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1. Waiting list mortality and 5-year transplant survival benefit of patients with MASLD: An Italian liver transplant registry study

Author

Vitale, A, Trapani, S, Russo, F, Miele, L, Svegliati Baroni, G, Marchesini, G, Burra, P, Ottoveggio, M, Romagnoli, R, Martini, S, De Simone, P, Carrai, P, Cescon, M, Morelli, M, De Carlis, L, Belli, L, Gruttadauria, S, Volpes, R, Colledan, M, Fagiuoli, S, Di Benedetto, F, De Maria, N, Rossi, G, Caccamo, L, Donato, F, Vennarecci, G, Di Costanzo, G, Vivarelli, M, Carraro, A, Sacerdoti, D, Ettorre, G, Giannelli, V, Agnes, S, Gasbarrini, A, Rossi, M, Ginanni Corradini, S, Mazzaferro, V, Bhoori, S, Manzia, T, Lenci, I, Zamboni, F, Mameli, L, Baccarani, U, Toniutto, P, Lupo, L, Tandoi, F, Rendina, M, Andorno, E, Giannini, E, Spada, M, Billato, I, Marchini, A, Romano, P, Brancaccio, G, D'Amico, F, Ricci, A, Cardillo, M, Cillo, U, Vitale A., Trapani S., Russo F. P., Miele L., Svegliati Baroni G., Marchesini G., Burra P., Ottoveggio M. S., Romagnoli R., Martini S., De Simone P., Carrai P., Cescon M., Morelli M. C., De Carlis L., Belli L., Gruttadauria S., Volpes R., Colledan M., Fagiuoli S., Di Benedetto F., De Maria N., Rossi G., Caccamo L., Donato F., Vennarecci G., Di Costanzo G. G., Vivarelli M., Carraro A., Sacerdoti D., Ettorre G. M., Giannelli V., Agnes S., Gasbarrini A., Rossi M., Ginanni Corradini S., Mazzaferro V., Bhoori S., Manzia T. M., Lenci I., Zamboni F., Mameli L., Baccarani U., Toniutto P., Lupo L. G., Tandoi F., Rendina M., Andorno E., Giannini E. G., Spada M., Billato I., Marchini A., Romano P., Brancaccio G., D'Amico F., Ricci A., Cardillo M., Cillo U., Vitale, A, Trapani, S, Russo, F, Miele, L, Svegliati Baroni, G, Marchesini, G, Burra, P, Ottoveggio, M, Romagnoli, R, Martini, S, De Simone, P, Carrai, P, Cescon, M, Morelli, M, De Carlis, L, Belli, L, Gruttadauria, S, Volpes, R, Colledan, M, Fagiuoli, S, Di Benedetto, F, De Maria, N, Rossi, G, Caccamo, L, Donato, F, Vennarecci, G, Di Costanzo, G, Vivarelli, M, Carraro, A, Sacerdoti, D, Ettorre, G, Giannelli, V, Agnes, S, Gasbarrini, A, Rossi, M, Ginanni Corradini, S, Mazzaferro, V, Bhoori, S, Manzia, T, Lenci, I, Zamboni, F, Mameli, L, Baccarani, U, Toniutto, P, Lupo, L, Tandoi, F, Rendina, M, Andorno, E, Giannini, E, Spada, M, Billato, I, Marchini, A, Romano, P, Brancaccio, G, D'Amico, F, Ricci, A, Cardillo, M, Cillo, U, Vitale A., Trapani S., Russo F. P., Miele L., Svegliati Baroni G., Marchesini G., Burra P., Ottoveggio M. S., Romagnoli R., Martini S., De Simone P., Carrai P., Cescon M., Morelli M. C., De Carlis L., Belli L., Gruttadauria S., Volpes R., Colledan M., Fagiuoli S., Di Benedetto F., De Maria N., Rossi G., Caccamo L., Donato F., Vennarecci G., Di Costanzo G. G., Vivarelli M., Carraro A., Sacerdoti D., Ettorre G. M., Giannelli V., Agnes S., Gasbarrini A., Rossi M., Ginanni Corradini S., Mazzaferro V., Bhoori S., Manzia T. M., Lenci I., Zamboni F., Mameli L., Baccarani U., Toniutto P., Lupo L. G., Tandoi F., Rendina M., Andorno E., Giannini E. G., Spada M., Billato I., Marchini A., Romano P., Brancaccio G., D'Amico F., Ricci A., Cardillo M., and Cillo U.

Abstract

Background & Aims: International consensus has recently introduced a new definition of metabolic dysfunction-associated steatotic liver disease (MASLD). We sought to analyse epidemiological trends, prognostic features, and transplant survival benefits of patients with MASLD and without MASLD waiting for liver transplantation (LT) in Italy. Methods: Using the Italian Liver Transplant Registry database, we analysed data from adult patients listed for primary LT attributable to end-stage chronic liver disease between January 2012 and December 2022. Independent multivariable waiting lists and post-transplant survival models were developed for patients with and without hepatocellular carcinoma (HCC). A Monte Carlo simulation was used to create 5-year transplant benefit distributions based on the presence of MASLD, HCC, and model for end-stage liver disease (MELD)-sodium values. Results: A total sample of 1,941 patients with MASLD and 11,201 patients without MASLD was considered. A significant increase in the prevalence of MASLD as an indication for LT was observed from 2012 to 2022, for both cohorts with HCC (from 17.7 to 30%) and without HCC (from 9.5 to 11.8%) cohorts. Projections suggest that, as early as next year, MASLD will overcome HCV as the second most common indication for transplantation after alcoholic liver disease in Italy. According to univariate and multivariate analyses, MASLD was not an independent predictive factor for patient survival after transplantation. However, it increased the risk of death for patients on the waiting list without HCC (hazard ratio 1.62, p <0.001). At the same MELD-sodium, the 5-year transplant benefit was higher in patients with non-HCC MASLD, followed by patients with HCC, whereas it was lower in patients without HCC and without MASLD. Conclusions: Patients with non-HCC MASLD had an increased waitlist mortality and 5-year transplant survival benefit compared with other candidates. Impact and implications: The present re

Published
2024

2. CT Coronary Angiography: Technical Approach and Atherosclerotic Plaque Characterization

Author

Dell'Aversana, S, Ascione, R, Vitale, R, Cavaliere, F, Porcaro, P, Basile, L, Napolitano, G, Boccalatte, M, Sibilio, G, Esposito, G, Franzone, A, Di Costanzo, G, Muscogiuri, G, Sironi, S, Cuocolo, R, Cavaglia, E, Ponsiglione, A, Imbriaco, M, Dell'Aversana S., Ascione R., Vitale R. A., Cavaliere F., Porcaro P., Basile L., Napolitano G., Boccalatte M., Sibilio G., Esposito G., Franzone A., Di Costanzo G., Muscogiuri G., Sironi S., Cuocolo R., Cavaglia E., Ponsiglione A., Imbriaco M., Dell'Aversana, S, Ascione, R, Vitale, R, Cavaliere, F, Porcaro, P, Basile, L, Napolitano, G, Boccalatte, M, Sibilio, G, Esposito, G, Franzone, A, Di Costanzo, G, Muscogiuri, G, Sironi, S, Cuocolo, R, Cavaglia, E, Ponsiglione, A, Imbriaco, M, Dell'Aversana S., Ascione R., Vitale R. A., Cavaliere F., Porcaro P., Basile L., Napolitano G., Boccalatte M., Sibilio G., Esposito G., Franzone A., Di Costanzo G., Muscogiuri G., Sironi S., Cuocolo R., Cavaglia E., Ponsiglione A., and Imbriaco M.

Abstract

Coronary computed tomography angiography (CCTA) currently represents a robust imaging technique for the detection, quantification and characterization of coronary atherosclerosis. However, CCTA remains a challenging task requiring both high spatial and temporal resolution to provide motion-free images of the coronary arteries. Several CCTA features, such as low attenuation, positive remodeling, spotty calcification, napkin-ring and high pericoronary fat attenuation index have been proved as associated to high-risk plaques. This review aims to explore the role of CCTA in the characterization of high-risk atherosclerotic plaque and the recent advancements in CCTA technologies with a focus on radiomics plaque analysis.

Published
2023

3. Dual-Energy CT of the Heart: A Review

Author

Dell'Aversana, S, Ascione, R, De Giorgi, M, De Lucia, D, Cuocolo, R, Boccalatte, M, Sibilio, G, Napolitano, G, Muscogiuri, G, Sironi, S, Di Costanzo, G, Cavaglia, E, Imbriaco, M, Ponsiglione, A, Dell'Aversana S., Ascione R., De Giorgi M., De Lucia D. R., Cuocolo R., Boccalatte M., Sibilio G., Napolitano G., Muscogiuri G., Sironi S., Di Costanzo G., Cavaglia E., Imbriaco M., Ponsiglione A., Dell'Aversana, S, Ascione, R, De Giorgi, M, De Lucia, D, Cuocolo, R, Boccalatte, M, Sibilio, G, Napolitano, G, Muscogiuri, G, Sironi, S, Di Costanzo, G, Cavaglia, E, Imbriaco, M, Ponsiglione, A, Dell'Aversana S., Ascione R., De Giorgi M., De Lucia D. R., Cuocolo R., Boccalatte M., Sibilio G., Napolitano G., Muscogiuri G., Sironi S., Di Costanzo G., Cavaglia E., Imbriaco M., and Ponsiglione A.

Abstract

Dual-energy computed tomography (DECT) represents an emerging imaging technique which consists of the acquisition of two separate datasets utilizing two different X-ray spectra energies. Several cardiac DECT applications have been assessed, such as virtual monoenergetic images, virtual non-contrast reconstructions, and iodine myocardial perfusion maps, which are demonstrated to improve diagnostic accuracy and image quality while reducing both radiation and contrast media administration. This review will summarize the technical basis of DECT and review the principal cardiac applications currently adopted in clinical practice, exploring possible future applications.

Published
2022

4. Outcomes of Sorafenib for Recurrent Hepatocellular Carcinoma After Liver Transplantation in the Era of Combined and Sequential Treatments

Author

Tovoli, F, Pallotta, D, Sansone, V, Iavarone, M, De Giorgio, M, Ielasi, L, Di Costanzo, G, Giuffrida, P, Sacco, R, Pressiani, T, Di Donato, M, Trevisani, F, Fagiuoli, S, Piscaglia, F, Granito, A, Tovoli, Francesco, Pallotta, Dante Pio, Sansone, Vito, Iavarone, Massimo, De Giorgio, Massimo, Ielasi, Luca, Di Costanzo, Giovan Giuseppe, Giuffrida, Paolo, Sacco, Rodolfo, Pressiani, Tiziana, Di Donato, Maria Francesca, Trevisani, Franco, Fagiuoli, Stefano, Piscaglia, Fabio, Granito, Alessandro, Tovoli, F, Pallotta, D, Sansone, V, Iavarone, M, De Giorgio, M, Ielasi, L, Di Costanzo, G, Giuffrida, P, Sacco, R, Pressiani, T, Di Donato, M, Trevisani, F, Fagiuoli, S, Piscaglia, F, Granito, A, Tovoli, Francesco, Pallotta, Dante Pio, Sansone, Vito, Iavarone, Massimo, De Giorgio, Massimo, Ielasi, Luca, Di Costanzo, Giovan Giuseppe, Giuffrida, Paolo, Sacco, Rodolfo, Pressiani, Tiziana, Di Donato, Maria Francesca, Trevisani, Franco, Fagiuoli, Stefano, Piscaglia, Fabio, and Granito, Alessandro

Published
2023

5. The role of antiplatelet therapies on incidence and mortality of hepatocellular carcinoma

Author

Lai, Q., De Matthaeis, N., Finotti, M., Galati, G., Marrone, G., Melandro, F., Morisco, F., Nicolini, D., Pravisani, R., Giannini, E. G., Aglitti, A., Aliberti, C., Baccarani, U., Bhoori, S., Borzio, M., Brancaccio, G., Burra, P., Cabibbo, G., Casadei Gardini, A., Carrai, P., Cillo, U., Conti, F., Cucchetti, A., D'Ambrosio, R., Dell'Unto, C., Di Costanzo, G. G., Di Sandro, S., Foschi, F. G., Fucilli, F., Gambato, M., Gasbarrini, A., Giuliante, F., Ghinolfi, D., Grieco, A., Gruttaduria, S., Guarino, M., Kostandini, A., Iavarone, M., Lenci, I., Levi Sandri, G. B., Losito, F., Lupo, L. G., Manzia, T. M., Mazzocato, S., Mescoli, C., Miele, L., Muley, M., Persico, M., Plaz Torres, M. C., Pompili, M., Ponziani, F. R., Rapaccini, G. L., Rendina, M., Renzulli, M., Rossi, M., Rreka, E., Russo, F. P., Sacco, R., Sangiovanni, A., Sessa, A., Simonetti, N., Sposito, C., Tortora, R., Trevisani, F., Vigano, L., Vigano, M., Villa, E., Vincenzi, V., Violi, P., and Vitale, A.

