Fausto Leoncini

@policlinicogemelli.it

Medical Doctor (Medical and surgical science - Inteventional pulmonology)
Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Fausto Leoncini


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https://researchid.co/igno1988

RESEARCH INTERESTS

Interventional pulmonology
16

Scopus Publications

Scopus Publications

  • Ultrathin bronchoscopy-guided small airway biopsy for diagnosing sarcoidosis: A prospective study
    Rocco Trisolini, Giovanni Sotgiu, Alessandra Cancellieri, Giuliana Pasciuto, Vanina Livi, Maria Chiara Flore, Marta Viscuso, Daniele Magnini, Fausto Leoncini, QuianQuian Zhang, Mariangela Puci, Luca Richeldi
    Pulmonology, 2025
    New ultrathin bronchoscopes (UTBs) enable the inspection and biopsy of small airways, potentially offering diagnostic advantages in sarcoidosis. In this prospective study, patients with suspected sarcoidosis underwent airway inspection with a UTB. Observed airway abnormalities were categorised into six predefined patterns. UTB-directed small airway biopsies (SABs) were collected from the upper lobes following a standardised procedure. We evaluated the prevalence and patterns of SAAs, as well as the diagnostic yield of UTB-directed SAB. Among 79 participants, 65 (82.3%) were diagnosed with sarcoidosis. Small airway abnormalities were identified in 26/65 (40%) patients, predominantly in those with parenchymal involvement on CT compared to those with lymphadenopathy only (58.1% VS. 23.5%, P = 0.005). The diagnostic yield of SABs for detecting granulomas was significantly higher in patients with SAAs than in those without (65.4% VS. 23.1%, P = 0.001) and in patients with parenchymal disease on CT compared to those without (54.8% VS. 26.5%, P = 0.02). Notably, random biopsies taken under direct visualisation from small airway carinas revealed peribronchiolar parenchyma in 23% of the patients. Small airway abnormalities are prevalent in sarcoidosis patients with parenchymal involvement, and biopsying these abnormalities yields a high rate of granuloma detection.
  • Intrathoracic Lymph Node Microcalcifications are Associated with a High Prevalence of Malignancy and Anaplastic Lymphoma Kinase Rearrangement: The "calce" Study
    Fausto Leoncini, Giovanni Sotgiu, Alessandra Cancellieri, Mariangela Puci, Stefania Cortese, Vanina Livi, Jacopo Simonetti, Daniela Paioli, Daniele Magnini, Federico Cappuzzo, Emilio Bria, Rocco Trisolini
    Journal of Bronchology and Interventional Pulmonology, 2024
    Background: Microcalcifications are acknowledged as a malignancy risk factor in multiple cancers. However, the prevalence and association of intrathoracic lymph node (ILN) calcifications with malignancy remain unexplored. Methods: In this cross-sectional study, we enrolled patients with known/suspected malignancy and an indication for endosonography for diagnosis or ILN staging. We assessed the prevalence and pattern of calcified ILNs and the prevalence of malignancy in ILNs with and without calcifications. In addition, we evaluated the genomic profile and PD-L1 expression in lung cancer patients, stratifying them based on the presence or absence of ILN calcifications. Results: A total of 571 ILNs were sampled in 352 patients. Calcifications were detected in 85 (24.1%) patients and in 94 (16.5%) ILNs, with microcalcifications (78/94, 83%) being the predominant type. Compared with ILNs without calcifications (214/477, 44.9%), the prevalence of malignancy was higher in ILNs with microcalcifications (73/78, 93.6%; P<0.0001) but not in those with macrocalcifications (7/16, 43.7%; P=0.93). In patients with lung cancer, the high prevalence of metastatic involvement in ILNs displaying microcalcifications was independent of lymph node size (< or >1 cm) and the clinical stage (advanced disease; cN2/N3 disease; cN0/N1 disease). The anaplastic lymphoma kinase (ALK) rearrangement was significantly more prevalent in patients with than in those without calcified ILNs (17.4% vs. 1.7%, P<0.001), and all of them exhibited microcalcifications. Conclusion: ILN microcalcifications are common in patients undergoing endosonography for suspected malignancy, and they are associated with a high prevalence of metastatic involvement and ALK rearrangement.
