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1. Immunonutrition supplementation for resectable gastric cancer during standard neoadjuvant chemotherapy of FLOT. A proof-of-concept protocol: I-SUPPLY

Author

V. Pusceddu, C. Donisi, A. Pretta, F. Loi, R. Badas, P. Ziranu, M. Puzzoni, E. Lai, S. Mariani, E. Palmas, M. Pozzari, E. Cimbro, A.P. D’Agata, S. Pinto, F. Coghe, S. Bergamini, D. Fanni, G. Faa, T. Yoshino, and M. Scartozzi

Subjects
immunonutrition supplementation, Immunoscore, immune nutrients, gastric cancer, tumour microenvironment, perioperative chemotherapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

The ‘immune pattern’ of the esophagogastric junction and gastric cancer (GC) has been related to tumour progression and/or response to therapies. GC can be classified as immunogenic or immune-resistant based on the infiltration of the tumour microenvironment (TME) from different immune cells (ICs), the most significant of which are activated lymphocytes (a-Ly) CD8+ and CD4+. From the amount of a-Ly infiltration in TME, we can identify tumours with high Immunoscore (IS) which correlates with better prognosis in terms of disease-free survival and overall survival (OS). IC activation and consequent immunogenic TME requires high nutrient absorption and synthesis and accumulation of protein, lipid, and nucleotides. However, tumour cells (TCs) promote their own proliferation by stealing micronutrients to ICs, therefore leading to an immunosuppressive TME phenotype. This proof-of-concept protocol aims to assess whether a controlled enteral immune nutrition (EIN) supplementation can revert the TME in favour of ICs over TCs, in both auxotrophic and non-auxotrophic malignancies, witnessed by an increase in IS in surgical specimen over biopsy controls. Secondary endpoints are: (i) tumour regression grade assessment compared to historical data from FLOT4/AIO; (ii) combined proportion score ratio; (iii) relapse-free survival at 3 years and OS; and (iv) quality of life by the European Organisation for Research and Treatment of Cancer quality-of-life questionnaire (EORTC QLQ)-30.

Published
2024
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2. Adherence to treatment in patients with solid and hematological cancers. Could spiritual and psychological support facilitate optimal adherence?

Author

F. Sancassiani, O. Mulas, C. Madeddu, E. Massa, G. La Nasa, G. Caocci, F. Romano, V. Garau, G. Orrù, M. Scartozzi, A. Nardi, and M. Carta

Subjects
adherence, cancer, risk factors, psychological support, spiritual support, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Objective: Cancer-related diseases pose a substantial public health challenge; however, recent treatments have enhanced patient outcomes. Adherence to therapy is crucial, and research focuses on elucidating the factors that influence it. Limited information exists on medication adherence in cancer patients. This study aims to identify risk factors for non-adherence in a cohort of people with solid and hematological tumors. Participants and Methods: This is a cross-sectional study in which participants were recruited from two Oncologic hospital units in Italy. The inclusion criteria were age ≥ 18 years, confirmed malignant neoplasm, and active treatment. Data included sociodemographic and clinical-oncological factors. Treatment adherence was assessed through a clinician-based dichotomous scale. Health-related quality of life (HRQoL) was evaluated with the Short Form Health Survey – 12 items (SF-12), satisfaction with care was measured using the Treatment Perception Questionnaire. Results: A total of 263 participants (132 females, 50.2%) was involved in this study. The mean age was 61.2±13.8. Non-adherence frequency was 9.9%. Factors associated with non-adherence were shorter time since care initiation (

Published
2023
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3. Low adherence to therapy and co-morbid depressive episodes are independent determinants of early death in people with cancer

Author

F. Sancassiani, O. Mulas, C. Madeddu, E. Massa, G. La Nasa, G. Caocci, F. Romano, V. Garau, G. Orrù, M. Scartozzi, A. Nardi, and M. Carta

Subjects
adherence, depression, cancer, psycho-oncology, death risk, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Objective: The demanding nature of oncological therapies may affect treatment motivation and adherence, leading to an increased risk of premature death. Exploring the interaction between depressive episodes and treatment adherence is essential, considering how depression may influence patients' willingness to continue treatment. This study aims to investigate the association between depressive episodes, low treatment adherence, and premature death in individuals with cancer. The study also assessed whether low adherence to therapy acted as a mediator in the relationship between depression and the risk of early death. Participants and Methods: This is a 9-month cohort study in which participants were enrolled in two Italian Oncology hospital units. The Patient Health Questionnaire (PHQ-9) was used for depression screening. Stratified analyses were conducted to explore the relationship between depression, low adherence, and premature death. Results: Out of 263 subjects, depressive episode frequency was 48.2% and low adherence was 9.9%. After 9 months, 13.7% had died. There was a significative association between experiencing a depressive episode (RR=2.14, 95% CI: 1.08-4.39) and low adherence (RR=2.2, 95% CI: 1.01-4.48) upon cohort entry and being deceased at month 9 of observation. The risk associated with depression was found to persist even after accounting for the level of adherence to therapy through standardization (MH-OR=3.11; 95% CI: 1.52-6.34). Conclusions: Individuals with cancer who experience a depressive episode or demonstrate low adherence to therapy are at risk for premature death. Early intervention targeting depressive symptoms and treatment adherence may improve oncological-related outcomes.

