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1. Indicators of guideline-concordant care in lung cancer defined with a modified Delphi method and piloted in a cohort of over 5,800 cases

Author

Andreano, A, Valsecchi, M, Russo, A, Siena, S, Andruccioli, M, Ardizzoia, A, Assi, A, Baisi, A, Bedini, A, Beretta, G, Bersani, M, Bertagna, F, Berti, E, Bertolini, A, Bettini, A, Bignardi, M, Bini, F, Bna, C, Bono, F, Ottoni, D, Borghesi, A, Borghetti, P, Brunelli, A, Buffoli, A, Cacioppo, C, Calati, A, Calcagno, A, Casagrande, S, Casartelli, C, Castellani, M, Castro, A, Catalano, G, Catena, L, Ceresoli, G, Cergnul, M, Ciocia, G, Colombo, A, Conti, B, Corti, D, Cortinovis, D, Cozzi, C, Crippa, F, De Monte, A, Candis, D, De Toma, D, De Marinis, F, Dimarco, B, Di Nuovo, F, Doglioni, C, Fabbris, V, Faccioli, P, Fagnani, D, Farina, G, Fariselli, L, Filipazzi, V, Franzi, F, Frata, P, Gajate, A, Gardani, G, Gasparini, M, Giordano, M, Grignani, F, Landoni, C, Lombardi, C, Lombardi, F, Luciani, A, Maffioli, L, Marchione, R, Mariani, P, Maspero, A, Meriggi, F, Miedico, A, Morbini, P, Muriana, G, Orlandoni, G, Paris, E, Pedrazzoli, P, Pepe, G, Pezzica, E, Piccoli, F, Pinotti, G, Quadri, A, Ravasio, A, Ravenna, F, Ricchiuti, E, Rinaldo, D, Roda, G, Rossi, G, Santoro, A, Soatti, C, Stiglich, F, Tagliabue, L, Tirelli, V, Tironi, A, Tomirotti, M, Travaini, L, Ucci, G, Vaghi, A, Vanzulli, A, Veronesi, G, Vittimberga, I, Zambelli, C, Andreano A., Valsecchi M. G., Russo A. G., Siena S., Andruccioli M., Ardizzoia A., Assi A., Baisi A., Bedini A. V., Beretta G., Bersani M., Bertagna F., Berti E., Bertolini A., Bettini A., Bignardi M., Bini F., Bna C., Bono F., Ottoni D. B., Borghesi A., Borghetti P., Brunelli A., Buffoli A., Cacioppo C., Calati A., Calcagno A., Casagrande S., Casartelli C., Castellani M., Castro A., Catalano G., Catena L., Ceresoli G. L., Cergnul M., Ciocia G., Colombo A., Conti B., Corti D., Cortinovis D., Cozzi C., Crippa F., De Monte A., Candis D. D., De Toma D., De Marinis F., DiMarco B., Di Nuovo F., Doglioni C., Fabbris V., Faccioli P., Fagnani D., Farina G., Fariselli L., Filipazzi V., Franzi F., Frata P., Gajate A. M. S., Gardani G., Gasparini M., Giordano M., Grignani F., Landoni C., Lombardi C., Lombardi F., Luciani A., Maffioli L. S., Marchione R., Mariani P., Maspero A., Meriggi F., Miedico A., Morbini P., Muriana G., Orlandoni G., Paris E., Pedrazzoli P., Pepe G., Pezzica E., Piccoli F., Pinotti G., Quadri A., Ravasio A., Ravenna F., Ricchiuti E., Rinaldo D., Roda G., Rossi G., Santoro A., Soatti C. P., Stiglich F., Tagliabue L., Tirelli V., Tironi A., Tomirotti M., Travaini L. L., Ucci G., Vaghi A., Vanzulli A., Veronesi G., Vittimberga I., Zambelli C., Andreano, A, Valsecchi, M, Russo, A, Siena, S, Andruccioli, M, Ardizzoia, A, Assi, A, Baisi, A, Bedini, A, Beretta, G, Bersani, M, Bertagna, F, Berti, E, Bertolini, A, Bettini, A, Bignardi, M, Bini, F, Bna, C, Bono, F, Ottoni, D, Borghesi, A, Borghetti, P, Brunelli, A, Buffoli, A, Cacioppo, C, Calati, A, Calcagno, A, Casagrande, S, Casartelli, C, Castellani, M, Castro, A, Catalano, G, Catena, L, Ceresoli, G, Cergnul, M, Ciocia, G, Colombo, A, Conti, B, Corti, D, Cortinovis, D, Cozzi, C, Crippa, F, De Monte, A, Candis, D, De Toma, D, De Marinis, F, Dimarco, B, Di Nuovo, F, Doglioni, C, Fabbris, V, Faccioli, P, Fagnani, D, Farina, G, Fariselli, L, Filipazzi, V, Franzi, F, Frata, P, Gajate, A, Gardani, G, Gasparini, M, Giordano, M, Grignani, F, Landoni, C, Lombardi, C, Lombardi, F, Luciani, A, Maffioli, L, Marchione, R, Mariani, P, Maspero, A, Meriggi, F, Miedico, A, Morbini, P, Muriana, G, Orlandoni, G, Paris, E, Pedrazzoli, P, Pepe, G, Pezzica, E, Piccoli, F, Pinotti, G, Quadri, A, Ravasio, A, Ravenna, F, Ricchiuti, E, Rinaldo, D, Roda, G, Rossi, G, Santoro, A, Soatti, C, Stiglich, F, Tagliabue, L, Tirelli, V, Tironi, A, Tomirotti, M, Travaini, L, Ucci, G, Vaghi, A, Vanzulli, A, Veronesi, G, Vittimberga, I, Zambelli, C, Andreano A., Valsecchi M. G., Russo A. G., Siena S., Andruccioli M., Ardizzoia A., Assi A., Baisi A., Bedini A. V., Beretta G., Bersani M., Bertagna F., Berti E., Bertolini A., Bettini A., Bignardi M., Bini F., Bna C., Bono F., Ottoni D. B., Borghesi A., Borghetti P., Brunelli A., Buffoli A., Cacioppo C., Calati A., Calcagno A., Casagrande S., Casartelli C., Castellani M., Castro A., Catalano G., Catena L., Ceresoli G. L., Cergnul M., Ciocia G., Colombo A., Conti B., Corti D., Cortinovis D., Cozzi C., Crippa F., De Monte A., Candis D. D., De Toma D., De Marinis F., DiMarco B., Di Nuovo F., Doglioni C., Fabbris V., Faccioli P., Fagnani D., Farina G., Fariselli L., Filipazzi V., Franzi F., Frata P., Gajate A. M. S., Gardani G., Gasparini M., Giordano M., Grignani F., Landoni C., Lombardi C., Lombardi F., Luciani A., Maffioli L. S., Marchione R., Mariani P., Maspero A., Meriggi F., Miedico A., Morbini P., Muriana G., Orlandoni G., Paris E., Pedrazzoli P., Pepe G., Pezzica E., Piccoli F., Pinotti G., Quadri A., Ravasio A., Ravenna F., Ricchiuti E., Rinaldo D., Roda G., Rossi G., Santoro A., Soatti C. P., Stiglich F., Tagliabue L., Tirelli V., Tironi A., Tomirotti M., Travaini L. L., Ucci G., Vaghi A., Vanzulli A., Veronesi G., Vittimberga I., and Zambelli C.

