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Peters S, Loi S, André F, Chandarlapaty S, Felip E, Finn SP, Jänne PA, Kerr KM, Munzone E, Passaro A, Pérol M, Smit EF, Swanton C, Viale G, Stahel RA. Antibody-drug conjugates in lung and breast cancer: Current evidence and future directions - a position statement from the ETOP IBCSG Partners Foundation. Ann Oncol 2024:S0923-7534(24)00108-X. [PMID: 38648979 DOI: 10.1016/j.annonc.2024.04.002] [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: 02/14/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024] Open
Abstract
Following the approval of the first antibody-drug conjugates (ADCs) in the early 2000s, development has increased dramatically, with 14 ADCs now approved and >100 in clinical development. In lung cancer, trastuzumab deruxtecan (T-DXd) is approved in human epidermal growth factor receptor 2 (HER2)-mutated, unresectable or metastatic non-small cell lung cancer, with ADCs targeting HER3 (patritumab deruxtecan), trophoblast cell-surface antigen 2 (datopotamab deruxtecan and sacituzumab govitecan [SG]) and mesenchymal-epithelial transition factor (telisotuzumab vedotin) in late-stage clinical development. In breast cancer, several agents are already approved and widely used, including trastuzumab emtansine, T-DXd and SG, and multiple late-stage trials are ongoing. Thus, in the coming years, we are likely to see significant changes to treatment algorithms. As the number of available ADCs increases, biomarkers (of response and resistance) to better select patients are urgently needed. Biopsy sample collection at the time of treatment selection and incorporation of translational research into clinical trial designs are therefore critical. Biopsy samples taken peri- and post-ADC treatment combined with functional genomics screens could provide insights into response/resistance mechanisms as well as the impact of ADCs on tumour biology and the tumour microenvironment, which could improve understanding of the mechanisms underlying these complex molecules. Many ADCs are undergoing evaluation as combination therapy, but a high bar should be set to progress clinical evaluation of any ADC-based combination, particularly considering the high cost and potential toxicity implications. Efforts to optimise ADC dosing/duration, sequencing and the potential for ADC rechallenge are also important, especially considering sustainability aspects. The ETOP IBCSG Partners Foundation are driving strong collaborations in this field and promoting the generation/sharing of databases, repositories and registries to enable greater access data. This will allow the most important research questions to be identified and prioritised, which will ultimately accelerate progress and help to improve patient outcomes.
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Affiliation(s)
- S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University, Lausanne, Switzerland
| | - S Loi
- Department of Clinical Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - F André
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France
| | - S Chandarlapaty
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - E Felip
- Medical Oncology Department, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - S P Finn
- Department of Histopathology and Cancer Molecular Diagnostics, St James's Hospital and Trinity College, Dublin, Ireland
| | - P A Jänne
- Department of Medical Oncology, Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - K M Kerr
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - E Munzone
- Division of Medical Senology, European Institute of Oncology IRCCS, Milan
| | - A Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Pérol
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - E F Smit
- Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - C Swanton
- Cancer Research UK (CRUK) Lung Cancer Centre of Excellence, UCL Cancer Institute, University College London, London, UK
| | - G Viale
- Department of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - R A Stahel
- Coordinating Center, ETOP IBCSG Partners Foundation, Bern, Switzerland.
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Passaro A, Wang J, Shah S, Bauml JM, Campelo RG, Cho BC. Letter to the Editor regarding 'Correspondence to: Amivantamab plus chemotherapy with and without lazertinib in EGFR-mutant advanced NSCLC after disease progression on osimertinib: primary results from the phase III MARIPOSA-2 study' by Moik F, Riedl JM, and Ay C. Ann Oncol 2024; 35:328-329. [PMID: 38029840 DOI: 10.1016/j.annonc.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- A Passaro
- Division of Thoracic Oncology, European Institute of Oncology, IRCCS, Milan, Italy.
| | - J Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - S Shah
- Janssen Research & Development, Spring House, USA
| | - J M Bauml
- Janssen Research & Development, Spring House, USA
| | - R G Campelo
- University Hospital A Coruña, A Coruña, Spain
| | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
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Passaro A, Wang J, Wang Y, Lee SH, Melosky B, Shih JY, Wang J, Azuma K, Juan-Vidal O, Cobo M, Felip E, Girard N, Cortot AB, Califano R, Cappuzzo F, Owen S, Popat S, Tan JL, Salinas J, Tomasini P, Gentzler RD, William WN, Reckamp KL, Takahashi T, Ganguly S, Kowalski DM, Bearz A, MacKean M, Barala P, Bourla AB, Girvin A, Greger J, Millington D, Withelder M, Xie J, Sun T, Shah S, Diorio B, Knoblauch RE, Bauml JM, Campelo RG, Cho BC. Amivantamab plus chemotherapy with and without lazertinib in EGFR-mutant advanced NSCLC after disease progression on osimertinib: primary results from the phase III MARIPOSA-2 study. Ann Oncol 2024; 35:77-90. [PMID: 37879444 DOI: 10.1016/j.annonc.2023.10.117] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Amivantamab plus carboplatin-pemetrexed (chemotherapy) with and without lazertinib demonstrated antitumor activity in patients with refractory epidermal growth factor receptor (EGFR)-mutated advanced non-small-cell lung cancer (NSCLC) in phase I studies. These combinations were evaluated in a global phase III trial. PATIENTS AND METHODS A total of 657 patients with EGFR-mutated (exon 19 deletions or L858R) locally advanced or metastatic NSCLC after disease progression on osimertinib were randomized 2 : 2 : 1 to receive amivantamab-lazertinib-chemotherapy, chemotherapy, or amivantamab-chemotherapy. The dual primary endpoints were progression-free survival (PFS) of amivantamab-chemotherapy and amivantamab-lazertinib-chemotherapy versus chemotherapy. During the study, hematologic toxicities observed in the amivantamab-lazertinib-chemotherapy arm necessitated a regimen change to start lazertinib after carboplatin completion. RESULTS All baseline characteristics were well balanced across the three arms, including by history of brain metastases and prior brain radiation. PFS was significantly longer for amivantamab-chemotherapy and amivantamab-lazertinib-chemotherapy versus chemotherapy [hazard ratio (HR) for disease progression or death 0.48 and 0.44, respectively; P < 0.001 for both; median of 6.3 and 8.3 versus 4.2 months, respectively]. Consistent PFS results were seen by investigator assessment (HR for disease progression or death 0.41 and 0.38 for amivantamab-chemotherapy and amivantamab-lazertinib-chemotherapy, respectively; P < 0.001 for both; median of 8.2 and 8.3 versus 4.2 months, respectively). Objective response rate was significantly higher for amivantamab-chemotherapy and amivantamab-lazertinib-chemotherapy versus chemotherapy (64% and 63% versus 36%, respectively; P < 0.001 for both). Median intracranial PFS was 12.5 and 12.8 versus 8.3 months for amivantamab-chemotherapy and amivantamab-lazertinib-chemotherapy versus chemotherapy (HR for intracranial disease progression or death 0.55 and 0.58, respectively). Predominant adverse events (AEs) in the amivantamab-containing regimens were hematologic, EGFR-, and MET-related toxicities. Amivantamab-chemotherapy had lower rates of hematologic AEs than amivantamab-lazertinib-chemotherapy. CONCLUSIONS Amivantamab-chemotherapy and amivantamab-lazertinib-chemotherapy improved PFS and intracranial PFS versus chemotherapy in a population with limited options after disease progression on osimertinib. Longer follow-up is needed for the modified amivantamab-lazertinib-chemotherapy regimen.
