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Magri V, De Renzi G, Marino L, De Meo M, Siringo M, Gelibter A, Gareri R, Cataldi C, Giannini G, Santini D, Nicolazzo C, Gazzaniga P. Circulating Cancer-Associated Macrophage-like Cells as a Blood-Based Biomarker of Response to Immune Checkpoint Inhibitors. Int J Mol Sci 2024; 25:3752. [PMID: 38612563 PMCID: PMC11011814 DOI: 10.3390/ijms25073752] [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: 02/19/2024] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Evidence has been provided that circulating cancer-associated macrophage-like cell (CAM-L) numbers increase in response to chemotherapy, with an inverse trend compared to circulating tumor cells (CTCs). In the era of evolving cancer immunotherapy, whether CAM-Ls might have a potential role as predictive biomarkers of response has been unexplored. We evaluated whether a serial blood evaluation of CTC to CAM-L ratio might predict response to immune checkpoint inhibitors in a cohort of non-small-cell lung cancer patients. At baseline, CTCs, CAM-Ls, and the CTC/CAM-L ratio significantly correlate with both progression-free survival (PFS) and overall survival (OS). The baseline CTC/CAM-L ratio was significantly different in early progressors (4.28 ± 3.21) compared to long responders (0.42 ± 0.47) (p = 0.001). In patients treated with immune checkpoint inhibitors, a CTC/CAM-L ratio ≤ 0.25 at baseline is associated with better PFS and OS. A baseline CTC/CAM-L ratio ≤ 0.25 is statistically significant to discriminate early progressions from durable response. The results of the present pilot study suggest that CAM-Ls together with CTCs could play an important role in evaluating patients treated with cancer immunotherapy.
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Affiliation(s)
- Valentina Magri
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (M.S.); (A.G.); (C.C.); (D.S.)
| | - Gianluigi De Renzi
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (G.G.); (C.N.); (P.G.)
| | - Luca Marino
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy;
| | - Michela De Meo
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (G.G.); (C.N.); (P.G.)
| | - Marco Siringo
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (M.S.); (A.G.); (C.C.); (D.S.)
| | - Alain Gelibter
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (M.S.); (A.G.); (C.C.); (D.S.)
| | - Roberta Gareri
- UOC di Oncologia Medica, Ospedale Leopoldo Parodi Delfino, 00034 Colleferro, Italy;
| | - Chiara Cataldi
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (M.S.); (A.G.); (C.C.); (D.S.)
| | - Giuseppe Giannini
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (G.G.); (C.N.); (P.G.)
| | - Daniele Santini
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (M.S.); (A.G.); (C.C.); (D.S.)
| | - Chiara Nicolazzo
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (G.G.); (C.N.); (P.G.)
| | - Paola Gazzaniga
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (G.G.); (C.N.); (P.G.)
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Magri V, Marino L, De Renzi G, De Meo M, Salvatori F, Buccilli D, Bianco V, Santini D, Nicolazzo C, Gazzaniga P. Early Detection of Disease Progression in Metastatic Cancers: Could CTCs Improve RECIST Criteria? Biomedicines 2024; 12:388. [PMID: 38397990 PMCID: PMC10887063 DOI: 10.3390/biomedicines12020388] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Early detection of disease progression is a crucial issue in the management of cancer patients, especially in metastatic settings. Currently, treatment selection mostly relies on criteria based on radiologic evaluations (RECIST). The aim of the present retrospective study is to evaluate the potential inclusion of circulating tumor cells (CTCs) in hybrid criteria. CTC counts from a total of 160 patients with different metastatic tumors were analyzed for this purpose. In our cohort, 73 patients were affected by breast cancer, 69 by colorectal cancer and 18 by prostate cancer. PFS and OS were evaluated according to the corresponding prediction of disease progression by CTCs and RECIST criteria. In breast cancer, CTC-I has an important impact on the progression-free survival (PFS) and overall survival (OS) values. When CTC-I predicted earlier than RECIST-I, the disease progression, the PFS and OS were shorter with respect to the opposite case. In particular, PFS was 11 (5-16) vs. 34 (23-45)-with p < 0.001-and OS was 80 (22-138) vs. 116 (43-189), p = 0.33. The results suggest a promising role of CTCs as complementary information which could significantly improve the clinical outcomes, and they encourage consideration of future trials to evaluate new hybrid criteria, particularly for patients with breast cancer.
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Affiliation(s)
- Valentina Magri
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (F.S.); (D.B.); (V.B.); (D.S.)
| | - Luca Marino
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00161 Rome, Italy;
| | - Gianluigi De Renzi
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (C.N.); (P.G.)
| | - Michela De Meo
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (C.N.); (P.G.)
| | - Francesca Salvatori
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (F.S.); (D.B.); (V.B.); (D.S.)
| | - Dorelsa Buccilli
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (F.S.); (D.B.); (V.B.); (D.S.)
| | - Vincenzo Bianco
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (F.S.); (D.B.); (V.B.); (D.S.)
| | - Daniele Santini
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy; (F.S.); (D.B.); (V.B.); (D.S.)
| | - Chiara Nicolazzo
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (C.N.); (P.G.)
| | - Paola Gazzaniga
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.D.R.); (M.D.M.); (C.N.); (P.G.)
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Nicolazzo C, Francescangeli F, Magri V, Giuliani A, Zeuner A, Gazzaniga P. Is cancer an intelligent species? Cancer Metastasis Rev 2023; 42:1201-1218. [PMID: 37540301 PMCID: PMC10713722 DOI: 10.1007/s10555-023-10123-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023]
Abstract
Some relevant emerging properties of intelligent systems are "adaptation to a changing environment," "reaction to unexpected situations," "capacity of problem solving," and "ability to communicate." Single cells have remarkable abilities to adapt, make adequate context-dependent decision, take constructive actions, and communicate, thus theoretically meeting all the above-mentioned requirements. From a biological point of view, cancer can be viewed as an invasive species, composed of cells that move from primary to distant sites, being continuously exposed to changes in the environmental conditions. Blood represents the first hostile habitat that a cancer cell encounters once detached from the primary site, so that cancer cells must rapidly carry out multiple adaptation strategies to survive. The aim of this review was to deepen the adaptation mechanisms of cancer cells in the blood microenvironment, particularly referring to four adaptation strategies typical of animal species (phenotypic adaptation, metabolic adaptation, niche adaptation, and collective adaptation), which together define the broad concept of biological intelligence. We provided evidence that the required adaptations (either structural, metabolic, and related to metastatic niche formation) and "social" behavior are useful principles allowing putting into a coherent frame many features of circulating cancer cells. This interpretative frame is described by the comparison with analog behavioral traits typical of various animal models.
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Affiliation(s)
- Chiara Nicolazzo
- Department of Molecular Medicine, Sapienza University of Rome, 00161, Rome, Italy
| | - Federica Francescangeli
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Valentina Magri
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161, Rome, Italy
| | - Alessandro Giuliani
- Environment and Health Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Ann Zeuner
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Paola Gazzaniga
- Department of Molecular Medicine, Sapienza University of Rome, 00161, Rome, Italy.
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Magri V, Marino L, Nicolazzo C, Gradilone A, De Renzi G, De Meo M, Gandini O, Sabatini A, Santini D, Cortesi E, Gazzaniga P. Prognostic Role of Circulating Tumor Cell Trajectories in Metastatic Colorectal Cancer. Cells 2023; 12:cells12081172. [PMID: 37190081 DOI: 10.3390/cells12081172] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND A large amount of evidence from clinical studies has demonstrated that circulating tumor cells are strong predictors of outcomes in many cancers. However, the clinical significance of CTC enumeration in metastatic colorectal cancer is still questioned. The aim of this study was to evaluate the clinical value of CTC dynamics in mCRC patients receiving first-line treatments. MATERIALS AND METHODS Serial CTC data from 218 patients were used to identify CTC trajectory patterns during the course of treatment. CTCs were evaluated at baseline, at a first-time point check and at the radiological progression of the disease. CTC dynamics were correlated with clinical endpoints. RESULTS Using a cut-off of ≥1 CTC/7.5 mL, four prognostic trajectories were outlined. The best prognosis was obtained for patients with no evidence of CTCs at any timepoints, with a significant difference compared to all other groups. Lower PFS and OS were recognized in group 4 (CTCs always positive) at 7 and 16 months, respectively. CONCLUSIONS We confirmed the clinical value of CTC positivity, even with only one cell detected. CTC trajectories are better prognostic indicators than CTC enumeration at baseline. The reported prognostic groups might help to improve risk stratification, providing potential biomarkers to monitor first-line treatments.
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Affiliation(s)
- Valentina Magri
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy
| | - Luca Marino
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy
| | - Chiara Nicolazzo
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Angela Gradilone
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Gianluigi De Renzi
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Michela De Meo
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Orietta Gandini
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Arianna Sabatini
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy
| | - Daniele Santini
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy
| | - Enrico Cortesi
- Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy
| | - Paola Gazzaniga
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
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Nicolazzo C, Magri V, Marino L, Belardinilli F, Di Nicolantonio F, De Renzi G, Caponnetto S, De Meo M, Giannini G, Santini D, Cortesi E, Gazzaniga P. Genomic landscape and survival analysis of ctDNA “neo-RAS wild-type” patients with originally RAS mutant metastatic colorectal cancer. Front Oncol 2023; 13:1160673. [PMID: 37064137 PMCID: PMC10093715 DOI: 10.3389/fonc.2023.1160673] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023] Open
Abstract
BackgroundThe term “neo-RAS wild-type” refers to the switch to RAS wild-type disease in plasma circulating tumor DNA (ctDNA) from originally RAS mutant colorectal cancers. Consistently, the hypothesis to re-determine RAS mutational status in ctDNA at disease progression in RAS mutant mCRC opened to a new perspective for clinically-based selection of patients to be treated with EGFR inhibitors. Currently, the genomic landscape of “neo-RAS wild-type” is unknown. This is a prospective study aimed to investigate clinical and genomic features associated with RAS mutation clearance in a large cohort of RAS mutant mCRC patients who converted to RAS wild- type in liquid biopsy at failure of first-line treatments. Secondary aim was to investigate the long term prognostic significance of “true neo-RAS wild- type”.Patients and methods70 patients with stage IV RAS mutant colorectal cancer were prospectively enrolled. Plasma samples were collected at progression from first-line treatment. RAS/BRAF mutations in plasma were assessed by RT-PCR. In RAS/BRAF wild-type samples, ctDNA was used to generate libraries using a 17 genes panel whose alteration has clinical relevance. To investigate the prognostic significance of RAS mutation clearance, test curves for PFS and OS were represented by Kaplan-Meier estimator plot and Log-rank test.ResultsThe most commonly detected actionable mutations in “neo-RAS wild-type” were: PIK3CA (35.7%); RET (11.9%); IDH1 (9.5%); KIT (7%); EGFR (7%); MET (4.7%); ERBB2 (4.7%); FGFR3 (4.7%). Both OS and post-progression survival were longer in patients with “neo-RAS wild-type” compared to those who remained RAS mutant (p<0.001 for both).ConclusionsDe-novo-targetable mutations occured in a large percentage of “neo-RAS wild-type”, being PIK3CA the most commonly detected. RAS mutation clearance in ctDNA is associated with long- term improvement of overall survival.
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Affiliation(s)
- Chiara Nicolazzo
- Lab. Liquid Biopsy, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Valentina Magri
- Department of Radiology, Oncology and Pathology, Sapienza University, Rome, Italy
| | - Luca Marino
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
| | - Francesca Belardinilli
- Lab. Liquid Biopsy, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Gianluigi De Renzi
- Lab. Liquid Biopsy, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Salvatore Caponnetto
- Department of Radiology, Oncology and Pathology, Sapienza University, Rome, Italy
| | - Michela De Meo
- Lab. Liquid Biopsy, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giannini
- Lab. Liquid Biopsy, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniele Santini
- Department of Radiology, Oncology and Pathology, Sapienza University, Rome, Italy
| | - Enrico Cortesi
- Department of Radiology, Oncology and Pathology, Sapienza University, Rome, Italy
| | - Paola Gazzaniga
- Lab. Liquid Biopsy, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- *Correspondence: Paola Gazzaniga,
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De Angelis ML, Francescangeli F, Nicolazzo C, Signore M, Giuliani A, Colace L, Boe A, Magri V, Baiocchi M, Ciardi A, Scarola F, Spada M, La Torre F, Gazzaniga P, Biffoni M, De Maria R, Zeuner A. An organoid model of colorectal circulating tumor cells with stem cell features, hybrid EMT state and distinctive therapy response profile. J Exp Clin Cancer Res 2022; 41:86. [PMID: 35260172 PMCID: PMC8903172 DOI: 10.1186/s13046-022-02263-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/18/2022] [Indexed: 12/11/2022]
Abstract
Background Circulating tumor cells (CTCs) are responsible for the metastatic dissemination of colorectal cancer (CRC) to the liver, lungs and lymph nodes. CTCs rarity and heterogeneity strongly limit the elucidation of their biological features, as well as preclinical drug sensitivity studies aimed at metastasis prevention. Methods We generated organoids from CTCs isolated from an orthotopic CRC xenograft model. CTCs-derived organoids (CTCDOs) were characterized through proteome profiling, immunohistochemistry, immunofluorescence, flow cytometry, tumor-forming capacity and drug screening assays. The expression of intra- and extracellular markers found in CTCDOs was validated on CTCs isolated from the peripheral blood of CRC patients. Results CTCDOs exhibited a hybrid epithelial-mesenchymal transition (EMT) state and an increased expression of stemness-associated markers including the two homeobox transcription factors Goosecoid and Pancreatic Duodenal Homeobox Gene-1 (PDX1), which were also detected in CTCs from CRC patients. Functionally, CTCDOs showed a higher migratory/invasive ability and a different response to pathway-targeted drugs as compared to xenograft-derived organoids (XDOs). Specifically, CTCDOs were more sensitive than XDOs to drugs affecting the Survivin pathway, which decreased the levels of Survivin and X-Linked Inhibitor of Apoptosis Protein (XIAP) inducing CTCDOs death. Conclusions These results indicate that CTCDOs recapitulate several features of colorectal CTCs and may be used to investigate the features of metastatic CRC cells, to identify new prognostic biomarkers and to devise new potential strategies for metastasis prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s13046-022-02263-y.