Abstract

Background: To identify indicators of guideline-concordant care in lung cancer, to implement such indicators with cancer registry data linked to health databases, and to pilot them in a cohort of patients from the cancer registry of the Milan Province. Methods: Thirty-four indicators were selected by revision of main guidelines by cancer epidemiologists, and then evaluated by a multidisciplinary panel of clinicians involved in lung cancer care and working on the pathway of lung cancer diagnosis and treatment in the Lombardy region, Italy. With a modified Delphi method, they assessed for each indicator the content validity as a quality measure of the care pathway, the degree of modifiability from the health professional, and the relevance to the health professional. Feasibility was assessed using the cancer registry and the routine health records of the Lombardy region. Feasible indicators were then calculated in the cohort of lung cancer patients diagnosed in 2007–2012 derived from the cancer registry of the Milan Province. Criterion validity was assessed reviewing clinical records of a random sample of 114 patients (threshold for acceptable discordance ≤20%). Finally, reliability was evaluated at the provider level. Results: Initially, 34 indicators were proposed for evaluation in the first Delphi round. Of the finally 22 selected indicators, 3 were not feasible because the required information was actually not available. The remaining 19 were calculated on the pilot cohort. After assessment of criterion validity (3 eliminated), 16 indicators were retained in the final set and evaluated for reliability. Conclusion: The developed and piloted set of indicators is now available to implement and monitor, over time, quality initiatives for lung cancer care in the studied health system.

Published
2021

2. Multidisciplinary teams for the proper management of patients with genitourinary tumors: When topics set scientific societies’ agenda

Author

Magnani, T, Bracarda, S, D'Angelillo, R, Artibani, W, Barni, S, Beretta, G, Brausi, M, Caffo, O, Corvò, R, Gallucci, M, Gunelli, R, Mirone, V, Novara, G, Pinto, C, Russi, E, Santoni, R, Tomirotti, M, Volpe, A, Conti, G, Valdagni, R, 2, 1, Magnani, Tiziana, Bracarda, Sergio, D'Angelillo, Rolando M, Artibani, Walter, Barni, Sandro, Beretta, Giordano, Brausi, Maurizio, Caffo, Orazio, Corvò, Renzo, Gallucci, Michele, Gunelli, Roberta, Mirone, Vincenzo, Novara, Giacomo, Pinto, Carmine, Russi, Elvio, Santoni, Riccardo, Tomirotti, Maurizio, Volpe, Alessandro, Conti, Giario, and Valdagni, Riccardo

