9 results on '"Tierno G"'
Search Results
2. 399P Role of geriatric assessment and oncological multidimensional prognostic index in elderly patients with metastatic colorectal cancer in a real-world setting
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Bergamo, F., primary, Brunello, A., additional, Procaccio, L., additional, Sergi, G., additional, Gatti, M., additional, Bergo, E., additional, Galiano, A., additional, Tierno, G., additional, Chiusole, B., additional, Feltrin, A., additional, Daniel, F., additional, Prete, A.A., additional, De Grandis, M.C., additional, Piva, V.M., additional, Barsotti, G., additional, Rasola, C., additional, Maddalena, G., additional, Cerma, K., additional, Lonardi, S., additional, and Zagonel, V., additional
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- 2022
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3. Comprehensive geriatric assessment (CGA) for outcome prediction in elderly patients (PTS) with glioblastoma (GBM): A mono-institutional experience
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Lombardi, G., primary, Bergo, E., additional, Bellu, L., additional, Caccese, M., additional, Lettiero, A., additional, Tierno, G., additional, Pambuku, A., additional, Brunello, A., additional, and Zagonel, V., additional
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- 2018
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4. P01.021 Comprehensive Geriatric Assessment (CGA) for outcome prediction in elderly patients (PTS)with glioblastoma (GBM): a mono-institutional experience
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Lombardi, G, Bergo, E, Bellu, L, Caccese, M, Lettiero, A, Tierno, G, Pambuku, A, Brunello, A, and Zagonel, V
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Poster Presentations ,Cancer Research ,Oncology ,Neurology (clinical) - Abstract
BACKGROUND: Treatment for GBM elderly PTS is still a challenge in neuro-oncology. Clinical tools, including CGA, are needed for improving treatment decision and outcome. To date, few studies exploring the impact of CGA on outcome have been performed in these PTS. The aim of this study was to evaluate CGA as a prognostic tool in terms of PFS and OS in elderly GBM PTS. MATERIAL AND METHODS: we performed a retrospective analysis of elderly PTS ≥ 65 years, treated at Veneto Institute of Oncology between January 2011 and January 2018, with newly histologically diagnosed GBM and receiving a baseline CGA after 3–4 weeks from surgery. CGA included the following domains: age, activities and instrumental activities of daily living (ADL, IADL), cognitive status(MMSE), mood (GDS), nutritional status (MNA), number of drugs, comorbidity (cumulative Illness Rating Scale-CIRS), presence of geriatric syndromes, presence of caregiver. PTS were classifiedaccording to Balducci’s criteria into Fit or Unfit (Frail and Vulnerable). RESULTS: 113 PTS were enrolled: 72 (64%) were male, KPS were ≥ 70 in 90 PTS (80%); 37 PTS (33%) had a radical surgery, 63% partial surgery and 4% received a biopsy. 90 PTS (80%) received Stupp treatment, 16 (14%) temozolomide or radiotherapy alone and, only 7 (6%) received no treatment. MGMT methylation status was analyzed in 96 PTS: 44% were metMGMT. According to CGA evaluation: 40 PTS (35.4%) were classified as Fit and 73 PTS (64.6%) Unfit. PFS was 11.2 (95% CI 6.0–16.4) and 7.2 (95% CI 5.8–8.6) months for Fit and Unfit PTS (p=0.1). On multivariate analysis, adjusted for type of surgery, MGMT methylation status and type of therapy, PFS wassignificantly different between the two groups (HR=0.6, 95% CI 0.2–0.9; p=0.04). OS was 16.4 (95% CI 14.6–18.2) and 10.6 (95% CI 8.3–12.8) ms for Fit and Unfit PTS (p=0.04); on multivariate analysis the HR was 0.51 (95% CI 0.2–0.9; p=0.04). CONCLUSION: CGA demonstrated significant outcome prediction in terms of OS and PFS, regardless of therapy. It could be a useful treatment decision-tool suggesting to treat FIT PTS with radiochemotherapy while a prospective study to evaluate the best treatment in Unfit PTS should be warrant.
