hospital, Negrar VR, Italy
| | - G Lippi
- Section of Clinical Biochemistry, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - F Bonnet
- Department of endocrinology, Inserm U1018, groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - G Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| |
Collapse
|
5
|
Bovo M, Carlot A, Lucchetta V, Lunardi G, Behr AU. Safe, controlled extubation with catheter in life threatening ACE inihibitor (ACEI) Angioedema. Trends in Anaesthesia and Critical Care 2018. [DOI: 10.1016/j.tacc.2018.09.103] [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: 11/25/2022]
|
6
|
Inno A, Salgarello M, Severi F, Pasetto S, Romano L, Carbognin G, Marchetti F, Gorgoni G, Casolino R, Cassandrini P, Cirillo M, Magarotto R, Modena A, Nicodemo M, Picece V, Turazza M, Alongi F, Valerio M, Lunardi G, Gori S. 18F-sodium fluoride (18F-NaF) PET/CT scan for the assessment of brain metastases (BMs). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx431.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
7
|
Gori S, Turazza M, Inno A, Lunardi G, Moroso S, La Verde N, Frassoldai A, Tarenzi E, Garrone O, Vici P, Laudadio L, Cretella E, Foglietta J, Leonardi V, Cavanna L, Barni S, Marchetti F, Valerio M, Carbognin G, Alongi F, Fabi A. The HERBA trial: a retrospective study on patients (pts) with HER2-positive (HER2+ve) breast cancer (BC) and brain metastases (BMs). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
8
|
Cirillo M, Carlucci L, Baldini E, Sacco C, Zagonel V, Leo S, Llimpe FR, Tonini G, Marialuisa M, Alfredo T, Farci D, Sava T, Zaninelli M, Valori V, Quaranta A, Carrozza F, Micheloni B, Marchetti F, Lunardi G, Zamboni S, Pinto C, Gori S. Oral Anticancer Therapy Project: clinical utility of a specific home care nursing program. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
9
|
Magarotto R, Micheloni B, Lunardi G, Duranti S, Inno A, Valerio M, Bustaggi M, Castagna S, Dalle Vedove A, Duma M, Mignolli L, Oliosi L, Platano M, Residori G, Righetti P, Ronconi A, Unguru C, Zivelonghi S, Gori S. Systematic pain evaluation in hospitalized cancer patients in a Medical Oncology Unit: feasibility and utility of pain monitoring by Numeric Rating Scale in cancer pain management. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw344.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
10
|
Bogina G, Munari E, Marconi M, Bortesi L, Turazza M, Cassandrini P, Cirillo M, Duranti S, Inno A, Magarotto R, Nicodemo M, Picece V, Lunardi G, Gori S. Neuroendocrine differentiation in breast carcinoma: clinicopathological features and outcome. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
11
|
Lunardi G, Magarotto R, Inno A, Cassandrini P, Cirillo M, Duranti S, Nicodemo M, Picece V, Turazza M, Marchetti F, Micheloni B, Valerio M, Zenari L, Gori S. Association between patient reported outcomes and vibratory perception threshold test for measuring neurotoxicity in patients with chemotherapy induced peripheral neuropathy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
12
|
Duranti S, Inno A, Rossi V, Turazza M, Fiorio E, Fabi A, Bisagni G, Foglietta J, Santini D, Pavese I, Zambelli A, Vici P, Leonardi V, Barni S, Saracchini S, Bogina G, Lunardi G, Marchetti F, Montemurro F, Gori S. Clinical and pathological factors predicting long-term disease control with lapatinib and capecitabine for patients with HER2 positive metastastic breast cancer: results from a multicenter retrospective study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
13
|
Inno A, Lunardi G, Turazza M, Pasetto S, Severi F, Gorgoni G, Bogina G, Bortesi L, Russo A, Alongi F, Fiorentino A, Duranti S, Massocco A, Marchetti F, Valerio M, Salgarello M, Gori S. FDG-PET/CT as a predictor of pathological complete response (pCR) in breast cancer (BC) patients (pts) treated with neoadjuvant chemotherapy (NAC): a single center retrospective study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
14
|
Gori S, Lunardi G, Inno A, Foglietta J, Cardinali B, Del Mastro L, Crinò L. Lapatinib concentration in cerebrospinal fluid in two patients with HER2-positive metastatic breast cancer and brain metastases. Ann Oncol 2014; 25:912-913. [PMID: 24667724 DOI: 10.1093/annonc/mdu041] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- S Gori
- Department of Medical Oncology, Sacro Cuore-Don Calabria Hospital, Negrar-Verona
| | - G Lunardi
- Department of Medical Oncology, Sacro Cuore-Don Calabria Hospital, Negrar-Verona
| | - A Inno
- Department of Medical Oncology, Sacro Cuore-Don Calabria Hospital, Negrar-Verona.
| | - J Foglietta
- Department of Medical Oncology, Azienda Ospedaliera di Perugia, Perugia
| | - B Cardinali
- Development of Innovative Therapies Unit, Department of Medical Oncology, IRCCS-AOU San Martino-IST National Institute for Cancer Research, Genova, Italy
| | - L Del Mastro
- Development of Innovative Therapies Unit, Department of Medical Oncology, IRCCS-AOU San Martino-IST National Institute for Cancer Research, Genova, Italy
| | - L Crinò
- Department of Medical Oncology, Azienda Ospedaliera di Perugia, Perugia
| |
Collapse
|
15
|
Sini V, Lunardi G, Cirillo M, Turazza M, Bighin C, Giraudi S, Levaggi A, Piccioli P, Bisagni G, Gnoni R, Stridi G, Porpiglia M, Picardo E, Ponzone R, Marenco D, Mansutti M, Puglisi F, Del Mastro L. Body mass index and circulating oestrone sulphate in women treated with adjuvant letrozole. Br J Cancer 2014; 110:1133-8. [PMID: 24448359 PMCID: PMC3950872 DOI: 10.1038/bjc.2014.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 09/05/2013] [Revised: 12/03/2013] [Accepted: 12/17/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Obesity is an independent adverse prognostic factor in early breast cancer patients, but it is still controversial whether obesity may affect adjuvant endocrine therapy efficacy. The aim of our study (ancillary to the two clinical trials Gruppo Italiano Mammella (GIM)4 and GIM5) was to investigate whether the circulating oestrogen levels during treatment with the aromatase inhibitor letrozole are related to body mass index (BMI) in postmenopausal women with breast cancer. METHODS Plasma concentration of oestrone sulphate (ES) was evaluated by radioimmunoassay in 370 patients. Plasma samples were obtained after at least 6 weeks of letrozole therapy (steady-state time). Patients were divided into four groups according to BMI. Differences among the geometric means (by ANOVA and ANCOVA) and correlation (by Spearman's rho) between the ES levels and BMI were assessed. RESULTS Picomolar geometric mean values (95% confidence interval, n=patients) of circulating ES during letrozole were 58.6 (51.0-67.2, n=150) when BMI was <25.0 kg m(-2); 65.6 (57.8-74.6, n=154) when 25.0-29.9 kg m(-2); 59.3 (47.1-74.6, n=50) when 30.0-34.9 kg m(-2); and 43.3 (23.0-81.7, n=16) when ≥35.0 kg m(-2). No statistically significant difference in terms of ES levels among groups and no correlation with BMI were observed. CONCLUSIONS Body mass index does not seem to affect circulating oestrogen levels in letrozole-treated patients.
