Publications by authors named "Francesco Foschi"
Article Synopsis
- * A study involving nearly 2,000 non-resectable HCC patients showed that LMWA had comparable safety and overall survival rates to PRFA and significantly better survival rates than TACE after 1, 3, and 5 years.
- * The results suggest that LMWA is a viable treatment option for early HCC, outperforming TACE while demonstrating similar efficacy to PRFA, which supports its potential inclusion in standardized treatment
Introduction: The most frequently used first-line treatment in patients with advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab. Upon progression after this treatment, the standard of care in many countries is sorafenib, due to the lack of reimbursement for other drugs. Several randomized trials are currently underway to clarify the best second-line therapy in patients with HCC.
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- * A retrospective analysis of 885 HCC patients showed no significant differences in overall survival, time to progression, or disease control rates between viral and nonviral patients treated with the combination therapy.
- * Common prognostic factors were identified across both groups, but there might be some stronger associations between immunological factors and outcomes specifically in viral patients, while treatment-related toxicities and second-line treatments showed nearly identical results for both etiology subgroups.
Article Synopsis
- * Patients taking metformin had significantly shorter OS (HR 1.9) and PFS (HR 1.6) compared to those not using the medication, while no such differences were found in the Lenvatinib cohort.
- * The findings suggest a negative impact of metformin usage on patient outcomes specifically in the context of Atezolizumab plus Bevacizumab treatment for HCC, highlighting the need for
Article Synopsis
- Type-2 diabetes often coexists with cirrhosis, negatively impacting complications and mortality rates among patients.
- A study analyzing data from the ANSWER trial focused on 85 patients receiving long-term human albumin (HA) in addition to standard treatment, revealing improved survival rates (86% vs. 57%) and fewer complications.
- The HA group experienced fewer instances of complications like infections and renal issues, although overall hospital admissions were similar between groups, with shorter hospital stays for those receiving HA.
Background And Aims: We aimed to characterize the epidemiologic and comorbidities profiles of patients with chronic Hepatitis D (CHD) followed in clinical practice in Italy and explored their interferon (IFN) eligibility.
Methods: This was a cross-sectional study of the PITER cohort consisting of consecutive HBsAg-positive patients from 59 centers over the period 2019-2023. Multivariable analysis was performed by logistic regression model.
Article Synopsis
- The 2022 Barcelona Clinic Liver Cancer algorithm advises against liver resection for patients with multiple small tumors (2 or 3 nodules, each ≤3 cm) in hepatocellular carcinoma.
- This study retrospectively analyzed data from over 12,000 patients to compare survival outcomes among those undergoing liver resection (LR), percutaneous radiofrequency ablation (PRFA), and transarterial chemoembolization (TACE).
- Results showed that LR had the highest survival rates at 1, 3, and 5 years (89.11%, 70.98%, 56.44% respectively) compared to PRFA and TACE, indicating that LR may offer better long-term outcomes in treating early multin
Introduction: Lenvatinib is indicated for the forefront treatment of advanced hepatocellular carcinoma (aHCC), but its use may be limited by the risk of esophagogastric varices (EGV) bleeding. This study assessed the prevalence, predictors, and complications of EGV in aHCC patients treated with lenvatinib.
Methods: In this multicenter international retrospective study, cirrhotic patients treated with lenvatinib for aHCC, were enrolled if upper-gastrointestinal endoscopy was available within 6 months before treatment.
Article Synopsis
- * The research identified independent prognostic factors affecting overall survival and progression-free survival, notably the severity of decreased appetite, immunotoxicity, diarrhea, fatigue, arterial hypertension, and proteinuria.
- * The findings underscore a significant relationship between the occurrence of AEs and therapy outcomes in HCC patients, similar to what has been observed in other treatment contexts, highlighting the importance of monitoring AEs for prognosis.
Antiangiogenics are associated with an increased risk of major adverse cardiac and cerebrovascular events (MACE). The identification of at-risk subjects is relevant in the case of hepatocellular carcinoma (HCC), for which anti-angiogenic TKIs and bevacizumab are used in first and subsequent lines of therapy, to select alternative drugs for patients with excessive risk. We verified the ability to predict MACE in sorafenib-treated patients of the 2022 European Society of Cardiology (ESC-2022) score for anti-angiogenics and the recently proposed CARDIOSOR score.
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- - The study examines the impact of Body Mass Index (BMI) on survival among patients with advanced liver cancer (HCC) undergoing first-line treatment with either atezolizumab plus bevacizumab or lenvatinib, focusing on underweight, normal-weight, and overweight classifications.
- - In a cohort of 1,292 patients, results indicated that underweight individuals had significantly shorter overall survival (OS) compared to normal-weight patients, while no significant differences in OS were observed between normal and overweight patients.
- - The research highlights the differing prognostic implications of BMI in cancer treatment, suggesting that underweight patients may require more focused clinical considerations in advanced HCC therapy.
Background & Aims: Chronic hepatitis D virus (HDV) often leads to end-stage liver disease and hepatocellular carcinoma (HCC). Comprehensive data pertaining to large populations with HDV and HCC are missing, therefore we sought to assess the characteristics, management, and outcome of these patients, comparing them to patients with hepatitis B virus (HBV) infection.
Methods: We analysed the Italian Liver Cancer database focusing on patients with positivity for HBV surface antigen and anti-HDV antibodies (HBV/HDV, n = 107) and patients with HBV infection alone (n = 588).
