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Article ; Online: Network meta-analysis of first-line systemic regimens for older patients with advanced NSCLC.

Luciani, Andrea / Dottorini, Lorenzo / Battaiotto, Elena / Petrelli, Fausto

2024

Abstract: Various immunotherapy treatments have received approval for the treatment of advanced non-small cell lung cancer (NSCLC), either as standalone or in conjunction with chemotherapy, contingent upon the extent of PD-L1 expression. These treatments are ... ...

Abstract	Various immunotherapy treatments have received approval for the treatment of advanced non-small cell lung cancer (NSCLC), either as standalone or in conjunction with chemotherapy, contingent upon the extent of PD-L1 expression. These treatments are commonly utilized in clinical practice. However, a specific gap exists in direct comparisons of these regimens in elderly patients. The aim of this network meta-analysis (NMA) was to examine the effectiveness of PD-1/PD-L1 inhibitors, either alone or in conjunction with chemotherapy, as the initial treatment for elderly patients diagnosed with advanced NSCLC. We extensively searched PubMed, EMBASE and the Cochrane Library to gather randomized clinical trials that utilized PD-1/PD-L1 inhibitors as the first-line therapy for advanced NSCLC. By means of Bayesian NMA, we conducted an analysis on hazard ratios (HRs) related to overall survival (OS). A total of 5240 patients were included in the 21 trials. Across all studies, cemiplimab exhibited a noteworthy superiority to chemotherapy in terms of OS [HR = 0.48, 95% confidence interval (CI): 0.3-0.77]. In the subgroup analysis, it was observed that patients with PD-L1 expression of 50% or higher experienced the greatest OS benefit from cemiplimab (HR = 0.48, 95% CI: 0.3-0.77). Conversely, the cohort with unselected PD-L1 scores (>1 or any score) exhibited the greatest OS benefit when treated with pembrolizumab combined with chemotherapy, as indicated by a HR of 0.69 (95% CI: 0.52-0.9). Chemotherapy combined with pembrolizumab and cemiplimab monotherapy may represent the reference regimens for older patients with NSCLC with unselected and >50% PD-L1 expression, respectively.
Language	English
Publishing date	2024-03-19
Publishing country	England
Document type	Journal Article
ZDB-ID	1065301-6
ISSN	1473-5741 ; 0959-4973
ISSN (online)	1473-5741
ISSN	0959-4973
DOI	10.1097/CAD.0000000000001602
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Zs.A 3125: Show issues

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Article ; Online: Reply to the letter to the editor 'Reply to Solinas et al, venous and arterial thromboembolic events with immune checkpoint inhibitors: A systematic review' by Frere et al.

Petrelli, Fausto / Solinas, Cinzia

Thrombosis research

2021 Volume 208, Page(s) 217–218

MeSH term(s)	Humans ; Immune Checkpoint Inhibitors ; Veins
Chemical Substances	Immune Checkpoint Inhibitors
Language	English
Publishing date	2021-03-11
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	121852-9
ISSN	1879-2472 ; 0049-3848
ISSN (online)	1879-2472
ISSN	0049-3848
DOI	10.1016/j.thromres.2021.03.001
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Zs.A 863: Show issues

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Article ; Online: Prognostic relevance of sidedness in older patients with colon cancer: A review and pooled analysis of 227,218 patients.

Petrelli, Fausto / Dottorini, Lorenzo / Luciani, Andrea

Journal of geriatric oncology

2023 Volume 15, Issue 1, Page(s) 101624

Abstract: Age is a major risk factor for sporadic colon cancer (CC). In the general population, the side of the tumor (right versus left) shows a possible significant prognostic effect, with right tumors displaying the worst outcome due to biological differences. ... ...

Abstract	Age is a major risk factor for sporadic colon cancer (CC). In the general population, the side of the tumor (right versus left) shows a possible significant prognostic effect, with right tumors displaying the worst outcome due to biological differences. However, little is known about the role of sidedness in the older population. We conducted a pooled analysis of observational and prospective studies to confirm or reject the hypothesis that side is a prognostic variable, even in older patients with CC. Using the terms ("colorectal" or "colon") and ("cancer" or "carcinoma") and ("elderly" or "older" or "65 years" or "70 years" or "75 years") and ("side" or "site" or "right" or "left"), we searched PubMed, Embase, and the Cochrane Library through January 2023. We selected studies in the English language to compare the prognosis of left versus right CC in older patients (with a lower age limit of 65 years). The primary endpoint was overall survival (OS). Hazard ratios (HRs) for OS with relative 95% confidence intervals (CIs) were extracted from each study. Summary HRs were calculated using random- or fixed-effects models, depending on the heterogeneity of the included studies. The review process led to the inclusion of 13 articles. The studies reported the OS data for a total of 227,218 patients with CC. The CC side was not independently associated with mortality risk in older CC patients (HR 0.97; 95% CI 0.9-1.04; p = 0.34). High heterogeneity was observed in the main analysis (P < 0.01; I2 = 85%). In conclusion, our analysis shows that the tumor being on the left or right side in older patients with CC has no significant role in the risk of overall death. These data support the use of other parameters, such as stage, biology, comorbidities, and life expectancy, to decide on treatment and the prolongation of screenings until a patient's latest years.
MeSH term(s)	Humans ; Aged ; Prognosis ; Prospective Studies ; Neoplasm Staging ; Colonic Neoplasms ; Proportional Hazards Models
Language	English
Publishing date	2023-09-09
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2556813-9
ISSN	1879-4076 ; 1879-4068
ISSN (online)	1879-4076
ISSN	1879-4068
DOI	10.1016/j.jgo.2023.101624
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Article ; Online: 10 years or less of extended adjuvant endocrine therapy for postmenopausal breast cancer patients: A systematic review and network meta-analysis.

