8 research outputs found
Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic
Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic
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Identification of Tissue-Resident Natural Killer and T Lymphocytes with Anti-Tumor Properties in Ascites of Ovarian Cancer Patients
Women with ovarian cancer have limited therapy options, with immunotherapy being unsatisfactory for a large group of patients. Tumor cells spread from the ovary or the fallopian tube into the abdominal cavity, which is commonly accompanied with massive ascites production. The ascites represents a unique peritoneal liquid tumor microenvironment with the presence of both tumor and immune cells, including cytotoxic lymphocytes. We characterized lymphocytes in ascites from patients with high-grade serous ovarian cancer. Our data reveal the presence of NK and CD8+ T lymphocytes expressing CD103 and CD49a, which are markers of tissue residency. Moreover, these cells express high levels of the inhibitory NKG2A receptor, with the highest expression level detected on tissue-resident NK cells. Lymphocytes with these features were also present at the primary tumor site. Functional assays showed that tissue-resident NK cells in ascites are highly responsive towards ovarian tumor cells. Similar results were observed in an in vivo mouse model, in which tissue-resident NK and CD8+ T cells were detected in the peritoneal fluid upon tumor growth. Together, our data reveal the presence of highly functional lymphocyte populations that may be targeted to improve immunotherapy for patients with ovarian cancer.This research was funded by a Research Award from the Wellbeing of Women (RG2331; F.C., E.B., J.B.), a Wellcome Investigator Award (094073/Z/10/Z; F.C.), the Cambridge NIHR BRC Cell Phenotyping Hub (F.C.), the Swedish cancer foundation society (20 0226 P 01 H; E.B. and CAN 2018/384; K.S.), the Swedish research council (2019-06328; E.B.), the Swedish Society for Medical Research (E.B.), the Swedish Society for Medicine (SLS-881711; E.B.), the Assar Gabrielsson founda- tion (BRG20-06; E.B.), Swedish state under the agreement between the Swedish government and the county council, the ALF agreement (ALFGBG-965552; K.S.), Italian Ministry of Health (Bando Ri- cerca Finalizzata PE-2016-02363915, D.M.), Associazione Italiana per la Ricerca sul Cancro (IG 14687; D.M.), Intramural research and clinical funding programs of Humanitas Research Hospital (5 X 1000; D.M.) and University of Milan (D.M.). O.H. was supported by a AstraZeneca-MedImmune- Cambridge PhD fellowship. V.C. is a recipient of a competitive fellowship awarded from the Ph.D. program of Experimental Medicine at the University of Milan
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Identification of Tissue-Resident Natural Killer and T Lymphocytes with Anti-Tumor Properties in Ascites of Ovarian Cancer Patients.
Peer reviewed: TrueFunder: Cambridge NIHR BRC Cell Phenotyping HubFunder: Swedish Society for Medical ResearchFunder: University of MilanFunder: AstraZeneca-MedImmune-Cambridge PhD fellowshipFunder: Experimental Medicine at the University of MilanFunder: Cancer Research UKFunder: Cancer Research UK Cambridge CentreFunder: Mark Foundation Institute for Integrated Cancer MedicineWomen with ovarian cancer have limited therapy options, with immunotherapy being unsatisfactory for a large group of patients. Tumor cells spread from the ovary or the fallopian tube into the abdominal cavity, which is commonly accompanied with massive ascites production. The ascites represents a unique peritoneal liquid tumor microenvironment with the presence of both tumor and immune cells, including cytotoxic lymphocytes. We characterized lymphocytes in ascites from patients with high-grade serous ovarian cancer. Our data reveal the presence of NK and CD8+ T lymphocytes expressing CD103 and CD49a, which are markers of tissue residency. Moreover, these cells express high levels of the inhibitory NKG2A receptor, with the highest expression level detected on tissue-resident NK cells. Lymphocytes with these features were also present at the primary tumor site. Functional assays showed that tissue-resident NK cells in ascites are highly responsive towards ovarian tumor cells. Similar results were observed in an in vivo mouse model, in which tissue-resident NK and CD8+ T cells were detected in the peritoneal fluid upon tumor growth. Together, our data reveal the presence of highly functional lymphocyte populations that may be targeted to improve immunotherapy for patients with ovarian cancer.This research was funded by a Research Award from the Wellbeing of Women (RG2331; F.C., E.B., J.B.), a Wellcome Investigator Award (094073/Z/10/Z; F.C.), the Cambridge NIHR BRC Cell Phenotyping Hub (F.C.), the Swedish cancer foundation society (20 0226 P 01 H; E.B. and CAN 2018/384; K.S.), the Swedish research council (2019-06328; E.B.), the Swedish Society for Medical Research (E.B.), the Swedish Society for Medicine (SLS-881711; E.B.), the Assar Gabrielsson founda- tion (BRG20-06; E.B.), Swedish state under the agreement between the Swedish government and the county council, the ALF agreement (ALFGBG-965552; K.S.), Italian Ministry of Health (Bando Ri- cerca Finalizzata PE-2016-02363915, D.M.), Associazione Italiana per la Ricerca sul Cancro (IG 14687; D.M.), Intramural research and clinical funding programs of Humanitas Research Hospital (5 X 1000; D.M.) and University of Milan (D.M.). O.H. was supported by a AstraZeneca-MedImmune- Cambridge PhD fellowship. V.C. is a recipient of a competitive fellowship awarded from the Ph.D. program of Experimental Medicine at the University of Milan
Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic
Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic