Francesco Agustoni
@smatteo.pv.it
Medical Oncology
Fondazione IRCCS Policlinico San Matteo - Pavia
RESEARCH INTERESTS
Medical Oncology, Non-small cell lung cancer
Scopus Publications
Scopus Publications
Riccardo Gerosa, Rita De Sanctis, Flavia Jacobs, Chiara Benvenuti, Mariangela Gaudio, Giuseppe Saltalamacchia, Rosalba Torrisi, Giovanna Masci, Chiara Miggiano, Francesco Agustoni,et al.
Elsevier BV
Arsela Prelaj, Monica Ganzinelli, Leonardo Provenzano, Laura Mazzeo, Giuseppe Viscardi, Giulio Metro, Giulia Galli, Francesco Agustoni, Carminia Maria Della Corte, Andrea Spagnoletti,et al.
Elsevier BV
Francesco Passiglia, Maria Lucia Reale, Giuseppe Lo Russo, Giulia Pasello, Gabriele Minuti, Alessandra Bulotta, Domenico Galetta, Giacomo Pelizzari, Claudio Sini, Emilio Bria,et al.
Elsevier BV
Francesco Rocco Bertuccio, Francesco Agustoni, Giulia Galli, Chandra Bortolotto, Jessica Saddi, Guido Baietto, Nicola Baio, Simone Montini, Paola Putignano, Gioacchino D’Ambrosio,et al.
MDPI AG
Pleural mesothelioma is an aggressive disease with diffuse nature, low median survival, and prolonged latency presenting difficulty in prognosis, diagnosis, and treatment. Here, we review all these aspects to underline the progress being made in its investigation and to emphasize how much work remains to be carried out to improve prognosis and treatment.
Chiara Catania, Andrea Riccardo Filippi, Claudia Sangalli, Gaia Piperno, Marco Russano, Carlo Greco, Vieri Scotti, Claudia Proto, Chiara Bennati, Marzia Di Pietro Paolo,et al.
Elsevier BV
Chandra Bortolotto, Gaia Messana, Antonio Lo Tito, Giulia Maria Stella, Alessandra Pinto, Chiara Podrecca, Riccardo Bellazzi, Alessia Gerbasi, Francesco Agustoni, Fei Han,et al.
MDPI AG
We investigated the association of T1/T2 mapping values with programmed death-ligand 1 protein (PD-L1) expression in lung cancer and their potential in distinguishing between different histological subtypes of non-small cell lung cancers (NSCLCs). Thirty-five patients diagnosed with stage III NSCLC from April 2021 to December 2022 were included. Conventional MRI sequences were acquired with a 1.5 T system. Mean T1 and T2 mapping values were computed for six manually traced ROIs on different areas of the tumor. Data were analyzed through RStudio. Correlation between T1/T2 mapping values and PD-L1 expression was studied with a Wilcoxon–Mann–Whitney test. A Kruskal–Wallis test with a post-hoc Dunn test was used to study the correlation between T1/T2 mapping values and the histological subtypes: squamocellular carcinoma (SCC), adenocarcinoma (ADK), and poorly differentiated NSCLC (PD). There was no statistically significant correlation between T1/T2 mapping values and PD-L1 expression in NSCLC. We found statistically significant differences in T1 mapping values between ADK and SCC for the periphery ROI (p-value 0.004), the core ROI (p-value 0.01), and the whole tumor ROI (p-value 0.02). No differences were found concerning the PD NSCLCs.
Andrea Riccardo Filippi, Francesco Agustoni, Stefano Arcangeli, Diego Cortinovis, Alessandra Ferrari, Daniela Cicognini, Jessica Saddi, Catherine Klersy, Paolo Pedrazzoli, Umberto Malapelle,et al.
Elsevier BV
Giulia Maria Stella, Vittorio Chino, Paola Putignano, Francesco Bertuccio, Francesco Agustoni, Laura Saracino, Stefano Tomaselli, Jessica Saddi, Davide Piloni, and Chandra Bortolotto
MDPI AG
Background and rationale. Novel coronavirus-related disease (COVID-19) has profoundly influenced hospital organization and structures worldwide. In Italy, the Lombardy Region, with almost 17% of the Italian population, rapidly became the most severely affected area since the pandemic beginning. The first and the following COVID-19 surges significantly affected lung cancer diagnosis and subsequent management. Much data have been already published regarding the therapeutic repercussions whereas very few reports have focused on the consequences of the pandemic on diagnostic procedures. Methods. We, here, would like to analyze data of novel lung cancer diagnosis performed in our Institution in Norther Italy where we faced the earliest and largest outbreaks of COVID-19 in Italy. Results. We discuss, in detail, the strategies developed to perform biopsies and the safe pathways created in emergency settings to protect lung cancer patients in subsequent therapeutic phases. Quite unexpectedly, no significant differences emerged between cases enrolled during the pandemic and those before, and the two populations were homogeneous considering the composition and diagnostic and complication rates. Conclusions. By pointing out the role of multidisciplinarity in emergency contexts, these data will be of help in the future for designing tailored strategies to manage lung cancer in a real-life setting.
Davide Piloni, Francesco R. Bertuccio, Cristiano Primiceri, Pietro Rinaldi, Vittorio Chino, David Michael Abbott, Federico Sottotetti, Chandra Bortolotto, Francesco Agustoni, Jessica Saddi,et al.
MDPI AG
Background. Growing evidence suggests that sublobar resections offer more favorable outcomes than lobectomy in early-stage lung cancer surgery. However, a percentage of cases that cannot be ignored develops disease recurrence irrespective of the surgery performed with curative intent. The goal of this work is thus to compare different surgical approaches, namely, lobectomy and segmentectomy (typical and atypical) to derive prognostic and predictive markers. Patients and Methods. Here we analyzed a cohort of 153 NSCLC patients in clinical stage TNM I who underwent pulmonary resection surgery with a mediastinal hilar lymphadenectomy from January 2017 to December 2021, with an average follow-up of 25.5 months. Partition analysis was also applied to the dataset to detect outcome predictors. Results. The results of this work showed similar OS between lobectomy and typical and atypical segmentectomy for patients with stage I NSCLC. In contrast, lobectomy was associated with a significant improvement in DFS compared with typical segmentectomy in stage IA, while in stage IB and overall, the two treatments were similar. Atypical segmentectomy showed the worst performance, especially in 3-year DFS. Quite unexpectedly, outcome predictor ranking analysis suggests a prominent role of smoking habits and respiratory function, irrespective of the tumor histotype and the patient’s gender. Conclusions. Although the limited follow-up interval cannot allow conclusive remarks about prognosis, the results of this study suggest that both lung volumes and the degree of emphysema-related parenchymal damage are the strongest predictors of poor survival in lung cancer patients. Overall, these data point out that greater attention should be addressed to the therapeutic intervention for co-existing respiratory diseases to obtain optimal control of early lung cancer.
Stefano Cavalieri, Viviana Vitolo, Amelia Barcellini, Sara Ronchi, Angelica Facoetti, Chiara Campo, Catherine Klersy, Silvia Molinelli, Francesco Agustoni, Virginia Valeria Ferretti,et al.
Future Medicine Ltd
ICONIC is a multicenter, open-label, nonrandomized phase II clinical trial aiming to assess the feasibility and clinical activity of the addition of carbon ion radiotherapy to immune checkpoint inhibitors in cancer patients who have obtained disease stability with pembrolizumab administered as per standard-of-care. The primary end point is objective response rate, and the secondary end points are safety, survival and disease control rate. Translational research is an exploratory aim. The planned sample size is 27 patients. The study combination will be considered worth investigating if at least four objective responses are observed. If the null hypothesis is rejected, ICONIC will be the first proof of concept of the feasibility and clinical activity of the addition of carbon ion radiotherapy to immune checkpoint inhibitors in oncology.
Riccardo Caccialanza, Emanuele Cereda, Francesco Agustoni, Catherine Klersy, Amanda Casirati, Elisabetta Montagna, Simona Carnio, Silvia Novello, Michele Milella, Sara Pilotto,et al.
Springer Science and Business Media LLC
Abstract Background Nutritional support, including nutritional counseling and oral nutritional supplements (ONS), has been recommended as a first-line strategy in patients with non-small cell lung cancer (NSCLC). Evidence on the efficacy of immunonutrition during immunotherapy in these patients is positive, but still limited some secondary endpoints, such as treatment toxicity and tolerance. We hypothesize that early systematic provision of ONS with a high-protein-high calorie mixture containing immunonutrients (Impact®) in addition to nutritional counseling, compared to nutritional counseling alone, is beneficial to patients with NSCLC receiving immunotherapy with or without chemotherapy. We designed the present study to evaluate the efficacy of early systematic provision of ONS enriched with immunonutrients compared to nutritional counseling alone, in patients with NSCLC undergoing immunotherapy. Study endpoints were: treatment response (primary endpoint: progression-free survival), treatment tolerance and toxicity, body weight, body composition, protein-calorie intake, quality of life, fatigue, muscle strength and immunological profile. Methods This is a pragmatic, multicentre, randomized (1:1), parallel-group, open label, controlled, pilot clinical trial (N = 180). Discussion The improvement of efficacy of nutritional support in oncology still deserves many efforts. Immunonutrition represents a promising approach also in patients with NSCLC, but evidence on its efficacy on clinical outcomes during immunotherapy is still inconclusive. The present pilot study, which guarantees early high-quality nutritional care (assessment and treatment) to all patients in agreement with current guidelines and recommendations, could represent one of the first proofs of efficacy of early oral immunonutrition in patients with cancer undergoing immunotherapy. Further large randomized trials addressing the improvement of supportive care could be hypothesized, accordingly. Trial registration This study is registered on ClinicalTrials.gov Identifier: NCT05384873.
Gennaro Ciliberto, Marco Canfora, Irene Terrenato, Chiara Agnoletto, Francesco Agustoni, Loredana Amoroso, Gustavo Baldassarre, Giuseppe Curigliano, Angelo Delmonte, Antonella De Luca,et al.
Springer Science and Business Media LLC
Abstract Background Molecular tumor boards (MTBs) match molecular alterations with targeted anticancer drugs upon failure of the available therapeutic options. Special and local needs are most likely to emerge through the comparative analysis of MTB networks, but these are rarely reported. This manuscript summarizes the state-of-art of 16 active Italian MTBs, as it emerges from an online survey curated by Alliance Against Cancer (ACC). Main text Most MTBs (13/16) are exclusively supported through local Institutional grants and meet regularly. All but one adopts a fully virtual or a mixed face-to-face/virtual calling/attendance meeting model. It appears that the ACC MTB initiative is shaping a hub-and-spoke virtual MTB network reminiscent of non-redundant, cost-effective healthcare organization models. Unfortunately, public awareness of MTB opportunities presently remains insufficient. Only one center has a website. Dedicated e-mail addresses are for the exclusive use of the MTB staff. More than half of ACC members consider a miscellanea of most or all solid and hematological malignancies, and more than one-third consider neoplasms arising at any anatomical location. The average number of Staff Members in MTBs is 9. More than 10 staff members simultaneously attend MTB meetings in 13 MTBs. A medical oncologist is invariably present and is in charge of introducing the clinical case either with (45%) or without previous discussion in organ-specific multidisciplinary Boards. All but two MTBs take charge of not only patients with no standard-of-care (SoC) therapy option, but also cases receiving NGS profiling in SoC settings, implying a larger number of yearly cases. All MTBs run targeted NGS panels. Three run whole-exome and/or RNAseq approaches. ESCAT-ESMO and/or Onco-KB levels of evidence are similarly used for diagnostic reporting. Most MTBs (11) provide a written diagnostic report within 15 days. Conclusions are invariably communicated to the patient by the medical oncologist. Conclusions MTB networking is crucial not only for molecular diagnosis and therapy assignment, but also for healthcare governance. Survey results show that MTBs review therapeutic opportunities at the crossover between standard-of-care with off-label, the former task being much beyond their scope. Societal and scientific implications of this beyond-the-scope MTB function may be relevant for healthcare in Italy and abroad.
Raffaella Fiamma Cabini, Francesca Brero, Andrea Lancia, Chiara Stelitano, Olga Oneta, Elena Ballante, Emanuela Puppo, Manuel Mariani, Emanuele Alì, Valentina Bartolomeo,et al.
