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1.
J Endocrinol Invest ; 2024 Jun 27.
Article in English | MEDLINE | ID: mdl-38935200

ABSTRACT

BACKGROUND:  Increasing evidence suggests that diabetes increases the risk of developing different types of cancer. Hyperinsulinemia, hyperglycemia and chronic inflammation, characteristic of diabetes, could represent possible mechanisms involved in cancer development in diabetic patients. At the same time, cancer increases the risk of developing new-onset diabetes, mainly caused by the use of specific anticancer therapies. Of note, diabetes has been associated with a ∼10% increase in mortality for all cancers in comparison with subjects who did not have diabetes. Diabetes is associated with a worse prognosis in patients with cancer, and more recent findings suggest a key role for poor glycemic control in this regard. Nevertheless, the association between glycemic control and cancer outcomes in oncologic patients with diabetes remains unsettled and poorly debated. PURPOSE:  The current review seeks to summarize the available evidence on the effect of glycemic control on cancer outcomes, as well as on the possibility that timely treatment of hyperglycemia and improved glycemic control in patients with cancer and diabetes may favorably affect cancer outcomes.

2.
ESMO Open ; 8(6): 102062, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38070434

ABSTRACT

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.


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

ABSTRACT

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.


Subject(s)
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
4.
ESMO Open ; 6(2): 100100, 2021 04.
Article in English | MEDLINE | ID: mdl-33819751

ABSTRACT

High mortality rates in elderly patients or in those with underlying chronic illnesses and/or a compromised immune system is a peculiar feature of COVID-19 infection. The possible coexistence of a cancer and COVID-19 infection in the same individual prompted concerns regarding their synergistic effect on prognosis. In order to balance patients' needs with the risks related to the infection, the question oncologists have asked from the beginning of the first wave of the pandemic has been: 'how can we deal with COVID-19 infection in cancer patients?' In pursuing its mission, the Associazione Italiana Oncologia Medica (AIOM) has made every possible effort to support cancer patients, health care professionals and institutions in the decision-making processes the pandemic has engendered within this scenario. The relevant documents as well as the educational and institutional initiatives the AIOM has taken are reported in this article.


Subject(s)
COVID-19 Vaccines , COVID-19 , Neoplasms , Societies, Medical , COVID-19/prevention & control , Central Venous Catheters , Clinical Trials as Topic , Humans , Influenza Vaccines , Neoplasms/therapy , Oncologists , Practice Guidelines as Topic
5.
Eur J Cancer ; 118: 35-40, 2019 09.
Article in English | MEDLINE | ID: mdl-31299580

ABSTRACT

BACKGROUND: Lenvatinib is a multi-kinase inhibitor approved for patients with radioactive iodine (RAI)-resistant differentiated thyroid cancer (DTC). Before the drug approval from the Italian National Regulatory Agency, a compassionate use programme has been run in Italy. This retrospective study aimed to analyse data from the first series of patients treated with lenvatinib in Italy. METHODS: The primary aim was to assess the response rate (RR) and progression-free survival (PFS). Secondary end-points include overall survival (OS) and toxicity data. RESULTS: From November 2014 to September 2016, 94 patients were treated in 16 Italian sites. Seventeen percent of patients had one or more comorbidities, hypertension being the most common (60%). Ninety-eight percent of patients were treated by surgery, followed by RAI in 98% of cases. Sixty-four percent of patients received a previous systemic treatment. Lenvatinib was started at 24 mg in 64 subjects. Partial response and stable disease were observed in 36% and in 41% of subjects, respectively; progression was recorded in 14% of patients. Drug-related side-effects were common; the most common were fatigue (13.6%) and hypertension (11.6%). Overall, median PFS and OS were 10.8 months (95% confidence interval [CI], 7.7-12.6) and 23.8 months (95% CI, 19.7-25.0) respectively. CONCLUSION: Lenvatinib is active and safe in unselected, RAI-refractory, progressive DTC patients in real-life setting. RR and PFS seem to be less favourable than those observed in the SELECT trial, likely due to a negative selection that included heavily pretreated patients or with poor performance status.