Subjects
Societies, Scientific, Cancer Research, genitourinary tumors, Genitourinary tumors, consensus conference, multidisciplinary approach, multidisciplinary team, statements, Medical Oncology, Settore MED/06, 030218 nuclear medicine & medical imaging, Task (project management), 03 medical and health sciences, 0302 clinical medicine, Settore MED/36, Multidisciplinary approach, Humans, Set (psychology), Italy, Health Policy, Urogenital Neoplasms, Health policy, Medical education, Genitourinary system, Consensus conference, Scientific, General Medicine, Genitourinary tumor, Oncology, 030220 oncology & carcinogenesis, Economic evaluation, Societies, Working group, Psychology
Abstract

Introduction: The multidisciplinary management of oncologic patients is identified as the bottom line element of quality in tumor care. Methods: In 2015, 7 Italian scientific societies representing the specialists involved in the diagnosis and treatment of genitourinary tumors joined efforts in the Italian uro-oncologic multidisciplinary teams (MDTs) project. The aims were to promote the reorganization of genitourinary cancer care, switching to a multidisciplinary approach, reach a consensus on the core elements for the setup of MDTs in genitourinary oncology, and support health policy makers and managers in remodeling of the assistance and care of uro-oncologic patients on a national level. Results: The first activity was the setup of 5 working groups, given the task of exploring selected topics: general principles, organization of MDTs, minimal requirements, economic evaluation, and relations with authorities. The groups participated in the writing of a document that was approved by the scientific societies and published on their web sites. Moreover, a few items summarizing the extensive document were approved in the first MDT Consensus Conference held in Milan in December 2015. Conclusions: The experience of this initial phase led to the opening of the team to other professionals and societies, in line with a correct management of patients with genitourinary tumors, which need a multidisciplinary as well as a multiprofessional approach with emerging techniques and procedures, and with a new project work package on genitourinary paths of care and indicators.

Published
2018
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8. Bridging Mediterranean cultures in the International Year of Soils 2015: a documentary exhibition on irrigation techniques in water scarcity conditions

Author

Barontini, S., primary, Boselli, V., primary, Louki, A., primary, Ben Slima, Z., primary, Ghaouch, F. E., primary, Labaran, R., primary, Raffelli, G., primary, Peli, M., primary, Al Ani, A. M., primary, Vitale, N., primary, Borroni, M., primary, Martello, N., primary, Bettoni, B., primary, Negm, A., primary, Grossi, G., primary, Tomirotti, M., primary, Ranzi, R., primary, and Bacchi, B., primary

Published
2017
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9. 'Incidence of different KRAS mutation in non-small cell lung cancer (NSCLC) patients, TAILOR STUDY

Author

Martelli,O, Rulli,E, Bettini,A, Farina,G, Longo,F, Moscetti,L, Pavese,I, Alabiso,O, Bertolini,A, Tomirotti,M, Farris,A, Veronese,S, Ferrari,V, Marsoni,S, Lauricella,C, Ganzinelli,M, Broggini,M, Marabese,M, Floriani,I, Copreni,E, Pellegrino,A, Ardizzoia,A, Gherardi,G, Bianchi,F, Scanni,A, Garassino,MC, PALMERI, Sergio, Martelli,O, Rulli,E, Bettini,A, Farina,G, Longo,F, Moscetti,L, Pavese,I, Alabiso,O, Bertolini,A, Tomirotti,M, Farris,A, Veronese,S, Ferrari,V, Marsoni,S, Lauricella,C, Ganzinelli,M, Broggini,M, Marabese,M, Floriani,I, Copreni,E, Pellegrino,A, Ardizzoia,A, Palmeri,S, Gherardi,G, Bianchi,F, Scanni,A, and Garassino,MC

Subjects
non-small cell lung cancer,TAILOR,kras
Published
2011

10. The impact of antithrombotic prophylaxis on infectious complications in cancer patients with central venous catheters: an observational study

Author

Fagnani D, Bertolini A, Catena L, Tomirotti M, Visini M, Alatri A, De Paoli A, Aondio GM, Milani M, Arpaia G, Cimminiello C, Franchi R, Porta C, Pugliese P, Borgonovo K, Duro M, Ardizzoia A, Filipazzi V, Isa L, Vergani C, Carpenedo M, VIALE, PIERLUIGI, Fagnani D, Bertolini A, Catena L, Tomirotti M, Visini M, Alatri A, De Paoli A, Aondio GM, Milani M, Arpaia G, Cimminiello C, Franchi R, Porta C, Pugliese P, Borgonovo K, Duro M, Ardizzoia A, Filipazzi V, Isa L, Vergani C, Carpenedo M, and Viale P

Subjects
Male, Catheterization, Central Venous, medicine.medical_specialty, Prosthesis-Related Infections, medicine.medical_treatment, central venous catheter, PROPHYLAXIS, Cohort Studies, Fibrinolytic Agents, Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Antithrombotic, medicine, Humans, Prospective Studies, Neoplasm Staging, business.industry, Incidence (epidemiology), Warfarin, Hematology, General Medicine, Odds ratio, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Surgery, Catheter, Venous thrombosis, Treatment Outcome, Italy, Regression Analysis, Female, Complication, business, Central venous catheter, Follow-Up Studies, medicine.drug
Abstract

