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Germani MM, Vetere G, Santamaria F, Intini R, Ghelardi F, Bensi M, Boccaccino A, Minelli A, Carullo M, Ciracì P, Passardi A, Santucci S, Giampieri R, Persano M, Fenocchio E, Puccini A, Lonardi S, Pietrantonio F, Salvatore L, Cremolini C. Treatment of patients with BRAF V600E-mutated metastatic colorectal cancer after progression to encorafenib and cetuximab: data from a real-world nationwide dataset. ESMO Open 2024; 9:102996. [PMID: 38613911 PMCID: PMC11024565 DOI: 10.1016/j.esmoop.2024.102996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Targeted therapy (TT) with encorafenib and cetuximab is the current standard for patients with BRAFV600E-mutated metastatic colorectal cancer (mCRC) who received one or more prior systemic treatments. However, the median progression-free survival (mPFS) is ∼4 months, and little is known about the possibility of administering subsequent therapies, their efficacy, and clinicopathological determinants of outcome. METHODS A real-world dataset including patients with BRAFV600E-mutated mCRC treated with TT at 21 Italian centers was retrospectively interrogated. We assessed treatments after progression, attrition rates, and outcomes. RESULTS Of the 179 patients included, 85 (47%), 32 (18%), and 7 (4%) received one, two, or three lines of treatment after TT, respectively. Those receiving TT in the second line were more likely to receive at least one subsequent therapy (53%), as compared with those treated with TT in the third line or beyond (30%; P < 0.0001), and achieved longer postprogression survival (PPS), also in a multivariate model (P = 0.0001). Among 62 patients with proficient mismatch repair/microsatellite stable (pMMR/MSS) tumors receiving one or more lines of treatment after second-line TT, combinatory chemotherapy ± anti-vascular endothelial growth factor (anti-VEGF) was associated with longer PFS and PPS as compared with trifluridine-tipiracil or regorafenib (mPFS: 2.6 versus 2.0 months, P = 0.07; PPS: 6.5 versus 4.4 months, P = 0.04). CONCLUSIONS Our real-world data suggest that TT should be initiated as soon as possible after the failure of first-line treatment in BRAFV600E-mutated mCRC. Among patients with pMMR/MSS tumors, combinatory chemotherapy ± anti-VEGF appears the preferred treatment choice after TT failure.
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Affiliation(s)
- M M Germani
- Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - G Vetere
- Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - F Santamaria
- Department of Experimental Medicine, Sapienza University of Rome, Rome
| | - R Intini
- Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua
| | - F Ghelardi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - M Bensi
- Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Medical Oncology Unit, Università Cattolica del Sacro Cuore, Rome
| | - A Boccaccino
- Oncology Unit, Ravenna Hospital, AUSL Romagna, Ravenna
| | - A Minelli
- Department of Medical Oncology, University Campus Bio-Medico, Rome
| | - M Carullo
- Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - P Ciracì
- Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - A Passardi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - S Santucci
- Oncology Unit, Ravenna Hospital, AUSL Romagna, Ravenna
| | - R Giampieri
- Oncologia Clinica, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Torrette di Ancona, Ancona; Oncologia Clinica, Azienda Ospedaliero-Universitaria delle Marche, Ancona
| | - M Persano
- Medical Oncology, University Hospital of Cagliari, Cagliari; Medical Oncology, University of Cagliari, Cagliari
| | - E Fenocchio
- Department of Medical Oncology, University of Turin Medical School, Candiolo Cancer Institute, FPO, IRCCS, Candiolo, Turin
| | - A Puccini
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, Milan, Italy
| | - S Lonardi
- Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua
| | - F Pietrantonio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - L Salvatore
- Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Medical Oncology Unit, Università Cattolica del Sacro Cuore, Rome
| | - C Cremolini
- Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa.
