Publications by authors named "Asioli S"
Drugs targeting mitochondrial energy metabolism are emerging as promising antitumor therapeutics. Glioma treatment is extremely challenging due to the high complexity of the tumor and the high cellular heterogeneity. From a metabolic perspective, glioma cancer cells can be classified into the oxidative metabolic phenotype (mainly depending on mitochondrial respiration for energy production) and glycolytic phenotype or "Warburg effect" (mainly depending on glycolysis).
View Article and Find Full Text PDF: Glioblastoma -wildtype (GBM -wt) is the most aggressive brain tumor in adults and is characterized by an immunosuppressive microenvironment. Different factors shaping its tumor microenvironment (TME) regulate tumor progression and treatment response. The aim of this study was to characterize the main immunosuppressive elements of the GBM -wt TME.
View Article and Find Full Text PDFIntroduction: Endoscopic endonasal approach (EEA) plays a central role in the treatment of GH-secreting pituitary adenomas (PAs)/pituitary neuroendocrine tumors (PitNETs), allowing to treat not only micro- or regular macro- PAs/PitNEts, but also more complex cases, otherwise requiring a transcranial or other open approaches.
Materials And Methods: All consecutive cases of GH-secreting PAs/PitNETs treated by EEA from May 1998 to June 2023 at our Institution were included. Patients clinical, bio-chemical, and neuroradiological features were considered, as well the surgical approach adopted for each case and its related complications.
Article Synopsis
- - Acromegaly is a rare condition caused by excessive growth hormone secretion, typically from a pituitary adenoma, leading to high levels of insulin-like growth factor 1 and various severe health issues.
- - Pituitary adenomas (PAs) show a wide range of clinical and biological characteristics and can behave aggressively, making them challenging to classify and treat effectively over time.
- - The latest WHO Classification categorizes GH-secreting PAs into different types based on hormonal features, but more research is needed to better understand their behavior and improve treatment strategies through precision medicine.
The endoscopic endonasal route has demonstrated to be the approach of choice for a large majority of clival chordomas (CCs). However, its results in elderly patients are under-evaluated in the literature. The aim of this study is to assess the surgical outcome for these patients, determining the factors associated with a larger tumor resection in this population.
View Article and Find Full Text PDFArticle Synopsis
- Recent studies show a partial loss of SMARCB1/INI1 expression in skull base chordomas, suggesting potential treatment options for these tumors; this study focused on 89 patients with spinal chordomas.
- The analysis found that 41.6% of patients exhibited partial SMARCB1/INI1 loss, primarily due to a deletion on chromosome 22, with significant implications for tumor location and surgical outcomes.
- Key findings indicated that tumor location (specifically in the sacrococcygeal region) and adequate surgical margins were linked to better disease-free survival rates, highlighting important factors for patient prognosis.
Article Synopsis
- * The 2022 WHO Classification states that instead of a grading or staging system, histological typing should be used to classify PitNETs, given the emerging understanding of their biological diversity through molecular subgroup studies.
- * The review discusses the challenges in creating a grading and staging system, emphasizing the need for a standardized approach combining histological and molecular findings to improve diagnosis and treatment timelines for patients with PitNETs.
Article Synopsis
- TP53 mutations are common in patients with IDH-wildtype GBM, but their impact on patient prognosis has not been well studied.
- This study analyzed 97 patients under 70 years old who received specific treatments and found that 19.4% had TP53 mutations, but this did not significantly affect overall survival rates.
- Although TP53 mutations didn't correlate with survival for all patients, they were linked to longer survival in a small group with overall survival over 36 months, indicating they might be important for certain long-term survivors.
The aim of this multicenter prospective survey called PIT-EASY was to assess the relevance of the European Pituitary Pathology Group (EPPG) diagnostic tools for pituitary neuroendocrine tumors (PitNETs) to improve the quality of their histological diagnosis. Each center performed at least 30 histological cases of PitNETs using the EPPG tools and assessed their value using a scorecard with 10 questions. For each center, the histological cases were carried out by pathologists with varying levels of expertise in pituitary pathology defined as junior, intermediate, and expert.
View Article and Find Full Text PDFArticle Synopsis
- Clivus metastases from distant tumors are rare and surgical management options remain debated, prompting a review of both institutional data and existing literature.
- A study involved four patients treated with endoscopic endonasal approach (EEA) for clival metastasis, all of whom aimed for biopsy, reported no complications, and had an average overall survival of 6 months.
- A systematic review of 39 additional patients indicated that EEA was the preferred surgical method in 92.3% of cases, mostly for biopsy purposes, with an overall survival averaging 9.4 months, highlighting the importance of careful diagnosis and treatment in advanced cancer stages.
How to standardize the diagnostic approach to pituitary neuroendocrine tumors.
Minerva Endocrinol (Torino)
September 2024
Article Synopsis
- * Accurate histopathological diagnosis is critical for assessing patient risk and ensuring consistent follow-up across different medical centers, particularly as the classification of these tumors evolves with increasing understanding of their biological mechanisms.
- * Recent updates to tumor classification, such as renaming "adenomas" to "Pituitary Neuroendocrine Tumors" and emphasizing specific genetic factors, highlight the need for continued interdisciplinary collaboration to enhance understanding and standardize diagnosis and treatment of these tumors.