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Affiliation(s)
- Maria Laura De Angelis
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Federica Francescangeli
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Chiara Nicolazzo
- Department of Molecular Medicine, Liquid Biopsy Unit, Sapienza University, Viale Regina Elena 324, 00161, Rome, Italy
| | - Michele Signore
- RPPA Unit, Proteomics Area, Core Facilities, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Alessandro Giuliani
- Environment and Health Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Lidia Colace
- Department of Surgical Sciences, Policlinico Umberto I/Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Alessandra Boe
- Core Facilities, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Valentina Magri
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marta Baiocchi
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Antonio Ciardi
- Department of Surgery "Pietro Valdoni", Policlinico Umberto I/Sapienza University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Francesco Scarola
- Department of Surgery "Pietro Valdoni", Policlinico Umberto I/Sapienza University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Massimo Spada
- Center of Animal Research and Welfare, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Filippo La Torre
- Surgical Sciences and Emergency Department, Policlinico Umberto I/Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Paola Gazzaniga
- Department of Molecular Medicine, Liquid Biopsy Unit, Sapienza University, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mauro Biffoni
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Ruggero De Maria
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy. .,Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Ann Zeuner
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Fabi A, Terrenato I, Vidiri A, Villani V, Tanzilli A, Airoldi M, Pedani F, Magri V, Palleschi M, Donadio M, Catania G, Nisticò C, Carapella C, Rudà R, Pace A, Maschio M, Telera S, Cognetti F. Eribulin in brain metastases of breast cancer: outcomes of the EBRAIM prospective observational trial. Future Oncol 2021; 17:3445-3456. [PMID: 34044585 DOI: 10.2217/fon-2021-0300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Eribulin shows some activity in controlling brain metastasis in breast cancer. Methods: This observational, multicenter study evaluated brain disease control rates, survival and safety in patients with brain metastatic breast cancer treated with eribulin in clinical practice. Results: A total of 34 patients were enrolled (mean age 49 years, 91% with visceral metastases) and 29 were evaluable for brain disease. Fourteen achieved disease control and showed a longer time without progression: 10 months (95% CI: 2.3-17.7) versus 4 months (95% CI: 3.3-4.7) in the control group (p = 0.029). Patients with clinical benefits at 6 months had longer survival. Leukopenia and neutropenia were the most frequent grade 3-4 toxicities. Conclusion: Eribulin confirms its effectiveness in patients with brain metastatic breast cancer. Further studies on larger cohorts are needed to confirm the results.
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Affiliation(s)
- Alessandra Fabi
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy.,Phase I Clinical Studies & Precision Medicine, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Irene Terrenato
- Clinical Trial Center - Biostatistics & Bioinformatics, IRCCS Regina Elena National Cancer Institute, 53 - 00144, Rome, Italy
| | - Antonello Vidiri
- Radiology & Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Veronica Villani
- Neuroncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Antonio Tanzilli
- Neuroncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Mario Airoldi
- Medical Oncology, Health & Science City, Corso Bramante 88, 10126, Turin, Italy
| | - Fulvia Pedani
- Medical Oncology, Health & Science City, Corso Bramante 88, 10126, Turin, Italy
| | - Valentina Magri
- Medical Oncology, La Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Michela Palleschi
- Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, 47014, Italy
| | - Michela Donadio
- Medical Oncology, Breast Unit, Health & Science City, Corso Bramante 88, 10126,Turin, Italy
| | - Giovanni Catania
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Cecilia Nisticò
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Carmine Carapella
- Neurosurgery Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Roberta Rudà
- Department of Neuro-Oncology, City of Health & Science, Corso Bramante 88, 10126, Turin, Italy
| | - Andrea Pace
- Neuroncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Marta Maschio
- Neuroncology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Stefano Telera
- Neurosurgery Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
| | - Francesco Cognetti
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 - 00144, Rome, Italy
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8
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Nicolazzo C, Loreni F, Caponnetto S, Magri V, Vestri AR, Zamarchi R, Gradilone A, Facchinetti A, Rossi E, Cortesi E, Gazzaniga P. Baseline CD44v6-positive circulating tumor cells to predict first-line treatment failure in patients with metastatic colorectal cancer. Oncotarget 2020; 11:4115-4122. [PMID: 33227095 PMCID: PMC7665234 DOI: 10.18632/oncotarget.27794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/17/2020] [Indexed: 01/16/2023] Open
Abstract
CD44v6, the CD44 isoform mostly involved in cancer cell migration and invasion, has been identified as a functional biomarker and therapeutic target in colon cancer stem cells. We here provide evidence that baseline CD44v6-positive CTC predict treatment failure in patients with metastatic colorectal cancer undergoing first-line chemotherapy. We suggest that CD44v6-positive CTC can be used to early detect intrinsic drug resistance in this cancer type.
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Affiliation(s)
- Chiara Nicolazzo
- Department of Molecular Medicine, Liquid Biopsy Unit, Sapienza University of Rome, Rome, Italy
| | - Flavia Loreni
- Department of Molecular Medicine, Liquid Biopsy Unit, Sapienza University of Rome, Rome, Italy
| | - Salvatore Caponnetto
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentina Magri
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Anna Rita Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Rita Zamarchi
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Angela Gradilone
- Department of Molecular Medicine, Liquid Biopsy Unit, Sapienza University of Rome, Rome, Italy
| | - Antonella Facchinetti
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy
| | - Elisabetta Rossi
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy
| | - Enrico Cortesi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Paola Gazzaniga
- Department of Molecular Medicine, Liquid Biopsy Unit, Sapienza University of Rome, Rome, Italy
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9
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De Marchis L, Minucci A, Gelibter A, Mazzuccato G, Magri V, Moscati G, Madaio R, Marchetti P, Urbani A, Cortesi E, Capoluongo E. BRCA screening among Jewish community of Rome. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Marazzi F, Barone R, Masiello V, Magri V, Mulè A, Santoro A, Cacciatori F, Boldrini L, Franceschini G, Moschella F, Naso G, Tomao S, Gambacorta MA, Mantini G, Masetti R, Smaniotto D, Valentini V. Oncotype DX Predictive Nomogram for Recurrence Score Output: The Novel System ADAPTED01 Based on Quantitative Immunochemistry Analysis. Clin Breast Cancer 2020; 20:e600-e611. [PMID: 32565110 DOI: 10.1016/j.clbc.2020.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Oncotype DX (ODX) predicts breast cancer recurrence risk, guiding the choice of adjuvant treatment. In many countries, access to the test is not always available. We used correlation between phenotypical tumor characteristics, quantitative classical immunohistochemistry (IHC), and recurrence score (RS) assessed by ODX to develop a decision supporting system for clinical use. PATIENTS AND METHODS Breast cancer patients who underwent ODX testing between 2014 and 2018 were retrospectively included in the study. The data selected for analysis were age, menopausal status, and pathologic and IHC features. IHC was performed with standardized quantitative methods. The data set was split into two subsets: 70% for the training set and 30% for the internal validation set. Statistically significant features were included in logistic models to predict RS ≤ 25 or ≤ 20. Another set was used for external validation to test reproducibility of prediction models. RESULTS The internal set included 407 patients. Mean (range) age was 53.7 (31-80) years, and 222 patients (54.55%) were > 50 years old. ODX results showed 67 patients (16.6%) had RS between 0 and 10, 272 patients between 11 and 25 (66.8%), and 68 patients > 26 (16.6%). Logistic regression analysis showed that RS score (for threshold ≤ 25) was significantly associated with estrogen receptor (P = .004), progesterone receptor (P < .0001), and Ki-67 (P < .0001). Generalized linear regression resulted in a model that had an area under the receiver operating characteristic curve (AUC) of 92.2 (sensitivity 84.2%, specificity 80.1%) and that was well calibrated. The external validation set (183 patients) analysis confirmed the model performance, with an AUC of 82.3 and a positive predictive value of 91%. A nomogram was generated for further prospective evaluation to predict RS ≤ 25. CONCLUSION RS was related to quantitative IHC in patients with RS ≤ 25, with a good performance of the statistical model in both internal and external validation. A nomogram for enhancing clinical approach in a cost-effective manner was developed. Prospective studies must test this application in clinical practice.
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Affiliation(s)
- Fabio Marazzi
- UOC di Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy
| | | | - Valeria Masiello
- UOC di Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy.
| | - Valentina Magri
- Breast Unit, Division of Medical Oncology, Department of Radiological Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Antonino Mulè
- UOC di Anatomia Patologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy
| | - Angela Santoro
- UOC di Anatomia Patologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy
| | - Federica Cacciatori
- UOC di Anatomia Patologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy
| | - Luca Boldrini
- UOC di Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy
| | - Gianluca Franceschini
- UOC di Chirurgia Senologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy
| | - Francesca Moschella
- UOC di Chirurgia Senologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy
| | - Giuseppe Naso
- Breast Unit, Division of Medical Oncology, Department of Radiological Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Silverio Tomao
- Breast Unit, Division of Medical Oncology, Department of Radiological Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Maria Antonietta Gambacorta
- UOC di Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy
| | - Giovanna Mantini
- UOC di Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy
| | - Riccardo Masetti
- UOC di Chirurgia Senologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy
| | - Daniela Smaniotto
- UOC di Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Rome, Italy; Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy
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11
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Belardinilli F, Capalbo C, Malapelle U, Pisapia P, Raimondo D, Milanetti E, Yasaman M, Liccardi C, Paci P, Sibilio P, Pepe F, Bonfiglio C, Mezi S, Magri V, Coppa A, Nicolussi A, Gradilone A, Petroni M, Di Giulio S, Fabretti F, Infante P, Coni S, Canettieri G, Troncone G, Giannini G. Clinical Multigene Panel Sequencing Identifies Distinct Mutational Association Patterns in Metastatic Colorectal Cancer. Front Oncol 2020; 10:560. [PMID: 32457828 PMCID: PMC7221020 DOI: 10.3389/fonc.2020.00560] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 10/02/2019] [Accepted: 03/27/2020] [Indexed: 12/12/2022] Open
Abstract
Extensive molecular characterization of human colorectal cancer (CRC) via Next Generation Sequencing (NGS) indicated that genetic or epigenetic dysregulation of a relevant, but limited, number of molecular pathways typically occurs in this tumor. The molecular picture of the disease is significantly complicated by the frequent occurrence of individually rare genetic aberrations, which expand tumor heterogeneity. Inter- and intratumor molecular heterogeneity is very likely responsible for the remarkable individual variability in the response to conventional and target-driven first-line therapies, in metastatic CRC (mCRC) patients, whose median overall survival remains unsatisfactory. Implementation of an extensive molecular characterization of mCRC in the clinical routine does not yet appear feasible on a large scale, while multigene panel sequencing of most commonly mutated oncogene/oncosuppressor hotspots is more easily achievable. Here, we report that clinical multigene panel sequencing performed for anti-EGFR therapy predictive purposes in 639 formalin-fixed paraffin-embedded (FFPE) mCRC specimens revealed previously unknown pairwise mutation associations and a high proportion of cases carrying actionable gene mutations. Most importantly, a simple principal component analysis directed the delineation of a new molecular stratification of mCRC patients in eight groups characterized by non-random, specific mutational association patterns (MAPs), aggregating samples with similar biology. These data were validated on a The Cancer Genome Atlas (TCGA) CRC dataset. The proposed stratification may provide great opportunities to direct more informed therapeutic decisions in the majority of mCRC cases.
