Fulvestrant and trastuzumab in patients with luminal HER2-positive advanced breast cancer (ABC): an Italian real-world experience (HERMIONE 9)

Purpose The most appropriate therapy for HR+/HER2-positive (HER2+) advanced breast cancer (ABC) is a matter of debate. Co-targeting of both receptors represents an attractive strategy to overcome the cross-talk between them. Methods The HERMIONE 9 is an observational retrospective multicentric study which aimed to describe the clinical outcome of patients with HR+/HER2+ABC who received the combination of Fulvestrant (F) and Trastuzumab (T) as part of their routine treatment at 10 Italian Institutions. Results Eighty-seven patients were included. Median age was 63 (range, 35–87) years. The median number of previous treatments was 3 (range, 0–10) and F and T were administered as≥3rd line in 67 patients. Among the 86 evaluable patients, 6 (6.9%) achieved CR, 18 (20.7%) PR, and 44 (50.6%) had SD ≥24 weeks with an overall CBR of 78.2%. At a median follow-up of 33.6 months, mPFS of the entire cohort was 12.9 months (range, 2.47–128.67). No diference was observed in mPFS between patients treated after progression or as maintenance therapy (mPFS 12.9 and 13.9 months in 64 and 23 patients, respectively), neither considering the number of previous treatment lines (≤3 or<3). Conclusion The combination of F and T was active in this cohort at poor prognosis and deserves further investigations possibly in combination with pertuzumab in patients with high ER expression

Psychosocial burden and professional and social support in patients with hereditary transthyretin amyloidosis (ATTRv) and their relatives in Italy

Hereditary transthyretin amyloidosis (hATTR), alias ATTR variant (ATTRv) is a severe and disabling disease causing sensory and motor neuropathy, autonomic dysfunction, and cardiomyopathy. The progressive decline of patient's functional autonomy negatively affects the patient's quality of life and requires increasing involvement of relatives in the patient's daily life. Family caregiving may become particularly demanding when the patient is no longer able to move independently. This study is focused on the psychosocial aspects of ATTRv from the patient and relative perspectives. In particular, it explored: the practical and psychological burdens experienced by symptomatic patients with ATTRv and their key relatives and the professional and social network support they may rely on; whether burden varied in relation to patients' and relatives' socio-demographic variables, patients' clinical variables, and perceived professional and social network support; and, any difference in burden and support between patients and their matched relatives

Efficacy and safety of T-DM1 in the 'common-practice' of HER2+ advanced breast cancer setting: a multicenter study

Ado-trastuzumab emtansine (T-DM1) is an antibody-drug conjugate approved for the treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive, metastatic breast cancer (mBC). The aim of this 'field-practice' study was to investigate the efficacy and safety of T-DM1, focusing on treatment line, previous lapatinib treatment and patterns of metastasis. Three hundred and three patients with HER2-positive mBC who received T-DM1 were identified by reviewing the medical records of 24 Italian Institutions. One hundred fourty-nine (49%) and 264 (87%) had received prior hormonal treatment and/or anti-HER2 targeted therapy, respectively. Particularly, 149 patients had been previously treated with lapatinib. The objective response rate (ORR) was 36.2%, and 44.5% when T-DM1 was administrated as second-line therapy. Considering only patients with liver metastases, the ORR was 44.4%. The median progression-free survival (PFS) was 7.0 months in the overall population, but it reached 9.0 and 12.0 months when TDM-1 was administered as second- and third-line treatment, respectively.In conclusion, in this 'real-word' study evaluating the effects of T-DM1 in patients with HER2-positive mBC who progressed on prior anti-HER2 therapies, we observed a clinically-relevant benefit in those who had received T-DM1 in early metastatic treatment-line and in subjects previously treated with lapatini

Changing the prehistory of Sindh and Las Bela coast: twenty-five years of Italian contribution

The paper discusses the prehistory of Lowr Sindh and Las Bela Coast, and the role played by the Italian archaeologists since the 1980's. New date are presented regarding mainly the radiocarbon chronology the Indus Delta settlement on rocky outcrops and the shell middens of Las Bela

Performance analysis of MWCNT/Epoxy composites produced by CRTM

In the present work, carbon fiber reinforced polymer laminates were manufactured by means of Compression Resin Transfer Molding using a commercial epoxy resin additivated with Multi Walled Carbon Nanotubes to impregnate a carbon fiber fabric. The weight loads of nanotubes investigated were equal to 0.5 and 1%. As a comparison, composite laminates were also obtained using the pristine resin. The same process parameters were used to manufactured additivated and unadditived composites. The presence of nanotube agglomerates and the filtering effect of the carbon fiber fabric during the resin flow into the mold were investigated by means of Dynamic Light Scattering and microscopic techniques. In addition, Differential Scanning Calorimetry was used to analyze the polymerization reaction and to measure both the glass transition temperature of nanoadditivated matrices and the apparent viscosity. Viscosity was measured through rheological analysis. Mechanical tests were carried out on samples obtained from additivated and unadditivated laminates. It was shown that the apparent viscosity of the additivated matrices tends to decrease as the shear rate increases, reaching values similar to those of the pristine resin at high shear rate. The polymerization reaction of the thermoset matrix is influenced by nanotubes, as well as the glass transition temperature which increases with nanotube weight load. The analysis of the laminates shows homogeneous dispersion of nanotubes, indicating that no filtering effect occurs. Finally, tensile and flexural tests show a reinforcement effect of nanotubes both on strength and stiffness of the composite

Performance analysis of MWCNT/Epoxy composites produced by CRTM

In the present work, carbon fiber reinforced polymer laminates were manufactured by means of Compression Resin Transfer Molding using a commercial epoxy resin additivated with Multi Walled Carbon Nanotubes to impregnate a carbon fiber fabric. The weight loads of nanotubes investigated were equal to 0.5 and 1%. As a comparison, composite laminates were also obtained using the pristine resin. The same process parameters were used to manufactured additivated and unadditived composites. The presence of nanotube agglomerates and the filtering effect of the carbon fiber fabric during the resin flow into the mold were investigated by means of Dynamic Light Scattering and microscopic techniques. In addition, Differential Scanning Calorimetry was used to analyze the polymerization reaction and to measure both the glass transition temperature of nanoadditivated matrices and the apparent viscosity. Viscosity was measured through rheological analysis. Mechanical tests were carried out on samples obtained from additivated and unadditivated laminates. It was shown that the apparent viscosity of the additivated matrices tends to decrease as the shear rate increases, reaching values similar to those of the pristine resin at high shear rate. The polymerization reaction of the thermoset matrix is influenced by nanotubes, as well as the glass transition temperature which increases with nanotube weight load. The analysis of the laminates shows homogeneous dispersion of nanotubes, indicating that no filtering effect occurs. Finally, tensile and flexural tests show a reinforcement effect of nanotubes both on strength and stiffness of the composite