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Granata R.,Head and Neck Medical Oncology Unit | Bossi P.,Head and Neck Medical Oncology Unit | Bertulli R.,Adult Sarcoma Medical Oncology Unit | Saita L.,Palliative Care
Pain Medicine (United States) | Year: 2014

Setting: In the last few years, the use of opioids for cancer pain has rapidly increased and new molecules have been developed. Currently, rapid-onset opioids are widely used in clinical practice for breakthrough cancer pain (BTcP). However, the tolerability of these molecules is still a matter of debate. Patients: We describe two cases of rapid-onset opioids misuse that have been recently observed at our palliative care unit. Discussion: The reported cases are explicative as they occurred in patients suffering from different types of cancer and with different causes of BTcP. Further investigations are needed to identify factors predicting addiction to this new class of molecules. © 2014 American Academy of Pain Medicine. Source

Barisella M.,Anatomic Pathology B Unit | Collini P.,Anatomic Pathology B Unit | Orsenigo M.,Experimental Molecular Pathology Unit | Aiello A.,Anatomic Pathology B Unit | And 3 more authors.
American Journal of Surgical Pathology | Year: 2010

All of the members of the peripheral primitive neuroectodermal tumor family (Ewing sarcomas, neuroectodermal tumors of bone, peripheral neuroepitheliomas, and Askin tumors) have similar morphologic and immunophenotypical features (ie, the proliferation of small and medium-sized round cells in a fibrous background showing strong and diffuse immunohistochemical positivity for CD99), and the common cytogenetic abnormality of a nonrandom translocation involving the EWS gene and one of several members of the erythroblastosis virus transforming sequence family of transcription factors. The combination of clinical information and morphologic/ immunophenotypical characteristics is usually sufficient for a correct diagnosis, but there are rare cases in which an unusual predominant or multidirectional immunophenotypical differentiation makes diagnosis a challenge and requires the use of molecular cytogenetic or molecular techniques. We describe 3 such cases in which we employed fluorescence in-situ hybridization analysis to detect translocation involving the EWS gene and reverse transcription polymerase chain reaction followed by sequencing to detect the fusion transcript EWS-FLI1. Copyright © 2010 by Lippincott Williams & Wilkins. Source

Radaelli S.,Fondazione IRCCS | Stacchiotti S.,Adult Sarcoma Medical Oncology Unit | Casali P.G.,Adult Sarcoma Medical Oncology Unit | Gronchi A.,Fondazione IRCCS
Expert Review of Anticancer Therapy | Year: 2014

Soft tissue sarcoma (STS) are a broad group of rare tumors. Cornerstone of treatment is surgery. Complementary radiotherapy is recommended in high-risk STS arising from extremities. Doxorubicine ± ifosfamide based cytotoxic chemotherapy, explored in few randomized trials, showed a certain degree of activity, playing an established role only in unresectable disease. Since peculiar chemosensitivity towards alternative drugs was described for different metastatic subtypes in second or further lines, the modern concept of 'histology-driven chemotherapy' has been accepted and employed: gemicitabine ± dacarbazine, trabectedin and taxanes used respectively in patients with leiomyosarcoma, solitary fibrous tumor, myxoid/round cell liposarcoma, angiosarcoma. Recent discoveries about molecular pathways involved in STS tumorogenesis led to develop molecular targeted agents such as imatinib used in advanced dermatofibrosarcoma protuberans (DFSP) or metastatic DFSP-related fibrosarcoma, pazopanib, approved as second line regimen in advanced non-adipocitic STS and recently sunitinib in solitary fibrous tumors, alveolar soft part sarcoma and extraskeletal myxoid chondrosarcoma. ©2014 Informa UK, Ltd. Source

Stacchiotti S.,Adult Sarcoma Medical Oncology Unit | Marrari A.,Adult Sarcoma Medical Oncology Unit | Dei Tos A.P.,Anatomic Pathology | Casali P.G.,Adult Sarcoma Medical Oncology Unit
Hematology/Oncology Clinics of North America | Year: 2013

This article highlights the data currently available on the activity of targeted medical treatment in a subgroup of rare entities within soft tissue sarcomas, including inflammatory myofibroblastic tumor, alveolar soft part sarcoma, solitary fibrous tumor, malignant perivascular epithelioid cell tumor (PEComa), and clear cell sarcoma. © 2013 Elsevier Inc. Source

Stacchiotti S.,Adult Sarcoma Medical Oncology Unit | Negri T.,Experimental Molecular Pathology Unit | Libertini M.,Adult Sarcoma Medical Oncology Unit | Palassini E.,Adult Sarcoma Medical Oncology Unit | And 7 more authors.
Annals of Oncology | Year: 2012

Background: To report on sunitinib activity in a retrospective series of 35 solitary fibrous tumor (SFT) treated at a single institution. Patients and methods: From April 2008, 35 patients with progressive advanced SFT (male/female: 20/15; mean age: 58 years; meningeal/extrameningeal: 6/29; locally advanced/metastatic: 15/20; prior chemotherapy: 25) were treated, on an individual use basis, with continuous-dosing sunitinib 37.5 mg/day. Platelet-derived growth factor receptor beta (PDGFRB) and vascular endothelial growth factor receptor 2 (VEGFR2) status were assessed by immunohistochemistry and, in a subgroup of patients, by real time PCR. Results: Thirty-one patients were assessable for response by RECIST (one early death; three early interruptions). Best responses were 2 partial response (PR), 16 stable disease, 13 progressive disease. A <30% decrease in size was observed in three patients. Fourteen of 29 patients assessable by Choi criteria had a PR. Median progression-free survival by RECIST was 6 months (range 1-22). In two of six patients, resistance to sunitinib was overcome by increasing sunitinib to 50 mg/day. PDGFRB and/or VEGFR2 were positive in all cases and not predictive of response; a less aggressive morphology corresponded to an increased response rate (53% PR by Choi in the malignant SFT, 20% PR in the pleomorphic/dedifferentiated SFT). Conclusions: Sunitinib is active in SFT. Response can be long-lasting. © The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. Source

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