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Article: Abemaciclib in Patients with End-Stage Renal Disease and Advanced Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer: A Report of 2 Cases.

Gebbia, Vittorio

2022 Volume 15, Issue 1, Page(s) 305–311

Abstract: Cyclin4/6-dependent kinase inhibitors (CDKIs) plus hormonotherapy currently represent the standard golden treatment for patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor-2-negative (her-2-) advanced breast carcinoma. ... ...

Abstract	Cyclin4/6-dependent kinase inhibitors (CDKIs) plus hormonotherapy currently represent the standard golden treatment for patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor-2-negative (her-2-) advanced breast carcinoma. Among CDKIs, abemaciclib is the most active. No data on the use of abemaciclib in patients with end-stage renal disease (ESRD) exist in the medical literature. Two women with ER+, her-2- metastatic breast cancer received standard hormonal therapy plus abemaciclib 100 mg b.i.d. under strict monitoring for toxicity. Although ESRD exposes patients to a higher risk of toxicity from antineoplastic agents, no unexpected or severe toxicity was recorded in both patients after 9 and 12 months of therapy. In 1 patient, grade 2 diarrhea started after 7 days of therapy and disappeared or was significantly reduced after using loperamide and dietary modifications. Both patients complained of grade 1 asthenia. Hematological parameters were in line with expected toxicity. No cardiovascular or hepatic side effects were observed. This report of two women with metastatic breast cancer suggests the potentially safe use of abemaciclib in ESRD, which should be confirmed in more extensive real-life studies.
Language	English
Publishing date	2022-03-28
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2458961-5
ISSN	1662-6575
ISSN	1662-6575
DOI	10.1159/000523856
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cancer survivors: long-term opioid therapy - the challenge.

Mercadante, Sebastiano / Grassi, Yasmine / Gebbia, Vittorio

BMJ supportive & palliative care

2024 Volume 14, Issue 1, Page(s) 65–67

Abstract: The use of opioids in cancer survivors with chronic pain raises concerns as it occurs with chronic non-malignant pain .Thus, in some circumstances advanced therapeuthic strategies should be performed to allow pain control for prolonged periods of time We ...

Abstract	The use of opioids in cancer survivors with chronic pain raises concerns as it occurs with chronic non-malignant pain .Thus, in some circumstances advanced therapeuthic strategies should be performed to allow pain control for prolonged periods of time We describe a case of a long-survivor patient receiving prolonged opioid therapy. She received multiple opioid rotations or some more complex treatments, including burst of ketamine and midazolam, which allowed to maintain an acceptable pain control for 12 years, despite her poor compliance. Different opioids in different phases were given. A high level of knowledge, experience, and assessment is mandatory to implement of pain management among survivors.
MeSH term(s)	Female ; Humans ; Analgesics, Opioid/adverse effects ; Cancer Survivors ; Chronic Pain/drug therapy ; Pain Management ; Ketamine/adverse effects ; Neoplasms
Chemical Substances	Analgesics, Opioid ; Ketamine (690G0D6V8H)
Language	English
Publishing date	2024-02-21
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	2045-4368
ISSN (online)	2045-4368
DOI	10.1136/spcare-2022-003974
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Article ; Online: Some Considerations on a Patient's Sense of Immortality: Bringing a Human Dimension to the Process.

Gebbia, Vittorio / Cusumano, Nicola / Piazza, Dario / Tralongo, Paolo

Journal of cancer education : the official journal of the American Association for Cancer Education

2024

Abstract: One of the most frequent, although widely understandable, reactions of people diagnosed with an incurable tumor is represented by incredulity, anger, and the denial of the impossibility of a definitive cure. Often, a picture of intense anxiety quickly ... ...

Abstract	One of the most frequent, although widely understandable, reactions of people diagnosed with an incurable tumor is represented by incredulity, anger, and the denial of the impossibility of a definitive cure. Often, a picture of intense anxiety quickly takes over, overlapping the ever-growing collective hysteria of modern society, the result of a complex cultural mechanism in which technocracy often prevails over thought, introspection, and, in a broader sense, humanism. In this health drama, all actors often complain of formal inaccuracies while paying little attention to substantive ones. We argue that a more human emphatic patient-family-doctor relationship training to consider the undeniable progress of medicine and the fragility of all of us.
Language	English
Publishing date	2024-02-19
Publishing country	England
Document type	Journal Article
ZDB-ID	632898-2
ISSN	1543-0154 ; 0885-8195 ; 1543-1154
ISSN (online)	1543-0154
ISSN	0885-8195 ; 1543-1154
DOI	10.1007/s13187-024-02410-3
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Article: Harmful Interference of Detoxifying Diets and Nutraceuticals with Adherence to Abemaciclib in Advanced Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor-2-Negative Breast Cancer: A Case Report.

