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6 results on '"Livi, Lorenzo"'

1. The prognostic relevance of HER2-positivity gain in metastatic breast cancer in the ChangeHER trial.

Author

Pizzuti L, Barba M, Mazzotta M, Krasniqi E, Maugeri-Saccà M, Gamucci T, Berardi R, Livi L, Ficorella C, Natoli C, Cortesi E, Generali D, La Verde N, Cassano A, Bria E, Moscetti L, Michelotti A, Adamo V, Zamagni C, Tonini G, Sergi D, Marinelli D, Paoletti G, Tomao S, Botticelli A, Marchetti P, Tinari N, Grassadonia A, Valerio MR, Mirabelli R, Fabbri MA, D'Ostilio N, Veltri E, Corsi D, Garrone O, Paris I, Sarobba G, Meattini I, Pistelli M, Giotta F, Lorusso V, Garufi C, Russo A, Cazzaniga M, Del Medico P, Roselli M, Vaccaro A, Perracchio L, di Benedetto A, Daralioti T, Sperduti I, De Maria R, Di Leo A, Sanguineti G, Ciliberto G, and Vici P

Subjects
Ado-Trastuzumab Emtansine administration & dosage, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Brain Neoplasms drug therapy, Brain Neoplasms epidemiology, Brain Neoplasms pathology, Breast Neoplasms drug therapy, Breast Neoplasms epidemiology, Breast Neoplasms pathology, Disease-Free Survival, Female, Humans, Middle Aged, Neoplasm Metastasis, Receptors, Progesterone genetics, Brain Neoplasms genetics, Breast Neoplasms genetics, Prognosis, Receptor, ErbB-2 genetics
Abstract

In metastatic breast cancer (mBC), the change of human epidermal growth factor receptor 2 (HER2) status between primary and metastatic lesions is widely recognized, however clinical implications are unknown. Our study address the question if relevant differences exist between subjects who preserve the HER2 status and those who gain the HER2 positivity when relapsed. Data of patients affected by HER2-positive mBC, treated with pertuzumab and/or trastuzumab-emtansine (T-DM1) in a real-world setting at 45 Italian cancer centers were retrospectively collected and analyzed. From 2003 to 2017, 491 HER2-positive mBC patients were included. Of these, 102 (20.7%) had been initially diagnosed as HER2-negative early BC. Estrogen and/or progesterone receptor were more expressed in patients with HER2-discordance compared to patients with HER2-concordant status (p < 0.0001 and p = 0.006, respectively). HER2-discordant tumors were characterized also by a lower rate of brain metastases (p = 0.01) and a longer disease free interval (p < 0.0001). Median overall survival was longer, although not statistically significant, in the subgroup of patients with HER2-discordant cancer with respect to patients with HER2-concordant status (140 vs 78 months, p = 0.07). Our findings suggest that patients with HER2-positive mBC with discordant HER2 status in early BC may have different clinical, biological and prognostic behavior compared to HER2-concordant patients.

Published
2021
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2. Could stereotactic body radiotherapy be a valid option in metastatic lung cancer with oligoprogressive disease?

Author

Aquilano, Michele, Loi, Mauro, Livi, Lorenzo, and Nuyttens, Joost

Subjects
STEREOTACTIC radiotherapy, LUNG cancer, METASTASIS, PROGNOSIS, OVERALL survival
Abstract