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- 2018
5. 381PD - Comprehensive geriatric assessment (CGA) for outcome prediction in elderly patients (PTS) with glioblastoma (GBM): A mono-institutional experience
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Lombardi, G., Bergo, E., Bellu, L., Caccese, M., Lettiero, A., Tierno, G., Pambuku, A., Brunello, A., and Zagonel, V.
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- 2018
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6. Management and Outcomes of Older Patients (Age ≥ 70 Years) with Advanced Soft Tissue Sarcoma and Role of Geriatric Assessment and Oncological Multidimensional Prognostic Index (Onco-MPI) in a Real-World Setting.
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Chiusole B, Tortorelli I, Galiano A, Murtas F, Ahcene-Djaballah S, Tierno G, Bergo E, Banzato A, Gatti M, Di Maggio A, Sergi G, Rastrelli M, Sbaraglia M, Zagonel V, and Brunello A
- Abstract
Background: Incidences of soft tissue sarcomas (STS) steadily increase with age. Yet, despite the high prevalence in advanced age, older patients (pts) are underrepresented in sarcoma clinical trials and evidence-based guidelines for chemotherapy are lacking. International oncological societies suggest using geriatric tools to evaluate older patients with cancer to optimise treatment indication. Comprehensive geriatric assessment (CGA) is a multidimensional assessment of older subjects, based on which pts can be classified as fit, vulnerable or frail. Onco-MPI (multidimensional prognostic index) is a CGA-based score which also considers tumour characteristics, classifying pts into three risk groups of death at one year: high-risk, intermediate-risk and low-risk. Methods: This is a single-centre retrospective study which aims at describing real-word management and outcomes of older pts with advanced stage STS and at assessing the ability of CGA and onco-MPI to predict survival in these pts. Consecutive pts with advanced stage STS aged 70 years or older and treated at the Istituto Oncologico Veneto from January 2009 to June 2020 were retrieved from a prospectively maintained database. Pts' demographics, CGA assessments and tumour characteristics were analysed. Statistical analysis was performed with R version 3.4.3 Results: Out of 101 pts, with a median age of 77 years, 76 received chemotherapy (75.3%), which was anthracycline-based for 46 pts (60.5%). Anthracyclines were used in a higher proportion in fit pts (58.9% fit vs. 45.1% vulnerable vs. 12.5% frail pts). Frail pts and pts in the onco-MPI high-risk group experienced a higher rate of chemotherapy-related toxicities. Median OS was 13.8 months (95% CI 11.3-17.7 months). According to CGA, the median OS was 19.53 months (95% CI 15.23-36.8) for fit pts, 12.83 months (95% CI 9.7-17.5) for vulnerable and 7.75 months (95% CI 2.73-30) for frail pts ( p = 0.005). Onco-MPI confirmed a predictive value for 1-year survival with intermediate risk pts not reaching a median OS at 1 year, and high-risk pts having a median one-year OS of 11.5 months (95%CI 9.7-NA), p = 0.02. In multivariate analysis, onco-MPI and CGA were associated with survival (high risk onco-MPI: HR 5.5, 95%CI 1.25-24.7 p = 0.02; fitness at CGA HR 0.552 95% 0.314-0.973; p = 0.040) as well as chemotherapy use (HR 0.24, 95% CI 0.11-0.51, p < 0.005). Conclusions: Both CGA and onco-MPI retain prognostic value for survival in pts with metastatic STS. Pts frail/vulnerable at CGA and pts within the onco-MPI high risk category should be offered an oncogeriatric management approach in order to optimise treatment-related survival and reduce toxicity.
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- 2023
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7. The oncological multidimensional prognostic index is a promising decision-making tool: A real-world analysis in older patients with metastatic colorectal cancer.
