Publications by authors named "Anna Koumarianou"

Assessing the response to systemic therapy in neuroendocrine tumors (NET) is challenging since morphological imaging response is often delayed and not necessarily reflective of clinical benefit. Peptide receptor radionuclide therapy (PRRT) has a complex mechanism of action, further complicating response assessment. In response to these challenges, the European Neuroendocrine Tumor Society (ENETS) Theranostics Task Force conducted a statement-based survey among experts to identify the current landscape and unmet needs in PRRT response assessment.

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Epithelioid hemangioendothelioma (EHE) is a rare malignant vascular tumor whose pleural EHE (pEHE) type is even more uncommon, with significant heterogeneity in the clinical behavior as well as challenging diagnosis and treatment decisions. Herein, we present a 74-year-old woman admitted to the hospital with dyspnea, pleural effusion, and refractory euvolemic hyponatremia. Chest computed tomography revealed a large right-side pleural effusion with irregular thickening of the parietal pleura and localized nodularity.

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Background: Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) and adjuvant chemotherapy is a therapeutic choice for women with advanced ovarian cancer. Whether NACT affects the tumor's molecular profile has not been determined.

Methods: This was a retrospective study of patients with advanced-stage epithelial ovarian cancer treated with NACT at oncology departments affiliated with the Hellenic Cooperative Oncology Group (HeCOG).

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Breast cancer (BC) is the most prominent tumor type among women, accounting for 32% of newly diagnosed cancer cases. BC risk factors include inherited germline pathogenic gene variants and family history of disease. However, the etiology of the disease remains occult in most cases.

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Background/aim: The application of next-generation sequencing (NGS) technology in the genetic investigation of hereditary cancer is important for clinical surveillance, therapeutic approach, and reducing the risk of developing new malignancies. The aim of the study was to explore genetic predisposition in individuals referred for hereditary cancer.

Materials And Methods: A total of 8,261 individuals were referred for multigene genetic testing, during the period 2020-2023, in the laboratory, and underwent multigene genetic testing using NGS.

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Precise classification of sarcomas is crucial to optimal clinical management. In this prospective, multicenter, observational study within the Hellenic Group of Sarcoma and Rare Cancers (HGSRC), we assessed the effect of expert pathology review, coupled with the application of molecular diagnostics, on the diagnosis and management of sarcoma patients. Newly diagnosed sarcoma patients were addressed by their physicians to one of the two sarcoma pathologists of HGSRC for histopathological diagnostic assessment.

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Background/aim: Gliomas are highly heterogeneous malignancies originating from diverse cell types within the brain. Although their precise etiology is frequently unknown, risk factors, such as chemical exposure, radiation, and specific uncommon genetic disorders have been identified. Diagnosis typically entails imaging tests, such as magnetic resonance imaging and computed tomography, complemented by a biopsy for confirmation, which may be further validated through genetic testing.

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Article Synopsis
  • Paraneoplastic syndromes, like dermatomyositis, can be the first sign of cancer and involve immune responses targeting both cancer and normal cells, often affecting skin and muscle.
  • Although these syndromes may improve with traditional cancer treatments, their response to immunotherapy is uncertain since autoimmune conditions are often excluded from trials.
  • This report highlights a case of a woman with advanced urothelial cancer and dermatomyositis who received anti-PD1 therapy and developed Stevens-Johnson syndrome, leading to a review of the link between these autoimmune conditions and cancer.
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Lung carcinoid tumours are neuroendocrine neoplasms originating from the bronchopulmonary tract's neuroendocrine cells, accounting for only 1%-3% of all lung cancers but 30% of all neuroendocrine tumours. The incidence of lung carcinoids, both typical and atypical, has been increasing over the years due to improved diagnostic methods and increased awareness among clinicians and pathologists. The most recent WHO classification includes a subgroup of lung carcinoids with atypical morphology and higher mitotic count and/or Ki67 labelling index.

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Immunotherapy has revolutionised the treatment of oncological patients, but its application in various endocrine tumours is rather limited and is mainly used when conventional therapies have failed. Immune checkpoint inhibitors (ICIs) have been employed in progressive adrenocortical carcinoma, primarily utilizing the anti-PD-L1 agent pembrolizumab, obtaining overall response rates ranging between 14% and 23%. In contrast, the response rate in phaeochromocytoma/paraganglioma was substantially less at 9%, considering the small number of patients treated.

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  • Pancreatic ductal adenocarcinoma (PDAC) has a very poor prognosis and limited treatment options, with a lack of comprehensive genomic data from large populations.
  • In a study involving 409 Greek patients, a genomic analysis using next generation sequencing (NGS) revealed that common mutations were found in genes, with 81.50% of samples showing the most frequent mutation.
  • The research also indicated potential treatment implications based on genomic findings, with an increase in possible benefit from NGS-oriented treatment from 1.91% to 13.74%, highlighting important characteristics and insights for PDAC in European patients.
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  • Dose-dense sequential (dds) chemotherapy has positively impacted long-term survival rates in early breast cancer patients, as shown in the observational trial HE 10/10.
  • The study analyzed the role of tumor infiltrating lymphocytes (TILs) and CD8 lymphocytes in predicting outcomes, finding that higher levels are linked to better survival.
  • With a median follow-up of over 10 years, the study reported disease-free survival (DFS) at 78.4% and overall survival (OS) at 81.7%, highlighting the regimen's efficacy and safety.
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  • Somatostatin receptor (SST) PET/CT is the primary imaging method for well-differentiated neuroendocrine tumors (NET), but higher-grade tumors often show more 18F-FDG uptake, which complicates their management.
  • A survey conducted at the ENETS Advisory Board Meeting highlighted strong support for the use of FDG PET/CT in specific situations, such as assessing NET G3 for curative surgery (82% agreement) and in neuroendocrine carcinoma (98% agreement) before surgery.
  • Despite wide support for FDG PET/CT in various clinical contexts for treatment decisions, there remains a lack of full consensus on its use, possibly due to issues like varying clinical access and
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Our aim was to evaluate the concordance between the Myriad MyChoice and two alternative homologous recombination deficiency (HRD) assays (AmoyDx HRD Focus NGS Panel and OncoScan™) in patients with epithelial ovarian cancer (EOC). Tissue samples from 50 patients with newly diagnosed EOC and known Myriad MyChoice HRD status were included. DNA aliquots from tumor samples, previously evaluated with Myriad MyChoice and centrally reassessed, were distributed to laboratories to assess their HRD status using the two platforms, after being blinded for the Myriad MyChoice CDx HRD status.