Purpose or objective: Oligoprogression (OPD) is defined as a condition where limited progression (1-3 metastases) is observed in patients undergoing systemic cancer treatment. Local treatment of OPD might delay systemic therapy line switch, which could be beneficial in patients experiencing prolonged global disease control with novel targeted or immune therapies. In this study we investigated the impact on outcome of stereotactic body radiotherapy (SBRT) in patients with OPD from metastatic lung cancer. Materials and methods: Data from a cohort of consecutive patients treated with Cyberknife and Linacbased SBRT between June 2015 and August 2021 were collected. All extracranial metastatic sites of OPD from lung cancer were included. Dose regimens consisted of 24 in 2 fractions, 30-51 Gy in 3 fractions, 30-55 Gy in 5 fractions, 52.5 Gy in 7 fractions and 44-56 Gy in 8 fractions. Dose was expressed as Biological Effective Dose for α/β=10 (BED10). Kaplan-Meyer method was used to calculate Overall Survival (OS), Local Control (LC) and Disease Progression-free Survival (DPFS) from the start date of SBRT to event. Results: Sixty-three patients, 34 female and 29 male were included. Median age was 75 years (range 25–83). All patients received concurrent systemic treatment before the start of the SBRT: 19 chemotherapy (CT) alone (30%), 26 CT plus immunotherapy (IT) or plus Tyrosin kinase inhibitors (TKI) (41%) and 18 IT/TKI alone (29%). SBRT was delivered to lung (n=29), mediastinal node (n=9), bone (n=7), adrenal gland (n=19), other visceral metastases (1) and other node metastases (n=4). A median BED10 of 104 (range 39-151) Gy10 was delivered. After a median follow up of 20 months (range 1-48), median overall survival was median OS was 23 months (figure 1). LC was 93% at 1 year and 87% at 2 years. DPFS was 7 months. At univariate analysis, age, type of systemic treatment, metastatic site receiving SBRT and BED were not significant prognostic factors for overall survival. Conclusion: SBRT in lung cancer patients for oligoprogression resulted in a long median OS of 23 months. One-year LC was 93%. Median DPFS was 7 months, translating into continuation of effective systemic treatment as other metastases grow slowly. SBRT could be useful to postpone the change of chemotherapy and/or immunotherapy. More research is needed to select OPD patients eligible for SBRT. [ABSTRACT FROM AUTHOR]

Published
2022

3. Liposarcoma: Clinico-pathological analysis, prognostic factors and survival in a series of 307 patients treated at a single institution.

Author

Muratori, Francesco, Frenos, Filippo, Bettini, Leonardo, Matera, Davide, Mondanelli, Nicola, Scorianz, Maurizio, Cuomo, Pierluigi, Scoccianti, Guido, Beltrami, Giovanni, Greto, Daniela, Livi, Lorenzo, Baldi, Giacomo, Roselli, Giuliana, Capanna, Rodolfo, and Campanacci, Domenico Andrea

Subjects
*LIPOSARCOMA, *MULTIVARIATE analysis, *METASTASIS, *RADIOTHERAPY, *CANCER chemotherapy, *CANCER relapse, *PROGNOSIS, *SOFT tissue tumors, *SURVIVAL, *RETROSPECTIVE studies, *TUMOR grading, *THERAPEUTICS, *TUMOR treatment
Abstract

Background and Objectives: Liposarcoma (LPS) is a malignant mesenchymal tumor and the most common soft tissue sarcoma. Four different subtypes are described: well differentiated (WD) LPS or atypical lipomatous tumor (ALT), dedifferentiated (DD) LPS, myxoid LPS, and pleomorphic LPS (PLS). The objective of the study was to investigate prognostic factors and clinical outcome of liposarcoma.Methods: We retrospectively examined the clinico-pathological features of a series of 307 patients affected by Liposarcoma at a mean follow-up of 69 months (range 6-257). ALT/WD LPS were analyzed separately. The influence of site, size, type of presentation, grading, histotype and local recurrence on local and systemic control and survival was assessed.Results: The statistical analysis indicated that only surgical margins represented a significant prognostic factor for local recurrence in ALT/WD LPS (P = 0.0007) and other subtypes of LPS (P = 0.0055). In myxoid, PLS and DD LPS, significant prognostic factors for metastasis free survival (MFS) were surgical margins (P = 0.0009), size of the tumor (P = 0.0358), histology (P = 0.0117) and local recurrence (P = 0.0015). In multivariate analysis, surgical margins (0.0180), size (0.0432) and local recurrence (0.0288) correlated independently with MFS. Margins (P = 0.0315), local recurrence (P = 0.0482) and metastases (P < 0.0001) were prognostic factors for overall survival (OS).Conclusion: Marginal surgery can be an accepted treatment for ALT/WD LPS. In other liposarcoma subtypes (Myxoid, DD, PLS) wide or radical surgery is recommended as the margins significantly influence local recurrence-free survival (LRFS), metastasis-free survival (MFS) and overall survival (OS). Local recurrence and metastases were significant prognostic factors for OS. [ABSTRACT FROM AUTHOR]

