1
|
Canova S, Trevisan B, Abbate MI, Colonese F, Sala L, Baggi A, Bianchi SP, D'Agostino A, Cortinovis DL. Novel Therapeutic Options for Small Cell Lung Cancer. Curr Oncol Rep 2023; 25:1277-1294. [PMID: 37870696 PMCID: PMC10640463 DOI: 10.1007/s11912-023-01465-7] [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] [Accepted: 09/19/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE OF REVIEW The aim of this review is to focus on the recent advances in the molecular knowledge of small cell lung cancer (SCLC) and potential promising new treatment strategies, like targeting the DNA damage pathway, epigenetics, angiogenesis, and oncogenic drivers. RECENT FINDINGS In the last few years, the addition of immunotherapy to chemotherapy has led to significant improvements in clinical outcomes in this complex neoplasia. Nevertheless, the prognosis remains dismal. Recently, numerous genomic alterations have been identified, and they may be useful to classify SCLC into different molecular subtypes (SCLC-A, SCLC-I, SCLC-Y, SCLC-P). SCLC accounts for 10-20% of all lung cancers, most patients have an extensive disease at the diagnosis, and it is characterized by poor prognosis. Despite the progresses in the knowledge of the disease, efficacious targeted treatments are still lacking. In the near future, the molecular characterisation of SCLC will be fundamental to find more effective treatment strategies.
Collapse
Affiliation(s)
- Stefania Canova
- SC Medical Oncology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Benedetta Trevisan
- SC Medical Oncology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Department of Medical-Surgical Specialties, University of Brescia, Radiological Sciences and Public Health, Brescia, Italy
| | - Maria Ida Abbate
- SC Medical Oncology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Francesca Colonese
- SC Medical Oncology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Luca Sala
- SC Medical Oncology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Alice Baggi
- SC Medical Oncology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Department of Medical-Surgical Specialties, University of Brescia, Radiological Sciences and Public Health, Brescia, Italy
| | - Sofia Paola Bianchi
- Radiation Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Anna D'Agostino
- SC Medical Oncology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Diego Luigi Cortinovis
- SC Medical Oncology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
- Medicine and Surgery Department, University of Milano Bicocca, Milan, Italy.
| |
Collapse
|
2
|
Cortinovis DL, Colonese F, Abbate MI, Sala L, Meazza Prina M, Cordani N, Sala E, Canova S. Harnessing DLL3 inhibition: From old promises to new therapeutic horizons. Front Med (Lausanne) 2022; 9:989405. [PMID: 36530878 PMCID: PMC9751403 DOI: 10.3389/fmed.2022.989405] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/18/2022] [Indexed: 10/15/2023] Open
Abstract
Small-cell lung cancer (SCLC) is an aggressive neuroendocrine tumor with a high relapse rate, limited therapeutic options, and poor prognosis. The combination of chemotherapy and immune-checkpoint inhibitors brings a new therapeutic era, although the lack of predictive biomarkers of response reduces the efficacy of applying the treatment to the entire population of patients with SCLC. The lack of treatments able to bind to a specific target has always been a substantial difference to the non-small cell lung cancer (NSCLC) counterpart. Delta-like canonical Notch ligand 3 is a protein frequently overexpressed in SCLC and is therefore being explored as a potentially promising therapeutic target in high-grade neuroendocrine lung cancer. In this article, we critically review the activity and efficacy of old DLL3 inhibitors antibody-drug conjugate (ADC) and their failures through new compounds and their possible applications in clinical practice, with a focus on new molecular classification of SCLC.
Collapse
Affiliation(s)
- Diego Luigi Cortinovis
- Department of Medical Oncology, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | | | - Maria Ida Abbate
- Department of Medical Oncology, San Gerardo Hospital, Monza, Italy
| | - Luca Sala
- Department of Medical Oncology, San Gerardo Hospital, Monza, Italy
| | | | - Nicoletta Cordani
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Elisa Sala
- Department of Medical Oncology, San Gerardo Hospital, Monza, Italy
| | - Stefania Canova
- Department of Medical Oncology, San Gerardo Hospital, Monza, Italy
| |
Collapse
|
3
|
Abbate MI, Cortinovis DL, Tiseo M, Vavalà T, Cerea G, Toschi L, Canova S, Colonese F, Bidoli P. Peritoneal carcinomatosis in non-small-cell lung cancer: retrospective multicentric analysis and literature review. Future Oncol 2019; 15:989-994. [DOI: 10.2217/fon-2018-0469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We investigated outcomes in patients with advanced non-small-cell lung cancer (NSCLC) and peritoneal involvement. Patients & methods: NSCLC patients with peritoneal carcinomatosis (PC) were included. We evaluated mOS1 (overall survival [OS] from NSCLC diagnosis) and mOS2 (OS from diagnosis of PC). Results: In total, 60 NSCLC patients were diagnosed with PC, 12 (20%) patients had a diagnosis of NSCLC and synchronous PC with a median OS of 9 months. Smokers had a shorter mOS1 and mOS2 compared with never-smokers; EGFR-mutated patients on tyrosine kinase inhibitors had longer mOS1 and mOS2 than EGFR wild-type patients. Conclusion: Metachronous PC is correlated to a short survival, irrespective of treatment line. Never-smokers and EGFR-mutated patients had improved mOS1 and mOS2 when compared with smokers and EGFR wild-type population.