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Procaccio L, Bergamo F, Gatti M, Chiusole B, Tierno G, Bergo E, Daniel F, Nappo F, Maddalena G, Rasola C, Barsotti G, De Grandis MC, Piva VM, Rizzato MD, Sergi G, Brunello A, Zagonel V, and Lonardi S
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- Aged, Humans, Prognosis, Geriatric Assessment methods, Colorectal Neoplasms drug therapy
- Abstract
Background: Approximately 50% of colorectal cancers occur in older patients. International societies recommend geriatric tools to optimise treatment of older patients. Comprehensive Geriatric Assessment (CGA) is a multidimensional assessment used to classify patients as fit, vulnerable, or frail. The CGA-based oncological multidimensional prognostic index (onco-MPI) also classifies patients as high-, intermediate-, or low-risk based on tumour characteristics. We investigated the role of CGA and onco-MPI in older patients with metastatic colorectal cancer (mCRC) in a real-world setting., Methods: Data for consecutive mCRC patients aged ≥70 years were retrieved from a prospectively maintained database from 2010 to 2020. We analyzed patients' and tumours' characteristics, and the CGA domains. Onco-MPI was calculated by a validated algorithm derived from CGA domains. Pearson's test was used to verify whether onco-MPI scores and chemotherapy administration were correlated., Results: The study included 488 mCRC patients with a mean age of 76.1 years. According to CGA, 52% of patients were fit, 28% vulnerable, and 20% frail. According to onco-MPI, 9% were low, 54% intermediate, and 37% high-risk. The median OS was 22.7 months. The following factors improved OS: 0-1 ECOG PS, low onco-MPI, fit based on CGA, chemotherapy administration, and doublet regimen. Chemotherapy administration significantly correlated with onco-MPI scores, leading to a survival gain regardless of the risk subgroups. First-line regimen had no impact on survival across the CGA and onco-MPI categories., Conclusion: CGA and onco-MPI scores confirmed their prognostic impact in older mCRC patients and may aid in decision-making and subgroup stratification in dedicated trials., Competing Interests: Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2022
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8. Comprehensive geriatric assessment is an independent prognostic factor in older patients with metastatic renal cell cancer treated with first-line Sunitinib or Pazopanib: a single center experience.
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Pierantoni F, Basso U, Maruzzo M, Lamberti E, Bimbatti D, Tierno G, Bergo E, Brunello A, and Zagonel V
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- Aged, Disease-Free Survival, Female, Geriatric Assessment, Humans, Indazoles, Male, Prognosis, Pyrimidines, Retrospective Studies, Sulfonamides, Sunitinib therapeutic use, Treatment Outcome, Carcinoma, Renal Cell drug therapy, Kidney Neoplasms drug therapy
- Abstract
Background: There is poor data on the prognostic role of Comprehensive Geriatric Assessment (CGA) in older patients with metastatic renal cell carcinoma (mRCC) treated with first line Tyrosine Kinase Inhibitors (TKIs)., Materials and Methods: We retrospectively reviewed the clinical charts of mRCC patients older than 70 years treated at our Institute with first-line Sunitinib or Pazopanib for at least 6 months. Every patient received a CGA at baseline and was identified as fit, vulnerable or frail according to Balducci's Criteria. We then assessed the impact of CGA category on survival, disease control and tolerability of TKIs., Results: We identified 86 eligible patients. Median age: 74.5 years, 56% males; 45.4% were fit, 37.2% vulnerable and 17.4% frail at CGA. There were no significant differences in the rate of Grade (G)1-2 and G3-4 toxicities, dose reduction rates, PFS and OS between Sunitinib and Pazopanib. Fit, vulnerable and frail patients achieved significantly different median PFS (18.9 vs 11.2 vs 5.1 months; p < 0.001) and OS (35.5 vs 14.6 vs 10.9 months; p < 0.001). Patients categorized as fit had higher chance of receiving a second-line treatment (66.6% vs 28.9% in