Gebbia, Vittorio / Piazza, Dario / Valerio, Maria Rosaria

Case reports in oncology

2021 Volume 14, Issue 3, Page(s) 1399–1406

Abstract: Many cancer patients use integrative therapies with a combination of natural products and diets. In the Western world, integrative medicine is often not shared with oncologists even during antineoplastic treatments. This behavior stems from the unmet ... ...

Abstract	Many cancer patients use integrative therapies with a combination of natural products and diets. In the Western world, integrative medicine is often not shared with oncologists even during antineoplastic treatments. This behavior stems from the unmet needs of cancer patients who may feel oncologists' underestimation of their symptoms and spiritual aspects. This case report demonstrates the potential harm of inadequate diet and nutraceutical intake in a 68-year-old woman with metastatic estrogen receptor-positive, human epidermal growth factor receptor-2-negative breast cancer. Her care team recommended hormone therapy with abemaciclib plus fulvestrant. Her diarrhea started after 10 days of therapy and did not disappear, despite the use of loperamide, causing a significant reduction in adherence and dose intensity of abemaciclib. The patient finally disclosed to her oncologist she was following a detoxifying diet and taking several nutraceuticals. Her diarrhea was correlated with abemaciclib but most probably exacerbated and prolonged by the diet. Evaluation of disease after 3 months showed progressive disease. Integrative medicine should be in the multidisciplinary management of cancer patients to avoid potentially harmful events and ameliorate patients' quality of life in a holistic approach.
Language	English
Publishing date	2021-09-23
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2458961-5
ISSN	1662-6575
ISSN	1662-6575
DOI	10.1159/000518779
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Article ; Online: Correlation between sentinel lymph node biopsy and non-sentinel lymph node metastasis in patients with cN0 breast carcinoma: comparison of invasive ductal carcinoma and invasive lobular carcinoma.

Cipolla, Calogero / Lupo, Simona / Grassi, Nello / Tutino, Giuseppe / Greco, Martina / Eleonora, D'Agati / Gebbia, Vittorio / Valerio, Maria Rosaria

World journal of surgical oncology

2024 Volume 22, Issue 1, Page(s) 100

Abstract: Background: Some studies have suggested that axillary lymph node dissection (ALND) can be avoided in women with cN0 breast cancer with 1-2 positive sentinel nodes (SLNs). However, these studies included only a few patients with invasive lobular ... ...

Abstract	Background: Some studies have suggested that axillary lymph node dissection (ALND) can be avoided in women with cN0 breast cancer with 1-2 positive sentinel nodes (SLNs). However, these studies included only a few patients with invasive lobular carcinoma (ILC), so the validity of omitting ALDN in these patients remains controversial. This study compared the frequency of non-sentinel lymph nodes (non-SLNs) metastases in ILC and invasive ductal carcinoma (IDC). Materials methods: Data relating to a total of 2583 patients with infiltrating breast carcinoma operated at our institution between 2012 and 2023 were retrospectively analyzed: 2242 (86.8%) with IDC and 341 (13.2%) with ILC. We compared the incidence of metastasis to SLNs and non-SLNs between the ILC and IDC cohorts and examined factors that influenced non-SLNs metastasis. Results: SLN biopsies were performed in 315 patients with ILC and 2018 patients with IDC. Metastases to the SLNs were found in 78/315 (24.8%) patients with ILC and in 460 (22.8%) patients with IDC (p = 0.31). The incidence of metastases to non-SLNs was significantly higher (p = 0.02) in ILC (52/78-66.7%) compared to IDC (207/460 - 45%). Multivariate analysis showed that ILC was the most influential predictive factor in predicting the presence of metastasis to non-SLNs. Conclusions: ILC cases have more non-SLNs metastases than IDC cases in SLN-positive patients. The ILC is essential for predicting non-SLN positivity in macro-metastases in the SLN. The option of omitting ALND in patients with ILC with 1-2 positive SLNs still requires further investigation.
MeSH term(s)	Humans ; Female ; Sentinel Lymph Node Biopsy ; Lymphatic Metastasis/pathology ; Carcinoma, Lobular/pathology ; Retrospective Studies ; Carcinoma, Ductal, Breast/pathology ; Breast Neoplasms/surgery ; Breast Neoplasms/pathology ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node/pathology ; Lymph Node Excision ; Lymph Nodes/pathology ; Axilla/pathology
Language	English
Publishing date	2024-04-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2118383-1
ISSN	1477-7819 ; 1477-7819
ISSN (online)	1477-7819
ISSN	1477-7819
DOI	10.1186/s12957-024-03375-9
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Article: Abemaciclib pharmacology and interactions in the treatment of HR+/HER2- breast cancer: a critical review.

