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1.
J Vet Dent ; : 8987564241255292, 2024 May 21.
Article in English | MEDLINE | ID: mdl-38772621

ABSTRACT

This retrospective case series describes a combined ventral extraoral and intraoral approach for mandibulectomy in cats and highlights the importance of prompt management of the postoperative iatrogenic malocclusion through dental extraction, crown height reduction with vital pulp therapy or root canal therapy of the contralateral mandibular canine tooth. Nine cats were reviewed for signalment, history and physical examination, diagnostic workup, tumor type, mandibulectomy extension, lymph node removal as well as both intraoperative and postoperative complications. The performed surgical procedure was a combination of an extraoral approach ventrally to the mandible and an intraoral approach to remove the whole or a part of the mandible. Lymphadenectomy was achieved using the same surgical access. None of the cats had intraoperative complications. Postoperative complications were limited to regional swelling and drooling lasting a week. Seven cats were able to eat immediately after the surgery. Of the other 2 cats, 1 regained the ability to eat within a month and 1 only ate from the owner's hands. The surgical approach for mandibulectomy described allowed better access and visualization of the caudal part of the mandible and direct access to regional lymph nodes. Moreover, if the expected postoperative malocclusion is managed during the same surgical procedure, there is a higher rate of postoperative eating ability compared to what is reported in the literature.

2.
Expert Opin Investig Drugs ; : 1-13, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38775361

ABSTRACT

INTRODUCTION: The global prevalence of colorectal cancer highlights the need to enhance treatment strategies for improved patient outcomes. The pivotal role of epidermal growth factor receptor (EGFR) signaling in regulating cellular processes for this disease pinpoints its value as a therapeutic target, despite the emergence of resistance mechanisms over time. AREAS COVERED: This review discusses the clinical evidence supporting the use of EGFR inhibitors in molecularly-selected patients based on molecular characteristics (notably BRAF V600E and KRAS G12C) including combination approaches targeting different points in in the signaling pathway, as well as strategies such as EGFR inhibitor rechallenge. The role of HER2 inhibitors and emerging approaches such as bispecific antibodies are also reviewed. EXPERT OPINION: Recently, inhibitors targeting the KRAS G12C variant have emerged, albeit with modest monotherapy activity compared to other tumor types, emphasizing the influence of histologic origins on the EGFR signaling pathway. Integration of EGFR inhibitors into precision medicine has facilitated tailored therapies addressing resistance mechanisms. Patient selection for EGFR inhibitor rechallenge guided by ctDNA findings is crucial, with ongoing investigations exploring novel combinations to enhance EGFR blockade, highlighting the transformative potential of precision medicine in shaping the future of mCRC treatment toward personalized and targeted approaches.

3.
Diagnostics (Basel) ; 14(8)2024 Apr 11.
Article in English | MEDLINE | ID: mdl-38667446

ABSTRACT

Cutaneous melanoma is one of the most lethal tumors among skin cancers, characterized by complex genetic and molecular alterations that result in uncontrolled cell proliferation and metastatic spread. Next-generation sequencing (NGS) enables the simultaneous examination of numerous genes, making this molecular technique essential for melanoma diagnosis, prognostic stratification, and therapy planning. Herein, we present the experience with our laboratory-designed NGS panel for the routine assessment of advanced-stage melanoma. A total of 260 specimens of advanced-stage melanomas were evaluated utilizing a laboratory-developed multi-gene NGS panel, which allowed the investigation of 229 amplicons in 25 oncogene/oncosuppressor genes. The NGS panel proved to be a reliable tool, failing to produce results in only 1.2% of the samples tested. BRAF and TERT were the two more commonly altered genes in 44.0% and 59.9% of samples, respectively. In 59.3% of the mutated cases, at least two concomitant variants were detected. In eight cases, both primary lesion and metastatic disease were analyzed by NGS. In all specimens (8/8, 100%), a perfect concordance in variants harbored by the primary and recurrence lesions was observed. Finally, this study described the validity of a laboratory-developed multi-gene NGS panel built specifically for advanced-stage melanomas in ordinary clinical practice.