  • Bronchoscopically-visible massive central airway cancer cavitation is associated with metastatic disease, lack of actionable mutations and poor prognosis: a case series
    Daniele Magnini, Emilio Bria, Alessandra Cancellieri, Vanina Livi, Fausto Leoncini, Marco Ferrari, Teresa Bruni, Daniela Paioli, Rocco Trisolini
    Monaldi Archives for Chest Disease, 2024
    Cavitating lung tumors occur in approximately 10-15% of the patients, are more commonly associated with squamous histology, and are typically located in the lung parenchyma. Herein we describe an exceedingly rare series of 5 patients, 4 of whom treatment-naïve, whose tumor caused the disruption of the normal airway anatomy at the level of lobar or segmental bronchi, leading to the formation of an endoscopically-visible cavity which ended up in the lung parenchyma or even into the pleural space. Sex (3 males, 2 females), smoking habit (2 never smokers, 2 former smokers, 1 current smoker), and histology (3 adenocarcinoma, 2 squamous cell carcinoma) were heterogeneous, but the 4 patients treatment-naïve presented with metastatic disease, poor ECOG performance status, similar clinical complaints of long duration, and lack of actionable mutations. The only patient who exhibited a meaningful response to treatment had the lowest symptoms’ duration, the smallest size of the cavitated mass, and the best performance status at the time of diagnosis. This series provides the first comprehensive description of a rare presentation of lung cancer characterized by similar clinical complaints, delayed diagnosis and poor prognosis.
  • Correction: Lung cancer multi-omics digital human avatars for integrating precision medicine into clinical practice: the LANTERN study (BMC Cancer, (2023), 23, 1, (540), 10.1186/s12885-023-10997-x)
    Filippo Lococo, Luca Boldrini, Charles-Davies Diepriye, Jessica Evangelista, Camilla Nero, Sara Flamini, Angelo Minucci, Elisa De Paolis, Emanuele Vita, Alfredo Cesario, Salvatore Annunziata, Maria Lucia Calcagni, Marco Chiappetta, Alessandra Cancellieri, Anna Rita Larici, Giuseppe Cicchetti, Esther G. C. Troost, Róza Ádány, Núria Farré, Ece Öztürk, Dominique Van Doorne, Fausto Leoncini, Andrea Urbani, Rocco Trisolini, Emilio Bria, Alessandro Giordano, Guido Rindi, Evis Sala, Giampaolo Tortora, Vincenzo Valentini, Stefania Boccia, Stefano Margaritora, Giovanni Scambia
    BMC Cancer, 2023
  • Lung cancer multi-omics digital human avatars for integrating precision medicine into clinical practice: the LANTERN study
    Filippo Lococo, Luca Boldrini, Charles-Davies Diepriye, Jessica Evangelista, Camilla Nero, Sara Flamini, Angelo Minucci, Elisa De Paolis, Emanuele Vita, Alfredo Cesario, Salvatore Annunziata, Maria Lucia Calcagni, Marco Chiappetta, Alessandra Cancellieri, Anna Rita Larici, Giuseppe Cicchetti, Esther G.C. Troost, Ádány Róza, Núria Farré, Ece Öztürk, Dominique Van Doorne, Fausto Leoncini, Andrea Urbani, Rocco Trisolini, Emilio Bria, Alessandro Giordano, Guido Rindi, Evis Sala, Giampaolo Tortora, Vincenzo Valentini, Stefania Boccia, Stefano Margaritora, Giovanni Scambia
    BMC Cancer, 2023
    Background The current management of lung cancer patients has reached a high level of complexity. Indeed, besides the traditional clinical variables (e.g., age, sex, TNM stage), new omics data have recently been introduced in clinical practice, thereby making more complex the decision-making process. With the advent of Artificial intelligence (AI) techniques, various omics datasets may be used to create more accurate predictive models paving the way for a better care in lung cancer patients. Methods The LANTERN study is a multi-center observational clinical trial involving a multidisciplinary consortium of five institutions from different European countries. The aim of this trial is to develop accurate several predictive models for lung cancer patients, through the creation of Digital Human Avatars (DHA), defined as digital representations of patients using various omics-based variables and integrating well-established clinical factors with genomic data, quantitative imaging data etc. A total of 600 lung cancer patients will be prospectively enrolled by the recruiting centers and multi-omics data will be collected. Data will then be modelled and parameterized in an experimental context of cutting-edge big data analysis. All data variables will be recorded according to a shared common ontology based on variable-specific domains in order to enhance their direct actionability. An exploratory analysis will then initiate the biomarker identification process. The second phase of the project will focus on creating multiple multivariate models trained though advanced machine learning (ML) and AI techniques for the specific areas of interest. Finally, the developed models will be validated in order to test their robustness, transferability and generalizability, leading to the development of the DHA. All the potential clinical and scientific stakeholders will be involved in the DHA development process. The main goals aim of LANTERN project are: i) To develop predictive models for lung cancer diagnosis and histological characterization; (ii) to set up personalized predictive models for individual-specific treatments; iii) to enable feedback data loops for preventive healthcare strategies and quality of life management. Discussion The LANTERN project will develop a predictive platform based on integration of multi-omics data. This will enhance the generation of important and valuable information assets, in order to identify new biomarkers that can be used for early detection, improved tumor diagnosis and personalization of treatment protocols. Ethics Committee approval number 5420 − 0002485/23 from Fondazione Policlinico Universitario Agostino Gemelli IRCCS – Università Cattolica del Sacro Cuore Ethics Committee. Trial registration clinicaltrial.gov - NCT05802771.
  • Ultrasound-guided needle aspiration biopsy of isolated anterior mediastinal masses
    M. Viscuso, V. Livi, A. Cancellieri, D. Paioli, D. Magnini, F. Leoncini, L. Richeldi, R. Trisolini
    Pulmonology, 2023
  • Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study
    Daniele Magnini, Giovanni Sotgiu, Giuseppe Bello, Mariangela Puci, Vanina Livi, Antonio Maria Dell’Anna, Paolo De Santis, Ruben Dell’Ariccia, Marta Viscuso, Maria Chiara Flore, Alessandra Bisanti, Daniela Paioli, Antonio Gullì, Fausto Leoncini, Massimo Antonelli, Rocco Trisolini
    Cancers, 2023
    Background and objective: Limited data exist regarding the adverse events of advanced diagnostic bronchoscopy, with most of the available information derived from retrospective datasets that primarily focus on early complications. Methods: We conducted a 15-month prospective cohort study among consecutive patients undergoing endosonography and/or guided bronchoscopy under general anesthesia. We evaluated the 30-day incidence of severe complications, any complication, unplanned hospital encounters, and deaths. Additionally, we analyzed the time of onset (immediate, within 1 h of the procedure; early, 1 h–24 h; late, 24 h–30 days) and identified risk factors associated with these events. Results: Thirty-day data were available for 697 out of 701 (99.4%) enrolled patients, with 85.6% having suspected malignancy and multiple comorbidities (median Charlson Comorbidity Index (IQR): 4 (2–5)). Severe complications occurred in only 17 (2.4%) patients, but among them, 10 (58.8%) had unplanned hospital encounters and 2 (11.7%) died within 30 days. A significant proportion of procedure-related severe complications (8/17, 47.1%); unplanned hospital encounters (8/11, 72.7%); and the two deaths occurred days or weeks after the procedure. Low-dose attenuation in the biopsy site on computed tomography was independently associated with any complication (OR: 1.87; 95% CI 1.13–3.09); unplanned hospital encounters (OR: 2.17; 95% CI 1.10–4.30); and mortality (OR: 4.19; 95% CI 1.74–10.11). Conclusions: Severe complications arising from endosonography and guided bronchoscopy, although uncommon, have significant clinical consequences. A substantial proportion of adverse events occur days after the procedure, potentially going unnoticed and exerting a negative clinical impact if a proactive surveillance program is not implemented.
