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Galiano A, Feltrin A, Pambuku A, Lo Mauro L, De Toni C, Murgioni S, Soldà C, Maruzzo M, Bergamo F, Brunello A, Zagonel V. What do cancer patients experience of the simultaneous care clinic? Results of a cross-sectional study on patient care satisfaction. Cancer Med 2024; 13:e7000. [PMID: 38400662 PMCID: PMC10891442 DOI: 10.1002/cam4.7000] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Veneto Institute of Oncology has activated a simultaneous care outpatient clinic (SCOC) in which cancer patients with advanced-stage cancer are evaluated by oncologist and palliative care specialists. This cross-sectional study investigated patients' perceptions of the quality of this service. MATERIALS AND METHODS An ad-hoc self-administered questionnaire, developed by SCOC team, was used to assess the satisfaction of patients admitted at SCOC consultation. The questionnaire, in addition to the socio-demographic questions, contains eight questions with the Likert scale: time dedicated, feel listened to, feel understood, feel free to speak openly and to express doubts and concerns, feeling about information and indication received, level of empathy of health care and quality of the relationship, level of professional/quality of performance and utility of consultation, and one open-ended question. The questionnaire has been proposed to all 174 consecutively admitted patients at SCOC. RESULTS One hundred and sixty-two patients filled in the questionnaire: 66.7% were male, median age was 71 years, 88.3% had metastatic disease. The time dedicated to SCOC consultation was judged more than adequate (55%) or adequate (35%) by 90% of subjects. Patients completely satisfied about being listened to were 92.5%, with 80.9% being completely satisfied with understanding of their issues and 92% with the freedom to speak and express doubts. Usefulness of the SCOC was rated as excellent by 40% and good by 54.4% of patients. No statistically significant differences were observed in the responses to the questions by gender, age (< or ≥70 years old) and type of tumor. CONCLUSION Our study shows high levels of satisfactions after SCOC consultation in advanced cancer subjects. Patients' feedback confirmed that SCOC model was effective in helping them during their treatment journey and decision at the end of life. This study encouraged us to enhance our practice of SCOC consultation. IMPLICATIONS FOR PRACTICE A joint evaluation of patients living with cancer by oncologist and palliative care team (SCOC-embedded model), has shown to enhance patients' experience/satisfaction with care-such as listening, understanding, receiving information, symptom control, and decision about future, independently of age, gender, and kind of tumor.
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Affiliation(s)
- Antonella Galiano
- Department of Oncology, Oncology Unit 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | | | - Ardi Pambuku
- Pain Therapy and Palliative Care UnitVeneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Leda Lo Mauro
- Clinical Nutrition Unit, Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Chiara De Toni
- Department of Oncology, Oncology Unit 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Sabina Murgioni
- Department of Oncology, Oncology Unit 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Caterina Soldà
- Department of Oncology, Oncology Unit 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Marco Maruzzo
- Department of Oncology, Oncology Unit 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Francesca Bergamo
- Department of Oncology, Oncology Unit 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Antonella Brunello
- Department of Oncology, Oncology Unit 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Vittorina Zagonel
- Department of Oncology, Oncology Unit 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
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Ruggiero E, Pambuku A, Caccese M, Lombardi G, Gallio I, Brunello A, Ceccato F, Formaglio F. Case report: The lesson from opioid withdrawal symptoms mimicking paraganglioma recurrence during opioid deprescribing in cancer pain. Front Pain Res (Lausanne) 2023; 4:1256809. [PMID: 37810433 PMCID: PMC10556467 DOI: 10.3389/fpain.2023.1256809] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Pain is one of the predominant and troublesome symptoms that burden cancer patients during their whole disease trajectory: adequate pain management is a fundamental component of cancer care. Opioid are the cornerstone of cancer pain relief therapy and their skillful management must be owned by physicians approaching cancer pain patients. In light of the increased survival of cancer patients due to advances in therapy, deprescription should be considered as a part of the opioid prescribing regime, from therapy initiation, dose titration, and changing or adding drugs, to switching or ceasing. In clinical practice, opioid tapering after pain remission could be challenging due to withdrawal symptoms' onset. Animal models and observations in patients with opioid addiction suggested that somatic and motivational symptoms accompanying opioid withdrawal are secondary to the activation of stress-related process (mainly cortisol and catecholamines mediated). In this narrative review, we highlight how the lack of validated guidelines and tools for cancer patients can lead to a lower diagnostic awareness of opioid-related disorders, increasing the risk of developing withdrawal symptoms. We also described an experience-based approach to opioid withdrawal, starting from a case-report of a symptomatic patient with a history of metastatic pheochromocytoma-paraganglioma.