Subject(s)
Antineoplastic Agents/therapeutic use , Iodine Radioisotopes/therapeutic use , Phenylurea Compounds/therapeutic use , Protein Kinase Inhibitors/therapeutic use , Quinolines/therapeutic use , Radiation Tolerance , Radiopharmaceuticals/therapeutic use , Thyroid Neoplasms/drug therapy , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/adverse effects , Cell Differentiation , Compassionate Use Trials , Disease Progression , Female , Humans , Italy , Male , Middle Aged , Patient Safety , Phenylurea Compounds/adverse effects , Progression-Free Survival , Protein Kinase Inhibitors/adverse effects , Quinolines/adverse effects , Retrospective Studies , Risk Factors , Thyroid Neoplasms/mortality , Thyroid Neoplasms/pathology , Thyroid Neoplasms/radiotherapy , Time Factors , Young Adult
6.
Support Care Cancer ; 25(9): 2779-2786, 2017 09.
Article in English | MEDLINE | ID: mdl-28391437

ABSTRACT

PURPOSE: Erythropoiesis-stimulating agents (ESAs) are often used in treatment of patients with chemotherapy-induced anemia. Many studies have demonstrated an improved hemoglobin (Hb) response when ESA is combined with intravenous iron supplementation and a higher effectiveness of intravenous iron over traditional oral iron formulations. A new formulation of oral sucrosomial iron featuring an increased bioavailability compared to traditional oral formulations has recently become available and could provide a valid alternative to those by intravenous (IV) route. Our study evaluated the performance of sucrosomial iron versus intravenous iron in increasing hemoglobin in anemic cancer patients receiving chemotherapy and darbepoetin alfa, as well as safety, need of transfusion, and quality of life (QoL). MATERIALS AND METHODS: The present study considered a cohort of 64 patients with chemotherapy-related anemia (Hb >8 g/dL <10 g/dL) and no absolute or functional iron deficiency, scheduled to receive chemotherapy and darbepoetin. All patients received darbepoetin alfa 500 mcg once every 3 weeks and were randomly assigned to receive 8 weeks of IV ferric gluconate 125 mg weekly or oral sucrosomial iron 30 mg daily. The primary endpoint was to demonstrate the performance of oral sucrosomial iron in improving Hb response, compared to intravenous iron. The Hb response was defined as the Hb increase ≥2 g/dL from baseline or the attainment Hb ≥ 12 g/dL. RESULTS: There was no difference in the Hb response rate between the two treatment arms. Seventy one percent of patients treated with IV iron achieved an erythropoietic response, compared to 70% of patients treated with oral iron. By conventional criteria, this difference is considered to be not statistically significant. There were also no differences in the proportion of patients requiring red blood cell transfusions and changes in QoL. Sucrosomial oral iron was better tolerated. CONCLUSION: In cancer patients with chemotherapy-related anemia receiving darbepoetin alfa, sucrosomial oral iron provides similar increase in Hb levels and Hb response, with higher tolerability without the risks or side effects of IV iron.


Subject(s)
Anemia/drug therapy , Darbepoetin alfa/therapeutic use , Hematinics/therapeutic use , Iron/therapeutic use , Neoplasms/complications , Quality of Life/psychology , Administration, Oral , Anemia/chemically induced , Darbepoetin alfa/administration & dosage , Female , Humans , Injections, Intravenous , Iron/administration & dosage , Male , Neoplasms/drug therapy , Pilot Projects , Retrospective Studies
7.
Placenta ; 35(7): 483-90, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24780198

ABSTRACT

INTRODUCTION: In the present study, we characterized the expression of Activating Protein 1 (AP-1) factors, key cell cycle regulators, in primary placental mesenchymal stromal cells (PDMSCs) derived from normal and preeclamptic (PE) pregnancies with fetal-placental compromise. METHODS: PDMSCs were isolated from control (n = 20) and preeclamptic (n = 24) placentae. AP-1 expression was determined by semi-quantitative RT-PCR (sqRT-PCR), Real Time PCR and Western Blot assay. PDMSCs were plated and JunB siRNA was performed. JunB and Cyclin-D1 expression were assessed by Real Time and Western Blot analyses. RESULTS: JunB expression was significantly increased while Cyclin-D1 expression was significantly down-regulated in PE relative to control PDMSCs. JunB siRNA was accompanied by JunB down-regulation and increased Cyclin-D1 in normal PDMSCs. CONCLUSIONS: We described, for the first time, AP-1 expression in PDMSCs derived from physiological and PE placentae. Importantly, we demonstrated that JunB over-expression in PE-PDMSCs affects Cyclin-D1 regulation. Our data suggest a possible contribution of these pathological placental cells to the altered cell cycle regulation typical of preeclamptic placentae.