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

Author

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

Subjects
atezolizumab, Cancer Research, Settore MED/12 - Gastroenterologia, Oncology, sorafenib, NAFLD, NASH, advanced HCC, advanced HCC, NASH, NAFLD, lenvatinib, sorafenib, atezolizumab, bevacizumab, lenvatinib, bevacizumab
Abstract

Background: A growing body of evidence suggests that non-viral hepatocellular carcinoma (HCC) might benefit less from immunotherapy. Materials and methods: We carried out a retrospective analysis of prospectively collected data from consecutive patients with non-viral advanced HCC, treated with atezolizumab plus bevacizumab, lenvatinib, or sorafenib, in 36 centers in 4 countries (Italy, Japan, Republic of Korea, and UK). The primary endpoint was overall survival (OS) with atezolizumab plus bevacizumab versus lenvatinib. Secondary endpoints were progression-free survival (PFS) with atezolizumab plus bevacizumab versus lenvatinib, and OS and PFS with atezolizumab plus bevacizumab versus sorafenib. For the primary and secondary endpoints, we carried out the analysis on the whole population first, and then we divided the cohort into two groups: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) population and non-NAFLD/NASH population. Results: One hundred and ninety patients received atezolizumab plus bevacizumab, 569 patients received lenvatinib, and 210 patients received sorafenib. In the whole population, multivariate analysis showed that treatment with lenvatinib was associated with a longer OS [hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.44-0.95; P = 0.0268] and PFS (HR 0.67; 95% CI 0.51-0.86; P = 0.002) compared to atezolizumab plus bevacizumab. In the NAFLD/NASH population, multivariate analysis confirmed that lenvatinib treatment was associated with a longer OS (HR 0.46; 95% CI 0.26-0.84; P = 0.0110) and PFS (HR 0.55; 95% CI 0.38-0.82; P = 0.031) compared to atezolizumab plus bevacizumab. In the subgroup of non-NAFLD/NASH patients, no difference in OS or PFS was observed between patients treated with lenvatinib and those treated with atezolizumab plus bevacizumab. All these results were confirmed following propensity score matching analysis. By comparing patients receiving atezolizumab plus bevacizumab versus sorafenib, no statistically significant difference in survival was observed. Conclusions: The present analysis conducted on a large number of advanced non-viral HCC patients showed for the first time that treatment with lenvatinib is associated with a significant survival benefit compared to atezolizumab plus bevacizumab, in particular in patients with NAFLD/NASH-related HCC.

Published
2022

7. The role of fetal programming in human carcinogenesis - May the Barker hypothesis explain interindividual variability in susceptibility to cancer insurgence and progression?

Author

F, Coghe, D, Fanni, C, Gerosa, A, Ravarino, M, Mureddu, G, Cerrone, P, Coni, G, Pichiri, T, Congiu, M, Piras, F, Cau, V, Aimola, A, Balestrieri, E, Lai, M, Manchia, A, Scano, G, Orrù, G, La Nasa, P, Van Eyken, L, Saba, M, Scartozzi, M, Castagnola, and G, Faa

Subjects
Epigenomics, Fetal Development, Carcinogenesis, Pregnancy, Neoplasms, Infant, Newborn, Birth Weight, Humans, Female
Abstract

The growing incidence of cancers is pushing oncologists to find out new explanations other than the somatic mutation theory, based on the accumulation of DNA mutations. In particular, the embryo-fetal exposure to an increasing number of environmental factors during gestation might represent a trigger able to influence the susceptibility of the newborn to develop cancer later in life. This idea agrees with the fetal programming theory, also known as the Barker hypothesis. Here the role of insulin-like growth factors, thymosin beta-4, and epigenome are discussed as mediators of cancer in prenatal human development. The role of epigenetic factors that during gestation increase the predisposition to develop cancer and the similarities in the gene expression (like MMP9, OPN, TP53 and CDKN2A) between embryonic development and cancer are key factors. Likewise, maternal obesity might be able to re-program embryo-fetal development with long-term changes, including an increased risk to develop neuroblastoma and acute leukemia. Birth weight alone and birth weight corrected for gestational age are proposed as important variables capable of predicting the vulnerability to develop cancers. According to the findings here reported, we hypothesize that cancer prevention should start during gestation by improving the quality of maternal diet. In conclusion, the Barker hypothesis should be applied to cancer as well. Therefore, the identification of the epigenetic factors of cancer appears mandatory, so that the cancer prevention might start in the womb before birth.

Published
2022

8. Connecting Northeast Asia: Renewable Energy and Prospects for Cooperation

Author

Cesare M. Scartozzi, Maximilian Ernst, Roberto Orsi, Henry Martin, Brussels School of Governance, Political Science, and Faculty of Economic and Social Sciences and Solvay Business School

Subjects
Renewable energy, China, Korea, Natural resource economics, business.industry, grid connectivity, General Medicine, Energy security, Japan, Republic of Korea, energy security, Business
Abstract

This article assesses the significance of renewable energy technologies in the integration of the Northeast Asian energy sector. First, it provides a country-level analysis of renewable energy trends in China, Korea, and Japan. Then, it analyzes how domestic trends are linked from a regional perspective, highlighting opportunities and challenges posed by renewable energy technologies. Finally, it assesses the current state of affairs in energy cooperation and provides an appraisal of future developments, with particular attention to the issue of grid connectivity.

Published
2021

9. Reframing Climate-Induced Socio-Environmental Conflicts: A Systematic Review

Author

Cesare M. Scartozzi

Subjects
021110 strategic, defence & security studies, Political science, 05 social sciences, Political Science and International Relations, Geography, Planning and Development, Socio environmental, 050602 political science & public administration, 0211 other engineering and technologies, Environmental ethics, 02 engineering and technology, Cognitive reframing, 0506 political science
Abstract

This article draws a comprehensive map of conflict climate change scholarship. It uses visualizations and descriptive statistics to trace the temporal, spatial, and topical evolution of the field of study via a bibliometric analysis of more than six hundred publications. It then proceeds to summarize findings, theoretical explanations, and methodological approaches. Overall, this systematic review shows a remarkable inconsistency of evidence among publications. As a way forward, this article recommends future research to use computational models, informed by a social-ecological perspective, to better explore the link between climate change and conflict. Resumen En este artículo se traza un mapa integral de la erudición conflictiva del cambio climático. Se utilizan visualizaciones y estadísticas descriptivas para rastrear la evolución temporal, espacial y temática del campo de estudio mediante un análisis bibliométrico de más de seiscientas publicaciones. Luego, continúa con un resumen de los hallazgos, las explicaciones teóricas y los enfoques metodológicos. En términos generales, esta revisión sistemática muestra una notable incoherencia de evidencias entre las publicaciones. En este artículo se recomiendan investigaciones a futuro para utilizar los modelos computacionales, informados con una perspectiva socioecológica, a fin de explorar mejor la conexión entre el cambio climático y los conflictos. Extrait Cet article offre une représentation complète des recherches portant sur les conflits liés au changement climatique. Il utilise des visualisations et des statistiques descriptives pour retracer l’évolution temporelle, spatiale et thématique de ce domaine d’étude via une analyse bibliométrique de plus de six cents publications. Il résume ensuite les constatations, explications théoriques et approches méthodologiques. Globalement, cette synthèse systématique montre une incohérence remarquable des preuves entre les publications. Pour aller de l'avant, cet article recommande que les recherches futures passent par des modèles informatiques éclairés par une perspective socio-écologique pour mieux explorer le lien entre le changement climatique et les conflits.