4.
AME Case Rep ; 8: 21, 2024.
Article in English | MEDLINE | ID: mdl-38234336

ABSTRACT

Background: Laryngeal neuroendocrine tumors (NETs) represent less than 1% of all malignancies originating from the larynx and available data are limited on case reports. Calcitonin secreting laryngeal NETs are extremely rare and serial dosing of calcitonin in these patients might reveal early relapse or persistence. Case Description: We report the case of a 71-year-old woman with persistent pharyngodynia who underwent surgery for an initial diagnosis of small cell undifferentiated neuroendocrine carcinoma (SCUNC) of the larynx (on the epiglottis extended to the left glosso-epiglottic vallecula). The immunohistochemical profile showed the presence of synaptophysin, neuron-specific enolase (NSE), chromogranin A, pan-cytokeratin, including cytokeratin AE1-AE2, and focally calcitonin. The circulating NSE was 13.4 microg/L (normal level <12.5 microg/L) and the basal serum level of calcitonin was 237 pg/mL (normal level <11.5 pg/mL). The patient was started on first-line carboplatin-etoposide chemotherapy because of early relapse to an axillary lymph node. After 4 cycles of treatment, a radiological stability and metabolic response were demonstrated together with a drastic decrease of circulating serum level of calcitonin (from 237 to 57.9 pg/mL). During the follow up, locoregional relapse of disease occurred, associated with an increase of serum calcitonin (89.3 pg/mL). Disease further progressed on and rechallenge with platinum-etoposide chemotherapy was administered, during which clinical progression was confirmed. Due to the lack of response, a revision of the histology was performed and concluded for a definitive diagnosis of moderately differentiated G2 NET, with a Ki-67 index of 22.6%. Conclusions: This is the eighth case report of laryngeal NET, highlighting the challenge in pathological differential diagnosis and therapeutic strategies. The association with elevated serum calcitonin and the trend of this parameter during clinical progression suggest a role of this marker in the diagnosis and early identification of recurrent laryngeal NETs.

5.
Pathol Res Pract ; 253: 155008, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38103361

ABSTRACT

BACKGROUND: TERT promoter mutation is one of the most common genomic alterations in urothelial carcinoma (UC). Its prognostic role on patients' outcomes is still not clear. METHODS: We performed a single-center retrospective analysis on patients with advanced UC treated with platinum-based chemotherapy or immunotherapy to assess the presence of somatic TERT-124[C>T] and TERT-146[C>T] mutations and their association with clinicopathologic factors and survival outcomes. Patients were assessed for Overall Survival (OS), Progression-Free Survival (PFS), and Overall Response Rate (ORR). RESULTS: We analyzed 45 UC tumors; 38 of them received first-line chemotherapy and 21 second-line pembrolizumab; 6 patients (13%) harbored -146 C > T TERTp mutation and 25 patients (56%)-124 C > T. The presence of TERT promoter mutations was associated with a higher rate of lower tract UC and a lower rate of synchronous or lymph node metastases. TERT wild-type patients showed higher 12- and 24-months OS-rates in the chemotherapy subgroup and 6-, 12- and 24-months OS rates in the pembrolizumab subgroup. The presence of TERT promoter mutations was also associated with a lower 6 months-PFS rate in patients receiving chemotherapy and in all the three time points in those treated by pembrolizumab. The ORRs of pembrolizumab were 21% and 71% in patients with or without TERT promoter mutations, respectively (p < 0.001). CONCLUSIONS: Our analysis suggests that the presence of TERT promoter mutations could negatively affect the outcome of UC patients treated by chemotherapy or pembrolizumab. This hypothesis should be further evaluated in wider cohorts.