Petrelli, Fausto / Cavallone, Matteo / Dottorini, Lorenzo

European journal of cancer (Oxford, England : 1990)

2023 Volume 193, Page(s) 113322

Abstract: Introduction: Adjuvant hormonal therapy, with or without prior chemotherapy, has been widely recognised as the preferred treatment strategy for resected breast cancer (BC) for a minimum duration of 5 years. If the effectiveness of therapy beyond a 5- ... ...

Abstract	Introduction: Adjuvant hormonal therapy, with or without prior chemotherapy, has been widely recognised as the preferred treatment strategy for resected breast cancer (BC) for a minimum duration of 5 years. If the effectiveness of therapy beyond a 5-year period has been established, there is still ongoing debate regarding the optimal duration for this prolonged period. A network meta-analysis (NMA) was conducted to ascertain the optimal duration of extended therapy for resected BC in postmenopausal women. Material and methods: A comprehensive search was conducted on online databases, including MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, to identify all randomised trials on extended duration of endocrine therapy. The search was limited to trials that had been published before 30th April 2023. The study focused on evaluating disease-free survival (DFS) as the primary outcome, with overall survival (OS) as the secondary endpoint. Under the Bayesian framework, NMA was performed using the GeMTC package. The relative rankings of the treatments were determined by utilising surface under the cumulative ranking curve (SUCRA) p scores. A network meta-regression analysis was employed to ascertain the impact of the baseline characteristics of the disease and the initial treatments administered. Results: In the overall population, increasing the duration by 5 years did not result in a significantly better DFS compared to durations of 2-3 and 3-4 more years (hazard ratio [HR] = 0.97, 95% confidence interval [CI] [0.88-1.08] and HR = 0.87, 95% CI [0.72-1.06]). This effect was independent of adjuvant chemotherapy and nodal status. However, the effect of 5 more years of AI was significantly better in node-positive BC and in those who received some years of tamoxifen instead of aromatase inhibitors (AIs) as initial adjuvant therapy. OS was not affected by the administration of extended endocrine therapy. Conclusions: We conclude that an extended course of AI lasting 2-3 years, following an initial 5-year treatment, may be considered an appropriate regimen for achieving DFS benefits. In node-positive BC cases, it has been observed that a duration of 10 years provides a greater advantage compared to shorter durations, especially when tamoxifen is administered initially. Therefore, it is suggested that a longer duration is a potential standard of care in these cases.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/drug therapy ; Antineoplastic Agents, Hormonal/therapeutic use ; Postmenopause ; Bayes Theorem ; Network Meta-Analysis ; Tamoxifen/therapeutic use ; Aromatase Inhibitors/therapeutic use ; Chemotherapy, Adjuvant ; Adjuvants, Immunologic/therapeutic use
Chemical Substances	Antineoplastic Agents, Hormonal ; Tamoxifen (094ZI81Y45) ; Aromatase Inhibitors ; Adjuvants, Immunologic
Language	English
Publishing date	2023-09-06
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	82061-1
ISSN	1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0277-5379 ; 0959-8049 ; 0964-1947
DOI	10.1016/j.ejca.2023.113322
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Zs.A 456: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 583: Show issues

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Article ; Online: Immune checkpoint inhibitor doublets: Are they beneficial for older patients? A systematic review and meta-analysis.

Dottorini, Lorenzo / Ghidini, Antonio / Deda, Rita / Sarno, Italo / Cavallone, Matteo / Luciani, Andrea / Petrelli, Fausto

Journal of geriatric oncology

2024 , Page(s) 101741

Abstract: Introduction: The introduction of immune checkpoint inhibitors (ICIs) has significantly transformed the treatment landscape for advanced malignancies. These inhibitors bolster the immune system's capacity to detect and destroy cancer cells. ICIs used in ...