Published
2020

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

Author

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

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

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

Published
2021

23. 417P Liquid biopsy driven anti-EGFR rechallenge in metastatic colorectal cancer

Author

Stefano Mariani, Milena Casula, Mara Persano, Alessio Lupi, Grazia Palomba, Nicole Liscia, Marco Puzzoni, Clelia Donisi, G. Pinna, E. Cimbro, Giovannella Palmieri, Andrea Pretta, A. Parrino, Marina Pisano, Riccardo Giampieri, Eleonora Lai, Valeria Pusceddu, Enrica Giglio, M. Scartozzi, and Pina Ziranu

Subjects
Oncology, medicine.medical_specialty, Colorectal cancer, business.industry, Internal medicine, medicine, Hematology, Liquid biopsy, medicine.disease, business
Published
2021

24. Chemotherapy toxicity and activity in patients with pancreatic ductal adenocarcinoma and germline BRCA1-2 pathogenic variants (gBRCA1-2pv): a multicenter survey

Author

M. Scartozzi, Giampaolo Tortora, Giulia Orsi, Alessandro Cavaliere, Emiliano Tamburini, A.M. Militello, E. Penzo, L.G. Forti, Michele Milella, I. Bernardini, M. Macchini, Silvia Noventa, Michele Reni, M.M. Valente, Monica Niger, Stefano Cascinu, Andrea Spallanzani, K. Bencardino, M. Di Marco, Ingrid Garajová, A. Bittoni, U. Peretti, S. Mosconi, Silvia Bozzarelli, Maria Grazia Rodriquenz, C. Paratore, I.G. Rapposelli, Guido Giordano, S. De Lorenzo, Elisa Giommoni, Orsi, G., Di Marco, M., Cavaliere, A., Niger, M., Bozzarelli, S., Giordano, G., Noventa, S., Rapposelli, I. G., Garajova, I., Tortora, G., Rodriquenz, M. G., Bittoni, A., Penzo, E., De Lorenzo, S., Peretti, U., Paratore, C., Bernardini, I., Mosconi, S., Spallanzani, A., Macchini, M., Tamburini, E., Bencardino, K., Giommoni, E., Scartozzi, M., Forti, L., Valente, M. M., Militello, A. M., Cascinu, S., Milella, M., Reni, M., Orsi G., Di Marco M., Cavaliere A., Niger M., Bozzarelli S., Giordano G., Noventa S., Rapposelli I.G., Garajova I., Tortora G., Rodriquenz M.G., Bittoni A., Penzo E., De Lorenzo S., Peretti U., Paratore C., Bernardini I., Mosconi S., Spallanzani A., Macchini M., Tamburini E., Bencardino K., Giommoni E., Scartozzi M., Forti L., Valente M.M., Militello A.M., Cascinu S., Milella M., and Reni M.

Subjects
Cancer Research, medicine.medical_specialty, FOLFIRINOX, medicine.medical_treatment, pancreatic cancer, Gastroenterology, Germ Cell, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Original Research, chemotherapy toxicity, Cisplatin, Chemotherapy, Antineoplastic Combined Chemotherapy Protocol, business.industry, BRCA1 Protein, Carcinoma, Gemcitabine, Oxaliplatin, Irinotecan, Pancreatic Neoplasms, Germ Cells, Oncology, chemotherapy activity, Fluorouracil, Pancreatic Ductal, germline BRCA, chemotherapy dose intensity, Toxicity, business, medicine.drug, Human, Carcinoma, Pancreatic Ductal
Abstract

Background Germline BRCA1-2 pathogenic variants (gBRCA1-2pv)-related pancreatic ductal adenocarcinoma (PDAC) showed increased sensitivity to DNA cross-linking agents. This study aimed at exploring safety profile, dose intensity, and activity of different chemotherapy regimens in this setting. Patients and methods gBRCA1-2pv PDAC patients of any age and clinical tumor stage who completed a first course of chemotherapy were eligible. A descriptive analysis of chemotherapy toxicity, dose intensity, response, and survival outcomes was performed. Results A total of 85 gBRCA1-2pv PDAC patients treated in 21 Italian centers between December 2008 and March 2021were enrolled. Seventy-four patients were assessable for toxicity and dose intensity, 83 for outcome. Dose intensity was as follows: nab-paclitaxel 72%, gemcitabine 76% (AG); cisplatin 75%, nab-paclitaxel 73%, capecitabine 73%, and gemcitabine 65% (PAXG); fluorouracil 35%, irinotecan 58%, and oxaliplatin 64% (FOLFIRINOX). When compared with the literature, grade 3-4 neutropenia, thrombocytopenia, and diarrhea were increased with PAXG, and unmodified with AG and FOLFIRINOX. RECIST responses were numerically higher with the three- (81%) or four-drug (73%) platinum-containing regimens that outperformed AG (41%) and oxaliplatin-based doublets (56%). Carbohydrate antigen 19.9 (CA19.9) reduction >89% at nadir was reported in two-third of metastatic patients treated with triplets and quadruplets, as opposed to 33% and 45% of patients receiving oxaliplatin-based doublets or AG, respectively. All patients receiving AG experienced disease progression, with a median progression-free survival (mPFS) of 6.4 months, while patients treated with platinum-containing triplets or quadruplets had an mPFS >10.8 months. Albeit still immature, data on overall survival seemed to parallel those on PFS. Conclusions Our data, as opposed to figures expected from the literature, highlighted that platinum-based regimens provoked an increased toxicity on proliferating cells, when dose intensity was maintained, or an as-expected toxicity, when dose intensity was reduced, while no change in toxicity and dose intensity was evident with AG. Furthermore, an apparently improved outcome of platinum-based triplets or quadruplets over other regimens was observed., Highlights • Nab-paclitaxel plus gemcitabine dose intensity and toxicity were as expected from the literature. • Toxicity with platinum-based triplets was unmodified to the price of consistently reduced dose intensity. • Dose intensity for platinum-based quadruplets was preserved to the price of greater hematological toxicity and diarrhea. • RECIST and CA19.9 responses were higher with platinum-based triplets and quadruplets in metastatic patients. • Longer progression-free and overall survival were observed with platinum-based three- and four-drug regimens in stage IV (AJCC/UICC TNM 8th Edition, 2017) patients.