Subject(s)
Cyclin D1/metabolism , Mesenchymal Stem Cells/metabolism , Placenta/metabolism , Pre-Eclampsia/metabolism , Transcription Factors/metabolism , Adult , Case-Control Studies , Cell Cycle , Cyclin D1/genetics , Female , Fos-Related Antigen-2/metabolism , Gene Expression , Humans , Infant, Newborn , Male , Mesenchymal Stem Cells/pathology , Placenta/pathology , Pre-Eclampsia/genetics , Pre-Eclampsia/pathology , Pregnancy , Proto-Oncogene Proteins c-fos/metabolism , RNA, Messenger/genetics , RNA, Messenger/metabolism , RNA, Small Interfering/genetics , Transcription Factor AP-1/genetics , Transcription Factor AP-1/metabolism , Transcription Factors/antagonists & inhibitors , Transcription Factors/genetics , Young Adult
8.
Placenta ; 35 Suppl: S4-9, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24321782

ABSTRACT

Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2013 there were twelve themed workshops, four of which are summarized in this report. These workshops related to various aspects of placental biology but collectively covered areas of pregnancy pathologies and placental metabolism: 1) diabetes in pregnancy; 2) lipids, fatty acids and the placenta; 3) oxygen in placental development and pathologies; 4) stem cells and pathologies.


Subject(s)
Diabetes, Gestational/metabolism , Dyslipidemias/physiopathology , Oxygen/physiology , Placentation , Animals , Female , Fetal Development , Humans , Pregnancy , Signal Transduction , Stem Cells/physiology
9.
Breast Cancer Res Treat ; 141(1): 101-10, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23942848

ABSTRACT

Clinical trials have shown the efficacy of trastuzumab-based adjuvant therapy in HER2-positive breast cancers, but routine clinical use awaits evaluation of compliance, safety, and effectiveness. Adjuvant trastuzumab-based therapy in routine clinical use was evaluated in the retrospective study GHEA, recording 1,002 patients treated according to the HERA protocol between March 2005 and December 2009 in 42 Italian oncology departments; 874 (87.23 %) patients completed 1-year trastuzumab treatment. In 128 patients (12.77 %), trastuzumab was withdrawn due to cardiac or non-cardiac toxicity (28 and 29 patients, respectively), disease progression (5 patients) or the clinician's decision (66 patients). In addition, 156 patients experienced minor non-cardiac toxicities; 10 and 44 patients showed CHF and decreased LVEF, respectively, at the end of treatment. Compliance and safety of adjuvant trastuzumab-based therapy in Italian hospitals were high and close to those reported in the HERA trial. With a median follow-up of 32 months, 107 breast cancer relapses were recorded (overall frequency, 10.67 %), and lymph node involvement, estrogen receptor negativity, lymphoid infiltration, and vascular invasion were identified as independent prognostic factors for tumor recurrence, indicating that relapses were associated with advanced tumor stage. Analysis of site and frequency of distant metastases showed that bone metastases were significantly more frequent during or immediately after trastuzumab (<18 months from the start of treatment) compared to recurrences in bone after the end of treatment and wash-out of the drug (>18 months from the start of treatment) (35.89 vs. 14.28 %, p = 0.0240); no significant differences were observed in recurrences in the other recorded body sites, raising the possibility that the protection exerted by trastuzumab is lower in bone metastases.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Carcinoma/drug therapy , Chemotherapy, Adjuvant , Adult , Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Agents/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor , Breast Neoplasms/chemistry , Breast Neoplasms/pathology , Carcinoma/chemistry , Carcinoma/secondary , Combined Modality Therapy , Disease-Free Survival , Female , Follow-Up Studies , Genes, erbB-2 , Heart Diseases/drug therapy , Humans , Italy , Medication Adherence , Middle Aged , Neoadjuvant Therapy , Neoplasm Invasiveness , Neoplasm Metastasis , Neoplasm Proteins/analysis , Neoplasm Staging , Prognosis , Receptor, ErbB-2/analysis , Retrospective Studies , Risk Factors , Trastuzumab
10.
Cancer Chemother Pharmacol ; 69(5): 1289-99, 2012 May.
Article in English | MEDLINE | ID: mdl-22302407