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Affiliation(s)
- A Passaro
- Division of Thoracic Oncology, European Institute of Oncology, IRCCS, Milan, Italy.
| | - J Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Wang
- Department of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - S-H Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - B Melosky
- British Columbia Cancer Agency, Vancouver, Canada
| | - J-Y Shih
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - J Wang
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - K Azuma
- Kurume University School of Medicine, Kurume, Japan
| | - O Juan-Vidal
- Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - M Cobo
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain
| | - E Felip
- Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - N Girard
- Institut Curie, Institut du Thorax Curie-Montsouris, Paris, France; Paris Saclay University, UVSQ, Versailles, France
| | - A B Cortot
- University of Lille, CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, UMR9020-UMR1277-Canther-Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille, France
| | - R Califano
- Department of Medical Oncology, Christie NHS Foundation Trust and Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | - F Cappuzzo
- IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S Owen
- Department of Medical Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - S Popat
- Royal Marsden Hospital NHS Foundation Trust and The Institute of Cancer Research, London, UK
| | - J-L Tan
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - J Salinas
- Centro de Especialidades Medicas Ambulatorias e Investigación Clínica, Córdoba, Argentina
| | - P Tomasini
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - R D Gentzler
- Hematology/Oncology, University of Virginia Cancer Center, Charlottesville, VA, USA
| | - W N William
- Centro Oncológico BP, Beneficência Portuguesa de São Paulo, and Grupo Oncoclínicas, São Paulo, Brazil
| | - K L Reckamp
- Cedars-Sinai Medical Center, Los Angeles, USA
| | - T Takahashi
- Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi, Japan
| | | | - D M Kowalski
- Department of Lung Cancer and Thoracic Tumours, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A Bearz
- Medical Oncology, Centro di Riferimento Oncologico-CRO, Aviano, Italy
| | - M MacKean
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - P Barala
- Janssen Research & Development, Spring House, PA, USA
| | - A B Bourla
- Janssen Research & Development, Raritan, NJ, USA
| | - A Girvin
- Janssen Research & Development, Spring House, PA, USA
| | - J Greger
- Janssen Research & Development, Spring House, PA, USA
| | - D Millington
- Janssen Research & Development, San Diego, CA, USA
| | - M Withelder
- Janssen Research & Development, Spring House, PA, USA
| | - J Xie
- Janssen Research & Development, Raritan, NJ, USA
| | - T Sun
- Janssen Research & Development, Raritan, NJ, USA
| | - S Shah
- Janssen Research & Development, Spring House, PA, USA
| | - B Diorio
- Janssen Research & Development, Raritan, NJ, USA
| | - R E Knoblauch
- Janssen Research & Development, Spring House, PA, USA
| | - J M Bauml
- Janssen Research & Development, Spring House, PA, USA
| | - R G Campelo
- University Hospital A Coruña, A Coruña, Spain
| | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
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Straudi S, Lamberti N, Baluardo L, Spadaro S, Volta CA, Contoli M, Papi A, Passaro A, Libanore M, Gallerani M, Volpato S, Manfredini R, Bergonzoni A, Lavezzi S, Wienand U, Vagnoni E, Manfredini F. From intensive care to rehabilitation: survey on the satisfaction with care received during prolonged hospitalization for COVID-19 at a northern Italian university hospital. Eur Rev Med Pharmacol Sci 2023; 27:11192-11199. [PMID: 38039051 DOI: 10.26355/eurrev_202311_34489] [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: 12/02/2023]
Abstract
OBJECTIVE Investigating the experiences perceived by COVID-19 inpatients is a fundamental research area that is starting to be explored. For this reason, our objective was to provide the first Italian survey on COVID-19 inpatients' satisfaction, obtained through a self-completed questionnaire previously used in a reference study in a UK cohort of COVID-19 patients. SUBJECTS AND METHODS Hospitalized COVID-19 patients (>20 days) admitted to Ferrara University Hospital who underwent rehabilitation during their hospital stay were invited to complete an anonymous questionnaire. The survey's questions explored the patients' satisfaction with the health services received, and their completion took place approximately one year after hospitalization. Information on sex, number of wards, ICU stays, and hospital discharge dates was collected. RESULTS Sixty-two completed questionnaires were analyzed. The average overall satisfaction score obtained from the answers indicated by the participants in the tenth question was 4.7 out of 5.0. Very positive responses were observed for information about discharge plans, privacy, management of pain, sleep quality, and feeling of safety. The possibility of being consulted about medications and side effects received a very low satisfaction score. Considering overall satisfaction, no significant differences were noted for sex or ICU stay. The obtained results were almost superimposable to those reported in the cohort of COVID-19 patients of the reference study. CONCLUSIONS This survey suggested that COVID-19 patients' healthcare satisfaction was high. Nevertheless, some areas must be improved, such as the communication and involvement of the patients in the decision-making of care and the discussion about medications or possible side effects.
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Affiliation(s)
- S Straudi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
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Hendriks LE, Kerr KM, Menis J, Mok TS, Nestle U, Passaro A, Peters S, Planchard D, Smit EF, Solomon BJ, Veronesi G, Reck M. Non-oncogene-addicted metastatic non-small-cell lung cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2023; 34:358-376. [PMID: 36669645 DOI: 10.1016/j.annonc.2022.12.013] [Citation(s) in RCA: 89] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Affiliation(s)
- L E Hendriks
- Department of Pulmonology, GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The Netherlands
| | - K M Kerr
- Aberdeen Royal Infirmary, Aberdeen University Medical School, Aberdeen, UK
| | - J Menis
- Medical Oncology Department, University and Hospital Trust of Verona, Verona, Italy
| | - T S Mok
- Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - U Nestle
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg; Department of Radiation Oncology, Kliniken Maria Hilf, Moenchengladbach, Germany
| | - A Passaro
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne University, Lausanne, Switzerland
| | - D Planchard
- Department of Medical Oncology, Thoracic Group, Gustave-Roussy, Villejuif, France
| | - E F Smit
- Thoracic Oncology Service, Netherlands Cancer Institute, Amsterdam; Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - B J Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - G Veronesi
- Faculty of Medicine and Surgery-Vita-Salute San Raffaele University, Milan; Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Reck
- Department of Thoracic Oncology, Airway Research Center North, German Center for Lung Research, Lung Clinic, Grosshansdorf, Germany
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Hendriks LE, Kerr KM, Menis J, Mok TS, Nestle U, Passaro A, Peters S, Planchard D, Smit EF, Solomon BJ, Veronesi G, Reck M. Oncogene-addicted metastatic non-small-cell lung cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2023; 34:339-357. [PMID: 36872130 DOI: 10.1016/j.annonc.2022.12.009] [Citation(s) in RCA: 112] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/24/2023] Open
Affiliation(s)
- L E Hendriks
- Department of Pulmonology, GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The Netherlands
| | - K M Kerr
- Aberdeen Royal Infirmary, Aberdeen University Medical School, Aberdeen, UK
| | - J Menis
- Medical Oncology Department, University and Hospital Trust of Verona, Verona, Italy
| | - T S Mok
- Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - U Nestle
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany; Department of Radiation Oncology, Kliniken Maria Hilf, Moenchengladbach, Germany
| | - A Passaro
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne University, Lausanne, Switzerland
| | - D Planchard
- Department of Medical Oncology, Thoracic Group, Gustave-Roussy Villejuif, France
| | - E F Smit
- Thoracic Oncology Service, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - B J Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - G Veronesi
- Faculty of Medicine and Surgery-Vita-Salute San Raffaele University, Milan, Italy; Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Reck
- Department of Thoracic Oncology, Airway Research Center North, German Center for Lung Research, Lung Clinic, Grosshansdorf, Germany
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Spitaleri G, Trillo Aliaga P, Catania C, Signore ED, Attili I, Santoro C, Giugliano F, Berton Giachetti PPM, Curigliano G, Passaro A, de Marinis F. Safety of mRNA-COVID-19 Vaccines in Patients With Thoracic Cancers. Clin Lung Cancer 2023; 24:e19-e26. [PMID: 36372676 PMCID: PMC9584758 DOI: 10.1016/j.cllc.2022.10.004] [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: 07/21/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Pivotal trials of COVID-19 vaccines did not include cancer patients with questions remaining in this population. Particularly in patients with thoracic malignancies receiving anticancer treatments, the safety of these vaccines has so far been little investigated. METHODS This is a prospective trial of patients with thoracic cancer receiving anticancer treatments and COVID-19 vaccines at the Division of Thoracic Oncology of European Institute of Oncology between February and September 2021. RESULTS A total 207 patients affected by thoracic cancers (199 lung cancers and 8 mesotheliomas) had received Covid-19 vaccines (206 mRNA vaccines and 1 virus-vectored vaccine). The majority of patients had at least one comorbidity (76.3%). They were concomitantly treating with targeted therapy (TT) (45.9%), immunotherapy (IO) (22.7%), and chemotherapy (CT) (14%). A total of 64 AEs (15.6%) were observed after administration of Sars-Cov-2 vaccine. The majority of AEs were grade 1 [G1] (6.3%) and G2 (8.8%), only two events were G3 (0.5%). The median follow-up was 9 months (range 1-22 months), during this follow-up 21 patients (10.1%) had a positive nasal swab, most of the patients were asymptomatic (67%) and the symptomatic ones (33%) had mild symptoms and fewer complications and hospitalizations. CONCLUSIONS COVID-19 m-RNA vaccines appear to be safe in the cohort of patients with thoracic malignances in active treatment, including those receiving immunotherapy. Considering the high morbidity and mortality associated with COVID-19 in patients with lung cancer receiving active treatments, our study supports the current vaccine prioritization, third and/or fourth dose, of all cancer patients with active treatment.