Published
2018
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4. The prognostic relevance of HER2-positivity gain in metastatic breast cancer in the ChangeHER trial

Author

Pietro Del Medico, Rossana Berardi, Enzo Veltri, Maria Rosaria Valerio, Alessandra Cassano, Daniele Marinelli, Vito Lorusso, Patrizia Vici, Nicola D’Ostilio, Silverio Tomao, Enrico Cortesi, Nicola Tinari, Emilio Bria, Domenico Sergi, Luca Moscetti, Giuseppe Sanguineti, Teresa Gamucci, Claudio Zamagni, Maddalena Barba, Clara Natoli, Theodora Daralioti, Giancarlo Paoletti, Antonino Grassadonia, Marina Elena Cazzaniga, Icro Meattini, Ornella Garrone, Andrea Michelotti, Giuseppina Sarobba, Nicla La Verde, Laura Pizzuti, Letizia Perracchio, Vincenzo Adamo, Giuseppe Tonini, A. Vaccaro, Francesco Giotta, Corrado Ficorella, Maria Agnese Fabbri, Antonio Russo, Paolo Marchetti, Gennaro Ciliberto, Mirco Pistelli, Rosanna Mirabelli, Marco Mazzotta, Daniele Generali, Marcello Maugeri-Saccà, Mario Roselli, Angelo Di Leo, Anna Di Benedetto, Isabella Sperduti, Ida Paris, Eriseld Krasniqi, Carlo Garufi, Lorenzo Livi, Ruggero De Maria, Andrea Botticelli, Domenico Corsi, Pizzuti, L, Barba, M, Mazzotta, M, Krasniqi, E, Maugeri-Sacca, M, Gamucci, T, Berardi, R, Livi, L, Ficorella, C, Natoli, C, Cortesi, E, Generali, D, La Verde, N, Cassano, A, Bria, E, Moscetti, L, Michelotti, A, Adamo, V, Zamagni, C, Tonini, G, Sergi, D, Marinelli, D, Paoletti, G, Tomao, S, Botticelli, A, Marchetti, P, Tinari, N, Grassadonia, A, Valerio, M, Mirabelli, R, Fabbri, M, D'Ostilio, N, Veltri, E, Corsi, D, Garrone, O, Paris, I, Sarobba, G, Meattini, I, Pistelli, M, Giotta, F, Lorusso, V, Garufi, C, Russo, A, Cazzaniga, M, Del Medico, P, Roselli, M, Vaccaro, A, Perracchio, L, di Benedetto, A, Daralioti, T, Sperduti, I, De Maria, R, Di Leo, A, Sanguineti, G, Ciliberto, G, Vici, P, Pizzuti, Laura, Barba, Maddalena, Mazzotta, Marco, Krasniqi, Eriseld, Maugeri-Saccà, Marcello, Gamucci, Teresa, Berardi, Rossana, Livi, Lorenzo, Ficorella, Corrado, Natoli, Clara, Cortesi, Enrico, Generali, Daniele, La Verde, Nicla, Cassano, Alessandra, Bria, Emilio, Moscetti, Luca, Michelotti, Andrea, Adamo, Vincenzo, Zamagni, Claudio, Tonini, Giuseppe, Sergi, Domenico, Marinelli, Daniele, Paoletti, Giancarlo, Tomao, Silverio, Botticelli, Andrea, Marchetti, Paolo, Tinari, Nicola, Grassadonia, Antonino, Valerio, Maria Rosaria, Mirabelli, Rosanna, Fabbri, Maria Agnese, D’Ostilio, Nicola, Veltri, Enzo, Corsi, Domenico, Garrone, Ornella, Paris, Ida, Sarobba, Giuseppina, Meattini, Icro, Pistelli, Mirco, Giotta, Francesco, Lorusso, Vito, Garufi, Carlo, Russo, Antonio, Cazzaniga, Marina, Del Medico, Pietro, Roselli, Mario, Vaccaro, Angela, Perracchio, Letizia, di Benedetto, Anna, Daralioti, Theodora, Sperduti, Isabella, De Maria, Ruggero, Di Leo, Angelo, Sanguineti, Giuseppe, Ciliberto, Gennaro, Vici, Patrizia, Pizzuti L., Barba M., Mazzotta M., Krasniqi E., Maugeri-Sacca M., Gamucci T., Berardi R., Livi L., Ficorella C., Natoli C., Cortesi E., Generali D., La Verde N., Cassano A., Bria E., Moscetti L., Michelotti A., Adamo V., Zamagni C., Tonini G., Sergi D., Marinelli D., Paoletti G., Tomao S., Botticelli A., Marchetti P., Tinari N., Grassadonia A., Valerio M.R., Mirabelli R., Fabbri M.A., D'Ostilio N., Veltri E., Corsi D., Garrone O., Paris I., Sarobba G., Meattini I., Pistelli M., Giotta F., Lorusso V., Garufi C., Russo A., Cazzaniga M., Del Medico P., Roselli M., Vaccaro A., Perracchio L., di Benedetto A., Daralioti T., Sperduti I., De Maria R., Di Leo A., Sanguineti G., Ciliberto G., and Vici P.

