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Iacovino ML, Celant S, Tomassini L, Arenare L, Caglio A, Canciello A, Salerno F, Olimpieri PP, Di Segni S, Sferrazza A, Piccirillo MC, Beretta GD, Pinto C, Blasi L, Cinieri S, Cavanna L, Di Maio M, Russo P, Perrone F. Comparison of baseline patient characteristics in Italian oncology drug monitoring registries and clinical trials: a real-world cross-sectional study. Lancet Reg Health Eur 2024; 41:100912. [PMID: 38665620 PMCID: PMC11041834 DOI: 10.1016/j.lanepe.2024.100912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
Background Generalizability of registrative clinical trials to real-world clinical practice is influenced by comparability of patients in the two settings. We compared characteristics of cancer patients in registrative trials with real-world clinical practice in Italy. Methods Data on age, sex and performance status (PS) were derived from web-based monitoring registries developed by Italian Medicines Agency (AIFA) and corresponding registrative trials reported in the European Public Assessment Reports (EPAR) of European Medicines Agency (EMA). Weighted means were calculated in registries and trials and differences were described. Multivariate analysis was performed using Principal Component Analysis and Cluster Analysis. Findings From January, 2013 to April, 2023, 419,461 unique pairs of patients and therapeutic indications were recorded in 129 AIFA registries. Within 140 related trials, 87,452 patients had been enrolled. Median age and rate of elderly (≥65 years old) patients were higher in monitoring registries than in clinical trials [mean difference of median age 5.3 years, p < 0.001; mean difference of elderly rate 17.17% (95% CI 1.06, 1.48)]. Overall, rate of female patients was not different between registries and trials [mean difference -0.55% (95% CI -1.06, -0.05)]. Mean rate of patients with deteriorated PS was low both in trials (3.1%) and in registries (4.3%) with a mean difference of 1.27% (95% CI 1.06, 1.48). Two clusters were identified with multivariate analysis: one including more registries (higher median age and elderly rate, lower female rate, higher rate of deteriorated patients), the other more trials (lower median age and elderly rate, higher female rate, lower rate of deteriorated patients). Interpretation This study supports that cancer patients enrolled in trials do only partially represent those who have been treated in Italy in clinical practice. Inclusiveness of registrative trials should be increased to ensure generalizability of results to real-world population. Funding Partially supported by Italian Ministry of Health.
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Affiliation(s)
| | | | | | - Laura Arenare
- National Cancer Institute, IRCCS Fondazione G.Pascale, Naples, Italy
| | - Andrea Caglio
- Department of Oncology, University, Ordine Mauriziano Hospital Umberto I, Turin, Italy
| | - Andrea Canciello
- National Cancer Institute, IRCCS Fondazione G.Pascale, Naples, Italy
| | - Flavio Salerno
- Department of Oncology, University, Ordine Mauriziano Hospital Umberto I, Turin, Italy
| | | | | | | | | | | | - Carmine Pinto
- Medical Oncology, Comprehensive Cancer Centre, AUSL-IRCCS di Reggio Emilia, Italy
| | - Livio Blasi
- Medical Oncology, Civic Hospital Cristina Benfratelli, Palermo, Italy
| | - Saverio Cinieri
- Medical Oncology and Breast Unit, Perrino Hospital, Brindisi, Italy
| | - Luigi Cavanna
- Medical Oncology and Hematology, Civil Hospital, Piacenza, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Francesco Perrone
- National Cancer Institute, IRCCS Fondazione G.Pascale, Naples, Italy
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Sciurti E, Signore MA, Velardi L, Di Corato R, Blasi L, Campa A, Martucci MC, Siciliano PA, Francioso L. Label-free electrochemical biosensor for direct detection of Oncostatin M (OSM) inflammatory bowel diseases (IBD) biomarker in human serum. Talanta 2024; 271:125726. [PMID: 38316076 DOI: 10.1016/j.talanta.2024.125726] [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: 11/24/2023] [Revised: 12/22/2023] [Accepted: 01/26/2024] [Indexed: 02/07/2024]
Abstract
Oncostatin M (OSM) is an interleukin-6 (IL-6) member family cytokine implicated in the pathogenesis of chronic diseases including inflammatory bowel disease (IBD). OSM is a novel diagnostic biomarker over-expressed in the serum of IBD patients. This paper reports on the first electrochemical OSM immunosensor, developed using a multistep fabrication process aimed at covalently immobilizing OSM antibodies on a mixed self-assembled monolayer coated gold working electrode. Cyclic voltammetry, atomic force microscopy (AFM), IR spectroscopy and optical characterizations were used to validate the sensor functionalization protocol. Electrochemical impedance spectroscopy (EIS) measurements were performed to assess the reliability of the immunosensor preparation and to verify the antibody-antigen complexes formation. The label-free immunosensor showed high sensitivity identifying OSM at clinically relevant concentrations (37-1000 pg mL-1) with low detection limit of 2.86 pg mL-1. Both sensitivity and selectivity of the proposed immunosensor were also demonstrated in human serum in the presence of interfering biomarkers, making it an innovative potential platform for the OSM biomarker detection in IBD patients' serum.
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Affiliation(s)
- E Sciurti
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy.
| | - M A Signore
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy
| | - L Velardi
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy
| | - R Di Corato
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy
| | - L Blasi
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy
| | - A Campa
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy
| | - M C Martucci
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy
| | - P A Siciliano
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy
| | - L Francioso
- Institute for Microelectronics and Microsystems - National Research Council (IMM - CNR), Via Monteroni, 73100 Lecce, Italy
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Barni S, Aschele C, Blasi L, Giordano M, Ortega C, Pinotti G, Artioli F, Fioretto L, Daniele B, Aprile G, Silva RR, Montesarchio V. [What patients with cancer think about the dehospitalization. A survey of Cipomo.]. Recenti Prog Med 2024; 115:232-237. [PMID: 38708534 DOI: 10.1701/4262.42402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
BACKGROUND Ministerial Decrete 77 (DM 77) promotes dehospitalization for chronic patients and defines out-of-hospital health facilities at this purpose. It has never been investigated how much patients with cancer know and judge this decree law. MATERIAL AND METHODS The Collegio italiano dei primari oncologi medici ospedalieri (Cipomo) carried out a survey with a dedicated questionnaire on oncological patients attending public hospital to investigate the liking of DM 77. RESULTS Anonymous responses were obtained from 1.443 patients. Median age 64ys, 42% males, 21% live alone, 70% have a companion. 19% thinks that oral chemotherapy could be managed outside the hospital, 26.68% carried out follow-up (FU),19.15% parenteral therapy, 32.16% basic examinations. Home is preferred by 21.8%, a health facility close to home by 36.3%, hospital by 37.54%. 59.67% would like FU in hospital by their personal oncologist, 5.47% by GP, 35.41% by both together and 9.45% by oncologist outside the hospital. Asked what they might feel about being followed out of the hospital, 29.94% say of not being treated at its best, 12.68% of not being able to be visited in hospital anymore, 5.27% of being abandoned, 30.7% of being freer and 10.88% of feeling less sick. Regarding the use of new technical tools to favor dehospitalisation, 44.15% answered yes, 15.88% no and 30.07% did not know. About the distance or traveling time from home to the therapy administration side, 20.26% answered this should be no more than 15 km or 30 mins, 9.91% no more than 30 km or 45 mins, 5.47% no more than 50 km or 60 mins but 39.5% say that the distance does not matter to them but only the continuity of care. The question related to the inconveniences with going to hospital for therapy: 40.81% waiting time, 20.47% lack of parking, 17.02% rotation of doctors,12.76% travel time and 5.62% bureaucracy. CONCLUSIONS The patients' answers suggest that dehospitalization could improve their quality of life, but at the condition of being able to maintain a close relationship with the personal oncologist.
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Affiliation(s)
- Sandro Barni
- Primario Emerito di Oncologia medica, Asst BG Ovest, Ospedale di Treviglio (Bergamo)
| | - Carlo Aschele
- Dipartimento di Oncologia medica, Ospedale Sant'Andrea, La Spezia
| | - Livio Blasi
- UO Oncologia medica (Arnas), Civico Benfratelli, Palermo
| | - Monica Giordano
- Dipartimento di Oncologia, Ospedale Sant'Anna, Asst-Lariana (Como)
| | - Cinzia Ortega
- Dipartimento di Oncologia, Ospedale San Lazzaro, Azienda sanitaria locale CN2, Alba (Cuneo)
| | | | | | - Luisa Fioretto
- Dipartimento di Oncologia medica, Azienda Usl Toscana Centro, Firenze
| | - Bruno Daniele
- Dipartimento di Oncologia, Ospedale del Mare, Asl Napoli 1 Centro, Napoli
| | - Giuseppe Aprile
- Dipartimento di Oncologia clinica, Ospedale San Bortolo, Vicenza, Azienda Ulss8 Berica, Vicenza
| | - Rosa Rita Silva
- Dipartimento di Oncologia, Asur Marche, Area Vasta 2, Fabriano (Ancona)
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Incorvaia L, Badalamenti G, Novo G, Gori S, Cortesi L, Brando C, Cinieri S, Curigliano G, Ricciardi GR, Toss A, Chiari R, Berardi R, Ballatore Z, Bono M, Bazan Russo TD, Gristina V, Galvano A, Damerino G, Blasi L, Bazan V, Russo A. Anthracycline-related cardiotoxicity in patients with breast cancer harboring mutational signature of homologous recombination deficiency (HRD). ESMO Open 2024; 9:102196. [PMID: 38118367 PMCID: PMC10837774 DOI: 10.1016/j.esmoop.2023.102196] [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: 07/19/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND The BRCA proteins play a key role in the homologous recombination (HR) pathway. Beyond BRCA1/2, other genes are involved in the HR repair (HRR). Due to the prominent role in the cellular repair process, pathogenic or likely pathogenic variants (PV/LPVs) in HRR genes may cause inadequate DNA damage repair in cardiomyocytes. PATIENTS AND METHODS This was a multicenter, hospital-based, retrospective cohort study to investigate the heart toxicity from anthracycline-containing regimens (ACRs) in the adjuvant setting of breast cancer (BC) patients carrying germline BRCA PV/LPVs and no-BRCA HRR pathway genes. The left ventricular ejection fraction (LVEF) was assessed using cardiac ultrasound before starting ACR therapy and at subsequent time points according to clinical indications. RESULTS Five hundred and three BC patients were included in the study. We predefined three groups: (i) BRCA cohort; (ii) no-BRCA cohort; (iii) variant of uncertain significance (VUS)/wild-type (WT) cohort. When baseline (T0) and post-ACR (T1) LVEFs between the three cohorts were compared, pre-treatment LVEF values were not different (BRCA1/2 versus HRR-no-BRCA versus VUS/WT cohort). Notably, during monitoring (T1, median 3.4 months), patients carrying BRCA or HRR no-BRCA germline pathogenic or likely pathogenic variants showed a statistically significant reduction of LVEF compared to baseline (T0). To assess the relevance of HRR on the results, we included the analysis of the subgroup of 20 BC patients carrying PV/LPVs in other genes not involved in HRR, such as mismatch repair genes (MUTYH, PMS2, MSH6). Unlike HRR genes, no significant differences in T0-T1 were found in this subgroup of patients. CONCLUSION Our data suggest that deleterious variants in HRR genes, leading to impaired HR, could increase the sensitivity of cardiomyocytes to ACR in early BC patients. In this subgroup of patients, other measurements, such as the global longitudinal strain, and a more in-depth assessment of risk factors may be proposed in the future to optimize cardiovascular risk management and improve long-term survival.
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Affiliation(s)
- L Incorvaia
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo
| | - G Badalamenti
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo
| | - G Novo
- Division of Cardiology, University Hospital Paolo Giaccone, Palermo; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Palermo
| | - S Gori
- Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella
| | - L Cortesi
- Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena
| | - C Brando
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo
| | - S Cinieri
- Complex Medical Oncology Unit, ASL Brindisi Senatore Antonio Perrino Hospital, Brindisi
| | - G Curigliano
- Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan
| | - G R Ricciardi
- Medical Oncology Unit, A.O. Papardo & Department of Human Pathology, University of Messina, Messina
| | - A Toss
- Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena
| | - R Chiari
- Medical Oncology, Ospedali Riuniti Padova Sud, Monselice
| | - R Berardi
- Medical Oncology, AOU Ospedali Riuniti Umberto I-GM Lancisi-G Salesi, Polytechnic University of the Marche Region, Ancona
| | - Z Ballatore
- Medical Oncology, AOU Ospedali Riuniti Umberto I-GM Lancisi-G Salesi, Polytechnic University of the Marche Region, Ancona
| | - M Bono
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo
| | - T D Bazan Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo
| | - V Gristina
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo
| | - A Galvano
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo
| | - G Damerino
- Division of Cardiology, University Hospital Paolo Giaccone, Palermo
| | - L Blasi
- Medical Oncology Unit, ARNAS Civico, Palermo
| | - V Bazan
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bind), Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - A Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo.
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5
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Cazzaniga ME, Pronzato P, Amoroso D, Bernardo A, Biganzoli L, Bisagni G, Blasi L, Bria E, Cognetti F, Crinò L, De Laurentiis M, Del Mastro L, De Placido S, Beano A, Ferraù F, Foladore S, Forcignanò R, Gamucci T, Garrone O, Gennari A, Giordano M, Giotta F, Giovanardi F, Latini L, Livi L, Marchetti P, Mattioli R, Michelotti A, Montemurro F, Putzu C, Riccardi F, Ricciardi G, Romagnoli E, Sarobba G, Spazzapan S, Tagliaferri P, Tinari N, Tonini G, Turletti A, Verusio C, Zambelli A, Mustacchi G. Clinical Outcomes of HER2-Negative Metastatic Breast Cancer Patients in Italy in the Last Decade: Results of the GIM 13-AMBRA Study. Cancers (Basel) 2023; 16:117. [PMID: 38201545 PMCID: PMC10777910 DOI: 10.3390/cancers16010117] [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: 10/13/2023] [Revised: 11/14/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
GIM 13-AMBRA is a longitudinal cohort study aimed at describing therapeutic strategies and the relative outcome parameters in 939 HER2-ve MBC patients. Taxanes-based regimens, or taxanes + targeted agents, mainly Bevacizumab, were the preferred first choice in both Luminal (30.2%) and TNBC (33.3%) patients. The median PFS1 was 12.5 months (95% CI 16.79-19.64), without any significant difference according to subtypes, while the median Time to first Treatment Change (TTC1) was significantly lower in TNBC patients (7.7 months-95% CI 5.7-9.2) in comparison to Luminal A (13.2 months, 95% CI 11.7-15.1) and Luminal B patients (11.8 months, 95% CI 10.3-12.8). PFS2 was significantly shorter in TNBC patients (5.5 months, 95% CI 4.3-6.5 vs. Luminal A-9.4, 95% CI 8.1-10.7, and Luminal B-7.7 95% CI 6.8-8.2, F-Ratio 4.30, p = 0.014). TTC2 was significantly lower in patients with TNBC than in those with the other two subtypes. The median OS1 was 35.2 months (95% CI 30.8-37.4) for Luminal A patients, which was significantly higher than that for both Luminal B (28.9 months, 95% CI 26.2-31.2) and TNBC (18.5 months, 95% CI 16-20.1, F-ratio 7.44, p = 0.0006). The GIM 13-AMBRA study is one of the largest collections ever published in Italy and provides useful results in terms of time outcomes for first, second, and further lines of treatment in HER2- MBC patients.