Collapse
Affiliation(s)
- V Sini
- 1] Medical Oncology Unit, Sacro Cuore Don Calabria Hospital, Via Sempreboni, 5, 37024 Negrar (Verona), Italy [2] Oncology Unit, Surgical and Medical Department of Clinical Sciences, Sant'Andrea Hospital, via di Grottarossa, 1035, 00189 Rome, Italy
| | - G Lunardi
- Medical Oncology Unit, Sacro Cuore Don Calabria Hospital, Via Sempreboni, 5, 37024 Negrar (Verona), Italy
| | - M Cirillo
- Medical Oncology Unit, Sacro Cuore Don Calabria Hospital, Via Sempreboni, 5, 37024 Negrar (Verona), Italy
| | - M Turazza
- Medical Oncology Unit, Sacro Cuore Don Calabria Hospital, Via Sempreboni, 5, 37024 Negrar (Verona), Italy
| | - C Bighin
- Medical Oncology Department, IRCSS AOU San Martino, IST, L.go R. Benzi, 10, 16132 Genoa, Italy
| | - S Giraudi
- Medical Oncology Department, IRCSS AOU San Martino, IST, L.go R. Benzi, 10, 16132 Genoa, Italy
| | - A Levaggi
- Medical Oncology Department, IRCSS AOU San Martino, IST, L.go R. Benzi, 10, 16132 Genoa, Italy
| | - P Piccioli
- Medical Oncology Department, IRCSS AOU San Martino, IST, L.go R. Benzi, 10, 16132 Genoa, Italy
| | - G Bisagni
- Department of Oncology, Azienda Ospedaliera ASMN, viale Risorgimento, 80, 42123 Reggio Emilia, Italy
| | - R Gnoni
- Department of Oncology, Azienda Ospedaliera ASMN, viale Risorgimento, 80, 42123 Reggio Emilia, Italy
| | - G Stridi
- Department of Oncology, Azienda Ospedaliera ASMN, viale Risorgimento, 80, 42123 Reggio Emilia, Italy
| | - M Porpiglia
- University Department of Gynecology and Obstetrics, S.Anna Hospital, Corso Spezia, 60, 10126 Turin, Italy
| | - E Picardo
- University Department of Gynecology and Obstetrics, S.Anna Hospital, Corso Spezia, 60, 10126 Turin, Italy
| | - R Ponzone
- Gynecological Oncology, Institute for Cancer Research and Treatment, Strada Provinciale 142, Km 3.95, 10060 Candiolo (Turin), Italy
| | - D Marenco
- 1] Gynecological Oncology, Institute for Cancer Research and Treatment, Strada Provinciale 142, Km 3.95, 10060 Candiolo (Turin), Italy [2] Gynecology and Obstetrics, Santa Croce Hospital, Piazza Amedeo Ferdinando, 3, 10024 Moncalieri (Turin), Italy
| | - M Mansutti
- Oncology Department, University Hospital of Udine, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy
| | - F Puglisi
- Oncology Department, University Hospital of Udine, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy
| | - L Del Mastro
- Medical Oncology Department, IRCSS AOU San Martino, IST, L.go R. Benzi, 10, 16132 Genoa, Italy
| |
Collapse
|
16
|
Migliarini S, Pacini G, Pelosi B, Lunardi G, Pasqualetti M. Lack of brain serotonin affects postnatal development and serotonergic neuronal circuitry formation. Mol Psychiatry 2013; 18:1106-18. [PMID: 23007167 DOI: 10.1038/mp.2012.128] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 07/19/2012] [Accepted: 07/23/2012] [Indexed: 12/11/2022]
Abstract
Despite increasing evidence suggests that serotonin (5-HT) can influence neurogenesis, neuronal migration and circuitry formation, the precise role of 5-HT on central nervous system (CNS) development is only beginning to be elucidated. Moreover, how changes in serotonin homeostasis during critical developmental periods may have etiological relevance to human mental disorders, remains an unsolved question. In this study we address the consequences of 5-HT synthesis abrogation on CNS development using a knock-in mouse line in which the tryptophan hydroxylase 2 (Tph2) gene is replaced by the eGFP reporter. We report that lack of brain 5-HT results in a dramatic reduction of body growth rate and in 60% lethality within the first 3 weeks after birth, with no gross anatomical changes in the brain. Thanks to the specific expression of the eGFP, we could highlight the serotonergic system independently of 5-HT immunoreactivity. We found that lack of central serotonin produces severe abnormalities in the serotonergic circuitry formation with a brain region- and time- specific effect. Indeed, we observed a striking reduction of serotonergic innervation to the suprachiasmatic and thalamic paraventricular nuclei, while a marked serotonergic hyperinnervation was found in the nucleus accumbens and hippocampus of Tph2∷eGFP mutants. Finally, we demonstrated that BDNF expression is significantly up-regulated in the hippocampus of mice lacking brain 5-HT, mirroring the timing of the appearance of hyperinnervation and thus unmasking a possible regulatory feedback mechanism tuning the serotonergic neuronal circuitry formation. On the whole, these findings reveal that alterations of serotonin levels during CNS development affect the proper wiring of the brain that may produce long-lasting changes leading to neurodevelopmental disorders.
Collapse
Affiliation(s)
- S Migliarini
- Department of Biology, Unit of Cellular and Developmental Biology, University of Pisa, Pisa, Italy
| | | | | | | | | |
Collapse
|
17
|
Bogina G, Zamboni G, Sapino A, Bortesi L, Marconi M, Lunardi G, Coati F, Massocco A, Molinaro L, Pegoraro C, Venturini M. Comparison of anti-estrogen receptor antibodies SP1, 6F11, and 1D5 in breast cancer: lower 1D5 sensitivity but questionable clinical implications. Am J Clin Pathol 2012; 138:697-702. [PMID: 23086770 DOI: 10.1309/ajcplx0qjrov2ijg] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
We compared the anti-estrogen receptors (ER) SP1, 6F11, and 1D5 antibodies in breast carcinoma cases with different ranges of positive cells to evaluate whether this could generate different therapies for patients. We selected 66 cases of breast cancer, each of which was immunostained with the 3 antibodies. 1D5 was less sensitive than SP1 and 6F11, as seen in 26, 20, and 21 negative cases, respectively. Nine cases showed differences in endocrine-therapy indications, of which 8 1D5-negative cases showed low positivity for SP1 and/or 6F11. However, these cases were prevalently G3, progesterone receptor-negative or low-positive, with high Ki-67 and positive HER-2 findings, all biological features associated with endocrine resistance. Finally ER values obtained with these 3 antibodies had no implications for chemotherapy.
