Publications by authors named "Antonella Savarese"

The aim of this study was to present a nationwide survey on the specialist's attitudes towards stereotactic body radiotherapy (SBRT) combined with poly (ADP-ribose) polymerase inhibitors (PARPi) with oligometastatic/oligoprogressive/oligorecurrent ovarian cancer (oMPR-OC) patients. The 19-item questionnaire was developed by specialists and distributed online. Replies were stratified by categories and analyzed using descriptive statistics.

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Objectives: Part 1 of the RUBY trial (NCT03981796) demonstrated improved survival in patients with primary advanced or recurrent endometrial cancer (EC) treated with dostarlimab plus carboplatin-paclitaxel versus placebo plus carboplatin-paclitaxel. Here, we examine additional efficacy and safety data from patients with mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) EC in the RUBY trial.

Methods: Patients were randomized 1:1 to dostarlimab 500 mg or placebo plus carboplatin-paclitaxel every 3 weeks for 6 cycles followed by dostarlimab or placebo every 6 weeks for up to 3 years.

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: Women undergoing genetic counseling for hereditary breast cancer often experience a high emotional burden. Distress and stress in the initial phases of genetic counseling can be significant predictors of long-term psychological health, influencing quality of life and well-being. : This study aimed to evaluate the mediating role of psychophysical stress in the relationship of anxiety and depression with quality of life and well-being in women undergoing genetic counseling for BRCA1/2 mutations.

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Article Synopsis
  • Early menopause from gynecological cancer treatment is a significant health issue, with hormone replacement therapy (HRT) being the most effective but underutilized solution among survivors and BRCA mutation carriers.
  • A national survey conducted by the MITO group revealed that while a majority of healthcare professionals discuss HRT, fewer are actually willing to prescribe it, especially for ovarian and endometrial cancer patients.
  • Despite some concerns, most respondents view HRT as safe for BRCA mutation patients after surgery, indicating a need for greater support and education to encourage its use in clinical settings.
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  • This text appears to reference a correction made to a previously published article in the journal Frontiers in Oncology.
  • The specific article is identified by its Digital Object Identifier (DOI): 10.3389/fonc.2023.1247291.
  • The correction might involve updates or clarifications to the original research findings or data presented in the article.
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  • PARP inhibitors, specifically niraparib, are used in maintenance therapy for platinum-sensitive ovarian cancer, regardless of BRCA mutation status.
  • A study evaluated the real-world efficacy and safety of niraparib in patients with relapsed ovarian cancer, collecting clinical data from those who received the treatment.
  • Results showed a median progression-free survival of 9.1 months for BRCA wild-type patients and 10.3 months for BRCA mutated patients, indicating that niraparib is effective and well tolerated in clinical practice.
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Background: Molecular Tumor Boards (MTB) operating in real-world have generated limited consensus on good practices for accrual, actionable alteration mapping, and outcome metrics. These topics are addressed herein in 124 MTB patients, all real-world accrued at progression, and lacking approved therapy options.

Methods: Actionable genomic alterations identified by tumor DNA (tDNA) and circulating tumor DNA (ctDNA) profiling were mapped by customized OncoKB criteria to reflect diagnostic/therapeutic indications as approved in Europe.

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Introduction: Endometrial cancer (EC) represents 3.4% of all newly diagnosed cancer cases and is responsible for 2.1% of all cancer-related deaths.

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  • Limited research has focused on how family cancer history and emotional factors like depression and anxiety impact individuals' perceptions of cancer risk and worries, prompting this study to investigate these relationships in women undergoing genetic counseling for breast/ovarian cancer.
  • The study surveyed 178 women, 52% of whom had existing cancer diagnoses, assessing their emotional distress, cancer-related worries, risk perception, and fears related to healthcare.
  • Results indicated that higher levels of depression and anxiety correlated with increased cancer-related worries and risk perception, with healthcare-related fears acting as a mediator; it was also found that a prior cancer diagnosis raised cancer worries but not risk perception, while having more family members with cancer influenced both outcomes.
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Introduction: Standard treatment of newly diagnosed, advanced ovarian carcinoma (OC) consists of cytoreductive surgery followed by platinum-based chemotherapy with or without bevacizumab. Maintenance therapy with PARP inhibitors and olaparib-bevacizumab has recently shown to significantly improve progression-free survival in the first-line setting. Some practical aspects of maintenance therapy, however, are still poorly defined.

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Introduction: Low molecular weight heparin (LMWH) has been the backbone of the treatment of cancer associated thrombosis (CAT). Direct-acting oral anticoagulants (DOACs) have shown efficacy and safety not inferior to LMWH and guidelines included DOACs as an option for CAT treatment. Nevertheless, DOACs are still poorly prescribed in patients with cancer.

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Background: A virtual reality experience (VRE) could represent a viable non-pharmacological intervention to reduce and better manage the main factors of psychophysical distress related to the diagnosis and treatment of cancer.

Aim: The study was a two-arm randomized controlled trial conducted at the Regina Elena National Cancer Institute - IRCCS (Rome, Italy) from April 2019 to January 2020 to evaluate VRE impact in patients affected by breast or ovarian cancer. Before starting the first cycle of chemotherapy (CT), patients were randomized to receive the VRE (VRE arm) as "distraction therapy" or to entertain themselves with conventional means (control arm).

