Intervista ad Andrea Zanzotto

Lunga intervista rilasciata da A. Zanzotto a F. Carbognin e a G. Mott nel 200

Problematiche geoambientali del territorio veneziano

Venezia, la sua laguna ed il territorio circostante sono un patrimonio artistico, storico, culturale ed ambientale tra i più noti al mondo. Il fragile equilibrio, tipico delle lagune, è per Venezia particolarmente vulnerabile; essa infatti risulta modellata da un forte contributo antropico, iniziato secoli or sono con le note deviazioni fluviali, ed è oggi esposta ad azioni antropiche di particolare rilevanza, quali quelle derivanti dalla presenza della zona industriale di Marghera che s'affaccia proprio sulla laguna. Questo delicato equilibrio è legato al particolare assetto geologico-territoriale dell'area veneziana. In questa relazione, forzatamente molto schematica in quanto sintetizza decenni di studi ed indagini a livello sia scientifico che tecnico-applicativo, si vuole indicare l'insostituibile apporto della geologia anche in un'area urbana, quale quella Veneziana. Questo "complesso urbano" è composto da una serie di centri: insulari (centro storico, Murano, Burano, Torcello, ecc.), litorali (Lido, Chioggia, Jesolo), di terraferma ed industriali (Mestre, Scorzè, Marghera, Malcontenta, Fusina, ecc.). Altra caratteristica del complesso veneziano è l'interazione dei vari centri urbani che, malgrado la dislocazione geografica, interagiscono nelle varie problematiche geoambientali con strette relazioni causa-effetto. Questa nota, frutto della collaborazione tra Enti di Ricerca, Pubbliche Amministrazioni e Liberi Professionisti, evidenzia la necessità di lavorare in modo sinergico per affrontare al meglio le complesse tematiche geologico-ambientali che si riscontrano in questo tipo di studi

PO-502 A potential role for HSP90 in HER2-driven breast cancer (BC)

Introduction HER2 (amplified in 30% of BC) is involved in the activation of many pathways and its function is regulated by HSP90. Thus, HSP90 co-targeting is emerging as a potential molecular target for HER2-directed BC therapy. Material and methods We analysed HER2 and HSP90 expression in a panel of BC cell lines, including MCF7 cells stably transfected with a constitutively active HER2. HER2/HSP90 expression and growth inhibition were monitored over time upon exposure to trastuzumab (T) and docetaxel (D), in the presence or absence of HSP90 silencing. We also retrospectively evaluated a series of 24 locally advanced/operable BC patients (pts) who underwent neoadjuvant T+D for HSP90 expression and correlated it with pathological complete response (pCR). Results and discussions In the BC cell lines analysed there was no clear-cut correlation between HSP90 and HER2 expression. HER2 transfection into MCF7 cells increased HSP90 mRNA and protein expression; however, treatment with T further increased HSP90 levels. Conversely D increased HER2, but did not affect HSP90, expression. In HER2 +BC cell lines, simultaneous T+D combination resulted in synergistic growth inhibition in vitro , while their staggered combination, particularly T followed by D, did not afford synergistic effects. Effects of simultaneous and staggered treatments on HSP90 and HER2 expression were analysed by WB: HER2 expression decreased in the simultaneous and staggered combination (D followed by T), while HSP90 expression did not change upon combined treatment. The effects of HSP90 silencing and overexepression on functional response to T+D are being analysed in HER2 +BC models: preliminary results indicate that HSP90 silencing in HER2 +BC decreases the therapeutic synergism of the simultaneous T+D combination. Accordingly, in locally advanced/operable pts undergoing neoadjuvant T+D, pCR occurred more frequently in pts with a baseline HSP90 score of 3+, as compared to 2+and 1+ (50.0% vs. 14.3% vs. none, p=0.05). These results suggest the possibility to classify HER2-positive pts into HSP90 defined subgroups and elaborate specific therapeutic strategies. Conclusion Preclinical data indicate that constitutive HER2 activation induces HSP90 expression and HSP90 modulation influences the functional response to combined treatment. Baseline HSP90 expression may potentially represent a pre-requisite of pharmacological response in HER2-addicted BC

Incorporating weekly carboplatin in anthracycline and paclitaxel-containing neoadjuvant chemotherapy for triple-negative breast cancer: propensity-score matching analysis and TIL evaluation

