Publications by authors named "Zambelli A"

Article Synopsis
  • CDK4/6 inhibitors have greatly improved treatment for hormone receptor-positive breast cancer, but developing resistance to these drugs remains a significant issue with few guidelines for alternative treatments.
  • Continuing CDK4/6 inhibition, possibly alongside endocrine therapy or new drugs, is an active area of research that may change treatment practices based on the results of ongoing clinical trials.
  • Evidence suggests switching to a different CDK4/6 inhibitor after progression can have limited benefits, and current biomarker analyses for patient selection have been inconsistent, indicating that further research and validation are necessary before making this approach standard practice.
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Article Synopsis
  • Breast cancer (BC) is the most common cancer affecting women worldwide, with millions diagnosed each year.
  • Research and treatment options continue to evolve, aiming to improve outcomes for patients.
  • Awareness campaigns and early detection efforts play a crucial role in reducing mortality rates associated with BC.
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Introduction: The growing evidence of increased life expectancy in the future reveals the high relevance of frailty in patients with chronic-degenerative diseases; identification and management of symptoms may improve significantly their quality of life. The objective of our study was to assess the symptom burden in patients with advanced chronic or prolonged infectious diseases.

Materials And Methods: A cross-sectional study was performed enrolling 88 patients, referred to palliative care consultation for chronic pain, and evaluated using the Edmonton Symptom Assessment System to define Total Symptom Distress Score (TSDS) and high symptom burden (HSB) when more than six symptoms along with Numerical Rating Scale ≥4 were present.

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Modern healthcare is experiencing a significant transformation, utilizing technology to improve patient outcomes and make processes more efficient. Breast cancer, being the most commonly diagnosed cancer in women globally, requires innovative approaches for effective management. Digital Therapeutics (DTx) and Clinical Decision Support Systems (CDSSs) have emerged as pivotal technologies, offering personalized, patient-centered care and optimizing clinical decision-making.

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Background: Recently, radiomics has emerged as a possible image-derived biomarker, predominantly stemming from retrospective analyses. We aimed to prospectively assess the predictive role of [F]FDG-PET radiomics in breast cancer (BC).

Methods: Patients affected by stage I-III BC eligible for neoadjuvant chemotherapy (NAC) staged with [F]FDG-PET/CT were prospectively enrolled.

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Breast cancer stands as the most frequently diagnosed cancer and the primary cause of cancer-related mortality among women worldwide, including Italy. With the increasing number of survivors, many are enrolled in regular follow-up programs. However, adherence to recommendations from scientific societies (such as ASCO, ESMO, AIOM) for breast cancer follow-up management varies in daily clinical practice across different cancer centers, potentially resulting in unequal management and escalating costs.

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Article Synopsis
  • Antibody-drug conjugates (ADCs) improve treatment outcomes and safety for metastatic breast cancer compared to traditional chemotherapy, but side effects (treatment-related adverse events, or TRAEs) are still a concern.
  • A meta-analysis of 23 clinical trials identified TRAE prevalence between 12% and 33%, with specific patterns of side effects linked to different ADCs.
  • Gastrointestinal issues were common across all ADCs, and the research emphasizes the need for personalized care approaches based on the specific toxicities associated with each treatment.
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The introduction of PARP inhibitors has revolutionized the management and treatment of patients with pathogenic germline variants of BRCA1/2 who have developed breast cancer. The implementation of PARP inhibitors in clinical settings can be challenging due to their overlapping indications with other drugs, including both recently approved medications and those with proven efficacy. This study utilized the Delphi method to present the first Italian consensus regarding genetic testing, the use of PARP inhibitors in both early and metastatic settings, and strategies for managing the potential toxicity of these novel drugs.

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Article Synopsis
  • * D3NS analyzes real-world cancer data from The Cancer Genome Atlas, focusing on bladder, ovarian, and kidney cancers, and utilizes a network of gene interactions for enhanced detection of meaningful patterns.
  • * The method successfully identifies tumor subtypes with different survival rates and links to various clinical outcomes, positioning D3NS as a valuable tool for future cancer research and clinical applications.
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Chronic pain is a common consequence of breast cancer (BC) and its treatments. Pain neuroscience education (PNE) is a non-pharmacological intervention that adopts a biopsychosocial approach and has already been proven to be effective for different chronic pain syndromes. The present review aims to critically assess clinical trials comparing the efficacy of PNE to traditional biomedical education (BME) in reducing BC-related pain and improving quality of life.

