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Brunelli M, Gobbo S, Malpeli G, Sirgiovanni G, Caserta C, Munari E, Francesconi S, Caliò A, Martignoni G, Cimadamore A, Veccia A, Antonelli A, Tucci M, Pierconti F, Hattab IM, Eccher A, Ascani S, Milella M, Buffoni L, Cheng L, Bracarda S. TROP-2, NECTIN-4 and predictive biomarkers in sarcomatoid and rhabdoid bladder urothelial carcinoma. Pathologica 2024; 116:55-61. [PMID: 38482675 PMCID: PMC10938277 DOI: 10.32074/1591-951x-937] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/22/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction The surface protein TROP-2/TACSTD2 and the cell adhesion protein NECTIN-4/NECTIN4 are responsible for the efficacy of anticancer therapies based on antibody-drug conjugates (ADC) targeting intracellular microtubules. In contrast with common histologic subtypes of bladder urothelial carcinoma (BUC), little is known of TROP-2 and NECTIN-4 expression in sarcomatoid and rhabdoid BUC. Aims In this study, we aimed to analyze TROP-2 and NECTIN-4 expression and additional predictive biomarkers by immunohistochemistry and fluorescence in situ hybridization (FISH) on 35 undifferentiated BUC (28 sarcomatoid and 7 rhabdoid). Wide genomic investigation was also performed on 411 BUC cases of the PanCancer Atlas, focusing on genes related to the microtubule pathways. Results Seven of 35 (20%) undifferentiated BUC showed expression of TROP-2. NECTIN-4 was expressed in 10 cases (29%). Seven cases (20%) co-expressed TROP-2 and NECTIN-4. HER-2 FISH was amplified in 5 cases (14%) while HER-2 immunoexpression was observed in 14 cases (40%). PD-L1 scored positive for combined proportion score (CPS) in 66% of cases and for tumor proportion score (TPS) in 51% of cases. Pan-NTRK1-2/3 was elevated in 9 cases (26%) and FGFR-2/3 was broken in 7 of 35 cases (20%). Of 28 sarcomatoid BUC, 9 (32%) were negative for all (TROP-2, NECTIN-4, PD-L1, HER-2, FGFR and pan-NTRK) biomarkers and 3 (11%) expressed all five biomarkers. Among cases with rhabdoid dedifferentiation, 1 of 7 (14%) showed activation of all biomarkers, whereas 2 of 7 (28%) showed none. The mRNA analysis identified microtubule-related genes and pathways suitable for combined ADC treatments in BUC. Conclusion Sarcomatoid and rhabdoid BUC do harbor positive expression of the ADC targets TROP-2 or NECTIN-4 in a relatively modest subset of cases, whereas the majority do not. Different combinations of other positive biomarkers may help the choice of medical therapies. Overall, these findings have important clinical implications for targeted therapy for BUC.
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Affiliation(s)
- Matteo Brunelli
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Stefano Gobbo
- Department of Translational Medicine, University of Ferrara, Italy
| | - Giorgio Malpeli
- Department of Human Sciences for the Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Grazia Sirgiovanni
- Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy
| | - Claudia Caserta
- Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy
| | - Enrico Munari
- Department of Molecular and Translational Medicine, University of Brescia, Italy
| | | | - Anna Caliò
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Guido Martignoni
- Pathology Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Alessia Cimadamore
- Institute of Pathological Anatomy, Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Veccia
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | - Isabelle Malak Hattab
- Department of Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School, Lifespan Academic Medical Center and the Legorreta Cancer Center at Brown University, Providence, RI, USA
| | - Albino Eccher
- Section of Pathology, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, University Hospital of Modena, Italy
| | - Stefano Ascani
- Unit of Pathology, S. Maria di Terni Hospital, University of Perugia, Terni, Italy
| | - Michele Milella
- Section of Oncology, University of Verona - School of Medicine, Verona University Hospital Trust, Italy
| | - Lucio Buffoni
- Medical Oncology, Humanitas Gradenigo, Torino, Italy
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School, Lifespan Academic Medical Center and the Legorreta Cancer Center at Brown University, Providence, RI, USA
| | - Sergio Bracarda
- Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera S. Maria, Terni, Italy
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Passiglia F, Lucia Reale M, Lo Russo G, Pasello G, Minuti G, Bulotta A, Galetta D, Pelizzari G, Sini C, Bria E, Roca E, Pilotto S, Genova C, Metro G, Citarella F, Chiari R, Cortinovis D, Delmonte A, Russo A, Tiseo M, Cerea G, Carta A, Scotti V, Vavalà T, Brambilla M, Buffoni L, Buosi R, Catania C, Gori S, Grisanti S, Agustoni F, Garbo E, Malapelle U, Novello S. Sotorasib in KRASp.G12C mutated advanced NSCLC: Real-world data from the Italian expanded access program. Lung Cancer 2024; 187:107444. [PMID: 38157806 DOI: 10.1016/j.lungcan.2023.107444] [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: 09/27/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Sotorasib showed a significant improvement of progression free survival (PFS), safety and quality of life over docetaxel in patients with KRASp.G12C-mutated advanced non-small-cell lung cancer (NSCLC) within the CodeBreak-200 study. Here we report real-world efficacy and tolerability data from NSCLC patients who received sotorasib within the Italian expanded access program (EAP). METHODS Sotorasib (960 mg, orally, once daily) was available on physician request for KRASp.G12C mutant advanced NSCLC patients. Clinical-pathological and molecular data were collected from the Italian ATLAS real-world registry. Patients underwent CT-scan and responses were evaluated by RECIST criteria. Efficacy and tolerability outcomes have been assessed. RESULTS A total of 196 advanced NSCLC patients were treated across 30 Italian centers. Median age was 69 years old (range 33-86). Most patients were male (61 %), former (49 %) or current smokers (43 %), with ECOG-PS 0/1 (84 %) and adenocarcinoma subtype (90 %). 45 % and 32 % of patients received sotorasib in 2nd and 3rd line, respectively. Overall, response rate was 26 % and the median duration of response was 5.7 months (95 % CI: 4.4-7.0). Median PFS and OS were 5.8 months (95 % CI: 5 - 6.5) and 8.2 months (95 % CI: 6.3 - 9.9). Grade 3-4 TRAEs occurred in 16.5 % of patients, with Grade ≥ 3 liver enzyme increase and TRAEs-related discontinuation reported in 12 % and 4.6 % of cases. CONCLUSION Real-world data from the Italian EAP confirm the tolerability and effectiveness of sotorasib in patients with KRASp.G12C-mutated advanced NSCLC and highlight the value of the national ATLAS network as source of real-world evidence driving the clinical management of NSCLC patients.
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Affiliation(s)
- Francesco Passiglia
- Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | | | - Giuseppe Lo Russo
- Thoracic Unit, Department of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Giulia Pasello
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy; Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Gabriele Minuti
- Clinical Trial Unit: Phase 1 and Precision Medicine, National Cancer Institute, IRCCS, Regina Elena, Rome, Italy
| | | | - Domenico Galetta
- Medical Thoracic Oncology Unit, Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Giacomo Pelizzari
- Dipartimento di Oncologia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Claudio Sini
- Medical Oncology, Ospedale Giovanni Paolo II - ATS Sardegna - ASSL Olbia, Olbia, Italy
| | - Emilio Bria
- Medical Oncology, Department of Traslational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elisa Roca
- Thoracic Oncology, Lung Unit, P. Pederzoli Hospital, Peschiera Del Garda (VR), Italy
| | - Sara Pilotto
- Department of Engineering for Innovation Medicine University of Verona, Section of Oncology, Verona, Italy
| | - Carlo Genova
- Lung Cancer Unit, Università degli Studi di Genova e Ospedale Policlinico San Martino IRCCS - DiMI, Genova, Italy
| | - Giulio Metro
- Medical Oncology Department, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Fabrizio Citarella
- Oncology Department, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Rita Chiari
- UOC Oncologia, AST Pesaro Urbino, Pesaro, Italy
| | | | - Angelo Delmonte
- Department of Medical Oncology, Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - Alessandro Russo
- Medical Oncology Unit, Centro Oncologico Ospedale Papardo, Messina, Italy
| | - Marcello Tiseo
- Department of Medicine and Surgery, University of Parma and Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Giulio Cerea
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Annamaria Carta
- SC Oncologia Medica, Ospedale Businco - ARNAS G. Brotzu, Cagliari, Italy
| | - Vieri Scotti
- Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Tiziana Vavalà
- Azienda Ospedaliero Universitaria (AOU) Città della Salute e della Scienza, Department of Oncology, SC Oncologia 1, Torino, Italy
| | - Marta Brambilla
- Thoracic Unit, Department of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Lucio Buffoni
- Medical Oncology Department, Humanitas Gradenigo, Turin, Italy
| | - Roberta Buosi
- Department of Medical Oncology, Ospedale Santo Spirito, Casale Monferrato, Alessandria, Italy
| | - Chiara Catania
- Medical Oncology Department, Humanitas Gavazzeni, Bergamo, Italy
| | - Stefania Gori
- Department of Medical Oncology, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Salvatore Grisanti
- Medical Oncology Department, Azienda Ospedaliera Spedali Civili, Brescia, Italy
| | - Francesco Agustoni
- Department of Internal Medicine and Medical Therapy, University of Pavia, and Department of Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Edoardo Garbo
- Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Umberto Malapelle
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, Orbassano (TO), Italy.
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Cani M, Bironzo P, Garetto F, Buffoni L, Cotogni P. Immune Checkpoint Inhibitors and Opioids in Patients with Solid Tumours: Is Their Association Safe? A Systematic Literature Review. Healthcare (Basel) 2022; 11:healthcare11010116. [PMID: 36611575 PMCID: PMC9818864 DOI: 10.3390/healthcare11010116] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) represent one of the most effective treatments for patients with cancer. As their activity relies on host immune system reactivity, the role of concomitant medications such as corticosteroids and antibiotics has been extensively evaluated. Preclinical data suggest that opioids may influence the immune system. METHODS a systematic literature revision was performed using specific keywords on the major search engines. Two authors analysed all the studies and provided a selection of the following inclusion and exclusion criteria, respectively: 1. data collection of patients older than 18 years old affected by solid tumours; 2. description of ICIs efficacy in terms of PFS, OS, TTF, and ORR; 3. concomitant ICIs-opioids treatment and 1. language different from English; 2. not pertinent analyses. RESULTS 523 studies were analysed, and 13 were selected and included in our series. A possible negative interaction between oral opioids and ICIs efficacy was observed. Most evidence was retrospective, and studies were heterogeneous. CONCLUSIONS Even if oral opioids seem to impact negatively on ICIs efficacy in cancer patients, to date there is not sufficient evidence to avoid their prescription in this population.