ABSTRACT

BACKGROUND: We present a comprehensive analysis of KRAS, PIK3CA, MET, and non-sensitizing EGFR mutations in advanced non-small cell lung cancer (NSCLC) patients treated with tyrosine kinase inhibitors (TKIs), with the aim of clarifying the relative contribution of these molecular alterations to resistance. PATIENTS AND METHODS: One hundred and sixty-six patients with advanced NSCLC treated with EGFR-TKIs with available archival tissue specimens were included. EGFR (exons 18-21), KRAS (exons 2, 3), PIK3CA (exons 9, 20), and MET (exons 14, 15) mutations were analyzed using PCR-based sequencing. Among all the mutations evaluated, only KRAS, PIK3CA, MET, and non-sensitizing EGFR mutations, defined as "TKI non-sensitizing mutations" were used for response, time to progression (TTP), and overall survival (OS) analysis. RESULTS: TKI non-sensitizing mutations were associated with disease progression (p = 0.001), shorter TTP (p < 0.0001), and worse OS (p = 0.03). Cox's multivariate analysis including histology and performance status showed that TKI non-sensitizing mutations were independent factors for shorter TTP (p < 0.0001) and worse OS (p = 0.01). CONCLUSIONS: When KRAS, PIK3CA, MET, and non-sensitizing EGFR mutations are concomitant, up to 96.0% of NSCLC patients unlikely to respond to TKIs can be identified, and they represented independent negative prognostic factors. Comprehensive molecular dissection of EGFR signaling pathways should be considered to select advanced NSCLC patients for TKIs therapies.


Subject(s)
Carcinoma, Non-Small-Cell Lung/drug therapy , Drug Resistance, Neoplasm/genetics , Lung Neoplasms/drug therapy , Patient Selection , Protein Kinase Inhibitors/therapeutic use , Adult , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/pathology , Class I Phosphatidylinositol 3-Kinases , ErbB Receptors/genetics , Female , Follow-Up Studies , Humans , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Male , Middle Aged , Multivariate Analysis , Mutation , Phosphatidylinositol 3-Kinases/genetics , Prognosis , Proportional Hazards Models , Protein Kinase Inhibitors/pharmacology , Proto-Oncogene Proteins/genetics , Proto-Oncogene Proteins c-met/genetics , Proto-Oncogene Proteins p21(ras) , Retrospective Studies , Survival Analysis , Time Factors , Treatment Outcome , ras Proteins/genetics
11.
J Endocrinol Invest ; 35(9): 817-23, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22080849

ABSTRACT

BACKGROUND: The few epidemiological data available in literature on neuroendocrine tumors (NET) are mainly based on Registry databases, missing therefore details on their clinical and natural history. AIM: To investigate epidemiology, clinical presentation, and natural history of NET. DESIGN AND SETTING: A large national retrospective survey was conducted in 13 Italian referral centers. Among 1203 NET, 820 originating in the thorax (T-NET), in the gastro-enteropancreatic tract (GEP-NET) or metastatic NET of unknown primary origin (U-NET) were enrolled in the study. RESULTS: 93% had a sporadic and 7% a multiple endocrine neoplasia type 1 (MEN1)-associated tumor; 63% were GEP-NET, 33% T-NET, 4% U-NET. Pancreas and lung were the commonest primary sites. Poorly differentiated carcinomas were <10%, all sporadic. The incidence of NET had a linear increase from 1990 to 2007 in all the centers. The mean age at diagnosis was 60.0 ± 16.4 yr, significantly anticipated in MEN1 patients (47.7 ± 16.5 yr). Association with cigarette smoking and other non-NET cancer were more prevalent than in the general Italian population. The first symptoms of the disease were related to tumor burden in 46%, endocrine syndrome in 23%, while the diagnosis was fortuity in 29%. Insulin (37%) and serotonin (35%) were the most common hormonal hypersecretions. An advanced tumor stage was found in 42%, more frequently in the gut and thymus. No differences in the overall survival was observed between T-NET and GEP-NET and between sporadic and MEN1-associated tumors at 10 yr from diagnosis, while survival probability was dramatically reduced in U-NET. CONCLUSIONS: The data obtained from this study furnish relevant information on epidemiology, natural history, and clinico-pathological features of NET, not available from the few published Register studies.


