Promising clinical performance of pretargeted immuno-PET with anti-CEA bispecific antibody and gallium-68-labelled IMP-288 peptide for imaging colorectal cancer metastases: a pilot study.

INTRODUCTION: This pilot study evaluated the imaging performance of pretargeted immunological positron emission tomography (immuno-PET) using an anti-carcinoembryonic antigen (CEA) recombinant bispecific monoclonal antibody (BsMAb), TF2 and the [68Ga]Ga-labelled HSG peptide, IMP288, in patients with metastatic colorectal carcinoma (CRC). PATIENTS AND METHODS: Patients requiring diagnostic workup of CRC metastases or in case of elevated CEA for surveillance were prospectively studied. They had to present with elevated CEA serum titre or positive CEA tumour staining by immunohistochemistry of a previous biopsy or surgical specimen. All patients underwent endoscopic ultrasound (EUS), chest-abdominal-pelvic computed tomography (CT), abdominal magnetic resonance imaging (MRI) and positron emission tomography using [18F]fluorodeoxyglucose (FDG-PET). For immuno-PET, patients received intravenously 120 nmol of TF2 followed 30 h later by 150 MBq of [68Ga]Ga-labelled IMP288, both I.V. The gold standard was histology and imaging after 6-month follow-up. RESULTS: Eleven patients were included. No adverse effects were reported after BsMAb and peptide injections. In a per-patient analysis, immuno-PET was positive in 9/11 patients. On a per-lesion analysis, 12 of 14 lesions were positive with immuno-PET. Median SUVmax, MTV and TLG were 7.65 [3.98-13.94, SD 3.37], 8.63 cm3 [1.98-46.64; SD 14.83] and 37.90 cm3 [8.07-127.5; SD 43.47] respectively for immuno-PET lesions. Based on a per-lesion analysis, the sensitivity, specificity, positive-predictive value and negative-predictive value were, respectively, 82%, 25%, 82% and 25% for the combination of EUS/CT/MRI; 76%, 67%, 87% and 33% for FDG-PET; and 88%, 100%, 100% and 67% for immuno-PET. Immuno-PET had an impact on management in 2 patients. CONCLUSION: This pilot study showed that pretargeted immuno-PET using anti-CEA/anti-IMP288 BsMAb and a [68Ga]Ga-labelled hapten was safe and feasible, with promising diagnostic performance. TRIAL REGISTRATION: ClinicalTrials.gov NCT02587247 Registered 27 October 2015.

[Retroperitoneal lymphadenectomy and survival of patients treated for an advanced ovarian cancer: the CARACO trial]. / Impact des curages rétropéritonéaux sur la survie des patientes atteintes d'un cancer de l'ovaire à un stade avancé : le protocole CARACO.

The standard management for advanced-stage epithelial ovarian cancer is optimum cytoreductive surgery followed by platinum based chemotherapy. However, retroperitoneal lymph node resection remains controversial. The multiple directions of the lymph drainage pathway in ovarian cancer have been recognized. The incidence and pattern of lymph node involvement depends on the extent of the disease and the histological type. Several published cohorts suggest the survival benefit of pelvic and para-aortic lymphadenectomy. A recent large randomized trial have demonstrated the potential benefit for surgical removal of bulky lymph nodes in term of progression-free survival but failed to show any overall survival benefit because of a critical methodology. Further randomised trials are needed to balance risks and benefits of systematic lymphadenectomy in advanced-stage disease. CARACO is a French ongoing trial, built to bring a reply to this important question. A huge effort for inclusion of the patients, and involving new teams, are mandatory.

Variable region gene segments of nine monoclonal antibodies specific to disialogangliosides (GD2, GD3) and their O-acetylated derivatives.