Springer Science and Business Media LLC
Abstract Background and purpose In the retrospective-prospective multi-center "Blue Sky Radiomics” study (NCT04364776), we plan to test a pre-defined radiomic signature in a series of stage III unresectable NSCLC patients undergoing chemoradiotherapy and maintenance immunotherapy. As a necessary preliminary step, we explore the influence of different image-acquisition parameters on radiomic features’ reproducibility and apply methods for harmonization. Material and methods We identified the primary lung tumor on two computed tomography (CT) series for each patient, acquired before and after chemoradiation with i.v. contrast medium and with different scanners. Tumor segmentation was performed by two oncological imaging specialists (thoracic radiologist and radio-oncologist) using the Oncentra Masterplan® software. We extracted 42 radiomic features from the specific ROIs (LIFEx). To assess the impact of different acquisition parameters on features extraction, we used the Combat tool with nonparametric adjustment and the longitudinal version (LongComBat). Results We defined 14 CT acquisition protocols for the harmonization process. Before harmonization, 76% of the features were significantly influenced by these protocols. After, all extracted features resulted in being independent of the acquisition parameters. In contrast, 5% of the LongComBat harmonized features still depended on acquisition protocols. Conclusions We reduced the impact of different CT acquisition protocols on radiomic features extraction in a group of patients enrolled in a radiomic study on stage III NSCLC. The harmonization process appears essential for the quality of radiomic data and for their reproducibility. ClinicalTrials.gov Identifier: NCT04364776, First Posted:April 28, 2020, Actual Study Start Date: April 15, 2020, https://clinicaltrials.gov/ct2/show/NCT04364776.
Chandra Bortolotto, Giulia Maria Stella, Gaia Messana, Antonio Lo Tito, Chiara Podrecca, Giovanna Nicora, Riccardo Bellazzi, Alessia Gerbasi, Francesco Agustoni, Robert Grimm,et al.
MDPI AG
This study aims to investigate the correlation between intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in magnetic resonance imaging (MRI) and programmed death-ligand 1 (PD-L1) expression in non-small cell lung cancer (NSCLC). Twenty-one patients diagnosed with stage III NSCLC from April 2021 to April 2022 were included. The tumors were distinguished into two groups: no PD-L1 expression (<1%), and positive PD-L1 expression (≥1%). Conventional MRI and IVIM-DWI sequences were acquired with a 1.5-T system. Both fixed-size ROIs and freehand segmentations of the tumors were evaluated, and the data were analyzed through a software using four different algorithms. The diffusion (D), pseudodiffusion (D*), and perfusion fraction (pf) were obtained. The correlation between IVIM parameters and PD-L1 expression was studied with Pearson correlation coefficient. The Wilcoxon–Mann–Whitney test was used to study IVIM parameter distributions in the two groups. Twelve patients (57%) had PD-L1 ≥1%, and 9 (43%) <1%. There was a statistically significant correlation between D* values and PD-L1 expression in images analyzed with algorithm 0, for fixed-size ROIs (189.2 ± 65.709 µm²/s × 104 in no PD-L1 expression vs. 122.0 ± 31.306 µm²/s × 104 in positive PD-L1 expression, p = 0.008). The values obtained with algorithms 1, 2, and 3 were not significantly different between the groups. The IVIM-DWI MRI parameter D* can reflect PD-L1 expression in NSCLC.
Francesco Falanga, Pietro Rinaldi, C. Primiceri, C. Bortolotto, O. Oneta, F. Agustoni, P. Morbini, L. Saracino, D. Eleftheriou, F. Sottotetti and G. Stella
Surgery is part of a multimodal therapeutic approach to malignant pleural mesothelioma (MPM) although its real beneficial effect is still controversial. The optimal precise sequence of treatments within the trimodality is unclear, and should be decided upon a multidisciplinary consensus for each individual patient. Here, we analyzed the perioperative data of 19 MPM patients who underwent extended pleurectomy/decortication (EPD) with curative intent. The mean age at diagnosis was 67 years; 11 males and eight females. Ten patients were diagnosed with MPM via medical thoracoscopy (MT), and nine via video-assisted thoracoscopic surgery (VATS). The vast majority of cases harbored epitheliod forms. We compared neoadjuvant chemotherapy (NCT) followed by surgery (11 cases) versus surgery followed by adjuvant chemotherapy (ACT, 8 cases) within a 3-year period. All patients had extended pleurectomy/decortication and none had an extended pneumonectomy. Analysis of survival curves suggested that the short-term outcomes are better with upfront EDP followed by ACT if compared to EDP preceded by NCT. Although limited, the data highlighted the safety and feasibility of EPD, with manageable postoperative complications and no major burden for the patients.