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Affiliation(s)
- Massimiliano Cani
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy
| | - Paolo Bironzo
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy
- Correspondence: ; Tel.: +39-01-1902-6865
| | - Ferdinando Garetto
- Medical Oncology Department, Humanitas Gradenigo, 10153 Turin, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 10153 Turin, Italy
- Cottolengo Hospice, Via Cesare Balbo 16, 10023 Chieri, Italy
| | - Lucio Buffoni
- Medical Oncology Department, Humanitas Gradenigo, 10153 Turin, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 10153 Turin, Italy
| | - Paolo Cotogni
- Pain Management and Palliative Care, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, Corso Bramante, 88/90, 10126 Turin, Italy
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Caccialanza R, Cereda E, Agustoni F, Klersy C, Casirati A, Montagna E, Carnio S, Novello S, Milella M, Pilotto S, Trestini I, Buffoni L, Ferrari A, Pedrazzoli P. Multicentre, randomised, open-label, parallel-group, clinical phase II study to evaluate immunonutrition in improving efficacy of immunotherapy in patients with metastatic non-small cell lung cancer, undergoing systematic nutritional counseling. BMC Cancer 2022; 22:1212. [PMID: 36434615 PMCID: PMC9700895 DOI: 10.1186/s12885-022-10296-x] [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: 05/24/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Nutritional support, including nutritional counseling and oral nutritional supplements (ONS), has been recommended as a first-line strategy in patients with non-small cell lung cancer (NSCLC). Evidence on the efficacy of immunonutrition during immunotherapy in these patients is positive, but still limited some secondary endpoints, such as treatment toxicity and tolerance. We hypothesize that early systematic provision of ONS with a high-protein-high calorie mixture containing immunonutrients (Impact®) in addition to nutritional counseling, compared to nutritional counseling alone, is beneficial to patients with NSCLC receiving immunotherapy with or without chemotherapy. We designed the present study to evaluate the efficacy of early systematic provision of ONS enriched with immunonutrients compared to nutritional counseling alone, in patients with NSCLC undergoing immunotherapy. Study endpoints were: treatment response (primary endpoint: progression-free survival), treatment tolerance and toxicity, body weight, body composition, protein-calorie intake, quality of life, fatigue, muscle strength and immunological profile. METHODS This is a pragmatic, multicentre, randomized (1:1), parallel-group, open label, controlled, pilot clinical trial (N = 180). DISCUSSION The improvement of efficacy of nutritional support in oncology still deserves many efforts. Immunonutrition represents a promising approach also in patients with NSCLC, but evidence on its efficacy on clinical outcomes during immunotherapy is still inconclusive. The present pilot study, which guarantees early high-quality nutritional care (assessment and treatment) to all patients in agreement with current guidelines and recommendations, could represent one of the first proofs of efficacy of early oral immunonutrition in patients with cancer undergoing immunotherapy. Further large randomized trials addressing the improvement of supportive care could be hypothesized, accordingly. TRIAL REGISTRATION This study is registered on ClinicalTrials.gov Identifier: NCT05384873.
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Affiliation(s)
- Riccardo Caccialanza
- grid.419425.f0000 0004 1760 3027Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy
| | - Emanuele Cereda
- grid.419425.f0000 0004 1760 3027Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy
| | - Francesco Agustoni
- grid.419425.f0000 0004 1760 3027Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Catherine Klersy
- grid.419425.f0000 0004 1760 3027Biometry and Clinical Epidemiology Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Amanda Casirati
- grid.419425.f0000 0004 1760 3027Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy
| | - Elisabetta Montagna
- grid.419425.f0000 0004 1760 3027Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy
| | - Simona Carnio
- grid.7605.40000 0001 2336 6580Department of Oncology, AOU San Luigi-Orbassano, University of Turin, Turin, Italy
| | - Silvia Novello
- grid.7605.40000 0001 2336 6580Department of Oncology, AOU San Luigi-Orbassano, University of Turin, Turin, Italy
| | - Michele Milella
- grid.411475.20000 0004 1756 948XMedical Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy
| | - Sara Pilotto
- grid.411475.20000 0004 1756 948XMedical Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy
| | - Ilaria Trestini
- grid.411475.20000 0004 1756 948XMedical Oncology, Department of Medicine, University of Verona Hospital Trust, 37134 Verona, Italy
| | - Lucio Buffoni
- Medical Oncology Unit, Humanitas Gradenigo, Turin, Italy
| | - Alessandra Ferrari
- grid.419425.f0000 0004 1760 3027Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Pedrazzoli
- grid.419425.f0000 0004 1760 3027Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy ,grid.8982.b0000 0004 1762 5736Internal Medicine Department, University of Pavia, Pavia, Italy
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Passiglia F, Righi L, Listì A, Tabbò F, Bironzo P, Reale M, Sini C, Vallone S, Arizio F, Parravicini MP, Mazilu L, Linardou H, Roca E, Buffoni L, Mohorcic K, Barbieri V, Pignataro D, Araujo A, Ares LP, Felip E, Secen N, Comanescu A, Szmytke E, Scagliotti G, Novello S. EP16.03-011 The European Program for ROutine Testing of Patients with Advanced Lung Cancer (EPROPA) 1 Year Activity. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1072] [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: 10/14/2022]
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Tagliamento M, Bironzo P, Curcio H, De Luca E, Pignataro D, Rapetti SG, Audisio M, Bertaglia V, Paratore C, Bungaro M, Olmetto E, Artusio E, Reale ML, Zichi C, Capelletto E, Carnio S, Buffoni L, Passiglia F, Novello S, Scagliotti GV, Di Maio M. A systematic review and meta-analysis of trials assessing PD-1/PD-L1 immune checkpoint inhibitors activity in pre-treated advanced stage malignant mesothelioma. Crit Rev Oncol Hematol 2022; 172:103639. [DOI: 10.1016/j.critrevonc.2022.103639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/08/2022] [Accepted: 02/16/2022] [Indexed: 12/29/2022] Open
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Suárez G, Geldhof P, Borloo J, Pérez-Caballero R, Robaina D, Buffoni L, Alonzo P, Martínez-Moreno A, Correa O, Tort J, Pérez J, Claerebout E. Evaluation of a Cooperia oncophora double-domain ASP-based vaccine against Cooperia spp. infections in cattle and sheep. Vet Parasitol 2021; 299:109578. [PMID: 34571323 DOI: 10.1016/j.vetpar.2021.109578] [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: 05/19/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022]
Abstract
A double-domain activation-associated secreted protein (dd-Co-ASP) isolated from the bovine small intestinal parasite Cooperia oncophora was previously shown to be an effective vaccine candidate to protect calves against a homologous challenge infection. The aim of this study was to investigate whether the dd-Co-ASP protein, purified from a Belgian C. oncophora isolate, would offer protection against a C. oncophora isolate from the southern hemisphere as well as other Cooperia species such as C. punctata in cattle and C. curticei in sheep. Two vaccination studies were performed, i.e. one in cattle and one in sheep, in which the protective effects of dd-Co-ASP, supplemented with Quil A as an adjuvant, were compared with an adjuvant control. Whereas our results showed a 75 % reduction in Cooperia spp. cumulative faecal egg counts, the results obtained in sheep demonstrated that dd-Co-ASP was ineffective in raising a protective immune response against a C. curticei challenge infection. Even though sequence analysis of the dd-Co-ASP gene revealed restricted sequence heterogeneity in the double domain ASP within and between bovine Cooperia species, the results of the vaccine study suggest that there is sufficient conservation at the protein level to yield cross-protection, holding promise for the development of a general Cooperia vaccine for use in cattle.
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Affiliation(s)
- G Suárez
- Unidad de Farmacología y Terapéutica, Facultad Veterinaria, Universidad de la República, Alberto Lasplaces 1620, 11600, Montevideo, Uruguay
| | - P Geldhof
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium.
| | - J Borloo
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - R Pérez-Caballero
- Animal Health Department (Parasitology and Parasitic Diseases), Faculty of Veterinary Medicine, University of Córdoba, Campus de Rabanales, Ctra. Madrid-Cádiz, km 396, 14014, Córdoba, Spain
| | - D Robaina
- Unidad de Farmacología y Terapéutica, Facultad Veterinaria, Universidad de la República, Alberto Lasplaces 1620, 11600, Montevideo, Uruguay
| | - L Buffoni
- Animal Health Department (Parasitology and Parasitic Diseases), Faculty of Veterinary Medicine, University of Córdoba, Campus de Rabanales, Ctra. Madrid-Cádiz, km 396, 14014, Córdoba, Spain
| | - P Alonzo
- Campo Experimental, Instituto de Higiene, Universidad de la República, Ruta 82 km 46, Canelones, Uruguay
| | - A Martínez-Moreno
- Animal Health Department (Parasitology and Parasitic Diseases), Faculty of Veterinary Medicine, University of Córdoba, Campus de Rabanales, Ctra. Madrid-Cádiz, km 396, 14014, Córdoba, Spain
| | - O Correa
- Departamento Parasitología, Facultad Veterinaria, Universidad de la República, Alberto Lasplaces 1620, 11600, Montevideo, Uruguay
| | - J Tort
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Avenida General Flores 2125, 11800, Montevideo, Uruguay
| | - J Pérez
- Anatomy and Comparative Pathology and Toxicology Department, Faculty of Veterinary Medicine, University of Córdoba, Campus de Rabanales, Ctra. Madrid-Cádiz, km 396, 14014, Córdoba, Spain
| | - E Claerebout
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
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Vavala T, Malapelle U, Veggiani C, Ludovini V, Papotti M, Leone A, Graziano P, Minari R, Bono F, Sapino A, Manotti L, Troncone G, Pisapia P, Girlando S, Buffoni L, Righi L, Colantonio I, Bertetto O, Novello S. Molecular profiling of advanced non-small cell lung cancer in the era of immunotherapy approach: a multicenter Italian observational prospective study of biomarker screening in daily clinical practice. J Clin Pathol 2021; 75:234-240. [PMID: 33509945 DOI: 10.1136/jclinpath-2020-207339] [Citation(s) in RCA: 3] [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: 12/12/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 01/14/2023]
Abstract
AIMS Heterogeneous implementation of molecular tests in current diagnostic algorithm at a European and international level is emerging as a major issue for efficient lung cancer molecular profiling. METHODS From May 2017 until October 2017, N=1612 patients referring to 13 Italian institutions were selected, at advanced stage non-small cell lung cancer (NSCLC), and prospectively evaluated. Principal endpoints were: the percentage of diagnoses performed on cytological and histological material, the proportion of requests for epidermal growth factor receptor (EGFR) mutational status, and resistance mutations detected on tissue and/or liquid biopsy samples after first-generation or second-generation tyrosine kinase inhibitors, the proportion of requests for anaplastic lymphoma kinase (ALK) gene rearrangements, ROS proto-oncogene 1 (ROS1) and Kirsten Rat Sarcoma (KRAS) determinations, the proportion of requests for programmed death-ligand1 (PD-L1) evaluation and, finally, the different assays used for the detection of EGFR mutations, ALK and ROS1 gene rearrangements and PD-L1 expression. RESULTS Of 1325 patients finally included, only 50.8% requests were related to driver mutations with target agents already available in first-line at that preplanned time, while 49.2% were associated with PD-L1, ROS1, KRAS and others. Multiplex genomic assays (such as next-generation sequencing) were considered by all participating centres. CONCLUSIONS To the best of our knowledge, this is the first study in a 'real-life daily practice' involving both pathologists and oncologists evaluating routinely workflow and trends towards improvements in molecular requests. Collected data aim to describe the applied algorithms and evolution of molecular screening for stage IV NSCLC in clinical practice.
