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Orgiano L, Cubeddu A, Camera S, Mascia R, Dessi M, Pedditzi E, Murru M, Piredda P, Barca M, Saba E, Palmas V, Camboni T, Massa E, Astara G, Manzin A, Madeddu C, Scartozzi M. CREAM study: Clinical correlation between immunotherapy-RElated clinical outcome and intestinal microbiote in metastatic patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.tps215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS215 Background: It's known that composition of intestinal flora can influence the development of inflammatory gastrointestinal diseases, even though the association of inflammation with specific intestinal microbes is still unknown, because the inflammation and its treatment can change the composition of microbiote. Some bacterial species are essential to maintain the mucosal physiological tolerance, although species such as Bacteroides, Clostridium and Faecalibacterium can induce the up-regulation of T-cells and stimulate the production of anti-inflammatory cytokines. Innovative therapies such as anti-CTLA-4 antibody and inhibitors of the PD-1 receptor are particularly involved in the up-regulation of lymphocyte system: among their side effects, the most relevant are those immune-mediated such as hypophysitis, thyroiditis and colitis. In particular this last one usually occurs within 16weeks from the start of treatment: about one third of patients develop intestinal inflammation of any grade as a result of immune system dysregulation. So, the high incidence of colitis in patients treated with immunotherapy offers the possibility to characterize the intestinal microbiote before the development of immune-mediated inflammation. In addition, our curiosity has been oriented to the response to immunotherapy and the HLA class expressed by our patients: which any better predictor of response to immunological treatment than this one? Methods: Our is a single-center study of clinical and biological parameters prospectively stratified. Specifically, we collect from patients eligible for immunotherapy a blood sample to analyze HLA class and an other one to analyze serum cytokines levels, inflammatory indices and a sample of fecal material at baseline and at least after 3 administrations of treatment: actually we enrolled 34 out of 40 planned patients; we suppose to complete the enrollment in 2 months. According to preliminary data published in literature, we expect to find an alteration of intestinal microbiote in metastatic patients treated with immunotherapy. Once we'll identify it, we want to assess whether there is any correlation with the patient's clinical outcome.
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Affiliation(s)
- Laura Orgiano
- AOU Cagliari, Department of Medical Oncology, Monserrato, Italy
| | - Alessio Cubeddu
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | | | - Roberta Mascia
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Mariele Dessi
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | | | | | | | | | | | | | | | - Elena Massa
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Giorgio Astara
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | | | - Clelia Madeddu
- Department of Internal Medical Sciences, Service of Medical Oncology, University of Cagliari, Cagliari, Italy
| | - Mario Scartozzi
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
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Orgiano L, Cubeddu A, Mascia R, Lai E, Dessì M, Pedditzi E, Piredda P, Saba E, Palmas V, Camboni T, Massa E, Astara G, Manzin A, Madeddu C, Scartozzi M. CREAM study: Clinical correlation between immunotherapy-RElated colitis And intestinal Microbiote in metastatic patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.027] [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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Astara G, Lai E, Tolu S, Mascia R, Impera V, Dessì M, Camera S, Pusole G, Cubeddu A, Pireddu A, Liscia N, Pretta A, Demurtas L, Ziranu P, Puzzoni M, Atzori F, Pusceddu V, Massa E, Madeddu C, Scartozzi M. Medical management of malignant bowel obstruction: our center experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Tolu S, Lai E, Impera V, Pusole G, Pretta A, Liscia N, Camera S, Cubeddu A, Mascia R, Pireddu A, Dessì M, Puzzoni M, Demurtas L, Ziranu P, Pusceddu V, Massa E, Madeddu C, Atzori F, Astara G, Scartozzi M. Management of breakthrough cancer pain in patients with oral mucositis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx437.009] [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: 11/14/2022] Open