Martorana, Federica / Sanò, Maria Vita / Valerio, Maria Rosaria / Fogli, Stefano / Vigneri, Paolo / Danesi, Romano / Gebbia, Vittorio

Therapeutic advances in drug safety

2024 Volume 15, Page(s) 20420986231224214

Abstract: Abemaciclib (ABE) in combination with endocrine therapy represents the mainstay treatment for either endocrine-resistant metastatic or high-risk early-stage HR+/HER2- breast cancer patients. Hence, an adequate knowledge of this agent pharmacodynamic, ... ...

Abstract	Abemaciclib (ABE) in combination with endocrine therapy represents the mainstay treatment for either endocrine-resistant metastatic or high-risk early-stage HR+/HER2- breast cancer patients. Hence, an adequate knowledge of this agent pharmacodynamic, pharmacokinetic, and of its drug-drug interactions (DDIs) is crucial for an optimal patients management. Additionally, ABE interference with food and complementary/alternative medicines should be taken into account in the clinical practice. Several online tools allow to freely check DDIs and can be easily consulted before prescribing ABE. According to one of this instruments, ABE display the lowest number of interactions among the available cyclin-dependent kinase 4/6 inhibitors. Still, clinicians should be aware that online tools cannot replace the technical datasheet of the drug as well as a comprehensive clinical assessment for each patient. Here we critically review the main pharmacological features of ABE, then focusing on its potential interactions with drugs, food, and alternative medicine, in order to provide a guide for its optimal use in the treatment of HR+/HER2- breast cancer patients.
Language	English
Publishing date	2024-04-25
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2583589-0
ISSN	2042-0994 ; 2042-0986
ISSN (online)	2042-0994
ISSN	2042-0986
DOI	10.1177/20420986231224214
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Article ; Online: The Impact of Neoadjuvant Chemotherapy on Axillary Surgical Management of Patients With Breast Cancer and Positive Axillary Lymph Nodes.

Cipolla, Calogero / Lupo, Simona / Grassi, Nello / Battaglia, Maria Cristina / Mesi, Chiara / Scandurra, Giuseppina / Gebbia, Vittorio / Valerio, Maria Rosaria

Anticancer research

2024 Volume 44, Issue 5, Page(s) 2047–2053

Abstract: Background/aim: Sentinel lymph node biopsy (SLNB) is effective in patients with breast cancer (BC) and positive axillary lymph nodes undergoing neoadjuvant chemotherapy (NAC). However, the frequency with which axillary lymphadenectomy (ALND) can be ... ...

Abstract	Background/aim: Sentinel lymph node biopsy (SLNB) is effective in patients with breast cancer (BC) and positive axillary lymph nodes undergoing neoadjuvant chemotherapy (NAC). However, the frequency with which axillary lymphadenectomy (ALND) can be avoided remains debated. This study aimed to identify patient populations that can benefit from this approach. Patients and methods: The data of 195 consecutive patients with BC and positive axillary lymph nodes at diagnosis who underwent NAC were retrospectively analyzed. In all cases, the positivity of the lymph nodes was confirmed by cytological examination. Patients converted to ycN0 after NAC were considered eligible for SLNB. Indications for ALND were failed mapping, fewer than three SLNs recovered, and positive SLNs. Results: Of 195 cN1 patients potentially eligible for SLNB, 71 (36.4%) remained clinically ycN+ after NAC and underwent elective ALND, while 124 (83.7%) converted to ycN0 after NAC and SLNB. The lymph node identification rate was 95.9% (119/124 patients) with three or more SLNs recovered in 83 cases (89.8%). One or two lymph nodes were recovered in 36 cases (30.2%). Nodal pathologic complete response (pCR) was found in 34/83 (40.9%) patients with three or more SLNs recovered. Considering all 195 patients initially included in the study, 55 patients (28.2%) achieved lymph node pCR after NAC. Nodal pCR varied based on hormone receptor and HER2 status, with rates ranging from 20.7% for ER+/ Conclusion: More than 80% of cN1 patients in our study were eligible for SLNB after NAC. ALND could be avoided in approximately 30% of cases, supporting the role of NAC in reducing the need for ALND among patients with lymph node metastases.
MeSH term(s)	Humans ; Breast Neoplasms/pathology ; Breast Neoplasms/drug therapy ; Breast Neoplasms/surgery ; Female ; Neoadjuvant Therapy ; Middle Aged ; Axilla ; Sentinel Lymph Node Biopsy/methods ; Aged ; Adult ; Lymph Node Excision/methods ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Retrospective Studies ; Lymphatic Metastasis
Language	English
Publishing date	2024-04-27
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.17008
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Zs.A 1642: Show issues

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Article ; Online: Letter to the Editor: statistics and clinical perception of patients' reported outcomes for palbociclib and abemaciclib: a sliding doors story.