Subjects
0301 basic medicine, Oncology, Cancer therapy, Receptor, ErbB-2, medicine.medical_treatment, Ado-Trastuzumab Emtansine, progesterone receptor, Settore MED/06, 0302 clinical medicine, human epidermal growth factor receptor 2 (HER2), Antineoplastic Combined Chemotherapy Protocols, estrogen, Neoplasm Metastasis, skin and connective tissue diseases, Multidisciplinary, Brain Neoplasms, Middle Aged, Prognosis, Metastatic breast cancer, Neoplasm Metastasi, 030220 oncology & carcinogenesis, Medicine, Female, Pertuzumab, metastatic breast cancer, Receptors, Progesterone, Breast Neoplasm, HER2 positivity, medicine.drug, Human, Adult, medicine.medical_specialty, medicine.drug_class, Science, trastuzumab-emtansine, Breast Neoplasms, cancer, Article, Disease-Free Survival, Brain Neoplasm, 03 medical and health sciences, Breast cancer, breast cancer, Settore MED/04 - PATOLOGIA GENERALE, pertuzumab, Internal medicine, Progesterone receptor, medicine, Humans, neoplasms, Aged, Chemotherapy, Antineoplastic Combined Chemotherapy Protocol, business.industry, Cancer, medicine.disease, HER2-positive, oncology, radiotherapy, chemotherapy, HER2, Radiation therapy, 030104 developmental biology, Estrogen, business, prognostic relevance
Abstract