Infections in cancer patients after implantation of a central venous device (CVD) are not infrequent and are potentially serious. The possibility of limiting this complication with antithrombotic drugs is still debated. For this observational study, we recorded the routine management of CVD in cancer patients in 18 oncology centers in Lombardy (northern Italy), assessing the effect of antithrombotic prophylaxis on catheter-related infections. Out of 1410 patients enrolled, 451 received antithrombotic prophylaxis continuously after implantation of the central line. During a median follow-up of 30 months, 57 catheter-related infections were reported in the 1390 patients seen at least once at follow-up visits (4.1 % of the whole series), giving an overall incidence of 0.10 infections per 1000 catheter days. This complication was significantly more frequent among patients with an indwelling central venous catheter, or peripherally inserted catheter, than among those with a port device, and the group not given antithrombotic prophylaxis had 0.14 infective complications/1000 CVD days compared with 0.05/1000 CVD days (odds ratio 2.4; 95% confidence interval 1.7-5.0) for those treated. Antithrombotic prophylaxis protected against infections at the catheter exit site and track but not against systemic infections. Confirming earlier evidence, this study found a reduction in catheter-related infections in patients given antithrombotic prophylaxis. However, this reduction, reflecting local infections, seems unlikely to be one of the mechanisms explaining the lower mortality among our patients treated with anticoagulants.

Published
2009

13. Nadroparin for the prevention of thromboembolic events in ambulatory patients with metastatic or locally advanced solid cancer receiving chemotherapy: a randomised, placebo-controlled, double-blind study

Author

Agnelli, G, Gussoni, G, Bianchini, C, Verso, M, Mandalà, M, Cavanna, L, Barni, S, Labianca, R, Buzzi, F, Scambia, G, Passalacqua, R, Ricci, S, Gasparini, G, Lorusso, V, Bonizzoni, E, Tonato, M, PROTECHT Investigators Agnelli, G, Amadori, D, Barbui, T, Cognetti, F, Crinò, L, Mannucci, Pm, Moia, M, Gianni, L, Prandoni, P, Cesana, B, de Braud, F, Del Favero, A, Lazzaro, A, Anselmi, E, Mordenti, P, Cabiddu, M, Petrelli, F, Ghilardi, M, Poletti, P, Marelli, B, Fumagalli, D, Sabatini, S, Fumi, G, Masi, C, Salutari, V, Malaggese, M, Brighenti, M, Lazzarelli, S, Donati, G, Di Donato, S, Arrighi, G, Orlandini, C, Amici, S, Verì, A, Sarmento, R, Pollera, C, Capomolla, E, Moschetti, L, Garufi, C, Campanella, C, Torsello, A, Misino, A, Ciuffreda, L, Dongiovanni, V, Addeo, A, Vitale, Fv, Ferraù, F, Priolo, D, Muggiano, A, Mulas, C, Tedde, A, Pogliani, Ea, Ardizzoia, A, Villa, F, Montedoro, M, Bravi, S, Biagioni, F, Palazzo, S, Filice, A, Gori, S, Porrozzi, S, Ciccarese, M, Petrucelli, L, Chiuri, Ve, Passardi, A, Ravaioli, E, Ceravolo, R, Crivellari, G, Nicoletto, Mo, Brandes, A, Bertolini, S, Benedetti, G, Bernardo, G, Teragni, C, Jirillo, A, Falci, C, Santoro, A, Masci, G, Monti, M, Casanova, C, Intrivici, C, Rinaldi, G, Massidda, B, Ionta, Mt, Dogliotti, Luigi, Russo, L, Collovà, E, Luoni, M, Maiello, E, Romano, Mp, Molica, S, Battaglia, C, Doni, L, Di Costanzo, F, Giuliodori, L, Silva, Rr, Sarobba, Mg, Pinna, A, Sorarù, M, Gaion, F, Ferrandina, G, Gilli, G, Locatelli, Mc, Zanaboni, F, Bologna, A, Ferretti, G, Chini, C, Farina, G, Bronner, L, Biscottini, B, Tomirotti, M, and Sciacca, V.

Published
2009

17. Microwave Remote Sensing of Snow Melting

Author

Cagnati A., Crepaz A., Macelloni G., Paloscia S., Pampaloni P., Ranzi R., Ruisi R., Santi E., Tedesco M., Tomirotti M., Valt M., and Zasso R.