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Affiliation(s)
| | - Carlo Capalbo
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | | | - Pasquale Pisapia
- Department of Public Health, University Federico II, Naples, Italy
| | - Domenico Raimondo
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | | | - Mahdavian Yasaman
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Carlotta Liccardi
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Paola Paci
- Institute for System Analysis and Computer Science "Antonio Ruberti", National Research Council, Rome, Italy
| | - Pasquale Sibilio
- Institute for System Analysis and Computer Science "Antonio Ruberti", National Research Council, Rome, Italy
| | - Francesco Pepe
- Department of Public Health, University Federico II, Naples, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Bari, Italy
| | - Silvia Mezi
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, Rome, Italy
| | - Valentina Magri
- Department of Surgery Pietro Valdoni, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Anna Coppa
- Department of Experimental Medicine, University La Sapienza, Rome, Italy
| | - Arianna Nicolussi
- Department of Experimental Medicine, University La Sapienza, Rome, Italy
| | - Angela Gradilone
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Marialaura Petroni
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Stefano Di Giulio
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | | | - Paola Infante
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Sonia Coni
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Gianluca Canettieri
- Department of Molecular Medicine, University La Sapienza, Rome, Italy.,Pasteur Institute-Cenci Bolognetti Foundation, Rome, Italy
| | | | - Giuseppe Giannini
- Department of Molecular Medicine, University La Sapienza, Rome, Italy.,Pasteur Institute-Cenci Bolognetti Foundation, Rome, Italy
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12
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Orlandi A, Iattoni E, Pizzuti L, Fabbri A, Botticelli A, Dio CD, Palazzo A, Garufi G, Indellicati G, Alesini D, Carbognin L, Paris I, Vaccaro A, Moscetti L, Cassano A, Vici P, Magri V, Naso G, Giannarelli D, Marchetti P, Bria E, Tortora G. Abstract P1-19-43: Palbociclib-fulvestrant (PALBO-FUL) and everolimus -exemestane (EVE-EXE) for second line hormonal treatment (HT) of metastatic breast cancer (MBC) with lobular histology: A propensity score matched analysis. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p1-19-43] [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: 11/16/2022]
Abstract
Abstract
Background: Recently, CDK4/6i proved to improve the efficacy of HT of pts affected by luminal MBC. However, the best sequence of HT is still unclear and it is still uncertain if pts with lobular histology derive the same benefit of ductal when receiving second line CDK4/6i. Particularly in lobular MBC, the dysregulation of the AKTpathway with the overexpression of cyclin E potentially represents an important mechanism of acquired resistance to HT, finally providing an intrinsic resistance to subsequent CDK4/6i. Thus, a multicentric retrospective study was conducted to determine the efficacy of PALBO-FUL versus EVE-EXE as second line HT of MBC with Lobular histology.Methods: Pts affected by Lobular MBC receiving PALBO-FUL or EVE-EXE for second line HT from 2013 to 2018 in 6 Italian centers were considered eligible. The primary endpoint was progression free survival (PFS). A propensity score (PS) adjustment for baseline characteristics was further accomplished for survival analysis. Results: Seventy-four of 376 screened pts were diagnosed for Lobular MBC; 46pts received PALBO-FUL, whereas 28 were treated with EVE-EXE, without imbalance in clinical characteristics. PFS resulted to be significantly longer for pts receiving EVE-EXE in comparison with PALBO-FUL (6.1 vs. 4.5 months, HR 0.58, 95% CI 0.35-0.96; p=0.025). Previous chemotherapy exposure resulted to be significantly associated with PFS at the multivariate analysis (HR 0.41, 95% CI 0.24-0.72, p=0.002). At the PS analysis, adjusted for previous chemotherapy exposure and synchronous/metachronous metastatic status, PFS was confirmed to be significantly longer for pts receiving EVE-EXE in comparison with PALBO-FUL (6.0 vs. 4.6 months, p=0.04)Conclusion: This retrospective real-world analysis generates the hypothesis of a potential benefit of EVE-EXE in comparison with PALBO-FUL for second line HT of MBC with Lobular histology. Nevertheless, the small pts’ sample calls for a larger and adequately sized prospective validation. However, these data allow to speculate on the best hormonal therapeutic sequence in MLBC. Indeed, in this setting a late exposure to CDK4/6i might not allow to exploit its efficacy, while once hormonal resistance is acquired the inhibition of AKT/m-TOR pathway may represent the best option.
Citation Format: Armando Orlandi, Elena Iattoni, Laura Pizzuti, Agnese Fabbri, Andrea Botticelli, Carmela Di Dio, Antonella Palazzo, Giovanna Garufi, Giulia Indellicati, Daniele Alesini, Luisa Carbognin, Ida Paris, Angela Vaccaro, Luca Moscetti, Alessandra Cassano, Patrizia Vici, Valentina Magri, Giuseppe Naso, Diana Giannarelli, Paolo Marchetti, Emilio Bria, Giampaolo Tortora. Palbociclib-fulvestrant (PALBO-FUL) and everolimus -exemestane (EVE-EXE) for second line hormonal treatment (HT) of metastatic breast cancer (MBC) with lobular histology: A propensity score matched analysis [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-19-43.
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Affiliation(s)
- Armando Orlandi
- 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Elena Iattoni
- 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | | | | | - Carmela Di Dio
- 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | - Giovanna Garufi
- 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | | | - Luisa Carbognin
- 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Ida Paris
- 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | | | | | | | | | | | | | | | - Emilio Bria
- 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
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13
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Krasniqi E, Pizzuti L, Barchiesi G, Sergi D, Carpano S, Botti C, Kayal R, Sanguineti G, Marchetti P, Botticelli A, Marinelli D, Gamucci T, Natoli C, Grassadonia A, Tinari N, Tomao S, Tonini G, Santini D, Michelotti A, Mentuccia L, Vaccaro A, Magnolfi E, Gelibter A, Magri V, Cortesi E, D'Onofrio L, Cassano A, Cazzaniga M, Moscetti L, Fabbri A, Scinto AF, Corsi D, Carbognin L, Bria E, La Verde N, Garufi C, Di Stefano P, Mirabelli R, Veltri E, Paris I, Giotta F, Lorusso V, Landucci E, Ficorella C, Roselli M, Adamo V, Ricciardi G, Russo A, Valerio MR, Berardi R, Pistelli M, Cannita K, Zamagni C, Garrone O, Baldini E, Livi L, Meattini I, Del Medico P, Generali D, De Maria R, Risi E, Ciliberto G, Villa A, Sperduti I, Mazzotta M, Barba M, Giordano A, Vici P. Impact of BMI on HER2+ metastatic breast cancer patients treated with pertuzumab and/or trastuzumab emtansine. Real-world evidence. J Cell Physiol 2020; 235:7900-7910. [PMID: 31943171 DOI: 10.1002/jcp.29445] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 11/08/2019] [Accepted: 12/04/2019] [Indexed: 12/27/2022]
Abstract
Body mass index (BMI) is a main indicator of obesity and its association with breast cancer is well established. However, little is known in the metastatic setting, especially in HER2-positive patients. We assessed the influence of BMI on clinical outcomes of patients treated with pertuzumab and/or trastuzumab emtansine (T-DM1) for HER2+ metastatic breast cancer (mBC). BMI was addressed as a categorical variable, being classified on the basis of the following ranges, that is, 18.5-24.9, 25-29.9, and 30.0-34.9, namely, normal weight, overweight, and Class I obesity. The outcomes chosen were progression-free survival to first-line chemotherapy (PFS1) and overall survival (OS). Overall (N = 709), no impact of BMI was observed on PFS1 (p = .15), while BMI ≥ 30 was associated with worse OS (p = .003). In subjects who progressed to first line (N = 575), analyzing data across PFS1 quartiles and strata of disease burden, BMI predicted lower PFS1 in patients within the I PFS1 quartile and with the lowest disease burden (p = .001). Univariate analysis showed a detrimental effect of BMI ≥ 30 on OS for women within the I PFS1 quartile (p = .03). Results were confirmed in multivariate analysis. According to PFS1 quartiles a higher percentage of patients with high BMI and low disease burden progressed within 6 months of therapy. The effect of BMI on prognosis was also confirmed in multivariate analysis of OS for overall population. In our cohort, a BMI ≥ 30 correlated with worse OS in patients with HER2+ mBC who received pertuzumab and/or T-DM1 but had no impact on PFS to first line. BMI predicted worse I PFS1 quartile.
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Affiliation(s)
- Eriseld Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giacomo Barchiesi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Domenico Sergi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Silvia Carpano
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Claudio Botti
- Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ramy Kayal
- Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Marchetti
- Medical Oncology Unit B, Policlinico Umberto I, Rome, Italy.,Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, "Sapienza" University of Rome, Rome, Italy
| | | | - Daniele Marinelli
- Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, "Sapienza" University of Rome, Rome, Italy
| | | | - Clara Natoli
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Antonino Grassadonia
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Silverio Tomao
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy
| | - Giuseppe Tonini
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Daniele Santini
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Aandrea Michelotti
- Dipartimento di Oncologia, Dei Trapianti e Delle Nuove Tecnologie, UO Oncologia Medica I, S. Chiara Hospital, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | | | | | - Alain Gelibter
- Medical Oncology Unit B, Policlinico Umberto I, Rome, Italy
| | | | - Enrico Cortesi
- Medical Oncology Unit B, Policlinico Umberto I, Rome, Italy
| | - Loretta D'Onofrio
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Alessandra Cassano
- Department of Medical Oncology, Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Marina Cazzaniga
- Research Unit Phase I Trials and Oncology Unit, ASST Monza, Monza, Italy
| | - Luca Moscetti
- Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Agnese Fabbri
- Medical Oncology Unit, Belcolle Hospital, Viterbo, Italy
| | | | - Domenico Corsi
- Medical Oncology Unit, Fatebenefratelli Hospital, Rome, Italy
| | - Luisa Carbognin
- University of Verona, Verona, Italy.,Division of Gynecologic Oncology, Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Emilio Bria
- University of Verona, Verona, Italy.,Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Roma, Italy
| | - Nicla La Verde
- Oncology Unit, ASST Fatebenefratelli Sacco Presidio Ospedaliero Fatebenefratelli, Milano, Italy
| | - Carlo Garufi
- Medical Oncology, "Santo Spirito" Hospital, Pescara, Italy
| | - Pia Di Stefano
- Medical Oncology, "Santo Spirito" Hospital, Pescara, Italy
| | - Rossana Mirabelli
- Department of Hematology & Oncology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy
| | - Enzo Veltri
- Oncology Unit, S. Maria Goretti Hospital, Latina, Italy
| | - Ida Paris
- Division of Gynecologic Oncology, Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Francesco Giotta
- Department of Medical Oncology, "Giovanni Paolo II" Institute, Bari, Italy
| | - Vito Lorusso
- Department of Medical Oncology, "Giovanni Paolo II" Institute, Bari, Italy
| | - Elisa Landucci
- Dipartimento di Oncologia, Dei Trapianti e Delle Nuove Tecnologie, UO Oncologia Medica I, S. Chiara Hospital, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Corrado Ficorella
- Department of Biotechnological and Applied Clinical Sciences, Medical Oncology, University of L'Aquila, L'Aquila, Italy
| | - Mario Roselli
- Department of Systems Medicine, Medical Oncology, University of Rome "Tor Vergata", Rome, Italy
| | - Vincenzo Adamo
- Department of Human Pathology, Medical Oncology Unit A.O. Papardo, University of Messina, Messina, Italy
| | - Giuseppina Ricciardi
- Department of Human Pathology, Medical Oncology Unit A.O. Papardo, University of Messina, Messina, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Maria Rosaria Valerio
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Rossana Berardi
- Oncology Clinic, Università Politecnica delle Marche, Ancona, Italy
| | - Mirco Pistelli
- Oncology Clinic, Università Politecnica delle Marche, Ancona, Italy
| | - Katia Cannita
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
| | - Claudio Zamagni
- Medical Oncology Unit, Addarii Institute of Oncology, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Ornella Garrone
- Medical Oncology, A.O. Ospedale di Insegnamento S. Croce e Carle, Cuneo, Italy
| | | | - Lorenzo Livi
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio," Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Icro Meattini
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio," Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Pietro Del Medico
- Division of Medical Oncology, Reggio Calabria General Hospital, Reggio Calabria, Italy
| | - Daniele Generali
- Breast Cancer Unit & Translational Research Unit, ASST Cremona, Cremona, Italy
| | - Ruggero De Maria
- Institute of General Pathology, Catholic University of the Sacred Heart, Rome, Italy
| | - Emanuela Risi
- Department of "Sandro Pitigliani" Medical Oncology, Santo Stefano Hospital, Prato, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alice Villa
- Endocrinology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Isabella Sperduti
- Department of Bio-Statistics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marco Mazzotta
- Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, "Sapienza" University of Rome, Rome, Italy
| | - Maddalena Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonio Giordano
- Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, Pennsylvania
| | - Patrizia Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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14
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Conte B, Fabi A, Poggio F, Blondeaux E, Dellepiane C, D’alonzo A, Buono G, Arpino G, Magri V, Naso G, Presti D, Mura S, Fontana A, Cognetti F, Molinelli C, Pastorino S, Bighin C, Miglietta L, Boccardo F, Lambertini M, Del Mastro L. T-DM1 EFFICACY AND ACTIVITY IN HER2-POSITIVE METASTATIC BREAST CANCER PATIENTS PROGRESSING AFTER FRONTLINE TAXANE PLUS PERTUZUMAB AND TRASTUZUMAB: AN ITALIAN MULTICENTER OBSERVATIONAL STUDY OF THE GRUPPO ITALIANO MAMMELLA (GIM) STUDY GROUP. Breast 2019. [DOI: 10.1016/s0960-9776(19)30674-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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15
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Marazzi F, Masiello V, Barone R, Magri V, Mulé A, Santoro A, Cacciatori F, Boldrini L, Franceschini G, Moschella F, Naso G, Tomao S, Mantini G, Masetti R, Smaniotto D, Valentini V. OncotypeDX® predictive nomogram for recurrence score output: A machine learning system based on quantitative immunochemistry analysis - ADAPTED01. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.085] [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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Magri V, Gottfried T, Di Segni M, Urban D, Peled M, Daher S, Stoff R, Bar J, Onn A. Correlation of body composition by computerized tomography and metabolic parameters with survival of nivolumab-treated lung cancer patients. Cancer Manag Res 2019; 11:8201-8207. [PMID: 31564979 PMCID: PMC6733251 DOI: 10.2147/cmar.s210958] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 04/02/2019] [Accepted: 08/08/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose Weight loss is a well-recognized prognostic parameter for survival of lung cancer patients. Computerized-tomography (CT)-based analysis of body composition and blood-based metabolic evaluation are promising prognostic tools. We aimed to assess the correlation between albumin, body mass index (BMI), skeletal muscle mass index (SMI), fat-free mass index (FFMI), fat mass index (FMI) and weight change, as well as their correlation with survival of lung cancer patients on nivolumab treatment. Methods Data were retrospectively collected. Weight was measured at a diagnosis of stage 4 disease and before start of nivolumab. Albumin levels were measured before starting nivolumab. BMI, SMI, FFMI, and FMI were evaluated from CT scans performed at start of nivolumab. Overall survival (OS) was from starting of nivolumab to death or censured at last follow-up. Statistical analysis was done to identify correlation between the various factors and between those factors and survival. Results Forty-six patients with advanced non-small cell lung cancer (NSCLC) were included. Median follow-up was 22 months. Pathology was Adenocarcinoma/Squamous/non-other specified in 25/15/6 respectively. All patients received nivolumab as an advanced-line treatment for stage IV NSCLC. We observed a significant correlation of weight loss (P=0.01, HR=2.85) and albumin (P=0.043, HR=0.34) with OS in multivariate analysis. A significant correlation was found between BMI to SMI, FFMI, FMI, and weight change. Conclusion Weight loss and low albumin levels are significant negative prognostic factors for NSCLC patients on immunotherapy. CT-based parameters of body composition remain to be proven as more reliable than standard clinical parameters.
