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367 results on '"Fumagalli, D"'

1. Low-Volume Metastases in Apparent Early-Stage Endometrial Cancer: Prevalence, Clinical Significance, and Future Perspectives

Author

Fumagalli, D, De Vitis, L, Caruso, G, Occhiali, T, Palmieri, E, Guillot, B, Pappalettera, G, Langstraat, C, Glaser, G, Reynolds, E, Fruscio, R, Landoni, F, Mariani, A, Grassi, T, Fumagalli D., De Vitis L. A., Caruso G., Occhiali T., Palmieri E., Guillot B. E., Pappalettera G., Langstraat C. L., Glaser G. E., Reynolds E. A., Fruscio R., Landoni F., Mariani A., Grassi T., Fumagalli, D, De Vitis, L, Caruso, G, Occhiali, T, Palmieri, E, Guillot, B, Pappalettera, G, Langstraat, C, Glaser, G, Reynolds, E, Fruscio, R, Landoni, F, Mariani, A, Grassi, T, Fumagalli D., De Vitis L. A., Caruso G., Occhiali T., Palmieri E., Guillot B. E., Pappalettera G., Langstraat C. L., Glaser G. E., Reynolds E. A., Fruscio R., Landoni F., Mariani A., and Grassi T.

Abstract

Endometrial cancer (EC) is the most diagnosed gynecologic malignancy, and its incidence and mortality are increasing. The prognosis is highly dependent on the disease spread. Surgical staging includes retroperitoneal evaluation to detect potential lymph node metastases. In recent years, systematic lymphadenectomy has been replaced by sentinel lymph node (SLN) biopsy and ultrastaging, allowing for the detection of macrometastases, micrometastases, and isolated tumor cells (ITCs). Micrometastases and ITCs have been grouped as low-volume metastases (LVM). The reported prevalence of LVM in studies enrolling more than one thousand patients with apparent early-stage EC ranges from 1.9% to 10.2%. Different rates of LVM are observed when patients are stratified according to disease characteristics and their risk of recurrence. Patients with EC at low risk for recurrence have low rates of LVM, while intermediate- and high-risk patients have a higher likelihood of being diagnosed with nodal metastases, including LVM. Macro- and micrometastases increase the risk of recurrence and cause upstaging, while the clinical significance of ITCs is still uncertain. A recent meta-analysis found that patients with LVM have a higher relative risk of recurrence [1.34 (95% CI: 1.07–1.67)], regardless of adjuvant treatment. In a retrospective study on patients with low-risk EC and no adjuvant treatment, those with ITCs had worse recurrence-free survival compared to node-negative patients (85.1%; CI 95% 73.8–98.2 versus 90.2%; CI 95% 84.9–95.8). However, a difference was no longer observed after the exclusion of cases with lymphovascular space invasion. There is no consensus on adjuvant treatment in ITC patients at otherwise low risk, and their recurrence rate is low. Multi-institutional, prospective studies are warranted to evaluate the clinical significance of ITCs in low-risk patients. Further stratification of patients, considering histopathological and molecular features of the disease, m

Published
2024

2. Pressure Support Ventilation During Extracorporeal Membrane Oxygenation Support in Patients With Acute Respiratory Distress Syndrome

Author

Fumagalli, B, Giani, M, Bombino, M, Fumagalli, D, Merelli, M, Chiesa, G, Rona, R, Bellani, G, Rezoagli, E, Foti, G, Fumagalli B., Giani M., Bombino M., Fumagalli D., Merelli M., Chiesa G., Rona R., Bellani G., Rezoagli E., Foti G., Fumagalli, B, Giani, M, Bombino, M, Fumagalli, D, Merelli, M, Chiesa, G, Rona, R, Bellani, G, Rezoagli, E, Foti, G, Fumagalli B., Giani M., Bombino M., Fumagalli D., Merelli M., Chiesa G., Rona R., Bellani G., Rezoagli E., and Foti G.

Abstract

In the initial phases of veno-venous extracorporeal membrane oxygenation (VV ECMO) support for severe acute respiratory distress syndrome (ARDS), ultraprotective controlled mechanical ventilation (CMV) is typically employed to limit the progression of lung injury. As patients recover, transitioning to assisted mechanical ventilation can be considered to reduce the need for prolonged sedation and paralysis. This study aimed to evaluate the feasibility of transitioning to pressure support ventilation (PSV) during VV ECMO and to explore variations in respiratory mechanics and oxygenation parameters following the transition to PSV. This retrospective monocentric study included 191 adult ARDS patients treated with VV ECMO between 2009 and 2022. Within this population, 131 (69%) patients were successfully switched to PSV during ECMO. Pressure support ventilation was associated with an increase in respiratory system compliance (p = 0.02) and a reduction in pulmonary shunt fraction (p < 0.001). Additionally, improvements in the cardiovascular Sequential Organ Failure Assessment score and a reduction in pulmonary arterial pressures (p < 0.05) were recorded. Ninety-four percent of patients who successfully transitioned to PSV were weaned from ECMO, and 118 (90%) were discharged alive from the intensive care unit (ICU). Of those who did not reach PSV, 74% died on ECMO, whereas the remaining patients were successfully weaned from extracorporeal support. In conclusion, PSV is feasible during VV ECMO and potentially correlates with improvements in respiratory function and hemodynamics.

Published
2024

3. The “ZEEP-PEEP test” to evaluate the response to positive end-expiratory pressure delivered by helmet: A prospective physiologic study

Author

Giani, M, Fumagalli, B, Cipulli, F, Rezoagli, E, Pozzi, M, Fumagalli, D, Fumagalli, L, Ferrari, K, Rona, R, Bellani, G, Lucchini, A, Foti, G, Giani M., Fumagalli B., Cipulli F., Rezoagli E., Pozzi M., Fumagalli D., Fumagalli L., Ferrari K., Rona R., Bellani G., Lucchini A., Foti G., Giani, M, Fumagalli, B, Cipulli, F, Rezoagli, E, Pozzi, M, Fumagalli, D, Fumagalli, L, Ferrari, K, Rona, R, Bellani, G, Lucchini, A, Foti, G, Giani M., Fumagalli B., Cipulli F., Rezoagli E., Pozzi M., Fumagalli D., Fumagalli L., Ferrari K., Rona R., Bellani G., Lucchini A., and Foti G.

Abstract

Introduction: The improvement in oxygenation after helmet application in hypoxemic patients may be explained by the alveolar recruitment obtained with positive end expiratory pressure (PEEP) or by the administration of a more accurate inspiratory fraction of oxygen (FiO2). We have designed the “ZEEP-PEEP test”, capable to distinguish between the FiO2-related or PEEP-related oxygenation improvement. Our primary aim was to describe the use of this test during helmet CPAP to assess the oxygenation improvement attributable to PEEP application. Material and methods: We performed a prospective physiological study including adult critically ill patients. Respiratory and hemodynamic parameters were recorded before helmet application (PRE step), after helmet application without PEEP (ZEEP step) and after the application of the PEEP valve (PEEP step), while maintaining a constant FiO2. We defined as “PEEP responders” patients showing a PaO2/FiO2 ratio improvement ≥10% after PEEP application. Results: 93 patients were enrolled. Compared to the PRE step, PaO2/FiO2 ratio was significantly improved during helmet CPAP both at ZEEP and PEEP step (189 ± 55, 219 ± 74 and 241 ± 82 mmHg, respectively, p < 0.01). Both PEEP responders (41%) and non-responders showed a significant improvement of PaO2/FiO2 ratio after the application of helmet at ZEEP, PEEP responders also showed a significant improvement of oxygenation after PEEP application (208 ± 70 vs 267 ± 85, p < 0.01). Conclusions: Helmet CPAP improved oxygenation. This improvement was not only due to the PEEP effect, but also to the increase of the effective inspired FiO2. Performing the ZEEP-PEEP test may help to identify patients who benefit from PEEP.