Abstract	Introduction: The introduction of immune checkpoint inhibitors (ICIs) has significantly transformed the treatment landscape for advanced malignancies. These inhibitors bolster the immune system's capacity to detect and destroy cancer cells. ICIs used in cancer immunotherapy are primarily categorized into two groups: anti-PD-1/L1 and anti-CTLA-4. The application of combination ICI therapy (ICI doublets) in older patients prompts questions about their relative efficacy compared to standard therapies, particularly in comparison to younger patient cohorts. Materials and methods: This study involved an extensive review of literature from databases including PubMed, Embase, and the Cochrane Register of Controlled Trials. Our primary aim was to assess overall survival (OS) outcomes in a cohort of older patients, specifically those aged 65 and above, undergoing treatment for advanced cancers. The treatment modalities considered included ICI doublets, ICI monotherapy (alone or in combination with non-ICI drugs), and non-ICI therapies. The study aimed to compare the OS outcomes across these different therapeutic approaches. Results: The analysis incorporated data from 18 trials, indicating that patients treated with ICI doublets exhibited a statistically significant improvement in OS compared to the control group (hazard ratio [HR] = 0.9, 95% confidence interval [CI] 0.84-0.96; P < 0.01). The addition of CTLA-4 inhibitors did not show significant advantages over anti-PD-1/L1 monotherapy (HR = 0.92, 95% CI 0.83-1.02; P = 0.13). When compared to non-ICI therapies, such as chemotherapy alone, ICI doublets demonstrated improved OS outcomes (HR = 0.89, 95% CI 0.82-0.97; P < 0.01). Discussion: Our findings suggest that ICI doublets may offer a modest improvement in the outcomes of older cancer patients compared to non-ICI-based treatments. Consequently, the use of ICI doublets in older patients should be considered on an individual basis, prioritizing cases where there are clear advantages over conventional therapy. This study underscores the importance of developing personalized treatment strategies for older patients, necessitating a cautious and individualized approach in medication selection.
Language	English
Publishing date	2024-03-09
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2556813-9
ISSN	1879-4076 ; 1879-4068
ISSN (online)	1879-4076
ISSN	1879-4068
DOI	10.1016/j.jgo.2024.101741
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Article ; Online: Surrogate endpoints for new anti-cancer drugs approvals: Are we follow the right way?

Perego, Gianluca / Petrelli, Fausto

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

2020 Volume 27, Issue 2, Page(s) 448–449

MeSH term(s)	Antineoplastic Agents/therapeutic use ; Biomarkers ; Drug Approval ; Humans ; Neoplasms/drug therapy
Chemical Substances	Antineoplastic Agents ; Biomarkers
Language	English
Publishing date	2020-12-29
Publishing country	England
Document type	Journal Article
ZDB-ID	1330764-2
ISSN	1477-092X ; 1078-1552
ISSN (online)	1477-092X
ISSN	1078-1552
DOI	10.1177/1078155220984834
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Zs.A 4488: Show issues

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Article ; Online: Lobular Carcinoma of the Breast and Utility of Oncotype Dx®: a Retrospective Decision Impact Analysis.

Barni, Sandro / Fabi, Alessandra / Petrelli, Fausto

Clinical breast cancer

2022 Volume 23, Issue 3, Page(s) e173–e174

Abstract: Purpose: It is still relatively questioned if the benefit of Recurrent Score (RS) extends to invasive lobular carcinoma (ILC), which represents 10-15% of all invasive Breast Cancer (BC). We present the results of the lobular carcinoma subgroup of the ... ...

Abstract	Purpose: It is still relatively questioned if the benefit of Recurrent Score (RS) extends to invasive lobular carcinoma (ILC), which represents 10-15% of all invasive Breast Cancer (BC). We present the results of the lobular carcinoma subgroup of the PONDx Italy study[1]. that collected data on real-life use of the Oncotype DX® test in Italian oncological community clinical practice. Methods: We present the results of the lobular carcinoma subgroup of the PONDx Italy study that collected data on real-life use of the Oncotype DX® test in Italian oncological community clinical practice. The study primarily evaluated the impact of the Oncotype DX assay results on physicians' treatment decisions. In the primary analysis, data from 1724 BC patients who underwent Oncotype DX testing were available from 27 reference centers located in 6 regions of Italy (Lombardia, Lazio, Emilia Romagna, Campania, Abruzzo, and Marche). Results: Among patients with data available, 214 had ILC. In this cohort, 100 (47%) of patients with ILC had treatment recommendations for CT + HT before the availability of their RS result. After the availability of the RS result, recommendations for CT+HT decreased to 47 cases (22%). Conclusion: the decision to opt for the Oncotype Dx test should not be based on the histology subgroup only because a small population of ER+ ILC BC patients may still attain important information from testing. Despite this information, its predictive value needs more dedicated trials to be confirmed.
MeSH term(s)	Humans ; Female ; Carcinoma, Lobular/genetics ; Carcinoma, Lobular/therapy ; Carcinoma, Lobular/pathology ; Breast Neoplasms/diagnosis ; Breast Neoplasms/genetics ; Breast Neoplasms/therapy ; Retrospective Studies ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/genetics ; Neoplasm Recurrence, Local/pathology ; Gene Expression Profiling/methods
Language	English
Publishing date	2022-12-14
Publishing country	United States
Document type	Editorial
ZDB-ID	2106734-X
ISSN	1938-0666 ; 1526-8209
ISSN (online)	1938-0666
ISSN	1526-8209
DOI	10.1016/j.clbc.2022.12.005
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Article ; Online: Cemiplimab in cutaneous squamous cell carcinomas (SCC): an overview and a clinical case.