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Affiliation(s)
- Elena Ruggiero
- Pain Therapy and Palliative Care with Hospice Unit, Veneto Institute of Oncology IOV—IRCCS, Padua, Italy
| | - Ardi Pambuku
- Pain Therapy and Palliative Care with Hospice Unit, Veneto Institute of Oncology IOV—IRCCS, Padua, Italy
| | - Mario Caccese
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Giuseppe Lombardi
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Ivan Gallio
- Pain Therapy and Palliative Care with Hospice Unit, Veneto Institute of Oncology IOV—IRCCS, Padua, Italy
| | - Antonella Brunello
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Filippo Ceccato
- Department of Medicine DIMED, University of Padova, Padova, Italy
- Endocrine Disease Unit, University-Hospital of Padova, Padova, Italy
| | - Fabio Formaglio
- Pain Therapy and Palliative Care with Hospice Unit, Veneto Institute of Oncology IOV—IRCCS, Padua, Italy
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Galiano A, Schiavon S, Nardi M, Guglieri I, Pambuku A, Martino R, Bolshinsky M, Murgioni S, Intini R, Soldà C, Marino D, Daniel F, De Toni C, Pittarello C, Chiusole B, Prete AA, Bimbatti D, Nappo F, Caccese M, Bergamo F, Brunello A, Lonardi S, Zagonel V. Simultaneous care in oncology: Assessment of benefit in relation to symptoms, sex, and age in 753 patients. Front Oncol 2022; 12:989713. [PMID: 36313660 PMCID: PMC9614371 DOI: 10.3389/fonc.2022.989713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/05/2022] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Early activation of palliative care for patients with advanced cancer is central in the treatment trajectory. At the Veneto Institute of Oncology, a simultaneous-care outpatient clinic (SCOC) has been active since 2014, where patients are evaluated by an oncologist together with a palliative care team. Recently, we reported on consecutive patients admitted at SCOC from 2018 to 2021 in terms of appropriateness, process, and outcome indicators. Here, we report further analysis in the same group of 753 patients, evaluating other parameters and the correlation between symptom intensity, gender, age, and survival. METHODS SCOC data were retrieved from a prospectively maintained database. RESULTS Among the patients, 42.2% were women, and the median age was 68 years, with 46.7% of patients aged ≥70 years. The most prevalent disease type was gastrointestinal cancer (75.2%), and 90.9% of the patients had metastatic disease. The median score for the distress thermometer was 4; the vast majority of the patients (98.6%) reported physical problems, and 69.4% presented emotional issues. Younger women demonstrated a significantly greater median distress than other patients (p=0.0018). Almost all symptoms had a higher prevalence on the 0-3 Edmonton Symptom Assessment Scale (ESAS) score, except for fatigue. About 43.8% of the patients received systemic anticancer treatment (SAT) in the last 60 days of life, 15.0% of whom received SAT in the last month and 3.1% in the last 2 weeks. For some symptoms, women frequently had more ESAS >3. Pain and nausea were significantly less reported by older patients compared with younger adults. Men had a lower risk of having MUST score ≥ 2 (p=0.0311). Men and older patients showed a lower prognosis awareness (p=0.0011 and p=0.0049, respectively). Older patients received less SAT within the last 30 days of life (p=0.0006) and had death risk decreased by 20.0%. CONCLUSION Our study identified two subgroups of patients with advanced cancer who require special attention and support due to important symptoms' burden detected by Patient Reported Outcome Measures tests: women and younger adults. These categories of patients require special attention and should be provided early access at SCOC. The role of an oncologist remains crucial to intercept all patients in need of early palliative care and balancing trade-offs of anticancer treatment in advanced metastatic disease.
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Affiliation(s)
- Antonella Galiano
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Stefania Schiavon
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Mariateresa Nardi
- Clinical Nutrition Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - Ardi Pambuku
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Rosalba Martino
- Hospital Psychology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Maital Bolshinsky
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Sabina Murgioni
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Rossana Intini
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Caterina Soldà
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Dario Marino
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Francesca Daniel
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Chiara De Toni
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Chiara Pittarello
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Benedetta Chiusole
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Alessandra Anna Prete
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Davide Bimbatti
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Floriana Nappo
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Mario Caccese
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Francesca Bergamo
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Antonella Brunello
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Sara Lonardi
- Department of Oncology, Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Vittorina Zagonel
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
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Brunello A, Galiano A, Schiavon S, Guglieri I, Nucci D, Pambuku A, Dal Col A, Bergamo F, Finotto S, Bolshinsky M, Stragliotto S, Rizzato M, Lonardi S, Zagonel V. 1273P Early integration between oncologic treatment and palliative care: Experience of the simultaneous care outpatient clinic at Veneto Institute of Oncology, ESMO Designated Center. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1406] [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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Brunello A, Galiano A, Schiavon S, Nardi M, Feltrin A, Pambuku A, De Toni C, Dal Col A, Lamberti E, Pittarello C, Bergamo F, Basso U, Maruzzo M, Finotto S, Bolshinsky M, Stragliotto S, Procaccio L, Rizzato MD, Formaglio F, Lombardi G, Lonardi S, Zagonel V. Simultaneous Care in Oncology: A 7-Year Experience at ESMO Designated Centre at Veneto Institute of Oncology, Italy. Cancers (Basel) 2022; 14:cancers14102568. [PMID: 35626172 PMCID: PMC9139444 DOI: 10.3390/cancers14102568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/12/2022] [Accepted: 05/20/2022] [Indexed: 12/12/2022] Open
Abstract
Benefits of early palliative care referral in oncology are well-validated. At the Veneto Institute of Oncology-IRCCS, a simultaneous-care outpatient clinic (SCOC) has been active since 2014, where patients with advanced cancer are evaluated by an oncologist together with a palliative care team. We prospectively assessed SCOC patients’ characteristics and SCOC outcomes through internal procedure indicators. Data were retrieved from the SCOC prospectively maintained database. There were 753 eligible patients. The median age was 68 years; primary tumor sites were gastrointestinal (75.2%), genitourinary (15.0%) and other sites (9.8%). Predominant symptoms were psychological issues (69.4%), appetite loss (67.5%) and pain (65.9%). Dyspnea was reported in 53 patients (7%) in the referral form, while it was detected in 226 patients (34.2%) during SCOC visits (p < 0.0001). Median survival of patients after the SCOC visit was 7.3 months. Survival estimates by the referring oncologist were significantly different from the actual survival. Psychological intervention was deemed necessary and undertaken in 34.6% of patients, and nutritional support was undertaken in 37.9% of patients. Activation of palliative care services was prompted for 77.7% of patients. Out of 357 patients whose place of death is known, 69.2% died at home, in hospice or residential care. With regard to indicators’ assessment, the threshold was reached for 9 out of 11 parameters (81.8%) requested by the procedure. This study confirmed the importance of close collaboration between oncologists and palliative care teams in responding properly to cancer patients’ needs. The introduction of a procedure with indicators allowed punctual assessment of a team’s performance.