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Affiliation(s)
- Marina Elena Cazzaniga
- Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, Università Milano Bicocca, 20900 Monza, Italy
| | - Paolo Pronzato
- Oncologia Medica IRCCS IRST San Martino, 16100 Genova, Italy; (P.P.); (L.D.M.)
| | - Domenico Amoroso
- Oncologia Medica, Ospedale Versilia USL Nord Ovest Toscana, 55041 Lido di Camaiore, Italy;
| | - Antonio Bernardo
- Oncologia Istituti Clinici Scientifici Maugeri Spa Società Benefit, 27100 Pavia, Italy;
| | - Laura Biganzoli
- U.O. Oncologia Medica, Ospedale Santo Stefano, 59100 Prato, Italy;
| | - Giancarlo Bisagni
- Oncologia Medica, IRCCS Arcispedale S. Maria Nuova, 42121 Reggio Emilia, Italy;
| | - Livio Blasi
- Oncologia Medica, ARNAS Civico–Di Cristina-Benfratelli, Presidio Ospedaliero ‘Civico e Benfratelli’, 20121 Palermo, Italy;
| | - Emilio Bria
- Oncologia Medica, A.O.U. Integrata Verona, Ospedale Borgo Roma, 37100 Verona, Italy;
| | - Francesco Cognetti
- Oncologia Medica 1, Istituto Nazionale Tumori “Regina Elena”, 00042 Roma, Italy
| | - Lucio Crinò
- Oncologia, Ospedale S. Maria della Misericordia, 06121 Perugia, Italy;
| | | | - Lucia Del Mastro
- Oncologia Medica IRCCS IRST San Martino, 16100 Genova, Italy; (P.P.); (L.D.M.)
| | - Sabino De Placido
- Oncologia Medica, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi Federico II, 80013 Napoli, Italy;
| | - Alessandra Beano
- Oncologia Medica, Città della Salute e della Scienza, ASL “Città di Torino”, 10024 Torino, Italy;
| | | | - Silva Foladore
- SSD Oncologica e dell’apparato Riproduttivo Femminile, Azienda Sanitaria Universitaria “Giuliano Isontina, 34121 Trieste, Italy;
| | | | | | - Ornella Garrone
- Oncologia Medica, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy;
| | - Alessandra Gennari
- Oncologia Medica, Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Dipartimento di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale, 28100 Novara, Italy;
| | | | - Francesco Giotta
- Oncologia, IRCCS Istituto Tumori ‘Giovanni Paolo II’, 70100 Bari, Italy;
| | - Filippo Giovanardi
- UOS Day Hospital Oncologico, AUSL Reggio Emilia, Presidio Ospedaliero di Guastalla, 42016 Guastalla, Italy;
| | | | - Lorenzo Livi
- Dipartimento di Scienze Biomediche, Sperimentali e Cliniche ‘Mario Serio’, Università degli Studi di Firenze, UOC Radioterapia, A.O.U. Careggi, 50100 Firenze, Italy;
| | | | - Rodolfo Mattioli
- Oncologia Medica, A.O. Ospedali Riuniti Marche Nord-Ospedale Santa Croce, 61032 Fano, Italy
| | | | - Filippo Montemurro
- Fondazione del Piemonte per l’Oncologia-Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 10024 Torino, Italy;
| | - Carlo Putzu
- Oncologia Medica, AOU Sassari, 07100 Sassari, Italy
| | - Ferdinando Riccardi
- Oncologia Medica, Azienda Ospedaliera ‘A. Cardarelli’ (AORN), 80013 Napoli, Italy
| | | | | | - Giuseppina Sarobba
- Oncologia Medica, Ospedale ‘San Francesco’, Azienda Sanitaria Locale 3 Nuoro, 08100 Nuoro, Italy
| | - Simon Spazzapan
- Centro di Riferimento Oncologico, IRCCS, 33081 Aviano, Italy;
| | | | - Nicola Tinari
- Oncologia Medica, Policlinico ‘SS. Annunziata’, 66100 Chieti, Italy;
| | - Giuseppe Tonini
- Policlinico Universitario Campus Biomedico, 00042 Roma, Italy;
| | - Anna Turletti
- Presidio Ospedaliero Martini, ASL TO1, 10024 Torino, Italy
| | - Claudio Verusio
- Oncologia Medica, ASST della Valle Olona, Ospedale di Saronno, 21047 Saronno, Italy;
| | - Alberto Zambelli
- Oncologia Medica, ASST Papa Giovanni XXIII, Ospedale Papa Giovanni XXIII, 24100 Bergamo, Italy;
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Cuccia F, D'Alessandro S, Blasi L, Chiantera V, Ferrera G. The Role of Radiotherapy in the Management of Vaginal Melanoma: A Literature Review with a Focus on the Potential Synergistic Role of Immunotherapy. J Pers Med 2023; 13:1142. [PMID: 37511755 PMCID: PMC10381892 DOI: 10.3390/jpm13071142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/05/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Among the mucosal melanomas, vaginal melanomas are very rare tumors, accounting for less than 20% of melanomas arising from the female genital tract. They occur most frequently in women in post-menopausal age, but younger patients may also experience this neoplasm, mainly located in the lower third of the vagina or the anterior wall. The optimal management of this tumor remains controversial, with surgery reported as the most frequently adopted approach. However, a clear benefit of surgical treatment in terms of survival has not yet been demonstrated. Conversely, radiotherapy may represent an attractive non-invasive alternative, and there are several favorable reports of the role of radiation therapy, either delivered with photons, brachytherapy, or hadrontherapy. A wide range of techniques and fractionation regimens are reported with substantially good tolerance to the treatment, and acute G3 or higher toxicities are reported only in the case of concurrent immunotherapy. Of note, due to the rarity of the disease, there is a lack of high-level evidence for the optimal therapeutic option. In this scenario, recent studies theorize the possibility of developing combinatorial approaches of radiotherapy with immunotherapy based on cutaneous melanomas reports. In this review, we aim to summarize the evidence available in the literature supporting the role of definitive radiotherapy for vaginal melanomas, with a focus on the combination of RT with immunotherapy, in terms of optimal timing and biological rationale.
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Affiliation(s)
- Francesco Cuccia
- Radiotherapy Unit, Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy
| | - Salvatore D'Alessandro
- Radiotherapy Unit, Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy
- Radiation Oncology School, University of Palermo, 90100 Palermo, Italy
| | - Livio Blasi
- Medical Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy
| | - Vito Chiantera
- Gynecological Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy
| | - Giuseppe Ferrera
- Radiotherapy Unit, Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy
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7
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Cuccia F, D'Alessandro S, Carruba G, Figlia V, Spera A, Cespuglio D, Mortellaro G, Iacoviello G, Lo Casto A, Tringali G, Craparo G, Blasi L, Ferrera G. Fractionated Stereotactic Radiotherapy with Helical Tomotherapy for Brain Metastases: A Mono-Institutional Experience. J Pers Med 2023; 13:1099. [PMID: 37511711 PMCID: PMC10381210 DOI: 10.3390/jpm13071099] [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: 05/26/2023] [Revised: 06/19/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Background: The present study reports on the outcomes of our mono-institutional experience of Helical Tomotherapy (HT)-based SRT for brain metastases. The use of this linac is less frequently reported for this kind of treatment. Methods: This retrospective study displays a series of patients treated with HT-SRT. The eligibility of using SRT for brain metastases was defined by a Karnofsky performance status of >70, a life expectancy of >6 months, and controlled extra-cranial disease; no SRT was allowed in the case of a number of brain metastases larger than 10. All the cases were discussed by a multidisciplinary board. Toxicity assessments were performed based on CTCAE v5.0. Survival endpoints were assessed using the Kaplan-Meier method, and univariate and multivariate analyses were carried out to identify any potential predictive factor for an improved outcome. Results: Sixty-four lesions in 37 patients were treated using HT-SRT with a median total dose of 30 Gy in five fractions. The median follow-up was 7 months, and the 1- and 2-year LC rates were both 92.5%. The IPFS rates were and 56.75% and 51.35%. The OS rates were 54% and 40%. The UA showed better IPFS rates significantly related to male sex (p = 0.049), a BED12 of ≥42 Gy (p = 0.006), and controlled extracranial disease (p = 0.03); in the MA, a favorable trend towards LC (p = 0.11) and higher BED (p = 0.11) schedules maintained a correlation with improved IPFS rates, although statistical significance was not reached. Conclusions: HT-based SRT for brain metastases showed safety and efficacy in our monoinstiutional experience. Higher RT doses showed statistical significance for improved outcomes of LC and OS.
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Affiliation(s)
| | | | - Giuseppe Carruba
- Division of Internationalization and Health Research (SIRS), ARNAS Civico Hospital, 90100 Palermo, Italy
| | - Vanessa Figlia
- Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy
| | - Antonio Spera
- Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy
| | | | | | | | - Antonio Lo Casto
- Radiation Oncology School, University of Palermo, 90133 Palermo, Italy
| | | | - Giuseppe Craparo
- Neuroradiology Unit, ARNAS Civico Hospital, 90100 Palermo, Italy
| | - Livio Blasi
- Medical Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy
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8
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Gebbia V, Cuggino R, Spada M, Blasi L, Mezzatesta P, Marchesa P, Arena G, Mandalà L, Firenze A. Nutritional management of the patient with pancreatic cancer: from the diagnostic and therapeutic pathway to an integrated hospital-territory approach. Clin Ter 2023; 174:203-210. [PMID: 36920140 DOI: 10.7417/ct.2023.2520] [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] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Abstract Pancreatic cancer is associated to a high risk of malnutrition and neoplastic cachexia even at first diagnosis. Malnutrition is a negative prognostic factor for the outcome of surgery or medical oncology treatments. Despite the good awareness of the problem and the knowledge of the guidelines, the early recognition of malnutrition and its management are still uneven, mainly due to the lack of implementation of standardized and shared protocols and the shortage of dedicated clinical nutritionists and dieticians. An early and appropriate nutritional intervention is mandatory to improve the outcome of patients with pancreatic cancer at any stage of disease. The Mini Nutritional Assessment is useful tool to screen patients malnourished or at risk of malnutrition. The need for the establishment and implementation of an integrated hospital - territorial assistance as well as a home-delivered nutrition service is discussed.
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Affiliation(s)
- V Gebbia
- Medical Oncology Unit, La Maddalena Clinic for Cancer, Palermo, and Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - R Cuggino
- Clinical Nutrition Service, ASP, Palermo, Italy
| | - M Spada
- Medical Oncology Unit, Fondazione Giglio, Cefalù, Ital
| | - L Blasi
- Medical Oncology Unit, ARNAS, Palermo, Italy
| | - P Mezzatesta
- Surgical Oncology Unit, La Maddalena Clinic for Cancer, Palermo
| | - P Marchesa
- Surgical Oncology Unit, ARNAS, Palermo, Italy
| | - G Arena
- Surgical Oncology Unit, Fondazione Giglio, Cefalù, Italy
| | - L Mandalà
- Surgical Oncology Unit, La Maddalena Clinic for Cancer, Palermo
| | - A Firenze
- Occupational Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
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9
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Sciurti E, Biscaglia F, Prontera C, Giampetruzzi L, Blasi L, Francioso L. Nanoelectrodes for Intracellular and Intercellular electrochemical detection: working principles, fabrication techniques and applications. J Electroanal Chem (Lausanne) 2022. [DOI: 10.1016/j.jelechem.2022.117125] [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: 12/28/2022]
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10
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Cuffini E, Casale C, Mantovani C, Gastino A, Lo Zito B, Blasi L, Bongiovanni D, Orlandi E, Cerrato M, Vella A, Leardi S, Chiofalo V, Cavallin C, Iorio G, Ricardi U, Levis M. OC-0925 Early adjuvant RT as a predictor of improved outcomes in patients with grade II and III meningiomas. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02705-0] [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]
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11
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Cerrato M, Badellino S, Menegatti F, Bonavero I, Grossi C, Lo Zito B, Orlandi E, Gastino A, Cuffini E, Blasi L, Mantovani C, Parise R, Ricardi U, Levis M. PD-0672 Cardiac toxicity predicts mortality in NSCLC patients: interim analysis of the LUNG-HEART Study. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02919-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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12
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Levis M, Botto B, Andreis A, Gastino A, Blasi L, Bartoncini S, Giorgi M, Fava A, Cavallo F, Ferrero S, Boccomini C, Orsucci L, Ricardi U. OC-0293 Early detection of chemo and RT-related heart toxicity in lymphoma patients: The CARDIOCARE Project. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02551-8] [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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13
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Gebbia V, Guarini A, Piazza D, Bertani A, Spada M, Verderame F, Sergi C, Potenza E, Fazio I, Blasi L, La Sala A, Mortillaro G, Roz E, Marchese R, Chiarenza M, Soto-Parra H, Valerio MR, Agneta G, Amato C, Lipari H, Baldari S, Ferraù F, Di Grazia A, Mancuso G, Rizzo S, Firenze A. Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer. Pulm Ther 2021; 7:295-308. [PMID: 34089169 PMCID: PMC8177259 DOI: 10.1007/s41030-021-00163-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/08/2021] [Accepted: 05/20/2021] [Indexed: 01/31/2023] Open
Abstract
To date, the virtual multidisciplinary tumor boards (vMTBs) are increasingly used to achieve high-quality treatment recommendations across health-care regions, which expands and develops the local MTB team to a regional or national expert network. This review describes the process of lung cancer-specific MTBs and the transition process from face-to-face tumor boards to virtual ones. The review also focuses on the project organization's description, advantages, and disadvantages. Semi-structured interviews identified five major themes for MTBs: current practice, attitudes, enablers, barriers, and benefits for the MTB. MTB teams exhibited positive responses to modeled data feedback. Virtualization reduces time spent for travel, allowing easier and timely patient discussions. This process requires a secure web platform to assure the respect of patients' privacy and presents the same unanswered problems. The implementation of vMTB also permits the implementation of networks especially in areas with geographical barriers facilitating interaction between large referral cancer centers and tertiary or community hospitals as well as easier access to clinical trial opportunities. Studies aimed to improve preparations, structure, and conduct of MTBs, research methods to monitor their performance, teamwork, and outcomes are also outlined in this article. Analysis of literature shows that MTB participants discuss 5-8 cases per meeting and that the use of a vMTB for lung cancer and in particular stage III NSCLC and complex stage IV cases is widely accepted by most health professionals. Despite still-existing gaps, overall vMTB represents a unique opportunity to optimize patient management in a patient-centered approach.
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Affiliation(s)
- Vittorio Gebbia
- Medical Oncology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, La Maddalena Clinic for Cancer, University of Palermo, Via San Lorenzo Colli n. 312D, 90100, Palermo, Italy.