Collapse
|
18
|
Natrella M, Duc L, Lunardi G, Cristoferi M, Fanelli G, Meloni T. Treatment of a transorbital penetrating injury: a particular endovascular approach. Interv Neuroradiol 2012; 18:191-4. [PMID: 22681735 DOI: 10.1177/159101991201800211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 03/03/2012] [Indexed: 11/17/2022] Open
Abstract
The management of craniocerebral penetrating injury currently represents a challenge for neurosurgeons and neuroradiologists and requires innovative planning. This report describes the case of a worker admitted to hospital with an intracranial piece of concrete-cutting saw stuck through the right eye. At the time of admission the patient was conscious and this fact influenced the choice of a particular approach. This patient escaped without neurological deficit or complications, except for the inevitable removal of an eye.
Collapse
Affiliation(s)
- M Natrella
- Department of Imaging and Interventional Radiology, Umberto Parini Regional Hospital, Aosta, Italy.
| | | | | | | | | | | |
Collapse
|
19
|
Lunardi G, Del Mastro L, Bighin C, Bisagni G, Driol P, Garrone O, Giraudi S, Marroni P, Piccioli P, Ponzone R, Porpiglia M, Venturini M. Effects of body mass index (BMI) on plasma levels of estrone sulfate (ES) in postmenopausal women with breast cancer (BC) during letrozole (L) treatment. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
20
|
Lunardi G, Lastraioli S, Bruzzi P, Pronzato P, Bisagni G, Ponzone R, Porpiglia M, Russo S, Del Mastro L, Venturini M. Single-nucleotide polymorphisms (SNPs) of CYP19A1 and plasma levels of estrone sulfate (ES) in postmenopausal women with breast cancer (BC) during letrozole (L) treatment. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.2606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
21
|
Lunardi G, Del Mastro L, Serra M, Driol P, Boni C, Cognetti F, Ponzone R, Porpiglia M, Venturini M, Pronzato P. Plasma levels of estrone sulfate (ES) in postmenopausal women with breast cancer (BC) during letrozole (L) treatment: Association with single nucleotide polymorphisms (SNPs) of CYP19A1. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
555 Background: The CYP19A1 gene encodes aromatase, a key enzyme for estrogen biosynthesis. We investigated the association between four CYP19A1 SNPs, affecting different circulating estrogen levels (rs10046 C>T, rs4646 G>T, rs749292 C>T, rs727479 T>G), and suppression of plasma ES levels induced by 6 weeks (time needed to reach L steady-state concentrations) of L (25 mg/d). Methods: Patients were enrolled into a prospective, italian multi-centre trial (GIM5) testing the correlation of CYP19A1 SNPs with the efficacy of L adjuvant therapy, after 5 years of tamoxifen, in postmenopausal early BC patients. Blood samples for hormone measurements were obtained immediately before starting L (baseline) and following 6 wks of treatment. SNPs were identified from DNA obtained from peripheral blood cells by Hexaprimer Amplification Refractory Mutation System PCR (H-ARMS-PCR). Plasma ES levels were evaluated by Radio Immuno Assay (RIA). Results: SNPs and hormone levels were evaluated in at least 129 patients. SNPs of CYP19A1 were associated with different baseline plasma ES levels. Mean inhibition of aromatase activity induced by L ranges from 71% to 79%, as a function of the SNPs. After 6 weeks of L no difference in ES levels was observed between patients with different SNPs (Table). Conclusions: L therapy induces a higher aromatase suppression in patients with SNPs associated with higher baseline plasma ES levels. The difference in ES levels associated with genetic variation at the CYP19A1 locus disappeared after L therapy. [Table: see text] [Table: see text]
Collapse
Affiliation(s)
- G. Lunardi
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - L. Del Mastro
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - M. Serra
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - P. Driol
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - C. Boni
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - F. Cognetti
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - R. Ponzone
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - M. Porpiglia
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - M. Venturini
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| | - P. Pronzato
- National Institute for Cancer Research, Genova, Italy; Azienda Ospedaliero-Universitaria, Udine, Italy; Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Regina Elena Institute, Roma, Italy; IRCC, Candiolo, Italy; S. Anna Hospital, Torino, Italy; Sacro Cuore Hospital, Negrar, Italy
| |
Collapse
|
22
|
|
23
|
Leandri M, Leandri S, Lunardi G. Effect of temperature on sensory and motor conduction of the rat tail nerves. Neurophysiol Clin 2008; 38:297-304. [DOI: 10.1016/j.neucli.2008.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Revised: 07/17/2008] [Accepted: 08/24/2008] [Indexed: 10/21/2022] Open
|
24
|
Lunardi G, Parodi A, Perasso L, Pohvozcheva AV, Scarrone S, Adriano E, Florio T, Gandolfo C, Cupello A, Burov SV, Balestrino M. The creatine transporter mediates the uptake of creatine by brain tissue, but not the uptake of two creatine-derived compounds. Neuroscience 2006; 142:991-7. [PMID: 16949212 DOI: 10.1016/j.neuroscience.2006.06.058] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2006] [Revised: 06/23/2006] [Accepted: 06/30/2006] [Indexed: 11/20/2022]
Abstract
Hereditary creatine transporter deficiency causes brain damage, despite the brain having the enzymes to synthesize creatine. Such damage occurring despite an endogenous synthesis is not easily explained. This condition is incurable, because creatine may not be delivered to the brain without its transporter. Creatine-derived compounds that crossed the blood-brain barrier in a transporter-independent fashion would be useful in the therapy of hereditary creatine transporter deficiency, and possibly also in neuroprotection against brain anoxia or ischemia. We tested the double hypothesis that: (1) the creatine carrier is needed to make creatine cross the plasma membrane of brain cells and (2) creatine-derived molecules may cross this plasma membrane independently of the creatine carrier. In in vitro mouse hippocampal slices, incubation with creatine increased creatine and phosphocreatine content of the tissue. Inhibition of the creatine transporter with 3-guanidinopropionic acid (GPA) dose-dependently prevented this increase. Incubation with creatine benzyl ester (CrOBzl) or phosphocreatine-Mg-complex acetate (PCr-Mg-CPLX) increased tissue creatine content, not phosphocreatine. This increase was not prevented by GPA. Thus, the creatine transporter is required for creatine uptake through the plasma membrane. Since there is a strong indication that creatine in the brain is mainly synthesized by glial cells and transferred to neurons, this might explain why hereditary transporter deficiency is attended by severe brain damage despite the possibility of an endogenous synthesis. CrOBzl and PCr-Mg-CPLX cross the plasma membrane in a transporter-independent way, and might be useful in the therapy of hereditary creatine transporter deficiency. They may also prove useful in the therapy of brain anoxia or ischemia.
