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4. Effects of a Personalized Diet on Nutritional Status and Renal Function Outcome in Nephrectomized Patients with Renal Cancer.

Author

Trevisani, Francesco, Laurenti, Fabiana, Fiorio, Francesco, Paccagnella, Matteo, Floris, Matteo, Capitanio, Umberto, Ghidini, Michele, Garrone, Ornella, Abbona, Andrea, Salonia, Andrea, Montorsi, Francesco, and Bettiga, Arianna

Abstract

Nutritional therapy (NT) based on a controlled protein intake represents a cornerstone in managing chronic kidney disease (CKD). However, if a CKD patient is at the same time affected by cancer, oncologists and nutritionists tend to suggest a dietary regimen based on high protein intake to avoid catabolism and malnutrition. International guidelines are not clear when we consider onco-nephrological patients and, as a consequence, no clinical shared strategy is currently applied in clinical practice. In particular, no precise nutritional management is established in nephrectomized patients for renal cell carcinoma (RCC), a specific oncological cohort of patients whose sudden kidney removal forces the remnant one to start a compensatory mechanism of adaptive hyperfiltration. Our study aimed to investigate the efficacy of a low–normal-protein high-calorie (LNPHC) diet based on a Mediterranean model in a consecutive cohort of nephrectomized RCC patients using an integrated nephrologist and nutritionist approach. A consecutive cohort of 40 nephrectomized RCC adult (age > 18) patients who were screened for malnutrition (malnutrition screening tool, MST < 2) were enrolled in a tertiary institution between 2020 and 2022 after signing a specific informed consent form. Each patient underwent an initial nephrological and nutritional evaluation and was subsequently subjected to a conventional CKD LNPHC diet integrated with aproteic foods (0.8 g/Kg/die: calories: 30–35 kcal per kg body weight/die) for a period of 6 months (±2 months). The diet was structured after considering eGFR (CKD-EPI 2021 creatinine formula), comorbidities, and nutritional status. MST, body mass index (BMI), phase angle (PA), fat mass percentage (FM%), fat-free mass index (FFMI), body cell mass index (BCMI), extracellular/intracellular water ratio (ECW/ICW), extracellular matrix/body cell mass ratio (ECM/BCM), waist/hip circumference ratio (WHC), lab test exams, and clinical variables were examined at baseline and after the study period. Our results clearly highlighted that the LNPHC diet was able to significantly improve several nutritional parameters, avoiding malnutrition and catabolism. In particular, the LNPHC diet preserved the BCM index (delta on median, ΔM + 0.3 kg/m2) and reduced the ECM/BCM ratio (ΔM − 0.03 *), with a significant reduction in the ECW/ICW ratio (ΔM − 0.02 *), all while increasing TBW (ΔM + 2.3% *). The LNPHC diet was able to preserve FFM while simultaneously depleting FM and, moreover, it led to a significant reduction in urea (ΔM − 11 mg/dL **). In conclusion, the LNPHC diet represents a new important therapeutic strategy that should be considered when treating onco-nephrological patients with solitary kidney due to renal cancer. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Baseline Values of Circulating IL-6 and TGF-β Might Identify Patients with HNSCC Who Do Not Benefit from Nivolumab Treatment

Author

Merlano, Marco Carlo, primary, Paccagnella, Matteo, additional, Denaro, Nerina, additional, Abbona, Andrea, additional, Galizia, Danilo, additional, Sangiolo, Dario, additional, Gammaitoni, Loretta, additional, Fiorino, Erika, additional, Minei, Silvia, additional, Bossi, Paolo, additional, Licitra, Lisa, additional, and Garrone, Ornella, additional

Published
2023
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7. A joint profile of cytokines and immune cell populations may identify HNSCC patients who benefit from nivolumab treatment. The Gruppo Oncologico Nord-Ovest (GONO) study Nivactor T-2