Subjects
clopidogrel, aspirin, Clinical Biochemistry, incidence, occurrence, survival, General Medicine, Biochemistry, Settore MED/18
Abstract

To evaluate the impact of antiplatelet therapy (APT)on the incidence of hepatocellular carcinoma (HCC) and mortality following its treatment.A systematic literature search was performed using PubMed and Cochrane Central Register of Controlled Trials Databases. Two HCC clinical settings were explored: (i) incidence, and (ii) death after any HCC treatment. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to compare the pooled data between patients who received or did not receive APT.A total of 20 studies were identified, of whom 15 focused on HCC incidence, including 2,685,009 patients, and five on post-treatment death, including 3281 patients. APT was associated with an overall reduced risk of HCC incidence (OR: 0.63; 95%CI = 0.51-0.79; p 0.001) as well as of post-treatment mortality (OR: 0.54; 95%CI = 0.35-0.83; p = 0.006).Current data suggest that APT correlated with higher HCC incidence and poor overall survival following tumour treatment.

Published
2023

6. Overview of prognostic systems for hepatocellular carcinoma and ITA.LI.CA external validation of MESH and CNLC classifications

Author

Vitale, A, Farinati, F, Finotti, M, Di Renzo, C, Brancaccio, G, Piscaglia, F, Cabibbo, G, Caturelli, E, Missale, G, Marra, F, Sacco, R, Giannini, E, Trevisani, F, Cillo, U, Bhoori, S, Borzio, M, Burra, P, Casadei Gardini, A, Carrai, P, Conti, F, Cozzolongo, R, Cucchetti, A, D'Ambrosio, R, Dell'Unto, C, De Matthaeis, N, Di Costanzo, G, Di Sandro, S, Famularo, S, Foschi, F, Fucilli, F, Galati, G, Gambato, M, Gasbarrini, A, Giuliante, F, Ghinolfi, D, Grieco, A, Gruttadauria, S, Guarino, M, Iavarone, M, Kostandini, A, Lai, Q, Lenci, I, Levi Sandri, G, Losito, F, Lupo, L, Marasco, G, Manzia, T, Mazzocato, S, Masarone, M, Melandro, F, Mescoli, C, Miele, L, Morisco, F, Muley, M, Nicolini, D, Pagano, D, Persico, M, Pompili, M, Ponziani, F, Pravisani, R, Rapaccini, G, Rendina, M, Renzulli, M, Romano, F, Rossi, M, Rreka, E, Russo, F, Sangiovanni, A, Sessa, A, Simonetti, N, Sposito, C, Tortora, R, Vigano, L, Vigano, M, Villa, E, Vincenzi, V, Violi, P, Azzaroli, F, Brunetto, M, Di Marco, A, Masotto, A, Mega, A, Nardone, G, Oliveri, F, Raimondo, G, Svegliati Baroni, G, Vidili, G, Zoli, M, Vitale A., Farinati F., Finotti M., Di Renzo C., Brancaccio G., Piscaglia F., Cabibbo G., Caturelli E., Missale G., Marra F., Sacco R., Giannini E. G., Trevisani F., Cillo U., Bhoori S., Borzio M., Burra P., Casadei Gardini A., Carrai P., Conti F., Cozzolongo R., Cucchetti A., D'ambrosio R., Dell'unto C., De Matthaeis N., Di Costanzo G. G., Di Sandro S., Famularo S., Foschi F. G., Fucilli F., Galati G., Gambato M., Gasbarrini A., Giuliante F., Ghinolfi D., Grieco A., Gruttadauria S., Guarino M., Iavarone M., Kostandini A., Lai Q., Lenci I., Levi Sandri G. V., Losito F., Lupo L. G., Marasco G., Manzia T. M., Mazzocato S., Masarone M., Melandro F., Mescoli C., Miele L., Morisco F., Muley M., Nicolini D., Pagano D., Persico M., Pompili M., Ponziani F. R., Pravisani R., Rapaccini G. L., Rendina M., Renzulli M., Romano F., Rossi M., Rreka E., Russo F. P., Sangiovanni A., Sessa A., Simonetti N., Sposito C., Tortora R., Vigano L., Vigano M., Villa E., Vincenzi V., Violi P., Azzaroli F., Brunetto M. R., Di Marco A., Masotto A., Mega A., Nardone G., Oliveri F., Raimondo G., Svegliati Baroni G., Vidili G., Zoli M., Vitale, A, Farinati, F, Finotti, M, Di Renzo, C, Brancaccio, G, Piscaglia, F, Cabibbo, G, Caturelli, E, Missale, G, Marra, F, Sacco, R, Giannini, E, Trevisani, F, Cillo, U, Bhoori, S, Borzio, M, Burra, P, Casadei Gardini, A, Carrai, P, Conti, F, Cozzolongo, R, Cucchetti, A, D'Ambrosio, R, Dell'Unto, C, De Matthaeis, N, Di Costanzo, G, Di Sandro, S, Famularo, S, Foschi, F, Fucilli, F, Galati, G, Gambato, M, Gasbarrini, A, Giuliante, F, Ghinolfi, D, Grieco, A, Gruttadauria, S, Guarino, M, Iavarone, M, Kostandini, A, Lai, Q, Lenci, I, Levi Sandri, G, Losito, F, Lupo, L, Marasco, G, Manzia, T, Mazzocato, S, Masarone, M, Melandro, F, Mescoli, C, Miele, L, Morisco, F, Muley, M, Nicolini, D, Pagano, D, Persico, M, Pompili, M, Ponziani, F, Pravisani, R, Rapaccini, G, Rendina, M, Renzulli, M, Romano, F, Rossi, M, Rreka, E, Russo, F, Sangiovanni, A, Sessa, A, Simonetti, N, Sposito, C, Tortora, R, Vigano, L, Vigano, M, Villa, E, Vincenzi, V, Violi, P, Azzaroli, F, Brunetto, M, Di Marco, A, Masotto, A, Mega, A, Nardone, G, Oliveri, F, Raimondo, G, Svegliati Baroni, G, Vidili, G, Zoli, M, Vitale A., Farinati F., Finotti M., Di Renzo C., Brancaccio G., Piscaglia F., Cabibbo G., Caturelli E., Missale G., Marra F., Sacco R., Giannini E. G., Trevisani F., Cillo U., Bhoori S., Borzio M., Burra P., Casadei Gardini A., Carrai P., Conti F., Cozzolongo R., Cucchetti A., D'ambrosio R., Dell'unto C., De Matthaeis N., Di Costanzo G. G., Di Sandro S., Famularo S., Foschi F. G., Fucilli F., Galati G., Gambato M., Gasbarrini A., Giuliante F., Ghinolfi D., Grieco A., Gruttadauria S., Guarino M., Iavarone M., Kostandini A., Lai Q., Lenci I., Levi Sandri G. V., Losito F., Lupo L. G., Marasco G., Manzia T. M., Mazzocato S., Masarone M., Melandro F., Mescoli C., Miele L., Morisco F., Muley M., Nicolini D., Pagano D., Persico M., Pompili M., Ponziani F. R., Pravisani R., Rapaccini G. L., Rendina M., Renzulli M., Romano F., Rossi M., Rreka E., Russo F. P., Sangiovanni A., Sessa A., Simonetti N., Sposito C., Tortora R., Vigano L., Vigano M., Villa E., Vincenzi V., Violi P., Azzaroli F., Brunetto M. R., Di Marco A., Masotto A., Mega A., Nardone G., Oliveri F., Raimondo G., Svegliati Baroni G., Vidili G., and Zoli M.

Abstract

Prognostic assessment in patients with HCC remains an extremely difficult clinical task due to the complexity of this cancer where tumour characteristics interact with degree of liver dysfunction, patient general health status, and a large span of available treatment options. Several prognostic systems have been proposed in the last three decades, both from the Asian and European/North American countries. Prognostic scores, such as the CLIP score and the recent MESH score, have been generated on a solid statistical basis from real life population data, while staging systems, such as the BCLC scheme and the recent CNLC classification, have been created by experts according to recent HCC prognostic evidences from the literature. A third category includes combined prognostic systems that can be used both as prognostic scores and staging systems. A recent example is the ITA.LI.CA prognostic system including either a prognostic score and a simplified staging system. This review focuses first on an overview of the main prognostic systems for HCC classified according to the above three categories, and, second, on a comprehensive description of the methodology required for a correct comparison between different systems in terms of prognostic performance. In this second section the main studies in the literature comparing different prognostic systems are described in detail. Lastly, a formal comparison between the last prognostic systems proposed for each of the above three categories is performed using a large Italian database including 6882 HCC patients in order to concretely apply the comparison rules previously described.

Published
2021

9. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author

Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, Avolio, A, Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., Avolio A., Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, Avolio, A, Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., and Avolio A.

Abstract

Background: Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods: All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73m2 at inclusion and follow-up visit. Results: Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR < 60 mL/min/1.73 m2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O'Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions: Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.

Published
2019

10. Development of a model based on case-mix analysis to predict 6-month patient survival after liver transplantation: a multicenter Italian study

Author

Avolio, A, Lai, Q, Franco, A, Bianco, G, Calia, R, Spoletini, G, Agnes, S, Grieco, A, Rossi, M, Corradini, S, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Donato, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, Cillo, U, Avolio A, Lai Q, Franco A, Bianco G, Calia R, Spoletini G, Agnes S, Grieco A, Rossi M, Corradini SG, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Donato C, Zamboni F, Mameli L, De Carlis L, Belli L, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Di Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Ettorre G, Giannelli V, Tisone G, Lenci I, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carraro A, Burra P, Cillo U, Avolio, A, Lai, Q, Franco, A, Bianco, G, Calia, R, Spoletini, G, Agnes, S, Grieco, A, Rossi, M, Corradini, S, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Donato, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, Cillo, U, Avolio A, Lai Q, Franco A, Bianco G, Calia R, Spoletini G, Agnes S, Grieco A, Rossi M, Corradini SG, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Donato C, Zamboni F, Mameli L, De Carlis L, Belli L, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Di Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Ettorre G, Giannelli V, Tisone G, Lenci I, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carraro A, Burra P, and Cillo U

Published
2019

11. THE CASE-MIX IN LIVER TRANSPLANTATION. DIFFERENT PERCEPTIONS (TRANSPLANT SURGEONS AND TRANSPLANT HEPATOLOGISTS) AND DIFFERENT CONCORDANCE LEVELS WITHIN CENTERS

Author

Calia, R, Avolio, A, Luciani, M, Franco, A, Lai, Q, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Morelli, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Agnes, S, Grieco, A, Spoletini, G, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Rossi, M, Corradini, S, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, Cillo, U, Calia R, Avolio A, Luciani M, Franco A, Lai Q, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Morelli C, Zamboni F, Mameli L, De Carlis L, Belli LS, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Di Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Agnes S, Grieco A, Spoletini G, Ettorre G, Giannelli V, Tisone G, Lenci I, Rossi M, Corradini SG, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carraro A, Burra P, Cillo U, Calia, R, Avolio, A, Luciani, M, Franco, A, Lai, Q, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Morelli, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Agnes, S, Grieco, A, Spoletini, G, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Rossi, M, Corradini, S, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, Cillo, U, Calia R, Avolio A, Luciani M, Franco A, Lai Q, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Morelli C, Zamboni F, Mameli L, De Carlis L, Belli LS, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Di Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Agnes S, Grieco A, Spoletini G, Ettorre G, Giannelli V, Tisone G, Lenci I, Rossi M, Corradini SG, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carraro A, Burra P, and Cillo U

Published
2019

12. Eculizumab treatment in patients with COVID-19: preliminary results from real life ASL Napoli 2 Nord experience

Author

Diurno, F., Numis, F. G., Porta, G., Cirillo, F., Maddaluno, S., Ragozzino, A., De Negri, P., Di Gennaro, C., Pagano, A., Allegorico, E., Bressy, L., Bosso, G., Ferrara, A., Serra, C., Montisci, A., D'Amico, M., Schiano Lo Morello, S., Di Costanzo, G., Tucci, A. G., Marchetti, P., Di Vincenzo, U., Sorrentino, I., Casciotta, A., Fusco, M., Buonerba, C., Berretta, M., Ceccarelli, M., Nunnari, G., Diessa, Y., Cicala, S., and Facchini, G.