Subject(s)
Intestinal Neoplasms/epidemiology , Multiple Endocrine Neoplasia Type 1/epidemiology , Neuroendocrine Tumors/epidemiology , Pancreatic Neoplasms/epidemiology , Stomach Neoplasms/epidemiology , Thoracic Neoplasms/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Disease Management , Female , Humans , Infant , Intestinal Neoplasms/mortality , Intestinal Neoplasms/therapy , Italy/epidemiology , Male , Middle Aged , Multiple Endocrine Neoplasia Type 1/mortality , Multiple Endocrine Neoplasia Type 1/therapy , Neuroendocrine Tumors/mortality , Neuroendocrine Tumors/therapy , Pancreatic Neoplasms/mortality , Pancreatic Neoplasms/therapy , Prevalence , Prognosis , Prospective Studies , Retrospective Studies , Stomach Neoplasms/mortality , Stomach Neoplasms/therapy , Survival Rate , Thoracic Neoplasms/mortality , Thoracic Neoplasms/therapy , Young Adult
12.
Eur J Cancer ; 48(5): 642-7, 2012 Mar.
Article in English | MEDLINE | ID: mdl-21757335

ABSTRACT

AIMS: Triple-negative breast cancers (TNBCs) lack expression of oestrogen, progesterone, and Human Epidermal Growth Factor 2 receptors. The NEMESI study described current Italian treatment practices in patients with operable, early-stage breast cancer (EBC). PATIENTS AND METHODS: Retrospective, observational study involving 63 Italian oncology centres. Eligible patients were aged ≥ 18 years with EBC (stage I-II) who had undergone surgery, received ≥ 1 cycle of adjuvant chemotherapy and/or adjuvant hormonal therapy and attended an oncology centre between 1 January 2008 and 30 June 2008. This subanalysis focused on patients with TNBC. Variables evaluated included: demographic data/clinical characteristics; tumour characteristics; adjuvant therapy; compliance to chemotherapy. Continuous variables were summarised using descriptive statistics. RESULTS: Of 1894 patients in the NEMESI study, 185 patients (9.8%) had TNBC. At diagnosis, 98 patients were aged 50-70 years and 114 were post-menopausal. Tumours were subcategorised as pT1mic/pT1a/pT1b/pT1c in 108 patients and pT2/pT3/pT4b in 77 patients. Mean tumour size was 2.1cm, tumours were highly undifferentiated in 144 patients and 128 patients were pNO. 179 patients received adjuvant chemotherapy; anthracyclines with or without taxanes were commonly used. 145 patients received radiotherapy. CONCLUSIONS: Adherence of Italian clinical practice to International Guidelines in the management of early-stage TNBC is satisfactory.


Subject(s)
Breast Neoplasms/metabolism , Breast Neoplasms/therapy , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/pathology , Chemotherapy, Adjuvant , Combined Modality Therapy , Female , Humans , Italy , Middle Aged , Radiotherapy, Adjuvant , Receptor, ErbB-2/metabolism , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Retrospective Studies
13.
Cancer Chemother Pharmacol ; 68(6): 1405-12, 2011 Dec.
Article in English | MEDLINE | ID: mdl-21468755

