Publications by authors named "Raffaele Giusti"

Background: Patients with head and neck cancer (HNC) bear a significant load, due to both disease-related symptoms and to toxicities associated with treatments. Evaluating quality of life (QoL) is crucial to gauge the physical and psychological impact on these patients. Our primary aim was to assess whether QoL has been incorporated as an endpoint in phase II and III clinical trials for HNC patients in the last 15 years.

View Article and Find Full Text PDF

Small-Cell Lung Cancer (SCLC) accounts for 15 % of all lung cancer cases. Due to comorbidities and its aggressive behaviour, patients are highly symptomatic even at a non-metastatic stage. Standardizing the care pathway and introducing a simultaneous care approach could address the unmet needs of this disease.

View Article and Find Full Text PDF

: Single-agent immune checkpoint inhibitor (IO) therapy is the standard for non-oncogene-addicted advanced non-small cell lung cancer (aNSCLC) with PD-L1 tumor proportion score ≥ 50%. Smoking-induced harm generates high tumor mutation burden (H-TMB) in smoking patients (S-pts), while never-smoking patients (NS-pts) typically have low TMB (L-TMB) and are unresponsive to IO. However, the molecular characterization of NS-pts with H-TMB remains unclear.

View Article and Find Full Text PDF

Background: Medical cannabis (MC) has gained traction in oncology for managing cancer-related symptoms, but its integration faces challenges due to limited evidence, inconsistent guidelines, and varied legal frameworks.

Methods: The TASMAN study aimed to assess the knowledge, attitudes, and practices of oncologists and palliative care providers globally regarding MC use in cancer care. A survey of healthcare providers from diverse regions and income levels was conducted.

View Article and Find Full Text PDF

Immunotherapy is increasingly used in advanced non-small-cell lung cancer (NSCLC), offering a significant anti-tumor response, as well as causing rising immune-related adverse effects. The incidence of immune checkpoint inhibitor-induced myocarditis-myositis-myasthenia gravis is increasing and particularly concerning due to its high mortality rate. Prompt recognition, diagnosis, and management are crucial.

View Article and Find Full Text PDF
Article Synopsis
  • Neoadjuvant chemoimmunotherapy is changing the treatment for resectable non-small cell lung cancer (NSCLC), but the importance of pathologic response is still uncertain.
  • A systematic review and individual patient data meta-analysis was conducted to assess how achieving complete pathologic response (pCR) or major pathologic response (MPR) affects long-term survival (EFS) and examine the role of adjuvant immunotherapy.
  • The findings showed that patients who achieved pCR or MPR had significantly better EFS rates, while adjuvant immunotherapy did not improve survival outcomes post-surgery.
View Article and Find Full Text PDF

Objective: The uPath PD-L1 (SP263) is an AI-based platform designed to aid pathologists in identifying and quantifying PD-L1 positive tumor cells in non-small cell lung cancer (NSCLC) samples stained with the SP263 assay.

Methods: In this preliminary study, we explored the diagnostic performance of the uPath PD-L1 algorithm in defining PD-L1 tumor proportion score (TPS) and predict clinical outcomes in a series of patients with advanced stage NSCLC treated with single agent PD-1/PD-L1 checkpoint blockade previously assessed with the SP263 assay in clinical practice.

Results: 44 patients treated from August 2015 to January 2019 were included, with baseline PD-L1 TPS of ≥ 50%, 1-49% and < 1% in 38.

View Article and Find Full Text PDF

Older patients have similar immune checkpoint inhibitor efficacy and rates of adverse events as younger patients, but appear to have decreased tolerability, particularly in the oldest patient cohort (>80 years), often leading to early cessation of therapy. We aimed to determine whether early discontinuation impacts efficacy of anti-PD-1 therapy in patients ≥80 years old. In this retrospective, multicenter, international cohort study, we examined 773 patients with 4 tumor types who were at least 80 years old and treated with anti-PD-1 therapy.

View Article and Find Full Text PDF

Cancer is a leading cause of morbidity and mortality worldwide, with pain experienced by most patients undergoing cancer treatment. Opioids are the recommended treatment for cancer pain management, but recent studies suggest a negative association between opioid use and survival rates among patients undergoing immunotherapy. However, conclusions cannot be drawn regarding causality from these observational data.

View Article and Find Full Text PDF
Article Synopsis
  • Immune checkpoint inhibitors (ICIs) may enhance lung cancer treatment when combined with chemoradiation, but there's concern about increased pneumonitis risk, necessitating careful evaluation of this combination.
  • A retrospective study analyzed 152 lung cancer patients who received chemoradiation (with or without ICIs) between January 2020 and December 2021, monitoring pneumonitis incidence through CT scans and tracking various clinical characteristics.
  • The cohort mainly included non-small cell lung cancer (NSCLC) patients, with the study aiming to determine any significant differences in pneumonitis rates and identify potential risk factors associated with the combination therapy.
View Article and Find Full Text PDF

Aim: This article is based on our previous research, which was presented as a post at the Congress Aiom 2022 Congress and published in as Conference Abstract (. 2022;108:1-194. doi: 10.