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Affiliation(s)
- Tiziana Vavala
- SC Oncology, ASL CN1, Saluzzo, Italy .,Department of Oncology, University of Turin, Torino, Italy
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Napoli, Campania, Italy
| | - Claudia Veggiani
- Pathology Unit, Hospital Maggiore della Carità, Novara, Piemonte, Italy
| | - Vienna Ludovini
- Molecular Biology Laboratory, Medical Oncology Division, Ospedale Santa Maria della Misericordia, Perugia, Umbria, Italy
| | - Mauro Papotti
- Department of Oncology, Unversity of Torino, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alvaro Leone
- Department of Pathology, San Camillo Forlanini Hospital, Rome, Italy
| | - Paolo Graziano
- Unit of Pathology, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Puglia, Italy
| | - Roberta Minari
- UO Medical Oncology, University Hospital of Parma, Parma, Italy
| | - Francesca Bono
- UO Anatomo-Pathology, San Gerardo Hospital, Monza, Italy
| | - Anna Sapino
- Department of Surgical Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Piemonte, Italy.,Department of Medical Sciences, University of Turin, Torino, Piemonte, Italy
| | - Laura Manotti
- Department of Oncology, UO Anatomo-Pathology, Hospital of Cremona, Cremona, Lombardia, Italy
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Napoli, Campania, Italy
| | - Pasquale Pisapia
- Department of Public Health, University of Naples Federico II, Napoli, Campania, Italy
| | | | - Lucio Buffoni
- Department of Oncology, University of Turin, Torino, Italy
| | - Luisella Righi
- Department of Oncology, University of Turin, Torino, Italy
| | - Ida Colantonio
- Department of Oncologia, Azienda Ospedaliera S Croce e Carle Cuneo, Cuneo, Piemonte, Italy
| | - Oscar Bertetto
- Rete Oncologica Piemonte e Valle d'Aosta Department, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Piemonte, Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, Torino, Italy
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9
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Brunetti G, Belisario DC, Storlino G, Colaianni G, Buffoni L, Ingravallo G, Ware CF, Colucci S, Ferracini R, Grano M, Roato I. LIGHT as regulator of bone homeostasis during osteolytic bone metastasis formation in non-small cell lung cancer patients. Bone Rep 2020. [DOI: 10.1016/j.bonr.2020.100656] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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10
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Brunetti G, Belisario DC, Bortolotti S, Storlino G, Colaianni G, Faienza MF, Sanesi L, Alliod V, Buffoni L, Centini E, Voena C, Pulito R, Novello S, Ingravallo G, Rizzi R, Mori G, Reseland JE, Ware CF, Colucci S, Ferracini R, Grano M, Roato I. LIGHT/TNFSF14 Promotes Osteolytic Bone Metastases in Non-small Cell Lung Cancer Patients. J Bone Miner Res 2020; 35:671-680. [PMID: 31826304 DOI: 10.1002/jbmr.3942] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/03/2019] [Accepted: 12/08/2019] [Indexed: 12/24/2022]
Abstract
Tumor necrosis factor superfamily member 14 (TNFSF14), LIGHT, is a component of the cytokine network that regulates innate and adaptive immune responses, which promote homeostasis of lymphoid organs, liver, and bone. Metastatic tumors often disrupt the tissue microenvironment, thus altering the homeostasis of the invaded organ; however, the underlying mechanisms required further studies. We investigated the role of LIGHT in osteolytic bone disease induced by metastatic non-small cell lung cancer (NSCLC). Patients diagnosed with NSCLC bone metastasis show significantly higher levels of LIGHT expressed in monocytes compared with non-bone metastatic tumors and healthy controls. Serum LIGHT levels were also higher in patients with bone metastases than in controls, suggesting a role for LIGHT in stimulating osteoclast precursors. In bone metastatic patients, we also detected increased RNA expression and serum RANKL levels, thus by adding anti-LIGHT or RANK-fragment crystallizable region (RANK-Fc) in PBMC cultures, a significant inhibition of osteoclastogenesis was observed. To model this observation in mice, we used the mouse lung cancer cell line LLC-1. After intratibial implantation, wild-type mice showed an increased number of osteoclasts but reduced numbers of osteoblasts and decreased osteoid formation. In contrast, Tnfsf14-/- mice showed no significant bone loss or other changes in bone homeostasis associated with this model. These data indicate LIGHT is a key control mechanism for regulating bone homeostasis during metastatic invasion. Thus, LIGHT may be a novel therapeutic target in osteolytic bone metastases. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Giacomina Brunetti
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Dimas C Belisario
- Center for Experimental Research and Medical Studies (CeRMS), A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Sara Bortolotti
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Giuseppina Storlino
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Graziana Colaianni
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Maria F Faienza
- Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Lorenzo Sanesi
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Valentina Alliod
- Department of Oncological Sciences, University of Turin Medical School, Turin, Italy
| | - Lucio Buffoni
- Department of Oncological Sciences, University of Turin Medical School, Turin, Italy
| | - Elisa Centini
- Center for Experimental Research and Medical Studies (CeRMS), A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Claudia Voena
- Center for Experimental Research and Medical Studies (CeRMS), A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Roberta Pulito
- Center for Experimental Research and Medical Studies (CeRMS), A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Silvia Novello
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Giuseppe Ingravallo
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Rita Rizzi
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Giorgio Mori
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Janne E Reseland
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo Blindern, Oslo, Norway
| | - Carl F Ware
- Infectious and Inflammatory Disease Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Silvia Colucci
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Riccardo Ferracini
- Department of Surgical Sciences (DISC), Orthopaedic Clinic-IRCCS, A.O.U. San Martino, Genoa, Italy
| | - Maria Grano
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Ilaria Roato
- Center for Experimental Research and Medical Studies (CeRMS), A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
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Buffoni L, Piva MM, Baska P, Januszkiewicz K, Norbury LJ, Prior KC, Dezen D, Silva AS, Wedrychowicz H, Mendes RE. Immunization with the recombinant myosin regulatory light chain (FhrMRLC) in Adjuplex® adjuvant elicits a Th1-biased immune response and a reduction of parasite burden in Fasciola hepatica infected rats. Parasitol Int 2019; 75:102037. [PMID: 31841659 DOI: 10.1016/j.parint.2019.102037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/07/2019] [Accepted: 12/07/2019] [Indexed: 01/22/2023]
Abstract
The aim of this study was to assess the immune response and the protective efficacy elicited by the vaccination with the recombinant Fasciola hepatica myosin regulatory light chain (FhrMRLC) in Adjuplex® adjuvant against the infection with F. hepatica in rats. Four groups of 15 animals each were used for the study, one group was immunized with the recombinant F. hepatica MRLC in Adjuplex® adjuvant and the other groups remained as adjuvant, positive and negative control groups. The parasitological study showed that a statistically significant reduction of 65.1% and 82.1% in fluke burden and fecal egg count, respectively, was detected in vaccinated animals. In addition, vaccination with FhrMRLC induced a well-defined humoral and cellular immune response characterized by a significant production of specific IgG and IL-2, IL-12, TNF-α and IFN-γ; which confirms the immunogenic capacity of the FhrMRLC.
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Affiliation(s)
- L Buffoni
- Department of Animal Health, Faculty of Veterinary, University of Cordoba, Campus de Rabanales, Ctra. Madrid-Cádiz km 376, 14014 Córdoba, Spain.
| | - M M Piva
- Laboratory of Veterinary Pathology, Federal Institute of Santa Catarina (IFC), Rod. SC 283, km 08, CP 58, Concórdia, SC 89703-720, Brazil
| | - P Baska
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), 8 Ciszewkiego, 02-786 Warsaw, Poland
| | - K Januszkiewicz
- Witold Stefański Institute of Parasitology, Polish Academy of Sciences, Twarda 51/55, 00-818 Warsaw, Poland
| | - L J Norbury
- School of Science, RMIT University, Bundoora 3083, Victoria, Australia
| | - K C Prior
- Laboratory of Veterinary Microbiology, Federal Institute of Santa Catarina (IFC), Rod. SC 283, km 08, CP 58, Concórdia, SC 89703-720, Brazil
| | - D Dezen
- Laboratory of Veterinary Microbiology, Federal Institute of Santa Catarina (IFC), Rod. SC 283, km 08, CP 58, Concórdia, SC 89703-720, Brazil
| | - A S Silva
- Department of Animal Science, Santa Catarina State University (UDESC), Sete de Setembro 77D, Chapecó, SC 89806-152, Brazil
| | - H Wedrychowicz
- Witold Stefański Institute of Parasitology, Polish Academy of Sciences, Twarda 51/55, 00-818 Warsaw, Poland
| | - R E Mendes
- Laboratory of Veterinary Pathology, Federal Institute of Santa Catarina (IFC), Rod. SC 283, km 08, CP 58, Concórdia, SC 89703-720, Brazil
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12
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Tagliamento M, Bironzo P, De Luca E, Pignataro D, Rapetti S, Audisio M, Bertaglia V, Paratore C, Bungaro M, Olmetto E, Artusio E, Reale M, Zichi C, Capelletto E, Carnio S, Buffoni L, Passiglia F, Novello S, Di Maio M. A systematic review and meta-analysis of trials assessing activity of PD-1/PD-L1 immune checkpoint inhibitors (ICIs) for pre-treated advanced malignant mesothelioma (aMM). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz449.032] [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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13
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Friedlaender A, Banna GL, Buffoni L, Addeo A. Poor-Performance Status Assessment of Patients with Non-small Cell Lung Cancer Remains Vague and Blurred in the Immunotherapy Era. Curr Oncol Rep 2019; 21:107. [PMID: 31768759 DOI: 10.1007/s11912-019-0852-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW In the latest decade, the introduction of immune-checkpoint inhibitors (ICIs) has dramatically improved the prognosis of patients with NSCLC. First-line ICIs or chemo-ICI trials have demonstrated OS advantages but the accrual was limited to Eastern Cooperative Oncology Group (ECOG) performance status (PS)0-1 patients. ICI studies have for the vast majority excluded patients with poor performance status. PS 2 particularly is known as a negative prognostic factor for survival and a predictive factor of adverse events and poor response to treatments. Data on the activity of ICIs in PS2 patients are limited and come from heterogeneous meta-analyses and small phase II or expanded access trials. Often, terms such as "unfit" or "frail" ascertain the eligibility of patients to undergo cytotoxic chemotherapy, without specifying PS. RECENT FINDINGS Other tools exist to aid in decision-making, and one simple, rapid, and validated screening test for frailty is the FRAIL scale consisting of 5 straightforward questions that can be self-administered and may represent an efficient and cost-effective way to screen large groups of patients for frailty. The Comprehensive Geriatric Assessment (CGA) is a widely used method to determine the medical, psychological, and functional capabilities of older patients. However, CGA is time-consuming and this could represent a real barrier to its adoption in clinical practice. For this reason, a quick screening tool, the G8 questionnaire, has been developed and demonstrated validity also in a younger population. A complementary tool to assess patients' frailty is Charlson comorbidity index (CCI) which has become the most widely used clinical index for a variety of disorders and cancers. Yet, none of these tools has been validated as predictive in ICI. In conclusion, solid data regarding the benefit of ICIs in ECOG PS2 NSCLC patients are currently lacking and the role of immunotherapy remains uncertain for PS2 patients. Prospective randomized trials addressing this question are warranted or ongoing. However, we are concerned that without a more extensive and objective assessment of patients' fitness and frailty by using and validating appropriate tools a clear answer may not come to light.
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Affiliation(s)
- Alex Friedlaender
- Oncology Department, Geneva University Hospital, 4 Rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland
| | | | - Lucio Buffoni
- Oncology Department, San Luigi Hospital University of Turin, Orbassano, Turin, Italy
| | - Alfredo Addeo
- Oncology Department, Geneva University Hospital, 4 Rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland.
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14
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Franceschini D, Bruni A, Borghetti P, Giaj-Levra N, Ramella S, Buffoni L, Badellino S, Andolina M, Comin C, Vattemi E, Bezzi M, Trovò M, Passaro A, Bearz A, Chiari R, Tindara F, Ferrari K, Piperno G, Filippi AR, Genovesi D, Scotti V. Is multidisciplinary management possible in the treatment of lung cancer? A report from three Italian meetings. Radiol Med 2019; 125:214-219. [PMID: 31605353 DOI: 10.1007/s11547-019-01094-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/01/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE To report criticisms and barriers to the "real-life" application of international guidelines and recent developments in the management of locally advanced non-small cell lung cancer (NSCLC) in Italy. METHODS Three 2-day courses were organized. During the first day, experts in different fields of thoracic oncology gave their lecture on diagnosis and therapy for locally advanced NSCLC. During the second day, all participants were divided into four groups to discuss on a clinical case as a multidisciplinary team (MDT). The aim was to stimulate the discussion on practical issues in the management of NSCLC patients in the real-life practice. RESULTS A total of 196 physicians were involved in the courses as learners. Invasive diagnosis of nodal disease for staging purposes, a priori definition of "surgical resectability" and a regular MDT with all crucial participants available were the three main key points identified for a good management of these patients. The main barriers to the clinical application of a good diagnostic and therapeutic approach to the patient were the absence of a regular and complete MDT in the South and Centre of Italy, while in the North of Italy, time for discussion of clinical cases in the MDT and waiting lists for staging and therapeutic interventions were deemed as the major concerns. CONCLUSION The meetings showed that diagnosis and treatment of locally advanced NSCLC are still extremely variable between different Italian regions. Logistic issues, waiting lists, paucity of well-trained staff and expertise seem to be the main barriers to international guidelines application.