Published
2024

4. Assessment of the management of carcinomatous meningitis from breast cancer globally: a study by the Breast International Group Brain Metastasis Task Force

Author

Razis, E., Escudero, M.J., Palmieri, C., Mueller, V., Bartsch, R., Rossi, G., Gampenrieder, S.P., Kolberg, H.C., Zdenkowski, N., Pavic, M., Connolly, R.M., Rosset, L., Arcuri, J., Tesch, H., Vallejos, C., Retamales, J., Musolino, A., Del Mastro, L., Christodoulou, C., Aebi, S., Paluch-Shimon, S., Gupta, S., Ohno, S., Macpherson, I., Ekholm, M., Zaman, K., Vidal, M., Chakiba, C., Fumagalli, D., Thulin, A., Witzel, I., Kotecki, N., Gil-Gil, M., and Linderholm, B.

Published
2022
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5. Outcome of patients with stage I immature teratoma after surveillance or adjuvant chemotherapy

Author

Marino, G, Grassi, T, De Ponti, E, Negri, S, Testa, F, Giuliani, D, Delle Marchette, M, Dell'Oro, C, Fumagalli, D, Donatiello, G, Besana, G, Marchetta, L, Bonazzi, C, Lissoni, A, Landoni, F, Fruscio, R, Marino, Giuseppe, Grassi, Tommaso, De Ponti, Elena, Negri, Serena, Testa, Filippo, Giuliani, Daniela, Delle Marchette, Martina, Dell'Oro, Cristina, Fumagalli, Diletta, Donatiello, Gianluca, Besana, Giulia, Marchetta, Liliana, Bonazzi, Cristina Maria, Lissoni, Andrea Alberto, Landoni, Fabio, Fruscio, Robert, Marino, G, Grassi, T, De Ponti, E, Negri, S, Testa, F, Giuliani, D, Delle Marchette, M, Dell'Oro, C, Fumagalli, D, Donatiello, G, Besana, G, Marchetta, L, Bonazzi, C, Lissoni, A, Landoni, F, Fruscio, R, Marino, Giuseppe, Grassi, Tommaso, De Ponti, Elena, Negri, Serena, Testa, Filippo, Giuliani, Daniela, Delle Marchette, Martina, Dell'Oro, Cristina, Fumagalli, Diletta, Donatiello, Gianluca, Besana, Giulia, Marchetta, Liliana, Bonazzi, Cristina Maria, Lissoni, Andrea Alberto, Landoni, Fabio, and Fruscio, Robert

Abstract

Objective Immature teratomas are rare malignant ovarian germ cell tumours, typically diagnosed in young women, where fertility-sparing surgery is the treatment of choice. The role of adjuvant chemotherapy in stage I disease remains controversial. We evaluated the impact of surveillance versus chemotherapy on the recurrence rate in stage I immature teratomas.Methods We collected a single centre retrospective series of patients with stage I immature teratomas treated with fertility-sparing surgery at San Gerardo Hospital, Monza, Italy, between 1980 and 2019. Potential risk factors for recurrence were investigated by multivariate logistic regression.Results Of the 74 patients included, 12% (9/74) received chemotherapy, while 88% (65/74) underwent surveillance. Median follow-up was 188 months. No difference in recurrence was found in stage IA/IB and IC immature teratomas [10% (6/60) vs. 28.6% (4/14) (P=0.087)], grade 1, grade 2, and grade 3 [7.1% (2/28) vs. 14.3% (4/28) vs. 22.2% (4/18) (p=0.39)], and surveillance versus chemotherapy groups [13.9% (9/65) vs. 11.1% (1/9)) (p = 1.00)]. In univariate analysis, the postoperative approach had no impact on recurrence. The 5-year disease-free survival was 87% and 90% in the surveillance and chemotherapy groups, respectively; the overall survival was 100% in both cohorts.Conclusions Our results support the feasibility of surveillance in stage I immature teratomas. Adjuvant chemotherapy may be reserved for relapses. However, the potential benefit of chemotherapy should be discussed, especially for high-risk tumours. Prospective series are warranted to confirm our findings.What is already known on this topic To date, no consensus has been reached regarding the role of adjuvant chemotherapy in stage I immature teratomas of the ovary. Some studies suggest that only surveillance is an acceptable choice. However, guidelines are not conclusive on this topic.What this study adds No difference in terms of recurrence was observed between

Published
2024

6. Incidence of sentinel lymph node metastases in apparent early-stage endometrial cancer: a multicenter observational study

Author

De Vitis, L, Fumagalli, D, Schivardi, G, Capasso, I, Grcevich, L, Multinu, F, Cucinella, G, Occhiali, T, Betella, I, Guillot, B, Pappalettera, G, Shahi, M, Fought, A, Mcgree, M, Reynolds, E, Colombo, N, Zanagnolo, V, Aletti, G, Langstraat, C, Mariani, A, Glaser, G, De Vitis, Luigi Antonio, Fumagalli, Diletta, Schivardi, Gabriella, Capasso, Ilaria, Grcevich, Leah, Multinu, Francesco, Cucinella, Giuseppe, Occhiali, Tommaso, Betella, Ilaria, Guillot, Benedetto E, Pappalettera, Giulia, Shahi, Maryam, Fought, Angela J, McGree, Michaela, Reynolds, Evelyn, Colombo, Nicoletta, Zanagnolo, Vanna, Aletti, Giovanni, Langstraat, Carrie, Mariani, Andrea, Glaser, Gretchen, De Vitis, L, Fumagalli, D, Schivardi, G, Capasso, I, Grcevich, L, Multinu, F, Cucinella, G, Occhiali, T, Betella, I, Guillot, B, Pappalettera, G, Shahi, M, Fought, A, Mcgree, M, Reynolds, E, Colombo, N, Zanagnolo, V, Aletti, G, Langstraat, C, Mariani, A, Glaser, G, De Vitis, Luigi Antonio, Fumagalli, Diletta, Schivardi, Gabriella, Capasso, Ilaria, Grcevich, Leah, Multinu, Francesco, Cucinella, Giuseppe, Occhiali, Tommaso, Betella, Ilaria, Guillot, Benedetto E, Pappalettera, Giulia, Shahi, Maryam, Fought, Angela J, McGree, Michaela, Reynolds, Evelyn, Colombo, Nicoletta, Zanagnolo, Vanna, Aletti, Giovanni, Langstraat, Carrie, Mariani, Andrea, and Glaser, Gretchen