Collapse
Affiliation(s)
| | | | - Marcello Tiseo
- Azienda Ospedaliero-Sanitaria San Luigi Gonzaga, Regione Gonzole 10, Orbassano, TO, Italy
| | - Tiziana Vavalà
- Azienda Ospedaliero-Sanitaria San Luigi Gonzaga, Regione Gonzole 10, Orbassano, TO, Italy
- Presidio Ospedaliero Saluzzo-Savigliano, Via Ospedali, 14, Savigliano, CN, Italy
| | - Giulio Cerea
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore 3, Milano, Italy
| | - Luca Toschi
- Istituto Clinico Humanitas, Via Alessandro Manzoni 56, Milano, Italy
| | - Stefania Canova
- Ospedale San Gerardo, Via GB Pergolesi 33, 20052 Monza, Italy
| | | | - Paolo Bidoli
- Ospedale San Gerardo, Via GB Pergolesi 33, 20052 Monza, Italy
| |
Collapse
|
4
|
Cortinovis DL, Hollander LH, Carlucci L, Grosso F, Ceresoli GL, Pacchetti I, Zucali PA, D'Incalci M, Tiseo M, Legramandi L, Canova S, Ugo F, Abbate MI, Taverna G, Cogliati V, Bidoli P. Trabectedin (T) as second line treatment option for patients with epithelioid malignant pleural mesothelioma (MPM) in progression following pemetrexed/platin-derivates chemotherapy: ATREUS trial. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.8513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8513 Background: Systemic chemotherapy in MPM is inevitably followed by relapse, and response rates to second line treatment are limited. T is an antineoplastic agent targeting both the malignant cells and the tumor microenvironment with demonstrated activity against a range of tumors. We aimed to study the activity and safety of T in advanced MPM. Methods: ATREUS, an Italian multicenter single arm phase II trial, assessed the activity T in MPM evaluating the proportion of patients responding to treatment and achieving progression free survival for 12 weeks (PFS12w). Pre-treated epithelioid and naive or pre-treated biphasic/sarcomatoid pts were treated until progression or unacceptable toxicity. Initial dose was 1.3 mg/m2, over 3 hours every 21 days, later reduced to 1.1 mg/m2to improve tolerability. In the epithelioid cohort, sample size was based on a Simon's Optimal Two-Stage Design. The study was set to reject, at an alpha error of 10% the hypothesis that PFS12w was ≤25% and to demonstrate, with a power of 85% the hypothesis that PFS12w was ≥40%. At least 20 out of 62 pts with assessed disease, no major protocol violations, either receiving ≥12 weeks of treatment or interrupting before for progression or death (per protocol – PP analysis) were to reach PFS12w in order to consider T effective. Results: 71 pts were enrolled and evaluable. Average age was 65.8 ± 8.75 years. 71.8% were male and 82.5% presented stage III or IV disease. 42.4% (25/59) of pts included in the PP analysis obtained PFS12w (95% CI: 29.6% - 55.9%). In a second, more conservative analysis, including pts withdrawn prematurely for toxicity or intercurrent illness as failures, PFS12w rate reached 38.5% (25/65 pts). The most frequent grade ≥3 treatment-related toxicities werehepatic toxicity (60.5%), non-febrile neutropenia (21.1%), and fatigue (6.6%). Five pts (7%) interrupted treatment for toxicities (2 liver, 1 multi-organ failure, 1 thrombocytopenia, 1 T intolerance). Conclusions: In pts with advanced epithelioid MPM, second line treatment with T showed an elevated rate of disease stabilization. Safety data is promising but require further evaluation. Clinical trial information: NCT02194231.