ABSTRACT

PURPOSE: In the present study, the combination of carboplatin (CBDCA) plus pemetrexed (PMX) for the treatment of patients with platinum-pretreated, pemetrexed-naïve, advanced non-small cell lung cancer (NSCLC) was investigated. Also, single nucleotide polymorphisms (SNPs) at the XRCC3, XPD, ERCC1, GARFT, DHFR, and TS genes were investigated. METHODS: Eighty patients treated with CBDCA/PMX at two Italian institutions were evaluable. Of these, 73 patients had blood samples collected for pharmacogenetic evaluation. RESULTS: Overall, the median age was 59 years (26-78), 59 patients (73.7%) had a performance status of 0, and 34 patients (42.5%) had stage IIIB disease. Thirty-eight patients (47.5%) had responded to prior first-line platinum-based therapy. Study treatment resulted into one complete and 33 partial responses for an overall response rate of 42.5%. The disease control rate was 77.5%. The median progression-free survival (PFS) and overall survival (OS) were 5.8 and 17.4 months, respectively. Responders achieved a significant longer PFS and OS versus non-responders (P = 0.007 and P = 0.003, respectively). The only grade 3-4 adverse event occurring in more than 5.0% of patients was neutropenia (6 patients, 7.5%). No statistically significant association was noted between polymorphisms of the genes analyzed and clinical outcome. CONCLUSIONS: In patients with platinum-pretreated, advanced NSCLC and favorable clinical prognostic factors, treatment with CBDCA/PMX is associated with a good clinical outcome and toxicity profile. None of the SNPs analyzed was found to be a useful predictor of treatment efficacy.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carboplatin/administration & dosage , Carboplatin/adverse effects , Carcinoma, Non-Small-Cell Lung/mortality , DNA-Binding Proteins/genetics , Disease-Free Survival , Endonucleases/genetics , Female , Glutamates/administration & dosage , Glutamates/adverse effects , Guanine/administration & dosage , Guanine/adverse effects , Guanine/analogs & derivatives , Humans , Lung Neoplasms/mortality , Male , Middle Aged , Pemetrexed , Pharmacogenetics , Polymorphism, Single Nucleotide , Retrospective Studies
14.
J Endocrinol Invest ; 34(6): e121-5, 2011 Jun.
Article in English | MEDLINE | ID: mdl-20671414

ABSTRACT

OBJECTIVE: The adjuvant radio/chemotherapy, usually employed after orchidectomy in patients with testicular tumors, allows a long-term survival with a consequent increased request for fertility. However, little is known about the effects of the anti-neoplastic treatment on sperm cytogenetic asset. Therefore, this prospective, longitudinal study was designed to evaluate the effects of radio- and/or chemotherapy on sperm chromosome. METHODS: Eleven patients with testicular tumor were enrolled and underwent sperm aneuploidy rate evaluation before and after 3, 6, 9, 12, 18, 24, and 36 months from radio- and/or chemo-therapy ending. A double and triple multicolor fluorescence in-situ hybridizations for chromosomes 8, 12, 18, X and Y were used to evaluate the sperm aneuploidy rate. To define normal sperm aneuploidy rate, 18 healthy, normozoospermic men were selected as controls. RESULTS: Before treatment, testicular tumor patients had a higher total sperm aneuploidy rate compared with normal men. Total sperm aneuploidy rate showed a slight, but statistically significant increase 6 months after anti-neoplastic treatment. This increase was mainly related to the high sperm aneuploidy rate found in 2 patients which remained elevated up to 12 months in both of them. CONCLUSION: These results showed that anti-neoplastic treatment caused only slight and transient sperm malsegregation events in patients with testicular tumor. However, since a subset of them had an elevated sperm aneuploidy rate for about 1 yr, we suggest to counsel them to refrain from fatherhood for this length of time.


Subject(s)
Aneuploidy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Infertility, Male/genetics , Oligospermia/genetics , Spermatozoa/pathology , Testicular Neoplasms/genetics , Adolescent , Adult , Case-Control Studies , Chromosomes, Human/genetics , Follow-Up Studies , Humans , In Situ Hybridization, Fluorescence , Longitudinal Studies , Male , Prognosis , Prospective Studies , Radiotherapy , Testicular Neoplasms/therapy , Young Adult
15.
Recent Pat Anticancer Drug Discov ; 5(3): 205-18, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20402651

ABSTRACT

Many studies have demonstrated that most cancers are clonal and are maintained by a cancer stem cell. Cancer stem cells have been identified in blood, breast, brain, lungs, gastrointestinal, prostate and ovarian cancer. Under normal homeostasis tissue specific stem cell division would be under strict control. When proliferation becomes independent of normal cellular controls, cancer develops. Studies indicate that cancer stem cells maintain their ability to differentiate, which explains the variety of cell types observed in tumors. Most therapies are directed at the fast growing tumor mass but not the slow dividing cancer stem cells and therefore the cancer is not eradicated. Understanding the process of transformation from a highly regulated stem cell to a cancer stem cell requires an understanding of genetic and epigenetic processes as well as having an understanding of the stem cell niche and the interaction of the stem cells with supportive cells in the niche. Current research is helping us to understand stem cells and stem cell regulation and in turn this will help to develop novel therapies to eliminate cancer and the initiating cancer stem cell. The relevant patents on the stem cell regulation and cancer therapy by stem cells are discussed.