Abstract

Objective Ultrastaging is accurate in detecting nodal metastases, but increases costs and may not be necessary in certain low-risk subgroups. In this study we examined the risk of nodal involvement detected by sentinel lymph node (SLN) biopsy in a large population of apparent early-stage endometrial cancer and stratified by histopathologic characteristics. Furthermore, we aimed to identify a subgroup in which ultrastaging may be omitted. Methods We retrospectively included patients who underwent SLN (with bilateral mapping and no empty nodal packets on final pathology) +/- systematic lymphadenectomy for apparent early-stage endometrial cancer at two referral cancer centers. Lymph node status was determined by SLN only, regardless of non-SLN findings. The incidence of macrometastasis, micrometastasis, and isolated tumor cells (ITC) was measured in the overall population and after stratification by histotype (endometrioid vs serous), myometrial invasion (none, <50%, >= 50%), and grade (G1, G2, G3). Results Bilateral SLN mapping was accomplished in 1570 patients: 1359 endometrioid and 211 non-endometrioid, of which 117 were serous. The incidence of macrometastasis, micrometastasis, and ITC was 3.8%, 3.4%, and 4.8%, respectively. In patients with endometrioid histology (n=1359) there were 2.9% macrometastases, 3.2% micrometastases, and 5.3% ITC. No macro/micrometastases and only one ITC were found in a subset of 274 patients with low-grade (G1-G2) endometrioid endometrial cancer without myometrial invasion (all <1%). The incidence of micro/macrometastasis was higher, 2.8%, in 708 patients with low-grade endometrioid endometrial cancer invading <50% of the myometrium. In patients with serous histology (n=117), the incidence of macrometastases, micrometastasis, and ITC was 11.1%, 6.0%, and 1.7%, respectively. For serous carcinoma without myometrial invasion (n=36), two patients had micrometastases for an incidence of 5.6%. Conclusions Ultrastaging may be safel

Published
2024

8. The use of breast imaging for predicting response to neoadjuvant lapatinib, trastuzumab and their combination in HER2-positive breast cancer: Results from Neo-ALTTO

Author

Di Cosimo, S., Campbell, C., Azim, H.A., Jr., Galli, G., Bregni, G., Curigliano, G., Criscitiello, C., Izquierdo, M., de la Pena, L., Fumagalli, D., Fein, L., Vinholes, J., Ng, W.M.J., Colleoni, M., Ferro, A., Naume, B.J., Patel, A., Huober, J., Piccart-Gebhart, M.J., Baselga, J., and de Azambuja, E.

Published
2018
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9. External validation of risk scores to predict in-hospital mortality in patients hospitalized due to coronavirus disease 2019

Author

Hassan, S, Ramspek, C, Ferrari, B, van Diepen, M, Rossio, R, Knevel, R, la Mura, V, Artoni, A, Martinelli, I, Bandera, A, Nobili, A, Gori, A, Blasi, F, Canetta, C, Montano, N, Rosendaal, F, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferarri, F, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scar-Amellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Maria Pesenti, A, Grasselli, G, Galazzi, A, Tet-Tamanti, M, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Harari, S, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Luigi Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Oud, J, Baysan, M, Wigb, J, van Heurn, L, ter Haar, S, Toppenberg, A, Heerdink, L, van IJlzinga Veenstra, A, Eikenboom, A, Wubbolts, J, Uzorka, J, Lijferink, W, Meier, R, de Jonge, I, Arbous, S, de Boer, M, van der Bom, J, Dekkers, O, Hassan S., Ramspek C. L., Ferrari B., van Diepen M., Rossio R., Knevel R., la Mura V., Artoni A., Martinelli I., Bandera A., Nobili A., Gori A., Blasi F., Canetta C., Montano N., Rosendaal F. R., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferarri F., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scar-Amellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Maria Pesenti A., Grasselli G., Galazzi A., Tet-Tamanti M., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Harari S., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Luigi Moreo G., Iannuzzi P., Fumagalli D., Leone S., Oud J. A., Baysan M., Wigb J., van Heurn L. J., ter Haar S. B., Toppenberg A. G. L., Heerdink L., van IJlzinga Veenstra A. A., Eikenboom A. M., Wubbolts J., Uzorka J., Lijferink W., Meier R., de Jonge I. -B., Arbous S. M., de Boer M. G. J., van der Bom J. G., Dekkers O. M., Hassan, S, Ramspek, C, Ferrari, B, van Diepen, M, Rossio, R, Knevel, R, la Mura, V, Artoni, A, Martinelli, I, Bandera, A, Nobili, A, Gori, A, Blasi, F, Canetta, C, Montano, N, Rosendaal, F, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferarri, F, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scar-Amellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Maria Pesenti, A, Grasselli, G, Galazzi, A, Tet-Tamanti, M, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Harari, S, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Luigi Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Oud, J, Baysan, M, Wigb, J, van Heurn, L, ter Haar, S, Toppenberg, A, Heerdink, L, van IJlzinga Veenstra, A, Eikenboom, A, Wubbolts, J, Uzorka, J, Lijferink, W, Meier, R, de Jonge, I, Arbous, S, de Boer, M, van der Bom, J, Dekkers, O, Hassan S., Ramspek C. L., Ferrari B., van Diepen M., Rossio R., Knevel R., la Mura V., Artoni A., Martinelli I., Bandera A., Nobili A., Gori A., Blasi F., Canetta C., Montano N., Rosendaal F. R., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferarri F., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scar-Amellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Maria Pesenti A., Grasselli G., Galazzi A., Tet-Tamanti M., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Harari S., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Luigi Moreo G., Iannuzzi P., Fumagalli D., Leone S., Oud J. A., Baysan M., Wigb J., van Heurn L. J., ter Haar S. B., Toppenberg A. G. L., Heerdink L., van IJlzinga Veenstra A. A., Eikenboom A. M., Wubbolts J., Uzorka J., Lijferink W., Meier R., de Jonge I. -B., Arbous S. M., de Boer M. G. J., van der Bom J. G., and Dekkers O. M.

Abstract

Background: The coronavirus disease 2019 (COVID-19) presents an urgent threat to global health. Prediction models that accurately estimate mortality risk in hospitalized patients could assist medical staff in treatment and allocating limited resources. Aims: To externally validate two promising previously published risk scores that predict in-hospital mortality among hospitalized COVID-19 patients. Methods: Two prospective cohorts were available; a cohort of 1028 patients admitted to one of nine hospitals in Lombardy, Italy (the Lombardy cohort) and a cohort of 432 patients admitted to a hospital in Leiden, the Netherlands (the Leiden cohort). The endpoint was in-hospital mortality. All patients were adult and tested COVID-19 PCR-positive. Model discrimination and calibration were assessed. Results: The C-statistic of the 4C mortality score was good in the Lombardy cohort (0.85, 95CI: 0.82−0.89) and in the Leiden cohort (0.87, 95CI: 0.80−0.94). Model calibration was acceptable in the Lombardy cohort but poor in the Leiden cohort due to the model systematically overpredicting the mortality risk for all patients. The C-statistic of the CURB-65 score was good in the Lombardy cohort (0.80, 95CI: 0.75−0.85) and in the Leiden cohort (0.82, 95CI: 0.76−0.88). The mortality rate in the CURB-65 development cohort was much lower than the mortality rate in the Lombardy cohort. A similar but less pronounced trend was found for patients in the Leiden cohort. Conclusion: Although performances did not differ greatly, the 4C mortality score showed the best performance. However, because of quickly changing circumstances, model recalibration may be necessary before using the 4C mortality score.