- GSTU Foundation, Palermo, Italy.
| | - Aurelia Guarini
- Medical Oncology Unit, Fondazione Ospedale Giglio, Cefalù, Palermo, Italy
| | | | - Alessandro Bertani
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS Ismett, UPMC, Palermo, Italy
| | - Massimiliano Spada
- Medical Oncology Unit, Fondazione Ospedale Giglio, Cefalù, Palermo, Italy
| | | | - Concetta Sergi
- Thoracic Surgery Unit, ARNAS, Ospedale Garibaldi, Nesima, Catania, Italy
| | - Enrico Potenza
- Thoracic Surgery Unit, ARNAS, Ospedale Garibaldi, Nesima, Catania, Italy
| | - Ivan Fazio
- Radiation Therapy Unit, Clinica Macchiarella, Palermo, Italy
| | - Livio Blasi
- Medical Oncology Unit, Arnas Civico, Palermo, Italy
| | - Alba La Sala
- Bronchial Endoscopy Unit, Arnas Civico, Palermo, Italy
| | | | - Elena Roz
- Pathology Unit, La Maddalena Clinic for Cancer, Palermo, Italy
| | - Roberto Marchese
- Thoracic Surgery Unit, La Maddalena Clinic for Cancer, Palermo, Italy
| | | | | | | | - Giuseppe Agneta
- Thoracic Surgery Unit, Ospedale Cervello Villa Sofia, Palermo, Italy
| | - Carmela Amato
- Patients Advocacy "Serena a Palermo", Palermo, Italy
| | - Helga Lipari
- Medical Oncology Unit, Ospedale Cannizzaro, Catania, Italy
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University Hospital G. Martino, Messina, Italy
| | - Francesco Ferraù
- Medical Oncology Unit, Ospedale San Vincenzo, Taormina, Messina, Italy
| | - Alfio Di Grazia
- Radiation Oncology Unit, Istituto Clinico Humanitas, Catania, Italy
| | - Gianfranco Mancuso
- Medical Oncology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, La Maddalena Clinic for Cancer, University of Palermo, Via San Lorenzo Colli n. 312D, 90100, Palermo, Italy
| | - Sergio Rizzo
- Medical Oncology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, La Maddalena Clinic for Cancer, University of Palermo, Via San Lorenzo Colli n. 312D, 90100, Palermo, Italy
| | - Alberto Firenze
- Risk Management Unit, Policlinico, University of Palermo, Palermo, Italy
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14
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Blasi L, Bordonaro R, Serretta V, Piazza D, Firenze A, Gebbia V. Virtual Clinical and Precision Medicine Tumor Boards, a Cloud-based Platform-mediated Implementation of Multidisciplinary Reviews among Oncology Centers in the Covid-19 Era: an Observational Study Protocol. JMIR Res Protoc 2021; 10:e26220. [PMID: 34387553 PMCID: PMC8437400 DOI: 10.2196/26220] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/26/2021] [Accepted: 05/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background Multidisciplinary tumor boards play a pivotal role in the patient-centered clinical management and in the decision-making process to provide best evidence-based, diagnostic, and therapeutic care to patients with cancer. Among the barriers to achieve an efficient multidisciplinary tumor board, lack of time and geographical distance play a major role. Therefore, the elaboration of an efficient virtual multidisciplinary tumor board (VMTB) is a key point to successfully obtain an oncology team and implement a network among health professionals and institutions. This need is stronger than ever during the COVID-19 pandemic. Objective This paper presents a research protocol for an observational study focused on exploring the structuring process and the implementation of a multi-institutional VMTB in Sicily, Italy. Other endpoints include analysis of cooperation between participants, adherence to guidelines, patients’ outcomes, and patient satisfaction. Methods This protocol encompasses a pragmatic, observational, multicenter, noninterventional, prospective trial. The study’s programmed duration is 5 years, with a half-yearly analysis of the primary and secondary objectives’ measurements. Oncology care health professionals from various oncology subspecialties at oncology departments in multiple hospitals (academic and general hospitals as well as tertiary centers and community hospitals) are involved in a nonhierarchic manner. VMTB employs an innovative, virtual, cloud-based platform to share anonymized medical data that are discussed via a videoconferencing system both satisfying security criteria and compliance with the Health Insurance Portability and Accountability Act. Results The protocol is part of a larger research project on communication and multidisciplinary collaboration in oncology units and departments spread in the Sicily region. The results of this study will particularly focus on the organization of VMTBs, involving oncology units present in different hospitals spread in the area, and creating a network to allow best patient care pathways and a hub-and-spoke relationship. The present results will also include data concerning organization skills and pitfalls, barriers, efficiency, number, and types with respect to clinical cases and customer satisfaction. Conclusions VMTB represents a unique opportunity to optimize patient management through a patient-centered approach. An efficient virtualization and data-banking system is potentially time-saving, a source for outcome data, and a detector of possible holes in the hull of clinical pathways. The observations and results from this VMTB study may hopefully be useful to design nonclinical and organizational interventions that enhance multidisciplinary decision-making in oncology. International Registered Report Identifier (IRRID) DERR1-10.2196/26220
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Affiliation(s)
| | | | | | - Dario Piazza
- GSTU Foundation for Cancer Research, Palermo, IT
| | | | - Vittorio Gebbia
- La Maddalena Cancer Center, via San Lorenzo Colli n. 312d, 90100, Palermo, Italy, palermo, IT
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15
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Indini A, Pinotti G, Artioli F, Aschele C, Bernardi D, Butera A, Defraia E, Fasola G, Gamucci T, Giordano M, Iaria A, Leo S, Ribecco AS, Rossetti R, Savastano C, Schena M, Silva RR, Grossi F, Blasi L. Management of patients with cancer during the COVID-19 pandemic: The Italian perspective on the second wave. Eur J Cancer 2021; 148:112-116. [PMID: 33743478 PMCID: PMC7904514 DOI: 10.1016/j.ejca.2021.01.040] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/19/2021] [Accepted: 01/28/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has been an overwhelming challenge for worldwide health systems. Since the beginning of year 2020, COVID-19 has represented a potential harm for cancer patients and has often hindered oncology care. The Collegio Italiano dei Primari Oncologi Medici (CIPOMO) is an Italian association of head physicians in oncology departments, which promotes working and research activities in oncology on a national basis. During the second wave of COVID-19 pandemic, the CIPOMO promoted a national survey aiming to evaluate the impact of COVID-19 on oncologists' clinical activity and what changes have been made compared with the Italian situation during the first wave of the pandemic. Overall, 138 heads of medical oncology departments participated in this survey: 75 (54%) from the North, 24 (17%) from the Centre and 39 (28%) from the South of Italy and islands. This survey provides an overview of Italian oncologists facing the second wave of COVID-19 pandemic. The lesson learned during the first wave of COVID-19 pandemic has led to a better organisation of clinical activities, and regular testing among healthcare practitioners, with better chances to grant patients' protection. However, the lack of standardised informatic platforms results in serious challenges in replacing frontal visits, often making a concrete reduction of patients' hospital accesses unfeasible. Oncologists need to keep preserving the continuum of care of patients. Standardisation of safety measures, together with the implementation of informatic platforms, can significantly improve oncology pathways during this second wave of COVID-19 pandemic.
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Affiliation(s)
- Alice Indini
- Medical Oncology Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Carlo Aschele
- Medical Oncology Department, Ospedale Sant'Andrea, La Spezia, Italy
| | | | - Alfredo Butera
- Medical Oncology Unit, Ospedale San Giovanni di Dio, Agrigento, Italy
| | | | - Gianpiero Fasola
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | | | | | - Antonino Iaria
- Oncology Unit, Azienda Sanitaria Provinciale, Presidio Ospedaliero Melito Porto Salvo, Reggio Calabria, Italy
| | - Silvana Leo
- Department of Medical Oncology, Vito Fazzi Hospital, Lecce, Italy
| | | | - Riccardo Rossetti
- Medical Oncology and Palliative Care Unit, Pantalla Hospital, Todi, Italy
| | | | - Marina Schena
- Medical Oncology, Azienda AUSL, Regional Hospital of Aosta, Aosta, Italy
| | - Rosa R Silva
- Medical Oncology, ASUR Marche, Area Vasta 2, Fabriano, Italy
| | - Francesco Grossi
- Medical Oncology Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Livio Blasi
- Medical Oncology Unit, ARNAS Civico, Palermo, Italy
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Zaniboni A, Barone CA, Banzi MC, Bergamo F, Blasi L, Bordonaro R, Bartolomeo MD, Costanzo FD, Frassineti GL, Garufi C, Giuliani F, Latiano TP, Martinelli E, Personeni N, Racca P, Tamburini E, Tonini G, Besse MG, Spione M, Falcone A. Italian results of the PRECONNECT study: safety and efficacy of trifluridine/tipiracil in metastatic colorectal cancer. Future Oncol 2021; 17:2315-2324. [PMID: 33663264 DOI: 10.2217/fon-2020-1278] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The international PRECONNECT Phase IIIb study demonstrated safety and efficacy of trifluridine/tipiracil in the management of patients with metastatic colorectal cancer. Post-hoc analyses in a national context are important because of the differences in disease management across countries. Post-hoc safety and efficacy analyses in the PRECONNECT Italian patient subset were conducted. Patients' quality of life was assessed from baseline to end of treatment. In Italy, 161 patients were enrolled. The median age was 64 years, with a performance status of 0-1. The most common hematological drug-related adverse events ≥grade 3 were neutropenia (41.0%) and anemia (13.7%). The median progression-free survival was reached at 3.0 months, with a disease control rate of 28.6%. The Quality of Life Questionnaire Core 30 score improved in 25.4% of the patients. Safety, efficacy and quality of life results confirmed trifluridine/tipiracil as a feasible and favorable treatment option for metastatic colorectal cancer patients.
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Affiliation(s)
- Alberto Zaniboni
- Fondazione Poliambulanza, Istituto Ospedaliero, Via Leonida Bissolati, 57, 25124, Brescia, Italy
| | - Carlo Antonio Barone
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Via della Pineta Sacchetti, 217, 00168, Roma, Italy
| | - Maria Chiara Banzi
- AUSL-IRCCS S. Maria Nuova, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Francesca Bergamo
- Istituto Oncologico Veneto - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy
| | - Livio Blasi
- Azienda Ospedaliera "Civico-Di Cristina-Benefratelli", Piazza Leotta Nicola, 4, 90127, Palermo, Italy
| | - Roberto Bordonaro
- Azienda Ospedaliera Garibaldi - Nesima, Via Palermo, 636, 95122, Catania, Italy
| | - Maria Di Bartolomeo
- Fondazione IRCCS - Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milano, Italy
| | - Francesco Di Costanzo
- Azienda Ospedaliero-Universitaria Careggi, Largo Piero Palagi, 1, 50139, Firenze, Italy
| | - Giovanni Luca Frassineti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Via Piero Maroncelli, 40, 47014, Meldola (FC), Italy
| | - Carlo Garufi
- Azienda Ospedaliera San Camillo Forlanini, Circonvallazione Gianicolense, 87, 00152, Roma, Italy
| | - Francesco Giuliani
- Medical Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, 65, 70124, Bari, Italy
| | - Tiziana Pia Latiano
- Ospedale IRCSS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (FG), Italy
| | - Erika Martinelli
- Università degli Studi della Campania "Luigi Vanvitelli", Via Vico Luigi De Crecchio 6 - 80138, Napoli, Italy
| | - Nicola Personeni
- Medical Oncology & Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center-IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano (Milan), Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090, Pieve Emanuele (Milan), Italy
| | - Patrizia Racca
- A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante, 88, 10126, Torino, Italy
| | | | - Giuseppe Tonini
- Policlinico Universitario Campus Biomedico, Via Álvaro del Portillo, 20000128, Roma, Italy
| | | | - Mario Spione
- Medical Affairs, Servier Italia, Via Luca Passi, 85, 00166, Roma, Italy
| | - Alfredo Falcone
- Dipartimento di Ricerca Traslazionale, Università degli Studi di Pisa, Lungarno Antonio Pacinotti, 43, 56126, Pisa, Italy
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17
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Aschele C, Negru ME, Pastorino A, Cavanna L, Zagonel V, Barone-Adesi F, Blasi L. Incidence of SARS-CoV-2 Infection Among Patients Undergoing Active Antitumor Treatment in Italy. JAMA Oncol 2021; 7:304-306. [PMID: 33331862 DOI: 10.1001/jamaoncol.2020.6778] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Carlo Aschele
- Medical Oncology Unit, Department of Oncology, Ospedale Sant'Andrea, La Spezia, Italy
| | - Maria Emanuela Negru
- Medical Oncology Unit, Department of Oncology, Ospedale Sant'Andrea, La Spezia, Italy
| | - Alessandro Pastorino
- Medical Oncology Unit, Department of Oncology, Ospedale Sant'Andrea, La Spezia, Italy
| | - Luigi Cavanna
- Department of Oncology-Hematology, G. da Saliceto Hospital, Piacenza, Italy
| | - Vittorina Zagonel
- Oncology Unit 1, Istituto Oncologico Veneto, IOV-IRCCS, Padova, Italy
| | - Francesco Barone-Adesi
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.,CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Livio Blasi
- Medical Oncology Unit, Ospedale Civico, Arnas, Palermo
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18
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De Santis S, Simone MD, Mercadante S, Mediati RD, Vellucci R, Marchetti P, Tonini G, Cuomo A, Caraceni A, Natoli S, Armento G, Blasi L, Mammucari M. Oxycodone/Acetaminophen: The Tailoring Combination Treatment for Specific Clinical Profile of Opioid Well-Responsive Cancer Pain. Cancer Manag Res 2021; 13:1747-1756. [PMID: 33642876 PMCID: PMC7903954 DOI: 10.2147/cmar.s290551] [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: 11/26/2020] [Accepted: 01/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background International guidelines recommend moderate-to-severe cancer pain to be treated with strong opioids. However, pain management remains an unsolved matter, at least in the demanding oncology and palliative care setting. Although cancer pain consists of multiple components, which interact in complex ways where combination therapy can better intercept multiple pain characteristics, few studies have used a non-opioid/opioid association to exploit possible synergistic actions. Even the efforts of a recent approach emphasizing appropriate pain assessment and accurate classification to obtain personalized pain management have not produced a satisfactory analgesic strategy. Objective This analysis was intended to evaluate the effectiveness of the immediate release fixed combination of oxycodone/acetaminophen (OxyIR/Par) for the treatment of moderate-to-severe intensity background pain used alone or in combination with other strong opioids in cancer patients with breakthrough cancer pain (BTcP). This is a secondary analysis of a wider observational, prospective, multicenter study [Italian Oncologic Pain multiSetting Multicentric Survey (IOPS-MS)] performed on 179 patients treated with opioids for cancer pain who received the fixed combination of oxycodone/acetaminophen (OxyIR/Par) for the treatment of background pain (BGP). Results Cancer patients with breakthrough cancer pain and controlled BGP (Background Pain) were classified according to the presence of analgesic therapy with tablets of fixed combination OxyIR/Par alone (group A, n=120) or tablets of fixed combination OxyIR/Par combined with other strong opioids (group B, n=59). Clinical features of group A were different to group B: higher mean Karnofsky Performance Status Index 70.3% (95% CI=67.2–73.5; median=70, CI=60–80) vs 58.3 (95% CI=53.4–63.2; median=50, CI=45–70) (P<0.001), and mainly group A patients were treated in an ambulatory setting (55.0% group A vs 33.9% group B) (p<0.001). Both groups had managed BGP with similar mean dosages (group A: 12.0, CI=10.5–13.4; group B: 13.1, CI=11.0–15.1) and frequencies of OxyIR/Par alone for group A and in association to other opioids for group B, but Breakthrough cancer Pain (BTcP) exhibited different characteristics in the two groups, showing a lower mean intensity numerical rating scale (NRS) of 7.5 (95% CI=7.2–7.7; median=7, CI=7–8 group A) vs 7.9 (95% CI=7.6, 8.2; median= 8, CI=7–9 group B) (P=0.04) and a higher percentage of patients had a faster onset, defined as the maximum intensity reached in less than 10 minutes, 81.7% (N=98) in group A vs 59.3% (n=35) in group B (P=0.002). Conclusion This is the first analysis about the efficacy of an immediate-release fixed combination of OxyIR/Par in the real world for moderate-to-severe background cancer pain and breakthrough cancer pain. The oral fixed combination OxyIR/Par provided an adequate level of analgesia for moderate–severe background cancer pain, in a different cohort of cancer patients with different performance status, both in ambulatory and palliative settings. The low dosage of fixed combination OxyIR/Par was effective alone or in association with other opioids.
