Publications by authors named "Trestini I"

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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Whereas an exercise intervention effectively improves patients' quality of life, little information is available about the contribution of each physical fitness component. This study aims to explore the association between physical fitness components and the quality-of-life domain in patients with cancer. Between September 2021 and August 2023, 160 patients with mixed cancer types visiting the Oncology Unit were selected on a consecutive basis according to selection criteria.

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Background And Aims: Patients undergoing pancreatic resection are commonly malnourished. It is still unclear whether nutritional scores reliably predict postoperative outcomes after pancreatic resection. This study evaluated whether five commonly used preoperative nutritional screening scores predicted severe complications and length of stay.

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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: Evidence demonstrates that physical exercise confers several psycho-physical benefits on patients with cancer. This study aims to investigate the role of oncologists in exercise promotion.

Patients And Methods: A multicenter, cross-sectional study was conducted by distributing an anonymous, self-administered questionnaire to patients with cancer.

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Article Synopsis
  • About 5% of non-small cell lung cancer (NSCLC) involves anaplastic lymphoma kinase (ALK) rearrangements, with EML4-ALK fusions being the most common type.
  • Targeting ALK has improved survival rates for patients with advanced ALK-positive NSCLC, but resistance to treatment and disease progression still occurs.
  • The tumor immune microenvironment (TIME) is crucial for understanding lung cancer development and treatment responses, shifting the focus from just tumor cells to the whole tumor ecosystem.
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Purpose: Exercise improves quality of life and reduces the side effects of cancer therapies. Nevertheless, attendance to exercise programs remains a challenge for patients. This study explored the feasibility of an exercise program in which women with breast cancer may be allowed to choose among three exercise delivery modalities.

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The COVID-19 pandemic has profoundly impacted on cancer patients' psychological well-being and clinical status. We assessed the levels of anxiety, depression, and distress and the attitude towards COVID-19 vaccination in cancer patients, accepting vaccination at the Verona University Hospital and Camposampiero Hospital in the Veneto region. Self-reported questionnaires were administered to patients undergoing COVID-19 vaccination between March and May 2021 (first and second dose).

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Article Synopsis
  • - The study explored the feasibility and initial effectiveness of a tailored exercise program for 44 patients with metastatic cancer, allowing them to choose between home-based, personal training, or group sessions to suit their preferences.
  • - Results showed a high recruitment rate of 81%, with a median attendance of 92%, and overall, patients displayed good adherence (88%) and tolerability (100%), despite 20% dropout mostly from personal training.
  • - Significant improvements were observed in cardiorespiratory fitness and flexibility, indicating that a patient-preferred exercise intervention can be both feasible and beneficial for those with metastatic cancer.
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Objective: This study aims to assess the safety, feasibility, and potential benefits of a combined aerobic and resistance exercise intervention for patients diagnosed with advanced pancreatic or lung cancer.

Methods: A prospective, single-arm study was conducted, enrolling patients with advanced lung or pancreatic cancer. Participants engaged in a 12-week exercise intervention comprising personalized bi-weekly aerobic and resistance training tailored to individual baseline conditions.

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Targeted therapy (TT) has revolutionized cancer treatment, successfully applied in various settings. Adjuvant TT in resected early-stage gastrointestinal stromal tumors (GIST), melanoma, non-small cell lung cancer (NSCLC), and breast cancer has led to practice-changing achievements. In particular, standard treatments include BRAF inhibitors for melanoma, osimertinib for NSCLC, hormone therapy or HER2 TT for breast cancer, and imatinib for GIST.

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Background And Aims: Body composition parameters and immunonutritional indexes provide useful information on the nutritional and inflammatory status of patients. We sought to investigate whether they predict the postoperative outcome in patients with pancreatic cancer (PC) who received neoadjuvant therapy (NAT) and then pancreaticoduodenectomy.

Methods: Data from locally advanced PC patients who underwent NAT followed by pancreaticoduodenectomy between January 2012 and December 2019 in four high-volume institutions were collected retrospectively.