Subjects
Treatment, Coronavirus, Betacoronavirus, SARS-CoV-2, Pneumonia, Viral, COVID-19, Humans, Eculizumab, Antibodies, Monoclonal, Humanized, Coronavirus Infections, Severe Acute Respiratory Syndrome, Complement Activation, Pandemics
Abstract

SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)-related pneumonia, referred to as COVID-19 (Coronavirus Disease 19), is a public health emergency as it carries high morbidity, mortality, and has no approved specific pharmacological treatments. In this case series, we aimed to report preliminary data obtained with anti-complement C5 therapy with eculizumab in COVID-19 patients admitted to intensive care unit (ICU) of ASL Napoli 2 Nord.This is a case series of patients with a confirmed diagnosis of SARS-CoV2 infection and severe pneumonia or ARDS who were treated with up to 4 infusions of eculizumab as an off-label agent. Patients were also treated with anticoagulant therapy with Enoxaparin 4000 IU/day via subcutaneous injection, antiviral therapy with Lopinavir 800 mg/day + Ritonavir 200 mg/day, hydroxychloroquine 400 mg/day, ceftriaxone 2 g/day IV, vitamine C 6 g/day for 4 days, and were on Non-Invasive Ventilation (NIV).We treated four COVID-19 patients admitted to the intensive care unit because of severe pneumonia or ARDS. All patients successfully recovered after treatment with eculizumab. Eculizumab induced a drop in inflammatory markers. Mean C Reactive Protein levels dropped from 14.6 mg/dl to 3.5 mg/dl and the mean duration of the disease was 12.8 days.Eculizumab has the potential to be a key player in treatment of severe cases of COVID-19. Our results support eculizumab use as an off-label treatment of COVID-19, pending confirmation from the ongoing SOLID-C19 trial.

Published
2020

14. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author

Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., Avolio A., Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G.G., Avolio A., Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, and Avolio, A

Subjects
Nephrology, Adult, Male, medicine.medical_specialty, Settore MED/18 - CHIRURGIA GENERALE, Renal function, lcsh:RC870-923, 03 medical and health sciences, 0302 clinical medicine, Calcineurin inhibitors, Calcineurin inhibitor, Internal medicine, Sex differences, Medicine, Humans, Meta-analysi, 030212 general & internal medicine, Longitudinal Studies, Renal insufficiency, Liver transplant, Aged, Retrospective Studies, Sex Characteristics, business.industry, Gender, Middle Aged, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Transplant Recipients, Liver Transplantation, Calcineurin, Transplantation, Meta-analysis, Clinical research, Cross-Sectional Studies, Italy, 030211 gastroenterology & hepatology, Observational study, Female, business, Research Article, Kidney disease, Follow-Up Studies, Glomerular Filtration Rate
Abstract

Background Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) 2 at inclusion and follow-up visit. Results Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR 2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O’Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.

Published
2019

19. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author

Colombo, D., Zagni, E., Zullo, A., Simoni, L., Fagiuoli, S., De Simone, P., Donati, D., Salizzoni, M., Angeli, P., Burra, P., Cillo, U., Toniutto, P., Rossi, M., Vennarecci, G., De Carlis, L., Donato, F., Cescon, M., Di Leo, A., Di Costanzo, G. G., Avolio, Alfonso Wolfango, Avolio A. (ORCID:0000-0003-2491-7625), Colombo, D., Zagni, E., Zullo, A., Simoni, L., Fagiuoli, S., De Simone, P., Donati, D., Salizzoni, M., Angeli, P., Burra, P., Cillo, U., Toniutto, P., Rossi, M., Vennarecci, G., De Carlis, L., Donato, F., Cescon, M., Di Leo, A., Di Costanzo, G. G., Avolio, Alfonso Wolfango, and Avolio A. (ORCID:0000-0003-2491-7625)

Abstract

Background: Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods: All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73m2 at inclusion and follow-up visit. Results: Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR < 60 mL/min/1.73 m2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O'Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions: Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.

Published
2019

20. Use of allogeneic platelet gel in the management of chemotherapy extravasation injuries: a case report

Author

Di Costanzo G, Loquercio G, Marcacci G, Iervolino V, Mori S, Petruzziello A, Barra P, and Cacciapuoti C

Subjects
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, lcsh:RC254-282
Abstract

Gaetano Di Costanzo,1 Giovanna Loquercio,1 Gianpaolo Marcacci,2 Vincenzo Iervolino,1 Stefano Mori,3 Arnolfo Petruzziello,1 Pasquale Barra,1 Carmela Cacciapuoti1 1Transfusion Service, Department of Haematology, National Cancer Institute “G Pascale” Foundation, IRCCS, Naples, Italy; 2Hematology-Oncology and Stem Cell Transplantation Unit, National Cancer Institute “G Pascale” Foundation, IRCCS, Naples, Italy; 3Department of Surgery, Melanoma – Soft Tissues – Head andNeck – Skin Cancers, National Cancer Institute “G Pascale” Foundation, IRCCS, Naples, Italy Abstract: The allogeneic platelet (PLT) gel offers to be a valid supportive measure in the management of chemotherapy extravasation injuries. We report a case of a 58-year-old patient with multiple myeloma enrolled for high-dose chemotherapy and autologous stem cell transplantation. As pretransplant therapy, the patient received induction therapy with bortezomib, adriblastina, and desametazone. A port was inserted in the vein on the back of the hand. After three cycles, the patient reported rapid development of redness, pain, and necrotic tissue in the left hand, and a diagnosis of extravasation was addressed. The patient presented a raw area on the back of the hand caused by cytotoxic/chemotherapeutic drug leakage because of the malposition of venous access devices. Skin ulcer was debrided, and the wound was reconstructed with a combination of local random rotational flap and abdomen skin graft. Two weeks later, a 20% skin flap necrosis was observed. In the context of wound healing, topical plasma-rich PLT gel is able to accelerate the regeneration and repair of tissue, so it was set out to assess PLT gel efficacy in this case. The PLT gel was applied topically once every 5 days, for a duration of 60days on average. There were no adverse reactions observed during the topical therapy. Complete wound healing was observed after 12 PLT-rich plasma applications. No ulcer recurrence was noted in the patient during the follow-up period of 2–19months. Keywords: growth factors, platelet gel, chemotherapy, management, extravasation

Published
2015

21. Refining sorafenib therapy: Lessons from clinical practice

Author

Bolondi, L, Craxi, A, Trevisani, F, Daniele, B, Di Costanzo, G, Fagiuoli, S, Camma, C, Bruzzi, P, Danesi, R, Spandonaro, F, Boni, C, Santoro, A, Colombo, M, Bolondi L., Craxi A., Trevisani F., Daniele B., Di Costanzo G. G., Fagiuoli S., Camma C., Bruzzi P., Danesi R., Spandonaro F., Boni C., Santoro A., Colombo M., Bolondi, L, Craxi, A, Trevisani, F, Daniele, B, Di Costanzo, G, Fagiuoli, S, Camma, C, Bruzzi, P, Danesi, R, Spandonaro, F, Boni, C, Santoro, A, Colombo, M, Bolondi L., Craxi A., Trevisani F., Daniele B., Di Costanzo G. G., Fagiuoli S., Camma C., Bruzzi P., Danesi R., Spandonaro F., Boni C., Santoro A., and Colombo M.

Abstract

Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients.

Published
2015

22. Undetectable HCV-RNA at treatment-week 8 results in high-sustained virological response in HCV G1 treatment-experienced patients with advanced liver disease: The International Italian/Spanish Boceprevir/Peginterferon/Ribavirin Name Patients Program

Author

Bruno, S, Bollani, S., Zignego, A. L., Pascasio, J. M., Magni, C., Ciancio, A., Caremani, M., Mangia, A., Marenco, S., Piovesan, S., Chemello, L., Babudieri, S., Moretti, A., Gea, F., Colletta, C., Perez Alvarez, R., Forns, X., Larrubia, J. R., Arenas, J., Crespo, J., Calvaruso, V., Ceccherini Silberstein, F., Maisonneuve, P., Craxì, A., Calleja, J. L., Di Marco, V., Monti, M., Rizzardini, G., Landonio, S., Rizzetto, M., Lapini, L. E., Piazzolla, V., Picciotto, A., Alberti, A., Cavaletto, L., Koch, M., Massari, M., Muratori, L., Cipriano, V., Montineri, A., Iacobello, C., Fangazio, S., Pirisi, M., Colombo, A., Bellati, G., Mazzotta, F., Pierotti, P., Traverso, A., Serviddio, G., Russello, M., Santantonio, T., Drenaggi, D., Marchionne, E., Zuin, M., Delliponti, M., Farina, F., Andreone, P., Scuteri, A., Galli, M., Giannini, EDOARDO GIOVANNI, Nerli, A., Carbonai, S., Coppola, N., Montalbano, M., Portelli, V., Di Biagio, A., Nicolini, LAURA AMBRA, Mastroianni, C., Madonia, S., Licata, A., Montalto, G., Giannitrapani, L., Mondelli, M., Pellicelli, A., Toniutto, P., Borgia, G., Gentile, I., De Luca, M., Di Costanzo, G. G., Corti, G., Sousa, M., Delgado, M. B., De La Revilla, J., Navarro, J. M., Barcena, R., Romero Gomez, M., Fernandez Rodriguez, C. M., Narvaez, I., Erdozain, J. C., Molina, E., Fernandez, I., Cuenca, B., Planas, R., Garcia Samaniego, J., Ladero, J. M., Gonzalez, J. M., Serra, M. A., Castellote, I., Sola, R., Anton, T., Ryan, I., Gonzalez, F., Martinez, E., Portu, J., Bruno, S, Bollani, S., Zignego, A.L., Pascasio, J.M., Magni, C., Ciancio, A., Caremani, M., Mangia, A., Marenco, S., Piovesan, S., Chemello, L., Babudieri, S., Moretti, A., Gea, F., Colletta, C., Perez-Alvarez, R., Forns, X., Larrubia, J.R., Arenas, J., Crespo, J., Calvaruso, V., Ceccherini Silberstein, F., Maisonneuve, P., Craxì, A., Calleja, J.L., Di Marco, V., Monti, M., Rizzardini, G., Landonio, S., Rizzetto, M., Lapini, L.E., Piazzolla, V., Picciotto, A., Alberti, A., Cavaletto, L., Koch, M., Massari, M., Muratori, L., Cipriano, V., Montineri, A., Iacobello, C., Fangazio, S., Pirisi, M., Colombo, A., Bellati, G., Mazzotta, F., Pierotti, P., Traverso, A., Serviddio, G., Russello, M., Santantonio, T., Drenaggi, D., Marchionne, E., Zuin, M., Delliponti, M., Farina, F., Andreone, P., Scuteri, A., Galli, M., Giannini, E.G., Nerli, A., Carbonai, S., Coppola, N., Montalbano, M., Portelli, V., Di Biagio, A., Nicolini, L.A., Mastroianni, C., Madonia, S., Licata, A., Montalto, G., Giannitrapani, L., Mondelli, M., Pellicelli, A., Toniutto, P., Borgia, G., Gentile, I., De Luca, M., Di Costanzo, G.G., Corti, G., Sousa, M., Delgado, M.B., De La Revilla, J., Navarro, J.M., Barcena, R., Romero-Gomez, M., Fernandez-Rodriguez, C.M., Narvaez, I., Erdozain, J.C., Molina, E., Fernandez, I., Cuenca, B., Planas, R., Garcia-Samaniego, J., Ladero, J.M., Gonzalez, J.M., Serra, M.A., Castellote, I., Sola, R., Anton, T., Ryan, I., Gonzalez, F., Martinez, E., Portu, J., Bollani, S, Zignego, A. L, Pascasio, J. M, Magni, C, Ciancio, A, Caremani, M, Mangia, A, Marenco, S, Piovesan, S, Chemello, L, Gentile, Ivan, Borgia, Guglielmo, Et, A, Babudieri, S, Moretti, A, Gea, F, Colletta, C, Perez Alvarez, R, Forns, X, Larrubia, J. R, Arenas, J, Crespo, J, Calvaruso, V, Ceccherini Silberstein, F, Maisonneuve, P, Craxì, A, Calleja, J. L., Bruno, S., Zignego, A., Pascasio, J., Larrubia, J., Calleja, J., Lapini, L., Giannini, E., Nicolini, L., Di Costanzo, G., Delgado, M., Navarro, J., Fernandez-Rodriguez, C., Erdozain, J., Ladero, J., Gonzalez, J., and Serra, M.

