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Trama A.,Fondazione Istituto Nazionale Dei Tumori
European Journal of Clinical Pharmacology | Year: 2011

Purpose: This review is aimed at: discussing the importance of measuring quality of life (QoL) in children, describing the measures actually available for measuring QoL in children, and listing methodological issues related to the inclusion of QoL outcomes in clinical trials. Methods: A literature review was carried out. Searches were conducted in Pubmed. All articles published within the last 20 years with the objectives of assessing and reviewing use and issues related to QoL instruments in children were reviewed. Results: Despite the numerous arguments in favour of assessing QoL, these data are not typically collected in paediatric clinical trials and research protocols. Because adult measures may fail to address the specific aspects of QoL that are important to the child, many different measures, both generic and disease-specific, have been developed to assess QoL in children; however, their quality in terms of psychometric properties often seems questionable. Methodological recommendations are provided for designing a study including QoL outcome. Conclusions: This review confirms the importance of measuring QoL in children because of increased survival rates of children with chronic health conditions and because children account for the highest prevalence of disabling conditions. However, measuring QoL in children is still a challenge mainly because of the limitations of the currently available measures. Further research is needed to reach a consensus on the most appropriate formats for child-centred instruments. © 2010 Springer-Verlag.


Hakenberg O.W.,University of Rostock | Comperat E.M.,University Pierre and Marie Curie | Minhas S.,University College London | Necchi A.,Fondazione Istituto Nazionale Dei Tumori | And 2 more authors.
European Urology | Year: 2015

Context Penile cancer has high mortality once metastatic spread has occurred. Local treatment can be mutilating and devastating for the patient. Progress has been made in organ-preserving local treatment, lymph node management, and multimodal treatment of lymphatic metastases, requiring an update of the European Association of Urology guidelines. Objective To provide an evidence-based update of treatment recommendations based on the literature published since 2008. Evidence acquisition A PubMed search covering the period from August 2008 to November 2013 was performed, and 352 full-text papers were reviewed. Levels of evidence were assessed and recommendations graded. Because there is a lack of controlled trials or large series, the levels of evidence and grades of recommendation are low compared with those for more common diseases. Evidence synthesis Penile squamous cell carcinoma occurs in distinct histologic variants, some of which are related to human papilloma virus infection; others are not. Primary local treatment should be organ preserving, if possible. There are no outcome differences between local treatment modes in superficial and T1 disease. Management of inguinal lymph nodes is crucial for prognosis. In impalpable nodes, invasive staging should be done depending on the risk factors of the primary tumour. Lymph node metastases should be treated by surgery and adjuvant chemotherapy in N2/N3 disease. Conclusions Organ preservation has become the standard approach to low-stage penile cancer, whereas in lymphatic disease, it is recognised that multimodal treatment with radical inguinal node surgery and adjuvant chemotherapy improves outcome. Patient summary Approximately 80% of penile cancer patients of all stages can be cured. With increasing experience in the management of penile cancer, it is recognized that organ-preserving treatment allows for better quality of life and sexual function and should be offered to all patients whenever feasible. Referral to centres with experience is recommended. © 2014 European Association of Urology.


Noci S.,Fondazione Istituto Nazionale Dei Tumori
Pharmacogenomics Journal | Year: 2015

We investigated the possible influence of 86 single-nucleotide polymorphisms (SNPs), known to associate with the risk of colorectal cancer (CRC), on overall survival and time to recurrence (TTR) in 733 Italian CRC patients followed up for up to 84 months after surgery. In the Cox multivariate analysis, adjusted for gender, age, pathological stage and adjuvant chemotherapy (yes/no), the risk of death significantly increased by rare allele count (P<0.05) for rs1801133 (MTHFR), rs4939827 (SMAD7), rs2306283 (SLCO1B1) and rs12898159 (BMP4), whereas for rs736775 (GPX3) the opposite was observed. Two additional SNPs associated with TTR, namely rs16892766 (downstream of EIF3H) and rs10749971 (COLCA2). Our findings show that some genetic variants previously found to associate with CRC risk are also associated with survival after treatment. The identification of alleles defining subgroups of patients with worse clinical outcome may have application in developing pharmacogenetic strategies aimed at personalizing CRC treatment.The Pharmacogenomics Journal advance online publication, 12 May 2015; doi:10.1038/tpj.2015.35. © 2015 Macmillan Publishers Limited


Ledermann J.A.,University College London | Canevari S.,Fondazione Istituto Nazionale Dei Tumori | Thigpen T.,University of Mississippi
Annals of Oncology | Year: 2015

Background: In cancer therapy, molecularly targeted agents have the potential to maximize antitumor efficacy while minimizing treatment-related toxicity. However, these agents may only be effective in specific tumor subtypes with defined genomic profiles. This emphasizes the importance of developing personalized cancer therapeutic strategies (i.e. through the use of companion diagnostic tests) to appropriately select and treat patients who are likely to benefit from specific targeted therapies, thus leading to improvements in clinical and safety outcomes. A potential biological target is the folate receptor (FR), which has been shown to be overexpressed on the surface of many cancers, including tumors of the lungs and ovaries. Design: We carried out a literature search to identify how the FR can be a potential target for selected tumors, and how the FR expression can be exploited by targeted therapies. Results: The two main therapeutic strategies for targeting the FR are based on the use of: (i) an anti-FR antibody (e.g. farletuzumab) and (ii) folate conjugates of folate-targeted chemotherapies and companion radiodiagnostic imaging agents (e.g. vintafolide and 99mtechnetium-etarfolatide). Both of these strategies are being assessed in phase III trials. Conclusions: The important role that the FR plays in cancer development and progression has led to the development of FR-targeted therapeutic approaches. To date, the promising data observed in phase II clinical trials have not been confirmed in phase III studies. Accordingly, there is a need for further research in the refinement of patient selection and identification of new therapeutic combinations. In particular, the development of these targeted therapies requires reliable methods to be developed to detect FR-positive tumors in order to help select patients who may benefit from treatment. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.


Mikuz G.,Innsbruck Medical University | Colecchia M.,Fondazione Istituto Nazionale Dei Tumori
Virchows Archiv | Year: 2012

Malignant transformation of germ cell tumors into somatic malignancy is uncommon. Its presentation differs from series to series, with 43 % of adult cases identified within the primary tumors and the remainder at the time of relapse or in the metastasis. Patients with stage I disease enjoy an excellent prognosis; whereas in metastatic sites when not completely resectable, the somatic type malignancies suffer a dismal prognosis. Radical surgery is significant for the prospects of cure and is standard chemotherapy for germ cell tumors; a transformation-oriented treatment can be effective for these patients. A deeper understanding of the biology of this phenomenon is essential for clinicians involved in such malignancies in order to permit a better control of the disease. © 2012 Springer-Verlag.

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