4 results on '"Bettiga, Arianna"'
Search Results
2. Renal function outcomes in patients with muscle‐invasive bladder cancer treated with neoadjuvant pembrolizumab and radical cystectomy in the PURE‐01 study.
- Author
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Trevisani, Francesco, Di Marco, Federico, Raggi, Daniele, Bettiga, Arianna, Vago, Riccardo, Larcher, Alessandro, Cinque, Alessandra, Salonia, Andrea, Briganti, Alberto, Capitanio, Umberto, Necchi, Andrea, and Montorsi, Francesco
- Subjects
IMMUNOTHERAPY ,URINARY diversion ,KIDNEY physiology ,BLADDER cancer ,IMMUNE checkpoint inhibitors ,CHRONIC kidney failure ,PEMBROLIZUMAB ,RENAL artery - Abstract
The use of pembrolizumab has been largely accepted in several advanced types of cancers. PURE 01 study (NCT02736266) enrolled consecutively 143 patients with muscle‐invasive bladder cancer who received 3 cycles of pembrolizumab 200 mg every 3 weeks before planned radical cystectomy (RC). Clinical, pathological and laboratory data were collected to investigate the relationship between renal function, immunotherapy and cancer‐related outcomes. Serum creatinine and estimated glomerular filtration rate (eGFR) using Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) creatinine‐equation 2009 were reported at baseline and after every cycle of pembrolizumab; the T stage from clinical classification TNM (cTNM) was stated before the treatment. Our analysis did not demonstrate a significant impairment of eGFR after any cycle of pembrolizumab, neither in the overall cohort nor in subgroups considering the T stages or the CKD G‐categories according to K‐DIGO 2012 classification. In conclusion, in neoadjuvant setting before RC our results suggest that pembrolizumab administration is safe for renal function preservation. What's new? Immune checkpoint inhibitors have been tested in the neoadjuvant setting of muscle‐invasive bladder cancer with promising pathological complete response rates, but to date there is no consensus on whether perioperative immunotherapy is appropriate. This study shows that pembrolizumab can safely be used as neo‐adjuvant immunotherapy in patients with muscle‐invasive bladder cancer affected by advanced chronic kidney disease, with no significant side effects in term of renal decay (acute kidney injury development or chronic kidney disease worsening) before surgery. The findings support that patients with severe renal dysfunction could be treated with immunotherapy before surgery without risks for renal function preservation. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
3. Renal Function Assessment Gap in Clinical Practice: An Awkward Truth.
- Author
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Trevisani, Francesco, Di Marco, Federico, Capitanio, Umberto, Larcher, Alessandro, Bettiga, Arianna, Dosio, Flaviano, Ghidini, Michele, Del Conte, Gianluca, Vago, Riccardo, Cinque, Alessandra, Gianolli, Luigi, Salonia, Andrea, Briganti, Alberto, Luis-Lima, Sergio, Negrín-Mena, Natalia, Montorsi, Francesco, and Porrini, Esteban
- Subjects
KIDNEY function tests ,GLOMERULAR filtration rate ,RADIONUCLIDE imaging - Abstract
Introduction: An accurate assessment of renal function is needed in the majority of clinical settings. Unfortunately, the most used estimated glomerular filtration rate (eGFR) formulas are affected by significant errors in comparison to gold standards methods of measured GFR (mGFR). Objective: The objective of the study is to determine the extent of the error of eGFR formulas compared to the mGFR in different specific clinical settings. Methods: A total retrospectively consecutive cohort of 1,320 patients (pts) enrolled in 2 different European Hospitals (Center 1: 470 pts; Center 2: 850 pts) was collected in order to compare the most common eGFR formulas used by physicians with the most widespread mGFR methods in daily clinical practice (Iohexol Plasma Clearance -Center 1 [mGFR-iox] and Renal Scintigraphy -Center 2 [mGFR-scnt]). The study cohort was composed by urological, oncological, and nephrological pts. The agreement between eGFR and mGFR was evaluated using bias (as median of difference), precision (as interquartile range of difference) accuracy (as P