Collapse
Affiliation(s)
- G Lunardi
- Section of Pharmacology, Department of Oncology, Biology and Genetics, University of Genova, Genova, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Pierantozzi M, Pietroiusti A, Brusa L, Galati S, Stefani A, Lunardi G, Fedele E, Sancesario G, Bernardi G, Bergamaschi A, Magrini A, Stanzione P, Galante A. Helicobacter pylori eradication and l-dopa absorption in patients with PD and motor fluctuations. Neurology 2006; 66:1824-9. [PMID: 16801644 DOI: 10.1212/01.wnl.0000221672.01272.ba] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To investigate if Helicobacter pylori (HP) eradication could make an effective and long-lasting improvement in the pharmacokinetic and clinical response to l-dopa in patients with Parkinson disease (PD) and motor fluctuations. METHODS In a group of 34 HP-infected, motor-fluctuating patients with PD, the short-term (1-week) and long-term (3-month) beneficial effect of HP eradication (n = 17) was investigated in a double-blind fashion in comparison with a generic antioxidant treatment (n = 17), by means of pharmacokinetic, clinical, and gastrointestinal assessments. Results were compared with placebo treatment. RESULTS Differently from the antioxidant-treated patients, the HP-eradicated patients showed a significant increase of l-dopa absorption, which was coupled with a significant improvement of clinical disability and with a prolonged "on-time" duration, whereas gastritis/duodenitis scores significantly decreased in line with a better l-dopa pharmacokinetics. CONCLUSIONS These data demonstrate a reversible Helicobacter pylori (HP)-induced interference with l-dopa clinical response related to the impaired drug absorption, probably due to active gastroduodenitis. Therefore, the authors suggest that HP eradication may improve the clinical status of infected patients with Parkinson disease and motor fluctuations by modifying l-dopa pharmacokinetics.
Collapse
Affiliation(s)
- M Pierantozzi
- IRCCS Santa Lucia Foundation, Department of Neuroscience, Tor Vergata University, and S. Raffaele Hospital, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Amadori D, Gasparini G, Vannozzi MO, Milandri C, Serra P, Di Costanzo F, Di Blasio B, Lunardi G. First line treatment of HER-2/neu positive advanced breast cancer patients with liposomal doxorubicin (Myocet), docetaxel and trastuzumab. A phase I-II study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10744 Background: Our preclinical data showed synergic effect of Adriamicyn followed by Taxotere in BC cell lines. The combination of anthracyclines, taxanes and trastuzumab could potentially obtain a high number of objective responses and a consistent impact on the time to progression and on the overall survival. The aim of this phase I-II study was to assess the maximum tolerated dose (MTD) of liposomal doxorubicin (Myocet-M) and Taxotere (T) in combination with Herceptin (H). A reduction of cardiotoxicity risk without reducing chemotherapy activity was supposed. Methods: Locally advanced or metastatic her-2/neu positive BC patients (pts) with LVEF ≥ 60% were enrolled in an open, single arm, non-randomized phase I-II escalation trial in 3 to 6 pts/cohorts. The treatment schedule was: M 50 mg/m2 (or 60, depending on dose level assignment) on day 1, T 30 mg/m2 on day 2 and 9, H 4 mg/kg on day 2 followed by weekly dose of 2 mg/kg, every three weeks. MTD dose was identified on the basis of DLT defined according to WHO grade classification of toxicity or specific conditions of LVEF decrease. A pharmacokinetic (PK) analysis of doxorubicin until 72 hours after M administration was planned. Results: Seven pts, median age 63 yrs, were enrolled. Four pts were allocated to dose level 50/30 (M/T) and other 3 pts to dose level 60/30. At the dose level 60/30 febrile neutropenia (DLT) occurred in 2 pts. Other 2 pts experienced febrile neutropenia (no DLT). One event of tachicardia (WHO grade 1) at maximum tolerated dose level was completely recovered without treatment. LVEF values were unmodified. Six patients were enrolled in the PK analysis. T pharmacokinetic data obtained on day 2 and on day 9 were not statistically different. Conclusions: The MTD was defined at M 50 mg/m2 in combination with T 30 mg/m2. The cardiac tolerability was good, with no significant change in LVEF values from baseline to the end of therapy. PK data indicated that the residual concentration of M found on day 2 was did not influence T pharmacokinetics, according to literature data. A phase II study is ongoing to assess activity and PK interactions between drugs. Till now 25 patients have been enrolled, the planned sample size is 45. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- D. Amadori
- Morgagni-Pierantoni Hospital, Forli, Italy; Azienda Complesso Ospedaliero S. Filippo Neri, Roma, Italy; IST, Genova, Italy; Istituto Oncologico Romagnolo, Forlì, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Azienda Ospedaliera Universitaria, Parma, Italy; DOBIG, Genova, Italy
| | - G. Gasparini
- Morgagni-Pierantoni Hospital, Forli, Italy; Azienda Complesso Ospedaliero S. Filippo Neri, Roma, Italy; IST, Genova, Italy; Istituto Oncologico Romagnolo, Forlì, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Azienda Ospedaliera Universitaria, Parma, Italy; DOBIG, Genova, Italy
| | - M. O. Vannozzi
- Morgagni-Pierantoni Hospital, Forli, Italy; Azienda Complesso Ospedaliero S. Filippo Neri, Roma, Italy; IST, Genova, Italy; Istituto Oncologico Romagnolo, Forlì, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Azienda Ospedaliera Universitaria, Parma, Italy; DOBIG, Genova, Italy
| | - C. Milandri
- Morgagni-Pierantoni Hospital, Forli, Italy; Azienda Complesso Ospedaliero S. Filippo Neri, Roma, Italy; IST, Genova, Italy; Istituto Oncologico Romagnolo, Forlì, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Azienda Ospedaliera Universitaria, Parma, Italy; DOBIG, Genova, Italy
| | - P. Serra
- Morgagni-Pierantoni Hospital, Forli, Italy; Azienda Complesso Ospedaliero S. Filippo Neri, Roma, Italy; IST, Genova, Italy; Istituto Oncologico Romagnolo, Forlì, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Azienda Ospedaliera Universitaria, Parma, Italy; DOBIG, Genova, Italy
| | - F. Di Costanzo
- Morgagni-Pierantoni Hospital, Forli, Italy; Azienda Complesso Ospedaliero S. Filippo Neri, Roma, Italy; IST, Genova, Italy; Istituto Oncologico Romagnolo, Forlì, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Azienda Ospedaliera Universitaria, Parma, Italy; DOBIG, Genova, Italy
| | - B. Di Blasio
- Morgagni-Pierantoni Hospital, Forli, Italy; Azienda Complesso Ospedaliero S. Filippo Neri, Roma, Italy; IST, Genova, Italy; Istituto Oncologico Romagnolo, Forlì, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Azienda Ospedaliera Universitaria, Parma, Italy; DOBIG, Genova, Italy
| | - G. Lunardi
- Morgagni-Pierantoni Hospital, Forli, Italy; Azienda Complesso Ospedaliero S. Filippo Neri, Roma, Italy; IST, Genova, Italy; Istituto Oncologico Romagnolo, Forlì, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Azienda Ospedaliera Universitaria, Parma, Italy; DOBIG, Genova, Italy
| |
Collapse
|
27
|
Brusa L, Bassi A, Lunardi G, Fedele E, Peppe A, Stefani A, Pasqualetti P, Stanzione P, Pierantozzi M. Delayed administration may improve entacapone effects in parkinsonian patients non-responding to the drug. Eur J Neurol 2004; 11:593-606. [PMID: 15379738 DOI: 10.1111/j.1468-1331.2004.00860.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Entacapone is a COMT inhibitor used in Parkinson's disease (PD) patients, as an adjunctive therapy to L-dopa in order to prolong its bioavailability and thus its clinical effect. However, previous studies reported entacapone-induced L-dopa to have lower C(max) and delayed t(max) values, coupled with a delayed onset of the clinical effect, possibly suggesting an interference between the two drugs. The aim of our study was to evaluate whether a delayed entacapone administration in association with standard L-dopa/carbidopa, may in some subjects improve the entacapone effects on L-dopa AUC and thus on the clinical 'on time' duration. METHODS Twenty-eight idiopathic advanced PD patients were blindly evaluated in three different test days, following administration of carbidopa/L-dopa or carbidopa/L-dopa plus co-administered entacapone or plus entacapone administered with 30 min of delay. RESULTS The AUC, the 'on time' and UPDRS score of the whole group were improved by both modalities of entacapone administration. An ex post analysis showed that the delayed entacapone administration produced a significant improvement in a subgroup of 10 non-responding patients to the co-administration. CONCLUSION We suggest that the delayed administration should be attempted in the subjects not improved by entacapone co-administration.
