Chromogranin A: From Laboratory to Clinical Aspects of Patients with Neuroendocrine Tumors

Background. Neuroendocrine tumors (NETs) are characterized by having behavior and prognosis that depend upon tumor histology, primary site, staging, and proliferative index. The symptoms associated with carcinoid syndrome and vasoactive intestinal peptide tumors are treated with octreotide acetate. The PROMID trial assesses the effect of octreotide LAR on the tumor growth in patients with well-differentiated metastatic midgut NETs. The CLARINET trial evaluates the effects of lanreotide in patients with nonfunctional, well-, or moderately differentiated metastatic enteropancreatic NETs. Everolimus has been approved for the treatment of advanced pancreatic NETs (pNETs) based on positive PFS effects, obtained in the treated group. Sunitinib is approved for the treatment of patients with progressive gastrointestinal stromal tumor or intolerance to imatinib, because a randomized study demonstrated that it improves PFS and overall survival in patients with advanced well-differentiated pNETs. In a phase II trial, pasireotide shows efficacy and tolerability in the treatment of patients with advanced NETs, whose symptoms of carcinoid syndrome were resistant to octreotide LAR. An open-label, phase II trial assesses the clinical activity of long-acting repeatable pasireotide in treatment-naive patients with metastatic grade 1 or 2 NETs. Even if the growth of the neoplasm was significantly inhibited, it is still unclear whether its antiproliferative action is greater than that of octreotide and lanreotide. Because new therapeutic options are needed to counter the natural behavior of neuroendocrine tumors, it would also be useful to have a biochemical marker that can be addressed better in the management of these patients. Chromogranin A is currently the most useful biomarker to establish diagnosis and has some utility in predicting disease recurrence, outcome, and efficacy of therapy

Benchmarking dell'offerta di trasporto delle regioni del Mediterraneo occidentale. Il ruolo della Regione Piemotne. Synthèse du Rapport

Quaderni d'Europa ; n.4- Indice #9- Premessa #13- Il Mediterraneo nelle rappresentazioni e nelle politiche #15- Il Mediterraneo occidentale #22- Il benchmarking dei trasporti #41- Il posizionamento e gli scenari del sistema dei trasporti e della logistica retroportuale del Piemonte #104- Riferimenti bibliografici #133- Les images de la Méditerranée #15- Le rôle des territoires portuaires et d'arrière-port #26- La méthodologie #40- L'offre de transport et de la logistique d'arrière-port #46- L'accessibilité #59- L'impact social et environnemental #61- L'activation économique #65- Le positionnement du Piémont #74- Offre de transport et logistique d'arrière-port #76- Accessibilité intra- et inter-régionale #79- Développement durable social et impact environnemental #81- Activation et caractérisation économique #83- Bibliographie #13

Benchmarking dell'offerta di trasporto delle regioni dello spazio alpino. Il ruolo della Regione Piemonte

Quaderni d'Europa ; n.1- Premessa #3- Indice #5- Introduzione #7- La percezione dello Spazio alpino #9- Dentro lo Spazio alpino #13- Il benchmarking dei trasporti #25- Il posizionamento e gli scenari del sistema dei trasporti del Piemonte #67- Allegati: dati ed elaborazioni #81- Riferimenti bibliografici #9

Classificazione della marginalità dei piccoli comuni del Piemonte 2009

Contributi di ricerca ; n.235/2009- Indice #6- Introduzione #8- I piccoli comuni del Piemonte #10- Marginalità socioeconomica #18- I risultati dell'analisi #30- Allegati #4

Classificazione della marginalità dei piccoli comuni del Piemonte 2008

Strumentires ; 12- Indice #3- Introduzione #9- I piccoli comuni del Piemonte #11- La marginalità socioeconomica #16- I risultati dell'analisi #32- Appendici #4

Da margine a centro. Verso un modello di governance per Corona Verde

Da margine a centro. Verso un modello di governance per Corona Verde- Indice #6- Parte 1. Obiettivi e presupposti teorici #12- Parte 2. Le analisi e il confronto con gli stakeholders #26- Parte 3. Dalle analisi ai modelli di governance #50- Parte 4. Le proposte operative #5

Radioresistance in rhabdomyosarcomas: Much more than a question of dose

Management of rhabdomyosarcoma (RMS), the most common soft tissue sarcoma in children, frequently accounting the genitourinary tract is complex and requires a multimodal therapy. In particular, as a consequence of the advancement in dose conformity technology, radiation therapy (RT) has now become the standard therapeutic option for patients with RMS. In the clinical practice, dose and timing of RT are adjusted on the basis of patients' risk stratification to reduce late toxicity and side effects on normal tissues. However, despite the substantial improvement in cure rates, local failure and recurrence frequently occur. In this review, we summarize the general principles of the treatment of RMS, focusing on RT, and the main molecular pathways and specific proteins involved into radioresistance in RMS tumors. Specifically, we focused on DNA damage/repair, reactive oxygen species, cancer stem cells, and epigenetic modifications that have been reported in the context of RMS neoplasia in both in vitro and in vivo studies. The precise elucidation of the radioresistance-related molecular mechanisms is of pivotal importance to set up new more effective and tolerable combined therapeutic approaches that can radiosensitize cancer cells to finally ameliorate the overall survival of patients with RMS, especially for the most aggressive subtypes