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Introduction: The combination of lenvatinib plus pembrolizumab demonstrated a relevant clinical benefit in patients with endometrial carcinoma. The safety profile was consistent with the established profiles of each drug in monotherapy, with the most frequent adverse events being hypertension, an on-target effect, hypothyroidism, diarrhea, nausea, vomiting, loss of appetite, fatigue, and weight loss.

Areas Covered: We first review the rationale based on the combination of a VEGFR inhibitor and an immune checkpoint inhibitor, highlighting the main pharmacokinetic and pharmacodynamic features of lenvatinib.

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Background: Endometrial cancer (EC) therapeutic and diagnostic approaches have been changed by the development of a new prognostic molecular classification, the introduction of dostarlimab in microsatellite instability (MSI) high pre-treated advanced EC patients with further expected innovation deriving from lenvatinib plus pembrolizumab regardless MSI status. How this is and will be translated and embedded in the clinical setting in Italy is not known; this is why we developed Multicentre Italian Trials in Ovarian cancer and gynaecologic malignancies (MITO) survey on the current practice and expected future changes in EC.

Methods: We designed a self-administered, multiple-choice online questionnaire available only for MITO members for one month, starting in April 2021.

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Objective: The aim of this study was to analyze the oncological outcome of stage I malignant ovarian germ cell tumors patients included in the MITO-9 study to identify those who might be recommended routine surveillance alone after complete surgical staging.

Methods: MITO-9 was a prospective observational study analyzing data collected between January 2013 and December 2019. Three groups were identified: group A included 13 patients stage IA dysgerminoma and IAG1 immature teratoma; group B included 29 patients with stage IB-C dysgerminomas, IA-C G2-G3 immature teratomas and stage IA mixed malignant ovarian germ cell tumors and yolk sac tumors; and group C included five patients (two patients with stage IC1 and one patient with stage IC2 yolk sac tumors and two patients with mixed-stage IC2 malignant ovarian germ cell tumors).

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Objective: Coronavirus disease 2019 (COVID-19) has caused rapid and drastic changes in cancer management. The Italian Society of Gynecology and Obstetrics (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and to assess the implementation of containment measures against COVID-19 diffusion.

Methods: The survey consisted of a self-administered, anonymous, online questionnaire.

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Objective: To evaluate the efficacy of visual inspection with acetic acid (VIA) screening combined with a cervical smear in Uganda.

Methods: Nine screening campaigns were held in Uganda between January 2011 and October 2019. In the last three campaigns, a new approach was used: the cervical smear was performed before the VIA test and, in case of a positive VIA test, the slide was sent for examination.

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Chemotherapy-induced neutropenia (CIN) has been associated with improved prognosis in several cancer conditions. Contrasting data have been produced in ovarian cancer.

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Article Synopsis
  • The study focused on advanced or recurrent cervical cancer (ARCC) patients to assess the safety and efficacy of combining the anti-EGFR antibody cetuximab (CET) with standard chemotherapy (carboplatin and paclitaxel).
  • In a randomized trial involving 108 patients, results showed no significant improvement in event-free survival (EFS), progression-free survival (PFS), or overall survival (OS) between the groups treated with chemotherapy alone and chemotherapy with CET, despite the expected benefits.
  • While the combination did not show increased efficacy, the research indicated a possibility of CET resistance linked to PIK3CA mutations, suggesting that further studies may be necessary to identify suitable
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Background: No biomarker is available to predict prognosis of patients with advanced ovarian cancer (AOC) and guide the choice of chemotherapy. We performed a prospective-retrospective biomarker study within the MITO2 trial on the treatment of AOC.

Patients And Methods: MITO2 is a randomised multicentre phase 3 trial conducted with 820 AOC patients assigned carboplatin/paclitaxel (carboplatin: AUC5, paclitaxel: 175 mg/m², every 3 weeks for 6 cycles) or carboplatin/PLD-pegylated liposomal doxorubicin (carboplatin: AUC5, PLD: 30 mg/m², every 3 weeks for 6 cycles) as first line treatment.

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Background: Risk of relapse or progression remains high in the treatment of most patients with epithelial ovarian cancer, and development of a molecular predictor could be a valuable tool for stratification of patients by risk. We aimed to develop a microRNA (miRNA)-based molecular classifier that can predict risk of progression or relapse in patients with epithelial ovarian cancer.

Methods: We analysed miRNA expression profiles in three cohorts of samples collected at diagnosis.

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Background: BRCA1 and, more commonly, BRCA2 mutations are associated with increased risk of male breast cancer (MBC). However, only a paucity of data exists on the pathology of breast cancers (BCs) in men with BRCA1/2 mutations. Using the largest available dataset, we determined whether MBCs arising in BRCA1/2 mutation carriers display specific pathologic features and whether these features differ from those of BRCA1/2 female BCs (FBCs).

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Article Synopsis
  • The study compares phenotype features and survival rates of triple-negative breast cancers (TNBCs) and non-TNBCs in high-risk women, finding no significant differences in overall or disease-free survival.
  • Out of 501 women, 14 TNBC cases were identified, mainly among BRCA1 mutation carriers, with MRI being more effective than mammography or ultrasound for detection.
  • TNBC patients tended to undergo more aggressive treatments, like mastectomies and chemotherapy, but with combined MRI screening and treatment, the survival outcomes for TNBCs approached those of non-TNBCs.
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