Collapse
Affiliation(s)
- L Brusa
- Clinica Neurologica, Università di Roma Tor Vergata, Rome, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Brusa L, Pierantozzi M, Bassi A, Fedele E, Lunardi G, Giacomini P, Stanzione P. Temporal administration of entacapone with slow release L-dopa: pharmacokinetic profile and clinical outcome. Neurol Sci 2004; 25:53-6. [PMID: 15221622 DOI: 10.1007/s10072-004-0230-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2003] [Accepted: 02/18/2004] [Indexed: 10/26/2022]
Abstract
Entacapone is a specific, peripherally acting catechol- O-methyltransferase (COMT) inhibitor that prevents peripheral degradation of L-dopa, thus improving its bioavailability. Entacapone is known to have pharmacokinetics similar to standard L-dopa but not to that of controlled-release (CR) L-dopa. The aim was to determine whether delayed entacapone administration may prolong CR L-dopa half-life in comparison to the co-administration modality. We compared plasma L-dopa concentrations after co-administration of CR L-dopa and entacapone or after administration of CR and a delayed (30 and 90 minutes) entacapone dose in 10 parkinsonian patients. The area under the concentration-time curve and other pharmacokinetic parameters were not changed by the delayed administration of entacapone. Different temporal modalities of entacapone administration had similar effects on CR L-dopa pharmacokinetics and on L-dopa-induced clinical improvement.
Collapse
Affiliation(s)
- L Brusa
- Neurology Clinic, Tor Vergata University of Rome, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
29
|
Venturini M, Catzeddu T, Del Mastro L, Bighin C, Maggi E, Clavarezza M, Lunardi G, Pastorino S, Lambiase A, Rosso R. Erlotinib given sequentially to capecitabine and vinorelbine as first-second line chemotherapy in metastatic breast cancer patients. A dose finding study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Venturini
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - T. Catzeddu
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - L. Del Mastro
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - C. Bighin
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - E. Maggi
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - M. Clavarezza
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - G. Lunardi
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - S. Pastorino
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - A. Lambiase
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| | - R. Rosso
- Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; Roche S.p.A, Monza, Italy
| |
Collapse
|
30
|
Boccardo F, Lunardi G, Guglielmini P, Parodi M, Murialdo R, Schettini G, Rubagotti A. Serum enterolactone levels and the risk of breast cancer in women with palpable cysts. Eur J Cancer 2004; 40:84-9. [PMID: 14687793 DOI: 10.1016/s0959-8049(03)00576-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Low levels of lignans, namely enterolactone, have been reported to be associated with an increased risk of breast cancer in the general female population. We assessed, retrospectively, the relationship between serum enterolactone concentrations and the occurrence of breast cancer in women with palpable cysts. The levels of enterolactone in cryopreserved serum aliquots, obtained from 383 women with palpable cysts at the time of their first cyst aspiration, were measured using a time-resolved fluoroimmunoassay (TR-FIA). After a median follow-up time of 6.5 years (range 0.5-12.75 years), 18 women were found to have developed an invasive breast cancer. Median values of serum enterolactone were significantly lower in women who subsequently developed breast cancer: 8.5 nM/l versus 16.0 nM/l: P=0.04. Odd Ratios (OR) for breast cancer were: 0.36 (P=0.03), 0.57 (P=0.3) and 0.38 (P=0.25) for 25th (8 nM/l), 50th (16 nM/l) and 75th (24 nM/l) percentile values, respectively. The receiver operating characteristic (ROC) analysis showed a satisfactory accuracy for enterolactone as a breast cancer risk indicator (area under the curve (AUC)=0.64: P=0.04). Logistic regression analysis confirmed that the enterolactone concentration had a strong protective effect on the breast cancer risk. These findings may have important clinical implications with regard to interventional diet-focused chemo-preventive trials.
Collapse
Affiliation(s)
- F Boccardo
- Academic Department of Medical Oncology, National Cancer Research Institute, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
| | | | | | | | | | | | | |
Collapse
|
31
|
Lunardi G, Vannozzi MO, Bighin C, Del Mastro L, Stevani I, Schettini G, Venturini M. Influence of trastuzumab on epirubicin pharmacokinetics in metastatic breast cancer patients. Ann Oncol 2003; 14:1222-6. [PMID: 12881383 DOI: 10.1093/annonc/mdg350] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Anthracycline cardiotoxicity is increased by the contemporaneous administration of trastuzumab. The mechanism by which it occurs is as yet unknown. The aim of this study was to evaluate whether trastuzumab modifies the pharmacokinetics of epirubicin and its metabolites. PATIENTS AND METHODS Women with HER2-positive metastatic breast cancer were treated with epirubicin 75 mg/m(2) i.v. bolus followed by docetaxel 75 mg/m(2) in a 1-h infusion, every 3 weeks for six cycles, and trastuzumab (once at 4 mg/m(2), then 2 mg/m(2) weekly thereafter) in a 30-min infusion. Epirubicin pharmacokinetic data of seven patients were evaluated at the first cycle of therapy (baseline, with trastuzumab administered 24 h after epirubicin), and at the sixth cycle (i.e. 15 weeks after baseline, with trastuzumab administered immediately before epirubicin). RESULTS No pharmacokinetic change in the parent compound epirubicin was detected. The area under the plasma concentration-time curve (AUC(0-24 h)) was 1230 +/- 318 [mean +/- standard deviation (SD)] at the first cycle and 1287 +/- 385 h. micro g/l at the sixth. The mean (+/-SD) maximum plasma concentration (C(max)) and the terminal elimination half-life at the first cycle (1303 +/- 490 micro g/l and 12.5 +/- 3.1 h, respectively) were similar to those obtained at the sixth cycle (1229 +/- 580 micro g/l and 11.5 +/- 2.9 h, respectively). Pharmacokinetic data of epirubicin metabolites evaluated at the first and sixth cycle of chemotherapy were superimposable without any statistical difference. CONCLUSION Enhanced anthracycline cardiotoxicity related to trastuzumab administration was not linked to pharmacokinetic interferences with epirubicin and its metabolites.
