Publications by authors named "Emilio Bria"

Article Synopsis
  • Small-Cell Lung Cancer (SCLC) makes up 15% of lung cancer cases and is often aggressive, leading to severe symptoms even before metastasis.
  • There is a lack of consistency in how palliative care is integrated with cancer treatments, which can leave patients with unmet needs.
  • A survey by 13 experts from Lazio found significant variation in the management of SCLC, prompting the group to develop practical recommendations to standardize patient care in the region.
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Background/objectives: HER2-positive breast cancer (HER2BC) is an aggressive subtype, with neoadjuvant treatment (NAT) aiming to achieve a pathological complete response (pCR) to improve long-term outcomes. Trastuzumab emtansine (T-DM1) has been established as the standard of care in the adjuvant setting for HER2BC patients who do not obtain pCR. The ATD study aimed to evaluate the real-world tolerability of T-DM1 in this setting.

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Lung cancer is still a leading cause of cancer-related deaths worldwide. Vital to ameliorating patient survival rates are early detection, precise evaluation, and personalized treatments. Recent years have witnessed a profound transformation in the field, marked by intricate diagnostic processes and intricate therapeutic protocols that integrate diverse omics domains, heralding a paradigm shift towards personalized and preventive healthcare.

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Background: In advanced pancreatic ductal adenocarcinoma (PDAC), first-line chemotherapy is the standard of care. Due to the absence of head-to-head comparisons in clinical trials, we performed this systematic review and network meta-analysis to compare treatment options for PDAC in terms of their efficacy and toxicity.

Methods: PubMed, the Cochrane Central Register of Controlled Trials, Embase, and oncological meetings websites were searched until Nov 15, 2023.

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Background: While immune checkpoint inhibitors (ICIs) are increasingly reshaping the therapeutic landscape of non-small-cell lung cancer (NSCLC), only a limited proportion of patients achieve a relevant and long-lasting benefit with these treatments, calling for the identification of clinical and, ideally modifiable, predictors of efficacy. Body composition phenotypes may reflect aspects of patients' immunology and thereby their ability to respond to ICIs. This study aims to explore the possible association between pre-treatment body composition phenotypes, tumour response, and clinical outcomes in patients receiving first-line pembrolizumab monotherapy for advanced NSCLC.

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Article Synopsis
  • The study aimed to analyze attrition rates from first-line to third-line therapies in patients with HER2-positive metastatic breast cancer across several European countries.
  • It found that 29.6% of patients discontinued treatment after first-line therapy and 34.2% after second-line therapy, often due to death or transition to palliative care.
  • Additionally, the time patients remained on treatment decreased with each line of therapy, indicating diminishing effectiveness of subsequent treatments.
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  • The uPath PD-L1 (SP263) is an AI platform designed to help pathologists identify and quantify PD-L1 positive tumor cells in non-small cell lung cancer (NSCLC) samples.
  • In a study of 44 patients with advanced NSCLC, the uPath PD-L1 algorithm demonstrated a significant correlation with baseline PD-L1 tumor proportion scores, but only about 61.4% of cases were categorized consistently in terms of PD-L1 expression.
  • The uPath score showed good diagnostic ability for predicting overall survival and progression-free survival, indicating its potential to enhance current biomarkers and improve patient outcomes.
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  • The ongoing FPG500 program aims to provide personalized targeted therapies for non-small cell lung cancer (NSCLC) based on genetic profiling, assessing patient eligibility through comprehensive genome profiling (CGP).
  • In 2022, a significant study involving 283 NSCLC patients revealed that 93% were eligible for sequencing, with 76% undergoing high-throughput genomic analysis, leading to the identification of potential driver mutations in 59% of them.
  • Results showed varying progression-free survival (PFS) and overall survival (OS) rates dependent on the type of treatment received, emphasizing the benefits of implementing CGP and molecular tumor board evaluations in improving patient outcomes.
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  • Second-line treatment for small-cell lung cancer (SCLC) typically depends on how long it's been since the last platinum therapy, with carboplatin and etoposide showing better results if the interval is over 90 days, but this study looks at its effectiveness post-chemo-immunotherapy.
  • A retrospective review of 93 patients who received this rechallenge after initial chemo-immunotherapy revealed a 59.1% overall response rate, with a median progression-free survival of 5 months and overall survival of 7 months.
  • The findings indicate that carboplatin and etoposide remain a valid second-line option for extensive-stage SCLC, providing consistent outcomes regardless of the platinum-free interval as long as it exceeds
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  • The study analyzes the genetic profiles of recurrent thymomas, using samples from 23 patients out of a cohort of 426 thymomas for comparison with primary tumors and a control group of non-recurrent cases.
  • Comprehensive genetic profiling (CGP) was conducted using the NGS Tru-Sight Oncology assay, revealing no significant differences in genetic alterations between initial tumors and recurrent ones, nor between recurrent and non-recurrent thymomas.
  • However, it was found that cell cycle control gene alterations are linked with early recurrence, and over 50% of patients may qualify for potential targeted therapies through a precision medicine approach.
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Background: In untreated ALK-positive non-small cell lung cancer no randomized controlled trials (RCTs) are available directly comparing next-generation ALK-inhibitors. We conducted a sensitivity analysis using the likelihood of being helped or harmed (LHH).

Methods: Phase III trials comparing ALK-inhibitors to crizotinib were included.