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Persano M, Rimini M, Tada T, Suda G, Shimose S, Kudo M, Cheon J, Finkelmeier F, Rimassa L, Presa J, Masi G, Yoo C, Lonardi S, Piscaglia F, Burgio V, Scartozzi M, Cascinu S, Casadei Gardini A. 67P Real-world data for atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Persano M, Rimini M, Cascinu S, Scartozzi M, Casadei Gardini A. 111P Identification of atezolizumab plus bevacizumab prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma: The ABE index. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Rimini M, Casadei Gardini A, Persano M, Suda G, Tada T, Shimose S, Kudo M, Cheon J, Finkelmeier F, Rimassa L, Presa J, Masi G, Yoo C, Lonardi S, Tovoli F, Piscaglia F, Iavarone M, Scartozzi M, Burgio V, Cascinu S, Cucchetti A. 65P Atezolizumab plus bevacizumab versus lenvatinib for unresectable hepatocellular carcinoma: A large real life worldwide population. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Persano M, Rimini M, Cascinu S, Scartozzi M, Casadei Gardini A. 108P Role of the prognostic nutritional index in predicting survival in advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Persano M, Rimini M, Cascinu S, Scartozzi M, Casadei Gardini A. 72MO Clinical outcomes and response (R) with atezolizumab plus bevacizumab (AB) or lenvatinib (L) in hepatocellular carcinoma (HCC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.108] [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: 12/05/2022] Open
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Boccaccino A, Borelli B, Intini R, Antista M, Bensi M, Rossini D, Passardi A, Tamberi S, Giampieri R, Antonuzzo L, Noto L, Roviello G, Zichi C, Salati M, Puccini A, Noto C, Parisi A, Rihawi K, Persano M, Crespi V, Libertini M, Giordano M, Moretto R, Lonardi S, Cremolini C. Encorafenib plus cetuximab with or without binimetinib in patients with BRAF V600E-mutated metastatic colorectal cancer: real-life data from an Italian multicenter experience. ESMO Open 2022; 7:100506. [PMID: 35696748 PMCID: PMC9271503 DOI: 10.1016/j.esmoop.2022.100506] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 11/15/2022] Open
Abstract
Background Encorafenib plus cetuximab with or without binimetinib showed increased objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) compared with chemotherapy plus anti-EGFR in previously treated patients with BRAF V600E-mutated (mut) metastatic colorectal cancer (mCRC). Although no formal comparison was planned, addition of binimetinib to encorafenib plus cetuximab did not provide significant efficacy advantage. Patients and methods This real-life study was aimed at evaluating safety, activity, and efficacy of encorafenib plus cetuximab with or without binimetinib in patients with BRAF V600E-mut mCRC treated at 21 Italian centers within a nominal use program launched in May 2019. Results Out of 133 patients included, 97 (73%) received encorafenib plus cetuximab (targeted doublet) and 36 (27%) the same therapy plus binimetinib (targeted triplet). Most patients had Eastern Cooperative Group Performance Status (ECOG-PS) of 0 or 1 (86%), right-sided primary tumor (69%), and synchronous disease (66%). Twenty (15%) tumors were DNA mismatch repair deficiency (dMMR)/microsatellite instability (MSI)-high. As many as 44 (34%) patients had received two or more prior lines of therapy, 122 (92%) were previously exposed to oxaliplatin, and 109 (82%) to anti-vascular endothelial growth factor (anti-VEGF). Most frequent adverse events were asthenia (62%) and anti-EGFR-related skin rash (52%). Any grade nausea (P = 0.03), vomiting (P = 0.04), and diarrhea (P = 0.07) were more frequent with the triplet therapy, while melanocytic nevi were less common (P = 0.06). Overall, ORR and disease control rate (DCR) were 23% and 69%, respectively, with numerically higher rates in the triplet group (ORR 31% versus 17%, P = 0.12; DCR 78% versus 65%, P = 0.23). Median PFS and OS were 4.5 and 7.2 months, respectively. Worse ECOG-PS, peritoneal metastases, and more than one prior treatment were independent poor prognostic factors for PFS and OS. Clonality of BRAF mutation measured as adjusted mutant allele fraction in tumor tissue was not associated with clinical outcome. Conclusions Our real-life data are consistent with those from the BEACON trial in terms of safety, activity, and efficacy. Patients in good general condition and not heavily pretreated are those more likely to derive benefit from the targeted treatment. Encorafenib plus cetuximab ± binimetinib is safe and effective for BRAF V600E mut mCRC even in the real-world setting. Median OS is slightly shorter than in the BEACON trial, probably due to less selected patients in real life. Patients deriving more benefit from targeted therapy are likely those in good general conditions and not heavily pretreated. BRAF adjusted MAF is worth further investigation to better characterize the genomic heterogeneity of BRAF V600E mut mCRC.