Published
2022

10. Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: comment

Author

Bandera, A, Nobili, A, Tettamanti, M, Harari, S, Bosari, S, Mannucci, P, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Peyvandi, F, Gualtierotti, R, Ferrari, B, Rossio, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Della Fiore, S, Di Pasquale, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Bandera A., Nobili A., Tettamanti M., Harari S., Bosari S., Mannucci P. M., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Peyvandi F., Gualtierotti R., Ferrari B., Rossio R., Boasi N., Pagliaro E., Massimo C., De Caro M., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Della Fiore S., Di Pasquale M., Contarini M. M. M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., Leone S., Bandera, A, Nobili, A, Tettamanti, M, Harari, S, Bosari, S, Mannucci, P, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Peyvandi, F, Gualtierotti, R, Ferrari, B, Rossio, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Della Fiore, S, Di Pasquale, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Bandera A., Nobili A., Tettamanti M., Harari S., Bosari S., Mannucci P. M., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Peyvandi F., Gualtierotti R., Ferrari B., Rossio R., Boasi N., Pagliaro E., Massimo C., De Caro M., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Della Fiore S., Di Pasquale M., Contarini M. M. M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., and Leone S.

Published
2022

11. Clinical risk scores for the early prediction of severe outocomes in patients hospitalized for COVID-19: comment

Author

Rossio, R, Tettamanti, M, Nobili, A, Harari, S, Mannucci, P, Bandera, A, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Ferrari, B, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Rossio R., Tettamanti M., Nobili A., Harari S., Mannucci P. M., Bandera A., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Ferrari B., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., Leone S., Rossio, R, Tettamanti, M, Nobili, A, Harari, S, Mannucci, P, Bandera, A, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Ferrari, B, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, Leone, S, Rossio R., Tettamanti M., Nobili A., Harari S., Mannucci P. M., Bandera A., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Ferrari B., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., and Leone S.

Published
2022

12. Let go of the myth: safety of indocyanine green for sentinel lymph node mapping in endometrial cancer

Author

Capasso, Ilaria, Cucinella, G., Volcheck, G., Mcgree, M., Fought, A. J., Chuzhyk, O., De Vitis, L. A., Schivardi, G., Fumagalli, D., Occhiali, T., Fanfani, Francesco, Chiantera, V., Scambia, Giovanni, Reynolds, E., Mariani, A., Glaser, G., Capasso I., Fanfani F. (ORCID:0000-0003-1991-7284), Scambia G. (ORCID:0000-0003-2758-1063), Capasso, Ilaria, Cucinella, G., Volcheck, G., Mcgree, M., Fought, A. J., Chuzhyk, O., De Vitis, L. A., Schivardi, G., Fumagalli, D., Occhiali, T., Fanfani, Francesco, Chiantera, V., Scambia, Giovanni, Reynolds, E., Mariani, A., Glaser, G., Capasso I., Fanfani F. (ORCID:0000-0003-1991-7284), and Scambia G. (ORCID:0000-0003-2758-1063)

Abstract

Objective Sentinel lymph node mapping by intracervical indocyanine green injection is the preferred method for surgical staging in endometrial cancer. Adverse reactions to indocyanine green are extremely rare, and information about the safety of this tracer in patients with a history of other allergies, asthma, or comorbidities is limited. We aim to evaluate the rate of adverse reactions to indocyanine green injected during sentinel lymph node mapping in patients with endometrial cancer and review the etiology of such reactions. Methods All patients with endometrial cancer undergoing sentinel lymph node mapping with indocyanine green cervical stroma injection at the Mayo Clinic in Rochester, Minnesota between June 2014 and December 2018 were retrospectively evaluated. Any adverse reaction occurring intra-operatively or within 7 days after surgery was identified. A thorough chart review was performed by an allergy specialist physician for any patient with an allergic-type reaction. Results We included 923 patients of which 565 (61.2%) had a history of allergy to antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), other medications, and/or environmental exposures. Of 490 patients who had previously received contrast media, 25 (5.1%) had a history of an adverse reaction. No immediate anaphylaxis or other allergic reactions were observed after indocyanine green injection. 10 (1.1%) patients developed a transient skin reaction within 7 days after surgery. None of these patients had a history of contrast media reaction. Based on timing and clinical/peri-operative history of affected patients, it was determined that skin reactions were likely induced by other newly prescribed medications or contact sensitivity, not administration of indocyanine green. Conclusion Indocyanine green injection for sentinel lymph node mapping in patients with endometrial cancer caused no immediate/delayed anaphylactic or other severe allergic reactions. This included patients with a hi

Published
2023

17. Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: comment

Author

Bandera, A., Nobili, A., Tettamanti, M., Harari, S., Bosari, S., Mannucci, P. M., Scudeller, L., Fusetti, G., Rusconi, L., Dell'Orto, S., Prati, D., Valenti, L., Giovannelli, S., Manunta, M., Lamorte, G., Ferrari, F., Gori, A., Muscatello, A., Mangioni, D., Alagna, L., Bozzi, G., Lombardi, A., Ungaro, R., Ancona, G., Zuglian, G., Bolis, M., Iannotti, N., Ludovisi, S., Comelli, A., Renisi, G., Biscarini, S., Castelli, V., Palomba, E., Fava, M., Fortina, V., Peri, C. A., Saltini, P., Viero, G., Itri, T., Ferroni, V., Pastore, V., Massafra, R., Liparoti, A., Muheberimana, T., Giommi, A., Bianco, R., De Azevedo, R. M., Chitani, G. E., Peyvandi, F., Gualtierotti, R., Ferrari, B., Rossio, R., Boasi, N., Pagliaro, E., Massimo, C., De Caro, M., Montano, N., Vigone, B., Bellocchi, C., Carandina, A., Fiorelli, E., Melli, V., Tobaldini, E., Blasi, F., Aliberti, S., Spotti, M., Terranova, L., Misuraca, S., D'Adda, A., Della Fiore, S., Di Pasquale, M., Contarini, M. M. M., Ori, M., Morlacchi, L., Rossetti, V., Gramegna, A., Pappalettera, M., Cavallini, M., Buscemi, A., Vicenzi, M., Rota, I., Costantino, G., Solbiati, M., Furlan, L., Mancarella, M., Colombo, G., Fanin, A., Passarella, M., Monzani, V., Canetta, C., Rovellini, A., Barbetta, L., Billi, F., Folli, C., Accordino, S., Maira, D., C. M., Hu, Motta, I., Scaramellini, N., Fracanzani, A. L., Lombardi, R., Cespiati, A., Cesari, M., Lucchi, T., Proietti, M., Calcaterra, L., Mandelli, C., Coppola, C., Cerizza, A., Pesenti, A. M., Grasselli, G., Galazzi, A., Monti, I., Galbussera, A. A., Crisafulli, E., Girelli, D., Maroccia, A., Gabbiani, D., Busti, F., Vianello, A., Biondan, M., Sartori, F., Faverio, P., Pesci, A., Zucchetti, S., Bonfanti, P., Rossi, M., Beretta, I., Spolti, A., Elia, D., Cassandro, R., Caminati, A., Cipollone, F., Guagnano, M. T., D'Ardes, D., Rossi, I., Vezzani, F., Spanevello, A., Cherubino, F., Visca, D., Contoli, M., Papi, A., Morandi, L., Battistini, N., Moreo, G. L., Iannuzzi, P., Fumagalli, D., Leone, S., Bandera, A, Nobili, A, Tettamanti, M, Harari, S, Bosari, S, Mannucci, P, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Peyvandi, F, Gualtierotti, R, Ferrari, B, Rossio, R, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Della Fiore, S, Di Pasquale, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, and Leone, S

