7 research outputs found
Successful treatment of gemcitabine-induced acute interstitial pneumonia with imatinib mesylate: A case report
Pursuit of Gene Fusions in Daily Practice: Evidence from Real-World Data in Wild-Type and Microsatellite Instable Patients
Agnostic biomarkers such as gene fusions allow to address cancer patients to targeted therapies; however, the low prevalence of these alterations across common malignancies poses challenges and needs a feasible and sensitive diagnostic process. RNA-based targeted next generation sequencing was performed on 125 samples of patients affected either by colorectal carcinoma, melanoma, or lung adenocarcinoma lacking genetic alterations in canonical driver genes, or by a colorectal carcinoma with microsatellite instability. Gene fusion rates were compared with in silico data from MSKCC datasets. For NTRK gene fusion detection we also employed a multitarget qRT-PCR and pan-TRK immunohistochemistry. Gene fusions were detected in 7/55 microsatellite instable colorectal carcinomas (12.73%), and in 4/70 of the âgene driver freeâ population (5.71%: 3/28 melanomas, 10.7%, and 1/12 lung adenocarcinomas, 8.3%). Fusion rates were significantly higher compared with the microsatellite stable and âgene driver positiveâ MSKCC cohorts. Pan-TRK immunohistochemistry showed 100% sensitivity, 91.7% specificity, and the occurrence of heterogeneous and/or subtle staining patterns. The enrichment of gene fusions in this âreal-worldâ cohort highlights the feasibility of a workflow applicable in clinical practice. The heterogeneous expression in NTRK fusion positive tumours unveils challenging patterns to recognize and raises questions on the effective translation of the chimeric protein
Assessing the role of colonic and other anatomical sites uptake by [18F]FDGâPET/CT and immuneâinflammatory peripheral blood indexes in patients with advanced nonâsmall cell lung cancer treated with firstâline immune checkpoint inhibitors
Abstract Background Inflammation in nonâsmall cell lung cancer (NSCLC) may impair the response to immune checkpoint inhibitors (ICIs) and can be indicated by peripheral blood inflammatory indexes. 2âdeoxyâ2â[18F]fluoroâDâglucose positron emission tomography/computed tomography ([18F] FDGâPET/CT) may be used as a marker of inflammation by measuring glucose metabolism in different colonic sites. Methods This retrospective analysis aimed to investigate the correlation between [18F] FDGPET/CT SUVratio in six gastrointestinal districts, the spleen, the pharynx and the larynx alongside the most avid tumor lesion with peripheral blood inflammatory indexes, including the neutrophilâtoâlymphocyte ratio (NLR), systemic immuneâinflammatory index (SII, i.e., NLR times platelets) and lactate dehydrogenase (LDH), in patients with [18F] FDGâPET/CT staged IV NSCLC who received firstâline immune checkpoint inhibitors (ICIs). The role of SUVratios and peripheral blood inflammatory indexes in predicting overall survival (OS) and progressionâfree survival (PFS) was then explored. Results A total of 43 patients were treated with firstâline ICI alone (58%) or in combination with chemotherapy (42%). A significant correlation was only found between the rectosigmoid SUVratio and NLR (pâ=â0.0465). NLRâ>5.5 and LDHâ>â333.5 were associated with a worse OS (pâ=â0.033 and pâ=â0.009, respectively). The SII was associated with a worse PFS in patients treated with ICI alone (pâ=â0.033). None of the SUVratios were significantly associated with OS or PFS, although a high left colon SUVratio showed a trend toward a worse PFS. Conclusion There was no significant correlation between [18F]FDG PET/CT uptake in different anatomical sites, and in the tumor, and systemic immuneâinflammatory indexes. The prognostic role of high left colon SUVratio deserves further investigation
International Survey on Frailty Assessment in Patients with Cancer
BACKGROUND: Frailty negatively affects the outcomes of patients with cancer, and its assessment might vary widely in the real world. The objective of this study was to explore awareness and use of frailty screening tools among the ONCOassist healthcare professionals (HCPs) users. MATERIALS AND METHODS: We sent 2 emails with a cross-sectional 15-item survey in a 3-week interval between April and May 2021. Differences in the awareness and use of tools according to respondentsâ continents, country income, and job types were investigated. RESULTS: Seven hundred thirty-seven HCPs from 91 countries (81% physicians, 13% nurses, and 5% other HCPs) completed the survey. Three hundred and eighty-five (52%) reported assessing all or the majority of their patients; 518 (70%) at baseline and before starting a new treatment. Three hundred and four (43%) HCPs were aware of performance status (PS) scores only, 309 (42%) age/frailty/comorbidity (AFC) screening, and 102 (14%) chemotoxicity predictive tools. Five hundred and thirty-seven (73%) reported using tools; 423 (57%) just PS, 237 (32%) AFC, and 60 (8%) chemotoxicity ones. Reasons for tools non-use (485 responders) were awareness (70%), time constraints (28%), and uselessness (2%). There were significant differences in awareness and use of screening tools among different continents, country income, job types, and medical specialties (P < .001 for all comparisons). CONCLUSION: Among selected oncology HCPs, there is still a worldwide lack of knowledge and usage of frailty screening tools, which may differ according to their geography, country income, and education. Targeted initiatives to raise awareness and education are needed to implement frailty assessment in managing patients with cancer