Breast cancer (BC) heterogeneity is composite in nature, with a wide variety of factors concurring to define several pathological entities, which differ by clinical presentation, pathologic features, therapy administered, and inherent outcomes1. Additional sources of breast cancer heterogeneity may raise during the disease course. In BC patients whose disease was initially diagnosed in the early stage and subsequently progressed with metastatic involvement of one single or multiple site/s, the molecular characteristics of metastatic lesions do not necessary mimic those of the disease initially diagnosed. A well-depicted molecular landscape is crucial for subtype definition, prognostic evaluation and appropriate therapeutic decisions. Accordingly, current guidelines suggest repeating the immunohistochemical (IHC) assessment in patients with metastatic spread and at least one secondary lesion amenable to biopsy2. Discordance in human epidermal growth factor receptor 2 (HER2) status between the tumor and metastatic lesions is widely acknowledged, and not yet completely unraveled in their biologic meaning and prognostic relevance3–11. The overexpression of HER2 or amplification of the related gene is extensively recognized as a feature associated with more aggressive biological behavior12,13. However, the extent to which changes in HER2 status may affect patients’ prognosis is still a matter of debate14. We herein propose an observational study of HER2-positive metastatic breast cancer (mBC) patients treated with the anti-HER2 targeted agents pertuzumab and/or trastuzumab emtansine (T-DM1). Our research question is whether relevant differences exist in long-term outcomes of patients with concordant HER2 status between the primary tumor and its secondary lesion/s compared to patients whose disease revealed HER2-positivity gain at the IHC assessment of metastatic lesions. In our historical cohorts, we also sought to identify factors associated with HER2-positivity gain at the IHC reassessment, for which an impact on prognosis may be foreseen.

Published
2021

5. Loss of HER2 and decreased T-DM1 efficacy in HER2 positive advanced breast cancer treated with dual HER2 blockade: the SePHER Study

Author

Nicla La Verde, Domenico Corsi, Patrizia Vici, Angelo Di Leo, Enzo Veltri, Lorenzo Livi, Marina Elena Cazzaniga, Laura Pizzuti, Pietro Del Medico, Caterina Marchiò, Maria Rosaria Valerio, Ornella Garrone, Giuseppina Sarobba, Rossella Loria, Gennaro Ciliberto, Eriseld Krasniqi, Marcello Maugeri-Saccà, Anna Sapino, Paolo Marchetti, Rossana Berardi, Rita Falcioni, Silverio Tomao, Clara Natoli, Vincenzo Adamo, Valentina Laquintana, Maddalena Barba, Claudio