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Affiliation(s)
- Valentina Magri
- Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomo-Patologiche, Umberto I, Policlinico di Roma, Sapienza, - Università di Roma, Rome, Italy
| | - Teodor Gottfried
- Thoracic Oncology Unit, Institute of Oncology, Sheba Medical Center, Ramat Gan 5262000, Israel
| | - Mattia Di Segni
- Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomo-Patologiche, Sapienza, Umberto I, Policlinico di Roma - Università di Roma, Rome, Italy.,U.O.C. Diagnostica per Immagini, Presidio Ospedaliero San Paolo, Rome, Italy
| | - Damien Urban
- Thoracic Oncology Unit, Institute of Oncology, Sheba Medical Center, Ramat Gan 5262000, Israel
| | - Michael Peled
- Institute of Pulmonology, Sheba Medical Center, Ramat Gan 5262000, Israel
| | - Sameh Daher
- Thoracic Oncology Unit, Institute of Oncology, Sheba Medical Center, Ramat Gan 5262000, Israel
| | - Ronen Stoff
- Thoracic Oncology Unit, Institute of Oncology, Sheba Medical Center, Ramat Gan 5262000, Israel
| | - Jair Bar
- Thoracic Oncology Unit, Institute of Oncology, Sheba Medical Center, Ramat Gan 5262000, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Amir Onn
- Institute of Pulmonology, Sheba Medical Center, Ramat Gan 5262000, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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17
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Pizzuti L, Krasniqi E, Barchiesi G, Della Giulia M, Izzo F, Sanguineti G, Marchetti P, Mazzotta M, Giusti R, Botticelli A, Gamucci T, Natoli C, Grassadonia A, Tinari N, Iezzi L, Tomao S, Tomao F, Tonini G, Santini D, Astone A, Michelotti A, De Angelis C, Mentuccia L, Vaccaro A, Magnolfi E, Gelibter A, Magri V, Cortesi E, D'Onofrio L, Cassano A, Rossi E, Cazzaniga M, Moscetti L, Omarini C, Piacentini F, Fabbri MA, Scinto AF, Corsi D, Carbognin L, Bria E, La Verde N, Samaritani R, Garufi C, Barni S, Mirabelli R, Sarmiento R, Veltri EM, D'Auria G, Paris I, Giotta F, Lorusso V, Cardillo F, Landucci E, Mauri M, Ficorella C, Roselli M, Adamo V, Ricciardi GRR, Russo A, Berardi R, Pistelli M, Fiorio E, Cannita K, Sini V, D'Ostilio N, Foglietta J, Greco F, Zamagni C, Garrone O, Di Cocco B, Baldini E, Livi L, Desideri I, Meattini I, Sarobba G, Del Medico P, De Tursi M, Generali D, De Maria R, Risi E, Ciliberto G, Sperduti I, Villa A, Barba M, Di Leo A, Vici P. Distinct HR expression patterns significantly affect the clinical behavior of metastatic HER2+ breast cancer and degree of benefit from novel anti-HER2 agents in the real world setting. Int J Cancer 2019; 146:1917-1929. [PMID: 31330065 PMCID: PMC7027476 DOI: 10.1002/ijc.32583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 04/15/2019] [Revised: 06/07/2019] [Accepted: 07/03/2019] [Indexed: 12/02/2022]
Abstract
We analyzed data from 738 HER2‐positive metastatic breast cancer (mbc) patients treated with pertuzumab‐based regimens and/or T‐DM1 at 45 Italian centers. Outcomes were explored in relation to tumor subtype assessed by immunohistochemistry (IHC). The median progression‐free survival at first‐line (mPFS1) was 12 months. Pertuzumab as first‐line conferred longer mPFS1 compared to other first‐line treatments (16 vs. 9 months, p = 0.0001), regardless of IHC subtype. Median PFS in second‐line (mPFS2) was 7 months, with no difference by IHC subtype, but it was more favorable with T‐DM1 compared to other agents (7 vs. 6 months, p = 0.03). There was no PFS2 gain in patients with tumors expressing both hormonal receptors (HRs; p = 0.17), while a trend emerged for tumors with one HR (p = 0.05). Conversely, PFS2 gain was significant in HRs‐negative tumors (p = 0.04). Median overall survival (mOS) was 74 months, with no significant differences by IHC subtypes. Survival rates at 2 and 3 years in patients treated with T‐DM1 in second‐line after pertuzumab were significantly lower compared to pertuzumab‐naïve patients (p = 0.01). When analyzed by IHC subtype, the outcome was confirmed if both HRs or no HRs were expressed (p = 0.02 and p = 0.006, respectively). Our results confirm that HRs expression impacts the clinical behavior and novel treatment‐related outcomes of HER2‐positive tumors when treatment sequences are considered. Moreover, multivariate analysis showed that HRs expression had no effect on PFS and OS. Further studies are warranted to confirm our findings and clarify the interplay between HER2 and estrogen receptor pathways in HER2‐positive (mbc) patients. What's new? About half of breast cancers positive for human epidermal growth factor (HER2) also express hormone receptors but the impact of hormone receptor status on the success of HER2‐directed treatments is not fully explored. Here the authors retrospectively assessed tumor behavior and treatment outcomes in 738 women with HER2+ metastatic breast cancer treated with new generation anti‐HER2 agents. Distinct hormone receptor expression patterns significantly affected the progression free and overall survival, justifying further studies to define optimal treatment regimens and the interplay between hormone receptor and HER2 signaling.
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Affiliation(s)
- Laura Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Eriseld Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giacomo Barchiesi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marina Della Giulia
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fiorentino Izzo
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Marchetti
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Sant'Andrea, Rome, Italy.,Medical Oncology Unit B, Policlinico Umberto I, Rome, Italy
| | - Marco Mazzotta
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Sant'Andrea, Rome, Italy
| | - Raffaele Giusti
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Sant'Andrea, Rome, Italy
| | | | | | - Clara Natoli
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze dell'Invecchiamento e Medicina Traslazionale -CeSI-MeT, Chieti, Italy
| | - Antonino Grassadonia
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze dell'Invecchiamento e Medicina Traslazionale -CeSI-MeT, Chieti, Italy
| | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze dell'Invecchiamento e Medicina Traslazionale -CeSI-MeT, Chieti, Italy
| | - Laura Iezzi
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze dell'Invecchiamento e Medicina Traslazionale -CeSI-MeT, Chieti, Italy
| | - Silverio Tomao
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, Rome, Italy
| | - Federica Tomao
- Department of Gynecology-Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppe Tonini
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Daniele Santini
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Antonio Astone
- Division of Medical Oncology, Villa San Pietro Hospital, Rome, Italy
| | - Andrea Michelotti
- UO Oncologia Medica I, S. Chiara Hospital, Dipartimentodi Oncologia, Dei Trapianti e Delle Nuove Tecnologie, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Claudia De Angelis
- UO Oncologia Medica I, S. Chiara Hospital, Dipartimentodi Oncologia, Dei Trapianti e Delle Nuove Tecnologie, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | | | | | - Alain Gelibter
- Medical Oncology Unit B, Policlinico Umberto I, Rome, Italy
| | | | - Enrico Cortesi
- Medical Oncology Unit B, Policlinico Umberto I, Rome, Italy
| | - Loretta D'Onofrio
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Alessandra Cassano
- Department of Medical Oncology, Policlinico Universitario "A. Gemelli", Rome, Italy.,Universita Cattolica del Sacro Cuore, Roma
| | - Ernesto Rossi
- Department of Medical Oncology, Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Marina Cazzaniga
- Research Unit Phase I trials and Oncology Unit, ASST Monza, Monza, Italy
| | - Luca Moscetti
- Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Claudia Omarini
- Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Federico Piacentini
- Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Maria A Fabbri
- Medical Oncology Unit, Belcolle Hospital, Viterbo, Italy
| | - Angelo F Scinto
- Medical Oncology Unit, Fatebenefratelli Hospital, Rome, Italy
| | - Domenico Corsi
- Medical Oncology Unit, Fatebenefratelli Hospital, Rome, Italy
| | - Luisa Carbognin
- Gynecology Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - Emilio Bria
- Department of Medical Oncology, Policlinico Universitario "A. Gemelli", Rome, Italy.,Universita Cattolica del Sacro Cuore, Roma
| | - Nicla La Verde
- Oncology Unit, ASST Fatebenefratelli Sacco Presidio Ospedaliero Fatebenefratelli, Milano, Italy
| | | | - Carlo Garufi
- Division of Medical Oncology, Pescara Hospital, Pescara, Italy
| | - Sandro Barni
- Department of Oncology, Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - Rosanna Mirabelli
- Department of Hematology & Oncology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy
| | | | - Enzo M Veltri
- Oncology Unit, S. Maria Goretti Hospital, Latina, Italy
| | | | - Ida Paris
- Gynecology Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - Francesco Giotta
- Department of Medical Oncology, "Giovanni PaoloII" Institute, Bari, Italy
| | - Vito Lorusso
- Department of Medical Oncology, "Giovanni PaoloII" Institute, Bari, Italy
| | | | - Elisabetta Landucci
- UO Oncologia Medica I, S. Chiara Hospital, Dipartimentodi Oncologia, Dei Trapianti e Delle Nuove Tecnologie, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Maria Mauri
- Division of Oncology, San Giovanni Hospital, Rome, Italy
| | - Corrado Ficorella
- Medical Oncology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mario Roselli
- Department of Systems Medicine, Medical Oncology, University of Rome "Tor Vergata", Rome, Italy
| | - Vincenzo Adamo
- Medical Oncology Unit A.O. Papardo & Department Human Pathology University of Messina
| | | | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Rossana Berardi
- Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Mirco Pistelli
- Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Elena Fiorio
- U.O.C. Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Katia Cannita
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
| | - Valentina Sini
- Oncology Unit, ASL Roma 1, Santo Spirito Hospital, Rome, Italy
| | | | | | - Filippo Greco
- Department of Pathology, Surgery and Oncology, "Mater Salutis" Hospital, ULSS21, Verona, Italy
| | - Claudio Zamagni
- Medical Oncology Unit, Addarii Institute of Oncology, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Ornella Garrone
- Medical Oncology, A.O. Ospedale di Insegnamento S. Crocee Carle, Cuneo, Italy
| | | | | | - Lorenzo Livi
- Radiation Oncology Unit and Department of Clinical and Experimental Biomedical Sciences "Mario Serio", Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Isacco Desideri
- Radiation Oncology Unit and Department of Clinical and Experimental Biomedical Sciences "Mario Serio", Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Icro Meattini
- Radiation Oncology Unit and Department of Clinical and Experimental Biomedical Sciences "Mario Serio", Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | | | - Pietro Del Medico
- Division of Medical Oncology, Reggio Calabria General Hospital, Reggio Calabria, Italy
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze dell'Invecchiamento e Medicina Traslazionale -CeSI-MeT, Chieti, Italy
| | - Daniele Generali
- Breast Cancer Unit & Translational Research Unit, ASST Cremona, Cremona, Italy
| | - Ruggero De Maria
- Department of Medical Oncology, Policlinico Universitario "A. Gemelli", Rome, Italy.,Universita Cattolica del Sacro Cuore, Roma
| | - Emanuela Risi
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Isabella Sperduti
- Bio-Statistics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alice Villa
- Department of Medical Oncology, Policlinico Universitario "A. Gemelli", Rome, Italy.,Universita Cattolica del Sacro Cuore, Roma
| | - Maddalena Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Angelo Di Leo
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Patrizia Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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18
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Botticelli A, Cerbelli B, Pisano A, Naso G, Monti M, Ascierto PA, Costarelli L, Magri V, Mauri M, Pignataro MG, Campagna D, Pernazza A, Nuti M, Fortunato L, Della Rocca C, D'Amati G, Marchetti P. Abstract P5-12-08: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-12-08] [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: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the conference.
Citation Format: Botticelli A, Cerbelli B, Pisano A, Naso G, Monti M, Ascierto PA, Costarelli L, Magri V, Mauri M, Pignataro MG, Campagna D, Pernazza A, Nuti M, Fortunato L, Della Rocca C, D'Amati G, Marchetti P. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-12-08.
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Affiliation(s)
- A Botticelli
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - B Cerbelli
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - A Pisano
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - G Naso
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - M Monti
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - PA Ascierto
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - L Costarelli
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - V Magri
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - M Mauri
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - MG Pignataro
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - D Campagna
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - A Pernazza
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - M Nuti
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - L Fortunato
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - C Della Rocca
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - G D'Amati
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
| | - P Marchetti
- Sapienza , University of Rome, Rome, Italy; San Giovanni Addolorata, Hospital, Rome, Italy; Istituto Nazionale Tumori -IRCCS- 'Fondazione G. Pascale', Naples, Italy
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19
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Fabi A, Giannarelli D, Botticelli A, Scagnoli S, Pellegrino A, Fabbri A, Corsi D, Magri V, Pizzuti L, Paris I, Bruni V, Pace R, Lanzetta G, Stani S, Moscetti L, Marchetti P, Piesco G, Cognetti F, Rossi V. Abstract P4-13-07: SEQUERPLUS: A multicenter real practice observational study investigating the endocrine-based (E) therapies sequential approach in hormonal receptor positive (HR+) HER2 negative (-) metastatic breast cancer (MBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-13-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Despite the sequential E therapy is recognized as the preferred approach for HR+/HER2- MBC, no data from clinical trials support the choice between the different sequential strategies.