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Affiliation(s)
- G Spitaleri
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - P Trillo Aliaga
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - C Catania
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Del Signore
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - I Attili
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - C Santoro
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | - F Giugliano
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | - P P M Berton Giachetti
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | - G Curigliano
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | - A Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F de Marinis
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Passaro A, Lo Russo G, Passiglia F, D'Arcangelo M, Sbrana A, Russano M, Bonanno L, Giusti R, Metro G, Bertolini F, Grisanti S, Carta A, Cecere F, Montrone M, Massa G, Attili I, de Marinis F. 1124P Pralsetinib in RET fusion-positive non-small cell lung cancer: A real-world data (RWD) analysis from the Italian expanded access program (EAP). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1248] [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: 11/01/2022] Open
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Degli Esposti L, Borghi C, Galvani M, Giacomini E, Manotti P, Marra A, Passaro A, Perrone V, Pieraccini F, Sangiorgi D, Navazio A. P342 REAL–WORLD ANALYSIS ON THE ECONOMIC VALUE OF REACHING LIPID TARGET IN ITALY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
The study aimed to evaluate the healthcare direct costs for Italian National Health System of patients treated with lipid–lowering drugs that do not achieve the low–density lipoprotein (LDL)–cholesterol target compared to those reaching their targets, and to analyze costs according to the distance from LDL target by using real–world data.
An observational analysis was performed on administrative and laboratory data from selected Italian Healthcare Departments. Patients were included if they presented at least one laboratory LDL test between 2012 and 2019 and if they were prescribed lipid–lowering drugs during 6 months prior the last LDL detection (index date). Mean annual direct costs were evaluated in the 12 months before index date in terms of all drugs prescribed, all–cause hospitalizations and all outpatient services. Distance to LDL target was calculated as difference between the index LDL level and LDL target. Total mean annual healthcare direct cost for patients that did not reach LDL target was higher compared to total cost of patients achieving LDL target (€3,678 vs €2,906). Costs were mainly driven by hospitalization (€1,330) followed by drugs expenditure (€1,012) and outpatient services (€563). Mean total annual healthcare costs increased with the distance from LDL target, specifically from €3,004 for patients with 10% distance from LDL target up to €4,823 for those 50% or more distance from LDL target. This trend was particularly evident for the cost item related to hospitalization, that went from €1,486 to €2,819 moving from 10% to ≥ 50 distance from LDL target. Results from this real–world study highlighted the higher economic burden for patients that do not reach the therapeutic LDL target, that tend to rise along with increasing distance from the LDL target. Overall, our findings could suggest that reducing the distance from LDL target could have a positive impact also on the economic outcomes for these patients.
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Affiliation(s)
- L Degli Esposti
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - C Borghi
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - M Galvani
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - E Giacomini
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - P Manotti
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - A Marra
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - A Passaro
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - V Perrone
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - F Pieraccini
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - D Sangiorgi
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - A Navazio
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
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Degli Esposti L, Borghi C, Galvani M, Giacomini E, Manotti P, Marra A, Passaro A, Perrone V, Pieraccini F, Sangiorgi D, Navazio A. P358 THE ROLE OF ADHERENCE TO LIPID–LOWERING THERAPIES IN ACHIEVING LIPID TARGET: FINDINGS FROM REAL–WORLD ANALYSIS IN ITALY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
The objective of the present real–world analysis was to evaluate the impact of adherence to lipid–lowering drugs in reaching the lipid target in settings of clinical practice in Italy.
The analysis was based on administrative and laboratory database of selected Healthcare Units in Italy covering approximately 10% of Italian population. Adult patients prescribed with statin and with at least a low–density lipoprotein (LDL) determination were included between 2012 and 2019. The index date was defined as the first prescription for statin within the inclusion period. Patients fell into 4 clusters collectively exhaustive and mutually exclusive based on their characteristics assessed during the year prior index date. Patients were considered as adherent if they had a proportion of days covered (PDC)≥80%. Among overall patients prescribed statin and with a LDL determination, 1% was with familial hypercholesterolemia, 28% with previous cardiovascular events, 21% with diabetes and 50% in primary prevention. Regardless their risk profile, the increasing of adherence was related to a higher achievement of LDL–target, with an increment of + 53.2% among familial hypercholesterolemia, +43.1% in diabetes and +30% in previous cardiovascular events and primary prevention clusters while progressing from low (PDC<40%) to high (PDC≥80%) levels of adherence. However, while in diabetes and primary prevention clusters 80% and 86% of adherent patients, respectively, had their cholesterol level under control, in the familial hypercholesterolemia and previous cardiovascular events clusters only 46% of adherent patients achieve the lipid target.
The analysis showed adherence to be a key factor for cholesterol control. However, our findings underline a therapeutic need for patients that, although adherent, fail to achieve the lipid target, especially among patients with previous cardiovascular events (that have low level of LDL to achieve) and with familial hypercholesterolemia (that have high LDL basal level), suggesting therapeutic intensification should be applied.
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Affiliation(s)
- L Degli Esposti
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - C Borghi
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - M Galvani
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - E Giacomini
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - P Manotti
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - A Marra
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - A Passaro
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - V Perrone
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - F Pieraccini
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - D Sangiorgi
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
| | - A Navazio
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI FORLÌ, AUSL ROMAGNA, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDAL
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Degli Esposti L, Borghi C, Galvani M, Giacomini E, Manotti P, Marra A, Passaro A, Perrone V, Pieraccini F, Sangiorgi D, Navazio A. P357 THE MANAGEMENT OF CHOLESTEROL LEVEL CONTROL WITH LIPID–LOWERING DRUGS IN ITALIAN CLINICAL PRACTICE: FINDINGS FROM THE STREAM (SUPPORTING WITH THE REAL–WORLD EVIDENCE THE ASSESSMENT OF MEDICINES AND HEALTH TECHNOLOGIES) STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
The study aimed to evaluate the proportion of patients not reaching their low–density lipoprotein (LDL)–cholesterol target according to their risk profile in real–world settings of Italian clinical practice.
This observational analysis was based on administrative and laboratory databases from a pool of Italian Entities covering around 10% of Italian population. All patients included had at least one laboratory LDL test between 2012 and 2019. Presence of lipid–lowering drugs was analyzed in the 6 months before index date (last LDL test detected), during which time adherence to these therapies was measured as proportion of days covered (PDC). Risk profile was assessed based on ESC guidelines.1 Among patients with LDL tests that received lipid–lowering drugs, 49.7% were deemed as very high–risk (VHR), 38.3% at high risk (HR), 12% with other risks (OR). Overall, 80% of patients did not reach their LDL–cholesterol target: 87.2% in the HR–cohort, 82.9% in the VHR–cohort (LDL level target 70 mg/dl and 55 mg/dl, respectively) and 49.6% in OR–cohort (LDL level target 116 mg/dl). Statin and ezetimibe combination was observed only in 6.5% of HR and OR and 10.3% of VHR patients, while patients were mainly in monotherapy with statins (87.5 VHR, 91.2% HR, 90.6% OR). Furthermore, patients adherent to treatment (PDC≥80%) accounted for the 52% of VHR–cohort, 47.2% of HR–cohort and 39.1% of OR–cohort. Our findings highlight the need to optimize the management of cholesterol control, especially among patients at risk. Despite the high proportion of patients not reaching LDL target, sub–optimal levels of adherence and a low use of combination regimens were observed, thus suggesting LDL–control could be supported by increasing adherence and/or the use of combination therapies and, if the target is not yet achieved, by the utilization of more recent therapies.