Author

Merlano, Marco Carlo, primary, Paccagnella, Matteo, additional, Denaro, Nerina, additional, Abbona, Andrea, additional, Galizia, Danilo, additional, Sangiolo, Dario, additional, Gammaitoni, Loretta, additional, Fiorino, Erika, additional, Minei, Silvia, additional, Bossi, Paolo, additional, Licitra, Lisa, additional, and Garrone, Ornella, additional

Published
2023
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8. Baseline Cytokine Profile Identifies a Favorable Outcome in a Subgroup of Colorectal Cancer Patients Treated with Regorafenib

Author

Abbona, Andrea, primary, Ricci, Vincenzo, additional, Paccagnella, Matteo, additional, Granetto, Cristina, additional, Ruatta, Fiorella, additional, Cauchi, Carolina, additional, Galizia, Danilo, additional, Ghidini, Michele, additional, Denaro, Nerina, additional, Merlano, Marco Carlo, additional, and Garrone, Ornella, additional

Published
2023
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12. Correlation between ribociclib resistance and circulating cytokines levels in metastatic breast cancer patients.

Author

Garrone, Ornella, primary, Paccagnella, Matteo, additional, Abbona, Andrea, additional, Ruatta, Fiorella, additional, Denaro, Nerina, additional, Vanella, Paola, additional, Tomasello, Gianluca, additional, Gambini, Donatella, additional, Aprile, Giuseppe, additional, Di Maio, Massimo, additional, and Merlano, Marco Carlo, additional

Published
2022
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14. Why Oncologists Should Feel Directly Involved in Persuading Patients with Head and Neck Cancer to Quit Smoking.

Author

Merlano, Marco Carlo, Denaro, Nerina, Galizia, Danilo, Abbona, Andrea, Paccagnella, Matteo, Minei, Silvia, Garrone, Ornella, and Bossi, Paolo

Subjects
EVALUATION of medical care, SMOKING cessation, HEAD & neck cancer, CANCER patients, RISK assessment, LYMPHOCYTES, TUMORS, ONCOLOGISTS, SQUAMOUS cell carcinoma, DISEASE risk factors
Abstract

Introduction: Among the risk factors for squamous cell carcinoma of the head and neck, smoking is still the most important today. Several studies agree on the effect of smoking on tumor microenvironment, while the definition of former smokers and the time of smoking cessation on biologic effect differs among papers. Methods: We conducted a narrative review on smoking effects in HNSCC. Results: There is evidence that smoker patients have a poorer prognosis than never smokers and former smokers. Translational studies show a relationship between smoking status and gene expression and support the importance of smoking cessation, for instance, demonstrating an inverse relationship between tumor-infiltrating lymphocytes and smoking. Conclusion: Convincing data suggest that quitting smoking at any time may improve patient outcomes. We advocate smoking cessation also after cancer diagnosis. [ABSTRACT FROM AUTHOR]

Published
2023
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16. Circulating Cytokines in Metastatic Breast Cancer Patients Select Different Prognostic Groups and Patients Who Might Benefit from Treatment beyond Progression

Author

Paccagnella, Matteo, primary, Abbona, Andrea, additional, Michelotti, Andrea, additional, Geuna, Elena, additional, Ruatta, Fiorella, additional, Landucci, Elisabetta, additional, Denaro, Nerina, additional, Vanella, Paola, additional, Lo Nigro, Cristiana, additional, Galizia, Danilo, additional, Merlano, Marco, additional, and Garrone, Ornella, additional

Published
2022
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18. Effect of eribulin on angiogenesis and endothelial adhesion molecules

Author

Abbona, Andrea, primary, Falletta, Antonella, additional, Paccagnella, Matteo, additional, Astigiano, Simonetta, additional, Martini, Stefania, additional, Denaro, Nerina, additional, Ruatta, Fiorella, additional, Barbieri, Ottavia, additional, Merlano, Marco, additional, and Garrone, Ornella, additional

