advanced intrahepatic cholangiocarcinoma icca treated with arterial directed therapies adt outcomes and safety from a multicenter italian experience

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predicting her2 status in esophagogastric cancer development and validation of an easy to use nomogram

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The SAFFO Study: Sex-Related Prognostic Role and Cut-Off Definition of Monocyte-to-Lymphocyte Ratio (MLR) in Metastatic Colorectal Cancer

Background: Emerging data suggest that gender-related immune system composition affects both immune response and efficacy of immunotherapy in cancer patients (pts). This study aimed to investigate the sex-related prognostic role of MLR in metastatic colorectal cancer (mCRC) pts. Methods: We analyzed a retrospective consecutive cohort of 490 mCRC patients treated from 2009 to 2018 at the Oncology Departments of Aviano and Pordenone (training set) and Udine (validation set), Italy. The prognostic impact of MLR on overall survival (OS) was evaluated with uni- and multivariable Cox regression models. The best cut-off value to predict survival was defined through ROC analyses. Results: Overall, we identified 288 males (59%) and 202 females (41%); 161 patients (33%) had a right-sided, 202 (42%) a left-sided primary, and 122 (25%) a rectal tumor. Interestingly, gender was associated with MLR (p = 0.004) and sidedness (p = 0.006). The obtained cut-off value for MLR in females and males was 0.27 and 0.49, respectively. According to univariate analysis of the training set, MLR (HR 9.07, p ≤ 0.001), MLR > 0.27 in females (HR 1.95, p = 0.003), and MLR > 0.49 in males (HR 2.65, p = 0.010) were associated with poorer OS, which was also confirmed in the validation set. In multivariate analysis, MLR > 0.27 in females (HR 2.77, p = 0.002), MLR > 0.49 in males (HR 5.39, p ≤ 0.001), BRAF mutation (HR 3.38, p ≤ 0.001), and peritoneal metastases (HR 2.50, p = 0.003) were still independently associated with worse OS. Conclusions: Males and females have a different immune response. Our study showed that high MLR, both in males and females, is an unfavorable Independent prognostic factor. Further prospective studies are needed to confirm these data

folfoxiri plus bevacizumab bev followed by maintenance with bev alone or bev plus metronomic chemotherapy metroct in mcrc final results of the phase ii randomized moma trial by gono

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Drug holidays and overall survival of patients with metastatic colorectal cancer

Different de-escalation strategies have been proposed to limit the risk of cumulative toxicity and guarantee quality of life during the treatment trajectory of patients with metastatic colorectal cancer (mCRC). Programmed treatment interruptions, defined as drug holidays (DHs), have been implemented in clinical practice. We evaluated the association between DHs and overall survival (OS). This was a retrospective study, conducted at the University Hospital of Udine and the IRCCS CRO of Aviano. We retrieved records of 608 consecutive patients treated for mCRC from 1 January 2005 to 15 March 2017 and evaluated the impact of different de-escalation strategies (maintenance, DHs, or both) on OS through uni-and multivariate Cox regression analyses. We also looked at attrition rates across treatment lines according to the chosen strategy. In our study, 19.24% of patients received maintenance therapy, 16.12% DHs, and 9.87% both, while 32.07% continued full-intensity first-line treatment up to progression or death. In uni-and multivariate analyses first-line continuous treatment and early discontinuation (treatment for less than 3 months) were associated to worse OS compared to non-continuous strategies (HR, 1.68; 95% CI, 1.22\u20132.32; p = 0.002 and HR,4.89; 95% CI, 3.33\u20137.19; p < 0.001, respectively). Attrition rates were 22.8%, 20.61%, and 19.64% for maintenance, DHs, or both, respectively. For continuous therapy and for treatment of less than 3 months it was 21.57% and 49%. De-escalation strategies are safe and effective options. DHs after initial induction chemotherapy may be considered in clinically selected patients with metastatic colorectal cancer

Milk yield estimation during suckling using the double oxytocin injection-milking and the double weighing-suckling methods in dairy goats

