Publications by authors named "Alessandra Cancellieri"

Background: In the last years, the knowledge about the non-small cell lung cancer (NSCLC) biology led to development of target therapies and immunotherapy. However, most indication were to advanced stages, with large nodal involvement or presence of distant metastases. However, the clinical response may be unpredictable, and in some cases, it is possible to see a large clinical response with resolution of the parameter that contraindicated surgical treatment.

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Background: Literature evidence reports that (ring finger protein 43) gene mutations could serve as predictive biomarkers of response to certain anti-cancer therapies. To delve deeper into the specific role of mutations in lung cancer and their relevance to therapy response, we provide the first report of marked efficacy of the dabrafenib and trametinib therapeutic combination in a patient with microsatellite-stable (MSS) non-small-cell lung cancer (NSCLC) with and mutations.

Case Description: An 85-year-old patient was diagnosed with NSCLC with the presence of MSS, and mutations.

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Article Synopsis
  • A 72-year-old man with a significant history of tobacco use and multiple health issues was referred for severe airway narrowing (stenosis) in his right main bronchus, which was linked to a recent respiratory failure.
  • He had been hospitalized for pneumonia related to obstruction and continued suffering from chest tightness and a persistent cough post-discharge, though he showed no signs of fever or weight loss.
  • His medical background includes previous treatments for squamous cell carcinoma, COPD, obesity, type II diabetes, and other serious conditions, including aortic valve replacement and rectal cancer surgery.
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Introduction: Low-malignant-potential adenocarcinoma has been defined as a type of non-mucinous tumor, which has a total tumor size measuring ≤ 3 cm, exhibits ≥ 15% lepidic growth, lacks non-predominant high-grade patterns (≥10% cribriform, ≥5% micropapillary, ≥5% solid), has an absence of angiolymphatic or visceral pleural invasion, spread through air spaces (STAS), necrosis and >1 mitosis per 2 mm. The aim of this study is to validate, with regard to cancer-specific survival (CSS) and disease-free survival (DFS), the proposed definition of LMP adenocarcinoma in an independent external cohort of lung adenocarcinoma patients having undergone surgical resection, and having presented with a long follow-up period.

Methods: Clinicopathological characteristics of patients who underwent lung resection for adenocarcinoma from 1 January 2005 to 31 December 2014 were retrospectively analyzed.

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Precision oncology has transformed non-small cell lung cancer (NSCLC) treatment by tailoring therapies to the genomic profile of the disease, significantly improving clinical outcomes. However, acquired resistance to molecularly targeted therapies remains a major challenge. This report details a 69-year-old woman with KRAS G12C-mutant metastatic NSCLC who developed resistance to sotorasib, a KRAS G12C inhibitor.

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Background: The prevalence of supraclavicular lymph nodes metastases (SNM) in advanced lung cancer has not been systematically evaluated, nor has then been a comparison of demographic, clinical, or molecular characteristics between patients with and without SNM.

Methods: In this prospective cohort study, the presence of SNM was evaluated using imaging studies (CT, PET, neck ultrasonography) in patients with suspected advanced lung cancer referred for biopsy aimed at diagnosis and molecular profiling. Ultrasound-guided biopsy confirmed or excluded metastatic involvement when suspicious supraclavicular nodes were identified.

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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.

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Dermatofibrosarcoma protuberans (DFSP) is a rare malignancy of mesenchymal origin of medium-low grade with a tendency to local recurrences but not to distant metastases. We present the case of a 37-year-old male who underwent surgical resection of a 1.2 cm DFSP lesion on the left shoulder in May 2020.

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Article Synopsis
  • The ongoing FPG500 program aims to provide personalized targeted therapies for non-small cell lung cancer (NSCLC) based on genetic profiling, assessing patient eligibility through comprehensive genome profiling (CGP).
  • In 2022, a significant study involving 283 NSCLC patients revealed that 93% were eligible for sequencing, with 76% undergoing high-throughput genomic analysis, leading to the identification of potential driver mutations in 59% of them.
  • Results showed varying progression-free survival (PFS) and overall survival (OS) rates dependent on the type of treatment received, emphasizing the benefits of implementing CGP and molecular tumor board evaluations in improving patient outcomes.
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Our case presents a unique occurrence marking the first documentation of a connection between a typical carcinoid in the context of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) and vascular anomalies, including a right-sided aortic arch with Kommerell's diverticulum. Kommerell's diverticulum is a rare congenital anomaly. The lusoria subclavian artery, another developmental anomaly, arises from the right aortic arch instead of the typical left side.