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Affiliation(s)
- Antonella Brunello
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Antonella Galiano
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Stefania Schiavon
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (S.S.); (A.P.); (A.D.C.); (F.F.)
| | - Mariateresa Nardi
- Clinical Nutrition Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Alessandra Feltrin
- Hospital Psychology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Ardi Pambuku
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (S.S.); (A.P.); (A.D.C.); (F.F.)
| | - Chiara De Toni
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Alice Dal Col
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (S.S.); (A.P.); (A.D.C.); (F.F.)
| | - Evelina Lamberti
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Chiara Pittarello
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Francesca Bergamo
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Umberto Basso
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Marco Maruzzo
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Silvia Finotto
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Maital Bolshinsky
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Silvia Stragliotto
- Department of Oncology, Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, 31033 Castelfranco Veneto, Italy; (S.S.); (S.L.)
| | - Letizia Procaccio
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Mario Domenico Rizzato
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Fabio Formaglio
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (S.S.); (A.P.); (A.D.C.); (F.F.)
| | - Giuseppe Lombardi
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Sara Lonardi
- Department of Oncology, Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, 31033 Castelfranco Veneto, Italy; (S.S.); (S.L.)
| | - Vittorina Zagonel
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
- Correspondence: ; Tel.: +39-049-8215953
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Lombardi G, De Salvo GL, Brandes AA, Eoli M, Rudà R, Faedi M, Lolli I, Pace A, Daniele B, Pasqualetti F, Rizzato S, Bellu L, Pambuku A, Farina M, Magni G, Indraccolo S, Gardiman MP, Soffietti R, Zagonel V. Regorafenib compared with lomustine in patients with relapsed glioblastoma (REGOMA): a multicentre, open-label, randomised, controlled, phase 2 trial. Lancet Oncol 2019; 20:110-119. [DOI: 10.1016/s1470-2045(18)30675-2] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 12/17/2022]
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Indraccolo S, Lombardi G, Fassan M, Pasqualini L, Giunco S, Marcato R, Gasparini A, Candiotto C, Nalio S, Fiduccia P, Fanelli GN, Pambuku A, Della Puppa A, D'Avella D, Bonaldi L, Gardiman MP, Bertorelle R, De Rossi A, Zagonel V. Genetic, Epigenetic, and Immunologic Profiling of MMR-Deficient Relapsed Glioblastoma. Clin Cancer Res 2018; 25:1828-1837. [PMID: 30514778 DOI: 10.1158/1078-0432.ccr-18-1892] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/25/2018] [Accepted: 11/28/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE In-depth characterization of recurrent glioblastoma (rGBM) might contribute to a better understanding of the mechanisms behind tumor progression and enable rGBM treatment with targeted drugs.Experimental Design: In this study, GBM samples were collected at diagnosis and recurrence from adult patients treated with Stupp protocol. Expression of mismatch repair (MMR) proteins was evaluated by IHC, followed by whole exome sequencing (WES) of tumor samples showing loss of MSH6 reactivity. Established genetic, epigenetic, and immunologic markers were assessed by standard methods and correlated with loss of MMR proteins and patient survival. RESULTS Expression of MMR proteins was partially or completely lost in 25.9% rGBM samples. Specifically, 12 samples showed partial or total MSH6 expression reduction. Conversely, 96.4% of GBM samples at diagnosis expressed MMR markers. WES disclosed lack of variants in MMR genes in primary samples, whereas two MSH6-negative rGBM samples shared a c.3438+1G>A* splicing MSH6 variant with a potential loss of function effect. MSH6-negative rGBM specimens had high tumor mutational burden (TMB), but no microsatellite instability. In contrast, GBM samples with partial loss of MMR proteins disclosed low TMB. MMR-deficient rGBM showed significant telomere shortening and MGMT methylation and are characterized by highly heterogeneous MHC class I expression. CONCLUSIONS Multilevel profiling of MMR-deficient rGBM uncovered hypermutated genotype uncoupled from enriched expression of immune-related markers. Assessment of MHC class I expression and TMB should be included in protocols aiming to identify rGBM patients potentially eligible for treatment with drugs targeting immune-checkpoint inhibitors.
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Affiliation(s)
- Stefano Indraccolo
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy.