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Lai E, Tolu S, Mascia R, Impera V, Pretta A, Liscia N, Pireddu A, Pusole G, Camera S, Cubeddu A, Dessì M, Puzzoni M, Demurtas L, Ziranu P, Atzori F, Pusceddu V, Massa E, Madeddu C, Astara G, Scartozzi M. Fentanyl pectin nasal spray for breakthrough cancer pain treatment: a single center experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx437.002] [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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Ziranu P, Massa E, Puzzoni M, Demurtas L, Madeddu C, Pusole G, Cubeddu A, Astara G, Mascia R, Pusceddu V, Pretta A, Dessi M, Atzori F, Lai E, Tolu S, Liscia N, Pireddu AG, Impera V, Puxeddu R, Scartozzi M. Prognostic neutrophil-to-lymphocyte ratio in head and neck cancer: A single center experience. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e17540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17540 Background: The Neutrophil-to-Lymphocytes ratio (NLR) represents a potential prognostic and predictive marker in a different tumor types. The purpose of our study was to investigate the prognostic value of the pretreatment inflammatory marker NLR in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Pretreatment NLR were retrospectively investigated for correlation with overall survival (OS). Kaplan-Meier statistic and long rang test were used. Univariate analysis for categorical and descriptive variables were performed. Results: Thirty-nine patients, from local to advanced stage disease, were included in our analysis. At a median follow up of 9.44 months (2.04 – 30.3), of the total patients 30.7% died and 41.9% had progression of disease. The median PFS was 4.6 months (2.9 – 27.2) and the median OS (mOS) was 18.9 months. Following ROC curve analysis the optimum cut-off value of NLR was 3.93 (p = 0.017). Patient with NLR > 3.92 had a mOS of 11.9 months, whereas the mOS for NLR ≤ 3.92 was 30.3 months (Log-rank p = 0.189). The 1 year Kaplan-Meier estimates of OS for NLR ≤ 3.92 vs. >3.92 was 72% vs. 45% respectively (Log-rank p = 0.243). According to COX univariate analysis, the risk of death increases of 7.7% each unitary rise of NLR mean value (p = 0.3407). Conclusions: In our limited case series NLR was not significantly associated with clinical outcome. Therefore, multicenter studied are needed to determine an optimal NLR cutoff value. [Table: see text]
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Affiliation(s)
- Pina Ziranu
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Elena Massa
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Marco Puzzoni
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Laura Demurtas
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Clelia Madeddu
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Grazia Pusole
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Alessio Cubeddu
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Giorgio Astara
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Roberta Mascia
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Valeria Pusceddu
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Andrea Pretta
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Mariele Dessi
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Francesco Atzori
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Eleonora Lai
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Simona Tolu
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Nicole Liscia
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Anna Grazia Pireddu
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Valentino Impera
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - Roberto Puxeddu
- Department of Otorhinolaryngology, University Hospital, University of Cagliari, Cagliari, Italy
| | - Mario Scartozzi
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
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Orgiano L, Dessi A, Cubeddu A, Lai E, Mascia R, Tolu S, Palmas V, Camboni T, Madeddu C, Massa E, Astara G, Manzin A, Scartozzi M. 403TiP CREAM study: Clinical correlation between ipilimumab-Related colitis And intestinal Microbiote in metastatic melanoma patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw588.009] [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: 11/14/2022] Open
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Solinas C, Pusole G, Demurtas L, Puzzoni M, Mascia R, Morgan G, Giampieri R, Scartozzi M. Tumor infiltrating lymphocytes in gastrointestinal tumors: Controversies and future clinical implications. Crit Rev Oncol Hematol 2016; 110:106-116. [PMID: 28109400 DOI: 10.1016/j.critrevonc.2016.11.016] [Citation(s) in RCA: 30] [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] [Received: 08/01/2016] [Revised: 11/06/2016] [Accepted: 11/23/2016] [Indexed: 02/08/2023] Open
Abstract
Chronic inflammation following infections, autoimmune diseases or exposure to environmental irritants plays a crucial role in tumor development and influences the host immune response to neoplastic cells. The presence of an anti-tumor immune infiltrate is often associated with better outcomes in gastro-intestinal primary cancers, particularly in those with high microsatellite instability (MSI-H). Immunotherapeutic drugs inhibiting the PD-1 and PD-L1 pathway showed promising results in the treatment of these patients in the metastatic setting. The aim of this review is to resume the role tumor infiltrating lymphocytes (TILs) play in gastrointestinal tumors, underlining their potential value as a prognostic and predictive biomarker. TILs assessment could identify subsets of patients with high extent of TILs and better prognosis, that could be spared from adjuvant systemic treatments. Immune infiltration parameters might be additional predictors of a greater benefit from the immunotherapy with the immune checkpoint blockade.