Collapse
Affiliation(s)
- G Lunardi
- Department of Pharmacology-Pharmacotoxicology Laboratory, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | | | | | | | | | | | | |
Collapse
|
32
|
Civalleri D, Vannozzi MO, De Cian F, DeCian F, Lunardi G, Steinweg M, Pastrone I, Viale M, Esposito M. Intraperitoneal mitoxantrone: a feasibility and pharmacokinetic study. Eur J Surg Oncol 2002; 28:172-9. [PMID: 11884053 DOI: 10.1053/ejso.2001.1218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fractionated doses have been advocated to prevent chemoperitonitis after intraperitoneal infusion of mitoxantrone. Patients with peritoneal carcinomatosis of various origin underwent surgery, including intestinal resections, with minimal residual disease. Peritoneal mitoxantrone in 1000 ml/m(2) saline was planned on the first post-operative day in groups of four patients (5 mg/m(2) for 3 and 5 days, 7.5 mg/m(2) for 3 and 4 days, 10 mg/m(2) for 2-4 days, if possible). Due to dose-limiting myelosuppression, only one and three patients received the 7.5-mg 4-day and 10-mg 3-day regimens, respectively. A total of 20 patients were consequently treated. Neither major complications nor severe pain were observed. Pharmacokinetics were completed on the 1st day in five 5-mg and five 10-mg patients, on the 5th day in three 5-mg patients, and on the 3rd day in one 10-mg patient. On the 1st day, mean peritoneal peak concentrations of mitoxantrone resulted 1.45 +/-0.56 (range 0.48-1.9) and 1.9+/-0.85 (range 1.27-3.13) microg/ml in the 5-mg and 10-mg patients, respectively. Mean dialysate/plasma exposure (AUC) ratio was 115. Even in patients with sutures, early post-operative fractionated intraperitoneal mitoxantrone appears feasible and safe, with a high local advantage, for up to 5 days of treatment and a maximum tolerated total dose of 20-25 mg/m(2).
Collapse
Affiliation(s)
- D Civalleri
- Università di Genova, Facoltà di Medicina e Chirurgia, Dipartimento di Chirurgia DICMI, Largo Rosanna Benzi 8, Genova, 16132, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Lunardi G, Venturini M, Vannozzi MO, Tolino G, Del ML, Bighin C, Schettini G, Esposito M. Influence of alternate sequences of epirubicin and docetaxel on the pharmacokinetic behaviour of both drugs in advanced breast cancer. Ann Oncol 2002; 13:280-5. [PMID: 11886006 DOI: 10.1093/annonc/mdf016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previously we observed a pharmacokinetic interference of epirubicin elimination when paclitaxel is given in combination in a sequence-dependent manner (i.e. when paclitaxel is administered as first drug). The aim of this study was to determine whether these sequence-dependent pharmacological effects were also evident when epirubicin was combined with docetaxel. PATIENTS AND METHODS Patients who received epirubicin 75 mg/m2 or 90 mg/m2 as an intravenous bolus followed immediately by docetaxel 70 mg/m2 or 80 mg/m2 over a 1-h infusion, or the opposite sequence, every 3 weeks were eligible for this study. The pharmacokinetics of docetaxel, epirubicin and its metabolites were studied at the first and second cycle of treatment. Pharmacokinetic data were normalised to the lower dose of each drug. Toxicity was recorded at nadir and graded according to National Cancer Institute Common Toxicity Criteria. RESULTS Twelve consecutive patients, each acting as their own control, entered the study. The sequence of drug administration of docetaxel and epirubicin did not affect the pharmacokinetics of the parent anthracycline. Statistically significant lower glucuronidation metabolism of epirubicin was observed in patients who received docetaxel before epirubicin. The pharmacokinetics of docetaxel were not influenced by the sequence of drug administration. No difference in haematological and non-haematological toxicity was observed in the two sequences of treatment. CONCLUSIONS The pharmacokinetics of the parent anthracycline and of docetaxel were similar between the two schemes of treatment. The metabolic variations observed, i.e. differences in the plasma levels of epirubicin glucuronides, seem not to have clinical relevance.
Collapse
Affiliation(s)
- G Lunardi
- Servizio di Farmacologia e Neuroscienze, Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Pierantozzi M, Pietroiusti A, Galante A, Sancesario G, Lunardi G, Fedele E, Giacomini P, Stanzione P. Helicobacter pylori-induced reduction of acute levodopa absorption in Parkinson's disease patients. Ann Neurol 2001; 50:686-7. [PMID: 11706979 DOI: 10.1002/ana.1267] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
35
|
Venturini M, Michelotti A, Papaldo P, Del Mastro L, Bergaglio M, Lionetto R, Lunardi G, Sguotti C, Frevola L, Donati S, Rosso R, Cognetti F. Identification of the highest dose of docetaxel associable with active doses of epirubicin. Results from a dose-finding study in advanced breast cancer patients. Ann Oncol 2001; 12:1097-106. [PMID: 11583191 DOI: 10.1023/a:1011663821703] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To determine the maximum tolerated dose (MTD) and the dose limiting toxicity (DLT) of docetaxel in combination with fixed doses of epirubicin. PATIENTS AND METHODS Women with locally advanced or metastatic breast cancer were given docetaxel, 60 mg/m2 in escalated doses by steps of 10 mg/m2, in association with two fixed doses of epirubicin (90 mg/m2, and 75 mg/m2). Since neutropenia was foreseen to be the most likely DLT, a third group with prophylactic G-CSF support was planned to define the MTD of docetaxel with 90 mg/m2 of epirubicin. Selected patients underwent pharmacokinetic evaluation of docetaxel. RESULTS Fifty-eight patients entered the study. At the first step (90 mg/m2 of epirubicin) the MTD was obtained at 60 mg/m2 of docetaxel. At the second step (75 mg/m2 of epirubicin) the MTD of docetaxel was 80 mg/m2. At the third step (epirubicin 90 mg/m2) G-CSF allowed a safe escalation of docetaxel up to 90 mg/m2. Neutropenia was the most common hematological adverse event. Without G-CSF, grade 4 neutropenia occurred in 69% of cycles, of which 11% was complicated by fever. In G-CSF group, grade 4 neutropenia and neutropenic fever occurred in 31% and 3%, respectively. Most frequent non-hematological adverse effects were asthenia (45%), nausea (39%) and mucositis (36%). No patient developed congestive heart failure. Two toxic deaths occurred. Overall response rate was 73% in 42 out of 58 patients, with no apparent epirubicin dose-related effect. No statistically significant effect of the two doses of epirubicin was observed in docetaxel pharmacokinetics. CONCLUSIONS On the basis of the toxicity profile, the docetaxel pharmacokinetics and the response rate observed, epirubicin 75 mg/m2 combined with docetaxel 80 mg/m2 can be recommended for further studies.