Subject(s)
Antineoplastic Agents/pharmacology , Neoplasms/pathology , Neoplastic Stem Cells/pathology , Antineoplastic Agents/therapeutic use , Cell Line, Tumor , Drug Delivery Systems , Humans , Neoplasms/drug therapy , Neoplasms/metabolism , Neoplastic Stem Cells/drug effects , Neoplastic Stem Cells/metabolism
16.
J Endocrinol Invest ; 33(5): 313-7, 2010 May.
Article in English | MEDLINE | ID: mdl-20009491

ABSTRACT

BACKGROUND: Prolactin (PRL) regulates prostate growth and differentiation. Some studies have suggested that PRL has a pro-apoptotic effect on a myeloma cell line and in newt spermatogonia. The proliferative effect of PRL on prostate cancer cell lines is, however, a controversial area. AIM: On this account, we evaluated the effects of PRL on the prostate cancer cell lines LNCaP and PC3 apoptosis and proliferation. MATERIALS AND METHODS: LNCaP and PC3 cells were exposed to increasing concentrations of PRL for 24, 48, 72 and 96 hours. Staining with propidium iodide (PI) and TUNEL assay followed by flow cytometry were used to detect apoptosis. LNCaP and PC3 proliferation was assessed by optical microscopy counting. RESULTS: PRL induced a dose-dependent decrease of DNA content and an increase of DNA fragmentation in LNCaP after 96 hours of incubation. These effects were observed with physiological concentrations of PRL and were counteracted by a prolactin receptor antagonist. On the other hand, PRL did not have any effect on DNA content or fragmentation in PC3 cells. No effect of PRL on LNCaP and PC3 proliferation was found. CONCLUSIONS: This study indicates that PRL induces apoptosis in the androgen-responsive cell line LNCaP, whereas no effect was observed in the androgen-insensitive PC3 cell line. These findings suggest that androgen responsiveness may be required for PRL to be effective on prostatic cells.


Subject(s)
Adenocarcinoma/pathology , Apoptosis/drug effects , Prolactin/pharmacology , Prostatic Neoplasms/pathology , Androgens/pharmacology , Cell Count , Cell Line, Tumor , Cell Proliferation/drug effects , DNA Fragmentation/drug effects , DNA, Neoplasm/biosynthesis , Dose-Response Relationship, Drug , Flow Cytometry , Humans , In Situ Nick-End Labeling , Lymph Nodes/drug effects , Male , Prolactin/antagonists & inhibitors , Receptors, Prolactin/antagonists & inhibitors
17.
Cell Prolif ; 42(6): 788-98, 2009 Dec.
Article in English | MEDLINE | ID: mdl-19732065

ABSTRACT

OBJECTIVES: The aim of this study was to determine whether normal human embryonic stem cells (hESC) would secrete factors that arrest growth of human epithelial cancer cell lines. MATERIALS AND METHODS: Cell proliferation was examined using the MTT assay then haemocytometer cell counts. Staining with propidium iodide followed by flow cytometry was used to detect cell cycle stages. Heat denaturation and molecular fractionation experiments were also performed. RESULTS: We found that hESC conditioned medium (hESC CM) inhibited SKOV-3 and HEY cell proliferation. Similar results were also obtained when we used breast and prostate cancer cell lines, whereas little or no inhibitory effect was observed when human fibroblasts were tested. Moreover, a co-culture model confirmed that inhibition of cancer cell proliferation is mediated by soluble factors produced by hESCs. We also determined that the proportion of cancer cells in G(1) phase was increased by hESC CM treatment, accompanied by decrease in cells in S and G(2)/M phases, suggesting that the factors slow progression of cancer cells by cell cycle inhibition. Heat denaturation and molecular fractionation experiments indicated a low molecular weight thermostable factor was responsible for these properties. CONCLUSIONS: Our findings provide evidence that the human embryonic microenvironment contains soluble factor(s) that are capable of inhibiting growth of cancer cells, and that exposure to such factors may represent a new cancer treatment strategy.