Published
2003

23. Endocrine therapy of breast cancer. The experience of the Italian Cooperative Group for Chemohormonal Therapy of Early Breast Cancer (GROCTA)

Author

Boccardo, Francesco, Amoroso, D, Rubagotti, Alessandra, Sismondi, P, Desanctis, C, Cappellini, M, Pacini, P, Castagnetta, L, Traina, A, Farris, A, Iacobelli, S, Mustacchi, G, Nenci, I, Villa, E, Aldrighetti, D, Mesiti, M, Schieppati, G, Giovaninetti, A, Piatto, E, Epifani, C, Scognamiglio, G, Spinelli, I, Venturini, S, Malacarne, P, Donati, D, Piano, A, Gallo, L, Rinaldi, E, Biasioli, R, Smerieri, F, Pini, M, Visca, V, Mensi, F, Scapaticci, R, Silvani, A, Benetti, Gp, Banducci, R, Scanni, A, Tomirotti, M, Bolognesi, A, Palazzotto, G, Dicarlo, A, Canaletti, R, Rodino, C, Trompeo, P, Allara, L, Marangolo, M, Cruciani, G, Saccani, F, Sassi, M, Beni, A, Gatti, C, Burani, G, Galletto, L, Genta, F, Delazzer, F, Marsilio, B, Buzzi, F, Bartolucci, R, Delia, Svanosio, M, Rolfo, F, Castagna, B, Daddato, F, Repinto, Crucitti, F, and Lombardi, C.

Published
1993

31. Chemotherapy in advanced ovarian cancer: Four systematic meta-analyses of individual patient data from 37 randomized trials

Author

Aabo, K, Adams, M, Adnitt, P, Alberts, DS, Athanazziou, A, Barley, V, Bell, DR, Bianchi, U, Bolis, G, Brady, MF, Brodovsky, HS, Bruckner, H, Buyse, M, Canetta, R, Chylak, V, Cohen, CJ, Colombo, N, Conte, PF, Crowther, D, Edmonson, JH, Gennatas, C, Gilbey, E, Gore, M, Guthrie, D, Kaye, SB, Laing, AH, Landoni, F, Leonard, RC, Lewis, C, Liu, PY, Mangioni, C, Marsoni, S, Meerpohl, H, Omura, GA, Parmar, MKB, Pater, J, Pecorelli, S, Presti, M, Sauerbrei, W, Skarlos, DV, Smalley, RV, Solomon, HJ, Stewart, LA, Sturgeon, JFG, Tattersall, MHN, Wharton, JT, Ten Bokkel Huinink, WW, Tomirotti, M, Torri, W, Trope, C, Turbow, MM, Vermorken, JB, Webb, MJ, Wilbur, DW, Williams, CJ, Wiltshaw, E, Yeap, BY, Aabo, K, Adams, M, Adnitt, P, Alberts, DS, Athanazziou, A, Barley, V, Bell, DR, Bianchi, U, Bolis, G, Brady, MF, Brodovsky, HS, Bruckner, H, Buyse, M, Canetta, R, Chylak, V, Cohen, CJ, Colombo, N, Conte, PF, Crowther, D, Edmonson, JH, Gennatas, C, Gilbey, E, Gore, M, Guthrie, D, Kaye, SB, Laing, AH, Landoni, F, Leonard, RC, Lewis, C, Liu, PY, Mangioni, C, Marsoni, S, Meerpohl, H, Omura, GA, Parmar, MKB, Pater, J, Pecorelli, S, Presti, M, Sauerbrei, W, Skarlos, DV, Smalley, RV, Solomon, HJ, Stewart, LA, Sturgeon, JFG, Tattersall, MHN, Wharton, JT, Ten Bokkel Huinink, WW, Tomirotti, M, Torri, W, Trope, C, Turbow, MM, Vermorken, JB, Webb, MJ, Wilbur, DW, Williams, CJ, Wiltshaw, E, and Yeap, BY

Abstract

The purpose of this systematic study was to provide an up to date and reliable quantitative summary of the relative benefits of various types of chemotherapy (non-platinum vs platinum, single-agent vs combination and carboplatin vs cisplatin) in the treatment of advanced ovarian cancer. Also, to investigate whether well-defined patient subgroups benefit more or less from cisplatin- or carboplatin-based therapy. Meta-analyses were based on updated individual patient data from all available randomized controlled trials (published and unpublished), including 37 trials, 5667 patients and 4664 deaths. The results suggest that platinum-based chemotherapy is better than non-platinum therapy, show a trend in favour of platinum combinations over single-agent platinum, and suggest that cisplatin and carboplatin are equally effective. There is no good evidence that cisplatin is more or less effective than carboplatin in any particular subgroup of patients.

Published
1998

41. Rationale for Treatment and Study Design of TAILOR: A Randomized Phase III Trial of Second-line Erlotinib Versus Docetaxel in the Treatment of Patients Affected by Advanced Non-Small-Cell Lung Cancer With the Absence of Epidermal Growth Factor Receptor Mutations.

Author

Farina G, Longo F, Martelli O, Pavese I, Mancuso A, Moscetti L, Labianca R, Bertolini A, Cortesi E, Farris A, Fagnani D, Locatelli MC, Valmadre G, Ardizzoia A, Tomirotti M, Rulli E, Garassino MC, and Scanni A

Published
2011
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43. Cetuximab-induced acneiform eruption and the response to isotretinoin

Author

M. Tomirotti, Emilio Berti, Barbara Galassi, Elvio Alessi, Pamela Vezzoli, Angelo V. Marzano, Francesco Onida, Vezzoli, P, Marzano, A, Onida, F, Alessi, E, Galassi, B, Tomirotti, M, and Berti, E