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Affiliation(s)
- Stefano De Santis
- Palliative Care and Oncologic Pain Service, S. Camillo-Forlanini Hospital, Rome, Italy
| | | | - Sebastiano Mercadante
- Anesthesia and Intensive Care & Pain Relief and Supportive Care, La Maddalena, Palermo, Italy
| | | | - Renato Vellucci
- Palliative Care and Pain Therapy Unit, Careggi Hospital, Florence, Italy
| | - Paolo Marchetti
- Molecular and Clinical Medicine Medical Oncology, La Sapienza University of Rome, Rome, Italy
| | - Giuseppe Tonini
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Arturo Cuomo
- Anesthesiology, Resuscitation, and Pain Therapy Department, National Cancer Institute, IRCCS Foundation, Naples, Italy
| | - Augusto Caraceni
- Palliative Care, Pain Therapy and Rehabilitation, National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - Silvia Natoli
- Department of Clinical Science and Translational Medicine - University of Rome Tor Vergata and Department of Emergency, Admission and Critical Area - Policlinic of Tor Vergata, Rome, Italy
| | - Grazia Armento
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Livio Blasi
- Medical Oncology Unit, ARNAS Ospedale Civico Di Cristina Benfratelli, Palermo, Italy
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La Verde N, Collovà E, Blasi L, Pinotti G, Palumbo R, Bonotto M, Garrone O, Brunello A, Rimanti A, Bareggi C, Zaniboni A, Frassoldati A, Foglietta J, Berardi R, Moretti A, Farina G, Porcu L, Barni S. Overall Survival in Metastatic Breast Cancer Patients in the Third Millennium: Results of the COSMO Study. Clin Breast Cancer 2020; 21:e489-e496. [PMID: 33342749 DOI: 10.1016/j.clbc.2020.11.001] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 10/09/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Metastatic breast cancer (MBC) is a life-threatening disease, and although some data suggest a trend in survival improvement, it has not yet been unequivocally demonstrated. This study aimed to evaluate the overall survival (OS) of MBC patients, assessing its correlation with prognostic factors. PATIENTS AND METHODS COSMO (Checking Overall Survival in a MBC Observational study) is an Italian longitudinal retrospective multicenter study that enrolled patients with MBC diagnosed between 2000 and 2008. The primary objective was to detect a temporal difference in OS; the secondary objective was to identify prognostic factors as causal factors of the temporal variation in OS. RESULTS A total of 3721 of 3930 patients from 31 centers were distributed in 3 periods: 886 (23.8%), 1302 (35.0%), and 1533 (41.2%) in 2000-2002, 2003-2005, and 2006-2008, respectively. With a median follow-up of 9.3 years, median OS was 2.8 years (95% confidence interval, 2.6-2.9). No difference in OS was found in the 3 cohorts (P for trend = .563). The worst prognosis was observed for patients with triple-negative MBC (OS, 1.5 years) and for those with central nervous system metastases (1.7 years); the best prognosis was observed in those with bone metastases or nonvisceral disease (3.4 and 3.2 years, respectively) and in patients with a disease-free interval, defined as the time between resection of the primary malignancy and diagnosis of MBC, of > 2 years (3 years). CONCLUSIONS The COSMO study found improvement in OS between 2000 and 2008. Molecular subtype remained the strongest prognostic factor, and the role of other prognostic factors was confirmed, in particular disease-free interval, site of metastasis, and age.
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Affiliation(s)
- Nicla La Verde
- Department of Oncology, PO Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Elena Collovà
- Department of Oncology, ASST Ovest Milanese, Legnano, MI, Italy
| | - Livio Blasi
- Department of Oncology, ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, Italy
| | | | | | - Marta Bonotto
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | - Ornella Garrone
- Department of Oncology, S. Croce & Carle Teaching Hospital, Cuneo, Italy
| | - Antonella Brunello
- Medical Oncology Unit 1, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - Anita Rimanti
- Department of Oncology, ASST Mantova, AO Carlo Poma, Mantova, Italy
| | - Claudia Bareggi
- Department of Oncology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Alberto Zaniboni
- Department of Medical Oncology, Poliambulanza Foundation, Brescia, Italy
| | | | | | - Rossana Berardi
- Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Anna Moretti
- Department of Oncology PO Fatebenefratelli, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Gabriella Farina
- Department of Oncology PO Fatebenefratelli, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Luca Porcu
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Oncology Department, Milan, Italy
| | - Sandro Barni
- Department of Oncology, ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, Italy
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20
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Cheli S, Zagonel V, Oliani C, Blasi L, Fioretto L. Is burnout affecting life satisfaction in oncologists? The moderating role of family concerns in an Italian sample. Psychooncology 2020; 30:385-391. [PMID: 33151607 DOI: 10.1002/pon.5589] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Burnout may represent a significant source of distress in health care professionals. Many studies have reported its negative effect on career satisfaction and personal life. The aim of the present study was to investigate the relation between burnout and life satisfaction in a large sample of Italian oncologists. METHODS An online survey was conducted of 14.5% of the Italian oncologists' population (n = 533) using Copenhagen Burnout Inventory, Satisfaction with Life Scale and additional questions exploring professional and personal factors. Moderated regression analysis was carried out to explore how burnout may relate to life satisfaction. RESULTS One out of 10 (10.5%) oncologists showed significant burnout symptoms, whereas 1 out of 3 (33.8%) reported being at least slightly dissatisfied with their own life. Family concerns significantly moderated the relationship between burnout and life satisfaction. Men and chiefs of cancer units or departments showed lower rates of burnout and life dissatisfaction than women and other oncologists, respectively. CONCLUSIONS Reported results are in line with existing data about a limited burnout prevalence in Italian oncologists. We discuss the potential role of gender inequality in explaining our findings. The present study suggests that family concerns may be considered a risk factor for both burnout and life dissatisfaction in oncologists.
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Affiliation(s)
- Simone Cheli
- School of Human Health Sciences, University of Florence, Florence, Italy.,Center for Psychology & Health, Tages Charity, Florence, Italy
| | - Vittorina Zagonel
- Oncology Unit 1, Istituto Oncologico Veneto, IOV-IRCCS Padova, Italy
| | | | - Livio Blasi
- Oncologia Medica, ARNAS Ospedale Civico, Palermo, Italy
| | - Luisa Fioretto
- Dipartimento Oncologico, USL Toscana Centro, Florence, Italy
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21
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Gebbia V, Aiello MM, Banna G, Blanco G, Blasi L, Borsellino N, Giuffrida D, Mauro ML, Mancuso G, Piazza D, Savio G, Parra HS, Valerio MR, Verderame F, Vigneri P. Metronomic oral vinorelbine in patients with advanced non-small cell lung cancer progressing after nivolumab immunotherapy: a retrospective analysis. Ecancermedicalscience 2020; 14:1113. [PMID: 33144881 PMCID: PMC7581333 DOI: 10.3332/ecancer.2020.1113] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Indexed: 11/06/2022] Open
Abstract
Purpose: The availability of immune checkpoint inhibitors has deeply changed the therapeutic scenario of patients with advanced non-small cell lung cancer (NSCLC). Up until now, chemotherapy still represents the first-line treatment for patients with advanced NSCLC not harbouring genetic mutations or lacking high expression of programmed death ligand even if the addition of immunotherapy to first-line chemotherapy has recently been shown to improve clinical outcome. We carried out a multi-institutional retrospective analysis on third-line chemotherapy with metronomic oral vinorelbine (VNR) in a series of patients with metastatic NSCLC pre-treated with first-line chemotherapy and second-line immunotherapy. Patients and methods: Thirty patients with metastatic NSCLC with progressive disease after first-line chemotherapy and subsequent immunotherapy were treated with metronomic oral VNR continuously at the fixed dose of 30 mg three times per week. Results: A partial response was achieved in 4 patients (13.3%), while 10 patients (33.3%) displayed disease stabilisation for an overall disease control rate of 46.7%. Median progression-free survival was 3.9 months (range 1–13 months) and median OS reached 8.1 months (range 4.0–24.0+ months) with a 12-month survival rate of 22%. Conclusion: Oral metronomic VNR appears to be active and safe in patients with metastatic NSCLC in progression after first-line chemotherapy and second-line immunotherapy. The results reported, although from a limited sample, may suggest its use for long-term stabilisation of the disease with good patient compliance.
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Affiliation(s)
- Vittorio Gebbia
- Medical Oncology Unit, La Maddalena Clinic for Cancer Medical Oncology, Palermo 90100, Italy.,PROMISE Department, University of Palermo, Palermo 90100, Italy
| | - Marco Maria Aiello
- Policlinico-Vittorio Emanuele, Università di Catania, Catania 95100, Italy
| | - Giuseppe Banna
- Medical Oncology Unit, Ospedale Cannizzaro, Catania 95100, Italy
| | - Giusi Blanco
- Medical Oncology Unit, IOM, Catania 95100, Italy
| | - Livio Blasi
- Medical Oncology Unit, ARNAS Civico, Palermo 90100, Italy
| | - Nicolò Borsellino
- Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo 90100, Italy
| | | | - Mario Lo Mauro
- Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo 90100, Italy
| | - Gianfranco Mancuso
- Medical Oncology Unit, La Maddalena Clinic for Cancer Medical Oncology, Palermo 90100, Italy
| | | | | | - Hector Soto Parra
- Policlinico-Vittorio Emanuele, Università di Catania, Catania 95100, Italy
| | | | | | - Paolo Vigneri
- Medical Oncology Unit, La Maddalena Clinic for Cancer Medical Oncology, Palermo 90100, Italy
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22
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Pantano F, Manca P, Armento G, Zeppola T, Onorato A, Iuliani M, Simonetti S, Vincenzi B, Santini D, Mercadante S, Marchetti P, Cuomo A, Caraceni A, Mediati RD, Vellucci R, Mammucari M, Natoli S, Lazzari M, Dauri M, Adile C, Airoldi M, Azzarello G, Blasi L, Chiurazzi B, Degiovanni D, Fusco F, Guardamagna V, Liguori S, Palermo L, Mameli S, Masedu F, Mazzei T, Melotti RM, Menardo V, Miotti D, Moroso S, Pascoletti G, De Santis S, Orsetti R, Papa A, Ricci S, Scelzi E, Sofia M, Aielli F, Valle A, Tonini G. Breakthrough Cancer Pain Clinical Features and Differential Opioids Response: A Machine Learning Approach in Patients With Cancer From the IOPS-MS Study. JCO Precis Oncol 2020; 4:2000158. [PMID: 33283139 PMCID: PMC7713587 DOI: 10.1200/po.20.00158] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE A large proportion of patients with cancer suffer from breakthrough cancer pain (BTcP). Several unmet clinical needs concerning BTcP treatment, such as optimal opioid dosages, are being investigated. In this analysis the hypothesis, we explore with an unsupervised learning algorithm whether distinct subtypes of BTcP exist and whether they can provide new insights into clinical practice. METHODS Partitioning around a k-medoids algorithm on a large data set of patients with BTcP, previously collected by the Italian Oncologic Pain Survey group, was used to identify possible subgroups of BTcP. Resulting clusters were analyzed in terms of BTcP therapy satisfaction, clinical features, and use of basal pain and rapid-onset opioids. Opioid dosages were converted to a unique scale and the BTcP opioids-to-basal pain opioids ratio was calculated for each patient. We used polynomial logistic regression to catch nonlinear relationships between therapy satisfaction and opioid use. RESULTS Our algorithm identified 12 distinct BTcP clusters. Optimal BTcP opioids-to-basal pain opioids ratios differed across the clusters, ranging from 15% to 50%. The majority of clusters were linked to a peculiar association of certain drugs with therapy satisfaction or dissatisfaction. A free online tool was created for new patients’ cluster computation to validate these clusters in future studies and provide handy indications for personalized BTcP therapy. CONCLUSION This work proposes a classification for BTcP and identifies subgroups of patients with unique efficacy of different pain medications. This work supports the theory that the optimal dose of BTcP opioids depends on the dose of basal opioids and identifies novel values that are possibly useful for future trials. These results will allow us to target BTcP therapy on the basis of patient characteristics and to define a precision medicine strategy also for supportive care.
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Affiliation(s)
- Francesco Pantano
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
| | - Paolo Manca
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy.,IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Grazia Armento
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
| | - Tea Zeppola
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
| | - Angelo Onorato
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
| | - Michele Iuliani
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
| | - Sonia Simonetti
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
| | - Bruno Vincenzi
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
| | - Daniele Santini
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
| | - Sebastiano Mercadante
- Anesthesia and Intensive Care and Pain Relief and Supportive Care, La Maddalena, Palermo, Italy
| | - Paolo Marchetti
- Molecular and Clinical Medicine Medical Oncology, La Sapienza University of Rome, Rome, Italy
| | - Arturo Cuomo
- Anesthesiology, Resuscitation, and Pain Therapy Department, National Cancer Institute, IRCCS Foundation Pascale, Naples, Italy
| | - Augusto Caraceni
- Palliative Care, Pain Therapy, and Rehabilitation, National Cancer Institute, IRCCS Foundation, Milan, Italy
| | | | - Renato Vellucci
- Palliative Care and Pain Therapy Unit, Careggi Hospital, Florence, Italy
| | | | - Silvia Natoli
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marzia Lazzari
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mario Dauri
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Claudio Adile
- Anesthesia and Intensive Care and Pain Relief and Supportive Care, La Maddalena, Palermo, Italy
| | - Mario Airoldi
- Second Medical Oncology Division, Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Giuseppe Azzarello
- Medical Specialties Department, Oncology and Oncologic Hematology, ASL 13 Mirano, Venice, Italy
| | - Livio Blasi
- Medical Oncology Unit, ARNAS Ospedale Civico Di Cristina Benfratelli, Palermo, Italy
| | | | | | - Flavio Fusco
- Palliative Care Unit, Department of Primary and Community Care, ASL 3 Genovese, Genoa, Italy
| | - Vittorio Guardamagna
- Palliative Care and Pain Therapy Unit, European Oncology Institute IRCCS, Milan, Italy
| | - Simeone Liguori
- Palliative Care and Pain Therapy Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Loredana Palermo
- Medical Oncology Unit, National Cancer Research Center "Giovanni Paolo II", Bari, Italy
| | - Sergio Mameli
- Pain Therapy Unit, "A. Businco" Hospital, ASL 8, Cagliari, Italy
| | - Francesco Masedu
- Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L'Aquila, L'Aquila, Italy
| | - Teresita Mazzei
- Section of Clinical Pharmacology and Oncology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Rita Maria Melotti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | | | - Danilo Miotti
- Pain Therapy ICS Maugeri, IRCCS Foundation, Pavia, Italy
| | - Stefano Moroso
- Medical Oncology, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Gaetano Pascoletti
- Medical Oncology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Stefano De Santis
- Palliative Care and Oncologic Pain Service, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Remo Orsetti
- Pain Medicine Unit, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Alfonso Papa
- Pain Relief, A.O. Dei Colli, Monaldi Hospital, Naples, Italy
| | - Sergio Ricci
- Division of Medical Oncology, Department of Oncology, S. Chiara University Hospital, Pisa, Italy
| | - Elvira Scelzi
- Medical Oncology, Castelfranco Veneto Hospital, Treviso, Italy
| | - Michele Sofia
- Department of Palliative Care, Hospice and Pain Therapy Unit, "G. Salvini" Hospital, Milan, Italy
| | - Federica Aielli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Giuseppe Tonini
- Medical Oncology Department, Campus Bio-Medico University of Rome, Rome, Italy
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23
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Garrone O, Giarratano T, Michelotti A, Saggia C, D'Onofrio L, Merlini L, Blondeaux E, Beano A, Coltelli L, Cazzaniga M, Montemurro F, Farnesi A, La Verde N, Vandone A, Collovà E, Blasi L, Ardito R, DeConciliis E, Airoldi M, Merlano M. 290P From the CLEOPATRA study to real life: Final results from the G.O.N.O. SUPER trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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24
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Negru M, Tondini C, Pastorino A, Caccese M, Cariello A, Bertolini A, Buzzatti G, Cinieri S, Comandone A, Grossi F, Franchini M, Caffo O, Garrone O, Mambrini A, Leone F, Chini C, Agustoni F, Artioli F, Blasi L, Aschele C. 1705P SARS-CoV-2 infection among cancer patients receiving antitumor treatment in Italy: A nationwide observational study (CIPOMO ONCO COVID-19). Ann Oncol 2020. [PMCID: PMC7506478 DOI: 10.1016/j.annonc.2020.08.1769] [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: 12/01/2022] Open
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25
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Gebbia V, Bordonaro R, Blasi L, Piazza D, Pellegrino A, Iacono C, Spada M, Tralongo P, Firenze A. Liability of clinical oncologists and the COVID-19 emergency: Between hopes and concerns. J Cancer Policy 2020; 25:100234. [PMID: 32562478 PMCID: PMC7282757 DOI: 10.1016/j.jcpo.2020.100234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 04/23/2020] [Revised: 05/11/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022]
Abstract
To contain COVID-19 spread, Italy is under a global lockdown except for health services and food supply. In this scenario, growing apprehension concerning legal consequences is rising among health professionals. Hospitals and health professionals are highly exposed to liability. More articulated legal regulations are strongly needed.