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Affiliation(s)
- A Boccaccino
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - B Borelli
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - R Intini
- Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCSP, Padova, Italy
| | - M Antista
- Medical Oncology Department, ENETS Center of Excellence, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M Bensi
- Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
| | - D Rossini
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - A Passardi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - S Tamberi
- UOC Oncologia Ravenna, AUSL Romagna, Ravenna, Italy
| | - R Giampieri
- Clinica Oncologica, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - L Antonuzzo
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - L Noto
- UOC Oncologia Medica, Policlinico "G.Rodolico" AOU Policlinico - San Marco, Catania, Italy
| | - G Roviello
- Department of Health Sciences, University of Florence, Florence, Italy
| | - C Zichi
- Oncologia Medica, A.O. Ordine Mauriziano - Umberto I, Torino, Italy
| | - M Salati
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy; PhD Program Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - A Puccini
- Università degli Studi di Genova, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - C Noto
- Università degli Studi di Udine, Dipartimento di Area Medica, Udine, Italy; Azienda Sanitaria Universitaria Friuli Centrale, Dipartimento di Oncologia medica, Udine, Italy
| | - A Parisi
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy; Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - K Rihawi
- IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - M Persano
- Medical Oncology, University of Cagliari, Cagliari, Italy
| | - V Crespi
- Department of Oncology, University of Turin, Torino, Italy
| | - M Libertini
- Oncology Unit, Poliambulanza Foundation, Brescia, Italy
| | - M Giordano
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - R Moretto
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - S Lonardi
- Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
| | - C Cremolini
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
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Romero-Ruiz A, Pineda B, Ovelleiro D, Perdices-Lopez C, Torres E, Vazquez MJ, Guler I, Jiménez Á, Pineda R, Persano M, Romero-Baldonado C, Arjona JE, Lorente J, Muñoz C, Paz E, Garcia-Maceira FI, Arjona-Sánchez Á, Tena-Sempere M. Molecular diagnosis of polycystic ovary syndrome in obese and non-obese women by targeted plasma miRNA profiling. Eur J Endocrinol 2021; 185:637-652. [PMID: 34403358 DOI: 10.1530/eje-21-0552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is diagnosed based on the clinical signs, but its presentation is heterogeneous and potentially confounded by concurrent conditions, such as obesity and insulin resistance. miRNA have recently emerged as putative pathophysiological and diagnostic factors in PCOS. However, no reliable miRNA-based method for molecular diagnosis of PCOS has been reported. The aim of this study was to develop a tool for accurate diagnosis of PCOS by targeted miRNA profiling of plasma samples, defined on the basis of unbiased biomarker-finding analyses and biostatistical tools. METHODS A case-control PCOS cohort was cross-sectionally studied, including 170 women classified into four groups: non-PCOS/lean, non-PCOS/obese, PCOS/lean, and PCOS/obese women. High-throughput miRNA analyses were performed in plasma, using NanoString technology and a 800 human miRNA panel, followed by targeted quantitative real-timePCR validation. Statistics were applied to define optimal normalization methods, identify deregulated biomarker miRNAs, and build classification algorithms, considering PCOS and obesity as major categories. RESULTS The geometric mean of circulating hsa-miR-103a-3p, hsa-miR-125a-5p, and hsa-miR-1976, selected among 125 unchanged miRNAs, was defined as optimal reference for internal normalization (named mR3-method). Ten miRNAs were identified and validated after mR3-normalization as differentially expressed across the groups. Multinomial least absolute shrinkage and selection operator regression and decision-tree models were built to reliably discriminate PCOS vs non-PCOS, either in obese or non-obese women, using subsets of these miRNAs as performers. CONCLUSIONS We define herein a robust method for molecular classification of PCOS based on unbiased identification of miRNA biomarkers and decision-tree protocols. This method allows not only reliable diagnosis of non-obese women with PCOS but also discrimination between PCOS and obesity. CAPSULE We define a novel protocol, based on plasma miRNA profiling, for molecular diagnosis of PCOS. This tool not only allows proper discrimination of the condition in non-obese women but also permits distinction between PCOS and obesity, which often display overlapping clinical presentations.