30 ), and total deviation index. Results: The most accurate eGFR formula in the comparison with gold standard method (Iohexol plasma clearance) in Center 1 was represented by s-creatinine and cystatin C combined Chronic Kidney Disease-Epidemiology Collaboration-cr-cy, even though the P30 is reduced (84%) under the threshold of 60 mL/min/1.73 m2 . Similar results were found in Center 2, with a wider discrepancy between mGFR-scnt and eGFR formulas due to the minor accuracy of the nuclear tool in respect to the mGFR-iox. Conclusions: The loss of accuracy observed for the formulas at lower values of GFR suggests the mandatory use of gold standards methods as Iohexol Plasma Clearance to assess the correct status of renal function for critical cases. The center 2 showed lower levels of agreement between mGFR and eGFR suggesting that the errors are partially accounted for the Renal Scintigraphy technique too. In particular, we suggest the use of mGFR-iox in oncological urological and nephrological pts with an eGFR lower than 60 mL/min/1.73 m2 . [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
4. The Association of Uromodulin Genotype with Renal Cancer Aggressiveness
- Author
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Fabio Benigni, Cristina Carenzi, Roberto Bertini, Alberto Briganti, Alessandro Larcher, Francesco Montorsi, F. Ripa, Riccardo Vago, Arianna Bettiga, Fabio Muttin, Andrea Salonia, Umberto Capitanio, Francesco Trevisani, Luca Rampoldi, Alessandra Cinque, Trevisani, Francesco, Larcher, Alessandro, Cinque, Alessandra, Capitanio, Umberto, Ripa, Francesco, Vago, Riccardo, Bettiga, Arianna, Benigni, Fabio, Carenzi, Cristina, Muttin, Fabio, Bertini, Roberto, Briganti, Alberto, Salonia, Andrea, Rampoldi, Luca, and Montorsi, Francesco
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0301 basic medicine ,medicine.medical_specialty ,Pathology ,Tamm–Horsfall protein ,Genotype ,Lymphovascular invasion ,Urology ,Population ,Metastatic renal cell carcinoma ,Tamm-Horsfall protein ,Renal function ,Gastroenterology ,03 medical and health sciences ,Renal cell carcinoma ,Internal medicine ,Uromodulin ,medicine ,education ,education.field_of_study ,biology ,business.industry ,Kidney cancer ,medicine.disease ,Genotype frequency ,030104 developmental biology ,biology.protein ,business - Abstract
The aim of the study was to investigate the association of the uromodulin (UMOD) genotype with patient health status and with renal cell carcinoma (RCC) aggressiveness.The UMOD genotype at the top single nucleotide variant rs4293393 was determined in a cohort of 211 patients diagnosed with a renal mass and treated with surgery. Clinical data were prospectively collected. Due to the higher frequency of allele T relative to the lower frequency of allele C, recessive homozygous (CC), and heterozygous (TC) patients were grouped together and compared with homozygous (TT) patients. Mann-Whitney and chi-square tests were used to compare clinical characteristics after stratification for the UMOD genotype. UMOD genotype frequencies resulted TT and TC-CC in 67% (n = 141) and 33% (n = 70) of the population, respectively. The rate of cM1 RCC at clinical staging was higher in patients with genotype TT relative to patients with genotype TC-CC (18% vs 1%, p = 0.001). Similarly, the rate of pT3-pT4 (41% vs 25%, p = 0.047) and lymphovascular invasion (29% vs 13%, p = 0.02) RCC at final pathology were higher in patients with genotype TT relative to patients with genotype TC-CC. Patient summary: In patients diagnosed with renal cell carcinoma and treated with surgery, uromodulin homozygous genotype is associated with more aggressive renal cell carcinoma clinical and pathological characteristics. In patients diagnosed with a renal mass and elected for surgical management, uromodulin homozygous genotype is associated with more aggressive renal cell carcinoma clinical and pathological characteristics. Further investigations are required to study the causal biologic mechanism underlying such relationship.
- Published
- 2019
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