Published
2021
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19. P-89 Cytokines behaviour during nivolumab treatment. A subgroup analysis of NIVACTOR study

Author

Denaro, Nerina, primary, Falletta, Antonella, additional, Abbona, Andrea, additional, Paccagnella, Matteo, additional, Galizia, Danilo, additional, Gammaitoni, Loretta, additional, Fiorino, Erika, additional, de Zarlo, Lorena, additional, Bossi, Paolo, additional, Licitra, Lisa, additional, Sangiolo, Dario, additional, and Merlano, Marco Carlo, additional

Published
2021
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20. Effect of moderate physical exercise on the immune system modulation in patients with breast cancer during preoperative chemotherapy: The NEO-RUNNER study.

Author

Garrone, Ornella, primary, Abbona, Andrea, additional, Falletta, Antonella, additional, Paccagnella, Matteo, additional, Croce, Nicoletta, additional, Vanella, Paola, additional, Ruatta, Fiorella, additional, Rubini, Daniela, additional, Vandone, Anna Maria, additional, Votero Prina, Antonio, additional, Denaro, Nerina, additional, and Merlano, Marco Carlo, additional

Published
2021
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21. Cytokine Profiling of End Stage Cancer Patients Treated with Immunotherapy

Author

Merlano, Marco Carlo, primary, Abbona, Andrea, additional, Paccagnella, Matteo, additional, Falletta, Antonella, additional, Granetto, Cristina, additional, Ricci, Vincenzo, additional, Fea, Elena, additional, Denaro, Nerina, additional, Ruatta, Fiorella, additional, Merlotti, Anna, additional, Bertetto, Oscar, additional, Crosetto, Nicola, additional, Galizia, Danilo, additional, Basiricò, Marco, additional, Gammaitoni, Loretta, additional, Sangiolo, Dario, additional, Aglietta, Massimo, additional, and Garrone, Ornella, additional

Published
2021
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23. Activation of immune response in refractory patients to standard treatment (T.R.A.N.S.L.A.T.E.)

Author

Abbona, Andrea, Sangiolo, Dario, Merlano, Marco, Garrone, Ornella, Anna, Merlotti, Monteverde, Martino, Lo Nigro, Cristiana, Falletta, Antonella, Occelli, Marcella, Varamo, Chiara, Aglietta, Massimo, Gammaitoni, Loretta, and Reali, Alessia

Abstract

Purpose/Objectives: The TRANSLATE project started in 2016 to test the immune effects of metronomic cyclophosphamide, daily low-dose IL-2 every other week, and a single flash of radiotherapy (RT) in peripheral blood. The rationale is based on self vaccination induced by radiotherapy (RT) 8 Gy single fraction on one metastatic lesion, T cells expansion by IL-2 treatment and selective Tregs down regulation by lowdose cyclophosphamide administration. Materials/Methods: We enrolled patients with end-stage breast, colon, kidney and prostate cancer. Analysis was performed at baseline, the day after RT, after 28 days from treatment start and at disease progression. Assay focused on Tregs, CD8+, NK, MDSC, CD3-PD1, IL-2, IL-4, IL-5, IL- 6, IL-10, IL-12, IL-13, IL-17a, TNFα, IFNγ, TGFβ. We divided patients into two groups depending on the time of disease progression (A > 3 months; B, < 3 months). We report preliminary data with the aim to show the changes observed post-RT in 20 pts. Results: At baseline, group B had higher rates of CD3-PD1, higher IL-2, IL-13, TNFα, and TGFβ; group A had higher IFN γ, IL-4, and IL-12. After RT, we observed a difference between the two groups in the rates of CD3-PD1 (lower in group B) and Tregs (higher in group A). Among cytokines, only TNFα reached a statistical significance (higher in group B). We also observed that TGFβ and IL-6 were higher in group B and IFNγ was higher in group A. The longitudinal analyses showed that CD3-PD1 remained stable between basal and post-RT in group A but decreased in group B. Tregs marginally increased in group A. TNFα, TGFβ, IL-4, IL-6, and IL-12 increased in group B. IL-4 decreased in group A and IL-6 and IL-12 also marginally decreased in the same group. IFNγ slightly increases in group A. Discussion: The limited number of patients reduced the interpretation of the study. However, following RT a positive trend of Th2 cytokines is observed in patients with early progressing disease, without the expected surge of IFNγ that was instead observed in patients with better outcome. Additional analyses are in progress and will be presented., Proceedings on Cancer-Immuno-Oncology, Vol 1 No 1 (2018)