Zamagni, Maria Agnese Fabbri, Carlo Garufi, Giulia Bon, Giuseppe Sanguineti, Giacomo Barchiesi, Enrico Cortesi, Rosanna Mirabelli, Francesco Giotta, Nicola D’Ostilio, Giuseppe Tonini, Emilio Bria, Daniele Marinelli, Manuela Porru, Luca Moscetti, Marco Mazzotta, Ida Paris, Andrea Michelotti, Mario Roselli, Alessandra Cassano, Teresa Gamucci, Antonio Russo, Isabella Sperduti, Corrado Ficorella, Daniele Generali, Ruggero De Maria, Carlo Leonetti, Bon G., Pizzuti L., Laquintana V., Loria R., Porru M., Marchio C., Krasniqi E., Barba M., Maugeri-Sacca M., Gamucci T., Berardi R., Livi L., Ficorella C., Natoli C., Cortesi E., Generali D., La Verde N., Cassano A., Bria E., Moscetti L., Michelotti A., Adamo V., Zamagni C., Tonini G., Barchiesi G., Mazzotta M., Marinelli D., Tomao S., Marchetti P., Valerio M.R., Mirabelli R., Russo A., Fabbri M.A., D'Ostilio N., Veltri E., Corsi D., Garrone O., Paris I., Sarobba G., Giotta F., Garufi C., Cazzaniga M., Del Medico P., Roselli M., Sanguineti G., Sperduti I., Sapino A., De Maria R., Leonetti C., Di Leo A., Ciliberto G., Falcioni R., Vici P., Bon, Giulia, Pizzuti, Laura, Laquintana, Valentina, Loria, Rossella, Porru, Manuela, Marchiò, Caterina, Krasniqi, Eriseld, Barba, Maddalena, Maugeri-Saccà, Marcello, Gamucci, Teresa, Berardi, Rossana, Livi, Lorenzo, Ficorella, Corrado, Natoli, Clara, Cortesi, Enrico, Generali, Daniele, La Verde, Nicla, Cassano, Alessandra, Bria, Emilio, Moscetti, Luca, Michelotti, Andrea, Adamo, Vincenzo, Zamagni, Claudio, Tonini, Giuseppe, Barchiesi, Giacomo, Mazzotta, Marco, Marinelli, Daniele, Tomao, Silverio, Marchetti, Paolo, Valerio, Maria Rosaria, Mirabelli, Rosanna, Russo, Antonio, Fabbri, Maria Agnese, D’Ostilio, Nicola, Veltri, Enzo, Corsi, Domenico, Garrone, Ornella, Paris, Ida, Sarobba, Giuseppina, Giotta, Francesco, Garufi, Carlo, Cazzaniga, Marina, Del Medico, Pietro, Roselli, Mario, Sanguineti, Giuseppe, Sperduti, Isabella, Sapino, Anna, De Maria, Ruggero, Leonetti, Carlo, Di Leo, Angelo, Ciliberto, Gennaro, Falcioni, Rita, Vici, Patrizia, Bon, G, Pizzuti, L, Laquintana, V, Loria, R, Porru, M, Marchio, C, Krasniqi, E, Barba, M, Maugeri-Sacca, M, Gamucci, T, Berardi, R, Livi, L, Ficorella, C, Natoli, C, Cortesi, E, Generali, D, La Verde, N, Cassano, A, Bria, E, Moscetti, L, Michelotti, A, Adamo, V, Zamagni, C, Tonini, G, Barchiesi, G, Mazzotta, M, Marinelli, D, Tomao, S, Marchetti, P, Valerio, M, Mirabelli, R, Russo, A, Fabbri, M, D'Ostilio, N, Veltri, E, Corsi, D, Garrone, O, Paris, I, Sarobba, G, Giotta, F, Garufi, C, Cazzaniga, M, Del Medico, P, Roselli, M, Sanguineti, G, Sperduti, I, Sapino, A, De Maria, R, Leonetti, C, Di Leo, A, Ciliberto, G, Falcioni, R, and Vici, P