Subject(s)
Antibodies, Monoclonal, Humanized , Carcinoma, Transitional Cell , Telomerase , Urinary Bladder Neoplasms , Humans , Carcinoma, Transitional Cell/drug therapy , Carcinoma, Transitional Cell/genetics , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/genetics , Urinary Bladder Neoplasms/pathology , Retrospective Studies , Platinum/therapeutic use , Mutation/genetics , Telomerase/genetics
6.
Pharmaceuticals (Basel) ; 16(4)2023 Apr 19.
Article in English | MEDLINE | ID: mdl-37111371

ABSTRACT

(1) Background: The oncology field has drastically changed with the advent of precision medicine, led by the discovery of druggable genes or immune targets assessed through next-generation sequencing. Biomarker-based treatments are increasingly emerging, and currently, six tissue-agnostic therapies are FDA-approved. (2) Methods: We performed a review of the literature and reported the trials that led to the approval of tissue-agnostic treatments and ongoing clinical trials currently investigating novel biomarker-based approaches. (3) Results: We discussed the approval of agnostic treatments: pembrolizumab and dostarlimab for MMRd/MSI-H, pembrolizumab for TMB-H, larotrectinib and entrectinib for NTRK-fusions, dabrafenib plus trametinib for BRAF V600E mutation, and selpercatinib for RET fusions. In addition, we reported novel clinical trials of biomarker-based approaches, including ALK, HER2, FGFR, and NRG1. (4) Conclusions: Precision medicine is constantly evolving, and with the improvement of diagnostic tools that allow a wider genomic definition of the tumor, tissue-agnostic targeted therapies are a promising treatment strategy tailored to the specific tumor genomic profile, leading to improved survival outcomes.

7.
Lung Cancer (Auckl) ; 14: 11-25, 2023.
Article in English | MEDLINE | ID: mdl-36762267

ABSTRACT

Precision medicine has revolutionized the therapeutic management of cancer patients with a major impact on non-small cell lung cancer (NSCLC), particularly lung adenocarcinoma, where advances have been remarkable. Tissue biopsy, required for tumor molecular testing, has significant limitations due to the difficulty of the biopsy site or the inadequacy of the histological specimen. In this context, liquid biopsy, consisting of the analysis of tumor-released materials circulating in body fluids, such as blood, is increasingly emerging as a valuable and non-invasive biomarker for detecting circulating tumor DNA (ctDNA) carrying molecular tumor signatures. In advanced/metastatic NSCLC, liquid biopsy drives target therapy by monitoring response to treatment and identifying eventual genomic mechanisms of resistance. In addition, recent data have shown a significant ability to detect minimal residual disease in early-stage lung cancer, underlying the potential application of liquid biopsy in the adjuvant setting, in early detection of recurrence, and also in the screening field. In this article, we present a review of the currently available data about the utility and application of liquid biopsy in lung cancer, with a particular focus on the approach to different techniques of analysis for liquid biopsy and a comparison with tissue samples as well as the potential practical uses in early and advanced/metastatic NSCLC.

8.
Expert Rev Mol Diagn ; 22(11): 997-1008, 2022 11.
Article in English | MEDLINE | ID: mdl-36503370

ABSTRACT

INTRODUCTION: The reactivation of telomerase represents a key moment in the carcinogenesis process. Mutations in the central promoter region of the telomerase reverse transcriptase (TERT) gene cause telomerase reactivation in approximately 90% of solid tumors. In some of these, its prognostic and predictive role in response to treatments has already been demonstrated, in others (such as tumors of the genitourinary tract like urothelial carcinoma) data are controversial and the research is still ongoing. In the future, TERT promoter mutations and telomerase activity could have diagnostic, prognostic, and therapeutic applications in many types of cancer. AREAS COVERED: We performed a review the literature with the aim of describing the current evidence on the prognostic and predictive role of TERT promoter mutations. In some tumor types, TERT promoter mutations have been associated with a worse prognosis and could have a potential value as biomarkers to guide therapeutic decisions. Mutations in TERT promoter seems to make the tumor particularly immunogenic and more responsive to immunotherapy, although data is controversial. EXPERT OPINION: We described the role of TERT promoter mutations in solid tumors with a particular focus in genitourinary cancers, considering their frequency in this tract.