Subjects
medicine.medical_specialty, Cetuximab, business.industry, cetuximab, egf, skin eruption, Dermatology, General Medicine, Acneiform eruption, MED/35 - MALATTIE CUTANEE E VENEREE, medicine, medicine.symptom, business, Isotretinoin, medicine.drug
Published
2008

44. Combined treatment with high-dose methotrexate, vincristine and procarbazine, without intrathecal chemotherapy, followed by consolidation radiotherapy for primary central nervous system lymphoma in immunocompetent patients

Author

Eugenio Villa, Andrés J.M. Ferreri, Michele Reni, Maurilio Ponzoni, Massimo Bernardi, Michele Spina, Maria Rosa Terreni, Lionello Camba, Fabio Ciceri, M. Tomirotti, Stefania Dell'Oro, Ferreri, Ajm, Reni, M, Dell'Oro, S, Ciceri, Fabio, Bernardi, M, Camba, L, Ponzoni, Maurilio, Terreni, Mr, Tomirotti, M, Spina, M, and Villa, E.

Subjects
Adult, Male, Antimetabolites, Antineoplastic, Cancer Research, Vincristine, medicine.medical_specialty, Lymphoma, medicine.medical_treatment, Salvage therapy, Procarbazine, Drug Administration Schedule, Central Nervous System Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Meningeal Neoplasms, medicine, Humans, Prospective Studies, Aged, Chemotherapy, Brain Neoplasms, business.industry, Primary central nervous system lymphoma, General Medicine, Middle Aged, medicine.disease, Antineoplastic Agents, Phytogenic, Survival Analysis, Surgery, Radiation therapy, Methotrexate, Treatment Outcome, Oncology, Chemotherapy, Adjuvant, Concomitant, Feasibility Studies, Female, Radiotherapy, Adjuvant, business, Progressive disease, medicine.drug
Abstract

Objectives: To assess the feasibility and the activity, as well as the efficacy to treat meninges, of chemotherapy (CHT) containing high-dose methotrexate (HD-MTX) followed by radiation therapy (RT), without intrathecal CHT, in patients with primary central nervous system lymphoma. Methods: Eligibility criteria were histologically proven diagnosis, disease limited to the CNS, age ≤70, ECOG performance status ≤3, HIV-negative and no prior treatment. Thirteen patients (1996–1999; median age 54 years) received two courses of vincristine 1.4 mg/m2 day 1, MTX 3 g/m2 days 3 and 10 and procarbazine 100 mg/m2 days 1–14 every 4 weeks. Patients who achieved a complete remission were referred to RT, those with progressive disease were excluded from further study; all the remaining patients received a third course of CHT followed by RT. Results: Twelve patients responded to CHT (overall response rate = 92%, complete response rate = 77%): 9 underwent consolidation RT, 3 did not. Two patients experienced severe acute toxicity; lethal pulmonary thromboembolism and transient renal failure. Five patients relapsed: 2 after CHT and 3 after RT. Relapse was local in all cases, with a case of concomitant hepatic involvement. No cases of ocular or meningeal relapse were observed. In contrast to high-dose cytarabine-containing CHT, salvage therapy with temozolomide produced good results. Two patients died of treatment-related neurotoxicity. Six patients are alive with a median follow-up of 17 months, and a 2-year overall survival (OS) of 61%. The median survival of the 9 patients who completed the planned treatment is 25+ months with a 2-year OS of 80%. Conclusions: HD-MTX, procarbazine and vincristine followed by RT, without intrathecal therapy, produce similar results with respect to other HD-MTX-containing regimens. These results seem to suggest that adequate meningeal treatment is possible without intrathecal drug delivery, even in CSF-positive patients. Corroborating data from a larger series are, however, necessary. Temozolomide should be tested in relapsed patients in a phase II prospective trial.

Published
2001

45. Conflict of interest among Italian medical oncologists: a national survey.

Author

DeCensi A, Numico G, Ballatori E, Artioli F, Clerico M, Fioretto L, Livellara V, Ruggeri B, Tomirotti M, Verusio C, and Roila F

Subjects
Adult, Aged, Cross-Sectional Studies, Disclosure, Female, Financial Support, Humans, Internet, Italy, Male, Medical Oncology economics, Middle Aged, Surveys and Questionnaires, Conflict of Interest, Drug Industry ethics, Medical Oncology ethics, Oncologists ethics
Abstract