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Affiliation(s)
- Davide Franceschini
- Radiation Oncology Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Alessio Bruni
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Niccolò Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Sara Ramella
- Radiation Oncology Department, Campus Bio-Medico, Rome, Italy
| | - Lucio Buffoni
- Oncology Department, San Luigi Hospital University of Turin, Orbassano, Turin, Italy
| | - Serena Badellino
- Radiation Oncology Department, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Maria Andolina
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Camilla Comin
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Michela Bezzi
- Endoscopic Pneumology Unit, ASST Spedali Civili Brescia, Brescia, Italy
| | - Marco Trovò
- Radiation Oncology Department, Azienda Sanitaria Universitaria Integrata Udine, 33100, Udine, Italy
| | - Antonio Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Alessandra Bearz
- Medical Oncology Unit, Centro di Riferimento Oncologico-IRCCS, Aviano, Italy
| | - Rita Chiari
- Medical Oncology Unit, Ospedale Madre Teresa di Calcutta, "AULSS6 Euganea-Padova", Padua, Italy
| | - Franchina Tindara
- Department of Human Pathology of the Adult and Evolutive Age "G. Barresi", Messina, Italy
| | - Katia Ferrari
- Section of Respiratory Medicine, Careggi University Hospital, Florence, Italy
| | - Gaia Piperno
- Division of Radiotherapy, European Institute of Oncology, IRCCS, Milan, Italy
| | - Andrea Riccardo Filippi
- Department of Medical Sciences and Infectious Diseases, Unit of Radiation Therapy, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Domenico Genovesi
- Radiation Oncology Department, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Vieri Scotti
- Department of Oncology, Radiation Therapy Unit, Careggi University Hospital, Florence, Italy
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15
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Bironzo P, Pignataro D, Audisio M, Tagliamento M, Paratore C, Tabbò F, Bungaro M, Zichi C, De Filippis M, Rapetti S, Cetoretta V, Carnio S, Mariniello A, Buffoni L, Lacidogna G, Di Maio M, Novello S. P2.04-15 Association Between Opioids and Outcome of 1st Line Immunotherapy in Advanced NSCLC Patients: A Retrospective Evaluation. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1520] [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: 11/24/2022]
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16
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Berardi R, Mastroianni C, Lo Russo G, Buosi R, Santini D, Montanino A, Carnaghi C, Tiseo M, Chiari R, Camerini A, Barni S, De Marino V, Ferrari D, Cristofano A, Doni L, Freddari F, Fumagalli D, Portalone L, Sarmiento R, Schinzari G, Sperandi F, Tucci M, Inno A, Ciuffreda L, Mariotti M, Mariani C, Caramanti M, Torniai M, Gallucci R, Bennati C, Bordi P, Buffoni L, Galeassi A, Ghidini M, Grossi E, Morabito A, Vincenzi B, Arvat E. Syndrome of inappropriate anti-diuretic hormone secretion in cancer patients: results of the first multicenter Italian study. Ther Adv Med Oncol 2019; 11:1758835919877725. [PMID: 31632468 PMCID: PMC6767731 DOI: 10.1177/1758835919877725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 08/30/2019] [Indexed: 11/22/2022] Open
Abstract
Background: Hyponatremia in cancer patients is often caused by the syndrome of
inappropriate antidiuretic hormone secretion (SIADH). The aim of this
observational multicenter study was to analyze the medical and economic
implications of SIADH in this setting. Methods: This study included 90 oncological patients from 28 Italian institutions that
developed SIADH between January 2010 and September 2015. Data on
clinical–pathological characteristics, anticancer therapies, hyponatremia,
and related treatments were statistically analyzed. Results: The majority were lung cancer patients (73%) with metastatic disease at the
onset of hyponatremia (83%). A total of 76 patients (84%) were hospitalized
because of SIADH and less than half (41%) received tolvaptan for SIADH
treatment. The duration of hospitalization was significantly longer in
patients who did not receive tolvaptan and in those who do not reach sodium
normalization during hospitalization. Patients who experienced a second
episode of hyponatremia following tolvaptan dose
modification/discontinuation presented a significantly lower serum sodium
value at the time of hospitalization and minimum sodium value during
hospitalization compared with patients who had not experienced another
episode. The severity of hyponatremia, defined as minimum sodium value
during hospitalization with a cut-off value of 110 mmol/l, and not obtaining
sodium correction during hospitalization significantly correlated with
overall survival rate. Conclusions: Hyponatremia due to SIADH could result in longer hospitalization and in a
decreased overall survival when not adequately treated, and tolvaptan
represents an effective treatment with a potential effect of both improving
overall survival and decreasing duration of hospitalization.
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Affiliation(s)
| | | | - Giuseppe Lo Russo
- Thoracic Oncology Fondazione IRCCS Istituto dei
Tumori, Milano, Italy
| | - Roberta Buosi
- Oncology Unit- S. Spirito Hospital - Casale M.to
– Alessandria, Italy
| | - Daniele Santini
- Medical Oncology Unit, Campus Bio-Medico
University of Rome, Rome, Italy
| | - Agnese Montanino
- Thoracic Medical Oncology, Istituto Nazionale
Tumori ‘Fondazione G Pascale’, IRCCS, Napoli, Italy
| | | | - Marcello Tiseo
- U.O. Oncologia Medica Azienda
Ospedaliero-Universitaria di Parma, Italy
| | - Rita Chiari
- Medical Oncology, Santa Maria della Misericordia
Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Andrea Camerini
- Medical Oncology, Azienda USL Toscana
nord-ovest, Ospedale Versilia, Italy
| | - Sandro Barni
- Oncology Unit, ASST Bergamo Ovest, Treviglio,
Italy
| | - Valeria De Marino
- U.O. Pneumologia ad indirizzo Oncologico.
Azienda dei colli-Monaldi, Napoli, Italy
| | - Daris Ferrari
- U.O. Oncologia Medica ASST Santi Paolo e Carlo,
Presidio Ospedaliero San Paolo, Milano, Italy
| | | | | | | | | | - Luigi Portalone
- Pneumologia Oncologica 2, Az. Osp. S. Camillo
Forlanini, Roma, Italy
| | | | - Giovanni Schinzari
- Polo Scienze Oncologiche ed Ematologiche, UOC
di Oncologia Medica, Università Cattolica del Sacro Cuore, Fondazione
Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Francesca Sperandi
- U.O. Oncologia Medica, Azienda
Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Marcello Tucci
- Division of Medical Oncology, Department of
Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin,
Italy
| | - Alessandro Inno
- Medical Oncology, Ospedale Sacro Cuore Don
Calabria, Negrar, Verona, Italy
| | - Libero Ciuffreda
- Azienda Ospedaliero Universitaria Città della
Salute e della Scienza, Torino, Italy
| | - Marita Mariotti
- Istituto Scientifico Romagnolo per lo Studio e
la Cura dei Tumori, Meldola, Italy
| | | | - Miriam Caramanti
- Clinica Oncologica, Università Politecnica
delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I,
GM Lancisi, G Salesi, Ancona, Italy Current address: UOC Oncologia, Ospedale
E.Profili di Fabriano Asur, Marche Area Vasta 2, Italy
| | - Mariangela Torniai
- Clinica Oncologica, Università Politecnica
delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I,
GM Lancisi, G Salesi, Ancona, Italy
| | - Rosaria Gallucci
- Thoracic Oncology Fondazione IRCCS Istituto dei
Tumori, Milano, Italy
| | - Chiara Bennati
- Dipartimento di Oncologia-Ematologia, AUSL
della Romagna, Ravenna, Italy
| | - Paola Bordi
- U.O. Oncologia Medica Azienda
Ospedaliero-Universitaria di Parma, Italy
| | - Lucio Buffoni
- Azienda Ospedaliero Universitaria Città della
Salute e della Scienza, Torino, Italy
| | | | - Michele Ghidini
- Medical Oncology and Hematology Unit, Humanitas
Cancer Center, Humanitas Clinical and Research Center-IRCCS, Rozzano
(Milan), Italy
| | - Emidio Grossi
- Division of Oncological Endocrinology,
Department of Medical Sciences, University of Turin, Italy
| | - Alessandro Morabito
- Thoracic Medical Oncology, Istituto Nazionale
Tumori ‘Fondazione G Pascale’, IRCCS, Napoli, Italy
| | - Bruno Vincenzi
- Medical Oncology Unit, Campus Bio-Medico
University of Rome, Rome, Italy
| | - Emanuela Arvat
- Division of Oncological Endocrinology,
Department of Medical Sciences, University of Turin, Italy
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Addeo A, Tabbò F, Robinson T, Buffoni L, Novello S. Corrigendum to “Precision medicine in ALK rearranged NSCLC: A rapidly evolving scenario” [Crit. Rev. Oncol./Hematol. 122 (February) (2018) 150–156]. Crit Rev Oncol Hematol 2019; 139:158. [DOI: 10.1016/j.critrevonc.2018.06.018] [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] Open
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Pellerino A, Buffoni L, Rudà R, Soffietti R. Complete response of spinal metastases from non-small cell lung cancer with ALK inhibitors. Neurology 2019; 93:217-219. [PMID: 31248938 DOI: 10.1212/wnl.0000000000007866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/29/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Alessia Pellerino
- From the Department of Neuro-Oncology (A.P., R.R., R.S.), University and City of Health and Science Hospital, Turin; and Oncology Department (L.B.), San Luigi Hospital, University of Turin, Orbassano, Italy.
| | - Lucio Buffoni
- From the Department of Neuro-Oncology (A.P., R.R., R.S.), University and City of Health and Science Hospital, Turin; and Oncology Department (L.B.), San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Roberta Rudà
- From the Department of Neuro-Oncology (A.P., R.R., R.S.), University and City of Health and Science Hospital, Turin; and Oncology Department (L.B.), San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Riccardo Soffietti
- From the Department of Neuro-Oncology (A.P., R.R., R.S.), University and City of Health and Science Hospital, Turin; and Oncology Department (L.B.), San Luigi Hospital, University of Turin, Orbassano, Italy
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Affiliation(s)
- Alfredo Addeo
- Oncology Department, Bristol Cancer Centre, Bristol, England
| | - Lucio Buffoni
- Department of Oncology, San Luigi Hospital, University of Turin, Turin, Italy
| | - Massimo Di Maio
- Department of Oncology, Mauriziano Hospital, University of Turin, Turin, Italy
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Addeo A, Buffoni L. SABR versus conventional fractionation regimens in NSCLC. Lancet Oncol 2019; 20:e230. [PMID: 31044707 DOI: 10.1016/s1470-2045(19)30175-5] [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] [Received: 02/15/2019] [Accepted: 02/19/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Alfredo Addeo
- University Hospital of Geneva, Geneva 1211, Switzerland.
| | - Lucio Buffoni
- Department of Oncology, San Luigi Hospital University of Turin, Turin, Italy
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Bruni A, Grossi F, Katia F, Capelletto E, Buffoni L, Badellino S, Poletti V, Chiari R, Giaj Levra N, Banna G, Vagge S, Borghetti P, Baldini E, Bria E, Tiseo M, Paci M, Ciammella P, Taraborrelli M, Ricardi U, Scotti V. The standard of care for stage III NSCLC in the era of immunotherapy: An Italian national survey on the current pattern of care among Italian thoracic oncologists. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy291.013] [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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22
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Schena M, La Rovere E, Solerio D, Bustreo S, Barone C, Daniele L, Buffoni L, Bironzo P, Sapino A, Gasparri G, Ciuffreda L, Ricardi U. Neoadjuvant chemo-radiotherapy for locally advanced esophageal cancer: A monocentric study. Tumori 2018; 98:451-7. [DOI: 10.1177/030089161209800409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Aims and background Multimodal therapy is a keystone of care in advanced esophageal cancer. Although neoadjuvant chemoradiotherapy is known to provide a survival advantage in selected cases, reliable prognostic and response predictive factors remain elusive. We report the outcome in a series of esophageal cancer patients treated at our center and the results of a retrospective analysis of epidermal growth factor receptor (EGFR) expression and EGFR/HER2 gene copy numbers taken as possible prognostic and predictive factors. Methods and study design Between 2001 and 2009, a total of 40 consecutive patients (34 men and 6 women; median age, 59 years) were treated for esophageal cancer. Treatment: cisplatin, 80 mg/m2 day 1, and 5-fluorouracil, 800 mg/m2/24 h on days 1–5, every 21 days, concomitant with 3D-conformal radiotherapy (54–59.4 in 30–33 fractions) for three up to four cycles. Surgery was performed in eligible patients 6–8 weeks after chemoradiation. EGFR expression and EGFR/HER2 amplification and gene copy number were studied by immunohistochemical analysis and fluorescence in situ hybridization, respectively. Results Acceptable toxicity following chemoradiation was recorded, with G3–G4 hematological toxicity in 20% of patients and G3–G4 dysphagia in less than 10%; 14 (35%) patients achieved complete response and 19 (48%) partial response; 18 underwent surgery after chemoradiation, of which 8 (20%) achieved pathologic complete response. The median survival was 29 months (95% CI, 25.7–32.1): 42 months for the resected and 20 for the unresected patients. EGFR and HER2 analysis in 28 patients showed that 89% had immunohistochemical EGFR expression, with 5 cases of EGFR and 10 of HER2 gene gain without a significant difference in response rate and survival in these patient subgroups. Conclusions Our results suggest a better outcome in patients who underwent surgery after chemoradiation. A larger sample size is necessary to clarify the role of EGFR and HER2 gene gain in predict response and survival.