Subject(s)
Carcinoma, Transitional Cell , Telomerase , Urinary Bladder Neoplasms , Humans , Carcinoma, Transitional Cell/genetics , Carcinoma, Transitional Cell/pathology , Mutation , Promoter Regions, Genetic , Telomerase/genetics , Telomerase/metabolism , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/genetics , Urinary Bladder Neoplasms/pathology
9.
Pathol Res Pract ; 236: 153983, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35751929

ABSTRACT

BACKGROUND: The therapeutic scenario of urothelial carcinoma is constantly expanding with the widening of the knowledge on molecular characteristics, thus claiming for the need of prognostic and predictive factors to guide treatment strategy. TERT promoter mutation is one of the most frequent genomic alterations in urothelial carcinoma and could present several implications, from diagnostic to prognostic or potentially even predictive. METHODS: We performed a single-center retrospective analysis on patients with advanced urothelial carcinoma treated with an immune checkpoint inhibitor as second line of therapy to assess the status of the TERT promoter and the potential implication of its mutation on survival outcomes. RESULTS: We analyzed tissue samples from 11 patients with a next-generation sequencing multi-gene panel. The most frequently altered genes were TP53 (54.5%, n = 6) and TERT promoter (36.3%, n = 4). Other mutations found were BRAF, SMAD4, PIK3CA / PDGRFA. The only type of detected TERT promoter mutation was the c 0.124 C>T (n = 4/4, 100%). Of the 4 TERT mutated patients, 2 presented a co-mutation of TP53. Patients with TERT promoter mutation treated with immunotherapy presented a low median overall survival (16.5 months) and progression-free survival (3.8 months). CONCLUSIONS: Our hypothesis-generating analysis suggests that the presence of TERT promoter mutation could have a negative prognostic value and should be further evaluated in wider cohorts.


Subject(s)
Carcinoma, Transitional Cell , Telomerase , Urinary Bladder Neoplasms , Carcinoma, Transitional Cell/genetics , Carcinoma, Transitional Cell/pathology , Carcinoma, Transitional Cell/therapy , Humans , Immunotherapy , Mutation/genetics , Retrospective Studies , Telomerase/genetics , Urinary Bladder Neoplasms/pathology
10.
ChemSusChem ; 15(13): e202200501, 2022 Jul 07.
Article in English | MEDLINE | ID: mdl-35438242

ABSTRACT

2,5-Furandicarboxylic acid (FDCA) is currently considered one of the most relevant bio-sourced building blocks, representing a fully sustainable competitor for terephthalic acid as well as the main component in green polymers such as poly(ethylene 2,5-furandicarboxylate) (PEF). The oxidation of biobased 5-hydroxymethylfurfural (HMF) represents the most straightforward approach to obtain FDCA, thus attracting the attention of both academia and industries, as testified by Avantium with the creation of a new plant expected to produce 5000 tons per year. Several approaches allow the oxidation of HMF to FDCA. Metal-mediated homogeneous and heterogeneous catalysis, metal-free catalysis, electrochemical approaches, light-mediated procedures, as well as biocatalytic processes share the target to achieve FDCA in high yield and mild conditions. This Review aims to give an up-to-date overview of the current developments in the main synthetic pathways to obtain FDCA from HMF, with a specific focus on process sustainability.