European Heart Journal (2020) 41, 111–188
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Affiliation(s)
- L Degli Esposti
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - C Borghi
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - M Galvani
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - E Giacomini
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - P Manotti
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - A Marra
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - A Passaro
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - V Perrone
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - F Pieraccini
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - D Sangiorgi
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
| | - A Navazio
- CLICON S.R.L., BOLOGNA; MEDICINE DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES UNIVERSITY OF BOLOGNA, BOLOGNA; UOC CARDIOLOGIA OSPEDALE MORGAGNI–PIERANTONI, FORLÌ; DIPARTIMENTO CURE PRIMARIE, AUSL DI REGGIO EMILIA, REGGIO EMILIA; U.O. FARMACIA OSPEDALIERA DIPARTIMENTO BIOTECNOLOGIE, TRASFUSIONALE E DI LABORATORIO AZIENDA OSPEDALIERO UNIVERSITARIA S.ANNA, FERRARA; AZIENDA OSPEDALIERA–UNIVERSITARIA S
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Passaro A, Leighl N, Blackhall F, Popat S, Kerr K, Ahn MJ, Arcila ME, Arrieta O, Planchard D, de Marinis F, Dingemans AM, Dziadziuszko R, Faivre-Finn C, Feldman J, Felip E, Curigliano G, Herbst R, Jänne PA, John T, Mitsudomi T, Mok T, Normanno N, Paz-Ares L, Ramalingam S, Sequist L, Vansteenkiste J, Wistuba II, Wolf J, Wu YL, Yang SR, Yang JCH, Yatabe Y, Pentheroudakis G, Peters S. ESMO expert consensus statements on the management of EGFR mutant non-small-cell lung cancer. Ann Oncol 2022; 33:466-487. [PMID: 35176458 DOI: 10.1016/j.annonc.2022.02.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [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: 12/16/2021] [Revised: 01/14/2022] [Accepted: 02/06/2022] [Indexed: 12/14/2022] Open
Abstract
The European Society for Medical Oncology (ESMO) held a virtual consensus-building process on epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancer in 2021. The consensus included a multidisciplinary panel of 34 leading experts in the management of lung cancer. The aim of the consensus was to develop recommendations on topics that are not covered in detail in the current ESMO Clinical Practice Guideline and where the available evidence is either limited or conflicting. The main topics identified for discussion were: (i) tissue and biomarkers analyses; (ii) early and locally advanced disease; (iii) metastatic disease and (iv) clinical trial design, patient's perspective and miscellaneous. The expert panel was divided into four working groups to address questions relating to one of the four topics outlined above. Relevant scientific literature was reviewed in advance. Recommendations were developed by the working groups and then presented to the entire panel for further discussion and amendment before voting. This manuscript presents the recommendations developed, including findings from the expert panel discussions, consensus recommendations and a summary of evidence supporting each recommendation.
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Affiliation(s)
- A Passaro
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy.
| | - N Leighl
- Division of Medical Oncology/Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Canada
| | - F Blackhall
- Division of Cancer Sciences, The University of Manchester, Manchester, UK; Department of Medical Oncology, The Christie National Health Service (NHS) Foundation Trust, Manchester, UK
| | - S Popat
- National Heart and Lung Institute, Imperial College, London, UK; Lung Unit, Royal Marsden Hospital, London, UK; The Institute of Cancer Research, London, UK
| | - K Kerr
- Aberdeen Royal Infirmary, Aberdeen University Medical School, Aberdeen, UK
| | - M J Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M E Arcila
- Department of Pathology, Molecular Diagnostics Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - O Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - D Planchard
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - F de Marinis
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - A M Dingemans
- Department of Respiratory Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - R Dziadziuszko
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdansk, Poland
| | - C Faivre-Finn
- The University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK
| | - J Feldman
- Lung Cancer Patient and Advocate, Co-Founder of EGFR Resisters Patient Group
| | - E Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milano, European Institute of Oncology IRCCS, Milan, Italy
| | - R Herbst
- Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, USA
| | - P A Jänne
- Lowe Center for Thoracic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - T John
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - T Mitsudomi
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Mok
- State Key Laboratory of Translational Oncology, Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, Hong Kong, China
| | - N Normanno
- Cell Biology and Biotherapy and Scientific Directorate, Istituto Nazionale Tumori, "Fondazione G.Pascale" IRCCS, Naples, Italy
| | - L Paz-Ares
- Lung Cancer Clinical Research Unit, and Complutense University, Madrid, Spain
| | - S Ramalingam
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Atlanta, Georgia
| | - L Sequist
- Department of Medicine, Massachusetts General Hospital, Boston, USA
| | - J Vansteenkiste
- Department of Respiratory Oncology, University Hospital KU Leuven, Leuven, Belgium
| | - I I Wistuba
- Department of Translational Molecular Pathology, Unit 951, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Wolf
- Lung Cancer Group Cologne, Department I for Internal Medicine and Center for Integrated Oncology Cologne/Bonn, University Hospital Cologne, Cologne, Germany
| | - Y L Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangdong, China
| | - S R Yang
- The Institute of Cancer Research, London, UK
| | - J C H Yang
- Department of Oncology, National Taiwan University Hospital and National Taiwan University Cancer Center, Taipei, Republic of China
| | - Y Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Epirus, Greece
| | - S Peters
- Oncology Department - CHUV, Lausanne University, Lausanne, Switzerland
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Attili I, Valenza C, Santoro C, Antonarelli G, Trillo Aliaga P, Del Signore E, Catania C, Spitaleri G, Passaro A, de Marinis F. 42P Comparative real-world analysis of pembrolizumab plus chemo vs platinum-doublet alone in metastatic non-squamous NSCLC with PD-L1 low. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Greco S, Bonsi B, Bella A, Fabbri N, Rocchi C, Bellio ME, Massoli L, Giaccari S, Gavioli M, Fazzin M, D'Urbano F, Rossin E, Feo CV, Parini S, Cavallesco GN, Passaro A. COVID-19: identifying the main outcome predictors. A retrospective cohort study in Northern Italy. Eur Rev Med Pharmacol Sci 2022; 26:722-732. [PMID: 35113448 DOI: 10.26355/eurrev_202201_27899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The need for efficient drugs and early treatment of patients with SARS-CoV-2 infection developing COVID-19 symptoms is of primary importance in daily clinical practice and it is certainly among the most difficult medical challenges in the current century. Recognizing those patients who will need stronger clinical efforts could effectively help doctors anticipate the eventual need for intensification of care (IoC) and choose the best treatment in order to avoid worse outcomes. PATIENTS AND METHODS We enrolled 501 patients, consecutively admitted to our two COVID hospitals, and collected their clinical, anamnestic and laboratory data on admission. The aim of this retrospective study was to identify those data that are strictly associated with COVID-19 outcomes (IoC and in-hospital death) and that could somehow be intended as predictors of these outcomes. This allowed us to provide a "sketch" of the patient who undergoes, more often than others, an intensification of care and/or in-hospital death. RESULTS Males were found to have a double risk of needing an IoC (OR=2.11) and a significant role was played by both the PaO2/FiO2 ratio on admission (OR=0.99) and serum LDH (OR=1.01). The main predictors of in-hospital death were age (OR=1.08) and the PaO2/FiO2 ratio on admission (OR=0.99). CONCLUSIONS Male patients with high serum LDH on admission are those who undergo more often an intensification of care among COVID-19 inpatients. Both age and respiratory performances on admission modify the prognosis within the hospitalization period.