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Affiliation(s)
- Antonio Romero-Ruiz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Beatriz Pineda
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - David Ovelleiro
- Area of Cellular Biology, Department of Experimental Biology, University of Jaen, Jaen, Spain
| | - Cecilia Perdices-Lopez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Córdoba, Spain
| | - Encarnación Torres
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - María J Vazquez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Ipek Guler
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
| | - Álvaro Jiménez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
| | - Rafael Pineda
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
| | - Mariasara Persano
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | | | | | - Juan Lorente
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Concepción Muñoz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | | | | | - Álvaro Arjona-Sánchez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Manuel Tena-Sempere
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Córdoba, Spain
- Institute of Biomedicine, University of Turku, Turku, Finland
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Ziranu P, Aimola V, Pretta A, Cerrone G, Persano M, Liscia N, Dubois M, Migliari M, Sarais F, Cimbro E, Parrino A, Spanu D, Mariani S, Donisi C, Pinna G, Pusceddu V, Puzzoni M, Lai E, Faa G, Scartozzi M. 490P New horizons in metastatic colorectal cancer: Role of CD44 expression. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Pretta A, Donisi C, Persano M, Pinna G, Cimbro E, Parrino A, Migliari M, Dubois M, Liscia N, Mariani S, Lai E, Puzzoni M, Pusceddu V, Ziranu P, Scartozzi M. P-127 Lymphocyte to monocyte ratio as a prognostic factor in stage IV pancreatic ductal adenocarcinoma naive patients before gemcitabine-nab-paclitaxel chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Pretta A, Pinna G, Donisi C, Persano M, Cimbro E, Parrino A, Migliari M, Dubois M, Liscia N, Mariani S, Lai E, Pusceddu V, Puzzoni M, Ziranu P, Scartozzi M. P-128 Influence of anti-diabetic medications on the outcomes of patients with pancreatic ductal adenocarcinoma and type 2 diabetes mellitus. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.183] [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] Open
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Pretta A, Persano M, Pinna G, Donisi C, Cimbro E, Parrino A, Migliari M, Dubois M, Mariani S, Liscia N, Lai E, Pusceddu V, Puzzoni M, Ziranu P, Scartozzi M. P-129 Concomitant RAS and BRAF mutations: Impact on overall survival and progression free survival in metastatic colorectal cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Persano M, Nollino L, Sambataro M, Rigato M, Negro I, Marchetto S, Paccagnella A. Real-world study on the effectiveness and safety of basal insulin IDegLira in type 2 diabetic patients previously treated with multi-injective insulin therapy. Eur Rev Med Pharmacol Sci 2021; 25:923-931. [PMID: 33577047 DOI: 10.26355/eurrev_202101_24661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Achieving glycemic target is paramount to control diabetes mellitus (DM) and reduce micro-vascular and macro-vascular complications. Despite the mostly recent-developed drugs, most patients still show an above desired glycated hemoglobin (HbA1c) level due to DM complex pathophysiology, therapeutic and dietary compliance and clinical inertia in introducing or intensifying insulin therapy. To support the promising results of clinical trials on the effectiveness and safety of the degludec/liraglutide combination (IDegLira) in type 2 DM patients with C-peptide values >1 ng/ml who were previously treated with basal-bolus multiple daily-dose insulin injections. PATIENTS AND METHODS This observational, prospective and non-randomized trial enrolled type 2 DM patients referred to our outpatient clinic between January 2019 and December 2019, who were shifted from multiple daily-dose insulin injection therapy to degludec/liraglutide combination