Subject(s)
Dicarboxylic Acids , Furaldehyde , Furaldehyde/analogs & derivatives , Furaldehyde/metabolism , Furans/metabolism
11.
Cancer Med ; 11(22): 4204-4213, 2022 11.
Article in English | MEDLINE | ID: mdl-35485165

ABSTRACT

BACKGROUND: After radical resection of a nonmetastatic Merkel cell carcinoma (M0 MCC), postoperative radiation therapy (RT) is recommended as it improves survival. However, the role of RT in specific subgroups of M0 MCC is unclear. We sought to identify whether there is a differential survival benefit from RT in specific M0 MCC patient subgroups. METHODS: M0 MCC patients from the Surveillance, Epidemiology, and End Results (SEER) database registry were collected. The best prognostic age, tumor size, and lymph node ratio (LNR, ratio between positive lymph nodes and resected lymph nodes) cutoffs were calculated. The primary endpoint was overall survival (OS). RESULTS: A total of 5644 M0 MCC patients (median age 77 years, 62% male) were included: 4022 (71%) node-negative (N0) and 1551 (28%) node-positive (N+). Overall, 2682 patients (48%) received RT. Age > 76.5 years, tumor size >13.5 mm, and LNR >0.215 were associated with worse OS. RT was associated with longer OS in the M0 MCC, N0, and N+ group and independently associated with a 25%, 27%, and 26% reduction in the risk for death, respectively. RT benefit on survival was increased in tumor size >13.5 mm in the N0 group and LNR >0.215 in the N+ group. No OS benefit from RT was observed in T4 tumors (N0 and N+ groups). CONCLUSIONS: RT was associated with improved survival in M0 MCC, irrespective of the nodal status. LNR >0.215 is a useful prognostic factor for clinical decision-making and for stratification and interpretation of clinical trials.


Subject(s)
Carcinoma, Merkel Cell , Skin Neoplasms , Humans , Male , Aged , Female , Carcinoma, Merkel Cell/radiotherapy , Carcinoma, Merkel Cell/surgery , Carcinoma, Merkel Cell/pathology , Lymph Node Ratio , Lymph Node Excision , Prognosis , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgery , Skin Neoplasms/pathology , Neoplasm Staging , Lymph Nodes/pathology , Retrospective Studies
12.
J Clin Med ; 11(5)2022 Mar 07.
Article in English | MEDLINE | ID: mdl-35268551

ABSTRACT

Large cell neuroendocrine carcinoma of the lung (LCNEC) is a rare and highly aggressive type of lung cancer, with a complex biology that shares similarities with both small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC). The prognosis of LCNEC is poor, with a median overall survival of 8-12 months. The diagnosis of LCNEC requires the identification of neuroendocrine morphology and the expression of at least one of the neuroendocrine markers (chromogranin A, synaptophysin or CD56). In the last few years, the introduction of next-generation sequencing allowed the identification of molecular subtypes of LCNEC, with prognostic and potential therapeutic implications: one subtype is similar to SCLC (SCLC-like), while the other is similar to NSCLC (NSCLC-like). Because of LCNEC rarity, most evidence comes from small retrospective studies and treatment strategies that are extrapolated from those adopted in patients with SCLC and NSCLC. Nevertheless, limited but promising data about targeted therapies and immune checkpoint inhibitors in patients with LCNEC are emerging. LCNEC clinical management is still controversial and standardized treatment strategies are currently lacking. The aim of this manuscript is to review clinical and molecular data about LCNEC to better understand the optimal management and the potential prognostic and therapeutic implications of molecular subtypes.