View Article and Find Full Text PDF

Purpose: Review the literature to propose suggestions or recommendations for controlling nausea and vomiting through integrative and non-pharmacological treatments for the MASCC/ESMO 2023 update of its antiemetic guidelines.

Methods: The authors identified available systematic reviews and/or meta-analyses for 12 integrative therapies, including acupressure, acupuncture, auricular therapy, electrical stimulation of point PC6, ginger use (i.e.

View Article and Find Full Text PDF
Article Synopsis
  • Immune-related liver injury (irLI) occurs more frequently in patients with hepatocellular carcinoma (HCC) treated with immune checkpoint inhibitors (ICIs) compared to those with other solid tumors, showing an incidence of 11.4% versus 2.6%.
  • Patients with HCC experienced irLI earlier (median of 1.4 months) than those with other cancers (median of 4.7 months), but had higher rates of irLI resolution (72.1% vs. 58.3%).
  • The study suggests that while irLI leads to improved overall survival in HCC patients with milder cases, it also results in lower need for corticosteroids, indicating a different response pattern compared to
View Article and Find Full Text PDF
Article Synopsis
  • - Geriatric patients aged 80 and older are often excluded from clinical trials for immune checkpoint inhibitors (ICIs), despite their potential different responses due to unique biological factors.
  • - A study analyzed data from 885 patients treated with ICIs, finding that those aged 80 and above with low levels of inflammatory markers (NLR and SII) exhibited significantly better treatment responses and longer survival outcomes.
  • - The research suggests that lower inflammatory levels before starting ICI treatment can be a useful predictor for improved effectiveness and survival rates in older cancer patients.
View Article and Find Full Text PDF

The neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammatory index (SII) have been reported as prognosticators in non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC), and melanoma. This analysis of the INVIDIa-2 study on influenza vaccination in patients with cancer treated with immune checkpoint inhibitors (ICIs) assessed NLR and SII on overall survival (OS) by literature-reported (LR), receiver operating characteristic curve (ROC)-derived (ROC) cutoffs or as continuous variable (CV). NLR and SII with ROC cutoffs of <3.

View Article and Find Full Text PDF

Background: The prospective multicentre observational INVIDIa-2 study investigated the clinical effectiveness of influenza vaccination in patients with advanced cancer receiving immune checkpoint inhibitors (ICI). In this secondary analysis of the original trial, we aimed to assess the outcomes of patients to immunotherapy based on vaccine administration.

Methods: The original study enrolled patients with advanced solid tumours receiving ICI at 82 Italian Oncology Units from Oct 1, 2019, to Jan 31, 2020.

View Article and Find Full Text PDF

Objectives: We described time to death and rates of palliative sedation during home palliative care leveraging a retrospective cohort of patients with advanced cancer.

Methods: The cohort consists of 143 patients with solid or haematological malignancies admitted to home palliative care in the Tuscany region in central Italy. Only patients for whom a date of death was available were included.

View Article and Find Full Text PDF

Purpose: No evidence exists as to whether type 2 diabetes mellitus (T2DM) impairs clinical outcome from immune checkpoint inhibitors (ICI) in patients with solid tumors.

Experimental Design: In a large cohort of ICI recipients treated at 21 institutions from June 2014 to June 2020, we studied whether patients on glucose-lowering medications (GLM) for T2DM had shorter overall survival (OS) and progression-free survival (PFS). We used targeted transcriptomics in a subset of patients to explore differences in the tumor microenvironment (TME) of patients with or without diabetes.

View Article and Find Full Text PDF

Underlying cancer pain has heterogenous aetiologies and mechanisms. It requires detailed and comprehensive pain assessment, combined with personalized treatment. A multidisciplinary team is essential to providing the best management of cancer pain at every disease stage, improving the quality of life and outcomes in patients with cancer.

View Article and Find Full Text PDF

Background: Real-life spectrum and survival implications of immune-related adverse events (irAEs) in patients treated with extended interval dosing (ED) immune checkpoint inhibitors (ICIs) are unknown.

Methods: Characteristics of 812 consecutive solid cancer patients who received at least 1 cycle of ED monotherapy (pembrolizumab 400 mg Q6W or nivolumab 480 mg Q4W) after switching from canonical interval dosing (CD; pembrolizumab 200 mg Q3W or nivolumab 240 mg Q2W) or treated upfront with ED were retrieved. The primary objective was to compare irAEs patterns within the same population (before and after switch to ED).

View Article and Find Full Text PDF