Collapse
Affiliation(s)
- M Venturini
- Division of Medical Oncology I, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Pierantozzi M, Pietroiusti A, Sancesario G, Lunardi G, Fedele E, Giacomini P, Frasca S, Galante A, Marciani MG, Stanzione P. Reduced L-dopa absorption and increased clinical fluctuations in Helicobacter pylori-infected Parkinson's disease patients. Neurol Sci 2001; 22:89-91. [PMID: 11487216 DOI: 10.1007/s100720170061] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We report that the area under the curve of L-dopa plasma concentration, following the administration of a single 250 mg L-dopa dose, is augmented after Helicobacter pylori (HP) eradication in six Parkinson's disease (PD) patients showing high IgG antibody titer against HP. A prolongation of L-dopa clinical benefit was also observed. We suggest that HP infection-activated gastric alterations may be responsible, at least in part, for the reported erratic efficacy of oral L-dopa therapy in some advanced PD patients. Given the high percentage of HP-positivity in the age cohorts including the largest prevalence of PD patients, we propose that HP eradication be recommended in all PD patients under L-dopa therapy.
Collapse
Affiliation(s)
- M Pierantozzi
- Neurological Clinic, University of Rome Tor Vergata, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Viale M, Vannozzi MO, Pastrone I, Mariggiò MA, Zicca A, Cadoni A, Cafaggi S, Tolino G, Lunardi G, Civalleri D, Lindup WE, Esposito M. Reduction of cisplatin nephrotoxicity by procainamide: does the formation of a cisplatin-procainamide complex play a role? J Pharmacol Exp Ther 2000; 293:829-36. [PMID: 10869382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Procainamide protects mice bearing P388 leukemic cells against the toxicity of cisplatin without diminishing antitumor activity. The mechanism of action of procainamide protection was investigated both in vitro and in vivo. HPLC studies showed that procainamide forms a complex with cisplatin in vitro that has a UV spectrum similar to that of DPR, a triamine platinum complex that contains procaine as ligand. We report here the effect of the reaction product of cisplatin and procainamide on both cisplatin-induced DNA interstrand cross-links (ISCLs) and on the total DNA platination of isolated DNA. Total DNA platination in vitro of isolated DNA was increased by 113% (P <.01) and 17% (P <.05) after incubation times of 1.75 and 6 h, respectively, compared with products from the reaction of cisplatin with water. Furthermore, the reaction product of cisplatin and procainamide was bound to DNA to a significantly greater extent than was cisplatin itself. ISCLs were decreased by 41% when this drug combination was incubated with DNA for 1.75 h, but no changes were observed after incubation for 6 h. We also examined the influence of the time interval between administration of cisplatin and procainamide on normal kidney injury, the renal distribution and urinary excretion of platinum, and the formation of cisplatin-DNA adducts in renal tissue of Sprague-Dawley rats after i.p. administration of 7.5 mg/kg cisplatin either with or without procainamide. The plasma concentrations of urea and creatinine and kidney histology demonstrated that procainamide provided effective protection in vivo in the rat when administered either simultaneously or at 0.5 and 1 h before or after cisplatin. The protection was accompanied by both higher renal levels of platinum and cisplatin-DNA adducts and by an increase in the formation of ISCLs. Moreover, a dose-dependent reduction of urinary excretion and concentration of platinum was also observed. We propose that procainamide, after accumulation in the kidney, may coordinate with cisplatin to form a less toxic DPR-like complex that renders rats less susceptible to cisplatin-induced toxicity.
Collapse
Affiliation(s)
- M Viale
- Servizio di Farmacologia Tossicologica, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Venturini M, Lunardi G, Del Mastro L, Vannozzi MO, Tolino G, Numico G, Viale M, Pastrone I, Angiolini C, Bertelli G, Straneo M, Rosso R, Esposito M. Sequence effect of epirubicin and paclitaxel treatment on pharmacokinetics and toxicity. J Clin Oncol 2000; 18:2116-25. [PMID: 10811677 DOI: 10.1200/jco.2000.18.10.2116] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Sequence-dependent clinical and pharmacokinetic interactions between paclitaxel and doxorubicin have been reported. Some data have shown an influence of paclitaxel on epirubicin metabolism, but no data are available about the effect of diverse sequences of these drugs. We investigated whether reversing the sequence of epirubicin and paclitaxel affects the pattern or degree of toxicity and pharmacokinetics. PATIENTS AND METHODS Patients receiving epirubicin 90 mg/m(2) by intravenous bolus followed by paclitaxel 175 mg/m(2) over 3-hour infusion or the opposite sequence every 3 weeks for four cycles were eligible. Toxicity was recorded at nadir. Pharmacokinetic data were evaluated at the first and the second cycle and were correlated with toxicity parameters. RESULTS Thirty-nine consecutive stage II breast cancer patients were treated. Twenty-one patients received epirubicin followed by paclitaxel (ET group), and 18 received the opposite sequence (TE group). No significant difference in nonhematologic toxicity was seen. A lower neutrophil and platelet nadir and a statistically significant slower neutrophil recovery was observed in the TE group. Area under the concentration-time curve (AUC) of epirubicin was higher in the TE group (2,346 ng/mL. h v 1,717 ng/mL. h; P =.002). An inverse linear correlation between epirubicin AUC and neutrophil recovery was also observed (P =.012). No difference was detected in paclitaxel pharmacokinetics. CONCLUSION Our results support a sequence-dependent effect of paclitaxel over epirubicin pharmacokinetics that is associated with increased myelotoxicity. Because schedule modifications of anthracyclines and paclitaxel can have clinical consequences, the classical way of administration (ie, anthracyclines followed by paclitaxel) should be maintained in clinical practice.
Collapse
Affiliation(s)
- M Venturini
- Department of Medical Oncology I and Pharmacotoxicology Laboratory, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Esposito M, Venturini M, Vannozzi MO, Tolino G, Lunardi G, Garrone O, Angiolini C, Viale M, Bergaglio M, Del Mastro L, Rosso R. Comparative effects of paclitaxel and docetaxel on the metabolism and pharmacokinetics of epirubicin in breast cancer patients. J Clin Oncol 1999; 17:1132. [PMID: 10561171 DOI: 10.1200/jco.1999.17.4.1132] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To investigate whether paclitaxel and docetaxel influence the pharmacokinetics and metabolism of epirubicin. PATIENTS AND METHODS We studied the pharmacokinetics and biotransformation patterns of epirubicin in 27 cycles and 20 breast cancer patients. Four patients received epirubicin alone 90 mg/m(2) by intravenous (IV) bolus; eight patients received the same dose of epirubicin followed immediately by paclitaxel 175 mg/m(2) in a 3-hour infusion; the other eight patients received epirubicin 90 mg/m(2) followed immediately by docetaxel 70 mg/m(2) in a 1-hour infusion. Epirubicin and its metabolites, epirubicinol (EOL) and 7-deoxydoxorubicinone (7d-Aone), were identified by high-pressure liquid chromatography. RESULTS No pharmacokinetic interaction between the parent compound epirubicin and taxanes was detected. Conversely, a significant effect on epirubicin metabolism by both paclitaxel and docetaxel was found. Epirubicin given with paclitaxel or docetaxel yielded areas under the plasma concentration-time curves (AUC) for 7d-Aone 1. 7-fold and 1.9-fold higher (P <.05), respectively, than epirubicin alone. The appearance of two polar metabolites sensitive to glucuronidase was also significantly greater in both taxane groups. Quantitatively different metabolic rates and patterns for EOL were observed in the paclitaxel and docetaxel combinations. The EOL AUC after paclitaxel treatment (1,521 +/- 150 ng/mL*h) was significantly higher (P <.01) than the corresponding values after epirubicin administered either as a single agent (692 +/- 46 ng/mL*h) or in combination with docetaxel (848 +/- 237 ng/mL*h). CONCLUSION There is no apparent pharmacokinetic interaction between the parent compound epirubicin and paclitaxel or docetaxel. A different pattern of interaction between these taxanes and epirubicin metabolism is clearly evident.