Subjects
Male, Settore MED/09 - Medicina Interna, boceprevir, cirrhosis, first-generation protease inhibitors, hepatitis C, IFN-based therapy, Adult, Aged, Antiviral Agents, Drug Therapy, Combination, Female, Hepacivirus, Hepatitis C, Chronic, Humans, Interferon-alpha, Italy, Middle Aged, Proline, RNA, Viral, Ribavirin, Spain, Treatment Outcome, Viral Load, Hepatology, Infectious Diseases, Virology, Medicine (all), Gastroenterology, first-generation protease inhibitor, chemistry.chemical_compound, Liver disease, Medicine, Viral, Chronic, Settore MED/12 - Gastroenterologia, Drug Therapy, Combination, Hepatitis C, RNA, virus diseases, Settore MED/07 - Microbiologia e Microbiologia Clinica, HCV, Viral load, Human, medicine.medical_specialty, Alpha interferon, Infectious Disease, Internal medicine, Boceprevir, hepatitis c, adult, aged, antiviral agents, drug therapy, combination, female, hepacivirus, hepatitis c, chronic, humans, interferon-alpha, italy, male, middle aged, proline, RNA, viral, ribavirin, spain, treatment outcome, viral load, hepatology, infectious diseases, virology, Decompensation, Adverse effect, Antiviral Agent, Hepaciviru, business.industry, medicine.disease, digestive system diseases, chemistry, Immunology, business, cirrhosi
Abstract

In many countries, first-generation protease inhibitors (PIs)/peginterferon/ribavirin (P/R) still represent the only treatment option for HCV-infected patients. Subjects with advanced disease and previous failure to P/R urgently need therapy, but they are under-represented in clinical trials. All treatment-experienced F3/4 Metavir patients who received boceprevir (BOC)+P/R in the Italian-Spanish Name Patient Program have been included in this study. Multivariate logistic regression analysis (MLR) was used to identify baseline and on-treatment predictors of SVR and adverse events (AEs). Four hundred and sixteen patients, mean age 57.7 (range 25-78 years), 70% males, 69.5% (289/416) F4, 14% (41/289) Child-Pugh class A6, 24% (70/289) with varices and 42% (173/416) prior null responders to P/R, were analysed. Overall, SVR rate (all 381 patients who received one dose of BOC) was 49%, (58% in F3, 45% in F4, 61% in relapsers, 51% in partial, 38% in null responders, and 72% in subjects with undetectable HCV-RNA at treatment-week (TW)8. Among patients with TW8 HCV-RNA ≥ 1000 IU/L, SVR was 8% (negative predictive value = 92%). Death occurred in 3 (0.8%) patients, while decompensation and infections were observed in 2.9% and 11%, respectively. At MLR, SVR predictors were TW4 HCV-RNA ≥ 1log10 -decline from baseline, undetectable TW8 HCV-RNA, prior relapse, albumin levels ≥3.5 g/dL and platelet counts ≥100 000/μL. Metavir F4, Child-Pugh A6, albumin, platelets, age and female gender were associated with serious and haematological AEs. Among treatment-experienced patients with advanced liver disease eligible for IFN-based therapy, TW8 HCV-RNA characterised the subset with either high or poor likelihood of achieving SVR. Using TW8 HCV-RNA as a futility rule, BOC/P/R appears to have a favourable benefit-risk profile.

Published
2015

23. Lack of correlation between serum anti-HBcore detectability and hepatocellular carcinoma in patients with HCV-related cirrhosis

Author

Stroffolini, T, Almasio, Pl, Persico, M, Bollani, S, Benvegnù, L, Di Costanzo, G, Pastore, G, Aghemo, A, Stornaiuolo, G, Mangia, A, Andreone, P, Stanzione, M, Mazzella, G, Saracco, G, Del Poggio, P, Bruno, S, Boccia, S, Di Marco, V, Giannini, EDOARDO GIOVANNI, Morisco, F, Picciotto, Antonino, Fagiuoli, S, Mazzaro, C., Stroffolini T, Almasio PL, Persico M, Bollani S, Benvegnù L, Di Costanzo G, Pastore G, Aghemo A, Stornaiuolo G, Mangia A, Andreone P, Stanzione M, Mazzella G, Saracco G, Del Poggio P, Bruno S, Italian Association of the Study of the Liver Disease (AISF), Stroffolini, T, Almasio, P, Persico, M, Bollani, S, Benvegnù, L, Di Costanzo, G, Pastore, G, Aghemo, A, Stornaiuolo, G, Mangia, A, Andreone, P, Stanzione, M, Mazzella, G, Saracco, G, Del Poggio, P, Bruno, S, Boccia, S, Di Marco, V, Giannini, E, Morisco, F, Picciotto, A, Fagiuoli, S, Mazzaro, C, Almasio, Pl, and Morisco, Filomena

Subjects
Liver Cirrhosis, Male, Pathology, Cirrhosis, Adult, Antibodies, Viral, blood, Carcinoma, Hepatocellular, blood/pathology/virology, Cohort Studies, Female, Hepatitis B Core Antigens, immunology, Hepatitis B virus, immunology, Hepatitis C, blood/complications/pathology, Humans, Liver Cirrhosis, blood/etiology/pathology, Liver Neoplasms, blood/pathology/virology, Male, Middle Aged, Retrospective Studies, Risk Factors, Antibodies, Viral, Gastroenterology, anti HBc, Cohort Studies, immunology, Risk Factors, HBV, HCC, CIRRHOSIS, Liver Neoplasms, virus diseases, HBV HCV COINFECTION, Middle Aged, Hepatitis B Core Antigens, Hepatitis C, Adult, Carcinoma, Hepatocellular, Female, Hepatitis B virus, Humans, Retrospective Studies, Hepatocellular carcinoma, HCV, medicine.medical_specialty, blood/pathology/virology, Antibodies, blood, blood/complications/pathology, Internal medicine, medicine, In patient, HEPATOCELLULAR CARCINOMA, Hepatology, business.industry, Carcinoma, Cancer, medicine.disease, digestive system diseases, blood/etiology/pathology, business
Abstract

BACKGROUND: While the likelihood of developing hepatocellular carcinoma (HCC) in patients coinfected with both HBV and HCV is increased, the role of previous exposure to HBV as a risk factor associated with tumor occurrence in subjects with HCV-related cirrhosis has not been fully investigated. AIM: To assess whether serum anti-HBc positivity, as a marker of previous HBV exposure, is associated with HCC development in HCV-related positive, hepatitis B surface antigen (HBsAg) negative patients with cirrhosis treated with alfa-interferon (IFN) monotherapy. PATIENTS AND: A database including 883 consecutive patients (557 men, mean age 54.7 yr) with histologically METHODS: proven cirrhosis treated with IFN between 1992 and 1997 was analyzed. All subjects have been surveilled every 6 months by ultrasound. Independent predictors of HCC were assessed by Cox multiple regression analysis. RESULTS: Mean follow-up was 96.1 months. Anti-HBc testing was available in 693 cases and, among them, 303 patients (43.7%) were anti-HBc seropositive. Anti-HBc positive patients were more often men (67.0% vs 58.7%, P = 0.03), had lower transaminase levels (3.3 ± 2.0 vs 3.8 ± 2.5 u.l.n., P = 0.004), and had higher rate of alcohol intake (38.3% vs 22.5%, P < 0.001) than anti-HBc negative patients. Overall, the incidence rates of HCC per 100 person-years were 1.84 (95% CI 1.34-2.47) in the anti-HBc positive patients and 1.86 (95% CI 1.41-2.42) in anti-HBc negative ones. By Cox multiple regression, there was no association of serum anti-HBc with HCC development (HR 1.03, 95% CI 0.69-1.52) or liver-related deaths incidence (HR 1.21; 95% CI 0.76-1.95). CONCLUSIONS: In comparison with anti-HBc negative subjects, serum anti-HBc positive patients with HCV-related/HBsAg negative cirrhosis treated with IFN monotherapy did not show a greater risk of HCC.

Published
2008

24. Metronomic oral cyclophosphamide (CTX) in patients (pts) with heavily pretreated metastatic castration-resistant prostate cancer (mCRPC)

Author

Fea, E., primary, Vanella, P., additional, Miraglio, E., additional, Cauchi, C., additional, Colantonio, I., additional, Denaro, N., additional, Di Costanzo, G., additional, Garrone, O., additional, Granetto, C., additional, Occelli, M., additional, Ricci, V., additional, Vandone, A.M., additional, and Merlano, M.C., additional

Published
2016
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25. Activation of Palliative Cares by hospital oncologists: first results of a survey conducted by Rete Oncologica del Piemonte e della Valle d'Aosta

Author

Alabiso, I., primary, Ballari, A., additional, Brignardello, E., additional, Numico, G., additional, Sperti, E., additional, Cristofano, A., additional, Russi, E., additional, Oliva, C., additional, Mistrangelo, M., additional, Levis, M., additional, Gallo, M., additional, Di Costanzo, G., additional, and Bertetto, O., additional

Published
2016
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27. ICON2: randomised trial of single-agent carboplatin against three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) in women with ovarian cancer

Author

Parmar MKB, Torri V, Bonaventura A, Bonazzi C, Colombo N, Delaloye JF, Marsoni S, Mangioni C, Sandercock J, Sessa C, Williams C, Tinazzi A, Flann M, Geiser K, Scorpiglione N, Stewart JF, Chaves J, Palmeiro E, Curtain A, McCormack T, Gennatas C, Marras F, Oppo TG, Balestrino M, Malzoni C, Malzoni M, Belli M, Geminiani ML, Crestani G, Monaco A, Vavala V, Piatto E, Barattini G, Fornara PG, Chetri MC, Santeufemia G, Artioli F, Carone D, Fanizza G, Trentadue R, Priolo D, Scollo P, Nigro SC, Petrina M, Mastrantonio P, Spanna GD, Zagni R, Belloni C, Colleoni R, Redaelli L, Cavagnini A, Di Costanzo G, Perroni D, Arienti S, Orfanotti G, Cantoni FM, Secli R, Bianchi A, Martinello R, Mollica G, Maizzi D, Picchiarelli ME, Fiorini G, Borsani M, Colombo E, Garsia S, Melgrati L, Paggi G, Brunenghi GM, Casini M, Isa L, Algeri R, Prozio G, Belfiore G, Angelini F, D'Aprile M, Moreschi M, Mauri ML, Natale N, Senzani FM, Pavanato G, Poggi G, Garuti G, Luerti M, Cruciani G, Pagano F, Baccolo M, Poddi ER, Bocciolone L, Sabelli MA, Maggi R, Restelli C, D'Antona A, Locatelli MC, Pessi A, Raina A, Chiari S, Gabriele A, Pittelli MR, Iacobelli P, Dogliotti L, Gorzegno G, Musso P, Vegna G, Coco G, Alletti DG, Picciotto F, Lucchese V, Epis A, di Palumbo VS, Drudi G, Ravaioli A, Zampella D, Morandi MG, Gorga G, Zucchelli C, Cariello S, Galletto L, Sussio M, Massacesi L, Massacesi M, Carli A, Tucci E, Tajani E, Corrado G, Bumma S, Durando A, Massobrio M, Sberveglieri M, Biasio M, Guercio E, Jura R, Danese S, Wierdis T, Farnelli C, Tarantino G, Grassi R, Repetti F, Rocchi B, Grampa M, Ercoli A, Griso C, Signori E, Zanini L, Presti M, Klimek M, Urbanski K, Biswas A, Viegas O, Kochli O, Dreher E, Fey M, Beck G, Ludin J, Bonnefoi H, Krauer F, Bauer J, Delmore G, Furrer C, Lorenz U, Thurlimann B, Bronz L, Sanna P, Wyss D, Goldhirsch A, Gyr T, Leidi L, Pastorelli G, Pagani O, Rey P, Hailer U, Benz J, Kaye SB, Reed NS, Symonds RP, Atkinson RJ, Axford AT, Rustin G, Seckl MJ, Green JA, Scott IV, Guthrie D, Harper PG, Calman F, Dobbs HJ, Weir P, Cassoni A, Lederman JA, Souhami RL, Bozzino J, Adab F, Redman CWE, Scoble JE, Paterson M, Daniel F, Cowley N, Williams CJ, Spooner D, Hong A, McIllmurray M, Hendy-Ibbs P, Hall V, Iveson TJ, Whitehouse JMA, Garry R, Lamont A, Robinson A, Trask CW, Clubb AW, Murrell D, Newman G, Wilkins M, Goldthorp WO, Roberts JK, Radstone DJ, Whipp MJ, Ledermann JA, Pater J, Buyse M, Omura G, Parmar, Mkb, Torri, V, Bonaventura, A, Bonazzi, C, Colombo, N, Delaloye, Jf, Marsoni, S, Mangioni, C, Sandercock, J, Sessa, C, Williams, C, Tinazzi, A, Flann, M, Geiser, K, Scorpiglione, N, Stewart, Jf, Chaves, J, Palmeiro, E, Curtain, A, Mccormack, T, Gennatas, C, Marras, F, Oppo, Tg, Balestrino, M, Malzoni, C, Malzoni, M, Belli, M, Geminiani, Ml, Crestani, G, Monaco, A, Vavala, V, Piatto, E, Barattini, G, Fornara, Pg, Chetri, Mc, Santeufemia, G, Artioli, F, Carone, D, Fanizza, G, Trentadue, R, Priolo, D, Scollo, P, Nigro, Sc, Petrina, M, Mastrantonio, P, Spanna, Gd, Zagni, R, Belloni, C, Colleoni, R, Redaelli, L, Cavagnini, A, Di Costanzo, G, Perroni, D, Arienti, S, Orfanotti, G, Cantoni, Fm, Secli, R, Bianchi, A, Martinello, R, Mollica, G, Maizzi, D, Picchiarelli, Me, Fiorini, G, Borsani, M, Colombo, E, Garsia, S, Melgrati, L, Paggi, G, Brunenghi, Gm, Casini, M, Isa, L, Algeri, R, Prozio, G, Belfiore, G, Angelini, F, D'Aprile, M, Moreschi, M, Mauri, Ml, Natale, N, Senzani, Fm, Pavanato, G, Poggi, G, Garuti, G, Luerti, M, Cruciani, G, Pagano, F, Baccolo, M, Poddi, Er, Bocciolone, L, Sabelli, Ma, Maggi, R, Restelli, C, D'Antona, A, Locatelli, Mc, Pessi, A, Raina, A, Chiari, S, Gabriele, A, Pittelli, Mr, Iacobelli, P, Dogliotti, L, Gorzegno, G, Musso, P, Vegna, G, Coco, G, Alletti, Dg, Picciotto, F, Lucchese, V, Epis, A, di Palumbo, V, Drudi, G, Ravaioli, A, Zampella, D, Morandi, Mg, Gorga, G, Zucchelli, C, Cariello, S, Galletto, L, Sussio, M, Massacesi, L, Massacesi, M, Carli, A, Tucci, E, Tajani, E, Corrado, G, Bumma, S, Durando, A, Massobrio, M, Sberveglieri, M, Biasio, M, Guercio, E, Jura, R, Danese, S, Wierdis, T, Farnelli, C, Tarantino, G, Grassi, R, Repetti, F, Rocchi, B, Grampa, M, Ercoli, A, Griso, C, Signori, E, Zanini, L, Presti, M, Klimek, M, Urbanski, K, Biswas, A, Viegas, O, Kochli, O, Dreher, E, Fey, M, Beck, G, Ludin, J, Bonnefoi, H, Krauer, F, Bauer, J, Delmore, G, Furrer, C, Lorenz, U, Thurlimann, B, Bronz, L, Sanna, P, Wyss, D, Goldhirsch, A, Gyr, T, Leidi, L, Pastorelli, G, Pagani, O, Rey, P, Hailer, U, Benz, J, Kaye, Sb, Reed, N, Symonds, Rp, Atkinson, Rj, Axford, At, Rustin, G, Seckl, Mj, Green, Ja, Scott, Iv, Guthrie, D, Harper, Pg, Calman, F, Dobbs, Hj, Weir, P, Cassoni, A, Lederman, Ja, Souhami, Rl, Bozzino, J, Adab, F, Redman, Cwe, Scoble, Je, Paterson, M, Daniel, F, Cowley, N, Williams, Cj, Spooner, D, Hong, A, Mcillmurray, M, Hendy-Ibbs, P, Hall, V, Iveson, Tj, Whitehouse, Jma, Garry, R, Lamont, A, Robinson, A, Trask, Cw, Clubb, Aw, Murrell, D, Newman, G, Wilkins, M, Goldthorp, Wo, Roberts, Jk, Radstone, Dj, Whipp, Mj, Ledermann, Ja, Pater, J, Buyse, M, and Omura, G