Ghidini, Antonio / Santangelo, Domenico / Vaccaro, Giovanni / Chillura, Mario / Petrelli, Fausto

Oral oncology

2022 Volume 128, Page(s) 105847

Abstract: Introduction: Cemiplimab, a monoclonal antibody directed against the PD-1 receptor of immune cells, has recent indication for the treatment of patients with locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC).: Case description: ... ...

Abstract	Introduction: Cemiplimab, a monoclonal antibody directed against the PD-1 receptor of immune cells, has recent indication for the treatment of patients with locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC). Case description: We present the clinical case of an elderly woman affected by locally advanced squamous carcinoma of the left cheek, in excellent response after only one course of therapy with cemiplimab, with good tolerability. Conclusions: Immunotherapy is a new therapeutic option in cSCC.
MeSH term(s)	Aged ; Antibodies, Monoclonal, Humanized/therapeutic use ; Carcinoma, Squamous Cell/drug therapy ; Carcinoma, Squamous Cell/pathology ; Female ; Humans ; Programmed Cell Death 1 Receptor/therapeutic use ; Skin Neoplasms/drug therapy ; Skin Neoplasms/pathology
Chemical Substances	Antibodies, Monoclonal, Humanized ; Programmed Cell Death 1 Receptor ; cemiplimab (6QVL057INT)
Language	English
Publishing date	2022-03-31
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	1120465-5
ISSN	1879-0593 ; 0964-1955 ; 1368-8375
ISSN (online)	1879-0593
ISSN	0964-1955 ; 1368-8375
DOI	10.1016/j.oraloncology.2022.105847
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Zs.A 4869: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.A 456: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Is adjuvant immunotherapy effective in patients with urothelial cancer?

Dalla Volta, Alberto / Petrelli, Fausto / Luciani, Andrea / Caramella, Irene / Grisanti, Salvatore / Berruti, Alfredo

Minerva urology and nephrology

2022 Volume 74, Issue 3, Page(s) 252–254

MeSH term(s)	Carcinoma, Transitional Cell/therapy ; Humans ; Immunologic Factors ; Immunotherapy ; Urinary Bladder Neoplasms/therapy
Chemical Substances	Immunologic Factors
Language	English
Publishing date	2022-02-11
Publishing country	Italy
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3062840-4
ISSN	2724-6442
ISSN (online)	2724-6442
DOI	10.23736/S2724-6051.22.04841-8
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Article ; Online: Antibody-drug conjugates in treating older patients suffering from cancer: what is the real value?

Perego, Gianluca / Ghidini, Antonio / Luciani, Andrea / Petrelli, Fausto

Human vaccines & immunotherapeutics

2021 Volume 17, Issue 12, Page(s) 5575–5578

Abstract: Immunotherapeutic drugs and target therapies have represented an epochal change in treating cancer patients. They represent an attractive option in oncologists' armamentarium, particularly if we consider the optimal balance between efficacy and toxicity. ...

Abstract	Immunotherapeutic drugs and target therapies have represented an epochal change in treating cancer patients. They represent an attractive option in oncologists' armamentarium, particularly if we consider the optimal balance between efficacy and toxicity. As a step forward, immuno- and target-therapies have merged intending to improve efficacy: antibody-drug conjugates ensure the perfect combination. They allow the delivery of large amounts of drugs to the target with a limited 'off-target' effect and a low rate of adverse events. These aspects could make immunoconjugates palatable as the first choice for fragile patients, but solid evidence does not exist on the use of these drugs in this population type, especially older people.
MeSH term(s)	Aged ; Antineoplastic Agents/adverse effects ; Humans ; Immunoconjugates/adverse effects ; Neoplasms/drug therapy
Chemical Substances	Antineoplastic Agents ; Immunoconjugates
Language	English
Publishing date	2021-12-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2021.1999711
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