13.
Ther Adv Med Oncol ; 14: 17588359211058391, 2022.
Article in English | MEDLINE | ID: mdl-35173818

ABSTRACT

INTRODUCTION: Radiological response assessment to immune checkpoint inhibitor is challenging due to atypical pattern of response and commonly used RECIST 1.1 criteria do not take into account the kinetics of tumor behavior. Our study aimed at evaluating the tumor growth rate (TGR) in addition to RECIST 1.1 criteria to assess the benefit of immune checkpoint inhibitors (ICIs). METHODS: Tumor real volume was calculated with a dedicated computed tomography (CT) software that semi-automatically assess tumor volume. Target lesions were identified according to RECIST 1.1. For each patient, we had 3 measurement of tumor volume. CT-1 was performed 8-12 weeks before ICI start, the CT at baseline for ICI was CT0, while CT + 1 was the first assessment after ICI. We calculated the percentage increase in tumor volume before (TGR1) and after immunotherapy (TGR2). Finally, we compared TGR1 and TGR2. If no progressive disease (PD), the group was disease control (DC). If PD but TGR2 < TGR1, it was called LvPD and if TGR2 ⩾ TGR1, HvPD. RESULTS: A total of 61 patients who received ICIs and 33 treated with chemotherapy (ChT) were included. In ICI group, 18 patients were HvPD, 22 LvPD, 21 DC. Median OS was 4.4 months (95% CI: 2.0-6.8, reference) for HvPD, 7.1 months (95% CI 5.4-8.8) for LvPD, p = 0.018, and 20.9 months (95% CI: 12.5-29.3) for DC, p < 0.001. In ChT group, 7 were categorized as HvPD, 17 as LvPD and 9 as DC. No difference in OS was observed in the ChT group (p = 0.786). CONCLUSION: In the presence of PD, a decrease in TGR may result in a clinical benefit in patients treated with ICI but not with chemotherapy. Monitoring TGR changes after ICIs administration can help physician in deciding to treat beyond PD.

14.
ChemSusChem ; 14(19): 4167-4175, 2021 Oct 05.
Article in English | MEDLINE | ID: mdl-34363734

ABSTRACT

Nowadays the issues related to the end of life of traditional plastics are very urgent due to the important pollution problems that plastics have caused. Biodegradable plastics can help to try to mitigate these problems, but even bioplastics need much attention to carefully evaluate the different options for plastic waste disposal. In this Minireview, three different end-of-life scenarios (composting, recycling, and upcycling) were evaluated in terms of literature review. As a result, the ability of bioplastics to be biodegraded by composting has been related to physical variables and materials characteristics. Hence, it is possible to deduce that the process is mature enough to be a good way to minimize bioplastic waste and valorize it for the production of a fertilizer. Recycling and upcycling options, which could open up many interesting new scenarios for the production of high-value materials, are less studied. Research in this area can be strongly encouraged.

15.
Future Oncol ; 17(33): 4583-4606, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34431316

ABSTRACT

Metastatic uveal melanoma (MUM) is the most common form of noncutaneous melanoma. It is different from its cutaneous counterpart and is characterized by a very poor prognosis. Despite groundbreaking improvements in the treatment of cutaneous melanoma, there have been few advances in the treatment of MUM, and standard treatments for MUM have not been defined. We performed a systematic review focusing our attention on all interventional studies, ongoing or already published, concerning the treatment of MUM. We present results from studies of chemotherapy, targeted therapy, immunotherapy and liver-directed therapies. Although the results in this setting have been disappointing until now, trials investigating novel immunotherapeutic strategies alone and in combination with targeted agents and liver-directed therapies are ongoing.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Liver Neoplasms/drug therapy , Melanoma/drug therapy , Uveal Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Clinical Trials as Topic , Humans , Immune Checkpoint Inhibitors/pharmacology , Immune Checkpoint Inhibitors/therapeutic use , Liver/drug effects , Liver/pathology , Liver Neoplasms/mortality , Liver Neoplasms/secondary , Melanoma/mortality , Melanoma/pathology , Molecular Targeted Therapy/methods , Multicenter Studies as Topic , Progression-Free Survival , Review Literature as Topic , Uveal Neoplasms/mortality , Uveal Neoplasms/pathology
16.
Polymers (Basel) ; 13(7)2021 Mar 27.
Article in English | MEDLINE | ID: mdl-33801582