To contain COVID-19 spread, Italy is under a global lockdown since February 21, 2020, except for health services and food supply. In this scenario, growing apprehension concerning legal consequences is rising among health professionals due to several ethical and legal questions. Even if medical ethicists may approve patients’ prioritization protocols, hospitals and health professionals remain highly exposed to liability. The so-called smart-working may be very useful, but it may harbor potential legal harms for health personnel and patients and safety. Moreover, personal umbrella policies also often exclude liability arising out of the transmission of a communicable disease, especially a pandemic state, is declared. Under the pressure of medical associations, Italian Government political forces have very recently presented an amendment to the recently released ordinances for the COVID-19 emergency aimed to reduce medical liability. Presumably, similar epidemics or other wide-scale similar events may happen again in an unpredictable future. Therefore, more articulated legal regulations are strongly needed starting from lessons learned from this epidemic.
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Affiliation(s)
- Vittorio Gebbia
- Medical Oncology Unit, La Maddalena Clinic for Cancer, Chair of Medical Oncology, Department Promise, University of Palermo, Italy.,Consultant at the Labor Court, Palermo, Italy
| | | | - Livio Blasi
- Medical Oncology Unit, Ospedale Civico, Arnas, Palermo, Italy
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26
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Indini A, Aschele C, Cavanna L, Clerico M, Daniele B, Fiorentini G, Fioretto L, Giordano M, Montesarchio V, Ortega C, Pinotti G, Scanni A, Zamagni C, Blasi L, Grossi F. Reorganisation of medical oncology departments during the novel coronavirus disease-19 pandemic: a nationwide Italian survey. Eur J Cancer 2020; 132:17-23. [PMID: 32311643 PMCID: PMC7136865 DOI: 10.1016/j.ejca.2020.03.024] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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: 03/31/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 12/30/2022]
Abstract
The novel severe acute respiratory syndrome coronavirus-2 pandemic is a global health problem, which started to affect China by the end of 2019. In Europe, Italy has faced this novel disease entity (named novel coronavirus disease [COVID-19]) first and severely. COVID-19 represents a significant hurdle for public health services and a potential harm for patients with cancer. The Collegio Italiano dei Primari Oncologi Medici (CIPOMO) is an Italian association of head physicians in oncology departments, which promotes working and research activities in oncology on a national basis. In the midst of the epidemic in Italy, the CIPOMO promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of oncologists and the implementation of containment measures of COVID-19 diffusion. Overall, 122 head physicians participated in this survey, with a homogeneous distribution on the national territory. Results show that the following measures for oncologic patients have been promptly implemented through the whole country: use of protective devices, triage of patients accessing the hospital, delay of non-urgent visits and use of telemedicine. Results of this survey suggest that Italian oncology departments have promptly set a proactive approach to the actual emergency. Oncologists need to preserve the continuum of care of patients, as the benefit of ensuring a well-delivered anti-cancer treatment plan outweighs the risk of COVID-19 infection. International cooperation is an important starting point, as heavily affected nations can serve as an example to find out ways to safely preserve health activity during the pandemic.
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Affiliation(s)
- Alice Indini
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carlo Aschele
- Medical Oncology Department, Ospedale Sant'Andrea, La Spezia, Italy
| | - Luigi Cavanna
- Oncology-Hematology Department, Hospital of Piacenza, Piacenza, Italy
| | - Mario Clerico
- Medical Oncology Department ASL Biella, Biella, Italy
| | | | - Giammaria Fiorentini
- Department of Oncology and Hematology, Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Luisa Fioretto
- Department of Oncology, SM Annunziata Hospital, Florence, Italy
| | | | | | - Cinzia Ortega
- Department of Medical Oncology, Ospedale S. Lazzaro ASL CN2 Alba-Bra, Cuneo, Italy
| | | | - Alberto Scanni
- Department of Medical Oncology, Fatebenefratelli e Oftalmico Hospital, Milan, Italy
| | - Claudio Zamagni
- Medical Oncology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - Livio Blasi
- Medical Oncology Unit, ARNAS Civico, Palermo, Italy
| | - Francesco Grossi
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Blasi L, Bordonaro R, Borsellino N, Butera A, Caruso M, Cordio S, Liborio DC, Ferraù F, Giuffrida D, Parra HS, Spada M, Tralongo P, Valenza R, Verderame F, Vitello S, Zerilli F, Piazza D, Firenze A, Gebbia V. Reactions and countermeasures of medical oncologists towards the incoming COVID-19 pandemic: a WhatsApp messenger-based report from the Italian College of Chief Medical Oncologists. Ecancermedicalscience 2020; 14:1046. [PMID: 32565899 PMCID: PMC7289620 DOI: 10.3332/ecancer.2020.1046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/23/2020] [Indexed: 12/30/2022] Open
Abstract
Background This descriptive, unplanned investigation has been undertaken to report reactions, attitudes and countermeasures which have been put in place and implemented by medical oncology units facing the COVID-19 outbreak in Southern Italy. Materials and methods Data have been retrospectively obtained from the time-related analysis of conversations via a WhatsApp messenger-based group chat between the medical directors belonging to the Italian College of Medical Oncology Directors. Overall number, intensity and time trend of conversations related to reactions during the 4 weeks of observation related to the crucial events which occurred between 24 February and 28 March, 2020 2020 are included. A sentiment analysis of conversations was also carried out. Results We report 956 conversations among 19 medical oncology units related to reactions to the crucial events, such as epidemic spread, Government ordinances and guidelines during the 4 weeks of observation. Data show significant awareness of problems linked to the COVID-19 spread among oncologists and rapid diffusion of countermeasures. Actions taken were correlated time wise to crucial events. A correlation between conversations and the volume of activity of oncology units was found. By analysing the sentiment analysis of raw data, positive emotions were reduced in percentage over the weeks. A significant increase in negative emotions was observed as the outbreak impacted on the healthcare system. Conclusion In our experience, the WhatsApp instant-messaging system seems to be a useful tool to share news and reactions between medical oncologists to rapidly implement necessary health measures and answers to most cancer patients' needs and queries in the COVID-19 pandemic scenario.
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Affiliation(s)
- Livio Blasi
- Medical Oncology Unit, Arnas, Ospedale Civico, Palermo, 90100, and National President of CIPOMO, Italy
| | - Roberto Bordonaro
- Medical Oncology Unit, Arnas, Ospedale Garibaldi, Catania, 95100, Italy
| | - Nicolò Borsellino
- Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo, 90100, Italy
| | - Alfredo Butera
- Medical Oncology Unit, Ospedale San Giovanni di Dio, Agrigento, 92100, Italy
| | - Michele Caruso
- Medical Oncology Unit, Istituto Clinico Humanitas, Catania, 95100, Italy
| | - Stefano Cordio
- Medical Oncology Unit, Ospedale Paterno Arezzo, Ragusa, 97100, Italy
| | - Di Cristina Liborio
- Medical Oncology Unit, Ospedale Vittorio Emanuele, Castelvetrano, 91022, Italy
| | - Francesco Ferraù
- Medical Oncology Unit, Ospedale San Vincenzo, Taormina, 98039, Italy
| | - Dario Giuffrida
- Medical Oncology Unit, Istituto Oncologico Mediterraneo, Viagrande, 95029, Italy
| | | | | | - Paolo Tralongo
- Medical Oncology Unit, Ospedale Umberto I, Siracusa, 96100, Italy
| | - Roberto Valenza
- Medical Oncology Unit, Ospedale Vittorio Emanuele, Gela, 93012, Italy
| | | | - Stefano Vitello
- Medical Oncology Unit, Ospedale Sant'Elia, Caltanissetta, 93100, Italy
| | - Filippo Zerilli
- Medical Oncology Unit, Ospedale San Antonio Abate, Trapani, 91100, Italy
| | | | | | - Vittorio Gebbia
- Medical Oncology Unit, Ospedale La Maddalena, University of Palermo, Palermo, 90100, Italy
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De Luca R, Meraviglia S, Blasi L, Maiorana A, Cicero G. Nivolumab in metastatic melanoma: good efficacy and tolerability in elderly patients. ACTA ACUST UNITED AC 2020; 27:e75-e80. [PMID: 32489255 DOI: 10.3747/co.27.5293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Nivolumab is an anti-PD-1 antibody that restores the antitumour immune function of T cells, blocking the binding of PD-1 with its ligand PD-L1. PD-1 is expressed on T cells and interacts with PD-L1 on tumour cells. The PD-1-PD-L1 link inhibits T cell activation. In metastatic melanoma, PD-1-PD-L1 binding plays a critical role, and the advent of the immune checkpoint inhibitor nivolumab has delivered new and effective treatment options with proven clinical benefit. In the present study, we evaluated the efficacy of nivolumab in elderly patients with metastatic melanoma. Methods The study enrolled 55 elderly patients (75 years of age and older) with a diagnosis of metastatic melanoma. Primary endpoints of the study were progression-free survival (pfs) and the objective response rate; secondary endpoints were overall survival, reduction in serum lactate dehydrogenase (ldh) from before to after treatment, and tolerability. Results Nivolumab was well tolerated and resulted in good disease control, with a manageable toxicity profile and significant clinical benefit. The duration of pfs was 5.1 months (95% confidence interval: 3.5 months to 6.8 months). A significant correlation was observed between reduction in serum ldh and pfs: 0.60 (95% confidence interval: 0.28 to 0.86; p = 0.002). Conclusions Nivolumab is an immunotherapy treatment that has proved to be an effective and well-tolerated therapeutic option in elderly patients with metastatic melanoma.
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Affiliation(s)
- R De Luca
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - S Meraviglia
- Central Laboratory of Advanced Diagnosis and Biomedical Research, Palermo, Italy
| | - L Blasi
- Medical Oncology Unit, arnas Ospedali Civico Di Cristina Benfratelli, Palermo, Italy
| | - A Maiorana
- Department of Surgical, Oncological and Oral Sciences, Section of Surgical Oncology, University of Palermo, Palermo, Italy
| | - G Cicero
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
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Cazzaniga ME, Verusio C, Ciccarese M, Fumagalli A, Sartori D, Valerio MR, Airoldi M, Moretti G, Ficorella C, Gianni L, Michelotti A, Zambelli A, Febbraro A, Generali D, Pistelli M, Garrone O, Musolino A, Vici P, Maur M, Mentuccia L, La Verde N, Bianchi GV, Artale S, Blasi L, De Laurentiis M, Atzori F, Turletti A, Porpiglia M, Santini D, Fabi A, Gebbia V, Schirone A, Palumbo R, Ferzi A, Frassoldati A, Scavelli C, Clivio L, Giordano M, Donadio M, Biganzoli L, Del Mastro L, Bisagni G, Livi L, Natoli C, Montemurro F, Riccardi F, Romagnoli E, Marchetti P, Torri V, Pronzato P, Mustacchi G. Is There Still a Role for Endocrine Therapy Alone in HR+/HER2- Advanced Breast Cancer Patients? Results from the Analysis of Two Data Sets of Patients Treated with High-Dose Fulvestrant as First-Line Therapy in the Real-World Setting: The EVA and GIM-13 AMBRA Studies. Breast Care (Basel) 2020; 15:30-37. [PMID: 32231495 DOI: 10.1159/000495469] [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: 07/23/2018] [Accepted: 11/15/2018] [Indexed: 11/19/2022] Open
Abstract
Background Different studies suggest that fulvestrant 500 mg every 28 days (HD-FUL) could be an active treatment in HR+ advanced breast cancer (ABC) patients even treated with aromatase inhibitors in the adjuvant setting. The aim of this analysis is to describe the outcome of ABC patients treated with HD-FUL as first-line treatment in terms of median duration of treatment and the overall response rate in a real-world setting. Methods For the purpose of the present analysis, we considered two data sets of HR+ ABC patients collected in Italy between 2012 and 2015 (EVA and GIM-13 AMBRA studies). Results Eighty-one and 91 patients have been identified from the two data sets. The median age was 63 years (range 35-82) for the EVA and 57.8 years (range 35.0-82.3) for the AMBRA patients. ORRs were 23.5 and 24.3% in the whole population, 26.9% in the patients with bone only, and 21.8 and 21.4% in those with visceral metastases. The median duration of HD-FUL was 11.6 months (range 1-48) and 12.4 months (range 2.9-70.0) in the two data sets, respectively. Conclusion These data suggest that HD-FUL should still continue to play a significant role as first-line therapy in HR+ ABC patients.
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Affiliation(s)
- Marina Elena Cazzaniga
- Research Unit Phase I Trials, ASST Monza, Monza, Italy.,Oncology Unit, ASST Monza, Monza, Italy
| | - Claudio Verusio
- Oncology Unit, ASST della Valle Olona - Presidio Ospedaliero di Saronno, Saronno, Italy
| | | | | | | | | | - Mario Airoldi
- Oncology Unit 2 - Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gabriella Moretti
- Oncology Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Corrado Ficorella
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche (DISCAB) - Università Degli Studi Dell'Aquila, L'Aquila, Italy
| | - Lorenzo Gianni
- Oncology Unit Rimini, Azienda USL Romagna, Rimini, Italy
| | - Andrea Michelotti
- Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | - Antonio Febbraro
- Oncology Unit, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Italy
| | | | - Mirco Pistelli
- Oncology Unit, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Ornella Garrone
- Oncology Unit, A.O.S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Antonino Musolino
- Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Patrizia Vici
- Oncology Unit 2, Istituto Nazionale Tumori Regina Elena - IFO, Rome, Italy
| | - Michela Maur
- Oncology Unit, Policlinico University Hospital of Modena, Modena, Italy
| | - Lucia Mentuccia
- Oncology Unit, ASL di Frosinone, Osp. "SS. Trinità", Sora, Italy
| | - Nicla La Verde
- Oncology Unit, ASST Fatebenefratelli Sacco Presidio Ospedaliero Fatebenefratelli, Milan, Italy
| | | | - Salvatore Artale
- Oncology Departement, Ospedale di Gallarate, ASST Valle Olona, Gallarate, Italy
| | - Livio Blasi
- Oncology Unit, ARNAS Civico Palermo, Palermo, Italy
| | | | | | | | - Mauro Porpiglia
- Oncology Unit, ASST della Valle Olona - Presidio Ospedaliero di Saronno, Saronno, Italy
| | | | - Alessandra Fabi
- Oncology Unit, Ospedale Moriggia Pelascini, Gravedona, Italy
| | | | - Alessio Schirone
- Oncology Department, Policlinico "Paolo Giaccone", Palermo, Italy
| | - Raffaella Palumbo
- Oncology Unit 2 - Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonella Ferzi
- Oncology Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Antonio Frassoldati
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche (DISCAB) - Università Degli Studi Dell'Aquila, L'Aquila, Italy
| | | | - Luca Clivio
- Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | - Michela Donadio
- Oncology Unit, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Italy
| | | | | | - Giancarlo Bisagni
- Oncology Unit, A.O.S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Lorenzo Livi
- Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Clara Natoli
- Oncology Unit 2, Istituto Nazionale Tumori Regina Elena - IFO, Rome, Italy
| | | | | | - Emanuela Romagnoli
- Oncology Unit, ASST Fatebenefratelli Sacco Presidio Ospedaliero Fatebenefratelli, Milan, Italy
| | - Paolo Marchetti
- Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Valter Torri
- Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Paolo Pronzato
- Oncology Departement, Ospedale di Gallarate, ASST Valle Olona, Gallarate, Italy
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Cremolini C, Antoniotti C, Rossini D, Lonardi S, Loupakis F, Pietrantonio F, Bordonaro R, Latiano TP, Tamburini E, Santini D, Passardi A, Marmorino F, Grande R, Aprile G, Zaniboni A, Murgioni S, Granetto C, Buonadonna A, Moretto R, Corallo S, Cordio S, Antonuzzo L, Tomasello G, Masi G, Ronzoni M, Di Donato S, Carlomagno C, Clavarezza M, Ritorto G, Mambrini A, Roselli M, Cupini S, Mammoliti S, Fenocchio E, Corgna E, Zagonel V, Fontanini G, Ugolini C, Boni L, Falcone A, Falcone A, Lonardi S, De Braud FGM, Bordonaro R, Maiello E, Tamburini E, Santini D, Frassineti GL, Gamucci T, Aprile G, Zaniboni A, Granetto C, Buonadonna A, Di Costanzo F, Tomasello G, Gianni L, Di Donato S, Carlomagno C, Clavarezza M, Racca P, Mambrini A, Roselli M, Allegrini G, Sobrero A, Aglietta M, Corgna E, Cortesi E, Corsi DC, Ballestrero A, Bonetti A, Di Clemente F, Ruggeri E, Ciardiello F, Benasso M, Vitello S, Cinieri S, Mosconi S, Silvestris N, Frassoldati A, Cupini S, Bertolini A, Tortora G, Bengala C, Ferrari D, Ardizzoia A, Milandri C, Chiara S, Romano G, Miraglia S, Scaltriti L, Pucci F, Blasi L, Brugnatelli S, Fioretto L, Ribecco AS, Longarini R, Frisinghelli M, Banzi M. Upfront FOLFOXIRI plus bevacizumab and reintroduction after progression versus mFOLFOX6 plus bevacizumab followed by FOLFIRI plus bevacizumab in the treatment of patients with metastatic colorectal cancer (TRIBE2): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol 2020; 21:497-507. [DOI: 10.1016/s1470-2045(19)30862-9] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 01/07/2023]
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Mustacchi G, Beano A, Fabi A, Livi L, Bernardo A, Riccardi F, Marchetti P, Garrone O, Diodati L, Biganzoli L, Giordano M, Turletti A, Blasi L, Milani A, Natoli C, Riemma M, D'Alonzo A, Arpino G, Pronzato P, Cazzaniga ME. Abstract P2-15-14: Triple negative (TNBC) metastatic breast cancer (MBC) patients (pts): Is chemotherapy (CHT) choice influenced by adjuvant (adj) treatments? Results from the GIM-13 AMBRA study. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-15-14] [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]
Abstract
Abstract
Background: TNBC shows a very bad prognosis: median time to relapse is 18 months and median overall survival (OS) is less than 24 months.