as per the physician's decision. The main assessment was HbA1c variation at 6 months from baseline. Secondary assessments included variation in fasting glycemia, routine anthropometric assessments, blood chemistry, blood pressure and patients' quality of life (measured by the Diabetes Treatment Satisfaction Questionnaire [DTSQ]), from baseline to 6 months. RESULTS HbA1c (8.4 vs. 7.4%; p<0.0001) and body weight (94.1 vs. 93 kg; p<0.0001) were significantly lower after 6 months for patients on the degludec/liraglutide combination. A similar trend was observed in fasting glycemia levels (159 vs. 125 mg/dl; p<0.0001). An improved glycemic control was achieved with degludec/liraglutide despite a reduction in total daily insulin units (42 U at 6 months vs. 22 U at baseline; p<0.0001). In addition, higher scores in the DTSQ were registered after 6 months on degludec/liraglutide (mean score: 27 vs. 20; p<0.0001). The combination therapy also proved more convenient than basal-bolus therapy in terms of costs, with an average per-patient cost difference of €-0.41±0.59/die (p<0.0001). CONCLUSIONS These real-world findings show that degludec/liraglutide seems to be more effective than basal-bolus insulin in achieving glycemic control, allowing cost sustainability and improving patient satisfaction.
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Affiliation(s)
- M Persano
- Endocrine, Metabolism, and Nutrition Disease Unit, Santa Maria di Ca' Foncello Hospital, Treviso, Italy.
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Fabbri M, Botticelli A, Omarini C, Cretella E, Fabi A, Alesini D, Pizzuti L, Piesco G, Vaccaro A, Atzori F, Piacentini F, Moscetti L, Orlandi A, Sini V, Mercanti A, Framarino M, Persano M, Ceccherini R, Ruggeri E. Efficacy and safety of neoadjuvant chemotherapy plus trastuzumab and pertuzumab in non-metastatic HER2-positive breast cancer in real life: NEOPEARL study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pretta A, Lai E, Liscia N, Impera V, Camera S, Musio F, Mariani S, Soro P, Persano M, Donisi C, Tolu S, Balconi F, Atzori F, Dessì M, Massa E, Madeddu C, Pusceddu V, Astara G, Demurtas L, Puzzoni M, Ziranu P, Scartozzi M. Overall survival and progression-free survival in metastatic colorectal cancer patients with concomitant RAS and BRAF mutations: a single center experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.295] [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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Mariani S, Soro P, Liscia N, Balconi F, Camera S, Donisi C, Impera V, Musio F, Persano M, Pireddu A, Pretta A, Tolu S, Pusceddu V, Lai E, Faloppi L, Demurtas L, Ziranu P, Puzzoni M, Scartozzi M. Effectiveness of CA 19.9 in predicting prognosis in metastatic pancreatic cancer patients treated with nab-paclitaxel plus gemcitabine. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.229] [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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Donisi C, Atzori F, Dessì M, Persano M, Scartozzi M. Safe chemotherapy for treating early breast cancer in G6PD-deficient patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz096.019] [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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Fadini GP, Dassie F, Cappellari R, Persano M, Vigili de Kreutzenberg S, Martini C, Parolin M, Avogaro A, Vettor R, Maffei P. Persistent Reduction of Circulating Myeloid Calcifying Cells in Acromegaly: Relevance to the Bone-Vascular Axis. J Clin Endocrinol Metab 2017; 102:2044-2050. [PMID: 28323966 DOI: 10.1210/jc.2017-00246] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/10/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT Acromegaly is a systemic disease characterized by persistent bone pathology and excess cardiovascular mortality. Despite multiple concomitant risk factors, atherosclerosis does not seem to be accelerated in acromegaly. OBJECTIVE To compare the levels of circulating myeloid calcifying cells (MCCs), which promote ectopic calcification and inhibit angiogenesis, in individuals with and without