Gebbia, Vittorio / Valerio, Maria Rosaria / Martorana, Federica / Sanò, Maria Vita / Vigneri, Paolo

Journal of comparative effectiveness research

2023 Volume 12, Issue 6, Page(s) e220212

MeSH term(s)	Humans ; Female ; Aminopyridines/therapeutic use ; Pyridines/therapeutic use ; Perception ; Breast Neoplasms ; Antineoplastic Combined Chemotherapy Protocols
Chemical Substances	abemaciclib (60UAB198HK) ; palbociclib (G9ZF61LE7G) ; Aminopyridines ; Pyridines
Language	English
Publishing date	2023-04-28
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2669725-7
ISSN	2042-6313 ; 2042-6305
ISSN (online)	2042-6313
ISSN	2042-6305
DOI	10.57264/cer-2022-0212
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Article ; Online: Breast Cancer in Two Ex-Votos, A Millennia Apart: Patients' Hope and Faith Expressed Through the Centuries in Votive Offerings.

Gebbia, Vittorio / Piazza, Dario / Valerio, Maria Rosaria / Di Paola, Jessica Joy / Cusumano, Nicola

Journal of religion and health

2023 Volume 62, Issue 3, Page(s) 1976–1984

Abstract: A votive offering or ex-voto includes a variety of usually non-professional artworks offered to divinities and placed in religious sites to fulfill a vow or in gratitude for recovery from an illness or injury. Unfortunately, the ancient period lacks a ... ...

Abstract	A votive offering or ex-voto includes a variety of usually non-professional artworks offered to divinities and placed in religious sites to fulfill a vow or in gratitude for recovery from an illness or injury. Unfortunately, the ancient period lacks a scientifically verifiable understanding of the true nature of cancer and its natural history and, consequently, a lack of effective treatment. This paper discusses two ex-votos potentially related to breast cancer distant more than 2000 years, one from the other. The ex-votos convey the complex relationship of humans with illness through an art expression stemming from the heart and minds of ordinary people.
MeSH term(s)	Humans ; Female ; Breast Neoplasms ; Religion and Medicine
Language	English
Publishing date	2023-02-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2017250-3
ISSN	1573-6571 ; 0022-4197
ISSN (online)	1573-6571
ISSN	0022-4197
DOI	10.1007/s10943-023-01775-x
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Article ; Online: Nutritional management of the patient with pancreatic cancer: from the diagnostic and therapeutic pathway to an integrated hospital-territory approach.

Gebbia, V / Cuggino, R / Spada, M / Blasi, L / Mezzatesta, P / Marchesa, P / Arena, G / Mandalà, L / Firenze, A

La Clinica terapeutica

2023 Volume 174, Issue 2, Page(s) 203–210

Abstract: Abstract: Pancreatic cancer is associated to a high risk of malnutrition and neoplastic cachexia even at first diagnosis. Malnutrition is a negative prognostic factor for the outcome of surgery or medical oncology treatments. Despite the good awareness ... ...

Abstract	Abstract: Pancreatic cancer is associated to a high risk of malnutrition and neoplastic cachexia even at first diagnosis. Malnutrition is a negative prognostic factor for the outcome of surgery or medical oncology treatments. Despite the good awareness of the problem and the knowledge of the guidelines, the early recognition of malnutrition and its management are still uneven, mainly due to the lack of implementation of standardized and shared protocols and the shortage of dedicated clinical nutritionists and dieticians. An early and appropriate nutritional intervention is mandatory to improve the outcome of patients with pancreatic cancer at any stage of disease. The Mini Nutritional Assessment is useful tool to screen patients malnourished or at risk of malnutrition. The need for the establishment and implementation of an integrated hospital - territorial assistance as well as a home-delivered nutrition service is discussed.
MeSH term(s)	Humans ; Malnutrition/diagnosis ; Malnutrition/etiology ; Malnutrition/therapy ; Cachexia/diagnosis ; Cachexia/etiology ; Cachexia/therapy ; Nutrition Assessment ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/therapy ; Hospitals ; Pancreatic Neoplasms
Language	English
Publishing date	2023-03-15
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	123320-8
ISSN	1972-6007 ; 0009-9074
ISSN (online)	1972-6007
ISSN	0009-9074
DOI	10.7417/CT.2023.2520
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