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padova, Padova, Italy
| | - Lorenza Pasqualini
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Silvia Giunco
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Raffaella Marcato
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Alessandra Gasparini
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Cinzia Candiotto
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Silvia Nalio
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Pasquale Fiduccia
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Giuseppe Nicolò Fanelli
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padova, Padova, Italy
| | - Ardi Pambuku
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | | | - Domenico D'Avella
- Neurosurgery, Department of Neurosciences DNS, University Hospital of Padova, Padova, Italy
| | - Laura Bonaldi
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Marina Paola Gardiman
- Surgical Pathology and Cytopathology Unit, University Hospital of Padova, Padova, Italy
| | - Roberta Bertorelle
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
| | - Anita De Rossi
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy.,Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Padova, Italy
| | - Vittorina Zagonel
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV -IRCCS, Padova, Italy
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8
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Lombardi G, Bergo E, Bellu L, Caccese M, Lettiero A, Tierno G, Pambuku A, Brunello A, Zagonel V. NCOG-12. COMPREHENSIVE GERIATRIC ASSESSMENT (CGA) FOR OUTCOME PREDICTION IN ELDERLY PATIENTS (PTS)WITH GLIOBLASTOMA (GBM): A MONO-INSTITUTIONAL EXPERIENCE. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Giuseppe Lombardi
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV IRCCS, Padova, Veneto, Italy
| | - Eleonora Bergo
- Medical Oncology Unit 1, Veneto Institute of Oncology, IOV IRCCS, Padova, Veneto, Italy
| | - Luisa Bellu
- Veneto Institute of Oncology, Padova, Veneto, Italy
| | - Mario Caccese
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV IRCCS, Padova, Veneto, Italy
| | - Annunziata Lettiero
- Medical Oncology Unit 1, Veneto Institute of Oncology, IOV IRCCS, Padova, Veneto, Italy
| | - Giuseppina Tierno
- Medical Oncology Unit 1, Veneto Institute of Oncology, IOV IRCCS, Padova, Veneto, Italy
| | - Ardi Pambuku
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV IRCCS, Padova, Veneto, Italy
| | - Antonella Brunello
- Medical Oncology Unit 1, Veneto Institute of Oncology, IOV IRCCS, Padova, Veneto, Italy
| | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV IRCCS, Padova, Veneto, Italy
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9
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Lombardi G, Caccese M, Simonelli M, Fassan M, Persico P, Lorenzi E, Bertorelle R, Gardiman M, Bellu L, Pambuku A, Santoro A, Zagonel V. Mismatch repair deficiency (MMRd) in glioma patients (PTS): Frequency and correlation with clinical, histological and molecular characteristics. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy273.362] [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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10
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Lombardi G, Bergo E, Bellu L, Caccese M, Lettiero A, Tierno G, Pambuku A, Brunello A, Zagonel V. Comprehensive geriatric assessment (CGA) for outcome prediction in elderly patients (PTS) with glioblastoma (GBM): A mono-institutional experience. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy273.369] [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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11
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Lombardi G, de Salvo G, Rudà R, Franceschi E, Eoli M, Faedi M, Pace A, Lolli I, Rizzato S, Germano D, Pasqualetti F, Farina M, Magni G, Bellu L, Caccese M, Pambuku A, Bergo E, Indraccolo S, Gardiman M, Soffietti R, Zagonel V. OS2.3 Updated results of REGOMA: A randomized, multicenter, controlled open-label phase II clinical trial evaluating regorafenib in relapsed glioblastoma <GBM> patients <PTS>. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- G Lombardi
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
| | - G de Salvo
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - R Rudà
- Department of Neuro-Oncology, University of Turin and City of Health and Science Hospital, Torino, Italy
| | - E Franceschi
- Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Science, Bologna, Italy
| | - M Eoli
- Fondazione IRCCS Istituto Besta, Milano, Italy
| | - M Faedi
- Department of Medical Oncology, IRST - IRCCS, Meldola, Italy
| | - A Pace
- Neuroncology Unit, IFO, Roma, Italy
| | - I Lolli
- Medical Oncology Unit, IRCCS “Saverio de Bellis”, Castellana Grotte, Italy
| | - S Rizzato
- Department of Oncology, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - D Germano
- Medical Oncology Unit, Azienda Ospedaliera “G. Rummo”, Benevento, Italy
| | - F Pasqualetti
- Department of Radiotherapy, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - M Farina
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - G Magni
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - L Bellu
- Radiotherapy Unit, IOV-IRCCS, Padova, Italy
| | - M Caccese
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
| | - A Pambuku
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
| | - E Bergo
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
| | - S Indraccolo
- Immunology and Molecular Oncology Unit, IOV-IRCCS, Padova, Italy
| | - M Gardiman
- Unità Anatomia Patologica, Azienda-Università di Padova, Padova, Italy
| | - R Soffietti
- Department of Neuro-Oncology, University of Turin and City of Health and Science Hospital, Torino, Italy
| | - V Zagonel
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
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12
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Lombardi G, Caccese M, Simonelli M, Fassan M, Persico P, Lorenzi E, Bertorelle R, Gardiman M, Bellu L, Pambuku A, Santoro A, Zagonel V. P01.018 Mismatch repair deficiency (MMRd) in glioma patients (PTS): frequency and correlation with clinical, histological and molecular characteristics. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- G Lombardi
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
| | - M Caccese
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
| | - M Simonelli
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
- Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - M Fassan
- Surgical Pathology Unit, Department of Medicine (DIMED), University-Hospital of Padua, Padova, Italy
| | - P Persico
- Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - E Lorenzi
- Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - R Bertorelle
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV - IRCCS, Padova, Italy
| | - M Gardiman
- Surgical Pathology Unit, Department of Medicine (DIMED), University-Hospital of Padua, Padova, Italy
| | - L Bellu
- Radiation Therapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padova, Italy
| | - A Pambuku
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
| | - A Santoro
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
- Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - V Zagonel
- Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV – IRCCS, Padova, Italy
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13
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Lombardi G, Bergo E, Bellu L, Caccese M, Lettiero A, Tierno G, Pambuku A, Brunello A, Zagonel V. P01.021 Comprehensive Geriatric Assessment (CGA) for outcome prediction in elderly patients (PTS)with glioblastoma (GBM): a mono-institutional experience. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G Lombardi
- Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - E Bergo
- Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - L Bellu
- Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - M Caccese
- Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - A Lettiero
- Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - G Tierno
- Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - A Pambuku
- Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - A Brunello
- Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - V Zagonel
- Veneto Institute of Oncology-IRCCS, Padova, Italy
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14
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Lombardi G, Bellu L, Villani V, Rizzato S, Russo M, Carosi M, De Carlo E, Biasini L, Gardiman MP, Fiduccia P, Pambuku A, Della Puppa A, Skrap M, Servadei F, D'Avella D, Carapella CM, Caccese M, Bertorelle R, Pace A, Zagonel V. A large, multicenter, retrospective study to identify a cutoff of MGMT methylation status by quantitative pyrosequencing approach in patients (PTS) with glioblastoma (GBM). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.2012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Giuseppe Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Luisa Bellu
- Radiotherapy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - Simona Rizzato
- Dipartimento di Oncologia, Azienda Sanitaria-Universitaria Integrata, Udine, Italy
| | - Marco Russo
- Università degli Studi di Parma, SC Neurologia, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | | | - Elisa De Carlo
- Oncologia Medica, Centro di Riferimento Oncologico, Aviano, Italy
| | - Lorena Biasini
- Immunology and Molecular Oncology, IOV-IRCSS, Padova, Italy
| | | | - Pasquale Fiduccia
- Clinical Trials and Biostatistic Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Ardi Pambuku
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | | | - Miran Skrap
- Dipartimento di Neuroscienze, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Franco Servadei
- SC Neurochirurgia-Neurotraumatologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | | | | | - Mario Caccese
- Department of Clinical and Experimental Oncology, Medical Oncology, Medical Oncology, 1, IOV-IRCCS, Padova, Italy
| | | | | | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
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15
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Lombardi G, De Salvo GL, Ruda R, Franceschi E, Eoli M, Faedi M, Pace A, Lolli I, Rizzato S, Germano D, Pasqualetti F, Farina M, Magni G, Bellu L, Pambuku A, Bergo E, Indraccolo S, Gardiman MP, Soffietti R, Zagonel V. Updated results of REGOMA: A randomized, multicenter, controlled open-label phase II clinical trial evaluating regorafenib in relapsed glioblastoma (GBM) patients (PTS). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.2047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Giuseppe Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Roberta Ruda
- Department of Neuro-Oncology, University of Turin and City of Health and Science, Turin, Italy
| | - Enrico Franceschi
- Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Marica Eoli
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marina Faedi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRST - IRCCS, Meldola, Italy
| | | | - Ivan Lolli
- Medical Oncology Unit, IRCCS Saverio de Bellis, Castellana Grotte, Italy
| | - Simona Rizzato
- Dipartimento di Oncologia, Azienda Sanitaria-Universitaria Integrata, Udine, Italy
| | - Domenico Germano
- Medical Oncology Unit, Azienda Ospedaliera "G. Rummo", Benevento, Italy
| | | | - Miriam Farina
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Giovanna Magni
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Luisa Bellu
- Radiotherapy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Ardi Pambuku
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Eleonora Bergo
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Stefano Indraccolo
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - Riccardo Soffietti
- Department of Neuro-Oncology, University of Turin and City of Health and Science, Turin, Italy
| | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
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Bergo E, Lombardi G, Del Bianco P, Dal Pos S, Berti F, Bellu L, Pambuku A, Zagonel V. Worsening of quality of life (QoL), cognitive functions (CF) and psychological status (PSY) can predict radiologic progressive disease (RPD) in glioblastoma (GBM) patients (PTS) treated with radiation therapy (RT) and temozolomide (TMZ): a mono-institutional prospective study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx431.003] [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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17
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Cuppari L, Lombardi G, Evangelista L, Pambuku A, Saladini G, Zagonel V. Suspicious for recurrent low and high grade glioma and indeterminate MRI: the role of 18F-DOPA PET/CT. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx431.005] [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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18
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Lombardi G, Ferrara M, Pambuku A, Lorusso M, Boaretto F, Schiavi F, Biasini L, Azzolin F, Opocher G, Zovato S, Zagonel V. Activity of temozolomide (TMZ) in patients (PTS) with malignant pheochromocytoma or paraganglioma (MPP): A mono-institutional retrospective study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx368.040] [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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19
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Bergo E, Lombardi G, Del Bianco P, Dal Pos S, Berti F, Bellu L, Pambuku A, Zagonel V. Worsening of quality of life (QoL), cognitive functions (CF) and psychological status (PSY) can predict radiologic progressive disease (RPD) in glioblastoma (GBM) patients (PTS) treated with radiation therapy (RT) and temozolomide (TMZ): A mono-institutional prospective study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx366.030] [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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20
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Lombardi G, De Salvo G, Brandes A, Eoli M, Rudà R, Faedi M, Lolli I, Pace A, Rizzato S, Germano D, Pasqualetti F, Farina M, Magni G, Pambuku A, Bergo E, Cabrini G, Indraccolo S, Gardiman M, Zagonel V. REGOMA: A randomized, multicenter, controlled open-label phase II clinical trial evaluating regorafenib activity in relapsed glioblastoma patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.009] [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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21
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Lombardi G, Pambuku A, Zagonel V. Elderly patients with glioblastoma: where are we going? Transl Cancer Res 2017. [DOI: 10.21037/tcr.2017.06.53] [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: 11/06/2022]
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22
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Lombardi G, Bellu L, Bertorelle R, Pambuku A, Gardiman M, Fiduccia P, Della Puppa A, Berti F, D’Avella D, Zagonel V. P09.28 MGMT promoter methylation status in glioblastoma (GBM) patients: a quantitative pyrosequencing approach and its prognostic role. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.284] [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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23