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Affiliation(s)
- Cinzia Solinas
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Boulevard de Waterloo, 127 1000 Brussels, Belgium.
| | - Grazia Pusole
- Medical Oncology, University of Cagliari, Policlinico Universitario ss 554 bivio Sestu km 4.5, Monserrato, CA, Italy.
| | - Laura Demurtas
- Medical Oncology, University of Cagliari, Policlinico Universitario ss 554 bivio Sestu km 4.5, Monserrato, CA, Italy.
| | - Marco Puzzoni
- Medical Oncology, University of Cagliari, Policlinico Universitario ss 554 bivio Sestu km 4.5, Monserrato, CA, Italy.
| | - Roberta Mascia
- Medical Oncology, University of Cagliari, Policlinico Universitario ss 554 bivio Sestu km 4.5, Monserrato, CA, Italy.
| | | | | | - Mario Scartozzi
- Medical Oncology, University of Cagliari, Policlinico Universitario ss 554 bivio Sestu km 4.5, Monserrato, CA, Italy.
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Puzzoni M, Pusole G, Mascia R, Demurtas L, Dessì A, Cubeddu A, Lai E, Tolu S, Ziranu P, Orgiano L, Pusceddu V, Astara G, Madeddu C, Massa E, Casula L, Palmieri G, Scartozzi M. Selection with a molecUlar PanEl foR Panitumumab EfficAcy in K-ras and n-ras wild type metastatic colorectal cancer (SUPER- PEAK). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.154] [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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Demurtas L, Lai E, Cubeddu A, Puzzoni M, Pusole G, Tolu S, Dessì A, Mascia R, Pusceddu V, Astara G, Madeddu C, Massa E, Ziranu P, Orgiano L, Casula L, Scartozzi M. REINVENT (REgorafenIb traNslational eValuation angiogENesis proTocol). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.151] [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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11
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Pusole G, Puzzoni M, Mascia R, Demurtas L, Dessì A, Cubeddu A, Lai E, Tolu S, Ziranu P, Orgiano L, Pusceddu V, Astara G, Madeddu C, Massa E, Casula L, Palmieri G, Scartozzi M. Selection with a molecUlar PanEl foR Panitumumab EfficAcy in K-ras and n-ras wild type metastatic colorectal cancer (SUPER- PEAK). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.46] [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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12
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Dessì A, Demurtas L, Tolu S, Puzzoni M, Cubeddu A, Lai E, Pusole G, Mascia R, Ziranu P, Orgiano L, Pusceddu V, Astara G, Madeddu C, Massa E, Casula L, Scartozzi M. REINVENT (REgorafenIb traNslational eValuation angiogENesis proTocol). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Orgiano L, Pani F, Pusceddu V, Astara G, Madeddu C, Massa E, Cubeddu A, Demurtas L, Dessì A, Lai E, Mascia R, Tolu S, Pusole G, Puzzoni M, Boi F, Mariotti S, Scartozzi M. Thyroid dysfunction in disguise and treatment-related fatigue in the spotlight among metastatic colorectal cancer patients receiving regorafenib: Implications for clinical management. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e15004] [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)
- Laura Orgiano
- AOU Cagliari, Department of Medical Oncology, Monserrato, Italy
| | - Fabiana Pani
- Endocrinology and Diabetes Unit, Department of Medical SciencesUniversity of Cagliari, Cagliari, Italy
| | - Valeria Pusceddu
- Department of Medical Oncology, Hospital-University, Cagliari, Italy
| | - Giorgio Astara
- AOU Cagliari, Department of Medical Oncology, Cagliari, Italy
| | - Clelia Madeddu
- AOU Cagliari, Department of Medical Oncology, Cagliari, Italy
| | - Elena Massa
- Department of Medical Oncology, Cagliari, Italy
| | | | - Laura Demurtas
- AOU Cagliari, Department of Medical Oncology, Monserrato, Italy
| | | | - Eleonora Lai
- AOU Cagliari, Department of Medical Oncology, Monserrato, Italy
| | - Roberta Mascia
- AOU Cagliari, Department of Medical Oncology, Cagliari, Italy
| | - Simona Tolu
- AOU Cagliari, Department of Medical Oncology, Monserrato, Italy
| | - Grazia Pusole
- AOU Cagliari, Department of Medical Oncology, Monserrato, Italy
| | - Marco Puzzoni
- AOU Cagliari, Department of Medical Oncology, Cagliari, Italy
| | - Francesco Boi
- AOU Cagliari, Department of Medical Sciences, Monserrato, Italy
| | - Stefano Mariotti
- Endocrinology, Department of Medical Sciences and Azienda, Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