  • Reducing Post-Operative Alveolo-Pleural Fistula by Applying PGA-Sheets (Neoveil) after Major Lung Resection: A Historical Case-Control Study
    Carolina Sassorossi, Maria Teresa Congedo, Dania Nachira, Diomira Tabacco, Marco Chiappetta, Jessica Evangelista, Adele di Gioia, Velia Di Resta, Claudio Sorino, Michele Mondoni, Fausto Leoncini, Giuseppe Calabrese, Antonio Giulio Napolitano, Adriana Nocera, Achille Lococo, Stefano Margaritora, Filippo Lococo
    Journal of Clinical Medicine, 2023
    Alveolo-pleural fistula remains a serious post-operative complication in lung cancer patients after surgery, which is associated with prolonged hospital stay and higher healthcare costs. The aim of this study is to evaluate the efficacy of a polyglycol acid (PGA)-sheet known as Neoveil in preventing post-operative air-leak in cases of detected intra-operative air-leak after lung resection. Between 11/2021 and 7/2022, a total of 329 non-small cell lung cancer (NSCLC) patients were surgically treated in two institutions. Major lung resections were performed in 251 cases. Among them, 44 patients with significant intra-operative air-leak at surgery were treated by reinforcing staple lines with Neoveil (study group). On the other hand, a historical group (selected by propensity score matched analysis) consisting of 44 lung cancer patients with significant intra-operative air leak treated by methods other than the application of sealant patches were considered as the control group. The presence of prolonged air-leak (primary endpoint), pleural drainage duration, hospital stay, and post-operative complication rates were evaluated. The results showed that prolonged air-leak (>5 days after surgery) was not observed in study group, while this event occurred in four patients (9.1%) in the control group. Additionally, a substantial reduction (despite not statistically significant) in the chest tube removal was noted in the study group with respect to the control group (3.5 vs. 4.5, p = 0.189). In addition, a significant decrease in hospital stay (4 vs. 6 days, p = 0.045) and a reduction in post-operative complications (2 vs. 10, p = 0.015) were observed in the study group when compared with the control group. Therefore, in cases associated with intra-operative air-leak after major lung resection, Neoveil was considered a safer and more effective aerostatic tool and represents a viable option during surgical procedures.
  • Rate and Predictors of Unforeseen PN1/PN2-Disease in Surgically Treated cN0 NSCLC-Patients with Primary Tumor > 3 cm: Nationwide Results from Italian VATS-Group Database
    Filippo Lococo, Dania Nachira, Marco Chiappetta, Isabella Sperduti, Maria Teresa Congedo, Elisa Meacci, Fausto Leoncini, Rocco Trisolini, Roberto Crisci, Carlo Curcio, Monica Casiraghi, Stefano Margaritora, and
    Journal of Clinical Medicine, 2023
    Background. Since no robust data are available on the real rate of unforeseen N1-N2 disease (uN) and the relative predictive factors in clinical-N0 NSCLC with peripheral tumours > 3 cm, the usefulness of performing a (mini)invasive mediastinal staging in this setting is debated. Herein, we investigated these issues in a nationwide database. Methods. From 01/2014 to 06/2020, 15,784 thoracoscopic major lung resections were prospectively recorded in the “Italian VATS-Group” database. Among them, 1982 clinical-N0 peripheral solid-type NSCLC > 3 cm were identified, and information was retrospectively reviewed. A mean comparison of more than two groups was made by ANOVA (Bonferroni correction for multiple comparisons), while associations between the categorical variables were estimated with a Chi-square test. The multivariate logistic regression model and Kaplan–Meyer method were used to identify the independent predictors of nodal upstaging and survival results, respectively. Results. At pathological staging, 229 patients had N1-involvement (11.6%), and 169 had uN2 disease (8.5%). Independent predictors of uN1 were SUVmax (OR: 1.98; CI 95: 1.44–2.73, p = 0.0001) and tumour-size (OR: 1.52; CI: 1.11–2.10, p = 0.01), while independent predictors of uN2 were age (OR: 0.98; CI 95: 0.96–0.99, p = 0.039), histology (OR: 0.48; CI 95: 0.30–0.78, p = 0.003), SUVmax (OR: 2.07; CI 95: 1.15–3.72, p = 0.015), and the number of resected lymph nodes (OR: 1.03; CI 95: 1.01–1.05, p = 0.002). Conclusions. The unforeseen N1-N2 disease in cN0/NSCLCs > 3 cm undergoing VATS resection is observable in between 12 and 8% of all cases. We have identified predictors that could guide physicians in selecting the best candidate for (mini)invasive mediastinal staging.