Published
2021

25. Oxaliplatin plus fluoropyrimidines as adjuvant therapy for colon cancer in older patients: A subgroup analysis from the TOSCA trial

Author

Gerardo Rosati, Sara Lonardi, Fabio Galli, Maria Di Bartolomeo, Monica Ronzoni, Maria G. Zampino, Maria Banzi, Alberto Zaniboni, Felice Pasini, Silvia Bozzarelli, Silvio K. Garattini, Daris Ferrari, Vincenzo Montesarchio, Andrea Mambrini, Libero Ciuffreda, Francesca Galli, Valeria Pusceddu, Chiara Carlomagno, Paolo Bidoli, Domenico Amoroso, Anna M. Bochicchio, Luca Frassineti, Domenico Corsi, Domenico Bilancia, Alessandro Pastorino, Alfonso De Stefano, Roberto Labianca, D. Bilancia, G. Rosati, V. Montesarchio, R.V. Iaffaioli, G. Nasti, B. Daniele, V. Zagonel, S. Lonardi, N. Pella, G. Aprile, F. Pasini, Roma P. Marchetti, A. Romiti, L. Ciuffreda, D. Ferrari, P. Foa, A. Zaniboni, R. Labianca, S. Mosconi, A. Sobrero, P. Bidoli, M. Cazzaniga, G.D. Beretta, D.C. Corsi, E. Cortesi, S. Barni, F. Petrelli, P. Allione, A.M. D'Arco, G. Valmadre, E. Piazza, E. Veltri, G. Vietti Ramus, L. Giustini, S. Tumulo, S. Cascinu, C. Granetto, F. Testore, M. Giordano, M. Moroni, M. Di Seri, A. Nuzzo, L. Angelelli, S. Gori, G. Farina, M. Aglietta, R. Franchi, M. Comandé, P. Giordani, G. Tonini, E. Bucci, A. Ballestrero, M. Benasso, C. Graiff, S. Bravi, O. Caffo, R.R. Silva, L. Frontini, S. Rota, L. Cozzi, M. Cantore, E. Maiello, S. Cinieri, N. Silvestris, S. Romito, V. Gebbia, M. Banzi, A. Santoro, F. Artioli, R. Mattioli, A. Contu, F. Di Costanzo, F. Leonardi, L. Cavanna, R. Passalacqua, D. Amoroso, P. Sozzi, M. D'Amico, D. Amadori, L. Frassineti, D. Turci, A. Ravaioli, E. Pasquini, A. Gambi, M. Faedi, G. Cruciani, E. Bajetta, M. Di Bartolomeo, L. Gianni, M. Ronzoni, M.T. Ionta, B. Massidda, M. Scartozzi, M.G. Zampino, A.M. Bochicchio, A. Ciarlo, A. Di Leo, S. Frustaci, G. Rangoni, A. Arizzoia, L. Pavesi, C. Verusio, G. Pinotti, A. Iop, S. De Placido, C. Carlomagno, V. Adamo, C. Ficorella, D. Natale, E. Greco, E. Rulli, F. Galli, D. Poli, L. Porcu, V. Torri, Rosati, G, Lonardi, S, Galli, F, Di Bartolomeo, M, Ronzoni, M, Zampino, M, Banzi, M, Zaniboni, A, Pasini, F, Bozzarelli, S, Garattini, S, Ferrari, D, Montesarchio, V, Mambrini, A, Ciuffreda, L, Pusceddu, V, Carlomagno, C, Bidoli, P, Amoroso, D, Bochicchio, A, Frassineti, L, Corsi, D, Bilancia, D, Pastorino, A, De Stefano, A, Labianca, R, Iaffaioli, R, Nasti, G, Daniele, B, Zagonel, V, Pella, N, Aprile, G, Marchetti, R, Romiti, A, Foa, P, Mosconi, S, Sobrero, A, Cazzaniga, M, Beretta, G, Cortesi, E, Barni, S, Petrelli, F, Allione, P, D'Arco, A, Valmadre, G, Piazza, E, Veltri, E, Ramus, G, Giustini, L, Tumulo, S, Cascinu, S, Granetto, C, Testore, F, Giordano, M, Moroni, M, Di Seri, M, Nuzzo, A, Angelelli, L, Gori, S, Farina, G, Aglietta, M, Franchi, R, Comande, M, Giordani, P, Tonini, G, Bucci, E, Ballestrero, A, Benasso, M, Graiff, C, Bravi, S, Caffo, O, Silva, R, Frontini, L, Rota, S, Cozzi, L, Cantore, M, Maiello, E, Cinieri, S, Silvestris, N, Romito, S, Gebbia, V, Santoro, A, Artioli, F, Mattioli, R, Contu, A, Di Costanzo, F, Leonardi, F, Cavanna, L, Passalacqua, R, Sozzi, P, D'Amico, M, Amadori, D, Turci, D, Ravaioli, A, Pasquini, E, Gambi, A, Faedi, M, Cruciani, G, Bajetta, E, Gianni, L, Ionta, M, Massidda, B, Scartozzi, M, Ciarlo, A, Di Leo, A, Frustaci, S, Rangoni, G, Arizzoia, A, Pavesi, L, Verusio, C, Pinotti, G, Iop, A, De Placido, S, Adamo, V, Ficorella, C, Natale, D, Greco, E, Rulli, E, Poli, D, Porcu, L, Torri, V, Rosati, G., Lonardi, S., Galli, F., Di Bartolomeo, M., Ronzoni, M., Zampino, M. G., Banzi, M., Zaniboni, A., Pasini, F., Bozzarelli, S., Garattini, S. K., Ferrari, D., Montesarchio, V., Mambrini, A., Ciuffreda, L., Pusceddu, V., Carlomagno, C., Bidoli, P., Amoroso, D., Bochicchio, A. M., Frassineti, L., Corsi, D., Bilancia, D., Pastorino, A., De Stefano, A., Labianca, R., Iaffaioli, R. V., Nasti, G., Daniele, B., Zagonel, V., Pella, N., Aprile, G., Marchetti, R. P., Romiti, A., Foa, P., Mosconi, S., Sobrero, A., Cazzaniga, M., Beretta, G. D., Cortesi, E., Barni, S., Petrelli, F., Allione, P., D'Arco, A. M., Valmadre, G., Piazza, E., Veltri, E., Ramus, G. V., Giustini, L., Tumulo, S., Cascinu, S., Granetto, C., Testore, F., Giordano, M., Moroni, M., Di Seri, M., Nuzzo, A., Angelelli, L., Gori, S., Farina, G., Aglietta, M., Franchi, R., Comande, M., Giordani, P., Tonini, G., Bucci, E., Ballestrero, A., Benasso, M., Graiff, C., Bravi, S., Caffo, O., Silva, R. R., Frontini, L., Rota, S., Cozzi, L., Cantore, M., Maiello, E., Cinieri, S., Silvestris, N., Romito, S., Gebbia, V., Santoro, A., Artioli, F., Mattioli, R., Contu, A., Di Costanzo, F., Leonardi, F., Cavanna, L., Passalacqua, R., Sozzi, P., D'Amico, M., Amadori, D., Turci, D., Ravaioli, A., Pasquini, E., Gambi, A., Faedi, M., Cruciani, G., Bajetta, E., Gianni, L., Ionta, M. T., Massidda, B., Scartozzi, M., Ciarlo, A., Di Leo, A., Frustaci, S., Rangoni, G., Arizzoia, A., Pavesi, L., Verusio, C., Pinotti, G., Iop, A., De Placido, S., Adamo, V., Ficorella, C., Natale, D., Greco, E., Rulli, E., Poli, D., Porcu, L., Torri, V., and Corsi, D. C.