ABSTRACT

With the aim to fully exploit the by-products obtained after the industrial extraction of starch from sweet potatoes, a cascading approach was developed to extract high-value molecules, such as proteins and pectins, and to valorize the solid fraction, rich in starch and fibrous components. This fraction was used to prepare new biocomposites designed for food packaging applications. The sweet potato residue was added to poly(3-hydroxybutyrate-co-3-hydroxyvalerate) in various amounts up to 40 wt % by melt mixing, without any previous treatment. The composites are semicrystalline materials, characterized by thermal stability up to 260 °C. For the composites containing up to 10 wt % of residue, the tensile strength remains over 30 MPa and the strain stays over 3.2%. A homogeneous dispersion of the sweet potato waste into the bio-polymeric matrix was achieved but, despite the presence of hydrogen bond interactions between the components, a poor interfacial adhesion was detected. Considering the significant percentage of sweet potato waste used, the biocomposites obtained show a low economic and environmental impact, resulting in an interesting bio-alternative to the materials commonly used in the packaging industry. Thus, according to the principles of a circular economy, the preparation of the biocomposites closes the loop of the complete valorization of sweet potato products and by-products.

17.
Eur J Cancer ; 150: 99-107, 2021 06.
Article in English | MEDLINE | ID: mdl-33892411

ABSTRACT

INTRODUCTION: Immune checkpoint inhibitors (ICIs) have become the standard of care in the management of advanced non-small cell lung cancer (NSCLC). Nevertheless, only a small proportion of patients benefit from ICIs. The aim of the present study is to assess whether 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography-computed tomography ([18F]FDG-PET/CT)-derived parameters may be used as biomarkers in patients with advanced NSCLC receiving first-line pembrolizumab. MATERIALS AND METHODS: This is a monocentric retrospective cohort study including patients with advanced NSCLC (stage IV) and Programmed death-ligand 1 (PD-L1) expression ≥50% treated with pembrolizumab. A control group of patients treated with epidermal growth factor receptor (EGFR) inhibitors for EGFR-mutated NSCLC was also enrolled. Only patients with a positive [18F]18F-FDG PET/CT result within 60 days from treatment initiation were included.Total metabolic tumour volume (tMTV) was calculated for each lesion using a dedicated software (PET VCAR; GE Healthcare), which semiautomatically delineates the tumour's contours with a maximum standardised uptake value (SUVmax) threshold of 42% within the lesion. tMTV was obtained summing each lesion's MTV. Potential prognostic parameters for overall survival (OS) were analysed (tMTV, SUVmax, bone/liver metastasis, neutrophil:lymphocyte ratio ≥4, Eastern Cooperative Oncology Group performance status ≥2, lactate dehydrogenase above the upper limit of normal). RESULTS: Overall, 34 patients treated with first line-pembrolizumab and 40 patients treated with EGFR tyrosine kinase inhibitors were included. In the pembrolizumab group, the median follow-up was 20.3, while the median OS was 4.7 months (95% confidence interval [CI] = 0.3-9.1) for patients with tMTV ≥75 cm3 vs not reached (NR) for patients with tMTV <75 cm3 (95% CI = NR-NR; hazard ratio [HR] = 5.37; 95% CI = 1.72-16.77; p = 0.004). No difference was found in the control group (HR = 1.43; 95% CI = 0.61-3.34; p = 0.411). CONCLUSION: Our data suggest that tMTV ≥75cm3 can be used as a prognostic biomarker of poor outcomes in patients with PD-L1-high advanced NSCLC treated with first-line pembrolizumab. This information could be useful for the selection of patients who may require the addition of chemotherapy to pembrolizumab.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Fluorodeoxyglucose F18 , Immune Checkpoint Inhibitors/therapeutic use , Lung Neoplasms/drug therapy , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Aged , Antibodies, Monoclonal, Humanized/adverse effects , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/metabolism , Clinical Decision-Making , Female , Humans , Immune Checkpoint Inhibitors/adverse effects , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/metabolism , Male , Neoplasm Staging , Predictive Value of Tests , Retrospective Studies , Treatment Outcome , Tumor Burden
18.
Polymers (Basel) ; 13(4)2021 Feb 10.
Article in English | MEDLINE | ID: mdl-33578771