The aim was to verify the validity of the double oxytocin-milking (DOT) method as milk yield estimator during the suckling period of lactating dairy goats. To this end, it was necessary to determine whether the weighing suckling weighing (WSW) and DOT methods of milk yield estimation satisfied the criteria to be considered valuable, the accuracy between both methods and the suitability of DOT to evaluate actual milk. At parturition, sixty lactating Murciano Granadina breed goats were separated into 2 groups, in mixed (MS; n = 24) and artificial rearing (ARS; n = 36) management systems. Until the sixth week of lactation (weaning), MS goats suckled one kid while kids from ARS goats were artificially reared; moreover, goats in both systems were submitted to once-a-day milking. Once per week, actual milk yield for ARS goats and potential milk yield were recorded using DOT method for all goats, except for 12 goats in ARS which remained as a control. Twelve goats from each management system were used to evaluate diurnal variation in milk production (DVM) by DOT method for 6 consecutive days in week 4 of lactation. No difference in DVM was found by DOT method in 4-h milk production of goats in MS (P = 0.099) or ARS (P = 0.220), which allowed sixfold multiplication of milked milk volume to obtain potential milk per day. ARS goats subjected to a weekly DOT and control group goats showed a similar (P = 0.379) lactation curve for the first 6 weeks of lactation. The DOT method slightly overestimated (3.4%, P = 0.005) the milk yield evaluated by WSW method for goats under an MS, but fitted the actual milk obtained by common milk records for the group of goats in an ARS submitted to the DVM test (P = 0.357) and the group in ARS alone (P = 0.163). The DOT method applied for 8 consecutive days led to a drop of 6 12% in milk yield during the following week for both production systems. In conclusion, DOT was an accurate method to estimate milk yield during the first weeks of lactation both in MS and ARS under the conditions of this experiment. © 2013 Elsevier B.V. All rights reserved.Fernández Martínez, N.; Balasch Parisi, S.; Pérez Baena, I.; Rodríguez Garcia, M.; Peris Ribera, CJ. (2013). Milk yield estimation during suckling using the double oxytocin injection-milking and the double weighing-suckling methods in dairy goats. Small Ruminant Research. 112(1-3):181-185. doi:10.1016/j.smallrumres.2012.12.023S1811851121-

Guideline Application in Real world: multi-Institutional Based survey of Adjuvant and first-Line pancreatic Ductal adenocarcinoma treatment in Italy. Primary analysis of the GARIBALDI survey

Background: Information about the adherence to scientific societies guidelines in the ‘real-world’ therapeutic management of oncological patients are lacking. This multicenter, prospective survey was aimed to improve the knowledge relative to 2017-2018 recommendations of the Italian Association of Medical Oncology (AIOM). Patients and methods: Treatment-naive adult patients with pancreatic adenocarcinoma were enrolled. Group A received adjuvant therapy, group B received primary chemotherapy, and group C had metastatic disease. The results on patients accrued until 31 October 2019 with a mature follow-up were presented. Results: Since July 2017, 833 eligible patients of 923 (90%) were enrolled in 44 Italian centers. The median age was 69 years (range 36-89 years; 24% &gt;75 years); 48% were female; 93% had Eastern Cooperative Oncology Group (ECOG) performance status (PS) score of 0 or 1; group A: 16%, group B: 30%; group C: 54%; 72% Nord, 13% Center, 15% South. In group A, guidelines adherence was 68% [95% confidence interval (CI) 59% to 76%]; 53% of patients received gemcitabine and 15% gemcitabine þ capecitabine; median CA19.9 was 29 (range 0-7300; not reported 15%); median survival was 36.4 months (95% CI 27.5-47.3 months). In group B, guidelines adherence was 96% (95% CI 92% to 98%); 55% of patients received nab-paclitaxel þ gemcitabine, 27% FOLFIRINOX, 12% gemcitabine, and 3% clinical trial; median CA19.9 was 337 (range 0-20220; not reported 9%); median survival was 18.1 months (95% CI 15.6-19.9 months). In group C, guidelines adherence was 96% (95% CI 94% to 98%); 71% of patients received nabpaclitaxel þ gemcitabine, 16% gemcitabine, 8% FOLFIRINOX, and 4% clinical trial; liver and lung metastases were reported in 76% and 23% of patients, respectively; median CA19.9 value was 760 (range 0-1374500; not reported 9%); median survival was 10.0 months (95% CI 9.1-11.1 months). Conclusions: The GARIBALDI survey shows a very high rate of adherence to guidelines and survival outcome in line with the literature. CA19.9 testing should be enhanced; nutritional and psychological counseling represent an unmet need. Enrollment to assess adherence to updated AIOM guidelines is ongoing