Attività della chemioterapia nel condrosarcoma mesenchimale: analisi retrospettiva di una casistica multicentrica di Italian Sarcoma Group

MCS is an ultra-rare sarcoma marked by the presence of HEY1-NCOA2 fusion and characterized by a poor prognosis in the advanced phase. Data on the activity of systemic agents in mesenchymal chondrosarcoma (MCS) are only retrospective and limited to case reports or small and heterogeneous series. They report a median progression-free survival (m-PFS) to anthracycline-based regimens of approximately 6 months, while a longer disease control was seen in the 3 patients (pts) from different series treated with trabectedin. This is to report on the results of an Italian, multicentric, retrospective study of the activity of cytotoxic chemotherapy in pts affected by MCS. Pts of any age with a centrally reviewed pathological diagnosis of MCS treated with anthracycline-based regimens and/or high-dose ifosfamide and/or trabectedin within the Italian Sarcoma Group centers between 2000 and 2022 were retrospectively reviewed. Response was assessed retrospectively by a dedicated radiologist of each participating center by RECIST v1.1. PFS and overall survival (OS) were estimated by Kaplan-Meier method. Duration of response (DoR) was calculated from the date of best response to the date of first evidence of progression for pts with complete response (CR) and partial response (PR). Our retrospective study confirmed that anthracycline-based regimens are active in MCS with a m-PFS of 7 months in the advanced phase. Trabectedin, although with no dimensional responses and in a small number of cases, obtained a prolonged disease control. On this basis, a confirmatory phase II single arm trial with trabectedin in mesenchymal chondrosarcoma is just started within the Italian Sarcoma Group

Causes and factors promoting the expansion of cardiovascular diseases in the Vologda Oblast (according to the research in epidemiology of cardiovascular disease)

The article focuses on the analysis of risk factors for cardiovascular diseases. The data of the research in epidemiology of cardiovascular disease (ESSE-2013), carried out in the Vologda Oblast, and the materials of the state statistics service comprise an information base. The ESSE-2013 questionnaire included several thematic blocks corresponding to the main factors influencing the development of cardiovascular diseases. The distribution of respondents’ answers reveals that there is a connection between cardiovascular diseases and effects of such factors as gender, age, heredity, and the body mass index. Of all the respondents who had infarction, 40% mention that their close relatives suffer from this disease as well. Of those who had a stroke, 30% have relatives with such a disease. The comparison of the respondents’ age and gender characteristics by the presence of cardiovascular diseases shows that men and women over 60 belong to the risk groups of such diseases as stroke, stenocardia and cardiac arrhythmia; the risk of heart attack is very high for men over 60; heart rhythm disorders – for women under 60. The study has not indicated a clear correlation between negative characteristics of lifestyles and risks for cardiovascular diseases. Thus, the research confirms the high importance of heredity and age and gender characteristics as risk factors for cardiovascular disease. At the same time, the impact of the lifestyle is not vivid. In this regard, it can be promising to monitor the impact of individual behavioral practices on risks for cardiovascular diseas

Safety and Tolerability of COVID-19 Vaccines in Patients with Cancer: A Single Center Retrospective Analysis

Background: Severe acute respiratory syndrome coronavirus 2 disease (COVID-19) has caused a worldwide challenging and threatening pandemic. Multinational, placebo-controlled, observer-blinded trials were conducted since the beginning of pandemic because safe and effective vaccines were needed urgently. In most trials of COVID-19 vaccines patients affected by malignancies or on treatment with immunosuppressive drugs were excluded. Patients and methods: A retrospective monocentric study was conducted at Medical Oncological Unit of Santa Chiara Hospital (Pisa, Italy) in this subset of population to investigate safety and tolerability of COVID-19 vaccines; 377 patients with solid tumor on treatment were enrolled. Vaccine-related adverse events were recorded using a face-to-face questionnaire including a toxicity grading scale. Most of the patients (94%) received mRNA vaccine as indicated by Italian health ministry guidelines. Mean age was 66 years (range 27–87), 62% of the patients were older than 65 years and 68% had at least one additional comorbidity. The majority (86%) of patients were in a metastatic setting and 29% received immunotherapy-based treatment. For statistical analysis, multivariate binary logistic regression models were performed and linear regression models were applied. Results: Adverse events were mild and transient and ended in a few days without any sequelae. No severe or uncommon adverse events were recorded. In multivariate analysis, we found that the female sex was associated with a greater risk of more severe and longer lasting adverse events, and a higher risk of adverse events was found for patients treated with immunotherapy. Conclusions: Our results demonstrate that COVID-19 vaccines were safe and well-tolerated in this population of patients being treated for solid tumors

Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study

BackgroundBRAF and MEK inhibitors target therapies (TT) and AntiPD1 immunotherapies (IT) are available first-line treatments for BRAF v600 mutant metastatic melanoma patients. ECOG PS (E), baseline LDH (L), and baseline number of metastatic sites (N) are well-known clinical prognostic markers that identify different prognostic categories of patients. Direct comparison between first-line TT and IT in different prognostic categories could help in first line treatment decision. MethodsThis is a retrospective analysis conducted in 14 Italian centers on about 454 metastatic melanoma patients, divided in 3 groups: group A-patients with E = 0, L within normal range, and N less than 3; group B-patients not included in group A or C; group C-patients with E > 0, L over the normal range, and N more than 3. For each prognostic group, we compared TT and IT in terms of progression free survival (PFS), overall survival (OS), and disease control rate (DCR). ResultsIn group A, results in 140 TT and 36 IT-treated patients were, respectively, median PFS 35.5 vs 11.6 months (HR (95% CI) 1.949 (1.180-3.217) p value 0.009); median OS not reached vs 55 months (HR (95% CI) 1.195 (0.602-2.373) p value 0.610); DCR 99% vs 75% p value <0.001). In group B, results in 196 TT and 38 IT-treated patients were, respectively, median PFS 11.5 vs 5 months (HR 1.535 (1.036-2.275) p value 0.033); median OS 19 vs 20 months (HR 0.886 (0.546-1.437) p value 0.623); DCR 85% vs 47% p value <0.001). In group C, results in 41 TT and 3 IT-treated patients were, respectively, median PFS 6.4 vs 1.8 months (HR 4.860 (1.399-16) p value 0.013); median OS 9 vs 5 months (HR 3.443 (0.991-11.9) p value 0.052); DCR 66% vs 33% p value 0.612). ConclusionsIn good prognosis, group A-TT showed statistically significant better PFS than IT, also in a long-term period, suggesting that TT can be a good first line option for this patient category. It is only in group B that we observed a crossing of the survival curves after the 3rd year of observation in favor of IT. Few patients were enrolled in group C, so few conclusions can be made on it