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Lombardi G, Bellu L, Pambuku A, Fiduccia P, Della Puppa A, Gardiman M, Berti F, D’Avella D, Zagonel V. P09.29 Anaplastic Astrocytoma (AA) and Glioblastoma (GBM): a real-life experience in Padua Neuro-Oncology Center. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.285] [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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24
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Lombardi G, Pambuku A, Bellu L, Farina M, Della Puppa A, Denaro L, Zagonel V. Effectiveness of antiangiogenic drugs in glioblastoma patients: A systematic review and meta-analysis of randomized clinical trials. Crit Rev Oncol Hematol 2017; 111:94-102. [PMID: 28259301 DOI: 10.1016/j.critrevonc.2017.01.018] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [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: 09/20/2016] [Revised: 01/17/2017] [Accepted: 01/24/2017] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND glioblastomas are highly vascularized tumors and various antiangiogenic drugs have been investigated in clinical trials showing unclear results. We performed a systematic review and a meta-analysis to clarify and evaluate their effectiveness in glioblastoma patients. PATIENTS AND METHODS we searched relevant published and unpublished randomized clinical trials analyzing antiangiogenic drugs versus chemotherapy in glioblastoma patients from January 2006 to January 2016 in MEDLINE, WEB of SCIENCE, ASCO, ESMO and SNO databases. RESULTS fourteen randomized clinical trials were identified (7 with bevacizumab, 2 cilengitide, 1 enzastaurin, 1 dasatinib, 1 vandetanib, 1 temsirolimus, 1 cediranib) including 4330 patients. Antiangiogenic drugs showed no improvement in overall survival with a pooled HR of 1.00, a trend for an inferior outcome, in terms of overall survival, was observed in the group of patients receiving antiangiogenic drug alone compared to cytotoxic drug alone (HR=1.24, p=0.056). Bevacizumab did not improve overall survival. Twelve trials (4113 patients) were analyzed for progression-free survival. Among antiangiogenic drugs, only bevacizumab demonstrated an improvement of progression-free survival (HR=0.63, p<0.001), both alone (HR=0.60, p=0.003) or in combination to chemotherapy (HR=0.63; p<0.001), both as first-line treatment (HR=0.70, p<0.001) or in recurrent disease (HR=0.52, p<0.001). CONCLUSIONS antiangiogenic drugs did not improve overall survival in glioblastoma patients, either as first or second-line treatment, and either as single agent or in combination with chemotherapy. Among antiangiogenic drugs, only bevacizumab improved progression-free survival regardless of treatment line, both as single agent or in combination with chemotherapy.
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Affiliation(s)
- Giuseppe Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV - IRCCS, Padua, Italy.
| | - Ardi Pambuku
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV - IRCCS, Padua, Italy
| | - Luisa Bellu
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV - IRCCS, Padua, Italy
| | - Miriam Farina
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology, IOV - IRCCS, Padua, Italy
| | | | - Luca Denaro
- Neurosurgery Department, University of Padua, Padua, Italy
| | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV - IRCCS, Padua, Italy
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Bergo E, Lombardi G, Del Bianco P, Berti F, Bellu L, Pambuku A, Zagonel V. A prospective analysis of quality of life (QoL), cognitive functions (CF) and psychological status (PSY) in glioblastoma (GBM) patients (PTS) treated with RT and temozolomide (TMZ). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw367.24] [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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26
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Lombardi G, Pambuku A, Bellu L, Fiduccia P, De Puppa A, Gardiman M, Berti F, D'Avella D, Zagonel V. Anaplastic astrocytoma (AA) and glioblastoma (GBM): a real-life experience in Padua Neuro-Oncology Center. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw367.27] [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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27
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Pambuku A, Lombardi G, Bertorelle R, Bellu L, Fiduccia P, Gardiman M, De Puppa A, Berti F, D'Avella D, Zagonel V. MGMT promoter methylation status in glioblastoma (GBM) patients: a quantitative pyrosequencing approach and its prognostic role. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw367.15] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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28
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Lombardi G, Bellu L, Pambuku A, Zagonel V. Effectiveness of antiangiogenic drugs (ADs) in glioblastoma (GBM) patients (PTS): a metanalysis of randomized clinical trials (RCTs). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw367.06] [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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29
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Pambuku A, Lombardi G, Bertorelle R, Bellu L, Fiduccia P, Gradiman M, Della Puppa A, Franco B, D'Avella D, Zagonel V. MGMT promoter methylation status in glioblastoma (GBM) patients: a quantitative pyrosequencing approach and its prognostic role. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.26] [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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Lombardi G, Bellu L, Pambuku A, Zagonel V. Effectiveness of antiangiogenic drugs (ADs) in glioblastoma (GBM) patients (PTS): a metanalysis of randomized clinical trials (RCTs). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Bergo E, Bergo E, Lombardi G, Del Bianco P, Berti F, Bellu L, Pambuku A, Zagonel V. A prospective analysis of quality of life (QoL), cognitive functions (CF) and psychological status (PSY) in glioblastoma (GBM) patients (PTS) treated with RT and Temozolomide (TMZ). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.31] [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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Bellu L, Lombardi G, Pambuku A, Fiduccia P, Della Puppa A, Gardiman M, Berti F, D'Avella D, Zagonel V. Anaplastic Astrocytoma (AA) and Glioblastoma (GBM): a real-life experience in Padua. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.23] [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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Bergo E, Lombardi G, Pambuku A, Della Puppa A, Bellu L, D'Avella D, Zagonel V. Cognitive Rehabilitation in Patients with Gliomas and Other Brain Tumors: State of the Art. Biomed Res Int 2016; 2016:3041824. [PMID: 27493954 PMCID: PMC4963561 DOI: 10.1155/2016/3041824] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/26/2016] [Accepted: 06/02/2016] [Indexed: 01/01/2023]
Abstract
Disease prognosis is very poor in patients with brain tumors. Cognitive deficits due to disease or due to its treatment have an important weight on the quality of life of patients and caregivers. Studies often take into account quality of life as a fundamental element in the management of disease and interventions have been developed for cognitive rehabilitation of neuropsychological deficits with the aim of improving the quality of life and daily-life autonomy of patients. In this literature review, we will consider the published studies of cognitive rehabilitation over the past 20 years.
