Publications by authors named "Sebastiano Filetti"
Article Synopsis
- Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and this study examined the potential of two microRNAs, miR-146a-5p and miR-221-3p, as biomarkers for diagnosing and monitoring PTC.
- The researchers conducted an observational study with PTC patients and healthy controls, analyzing levels of these microRNAs through digital PCR before and after surgery.
- Results showed that both microRNAs are effective in differentiating PTC patients from healthy individuals, with specific fold changes indicating disease progression, making them useful for ongoing patient monitoring.
Article Synopsis
- * Recent advancements in diagnostic methods, like TIRADS, help predict the risk of malignancy, potentially reducing the need for biopsies, though larger nodules still require cytological evaluation.
- * Management strategies now include options like active surveillance and local treatments instead of solely relying on surgery, supported by shared decision-making tools for better clinician-patient communication.
Context: The utility of thyroglobulin (Tg) in the follow-up of differentiated thyroid cancer (DTC) patients has been well-documented. Although third-generation immunoassays have improved accuracy, limitations persist (interfering anti-Tg antibodies and measurement variability). Evolving treatment strategies require a reevaluation of Tg thresholds for optimal patient management.
View Article and Find Full Text PDFThere is some controversy on the potential relationship between autoimmune processes and clinicopathologic features as well as prognosis of differentiated thyroid cancer (DTC), and the evidence is limited by its largely retrospective nature. We examined the relationship between the presence of autoimmune thyroiditis (AT) and 1-year thyroid cancer treatment outcomes in a large multicenter study using prospectively collected data. We included data from consecutive DTC patients enrolled in the Italian Thyroid Cancer Observatory (ITCO) database (NCT04031339).
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- Recent research highlights the importance of improving risk stratification for patients with differentiated thyroid cancer (DTC) beyond the existing 2015 American Thyroid Association (ATA) guidelines.
- A study utilizing the Italian Thyroid Cancer Observatory database analyzed 4,773 DTC cases to develop a decision tree model that predicts persistent/recurrent disease by considering a range of predictive factors.
- The new model demonstrated better performance than the ATA guidelines by increasing sensitivity and predictive accuracy, suggesting that incorporating additional variables like age and tumor size can enhance patient risk assessment.
The actual rates of suspicious thyroid nodules (TNs) and confirmed thyroid cancer (TC) in putatively "at-risk" selected populations (e.g., individuals with family history of TC) are still uncertain.
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- * While multikinase inhibitors for RET mutations initially showed limited effectiveness and high toxicity, newer selective inhibitors like selpercatinib and pralsetinib demonstrate better efficacy and tolerability, although direct comparisons with older multikinase drugs are lacking.
- * Advancements in high-throughput technology have uncovered rare cancer alterations, such as deletions and insertions, prompting further investigation into their functional impact and potential responsiveness to RET inhibitors. *
The role of minimal extrathyroidal extension (mETE) as a risk factor for persistent papillary thyroid carcinoma (PTC) is still debated. The aims of this study were to assess the clinical impact of mETE as a predictor of worse initial treatment response in PTC patients and to verify the impact of radioiodine therapy after surgery in patients with mETE. We reviewed all records in the Italian Thyroid Cancer Observatory database and selected 2237 consecutive patients with PTC who satisfied the inclusion criteria (PTC with no lymph node metastases and at least 1 year of follow-up).
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- Cancer stem-like cells (CSCs), especially glioblastoma stem-like cells, drive cancer growth, treatment resistance, and metastasis due to their self-renewal abilities.
- A study found that four transcription factors (SOX2, SALL2, OLIG2, and POU3F2) are essential for reprogramming differentiated glioblastoma cells into a stem-like state, with FOSL1 identified as a potential regulator of these factors.
- Experiments using NTERA-2 and HEK293T cells showed that FOSL1 can directly influence the four transcription factors, alter stemness markers, and affect the cells' ability to form aggregates, indicating its role in stemness reprogram
Article Synopsis
- Despite significant advances in epigenetic research over the past five decades, most clinical applications remain limited, with only a few hospitals utilizing epigenetic biomarkers for patient care.