Methods: AMBRA is a longitudinal cohort study, describing the choice of 1st- and subsequent treatments in HER2-ve MBC pts in the years 2012-2015. The present analysis is focused on TNBC pts (127 out of 879 evaluable; 14.4%) and CHT strategies, overall and according to adj treatment. Kaplan Meyer probability of survival from primary (DFS), 1st(PFS1) and 2nd(PFS2) progression and Time from last CHT and death were calculated for the whole population and according the main adj regimens.
Results: Median age at primary diagnosis was 53 years. The most used regimens in the adj setting were anthra/taxane(tax) 50.7%, anthra 22.1% or others (CMF included) 20.6%. Median time to events was: DFS 23.2, PFS1 6.5 and PFS2 4.3 months, respectively.
CHT choices in the metastatic setting according to adj treatment were:
Adj Anthra-basedAdj Taxane-basedAdj other1st-lineTax* 57.6% - VRL/CAPE 18.2% - Plat 15.2% Other 3% - None 6.1%Tax* 46.2% - VRL/CAPE 24.6% Plat 24.6% - Other 4.6%Tax*52% - VRL/CAPE 16% - Anthra 16% - Anthra/Tax 8%2nd-lineTax**18.2% - Anthra 13.6% - VRL/CAPE 22.7% - Plat 27.3% - Erib 9.1% - Other 9.1%Tax**22% - VRL/CAPE 22% Plat 22% - Erib 14.6% - Other 17.1%VRL/CAPE 38.5% - Anthra 23.1% - Tax**23.1% - Plat 15.4%3rd lineVRL/CAPE 37.5% - Erib 25% - Anthra 18.8% - Tax***12.5% - Plat 6.3%Erib 26.9% - VRL/CAPE 23.1% - Plat 15.4% - Anthra 11.5% - Tax***11.5% - Other 11.5%VRL/CAPE 42.9% - Erib 28.6% - Plat 14.3% - Other 14.3%*docetaxel 8.4%, nab-paclitaxel 7%, paclitaxel 59%**docetaxel 7%, nab-paclitaxel 71.4%, paclitaxel 21%***docetaxel 20%, nab-paclitaxel 80%At a median follow up of 3.3 years 50% of pts are still alive.
OS rates at 5 and 8 years from primary are 50% and 40%. OS rates from 1st progression are 50% and 20% at 22 and 40 months. Median OS (months) according to 1st line regimen was similar (ns) across the regimens (paclitaxel+bevacizumab: 17.8; Platinum-based: 14.1; CAPE/VRL: 16.3). Median time from last CHT and death was 1.5 months (29.6%< 1 month; 14% < 2 weeks)
Conclusion: Our results show that taxanes play a crucial role in MBC even if used in 50% of Adj. CAPE/VRL, Platinum regimens and Eribuline are also widely used. Time from last CHT administration and Death is very short in 30% of cases
Citation Format: Giorgio Mustacchi, Alessandra Beano, Alessandra Fabi, Lorenzo Livi, Antonio Bernardo, Ferdinando Riccardi, Paolo Marchetti, Ornella Garrone, Lucrezia Diodati, Laura Biganzoli, Monica Giordano, Anna Turletti, Livio Blasi, Andrea Milani, Clara Natoli, Marta Riemma, Alessia D'Alonzo, Grazia Arpino, Paolo Pronzato, Marina E Cazzaniga, on behalf of GIM-13 AMBRA Study Group. Triple negative (TNBC) metastatic breast cancer (MBC) patients (pts): Is chemotherapy (CHT) choice influenced by adjuvant (adj) treatments? Results from the GIM-13 AMBRA study [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-15-14.
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Affiliation(s)
| | - Alessandra Beano
- 2A.O.U. Città della Salute e della Scienza- SSCVD Oncologia Medica Senologica, Torino, Italy
| | - Alessandra Fabi
- 3Istituto Nazionale Tumori “Regina Elena”- Oncologia Medica 1, Roma, Italy
| | - Lorenzo Livi
- 4AOU Careggi - Radioterapia Oncologica, Firenze, Italy
| | | | | | | | - Ornella Garrone
- 8Breast Unit, Medical Oncology S.Croce and Carle Teaching Hospital Cuneo, Trieste, Italy
| | - Lucrezia Diodati
- 9Azienda Ospedaliera Universitaria Pisana- Oncologia Medica, Pisa, Italy
| | - Laura Biganzoli
- 10Ospedale Santo Stefano- U.O. Oncologia Medica, Prato, Italy
| | | | | | - Livio Blasi
- 13ARNAS Civico Palermo-Oncologia Medica, Palermo, Italy
| | - Andrea Milani
- 14Candiolo Cancer Institute, FPO-IRCCS, Torino, Italy
| | - Clara Natoli
- 15Dep. of Medical, Oral and Biotechnological Sciences and CeSI-MeT- University G. D'Annunzio, Chieti, Italy
| | - Marta Riemma
- 16INT Fondazione Giovanni Pascale-IRCCS -Breast Oncology Unit, Napoli, Italy
| | - Alessia D'Alonzo
- 17Ospedale Policlinico San Martino- Oncologia Medica, Genova, Italy
| | - Grazia Arpino
- 18Università degli Studi di Napoli "Federico II"-Dip. Medicina Clinica e Chirurgia – Oncologia, Napoli, Italy
| | - Paolo Pronzato
- 17Ospedale Policlinico San Martino- Oncologia Medica, Genova, Italy
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Adamo V, Ricciardi GRR, Giuffrida D, Scandurra G, Russo A, Blasi L, Spadaro P, Iacono C, Soto Parra HJ, Savarino A, Ferraú F, Zerilli F, Verderame F, Butera A, Santangelo C, Franchina V, Caruso M. Eribulin mesylate use as third-line therapy in patients with metastatic breast cancer (VESPRY): a prospective, multicentre, observational study. Ther Adv Med Oncol 2019; 11:1758835919895755. [PMID: 31903098 PMCID: PMC6923689 DOI: 10.1177/1758835919895755] [Citation(s) in RCA: 10] [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: 03/29/2019] [Accepted: 11/15/2019] [Indexed: 11/15/2022] Open
Abstract
Background In real-world practice, eribulin mesylate provides significant survival benefit, with a manageable safety profile in heavily pretreated patients with metastatic breast cancer (MBC). Methods In this prospective, open-label, multicentre, observational study we evaluated the effectiveness and tolerability of eribulin as third-line treatment in a homogeneous population. The primary endpoints were the safety profile and response in metastatic sites; secondary endpoints included the response in different subtypes, overall response rate (ORR), progression-free survival (PFS) and overall survival (OS). Results From 2013 to 2016, 118 women were treated in 21 Sicilian institutions; the median age was 58 years (range 29-79), with 69% of patients under 65. The median cycles of eribulin were 5.5 (range 1-26). The most common adverse event was neutropenia (9.3%, 3 cases of grade 3, 4 of grade 4); only 1 case of QT prolongation was reported. Eribulin was effective in controlling metastatic disease in all sites, and it achieved the highest ORR in brain (16%) and liver (14.9%). Median OS was 31.8 months (95% CI 27.9-34.4) and median PFS 5.5 months (95% CI 4.2-6.6). PFS was 5.2 months (95% CI 2.8-8.4) in patients with triple-negative subtype. Median PFS was longer in patients over 65 years (6.1 months, 95% CI 4.4-8.3). In patients who had visceral metastases PFS was 5.5 months (95% CI 95% 3.5-6.6) and OS 33.9 months (95% CI 29.8-40.8). Conclusions Eribulin as third-line treatment shows an acceptable safety profile and a substantial antitumour activity in the treatment of MBC, even in elderly patients and in those with visceral disease.
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Affiliation(s)
- Vincenzo Adamo
- Medical Oncology Unit A.O. Papardo and Department of Human Pathology University of Messina, Contrada Papardo, Messina, Italy
| | | | - Dario Giuffrida
- Department of Medical Oncology, Mediterranean Institute of Oncology, Viagrande, CT, Italy
| | | | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Livio Blasi
- UOC Oncologia Medica, ARNAS Civico, Palermo, Piazza Nicola Leotta, Italy
| | - Pietro Spadaro
- U.O. di Oncologia ed Ematologia, Casa di Cura Villa Salus, Messina, Italy
| | - Carmelo Iacono
- Medical Oncology Department, Ospedale Maria Paterno Arezzo, Ragusa, Italy
| | - Hector J Soto Parra
- Medical Oncology Department, University Hospital Policlinico Vittorio Emanuele, Catania, Italy
| | - Antonino Savarino
- Unità Operativa di Oncologia, Ospedale "Barone Lombardo" di Canicattì, Contrada Giarre, Canicattì, AG, Italy
| | - Francesco Ferraú
- Medical Oncology Department, Ospedale S Vincenzo, Taormina, ME, Italy
| | | | | | | | | | - Veronica Franchina
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology University of Messina, Contrada Papardo, Messina, Italy
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Cazzaniga M, Pronzato P, Del Mastro L, Natoli C, Montemurro F, Bisagni G, Blasi L, Turletti A, Giordano M, Biganzoli L, Michelotti A, Garrone O, Marchetti P, Riccardi F, Bernardo A, Livi L, Cognetti F, Donadio M, Romagnoli E, Mustacchi G. Changes in hormone-receptor status in luminal breast cancers between primary tumour and metastases: Results of the observational cohort GIM-13 AMBRA study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cuccia F, Mortellaro G, Cespuglio D, Valenti V, DE Gregorio G, Quartuccio E, Blasi L, Francaviglia N, Gallo C, Lo Casto A, Ferrera G. A Case Report of Adult Pineoblastoma Occurring in a Pregnant Woman. Anticancer Res 2019; 39:2627-2631. [PMID: 31092461 DOI: 10.21873/anticanres.13386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 03/25/2019] [Revised: 04/13/2019] [Accepted: 04/19/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Pineoblastoma of the adult age is an uncommon tumor with only 200 cases reported. A standardized approach for an optimal adjuvant strategy is currently lacking. The case presented herein also deals with the issue of central nervous system tumors in pregnancy. CASE REPORT A 21-year-old pregnant woman presented with massive hydrocephalus due to a mass in the pineal region detected with MRI. After positioning an urgent ventricular derivation, a cesarean section was performed. During a third ventriculocisternostomy, a biopsy revealed a pineoblastoma. After a maximal safe resection, postoperative craniospinal irradiation for a total dose of 36 Gy plus a sequential boost to the tumor bed to 54 Gy, and adjuvant chemotherapy with CDDP plus CCNU plus vincristine were performed. After one year, the patient is alive with no evidence of disease. CONCLUSION The use of adjuvant radio-chemotherapy provided excellent outcomes in our case. The advanced gestational age facilitated the choice of the therapeutic strategy.
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Affiliation(s)
- Francesco Cuccia
- Radiation Oncology School, University of Palermo, Palermo, Italy
| | | | | | - Vito Valenti
- Radiation Oncology School, University of Palermo, Palermo, Italy
| | | | | | - Livio Blasi
- Oncology Unit, ARNAS Civico Hospital, Palermo, Italy
| | | | | | - Antonio Lo Casto
- Radiation Oncology School, Section of Radiological Sciences, DIBIMED, University of Palermo, Palermo, Italy
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Mustacchi G, Pronzato P, Arpino G, D'Alonzo A, Piezzo M, Natoli C, Milani A, Bologna A, Blasi L, De Placido S, Diodati L, Beano A, Romagnoli E, Cazzaniga ME. Triple-negative (TNBC) metastatic breast cancer (MBC) patients (pts): Is chemotherapy (CHT) choice influenced by adjuvant (adj) treatments? Results from the GIM-13 AMBRA study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e12549] [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: 11/20/2022] Open
Abstract
e12549 Background: TNBC shows a very bad prognosis: median time to relapse is 18 months and median overall survival (OS) is less than 24 months. Methods: AMBRA is a longitudinal cohort study, describing the choice of 1st- and subsequent treatments in HER2-ve MBC pts in the years 2012-2015. The present analysis is focused on TNBC pts (127 out of 879 evaluable; 14.4%) and CHT strategies, overall and according to adj treatment. Kaplan Meyer probability of survival from primary (DFS), 1st (PFS1) and 2nd (PFS2) progression and Time from last CHT and death were calculated for the whole population and according the main adj regimens. Results: Median age at primary diagnosis was 53 years. The most used regimens in the adj setting were anthra/taxane(tax) 50.7%, anthra 22.1% or others (CMF included) 20.6%). Median time to events was: DFS 23.2, PFS16.5 and PFS2 4.3 months, respectively. CHT choices in the metastatic setting according to adj treatment were: Conclusions: Our results show that taxanes play a crucial role in MBC even if used in 50% of Adj. CAPE/VRL, Platinum regimens and Eribuline are also widely used. Time from last CHT administration and Death is very short in 30% of cases[Table: see text]
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Affiliation(s)
| | - Paolo Pronzato
- San Martino- IST Ist Naz Per La Ricerca Sul Cancro, Genova, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, Oncology Division, University Federico II, Naples, Italy
| | - Alessia D'Alonzo
- Ospedale Policlinico San Martino- Oncologia medica, Genova, Italy
| | - Michela Piezzo
- Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" -Breast Oncology Unit, Naples, Italy
| | - Clara Natoli
- Department of Medical, Oral & Biotechnological Sciences University G. D’Annunzio, Chieti-Pescara, Chieti, Italy
| | - Andrea Milani
- Investigative Clinical Oncology - Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | | | - Livio Blasi
- Fondazione San Raffaele-Giglio, Palerio, Italy
| | - Sabino De Placido
- Oncology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | | | - Alessandra Beano
- Oncology Department Aou Città Della Salute e Della Scienza, Torino, Italy
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Cazzaniga ME, Blasi L, Pronzato P, Giordano M, Garrone O, Donadio M, Del Mastro L, Livi L, Natoli C, Michelotti A, Turletti A, Riccardi F, De Laurentiis M, Marchetti P, Montemurro F, Romagnoli E, De Placido S, Biganzoli L, Bologna A, Bria E, Mustacchi G. Abstract P4-13-04: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-13-04] [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]
Abstract
Abstract
This abstract was not presented at the conference.
Citation Format: Cazzaniga ME, Blasi L, Pronzato P, Giordano M, Garrone O, Donadio M, Del Mastro L, Livi L, Natoli C, Michelotti A, Turletti A, Riccardi F, De Laurentiis M, Marchetti P, Montemurro F, Romagnoli E, De Placido S, Biganzoli L, Bologna A, Bria E, Mustacchi G. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-13-04.