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Affiliation(s)
- Marina Schena
- Department of Onco-Hematology, Oncology Unit, San Giovanni Battista Hospital, Turin
| | - Erika La Rovere
- Department of Onco-Hematology, Oncology Unit, San Giovanni Battista Hospital, Turin
| | - Dino Solerio
- Department of Clinical Physiopathology, Esophageal Surgery Unit, University of Turin, San Giovanni Battista Hospital, Turin, Italy
| | - Sara Bustreo
- Department of Onco-Hematology, Oncology Unit, San Giovanni Battista Hospital, Turin
| | - Carla Barone
- Department of Onco-Hematology, Oncology Unit, San Giovanni Battista Hospital, Turin
| | - Lorenzo Daniele
- Department of Biomedical Sciences and Human Oncology, University of Turin, Turin
| | - Lucio Buffoni
- Department of Onco-Hematology, Oncology Unit, San Giovanni Battista Hospital, Turin
| | - Paolo Bironzo
- Department of Onco-Hematology, Oncology Unit, San Giovanni Battista Hospital, Turin
| | - Anna Sapino
- Department of Biomedical Sciences and Human Oncology, University of Turin, Turin
| | - Guido Gasparri
- Department of Clinical Physiopathology, Esophageal Surgery Unit, University of Turin, San Giovanni Battista Hospital, Turin, Italy
| | - Libero Ciuffreda
- Department of Onco-Hematology, Oncology Unit, San Giovanni Battista Hospital, Turin
| | - Umberto Ricardi
- Department of Medical and Surgical Sciences, Radiation Oncology Unit, University of Turin, San Giovanni Battista Hospital, Turin, Italy
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23
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Finocchiaro CY, Rota A, Barbieri V, Bettini A, Bianco R, Borra G, Buffoni L, Bulotta A, Carta A, Cortinovis D, Costanzo R, Cusmai A, Danesi R, D’Argento E, Del Conte A, Franchina T, Gilli M, Gregorc V, Irtelli L, Landi L, Malorgio F, Mancuso G, Martelli O, Mazzanti P, Melotti B, Migliorino MR, Minotti V, Montrone M, Morabito A, Roca E, Romano G, Rossi A, Savio G, Tiseo M, Boscardini I, Piccolo L, Pilotto S, Malapelle U. Listening understanding and acting (lung): focus on communicational issue in thoracic oncology. Transl Cancer Res 2018; 8:S16-S22. [PMID: 35117061 PMCID: PMC8798889 DOI: 10.21037/tcr.2018.12.32] [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: 11/28/2018] [Accepted: 12/21/2018] [Indexed: 12/03/2022]
Abstract
Background In the field of oncological assistance, nowadays we have to deal with a complex scenario where patients got used to obtain a huge amount of information through internet or social media and to apply them in performing their health-related decisions. This landscape requires that clinicians become able to handle therapeutical approaches and adequate skills in communication tools to satisfy the current needs. Our project aimed to build a communication model based on clinical oncologists’ real experiences in order to find a simple way to share with patients all the innovative therapeutical opportunities today available in lung cancer. The final goal is to design a flexible and personalized model adaptable to clinician’s personal characteristics and to the specific patient he is facing. We applied both traditional educational tools and innovative techniques in order to make the results effective and applicable to support peer learning. Methods The first step consisted in a Board synthesized the definition of the diagnostic process, the identification of treatment strategies and any potential communication barrier clinicians may face dealing with patients. The second step consisted in teamwork including a theoretical part and a training part. In the third step we produce five training videos and video interviews regarding communication praxis and a “Small communication manual”. The last step consisted in the publication of the produced material on website and its diffusion through the social media. Results In medicine, the universal application of a single model of communication does not represent the optimal solution. By contrary, the availability of simple and practical suggestions to improve the communicative style could allow clinicians to abandon stereotyped formulas identically repurposed to all patients. The “from bottom to top” training, starting from real-life to take advantage of the clinician’s experience, give the clinicians the possibility to meditate about their own communicative style and to train in the context of a protected environment. Applying these rules, we design an effective communication model, based on healthcare humanization, which could represent a fundamental support for the patient in order to be gently driven by the clinician to the most appropriate therapeutical choice, balancing efficacy and quality of life. The relational training may improve the quality of clinician-patient communication and could be widespread to other clinicians through the media. Conclusions Considering the innovative therapeutical options available, particularly for lung cancer patients, and the increasing access of health-related information through internet or social media the clinician-patient communication has become crucial to support the achievement of the most appropriate therapeutical choice for the patient, facing the intricate illness experience. Building a shareable and easy-to-apply communication model represents a challenge aimed to help clinicians and including technology not as a threat, but as a positive tool.
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Affiliation(s)
| | | | - Vito Barbieri
- UO Oncologia Medica, AOU “Mater Domini”, Germaneto, Catanzaro, Italy
| | - Anna Bettini
- ASST Papa Giovanni XXIII, UO Oncologia, Bergamo, Italy
| | | | - Gloria Borra
- AOU Maggiore della Carità di Novara, Novara, Italy
| | - Lucio Buffoni
- AOU San Luigi Orbassano, Oncologia Medica, Torino, Italy
| | - Alessandra Bulotta
- Dipartimento di Oncologia Medica, IRCCS Ospedale Scientifico San Raffaele, Milano, Italy
| | - Annamaria Carta
- AOB Cagliari, UO Oncologia Medica, Ospedale Businco, Cagliari, Italy
| | - Diego Cortinovis
- Struttura Semplice Lung Unit, Ospedale San Gerardo, ASST Monza, Monza, Italy
| | - Raffaele Costanzo
- UO Complessa di Oncologia medica Toraco-Polmonare, Istituto Nazionale Tumori, Napoli, Italy
| | | | - Romano Danesi
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy
| | - Ettore D’Argento
- UOC di Oncologia Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Alessandro Del Conte
- IRCCS, Centro di Riferimento Oncologico, SOC Oncologia Medica e dei Tumori Immunocorrelati, Aviano (PN), Italy
| | - Tindara Franchina
- Dipartimento di Patologia Umana “G.Barresi”, Università degli studi di Messina, Messina, Italy
| | - Marina Gilli
- AORN dei Colli, UOSD DH PNL Oncologico, Napoli, Italy
| | - Vanesa Gregorc
- Dipartimento di Oncologia Medica, IRCCS Ospedale Scientifico San Raffaele, Milano, Italy
| | - Luciana Irtelli
- Clinica Oncologica, ASL Lanciano Vasto Chieti, Chieti, Italy
| | - Lorenza Landi
- Unità Operativa di Oncologia ed Ematologia, AUSL Romagna, Ravenna, Italy
| | | | | | - Olga Martelli
- AO Complesso Ospedaliero San Giovanni-Addolorata, Roma, Italy
| | - Paola Mazzanti
- UO Clinica Oncologica, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Barbara Melotti
- Oncologia Medica, Azienda Ospedaliera S.Orsola-Malpighi, Bologna, Italy
| | - Maria Rita Migliorino
- UOSD di Pneumologia Oncologica Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy
| | - Vincenzo Minotti
- Divisione Struttura Complessa Oncologia Medica, Ospedale S. Maria della Misericordia Perugia, Perugia, Italy
| | - Michele Montrone
- SSD Oncologia Medica per la Patologia Toracica, IRCCS Istituto Tumori “Giovanni Paolo II” di Bari, Bari, Italy
| | - Alessandro Morabito
- Struttura Complessa Oncologia Medica Toraco-Polmonare, Divisione di Oncologia Medica, Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy
| | - Elisa Roca
- Oncologia Medica, Spedali Civili di Brescia, Brescia, Italy
| | | | - Antonio Rossi
- Divisione di Oncologia Medica, Fondazione IRCCS Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Foggia, Italy
| | | | - Marcello Tiseo
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Parma, Italy
| | - Ivano Boscardini
- Docente di tecniche di comunicazione, CREMS Centro di Ricerca in Economia e Management in Sanità e nel Sociale, Università Cattaneo LIUC, Castellanza, VA, Italy
| | | | - Sara Pilotto
- Università degli Studi di Verona, UO Oncologia Medica, AOUI Verona, Verona, Italy
| | - Umberto Malapelle
- Anatomia Patologica, Dip.to di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
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Addeo A, Tabbò F, Robinson T, Buffoni L, Novello S. Precision medicine in ALK rearranged NSCLC: A rapidly evolving scenario. Crit Rev Oncol Hematol 2017; 122:150-156. [PMID: 29458783 DOI: 10.1016/j.critrevonc.2017.12.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE The identification of anaplastic lymphoma kinase (ALK) rearrangements in 2-5% of non-small cell lung cancer (NSCLC) patients led to the rapid clinical development of its oral tyrosine kinase inhibitor (TKI). Crizotinib was the first ALK inhibitor approved and utilised in the treatment of ALK+ NSCLC patients in the second line setting first and subsequently in the first line one. Since then many other ALK inhibitors have been developed (ceritinib, alectinib, brigatinib, lorlatinib,etc) and the treatment paradigm of these patients has considerably drifted. The questions regarding their treatment at progression remains unanswered at the moment. OBJECTIVE Our review clarifies what it is the state of the art in the treatment of ALK rearranged NSCLC patients, highlights the mechanisms of primary and secondary resistance mutations and suggests a treatment algorithm based on specific primary resistance or acquired mutations. EVIDENCE REVIEW Studies that enrolled ALK+ NSCLC patients with locally advance or metastatic disease receiving treatment with ALK inhibitor, first or second line, were identified using electronic databases (MEDLINE, EMBASE, and Cochrane library). Trials were excluded if they were phase 1, enrolled less than 10 patients. FINDING Overall 1942 patients were included in our review. It confirms the role and the efficacy in first line of Alectinib but it highlights also that all the ALK inhibitors could play a crucial role during the patients' journey. Identifying the different mutations and utilising the most active ALK inhibitor depending on the "up-to-date" driven mutation is the way forward in the management of those patients. CONCLUSIONS AND RELEVANCE the review shows the rapid drifting in the management of ALK+ NSCLC patients and the importance of fully understanding and acknowledging the role of the resistance mutation, primary or acquired. We strongly advocate a comprehensive genomic approach in the management of ALK+ NSCLC patients who develop resistance mutations that are still targetable by a different ALK inhibitor.