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Affiliation(s)
- S Greco
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
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Cervellati C, Vergallo A, Trentini A, Campo G, Vieceli Dalla Sega F, Rizzo P, Bonaccorsi G, Rosta V, Renzini C, Pacifico S, Passaro A, Hampel H, Zuliani G. Age, Sex, Hypertension and HDL-C Alter Serum BACE1 Activity in Cognitively Normal Subjects: Implications for Alzheimer's Disease. J Prev Alzheimers Dis 2022; 9:708-714. [PMID: 36281675 DOI: 10.14283/jpad.2022.78] [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] [Indexed: 06/16/2023]
Abstract
BACKGROUND Increasing evidence indicates that β-secretase 1 (BACE1) activity and concentration in blood are candidate biomarkers for Alzheimer's disease (AD). Investigating potential demographic, biological, and clinical determinants of BACE1 in the blood matrix is the critical step to validate and qualify BACE1 bio-indicators for different contexts-of-use (CoU), such as risk assessment, early detection, diagnosis, prognosis, management of AD, and outcome of amyloid pathway targeted drugs. OBJECTIVES To evaluate the influence of age, sex, HDL-cholesterol and comorbidities (cardiovascular diseases, hypertension, diabetes) on circulating BACE-1 activity. DESIGN prospective analysis of serum samples, clinical, biological, and demographic variables. SETTING Three cohorts: 1) Memory Clinic of the Department of Internal Medicine, S. Anna University Hospital, Ferrara (Italy); 2) outpatients attending the Menopause and Osteoporosis Centre (MOC) of the University of Ferrara (Ferrara, Italy); 3) Prevention Center of the University of Ferrara. PARTICIPANTS 504 cognitively healthy individuals (median age: 62 years, interquartile range: 51-73) and 175 patients with AD (78 years, 74-82). MEASUREMENTS serum BACE1 (sBACE1), age, sex, HDL-cholesterol, major comorbidities. RESULTS Age was the strongest independent predictor of sBACE1 variance (β=0.425, p<0.0001), followed by sex (β=0.180, p<0.0001), high density lipoprotein-cholesterol (HDL-C) (β=-0.168, p<0.0001) and hypertension (β=0.111, p<0.05) (overall model, R2: 0.232). The probability of having elevated sBACE1 activity increased after 70 years of age, with women being more susceptible to higher sBACE1 activity than men. CONCLUSIONS We provide evidence about potential clinical and biological determinants of sBACE1 activity with a strong association among biomarker, female sex, and older age.
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Affiliation(s)
- C Cervellati
- Dr. Alessandro Trentini, PhD, Department of Environmental and Prevention Sciences, University of Ferrara, via Luigi Borsari 46, 44121 Ferrara, Italy, tel. +39 0532 455322; fax. +39 0532 455322, e-mail: , orcid: 0000-0003-3579-7921
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Attili I, Passaro A, de Marinis F. Anti-TIGIT to overcome resistance to immune checkpoint inhibitors in lung cancer: limits and potentials. Ann Oncol 2021; 33:119-122. [PMID: 34839015 DOI: 10.1016/j.annonc.2021.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- I Attili
- Division of Thoracic Oncology, European Institute of Oncology, IRCCS, Milan, Italy.
| | - A Passaro
- Division of Thoracic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - F de Marinis
- Division of Thoracic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
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Yang JH, Schuler M, Popat S, Miura S, Park K, Passaro A, de Marinis F, Solca F, Märten A, Kim E. 1212P Afatinib for the treatment of NSCLC with uncommon EGFR mutations: An updated database of 1023 cases. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1817] [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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D'Amuri A, Sanz J, Capatti E, Di Vece F, Vaccari F, Lazzer S, Nora ED, Zuliani G, Passaro A. Effect of moderate intensity continuous training and high intensity continuous training on IL-18 levels in a population of obese adults: A randomized controlled trial. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.819] [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: 10/20/2022]
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Greco S, De Giorgi A, Fabbri N, Passaro A. Reply Letter - SARS-CoV-2 infection and H1N1 vaccination: does a relationship between the two factors really exist? A retrospective analysis of a territorial cohort in Ferrara, Italy. Eur Rev Med Pharmacol Sci 2021; 25:3403-3404. [PMID: 34002811 DOI: 10.26355/eurrev_202105_25817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- S Greco
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
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Greco S, Bella A, Bonsi B, Fabbri N, Califano A, Morrone S, Chessa P, Pistolesi C, Zuliani G, De Motoli F, Manfredini R, De Giorgi A, Passaro A. SARS-CoV-2 infection and H1N1 vaccination: does a relationship between the two factors really exist? A retrospective analysis of a territorial cohort in Ferrara, Italy. Eur Rev Med Pharmacol Sci 2021; 25:2795-2801. [PMID: 33829464 DOI: 10.26355/eurrev_202103_25441] [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: 02/08/2023]
Abstract
OBJECTIVE SARS-CoV-2 has been compared with other strains of coronaviruses, SARS-CoV and MERS-CoV, and with the flu viruses: all of them manifest themselves with respiratory symptoms and, although their genetic patterns are similar, the spread of SARS-CoV-2 infection has quickly reached global dimensions, demonstrating that SARS-CoV-2 is a virus with greater spreading capacity, albeit less lethal. Compared with influenza viruses, coronaviruses have a longer incubation period and the patients with coronaviruses' syndromes develop more severe diseases requiring frequent hospitalizations and intensive care admissions. The aim was to explore the relationships between seasonal influenza vaccination and coronavirus infection and to understand whether this hypothetic role by the flu vaccines modifies SARS-CoV-2 infection's outcomes. PATIENTS AND METHODS In this retrospective, multicenter study, we enrolled 952 patients diagnosed with SARS-CoV-2 infection; 448 were admitted to our two main hospitals in Ferrara territory, while the remaining 504 were isolated at home. We compared the group of patients who had been vaccinated for influenza in the previous 12 months to that of unvaccinated patients. RESULTS Significant differences were found for both the need for hospitalization and 30-day mortality between vaccinated and unvaccinated patients. We found age to be the only independent risk factor for a worse 30-day prognosis, while gender, influenza vaccinations and age itself were independent risk factors for undergoing hospitalization. CONCLUSIONS In our groups of patients, we found a relationship between seasonal influenza vaccinations and SARS-CoV-2 infection. Age seems to be the main risk factor for short-term mortality in COVID-19 inpatients, while the influenza vaccination is, together with gender and age itself, a determining factor in predicting the need for hospitalization.
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Affiliation(s)
- S Greco
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
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Gyawali B, de Vries EGE, Dafni U, Amaral T, Barriuso J, Bogaerts J, Calles A, Curigliano G, Gomez-Roca C, Kiesewetter B, Oosting S, Passaro A, Pentheroudakis G, Piccart M, Roitberg F, Tabernero J, Tarazona N, Trapani D, Wester R, Zarkavelis G, Zielinski C, Zygoura P, Cherny NI. Biases in study design, implementation, and data analysis that distort the appraisal of clinical benefit and ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) scoring. ESMO Open 2021; 6:100117. [PMID: 33887690 PMCID: PMC8086024 DOI: 10.1016/j.esmoop.2021.100117] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 12/15/2022] Open
Abstract
Background The European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) is a validated, widely used tool developed to score the clinical benefit from cancer medicines reported in clinical trials. ESMO-MCBS scores assume valid research methodologies and quality trial implementation. Studies incorporating flawed design, implementation, or data analysis may generate outcomes that exaggerate true benefit and are not generalisable. Failure to either indicate or penalise studies with bias undermines the intention and diminishes the integrity of ESMO-MCBS scores. This review aimed to evaluate the adequacy of the ESMO-MCBS to address bias generated by flawed design, implementation, or data analysis and identify shortcomings in need of amendment. Methods As part of a refinement of the ESMO-MCBS, we reviewed trial design, implementation, and data analysis issues that could bias the results. For each issue of concern, we reviewed the ESMO-MCBS v1.1 approach against standards derived from Helsinki guidelines for ethical human research and guidelines from the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use, the Food and Drugs Administration, the European Medicines Agency, and European Network for Health Technology Assessment. Results Six design, two implementation, and two data analysis and interpretation issues were evaluated and in three, the ESMO-MCBS provided adequate protections. Seven shortcomings in the ability of the ESMO-MCBS to identify and address bias were identified. These related to (i) evaluation of the control arm, (ii) crossover issues, (iii) criteria for non-inferiority, (iv) substandard post-progression treatment, (v) post hoc subgroup findings based on biomarkers, (vi) informative censoring, and (vii) publication bias against quality-of-life data. Conclusion Interpretation of the ESMO-MCBS scores requires critical appraisal of trials to understand caveats in trial design, implementation, and data analysis that may have biased results and conclusions. These will be addressed in future iterations of the ESMO-MCBS. We reviewed trial design, implementation, and data analysis issues that could bias the results of trials. These issues could skew the results of ESMO-MCBS scores. Six design, two implementation, and two analysis issues were reviewed, and seven shortcomings were identified. These issues will be addressed in future versions of the MCBS scale. Interpretation of MCBS scores requires critical appraisal of trials.