Giulia Maria Stella, Filippo Scialò, Chandra Bortolotto, Francesco Agustoni, Vincenzo Sanci, Jessica Saddi, Lucio Casali, Angelo Guido Corsico, and Andrea Bianco
MDPI AG
It is well known that lung cancer relies on a number of genes aberrantly expressed because of somatic lesions. Indeed, the lungs, based on their anatomical features, are organs at a high risk of development of extremely heterogeneous tumors due to the exposure to several environmental toxic agents. In this context, the microbiome identifies the whole assemblage of microorganisms present in the lungs, as well as in distant organs, together with their structural elements and metabolites, which actively interact with normal and transformed cells. A relevant amount of data suggest that the microbiota plays a role not only in cancer disease predisposition and risk but also in its initiation and progression, with an impact on patients’ prognosis. Here, we discuss the mechanistic insights of the complex interaction between lung cancer and microbiota as a relevant component of the microenvironment, mainly focusing on novel diagnostic and therapeutic objectives.
Chiara Catania, Gaia Piperno, Alessandro Russo, Carlo Greco, Francesco Agustoni, Vieri Scotti, Claudia Proto, Claudia Sangalli, Fabiola Patani, Anna Santacaterina,et al.
Elsevier BV
S. Pilotto, F. Agustoni, A. Morelli, F. Lobascio, E. Cereda, P. Bironzo, I. Trestini, M. Milella, S. Novello, P. Pedrazzoli and R. Caccialanza
Erica Quaquarini, Federico Sottotetti, Francesco Agustoni, Emma Pozzi, Alberto Malovini, Cristina Maria Teragni, Raffaella Palumbo, Giuseppe Saltalamacchia, Barbara Tagliaferri, Emanuela Balletti,et al.
MDPI AG
Introduction: Immune checkpoint inhibitors (ICIs) have become the standard of treatment for patients with non-small cell lung cancer (NSCLC). However, there are still many uncertainties regarding the selection of the patient who could benefit more from this treatment. This study aims to evaluate the prognostic and predictive role of clinical and biological variables in unselected patients with advanced NSCLC candidates to receive ICIs. Methods: This is an observational and prospective study. The primary objective is the evaluation of the relationship between clinical and biological variables and the response to ICIs. Secondary objectives included: safety; assessment of the relationship between clinical and biological parameters/concomitant treatments and progression-free survival at 6 months and overall survival at 6 and 12 months. Nomograms to predict these outcomes have been generated. Results: A total of 166 patients were included. An association with response was found in the presence of the high immunohistochemical PD-L1 expression, squamous cell histotype, and early line of treatment, whereas a higher probability of progression was seen in the presence of anemia, high LDH values and neutrophil/lymphocyte ratio (NLR), pleural involvement, and thrombosis before treatment. The nomogram showed that anemia, PD-L1 expression, NLR, and LDH represented the most informative predictor as regards the three parameters of interest. Conclusions: In the era of personalized medicine, the results are useful for stratifying the patients and tailoring the treatments, considering both the histological findings and the clinical features of the patients.
Jennifer G. Whisenant, Javier Baena, Alessio Cortellini, Li-Ching Huang, Giuseppe Lo Russo, Luca Porcu, Selina K. Wong, Christine M. Bestvina, Matthew D. Hellmann, Elisa Roca,et al.
Elsevier BV
A. Lasagna, D. Lilleri, F. Agustoni, E. Percivalle, S. Borgetto, N. Alessio, G. Comolli, A. Sarasini, F. Bergami, J.C. Sammartino,et al.
Elsevier BV
Background
The durability of immunogenicity of SARS-CoV-2 vaccination in cancer patients remains to be elucidated. We prospectively evaluated the immunogenicity of the vaccine in triggering both the humoral and the cell-mediated immune response in cancer patients treated with anti PD-1/PD-L1 with or without chemotherapy six months after BNT162b2 vaccine.
Patients and methods
In the previous study, 88 patients were enrolled, while the analyses below refer to the 60 patients still on immunotherapy at the time of the follow up. According to previous SARS-CoV-2 exposure, patients were classified in SARS-CoV-2 naïve (without previous SARS-CoV-2 exposure) and SARS-CoV-2 experienced (with previous SARS-CoV-2 infection). Neutralizing antibody (NT Abs) titer against B.1.1 strain and total anti-Spike IgG concentration were quantified in serum samples. ELISpot assay was used for quantification of anti-Spike interferon gamma (IFNγ) producing cells/106 peripheral blood mononuclear cells (PBMC). Fifty patients (83.0%) were on immunotherapy alone, while ten patients (7%) were on chemo-immunotherapy. We analyzed separately patients on immunotherapy and patients on chemo-immunotherapy.