- The concept of precision medicine, which tailors treatment based on individual genetic and epigenetic profiles, is not widely adopted in everyday medical practices, as many still rely on a more traditional, reductionist approach.
- The paper highlights the progress in understanding epigenetic biomarkers and emphasizes the need to shift towards network medicine, where molecular diagnostics can inform more personalized treatment strategies, particularly for diseases like cancer.
Molecular analysis of fine-needle aspiration cytology in thyroid disease: where are we?
Curr Opin Otolaryngol Head Neck Surg
April 2021
Article Synopsis
- The prevalence of thyroid nodules is high, yet only about 5% are cancerous; cytology is usually used to check for cancer but often ends up being inconclusive.
- *Molecular testing has emerged as a better method to assess the risk of malignancy and guide management, but challenges remain with certain mutations and specific cancer types.
- *For molecular tests to be effective in clinical practice, they must be used in the right cases, as they can help avoid unnecessary surgeries for uncertain thyroid nodules.
Context: Current guidelines recommend a selective use of radioiodine treatment (RAI) for papillary thyroid cancer (PTC).
Objective: This work aimed to determine how policy changes affect the use of RAI and the short-term outcomes of patients.
Methods: A retrospective analysis of longitudinal data was conducted in an academic referral center of patients with nonaggressive PTC variants; no extrathyroidal invasion or limited to soft tissues, no distant metastases, and 5 or fewer central-compartment cervical lymph node metastases.
Article Synopsis
- Ultrasonographic risk-stratification systems (RSS), like various Thyroid Imaging Reporting and Data Systems (TIRADS), were designed to enhance reporting and minimize unnecessary fine-needle aspiration biopsies for thyroid nodules.
- The study included 818 patients who underwent thyroid biopsies, showing that malignancy risk was higher in those aged 65 and younger (8.1%) compared to those older than 65 (3.8%).
- Despite the lower specificity in older patients, all RSS demonstrated effective diagnostic performance, particularly the ACR TIRADS, and could significantly reduce the number of biopsies needed for elderly patients by acting as useful rule-out tests.
Article Synopsis
- Network Medicine is a scientific field that focuses on understanding the interconnected mechanisms behind complex human diseases.
- The next phase of research will focus on developing new analytics to improve network optimization for precision medicine.
- Achieving these advancements will need a diverse team of scientists working together with large datasets shared around the world.
Article Synopsis
- - A survey conducted between March 18 and April 4, 2020, among 137 cancer patients in Rome aimed to assess the emotional impact of the Covid-19 pandemic using a new questionnaire (C-19EIS) and a validated health-related quality of life tool (EORTC QLQ-C30).
- - The results indicated that cancer patients generally experienced significant emotional distress, with median C-19EIS scores showing high concern about the pandemic, particularly among women and younger patients.
- - Analysis revealed a strong negative correlation between emotional distress (C-19EIS scores) and emotional well-being (EORTC QLQ-C30), suggesting that higher concern about Covid-19 was linked to
Article Synopsis
- Hürthle cell carcinomas (HCC) are uncommon thyroid cancers that have poor responses to treatments like radioactive iodine and kinase inhibitors.
- This study analyzed the mutations present in primary and metastatic HCC tissues from two patients, discovering the SETD2 mutation associated with decreased activity of both the H3K36me3 methylation and the p53 protein.
- The findings indicate that mutations in SETD2 may contribute to HCC progression by destabilizing p53 and promoting characteristics of cancer stem cells, suggesting a need for more research into their prevalence and potential treatments.
Real-World Performance of the American Thyroid Association Risk Estimates in Predicting 1-Year Differentiated Thyroid Cancer Outcomes: A Prospective Multicenter Study of 2000 Patients.
Thyroid
February 2021
Article Synopsis
- The study assesses the effectiveness of the 2015 American Thyroid Association (ATA) risk stratification system in predicting outcomes for patients with differentiated thyroid cancer (DTC) one year post-treatment.
- It involved a review of data from 2,071 patients across 40 treatment centers, classifying risk levels as low, intermediate, or high based on the ATA guidelines.
- Findings indicated that the initial ATA risk classification was a strong predictor of persistent disease, with the center where treatment occurred having little impact on these predictions.