Despite the weak immunogenicity of gangliosides, a limited number of highly specific murine monoclonal antibodies (MAbs) were elicited. This study investigated the reactivity and the structure of the VH and V kappa genes of nine hybridomas obtained from independent fusions producing antibodies against disialogangliosides GD2 and GD3 and their O-acetylated derivatives. These antibodies depended on four types of V kappa genes. They were also encoded by VH genes of the J558 family (5 out of 9) and occasionally by VH genes of the S107, 7183, and 3609 families, rearranged with a variety of DH and JH genes. The 8B6 and 7H2 MAbs specific for GD2-O-acetylated, respectively, used the VH gene of the S107 and 7183 families. The length of H chain CDR3 ranged from 8 to 11 amino acids. A set of S107 and 3609 germline genes closed from A/J murine fetal liver and matched with the VH segment of hybridomas 8B6 and 10B8 revealed somatic mutations. Although the relative number of sequences does not preclude any formal conclusions regarding the preferential use of V genes in the immune recognition of carbohydrate structures, our results clearly indicate that MAbs directed to very similar structures as GD2 and GD3 were encoded by different VH and V kappa genes.

[The oral health status in a sample of recruits form different regions of Italy]. / Stato di salute orale in un campione di reclute delle varie regioni d'Italia.

The present epidemiological study was carried out 700 national servicemen doing service at the barracks Carlo Alberto Dalla Chiesa of Fosano (Cuneo) in the period April-August 1989, for the purposes of determining the state of oral health in a large sample of the Italian young male population and the diffusion of actions aimed at caries prophylaxis. The DMF index of the group in question is 7.14. 83.44% of DMF teeth were subjected to conservative dental treatment, 5.58% were extracted and 10.98% presented ongoing processes of caries requiring treatment. The results obtained show that, although caries is still very widespread in Italy in relation to other European countries and the United States, considerable progress has been made compared to the past as regards the secondary prevention of the pathology. Nevertheless, much remains to be done for the primary prophylaxis of caries. These data were confirmed by those obtained on periodontopathies. Although, the serious forms of periodontal disease in youth are very rare, very few conscripts are aware of the most elementary principles of oral hygiene.

[The clinico-radiological assessment of dental anomalies with real and apparent numerical defects]. / Valutazione clinico-radiologica delle anomalie dentarie di numero in difetto reali ed apparenti.

Dental anomalies involving real shortfall in the number of teeth (agenesis) or apparent deficiency (impaction) have been studied in a population sample including 700 national servicemen aged between 19 and 26, in the period April-August 1989. The study was carried out by means of careful objective examination and the systematic performance of orthopantomography showed that 5.14% of the population examined is affected by dental agenesis. The tooth most often involved in agenesis is the lateral maxillary incisor followed by the third mandibular molar, the second mandibular premolar and the second maxillary premolar. As regards apparent agenesis, the upper and lower wisdom teeth were the most frequently involved in physiological or pathological bone impaction (this event occurs in almost 50% of third molars). The maxillary cuspid is also impacted with some frequency. The data obtained were compared with those in the world literature.

[Median mandibular cysts. A case report]. / Cisti mediane della mandibola. Caso monografico.

A case of median mandibular cyst is reported. The main aspects of the origin, diagnosis and therapy of median mandibular cysts are described, together with endodontic problems and differential diagnosis.

[Impacted teeth in the maxillary sinus and endosinusal cysts. A case report]. / Denti inclusi nel seno mascellare e cisti endosinusale. Descrizione di un caso.

A case of impacted teeth and maxillary sinus cyst is reported. The etiopathogenesis, anatomo-pathology, symptomatology and diagnosis of impacted and heterotopic teeth are also described.

[Ceftizoxime in oral surgery]. / Ceftizoxima in chirurgia orale.

Clinical and statistical investigation on the use of ceftizoxime in the treatment of peri- and postoperative infections in odontostomatological and maxillofacial surgery. A sample of 48 patients in the Odontostomatologic Division of the Hospital of Asti is examined. Principles and experience of surgical antimicrobial prophylaxis according to its antibacterial activity, pharmacokinetic properties and therapeutic use are reported.