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Orgiano L, Dessi A, Demurtas L, Puzzoni A, Cubeddu A, Pusole M, Mascia R, Astara G, Madeddu C, Massa E, Pusceddu V, Scartozzi M. The liquid biopsy as a new ally to fight cancer? Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.61] [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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Mascia R, Parnanzini D, Cugudda S, Ionta M, De Lisa A, Francesco A. Testicular cancer: clinical features in a retrospective survey analysis of a single institution of Sardinia. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv341.44] [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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16
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Atzori F, Pani F, Baghino G, Cugudda S, Mascia R, Mariotti S, Ionta MT. Thyroid dysfunction and autoimmunity in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors as a potential clinical biomarker of response. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e15588] [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)
| | - Fabiana Pani
- Endocrinology and Diabetes Unit, Department of Medical SciencesUniversity of Cagliari, Cagliari, Italy
| | - Germana Baghino
- Endocrinology Unit, Department of Medical Sciences and Azienda, Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Silvia Cugudda
- Department of Medical Oncology, University-Hospital, Cagliari, Italy
| | - Roberta Mascia
- Medical Oncology Azienda Universitaria of Cagliari, Cagliari, Italy
| | - Stefano Mariotti
- Endocrinology, Department of Medical Sciences and Azienda, Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
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Abstract
Neuromuscular and vascular hamartoma is an extremely rare stricturing condition of the small bowel. It consists of abnormal mixtures of intestinal tissues: disorganized fascicles of smooth muscle derived from the submucosa, bundles of nonmyelinated nerve fibers with scattered abnormal ganglion cells and hemangiomatous vessels, occurring focally and causing recurrent obstructive symptoms or occult chronic gastrointestinal bleeding. In this paper we report our experience with this tumor.
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Affiliation(s)
- F Scintu
- Chirurgia Generale II, University of Cagliari, Cagliari, Italy.
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Scintu F, Capra F, Giordano M, Frau G, Mascia R, Comella D, Rais M, Casula G. [Neuromuscular and vascular hamartoma of the small intestine. Report of a clinical case and review of the literature]. Chir Ital 2001; 53:393-8. [PMID: 11452826] [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: 02/20/2023]
Abstract
We present the case of a 50-year old patient, operated on for three adjoining annular strictures in the jejunum with proximal dilatation. He presented with a one-year history of recurrent cramping in the upper abdomen and vomiting, with two episodes of intestinal obstruction. Microscopic examination of the stricture revealed, in the submucosa, disorganised fascicles of smooth muscle derived from the muscularis mucosae, bundles of non-myelinated nerve fibres with scattered abnormal ganglion cells and haemangiomatous vessels. The pathological findings observed were similar to those described as neuromuscular and vascular hamartoma, a rare stricturing condition of the small intestine. Many authors have questioned the hamartomatous nature of this disorder, since identical features may be seen in Crohn's disease, in ischaemic enteritis, in radiation enteritis and in non-steroidal antiinflammatory drug-induced small intestinal strictures. On the basis of a review of the 5 previously described cases and of our own experience, we believe that neuro muscular and vascular hamartoma of the small bowel should be considered as a distinct entity if histological hallmarks of Crohn's disease are absent, in patients with no history of gastrointestinal disease, or of chronic ingestion of non-steroidal antiinflammatory drugs.
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Affiliation(s)
- F Scintu
- Chirurgia Generale II, Università di Cagliari
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Dessy E, Corrias A, Nurchi AM, Puxeddu E, Mascia R, Frau G. Congenital hepatic dysplasia from cytomegalovirus. Pathologica 1993; 85:91-5. [PMID: 8390640] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The Authors report on a case of liver dysplasia in a four-month-old infant affected by prenatal cytomegalovirus infection. Immunologic, histologic and ultrastructural studies suggest an embryopathic origin of the lesions.
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Affiliation(s)
- E Dessy
- Institute of Anatomic Pathology 2nd, University of Cagliari
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