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Background: Hereditary cancer predisposition syndromes are responsible for approximately 5-10% of all diagnosed cancer cases. In order to identify individuals at risk in a cost-efficient manner, family members of individuals carrying pathogenic alterations are tested only for the specific variant that was identified in their carrier relative. The purpose of this study was to investigate the clinical use and implementation of cascade family testing (CFT) in families of breast cancer patients with pathogenic/likely pathogenic variants (PVs/LPVs) in cancer-related predisposition genes.

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This ENETS guidance paper for well-differentiated nonfunctioning pancreatic neuroendocrine tumours (NF-Pan-NET) has been developed by a multidisciplinary working group, and provides up-to-date and practical advice on the management of these tumours. Using the extensive experience of centres treating patients with NF-Pan-NEN, the authors of this guidance paper discuss 10 troublesome questions in everyday clinical practice. Our many years of experience in this field are still being verified in the light of the results of new clinical, which set new ways of proceeding in NEN.

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  • The study investigated the clinical significance of circulating tumor cells (CTCs) in patients with metastatic castration-resistant prostate cancer (mCRPC) who were receiving cabazitaxel treatment.
  • Results showed that a high number of CTCs detected at baseline and after the first treatment cycle were linked to shorter progression-free survival (PFS) and overall survival (OS).
  • The presence of non-apoptotic CTCs at baseline was identified as an independent predictor of poorer OS, suggesting that monitoring CTCs could help gauge treatment effectiveness and patient prognosis.
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Clinical Relevance: Treatment with aromatase inhibitors (AIs) in patients with breast cancer can lead to dry eye disease (DED).

Background: The purpose of the study is to determine the prevalence and risk factors of DED in patients treated with AIs for breast cancer.

Methods: Participants in this cross-sectional study were patients with breast cancer treated with AIs.

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Background/aim: Germline copy number variation (CNV) is a type of genetic variant that predisposes significantly to inherited cancers. Today, next-generation sequencing (NGS) technologies have contributed to multi gene panel analysis in clinical practice.

Materials And Methods: A total of 2,163 patients were screened for cancer susceptibility, using a solution-based capture method.

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This ENETS guidance paper, developed by a multidisciplinary working group, provides an update on the previous colorectal guidance paper in a different format. Guided by key clinical questions practical advice on the diagnosis and management of neuroendocrine tumours (NET) of the caecum, colon, and rectum is provided. Although covered in one guidance paper colorectal NET comprises a heterogeneous group of neoplasms.

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The management of neuroendocrine tumors (NETs) represents a clinical challenge due to heterogeneity of their clinical behaviour, molecular biology and response to treatment. Over the years, several circulating biomarkers have been developed for the early diagnosis and follow-up of NETs. The specific secretory products of tumors associated with a secretory syndrome (functioning tumors) may be used as diagnostic and/or prognostic biomarkers while the most common non-specific circulating biomarkers, that may be increased in both functioning and non-functioning tumors, are chromogranin A and the neuron specific enolase.

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Background/aim: Nivolumab is an FDA-approved immune checkpoint inhibitor (ICI) for patients with advanced, pre-treated non-small cell lung cancer (NSCLC). However, treatment profiles and patient outcomes often differ in routine clinical practice while the financial impact of approved therapies is largely unknown. In this study, we investigated the efficacy, tolerability, and economic impact of nivolumab in real-world settings (RWS) in Greece.

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Background: Trifluridine/tipiracil (FTD/TPI) is an oral antimetabolite agent comprised of trifluridine, a thymidine-based nucleoside analogue that inhibits cell proliferation following its incorporation into DNA, and tipiracil that helps maintain the blood concentration of trifluridine by inhibiting the enzyme thymidine phosphorylase which inactivates trifluridine. It is approved as a third-line treatment option for patients with metastatic colorectal cancer (mCRC) and is administered at 35 mg/m two times daily from day 1 to 5 and from day 8 to 12 every 28 days. The aim of this investigator-initiated retrospective study (RETRO-TAS; NCT04965870) was to document real-world data on the clinical efficacy of FTD/TPI in patients with chemorefractory mCRC.

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Article Synopsis
  • The study aimed to gather real-world data on the EGFR mutational profile and treatment strategies for advanced non-small-cell lung cancer (NSCLC) patients after first/second-generation EGFR-TKI treatment.
  • Ninety-six patients were enrolled in Greece, with re-biopsies conducted for some who were negative for the T790M mutation.
  • Results showed that 21.9% of patients were T790M-positive, and those receiving third-generation EGFR-TKIs had better outcomes, highlighting the importance of mutational status and treatment choices in improving response rates and progression-free survival.
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We conducted a retrospective/prospective worldwide study on patients with neuroendocrine neoplasms (NENs) and a molecularly proven SARS-CoV-2 positivity. Preliminary results regarding 85 patients of the INTENSIVE study have been published in 2021. Now we are reporting the 2-year analysis.

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