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Environmental stress significantly affects plant growth, development, and survival. Plants respond to stressors such as temperature fluctuations, water scarcity, nutrient deficiencies, and pathogen attacks through intricate molecular and physiological adaptations. Epigenetic mechanisms are crucial in regulating gene expression in response to environmental stress.

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The treatment of early triple-negative breast cancer (eTNBC) has improved patients' prognosis but often leads to adverse events and sequelae affecting quality of life (QoL). Pain Neuroscience Education (PNE) is a promising non-pharmacological intervention in this field. Preliminary data have shown the beneficial effect of PNE in BC survivors.

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Background: Breast units (BUs) provide breast cancer (BC) care, including prevention, treatment, and genetic assessment. Genetic research has highlighted BRCA1/2 mutations as key hereditary BC risk factors. BRCA testing is crucial for personalized treatment and prevention strategies.

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Background: Bone health management in premenopausal women with breast cancer (BC) under hormone-deprivation therapies (HDTs) is often challenging, and the effectiveness of bone-active drugs is still unknown.

Methods: This retrospective multicenter study included 306 premenopausal women with early BC undergoing HDTs. Bone mineral density (BMD) and morphometric vertebral fractures (VFs) were assessed 12 months after HDT initiation and then after at least 24 months.

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Background: During targeted treatment, HER2-positive breast cancers invariably lose HER2 DNA amplification. In contrast, and interestingly, HER2 proteins may be either lost or gained. To longitudinally and systematically appreciate complex/discordant changes in HER2 DNA/protein stoichiometry, HER2 DNA copy numbers and soluble blood proteins (aHER2/sHER2) were tested in parallel, non-invasively (by liquid biopsy), and in two-dimensions, hence HER2-2D.

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Background: Abemaciclib-induced diarrhea is a relevant concern in clinical practice. Postbiotics have emerged as a promising option for managing it.

Materials And Methods: We conducted a retrospective-prospective, 2-group, observational study to assess the impact of the postbiotic PostbiotiX-Restore, derived by Lactobacillus paracasei CNCM I-5220, on abemaciclib-induced diarrhea in patients with hormone receptor-positive HER2-negative breast cancer.

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Based on the unprecedented results observed in recent clinical trials, antibody-drug conjugates (ADCs) have revolutionized the treatment algorithm of metastatic breast cancer (mBC). The strategy of sequencing different ADCs in other lines of therapy is highly attractive, but the proportion of patients who have undergone such a strategy in the context of published clinical trials is still limited, especially for modern ADCs. HER2-positive disease is primarily managed with a sequence of different ADCs.

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Aberrant cyclin-dependent kinase 2 (CDK2) activation has been identified as a main resistance mechanism to CDK4/6 inhibition in hormone-receptor positive (HR+) breast cancer. Additionally, consistent preclinical evidence states its crucial role in MYC and CCNE1 overexpressed cancer survival, such as triple-negative breast cancers (TNBC), thus representing an appealing and relatively unexplored target treatment opportunity. Despite emerging initial results of novel CDK2 inhibitors (CDK2i) activity, a comprehensive outcomes collection is currently absent from the scientific literature.

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Purpose: In Italy, Lombardy was the first region to reimburse multigene assays (MGAs) for patients otherwise candidates for chemotherapy. This is a real-world experience of MGAs usage in six referral cancer centers in Lombardy.

Methods: Among MGAs, Oncotype DX (RS) was used in 97% of cases.

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Backgrounds: The majority of breast cancer (BC) patients treated with neo-adjuvant chemotherapy (NAC) achieves a pathologic partial response with different patterns of residual disease. No clear correlation between these patterns and oncological results was described. Our aims were to define the predictive factors for different patterns of residual disease and compare the outcomes between the scattered versus the circumscribed pattern.

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Article Synopsis
  • Breast cancer is a common health issue for women, and researchers are studying how diet affects it.
  • This review looked at recent research (2013-2023) about the effects of sugar, dairy, and soy on breast cancer, analyzing 35 studies.
  • Results were mixed: high sugar intake had little evidence linking it to breast cancer, while dairy and soy may help protect against it, but many factors like menopause and cancer type can change the findings.
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GIM 13-AMBRA is a longitudinal cohort study aimed at describing therapeutic strategies and the relative outcome parameters in 939 HER2-ve MBC patients. Taxanes-based regimens, or taxanes + targeted agents, mainly Bevacizumab, were the preferred first choice in both Luminal (30.2%) and TNBC (33.

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