ABSTRACT

The dynamic and equilibrium water vapor sorption properties of amorphous and highly crystalline poly(ethylene vanillate) (PEV) films were determined via gravimetric analysis, at 20 °C, over a wide range of relative humidity (0-95% RH). At low RH%, the dynamic of the sorption process obeys Fick's law while at higher relative humidity it is characterized by a drift ascribable to non-Fickian relaxations. The non-Fickian relaxations, which are responsible for the incorporation of additional water, are correlated with the upturn of the sorption isotherms and simultaneously the hysteresis recorded between sorption and desorption cycles. The sorption isotherms of amorphous and highly crystalline PEV are arranged in the same concentration range of that of PET proving the similarity of the two polyesters. Water diffusion coefficients, whose determination from individual kinetic sorption/desorption curves required treatment with the Barens-Hopfenberg model, were demonstrated to be ≈ 10× higher for amorphous PEV compared to amorphous PET. Such a difference originates from the enhanced segmental flexibility of PEV chains.

19.
PLoS One ; 15(9): e0239629, 2020.
Article in English | MEDLINE | ID: mdl-32946525

ABSTRACT

Agro-waste reduction and reuse are among the current main social challenges. In this perspective, the present research was aimed at the complete valorisation of Garganega grape pomace by recovering bioactive phenol extracts and by testing the solid fibre extract residues in composite formulation for packaging applications. The pomace was derived from white wine production, therefore, respect to red pomace, it was promptly removed from must after pressing, and its exploitation can be particularly interesting and valuable as still rich in active compounds. Phenol extracts were obtained both via solvent-based and pressurised liquid extractions and their phytochemical compositions were compared in terms of total amount of phenols, flavonoids, flavanols, anthocyanins, hydroxycinnamic acids, and reducing sugars. Antioxidant activity and detailed phenol profiles were also achieved. The highest phenol yield was obtained via solvent-based extraction with 75% acetone (v/v), solid/liquid ratio 1:5, 2h incubation at 50°C (77.9 gGAeq/kgDW). The fibrous solid residue of the extraction was characterized via thermogravimetric analysis and used for composite preparation by melt mixing with the renewable and biodegradable PHBV polymer through a green approach (solvent-less process). The composites resulted thermally stable at high temperatures, showing initial degradation processes only at temperatures higher than 250°C. Differential scanning calorimetry analyses were carried out to study melting and crystallization phenomena, while mechanical properties were investigated by tensile tests. The materials finally showed properties similar to those of the matrix. The bio-composites can be considered as an alternative to plain PHBV, since they are less expensive and eco-friendlier thanks to a reduced polymeric content, and they could represent a suitable way for full agro-waste exploitation.


Subject(s)
Antioxidants/chemistry , Food Technology/methods , Industrial Waste , Plant Extracts/chemistry , Vitis/chemistry , Waste Management/methods , Flavonoids/chemistry , Phenols/chemistry , Wine
20.
Polymers (Basel) ; 12(7)2020 Jul 10.
Article in English | MEDLINE | ID: mdl-32664324

ABSTRACT

Two winery residues, namely vine shoots (ViSh) and wine pomace (WiPo), were up-cycled as fillers in PHBV-based biocomposites. Answering a biorefinery approach, the impact of a preliminary polyphenols extraction step using an acetone/water mixture on the reinforcing effect of fillers was assessed. Biocomposites (filler content up to 20 wt%) were prepared by melt-mixing and compared in terms of final performance (thermal, mechanical and barrier). It was shown that the reinforcing effect was slightly better in the case of vine shoots, while it was not significantly affected by the pre-treatment, demonstrating that these two winery residues could be perfectly used as fillers in composite materials even after an extraction process to maximize their potential of valorization.

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