  • Ultrasound-Guided Needle Aspiration Biopsy of Superficial Metastasis of Lung Cancer with and without Rapid On-Site Evaluation: A Randomized Trial
    Vanina Livi, Giovanni Sotgiu, Alessandra Cancellieri, Daniela Paioli, Fausto Leoncini, Daniele Magnini, Rocco Trisolini
    Cancers, 2022
    Background and Objective: Studies which evaluated the role of an ultrasound-guided needle aspiration biopsy (US-NAB) of metastases from lung cancer located in “superficial” organs/tissues are scant, and none of them assessed the possible impact of rapid on-site evaluation (ROSE) on diagnostic accuracy and safety outcomes. Methods: Consecutive patients with suspected superficial metastases from lung cancer were randomized 1:1 to US-NAB without (US-NAB group) or with ROSE (ROSE group). The diagnostic yield for a tissue diagnosis was the primary outcome. Secondary outcomes included the diagnostic yield for cancer genotyping, the diagnostic yield for PD-L1 testing, and safety. Results: During the study period, 136 patients were randomized to receive an US-NAB with (n = 68) or without ROSE (n = 68). We found no significant differences between the ROSE group and the US-NAB group in terms of the diagnostic yields for tissue diagnosis (94.1% vs. 97%, respectively; p = 0.68), cancer genotyping (88% vs. 91.8%, respectively; p = 0.56), and PD-L1 testing (93.5% vs. 90.6%, respectively; p = 0.60). Compared to the diagnostic US-NAB procedures, the non-diagnostic procedures were characterized by less common use of a cutting needle (66.6% vs. 96.9%, respectively; p = 0.0004) and less common retrieval of a tissue core (37.5% vs. 98.5%; p = 0.0001). Only one adverse event (vasovagal syncope) was recorded. Conclusion: US-NAB of superficial metastases is safe and has an excellent diagnostic success regardless of the availability of ROSE. These findings provide a strong rationale for using US-NAB as the first-step method for tissue acquisition whenever a suspected superficial metastatic lesion is identified in patients with suspected lung cancer.
  • Endosonography in mediastinal staging of lung cancer: a concise literature review
    Fausto Leoncini, Daniele Magnini, Vanina Livi, Maria Chiara Flore, Lucia Maria Porro, Daniela Paioli, Rocco Trisolini
    Video Assisted Thoracic Surgery, 2022
  • Accuracy and Reproducibility of Endoscopic Ultrasound B-Mode Features for Observer-Based Lymph Nodal Malignancy Prediction
    Roel L.J. Verhoeven, Fausto Leoncini, Jorik Slotman, Chris de Korte, Rocco Trisolini, Erik H.F.M. van der Heijden, and
    Respiration, 2021
  • Pattern of cancer patient referral and organisational model of an interventional pulmonology programme during the covid-19 pandemic
    Rocco Trisolini, Daniele Magnini, Vanina Livi, Fausto Leoncini, Lucia M. Porro, Maria C. Flore, Daniela Paioli, Giovanni Sotgiu
    Erj Open Research, 2021
  • Predictive Value of Endobronchial Ultrasound Strain Elastography in Mediastinal Lymph Node Staging: The E-Predict Multicenter Study Results
    Roel Lambertus Johannes Verhoeven, Rocco Trisolini, Fausto Leoncini, Piero Candoli, Michela Bezzi, Alessandro Messi, Mark Krasnik, Chris L. de Korte, Jouke T. Annema, Erik H.F.M. van der Heijden
    Respiration, 2020
  • Endobronchial Ultrasound for the Diagnosis of Centrally Located Lung Tumors: A Systematic Review and Meta-Analysis
    Jolanda C. Kuijvenhoven, Fausto Leoncini, Laurence C. Crombag, René Spijker, Peter I. Bonta, Daniël A. Korevaar, Jouke T. Annema
    Respiration, 2020
  • Competence in endosonographic techniques
    Piero Candoli, Loris Ceron, Rocco Trisolini, Micaela Romagnoli, Lucio Michieletto, Simone Scarlata, Thomas Galasso, Fausto Leoncini, Valeria Pasini, Donatella Dennetta, Francesca Marchesani, Mariagioconda Zotti, Lorenzo Corbetta
    Panminerva Medica, 2019