Published
2018
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24. Breaking the brake: targeting the immunosuppressive cells to optimize immunotherapy of cancer

Author

Merlano, Marco C., Abbona, Andrea, and Garrone, Ornella

Subjects
bacteria, chemical and pharmacologic phenomena, biochemical phenomena, metabolism, and nutrition
Abstract

Introduction: Immune suppression is a physiological phenomenon resulting from the cooperation of many actors, both humoral and cellular, which continuously interplay each other leading to the impairment of immune response. Immune suppression is necessary to avoid tissue damages and, ultimately, life-threatening situations which could be induced by the maintenance over time of the immune response. Unfortunately, during neoplastic disease, immune suppression favors tumor progression. Cell mediated immune suppression: Immune response starts with the antigens recognition by APCs, their presentation to naïve T-cells and the reactive T-cells generation. Tumor has profound influence on the DCs maturation, and immature or partially matured DCs are largely represented in most tumors and mediate immune suppression. A second key-point leading to the impairment of the immune response is the capability of effector T cells to cross the vascular endothelium to reach their targets. Thus, endothelial cells may represent powerful mediators of immune suppression, selecting the populations of cells which can cross the barrier and preventing homing, or directly killing those that must be stopped. The third and most important area of immune-suppression is the local tumor microenvironment (TME) where the plasticity of immune cells and stromal cells allows the polarization toward a Th2 response. Indeed, tumor cells may directly secrete immune suppressive cytokines and chemokines prone to impair immune attack. In addition, the persistence of inflammation changes in the TME, such as pH modification and hypoxia, may impair the activity of effector T cells, both directly and indirectly. Targeting of immunosuppressive cells: There are two main opportunities to target immunosuppressive cells. It is possible target specific cell lines directly using classic anticancer drugs. For example cyclophosphamide and gemcitabine, can directly target Treg and MDSC respectively. It is also possible to exploit the plasticity of immune cells to reprogram them towards a Th1 response. For example, inhibition of PD-1/PD-L1 axis prevents Tregs (iTregs) induction leading to the reduction of this population into the TME. Translational data on targeting immunosuppressive cells will be discussed., Proceedings on Cancer-Immuno-Oncology, Vol 1 No 1 (2018)

Published
2018
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26. Abstract 4137: Circulating TGFâ and TNFá in metastatic breast cancer patients treated with eribulin. The TRANSERI project

Author

Garrone, Ornella, primary, Nigro, Cristiana Lo, additional, Michelotti, Andrea, additional, Montemurro, Fillippo, additional, Vandone, Anna Maria, additional, Abbona, Andrea, additional, Paccagnella, Matteo, additional, Falletta, Antonella, additional, Genua, Elena, additional, Angelis, Claudia De, additional, Tonissi, Federica, additional, and Vanella, Paola, additional

Published
2019
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27. The TRANSERI study: Effect of eribulin (E) on circulating TGFβ and TNFα in metastatic breast cancer (mBC) patients (pts)—Relationship with outcome.

Author

Garrone, Ornella, primary, Lo Nigro, Cristiana, additional, Michelotti, Andrea, additional, Vandone, Anna Maria, additional, Abbona, Andrea, additional, De Angelis, Claudia, additional, Tonissi, Federica, additional, Vanella, Paola, additional, Denaro, Nerina, additional, and Merlano, Marco Carlo, additional

Published
2018
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