Methods: In this retrospective study descriptive statistics are reported using the median (Interquartile range, IQR) or frequency. Progression Free Survival (PFS) curves were estimated with the Kaplan-Meier method and compared with the log-rank test. Analysis were performed by SPSS version 21.0 (SPSS Inc., Chicago, IL).
Results: From January 2006 to December 2017, 240 patients (pts) with HR+/HER2- MBC receiving at least two consecutive E therapies as first approach were selected from 12 italian cancer centers. The median age at the time of metastasis onset was 63.5 (IQR: 55-72.5) years; 184 (76.7%) pts were in menopausal status; 38 (16%) had de novo stage IV disease and the remaining 202 (84%) had recurrent BC with a median time of 78 months (5-396 months). At the beginning of MBC diagnosis, 148 (62%) pts had a single site of distant disease, 108 (45%) of whom had bone only disease and 45 (18.8%) presented visceral involvement too. The aromatase inhibitor (AI) was chosen as I-line therapy in 146 (60.9%) pts, followed by Fulvestrant (F) in 62 (25.8%) pts; the alternative I-line options were everolimus-exemestane (Eve-Exe), tamoxifene (T), Palbociclib (P)+AI and F+AI in 13 (5.4%), 14 (5.8%), 1 (0.4%) and 4 (1.7%) pts, respectively. The most favourite II-line option resulted F for 111 (46.2%) pts while the Eve-Exe combination was chosen in 70 (29.2%) pts, AI in 30 (12.5%) pts; T, AI+F, P+F and antiprogestincwere administered in 4 (1.7%), 4 (1.7%), 19 (7.9%) and 2 (0.8%) pts, respectively. For I and II-line, the AI followed by F (40%) and F followed by Eve-Exe (18%) were the most common sequential therapeutic approaches; the several alternative options were scanty used (in less than 10%). The median Progression-Free Survival (PFS) from first and second-line E therapies resulted 15.7 (95% CI 13.3-18.1) and 10.3 months (95% CI 8.7-11.9), respectively. Among 194 pts with disease progression after second-line E therapy, 87 (44.8%) received further E therapies with a median PFS 9.4 months (95% CI 7.9-10.9). The remaining 70 (29.2%) pts was treated with palliative chemotherapy. Interestingly, the median Overall Survival (OS) was even longer for pts receiving more lines of E therapies compared to the group with earlier introduction of chemotherapy (204.3 vs 92.8; p=0.007).
Finally, in the subgroup analyses a longer PFS benefit was observed in pts with disease recurrence over 12 months from initial diagnosis (38.1 vs 30.3 months p=0.04) and limited sites of disease involvement at the time of MBC diagnosis (37.6 vs 28.3 months, p=0.03)
Conclusions: The sequential use in first and second-line setting of E therapies for HR+/HER2- MBC improves median PFS up to 32.3 months. According to real practice experience the optimal sequences could be AIs followed by F and F followed by Eve-Exe. A role for these compounds should be redefined in the light of recently introduction of CDK 4/6 inhibitors in combination with AIs or F for the first or later lines.
Citation Format: Fabi A, Giannarelli D, Botticelli A, Scagnoli S, Pellegrino A, Fabbri A, Corsi D, Magri V, Pizzuti L, Paris I, Bruni V, Pace R, Lanzetta G, Stani S, Moscetti L, Marchetti P, Piesco G, Cognetti F, Rossi V. SEQUERPLUS: A multicenter real practice observational study investigating the endocrine-based (E) therapies sequential approach in hormonal receptor positive (HR+) HER2 negative (-) metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-13-07.
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Affiliation(s)
- A Fabi
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - D Giannarelli
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - A Botticelli
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - S Scagnoli
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - A Pellegrino
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - A Fabbri
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - D Corsi
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - V Magri
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - L Pizzuti
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - I Paris
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - V Bruni
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - R Pace
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - G Lanzetta
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - S Stani
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - L Moscetti
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - P Marchetti
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - G Piesco
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - F Cognetti
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - V Rossi
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
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20
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Capalbo C, Belardinilli F, Raimondo D, Milanetti E, Malapelle U, Pisapia P, Magri V, Prete A, Pecorari S, Colella M, Coppa A, Bonfiglio C, Nicolussi A, Valentini V, Tessitore A, Cardinali B, Petroni M, Infante P, Santoni M, Filetti M, Colicchia V, Paci P, Mezi S, Longo F, Cortesi E, Marchetti P, Troncone G, Bellavia D, Canettieri G, Giannini G. A Simplified Genomic Profiling Approach Predicts Outcome in Metastatic Colorectal Cancer. Cancers (Basel) 2019; 11:cancers11020147. [PMID: 30691222 PMCID: PMC6406354 DOI: 10.3390/cancers11020147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/24/2018] [Revised: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 12/22/2022] Open
Abstract
The response of metastatic colorectal cancer (mCRC) to the first-line conventional combination therapy is highly variable, reflecting the elevated heterogeneity of the disease. The genetic alterations underlying this heterogeneity have been thoroughly characterized through omic approaches requiring elevated efforts and costs. In order to translate the knowledge of CRC molecular heterogeneity into a practical clinical approach, we utilized a simplified Next Generation Sequencing (NGS) based platform to screen a cohort of 77 patients treated with first-line conventional therapy. Samples were sequenced using a panel of hotspots and targeted regions of 22 genes commonly involved in CRC. This revealed 51 patients carrying actionable gene mutations, 22 of which carried druggable alterations. These mutations were frequently associated with additional genetic alterations. To take into account this molecular complexity and assisted by an unbiased bioinformatic analysis, we defined three subgroups of patients carrying distinct molecular patterns. We demonstrated these three molecular subgroups are associated with a different response to first-line conventional combination therapies. The best outcome was achieved in patients exclusively carrying mutations on TP53 and/or RAS genes. By contrast, in patients carrying mutations in any of the other genes, alone or associated with mutations of TP53/RAS, the expected response is much worse compared to patients with exclusive TP53/RAS mutations. Additionally, our data indicate that the standard approach has limited efficacy in patients without any mutations in the genes included in the panel. In conclusion, we identified a reliable and easy-to-use approach for a simplified molecular-based stratification of mCRC patients that predicts the efficacy of the first-line conventional combination therapy.
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Affiliation(s)
- Carlo Capalbo
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
- Department of Medical Oncology Sant' Andrea Hospital, I-00189 Rome, Italy.
| | | | - Domenico Raimondo
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
| | | | - Umberto Malapelle
- Department of Public Health, University Federico II, 80131 Naples, Italy.
| | - Pasquale Pisapia
- Department of Public Health, University Federico II, 80131 Naples, Italy.
| | - Valentina Magri
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Alessandra Prete
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Silvia Pecorari
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | | | - Anna Coppa
- Department of Experimental Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Caterina Bonfiglio
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Arianna Nicolussi
- Department of Experimental Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Virginia Valentini
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Alessandra Tessitore
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Beatrice Cardinali
- Institute of Cell Biology and Neurobiology, National Research Council, Campus A. Buzzati-Traverso, 00015 Monterotondo Scalo, Italy.
| | - Marialaura Petroni
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, 00161 Rome, Italy.
| | - Paola Infante
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, 00161 Rome, Italy.
| | - Matteo Santoni
- Oncology Unit, Macerata Hospital, 62012 Macerata, Italy.
| | - Marco Filetti
- Department of Medical Oncology Sant' Andrea Hospital, I-00189 Rome, Italy.
| | - Valeria Colicchia
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Paola Paci
- Institute for Systems Analysis and Computer Science "Antonio Ruberti", National Research Council, 00185 Rome, Italy.
| | - Silvia Mezi
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Flavia Longo
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Enrico Cortesi
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Paolo Marchetti
- Department of Medical Oncology Sant' Andrea Hospital, I-00189 Rome, Italy.
| | - Giancarlo Troncone
- Department of Public Health, University Federico II, 80131 Naples, Italy.
| | - Diana Bellavia
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Gianluca Canettieri
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
- Pasteur Institute-Cenci Bolognetti Foundation, 00161 Rome, Italy.
| | - Giuseppe Giannini
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
- Pasteur Institute-Cenci Bolognetti Foundation, 00161 Rome, Italy.
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21
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Pizzuti L, Giordano A, Michelotti A, Mazzotta M, Natoli C, Gamucci T, De Angelis C, Landucci E, Diodati L, Iezzi L, Mentuccia L, Fabbri A, Barba M, Sanguineti G, Marchetti P, Tomao S, Mariani L, Paris I, Lorusso V, Vallarelli S, Cassano A, Aroldi F, Orlandi A, Moscetti L, Sergi D, Sarobba MG, Tonini G, Santini D, Sini V, Veltri E, Vaccaro A, Ferrari L, De Tursi M, Tinari N, Grassadonia A, Greco F, Botticelli A, La Verde N, Zamagni C, Rubino D, Cortesi E, Magri V, Pomati G, Scagnoli S, Capomolla E, Kayal R, Scinto AF, Corsi D, Cazzaniga M, Laudadio L, Forciniti S, Mancini M, Carbognin L, Seminara P, Barni S, Samaritani R, Roselli M, Portarena I, Russo A, Ficorella C, Cannita K, Carpano S, Pistelli M, Berardi R, De Maria R, Sperduti I, Ciliberto G, Vici P. Palbociclib plus endocrine therapy in HER2 negative, hormonal receptor-positive, advanced breast cancer: A real-world experience. J Cell Physiol 2018; 234:7708-7717. [PMID: 30536609 DOI: 10.1002/jcp.27832] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 10/10/2018] [Accepted: 11/06/2018] [Indexed: 12/11/2022]
Abstract
Data from 423 human epidermal growth factor receptor 2-negative (HER2-), hormone receptor-positive (HR+) advanced breast cancer (aBC) patients treated with palbociclib and endocrine therapy (ET) were provided by 35 Italian cancer centers and analyzed for treatment outcomes. Overall, 158 patients were treated in first line and 265 in second/later lines. We observed 19 complete responses and 112 partial responses. The overall response rate (ORR) was 31% (95% confidence interval [CI], 26.6-35.4) and clinical benefit was 52.7% (95% CI, 48-57.5). ORR was negatively affected by prior exposure to everolimus/exemestane ( p = 0.002) and favorably influenced by early line-treatment ( p < 0.0001). At 6 months, median progression-free survival was 12 months (95% CI, 8-16) and median overall survival was 24 months (95% CI, 17-30). More favorable outcomes were associated with palbociclib in early lines, no visceral metastases and no prior everolimus/exemestane. The main toxicity reported was neutropenia. Our results provide further support to the use of palbociclib with ET in HER2-, HR+ aBC. Differences in outcomes across patients subsets remain largely unexplained.