Collapse
Affiliation(s)
| | | | - Luciano Carlucci
- IRCCS - Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Federica Grosso
- Oncology, SS Antonio e Biagio General Hospital, Alessandria, Italy
| | | | - Ilaria Pacchetti
- IRCCS - Mario Negri Institute for Pharmacological Research, Milan, Italy
| | | | - Maurizio D'Incalci
- IRCCS - Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Marcello Tiseo
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Lorenzo Legramandi
- IRCCS - Mario Negri Institute for Pharmacological Research, Milan, Italy
| | | | - Francesca Ugo
- SC Oncologia SS Antonio e Biagio and C Arrigo Hospital, Alessandria, Italy
| | | | | | | | | |
Collapse
|
5
|
Tiseo M, Crinò L, Galetta D, Abbate MI, Delmonte A, Grossi F, De Marinis F, Ricciardi S, Manzo A, Palla A, Tondini C, Tassinari D, Frassoldati A, Verderame F, Cogoni AA, Cognetti F, Palmiotti G, Illiano A, Silvestris F, Soto Parra HJ. P3.02c-092 Nivolumab in Multi-Treated Patients with Advanced Sq-NSCLC: Data from the Italian Cohort of Expanded Access Programme (EAP). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1888] [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]
|
6
|
Cortinovis DL, Hollander LH, Floriani IC, Grosso F, Marinello A, Ceresoli GL, Pacchetti I, Zucali PA, D'Incalci M, Canova S, Abbate MI, Ugo F, Vukcaj S, Bidoli P. Activity and safety of trabectedin in patients with sarcomatoid / biphasic malignant pleural mesothelioma (MPM). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.7561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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)
| | | | | | - Federica Grosso
- Oncology SS Antonio e Biagio General Hospital, Alessandria, Italy
| | | | | | - Ilaria Pacchetti
- IRCCS - Mario Negri Institute for Pharmacological Research, Milano, Italy
| | | | - Maurizio D'Incalci
- IRCCS Mario Negri Institute for Pharmacological Research Oncology Department, Milan, Italy
| | | | | | - Francesca Ugo
- SC Oncologia SS Antonio e Biagio and C Arrigo Hospital, Alessandria, Italy
| | | | | |
Collapse
|
7
|
Conti F, Carpano S, Sergi D, Di Lauro L, Amodio A, Vici P, Abbate MI, Ferranti FR, Viola G, Botti C, Foggi P, Sperduti I, Lopez M. [High-dose CEF (cyclophosphamide, epirubicin, fluorouracil) as primary chemotherapy in locally advanced breast cancer: long-term results]. Clin Ter 2007; 158:331-341. [PMID: 17953285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE To determine wether primary CEF is effective in locally advanced breast cancer, as measured by response, local recurrences, disease free survival (DFS) and overall survival (OS). MATERIAL AND METHODS From 1990 to 1998, 62 patients with stage III disease were enrolled into a prospective study at Regina Elena Institute for Cancer Research, Rome. Inflammatory breast cancer (IBC) was included. Patients received three 21 days cycles of chemotherapy that consisted in epirubicin 50 mg/m2, cyclophosphamide 400 mg/m2, and fluorouracil 500 mg/m2 i.v. on days 1 and 8. G-CSF (300 microg) was given subcutaneously every other day from day 5 to day 17. After primary chemotherapy, whenever possible, mastectomy or conservative surgery was performed. Subsequently responding patients received the same regimen, while non responders were given a non cross resistant chemotherapy. In case of conservative surgery or initial T4 tumor radiation therapy was performed at the end of adjuvant chemotherapy. ER positive patients received tamoxifen 20 mg/d for five years. RESULTS Seven IIIA patients had a median OS of 43 months (C.I. 95%, 31-55) and DFS of 42 months (C.I. 95%, 16-68), while 15 IBC patients had a median OS of 52 months (C.I. 95%, 52-79) and DFS of 27 months (C.I. 95%, 14-39). Forty IIIB non inflammatory breast cancer patients had a median DFS of 87 months (C.I. 95%, 1-175); median OS was not reached. Ten-year OS was 28.6% for stage IIIA, 50.6% for stage IIIB and 36% for IBC. CONCLUSION Primary CEF appear to be an effective treatment. In our study we obtained a good local control and interesting long term data of disease free and overall survival.
Collapse
Affiliation(s)
- F Conti
- Divisione di Oncologia Medica B, Istituto Nazionale Tumori Regina Elena, Roma, Italia
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Conti F, Sergi D, Foggi P, Abbate MI, Lopez M. [New combination chemotherapy regimens in the primary treatment of operable breast cancer]. Clin Ter 2007; 158:55-75. [PMID: 17405660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Primary (neoadjuvant) systemic chemotherapy is the standard treatment for locally advanced breast cancer and a standard option for primary operable disease. Although survival results are similar, primary chemotherapy has the following advantages in comparison to adjuvant chemotherapy: it represents a chemosensitivity test in vivo and can be of value in determining the prognosis of the patient since pathologic complete responses are related to improved survival. Among a variety of primary chemotherapy regimens currently available, the most effective seem to be those containing both anthracyclines and taxanes, expecially when these agents are administered sequentially. There are also several ongoing studies evaluating primary hormonal therapy and the combination of cytotoxic chemotherapy and targeted agents. It is conceivable that in the future primary chemotherapy of breast cancer will be increasingly used. In fact, besides its clinical effectiveness, primary chemotherapy is extremely important to evaluate new agents and to find useful prognostic and predictive factors.
Collapse
Affiliation(s)
- F Conti
- Istituto Nazionale Tumori Regina Elena, Roma, Italia
| | | | | | | | | |
Collapse
|