Histopathology of growth hormone-secreting pituitary tumors: State of the art and new perspectives.
Best Pract Res Clin Endocrinol Metab
May 2024
Article Synopsis
- Somatotroph adenomas, a type of pituitary neuroendocrine tumor (PitNET), usually arise from the adenohypophysis and lead to conditions like acromegaly and gigantism, but some variants may be silent and not show obvious symptoms.
- Histopathological evaluation requires a detailed analysis of the tumor, including its morphology, hormone secretion, and specific markers to understand its origin and potential behavior, especially in cases that don't function typically or are metastatic.
- Recent studies stress the significance of genetic and epigenetic evaluations in identifying aggressive tumor variants to enhance targeted treatment strategies for pituitary adenomas.
Article Synopsis
- The 2021 fifth edition of the WHO Classification of Tumors of the CNS introduced updated naming and grading systems, focusing on integrated diagnoses and detailed reports for better understanding of tumors.
- This edition put a stronger emphasis on molecular diagnostics alongside traditional methods, introducing new tumor types based on advanced techniques like DNA methylome profiling.
- The review highlights significant changes in classifying pediatric CNS tumors, detailing relevant molecular alterations that are crucial for diagnosis, prognosis, and treatment strategies important for both patients and oncologists.
Article Synopsis
- * The duplication modifies the normal gene arrangement, leading to increased hormone production and causing gigantism due to a new regulatory domain (neo-TAD) that disrupts typical genetic control.
- * The case study of a female patient highlights the challenges in diagnosing and treating X-LAG, showcasing the use of advanced medical techniques and surgical interventions to achieve hormone regulation in affected children.
Article Synopsis
- Adult Diffuse midline glioma (DMG) is a rare brain tumor in adults, treated primarily with radiotherapy and chemotherapy, but the effectiveness of these treatments has been under-evaluated.
- A study of 49 patients revealed that while concurrent chemotherapy didn’t improve overall survival (OS), adjuvant temozolomide treatment significantly extended OS from 9.0 to 21.2 months.
- The results suggest that following initial treatment with radiotherapy, adjuvant chemotherapy can enhance survival outcomes, and for patients who experience disease progression, second-line systemic treatment could offer further survival benefits.
Article Synopsis
- Glioblastoma -wildtype is the most aggressive and common primary brain tumor, with ongoing research uncovering its complex genetic makeup and aggressive behavior.* -
- The telomerase reverse transcriptase (TERT) gene is frequently mutated in this cancer, found in 80-90% of GBM -wildtype cases, making it a promising target for treatment despite challenges in developing effective inhibitors.* -
- Recent studies are exploring new immunological methods to inhibit TERT, and this review examines TERT's role in glioblastoma, its inhibition challenges, and potential combination treatment approaches to enhance effectiveness.*
Article Synopsis
- The study focuses on using machine learning to predict outcomes (Gross Total Resection, Biochemical Remission, and hypothalamus-pituitary axis improvement) for patients undergoing pituitary adenoma surgery, with the goal of personalizing patient care.
- It uses data from a large cohort of patients in Bologna for model development and validates the models with another cohort from Zurich, demonstrating effective predictions.
- Results showed good performance of the models, with the highest accuracy for predicting improvement in the hypothalamus-pituitary axis, suggesting machine learning could enhance surgical decision-making for individual patients.
Article Synopsis
- PATZ1-rearranged CNS tumors may or may not be a distinct tumor type, as researchers investigated a pediatric series of 7 cases using various advanced analysis techniques to understand their characteristics.* -
- MRI results showed these tumors mainly occur in the occipital lobe and have two major types: one resembling glial cells (NET) and another showing spindle cell features (SM), both identified via histologic analysis.* -
- Although both groups share molecular similarities, gene expression analysis revealed they form two distinct subgroups, with those in the SM group showing important genes related to tumor progression; most patients are disease-free following treatment.*
Chronic myelomonocytic leukemia (CMML) is a hematological neoplasm characterized by monocytosis, splenomegaly, thrombocytopenia, and anemia. Moreover, it is associated with mutations and, rarely, with variants. We present the case of an 84-year-old patient with persistent anemia and monocytosis.
View Article and Find Full Text PDFPre-operative incisional biopsy of oral squamous cell carcinoma: high podoplanin expression is related to perineural invasion and may be a useful predictor of disease progression.
Oral Surg Oral Med Oral Pathol Oral Radiol
January 2024
Objective: Immunohistochemical analysis of podoplanin expression as a pre-operative molecular marker for perineural invasion (PNI) may represent an attractive strategy for surgical management of oral squamous cell cancer (OSCC). We evaluated the relationship between podoplanin expression and PNI in pre-operative incisional biopsies of OSCC.
Study Design: After performing pathological staging and histologic and immunohistochemical evaluation of 83 surgical specimens, we performed multivariable logistic regression analysis to examine the relationship between PNI and independent variables.
Primary diffuse large B-cell lymphoma of the primary central nervous system (CNS-DLBCL) is an aggressive disease, with dismal prognosis despite the use of high-dose methotrexate-based polychemotherapy. Our study aimed to expand the biologic profiles of CNS-DLBCL and to correlate them with clinical/imaging findings to gain diagnostic insight and possibly identify new therapeutic targets. We selected 61 CNS-DLBCL whose formalin-fixed paraffin-embedded samples were available at first diagnosis.
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