Objectives: To assess Italian medical oncologists' opinion on the implications of conflict of interest (COI) on medical education, care and research, and to evaluate their direct financial relationships., Design: National cross-sectional survey conducted between March and April 2017 among Italian oncologists., Setting: Online survey sponsored by the Italian College of Medical Oncology Chiefs through its website., Participants: Italian oncologists who filled out an anonymous questionnaire including 19 items and individual and working characteristics., Main Outcome Measure: The proportion of medical oncologists perceiving COI as an outstanding issue and those receiving direct payments from industry., Results: There were 321 respondents, representing 13% of Italian tenured medical oncologists. Overall, 62% declared direct payments from the pharmaceutical industry in the last 3 years. Sixty-eight per cent felt the majority of Italian oncologists have a COI with industry, but 59% suppose this is not greater than that of other specialties. Eighty-two per cent consider that most oncology education is supported by industry. More than 75% believe that current allocation of industry budget on marketing and promotion rather than research and development is unfair, but 75% consider it appropriate to receive travel and lodging hospitality from industry. A median net profit margin of €5000 per patient enrolled in an industry trial was considered appropriate for the employee institution. Sixty per cent agree to receive a personal fee for patients enrolled in industry trials, but 79% state this should be reported in the informed consent. Over 90% believe that scientific societies should publish a financial report of industry support. Finally, 79% disagree to being a coauthor of an article written by a medical writer when no substantial scientific contribution is made., Conclusions: Among Italian oncologists COI is perceived as an important issue influencing costs, education, care and science. A more rigorous policy on COI should be implemented., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Published
2018
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46. Temporary ovarian suppression during chemotherapy to preserve ovarian function and fertility in breast cancer patients: A GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology.

Author

Lambertini M, Cinquini M, Moschetti I, Peccatori FA, Anserini P, Valenzano Menada M, Tomirotti M, and Del Mastro L

Subjects
Chemotherapy, Adjuvant, Female, Fertility drug effects, Humans, Antineoplastic Agents, Hormonal therapeutic use, Breast Neoplasms drug therapy, Fertility Preservation methods, Gonadotropin-Releasing Hormone analogs & derivatives, Primary Ovarian Insufficiency prevention & control
Abstract

The development of premature ovarian failure and subsequent infertility are possible consequences of chemotherapy use in pre-menopausal women with early-stage breast cancer. Among the available strategies for fertility preservation, pharmacological protection of the ovaries using luteinising hormone-releasing hormone analogues (LHRHa) during chemotherapy has the potential to restore ovarian function and fertility after anticancer treatments; however, the possible efficacy and clinical application of this strategy has been highly debated in the last years. Following the availability of new data on this controversial topic, the Panel of the Italian Association of Medical Oncology (AIOM) Clinical Practice Guideline on fertility preservation in cancer patients decided to apply the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology around the relevant and current question on the clinical utility of temporary ovarian suppression with LHRHa during chemotherapy as a strategy to preserve ovarian function and fertility in breast cancer patients. To answer this question, preservation of ovarian function and fertility were judged as critical outcomes for the decision-making. Three possible outcomes of harm were identified: LHRHa-associated toxicities, potential antagonism between concurrent LHRHa and chemotherapy, and lack of the prognostic impact of chemotherapy-induced premature ovarian failure. According to the GRADE evaluation conducted, the result was a strong positive recommendation in favour of using this option to preserve ovarian function and fertility in breast cancer patients. The present manuscript aims to update and summarise the evidence for the use of this strategy in light of the new data published up to January 2016, according to the GRADE process., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Published
2017
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47. Secondary breast angiosarcoma and paclitaxel-dependent prolonged disease control: report of two cases and review of the literature.

Author

Gambini D, Visintin R, Locatelli E, Bareggi C, Galassi B, Runza L, Blundo C, Sosnovskikh I, and Tomirotti M

Subjects
Aged, 80 and over, Antineoplastic Agents, Phytogenic administration & dosage, Drug Administration Schedule, Female, Humans, Induction Chemotherapy, Middle Aged, Paclitaxel administration & dosage, Treatment Outcome, Antineoplastic Agents, Phytogenic therapeutic use, Breast Neoplasms drug therapy, Breast Neoplasms prevention & control, Hemangiosarcoma drug therapy, Hemangiosarcoma prevention & control, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local prevention & control, Paclitaxel therapeutic use
Abstract

Secondary breast angiosarcomas are a well-known entity generally characterized by a poor outcome, especially in patients with advanced disease. Among the drugs with demonstrated activity, taxane derivatives are one of the most effective histology-driven treatments against angiosarcomas. We report two cases of secondary breast angiosarcoma, both characterized by a very peculiar behavior towards paclitaxel. Both patients showed local recurrence of angiosarcoma after primary surgery, and they achieved complete remission following treatment with weekly paclitaxel. When a locoregional recurrence was observed as a result of a brief treatment interruption or a treatment delay, a new complete remission was rapidly achieved with the resumption of the drug, without evidence of any significant adverse effects.

Published
2015
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48. Sunitinib-induced complete response in metastatic renal cancer expressing neuroendocrine markers: a new predictive factor?

