Identifying and managing CAR T-cell-mediated toxicities: on behalf of an Italian CAR-T multidisciplinary team.

INTRODUCTION: Chimeric antigen receptor (CAR)-T-cell therapy is a new treatment for patients with hematologic malignancies in which other therapies have failed. AREAS COVERED: The review provides an overview for recognizing and managing the most acute toxicities related to CAR-T cells. EXPERT OPINION: The development of immune-mediated toxicities is a common challenge of CAR-T therapy. The mechanism that determines this toxicity is still unclear, although an unfavorable tumor microenvironment and a pro-inflammatory state put patients at risk. The monitoring, diagnosis, and treatment of post-CAR-T toxicities must be determined and based on international guidelines and internal clinical practice. It is urgent to identify biomarkers that can identify patients at greater risk of developing complications. The adoption of consistent grading criteria is necessary to improve toxicity management strategies continually. The first-line therapy consists of supportive care and treatment with tocilizumab or corticosteroids. An early start of cytokine blockade therapies could mitigate toxicity. The plan will include cytokine release prophylaxis, a risk-adapted treatment, prevention of on-target/off-tumor effect, and a switch on/off CAR-T approach.

Advanced diagnostic plan applied to the Royal Villa in Naples.

To achieve adequate restoration project, the moment of choice of the type of intervention is a very delicate phase that necessarily involves a thorough understanding of the asset in all its aspects, as the location, the history, the architecture, the state of preservation, the pathologies causing the degradation, the degradation in itself, the analysis of constituent materials. The set of all that can be investigated on a product (cultural), to obtaining important information for subsequent maintenance, conservation and/or restoration actions, is what is called a diagnostic plan. In this case it was applied directly on a monument of national importance: the Royal Villa in Naples (today the Municipal Villa). The analysis were performed in situ and in the laboratory (SEM-EDS) on samples taken directly at the Villa, which allowed the creation of a series of analytical cards, containing digital data, required for the selection of expense future of intervention.

The roman thermal complex from Curinga (Calabria - Italy).

Since ancient times, the Calabrian territories were affected continuously and in different dominations: first Magna Greece civilisation and after the Roman domination. The latter influenced strongly some areas of the Calabrian territory, where we witnessed a gradual replacement of small farmer properties with plants of the first Roman villas. An example of Roman thermal plant was in the city of Curinga (CZ), where in 1966 were found the remains of a thermal building dating to late-Roman period, probably a part of a much more complex structure identifiable as a large Roman villa. In this context are exposed the results of a first scientific aim to study the thermal complex of Curinga, with the development of a specific diagnosis protocol and its next application to the artefact itself, to get a general but exhaustive survey of its conditions, its conservation and degradation state, essential for the execution of future maintenance projects.