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  • The study analyzes the genetic profiles of recurrent thymomas, using samples from 23 patients out of a cohort of 426 thymomas for comparison with primary tumors and a control group of non-recurrent cases.
  • Comprehensive genetic profiling (CGP) was conducted using the NGS Tru-Sight Oncology assay, revealing no significant differences in genetic alterations between initial tumors and recurrent ones, nor between recurrent and non-recurrent thymomas.
  • However, it was found that cell cycle control gene alterations are linked with early recurrence, and over 50% of patients may qualify for potential targeted therapies through a precision medicine approach.
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  • * A study involving 352 patients found that microcalcifications were present in 83% of calcified ILNs, and 93.6% of these ILNs were associated with malignancy, compared to only 44.9% in ILNs without calcifications.
  • * Patients with lung cancer who had calcified ILNs also showed a higher occurrence of ALK rearrangement, indicating a potential genomic link related to the presence of microcalcifications.
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We describe the case of a young 33-year-old woman that was referred to our clinic for evidence of migrant cavitary nodules at CT scan, dyspnea, and blood sputum. Her physical examination showed translucent and thin skin, evident venous vascular pattern, vermilion of the lip thin, micrognathia, thin nose, and occasional Raynaud phenomenon. We prescribed another CT scan that showed multiple pulmonary nodules in both lungs, some of which had evidence of cavitation.

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Background: Intracranial mesenchymal tumors are a rare type of neoplasm (0.3% of all soft tissue tumors) characterized by a fusion of a family gene (usually , rarely ) to family genes (, and ) with a slow-growing and favorable prognosis. Mesenchymal tumors are most frequently localized in the subcutaneous tissue (typically in the limbs and hands) of young adults and have rarely been diagnosed in the central nervous system.

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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 five patients, four 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 that 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 Eastern Cooperative Oncology Group (ECOG) performance status, similar clinical complaints of long duration, and a lack of actionable mutations.

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  • In patients with extensive-stage small cell lung cancer (ES-SCLC) receiving maintenance immunotherapy (IT), higher levels of the adipokine leptin and a favorable leptin-to-visceral fat ratio were linked to improved progression-free survival (PFS).
  • A study using blood samples and CT scans found that clusters of patients with high leptin and low pro-inflammatory markers had better outcomes, with significantly longer PFS and overall survival (OS) compared to others.
  • The findings suggest that adipokines may influence the effectiveness of immunotherapy in cancer treatment, indicating a need for further research on metabolic immune dysfunctions in a larger patient cohort.
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Background: The ability of high-definition (HD) videobronchoscopy to detect airway involvement in sarcoidosis has not been evaluated previously.

Research Question: What is the role of HD videobronchoscopy in the identification of sarcoidosis-associated airway abnormalities (AAs)? What are the patterns of AAs more commonly observed and more frequently associated with the detection of granulomas in endobronchial biopsy (EBB)?

Study Design And Methods: In this prospective international multicenter cohort study, consecutive patients with suspected sarcoidosis underwent airway inspection with an HD videobronchoscope and EBB using a standardized workflow. AAs were classified according to six patterns defined a priori: nodularity, cobblestoning, thickening, plaque, increased vascularity, and miscellaneous.

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Background: The role of salvage surgery after tyrosine kinase inhibitors in advanced oncogene-addicted non-small cell lung cancer is largely unexplored.

Patients: We aimed to describe the pathological features and surgical early-outcomes of Anaplastic Lymphome Kinase anaplastic lymphome kinase positive non-small cell lung cancer patients undergoing surgery after first-line alectinib treatment. We retrospectively collected and analyzed multicentric data of 10 patients treated with alectinib for advanced-stage anaplastic lymphome kinase positive lung adenocarcinoma who underwent anatomical surgical resection from January 2020 to Decemeber 2021.

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Article Synopsis
  • - The study evaluated the effectiveness and safety of ultrasound-guided needle aspiration biopsy (US-NAB) for diagnosing superficial metastases in lung cancer patients, comparing procedures with and without rapid on-site evaluation (ROSE).
  • - A total of 136 patients were randomized, showing no significant differences in diagnostic accuracy between the ROSE and non-ROSE groups, with high diagnostic yields for tissue diagnosis, cancer genotyping, and PD-L1 testing.
  • - The results indicate that US-NAB is a safe and highly effective method for acquiring tissue samples from superficial metastatic lesions, regardless of whether ROSE is used, supporting its use as the preferred first-step diagnostic procedure in suspected lung cancer cases.
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We report an unusual mediastinal recurrence along descending thoracic aorta during oncologic follow-up in a 47-year-old female smoker issued by lung adenocarcinoma with a history of left lower lobectomy and lingulectomy en bloc followed by adjuvant chemotherapy for stage III A-N2. Regional recurrence occurring along the staple line was suspected and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) combined to PET/CT allowed to reach definitive tissue diagnosis. High focal hypermetabolic activity on PET/CT at the site of suspect recurrence was necessary to check the lesion sampling by EBUS-TBNA.

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Background: The PD-L1 assessment is mandatory for the selection of patients affected by advanced non-small-cell lung cancer (NSCLC) who can benefit from the PD-1/PD-L1 checkpoint inhibitors therapy. Previous studies tested PD-L1 on cytological smears to evaluate this sample as an alternative to formalin-fixed paraffin-embedded (FFPE) ones, but several critical issues needed to be clarified.

Aim: We evaluated the cyto-histological agreement (CHA) and the PD-L1 interobserver agreement (IrOA) among three different pathologists (Path1, Path2, Path3) on 160 paired cytological smears and histological samples of advanced NSCLC.

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