Background The generation of data capturing the risk-benefit ratio of incorporating carboplatin (Cb) to neoadjuvant chemotherapy (NACT) for triple-negative breast cancer (TNBC) in a clinical practice setting is urgently needed. Tumour-infiltrating lymphocytes (TILs) have an established role in TNBC receiving NACT, however, the role of TIL dynamics under NACT exposure in patients receiving the current standard of care is largely uncharted. Methods Consecutive TNBC patients receiving anthracycline-taxane [A-T] +/- Cb NACT at three Institutions were enrolled. Stromal-TILs were evaluated on pre-NACT and residual disease (RD) specimens. In the clinical cohort, propensity-score-matching was used to control selection bias. Results In total, 247 patients were included (A-T = 40.5%, A-TCb = 59.5%). After propensity-score-matching, pCR was significantly higher for A-TCb vs A-T (51.9% vs 34.2%, multivariate: OR = 2.40, P = 0.01). No differences in grade >= 3 haematological toxicities were observed. TILs increased from baseline to RD in the overall population and across A-T/A-TCb subgroups. TIL increase from baseline to RD was positively and independently associated with distant disease-free survival (multivariate: HR = 0.43, P = 0.05). Conclusions We confirmed in a clinical practice setting of TNBC patients receiving A-T NACT that the incorporation of weekly Cb significantly improved pCR. In addition, A-T +/- Cb enhanced immune infiltration from baseline to RD. Finally, we reported a positive independent prognostic role of TIL increase after NACT exposure

a propensity score analysis exploring the impact of the addition of adjuvant chemotherapy act to hormone therapy aht in a multi center series of resected luminal early stage pure invasive lobular breast carcinoma ilc

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Real-world ANASTASE study of atezolizumab+nab-paclitaxel as first-line treatment of PD-L1-positive metastatic triple-negative breast cancer

The combination of atezolizumab and nab-paclitaxel is recommended in the EU as first-line treatment for PD-L1-positive metastatic triple-negative breast cancer (mTNBC), based on the results of phase III IMpassion130 trial. However, ‘real-world’ data on this combination are limited. The ANASTASE study (NCT05609903) collected data on atezolizumab plus nab-paclitaxel in PD-L1-positive mTNBC patients enrolled in the Italian Compassionate Use Program. A retrospective analysis was conducted in 29 Italian oncology centers among patients who completed at least one cycle of treatment. Data from 52 patients were gathered. Among them, 21.1% presented de novo stage IV; 78.8% previously received (neo)adjuvant treatment; 55.8% patients had only one site of metastasis; median number of treatment cycles was five (IQR: 3–8); objective response rate was 42.3% (95% CI: 28.9–55.7%). The median time-to-treatment discontinuation was 5 months (95% CI: 2.8–7.1); clinical benefit at 12 months was 45.8%. The median duration of response was 12.7 months (95% CI: 4.1–21.4). At a median follow-up of 20 months, the median progression-free survival was 6.3 months (95% CI: 3.9–8.7) and the median time to next treatment or death was 8.1 months (95% CI: 5.5–10.7). At 12 months and 24 months, the overall survival rates were 66.3% and 49.1%, respectively. The most common immune-related adverse events included rash (23.1%), hepatitis (11.5%), thyroiditis (11.5%) and pneumonia (9.6%). Within the ANASTASE study, patients with PD-L1-positive mTNBC treated with first-line atezolizumab plus nab-paclitaxel achieved PFS and ORR similar to those reported in the IMpassion130 study, with no unexpected adverse events

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

We analyzed data from 738 HER2\u2010positive metastatic breast cancer (mbc) patients treated with pertuzumab\u2010based regimens and/or T\u2010DM1 at 45 Italian centers. Outcomes were explored in relation to tumor subtype assessed by immunohistochemistry (IHC). The median progression free survival at first\u2010line (mPFS1) was 12 months. Pertuzumab as first\u2010line conferred longer mPFS1 compared to other first\u2010line treatments (16 vs 9 months, p=0.0001), regardless of IHC subtype. Median PFS in second\u2010line (mPFS2) was 7 months, with no difference by IHC subtype, but it was more favorable with T\u2010DM1 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\u2010negative 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\u2010DM1 in second\u2010line following pertuzumab were significantly lower compared to pertuzumab\u2010na\uefve 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\u2010related outcomes of HER2\u2010positive 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 (ER) pathways in HER2\u2010positive (mbc) patients

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]