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Affiliation(s)
- Laura Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonio Giordano
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea, Rome, Italy
| | - Andrea Michelotti
- UO Oncologia Medica I, Ospedale S. Chiara, Dipartimento di Oncologia, Dei Trapianti e Delle Nuove Tecnologie, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Marco Mazzotta
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze Dell'Invecchiamento e Medicina Traslazionale-CeSI-MeT, Chieti, Italy
| | - Clara Natoli
- Medical Oncology Unit, SS Trinità Hospital, Loc. San MarcianoHospital, Sora, Frosinone, Italy
| | - Teresa Gamucci
- Medical Oncology Unit, SS Trinità Hospital, Sora, Italy.,Medical Oncology, Sandro Pertini Hospital, Rome, Italy
| | - Claudia De Angelis
- UO Oncologia Medica I, Ospedale S. Chiara, Dipartimento di Oncologia, Dei Trapianti e Delle Nuove Tecnologie, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Elisabetta Landucci
- UO Oncologia Medica I, Ospedale S. Chiara, Dipartimento di Oncologia, Dei Trapianti e Delle Nuove Tecnologie, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Lucrezia Diodati
- UO Oncologia Medica I, Ospedale S. Chiara, Dipartimento di Oncologia, Dei Trapianti e Delle Nuove Tecnologie, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Laura Iezzi
- Medical Oncology Unit, SS Trinità Hospital, Loc. San MarcianoHospital, Sora, Frosinone, Italy
| | | | - Agnese Fabbri
- Medical Oncology Unit, Belcolle Hospital, Viterbo, Italy
| | - Maddalena Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Marchetti
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze Dell'Invecchiamento e Medicina Traslazionale-CeSI-MeT, Chieti, Italy.,Department of Clinical and Molecular Medicine, A Oncology Division, "Sapienza" University of Rome, Rome, Italy
| | - Silverio Tomao
- Department of Clinical and Molecular Medicine, A Oncology Division, La "Sapienza" University of Rome, Rome, Italy
| | - Luciano Mariani
- HPV Unit, Department of Gynaecologic Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ida Paris
- Gynecology Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - Vito Lorusso
- Division of Medical Oncology, IRCCS, Giovanni Paolo II Hospital, Bari, Italy
| | - Simona Vallarelli
- Division of Medical Oncology, IRCCS, Giovanni Paolo II Hospital, Bari, Italy
| | - Alessandra Cassano
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Francesca Aroldi
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Armando Orlandi
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Luca Moscetti
- Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Domenico Sergi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Giuseppe Tonini
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Daniele Santini
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Valentina Sini
- Oncology Unit, ASL Roma 1, Santo Spirito Hospital, Rome, Italy
| | - Enzo Veltri
- Division of Medical Oncology, Ospedale S. Maria Goretti, Latina, Italy
| | - Angela Vaccaro
- Medical Oncology Unit, SS Trinità Hospital, Loc. San MarcianoHospital, Sora, Frosinone, Italy
| | - Laura Ferrari
- Medical Oncology Unit, SS Trinità Hospital, Loc. San MarcianoHospital, Sora, Frosinone, Italy
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze Dell'Invecchiamento e Medicina Traslazionale-CeSI-MeT, Chieti, Italy
| | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze Dell'Invecchiamento e Medicina Traslazionale-CeSI-MeT, Chieti, Italy
| | - Antonino Grassadonia
- Department of Medical, Oral and Biotechnological Sciences, Centro Scienze Dell'Invecchiamento e Medicina Traslazionale-CeSI-MeT, Chieti, Italy
| | - Filippo Greco
- ASST Fatebenefratelli Sacco PO Fatebenefratelli, Department of Oncology, Milan, Italy
| | - Andrea Botticelli
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea, Rome, Italy
| | - Nicla La Verde
- Department of Oncology, ASST Fatebenefratelli Sacco PO Fatebenefratelli, Milan, Italy
| | - Claudio Zamagni
- SSD Oncologia Medica "Addarii", S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Daniela Rubino
- SSD Oncologia Medica "Addarii", S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Enrico Cortesi
- Medical Oncology, Policlinico Umberto I, Sapienza, University of Rome, Rome, Italy
| | - Valentina Magri
- Medical Oncology, Policlinico Umberto I, Sapienza, University of Rome, Rome, Italy
| | - Giulia Pomati
- Medical Oncology, Policlinico Umberto I, Sapienza, University of Rome, Rome, Italy
| | - Simone Scagnoli
- Medical Oncology, Policlinico Umberto I, Sapienza, University of Rome, Rome, Italy
| | | | - Ramy Kayal
- Department of Radiology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Domenico Corsi
- Medical Oncology Unit, Ospedale San Pietro Fatebenefratelli, Rome, Italy
| | | | | | | | - Maria Mancini
- Medical Oncology, Ospedale F. Renzetti, Lanciano, Italy
| | - Luisa Carbognin
- Department of Pathology, Surgery and Oncology, "Mater Salutis" Hospital, ULSS21, Verona, Italy
| | - Patrizia Seminara
- Department of Clinical and Molecular Medicine, A Oncology Division, "Sapienza" University of Rome, Rome, Italy
| | - Sandro Barni
- Department of Oncology, Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy
| | | | - Mario Roselli
- Medical Oncology Unit, Department of Systems Medicine, Tor Vergata Clinical Center University Hospital, Tor Vergata University Hospital, Rome, Italy
| | - Ilaria Portarena
- Medical Oncology Unit, Department of Systems Medicine, Tor Vergata Clinical Center University Hospital, Tor Vergata University Hospital, Rome, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Corrado Ficorella
- Medical Oncology Department, S. Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Katia Cannita
- Medical Oncology Department, S. Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Silvia Carpano
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mirco Pistelli
- Azienda Ospedaliero Universitaria Ospedali Riuniti Clinica di Oncologia, Università Politecnica delle Marche, Ancona, Italy
| | - Rossana Berardi
- Azienda Ospedaliero Universitaria Ospedali Riuniti Clinica di Oncologia, Università Politecnica delle Marche, Ancona, Italy
| | - Ruggero De Maria
- Institute of General Pathology, Catholic University of the Sacred Heart, Rome, Italy
| | - Isabella Sperduti
- Bio-statistics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Gamucci T, Pizzuti L, Natoli C, Mentuccia L, Sperduti I, Barba M, Sergi D, Iezzi L, Maugeri-Saccà M, Vaccaro A, Magnolfi E, Gelibter A, Barchiesi G, Magri V, D'Onofrio L, Cassano A, Rossi E, Botticelli A, Moscetti L, Omarini C, Fabbri MA, Scinto AF, Corsi D, Carbognin L, Mazzotta M, Bria E, Foglietta J, Samaritani R, Garufi C, Mariani L, Barni S, Mirabelli R, Sarmiento R, Graziano V, Santini D, Marchetti P, Tonini G, Di Lauro L, Sanguineti G, Paoletti G, Tomao S, De Maria R, Veltri E, Paris I, Giotta F, Latorre A, Giordano A, Ciliberto G, Vici P. A multicenter REtrospective observational study of first-line treatment with PERtuzumab, trastuzumab and taxanes for advanced HER2 positive breast cancer patients. RePer Study. Cancer Biol Ther 2018; 20:192-200. [PMID: 30403909 PMCID: PMC6343690 DOI: 10.1080/15384047.2018.1523095] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Indexed: 10/27/2022] Open
Abstract
We carried out a retrospective observational study of 264 HER2-positive advanced breast cancer (ABC) patients to explore the efficacy of first-line treatment with pertuzumab/trastuzumab/taxane in real-world setting. Survival data were analyzed by Kaplan Meier curves and log rank test. Median follow-up, length of pertuzumab/trastuzumab/taxane treatment and of pertuzumab, trastuzumab maintenance were 21, 4 and 15 months, respectively. The response rate was 77.3%, and the clinical benefit rate 93.6%. Median progression-free survival (mPFS) was 21 months, and median overall survival (mOS) was not reached. When comparing patients by trastuzumab-pretreatment, similar PFS were observed, although a longer OS was reached in trastuzumab-naïve patients (p = 0.02). Brain metastases at baseline and their development in course of therapy were associated with significantly shorter PFS (p = 0.0006) and shorter OS, although at a not fully statistically relevant extent (p = 0.06). The addition of maintenance endocrine therapy (ET) to pertuzumab/trastuzumab maintenance was associated with longer PFS (p = 0.0001), although no significant differences were detected in OS (p = 0.31). Results were confirmed by propensity score analysis (p = 0.003 and p = 0.46, respectively). In multivariate models, longer PFS was related to lower Performance Status (PS) (p = 0.07), metastatic stage at diagnosis (p = 0.006) and single metastatic site (p < 0.0001). An OS advantage was observed with lower PS (p < 0.0001), single metastatic site (p = 0.004), no prior exposure to trastuzumab (p = 0.004) and response to pertuzumab-based treatment (p = 0.003). Our results confirm that trastuzumab/pertuzumab/taxane is the standard of care as first-line treatment of patients with HER2-positive ABC even in the real-world setting. Moreover, the double-maintenance therapy (HER2 block and ET) is strongly recommended when feasible.
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Affiliation(s)
- Teresa Gamucci
- a Medical Oncology Unit , ASL Frosinone , Frosinone , Italy.,b Medical Oncology , Sandro Pertini Hospital , Roma , Italy
| | - Laura Pizzuti
- c Division of Medical Oncology 2 , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Clara Natoli
- d Department of Medical, Oral and Biotechnological Sciences , Centro Scienze dell'Invecchiamento e Medicina Traslazionale -CeSI-MeT , Chieti , Italy
| | | | - Isabella Sperduti
- e Bio-Statistics Unit , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Maddalena Barba
- c Division of Medical Oncology 2 , IRCCS Regina Elena National Cancer Institute , Rome , Italy.,f Scientific Direction , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Domenico Sergi
- c Division of Medical Oncology 2 , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Laura Iezzi
- d Department of Medical, Oral and Biotechnological Sciences , Centro Scienze dell'Invecchiamento e Medicina Traslazionale -CeSI-MeT , Chieti , Italy
| | - Marcello Maugeri-Saccà
- c Division of Medical Oncology 2 , IRCCS Regina Elena National Cancer Institute , Rome , Italy.,f Scientific Direction , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Angela Vaccaro
- a Medical Oncology Unit , ASL Frosinone , Frosinone , Italy
| | | | - Alain Gelibter
- g Medical Oncology Unit , Policlinico Umberto I , Rome , Italy
| | | | - Valentina Magri
- g Medical Oncology Unit , Policlinico Umberto I , Rome , Italy
| | - Loretta D'Onofrio
- h Department of Oncology , University Campus Biomedico of Rome , Rome , Italy
| | - Alessandra Cassano
- i Department of Medical Oncology , Policlinico Universitario "A. Gemelli" , Rome , Italy
| | - Ernesto Rossi
- i Department of Medical Oncology , Policlinico Universitario "A. Gemelli" , Rome , Italy
| | - Andrea Botticelli
- j Department of Clinical and Molecular Medicine , "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea , Rome , Italy
| | - Luca Moscetti
- k Division of Medical Oncology, Department of Oncology and Hematology , University Hospital of Modena , Modena , Italy
| | - Claudia Omarini
- k Division of Medical Oncology, Department of Oncology and Hematology , University Hospital of Modena , Modena , Italy
| | | | | | - Domenico Corsi
- m Medical Oncology Unit , San Pietro Fatebenefratelli Hospital , Rome , Italy
| | - Luisa Carbognin
- n U.O.C. Oncology , University of Verona, Azienda Ospedaliera Universitaria Integrata , Verona , Italy
| | - Marco Mazzotta
- j Department of Clinical and Molecular Medicine , "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea , Rome , Italy
| | - Emilio Bria
- n U.O.C. Oncology , University of Verona, Azienda Ospedaliera Universitaria Integrata , Verona , Italy
| | - Jennifer Foglietta
- o Department of Medical Oncology , University of Perugia, Santa Maria della Misericordia Hospital , Perugia , Italy
| | | | - Carlo Garufi
- q Division of Medical Oncology , Pescara Hospital , Pescara , Italy
| | - Luciano Mariani
- r HPV Unit, Department of Gynaecologic Oncology , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Sandro Barni
- s Department of Oncology, Oncology Unit , ASST Bergamo Ovest , Treviglio , Italy
| | - Rosanna Mirabelli
- t Department of Hematology & Oncology , Azienda Ospedaliera Pugliese-Ciaccio , Catanzaro , Italy
| | | | - Vincenzo Graziano
- v Medical Oncology Unit , SS Annunziata Hospital , Chieti , Italy.,w Breast Medical Oncology Unit , G. Bernabeo Hospital , Ortona , Italy
| | - Daniele Santini
- h Department of Oncology , University Campus Biomedico of Rome , Rome , Italy
| | - Paolo Marchetti
- j Department of Clinical and Molecular Medicine , "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea , Rome , Italy
| | - Giuseppe Tonini
- h Department of Oncology , University Campus Biomedico of Rome , Rome , Italy
| | - Luigi Di Lauro
- c Division of Medical Oncology 2 , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Giuseppe Sanguineti
- x Department of Radiation Oncology , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Giancarlo Paoletti
- c Division of Medical Oncology 2 , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Silverio Tomao
- g Medical Oncology Unit , Policlinico Umberto I , Rome , Italy
| | - Ruggero De Maria
- y Institute of General Pathology , Catholic University of the Sacred Heart , Rome , Italy
| | - Enzo Veltri
- z Oncology Unit , S. Maria Goretti Hospital , Latina , Italy
| | - Ida Paris
- aa Gynecology Oncology Unit , Catholic University of the Sacred Heart , Rome , Italy
| | - Francesco Giotta
- ab Department of Medical Oncology , "Giovanni Paolo II" Institute , Bari , Italy
| | - Agnese Latorre
- ab Department of Medical Oncology , "Giovanni Paolo II" Institute , Bari , Italy
| | - Antonio Giordano
- ac Center for Biotechnology , Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University , Philadelphia , PA , USA
| | - Gennaro Ciliberto
- f Scientific Direction , IRCCS Regina Elena National Cancer Institute , Rome , Italy
| | - Patrizia Vici
- c Division of Medical Oncology 2 , IRCCS Regina Elena National Cancer Institute , Rome , Italy
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23
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Conte B, Fabi A, Poggio F, Blondeaux E, Dellepiane C, D'Alonzo A, Staiano A, Buono G, Arpino G, Magri V, Naso G, Presti D, Mura S, Fontana A, Cognetti F, Molinelli C, Pastorino S, Bighin C, Lambertini M, Del Mastro L. Effectiveness of trastuzumab emtansine (TDM1) in patients with HER2-positive advanced breast cancer (ABC) progressing after taxane plus pertuzumab plus trastuzumab. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.316] [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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Bassanelli M, Giannarelli D, Ricciuti B, Magri V, Cecere F, Roberto M, Giacinti S, Barucca V, Cassese R, De Giglio A, Scagnoli S, Milella M, Santarelli M, Bengala C, Ruggeri E, Marchetti P, Cognetti F, Gelibter A, Cortesi E, Chiari R, Ceribelli A. P1.15-01 Radiotherapy (RT) and Nivolumab in Non-Small-Cell Lung Cancer (NSCLC): A Multicenter Real-Life Experience. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Belardinilli F, Capalbo C, Pisapia P, Malapelle U, Raimondo D, Magri V, Coppa A, Mezi S, Troncone G, Giannini G. PO-320 Gene panel mutation screening for a better molecular stratification of colorectal cancer patients. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.350] [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: 11/03/2022] Open
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26
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Bassanelli M, Giannarelli D, Ricciuti B, Magri V, Cecere FL, Roberto M, Giacinti S, Barucca V, Cassese R, De Giglio A, Scagnoli S, Milella M, Santarelli M, Bengala C, Ruggeri EM, Marchetti P, Cognetti F, Gelibter A, Chiari R, Ceribelli A. Updated outcomes of previously irradiated non-small-cell lung cancer (NSCLC) patients (pts) receiving programmed death 1 (PD-1) inhibitors. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15158] [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)
| | | | - Biagio Ricciuti
- Clinical Oncology, S. Maria della Misericordia Hospital, Perugia, Italy
| | | | | | - Michela Roberto
- Sant Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Viola Barucca
- Department of Oncology; Misericordia Hospital, Grosseto, Italy
| | - Raffaele Cassese
- department of Radiotherapy- San Camillo de Lellis Hospital, Rieti, Italy
| | - Andrea De Giglio
- Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | | | - Michele Milella
- Medical Oncology A, Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | - Paolo Marchetti
- S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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27
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Di Segni M, de Soccio V, Cantisani V, Bonito G, Rubini A, Di Segni G, Lamorte S, Magri V, De Vito C, Migliara G, Bartolotta TV, Metere A, Giacomelli L, de Felice C, D'Ambrosio F. Automated classification of focal breast lesions according to S-detect: validation and role as a clinical and teaching tool. J Ultrasound 2018; 21:105-118. [PMID: 29681007 DOI: 10.1007/s40477-018-0297-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 03/17/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To assess the diagnostic performance and the potential as a teaching tool of S-detect in the assessment of focal breast lesions. METHODS 61 patients (age 21-84 years) with benign breast lesions in follow-up or candidate to pathological sampling or with suspicious lesions candidate to biopsy were enrolled. The study was based on a prospective and on a retrospective phase. In the prospective phase, after completion of baseline US by an experienced breast radiologist and S-detect assessment, 5 operators with different experience and dedication to breast radiology performed elastographic exams. In the retrospective phase, the 5 operators performed a retrospective assessment and categorized lesions with BI-RADS 2013 lexicon. Integration of S-detect to in-training operators evaluations was performed by giving priority to S-detect analysis in case of disagreement. 2 × 2 contingency tables and ROC analysis were used to assess the diagnostic performances; inter-rater agreement was measured with Cohen's k; Bonferroni's test was used to compare performances. A significance threshold of p = 0.05 was adopted. RESULTS All operators showed sensitivity > 90% and varying specificity (50-75%); S-detect showed sensitivity > 90 and 70.8% specificity, with inter-rater agreement ranging from moderate to good. Lower specificities were improved by the addition of S-detect. The addition of elastography did not lead to any improvement of the diagnostic performance. CONCLUSIONS S-detect is a feasible tool for the characterization of breast lesions; it has a potential as a teaching tool for the less experienced operators.
