Impact of inotuzumab ozogamicin on outcome in relapsed or refractory acute B-cell lymphoblastic leukemia patients prior to allogeneic hematopoietic stem cell transplantation and risk of sinusoidal obstruction syndrome/venous occlusive disease

: We evaluated 58 patients with relapsed or refractory (r/r) acute B-lymphoblastic leukemia (B-ALL; median age 42.5 years; range, 16-69 years), treated with inotuzumab ozogamicin (INO) between 2016-2022 and who received an allogeneic hematopoietic stem cell transplantation (allo-HCT) consecutively. Forty-seven (81%) of the 58 patients were heavily pretreated receiving intensive chemotherapy +/- tyrosine kinase inhibitor, blinatumomab in 24 (41%) and allo-HCT at first-line in 11 (19%) patients. Complete remission rate prior to allo-HCT was 84%. Median follow-up was 30.5 months and median overall survival (OS) measured from start of INO was 11.2 months. One- and 2-year OS rates were 50% (95% confidence interval [CI]: 38.4-56.1) and 36.7% (95% CI: 25.5-52.9), respectively. Sinusoidal obstruction syndrome/venous occlusive disease (SOS/ VOD) after allo-HCT occurred in 17 (29%) patients. Of those, nine (53%) patients died due to SOS/VOD and multi-organ failure. Two had received >2 INO cycles (3 cycles, 5 cycles, N=1, each), all others ≤2 INO cycles prior to allo-HCT. Logistic regression analysis revealed conditioning with double alkylators (P=0.038) and allo-HCT during first-line therapy (P=0.050) as significant risk factors for SOS/VOD and in trend allo-HCT ≤60 days from last INO application (P=0.07), whereas number of INO cycles before allo-HCT and time between last INO application and allo-HCT were not significant. Relapse/progressive disease occurred in 20 (34%) patients. Of those, five (25%) patients are still alive, whereas 15 succumbed of their disease. Treatment with INO seems to be an effective approach with successful bridge-to-transplant. However, risk of SOS/VOD is high, necessitating continuous monitoring and recognition of SOS/VOD risk factors

Clinical characteristics and molecular aspects of low-grade serous ovarian and peritoneal cancer: a multicenter, observational, retrospective analysis of MITO Group (MITO 22)

BACKGROUND: Low-grade serous ovarian and peritoneal cancer (LGSC) is a rare disease and few data on the clinical and genomic landscape have been published.METHODS: A retrospective analysis of patients diagnosed with LGSC between 1996 and 2019 was conducted in MITO centers. Objective Response Rate (ORR) to treatments, progression-free survival (PFS) and overall survival (OS) were assessed. Additionally, the tumor molecular profile of 56 patients was evaluated using the Next Generation Sequencing (NGS) FoundationOne CDX (Foundation Medicine (R)).RESULTS: A total of 128 patients with complete clinical data and pathologically confirmed diagnosis of LGSC were identified. ORR to first and subsequent therapies were 23.7% and 33.7%, respectively. PFS was 43.9 months (95% CI:32.4-53.1) and OS was 105.4 months (95% CI: 82.7-not reached). The most common gene alterations were: KRAS (n = 12, 21%), CDKN2A/B (n = 11, 20%), NRAS (n = 8, 14%), FANCA (n = 8, 14%), NF1 (n = 7, 13%) and BRAF (n = 6, 11%). Unexpectedly, pathogenetic BRCA1 (n = 2, 4%), BRCA2 (n = 1, 2%) and PALB2 (n = 1, 2%) mutations were found.CONCLUSIONS: MITO 22 suggests that LGSC is an heterogenous disease for both its clinical behavior in response to standard therapies and its molecular alterations. Future prospective studies should test treatments according to biological and molecular tumor's characteristics

Ponatinib alone or with chemo-immunotherapy in heavily pre-treated Philadelphia-like acute lymphoblastic leukemia: a CAMPUS ALL real-life study

Not available

Outcome of 421 adult patients with Philadelphia-negative acute lymphoblastic leukemia treated under an intensive program inspired by the GIMEMA LAL1913 clinical trial: a Campus ALL study

The introduction of pediatric-inspired regimens in adult Philadelphia-negative acute lymphoblastic leukemia (Ph-ALL) has significantly improved patients’ prognosis. Within the Campus ALL network we analyzed the outcome of adult Ph-ALL patients treated according to the GIMEMA LAL1913 protocol outside the clinical trial, to compare the real-life data with the study results. We included 421 consecutive patients, with a median age of 42 years. The complete remission (CR) rate after the first course of chemotherapy was 94% and a measurable residual disease (MRD) negativity after the third course was achieved in 72% of patients. The 3-year overall survival (OS) and disease-free survival (DFS) were 67% and 57%, respectively. In a multivariate analysis, MRD positivity negatively influenced DFS. In a time-dependent analysis including only very high risk (VHR) and MRD positive cases, transplanted (HSCT) patients had a significantly better DFS than non-HSCT ones (P=0.0017). During induction, grade ≥2 pegaspargase-related hepato-toxicity was observed in 25% of patients (vs 12% in the GIMEMA LAL1913 trial, P=0.0003). In this large real-life cohort of Ph-ALL, we confirmed the very high CR rate and a superimposable OS and DFS compared to the GIMEMA LAL1913 clinical trial: CR rate after C1 94% vs 85%, P=0.0004; 3-year OS 67% vs 67%, P=0.94; 3-year DFS 57% vs 63%, P=0.17. HSCT confirms its important role in VHR and MRD-positive patients. The rate of pegaspargase-related toxicity was significantly higher in the real-life setting, emphasizing the importance of dose adjustment in the presence of risk factors to avoid excessive toxicity

Monolithic integration of a silicon solar cell and a nanostructured thermoelectric generator

The possibility of enhancing the power conversion efficiency of a crystalline silicon solar cell by monolithic integration with a nanostructured thermoelectric generator(TEG) is carried out. It is well known that the cell efficiency degrades with increasing temperatures, mainly due to the temperature sensitivity of the open circuit voltage (Voc); the energy loss induced by the cell heating is unavoidable as the incident spectrum is characterized by photons with energy greater than the silicon energy band gap: the excited electrons fall back to the minimum of the conduction band by the process of thermalization, yielding the excess energy to the lattice phonons. By controlling the temperature of a bottom plate, a temperature gradient is generated across the silicon nanowires (SiNWs), previously formed on the rear face by means of the metal assisted chemical etching (MACE) technique. Thanks to the Seebeck effect, a voltage drop is present between the hot side, i.e. the heated cell, and the cold bottom plate. This voltage adds to the output voltage of the solar cell, mitigating the degrading effect of temperature on Voc. The advantage of the integrated approach lies in the fact that the nanostructured TEG adds no series resistance to the solar device, diffrently from an hybrid approach which couples the two individual subsystems, i.e. the photovoltaic cell and the TEG, by an external electrical series connection, hence, adding the series resistance of the TEG to the one of the solar cell. Following the integrated approach, the fill factor remains undisputed, without affecting the overall system PCE

ENYGO Teach the Teachers & Complications in Gyneacological Oncology workshop

Complicanze in ginecologia oncologi

Low-Cost, High-Yield Zinc Oxide-Based Nanostars for Alkaline Overall Water Splitting

The investigation of high-efficiency and sustainable electrocatalysts for hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) in alkaline media is critical for renewable energy technologies. Here, we report a low-cost and high-yield method to obtain ZnOHF-ZnO-based 2D nanostars (NSs) by means of chemical bath deposition (CBD). The obtained NSs, cast onto graphene paper substrates, were used as active materials for the development of a full water splitting cell. For the HER, NSs were decorated with an ultralow amount of Pt nanoparticles (11.2 μg cm -2), demonstrating an overpotential of 181 mV at a current density of 10 mA cm -2. The intrinsic activity of Pt was optimized, thanks to the ZnO supporting nanostructures, as outlined by the mass activity of Pt (0.9 mA mg -1) and its turnover frequency (0.27 s -1 for a Pt loading of 11.2 μg cm -2). For the OER, bare NSs showed a remarkable result of 355 mV at 10 mA cm -2 in alkaline media. Pt-decorated and bare NSs were used as the cathode and anode, respectively, for alkaline electrochemical water splitting, assessing a stable overpotential of 1.7 V at a current density of 10 mA cm -2. The reported data pave the way toward large-scale production of low-cost electrocatalysts for green hydrogen production