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Affiliation(s)
- Alfredo Addeo
- Oncology Department, University Hospital Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, CH, Switzerland.
| | - Fabrizio Tabbò
- Oncology Department, San Luigi Hospital University of Turin, Orbassano, Turin, Italy
| | - Tim Robinson
- Oncology Department, Bristol University Hospital Trust, Horfield Road, Bristol, UK
| | - Lucio Buffoni
- Oncology Department, San Luigi Hospital University of Turin, Orbassano, Turin, Italy
| | - Silvia Novello
- Oncology Department, San Luigi Hospital University of Turin, Orbassano, Turin, Italy
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25
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Gobbini E, Reale M, De Luca E, Righi L, Gianetta M, Capelletto E, Buffoni L, Giaj Levra M, Novello S. DNA amount comparison between cytologic and histologic samples for epithelial growth factor receptor (EGFR) testing in non-small-cell lung cancer (NSCLC) patients: a single institution experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426.012] [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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26
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Gobbini E, Galetta D, Tiseo M, Graziano P, Rossi A, Bria E, Di Maio M, Rossi G, Gregorc V, Riccardi F, Scotti V, Ceribelli A, Buffoni L, Delmonte A, Franchina T, Migliorino MR, Cortinovis D, Pisconti S, Bordi P, Catino A, Maiello E, Arizio F, Novello S. Molecular profiling in Italian patients with advanced non-small-cell lung cancer: An observational prospective study. Lung Cancer 2017; 111:30-37. [DOI: 10.1016/j.lungcan.2017.06.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/14/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022]
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Abstract
OPINION STATEMENT Twenty years ago, an individual patient data meta-analysis of eight cisplatin-based adjuvant chemotherapy (AC) studies in completely resected early stage non-small cell lung cancer (NSCLC) demonstrated a 13 % reduction of the risk of death favoring chemotherapy that was of borderline statistical significance (p = 0.08). This marginal benefit boosted a new generation of randomized trials to evaluate the role of modern platinum-based regimens in resectable stages of NSCLC and, although individual studies generated conflicting results, overall they contributed to confirm the role of AC which is now recommended for completely resected stage II and III NSCLC, mostly 4 cycles, while subset analyses suggested a benefit in patients with large IB tumors. Cisplatin-based therapy was the core regimen of those adjuvant clinical trials and even if a substitution with other platinum-derived was also suggested, mainly based on extrapolated data from studies in advanced disease, cisplatin was confirmed to be slightly superior to carboplatin and is still the drug of choice in the adjuvant setting. Currently, any attempt to improve efficacy of cisplatin-based chemotherapy through antiangiogenic drugs association or pharmacogenomics approaches have failed, while results of additional studies are eagerly awaited. In the context of promising targeted therapies, even if several randomized trials in the advanced setting evaluated tyrosine kinase inhibitors (TKis) versus platinum-based chemotherapy and showed impressive results, clinical experience with TKIs in the adjuvant setting is still limited and most of the trials have not required patients to be molecularly tested for the drug-specific molecular predictive factor. At the present time, the role of targeted agents as adjuvant approaches remains largely not investigated. Finally, with the negative experience of the use of vaccines in this setting, the integration of immunotherapy (mainly immunocheckpoint inhibitors) in platinum-based schedules has just started to be evaluated, representing a potential future clinical option, but still far from clinical practice.
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Affiliation(s)
- Lucio Buffoni
- Department of Oncology at San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Torino, Italy
| | - Tiziana Vavalà
- Department of Oncology, ASL CN1, Via C. Boggio, 12, 12100, Cuneo, Italy.
| | - Silvia Novello
- Department of Oncology at San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Torino, Italy
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Gobbini E, Gregorc V, Galetta D, Riccardi F, Bordi P, Scotti V, Ceribelli A, Buffoni L, Maiello E, Delmonte A, Franchina T, Migliorino MR, Cortinovis D, Pisconti S, Di Maio M, Graziano P, Bria E, Rossi G, Rossi A, Pasello G, Sergi C, Martelli O, Cinieri S, Lunghi A, Novello S. P2.03b-063 Molecular Profiling in Advanced Non-Small-Cell Lung Cancer: Preliminary Data of an Italian Observational Prospective Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1344] [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: 11/28/2022]
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Escamilla A, Zafra R, Pérez J, McNeilly TN, Pacheco IL, Buffoni L, Martínez-Moreno FJ, Molina-Hernández V, Martínez-Moreno A. Distribution of Foxp3 + T cells in the liver and hepatic lymph nodes of goats and sheep experimentally infected with Fasciola hepatica. Vet Parasitol 2016; 230:14-19. [PMID: 27884436 DOI: 10.1016/j.vetpar.2016.10.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 10/20/2016] [Accepted: 10/22/2016] [Indexed: 10/24/2022]
Abstract
Foxp3 regulatory T cells (Tregs) are now considered to play a key role in modulation of immune responses during parasitic helminth infections. Immunomodulation is a key factor in Fasciola hepatica infection; however, the distribution and role of Foxp3+ Tregs cells have not been investigated in F. hepatica infected ruminants. The aim of this study was to evaluate the presence of Foxp3+ Tregs in the liver and hepatic lymph nodes from experimentally infected sheep and goats during acute and chronic stages of infection. Three groups of goats (n=6) and three groups of sheep (n=6) were used in this study. Goats in groups 1-2 and sheep in groups 4-5 were orally infected with metacercarie of ovine origin. Groups 1 and 4 were killed during the acute stage of the infection, at nine days post infection (dpi); groups 2 and 5 were killed during the chronic stage, at 15 and19 weeks post infection respectively (wpi). Groups 3 (goats) and 6 (sheep) were left as uninfected controls. Fluke burdens and liver damage were assessed and the avidin-biotin-complex method was used for the immunohistochemical study. At nine dpi in acute hepatic lesions, the number of both Foxp3+ and CD3+ T lymphocytes increased significantly in goats and sheep. In the chronic stages of infection (15-19wpi), the number of Foxp3+ and CD3+ T lymphocytes were also significantly increased with respect to control livers, particularly in portal spaces with severely enlarged bile ducts (response to adult flukes) while the increase was lower in granulomas, chronic tracts and smaller portal spaces (response to tissue damage). Foxp3+ Tregs were increased in the cortex of hepatic lymph nodes of sheep (chronic infection) and goats (acute and chronic infection). The estimated proportion of T cells which were Foxp3+ was significantly increased in the large bile ducts and hepatic lymph node cortex of chronically infected goats but not sheep. This first report of the expansion of Foxp3+ Tregs in acute and chronic hepatic lesions in ruminants suggests that these cells may be involved in both parasite survival and modulation of hepatic damage. Future studies should be focused on the investigation of parasite molecules and cytokines involved in this process.
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Affiliation(s)
- A Escamilla
- Department of Anatomy and Comparative Pathology, Faculty of Veterinary Medicine, University of Córdoba, Spain
| | - R Zafra
- Department of Anatomy and Comparative Pathology, Faculty of Veterinary Medicine, University of Córdoba, Spain
| | - J Pérez
- Department of Anatomy and Comparative Pathology, Faculty of Veterinary Medicine, University of Córdoba, Spain
| | - T N McNeilly
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik EH26 OPZ, UK
| | - I L Pacheco
- Department of Anatomy and Comparative Pathology, Faculty of Veterinary Medicine, University of Córdoba, Spain
| | - L Buffoni
- Department of Animal Health (Parasitology), Faculty of Veterinary Medicine, University of Córdoba, Spain
| | - F J Martínez-Moreno
- Department of Animal Health (Parasitology), Faculty of Veterinary Medicine, University of Córdoba, Spain
| | | | - A Martínez-Moreno
- Department of Animal Health (Parasitology), Faculty of Veterinary Medicine, University of Córdoba, Spain.
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Gobbini E, Grecorc V, Galetta D, Riccardi F, Tiseo M, Scotti V, Ceribelli A, Buffoni L, Maiello E, Delmonte A, Franchina T, Migliorino M, Cortinovis D, Pisconti S, Di Maio M, Graziano P, Bria E, Rossi G, Rossi A, Novello S. Molecular profiling in advanced non-small-cell lung cancer: preliminary data of the Italian observational prospective study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw332.11] [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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31
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Ardizzoni A, Tiseo M, Boni L, Di Maio M, Buffoni L, Belvedere O, Grossi F, D'Alessandro V, de Marinis F, Barbera S, Caroti C, Favaretto A, Cortinovis D, Morrica B, Tixi L, Ceschia T, Parisi S, Ricardi U, Grimaldi A, Loreggian L, Navarria P, Huber RM, Belani C, Brunsvig PF, Scagliotti GV, Scolaro T. Randomized phase III PITCAP trial and meta-analysis of induction chemotherapy followed by thoracic irradiation with or without concurrent taxane-based chemotherapy in locally advanced NSCLC. Lung Cancer 2016; 100:30-37. [PMID: 27597278 DOI: 10.1016/j.lungcan.2016.07.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 07/18/2016] [Accepted: 07/26/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Chemo-radiotherapy is standard of care in the treatment of unresectable stage III NSCLC. We aimed at assessing whether the addition of concurrent taxane-chemotherapy to thoracic irradiation following chemotherapy was able to improve treatment outcome. MATERIAL AND METHODS In PITCAP trial, patients with unresectable stage III NSCLC were randomized to receive 2 cycles of platinum-paclitaxel followed by 60-61.2Gy thoracic irradiation (control arm) or by same radiotherapy with concomitant weekly paclitaxel (experimental arm). A literature-based meta-analysis including all studies with same design was also performed. RESULTS At the time of the second interim analysis, when 151 patients were randomized, accrual was terminated. With a median follow-up of 6.1 years, median survival was 13.2 vs 15.1 months, with a 3-year survival rate of 19.5 vs 21.2% in the control and experimental arm, respectively (HR: 0.97; 95% CI 0.69-1.36; p=0.845). Treatment toxicity was manageable in both arms. The meta-analysis of 5 trials (n=866) confirmed the lack of a meaningful effect on 1-year overall survival of a taxane added concurrently to radiotherapy. CONCLUSIONS These results do not support a meaningful survival benefit with the addition of single agent taxane given concurrently to radiotherapy after platinum-based induction in locally advanced NSCLC.
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Affiliation(s)
- Andrea Ardizzoni
- Medical Oncology Unit, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Marcello Tiseo
- Medical Oncology Unit, University Hospital, Parma, Italy.
| | - Luca Boni
- Clinical Trials Coordinating Center, Istituto Toscano Tumori, University Hospital Careggi, Firenze, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Torino, Orbassano, Torino, Italy
| | - Lucio Buffoni
- Department of Oncology, University of Torino, Orbassano, Torino, Italy
| | - Ornella Belvedere
- Department of Oncology, Medical Oncology Unit, University Hospital, Udine, Italy
| | - Francesco Grossi
- Medical Oncology Unit A, IRCCS San Martino University Hospital - IST National Cancer Research Institute, Genova, Italy
| | - Vito D'Alessandro
- Respiratory Oncology Section, I Internal Medicine Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Filippo de Marinis
- Division of Thoracic Oncology, European Institute of Oncology (IEO), Milan, Italy
| | - Santi Barbera
- Division of Oncologic Pneumology, Mariano Santo Hospital, Cosenza, Italy
| | - Cinzia Caroti
- Academic Unit of Medical Oncology, IRCCS San Martino University Hospital - IST National Cancer Research Institute, Genova, Italy
| | - Adolfo Favaretto
- Department of Clinical and Experimental Oncology, Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | | | - Brunello Morrica
- Radiotherapy Unit, Istituto Nazionale Tumori Fondazione G. Pascale, Napoli, Italy
| | - Lucia Tixi
- Department of Internal Medicine, IRCCS San Martino University Hospital - IST National Cancer Research Institute, Genova, Italy
| | - Tino Ceschia
- Department of Oncology, Radiotherapy Unit, University Hospital, Udine, Italy
| | - Salvatore Parisi
- Radiotherapy Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Torino, Italy
| | | | - Lucio Loreggian
- Radiotherapy Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Pierina Navarria
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Rudolf M Huber
- Pneumologie, Medizinische Klinik Innenstadt, University of Munich, Munich, Germany
| | - Chandra Belani
- University of Pittsburgh Cancer Institute, Pittsburgh, PA, United States
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Satolli MA, Buffoni L, Spadi R, Roato I. Gastric cancer: The times they are a-changin'. World J Gastrointest Oncol 2015; 7:303-16. [PMID: 26600930 PMCID: PMC4644853 DOI: 10.4251/wjgo.v7.i11.303] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/15/2015] [Accepted: 08/13/2015] [Indexed: 02/05/2023] Open
Abstract
Gastric cancer is the third leading cause of cancer death worldwide. Even though during these last decades gastric cancer incidence decreased in Western countries, it remains endemic and with a high incidence in Eastern countries. The survival in advanced and metastatic stage of gastric cancer is still very poor. Recently the Cancer Genoma Atlas Research Network identified four subtypes with different molecular profiles to classify gastric cancer in order to offer the optimal targeted therapies for pre-selected patients. Indeed, the key point is still the selection of patients for the right treatment, on basis of molecular tumor characterization. Since chemotherapy reached a plateau of efficacy for gastric cancer, the combination between cytotoxic therapy and biological agents gets a better prognosis and decreases chemotherapeutic toxicity. Currently, Trastuzumab in combination with platinum and fluorouracil is the only approved targeted therapy in the first line for c-erbB2 positive patients, whereas Ramucirumab is the only approved targeted agent for patients with metastatic gastric cancer. New perspectives for an effective treatment derived from the immunotherapeutic strategies. Here, we report an overview on gastric cancer treatments, with particular attention to recent advances in targeted therapies and in immunotherapeutic approach.