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Affiliation(s)
- B Gyawali
- Department of Oncology, Queen's University, Kingston, Ontario, Canada; Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada; Division of Cancer Care and Epidemiology, Queen's University, Kingston, Ontario, Canada.
| | - E G E de Vries
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - U Dafni
- Laboratory of Biostatistics, School of Health Sciences, National and Kapodistrian University of Athens, Athens; Frontier Science Foundation-Hellas, Athens, Greece
| | - T Amaral
- Skin Cancer Center, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - J Barriuso
- The Christie NHS Foundation Trust and Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - J Bogaerts
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - A Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan; European Institute of Oncology, IRCCS, Milan, Italy
| | - C Gomez-Roca
- Institut Universitaire du Cancer de Toulouse (IUCT), Toulouse, France
| | - B Kiesewetter
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - S Oosting
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A Passaro
- Division of Thoracic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - M Piccart
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - F Roitberg
- WHO Cancer Management Consultant, Geneva, Switzerland; Instituto do Cancer do Estado de São Paulo (ICESP HCFMUSP), São Paulo, Brazil
| | - J Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), UVic-UCC, IO-Quiron, Barcelona, Spain
| | - N Tarazona
- Department of Medical Oncology, Biomedical Research Institute INCLIVA, CIBERONC, University of Valencia, Valencia, Spain
| | - D Trapani
- European Institute of Oncology, IRCCS, Milan, Italy
| | - R Wester
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - G Zarkavelis
- University of Ioannina-Department of Medical Oncology, Ioannina, Greece
| | - C Zielinski
- Central European Cooperative Oncology Group and Central European Cancer Center, Wiener Privatklinik, Vienna, Austria
| | - P Zygoura
- Frontier Science Foundation-Hellas, Athens, Greece
| | - N I Cherny
- Cancer Pain and Palliative Medicine Service, Department of Medical Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
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Passaro A, Giannarelli D, Bria E, Novello S, Galetta D, Gelibter A, Reale M, Carnio S, Vita E, Stefani A, Pizzutilo P, Stati V, Attili I, de Marinis F. 104P Fast progression in high PD-L1 NSCLC treated with pembrolizumab in first-line: A prognostic scoring system based on clinical features. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01946-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Greco S, Zenunaj G, Bonsi B, Bella A, Lopreiato M, Luciani F, Pedrini D, Vestita G, Dalla Nora E, Passaro A. SARS-CoV-2 and finding of vein thrombosis: can IMPROVE and IMPROVEDD scores predict COVID-19 outcomes? Eur Rev Med Pharmacol Sci 2021; 25:2123-2130. [PMID: 33660832 DOI: 10.26355/eurrev_202102_25118] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Diffuse thrombosis represents one of the most predominant causes of death by COVID-19 and SARS-CoV-2 infection seems to increase the risk of developing venous thromboembolic diseases (VTE). Aim of this study is to analyze the relationship between validated predictive scores for VTE such as IMPROVE and IMPROVEDD and: (1) Intensification of Care (IoC, admission to Pulmonology Department or Intensive Care Unit) (2) in-hospital mortality rate 3) 30-days mortality rate. PATIENTS AND METHODS We retrospectively evaluated 51 adult patients with laboratory diagnosis of SARS-CoV-2 infection and calculated IMPROVE and IMPROVEDD scores. All patients underwent venous color-Doppler ultrasound of the lower limbs to assess the presence of superficial vein thrombosis (SVT) and/or deep vein thrombosis (DVT). Patients with normal values of D-dimer did not receive heparin therapy (LMWH); patients with ≥ 4 ULN values of D-dimer or with a diagnosis of DVT were treated with therapeutic LMWH dosage, while the remaining patients were treated with prophylactic LMWH dosages. RESULTS We found strong relations between IMPROVE score and the need for IoC and with the in-hospital mortality rate and between the IMPROVEDD score and the need for IoC. We defined that an IMPROVE score greater than 4 points was significantly associated to in-hospital mortality rate (p = 0.05), while an IMPROVEDD score greater than 3 points was associated with the need for IoC (p = 0.04). Multivariate logistic analysis showed how IMPROVE score was significantly associated to in-hospital and 30-days mortality rates. CONCLUSIONS IMPROVE score can be considered an independent predictor of in-hospital and 30-days mortality.
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Affiliation(s)
- S Greco
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
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Chih-Hsin Yang J, Schuler M, Popat S, Miura S, Heeke S, Passaro A, de Marinis F, Park K, Kim E. MO01.36 Afatinib in Asian and Non-Asian Patients (pts) with EGFR Mutation-Positive (EGFRm+) NSCLC Harboring Major Uncommon Mutations. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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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De Giorgi A, Fabbian F, Greco S, Di Simone E, De Giorgio R, Passaro A, Zuliani G, Manfredini R. Prediction of in-hospital mortality of patients with SARS-CoV-2 infection by comorbidity indexes: an Italian internal medicine single center study. Eur Rev Med Pharmacol Sci 2020; 24:10258-10266. [PMID: 33090437 DOI: 10.26355/eurrev_202010_23250] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Clinical outcomes in patients hospitalized for severe acute respiratory syndrome due to coronavirus (SARS-CoV-2) infection seems to be closely related with burden of comorbidities. A comorbidity score could help in clinical stratification of patients admitted to internal medicine units. Our aim was to assess a novel modified Elixhauser index (mEi) and the Charlson Comorbidity Index (CCI) for predicting in-hospital mortality (IHM) in internal medicine patients with SARS-CoV-2 infection. PATIENTS AND METHODS This single-center retrospective study enrolled all consecutive patients discharged from internal medicine unit with confirmed SARS-CoV-2 infection. Both the mEi and CCI were easily calculated from administrative data. Comorbidity scores were tested using receiver operating characteristic (ROC) analysis, and the respective area under the curve (AUC). RESULTS The total sample consisted of 151 individuals, and 30 (19.9%) died during their hospital stay. Deceased subjects were older (82.8±10.8 vs. 63.3±18.1 years; p<0.001) and had a higher burden of comorbidities: the mEi and CCI were 29.9±11 vs. 8.8±9.2 and 4.6±2.6 vs. 1.2±2 (p<0.001), respectively. Only the mEi was independently associated with IHM (OR 1.173), and ROC curves analysis showed that the AUCs were 0.863 and 0.918 for the CCI and for mEi, respectively. CONCLUSIONS In patients admitted to internal medicine wards with SARS-CoV-2 infection, the mEi showed a better performance in predicting IHM than CCI.
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Affiliation(s)
- A De Giorgi
- COVID-19 Internal Medicine Units (Clinica Medica, Medicina Interna Universitaria, Medicina Ospedaliera 2), Azienda Ospedaliero-Universitaria "S. Anna", Ferrara, Italy.
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Colonna R, Semprini C, Nora ED, Molina JS, Miselli A, Zuliani G, Passaro A. Serum IL-18 increase and inflammosome activation in gluteal adipose tissue. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.365] [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: 11/28/2022]
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Lo Coco G, Molina JS, Luciani F, Semprini C, Nora ED, Zuliani G, Vigna G, Passaro A. Association between size of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol particles and cardiovascular events in type 2 diabetes subjects. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.628] [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: 10/22/2022]
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Semprini C, D'Amuri A, Molina JS, Vaccari F, Lazzer S, Capatti E, Di Vece F, Nora ED, Zuliani G, Passaro A. Effect of endurance training and high intensity interval training on body composition and cardio-metabolic risk factors in a population of obese adults: A randomized controlled trial. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.788] [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: 10/22/2022]
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Luciani F, Molina JS, Lo Coco G, Nora ED, Bosi C, Semprini C, Dall'Agata M, Colangiulo A, Passaro A, Vigna G. Cardiovascular events, LDL and HDL subfraction size in a cohort of FH patients. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.467] [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: 11/27/2022]
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Yang JH, Schuler M, Popat S, Miura S, Heeke S, Passaro A, de Marinis F, Park K, Kim E. 395P Afatinib in Asian and non-Asian patients (pts) with EGFR mutation positive (EGFRm+) NSCLC harboring major uncommon mutations. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.389] [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: 10/22/2022] Open
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D'accolti M, Soffritti I, Passaro A, Zuliani G, Antonioli P, Mazzacane S, Manfredini R, Caselli E. SARS-CoV-2 RNA contamination on surfaces of a COVID-19 ward in a hospital of Northern Italy: what risk of transmission? Eur Rev Med Pharmacol Sci 2020; 24:9202-9207. [PMID: 32965015 DOI: 10.26355/eurrev_202009_22872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE SARS-CoV-2 can reportedly exist on inanimate surfaces for a long duration, but there is limited data available from Italian COVID-19 hospital wards, especially for non-intensive care units hosting patients that do not require mechanical ventilation. Identification of the extent of environmental contamination can help in understanding possible virus transmission routes, limit hospital infections and protect healthcare workers. Thus, we investigated virus contamination on surfaces of the acute COVID-19 ward of an Italian hospital. MATERIALS AND METHODS Ward surfaces, including four points inside and six points outside the patients' rooms were sampled by swabs, seven hours after routine sanitation. To minimize the risk of underestimation of virus detection, two different sensitive molecular methods were used comparatively, and specific internal controls were added to enhance the efficiency of all the analysis steps. RESULTS SARS-CoV-2 contamination was detected in only three out of all the collected samples, i.e., on two floors and one-bathroom sink, likely reflecting aerosol and saliva contamination, respectively. The overall level of contamination was low, and the floors exhibited a very low level of SARS-CoV-2 presence, evidenced by only one of the two methods used. CONCLUSIONS The existence of SARS-CoV-2 on hospital surfaces may be limited, although it was reported to persist for a longer duration on surfaces under controlled laboratory conditions. Thus, effective transmission of SARS-CoV-2 by surfaces/fomites within the hospital ward may be a rare event. However, the results highlight the importance of assessing method sensitivity and including controls when investigating low-level virus contamination so as to avoid the risk of underestimation of virus presence.