Subjects
0301 basic medicine, Oncology, Male, Cancer Research, Colorectal cancer, Leucovorin, Efficacy, Older patient, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, Stage (cooking), Aged, 80 and over, Colonic Neoplasm, Prognostic factor, Middle Aged, Prognosis, Colon cancer, Survival Rate, Oxaliplatin, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Colonic Neoplasms, Female, Fluorouracil, medicine.drug, Human, Compliance, Adult, medicine.medical_specialty, Prognosi, Adjuvant chemotherapy, Older patients, Prognostic factors, Subgroup analysis, Follow-Up Studie, 03 medical and health sciences, Internal medicine, Post-hoc analysis, medicine, Adjuvant therapy, Humans, Capecitabine, Cancer staging, Aged, Antineoplastic Combined Chemotherapy Protocol, business.industry, medicine.disease, 030104 developmental biology, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract

Background: Previous studies on oxaliplatin and fluoropyrimidines as adjuvant therapy in older patients with stage III colon cancer (CC) produced conflicting results. Patients and methods: We assessed the impact of age on time to tumour recurrence (TTR), disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) in 2360 patients with stage III CC (1667 aged

Published
2021

28. P30.02 Assessing SIADH (Syndrome of Inapproriate Antidiuretic Hormone Secretion) Management and Outcome Among Lung Cancer Patients: The Assert Trial

Author

M.C. Garassino, Erika Rijavec, Stefania Gori, R. Berardi, M. Scartozzi, V. De Marino, V. Montesarchio, Giuseppe Altavilla, G. Tonini, Luigi Cavanna, L. Palermo, Roberta Buosi, Daris Ferrari, Francesco Cognetti, M. Tiseo, Mariangela Torniai, Graziella Pinotti, Alberto Morabito, and Salvatore Palazzo

Subjects
Pulmonary and Respiratory Medicine, Oncology, medicine.medical_specialty, business.industry, Internal medicine, Medicine, Secretion, business, Lung cancer, medicine.disease, Hormone, Antidiuretic
Published
2021

29. 1479P Exploring second-line therapy outcome in pancreatic ductal adenocarcinoma (PDAC) patients with germlineBRCA1-2 pathogenic variants (gBRCA1-2pv)

Author

Enrico Vasile, U. Peretti, I. Bernardini, C. Paratore, Silvia Bozzarelli, Giulia Orsi, Michele Milella, Silvia Noventa, M.M. Valente, M. Scartozzi, Monica Niger, M. Macchini, I.G. Rapposelli, Andrea Spallanzani, M. Di Marco, Stefano Cascinu, Maria Grazia Rodriquenz, Guido Giordano, Floriana Nappo, and Michele Reni

Subjects
Oncology, medicine.medical_specialty, Second-line therapy, Pancreatic ductal adenocarcinoma, business.industry, Internal medicine, medicine, Hematology, business, Outcome (game theory)
Published
2021

31. Prognostic Role of a New Index (RAPID Index) in Advanced Hepatocellular Carcinoma Patients Receiving Sorafenib: Training and Validation Cohort

Author

Giulia Rovesti, Luca Faloppi, Fabio Gelsomino, Giorgio Ercolani, Eleonora Molinaro, Mario Domenico Rizzato, Andrea Casadei-Gardini, Alessandro Cucchetti, Kalliopi Andrikou, Laura Riggi, Stefano Cascinu, M. Scartozzi, Antonio Pellino, Matteo Canale, Fabio Conti, Giulia Orsi, Francesco Giuseppe Foschi, Sara Lonardi, Vincenzo Dadduzio, Giorgia Marisi, Andrea Spallanzani, Paola Ulivi, Paola Biason, Leonardo Solaini, Casadei-Gardini, A, Solaini, L, Riggi, L, Molinaro, E, Dadduzio, V, Rizzato, Md, Pellino, A, Faloppi, L, Marisi, G, Ulivi, P, Canale, M, Orsi, G, Rovesti, G, Andrikou, K, Spallanzani, A, Gelsomino, F, Foschi, Fg, Conti, F, Cucchetti, A, Ercolani, G, Biason, P, Lonardi, S, Cascinu, S, Scartozzi, M, Casadei-Gardini, Andrea, Solaini, Leonardo, Riggi, Laura, Molinaro, Eleonora, Dadduzio, Vincenzo, Rizzato, Mario Domenico, Pellino, Antonio, Faloppi, Luca, Marisi, Giorgia, Ulivi, Paola, Canale, Matteo, Orsi, Giulia, Rovesti, Giulia, Andrikou, Kalliopi, Spallanzani, Andrea, Gelsomino, Fabio, Foschi, Francesco Giuseppe, Conti, Fabio, Cucchetti, Alessandro, Ercolani, Giorgio, Biason, Paola, Lonardi, Sara, Cascinu, Stefano, and Scartozzi, Mario