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Buffoni L, Consito L, Filippi AR, Ruffini E, Solidoro P, Bironzo P, Satolli MA, Schena M, Ciuffreda L. Advanced non-small cell lung cancer in elderly patients: A review. World J Respirol 2015; 5:102-111. [DOI: 10.5320/wjr.v5.i2.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 01/15/2015] [Accepted: 04/07/2015] [Indexed: 02/06/2023] Open
Abstract
Over 50% of patients diagnosed with non-small-cell lung cancer (NSCLC) are 65 years old while 30% exceed 70 years old. Comparing elderly patients to their younger counterpart they poorly tolerate chemotherapy due to progressive reduction of organ function and age-related co-existing pathologies. Due to this reason elderly are usually excluded from platinum-based chemotherapy, which still represent the standard of care for advanced NSCLC. In every-day practice, single-agent schedule with a third-generation drug is the recommended option for elderly patients with advanced NSCLC. A modest increase in toxicity for elderly patients has been demonstrated by subgroup analyses concluding for platinum-based combination chemotherapy being similar in young patients and fit elderly. Even though the cited evidence, feasibility of chemotherapy based on platinum remains an open question. Prospective randomised trials are warranted in order to change guide lines and give the clinicians a new therapeutic option. Recent emerging role of molecular target in selecting patients for new targeted therapies suggest dedicated trials for elderly patients. The same is for more accurate evaluation of elderly patients with increasing evidence for a comprehensive geriatric assessment as a valid tool for customized treatment in NSCLC elderly patients. Suitable evidences for the treatment of elderly patients affected by advanced NSCLC together with more appropriate and validated tools for patients selection are reviewed along the manuscript.
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Escamilla A, Zafra R, Mozos E, Bautista M, Pacheco I, Ruiz M, Buffoni L, Pérez R, Martínez-Moreno A, Pérez J. Fasciola hepatica induces apoptosis of inflammatory cells in sheep at different stages of infection. J Comp Pathol 2015. [DOI: 10.1016/j.jcpa.2014.10.169] [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: 10/24/2022]
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Pacheco I, Ruiz M, Escamilla A, Zafra R, Buffoni L, Martínez-Moreno F, Martínez-Moreno A, Dalton J, Mulcahy G, Pérez J. Liver Changes in Sheep Vaccinated with Recombinant Cathepsin L1 and Challenged with Fasciola hepatica. J Comp Pathol 2015. [DOI: 10.1016/j.jcpa.2014.10.065] [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: 10/24/2022]
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36
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Agnoletti A, Mencarani C, Panciani PP, Buffoni L, Ronchetti G, Spena G, Tartara F, Buglione M, Pagano M, Ducati A, Fontanella M, Garbossa D. Surgery in cerebral metastases: are numbers so important? J Cancer Res Ther 2014; 10:79-83. [PMID: 24762491 DOI: 10.4103/0973-1482.131390] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The prognosis of cerebral metastases (MTS) is linked to progression of both systemic and local disease. The importance of MTS resection has been already pointed out. The observation of a high mortality for not-neurological causes confirms that the modern treatments allow a significant control of the disease within the nervous system. Nevertheless, management difficulties increase with multiple lesions and in these cases the role of surgery has still to be defined. MATERIALS AND METHODS We collected the clinical data of patients operated in two centers for cerebral MTS from lung carcinoma during 8 years. Patient selection for surgery followed definite criteria; the limit for multiple MTS was three. We analyzed the functional and survival outcomes of the cohort. RESULTS AND CONCLUSIONS Our series included 242 patients: 105 had multiple MTS. Statistical analysis did not show significant differences in mean survival and outcomes between patients with single and multiple lesions. The decease occurred for neurological causes in 15.7% of cases. The selection of candidates for surgery requires several considerations and entails the success rate of this treatment. In patients with the multiple lesions who fulfilled the selection criteria we observed a nevertheless satisfying success after the operation. Our results imply that surgery may be applied also in selected patients with more diffuse intracranial disease. A pre-operative accurate patient selection is related to acceptable quality-of-life following the operation even in cases of multiple MTS.
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Affiliation(s)
| | | | - Pier Paolo Panciani
- Department of Neuroscience, Division of Neurosurgery, University of Torino; Division of Neurosurgery, University of Brescia, Italy
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Guerrera F, Tabbo F, Bessone L, Di Gangi S, Buffoni L, Delsedime L, Filosso PL, Oliaro A, Ruffini E, Inghirami G. P-202 * LUNG CANCER BIOBANKING: INTEGRATED APPROACH FOR PRECISION MEDICINE. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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38
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Filippi AR, Badellino S, Guarneri A, Levis M, Botticella A, Mantovani C, Ragona R, Racca P, Buffoni L, Novello S, Ricardi U. Outcomes of Single Fraction Stereotactic Ablative Radiotherapy for Lung Metastases. Technol Cancer Res Treat 2014; 13:37-45. [DOI: 10.7785/tcrt.2012.500355] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Stereotactic Ablative Radiotherapy (SABR) has been previously investigated as an alternative to thoracic surgery in patients with a limited number of pulmonary nodules from different primary tumors. We here report the clinical outcomes of a series of consecutive patients homogenously selected and treated with single dose SABR in our Institution. Eligibility criteria were: 1–5 lung metastases, maximum tumor diameter <50 mm, absent or controlled extra-thoracic disease, adequate pulmonary function, no prior radiotherapy, performance status ECOG 0–1. All patients were treated with a single dose of 26 Gy prescribed to the 80% isodose, by 3D-CRT or by IGRT-VMAT. Follow-up consisted of clinical evaluation and periodic CT scans. Primary endpoints were Local Control (LC), toxicity and Progression-Free Survival (PFS). Secondary endpoints were Cancer-Specific Survival (CSS) and Overall Survival (OS). Out of 102 patients treated with SABR between october 2003 and october 2011, we selected 67 patients for a total of 90 lesions. Main primary tumor sites were lung and colon-rectum (37.3% and 43.3% of lesions, respectively). Median follow up time was 24 months. Treated metastasis progression at SABR site was observed in 10 lesions (11.1%), and actuarial LC rates at 1 and 2 years were respectively 93.4% and 88.1%. Systemic failure occurred in 37 patients (55.2%) at a median interval of 8 months after SABR. PFS rates were 72% and 55.4% at 1 and 2 year. Seven patients had grade 1 (10.4%) and 8 grade 2–3 late radiological toxicity (11.9%), while 6 experienced late chest wall toxicity (2 rib fractures, 4 chronic chest pain, 8.9%). CSS rates at 1 and 2 years were 90% and 76%, while OS rates were 85.1% and 70.5%, respectively. Median survival time was 40 months. On multivariate analysis, a disease-free interval longer than 24 months was close to significance for a benefit in CSS ( p = 0.07; HR 0.34 [95% CI 0.1–1.12]). The study includes a cohort of patients treated with single fraction 26 Gy SABR followed for a prolonged time interval. Single fraction SABR appears to be an effective treatment option, with little observed acute toxicity and limited late toxicity (<15%); its advantages also include a high patients' compliance, a short overall treatment time and an easy combination with systemic therapies. These results might provide supportive evidence to the use of single fraction SABR as a valid and acceptable alternative to surgery for pulmonary metastases from different primary tumors.
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Affiliation(s)
- Andrea R. Filippi
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Serena Badellino
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Alessia Guarneri
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Mario Levis
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Angela Botticella
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Cristina Mantovani
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Riccardo Ragona
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Patrizia Racca
- Medical Oncology 1, University Hospital S. Giovanni Battista, Torino, Italy
| | - Lucio Buffoni
- Medical Oncology 1, University Hospital S. Giovanni Battista, Torino, Italy
| | - Silvia Novello
- Department of Oncology, Thoracic Oncology, University of Torino, Orbassano, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
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Rolfo C, Raez LE, Bronte G, Santos ES, Papadimitriou K, Buffoni L, van Meerbeeck JP, Russo A. BIBF 1120/nintedanib: a new triple angiokinase inhibitor-directed therapy in patients with non-small cell lung cancer. Expert Opin Investig Drugs 2013; 22:1081-8. [DOI: 10.1517/13543784.2013.812630] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Christian Rolfo
- Antwerp University Hospital, Oncology Department, Phase I â Early Clinical Trials Unit,
Edegem, Belgium
| | - Luis E Raez
- Memorial Cancer Institute, Memorial Health Care System, Thoracic Oncology Program,
Pembroke Pines, FL, USA
| | - Giuseppe Bronte
- University of Palermo, Department of Surgical and Oncology Sciences, Section of Medical Oncology,
Palermo, Italy
| | - Edgardo S Santos
- Lynn Cancer Institute, Thoracic Oncology,
Boca Raton, Florida, USA
| | | | - Lucio Buffoni
- San Giovanni Battista Molinette Hospital, Department of Medical Oncology,
Turin, Italy
| | - Jan P van Meerbeeck
- Ghent University Hospital, Department of Respiratory Medicine,
Ghent, Belgium
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Zafra R, Pérez J, Buffoni L, Martínez-Moreno FJ, Acosta I, Mozos E, Martínez-Moreno A. Peripheral blood lymphocyte subsets in Fasciola hepatica infected and immunised goats. Vet Immunol Immunopathol 2013; 155:135-8. [PMID: 23838471 DOI: 10.1016/j.vetimm.2013.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 05/21/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
Abstract
The proportions of CD4(+), CD8(+) and WC1+ T lymphocytes from peripheral blood using flow cytometry were investigated in goats infected with Fasciola hepatica and previously immunised with recombinant Cathepsin-L1 (rCL1) and Glutathione-S-transferase sigma class (GST). The immunisation trial did not induce protective responses, and no significant differences were recorded between immunised and non-immunised groups. However, there was a significant decrease in the proportion of CD4(+) T lymphocytes in the infected groups both at 5 weeks post-infection (wpi), coinciding with the migratory stage of the infection, and at 12 wpi in the biliary stage of the infection. The proportional decrease in this circulating population may be related to the recruitment of CD4(+) T cells in liver and hepatic lymph nodes and also to the immunomodulatory effect of the parasite through the interaction of F. hepatica excretory-secretory products (FhESP) with this cell population. To date, this is the first report about the effect of F. hepatica infection in peripheral lymphocyte subsets in goats.