Subjects
0301 basic medicine, Oncology, Cancer Research, Receptor, ErbB-2, Apoptosis, Ado-Trastuzumab Emtansine, Settore MED/06, chemistry.chemical_compound, 0302 clinical medicine, Trastuzumab, Antineoplastic Combined Chemotherapy Protocols, Tumor Cells, Cultured, skin and connective tissue diseases, Aged, 80 and over, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prognosis, Gene Expression Regulation, Neoplastic, Survival Rate, 030220 oncology & carcinogenesis, Female, Pertuzumab, medicine.drug, T-DM1 efficacy, musculoskeletal diseases, Adult, medicine.medical_specialty, HER2+ breast cancer, Trastuzumab/pertuzumab blockade, Breast Neoplasms, Antibodies, Monoclonal, Humanized, lcsh:RC254-282, 03 medical and health sciences, Settore MED/04 - PATOLOGIA GENERALE, Internal medicine, medicine, Biomarkers, Tumor, Humans, neoplasms, Aged, Cell Proliferation, Retrospective Studies, Taxane, business.industry, Research, Cancer, medicine.disease, Blockade, Log-rank test, 030104 developmental biology, chemistry, Trastuzumab emtansine, Cancer cell, business
Abstract

BackgroundHER2-targeting agents have dramatically changed the therapeutic landscape of HER2+ advanced breast cancer (ABC). Within a short time frame, the rapid introduction of new therapeutics has led to the approval of pertuzumab combined with trastuzumab and a taxane in first-line, and trastuzumab emtansine (T-DM1) in second-line. Thereby, evidence of T-DM1 efficacy following trastuzumab/pertuzumab combination is limited, with data from some retrospective reports suggesting lower activity. The purpose of the present study is to investigate T-DM1 efficacy in pertuzumab-pretreated and pertuzumab naïve HER2 positive ABC patients. We also aimed to provide evidence on the exposure to different drugs sequences including pertuzumab and T-DM1 in HER2 positive cell lines.MethodsThe biology of HER2 was investigated in vitro through sequential exposure of resistant HER2 + breast cancer cell lines to trastuzumab, pertuzumab, and their combination. In vitro experiments were paralleled by the analysis of data from 555 HER2 + ABC patients treated with T-DM1 and evaluation of T-DM1 efficacy in the 371 patients who received it in second line. Survival estimates were graphically displayed in Kaplan Meier curves, compared by log rank test and, when possibile, confirmed in multivariate models.ResultsWe herein show evidence of lower activity of T-DM1 in two HER2+ breast cancer cell lines resistant to trastuzumab+pertuzumab, as compared to trastuzumab-resistant cells. Lower T-DM1 efficacy was associated with a marked reduction of HER2 expression on the cell membrane and its nuclear translocation. HER2 downregulation at the membrane level was confirmed in biopsies of four trastuzumab/pertuzumab-pretreated patients.Among the 371 patients treated with second-line T-DM1, median overall survival (mOS) from diagnosis of advanced disease and median progression-free survival to second-line treatment (mPFS2) were 52 and 6 months in 177 patients who received trastuzumab/pertuzumab in first-line, and 74 and 10 months in 194 pertuzumab-naïve patients (p = 0.0006 and 0.03 for OS and PFS2, respectively).ConclusionsOur data support the hypothesis that the addition of pertuzumab to trastuzumab reduces the amount of available plasma membrane HER2 receptor, limiting the binding of T-DM1 in cancer cells. This may help interpret the less favorable outcomes of second-line T-DM1 in trastuzumab/pertuzumab pre-treated patients compared to their pertuzumab-naïve counterpart.

Published
2020

6. Local treatment for relapsing glioblastoma: A decision-making tree for choosing between reirradiation and second surgery.

Author

Scoccianti, Silvia, Perna, Marco, Olmetto, Emanuela, Delli Paoli, Camilla, Terziani, Francesca, Ciccone, Lucia Pia, Detti, Beatrice, Greto, Daniela, Simontacchi, Gabriele, Grassi, Roberta, Scoccimarro, Erika, Bonomo, Pierluigi, Mangoni, Monica, Desideri, Isacco, Di Cataldo, Vanessa, Vernaleone, Marco, Casati, Marta, Pallotta, Stefania, and Livi, Lorenzo

Subjects
*GLIOBLASTOMA multiforme, *FIX-point estimation, *LIFE expectancy, *DECISION making, *PROGNOSIS
Abstract

• Localised recurrent glioblastoma (recGBM) should be considered for local treatment. • An overview on the use of reirradiation or second surgery in recGBM is herein provided. • A simple and practical algorithm to choose surgery versus RT for recGBM is proposed. • Estimation of life expectancy, prognostic score systems and predictive factors, and expected toxicity are its keypoints. In case of circumscribed recurrent glioblastoma (rec-GBM), a second surgery (Re-S) and reirradiation (Re-RT) are local strategies to consider. The aim is to provide an algorithm to use in the daily clinical practice. The first step is to consider the life expectancy in order to establish whether the patient should be a candidate for active treatment. In case of a relatively good life expectancy (>3 months) and a confirmed circumscribed disease(i.e. without multiple lesions that are in different lobes/hemispheres), the next step is the assessment of the prognostic factors for local treatments. Based on the existing prognostic score systems, patients who should be excluded from local treatments may be identified; based on the validated prognostic factors, one or the other local treatment may be preferred. The last point is the estimation of expected toxicity, considering patient-related, tumor-related and treatment-related factors impacting on side effects. Lastly, patients with very good prognostic factors may be considered for receiving a combined treatment. [ABSTRACT FROM AUTHOR]

Published
2021
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