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Affiliation(s)
- M D'accolti
- Section of Microbiology, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy.
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Yang JH, Schuler M, Popat S, Miura S, Heeke S, Passaro A, de Marinis F, Park K, Kim E. 1341P Afatinib in Asian and non-Asian patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC harboring uncommon mutations. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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De Giorgi A, Fabbian F, Di Simone E, Greco S, De Giorgio R, Zuliani G, Passaro A, Caselli E, Manfredini R. Morning vs. evening administration of antiviral therapy in COVID-19 patients. A preliminary retrospective study in Ferrara, Italy. Eur Rev Med Pharmacol Sci 2020; 24:8219-8225. [PMID: 32767353 DOI: 10.26355/eurrev_202008_22511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE At the end of 2019, the Novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), spread rapidly from China to the whole world. Circadian rhythms can play crucial role in the complex interplay between viruses and organisms, and temporized schedules (chronotherapy) have been positively tested in several medical diseases. We aimed to compare the possible effects of a morning vs. evening antiviral administration in COVID patients. PATIENTS AND METHODS We retrospectively evaluated all patients admitted to COVID internal medicine units with confirmed SARS-CoV-2 infection, and treated with darunavir-ritonavir (single daily dose, for seven days). Age, sex, length of stay (LOS), pharmacological treatment, and timing of antiviral administration (morning or evening), were recorded. Outcome indicators were death or LOS, and laboratory parameters, e.g., variations in C-reactive protein (CRP) levels, ratio of arterial oxygen partial pressure (PaO2, mmHg) to fractional inspired oxygen (FiO2) (PaO2/FiO2), and leucocyte count. RESULTS The total sample consisted of 151 patients, 33 (21.8%) of whom were selected for antiviral treatment. The mean age was 61.8±18.3 years, 17 (51.5%) were male, and the mean LOS was 13.4±8.6 days. Nine patients (27.3%) had their antiviral administration in the morning, and 24 (72.7%) had antiviral administration in the evening. No fatalities occurred. Despite the extremely limited sample size, morning group subjects showed a significant difference in CRP variation, compared to that in evening group subjects (-65.82±33.26 vs. 83.32±304.89, respectively, p<0.032). No significant differences were found for other parameters. CONCLUSIONS This report is the first study evaluating temporized morning vs. evening antiviral administration in SARS-CoV-2 patients. The morning regimen was associated with a significant reduction in CRP values. Further confirmations with larger and multicenter samples of patients could reveal novel potentially useful insights.
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Affiliation(s)
- A De Giorgi
- COVID-19 Internal Medicine Units (Clinica Medica, Medicina Interna Universitaria, Medicina Ospedaliera 2), Azienda Ospedaliero-Universitaria "S. Anna", Ferrara, Italy.
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Passaro A, Peters S, Mok TSK, Attili I, Mitsudomi T, de Marinis F. Testing for COVID-19 in lung cancer patients. Ann Oncol 2020; 31:832-834. [PMID: 32278879 PMCID: PMC7144604 DOI: 10.1016/j.annonc.2020.04.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- A Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne University, Lausanne, Switzerland
| | - T S K Mok
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Chinese University of Hong Kong, Hong Kong, China
| | - I Attili
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - T Mitsudomi
- Thoracic Surgery, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - F de Marinis
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Passiglia F, Bertolaccini L, Del Re M, Facchinetti F, Ferrara R, Franchina T, Malapelle U, Menis J, Passaro A, Pilotto S, Ramella S, Rossi G, Trisolini R, Novello S. Diagnosis and treatment of early and locally advanced non-small-cell lung cancer: The 2019 AIOM (Italian Association of Medical Oncology) clinical practice guidelines. Crit Rev Oncol Hematol 2020; 148:102862. [PMID: 32062311 DOI: 10.1016/j.critrevonc.2019.102862] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/11/2019] [Accepted: 12/26/2019] [Indexed: 12/12/2022] Open
Abstract
The Italian Association of Medical Oncology (AIOM) has developed clinical practice guidelines for the diagnosis and treatment of patients with early and locally advanced non-small cell lung cancer. In the current paper a panel of AIOM experts in the field of thoracic malignancies discussed these topics, analyzing available scientific evidences, with the final aim of providing a summary of clinical recommendations, which may guide physicians in their current practice.
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Affiliation(s)
- F Passiglia
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, TO, Italy
| | - L Bertolaccini
- Division of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Del Re
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Italy
| | - F Facchinetti
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France
| | - R Ferrara
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - T Franchina
- Department of Human Pathology "G. Barresi", University of Messina, Italy
| | - U Malapelle
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - J Menis
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy, Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - A Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Pilotto
- U.O.C. Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - S Ramella
- Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy
| | - G Rossi
- Pathologic Anatomy, Azienda USL della Romagna, S. Maria delle Croci Hospital of Ravenna and Degli Infermi Hospital of Rimini, Italy
| | - R Trisolini
- Interventional Pulmonology Unit, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - S Novello
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, TO, Italy.
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Passiglia F, Pilotto S, Facchinetti F, Bertolaccini L, Del Re M, Ferrara R, Franchina T, Malapelle U, Menis J, Passaro A, Ramella S, Rossi G, Trisolini R, Novello S. Treatment of advanced non-small-cell lung cancer: The 2019 AIOM (Italian Association of Medical Oncology) clinical practice guidelines. Crit Rev Oncol Hematol 2020; 146:102858. [PMID: 31918343 DOI: 10.1016/j.critrevonc.2019.102858] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 12/03/2019] [Indexed: 01/10/2023] Open
Abstract
The Italian Association of Medical Oncology (AIOM) has developed clinical practice guidelines for the treatment of patients with advanced non-small cell lung cancer (NSCLC). In the current paper a panel of AIOM experts in the field of thoracic malignancies discussed the available scientific evidences, with the final aim of providing a summary of clinical recommendations, which may guide physicians in their current practice.
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Affiliation(s)
- F Passiglia
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano (TO), Italy
| | - S Pilotto
- U.O.C. Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - F Facchinetti
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France
| | - L Bertolaccini
- Division of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Del Re
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Italy
| | - R Ferrara
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - T Franchina
- Department of Human Pathology "G. Barresi", University of Messina, Italy
| | - U Malapelle
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - J Menis
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - A Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Ramella
- Radiotherapy Unit, Campus Bio-Medico University, Rome, Italy
| | - G Rossi
- Pathologic Anatomy, Azienda USL della Romagna, S. Maria delle Croci Hospital of Ravenna and Degli Infermi Hospital of Rimini, Italy
| | - R Trisolini
- Interventional Pulmonology Unit, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - S Novello
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano (TO), Italy.