Subjects
Adult, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Critical Care, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Ce - Letter to the Editor, MEDLINE, Cohort Studies, Hospital, Internal Medicine, Medicine, Humans, Hospital Mortality, Intensive care medicine, Aged, Aged, 80 and over, business.industry, SARS-CoV-2, COVID-19, Middle Aged, Respiration, Artificial, Hospitals, Hospitalization, Survival Rate, Italy, Emergency Medicine, business, Human
Abstract

During the COVID-19 2020 outbreak, a large body of data has been provided on general management and outcomes of hospitalized COVID-19 patients. Yet, relatively little is known on characteristics and outcome of patients managed in Internal Medicine Units (IMU). To address this gap, the Italian Society of Internal Medicine has conducted a nationwide cohort multicentre study on death outcome in adult COVID-19 patients admitted and managed in IMU. This study assessed 3044 COVID-19 patients at 41 referral hospitals across Italy from February 3rd to May 8th 2020. Demographics, comorbidities, organ dysfunction, treatment, and outcomes including death were assessed. During the study period, 697 patients (22.9%) were transferred to intensive care units, and 351 died in IMU (death rate 14.9%). At admission, factors independently associated with in-hospital mortality were age (OR 2.46, p = 0.000), productive cough (OR 2.04, p = 0.000), pre-existing chronic heart failure (OR 1.58, p = 0.017) and chronic obstructive pulmonary disease (OR 1.17, p = 0.048), the number of comorbidities (OR 1.34, p = 0.000) and polypharmacy (OR 1.20, p = 0.000). Of note, up to 40% of elderly patients did not report fever at admission. Decreasing PaO

Published
2022

18. Using Reanalysis in Crop Monitoring and Forecasting Systems

Author

Toreti, A, Maiorano, A, De Sanctis, G, Webber, H, Ruane, A. C, Fumagalli, D, Ceglar, A, Niemeyer, S, and Zampieri, M

Subjects
Meteorology And Climatology
Abstract

Weather observations are essential for crop monitoring and forecasting but they are not always available and in some cases they have limited spatial representativeness. Thus, reanalyses represent an alternative source of information to be explored. In this study, we assess the feasibility of reanalysis-based crop monitoring and forecasting by using the system developed and maintained by the European Commission- Joint Research Centre, its gridded daily meteorological observations, the biased-corrected reanalysis AgMERRA and the ERA-Interim reanalysis. We focus on Europe and on two crops, wheat and maize, in the period 1980-2010 under potential and water-imited conditions. In terms of inter-annual yield correlation at the country scale, the reanalysis-driven systems show a very good performance for both wheat and maize (with correlation values higher than 0.6 in almost all EU28 countries) when compared to the observations-driven system. However, significant yield biases affect both crops. All simulations show similar correlations with respect to the FAO reported yield time series. These findings support the integration of reanalyses in current crop monitoring and forecasting systems and point to the emerging opportunities linked to the coming availability of higher-resolution reanalysis updated at near real time.

Published
2018
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19. Expectant management of placenta accreta after a mid-trimester pregnancy loss: a case report and a short review

Author

Fumagalli, D, Bignardi, T, Vanzulli, A, Francesca Corbella, P, Giuseppe Meroni, M, Interdonato, M, Diletta Fumagalli, Tommaso Bignardi, Angelo Vanzulli, Paola Francesca Corbella, Mario Giuseppe Meroni, Maria Lieta Interdonato, Fumagalli, D, Bignardi, T, Vanzulli, A, Francesca Corbella, P, Giuseppe Meroni, M, Interdonato, M, Diletta Fumagalli, Tommaso Bignardi, Angelo Vanzulli, Paola Francesca Corbella, Mario Giuseppe Meroni, and Maria Lieta Interdonato

Abstract

Objectives: Placenta accreta spectrum (PAS) disorders are a significant cause of maternal morbidity and mortality. Traditionally women with PAS are offered surgery, while expectant management is still considered investigational.Case presentation: We present a case of expectant management of PAS after pregnancy loss at 19-weeks. PAS was suspected at sonography and confirmed by MRI. Patient was offered expectant management to preserve fertility. This consisted of leaving the placenta in situ, followed by in- and out-patient clinical and sonographic examinations and blood tests. After five weeks placental detachment occurred without major complications.Conclusions: Our report suggests that expectant management could be a safe option in selected cases of PAS after mid-trimester pregnancy loss. We recommend expectant management should be offered in referral centers for PAS.

Published
2022

20. 2MO Development of a prognostic gene-expression signature for early stage HER2-positive breast cancer patients

Author

Di Cosimo, S., primary, Ciniselli, C.M., additional, Sotiriou, C., additional, Pogue-Geile, K., additional, Fumagalli, D., additional, de Azambuja, E., additional, Venet, D., additional, De Cecco, L., additional, Pong, N., additional, Cappelletti, V., additional, Tagliabue, E., additional, Wang, Y., additional, Saura Manich, C., additional, Nuciforo, P.G., additional, Kuemmel, S., additional, Pusztai, L., additional, Daidone, M.G., additional, Pizzamiglio, S., additional, Pruneri, G., additional, and Verderio, P., additional

Published
2022
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22. Clinical risk scores for the early prediction of severe outocomes in patients hospitalized for COVID-19: comment

Author

Rossio R., Tettamanti M., Nobili A., Harari S., Mannucci P. M., Bandera A., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Ferrari B., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., Leone S., Rossio, R, Tettamanti, M, Nobili, A, Harari, S, Mannucci, P, Bandera, A, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Ferrari, B, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, and Leone, S

Subjects
Male, Outcome Assessment, Disease, 030204 cardiovascular system & hematology, Respiratory failure, 0302 clinical medicine, Risk Factors, Epidemiology, Early prediction, Outcome Assessment, Health Care, 030212 general & internal medicine, Framingham Risk Score, Respiration, Area under the curve, Middle Aged, Hospitalization, Survival Rate, Italy, Artificial, Emergency Medicine, Female, Clinical risk factor, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Ce - Letter to the Editor, MEDLINE, Risk Assessment, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, Internal Medicine, medicine, Intubation, Intratracheal, Humans, In patient, Derivation, COVID-19, Risk prediction model, SARS-CoV 2, Selection (genetic algorithm), Aged, Retrospective Studies, SARS-CoV-2, business.industry, Retrospective cohort study, Respiration, Artificial, Im - Original, Health Care, Intratracheal, ROC Curve, Intubation, business
Abstract