acromegaly. DESIGN Cross-sectional case-control study. SETTING Tertiary ambulatory referral endocrinology center. PATIENTS 44 acromegalic patients (25 active; 19 inactive), 44 control subjects matched by age, sex, risk factors, and medications, and 8 patients cured of acromegaly. INTERVENTION MCCs were measured using flow cytometry based on the expression of osteocalcin (OC) and bone alkaline phosphatase (BAP) on monocytes and circulating CD34+ stem cells. MAIN OUTCOME MEASURE Differences in MCCs between patients and controls. RESULTS OC+BAP+ MCCs were severely reduced in acromegalic compared with control patients (0.17% ± 0.02% vs 1.00% ± 0.24%; P < 0.001), as were the total OC+ and BAP+ monocytic cells. Patients with inactive acromegaly and those cured of acromegaly displayed persistently reduced levels of MCCs. In the controls, but not acromegalic patients, MCCs were increased in the presence of diabetes or cardiovascular disease. A direct correlation was noted between MCCs and parathyroid hormone (r = 0.61; P < 0.0001), supporting a link between bone biology and MCCs. CONCLUSIONS In patients with acromegaly, the levels of MCCs are reduced and remain low, even years after a complete cure. This finding might be related to low atherosclerotic calcification and the persistence of bone pathology after acromegaly remission or cure.
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Affiliation(s)
- Gian Paolo Fadini
- Department of Medicine, University of Padua, Padua 35128, Italy
- Venetian Institute of Molecular Medicine, Padua 35128, Italy
| | | | | | | | | | - Chiara Martini
- Department of Medicine, University of Padua, Padua 35128, Italy
| | - Matteo Parolin
- Department of Medicine, University of Padua, Padua 35128, Italy
| | - Angelo Avogaro
- Department of Medicine, University of Padua, Padua 35128, Italy
| | - Roberto Vettor
- Department of Medicine, University of Padua, Padua 35128, Italy
| | - Pietro Maffei
- Department of Medicine, University of Padua, Padua 35128, Italy
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Menegazzo L, Ciciliot S, Poncina N, Mazzucato M, Persano M, Bonora B, Albiero M, Vigili de Kreutzenberg S, Avogaro A, Fadini GP. NETosis is induced by high glucose and associated with type 2 diabetes. Acta Diabetol 2015; 52:497-503. [PMID: 25387570 DOI: 10.1007/s00592-014-0676-x] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/24/2014] [Indexed: 12/28/2022]
Abstract
AIMS The role of neutrophils in diabetes and its complications is unclear. Upon challenge with microbes and inflammatory triggers, neutrophils release enzymes and nuclear material, forming neutrophils extracellular traps (NETs) and thereby dying by NETosis. We herein tested NET formation and NETosis products in high glucose and in the setting of type 2 diabetes (T2D). METHODS NETosis was assessed in vitro in cells exposed to 0, 5, 25 mM glucose and 25 mM mannitol, DMSO and PMA using immunofluorescence staining for elastase, DNA and chromatin. Single-cell morphometric analysis was used to detect enter of elastase in the nucleus and extrusion of nuclear material. Release of NETs was quantified by staining with Hoechst 33342. In 38 T2D and 38 age- and sex-matched non-diabetic individuals, we determined plasma elastase, mono- and oligonucleosomes and double-strand (ds) DNA, as circulating NETosis products. RESULTS NETosis was accurately reproduced in vitro: high (25 mM) glucose increased NETosis rate and release of NETs compared with 5 mM glucose and 25 mM mannitol. T2D patients showed increased plasma elastase, mono- and oligonucleosomes and dsDNA compared with non-diabetic control individuals. A positive correlation was found between HbA1c and mono- and oligonucleosomes, whereas dsDNA was correlated with the presence of nephropathy and cardiovascular disease. Serum IL-6 concentrations were higher in T2D compared with CTRL and correlated with serum dsDNA levels. CONCLUSIONS High glucose and hyperglycemia increase release of NETs and circulating markers of NETosis, respectively. This finding provides a link among neutrophils, inflammation and tissue damage in diabetes.