Subjects
Sorafenib, medicine.medical_specialty, Index (economics), Lymphocyte, Pharmaceutical Science, Gastroenterology, chemistry.chemical_compound, Internal medicine, Lactate dehydrogenase, medicine, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Systemic inflammatory index, α-Fetoprotein, In patient, Neutrophil to lymphocyte ratio, alpha-Fetoprotein, business.industry, medicine.disease, medicine.anatomical_structure, chemistry, Hepatocellular carcinoma, business, Validation cohort, Research Article, medicine.drug
Abstract

Background and Aims: The aim of the present study is to evaluate a new index influenced by the balance between the immune system, α-fetoprotein (AFP), and lactate dehydrogenase (LDH) (RAPID index) as a prognostic factor in patients treated with sorafenib. Methods: This study was conducted on a training cohort of 159 hepatocellular carcinoma (HCC) patients and a validation cohort of 68 HCC patients treated with sorafenib. The RAPID index was calculated as neutrophil/lymphocyte count × LDH × AFP. Results: In the training cohort, the median overall survival (OS) was 23.2 months (95% CI 11–25) and 12.1 months (95% CI 9–15) for patients with a low (≤3,226) and high (>3,226) RAPID index, respectively (ref. p = 0.017). Following adjustment for clinical covariates, multivariate analysis confirmed the RAPID index ≤3,226 versus >3,226 (HR = 0.37, 95% CI 0.18–0.74, p = 0.0054) as an independent prognostic factor for OS. In the validation cohort, the median OS was 26.9 months (95% CI 17.6–26.9) and 7.0 months (95% CI 6.2–9.2) for patients with a low (≤ 3,226) and high (>3,226) RAPID index, respectively (ref. p < 0.0001). Performing the same multivariate analysis of the training cohort (AFP, Eastern Cooperative Oncology Group, aspartate aminotransferase, neutrophil, platelet, systemic inflammatory index and RAPID index), the RAPID index 3,226 (HR = 3.86, 95% CI 1.45–10.29, p = 0.007) was found to be an independent prognostic factor for predicting OS. Conclusion: The low cost, easy assessment, and reproducibility of a full blood count make the RAPID index a promising tool for assessing HCC prognosis in future clinical practice.

Published
2019

32. Assad’s Strategic Narrative: The Role of Communication in the Syrian Civil War

Author

Cesare M. Scartozzi

Subjects
050502 law, Cultural Studies, Economics and Econometrics, Sociology and Political Science, 05 social sciences, Crisis management, 050601 international relations, 0506 political science, Spanish Civil War, Law, Political Science and International Relations, Narrative, Sociology, Meaning (existential), 0505 law
Abstract

If Bashar al-Assad’s regime wants to survive in the Syrian civil war, it should be able to shape the meaning of its own actions in the conflict and efficiently convey them to the domestic and international audiences. In 2013, after two initial years of communication failures, the regime began delivering an assertive and coherent communication strategy that has created material and political support to al-Assad’s actions. This article analyzes the strategic narratives that the Syrian regime has used since the early outbreak of the civil war and it question the significance of strategic narrative in crisis management.

Published
2015

33. 65P Prognostic role of PECS2 index in advanced biliary tract cancer (BTC) patients treated with first line chemotherapy: Training and validation cohorts

Author

Eleonora Lai, N. Silvestris, F. de Braud, Silvia Cesario, G. Aprile, Hyungwoo Cho, Giovanni Brandi, Cheol-In Yoo, Monica Niger, Jae Ho Jeong, M. Scartozzi, A. Casadei Gardini, Francesco Leone, Massimo Aglietta, Roberto Filippi, Daniele Santini, Mariaelena Casagrande, Giulia Rovesti, Luca Faloppi, and Stefano Cascinu

Subjects
Oncology, medicine.medical_specialty, Biliary tract cancer, Index (economics), business.industry, Internal medicine, medicine, Hematology, First line chemotherapy, business
Published
2020

34. A New Taxonomy for International Relations: Rethinking the International System as a Complex Adaptive System

Author

Cesare M. Scartozzi

Subjects
International relations, Formal grammar, Computer science, Management science, Multidisciplinary approach, Taxonomy (general), Interoperability, Complex system, Information processing, Complex adaptive system
Abstract

The international system is a complex adaptive system with emergent properties and dynamics of self-organization and information processing. As such, it is better understood with a multidisciplinary approach that borrows methodologies from the field of complexity science and integrates them to the theoretical perspectives offered by the field of international relations (IR). This study is set to formalize a complex systems theory approach to the study of international affairs and introduce a new taxonomy for IR with the two-pronged aim of improving interoperability between different epistemological communities and outlining a formal grammar that set the basis for modeling international politics as a complex adaptive system.

Published
2018

35. Excessive range of statin dose in Western Australian primary care

Author

Simon B. Dimmitt, J. B. Warren, Hans G. Stampfer, A. Moran, and M. Scartozzi

Subjects
medicine.medical_specialty, Statin, business.industry, medicine.drug_class, Atorvastatin, nutritional and metabolic diseases, Pharmacy, Effective dose (pharmacology), Blood pressure, Internal medicine, Internal Medicine, medicine, Physical therapy, lipids (amino acids, peptides, and proteins), Rosuvastatin, cardiovascular diseases, Dosing, Medical prescription, business, medicine.drug
Abstract

Background Statins are very effective in reducing coronary disease and ischaemic stroke but guidelines although evolving have not been clear on statin dose. Aim To audit and review community statin prescribing. Methods A retrospective audit of the type and dose of statin dispensed was undertaken at five pharmacies in and around Perth, the capital city of Western Australia. Patients were de-identified. Results Statins made up 6.5% of all prescriptions. Statin dose when adjusted for different potency effectively varied 64-fold between patients. Rosuvastatin and atorvastatin accounted for 79% of prescriptions, at a mean dose of 10 times the effective dose 50. Conclusion The extraordinarily wide variation in statin dose is at odds with the more consistent doses of other drugs used in the management of arterial disease. Unnecessarily high statin dosing increases side-effects and may not improve clinical outcomes appreciably. Rational prescribing of statins based on the pharmacodynamic evidence, with lower doses in most patients, combined with close attention to reduction of smoking, blood pressure and weight, is likely to reduce arterial disease most efficiently and safely.