Subject(s)
Breast Neoplasms/pathology , Embryonic Stem Cells/metabolism , Ovarian Neoplasms/pathology , Prostatic Neoplasms/pathology , Cell Line, Tumor , Coculture Techniques , Culture Media, Conditioned , Female , Flow Cytometry , Humans , Male
18.
J Chromatogr A ; 1189(1-2): 196-206, 2008 May 02.
Article in English | MEDLINE | ID: mdl-18190924

ABSTRACT

In the present work, a novel strategy including the use of two different comprehensive HPLC methods has been employed to study the whole carotenoid composition of mandarin essential oil. Thus, two different fully orthogonal two-dimensional HPLC methods have been used. A silica microbore column was coupled to a C(18) monolithic column to study the mandarin saponified extract, while the coupling of a cyano microbore column to a C(18) monolithic column was employed to study the intact mandarin essential oil sample in order to characterize the native carotenoid esters composition. Detection was performed by connecting a photodiode array detection (DAD) system in parallel with a MS detection system operated with an atmospheric pressure chemical ionization (APCI) interface. Thus, the carotenoid identification was carried out by combining the information provided by the DAD and MS systems and the peaks relative position in the two-dimensional chromatograms.


Subject(s)
Carotenoids/analysis , Chromatography, High Pressure Liquid/methods , Citrus/chemistry , Mass Spectrometry/methods , Carotenoids/chemistry , Molecular Structure
19.
J Ethnopharmacol ; 97(2): 261-6, 2005 Feb 28.
Article in English | MEDLINE | ID: mdl-15707763

ABSTRACT

Several species of Nepeta genus are utilized in folk medicine for treatment of contusions, rheumatic pains, fever, cutaneous eruptions. Some species are employed for their anti-inflammatory properties. In this paper, we report the results of phytochemical studies on aerial parts of Nepeta sibthorpii Bentham (Lamiaceae), an endemic plant of Greece. The bioassay-guided fractionation of methanol extract led to the isolation of ursolic acid and polyphenol fraction. By HPLC, we determined some phenolics: chlorogenic acid (0.315 mg/g) and the flavonoids rutin (0.091 mg/g), luteolin-7-O-glucoside (0.387 mg/g) and a luteolin derivative. We assayed the radical scavenging activity of Nepeta sibthorpii methanol extract by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) method. Moreover, we studied the anti-inflammatory activity of Nepeta sibthorpii methanol extract (50 mg/kg, os), ursolic acid and polyphenol fraction (dose corresponding to 50 mg/kg of methanol extract, os) in the carrageenan-induced paw oedema in rat. In this experimental model, we observed a significant inhibition of paw oedema. We suppose that the anti-inflammatory effect of methanol extract could be related to the free radical scavenging activity and that it depends on a synergic action of all the components of the methanol extract, even if ursolic acid can be considered the main responsible for this activity.


Subject(s)
Anti-Inflammatory Agents/isolation & purification , Medicine, Traditional , Nepeta , Plant Extracts/isolation & purification , Animals , Anti-Inflammatory Agents/therapeutic use , Carrageenan/toxicity , Edema/chemically induced , Edema/drug therapy , Ethnopharmacology , Free Radical Scavengers , Greece , Male , Phytotherapy , Plant Extracts/therapeutic use , Plant Leaves , Rats , Rats, Wistar
20.
Food Addit Contam ; 21(7): 649-57, 2004 Jul.
Article in English | MEDLINE | ID: mdl-15370838

ABSTRACT

Potentiometric stripping analysis was used to determine simultaneously the content of zinc(II), cadmium(II), lead(II) and copper(II) in potatoes, whereas the concentration of selenium was determined by cathodic stripping potentiometric analysis. Metal cations were extracted from potatoes by hydrogen peroxide/hydrochloric acid treatments. The relative standard deviation of the methods ranged from 2.3 to 4.1% and the detection limits were lower than 2.5 microg kg(-1). The results obtained with the proposed methods were compared with those obtained with graphite furnace atomic absorption spectroscopy, a common method for determining metals. The results of the two methods agreed to within 6.1%. Twelve samples of yellow flesh potatoes from different cultivars were analysed. Of all the metals determined, Cu and Zn were the most abundant with concentrations between 0.5 and 4.6 mg kg(-1). Selenium was only found in three samples in very low amounts (<0.1 mg kg(-1)), whilst Pb and Cd concentrations were in the range 0.01-0.27 mg kg(-1).


Subject(s)
Cadmium/analysis , Food Contamination/analysis , Lead/analysis , Solanum tuberosum/chemistry , Trace Elements/analysis , Copper/analysis , Potentiometry/methods , Reproducibility of Results , Selenium/analysis , Zinc/analysis
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