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1.
ESMO Open ; 8(6): 102062, 2023 Dec.
Article En | MEDLINE | ID: mdl-38070434

Cancer management has significantly evolved in recent years, focusing on a multidisciplinary team approach to provide the best possible patient care and address the various comorbidities, toxicities, and complications that may arise during the patient's treatment journey. The co-occurrence of diabetes and cancer presents a significant challenge for health care professionals worldwide. Management of these conditions requires a holistic approach to improve patients' overall health, treatment outcomes, and quality of life, preventing diabetes complications and cancer treatment side-effects. In this article, a multidisciplinary panel of experts from different Italian scientific societies provide a critical overview of the co-management of cancer and diabetes, with an increasing focus on identifying a novel specialty field, 'diabeto-oncology', and suggest new co-management models of cancer patients with diabetes to improve their care. To better support cancer patients with diabetes and ensure high levels of coordinated care between oncologists and diabetologists, 'diabeto-oncology' could represent a new specialized field that combines specific expertise, skills, and training.


Diabetes Mellitus , Neoplasms , Humans , Quality of Life , Consensus , Neoplasms/complications , Neoplasms/epidemiology , Neoplasms/therapy , Medical Oncology , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Italy/epidemiology
2.
ESMO Open ; 8(3): 101573, 2023 Jun.
Article En | MEDLINE | ID: mdl-37263082

Increasing evidence suggests that patients with diabetes, particularly type 2 diabetes (T2D), are characterized by an increased risk of developing different types of cancer, so cancer could be proposed as a new T2D-related complication. On the other hand, cancer may also increase the risk of developing new-onset diabetes, mainly caused by anticancer therapies. Hyperinsulinemia, hyperglycemia, and chronic inflammation typical of T2D could represent possible mechanisms involved in cancer development in diabetic patients. MicroRNAs (miRNAs) are a subset of non-coding RNAs, ⁓22 nucleotides in length, which control the post-transcriptional regulation of gene expression through both translational repression and messenger RNA degradation. Of note, miRNAs have multiple target genes and alteration of their expression has been reported in multiple diseases, including T2D and cancer. Accordingly, specific miRNA-regulated pathways are involved in the pathogenesis of both conditions. In this review, a panel of experts from the Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE), and Italian Society of Pharmacology (SIF) provide a critical view of the evidence about the involvement of miRNAs in the pathophysiology of both T2D and cancer, trying to identify the shared miRNA signature and pathways able to explain the strong correlation between the two conditions, as well as to envision new common pharmacological approaches.


Diabetes Mellitus, Type 2 , MicroRNAs , Neoplasms , Humans , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/genetics , Diabetes Mellitus, Type 2/physiopathology , Diabetes Mellitus, Type 2/therapy , Neoplasms/complications , Neoplasms/genetics , Neoplasms/therapy , MicroRNAs/genetics , MicroRNAs/metabolism , Insulin-Secreting Cells/pathology , Insulin Resistance/genetics , Molecular Targeted Therapy/trends
3.
ESMO Open ; 6(3): 100153, 2021 06.
Article En | MEDLINE | ID: mdl-33984679

Most anticancer molecules are administered in body-size-based dosing schedules, bringing up unsolved issues regarding pharmacokinetic data in heavy patients. The worldwide spread of obesity has not been matched by improved methods and strategies for tailored drug dosage in this population. The weight or body surface area (BSA)-based approaches may fail to fully reflect the complexity of the anthropometric features besides obesity in cancer patients suffering from sarcopenia. Likewise, there is a lack of pharmacokinetic data on obese patients for the majority of chemotherapeutic agents as well as for new target drugs and immunotherapy. Therefore, although the available findings point to the role of dose intensity in cancer treatment, and support full weight-based dosing, empirical dose capping often occurs in clinical practice in order to avoid toxicity. Thus a panel of experts of the Associazione Italiana Oncologia Medica (AIOM), Associazione Medici Diabetologi (AMD), Società Italiana Endocrinologia (SIE), and Società Italiana Farmacologia (SIF), provides here a consensus statement for appropriate cytotoxic chemotherapy and new biological cancer drug dosing in obese patients.


Antineoplastic Agents , Neoplasms , Physicians , Consensus , Humans , Neoplasms/complications , Neoplasms/drug therapy , Obesity/complications
4.
ESMO Open ; 6(3): 100155, 2021 06.
Article En | MEDLINE | ID: mdl-34020401

Pancreatic cancer (PC) is a common cause of cancer-related death, due to difficulties in detecting early-stage disease, to its aggressive behaviour, and to poor response to systemic therapy. Therefore, developing strategies for early diagnosis of resectable PC is critical for improving survival. Diabetes mellitus is another major public health problem worldwide. Furthermore, diabetes can represent both a risk factor and a consequence of PC: nowadays, the relationship between these two diseases is considered a high priority for research. New-onset diabetes can be an early manifestation of PC, especially in a thin adult without a family history of diabetes. However, even if targeted screening for patients at higher risk of PC could be a promising approach, this is not recommended in asymptomatic adults with new-onset diabetes, due to the much higher incidence of hyperglycaemia than PC and to the lack of a safe and affordable PC screening test. Prompted by a well-established and productive multidisciplinary cooperation, the Italian Association of Medical Oncology (AIOM), the Italian Medical Diabetologists Association (AMD), the Italian Society of Endocrinology (SIE), and the Italian Society of Pharmacology (SIF) here review available evidence on the mechanisms linking diabetes and PC, addressing the feasibility of screening for early PC in patients with diabetes, and sharing a set of update statements with the aim of providing a state-of-the-art overview and a decision aid tool for daily clinical practice.


Diabetes Mellitus , Pancreatic Neoplasms , Physicians , Consensus , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Humans , Medical Oncology , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/epidemiology
5.
Nat Prod Res ; 21(13): 1145-50, 2007 Nov.
Article En | MEDLINE | ID: mdl-17987493

The chemical composition of the volatile concentrate obtained by supercritical CO2 extraction of aerial parts of Crithmum maritimum L. growing spontaneously in one area of Mediterranean coast (Buggerru, Sardinia Island, Italy) and in two areas of the Atlantic coast (Figueira da Foz and S. Pedro de Moel, Portugal) was investigated by GC and GC-MS. The major oil components identified were p-cymene, beta-phellandrene, gamma-terpinene, thymol methyl ether and dillapiole. The results showed the presence of two chemotypes of C. maritimum with different dillapiole contents, ranging from 0.2 to 64.2% in Portuguese and Italian plants, respectively. The minimal inhibitory concentration (MIC) and the minimal lethal concentration (MLC) were used to evaluate the antifungal activity of the oils against yeasts and dermatophyte strains. All the oils exhibited significant antifungal activity against dermatophyte strains. The oil with the higher amount of dillapiole (64.2%) was the most active with MIC values ranging from 0.08-0.32 microL mL(-1).


Apiaceae/chemistry , Oils, Volatile/isolation & purification , Allyl Compounds/isolation & purification , Allyl Compounds/pharmacology , Antifungal Agents/isolation & purification , Antifungal Agents/pharmacology , Carbon Dioxide/chemistry , Chromatography, Supercritical Fluid/methods , Dioxoles/isolation & purification , Dioxoles/pharmacology , Microbial Sensitivity Tests , Mitosporic Fungi/drug effects , Oils, Volatile/pharmacology , Plant Leaves/chemistry
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