Published
2015

37. Immune Inflammation Indicators Predict Outcome in Anal Cancer Patients Undergoing Concurrent Chemoradiation

Author

Massimiliano Mistrangelo, Pierfrancesco Franco, Stefano Cascinu, Umberto Ricardi, Lorenzo Fornaro, C. Casadei, Kalliopi Andrikou, A. Casadei Gardini, Francesca Arcadipane, Paola Cassoni, Francesco Montagnani, G.C. Franco, and M. Scartozzi

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Radiation, business.industry, Concurrent chemoradiation, medicine.disease, Outcome (game theory), Internal medicine, Medicine, Anal cancer, Radiology, Nuclear Medicine and imaging, business, Immune inflammation
Published
2018

38. Robotic rehabilitation effect on upper limb recovery in post-acute stroke

Author

M. Gasperi, R. Coser, G. Grisenti, M. Scartozzi, N. Mazzini, E. Girardi, and D. Quaglia

Subjects
medicine.medical_specialty, medicine.anatomical_structure, Physical medicine and rehabilitation, business.industry, Rehabilitation, Biophysics, Medicine, Upper limb, Orthopedics and Sports Medicine, Robotic rehabilitation, business, Acute stroke
Published
2018

39. EP-1487: The prognostic role of haemoglobin in patients undergoing concurrent chemo-radiation for anal cancer

Author

Stefania Martini, C. Casadei, Kalliopi Andrikou, Paola Cassoni, Francesca Arcadipane, Lorenzo Fornaro, Francesco Montagnani, Massimiliano Mistrangelo, A. Casadei Gardini, Giuseppe Carlo Iorio, Pierfrancesco Franco, Stefano Cascinu, M. Scartozzi, and Umberto Ricardi

Subjects
Oncology, medicine.medical_specialty, business.industry, Internal medicine, medicine, Anal cancer, Radiology, Nuclear Medicine and imaging, In patient, Hematology, medicine.disease, business, Chemo radiation
Published
2018

40. EP-1461: Immune inflammation indicators in anal cancer patients treated with concurrent chemo-radiation

Author

C. Casadei, Giuseppe Carlo Iorio, Umberto Ricardi, Pierfrancesco Franco, Francesco Montagnani, Stefano Cascinu, Kalliopi Andrikou, Stefania Martini, Lorenzo Fornaro, Paola Cassoni, M. Scartozzi, A. Casadei Gardini, Massimiliano Mistrangelo, and Francesca Arcadipane

Subjects
Oncology, business.industry, Cancer research, Medicine, Anal cancer, Radiology, Nuclear Medicine and imaging, Hematology, business, medicine.disease, Chemo radiation, Immune inflammation
Published
2018

41. ASSERT: A prospective, observational study measuring sodium improvement and outcomes in patients treated for moderate to severe hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) in Italy (lung cancer cohort)

Author

M. Scartozzi, G. Lo Russo, Daris Ferrari, M. Tiseo, Erika Rijavec, Alessandro Morabito, C. Ferrara, V. De Marino, Roberta Buosi, M.G. Giustra, R. Berardi, Giuseppe Altavilla, Graziella Pinotti, R. Evans, and Luigi Cavanna

Subjects
medicine.medical_specialty, business.industry, Tolvaptan, Hematology, medicine.disease, Hypertonic saline, Clinical trial, Oncology, Internal medicine, Cohort, Syndrome of inappropriate antidiuretic hormone secretion, medicine, Clinical endpoint, Lung cancer, Hyponatremia, business, medicine.drug
Abstract

Background Hyponatremia (serum sodium concentration [Na+] Methods ASSERT was a prospective, observational, non-interventional study conducted from October 2015 to June 2017 in cancer patients requiring treatment for hyponatremia secondary to SIADH at 18 Italian oncology centres. Management of hyponatremia primarily included water restriction, tolvaptan and hypertonic saline, in accordance with local standard of care/guideline recommendations. The primary endpoint was change in serum [Na+] from baseline visit to end of the first month of the observational period, or earlier discontinuation. Results The full analysis set (FAS) included 68 adult cancer patients (lung cancer, n = 48, SCLC, n = 33). Group 1 patients received ≥1 dose of tolvaptan during the observational period; Group 2 patients did not receive tolvaptan. Overall survival (FAS) was significantly higher in Group 1 vs Group 2 (median 123 vs 56 days; p = 0.001), as was mean survival (299.4 vs 74.9 days; p = 0.001). In a linear regression analysis of the relationship between sodium levels and tolvaptan dose intensity for the lung cancer and SCLC cohorts, dose intensity correlated significantly with clinical response after 6 months of treatment in both cohorts (p = 0.005 and p = 0.023, respectively). In the lung cancer cohort, a significantly higher percentage of patients achieved serum [Na+] ≥130 mmol/L in Group 1 vs Group 2 during 6 months of follow-up (Group 1, 87.5% vs Group 2, 62.5%; p = 0.033). These results were similar to those observed in the FAS. Conclusions Hyponatremia secondary to SIADH is a potentially modifiable risk factor, which might be implicated in the survival of lung cancer patients. Correction of hyponatremia may be preferentially achieved with pharmacological treatment, rather than the non-pharmacological approaches routinely used in clinical practice. Clinical trial identification NCT102573077. Editorial acknowledgement Sarah Stowell PhD, CMPP of Ashley Medical Communications, funded by Otsuka Pharmaceutical Europe Ltd. Legal entity responsible for the study Otsuka Pharmaceutical Italy Srl. Funding Otsuka Pharmaceutical Italy Srl. Disclosure R. Berardi: Honoraria (self), Advisory / Consultancy: Otsuka Pharmaceutical. C. Ferrara: Full / Part-time employment: Otsuka Pharmaceutical Italy. M.G. Giustra: Full / Part-time employment: Otsuka Pharmaceutical Italy. R. Evans: Full / Part-time employment: Otsuka Pharmaceutical Europe. All other authors have declared no conflicts of interest.