Background And Aims: The efficacy of systemic therapy for unresectable advanced hepatocellular carcinoma (aHCC) has not been proven in patients with Child-Pugh (C-P) B cirrhosis. Nevertheless, in real-world these patients are treated both with tyrosine kinase inhibitors (TKIs) and with metronomic capecitabine (MC). This study aimed to compare sorafenib and MC outcomes versus best supportive care (BSC) in C-P B patients.
View Article and Find Full Text PDFComparative Analysis of Subclassification Systems in Patients with Intermediate-Stage Hepatocellular Carcinoma (Barcelona Clinic Liver Classification B) Receiving Systemic Therapy.
Curr Oncol
January 2024
Background: Intermediate-stage hepatocellular carcinoma (BCLC B HCC) occurs in a heterogeneous group of patients and can be addressed with a wide spectrum of treatments. Consequently, survival significantly varies among patients. In recent years, several subclassification systems have been proposed to stratify patients' prognosis.
View Article and Find Full Text PDFBackground: Data concerning the use of lenvatinib in very old patients (≥ 80 years) are limited, although the incidence of hepatocellular carcinoma (HCC) in this patient population is constantly increasing.
Objective: This analysis aimed to evaluate the efficacy and safety of lenvatinib in a large cohort of very old patients (≥ 80 years) with unresectable HCC.
Patients And Methods: The study was conducted on a cohort of 1325 patients from 46 centers in four Western and Eastern countries (Italy, Germany, Japan, and the Republic of Korea) who were undergoing first-line treatment with lenvatinib between July 2010 and February 2022.
Development and internal validation of a multivariable model for the prediction of the probability of 1-year readmission to the emergency department for acute alcohol intoxication.
Intern Emerg Med
April 2024
Article Synopsis
- A multivariable logistic regression model was developed to predict the likelihood of 1-year readmission to the emergency department for patients with acute alcohol intoxication, using data from 3,304 patients at a hospital in Italy.
- The model initially included various predictors such as age, sex, and several health and social factors, and underwent optimization to improve its simplicity while maintaining accuracy.
- The final reduced model showed strong predictive performance and should be tested in other patient groups to confirm its clinical usefulness.
Atezolizumab plus bevacizumab (AB) and lenvatinib can be alternatively used as first-line systemic treatment of unresectable hepatocellular carcinoma (HCC). However, no direct comparison of the two regimens has been performed in randomized clinical trials, making the identification of baseline differential predictors of response of major relevance to tailor the best therapeutic option to each patient. Baseline clinical and laboratory characteristics of real-world AB-treated HCC patients were analyzed in uni- and multivariate analyses to find potential prognostic factors of overall survival (OS).
View Article and Find Full Text PDFBackground And Aims: Hepatocellular carcinoma (HCC) recurrence is common in patients treated with liver resection (LR). In this study, we aimed to evaluate the incidence and preoperative predictors of non-transplantable recurrence in patients with single HCC ≤5 cm treated with frontline LR.
Methods: From the Italian Liver Cancer (ITA.
Splanchnic vein thrombosis (SVT) is a manifestation of venous thromboembolism in an unusual site. Portal, mesenteric, and splenic veins are the most common vessels involved in SVT which occurs mainly in patients with liver cirrhosis, although non-cirrhotic patients could be affected as well. Thrombosis of hepatic veins, also known as Budd-Chiari syndrome, is another manifestation of SVT.
View Article and Find Full Text PDFPurpose: Hepatitis C virus (HCV) spreads from contact with blood of an infected person. HCV infections are common among people who use drugs (PWUDs), when sharing needles, syringes, or other equipment for injected drugs. The advent of pangenotypic direct-antiviral agents (DAA) in 2017 transformed the treatment landscape for HCV, but PWUDs remain a complex and hard-to-treat population with high risk of HCV reinfection.
View Article and Find Full Text PDFBackground & Aims: Alcohol abuse and metabolic disorders are leading causes of hepatocellular carcinoma (HCC) worldwide. Alcohol-related aetiology is associated with a worse prognosis compared with viral agents, because of the lower percentage of patients diagnosed with HCC under routine surveillance and a higher burden of comorbidity in alcohol abusers. This study aimed to describe the evolving clinical scenario of alcohol-related HCC over 15 years (2006-2020) in Italy.
View Article and Find Full Text PDFIntroduction: The aim of this retrospective proof-of-concept study was to compare different second-line treatments for patients with hepatocellular carcinoma and progressive disease (PD) after first-line lenvatinib or atezolizumab plus bevacizumab.
Materials And Methods: A total of 1381 patients had PD at first-line therapy. 917 patients received lenvatinib as first-line treatment, and 464 patients atezolizumab plus bevacizumab as first-line.
Purpose Of Review: We discuss two recent controversial issues in the research field of fatty liver: the proposal to replace nonalcoholic fatty liver disease (NAFLD) with metabolically associated fatty liver disease (MAFLD) and the suggestion to extend to primary care the noninvasive testing for liver fibrosis that was developed for secondary care.
Recent Findings: There is preliminary evidence that MAFLD-only patients are at greater risk of fibrosis than NAFLD-only patients. There are a large number of false positives associated with the downshift of noninvasive testing for liver fibrosis from secondary to primary care.
Article Synopsis
- A retrospective multi-centre study compared the effectiveness and safety of two treatment regimens—lenvatinib and atezolizumab plus bevacizumab—for patients with unresectable hepatocellular carcinoma (HCC).
- The analysis involved 1341 patients on lenvatinib and 864 on the combination therapy, with overall survival (OS) as the main measure, showing no significant survival advantage for either treatment overall.
- However, the results suggested that patients with viral liver disease might benefit more from the combination therapy, while those with non-alcoholic fatty liver disease could have better outcomes with lenvatinib, alongside a generally better safety profile for the combination treatment.