Author

Gambini D, Locatelli E, Gianelli U, Bareggi C, Galassi B, Visintin R, Massironi S, Dell'orto PG, and Tomirotti M

Subjects
Angiogenesis Inhibitors therapeutic use, Antineoplastic Agents therapeutic use, Biomarkers, Tumor biosynthesis, Carcinoma, Renal Cell surgery, Humans, Kidney Neoplasms pathology, Kidney Neoplasms surgery, Male, Middle Aged, Nephrectomy, Pancreatic Neoplasms secondary, Positron-Emission Tomography, Sunitinib, Carcinoma, Renal Cell drug therapy, Indoles therapeutic use, Kidney Neoplasms drug therapy, Pancreatic Neoplasms drug therapy, Pyrroles therapeutic use
Abstract

Background: To date, no predictive factors are recognized and applied in the therapeutic choice for metastatic renal cell carcinoma. Due to significant side-effects and costs, which are relevant issues in this setting, optimization of treatments has become a priority., Case Report: We herein report a case of complete remission of metastatic renal cell carcinoma after 1 year of treatment with sunitinib. Since pancreatic metastases were detected by a 68Ga-DOTA-NOC positron emission tomography, it was decided to perform a histological revision of the specimens, with immunohistochemical staining for neuroendocrine markers on the primary tumor., Conclusion: On the basis of the detection of neuroendocrine markers on the primary neoplasm, together with pancreatic metastases positive on a 68Ga-DOTA-NOC positron emission tomography (PET), we hypothesize and discuss about a potential role of specific neuroendocrine markers as predictive indicators of response to sunitinib (and allegedly to other target therapies) in the treatment of this neoplasm., (Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Published
2014

49. Remission of autoimmune hyperthyroidism after chemotherapy for cancer.

Author

Baldini M, Gambini D, Airaghi L, Tomirotti M, and Cappellini MD

Subjects
Adult, Antithyroid Agents administration & dosage, Breast Neoplasms epidemiology, Breast Neoplasms physiopathology, Carcinoma, Ductal, Breast epidemiology, Carcinoma, Ductal, Breast physiopathology, Comorbidity, Female, Graves Disease drug therapy, Graves Disease epidemiology, Graves Disease physiopathology, Humans, Methimazole administration & dosage, Remission Induction, Thyroxine blood, Triiodothyronine blood, Breast Neoplasms drug therapy, Carcinoma, Ductal, Breast drug therapy, Graves Disease therapy
Published
2014
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50. Erlotinib versus docetaxel as second-line treatment of patients with advanced non-small-cell lung cancer and wild-type EGFR tumours (TAILOR): a randomised controlled trial.

Author

Garassino MC, Martelli O, Broggini M, Farina G, Veronese S, Rulli E, Bianchi F, Bettini A, Longo F, Moscetti L, Tomirotti M, Marabese M, Ganzinelli M, Lauricella C, Labianca R, Floriani I, Giaccone G, Torri V, Scanni A, and Marsoni S

Subjects
Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung mortality, Disease-Free Survival, Docetaxel, ErbB Receptors genetics, Erlotinib Hydrochloride, Female, Humans, Lung Neoplasms mortality, Male, Middle Aged, Mutation, Proto-Oncogene Proteins genetics, Proto-Oncogene Proteins p21(ras), ras Proteins genetics, Antineoplastic Agents therapeutic use, Carcinoma, Non-Small-Cell Lung drug therapy, ErbB Receptors antagonists & inhibitors, Lung Neoplasms drug therapy, Protein Kinase Inhibitors therapeutic use, Quinazolines therapeutic use, Taxoids therapeutic use
Abstract

Background: Erlotinib is registered for treatment of all patients with advanced non-small-cell lung cancer (NSCLC). However, its efficacy for treatment of patients whose tumours are EGFR wild-type-which includes most patients-is still contentious. We assessed the efficacy of erlotinib compared with a standard second-line chemotherapy in such patients., Methods: We did this randomised controlled trial in 52 Italian hospitals. We enrolled patients who had metastatic NSCLC, had had platinum-based chemotherapy, and had wild-type EGFR as assessed by direct sequencing. Patients were randomly assigned centrally (1:1) to receive either erlotinib orally 150 mg/day or docetaxel intravenously 75 mg/m(2) every 21 days or 35 mg/m(2) on days 1, 8, and 15, every 28 days. Randomisation was stratified by centre, stage, type of first-line chemotherapy, and performance status. Patients and investigators who gave treatments or assessed outcomes were not masked to treatment allocation, investigators who analysed results were. The primary endpoint was overall survival in the intention-to-treat population. The study is registered at ClinicalTrials.gov, number NCT00637910., Findings: We screened 702 patients, of whom we genotyped 540. 222 patients were enrolled (110 assigned to docetaxel vs 112 assigned to erlotinib). Median overall survival was 8·2 months (95% CI 5·8-10·9) with docetaxel versus 5·4 months (4·5-6·8) with erlotinib (adjusted hazard ratio [HR] 0·73, 95% CI 0·53-1·00; p=0·05). Progression-free survival was significantly better with docetaxel than with erlotinib: median progression-free survival was 2·9 months (95% CI 2·4-3·8) with docetaxel versus 2·4 months (2·1-2·6) with erlotinib (adjusted HR 0·71, 95% CI 0·53-0·95; p=0·02). The most common grade 3-4 toxic effects were: low absolute neutrophil count (21 [20%] of 104 in the docetaxel group vs none of 107 in the erlotinib group), skin toxic effects (none vs 15 [14%]), and asthenia (ten [10%] vs six [6%])., Interpretation: Our results show that chemotherapy is more effective than erlotinib for second-line treatment for previously treated patients with NSCLC who have wild-type EGFR tumours., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Published
2013
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