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A 41-year-old woman, never-smoker, accessed the emergency room for an episode of hemoptysis in September 2019. CT scan showed a defect of opacification in the left pulmonary artery and a solid mass of 12 cm in the left annex. PET confirmed high metabolic activity in the ovarian mass and, surprisingly, in the left hilar lung.

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Introduction: Radiotherapy (RT) shows potential for improving local control in cases of oligoprogressive metastatic breast cancer (mBC). This retrospective analysis aims to evaluate the advantages of RT in such a clinical scenario.

Methods: We conducted a retrospective analysis including patients with mBC who received radiation therapy (RT) for up to three sites of oligoprogression while continuing systemic therapy.

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In recent years, the widespread use of next-generation sequencing (NGS) allowed clinicians to identify and treat non-small cell lung cancer (NSCLC) efficiently with target therapy. RET inhibitors, like selpercatinib and pralsetinib, for RET rearrangements in lung cancer showed high efficacy and clinical benefit. Nevertheless, to date, the use of molecular-targeted agents has not been tested in all lung cancer subtypes.

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Introduction: To date, for all non-small cell lung cancer (NSCLC) cases, it is recommended to test for driver alterations to identify actionable therapeutic targets. In this light, comprehensive genomic profiling (CGP) with next generation sequencing (NGS) has progressively gained increasing importance in clinical practice. Here, with the aim of assessing the distribution and the real-world frequency of gene alterations and their correlation with patient characteristics, we present the outcomes obtained using FoundationOne (F1CDx) and FoundationLiquid CDx (F1L/F1LCDx) NGS-based profiling in a nationwide initiative for advanced NSCLC patients.

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Article Synopsis
  • Advancements in antiemetic drugs have improved the management of chemotherapy-induced nausea and vomiting (CINV), but about 30% of adult patients still experience persistent symptoms, leading to complications.
  • Supportive care interventions, including physical exercise and nutritional counseling, have proven effective in reducing CINV severity, while psychological interventions and acupuncture have also shown promise.
  • The review aims to update current guidelines for preventing and treating CINV and to explore various non-drug interventions available for cancer patients.
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Background: During targeted treatment, HER2-positive breast cancers invariably lose HER2 DNA amplification. In contrast, and interestingly, HER2 proteins may be either lost or gained. To longitudinally and systematically appreciate complex/discordant changes in HER2 DNA/protein stoichiometry, HER2 DNA copy numbers and soluble blood proteins (aHER2/sHER2) were tested in parallel, non-invasively (by liquid biopsy), and in two-dimensions, hence HER2-2D.

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Article Synopsis
  • * A study involving 352 patients found that microcalcifications were present in 83% of calcified ILNs, and 93.6% of these ILNs were associated with malignancy, compared to only 44.9% in ILNs without calcifications.
  • * Patients with lung cancer who had calcified ILNs also showed a higher occurrence of ALK rearrangement, indicating a potential genomic link related to the presence of microcalcifications.
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Introduction: Combinations of immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) can be responsible for major adverse cardiovascular events (MACEs). We performed a meta-analysis to assess the relative risk (RR) of MACEs and hypertension in cancer patients treated with ICI+TKI combinations.

Research Design And Methods: We selected prospective trials through MEDLINE/PubMed, Cochrane Library, and ASCOMeeting abstracts.

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JCO .Although the CNS activity of selpercatinib in patients with fusion-positive non-small cell lung cancer (NSCLC) has been previously described, the ability of potent RET inhibition to prevent new CNS metastases from developing has been challenging to measure without randomized data. Serial CNS scans were studied from LIBRETTO-431, a randomized phase III trial of selpercatinib versus platinum/pemetrexed ± pembrolizumab whose primary results have been previously disclosed.

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Artificial Intelligence (AI) has revolutionized the management of non-small-cell lung cancer (NSCLC) by enhancing different aspects, including staging, prognosis assessment, treatment prediction, response evaluation, recurrence/prognosis prediction, and personalized prognostic assessment. AI algorithms may accurately classify NSCLC stages using machine learning techniques and deep imaging data analysis. This could potentially improve precision and efficiency in staging, facilitating personalized treatment decisions.

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Article Synopsis
  • * Researchers compared hormone levels among three groups: male patients with ALK-positive ANSCLC (cohort A), female patients with ALK-positive ANSCLC (cohort B), and male patients with ALK-negative ANSCLC (cohort C).
  • * Results indicated that male patients in cohort A had significantly lower testosterone and higher follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels compared to cohort C, suggesting that androgen deficiency symptoms should
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Article Synopsis
  • Recent improvements in breast cancer survival rates are not reflected for gender minorities, as they are often excluded from clinical trials.
  • A review of 51 phase III clinical trials showed that only 35.3% allowed men to enroll, and none reported on transgender or gender-diverse participants.
  • The study calls for more inclusive trial criteria to better represent gender minorities, highlighting a significant underrepresentation and varying enrollment rates across different drug classes.
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Purpose: The aim of this multi-center, retrospective/prospective cohort observational study was to evaluate outcomes in routine clinical practice of first-line chemo-immunotherapy with cis/carboplatin, pemetrexed and pembrolizumab in patients with advanced non-squamous non-small cell lung cancer (NSCLC) in 33 Italian centers.

Methods: The outcome measure was to evaluate overall survival (OS) in a real-world patient population. Secondary endpoints were: progression-free survival (PFS), objective response rate (ORR), duration of response (DoR) and incidence of treatment-related adverse events (AEs).

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