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Affiliation(s)
- R Zafra
- Institute of Animal Health, University of Las Palmas de Gran Canaria, Trasmontaña s/n, Arucas, Las Palmas, Spain
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Zafra R, Buffoni L, Martínez-Moreno F, Bautista M, Escamilla A, Pacheco I, Pérez J, Martínez-Moreno A. Flow Cytometry from Whole Blood of Goats Infected Experimentally with Fasciola hepatica. J Comp Pathol 2013. [DOI: 10.1016/j.jcpa.2012.11.147] [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: 10/27/2022]
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Zafra R, Pérez-Écija RA, Buffoni L, Pacheco IL, Martínez-Moreno A, LaCourse EJ, Perally S, Brophy PM, Pérez J. Early hepatic and peritoneal changes and immune response in goats vaccinated with a recombinant glutathione transferase sigma class and challenged with Fasciola hepatica. Res Vet Sci 2012; 94:602-9. [PMID: 23261152 DOI: 10.1016/j.rvsc.2012.10.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 09/05/2012] [Accepted: 10/28/2012] [Indexed: 11/25/2022]
Abstract
Changes and local immune response were evaluated in the peritoneal cell populations, duodenal lamina propria and liver from goats immunized with recombinant glutathione transferase sigma class (rFhGST-S1) during early stages of infection with Fasciola hepatica. Group 1 (n=7) was unimmunized and uninfected; group 2 (n=10) was immunized with adjuvant Quil A and infected; group 3 (n=10) was immunised with rFhGST-S1 and infected. Three goats from each group were killed at 7-9 days post-infection (dpi) to evaluate early changes and immune response. The remaining goats were killed at 15 weeks post-infection (wpi). rFhGST-S1 vaccination induced variable response: three goats showed low fluke burden at 15 wpi and two goats showed low hepatic damage at early infection stages. This response was associated to a severe infiltrate of eosinophils in peritoneal fluid and hepatic necrotic foci, high iNOS expression in peritoneal cells and abundant infiltrate of eosinophils surrounding hepatic migrating flukes. T lymphocyte subsets were found in the vicinity of necrotic areas but they were absent in the vicinity of migrating larvae. No significant variation for T cell subsets, except for CD4 and γδ T lymphocytes, that were higher in the Quil A group compared to the rFhGST-S1 group. Expression of IL4 and IFN-γ in the hepatic inflammatory infiltrates was very occasional.
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Affiliation(s)
- R Zafra
- Department of Anatomy and Comparative Pathology, School of Veterinary Medicine, University of Cordoba, Animal Health Building, Campus Rabanales, Cordoba, Spain
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Schena M, La Rovere E, Solerio D, Bustreo S, Barone C, Daniele L, Buffoni L, Bironzo P, Sapino A, Gasparri G, Ciuffreda L, Ricardi U. Neoadjuvant chemo-radiotherapy for locally advanced esophageal cancer: a monocentric study. Tumori 2012. [PMID: 23052161 DOI: 10.1700/1146.12639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
AIMS AND BACKGROUND Multimodal therapy is a keystone of care in advanced esophageal cancer. Although neoadjuvant chemoradiotherapy is known to provide a survival advantage in selected cases, reliable prognostic and response predictive factors remain elusive. We report the outcome in a series of esophageal cancer patients treated at our center and the results of a retrospective analysis of epidermal growth factor receptor (EGFR) expression and EGFR/HER2 gene copy numbers taken as possible prognostic and predictive factors. METHODS AND STUDY DESIGN Between 2001 and 2009, a total of 40 consecutive patients (34 men and 6 women; median age, 59 years) were treated for esophageal cancer. TREATMENT cisplatin, 80 mg/m² day 1, and 5-fluorouracil, 800 mg/m²/24 h on days 1-5, every 21 days, concomitant with 3D-conformal radiotherapy (54-59.4 in 30-33 fractions) for three up to four cycles. Surgery was performed in eligible patients 6-8 weeks after chemoradiation. EGFR expression and EGFR/HER2 amplification and gene copy number were studied by immunohistochemical analysis and fluorescence in situ hybridization, respectively. RESULTS Acceptable toxicity following chemoradiation was recorded, with G3-G4 hematological toxicity in 20% of patients and G3-G4 dysphagia in less than 10%; 14 (35%) patients achieved complete response and 19 (48%) partial response; 18 underwent surgery after chemoradiation, of which 8 (20%) achieved pathologic complete response. The median survival was 29 months (95% CI, 25.7-32.1): 42 months for the resected and 20 for the unresected patients. EGFR and HER2 analysis in 28 patients showed that 89% had immunohistochemical EGFR expression, with 5 cases of EGFR and 10 of HER2 gene gain without a significant difference in response rate and survival in these patient subgroups. CONCLUSIONS Our results suggest a better outcome in patients who underwent surgery after chemoradiation. A larger sample size is necessary to clarify the role of EGFR and HER2 gene gain in predict response and survival.
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Affiliation(s)
- Marina Schena
- Department of Onco-Hematology, Oncology Unit, San Giovanni Battista Hospital, Turin, Italy.
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Zafra R, Pérez-Écija RA, Buffoni L, Moreno P, Bautista MJ, Martínez-Moreno A, Mulcahy G, Dalton JP, Pérez J. Early and late peritoneal and hepatic changes in goats immunized with recombinant cathepsin L1 and infected with Fasciola hepatica. J Comp Pathol 2012; 148:373-84. [PMID: 23083835 DOI: 10.1016/j.jcpa.2012.08.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 08/01/2012] [Accepted: 08/21/2012] [Indexed: 01/28/2023]
Abstract
The aim of the present study was to study peritoneal and hepatic changes during early [7-9 days postinfection (dpi)] and late [15 weeks postinfection (wpi)] infection of goats immunized with recombinant F. hepatica pro cathepsin L1 (rCL1) in Quil A and challenged with Fasciola hepatica. Despite finding no significant reduction in fluke burdens between the control and immunized group, at 15 dpi the rCL1-vaccinated group showed significantly higher weight gain and reduced severity of hepatic lesions compared with the control group that received only Quil A. In the rCL1-vaccinated group, two of three goats sacrificed at 7-9 dpi had little hepatic damage and had a higher percentage of peritoneal eosinophils and elevated induced nitric oxide synthase (iNOS) expression in peritoneal cells than the goats from the control group. Moreover, while these two goats showed a heavy infiltration of eosinophils surrounding migrating flukes, the remaining animals examined at 7-9 dpi had no inflammatory infiltration surrounding migrating flukes. Two out of seven goats in the rCL1-vaccinated group had low fluke burdens and little hepatic damage at 15 wpi, suggesting an effective protective response in some of the vaccinated goats. This protective response did not correlate with peripheral eosinophilia or with serum titres of anti-rCL1 immunoglobulin (Ig) G. The results of the present work suggest that an eosinophil-mediated immune response plays a crucial role in the early effective host response against F. hepatica in goats. Adjuvants designed to increase cell-mediated immunity should be tested in future vaccine trials against F. hepatica.
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Affiliation(s)
- R Zafra
- Animal Health Institute (IUSA), University of Las Palmas de Gran Canaria, Campus Trasmontaña, Aurcas, Spain
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Schena M, Guarrera S, Buffoni L, Salvadori A, Voglino F, Allione A, Pecorari G, Ruffini E, Garzino-Demo P, Bustreo S, Consito L, Bironzo P, Matullo G. DNA repair gene expression level in peripheral blood and tumour tissue from non-small cell lung cancer and head and neck squamous cell cancer patients. DNA Repair (Amst) 2012; 11:374-80. [DOI: 10.1016/j.dnarep.2012.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 12/28/2011] [Accepted: 01/05/2012] [Indexed: 12/22/2022]
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Buffoni L, Martínez-Moreno FJ, Zafra R, Mendes RE, Pérez-Écija A, Sekiya M, Mulcahy G, Pérez J, Martínez-Moreno A. Humoral immune response in goats immunised with cathepsin L1, peroxiredoxin and Sm14 antigen and experimentally challenged with Fasciola hepatica. Vet Parasitol 2011; 185:315-21. [PMID: 22001704 DOI: 10.1016/j.vetpar.2011.09.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 09/12/2011] [Accepted: 09/20/2011] [Indexed: 10/17/2022]
Abstract
The humoral immune response was analysed in goats immunised with FhCL1, FhPrx, Sm14, and experimentally challenged with Fasciola hepatica. All immunised animals developed significant levels of anti-fluke specific antibodies and those immunised with FhCL1 showed the highest antibody titre. After experimental infection, an increase in the antibody level was detected only in goats immunised with FhCL1. In the adjuvant-control animals, the experimental challenge induced significant production of specific antibodies against FhCL1, FhPrx and Sm14. While liver fluke specific humoral responses were seen in all groups, no significant protection in any of the vaccinated groups was found.
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Affiliation(s)
- L Buffoni
- Animal Health Department (Parasitology and Parasitic Diseases), Faculty of Veterinary Medicine, University of Córdoba, Campus de Rabanales, Ctra. Madrid-Cádiz, km 396, 14014 Córdoba, Spain.
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Ricardi U, Filippi AR, Guarneri A, Ragona R, Mantovani C, Giglioli F, Botticella A, Ciammella P, Iftode C, Buffoni L, Ruffini E, Scagliotti GV. Stereotactic body radiation therapy for lung metastases. Lung Cancer 2011; 75:77-81. [PMID: 21726918 DOI: 10.1016/j.lungcan.2011.04.021] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Revised: 04/22/2011] [Accepted: 04/26/2011] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Stereotactic body radiation therapy (SBRT) has an emerging role in patients affected with pulmonary metastases. Purpose of this study was to evaluate efficacy and tolerability of SBRT in a cohort of patients treated between 2003 and 2009 at our institution. METHODS A total of 61 patients with oligometastatic lung tumors (single pulmonary nodules in 73.7%) were included in the study. SBRT was performed with a stereotactic body frame and a 3D-conformal technique. Fifty-one patients received 26 Gy in 1 fraction, 22 a dose of 45 Gy in 3 fractions and 3 a dose of 36 Gy in 4 fractions. Primary tumor was lung cancer in 45.7% of patients, colorectal cancer in 21.3% and a variety of other origins in 33%. The primary endpoint was local control, secondary endpoints were survival and toxicity. RESULTS After a median follow-up interval of 20.4 months, local control rates at 2 and 3 years were 89% and 83.5%, overall survival 66.5% and 52.5%, cancer-specific survival 75.4% and 67%, progression-free survival 32.4% and 22.3%. Tumor volume was significantly associated to survival, with highest rates in patients with single small tumors. Median survival time was 42.8 months, while median progression-free survival time was 11.9 months. Toxicity profiles were good, with just one case of grade III toxicity (pneumonitis). CONCLUSION This study shows that SBRT is an effective and safe local treatment option for patients with lung metastases. Definitive results are strictly correlated to clinical selection of patients.
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Affiliation(s)
- Umberto Ricardi
- Radiation Oncology Department, University Hospital S. Giovanni Battista di Torino, Via Genova 3, 10126, Torino, Italy
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Buffoni L, Zafra R, Pérez-Ecija A, Martínez-Moreno FJ, Martínez-Galisteo E, Moreno T, Pérez J, Martínez-Moreno A. Immune response of goats immunised with glutathione S-transferase and experimentally challenged with Fasciola hepatica. Parasitol Int 2009; 59:147-53. [PMID: 20035898 DOI: 10.1016/j.parint.2009.12.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Revised: 12/14/2009] [Accepted: 12/16/2009] [Indexed: 10/20/2022]
Abstract
Glutathione S-transferase (FhGST) purified from Fasciola hepatica adult worms was used to immunise goats against F. hepatica in an experimental infection; the level of protection, in terms of fluke burden, faecal egg counts and hepatic damage was determined, as well as the humoral and cellular immune response elicited. Animals were allocated into three groups of six animals each: group 1 (immunised with FhGST and infected), group 2 (unimmunised and infected), and group 3 (unimmunised and uninfected). There was no significant reduction of fluke burden (9.3%) or faecal egg counts; hepatic damage was also similar in both infected groups. However, immunisation with FhGST induced the development of a well-defined immune response, characterized by the production of specific-FhGST antibodies as well as the appearance of circulating IL-4.
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Affiliation(s)
- L Buffoni
- Animal Health Department (Parasitology), Faculty of Veterinary Medicine, University of Córdoba, Campus de Rabanales, Ctra. Madrid-Cádiz, Córdoba, Spain
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Mendes R, Zafra R, Pérez-Écija A, Buffoni L, Matínez-Moreno A, Pérez J. Evaluation of the Local Immune Response to Fasciola Hepatica in Liver and Hepatic Lymph Nodes (Hln) of Goats Immunized with SM14. J Comp Pathol 2009. [DOI: 10.1016/j.jcpa.2009.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mendes R, Pérez-Écija A, Zafra R, Buffoni L, Matínez-Moreno A, Pérez J. Evaluation of the Local Immune Response to Fasciola Hepatica in Liver and Hepatic Lymph Nodes (HLN) of Goats Immunized with Cathepsin-L1 (CL1). J Comp Pathol 2009. [DOI: 10.1016/j.jcpa.2009.08.084] [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: 12/01/2022]
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