Results
Median T-cell response at six months was significantly lower than that measured at three weeks after vaccination (50 interquartile range (IQR) 20-118.8 vs 175IQR 67.5-371.3 IFNγ producing cells/106 PBMC;p<0.0001). The median reduction of IgG concentration was 88% in SARS-CoV-2 naïve subject, 2.1% in SARS-CoV-2 experienced subjects. SARS-CoV-2 NT Abs titer was stable maintained in SARS-CoV-2 experienced subjects while a significant decrease was observed in SARS-CoV-2 naïve subjects (from median 1:160 IQR 1:40-1:640 to median 1:20 IQR 1:10-1:40;p<0.0001). A weak correlation was observed between SARS-CoV-2 NT Abs and Spike-specific IFNγ producing cells at both six months and three weeks after vaccination (r=0.467;p=0.0002 and r=0.428;p=0.0006,respectively).
Conclusions
Our work highlights a reduction in the immune response in cancer patients, particularly in SARS-CoV-2 naïve subjects. Our data support administering third dose of COVID-19 vaccine to cancer patients treated with PD1/PD-L1 inhibitors.
Fred R. Hirsch, Mary W. Redman, James Moon, Francesco Agustoni, Roy S. Herbst, Thomas J. Semrad, Marileila Varella-Garcia, Chris J. Rivard, Karen Kelly, David R. Gandara,et al.
Elsevier BV
BACKGROUND
The phase III S0819 trial investigated addition of cetuximab to first-line chemotherapy (CT) in NSCLC. Subgroup analyses suggested an OS benefit among patients with EGFR copy number gain in squamous cell carcinomas (SCC), (HR = 0.58 [0.39-0.86], P = .0071). A more detailed model based on EGFR FISH, EGFR IHC and KRAS mutation status was evaluated to yield a more precise predictive paradigm of cetuximab-based therapy in advanced NSCLC.
METHODS
FISH was performed using the Colorado Scoring Criteria; H-Score was used to quantify EGFR IHC expression (cut-off ≥ 200). A Cox model was used to assess treatment effects for OS and PFS within biomarker and clinical subgroups. KRAS mutation was analyzed using Therascreen. The false discovery rate controlled for multiple comparisons. S0819 ClinicalTrials.gov Identifier: NCT00946712.
RESULTS
Of 1,313 eligible patients, assay results were obtained for FISH on 976 patients (41% positive), for IHC on 945 patients (31% positive), and KRAS mutation status on 627 patients (26% positive). In SCC patients, OS was significantly improved with addition of cetuximab when both EGFR FISH and EGFR IHC were positive (N = 58), (OS HR: 0.32 [95% CI 0.18-0.59]; P = .0002, q = 0.08), median 12.6 versus 4.6 months. The results were independent of KRAS mutation status. In Non-SCC, no predictive value of EGFR IHC, EGFR FISH status and/or KRAS status was seen.
CONCLUSIONS
In NSCLC SCC, a combination index of EGFR FISH plus EGFR IHC results was associated with improved OS when cetuximab was added to CT, representing a potential predictive molecular paradigm for patients suitable for EGFR-antibody therapy.
Laura Saracino, Chandra Bortolotto, Stefano Tomaselli, Elia Fraolini, Matteo Bosio, Giulia Accordino, Francesco Agustoni, David M. Abbott, Emma Pozzi, Dimitrios Eleftheriou,et al.