Coronavirus disease of 2019 (COVID-19) is associated with severe acute respiratory failure. Early identification of high-risk COVID-19 patients is crucial. We aimed to derive and validate a simple score for the prediction of severe outcomes. A retrospective cohort study of patients hospitalized for COVID-19 was carried out by the Italian Society of Internal Medicine. Epidemiological, clinical, laboratory, and treatment variables were collected at hospital admission at five hospitals. Three algorithm selection models were used to construct a predictive risk score: backward Selection, Least Absolute Shrinkage and Selection Operator (LASSO), and Random Forest. Severe outcome was defined as the composite of need for non-invasive ventilation, need for orotracheal intubation, or death. A total of 610 patients were included in the analysis, 313 had a severe outcome. The subset for the derivation analysis included 335 patients, the subset for the validation analysis 275 patients. The LASSO selection identified 6 variables (age, history of coronary heart disease, CRP, AST, D-dimer, and neutrophil/lymphocyte ratio) and resulted in the best performing score with an area under the curve of 0.79 in the derivation cohort and 0.80 in the validation cohort. Using a cut-off of 7 out of 13 points, sensitivity was 0.93, specificity 0.34, positive predictive value 0.59, and negative predictive value 0.82. The proposed score can identify patients at low risk for severe outcome who can be safely managed in a low-intensity setting after hospital admission for COVID-19.

Published
2021

26. Adjuvant Olaparib for Patients with BRCA1- or BRCA2-Mutated Breast Cancer

Author

Tutt A, Garber J, Kaufman B, Viale G, Fumagalli D, Rastogi P, Gelber R, de Azambuja E, Fielding A, Balmana J, Domchek S, Gelmon K, Hollingsworth S, Korde L, Linderholm B, Bandos H, Senkus E, Suga J, Shao Z, Pippas A, Nowecki Z, Huzarski T, Ganz P, Lucas P, Baker N, Loibl S, McConnell R, Piccart M, Schmutzler R, Steger G, Costantino J, Arahmani A, Wolmark N, McFadden E, Karantza V, Lakhani S, Yothers G, Campbell C, Geyer C, OlympiA Clinical Trial Steering, and OlympiA Clinical Trial Steering Committee and Investigators

Abstract

BACKGROUND Poly(adenosine diphosphate-ribose) polymerase inhibitors target cancers with defects in homologous recombination repair by synthetic lethality. New therapies are needed to reduce recurrence in patients with BRCA1 or BRCA2 germline mutation-associated early breast cancer. METHODS We conducted a phase 3, double-blind, randomized trial involving patients with human epidermal growth factor receptor 2 (HER2)-negative early breast cancer with BRCA1 or BRCA2 germline pathogenic or likely pathogenic variants and high-risk clinicopathological factors who had received local treatment and neoadjuvant or adjuvant chemotherapy. Patients were randomly assigned (in a 1:1 ratio) to 1 year of oral olaparib or placebo. The primary end point was invasive disease-free survival. RESULTS A total of 1836 patients underwent randomization. At a prespecified event-driven interim analysis with a median follow-up of 2.5 years, the 3-year invasive disease-free survival was 85.9% in the olaparib group and 77.1% in the placebo group (difference, 8.8 percentage points; 95% confidence interval [CI], 4.5 to 13.0; hazard ratio for invasive disease or death, 0.58; 99.5% CI, 0.41 to 0.82; P

Published
2021

27. Copy Number Aberration Analysis to Predict Response to Neoadjuvant Anti-HER2 Therapy: Results from the NeoALTTO Phase III Clinical Trial

Author

Venet, D, Rediti, M, Maetens, M, Fumagalli, D, Brown, DN, Majjaj, S, Salgado, R, Pusztai, L, Harbeck, N, El-Abed, S, Wang, Y, Saura, C, Gomez, H, Semiglazov, VF, de Azambuja, E, Huober, J, Nuciforo, P, Di Cosimo, S, Piccart, M, Loi, S, Rothe, F, Sotiriou, C, Venet, D, Rediti, M, Maetens, M, Fumagalli, D, Brown, DN, Majjaj, S, Salgado, R, Pusztai, L, Harbeck, N, El-Abed, S, Wang, Y, Saura, C, Gomez, H, Semiglazov, VF, de Azambuja, E, Huober, J, Nuciforo, P, Di Cosimo, S, Piccart, M, Loi, S, Rothe, F, and Sotiriou, C

Abstract

PURPOSE: The heterogeneity of response to anti-HER2 agents represents a major challenge in patients with HER2-positive breast cancer. To better understand the sensitivity and resistance to trastuzumab and lapatinib, we investigated the role of copy number aberrations (CNA) in predicting pathologic complete response (pCR) and survival outcomes in the NeoALTTO trial. EXPERIMENTAL DESIGN: The neoadjuvant phase III NeoALTTO trial enrolled 455 patients with HER2-positive early-stage breast cancer. DNA samples from 269 patients were assessed for genome-wide copy number profiling. Recurrent CNAs were found with GISTIC2.0. RESULTS: CNA estimates were obtained for 184 patients included in NeoALTTO. Among those, matched transcriptome and whole-exome data were available for 154 and 181 patients, respectively. A significant association between gene copy number and pCR was demonstrated for ERBB2 amplification. Nevertheless, ERBB2 amplification ceased to be predictive once ERBB2 expression level was considered. GISTIC2.0 analysis revealed 159 recurrent CNA regions. Lower copy number levels of the 6q23-24 locus predicted absence of pCR in the whole cohort and in the estrogen receptor-positive subgroup. 6q23-24 deletion was significantly more frequent in TP53 wild-type (WT) compared with TP53-mutated, resulting in copy number levels significantly associated with lack of pCR only in the TP53 WT subgroup. Interestingly, a gene-ontology analysis highlighted several immune processes correlated to 6q23-24 copy number. CONCLUSIONS: Our analysis identified ERBB2 copy number as well as 6q23-24 CNAs as predictors of response to anti-HER2-based treatment. ERBB2 expression outperformed ERBB2 amplification. The complexity of the 6q23-24 region warrants further investigation.