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Affiliation(s)
- ME Cazzaniga
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - L Blasi
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - P Pronzato
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - M Giordano
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - O Garrone
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - M Donadio
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - L Del Mastro
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - L Livi
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - C Natoli
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - A Michelotti
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - A Turletti
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - F Riccardi
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - M De Laurentiis
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - P Marchetti
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - F Montemurro
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - E Romagnoli
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - S De Placido
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - L Biganzoli
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - A Bologna
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - E Bria
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - G Mustacchi
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
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Cazzaniga M, Verusio C, Ciccarese M, Fumagalli A, Sartori D, Valerio MR, Airoldi M, Moretti G, Ficorella C, Arcangeli V, Diodati L, Zambelli A, Febbraro A, Generali D, Pistelli M, Garrone O, Musolino A, Vici P, Maur M, Mentuccia L, La Verde N, Bianchi G, Artale S, Blasi L, Piezzo M, Atzori F, Turletti A, Benedetto C, Cursano MC, Fabi A, Gebbia V, Schirone A, Palumbo R, Ferzi A, Frassoldati A, Scavelli C, Clivio L, Torri V. Correction 2: Everolimus (EVE) and exemestane (EXE) in patients with advanced breast cancer aged ≥ 65 years: new lessons for clinical practice from the EVA study. Oncotarget 2018; 9:36720-36721. [PMID: 30613355 PMCID: PMC6291174 DOI: 10.18632/oncotarget.26431] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Marina Cazzaniga
- Research Unit Phase I trials, ASST Monza, Monza, Italy.,Oncology Unit, ASST Monza, Monza, Italy
| | - Claudio Verusio
- Oncology Unit, ASST della Valle Olona-Presidio Ospedaliero di Saronno, Saronno, Italy
| | | | | | | | | | - Mario Airoldi
- Oncology Unit 2-Città della Salute e della Scienza di Torino, Torino, Italy
| | - Gabriella Moretti
- Oncology Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Corrado Ficorella
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche (DISCAB)-Università Degli Studi Dell'Aquila, L'Aquila, Italy
| | | | - Lucrezia Diodati
- Oncology Unit 2, Azienda Osp edaliera Universitaria Pisa via Roma 67, Pisa, Italy
| | | | - Antonio Febbraro
- Oncology Unit, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Italy
| | | | - Mirco Pistelli
- Oncology Unit, AOU Ospedali Riuniti Umberto I-GM Lancisi-G Salesi, Ancona, Italy
| | - Ornella Garrone
- Oncology Unit, AOS Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Antonino Musolino
- Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Patrizia Vici
- Oncology Unit 2, Istituto Nazionale Tumori Regina Elena-IFO, Roma, Italy
| | - Michela Maur
- Oncology Unit, Policlinico University Hospital of Modena, Modena, Italy
| | - Lucia Mentuccia
- Oncology Unit, ASL di Frosinone Osp. "SS. Trinità", Sora, Italy
| | - Nicla La Verde
- Oncology Unit, ASST Fatebenefratelli Sacco Presidio Ospedaliero Fatebenefratelli, Milano, Italy
| | - Giulia Bianchi
- Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Salvatore Artale
- Oncology Departement, Ospedale di Gallarate ASST Valle Olona, Gallarate, Italy
| | - Livio Blasi
- Oncology Unit, ARNAS Civico Palermo, Palermo, Italy
| | - Michela Piezzo
- National Cancer Institute "Fondazione Giovanni Pascale", Napoli, Italy
| | - Francesco Atzori
- Struttura Complessa di Oncologia Medica Azienda Ospedaliero-Universitaria Cagliari, Cagliari, Italy
| | - Anna Turletti
- Oncology Unit, Ospedale Martini della ASL Città di Torino, Torino, Italy
| | - Chiara Benedetto
- Dipartimento Universitario Ginecologia e Ostetricia 1, Ospedale S. Anna Torino, Turin, Italy
| | | | | | | | - Alessio Schirone
- Oncolgy Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Antonella Ferzi
- Oncology Unit, ASST OVEST Milanese, Presidio di Legnano, Legnano, Italy
| | | | | | - Luca Clivio
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Valter Torri
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
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Adamo V, Ricciardi G, Schifano S, Russo A, Gebbia V, Blasi L, Giuffrida D, Scandurra G, Savarino A, Butera A, Borsellino N, Verderame F, Caruso M. Nab-paclitaxel (nab-P) in metastatic breast cancer (MBC) in elderly patients: A real life setting (NEREIDE study). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cazzaniga M, Verusio C, Ciccarese M, Fumagalli A, Sartori D, Valerio MR, Ancona C, Airoldi M, Moretti G, Ficorella C, Arcangeli V, Diodati L, Zambelli A, Febbraro A, Generali D, Pistelli M, Garrone O, Musolino A, Vici P, Maur M, Mentuccia L, La Verde N, Bianchi G, Artale S, Blasi L, Piezzo M, Atzori F, Turletti A, Benedetto C, Cursano MC, Fabi A, Gebbia V, Schirone A, Palumbo R, Ferzi A, Frassoldati A, Scavelli C, Clivio L, Torri On Behalf Of The Eva Study Group V. Everolimus (EVE) and exemestane (EXE) in patients with advanced breast cancer aged ≥ 65 years: new lessons for clinical practice from the EVA study. Oncotarget 2018; 9:31877-31887. [PMID: 30159129 PMCID: PMC6112755 DOI: 10.18632/oncotarget.25874] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 07/12/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The present analysis focuses on real-world data of Everolimus-Exemestane in advanced HR+ve, HER2-ve elderly breast cancer patients (aged 65 years) included in the EVA study, with unique findings in those aged 70 years. METHODS Data are collected from clinical records and analysed according to age cut-off (< 65 years; 65 - 69 years and {greater than or equal to} 70 years). Relationship of analyzed variables with response were tested by mean of a Mantel-Haenszel chi square test. Time to event analysis was described by Kaplan Meier approach and association with baseline characteristics was analysed by stratified log-rank test and proportional hazard model. RESULTS From July 2013 to December 2015, the EVA study enrolled overall 404 pts. 154 patients out of 404 (38,1%) were aged {greater than or equal to} 65 years, of whom 87 were {greater than or equal to} 70 years. Median duration of EVE treatment was 28.5 weeks (95% CI 19.0 - 33.8) in patients aged 65-69 years and 24,4 weeks (95% CI 19,2 - 33,2) in those aged {greater than or equal to} 70 years. Fewer patients aged 65 years received the highest EVE Dose-Intensity (>7.5 mg/day) in comparison to younger patients (49,6% vs. 66,8%). Grade 3–4 toxicities occurred to 55 patients (35,7%), mainly stomatitis (10,9%), rash (5,8%) and non-infectious pneumonitis (NIP) (3,6%). Some toxicities, such as weight loss and anaemia were peculiarly observed in patients aged {greater than or equal to} 70 years. Five treatment-related deaths were collected (3,2%). CONCLUSIONS EVE-EXE combination remains one of the potential treatments in HR+ patients also for elderly ones.
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Affiliation(s)
- Marina Cazzaniga
- Research Unit Phase I trials, ASST Monza, Monza, Italy.,Oncology Unit, ASST Monza, Monza, Italy
| | - Claudio Verusio
- Oncology Unit, ASST della Valle Olona-Presidio Ospedaliero di Saronno, Saronno, Italy
| | | | | | | | | | - Cristina Ancona
- Oncology Department, Policlinico di Palermo Paolo Giaccone, Palermo, Italy
| | - Mario Airoldi
- Oncology Unit 2-Città della Salute e della Scienza di Torino, Torino, Italy
| | - Gabriella Moretti
- Oncology Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Corrado Ficorella
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche (DISCAB)-Università Degli Studi Dell'Aquila, L'Aquila, Italy
| | | | - Lucrezia Diodati
- Oncology Unit 2, Azienda Osp edaliera Universitaria Pisa via Roma 67, Pisa, Italy
| | | | - Antonio Febbraro
- Oncology Unit, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Italy
| | | | - Mirco Pistelli
- Oncology Unit, AOU Ospedali Riuniti Umberto I-GM Lancisi-G Salesi, Ancona, Italy
| | - Ornella Garrone
- Oncology Unit, AOS Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Antonino Musolino
- Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Patrizia Vici
- Oncology Unit 2, Istituto Nazionale Tumori Regina Elena-IFO, Roma, Italy
| | - Michela Maur
- Oncology Unit, Policlinico University Hospital of Modena, Modena, Italy
| | - Lucia Mentuccia
- Oncology Unit, ASL di Frosinone Osp. "SS. Trinità", Sora, Italy
| | - Nicla La Verde
- Oncology Unit, ASST Fatebenefratelli Sacco Presidio Ospedaliero Fatebenefratelli, Milano, Italy
| | - Giulia Bianchi
- Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Salvatore Artale
- Oncology Departement, Ospedale di Gallarate ASST Valle Olona, Gallarate, Italy
| | - Livio Blasi
- Oncology Unit, ARNAS Civico Palermo, Palermo, Italy
| | - Matilde Piezzo
- National Cancer Institute "Fondazione Giovanni Pascale", Napoli, Italy
| | - Francesco Atzori
- Struttura Complessa di Oncologia Medica Azienda Ospedaliero-Universitaria Cagliari, Italy
| | - Anna Turletti
- Oncology Unit, Ospedale Martini della ASL Città di Torino, Torino, Italy
| | - Chiara Benedetto
- Dipartimento Universitario Ginecologia e Ostetricia 1, Ospedale S. Anna Torino, Turin, Italy
| | | | | | | | - Antonio Schirone
- Oncolgy Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Antonella Ferzi
- Oncology Unit, ASST OVEST Milanese, Presidio di Legnano, Legnano, Italy
| | | | | | - Luca Clivio
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
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Berardi R, Antonuzzo A, Blasi L, Buosi R, Lorusso V, Migliorino MR, Montesarchio V, Zilembo N, Sabbatini R, Peri A. Practical issues for the management of hyponatremia in oncology. Endocrine 2018; 61:158-164. [PMID: 29417373 DOI: 10.1007/s12020-018-1547-y] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/23/2018] [Indexed: 12/28/2022]
Abstract
Hyponatremia is common in cancer patients and has a negative impact on outcomes and survival. Both the diagnosis and treatment of hyponatremia are challenging. Easy-to-use, practical guidelines are needed. The aim of this article is to discuss practical issues related to the diagnostic workup and management of hyponatremia, with particular attention to complex patients, such as those affected by neoplastic diseases. Admittedly, these patients may present several comorbidities, which may cause sodium alterations. In addition, multidrug therapy may precipitate serum sodium fall. An algorithm for the diagnosis and treatment of hyponatremia was also developed, based on the discussion of the results of a questionnaire completed by the authors and of the published recommendations/guidelines on hyponatremia. The goal was to produce an algorithm that was as simple as possible but still comprehensive, without compromising information completeness. Many explanatory notes were added with the aim of guiding clinicians throughout the management of complex patients with hyponatremia, such as those with cancer. The resulting algorithm and supporting literature are presented.
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Affiliation(s)
- Rossana Berardi
- Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I-GM Lancisi-G Salesi, via Conca 71, Ancona, 60126, Italy
| | - Andrea Antonuzzo
- Unit of Medical Oncology 1, Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori Pisa, Via Roma 67, Pisa, PI, 56126, Italy
| | - Livio Blasi
- Medical Oncology Unit, A.R.N.A.S. Civico, Palermo, Italy
| | - Roberta Buosi
- Department of Medical Oncology, Ospedale Santo Spirito, Via Giovanni Giolitti 2, Casale Monferrato, AL, 15033, Italy
| | - Vito Lorusso
- Department of Medical Oncology, National Cancer Research Centre "Giovanni Paolo II", Via Samuel F. Hahnemann 10, Bari, 70126, Italy
| | - Maria Rita Migliorino
- First Oncological Pulmonary Unit, San Camillo, High Specialization Hospital, Circonvallazione Gianicolense 87, Roma, RM, 00152, Italy
| | - Vincenzo Montesarchio
- Unit of Oncology, A.O.R.N. dei Colli "Ospedali Monaldi-Cotugno-CTO", Via Gaetano Quagliariello 54, Napoli, Italy
| | - Nicoletta Zilembo
- Fondazione IRCCS Istituto Nazionale dei Tumori, Medical Oncology 1, via Venezian 1, Milano, MI, 20133, Italy
| | - Roberto Sabbatini
- Department of Oncology and Haematology, AOU Policlinico di Modena, Via del Pozzo 71, Modena, MO, 41124, Italy
| | - Alessandro Peri
- Endocrine Unit, Department of Experimental and Biomedical Sciences "Mario Serio", Center for Research, Transfer and Higher Education on Chronic, Inflammatory, Degenerative and Neoplastic Disorders for the Development of Novel Therapies, University of Florence, Viale Pieraccini 6, Florence, 20139, Italy.
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De Luca R, Blasi L, Alù M, Gristina V, Cicero G. Clinical efficacy of nab-paclitaxel in patients with metastatic pancreatic cancer. Drug Des Devel Ther 2018; 12:1769-1775. [PMID: 29950811 PMCID: PMC6016012 DOI: 10.2147/dddt.s165851] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose Pancreatic carcinoma is the neoplasia with the major mortality, and main standard treatments in this cancer increase survival but do not lead to complete recovery of the patient. The aim of this study was to evaluate the efficacy of Abraxane® (nab-paclitaxel) in Italian patients with metastatic pancreatic cancer (MPC). Patients and methods We conducted a retrospective analysis of 80 patients. Overall survival (OS) was the primary end point for evaluating the efficacy of nab-paclitaxel in combination with gemcitabine treatment, while carbohydrate antigen 19-9 (CA 19-9) reduction, safety, progression-free survival (PFS), overall response rate and reduction in pain were secondary end points. Results The median OS was 8 months, and the median PFS was 5 months. A considerable difference in CA 19-9 before and after treatment was observed. Descriptive and correlation analyses were done to examine the relationship between CA 19-9 response and OS. Linear regression analysis between OS and CA 19-9 response revealed that CA 19-9 is an important predictor of OS, showing a positive correlation. Conclusion Nab-paclitaxel is a well-tolerated and effective treatment for patients affected by MPC. The drug showed an improved tolerability profile, significant pain relief and an increase in survival rate.
