Diffuse large B-cell lymphoma in octogenarians aged 85 and older can benefit from treatment with curative intent: a report on 129 patients prospectively registered in the Elderly Project of the Fondazione Italiana Linfomi (FIL)

Octogenarian patients with diffuse large B-cell lymphoma are managed mainly with palliation, but recent improvement in their overall condition makes potentially curative treatment a possibility. Studies have shown that half of selected octogenarians may be cured using reduced-dose anthracycline chemoimmunotherapy. However, patients aged >85 (late octogenarians [LO]) were underrepresented, and selection criteria were poorly defined. We analyzed the clinical characteristics and outcomes of LO enrolled in the FIL Elderly Project in terms of the treatment received (palliative vs. curative) and of their simplified geriatric assessment (sGA), then compared them with early octogenarians (EO) aged 80-84 and with those aged 65-79 classified as UNFIT or FRAIL according to sGA enrolled in the same study. Of the 1,163 patients, 370 were >80 and 129 LO. Clinical characteristics were similar between LO and EO, but LO more frequently received palliation (50% vs. 23%; P=0.001) and had worse 2-year overall survival (OS) (48% vs. 63%; P=0.001) and 2-year progression-free survival (PFS) (43% vs. 56%; P=0.01). Patients receiving anthracycline did better than patients receiving palliation (P<0.001), without any difference between full or reduced doses. Rituximab within palliation improved outcome (2-yr OS with or without rituximab 42% vs. 22%; P=0.008). Elderly Prognostic Index (EPI) performed better than sGA in identifying different risk categories, and high-risk EPI retained an independent unfavorable effect on OS and PFS, together with treatment without anthracycline. In conclusion, late octogenarians can benefit from a curative approach with reduced-dose anthracycline and from rituximab within palliation. EPI may help in patient selection more than sGA can

THE ELDERLY PROGNOSTIC INDEX (EPI) PREDICTS EARLY MORTALITY IN OLDER PATIENTS WITH DLBCL. A SUBSTUDY OF THE ELDERLY PROJECT BY THE FONDAZIONE ITALIANA LINFOMI (FIL)

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Meaning of color in Chinese culture

Il significato del colore nell'architettura tradizionale cinese

Workflow for the identification and validation of microRNAs: the colorectal cancer experience

MicroRNAs are promising non invasive diagnostic biomarkers that can be easily detected in plasma. However, several factors, both pre-analytical and analytical, must be taken into account during the identification and validation of miRNA biomarkers.The workflow for the identification of a biomarker should start with a discovery phase, ideally based on high-throughput technologies to identify candidate biomarkers that will be further investigated in the subsequent validation phases[1].The discovery phase should also allow the setting-up of all the aspects of the pre-analytical phase of sample collection/processing and the pre-processing steps of the data, such as data normalization[2].During validation phase(s) the performance of the candidate biomarkers should be adequately explored using advanced statistical methodologies to identify powerful miRNA-based signatures[1]. Assay-oriented step(s) may be included in the workflow to set-up new assays easy transferable to the clinical setting. In this workflow the availability of stored material could be of help in the biomarker development pipeline. As part of the ongoing EDERA project (http://www.ederaproject.it) at Istituto Nazionale Tumori (INT), we applied the described workflow for the identification and validation of miRNAs for the early detection of colorectal cancer, using individuals positive to the fecal occult blood test as target population. The discovery phase was performed on retrospective plasma samples stored in our biobank; miRNAs profiling was done using the TaqMan\uae Array Human MicroRNA Card A (Applied Biosystems). The validation phase consisted of two phases based on plasma samples prospectively collected at INT and during a multi-centric study. [1]Verderio P,et al.BJC.2016.doi:10.1038/bjc.2016.164[in press] [2]Verderio P,et al.Anal Biochem.2014;461:7-