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Affiliation(s)
- E. Bergo
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - G. Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - A. Pambuku
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - A. Della Puppa
- Neurosurgery Department, Azienda Ospedaliera di Padova, Padua, Italy
| | - L. Bellu
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - D. D'Avella
- Neurosurgery Department, University of Padua, Padua, Italy
| | - V. Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
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Banzato A, Denas G, Lombardi G, Pambuku A, Bianchi A, Pengo V. The Three Players of Mechanical Valve Thrombosis: Cancer, Anticancer Therapy, and Thromboprophylaxis. J Heart Valve Dis 2016; 25:522-524. [PMID: 28009964] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Alberto Banzato
- Cardiology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Gentian Denas
- Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padua, Italy. Electrronic correspondence:
| | - Giuseppe Lombardi
- Medical Oncology 1, Department of Clinical and Experimental Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Ardi Pambuku
- Medical Oncology 1, Department of Clinical and Experimental Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Vittorio Pengo
- Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padua, Italy
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Lombardi G, Pambuku A, Bellu L, Farina M, Pintacuda G, Zagonel V. Effectiveness of antiangiogenic drugs (ADs) in glioblastoma (GBM) patients (PTS): A metanalysis of randomized clinical trials (RCTs). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e13501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Giuseppe Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Ardi Pambuku
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Luisa Bellu
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Miriam Farina
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology - IRCCS, Padua, Italy
| | - Giovanna Pintacuda
- Oncological Radiology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Vittorina Zagonel
- Medical Oncology 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
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Bergo E, Lombardi G, Guglieri I, Capovilla E, Pambuku A, Zagone V. Neurocognitive functions and health-related quality of life in glioblastoma patients: a concise review of the literature. Eur J Cancer Care (Engl) 2015; 28:e12410. [PMID: 26531122 DOI: 10.1111/ecc.12410] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 11/29/2022]
Abstract
The maintenance of quality of life in patients with high-grade glioma is an important endpoint during treatment, particularly in those with glioblastoma multiforme, given its dismal prognosis; thus, the primary aims of treatments are to reduce morbidity, restore or preserve neurological functions, and the capacity to perform daily activities. This review aims to summarise what is currently known about neurocognitive outcome and quality of life in patients with high-grade glioma, particularly in glioblastoma patients. We considered all the variables that can influence neurocognitive functions, the perception of quality of life and their role as predictors for treatment outcomes.
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Affiliation(s)
- E Bergo
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV- IRCCS, Padua.,Psycho-Oncology Unit, Veneto Institute of Oncology IOV- IRCCS, Padua, Italy
| | - G Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV- IRCCS, Padua
| | - I Guglieri
- Psycho-Oncology Unit, Veneto Institute of Oncology IOV- IRCCS, Padua, Italy
| | - E Capovilla
- Psycho-Oncology Unit, Veneto Institute of Oncology IOV- IRCCS, Padua, Italy
| | - A Pambuku
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV- IRCCS, Padua
| | - V Zagone
- Department of Clinical and Experimental Oncology, Medical Oncology 1 Unit, Veneto Institute of Oncology IOV- IRCCS, Padua
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Bellu L, Lombardi G, Pambuku A, Bergo E, Vittorina Z. Alternative schedule of Fotemustine in elderly patients with recurrent glioblastoma: a phase II prospective study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.38] [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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Lombardi G, Pace A, Pasqualetti F, Rizzato S, Faedi M, Anghileri E, Nicolotto E, Bazzoli E, Bellu L, Villani V, Fabi A, Ferrazza P, Gurrieri L, Dall'Agata M, Eoli M, Della Puppa A, Pambuku A, Berti F, Rudà R, Zagonel V. Clinical and molecular predictors of survival in elderly glioblastoma patients treated with radiotherapy and concomitant temozolomide: a multicenter study of aino (Italian Association of Neuro-Oncology). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.13] [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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Bellu L, Lombardi G, Pambuku A, Bergo E, Zagonel V. 2921 Low-dose Fotemustine in elderly patients with recurrent glioblastoma: A phase II prospective study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31636-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bergo E, Lombardi G, Fiduccia P, Bellu L, Pambuku A, Zagonel V. 2916 A prospective study analyzing quality of life and cognitive function in patients with glioblastoma treated with RT and Temozolomide: Impact of age and gender. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31631-8] [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: 11/30/2022]
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Lombardi G, Pace A, Pasqualetti F, Rizzato S, Faedi M, Anghileri E, Nicolotto E, Bazzoli E, Bellu L, Villani V, Fabi A, Ferrazza P, Gurrieri L, Dall'Agata M, Eoli M, Della Puppa A, Pambuku A, D'Avella D, Ruda R, Zagonel V. Temozolomide (TMZ) and radiation therapy (RT) combination in elderly patients with glioblastoma: A multicenter retrospective study of AINO (Italian Association of Neuro-Oncology). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Giuseppe Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Andrea Pace
- Neuro-Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy
| | | | - Simona Rizzato
- Department of Oncology, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Marina Faedi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Elena Anghileri
- Unit of Molecular Neuro-Oncology, Fondazione I.R.C.C.S. Istituto Neurologico C. Besta, Milan, Italy
| | - Elisa Nicolotto
- Department of Neuro-Oncology, University of Turin and City of Health and Science, Turin, Italy
| | - Elena Bazzoli
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy; IRCCS, Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy, Verona, Brescia, Italy
| | - Luisa Bellu
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Veronica Villani
- Neuro-Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy
| | - Alessandra Fabi
- Division of Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Ferrazza
- Department of Radiotherapy, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Lorena Gurrieri