Published
1998

29. An Overview of R&D Activities in Europe on Critical Information Infrastructure Protection (CIIP)

Author

Bologna, S., Di Costanzo, G., Luiijf, H.A.M., Setola, R., and TNO Defensie en Veiligheid

Subjects
Physics
Abstract

In recent years there has been an increasing R&D interest in critical infrastructures and their protection. However, this represents a still very immature field of research with very fuzzy and confused boundaries. This paper reports an initial overview of R&D activities in Europe on this topic to illustrate the state of art and to emphasize the major areas of research but also to identify the most relevant lacks.

Published
2006

33. ICON2: Randomised trial of single-agent carboplatin against three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) in women with ovarian cancer

Author

Parmar, M, Torri, V, Bonaventura, A, Bonazzi, C, Colombo, N, Delaloye, J, Marsoni, S, Mangioni, C, Sandercock, J, Sessa, C, Williams, C, Tinazzi, A, Flann, M, Geiser, K, Scorpiglione, N, Stewart, J, Chaves, J, Palmeiro, E, Curtain, A, Mccormack, T, Gennatas, C, Marras, F, Oppo, T, Balestrino, M, Malzoni, C, Malzoni, M, Belli, M, Geminiani, M, Crestani, G, Monaco, A, Vavala, V, Piatto, E, Barattini, G, Fornara, P, Chetri, M, Santeufemia, G, Artioli, F, Carone, D, Fanizza, G, Trentadue, R, Priolo, D, Scollo, P, Nigro, S, Petrina, M, Mastrantonio, P, Spanna, G, Zagni, R, Belloni, C, Colleoni, R, Redaelli, L, Cavagnini, A, Di Costanzo, G, Perroni, D, Arienti, S, Orfanotti, G, Cantoni, F, Secli, R, Bianchi, A, Martinello, R, Mollica, G, Maizzi, D, Picchiarelli, M, Fiorini, G, Borsani, M, Colombo, E, Garsia, S, Melgrati, L, Paggi, G, Brunenghi, G, Casini, M, Isa, L, Algeri, R, Prozio, G, Belfiore, G, Angelini, F, D'Aprile, M, Moreschi, M, Mauri, M, Natale, N, Senzani, F, Pavanato, G, Poggi, G, Garuti, G, Luerti, M, Cruciani, G, Pagano, F, Baccolo, M, Poddi, E, Bocciolone, L, Sabelli, M, Maggi, R, Restelli, C, D'Antona, A, Locatelli, M, Pessi, A, Raina, A, Chiari, S, Gabriele, A, Pittelli, M, Iacobelli, P, Dogliotti, L, Gorzegno, G, Musso, P, Vegna, G, Coco, G, Alletti, D, Picciotto, F, Lucchese, V, Epis, A, di Palumbo, V, Drudi, G, Ravaioli, A, Zampella, D, Morandi, M, Gorga, G, Zucchelli, C, Cariello, S, Galletto, L, Sussio, M, Massacesi, L, Massacesi, M, Carli, A, Tucci, E, Tajani, E, Corrado, G, Bumma, S, Durando, A, Massobrio, M, Sberveglieri, M, Biasio, M, Guercio, E, Jura, R, Danese, S, Wierdis, T, Farnelli, C, Tarantino, G, Grassi, R, Repetti, F, Rocchi, B, Grampa, M, Ercoli, A, Griso, C, Signori, E, Zanini, L, Presti, M, Klimek, M, Urbanski, K, Biswas, A, Viegas, O, Kochli, O, Dreher, E, Fey, M, Beck, G, Ludin, J, Bonnefoi, H, Krauer, F, Bauer, J, Delmore, G, Furrer, C, Lorenz, U, Thurlimann, B, Bronz, L, Sanna, P, Wyss, D, Goldhirsch, A, Gyr, T, Leidi, L, Pastorelli, G, Pagani, O, Rey, P, Hailer, U, Benz, J, Kaye, S, Reed, N, Symonds, R, Atkinson, R, Axford, A, Rustin, G, Seckl, M, Green, J, Scott, I, Guthrie, D, Harper, P, Calman, F, Dobbs, H, Weir, P, Cassoni, A, Lederman, J, Souhami, R, Bozzino, J, Adab, F, Redman, C, Scoble, J, Paterson, M, Daniel, F, Cowley, N, Spooner, D, Hong, A, Mcillmurray, M, Hendy Ibbs, P, Hall, V, Iveson, T, Whitehouse, J, Garry, R, Lamont, A, Robinson, A, Trask, C, Clubb, A, Murrell, D, Newman, G, Wilkins, M, Goldthorp, W, Roberts, J, Radstone, D, Whipp, M, Ledermann, J, Pater, J, Buyse, M, Omura, G, Parmar, MKB, McCormack, T, McIllmurray, M, Omura, G., COLOMBO, NICOLETTA, Parmar, M, Torri, V, Bonaventura, A, Bonazzi, C, Colombo, N, Delaloye, J, Marsoni, S, Mangioni, C, Sandercock, J, Sessa, C, Williams, C, Tinazzi, A, Flann, M, Geiser, K, Scorpiglione, N, Stewart, J, Chaves, J, Palmeiro, E, Curtain, A, Mccormack, T, Gennatas, C, Marras, F, Oppo, T, Balestrino, M, Malzoni, C, Malzoni, M, Belli, M, Geminiani, M, Crestani, G, Monaco, A, Vavala, V, Piatto, E, Barattini, G, Fornara, P, Chetri, M, Santeufemia, G, Artioli, F, Carone, D, Fanizza, G, Trentadue, R, Priolo, D, Scollo, P, Nigro, S, Petrina, M, Mastrantonio, P, Spanna, G, Zagni, R, Belloni, C, Colleoni, R, Redaelli, L, Cavagnini, A, Di Costanzo, G, Perroni, D, Arienti, S, Orfanotti, G, Cantoni, F, Secli, R, Bianchi, A, Martinello, R, Mollica, G, Maizzi, D, Picchiarelli, M, Fiorini, G, Borsani, M, Colombo, E, Garsia, S, Melgrati, L, Paggi, G, Brunenghi, G, Casini, M, Isa, L, Algeri, R, Prozio, G, Belfiore, G, Angelini, F, D'Aprile, M, Moreschi, M, Mauri, M, Natale, N, Senzani, F, Pavanato, G, Poggi, G, Garuti, G, Luerti, M, Cruciani, G, Pagano, F, Baccolo, M, Poddi, E, Bocciolone, L, Sabelli, M, Maggi, R, Restelli, C, D'Antona, A, Locatelli, M, Pessi, A, Raina, A, Chiari, S, Gabriele, A, Pittelli, M, Iacobelli, P, Dogliotti, L, Gorzegno, G, Musso, P, Vegna, G, Coco, G, Alletti, D, Picciotto, F, Lucchese, V, Epis, A, di Palumbo, V, Drudi, G, Ravaioli, A, Zampella, D, Morandi, M, Gorga, G, Zucchelli, C, Cariello, S, Galletto, L, Sussio, M, Massacesi, L, Massacesi, M, Carli, A, Tucci, E, Tajani, E, Corrado, G, Bumma, S, Durando, A, Massobrio, M, Sberveglieri, M, Biasio, M, Guercio, E, Jura, R, Danese, S, Wierdis, T, Farnelli, C, Tarantino, G, Grassi, R, Repetti, F, Rocchi, B, Grampa, M, Ercoli, A, Griso, C, Signori, E, Zanini, L, Presti, M, Klimek, M, Urbanski, K, Biswas, A, Viegas, O, Kochli, O, Dreher, E, Fey, M, Beck, G, Ludin, J, Bonnefoi, H, Krauer, F, Bauer, J, Delmore, G, Furrer, C, Lorenz, U, Thurlimann, B, Bronz, L, Sanna, P, Wyss, D, Goldhirsch, A, Gyr, T, Leidi, L, Pastorelli, G, Pagani, O, Rey, P, Hailer, U, Benz, J, Kaye, S, Reed, N, Symonds, R, Atkinson, R, Axford, A, Rustin, G, Seckl, M, Green, J, Scott, I, Guthrie, D, Harper, P, Calman, F, Dobbs, H, Weir, P, Cassoni, A, Lederman, J, Souhami, R, Bozzino, J, Adab, F, Redman, C, Scoble, J, Paterson, M, Daniel, F, Cowley, N, Spooner, D, Hong, A, Mcillmurray, M, Hendy Ibbs, P, Hall, V, Iveson, T, Whitehouse, J, Garry, R, Lamont, A, Robinson, A, Trask, C, Clubb, A, Murrell, D, Newman, G, Wilkins, M, Goldthorp, W, Roberts, J, Radstone, D, Whipp, M, Ledermann, J, Pater, J, Buyse, M, Omura, G, Parmar, MKB, McCormack, T, McIllmurray, M, Omura, G., and COLOMBO, NICOLETTA

Abstract

A series of meta-analyses of randomised controlled trials raised the question of whether the three-drug combination of CAP (cyclophosphamide, doxorubicin, and cisplatin) was more or less effective than optimal-dose single-agent carboplatin for women with advanced ovarian cancer.