Published
2021

28. Genomic and Transcriptomic Analyses of Breast Cancer Primaries and Matched Metastases in AURORA, the Breast International Group (BIG) Molecular Screening Initiative

Author

Aftimos, P, Oliveira, M, Irrthum, A, Fumagalli, D, Sotiriou, C, Gal-Yam, EN, Robson, ME, Ndozeng, J, Di Leo, A, Ciruelos, EM, de Azambuja, E, Viale, G, Scheepers, ED, Curigliano, G, Bliss, JM, Reis-Filho, JS, Colleoni, M, Balic, M, Cardoso, F, Albanell, J, Duhem, C, Marreaud, S, Romagnoli, D, Rojas, B, Gombos, A, Wildiers, H, Guerrero-Zotano, A, Hall, P, Bonetti, A, Larsson, KF, Degiorgis, M, Khodaverdi, S, Greil, R, Sverrisdottir, A, Paoli, M, Seyll, E, Loibl, S, Linderholm, B, Zoppoli, G, Davidson, NE, Johannsson, OT, Bedard, PL, Loi, S, Knox, S, Cameron, DA, Harbeck, N, Montoya, ML, Brandao, M, Vingiani, A, Caballero, C, Hilbers, FS, Yates, LR, Benelli, M, Venet, D, Piccart, MJ, Aftimos, P, Oliveira, M, Irrthum, A, Fumagalli, D, Sotiriou, C, Gal-Yam, EN, Robson, ME, Ndozeng, J, Di Leo, A, Ciruelos, EM, de Azambuja, E, Viale, G, Scheepers, ED, Curigliano, G, Bliss, JM, Reis-Filho, JS, Colleoni, M, Balic, M, Cardoso, F, Albanell, J, Duhem, C, Marreaud, S, Romagnoli, D, Rojas, B, Gombos, A, Wildiers, H, Guerrero-Zotano, A, Hall, P, Bonetti, A, Larsson, KF, Degiorgis, M, Khodaverdi, S, Greil, R, Sverrisdottir, A, Paoli, M, Seyll, E, Loibl, S, Linderholm, B, Zoppoli, G, Davidson, NE, Johannsson, OT, Bedard, PL, Loi, S, Knox, S, Cameron, DA, Harbeck, N, Montoya, ML, Brandao, M, Vingiani, A, Caballero, C, Hilbers, FS, Yates, LR, Benelli, M, Venet, D, and Piccart, MJ

Abstract

AURORA aims to study the processes of relapse in metastatic breast cancer (MBC) by performing multi-omics profiling on paired primary tumors and early-course metastases. Among 381 patients (primary tumor and metastasis pairs: 252 targeted gene sequencing, 152 RNA sequencing, 67 single nucleotide polymorphism arrays), we found a driver role for GATA1 and MEN1 somatic mutations. Metastases were enriched in ESR1, PTEN, CDH1, PIK3CA, and RB1 mutations; MDM4 and MYC amplifications; and ARID1A deletions. An increase in clonality was observed in driver genes such as ERBB2 and RB1. Intrinsic subtype switching occurred in 36% of cases. Luminal A/B to HER2-enriched switching was associated with TP53 and/or PIK3CA mutations. Metastases had lower immune score and increased immune-permissive cells. High tumor mutational burden correlated to shorter time to relapse in HR+/HER2- cancers. ESCAT tier I/II alterations were detected in 51% of patients and matched therapy was used in 7%. Integration of multi-omics analyses in clinical practice could affect treatment strategies in MBC. SIGNIFICANCE: The AURORA program, through the genomic and transcriptomic analyses of matched primary and metastatic samples from 381 patients with breast cancer, coupled with prospectively collected clinical data, identified genomic alterations enriched in metastases and prognostic biomarkers. ESCAT tier I/II alterations were detected in more than half of the patients.This article is highlighted in the In This Issue feature, p. 2659.

Published
2021

30. Genomic grade adds prognostic value in invasive lobular carcinoma†

Author

Metzger-Filho, O., Michiels, S., Bertucci, F., Catteau, A., Salgado, R., Galant, C., Fumagalli, D., Singhal, S. K., Desmedt, C., Ignatiadis, M., Haussy, S., Finetti, P., Birnbaum, D., Saini, K. S., Berlière, M., Veys, I., de Azambuja, E., Bozovic, I., Peyro-Saint-Paul, H., Larsimont, D., Piccart, M., and Sotiriou, C.

Published
2013
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35. LBA12 PALLAS: A randomized phase III trial of adjuvant palbociclib with endocrine therapy versus endocrine therapy alone for HR+/HER2- early breast cancer

Author

Mayer, E.L., primary, Gnant, M.I., additional, DeMichele, A., additional, Martin, M., additional, Burstein, H., additional, Prat, A., additional, Rubovszky, G., additional, Miller, K.D., additional, Pfeiler, G., additional, Winer, E.P., additional, Zdenkowski, N., additional, Anderson, D., additional, Nowecki, Z., additional, Loibl, S., additional, Fohler, H., additional, Metzger, O., additional, Fumagalli, D., additional, Puyana Theall, K., additional, Fesl, C., additional, and Dueck, A., additional

Published
2020
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36. Socio-Cognitive Engineering of a Robotic Partner for Child’s Diabetes Self-Management

Author

Neerincx, M.A., Vught, W., Blanson Henkemans, O., Oleari, E., Broekens, J., Peters, R., Kaptein, F., Demiris, Y., Kiefer, B., Fumagalli, D., and Bierman, B.

Subjects
Diabetes management, Conversational agent, Socio-cognitive engineering, technology, industry, and agriculture, Child-robot interaction, Human-robot partnership, Personal health, Healthy for Life, human activities, Healthy Living, Pervasive lifestyle support
Abstract

Social or humanoid robots do hardly show up in "the wild", aiming at pervasive human benefits such as child health. This paper presents the socio-cognitive engineering (SCE) methodology for the required field research \& development of robots, focusing on the incremental development of a social robot and child-robot activities that support the daily diabetes management processes of children, aged between 7 and 14 years (i.e., supporting a healthy lifestyle). The SCE methodology helps to integrate into the human-agent/robot system: (a) theories, models and methods from different scientific disciplines, (b) technologies from different fields, (c) varying diabetes management practices, and (d) last but not least, the diverse individual and context-dependent needs of the patients and caregivers. The resulting system represents a new type of long-term human-robot partnerships with evolving collective intelligence. The current prototype is based on four human-robot partnership functions, a knowledge-base and interaction design for child's prolonged disease self-management. It has been developed and tested in three cycles, and proved to support the children on the three basic needs of the Self-Determination Theory: autonomy, competence and relatedness. To our knowledge, this is the first design \& test of a robot system "in the wild" for prolonged "blended" care of children with a chronic disease, showing positive results in a 3 month evaluation period.

Published
2019

38. Improving WOFOST model to simulate winter wheat phenology in Europe : Evaluation and effects on yield

Author

Ceglar, A., van der Wijngaart, R., de Wit, A., Lecerf, R., Boogaard, H., Seguini, L., van den Berg, M., Toreti, A., Zampieri, M., Fumagalli, D., Baruth, B., Ceglar, A., van der Wijngaart, R., de Wit, A., Lecerf, R., Boogaard, H., Seguini, L., van den Berg, M., Toreti, A., Zampieri, M., Fumagalli, D., and Baruth, B.

Abstract

This study describes and evaluates improvements to the MARS crop yield forecasting system (MCYFS) for winter soft wheat (Triticum aestivum) in Europe, based on the WOFOST crop simulation model, by introducing autumn sowing dates, realistic soil moisture initialization, adding vernalization requirements and photoperiodicity, and phenology calibration. Dataset of phenological observations complemented with regional cropping calendars across Europe is used. The calibration of thermal requirements for anthesis and maturity is done by pooling all available observations within European agro-environmental zones and minimizing an objective function that combines the differences between observed and simulated anthesis, maturity and harvest dates. Calibrated phenology results in substantial improvement in simulated dates of anthesis with respect to the original MCYFS simulations. The combined improvements to the system result in a physically more plausible spatial distribution of crop model indicators across Europe. Crop yield indicators point to better agreement with recorded national winter wheat yields with respect to the original MCYFS simulations, most pronounced in central, eastern and southern Europe. However, model skill remains low in large parts of western Europe, which may possibly be attributed to the impacts of wet conditions.