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Affiliation(s)
- Lisa Menegazzo
- Department of Medicine, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
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Mancini A, Raimondo S, Di Segni C, Persano M, Di Geronimo E, Silvestrini A, Pontecorvi A, Meucci E, Tamburrelli FC. Comparison of plasma antioxidant levels in middle-aged and old male with idiopatic osteoporosis: preliminary data. Eur Rev Med Pharmacol Sci 2014; 18:2013-2019. [PMID: 25027340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES With the purpose of evaluating the role of oxidative stress (OS) in male idiopatic osteoporosis, we have evaluated plasma total antioxidant capacity (TAC) in patients classified according to age (< 65 or ≥ 65 yrs), with normal hormone values and in age-matched healthy control subjects. PATIENTS AND METHODS TAC was evaluated with a colorimetric method, using the system metamyoglobin-H2O2 and the chromogen ABTS; the latency time (LAG, sec) in the appearance of ABTS radical species is proportional to antioxidant content of the system. RESULTS We found slightly increased LAG values in middle-aged patients, compared with age-matched controls, probably expression of a compensatory mechanism to OS; on the contrary aged patients showed significantly lower LAG values in comparison with age-matched controls, suggesting a defective compensatory mechanism and, therefore, a risk for oxidative damage. CONCLUSIONS OS could be a possible mechanism underlying male osteoporosis, both in middle-aged and aged patients, but compensatory mechanisms seem to be defective in the last group.
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Affiliation(s)
- A Mancini
- Department of Medical Sciences, Division of Endocrinology, Catholic University of the Sacred Heart, Rome, Italy.
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Mancini A, Raimondo S, Persano M, Di Segni C, Cammarano M, Gadotti G, Silvestrini A, Pontecorvi A, Meucci E. Estrogens as antioxidant modulators in human fertility. Int J Endocrinol 2013; 2013:607939. [PMID: 24363671 PMCID: PMC3863713 DOI: 10.1155/2013/607939] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 10/28/2013] [Accepted: 10/28/2013] [Indexed: 11/30/2022] Open
Abstract
Among treatments proposed for idiopathic male infertility, antiestrogens, like tamoxifen, play a possible role. On the other hand, oxidative stress is a mechanism well recognized for deleterious effects on spermatozoa function. After reviewing the literature on the effects of estrogens in modulation of antioxidant systems, in both sexes, and in different in vivo and in vitro models, we suggest, also on the basis of personal data, that a tamoxifen treatment could be active via an increase in seminal antioxidants.
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Affiliation(s)
- A. Mancini
- Division of Endocrinology, Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
- *A. Mancini:
| | - S. Raimondo
- Division of Endocrinology, Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - M. Persano
- Division of Endocrinology, Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - C. Di Segni
- Division of Endocrinology, Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - M. Cammarano
- Division of Endocrinology, Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - G. Gadotti
- Division of Endocrinology, Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - A. Silvestrini
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of the Sacred Heart, Rome, Italy
| | - A. Pontecorvi
- Division of Endocrinology, Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - E. Meucci
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of the Sacred Heart, Rome, Italy
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