Published
1998

36. Identification of lenvatinib prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma

Author

Marianna Silletta, V. Burgio, Gianluca Masi, A. Takata, M.G. Viola, Mario Domenico Rizzato, Kazuto Tajiri, H. Toyoda, M. Scartozzi, Francesca Salani, Syusuke Okamura, Francesco Giuseppe Foschi, Takashi Kumada, G. Astara, I.G. Rapposelli, Fabio Conti, Emiliano Tamburini, Claudia Campani, Kazuhito Kawata, Fabio Marra, A. Forgione, A. Hiraoka, Giovanni Luca Frassineti, R. Tortora, Takuji Torimura, Shigeo Shimose, Masahito Nakano, Masanori Atsukawa, Stefano Cascinu, Andrea Casadei-Gardini, H. Shibata, G.G. Di Costanzo, Caterina Vivaldi, Antonio Pellino, Claudia Angela Maria Fulgenzi, Toshifumi Tada, Eleonora Lai, Fabio Piscaglia, S. Lonardi, Margherita Rimini, Rapposelli, I. G., Shimose, S., Kumada, T., Okamura, S., Hiraoka, A., Di Costanzo, G. G., Marra, F., Tamburini, E., Forgione, A., Foschi, F. G., Silletta, M., Lonardi, S., Masi, G., Scartozzi, M., Nakano, M., Shibata, H., Kawata, K., Pellino, A., Vivaldi, C., Lai, E., Takata, A., Tajiri, K., Toyoda, H., Tortora, R., Campani, C., Viola, M. G., Piscaglia, F., Conti, F., Fulgenzi, C. A. M., Frassineti, G. L., Rizzato, M. D., Salani, F., Astara, G., Torimura, T., Atsukawa, M., Tada, T., Burgio, V., Rimini, M., Cascinu, S., Casadei-Gardini, A., Rapposelli I.G., Shimose S., Kumada T., Okamura S., Hiraoka A., Di Costanzo G.G., Marra F., Tamburini E., Forgione A., Foschi F.G., Silletta M., Lonardi S., Masi G., Scartozzi M., Nakano M., Shibata H., Kawata K., Pellino A., Vivaldi C., Lai E., Takata A., Tajiri K., Toyoda H., Tortora R., Campani C., Viola M.G., Piscaglia F., Conti F., Fulgenzi C.A.M., Frassineti G.L., Rizzato M.D., Salani F., Astara G., Torimura T., Atsukawa M., Tada T., Burgio V., Rimini M., Cascinu S., and Casadei-Gardini A.

Subjects
Oncology, Cancer Research, medicine.medical_specialty, lenvatinib prognostic index, Carcinoma, Hepatocellular, hepatocellular carcinoma, recursive partitioning analysis, Humans, Phenylurea Compounds, Prognosis, Quinolines, Chemoembolization, Therapeutic, Liver Neoplasms, Recursive partitioning, Prognostic score, chemistry.chemical_compound, Internal medicine, medicine, Original Research, business.industry, Carcinoma, Treatment options, Hepatocellular, medicine.disease, chemistry, Hepatocellular carcinoma, Cohort, Chemoembolization, Therapeutic, Medium Risk, Lenvatinib, business
Abstract

Background After the advent of new treatment options for advanced hepatocellular carcinoma (HCC), the identification of prognostic factors is crucial for the selection of the most appropriate therapy for each patient. Patients and methods With the aim to fill this gap, we applied recursive partitioning analysis (RPA) to a cohort of 404 patients treated with lenvatinib. Results The application of RPA resulted in a classification based on five variables that originated a new prognostic score, the lenvatinib prognostic index (LEP) index, identifying three groups: low risk [patients with prognostic nutritional index (PNI) >43.3 and previous trans-arterial chemoembolization (TACE)]; medium risk [patients with PNI >43.3 but without previous TACE and patients with PNI, Highlights • This study shows a new prognostic index (LEP index) for patients undergoing systemic therapy for hepatocellular carcinoma. • LEP index is an easy-to-use tool, based on clinical and laboratory features, that identifies three risk groups. • LEP index may be used to stratify hepatocellular carcinoma patients in order to select the most appropriate treatment.

Published
2021

37. Platelets and hepatocellular cancer: Bridging the bench to the clinics

Author

Lai, aEmail Author, Q., Vitale, bEmail Author, A., Manzia, cEmail Author, T. M., Foschi, dEmail Author, F. G., Sandri, eEmail Author, G. B. L., Gambato, bEmail Author, M., Melandro, fEmail Author, F., Russo, bEmail Author, F. P., Miele, gEmail Author, L., Viganò, hEmail Author, L., Burra, bEmail Author, P., Giannini, iEmail Author, E. G., Aliberti, C., Baccarani, U., Bhoori, S., Borzio, M., Brancaccio, G., Cabibbo, G., Casadei, Gardini, Carrai, A., Cillo, P., Conti, U., Cucchetti, F., D’Ambrosio, A., Dell’Unto, R., Dematthaeis, C., Costanzo, Di, G. G., Di Sandro, S., Fucilli, F., Galati, G., Gasbarrini, A., Giuliante, F., Ghinolfi, D., Grieco, A., Gruttaduria, S., Guarino, M., Kostandini, A., Iavarone, M., Lenci, I., Losito, F., Lupo, L. G., Mazzocato, S., Mescoli, C., Miele, L., Morisco, F., Muley, M., Nicolini, D., Persico, M., Pompili, M., Ponziani, F. R., Pravisani, R., Rapaccini, G. L., Rendina, M., Renzulli, M., Rossi, M., Rreka, E., Sacco, R., Sangiovanni, A., Sessa, A., Simonetti, N., Sposito, C., Tortora, R., Trevisani, F., Viganò, M., Villa, E., Vincenzi, V., Violi, P., Associazione Italiana per lo Studio del Fegato (AISF) HCC Special Interest Group, Lai, Q., aEmail Author, Vitale, A., bEmail Author, Manzia, T. M., cEmail Author, Foschi, F. G., dEmail Author, Sandri, G. B. L., eEmail Author, Gambato, M., bEmail Author, Melandro, F., fEmail Author, Russo, F. P., bEmail Author, Miele, L., gEmail Author, Viganò, L., hEmail Author, Burra, P., bEmail Author, Giannini, E. G., iEmail Author, Aliberti, C., Baccarani, U., Bhoori, S., Borzio, M., Brancaccio, G., Cabibbo, G., Casadei, Gardini, A., Carrai, P., Cillo, U., Conti, F., Cucchetti, A., D’Ambrosio, R., Dell’Unto, C., Dematthaei, Di, Costanzo, G., G., Di Sandro, S., Fucilli, F., Galati, G., Gasbarrini, A., Giuliante, F., Ghinolfi, D., Grieco, A., Gruttaduria, S., Guarino, M., Kostandini, A., Iavarone, M., Lenci, I., Losito, F., Lupo, L. G., Mazzocato, S., Mescoli, C., Miele, L., Morisco, F., Muley, M., Nicolini, D., Persico, M., Pompili, M., Ponziani, F. R., Pravisani, R., Rapaccini, G. L., Rendina, M., Renzulli, M., Rossi, M., Rreka, E., Sacco, R., Sangiovanni, A., Sessa, A., Simonetti, N., Sposito, C., Tortora, R., Trevisani, F., Viganò, M., Villa, E., Vincenzi, V., Violi, P., Associazione Italiana per lo Studio del Fegato (AISF) HCC Special Interest, Group, Lai Q., Vitale A., Manzia T.M., Foschi F.G., Sandri G.B.L., Gambato M., Melandro F., Russo F.P., Miele L., Vigano L., Burra P., Giannini E.G., Aglitti A., Aliberti C., Baccarani U., Bhoori S., Borzio M., Brancaccio G., Cabibbo G., Casadei Gardini A., Carrai P., Cillo U., Conti F., Cucchetti A., D'ambrosio R., Dell'unto C., Dematthaeis N., Di Costanzo G.G., Di Sandro S., Fucilli F., Galati G., Gasbarrini A., Giuliante F., Ghinolfi D., Grieco A., Gruttaduria S., Guarino M., Kostandini A., Iavarone M., Lenci I., Losito F., Lupo L.G., Mazzocato S., Mescoli C., Morisco F., Muley M., Nicolini D., Persico M., Pompili M., Ponziani F.R., Pravisani R., Rapaccini G.L., Rendina M., Renzulli M., Rossi M., Rreka E., Sacco R., Sangiovanni A., Sessa A., Simonetti N., Sposito C., Tortora R., Trevisani F., Vigano M., Villa E., Vincenzi V., Violi P., Lai, Q., Vitale, A., Manzia, T. M., Foschi, F. G., Sandri, G. B. L., Gambato, M., Melandro, F., Russo, F. P., Vigano, L., Burra, P., Giannini, E. G., Casadei Gardini, A., Carrai, P., Cillo, U., Conti, F., Cucchetti, A., D'Ambrosio, R., Dell'Unto, C., Dematthaeis, N., Di Costanzo, G. G., and Vigano, M.

Subjects
Cancer Research, Integrins, Platelet-derived growth factor, Endothelium, Settore MED/12 - GASTROENTEROLOGIA, medicine.medical_treatment, Integrin, Review, lcsh:RC254-282, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Platelet-to-lymphocyte ratio, Selectins, Vascular endothelial growth factor, medicine, Platelet, Selectin, business.industry, Growth factor, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Extravasation, Settore MED/01, medicine.anatomical_structure, Oncology, chemistry, Tumor progression, 030220 oncology & carcinogenesis, Cancer research, 030211 gastroenterology & hepatology, business
Abstract

Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells' extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet-tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC. Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells’ extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet–tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC.

Published
2019

38. Refining sorafenib therapy: lessons from clinical practice

Author

Federico Spandonaro, Luigi Bolondi, Massimo Colombo, Stefano Fagiuoli, Giovan Giuseppe Di Costanzo, Antonio Craxì, Corrado Boni, Romano Danesi, Calogero Cammà, Armando Santoro, Bruno Daniele, Paolo Bruzzi, Franco Trevisani, Bolondi L., Craxi A., Trevisani F., Daniele B., Di Costanzo G.G., Fagiuoli S., Cammà Calogero., Bruzzi P., Danesi R., Spandonaro F., Boni C., Santoro A., Colombo M., L. Bolondi, A. Craxi, F. Trevisani, B. Daniele, G. G. Di, S. Fagiuoli, C. Cammà, P. Bruzzi, R. Danesi, F. Spandonaro, C. Boni, A. Santoro, M. Colombo, Bolondi, L, Craxi, A, Trevisani, F, Daniele, B, Di Costanzo, G, Fagiuoli, S, Camma, C, Bruzzi, P, Danesi, R, Spandonaro, F, Boni, C, Santoro, A, and Colombo, M

Subjects
Cancer Research, Settore SECS-P/06 - Economia Applicata, Antineoplastic Agent, Age Factor, Child–Pugh B, postprogression treatment, response assessment, dose modification, Clinical Trials as Topic, Liver Neoplasms, adverse event management, Age Factors, Child-Pugh B, hepatocellular carcinoma, General Medicine, Prognosis, child–Pugh B, elderly hepatocellular carcinoma, mRECIST, eal-world data, sorafenib, Combined Modality Therapy, Clinical Practice, Treatment Outcome, Oncology, Liver Neoplasm, Hepatocellular carcinoma, Retreatment, Disease Progression, Human, medicine.drug, Phenylurea Compound, Niacinamide, Sorafenib, medicine.medical_specialty, Carcinoma, Hepatocellular, Disease Response, Prognosi, elderly, hepatocellular carcinoma, Protein Kinase Inhibitor, Antineoplastic Agents, elderly, Adverse event management, Child–Pugh B, dose modification, elderly, hepatocellular carcinoma, mRECIST, postprogression treatment, real-world data, response assessment, sorafenib, medicine, Humans, Intensive care medicine, Adverse effect, Protein Kinase Inhibitors, Dose Modification, real-world data, business.industry, Phenylurea Compounds, medicine.disease, Discontinuation, Surgery, business
Abstract

ABSTRACT Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients.

Published
2015
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39. Assessing the Consumption of Ultra-Processed Foods in People with Diabetes: Is a Specific NOVA Questionnaire Always Necessary?

Author

D'Abbronzo G, Quaglia C, Di Costanzo G, Testa R, Giacco R, Riccardi G, Vaccaro O, and Vitale M

Subjects
Humans, Male, Female, Middle Aged, Surveys and Questionnaires, Aged, Diabetes Mellitus, Food Handling, Diet statistics & numerical data, Energy Intake, Diet Surveys, Adult, Reproducibility of Results, Feeding Behavior, Nutrition Assessment, Food, Processed, Fast Foods
Abstract

Background/objectives: Despite the accumulating evidence on the detrimental impact of UPFs on health, a common limit of the available studies concerns the instruments used to collect information about the consumption of processed foods. Recently, a specific NOVA-FFQ was proposed for the evaluation of ultra-processed food (UPF) consumption, but it does not allow the simultaneous assessment of energy and nutrient intake. We evaluate the concordance between the NOVA-FFQ and a common questionnaire (EPIC-FFQ) when assessing (1) the intake of foods with different degrees of processing and (2) the relationship between diet composition and cardiometabolic profile., Methods: One hundred and thirty people with diabetes (70 men and 60 women) completed the NOVA-FFQ and the EPIC-FFQ in random order two weeks apart. Anthropometric and major cardiovascular risk factors were measured., Results: Non-significant differences were detected for processed culinary ingredients and processed foods; larger significant differences were observed for minimally processed foods and UPFs, which were somewhat underestimated by the EPIC-FFQ (-24% vs. -21%, respectively; p < 0.001). However, Bland-Altman plots showed intraindividual differences between the two questionnaires within an acceptable range, and the intraclass correlation showed a moderate consistency. Furthermore, the energy and nutrient composition of the diet and the metabolic parameters were comparable for people classified in the highest tertile of UPF consumption by either method., Conclusions: The NOVA-FFQ provides more detailed information on the consumption of UPF foods; however, the EPIC-FFQ is a valid alternative, particularly practical when the simultaneous assessment of the overall quality of the diet is needed.