Published
2019

43. Nutrition, Sustainability, and Culture. Grounding and Defence of the Right to Nutrition

Author

Fumagalli, D., Meijboom, Franck (Thesis Advisor), Philips, Jos, Fumagalli, D., Meijboom, Franck (Thesis Advisor), and Philips, Jos

Abstract

The thesis is an inquiry on the nature of Human Rights, In particular of the Social, Economic and Cultural Rights and the Right to Adequate Food. After introducing the main problems of the Human Rights doctrine, the thesis analyses the debate and the problems related to the formulation of the Right to Adequate Food.

Published
2018

44. Feasibility of developing reliable gene expression modules from FFPE derived RNA profiled on Affymetrix arrays

Author

Sapino, A, Jose, V, Fumagalli, D, Rothe, F, Majjaj, S, Loi, S, Michiels, S, Sotiriou, C, Sapino, A, Jose, V, Fumagalli, D, Rothe, F, Majjaj, S, Loi, S, Michiels, S, and Sotiriou, C

Abstract

The reliability of differential gene expression analysis on formalin-fixed, paraffin-embedded (FFPE) expression profiles generated using Affymetrix arrays is questionable, due to the high range of percent-present values reported in studies which profiled FFPE samples using this technology. Moreover, the validity of gene-modules derived from external datasets in FFPE microarray expression profiles is unknown. By generating matched gene expression profiles using RNAs derived from fresh-frozen (FF) and FFPE preserved breast tumors with Affymetrix arrays and FF/FFPE RNA specific amplification-and-labeling kits, the reliability of differential expression analysis and the validity of gene modules derived from external datasets were investigated. Specifically, the reliability of differential expression analysis was investigated by developing de-novo ER/HER2 pathway gene-modules from the matched datasets and validating them on external FF/FFPE gene expression datasets using ROC analysis. Spearman's rank correlation coefficient of module scores between matched FFPE/frozen datasets was used to measure the reliability of gene-modules derived from external datasets in FFPE expression profiles. Independent of the array/amplification-kit/sample preservation method used, de-novo ER/HER2 gene-modules derived from all matched datasets showed similar prediction performance in the independent validation (AUC range in FFPE dataset; ER: 0.93-0.95, HER2: 0.85-0.91), except for the de-novo ER/HER2 gene-module derived from the FFPE dataset using the 3'IVT kit (AUC range in FFPE dataset; ER: 0.79-0.81, HER2: 0.78). Among the external gene modules considered, roughly ~50% gene modules showed high concordance between expression profiles derived from matching FF and FFPE RNA. The remaining discordant gene modules between FF and FFPE expression profiles showed high concordance within matching FF datasets and within matching FFPE datasets independently, implying that microarrays still require im

Published
2018

45. Lucitanib for the treatment of HR+ HER2- metastatic breast cancer (MBC) patients (pts): Results from the multicohort phase II FINESSE trial

Author

Hui, R., primary, Pearson, A., additional, Cortes Castan, J., additional, Campbell, C., additional, Poirot, C., additional, Azim, H.A., additional, Fumagalli, D., additional, Lambertini, M., additional, Daly, F., additional, Arahmani, A., additional, Perez-Garcia, J., additional, Aftimos, P.G., additional, Bedard, P., additional, Xuereb, L., additional, Loibl, S., additional, Loi, S., additional, Pierrat, M.-J., additional, Turner, N.C., additional, André, F., additional, and Curigliano, G., additional

Published
2018
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46. Abstract P2-09-07: Low levels of HER2 extracellular domain (ECD) compared to intracelluar domain (ICD) in NeoALTTO may segregate benefit from lapatinib and trastuzumab in breast cancer

Author

Rimm, DL, primary, Carvajal-Hausdorf, D, additional, Harbeck, N, additional, Fumagalli, D, additional, Rodrik-Outmezguine, V, additional, delaPena, L, additional, deAzambuja, E, additional, Huober, J, additional, Baselga, J, additional, Piccart, M, additional, Holmes, E, additional, and Pusztai, L, additional

Published
2018
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47. Abstract P2-05-04: Deregulation of A-to-I RNA editing is associated with poor prognosis in HER2+ breast cancers in the neoALTTO trial

Author

Venet, D, primary, Rothé, F, additional, Dupont, F, additional, Maetens, M, additional, Fumagalli, D, additional, Salgado, R, additional, Bradbury, I, additional, Pusztai, L, additional, Harbeck, N, additional, Izquierdo, M, additional, de la Pena, L, additional, Ignatiadis, M, additional, de Azambuja, E, additional, Huober, J, additional, Nuciforo, P, additional, Baselga, J, additional, Piccart, M, additional, Loi, S, additional, and Sotiriou, C, additional

Published
2018
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48. Abstract PD3-03: Circulating tumor DNA in HER2 amplified breast cancer: A translational research substudy of the NeoALTTO phase 3 trial

Author

Ignatiadis, M, primary, Silva, MJ, additional, Campbell, C, additional, Bradbury, I, additional, de Azambuja, E, additional, Maetens, M, additional, Fumagalli, D, additional, Rodrik-Outmezguine, V, additional, Di Cosimo, S, additional, Rosa, D, additional, Chia, S, additional, Wardley, A, additional, Ueno, T, additional, Janni, W, additional, Huober, J, additional, Baselga, J, additional, Piccart, M, additional, Sotiriou, C, additional, Loi, S, additional, Rothé, F, additional, and Dawson, S, additional

Published
2018
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49. Abstract GS1-04: Copy number aberration analysis to predict response to neoadjuvant anti-HER2 therapy: Results from the NeoALTTO phase III trial

Author

Sotiriou, C, primary, Rothé, F, additional, Maetens, M, additional, Fumagalli, D, additional, Brown, DN, additional, Salgado, R, additional, Bradbury, I, additional, Pusztai, L, additional, Harbeck, N, additional, Ignatiadis, M, additional, Sarp, S, additional, de la Pena, L, additional, de Azambuja, E, additional, Huober, J, additional, Nuciforo, P, additional, Baselga, J, additional, Piccart, M, additional, Loi, S, additional, and Venet, D, additional

Published
2018
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50. Abstract P2-09-03: Identifying clinically relevant subgroups of women with HER2-positive breast cancer: An analysis of Neo-ALTTO using the 41-gene TRAR score

Author

Di Cosimo, S, primary, Triulzi, T, additional, De Cecco, L, additional, Pizzamiglio, S, additional, de Azambuja, E, additional, Fumagalli, D, additional, Pusztai, L, additional, Harbeck, N, additional, Izquierdo, M, additional, de la Pena, L, additional, Huober, J, additional, Baselga, J, additional, Piccart, M, additional, Verderio, P, additional, and Tagliabue, E, additional

Published
2018
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