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Gottfried M, de Marinis F, Tu H, Laktionov K, Feng J, Poltoratskiy A, Zhao J, Tan EH, Lee V, Kowalski D, Yang CT, Srinivasa B, Passaro A, Clementi L, Tang W, Huang DL, Cseh A, Park K, Zhou C, Wu YL. Activity of afatinib in patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC and baseline brain metastases: Pooled analysis of three large phase IIIb trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Passaro A, De Marinis F, Tu H, Laktionov K, Feng J, Poltoratskiy A, Zhao J, Tan EH, Gottfried M, Lee V, Kowalski D, Yang CT, Srinivasa B, Clementi L, Tang W, Huang DL, Cseh A, Park K, Zhou C, Wu YL. Activity of afatinib in patients (pts) with NSCLC harboring uncommon EGFR mutations: Pooled analysis of three large phase IIIB trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437.029] [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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de Marinis F, Laktionov K, Poltoratskiy A, Egorova I, Hochmair M, Passaro A, Migliorino M, Metro G, Gottfried M, Tsoi D, Ostoros G, Rizzato S, Mukhametshina G, Schumacher M, Novello S, Tang W, Clementi L, Cseh A, Kowalski D. Afatinib in EGFR TKI-naïve patients with EGFR mutation-positive (EGFRm+) NSCLC: Interim analysis of a phase IIIb, multi-national, open-label study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz259.015] [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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40
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de Marinis F, Tu H, Laktionov K, Feng J, Poltoratskiy A, Zhao J, Egorova I, Tan EH, Gottfried M, Lee V, Kowalski D, Yang CT, Srinivasa B, Passaro A, Clementi L, Tang W, Huang DCL, Cseh A, Zhou C, Wu YL. A combined analysis of two phase IIIb studies of afatinib in EGFR TKI-naïve patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz259.017] [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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41
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De Marinis F, Laktionov K, Poltoratskiy A, Egorova I, Hochmair M, Passaro A, Migliorino M, Metro G, Gottfried M, Tsoi D, Ostoros G, Rizzato S, Mukhametshina G, Schumacher M, Novello S, Dziadziuszko R, Tang W, Clementi L, Cseh A, Kowalski D. P2.14-58 A Phase IIIb, Open-Label Study of Afatinib in Caucasian EGFR TKI-Naïve Patients with EGFRm+ NSCLC: An Interim Analysis. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1843] [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: 10/25/2022]
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Passaro A, Mancuso P, Gandini S, Spitaleri G, Labanca V, Guerini-Rocco E, Barberis M, Catania C, Del Signore E, de Marinis F, Bertolini F. Correction to: Gr-MDSC-linked asset as a potential immune biomarker in pretreated NSCLC receiving nivolumab as second-line therapy. Clin Transl Oncol 2019; 22:621. [PMID: 31432394 DOI: 10.1007/s12094-019-02198-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Acknowledgements section was missing.
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Affiliation(s)
- A Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy.
| | - P Mancuso
- Laboratory of Hematology-Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Gandini
- Division of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - G Spitaleri
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy
| | - V Labanca
- Laboratory of Hematology-Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Guerini-Rocco
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - M Barberis
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - C Catania
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy
| | - E Del Signore
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy
| | - F de Marinis
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy
| | - F Bertolini
- Laboratory of Hematology-Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Colonna R, Miselli M, Sanz J, Nora ED, Zuliani G, Passaro A. Il-18 As A Possible Link Between Physical Inactivity And Insulin Resistance. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.387] [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: 10/26/2022]
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Passaro A, Mancuso P, Gandini S, Spitaleri G, Labanca V, Guerini-Rocco E, Barberis M, Catania C, Del Signore E, de Marinis F, Bertolini F. Gr-MDSC-linked asset as a potential immune biomarker in pretreated NSCLC receiving nivolumab as second-line therapy. Clin Transl Oncol 2019; 22:603-611. [PMID: 31254252 DOI: 10.1007/s12094-019-02166-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 02/26/2019] [Accepted: 06/16/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Immunotherapy is a new standard first-line treatment for non-small cell lung cancers (NSCLC) with high programmed cell death-ligand 1 (PD-L1) expression (≥ 50%) and second-line treatment regardless of PD-L1 status, though not all patients benefit from this approach. Much effort is ongoing to identify robust prognostic and predictive biomarkers of response to immune checkpoint inhibitors, overcoming PD-L1 that appears limited in its ability to discriminate patient candidates to this new class of anticancer agents. The purpose of this research study is to identify potential new biomarkers for immunotherapy in lung cancer. METHODS Fifty-three consecutive patients with advanced NSCLC treated with nivolumab were enrolled in the study. All the patients received a blood analysis looking for the relationship between different populations of baseline white blood cells and granulocytic myeloid-derived suppressor cells (Gr-MDSC) detected by flow cytometry, to identify and characterize patients with poor likelihood of benefit from nivolumab in NSCLC second-line setting, regardless of clinical feature and PDL1 expression. RESULTS Univariate analysis showed that high baseline levels of Gr-MDSC and low baseline CD8/Gr-MDSC ratio are associated with significantly better (P = 0.02) response to immunotherapy treatment. Log-rank tests suggested a significant improvement in OS and PFS with high baseline levels of Gr-MDSC levels (≥ 6 cell/μl), low absolute neutrophil count (< 5840/μl), high eosinophil count (> 90 /μl), and NLR < 3. The multivariate analysis showed a statistically significant improvement for PFS (P = 0.003) and OS (P = 0.05) in favour of the identified good prognostic Gr-MDSC-linked asset group, compared with the poor prognosis group. CONCLUSION The role of Gr-MDSC appears interesting as a potential biomarker in NSCLC patients receiving immune-checkpoint inhibitors. Further analyses are needed to confirmed and study in deep the role of these particular cells and their role in cancer response and progression during ICI therapy.
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Affiliation(s)
- A Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy.
| | - P Mancuso
- Laboratory of Hematology-Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Gandini
- Division of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - G Spitaleri
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy
| | - V Labanca
- Laboratory of Hematology-Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Guerini-Rocco
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - M Barberis
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - C Catania
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy
| | - E Del Signore
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy
| | - F de Marinis
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via G. Ripamonti, 435, 20141, Milan, Italy
| | - F Bertolini
- Laboratory of Hematology-Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Passaro A, Laktionov K, Poltoratskiy A, Egorova I, Hochmair M, Migliorino M, Metro G, Gottfried M, Tsoi D, Ostoros G, Rizzato S, Mukhametshina G, Schumacher M, Novello S, Dziadziuszko R, Tang W, Clementi L, Cseh A, Kowalski D, De Marinis F. Afatinib in EGFR TKI-naïve patients (pts) with locally advanced/metastatic NSCLC harbouring EGFR mutations: An interim analysis of a phase IIIB trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.013] [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: 11/13/2022] Open
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Gianoncelli L, Spitaleri G, Passaro A, Fumagalli C, Trillo Aliaga P, Del Signore E, Stati V, Ferraro E, Guerini-Rocco E, Catania C, Barberis M, de Marinis F. Correlation among different KRAS alterations, genetic co-mutations and PD-L1 expression in patients treated with immunotherapy in metastatic NSCLC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.050] [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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Passaro A, Prelaj A, Spitaleri G, Del Signore E, Rossi G, Guerini-Rocco E, Barberis M, Catania C, de Marinis F. Clinical and treatment features associated with improved 5-year survival rate in ALK-positive lung cancer treated with ALK-TKIs. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.042] [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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48
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Dalla Nora E, Miselli M, Francesconi D, D'amuri A, Colonna R, Sanz J, Morieri M, Zuliani G, Passaro A. Gene expression of FNDC5 and related genes in gluteal subcutaneous adipose tissue and plasma irisin levels after acute inactivity. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.524] [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: 11/26/2022]
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49
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Metro G, Passaro A, Lo Russo G, Bonanno L, Giusti R, Gregorc V, Capelletto E, Martelli O, Cecere F, Giannarelli D, Luciani A, Bearz A, Tuzi A, Scotti V, Tonini G, Galetta D, Carta A, Soto Parra H, Morabito A, Chiari R. Efficacy of ceritinib administered to patients with crizotinib-refractory, ALK-positive, advanced NSCLC within the Italian compassionate use program. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426.007] [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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50
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Passaro A, Metro G, Tiseo M, Migliorino M, Santo A, Sperandi F, Maione P, Puppo G, Grossi F, Soto Parra H, Borra G, Roca E, Rocco D, Stasi I, Galetta D, Carta A, Milella M, Fasola G, Gebbia V, Ferrari S, De Marinis F. ASTRIS, a real world treatment study of osimertinib in patients (pts) with EGFR T790M positive non-small cell lung cancer (NSCLC): preliminary analysis of the Italian cohort. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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