Published
2024
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40. CT Coronary Angiography: Technical Approach and Atherosclerotic Plaque Characterization.

Author

Dell'Aversana S, Ascione R, Vitale RA, Cavaliere F, Porcaro P, Basile L, Napolitano G, Boccalatte M, Sibilio G, Esposito G, Franzone A, Di Costanzo G, Muscogiuri G, Sironi S, Cuocolo R, Cavaglià E, Ponsiglione A, and Imbriaco M

Abstract

Coronary computed tomography angiography (CCTA) currently represents a robust imaging technique for the detection, quantification and characterization of coronary atherosclerosis. However, CCTA remains a challenging task requiring both high spatial and temporal resolution to provide motion-free images of the coronary arteries. Several CCTA features, such as low attenuation, positive remodeling, spotty calcification, napkin-ring and high pericoronary fat attenuation index have been proved as associated to high-risk plaques. This review aims to explore the role of CCTA in the characterization of high-risk atherosclerotic plaque and the recent advancements in CCTA technologies with a focus on radiomics plaque analysis.

Published
2023
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41. Clinical outcomes with atezolizumab plus bevacizumab or lenvatinib in patients with hepatocellular carcinoma: a multicenter real-world study.

Author

Persano M, Rimini M, Tada T, Suda G, Shimose S, Kudo M, Cheon J, Finkelmeier F, Lim HY, Rimassa L, Presa J, Masi G, Yoo C, Lonardi S, Tovoli F, Kumada T, Sakamoto N, Iwamoto H, Aoki T, Chon HJ, Himmelsbach V, Pressiani T, Kawaguchi T, Montes M, Vivaldi C, Soldà C, Piscaglia F, Hiraoka A, Sho T, Niizeki T, Nishida N, Steup C, Iavarone M, Di Costanzo G, Marra F, Scartozzi M, Tamburini E, Cabibbo G, Foschi FG, Silletta M, Hirooka M, Kariyama K, Tani J, Atsukawa M, Takaguchi K, Itobayashi E, Fukunishi S, Tsuji K, Ishikawa T, Tajiri K, Ochi H, Yasuda S, Toyoda H, Ogawa C, Nishimura T, Hatanaka T, Kakizaki S, Shimada N, Kawata K, Tada F, Ohama H, Nouso K, Morishita A, Tsutsui A, Nagano T, Itokawa N, Okubo T, Arai T, Imai M, Kosaka H, Naganuma A, Koizumi Y, Nakamura S, Kaibori M, Iijima H, Hiasa Y, Cammarota A, Burgio V, Cascinu S, and Casadei-Gardini A

Subjects
Humans, Bevacizumab therapeutic use, Carcinoma, Hepatocellular drug therapy, Liver Neoplasms drug therapy
Abstract

Purpose: The purpose of this study is to compare response rates of lenvatinib and atezolizumab plus bevacizumab, in first-line real-world setting., Methods: Overall cohort included Western and Eastern hepatocellular carcinoma (HCC) patient populations from 46 centres in 4 countries (Italy, Germany, Japan, and Republic of Korea)., Results: 1312 patients were treated with lenvatinib, and 823 patients were treated with atezolizumab plus bevacizumab. Objective response rate (ORR) was 38.6% for patients receiving lenvatinib, and 27.3% for patients receiving atezolizumab plus bevacizumab (p < 0.01; odds ratio 0.60). For patients who achieved complete response (CR), overall survival (OS) was not reached in both arms, but the result from univariate Cox regression model showed 62% reduction of death risk for patients treated with atezolizumab plus bevacizumab (p = 0.05). In all multivariate analyses, treatment arm was not found to be an independent factor conditioning OS. Comparing ORR achieved in the two arms, there was a statistically significant difference in favor of lenvatinib compared to atezolizumab plus bevacizumab in all subgroups except for Eastern patients, Child-Pugh B patients, presence of portal vein thrombosis, α-feto-protein ≥ 400 ng/mL, presence of extrahepatic disease, albumin-bilirubin (ALBI) grade 2, and no previous locoregional procedures., Conclusion: Lenvatinib achieves higher ORR in all patient subgroups. Patients who achieve CR with atezolizumab plus bevacizumab can achieve OS so far never recorded in HCC patients. This study did not highlight any factors that could identify patient subgroups capable of obtaining CR., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2023
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42. Artificial intelligence and radiomics in magnetic resonance imaging of rectal cancer: a review.

Author

Di Costanzo G, Ascione R, Ponsiglione A, Tucci AG, Dell'Aversana S, Iasiello F, and Cavaglià E

Abstract

Rectal cancer (RC) is one of the most common tumours worldwide in both males and females, with significant morbidity and mortality rates, and it accounts for approximately one-third of colorectal cancers (CRCs). Magnetic resonance imaging (MRI) has been demonstrated to be accurate in evaluating the tumour location and stage, mucin content, invasion depth, lymph node (LN) metastasis, extramural vascular invasion (EMVI), and involvement of the mesorectal fascia (MRF). However, these features alone remain insufficient to precisely guide treatment decisions. Therefore, new imaging biomarkers are necessary to define tumour characteristics for staging and restaging patients with RC. During the last decades, RC evaluation via MRI-based radiomics and artificial intelligence (AI) tools has been a research hotspot. The aim of this review was to summarise the achievement of MRI-based radiomics and AI for the evaluation of staging, response to therapy, genotyping, prediction of high-risk factors, and prognosis in the field of RC. Moreover, future challenges and limitations of these tools that need to be solved to favour the transition from academic research to the clinical setting will be discussed., Competing Interests: The authors declare that they have no conflicts of interest., (© The Author(s) 2023.)

Published
2023
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43. Atezolizumab plus bevacizumab versus lenvatinib or sorafenib in non-viral unresectable hepatocellular carcinoma: an international propensity score matching analysis.

Author

Rimini M, Rimassa L, Ueshima K, Burgio V, Shigeo S, Tada T, Suda G, Yoo C, Cheon J, Pinato DJ, Lonardi S, Scartozzi M, Iavarone M, Di Costanzo GG, Marra F, Soldà C, Tamburini E, Piscaglia F, Masi G, Cabibbo G, Foschi FG, Silletta M, Pressiani T, Nishida N, Iwamoto H, Sakamoto N, Ryoo BY, Chon HJ, Claudia F, Niizeki T, Sho T, Kang B, D'Alessio A, Kumada T, Hiraoka A, Hirooka M, Kariyama K, Tani J, Atsukawa M, Takaguchi K, Itobayashi E, Fukunishi S, Tsuji K, Ishikawa T, Tajiri K, Ochi H, Yasuda S, Toyoda H, Ogawa C, Nishimur T, Hatanaka T, Kakizaki S, Shimada N, Kawata K, Tanaka T, Ohama H, Nouso K, Morishita A, Tsutsui A, Nagano T, Itokawa N, Okubo T, Arai T, Imai M, Naganuma A, Koizumi Y, Nakamura S, Joko K, Iijima H, Hiasa Y, Pedica F, De Cobelli F, Ratti F, Aldrighetti L, Kudo M, Cascinu S, and Casadei-Gardini A

Subjects
Humans, Sorafenib pharmacology, Sorafenib therapeutic use, Bevacizumab pharmacology, Bevacizumab therapeutic use, Propensity Score, Retrospective Studies, Carcinoma, Hepatocellular drug therapy, Non-alcoholic Fatty Liver Disease, Liver Neoplasms drug therapy
Abstract

Background: A growing body of evidence suggests that non-viral hepatocellular carcinoma (HCC) might benefit less from immunotherapy., Materials and Methods: We carried out a retrospective analysis of prospectively collected data from consecutive patients with non-viral advanced HCC, treated with atezolizumab plus bevacizumab, lenvatinib, or sorafenib, in 36 centers in 4 countries (Italy, Japan, Republic of Korea, and UK). The primary endpoint was overall survival (OS) with atezolizumab plus bevacizumab versus lenvatinib. Secondary endpoints were progression-free survival (PFS) with atezolizumab plus bevacizumab versus lenvatinib, and OS and PFS with atezolizumab plus bevacizumab versus sorafenib. For the primary and secondary endpoints, we carried out the analysis on the whole population first, and then we divided the cohort into two groups: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) population and non-NAFLD/NASH population., Results: One hundred and ninety patients received atezolizumab plus bevacizumab, 569 patients received lenvatinib, and 210 patients received sorafenib. In the whole population, multivariate analysis showed that treatment with lenvatinib was associated with a longer OS [hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.44-0.95; P = 0.0268] and PFS (HR 0.67; 95% CI 0.51-0.86; P = 0.002) compared to atezolizumab plus bevacizumab. In the NAFLD/NASH population, multivariate analysis confirmed that lenvatinib treatment was associated with a longer OS (HR 0.46; 95% CI 0.26-0.84; P = 0.0110) and PFS (HR 0.55; 95% CI 0.38-0.82; P = 0.031) compared to atezolizumab plus bevacizumab. In the subgroup of non-NAFLD/NASH patients, no difference in OS or PFS was observed between patients treated with lenvatinib and those treated with atezolizumab plus bevacizumab. All these results were confirmed following propensity score matching analysis. By comparing patients receiving atezolizumab plus bevacizumab versus sorafenib, no statistically significant difference in survival was observed., Conclusions: The present analysis conducted on a large number of advanced non-viral HCC patients showed for the first time that treatment with lenvatinib is associated with a significant survival benefit compared to atezolizumab plus bevacizumab, in particular in patients with NAFLD/NASH-related HCC., Competing Interests: Disclosure LR has received consulting fees from Amgen, ArQule, AstraZeneca, Basilea, Bayer, BMS, Celgene, Eisai, Exelixis, Genenta, Hengrui, Incyte, Ipsen, IQVIA, Lilly, MSD, Nerviano Medical Sciences, Roche, Sanofi, Servier, Taiho Oncology, Zymeworks; lecture fees from AbbVie, Amgen, Bayer, Eisai, Gilead, Incyte, Ipsen, Lilly, Merck Serono, Roche, Sanofi; travel expenses from Ipsen; and institutional research funding from Agios, ARMO BioSciences, AstraZeneca, BeiGene, Eisai, Exelixis, Fibrogen, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche, Zymeworks. ACG has received grants and personal fees from MSD, Eisai, Bayer, and is an advisor for MSD, Eisai, Bayer, Bristol-Myers Squibb, AstraZeneca, and GSK. MK has received grants from Taiho Pharmaceuticals, Chugai Pharmaceuticals, Otsuka, Takeda, Sumitomo Dainippon-Sumitomo, Daiichi Sankyo, AbbVie, Astellas Pharma, and Bristol-Myers Squibb; has received grants and personal fees from MSD, Eisai, and Bayer; and is an adviser for MSD, Eisai, Bayer, Bristol-Myers Squibb, Eli Lilly, and ONO Pharmaceutical. FPi has received consulting or lecture fees from in the last 2 years from Astrazeneca, Bayer, Bracco, EISAI, ESAOTE, Exact Sciences, IPSEN, MSD, Roche, Samsung, and Tiziana Life Sciences. All other authors have declared no conflicts of interest. Data sharing All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2022
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44. Dual-Energy CT of the Heart: A Review.

Author

Dell'Aversana S, Ascione R, De Giorgi M, De Lucia DR, Cuocolo R, Boccalatte M, Sibilio G, Napolitano G, Muscogiuri G, Sironi S, Di Costanzo G, Cavaglià E, Imbriaco M, and Ponsiglione A

Abstract

Dual-energy computed tomography (DECT) represents an emerging imaging technique which consists of the acquisition of two separate datasets utilizing two different X-ray spectra energies. Several cardiac DECT applications have been assessed, such as virtual monoenergetic images, virtual non-contrast reconstructions, and iodine myocardial perfusion maps, which are demonstrated to improve diagnostic accuracy and image quality while reducing both radiation and contrast media administration. This review will summarize the technical basis of DECT and review the principal cardiac applications currently adopted in clinical practice, exploring possible future applications.