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Affiliation(s)
- Mattia Di Segni
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy.
| | - Valeria de Soccio
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy
| | - Vito Cantisani
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy
| | - Giacomo Bonito
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy
| | - Antonello Rubini
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy
| | | | - Sveva Lamorte
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy
| | - Valentina Magri
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, Italy
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, Italy
| | | | - Alessio Metere
- Department of Surgical Sciences, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | - Carlo de Felice
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy
| | - Ferdinando D'Ambrosio
- U.O.C. Diagnostica per Immagini, P. O San Paolo - ASL Roma 4, Largo dei Donatori del Sangue 1, 00053, Civitavecchia (RM), Italy
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Bassanelli M, Giannarelli D, Gelibter A, Cecere FL, Chiari R, Giacinti S, Scagnoli S, Milella M, Ricciuti B, Roberto M, Magri V, Ferraresi V, Brambilla M, Santarelli M, Marchetti P, Cortesi E, Ceribelli A. Systemic effect of radiotherapy (RT) followed by programmed death 1 (PD-1) inhibitors in non-small-cell lung cancer (NSCLC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.177] [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
177 Background: RT-induced abscopal effect seems increase the efficacy of immunotherapy. The aim of this study was to evaluate the outcome of patients (pts) with NSCLC previously undergone to RT before receiving PD-1 inhibitors. Methods: We conducted an observational, retrospective analysis of 63 consecutive pts with advanced NSCLC who received RT followed by PD-1 inhibitors at five Italian institutions. Tumor response to treatment was defined according to Response Evaluation Criteria in Solid Tumors version 1.1. Median overall survival (OS) and the 95% confidence interval (CI) were estimated with the Kaplan -Meier method. Results: 63 pts (median age 66 years; male:60.3%) with advanced NSCLC (adenocarcinoma [adc]:71.4%; squamous cells [sqc]:28.6%) were treated with PD-1 inhibitors after RT. RT was delivered a median of 70 days before the start of immunotherapy.47 pts(74.5%)received extracranical RT and 16 pts (25.7%) performed cranial irradiation. Median OS was 11.7 months (mo) [95% CI, 4.7-18.7] (adc: 13.0 mo [95% CI,7.3-18.7], sqc 5.1 mo [95%CI,2.9-7.3]). Median progression free survival (PFS) was 5.1 mo [95% CI,2.5-7.7] (adc: 9.0 mo[ 95% CI,2.6-15.3]; sqc: 3.5 mo [95% CI,2.0-5.1]). A better performance status (PS) according to ECOG scale was associated with an improved OS (PS 0[21 pts]: 15.4 mo [95% CI,10.8-19.9]; PS1[33 pts]: 11.7 mo [95%CI,4.0-19.4]; PS2[9 pts]: 4.1 mo [95% CI,0.9-7.3]). Median OS in 46 pts who received ≤ 1 previous systemic therapy was 13.0 mo [95% CI, 9.4-16.6] and in 17 pts who received ≥2 previous treatments was 7.4 mo [95% CI, 3.1-11.7]. Median OS in 45 pts aged < 70 years was 11.7 mo [95% CI, 4.7-18.7] and in 18 elderly (≥ 70 years) was 6.5 mo [95% CI, 0.0-17.7]. 9(14.3%) partial response, 23(36.5%) stable disease and 25(39.7%) progressive disease have been observed. Conclusions: The synergic combination of RT and PD-1 inhibitors leads to an enhancement of systemic antitumor immune responses, triggering the abscopal effect, resulting in prolonged OS.
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Affiliation(s)
| | | | | | | | | | - Silvana Giacinti
- Department of Clinical and Molecolar Medicine, Sapienza University of Rome, Rome, Italy
| | | | | | - Biagio Ricciuti
- Clinical Oncology, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Michela Roberto
- Saint Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Caponnetto S, Gelibter A, Mosillo C, Magri V, Scagnoli S, Pomati G, Piesco G, Verkhovskaya S, Pisegna S, Sirgiovanni G, Napoli V, Buscicchio D, Iannantuono G, Marinelli D, Mammone G, Pannunzio S, Nicolo' E, Stefani A, Astorino V, Mancini M, Cortesi E. Comparative effects of Folfirinox and Gemcitabine/nab-paclitaxel as first and second line chemotherapy for metastatic pancreatic cancer: single choice or sequence. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx425.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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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30
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Caponnetto S, Iannantuono GM, Barchiesi G, Magri V, Gelibter A, Cortesi E. Prolactin as a Potential Early Predictive Factor in Metastatic Non-Small Cell Lung Cancer Patients Treated with Nivolumab. Oncology 2017; 93:62-66. [PMID: 28407622 DOI: 10.1159/000464328] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/28/2016] [Accepted: 02/14/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIMS Prolactin (PRL) is a peptide hormone and several studies have demonstrated its role as a cytokine in human T cell-mediated immunity. We are unaware if PRL is a positive or negative immunomodulator, but its effects on the regulation of T cells could inhibit the antitumor activity elicited by nivolumab (NIVO). We aimed to assess whether the occurrence of hyperprolactinemia in metastatic non-small cell lung cancer (mNSCLC) patients treated with NIVO is associated with poor clinical outcomes. METHODS We evaluated 26 mNSCLC patients treated with NIVO. Blood samples were collected in every patient to evaluate PRL basal levels before starting the therapy with NIVO and before each following administration of NIVO. All patients underwent a conventional CT to investigate the effect of therapy according to Immune-related Response Evaluation Criteria in Solid Tumors (IrRECIST). RESULTS Twenty patients (77%) developed hyperprolactinemia during the treatment, whereas 6 patients (23%) had stable levels of PRL during the therapy (p = 0.001). A total of 95% of the 20 patients with hyperprolactinemia had progressive disease (PD), according to CT results, whereas only 2 patients (33%) out of 6 with stable PRL levels had PD (p = 0.004). CONCLUSIONS Hyperprolactinemia in mNSCLC patients treated with NIVO could potentially represent a negative early predictive factor for poor clinical outcomes, thus anticipating PD shown by CT scan.
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Affiliation(s)
- Salvatore Caponnetto
- Division of Medical Oncology, Department of Radiological, Oncological, and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
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Giotta F, Acito L, Candeloro G, Del Medico P, Gadaleta-Caldarola G, Giordano G, Gueli R, Lugini A, Magri V, Mandarà M, Masci G, Pisconti S, Pistelli M, Rizzi A, Salesi N, Schirone A, Scognamiglio G, Tedeschi M, Zucchinelli P. Eribulin in Male Patients With Breast Cancer: The First Report of Clinical Outcomes. Oncologist 2016; 21:1298-1305. [PMID: 27742906 PMCID: PMC5189626 DOI: 10.1634/theoncologist.2016-0022] [Citation(s) in RCA: 8] [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: 01/21/2016] [Accepted: 04/14/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Evidence on the management and treatment of male breast cancer is scant. We report the analysis of a multicenter Italian series of patients with male breast cancer treated with eribulin. To our knowledge, this is the first report on the use or eribulin in this setting. PATIENTS AND METHODS Patients were retrospectively identified in 19 reference centers. All patients received eribulin treatment, according to the standard practice of each center. Data on the identified patients were collected using a standardized form and were then centrally reviewed by two experienced oncologists. RESULTS A total of 23 patients (median age, 64 years; range, 42-80) were considered. The median age at the time of diagnosis of breast cancer was 57 years (range, 42-74). HER2 status was negative in 14 patients (61%), and 2 patients (9%) had triple-negative disease. The most common metastatic sites were the lung (n = 14; 61%) and bone (n = 13; 56%). Eribulin was administered for a median of 6 cycles (range, 3-15). All patients reported at least stable disease; two complete responses (9%) were documented. Eribulin was well-tolerated, with only four patients (17%) reporting grade 3 adverse events and two (9%) with treatment interruptions because of toxicity. Eight subjects (35%) did not report any adverse event during treatment. For patients with a reported fatal event, the median overall survival from the diagnosis of metastatic disease was 65 months (range, 22-228). CONCLUSION Although hampered by all the limitations of any retrospective case series, the results of the present study suggest, for the first time, the use of eribulin as therapy for male breast cancer. IMPLICATIONS FOR PRACTICE Evidence on the management and treatment of male breast cancer is eagerly awaited. Although hampered by all the limitations of any retrospective case series, the results of the present study suggest, for the first time, the use of eribulin as therapy for male breast cancer.
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Affiliation(s)
- Francesco Giotta
- Oncologia Medica, Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Tumori "Giovanni Paolo II," Bari, Italy
| | - Luigi Acito
- Oncologia Medica, Ospedale A. Murri, Fermo, Italy
| | | | | | | | - Guido Giordano
- Ospedale Sacro Cuore di Gesú Fatebenefratelli, Benevento, Italy
| | - Rossana Gueli
- Ospedale di Circolo e Fondazione Macchi Varese, Varese, Italy
| | | | | | | | | | | | | | | | | | - Alessio Schirone
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Istituti di Ricovero e Cura a Carattere Scientifico, Meldola, Italy
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Caponnetto S, Mancini M, Manai C, Magri V, Iannantuono G, Pellegrino D, Mosillo C, Piesco G, Pomati G, Scagnoli S, Urbano F, Verkhovskaya S, Barchiesi G, Zancla S, Cortesi E. Prolactin as a potential negative predictive factor in metastatic non-small cell lung cancers (NSCLC) patients in treatment with Nivolumab (NIVO). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.45] [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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Caponnetto S, Mancini M, Scagnoli S, Barchiesi G, Mosillo C, Iannantuono G, Verkhovskaia S, Magri V, Piesco G, Pomati G, Pellegrino D, Urbano F, Zancla S, Manai C, Cortesi E. Prolactin as a possible predictive factor in metastatic non-small cell lung cancers (NSCLC) patients in treatment with Nivolumab (NIVO). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw332.36] [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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Cortesi E, Palleschi M, Magri V, Naso G. The promise of liquid biopsy in cancer: a clinical perspective. Chin J Cancer Res 2015; 27:488-90. [PMID: 26543335 DOI: 10.3978/j.issn.1000-9604.2015.10.01] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The clinical utility of liquid biopsy in cancer treatment will increase as circulating tumor cells (CTCs) analysis move from the enumeration to the real-time measurement of tumor characteristics. Intratumor heterogeneity is becoming increasingly recognized as a major drawback to the shift to personalized medicine. Spatial and temporal heterogeneity might be reflected by the serial assessment of CTCs. Indeed, the developing technologies for CTCs analysis now allow digital genomic and next-generation sequencing approaches, able to differentiate molecular subtypes of the disease and to monitor genetic variation over time. The liquid biopsy of cancer might offer a real-time assessment of tumor biology, providing the opportunity to serially evaluate patients most likely to benefit from targeted drugs based on a dynamic characterization of the disease at the molecular level. Although hurdles remain before liquid biopsy is seen in routine clinical practice, the information derived from CTCs may facilitate the real-time identification of actionable mutations in cancer leading the way toward personalized medicine.