Collapse
Affiliation(s)
- M Esposito
- Pharmacotoxicology Laboratory, Department of Preclinical Oncology, Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Incubation of hippocampal slices with different concentrations of creatine (0.5, 1, 10, 25 mM) results in a dose-dependent increase in intracellular phosphocreatine (PCr). Electrophysiological evidence suggests that this effect can protect neurons from anoxic damage by delaying the depletion of ATP during oxygen deprivation. In this paper we show that incubation of brain slices with varying doses of creatine increases intracellular phosphocreatine and delays anoxic depolarization (AD) in a dose-dependent way. Specifically, addition to the incubation medium of 1 mM creatine significantly increased AD latency during hypoxia and prevented irreversible neuronal damage. Adding 0.5 mM creatine had no significant effect. Higher concentrations of creatine (up to 25 mM) did not provide any better protection. Our data also suggest a linear correlation between intracellular PCr and AD latency. These data report neural protection by exogenous creatine at concentrations lower than those usually reported in the literature.
Collapse
Affiliation(s)
- M Balestrino
- Department of Neurological Sciences, University of Genova, Via De Toni 5, 16132, Genoa, Italy
| | | | | |
Collapse
|
41
|
Lunardi G, Leandri M, Albano C, Cultrera S, Fracassi M, Rubino V, Favale E. Clinical effectiveness of lamotrigine and plasma levels in essential and symptomatic trigeminal neuralgia. Neurology 1997; 48:1714-7. [PMID: 9191794 DOI: 10.1212/wnl.48.6.1714] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
This paper reports on the effectiveness of oral lamotrigine in 15 patients suffering from "essential" trigeminal neuralgia and in five patients suffering symptomatic trigeminal neuralgia concomitant with multiple sclerosis. We recorded objective and subjective pain ratings and correlated them to daily dosage (400 mg maximum) and plasma levels of the drug. We detected pain relief proportional to daily dosage and to drug plasma levels. Eleven of the cases affected by the "essential" form of neuralgia showed complete pain relief on reaching their maximum daily dosage. All cases affected by the symptomatic form had complete pain relief. We could detect no changes from these results by the end of the follow-up period (3 to 8 months after the study ended).
Collapse
Affiliation(s)
- G Lunardi
- Department of Neuroscience, University of Genoa, Italy
| | | | | | | | | | | | | |
Collapse
|
42
|
Affiliation(s)
- G Lunardi
- Dipartimento di Scienze Neurologiche, Università di Genova, Italy
| | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
We report an unblinded, open-label, add-on trial of fluoxetine, a selective serotonin reuptake inhibitor, in 17 patients with complex partial seizures with and without secondary generalization (mean follow-up duration, 14 +/- 1.1 months). Six patients showed complete disappearance of their daily seizures; in the others the seizure frequency was lowered by 30%. No patient reported side effects.
Collapse
Affiliation(s)
- E Favale
- Institute of Clinical Neurology, Genoa University, Italy
| | | | | | | | | |
Collapse
|
44
|
Abstract
The use of information technology is reduced in health area. Its introduction as a management tool and decision support can change the actual kinds of planning within health organizations. The purpose of this work is to develop a system in order to enable and process the nursing prescription. The system named DSSPPNC-Decision Support System in Planning and Prescription of Nursing Care-is a computational tool that enables the information access under the form of Nursing Assistance Protocols. The results of the present work will involve sensible changes in the nursing assistential practice, with repercussion in the type of assistance management and to care the individual hospitalized, making opportune and approaching the nurse to the patient, through raising of problems, aiming care planning and accomplishment, results valuation and supervision and control of the staff engaged to in assistance.
Collapse
|
45
|
Loeb C, Mainardi P, Besio G, Lunardi G, Cogliolo I, Pioli F. Plasma and CSF amino acid levels in ALS. Acta Neurol Scand 1994; 90:223-4. [PMID: 7847066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
46
|
Bandoli G, Lunardi G, Clemente DA. Structural and spectroscopic properties of the 1?1 complex of ?2, 2?-bis-1,3-dithiole (TTF) and 1,2,4,5-tetracyanobenzene (TCNB). ACTA ACUST UNITED AC 1993. [DOI: 10.1007/bf01161279] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Marchi M, Volpe G, Augliera A, Codignola A, Lunardi G, Raiteri M. Cholinergic modulation of dopamine release in corpus striatum and substantia nigra of the rat. Neurochem Int 1992; 20 Suppl:271S-274S. [PMID: 1365441 DOI: 10.1016/0197-0186(92)90251-l] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M Marchi
- Istituto di Farmacologia e Farmacognosia, Università degli Studi di Genova, Italy
| | | | | | | | | | | |
Collapse
|
48
|
Lunardi G, Pecile C. N,N’‐dicyanoquinonediimines as a molecular constituent of organic conductors: Vibrational behavior and electron–molecular vibration coupling. J Chem Phys 1991. [DOI: 10.1063/1.461503] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
49
|
Marchi M, Augliera A, Codignola A, Lunardi G, Fedele E, Fontana G, Raiteri M. Cholinergic modulation of [3H]dopamine release from dendrosomes of rat substantia nigra. Naunyn Schmiedebergs Arch Pharmacol 1991; 344:275-80. [PMID: 1961254 DOI: 10.1007/bf00183000] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Dendrosomes prepared from substantia nigra are able to take up and release [3H]dopamine in a CA(2+)-dependent manner. The Vmax values of [3H]dopamine uptake in substantia nigra dendrosomes was about 5 times lower than that in caudate putamen synaptosomes. The pattern of the K(+)-dependency of the [3H]dopamine release in substantia nigra dendrosomes was significantly different from that found in caudate putamen synaptosomes. The release of [3H]dopamine evoked by 15 mmol/l KCl from superfused dendrosomes was increased in a concentration-dependent manner by acetylcholine. The maximal potentiation produced by acetylcholine was about 40%. The potentiation of [3H]dopamine release by 10 mumol/l acetylcholine was insensitive to mecamylamine but antagonized by atropine and by pirenzepine. The effects of acetylcholine on the release of [3H]acetylcholine from substantia nigra nerve endings was also studied. Exogenous acetylcholine added to the superfusion medium decreased in a concentration-dependent manner the release of acetylcholine. This effect was not antagonized by mecamylamine or pirenzepine but fully antagonized by atropine. The data suggest the existence, in the substantia nigra of the rat, of two distinct muscarinic receptor subtypes regulating respectively dopamine release from dopamine dendrites and acetylcholine release from cholinergic nerve terminals.
Collapse
Affiliation(s)
- M Marchi
- Istituto di Farmacologia e Farmacognosia, Università degli Studi di Genova, Italy
| | | | | | | | | | | | | |
Collapse
|