Springer Science and Business Media LLC
Abstract Background Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy that most commonly affects the pleural layers. MPM has a strong association with asbestos, mainly caused by exposure to its biopersistent fibers in at least 80% of cases. Individuals with a chronic exposure to asbestos might develop disease with a 20–40-year latency with few or no symptoms. Such has been the case in the Italian regions of Piedmont and Lombardy, where industrial production of materials laden with asbestos, mainly cements, has been responsible for the onset of a large epidemic. Since 2018, a multidisciplinary team at San Matteo hospital in Pavia has been collecting data on over 100 patients with MPM. The main goal of this project is to define and describe an integrated profile for each MPM case at diagnosis by using data mining and partition analysis. Methods Here we bring together exhaustive epidemiologic, histologic and radiologic data of 88 MPM patients that came to our observation and draw correlations with predictive and prognostic significance. Results The median overall survival (OS) was 15.6 months. Most patients presented with pleural effusion, irrespective of disease stage. Quite unexpectedly, no statistically significant association was demonstrated between OS and TNM disease stage at diagnosis. Although average OS is similar in male and female patients, partition analysis of data underlined a significant differential hierarchy of predictor categories based on patient gender. In females with no smoking history, full chemotherapeutic regimens are associated with better outcomes. Moreover, concerning second line treatments, vinorelbine emerged as the most advantageous choice for female patients, whereas in the male subgroup no statistically significant difference resulted between gemcitabine and vinorelbine. Conclusion A multidisciplinary approach to MPM is mandatory to define better therapeutic approaches, personalize the management and improve patient outcomes.
Alessio Bruni, Vieri Scotti, Paolo Borghetti, Stefano Vagge, Salvatore Cozzi, Elisa D’Angelo, Niccolò Giaj Levra, Alessandra Fozza, Maria Taraborrelli, Gaia Piperno,et al.
Frontiers Media SA
Citation: Bruni A, Scotti V, Borghetti P, Vagge S, Cozzi S, D’Angelo E, Giaj Levra N, Fozza A, Taraborrelli M, Piperno G, Vanoni V, Sepulcri M, Trovò M, Nardone V, Lattanzi E, Bou Selman S, Bertolini F, Franceschini D, Agustoni F, JereczekFossa BA, Magrini SM, Livi L, Lohr F and Filippi AR (2021) Corrigendum: A Real-World, Multicenter, Observational Retrospective Study of Durvalumab After Concomitant or Sequential Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer. Front. Oncol. 11:802949. doi: 10.3389/fonc.2021.802949 CORRECTION published: 16 November 2021 doi: 10.3389/fonc.2021.802949
A. Lasagna, F. Agustoni, E. Percivalle, S. Borgetto, A. Paulet, G. Comolli, A. Sarasini, F. Bergami, J.C. Sammartino, A. Ferrari,et al.
Elsevier BV
Background
Very few cancer patients were enrolled in COVID-19 vaccine studies. In order to address this gap of knowledge, real world studies are mandatory. Aim of this study was to assess both humoral and cellular response after a mRNA vaccination schedule.
Patients and methods
Eighty-eight consecutive cancer patients treated with PD-1/PD-L1 inhibitors were enrolled from the beginning of the vaccination campaign for frail patients. Blood samples for humoral and cell-mediated immune response evaluation were obtained before vaccination (T0), before the second administration (T1) and 21 days after the second dose (T2). The primary end-point was the evaluation of the percentage of participants showing a significant increase in SARS-CoV-2 specific T cells, measured by an ELISPOT assay, after the second dose of BNT162b2 vaccine. The proportion of patients who reached the primary endpoint is computed together with its exact binomial 95% confidence interval (95%CI).
Results
In SARS-CoV-2 naïve subjects, Spike-specific T-cell response was almost undetectable at T0 (median 0.0 IFNγ SFU/million PBMC IQR 0-7.5) and significantly increased at T1 and T2 (median 15.0 IFNγ SFU/million PBMC 25th-75th 0-40 vs 90 IFNγ SFU/million PBMC 25th-75th 32.5-224; respectively) (p<0.001). Focusing on naïve and experienced SARS-CoV-2 subjects no differences were reported both in terms of CD4 and CD8-specific T-cell response, suggesting that BNT162b2 is able to elicit both adaptive responses after complete vaccination schedule, regardless previous SARS-CoV-2 exposure. The level of SARS-CoV-2 NT Abs was low at T1 in SARS-CoV-2 naïve subjects [median 1:5 (IQR 1:5-1:20)] but reached a significantly higher median 1:80 (25th-75th 1:20-1:160) at T2 (p<0.0001). Moreover no COVID-19 cases were documented throughout the period of study.
Conclusions
Our data have demonstrated that the administration of a full course of BNT162b2 vaccine elicited a sustained immune response against SARS-CoV-2 regardless to the type of cancer and/or the type of ICIs.