- Department of Oncology, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Monia Dall'Agata
- Biostatistics and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Marica Eoli
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy, Milan, Italy
| | | | - Ardi Pambuku
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | | | - Roberta Ruda
- Department of Neuro-Oncology, University of Turin and City of Health and Science, Turin, Italy
| | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology-IRCCS, Padua, Italy
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Lombardi G, Corona G, Bellu L, Della Puppa A, Pambuku A, Fiduccia P, Bertorelle R, Gardiman MP, D'Avella D, Toffoli G, Zagonel V. Diagnostic value of plasma and urinary 2-hydroxyglutarate to identify patients with isocitrate dehydrogenase-mutated glioma. Oncologist 2015; 20:562-7. [PMID: 25862748 DOI: 10.1634/theoncologist.2014-0266] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 01/15/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Mutant isocitrate dehydrogenase (IDH) 1/2 enzymes can convert α-ketoglutarate into 2-hydroxyglutarate (2HG). The aim of the present study was to explore whether 2HG in plasma and urine could predict the presence of IDH1/2 mutations in patients with glioma. MATERIALS AND METHODS All patients had histological confirmation of glioma and a recent brain magnetic resonance imaging scan showing the neoplastic lesion. Plasma and urine samples were taken from all patients, and the 2HG concentrations were determined using liquid chromatography tandem mass spectrometry. RESULTS A total of 84 patients were enrolled: 38 with R132H-IDH1 mutated and 46 with wild type. Among the 38 patients with mutant IDH1, 21 had high-grade glioma and 17 had low-grade glioma. Among the 46 patients with IDH1 wild-type glioma, 35 and 11 had high- and low-grade glioma, respectively. In all patients, we analyzed the mean 2HG concentration in the plasma, urine, and plasma/urine ratio (Ratio_2HG). We found a significant difference in the Ratio_2HG between patients with and without an IDH1 mutation (22.2 ± 8.7 vs. 15.6 ± 6.8; p < .0001). The optimal cutoff value for Ratio_2HG to identify IDH1 mutation was 19 (sensitivity, 63%; specificity, 76%; accuracy, 70%). In the patients with high-grade glioma only, the optimal cutoff value was 20 (sensitivity, 76%; specificity, 89%; accuracy, 84%; positive predictive value, 80%; negative predictive value, 86%). In 7 of 7 patients with high-grade glioma, we found a correlation between the Ratio_2HG value and the response to treatment. CONCLUSION Ratio_2HG might be a predictor of the presence of IDH1 mutation. The measurement of 2HG could be useful for disease monitoring and also to assess the treatment effects in these patients.
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Affiliation(s)
- Giuseppe Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Giuseppe Corona
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Luisa Bellu
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Alessandro Della Puppa
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Ardi Pambuku
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Pasquale Fiduccia
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Roberta Bertorelle
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Marina Paola Gardiman
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Domenico D'Avella
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Giuseppe Toffoli
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
| | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Clinical Trials and Biostatistics Unit, and Molecular Immunology and Oncology Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy; Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy; Neurosurgery Department and Pathology Department, Neurological Sciences, Padua Hospital, Padua, Italy; Neurosurgery Department, University of Padua, Padua, Italy
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Lombardi G, Puppa AD, Zustovich F, Pambuku A, Farina P, Zagonel V. P17.53 * THE COMBINATION OF CARMUSTINE WAFERS AND FOTEMUSTINE IN RECURRENT GLIOBLASTOMA PATIENTS: OUR EXPERIENCE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.382] [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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Lombardi G, Corona G, Farina P, Pambuku A, Bellu L, Della Puppa A, Fiduccia P, Bertorelle R, Gardiman MP, Toffoli G, Zagonel V. Diagnostic value of plasma and urinary 2-hydroxyglutarate to identify patients with IDH-mutated glioma. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.2037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Giuseppe Lombardi
- Medical Oncology 1, Venetian Institute of Oncology-IRCCS, Padua, Italy
| | - Giuseppe Corona
- Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy
| | - Patrizia Farina
- Medical Oncology 1, Venetian Institute of Oncology-IRCCS, Padua, Italy
| | - Ardi Pambuku
- Medical Oncology 1, Venetian Institute of Oncology-IRCCS, Padua, Italy
| | - Luisa Bellu
- Medical Oncology 1, Venetian Institute of Oncology-IRCCS, Padua, Italy
| | | | - Pasquale Fiduccia
- Medical Oncology 1, Venetian Institute of Oncology-IRCCS, Padua, Italy
| | - Roberta Bertorelle
- Molecular Immunology and Oncology, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Marina Paola Gardiman
- Pathology Department, Neurological Sciences, Azienda Ospedale–University of Padua, Padua, Italy
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy
| | - Vittorina Zagonel
- Medical Oncology 1, Venetian Institute of Oncology-IRCCS, Padua, Italy
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Lombardi G, Pambuku A, Bellu L, Della Puppa A, Rumanò L, Gardiman MP, Pomerri F, Zagonel V. Cisplatin and temozolomide combination in the treatment of supratentorial anaplastic ependymoma. Chemotherapy 2013; 59:176-80. [PMID: 24192541 DOI: 10.1159/000355662] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/06/2013] [Indexed: 11/19/2022]
Abstract
Anaplastic ependymomas are rare tumors in adult patients. Maximal safe resection and use of radiation therapy are standard treatment approaches in patients with anaplastic ependymoma. Recurrent anaplastic ependymomas are treated by reoperation when the tumors are surgically accessible, by radiotherapy if not previously administered and by salvage chemotherapy. However, the role of chemotherapy is still unclear. A few retrospective studies showed interesting results with platinum-based regimens, while the administration of temozolomide alone demonstrated conflicting results. We present, for the first time, the case of a patient with anaplastic ependymoma refractory to platinum-based chemotherapy and temozolomide only, but showing a prolonged reduction of the lesion after receiving combination chemotherapy with cisplatin and temozolomide. A brief review of the literature on the treatment of anaplastic ependymoma follows.
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Affiliation(s)
- Giuseppe Lombardi
- Medical Oncology 1, Veneto Institute of Oncology - IRCCS, Padua, Italy
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