Publications by authors named "LaMarca A"

Brazil, Russia, India, China, and South Africa (BRICS) are a group of developing countries with shared economic, healthcare, and scientific interests. These countries navigate multiple syndemics, and the COVID-19 pandemic placed severe strain on already burdened BRICS' healthcare systems, hampering effective pandemic interventions. Genomic surveillance and molecular epidemiology remain indispensable tools for facilitating informed pandemic intervention.

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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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Background: Twice-yearly subcutaneous lenacapavir has been shown to be efficacious for prevention of HIV infection in cisgender women. The efficacy of lenacapavir for preexposure prophylaxis (PrEP) in cisgender men, transgender women, transgender men, and gender-nonbinary persons is unclear.

Methods: In this phase 3, double-blind, randomized, active-controlled trial, we randomly assigned participants in a 2:1 ratio to receive subcutaneous lenacapavir every 26 weeks or daily oral emtricitabine-tenofovir disoproxil fumarate (F/TDF).

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• This Clinical Practice Guideline provides key recommendations for managing rare endocrine tumours. • Neuroendocrine neoplasms of different origins, parathyroid carcinoma and intrathyroid thymic neoplasms are included. • The guideline covers clinical imaging and pathological diagnosis, staging and risk assessment, treatment and follow-up.

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A raise in the incidence of NENs is expected. Therefore, the identification of new therapeutic strategies, such as immunotherapy, remains crucial. To date, immune checkpoint inhibitors as monotherapy have shown modest activity in unselected NENs.

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Article Synopsis
  • This review provides a detailed comparison of international guidelines for managing advanced, non-functioning, well-differentiated pancreatic neuroendocrine tumors (panNETs), which vary in clinical behavior and prognosis.
  • It highlights differences in therapeutic strategies among ESMO, NCCN, ASCO, ENETS, and NANETS, focusing on first-line therapies, treatment pathways, and factors like tumor grading and the Ki-67 index.
  • The analysis stresses the importance of a personalized approach to treatment and the crucial role of multidisciplinary teams in optimizing care for patients with advanced NF panNETs.
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  • The incidence and prevalence of well-differentiated small intestine neuroendocrine tumors (Si-NET) are rising, with most cases being non-functioning and often discovered incidentally during routine procedures or late-stage imaging.
  • About 30% of patients experience symptoms related to the carcinoid syndrome, highlighting the disease's subtle presentation.
  • Effective treatment planning requires thorough biochemical assessment and staging, ideally conducted in specialized ENETS Centres of Excellence or expert centers, as outlined in guidance focusing on management strategies for Si-NET grades 1-3.
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Biliary tract cancers (BTC) are a heterogeneous group of cancers that continue to present a particularly poor prognosis. BTC treatment is rapidly evolving yet facing many challenges to improve patient outcomes and maximize benefit from treatment. Only a minority of patients are diagnosed with early-stage disease and are suitable for curative resection.

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Background: Resection of perihilar cholangiocarcinoma (pCCA) is a complex procedure with a high risk of postoperative mortality and early disease recurrence. The objective of this study was to compare patient characteristics and overall survival (OS) between pCCA patients who underwent an R1 resection and patients with localized pCCA who received palliative systemic chemotherapy.

Methods: Patients with a diagnosis of pCCA between 1997-2021 were identified from the European Network for the Study of Cholangiocarcinoma (ENS-CCA) registry.

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COVID-19 is an infectious disease caused by SARS-CoV-2 that has become a serious threat to public health owing to its rapid spread from aerosols from infected people. Despite being considered a strictly human disease, there are reports in the literature about animals with confirmed presence of the virus. Owing to the scarcity of scientific literature on the potential for infection of animals and their importance for One Health, the objective of this work was to research SARS-CoV-2 RNA in felines (Felis silvestris catus) and dogs (Canis lupus familiaris) domiciled.

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There is a clinical need for F-labeled somatostatin analogs for the imaging of neuroendocrine tumors (NET), given the limitations of using [Ga]Ga-DOTA-peptides, particularly with regard to widespread accessibility. We have shown that [F]fluoroethyl-triazole-[Tyr]-octreotate ([F]FET-βAG-TOCA) has favorable dosimetry and biodistribution. As a step toward clinical implementation, we conducted a prospective, noninferiority study of [F]FET-βAG-TOCA PET/CT compared with [Ga]Ga-DOTA- peptide PET/CT in patients with NET.