Published
2019

42. AGT gene polymorphisms predict early dose modification of sorafenib for dermatological adverse events: towards tailored medicine for patients with hepatocellular carcinoma

Author

Francesco Tovoli, Pietro Lampertico, Enrico Galmozzi, Luca Faloppi, Carmine Tinelli, Massimo Iavarone, Fabio Piscaglia, Giorgia Marisi, Angelo Sangiovanni, Andrea Casadei-Gardini, A. De Silvestri, A. Cimino, Stefano Cascinu, M. Scartozzi, Fabio Facchetti, and Luca Ielasi

Subjects
Sorafenib, Oncology, medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, medicine.disease, Hepatocellular carcinoma, Internal medicine, medicine, Adverse effect, business, Gene, Dose Modification, medicine.drug
Published
2019

43. Validation of a simple scoring system to predict sorafenib effectiveness in patients with hepatocellular carcinoma

Author

M. Scartozzi, G. Cordone, Vincenzo Palmieri, Luca Faloppi, R. Tortora, G. Ercoloani, G.G. Di Costanzo, N. Silvestris, Stefano Cascinu, Giorgia Marisi, Francesco Giuseppe Foschi, R. Granata, A. Casadei Gardini, and Oronzo Brunetti

Subjects
Oncology, Sorafenib, medicine.medical_specialty, Scoring system, Hepatology, business.industry, Gastroenterology, medicine.disease, Simple (abstract algebra), Hepatocellular carcinoma, Internal medicine, medicine, In patient, business, medicine.drug
Published
2017

45. Excessive range of statin dose in Western Australian primary care

Author

S B, Dimmitt, A, Moran, M, Scartozzi, H G, Stampfer, and J B, Warren

Subjects
Stroke, Primary Health Care, Humans, Coronary Disease, Western Australia, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Practice Patterns, Physicians', Drug Prescriptions, Retrospective Studies
Abstract

Statins are very effective in reducing coronary disease and ischaemic stroke but guidelines although evolving have not been clear on statin dose.To audit and review community statin prescribing.A retrospective audit of the type and dose of statin dispensed was undertaken at five pharmacies in and around Perth, the capital city of Western Australia. Patients were de-identified.Statins made up 6.5% of all prescriptions. Statin dose when adjusted for different potency effectively varied 64-fold between patients. Rosuvastatin and atorvastatin accounted for 79% of prescriptions, at a mean dose of 10 times the effective dose 50.The extraordinarily wide variation in statin dose is at odds with the more consistent doses of other drugs used in the management of arterial disease. Unnecessarily high statin dosing increases side-effects and may not improve clinical outcomes appreciably. Rational prescribing of statins based on the pharmacodynamic evidence, with lower doses in most patients, combined with close attention to reduction of smoking, blood pressure and weight, is likely to reduce arterial disease most efficiently and safely.

Published
2014

46. Corrections to 'Cetuximab rechallenge in metastatic colorectal cancer patients: how to come away from acquired resistance?'

Author

Marco Imperatori, Olga Venditti, Giuseppe Tonini, Giuseppe Cicero, F. Recine, Carlo Garufi, Andrea Mancuso, Daniele Santini, Raffaele Addeo, Alfredo Falcone, Giuseppe Bronte, Anna Maria Frezza, Stefano Cascinu, Gaia Schiavon, Gianluca Masi, M. Scartozzi, Bruno Vincenzi, A. Russo, Evaristo Maiello, Santini, D., Vincenzi, B., Addeo, R., Garufi, C., Masi, G., Scartozzi, M., Mancuso, A., Frezza, A., Venditti, O., Imperatori, M., Schiavon, G., Bronte, G., Cicero, G., Recine, F., Maiello, E., Cascinu, S., Russo, A., Falcone, A., and Tonini, G.

Subjects
0301 basic medicine, Oncology, medicine.medical_specialty, Cetuximab, business.industry, Colorectal cancer, Hematology, medicine.disease, 03 medical and health sciences, 030104 developmental biology, Acquired resistance, Internal medicine, medicine, business, medicine.drug
Abstract

Nessuno

Published
2017

49. Primary tumor site (pTS) as a key factor in adjuvant treatment decision in resected N+ colorectal cancer patients

Author

Luca Cantini, Elena Maccaroni, M. Del Prete, Rossana Berardi, Andrea Lanese, M. Di Pietro Paolo, S. Delprete, Miriam Caramanti, G. Pusole, Tania Meletani, Alessandro Bittoni, M. Scartozzi, Maria Giuditta Baleani, Riccardo Giampieri, and Valeria Pusceddu

Subjects
Oncology, medicine.medical_specialty, Colorectal cancer, business.industry, medicine.medical_treatment, Hematology, medicine.disease, Tumor site, Internal medicine, medicine, Key (cryptography), Treatment decision making, business, Adjuvant
Published
2017

50. Second-line treatment efficacy in elderly vs. non-elderly advanced gastric cancer patients: an Italian multicentre real-world study

Author

Francesco Leone, Lorenzo Gerratana, Mario Uccello, A. Avallone, G. Aprile, Gerardo Rosati, Valentina Fanotto, Giorgia Peverelli, Saverio Cinieri, L. Fornaro, G. Tomasello, M. Scartozzi, S. Di Donato, Riccardo Giampieri, Daniele Santini, Francesca Battaglin, Antonio Pellegrino, Lorenza Rimassa, Davide Melisi, N. Silvestris, and Lorenzo Antonuzzo

Subjects
Oncology, medicine.medical_specialty, business.industry, Non elderly, Internal medicine, Medicine, Hematology, Advanced gastric cancer, Line (text file), business, Treatment efficacy
Published
2017

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