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Affiliation(s)
- Enrico Cortesi
- Medical Oncology Unit, Department of Radiological Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
| | - Michela Palleschi
- Medical Oncology Unit, Department of Radiological Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
| | - Valentina Magri
- Medical Oncology Unit, Department of Radiological Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
| | - Giuseppe Naso
- Medical Oncology Unit, Department of Radiological Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
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Moscetti L, Vici P, Sperduti I, Palleschi M, Magri V, Iezzi L, Fabbri M, D'Onofrio L, Mentuccia L, Vaccaro A, Trenta P, Ramponi S, Roma C, Ruggeri E. Safety analysis, correlation with response and previous treatments of the association of everolimus (EVE) and exemestane (EXE) in 181 metastatic breast cancer patients (MBC). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.34] [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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36
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Moscetti L, Vici P, Sperduti I, Fabbri M, Natoli C, Mancini M, Sini V, D'Onofrio L, Pizzuti L, Vaccaro A, Magnolfi E, Magri V, Trenta P, Ramponi S, Roma C, Ruggeri E. 1851 Safety analysis, correlation with response and previous treatments of the association of everolimus (EVE) and exemestane (EXE) in 181 metastatic breast cancer patients (MBC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30801-2] [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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37
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Magri V, Wagenlehner FME, Marras E, VAN Till JWO, Houbiers J, Panagopoulos P, Petrikkos GL, Perletti G. Influence of infection on the distribution patterns of NIH-Chronic Prostatitis Symptom Index scores in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Exp Ther Med 2013; 6:503-508. [PMID: 24137216 PMCID: PMC3786822 DOI: 10.3892/etm.2013.1174] [Citation(s) in RCA: 6] [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: 03/28/2013] [Accepted: 06/11/2013] [Indexed: 02/06/2023] Open
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition for which the etiological determinants are still poorly defined. To better characterize the diagnostic and therapeutic profile of patients, an algorithm known as UPOINT was created, addressing six major phenotypic domains of CP/CPPS, specifically the urinary (U), psycho-social (P), organ-specific (O), infection (I), neurological/systemic (N) and muscular tenderness (T) domains. An additional sexual dysfunction domain may be included in the UPOINT(S) system. The impact of the infection domain on the severity of CP/CPPS symptoms is a controversial issue, due to the contradictory results of different trials. The aim of the present retrospective study was to further analyze the extent to which a positive infection domain of UPOINTS may modify the pattern of CP/CPPS symptom scores, assessed with the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). In a cohort of 935 patients that was divided on the basis of the presence or absence of prostatic infection, more severe clinical symptoms were shown by the patients with infection (median NIH total score: 24 versus 20 points in uninfected patients; P<0.001). Moreover, NIH-CPSI score distribution curves were shifted towards more severe symptoms in patients with a positive infection domain. Division of the patients into the six most prominent phenotypic clusters of UPOINTS revealed that the ‘prostate infection-related sexual dysfunction’ cluster, including the highest proportion of patients with evidence of infection (80%), scored the highest number of NIH-CPSI points among all the clusters. To assess the influence of the infection domain on the severity of patients’ symptoms, all subjects with evidence of infection were withdrawn from the ‘prostate infection-related sexual dysfunction’ cluster. This modified cluster showed symptom scores significantly less severe than the original cluster, and the CPSI values became comparable to the scores of the five other clusters, which were virtually devoid of patients with evidence of infection. These results suggest that the presence of pathogens in the prostate gland may significantly affect the clinical presentation of patients affected by CP/CPPS, and that the infection domain may be a determinant of the severity of CP/CPPS symptoms in clusters of patients phenotyped with the UPOINTS system. This evidence may convey considerable therapeutic implications.
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Affiliation(s)
- V Magri
- Urology and Sonography Outpatient Clinic, Azienda Ospedaliera Istituti Clinici di Perfezionamento, Milan, Italy
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Pochesci A, Trenta P, Iacovelli R, Palleschi M, Prete A, Magri V, Mosillo C, Pellegrino D, De Benedetto A, Cortesi E. 71PD REVERSIBLE EPIDERMAL GROWTH FACTOR RECEPTOR TYROSINE KINASES INIHIBITORS (REGFR-TKIS), ERLOTINIB OR GEFITINIB, COMPARED TO CHEMOTHERAPY (CHT) IN PREVIOUSLY TREATED METASTATIC NON SMALL CELL LUNG CANCER (NSCLC) PATIENTS (PTS): A META-ANALYSIS. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70291-5] [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: 11/26/2022]
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Alesini D, Iacovelli R, Palazzo A, Altavilla A, Risi E, Urbano F, Manai C, Passaro A, Magri V, Cortesi E. Multimodality Treatment of Gynecomastia in Patients Receiving Antiandrogen Therapy for Prostate Cancer in the Era of Abiraterone Acetate and New Antiandrogen Molecules. Oncology 2013; 84:92-9. [DOI: 10.1159/000343821] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 09/17/2012] [Indexed: 11/19/2022]
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40
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Vral A, Magri V, Montanari E, Gazzano G, Gourvas V, Marras E, Perletti G. Topographic and quantitative relationship between prostate inflammation, proliferative inflammatory atrophy and low-grade prostate intraepithelial neoplasia: a biopsy study in chronic prostatitis patients. Int J Oncol 2012; 41:1950-8. [PMID: 23026863 PMCID: PMC3583840 DOI: 10.3892/ijo.2012.1646] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 09/14/2012] [Indexed: 01/07/2023] Open
Abstract
Inflammatory processes are important components in the pathogenesis of many human cancers. According to the 'injury and regeneration' model for prostate carcinogenesis, injury caused by pathogens or pro-inflammatory cytotoxic agents would trigger proliferation of prostatic glandular cells, leading to the appearance of epithelial lesions named 'Proliferative Inflammatory Atrophy' (PIA). Inflammatory cells infiltrating the prostate would release genotoxic reactive oxygen species, leading atrophic cells to neoplastic progression. The hypothesis pointing to PIA as risk-lesion for prostate cancer has been extensively investigated at the cellular and molecular levels, but few morphological data are available linking PIA or prostatic intraepithelial neoplasia (PIN) to inflammation or clinical prostatitis. We investigated at the morphological level 1367 prostate biopsies from 98 patients with a recent history of chronic prostatitis, and 32 patients with biopsies positive for carcinoma. Our results show that i) PIA is found more frequently in biopsy cores containing a severe or moderate inflammatory focus, compared to NON-PIA lesions (partial or cystic atrophy); ii) the PIA lesion post-atrophic hyperplasia is more frequently found in tissues showing mild or no inflammation; iii) the extent of PIA per patient correlates with the burden of moderate or severe inflammation, whereas NON-PIA lesions do not; iv) low-grade PIN is in over 90% of cases emerging from normal, non-atrophic glands and is more frequently found in biopsy cores with absent or mild inflammatory burden; v) the inverse relationship between the prevalence of low-grade PIN and the extent of PIA lesions per patient is described by a power law function, suggesting the low likelihood of the concomitant presence of these lesions in the same tissue; vi) NON-PIA lesions correlate inversely with neoplasia in patients with prostate cancer; vii) the total scores of the NIH-CPSI questionnaire correlate with both PIA and inflammation burdens at diagnosis of prostatitis but not after pharmacological intervention. These results point to a positive association between tissue inflammation, clinical prostatitis and the putative cancer risk-lesion PIA, but do not support a model whereby low-grade PIN would arise from PIA.
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Affiliation(s)
- A Vral
- Section of Histology, Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
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Perletti G, Skerk V, Magri V, Markotic A, Mazzoli S, Parnham MJ, Wagenlehner FME, Naber KG. Macrolides for the treatment of chronic bacterial prostatitis: an effective application of their unique pharmacokinetic and pharmacodynamic profile (Review). Mol Med Rep 2011; 4:1035-44. [PMID: 21874250 DOI: 10.3892/mmr.2011.575] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 08/02/2011] [Indexed: 11/06/2022] Open
Abstract
Chronic bacterial prostatitis (CBP) is a persistent infection of the prostate characterized by poor quality of life mainly due to frequent relapse episodes caused by incomplete eradication of causative pathogens. Aggressive antibacterial therapy is required to attenuate the severe symptoms of CBP and to achieve a permanent cure. Although fluoroquinolones are currently recommended as first-choice agents, macrolide antibiotics are emerging as a noteworthy option for the treatment of CBP. Macrolide antibiotics are characterized by an impressive array of distinct pharmacokinetic (PK) and pharmacodynamic (PD) properties. These properties include high intracellular accumulation in phagocytes and at sites of infection, including the prostate; broad antibiotic but also biofilm-inhibiting properties; immunomodulating and inflammation-resolving activities. These features offer particular advantages for the treatment of chronic infections of the prostate gland, which are not easily amenable to drug therapy. Macrolides may be exploited to counteract the unsatisfactory rates of clinical symptom improvement and pathogen eradication. The results of a number of clinical trials support this proposal.
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Affiliation(s)
- G Perletti
- Department of Biomedical, Inf., Comm. and Env. Sciences, University of Insubria, Busto A, I-21052 Varese, Italy.
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Magri V, Marras E, Škerk V, Markotić A, Restelli A, Garlaschi MC, Perletti G. Eradication of Chlamydia trachomatis parallels symptom regression in chronic bacterial prostatitis patients treated with a fluoroquinolone-macrolide combination. Andrologia 2010; 42:366-75. [DOI: 10.1111/j.1439-0272.2009.01033.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Perletti G, Magri V, Wagenlehner F, Naber K. CXA-101. DRUG FUTURE 2010. [DOI: 10.1358/dof.2010.35.12.1541551] [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: 04/08/2023]
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45
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Willems P, Magri V, Cretnik M, Fasano M, Jakubowska A, Levanat S, Lubinski J, Marras E, Musani V, Thierens H, Vandersickel V, Perletti G, Vral A. Characterization of the c.190T>C missense mutation in BRCA1 codon 64 (Cys64Arg). Int J Oncol 2009; 34:1005-15. [PMID: 19287957 DOI: 10.3892/ijo_00000226] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In the Milan area (Northern Italy), we identified a family characterized by a high prevalence of ovarian and breast cancer cases (5 out of 6 subjects, over 3 generations), and a predominant prevalence of ovarian lesions (4 out of 5 patients). Analysis of BRCA1 and BRCA2 genes allowed the identification of the missense c.190T>C mutation in codon 64 (Cys64Arg) of BRCA1. The aims of the present investigation were to characterize the functional implications of the c.190T>C mutation at the molecular level, and to search whether additional polymorphisms might be linked to the peculiar phenotypic features observed in the Italian pedigree. Molecular modelling studies suggested that substitution of the cysteine 64 with an arginine likely disrupts the architecture of the BRCA1 RING finger domain, responsible for the interaction with BARD1, essential for the tumor-suppressor activity of the BRCA1-BARD1 complex. By splicing site information analysis, exonic splicing enhancer site characterization, and analysis of transcript fragment length and sequence, we showed that the c.190T>C mutation was able to modulate the splicing of exon 5 in a fashion opposite to the c.190T>G transversion, responsible for the functionally-related Cys64Gly amino acid substitution. Genotyping of BRCA1 and BRCA2 in the Italian family revealed the presence of two significant polymorphisms: the cancer-associated c.2612C>T SNP in BRCA1, and the c.-26G>A SNP in the BRCA2 gene, acting as an ovarian cancer risk modifier in carriers of deleterious BRCA1 mutations. Analysis of these SNPs in a genotypically-unrelated Polish family, characterized by prevalent breast neoplasms in carriers of the c.190T>C mutation, revealed a genetic profile consistent with the hypothetic role of both polymorphisms.
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Affiliation(s)
- P Willems
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
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Perletti G, Wagenlehner FME, Naber KG, Magri V. Enhanced distribution of fourth-generation fluoroquinolones in prostatic tissue. Int J Antimicrob Agents 2008; 33:206-10. [PMID: 19091519 DOI: 10.1016/j.ijantimicag.2008.09.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Revised: 09/11/2008] [Accepted: 09/12/2008] [Indexed: 11/27/2022]
Abstract
A recently published pharmacokinetic trial showed that the fluoroquinolone moxifloxacin administered to healthy volunteers at the single oral dose of 400mg accumulates in prostatic secretions (PS) up to a median concentration of 3.99 mg/L and reaches a PS/plasma concentration ratio of 1.57, far higher than values shown by other fluoroquinolones such as norfloxacin (ratio 0.1) or ciprofloxacin (ratio 0.2). Ion trapping mechanisms were hypothesised to be among the determinants of this effect. However, whether ion trapping would solely account for the observed differences in fluoroquinolone pharmacokinetics was left to further research and discussion. In this hypothesis paper, we review various published evidence on the tissue distribution of moxifloxacin and other quinolones, suggesting that increased lipophilicity, binding to cellular matrices and fast cellular uptake/release kinetics may be mechanisms compatible with enhanced prostatic accumulation and secretion of fourth-generation fluoroquinolones.
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Affiliation(s)
- G Perletti
- Department of Structural and Functional Biology, Laboratory of Toxicology and Pharmacology, University of Insubria, Varese, Italy.
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Magri V, Trinchieri A, Perletti GP, Restelli A, Garlaschi M, Torresani E. NUOVE PROSPETTIVE DI GESTIONE DELLE PROSTATITI CRONICHE BATTERICHE. DALL’INQUADRAMENTO CLINICO ALLA GESTIONE TERAPEUTICA. Microbiol Med 2006. [DOI: 10.4081/mm.2006.3073] [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: 11/23/2022] Open
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Restelli A, Garlaschi M, Granata P, Arcuri C, Magri V, Torresani E. PROSTATITE CRONICA: POSSIBILE RUOLO PATOGENO DI CORYNEBACTERIUM GLUCURONOLYTICUM/SEMINALE. Microbiol Med 2005. [DOI: 10.4081/mm.2005.3499] [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: 11/22/2022] Open
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Restelli A, Garlaschi C, Colombo R, Granata P, Arcuri C, Bringhenti A, Magri V, Trincheri A, Scarazatti E. RUOLO EZIOPATOGENETICO DEI MICOPLASMI UROGENITALI NELLE PROSTATITI CRONICHE. Microbiol Med 2004. [DOI: 10.4081/mm.2004.3900] [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: 11/22/2022] Open
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Garlaschi M, Bonamore R, Cariani L, Calmi S, Gritti S, Follesa A, Magri V, Trinchieri A. CHLAMYDIA TRACHOMATIS IN UNA POPOLAZIONE AFFETTA DA PROSTATITE CRONICA: RUOLO EZIOPATOGENETICO. Microbiol Med 2004. [DOI: 10.4081/mm.2004.3863] [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: 11/23/2022] Open
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