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Bone health is often threatened in cancer patients. Bone metastasis and osteoporosis frequently occur in patients with cancer and may lead to different skeletal-related events, which may negatively affect patients' quality of life and are associated with high mortality risk. Physical exercise has been recognized as a potential adjunctive strategy in the cancer setting to improve physical function as well as treatment-related side effects.

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Background: Nutritional support, including nutritional counseling and oral nutritional supplements (ONS), has been recommended as a first-line strategy in patients with non-small cell lung cancer (NSCLC). Evidence on the efficacy of immunonutrition during immunotherapy in these patients is positive, but still limited some secondary endpoints, such as treatment toxicity and tolerance. We hypothesize that early systematic provision of ONS with a high-protein-high calorie mixture containing immunonutrients (Impact®) in addition to nutritional counseling, compared to nutritional counseling alone, is beneficial to patients with NSCLC receiving immunotherapy with or without chemotherapy.

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Objectives: Excess adiposity is associated with several factors involved in carcinogenesis and breast cancer progression. Evidence supporting the role of body composition in breast cancer treatment is promising, but still scanty and mainly focused on adjuvant treatment. The aim of this study was to evaluate the changes in body composition during neoadjuvant chemotherapy and its association with pathologic complete response and survival outcome in patients treated for operable/locally advanced breast cancer.

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Purpose: Supportive care, including exercise, nutritional and psychological support, is becoming increasingly important in cancer given their impact on 'patients' quality and quantity of life. The purpose of this study was to explore willingness, preferences barriers and facilitators for a multimodal intervention in patients with cancer.

Methods: An anonymous questionnaire was proposed on randomly selected days to the patients visiting the cancer outpatients' facilities at the Oncology Unit of the University Hospital of Verona.

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Introduction: Selpercatinib is a RET selective tyrosine kinase inhibitor with nanomolar potency against diverse RET alterations, including fusions, activating point mutations, and acquired resistance mutations. Rearranged during transfection (RET) gene is a validated target in non-small-cell lung cancer (NSCLC). Selpercatinib is currently approved for adult patients with metastatic RET fusion-positive NSCLC.

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Purpose: To determine the impact of exercise on functional capacity, measured through the "Six minutes walking test" (6MWT) in patients with advanced cancer stage.

Methods: Systematic research on PubMed, Cochrane Library, and SportDiscus was conducted. Randomized controlled trials were eligible if they examined the effect of exercise on 6MWT.

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Article Synopsis
  • Lung cancer management requires a multidisciplinary team of healthcare providers due to the complexity of the disease and advancements in treatment tools.
  • Supportive care, which includes exercise, nutrition, smoking cessation, and psychological support, is crucial for alleviating symptoms and improving patients' overall well-being, yet it is often underutilized.
  • Integrating supportive care into the treatment approach poses challenges, including the need for specialists to personalize care, which is essential for comprehensive and patient-centered treatment.
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  • - Nutritional habits significantly influence the health of the gastrointestinal (GI) tract and can affect the progression of GI disorders and cancers, making it crucial to adopt specific nutritional strategies for prevention and management.
  • - The nutritional status of patients with GI cancer plays a key role in their prognosis, quality of life, and ability to tolerate chemotherapy, with malnutrition being a common issue that can develop into cachexia.
  • - Clinical studies highlight the need for specialized nutritional counseling and interventions early in treatment to optimize nutrient delivery, prevent weight loss, and improve overall treatment outcomes, including exploring new methods linking nutrition, epigenetics, and metabolism.
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Although there is substantial evidence on the impact of nutritional-status deterioration on quality of life, treatment tolerance, morbidity, and mortality in people with cancer, clinical nutrition intervention trials in oncology are still limited. The rationale for deepening this topic is also justified by the availability of innovative treatment options, such as immunotherapy, which take into consideration potential modulation of the immune system by several factors. In this article, we aimed to focus on the unexplored issue of immunonutrition and its potential modulatory activity on treatment response in people receiving immunotherapy.

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