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Affiliation(s)
- Rossella De Luca
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Livio Blasi
- Medical Oncology Unit, ARNAS Hospital Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Massimiliano Alù
- Medical Oncology Unit, ARNAS Hospital Civico, Di Cristina, Benfratelli, Palermo, Italy
| | - Valerio Gristina
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Giuseppe Cicero
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
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Garrone O, Giarratano T, Saggia C, Bertolini I, Beano A, Blondeaux E, Riva F, D'Onofrio L, Merlini L, Coltelli L, La Verde NM, Vandone AM, Milani A, Collovà E, Ardito R, Airoldi M, De Conciliis E, Blasi L, Di Maio M, Merlano MC. Moving from the CLEOPATRA study to real life: Results from the G.O.N.O. SUPER trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13006] [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: 11/20/2022] Open
Affiliation(s)
- Ornella Garrone
- Medical Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | | | - Chiara Saggia
- Medical Oncology, A.O.U. Ospedale Maggiore della Carità, Novara, Italy
| | - Ilaria Bertolini
- Medical Oncology Unit II, Azienda Ospedaliera Universitaria, Pisa, Italy
| | - Alessandra Beano
- Oncology Department AOU Città della salute e della scienza, Torino, Italy
| | | | | | | | | | - Luigi Coltelli
- Medical Oncology Az USL NordOvest Toscana, Pontedera, Italy
| | - Nicla Maria La Verde
- ASST Fatebenefratelli Sacco PO Fatebenefratelli Deparment of Oncology, Milano, Italy
| | | | - Andrea Milani
- Investigative Clinical Oncology - Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | | | - Raffaele Ardito
- IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - Mario Airoldi
- 2nd Medical Oncology Division, A. O. Città della Salute e della Scienza di Torino, Torino, Italy
| | | | - Livio Blasi
- Medical Oncology ARNAS Civico di Cristina Benfratelli, Palermo, Italy
| | - Massimo Di Maio
- Medical Oncology Mauriziano Hospital, University of Torino, Torino, Italy
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Cazzaniga ME, Pronzato P, Meattini I, Biganzoli L, Taverniti C, Natoli C, De Placido S, Aversa C, Bordin E, Giordano M, Bologna A, Diodati L, Blasi L, Garrone O, Romagnoli E, Mocerino C, D'Alonzo A, Piezzo M, Mustacchi G. Validation of time to treatment change (TTC) as a surrogate end-point of progression free survival (PFS) for observational trials in metastatic breast cancer patients (MBC): The GIM-13 AMBRA study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13081] [Citation(s) in RCA: 1] [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)
| | - Paolo Pronzato
- San Martino- IST Ist Naz Per La Ricerca Sul Cancro, Genova, Italy
| | | | - Laura Biganzoli
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | | | - Clara Natoli
- Department of Experimental and Clinical Sciences, University, Chieti, Italy
| | | | - Caterina Aversa
- Medical Oncology I Fondazione del Piemonte per l'Oncologia Irccs Candiolo, Candiolo (Turin), Italy
| | - Elio Bordin
- ASL "Città di Torino" Ospedale Martini, Torino, Italy
| | | | | | | | - Livio Blasi
- Fondazione San Raffaele-Giglio, Palerio, Italy
| | - Ornella Garrone
- Medical Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | | | | | - Alessia D'Alonzo
- Ospedale Policlinico San Martino- Oncologia medica, Genova, Italy
| | - Michela Piezzo
- IRCCS INT Fondazione Giovanni Pascale - Breast Oncology Unit, Naples, Italy
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Mustacchi G, Pronzato P, D'Alonzo A, Mocerino C, Romagnoli E, Garrone O, Blasi L, De Laurentiis M, Michelotti A, Bologna A, Giordano M, Turletti A, Montemurro F, De Placido S, Natoli C, Taverniti C, Biganzoli L, Meattini I, Marchetti P, Cazzaniga ME. Nab-paclitaxel (Nab-P) in patients (pts) with HER2-ve advanced breast cancer (ABC): A focus on the elderly— Preliminary results of the GIM-13 AMBRA study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13078] [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: 11/20/2022] Open
Affiliation(s)
| | - Paolo Pronzato
- San Martino- IST Ist Naz Per La Ricerca Sul Cancro, Genova, Italy
| | - Alessia D'Alonzo
- Ospedale Policlinico San Martino- Oncologia medica, Genova, Italy
| | | | | | - Ornella Garrone
- Medical Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Livio Blasi
- Fondazione San Raffaele-Giglio, Palerio, Italy
| | | | - Andrea Michelotti
- Oncology Unit I, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | | | - Anna Turletti
- Medical Oncology, ASLTO1 Ospedale Martini, Torino, Italy
| | - Filippo Montemurro
- Investigative Clinical Oncology - Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | | | - Clara Natoli
- Department of Experimental and Clinical Sciences, University, Chieti, Italy
| | | | - Laura Biganzoli
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | | | - Paolo Marchetti
- S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Adamo V, Ricciardi G, Schifano S, Russo A, Gebbia V, Blasi L, Giuffrida D, Scandurra G, Savarino A, Butera A, Borsellino N, Verderame F, Caruso M. Safety and efficacy of the treatment with Nab-paclitaxel in mEtastaticbREast cancer In elDerlypatiEnts: NEREIDE Study. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30567-7] [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: 11/16/2022]
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La Verde N, Collovà E, Blasi L, Pinotti G, Bernardo A, Bonotto M, Garrone O, Brunello A, Cavazzini MG, Bareggi C, Prochilo T, Porcu L, Moretti A, Barni S. Abstract P1-14-04: Overall survival in metastatic breast cancer patients in the third millennium: Results of an Italian study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-14-04] [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]
Abstract
Abstract
BACKGROUND - Metastatic breast cancer (MBC) is a life-threatening disease. It is important to provide data about real-life MBC patients (pts) to understand the current prognostic factors. The aim of the present observational study, named COSMO (Checking Overall Survival in a MBC Observational study) is to describe the overall survival (OS) in a large cohort of MBC pts, assessing its correlation with specific prognostic factors (demographic, clinic, pathologic and biological).
PATIENTS AND METHODS - The COSMO study is a multicenter, retrospective, cohort study, developed throughout the collaboration of 31 Italian oncological centers. Data about pts diagnosed as metastatic from 01/01/2000 to 31/12/2008, were collected. The association between molecular subtypes, metastatic sites, disease free interval (DFI) and OS were assessed. Pts were classified in three subgroups, based on the biological characteristics of their tumor: luminal, HER2-positive (regardless of hormone receptor) and triple negative (TN). Metastatic sites were categorized as visceral versus non-visceral disease, only bone and central nervous system (CNS) metastases. DFI was calculated from diagnosis to first relapse only for M0 pts.
RESULTS - Of 3931 MBC pts enrolled in the study, 3720 were evaluable, with a median age of 61 years (interquartile range, IQR, 51-71). 1804 (62,1%) pts had a luminal disease, 691 (23,8%) HER2-positive, 410 (14.1%) TN. Median DFI was 3.2 years (IQR 1.7- 6.0). Regarding metastatic sites, pts with visceral disease were 2332 (63%); 826 (22,2%) pts had bone isolated metastases; in 306 (8,3%) pts, CNS metastases were reported. With a median follow up of 9 years (IQR 5.7-11.0) and 3098 (83.3%) recorded events, we founded a median OS of 2.8 years (95%CI: 2.7-2.9) years. OS was strictly depending from molecular subtypes with a better prognosis for HER2-positive versus luminal and TN MBC pts, median OS of 3.1 (95%CI 2.8-3.4), 3.0 (95%CI: 2.9-3.1) and 1.5 (95%CI: 1.3-1.7) years respectively (p-value<0.001). 525 (14,1%) pts received trastuzumab. Metastatic sites affect prognosis, with a better OS for bone disease (3.4 years, 95%CI: 3.1-3.6) versus visceral disease (2.2 years 95%CI: 2.0- 2.3). Brain metastasis correlate with the worst prognosis: OS of 1.5 years (95% CI: 0.8 – 1.7). Even DFI shows a correlation with prognosis: pts with DFI>2 years show a median OS of 3 years (95% CI: 2.9 – 3.2), while those with DFI<2 years have a median OS of 2.4 years (95% CI: 2.3-2.6); HR was 0.69 (95%CI: 0,62-0,76) for every five years of increase in DFI (p-value<0.001).
CONCLUSIONS - Molecular subtype is crucial for prognosis: HER2-positive subtype has the best prognosis, while TN subtype has the shorter OS. Having a longer DFI from diagnosis (>2 years) correlate with a better prognosis. Our study confirm that sites of metastasis affects outcome: visceral involvement correlates with poor prognosis and, particularly, pts with brain metastasis represent the worst subgroup, while pts with solely bone disease have the best prognosis. The COSMO study provides a view on the Italian landscape of MBC between 2000 and 2008, adding new insights about pts prognosis.
Citation Format: La Verde N, Collovà E, Blasi L, Pinotti G, Bernardo A, Bonotto M, Garrone O, Brunello A, Cavazzini MG, Bareggi C, Prochilo T, Porcu L, Moretti A, Barni S, On Behalf of COSMO Study Group. Overall survival in metastatic breast cancer patients in the third millennium: Results of an Italian study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-14-04.
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Affiliation(s)
- N La Verde
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - E Collovà
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - L Blasi
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - G Pinotti
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - A Bernardo
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - M Bonotto
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - O Garrone
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - A Brunello
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - MG Cavazzini
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - C Bareggi
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - T Prochilo
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - L Porcu
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - A Moretti
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
| | - S Barni
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, MI, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy; ASST Ovest Milanese, Legnano, MI, Italy; Istituti Clinici Scientifici Maugeri, Pavia, PV, Italy; ASST Bergamo Ovest Ospedale di Treviglio, Treviglio, BG, Italy; Fondazione Poliambulanza di Brescia, Brescia, BS, Italy; ASST-Settelaghi Varese, Varese, VA, Italy; Università degli Studi di Udine, Scuola di Specializzazione in Oncologia Medica, Udine, UD, Italy; S. Croce & Carle Teaching Hospital, Oncology, Cuneo, CN, Italy; IRCCS Istituto Oncologico Veneto, Padova, PD, Italy; ASST Mantova, AO Carlo Poma, Mantova, MN, Italy; ARNAS AO Ospedale Civico Cristina Benfratelli, Palermo, PA, Italy; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, MI, Italy
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Formica V, Ionta MT, Massidda B, Vessia G, Maiorino L, Casaretti R, Natale D, Barberis G, Filippelli G, Greco E, Blasi L, Mancarella S, Russo A, Barbato E, Di Lullo L, Roselli M. Predictive factors for 6 vs 12 cycles of Folfiri-Bevacizumab in metastatic colorectal cancer. Oncotarget 2018; 9:2876-2886. [PMID: 29416820 PMCID: PMC5788688 DOI: 10.18632/oncotarget.23355] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/01/2017] [Indexed: 11/30/2022] Open
Abstract
Early switching to de-intensified maintenance regimen is still a matter of debate in metastatic colorectal cancer (mCRC). The MARTHA trial, a S.I.C.O.G. phase III randomized trial, compared FOLOFIRI+bevacizumab (B) for 12 cycles (6 months) followed by B for up to 12 months (FOLFIRI +B*12 arm) vs FOLFIRI+B for 6 cycles (3 months) followed by capecitabine+B for 4 cycles followed by B for up to 12 months (FOLFIRI+B*6 arm). Chemotherapy-naïve mCRC patients were randomized, primary endpoint was progression free survival (PFS), with overall survival (OS) as a secondary endpoint. A novel analysis, the Death Pace Analysis (DPA), was performed to identify patients who benefited from a specific treatment. No PFS difference was seen in 198 enrolled patients (101 in FOLFIRI+B*12, 97 in FOLFIRI+B*6). A non-significant superior OS was observed for FOLFIRI+B*6 (HR 0.74, p 0.098). The DPA demonstrated that 14% of patients were identifiable as FOLFIRI+B*6-benefiting patients. According to a logistic regression analysis including 23 clinicopathological variables, baseline Hb was the only independent predictor of DPA-defined FOLFIRI+B*6-benefit status. Among patients with Hb ≤ 11.1 gr/dL a statistically significant prolonged OS was observed for FOLFIRI+B*6 over FOLFIRI+B*12 (median OS: 20.7 vs 12.6 months, respectively, HR 0.54, p 0.048). No survival difference was observed between arms in patients with Hb > 11.1. mCRC patients with low baseline Hb levels are better treated with FOLFIRI+B*6 first-line strategy. Possible biological explanations for this finding are being investigated.
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Affiliation(s)
- Vincenzo Formica
- Department of Systems Medicine, Medical Oncology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Maria Teresa Ionta
- Medical Oncology II, Azienda Ospedaliero, Universitaria di Cagliari, Cagliari, Italy
| | - Bruno Massidda
- Medical Oncology II, Azienda Ospedaliero, Universitaria di Cagliari, Cagliari, Italy
| | - Giacomo Vessia
- Oncologia Medica, Ospedale Della Murgia, Altamura, Italy
| | | | - Rossana Casaretti
- Istituto Nazionale per lo Studio e la Cura dei Tumori “Fondazione G. Pascale”- IRCCS, Naples, Italy
| | | | | | | | | | - Livio Blasi
- UOC Oncologia Medica, ARNAS Civico, Palermo, Italy
| | | | - Anna Russo
- Oncologia Medica, Policlinico “Paolo Giaccone”, Palermo, Italy
| | - Enrico Barbato
- Oncologia medica, Ospedale “ Moscati “ Aversa, Aversa, Italy
| | | | - Mario Roselli
- Department of Systems Medicine, Medical Oncology Unit, Tor Vergata University Hospital, Rome, Italy
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48
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Bronte G, Franchina T, Alù M, Sortino G, Celesia C, Passiglia F, Savio G, Laudani A, Russo A, Picone A, Rizzo S, De Tursi M, Gambale E, Bazan V, Natoli C, Blasi L, Adamo V, Russo A. The comparison of outcomes from tyrosine kinase inhibitor monotherapy in second- or third-line for advanced non-small-cell lung cancer patients with wild-type or unknown EGFR status. Oncotarget 2017; 7:35803-35812. [PMID: 26993607 PMCID: PMC5094963 DOI: 10.18632/oncotarget.8130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 01/21/2016] [Accepted: 02/28/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Second-line treatment for advanced non-small-cell lung cancer (NSCLC) patients includes monotherapy with a third-generation cytotoxic drug (CT) or a tyrosine kinase inhibitor (TKI). These options are the actual standard for EGFR wild-type (WT) status, as patients with EGFR mutations achieve greater benefit by the use of TKI in first-line treatment. Some clinical trials and meta-analyses investigated the comparison between CT and TKI in second-line, but data are conflicting. METHODS We designed a retrospective trial to gather information about TKI sensitivity in comparison with CT. We selected from clinical records patients treated with at least 1 line of CT and at least 1 line of TKI. We collected data about age, sex, performance status, comorbidity, smoking status, histotype, metastatic sites, EGFR status, treatment schedule, better response and time-to-progression (TTP) for each line of treatment and overall survival (OS). RESULTS 93 patients met selection criteria. Mean age 66,7 (range: 46-84). M/F ratio is 3:1. 39 EGFR-WT and 54 EGFR-UK. All patients received erlotinib or gefitinib as second-line treatment or erlotinib as third-line treatment. No TTP differences were observed for both second-line (HR:0,91; p = 0,6333) and third-line (HR:1.1; p = 0,6951) treatment (TKI vs CT). A trend of a benefit in OS in favor of 3rd-line TKI (HR:0,68; p = 0,11). CONCLUSIONS This study explores the role of TKIs in EGFR non-mutated NSCLC patients. OS analysis highlights a trend to a benefit in patients who received TKI in third-line, even if this result is statistically non-significant. Further analysis are needed to find an explanation for this observation.
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Affiliation(s)
- Giuseppe Bronte
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Tindara Franchina
- Medical Oncology Unit-AOOR Papardo-Piemonte, Messina and Department of Human Pathology, University of Messina, Messina, Italy
| | | | - Giovanni Sortino
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Claudia Celesia
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Francesco Passiglia
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | | | - Agata Laudani
- Medical Oncology Unit, A.R.N.A.S. Civico, Palermo, Italy
| | - Alessandro Russo
- Medical Oncology Unit-AOOR Papardo-Piemonte, Messina and Department of Human Pathology, University of Messina, Messina, Italy
| | - Antonio Picone
- Medical Oncology Unit-AOOR Papardo-Piemonte, Messina and Department of Human Pathology, University of Messina, Messina, Italy
| | - Sergio Rizzo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio", Chieti, Italy
| | - Elisabetta Gambale
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio", Chieti, Italy
| | - Viviana Bazan
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Clara Natoli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio", Chieti, Italy
| | - Livio Blasi
- Medical Oncology Unit, A.R.N.A.S. Civico, Palermo, Italy
| | - Vincenzo Adamo
- Medical Oncology Unit-AOOR Papardo-Piemonte, Messina and Department of Human Pathology, University of Messina, Messina, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
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Garassino M, Cortesi E, Grossi F, Chiari R, Parra HS, Cascinu S, Cognetti F, Turci D, Blasi L, Bengala C, Mini E, Baldini E, Gamucci T, Ceresoli G, Antonelli P, Vasile E, Pinto C, Galetta D, Macerelli M, De Marinis F. MA 11.11 Italian Nivolumab Expanded Access Program in Non-Squamous NSCLC Patients: Results in Never Smokers and EGFR Positive Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.550] [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: 10/18/2022]
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50
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Adamo V, Ricciardi G, Schifano S, Russo A, Gebbia V, Blasi L, Giuffrida D, Scandurra G, Savarino A, Butera A, Borsellino N, Verderame F, Caruso M. Safety and efficacy of the treatment with Nab-paclitaxel in mEtastatic bREast cancer In elDerly patiEnts: NEREIDE study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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