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Biliary tract cancers (BTCs) encompass a heterogeneous group of rare tumors, including intrahepatic cholangiocarcinoma (iCCA), extrahepatic cholangiocarcinoma (eCCA), gallbladder cancer (GBC) and ampullary cancer (AC). The present first-line palliative treatment regimen comprises gemcitabine and cisplatin in combination with immunotherapy based on two randomized controlled studies. Despite the thorough investigation of these palliative treatments, long-term survival remains low.

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Mouse double minute 2 homolog (MDM2) is a key negative regulator of the tumor suppressor p53. Blocking the MDM2-p53 interaction, and restoring p53 function, is therefore a potential therapeutic strategy in -amplified, wild-type tumors. is amplified in several tumor types, including biliary tract cancer (BTC), pancreatic ductal adenocarcinoma (PDAC), lung adenocarcinoma and bladder cancer, all of which have limited treatment options and poor patient outcomes.

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Article Synopsis
  • 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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  • Biliary tract tumours, such as those affecting the bile duct and gallbladder, are rare and typically diagnosed at advanced stages, leading to poor treatment options and a five-year survival rate below 20%.
  • First-line chemotherapy using gemcitabine-cisplatin shows only modest effectiveness, prompting the need for better therapeutic strategies, with the ABC-06 trial presenting FOLFOX as the standard second-line therapy.
  • While nal-IRI plus 5-FU/LV from the NIFTY trial shows promise, conflicting results from the NALIRICC trial and challenges in patient care highlight the need for more effective first-line treatments and ongoing research into tailored therapies.
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Cholangiocarcinomas (CCA) are a heterogeneous group of tumors that are classified as intrahepatic, perihilar, or distal according to the anatomic location within the biliary tract. Each CCA subtype is associated with distinct genomic alterations, including single nucleotide variants, copy number variants, and chromosomal rearrangements or gene fusions, each of which can influence disease prognosis and/or treatment outcomes. Molecular profiling using next-generation sequencing (NGS) is a powerful technique for identifying unique gene variants carried by an individual tumor, which can facilitate their accurate diagnosis as well as promote the optimal selection of gene variant-matched targeted treatments.

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Precision medicine is a major achievement that has impacted on management of patients diagnosed with advanced cholangiocarcinoma (CCA) over the last decade. Molecular profiling of CCA has identified targetable alterations, such as fibroblast growth factor receptor-2 (FGFR-2) fusions, and has thus led to the development of a wide spectrum of compounds. Despite favourable response rates, especially with the latest generation FGFRi, there are still a proportion of patients who will not achieve a radiological response to treatment, or who will have disease progression as the best response.

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Advanced pancreatic cancer is associated with a poor prognosis, often less than 1 year. Honest prognosis discussions guide early community palliative care services input, facilitating timely advance care planning and improving quality of life. The aims were to assess if patients were offered prognosis discussions and community palliative care services referral.

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Introduction: Chronic conditions such as stroke, Parkinson's disease, spinal cord injury, multiple sclerosis, vestibular disorders, chronic pain, arthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease are leading causes of disability among middle-aged and older adults. While evidence-based treatment can optimize clinical outcomes, few people with chronic conditions engage in the recommended levels of exercise for clinical improvement and successful management of their condition. Rehabilitation technologies that can augment therapeutic care-i.

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Article Synopsis
  • Cirrhosis is a common condition in patients with advanced intrahepatic cholangiocarcinoma (iCC), affecting approximately 28.6% of those studied.
  • Patients with cirrhosis experienced higher rates of severe side effects from chemotherapy and had a shorter overall survival (9.1 months) compared to those without cirrhosis (13.1 months).
  • The study suggests the need for incorporating cirrhosis assessment into treatment plans for patients with advanced iCC to improve management outcomes.
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The treatment of advanced unresectable HCC (aHCC) remains a clinical challenge, with limited therapeutic options and poor prognosis. The results of IMbrave150 and HIMALAYA have changed the treatment paradigm for HCC and established immune checkpoint inhibition (ICI), either combined with anti-angiogenic therapy or dual ICI, as preferred first-line therapy for eligible patients with aHCC. Numerous other combination regimens involving ICI are under investigation with the aim of improving the tumour response and survival of patients with all stages of HCC.

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