vulnerable/frail; p = 0.002). The incidence of G3/4 events was significantly lower in the fit subgroup (19% vs 45% in vulnerable/frail; p = 0.0025)., Conclusions: In our retrospective single-center experience, CGA could accurately discriminate patients with higher risk of experiencing G3/4 toxicities, shorter PFS, and lower chance of receiving a second line treatment. CGA strongly impacted on OS, independently from International mRCC Database Consortium (IMDC) classification., Competing Interests: Declaration of Competing Interest UB declares the following COIs: advisory role for Janssen-Cilag, Incyte, Bristol-Meyers Squibb, MSD; research funding from Ipsen; and receiving speaker's fee from Bristol-Meyers Squibb, Pfizer, Sanofi Aventis, Janseen-Cilag and Novartis. AB declares the following COIs: advisory role for Eisai, Eli Lilly, Roche; travel or accommodations expenses from Pharmamar and Ipsen. VZ declares the following COIs: advisory role for Bristol-Meyers Squibb and Merck; speaker's fees from Bayer, Roche, Bristol-Meyers Squibb, Astellas Pharma, Servier, AstraZeneca and Eli Lilly; travel and accommodations expenses from Bayer, Roche and Servier. The other authors do not declare relevant conflicts of interest concerning the topic of this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
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- 2021
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9. Prevalence of pain in patients with cancer aged 70 years or older: A prospective observational study.
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Brunello A, Ahcene-Djaballah S, Lettiero A, Tierno G, Fiduccia P, Guglieri I, Dadduzio V, Maruzzo M, Schiavon S, Lonardi S, and Zagonel V
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- Affect, Aged, Aged, 80 and over, Analgesics, Opioid therapeutic use, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Cancer Pain drug therapy, Cancer Pain physiopathology, Cancer Pain psychology, Cognition, Female, Geriatric Assessment, Humans, Italy epidemiology, Linear Models, Logistic Models, Male, Neoplasms pathology, Neoplasms physiopathology, Neoplasms psychology, Pain drug therapy, Pain epidemiology, Pain physiopathology, Pain psychology, Pain Measurement, Prospective Studies, Sex Factors, Cancer Pain epidemiology, Frailty epidemiology, Neoplasms epidemiology
- Abstract
Background: Pain is a common symptom among patients with cancer, yet pain prevalence and management in older cancer pts. are poorly known., Methods: Patients aged ≥70 years referred to Istituto Oncologico Veneto IRCCS from January 2011 to December 2013 were evaluated with Comprehensive Geriatric Assessment (CGA). Pain was assessed by means of short form of McGill Pain Questionnaire (MPQ-sf), Brief Pain Inventory (BPI-sf), and numerical rating scale (NRS). Pts with completed CGA, no severe cognitive impairment and completed pain assessment were enrolled., Results: Enrolled patients were 745; 51% male, median age 76 years, median ECOG Performance Status (PS) 1. Frail patients at CGA were 45.2%. Patients with pain were 266 (35.7%). Mean Average Pain Intensity (API) was significantly higher among females, patients fit at CGA, with advanced disease, poorer PS and more comorbidity. Pain was detected by the oncologist in 20.4% of cases and deemed cancer-related in 54.8%. Gender, PS, status of disease, stage, function disability, mood, cognitive functioning and frailty were significantly associated with reporting of pain. At BPI, moderate-severe pain was found in 81 patients. The degree of agreement between API and pain intensity evaluated by physician was minimal. Patients on pain medications were 184, with 113 patients reporting rates of pain relief ≥50%., Conclusion: About one third of older patients with cancer report pain, which is not cancer-related in about half of cases. Female gender, fitness at CGA, advanced stage, poorer PS, higher number of comorbidities and primary site were associated with significant differences in pain reporting., (Copyright © 2019. Published by Elsevier Ltd.)
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- 2019
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