Published
2022
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45. Identification of lenvatinib prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma.

Author

Rapposelli IG, Shimose S, Kumada T, Okamura S, Hiraoka A, Di Costanzo GG, Marra F, Tamburini E, Forgione A, Foschi FG, Silletta M, Lonardi S, Masi G, Scartozzi M, Nakano M, Shibata H, Kawata K, Pellino A, Vivaldi C, Lai E, Takata A, Tajiri K, Toyoda H, Tortora R, Campani C, Viola MG, Piscaglia F, Conti F, Fulgenzi CAM, Frassineti GL, Rizzato MD, Salani F, Astara G, Torimura T, Atsukawa M, Tada T, Burgio V, Rimini M, Cascinu S, and Casadei-Gardini A

Subjects
Humans, Phenylurea Compounds, Prognosis, Quinolines, Carcinoma, Hepatocellular drug therapy, Chemoembolization, Therapeutic, Liver Neoplasms drug therapy
Abstract

Background: After the advent of new treatment options for advanced hepatocellular carcinoma (HCC), the identification of prognostic factors is crucial for the selection of the most appropriate therapy for each patient., Patients and Methods: With the aim to fill this gap, we applied recursive partitioning analysis (RPA) to a cohort of 404 patients treated with lenvatinib., Results: The application of RPA resulted in a classification based on five variables that originated a new prognostic score, the lenvatinib prognostic index (LEP) index, identifying three groups: low risk [patients with prognostic nutritional index (PNI) >43.3 and previous trans-arterial chemoembolization (TACE)]; medium risk [patients with PNI >43.3 but without previous TACE and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage B (BCLC-B)]; high risk [patients with PNI <43.3 and ALBI grade 2 and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage C (BCLC-C)]. Median overall survival was 29.8 months [95% confidence interval (CI) 22.8-29.8 months] in low risk patients (n = 128), 17.0 months (95% CI 15.0-24.0 months) in medium risk (n = 162) and 8.9 months (95% CI 8.0-10.7 months) in high risk (n = 114); low risk hazard ratio (HR) 1 (reference group), medium risk HR 1.95 (95% CI 1.38-2.74), high risk HR 4.84 (95% CI 3.16-7.43); P < 0.0001. The LEP index was validated in a cohort of 127 Italian patients treated with lenvatinib. While the same classification did not show a prognostic value in a cohort of 311 patients treated with sorafenib, we also show a possible predictive role in favor of lenvatinib in the low risk group., Conclusions: LEP index is a promising, easy-to-use tool that may be used to stratify patients undergoing systemic treatment of advanced HCC., Competing Interests: Disclosure The authors have declared no conflicts of interest. Data sharing Data are available upon reasonable request., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2021
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46. Evaluation of a multiparametric MRI radiomic-based approach for stratification of equivocal PI-RADS 3 and upgraded PI-RADS 4 prostatic lesions.

Author

Brancato V, Aiello M, Basso L, Monti S, Palumbo L, Di Costanzo G, Salvatore M, Ragozzino A, and Cavaliere C

Subjects
Aged, Aged, 80 and over, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Grading, Predictive Value of Tests, Prostatic Neoplasms surgery, ROC Curve, Retrospective Studies, Multiparametric Magnetic Resonance Imaging methods, Prostatectomy methods, Prostatic Neoplasms pathology
Abstract

Despite the key-role of the Prostate Imaging and Reporting and Data System (PI-RADS) in the diagnosis and characterization of prostate cancer (PCa), this system remains to be affected by several limitations, primarily associated with the interpretation of equivocal PI-RADS 3 lesions and with the debated role of Dynamic Contrast Enhanced-Magnetic Resonance Imaging (DCE-MRI), which is only used to upgrade peripheral PI-RADS category 3 lesions to PI-RADS category 4 if enhancement is focal. We aimed at investigating the usefulness of radiomics for detection of PCa lesions (Gleason Score ≥ 6) in PI-RADS 3 lesions and in peripheral PI-RADS 3 upgraded to PI-RADS 4 lesions (upPI-RADS 4). Multiparametric MRI (mpMRI) data of patients who underwent prostatic mpMRI between April 2013 and September 2018 were retrospectively evaluated. Biopsy results were used as gold standard. PI-RADS 3 and PI-RADS 4 lesions were re-scored according to the PI-RADS v2.1 before and after DCE-MRI evaluation. Radiomic features were extracted from T2-weighted MRI (T2), Apparent diffusion Coefficient (ADC) map and DCE-MRI subtracted images using PyRadiomics. Feature selection was performed using Wilcoxon-ranksum test and Minimum Redundancy Maximum Relevance (mRMR). Predictive models were constructed for PCa detection in PI-RADS 3 and upPI-RADS 4 lesions using at each step an imbalance-adjusted bootstrap resampling (IABR) on 1000 samples. 41 PI-RADS 3 and 32 upPI-RADS 4 lesions were analyzed. Among 293 radiomic features, the top selected features derived from T2 and ADC. For PI-RADS 3 stratification, second order model showed higher performances (Area Under the Receiver Operating Characteristic Curve-AUC- = 80%), while for upPI-RADS 4 stratification, first order model showed higher performances respect to superior order models (AUC = 89%). Our results support the significant role of T2 and ADC radiomic features for PCa detection in lesions scored as PI-RADS 3 and upPI-RADS 4. Radiomics models showed high diagnostic efficacy in classify PI-RADS 3 and upPI-RADS 4 lesions, outperforming PI-RADS v2.1 performance.

Published
2021
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47. Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility.

Author

Brancato V, Di Costanzo G, Basso L, Tramontano L, Puglia M, Ragozzino A, and Cavaliere AC

Abstract

The role of dynamic contrast-enhanced-MRI (DCE-MRI) for Prostate Imaging-Reporting and Data System (PI-RADS) scoring is a controversial topic. In this retrospective study, we aimed to measure the added value of DCE-MRI in combination with T2-weighted (T2W) and diffusion-weighted imaging (DWI) using PI-RADS v2.1, in terms of reproducibility and diagnostic accuracy, for detection of prostate cancer (PCa) and clinically significant PCa (CS-PCa, for Gleason Score ≥ 7). 117 lesions in 111 patients were identified as suspicion by multiparametric MRI (mpMRI) and addressed for biopsy. Three experienced readers independently assessed PI-RADS score, first using biparametric MRI (bpMRI, including DWI and T2W), and then multiparametric MRI (also including DCE). The inter-rater and inter-method agreement (bpMRI- vs. mpMRI-based scores) were assessed by Cohen's kappa (κ). Receiver operating characteristics (ROC) analysis was performed to evaluate the diagnostic accuracy for PCa and CS-PCa detection among the two scores. Inter-rater agreement was excellent for the three pairs of readers (κ ≥ 0.83), while the inter-method agreement was good (κ ≥ 0.73). Areas under the ROC curve (AUC) showed similar high-values (0.8 ≤ AUC ≤ 0.85). The reproducibility of PI-RADS v2.1 scoring was comparable and high among readers, without relevant differences, depending on the MRI protocol used. The inclusion of DCE did not influence the diagnostic accuracy., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Published
2020
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48. Multiparametric MRI for Prostate Cancer Detection: New Insights into the Combined Use of a Radiomic Approach with Advanced Acquisition Protocol.

Author

Monti S, Brancato V, Di Costanzo G, Basso L, Puglia M, Ragozzino A, Salvatore M, and Cavaliere C

Abstract

Prostate cancer (PCa) is a disease affecting an increasing number of men worldwide. Several efforts have been made to identify imaging biomarkers to non-invasively detect and characterize PCa, with substantial improvements thanks to multiparametric Magnetic Resonance Imaging (mpMRI). In recent years, diffusion kurtosis imaging (DKI) was proposed to be directly related to tissue physiological and pathological characteristic, while the radiomic approach was proven to be a key method to study cancer imaging phenotypes. Our aim was to compare a standard radiomic model for PCa detection, built using T2-weighted (T2W) and Apparent Diffusion Coefficient (ADC), with an advanced one, including DKI and quantitative Dynamic Contrast Enhanced (DCE), while also evaluating differences in prediction performance when using 2D or 3D lesion segmentation. The obtained results in terms of diagnostic accuracy were high for all of the performed comparisons, reaching values up to 0.99 for the area under a receiver operating characteristic curve (AUC), and 0.98 for both sensitivity and specificity. In comparison, the radiomic model based on standard features led to prediction performances higher than those of the advanced model, while greater accuracy was achieved by the model extracted from 3D segmentation. These results provide new insights into active topics of discussion, such as choosing the most convenient acquisition protocol and the most appropriate postprocessing pipeline to accurately detect and characterize PCa., Competing Interests: The authors declare no conflict of interest.

Published
2020
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49. The effects of the use of platelet-rich plasma gel on local recurrence in an animal model of human fibrosarcoma.

Author

Barbieri A, Bimonte S, Loquercio G, Rea D, Cascella M, Anniciello A, Luciano A, Palma G, Di Costanzo G, Rosa A, Giuliano P, and Arra C

Abstract

Background: Platelet-rich-plasma (PRP) is largely used, thanks to its properties, as wound therapy after surgical resection. Several studies and clinical findings have demonstrated that the PRP can accelerate the regeneration and the repair of tissues through the action of the platelet-derived growth factors., Material and Methods: Our study aimed to investigate the effects of PRP-gel on the rate of tumor relapse by using a mouse model of Human Fibrosarcoma (HF). The radical resection of tumors of mice was conducted under fluorescence-guidance (FGR) by using MacroFluo microscope, after a primary tumor removal with bright-light surgery (BLS)., Results: It was found that the lesion recurrence and the tumor growth were reduced in mice treated with PRP observed in each group of treatment (50%) after 30 days from tumor excision, respect to controls (without statistical significance; p  = 0.12). The histopathological and immune-histochemical analysis did not report differences in cellular morphology between the tumors of control and PRP-treated mice., Conclusion: Our data suggest that PRP-gel, used as an adjuvant treatment for the stimulation of tissue repair and speed up recovery, can impair tumor growth and slow the tumor., Competing Interests: Competing interestsThe authors declare that they have no competing interests.

Published
2019
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50. Genetic profiling using plasma-derived cell-free DNA in therapy-naïve hepatocellular carcinoma patients: a pilot study.

Author

Ng CKY, Di Costanzo GG, Tosti N, Paradiso V, Coto-Llerena M, Roscigno G, Perrina V, Quintavalle C, Boldanova T, Wieland S, Marino-Marsilia G, Lanzafame M, Quagliata L, Condorelli G, Matter MS, Tortora R, Heim MH, Terracciano LM, and Piscuoglio S

Subjects
Aged, Aged, 80 and over, Biomarkers, Tumor blood, Biopsy methods, Carcinoma, Hepatocellular blood, Carcinoma, Hepatocellular pathology, Circulating Tumor DNA blood, DNA Mutational Analysis methods, Feasibility Studies, Female, High-Throughput Nucleotide Sequencing, Humans, Liver pathology, Liver Neoplasms blood, Liver Neoplasms pathology, Male, Middle Aged, Mutation, Pilot Projects, Tumor Burden genetics, Biomarkers, Tumor genetics, Carcinoma, Hepatocellular genetics, Circulating Tumor DNA genetics, Liver Neoplasms genetics
Abstract

Background: Hepatocellular carcinomas (HCCs) are not routinely biopsied, resulting in a lack of tumor materials for molecular profiling. Here we sought to determine whether plasma-derived cell-free DNA (cfDNA) captures the genetic alterations of HCC in patients who have not undergone systemic therapy., Patients and Methods: Frozen biopsies from the primary tumor and plasma were synchronously collected from 30 prospectively recruited, systemic treatment-naïve HCC patients. Deep sequencing of the DNA from the biopsies, plasma-derived cfDNA and matched germline was carried out using a panel targeting 46 coding and non-coding genes frequently altered in HCCs., Results: In 26/30 patients, at least one somatic mutation was detected in biopsy and/or cfDNA. Somatic mutations in HCC-associated genes were present in the cfDNA of 63% (19/30) of the patients and could be detected 'de novo' without prior knowledge of the mutations present in the biopsy in 27% (8/30) of the patients. Mutational load and the variant allele fraction of the mutations detected in the cfDNA positively correlated with tumor size and Edmondson grade. Crucially, among the seven patients in whom the largest tumor was ≥5 cm or was associated with metastasis, at least one mutation was detected 'de novo' in the cfDNA of 86% (6/7) of the cases. In these patients, cfDNA and tumor DNA captured 87% (80/92) and 95% (87/92) of the mutations, suggesting that cfDNA and tumor DNA captured similar proportions of somatic mutations., Conclusion: In patients with high disease burden, the use of cfDNA for genetic profiling when biopsy is unavailable may be feasible. Our results support further investigations into the clinical utility of cfDNA in a larger cohort of patients.

Published
2018
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