Fabrizio Nelli

Azienda Sanitaria Locale Viterbo | ASL Viterbo · Medical Oncology

Extramammary Paget's disease is a rare skin cancer that usually arises from the secretory cells of the apocrine glands. In most cases, an extramammary Paget's tumor occurs as a single intraepithelial form not associated with another cancer, although rarely, it may be associated with other loco-regional or distant cancer. It is generally slow-growin...

Background Numerous research studies have looked into how the primary tumor location (PTL) affects patients’ prognosis for colorectal cancer (CRC). Our research aimed to investigate the prognostic effects of PTL in patients with synchronous (SM) and metachronous (MM) colorectal cancer liver metastases (CRCLM). Material and methods From 2016 to 2021...

Background Immunosuppressive dosing of corticosteroids at the start of treatment impairs immune checkpoint inhibitor (ICI) efficacy in advanced non-small cell lung cancer (NSCLC). Previous cumulative dose and intake modality of corticosteroids may result in different levels of immunosuppression. We sought to determine whether these aspects could pr...

Background The adaptive immune response following COVID-19 vaccination is essential for humoral immunogenicity and clinical protection against symptomatic infection. We present the results of circulating lymphocytes profiling and their correlation with antibody response in cancer patients tested serologically six months after receiving a two-dose s...

Background: Since the beginning of the covid19 pandemic, clinical and demographic data showed that cancer patients are at high risk of developing severe consequences of Sars-Cov2 disease. For this reason, vaccination is strongly recommended, especially for patients on active treatment. Nevertheless, the efficacy of the Sars-Cov2 vaccine in cancer p...

Background: There is no clear information on the proportion of patients who need therapy for immune-related thyroid dysfunction (irTD) or who need to delay, omit, or discontinue immunotherapy. Furthermore, it is not well known whether irTD correlates with better outcomes or not. Patients and methods: We conducted a retrospective study in patient...

Background Preliminary analysis from Vax-On study did not find a correlation between cancer treatment type and antibody response to COVID-19 vaccination. We performed a secondary subgroup analysis to verify the effects of comprehensive cancer treatment classification on vaccine immunogenicity. Methods The Vax-On prospectively enrolled patients who...

Small cell lung cancer (SCLC) is an aggressive disease, difficult to treat. There have been no significant therapeutic advances over platinum and etoposide chemotherapy in the last 20 years until the introduction of immunotherapy. In 2020 atezolizumab, an immune checkpoint inhibitor against PD-L1 was approved in Italy in combination with carboplati...

Introduction: Pemetrexed maintenance significantly improved progression-free survival (PFS) and overall survival (OS) in advanced nonsquamous non-small-cell lung cancer (NSCLC) patients not progressing after induction chemotherapy. Objectives: This study is aimed at examine the association of various clinical factor and survival in a real-world...

Lung cancer is a disease extremely heterogeneous in the molecular aspect and knowing the mutational profile of patients is essential in order to initiate the most appropriate treatment. In 2018, alectinib was approved in Italy for the first-line treatment of patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer...

Immune-related thyroid dysfunction (irTD) is common and occurs in 10-20 % of patients treated with immune checkpoint blockade and it seems to correlate with improved outcomes. The proportion of the patients who needs therapy for irTD, as well as the need to delay, omit or interruption is not well known. Material and methods We reviewed the data of...

With the advent of immunotherapy, the life expectancy of patients with advanced non-small cell lung cancer (NSCLC) is dramatically improved. As described in the most recent clinical trials, the addition of immunotherapy to the available therapeutic strategies, restoring an efficient immune response against neoplasms and establishing an immunologica...

Background The impact of previous cumulative exposure to CS before treatment start is unknown, while its use for the treatment of immune-related adverse events during PD-(L)1 therapy does not seem to reduce efficacy. We used real-world data to evaluate the effect of CS immunosuppressive dose (cumulative dose of > 700 mg of prednisone equivalent) or...

Background/aim: Recent data highlighted that location of metastatic colorectal cancer (mCRC) may have a prognostic impact and also a predictive value of the outcomes of first-line therapy. Materials and methods: The records of mCRC patients who underwent first-line therapy from 2011 to April 2018 at our Institute were retrospectively reviewed. P...

Purpose To test the efficacy of adding cisplatin to first-line treatment for elderly patients with advanced non–small-cell lung cancer (NSCLC) within a combined analysis of two parallel phase III trials, MILES-3 and MILES-4. Patients and Methods Patients with advanced NSCLC who were older than age 70 years with Eastern Cooperative Oncology Group p...

Objectives: The aim of our study was to explore the effectiveness of the combination of D-mannose, Salicin, and Lactobacillus acidophilus (La-14) in patients complaining recurrent symptomatic cystitis due to E. coli. Materials and methods: From July 2013 to September 2014, 85 consecutive subjects (68 women and 17 men) affected by recurrent sympt...

337 Background: Abiraterone acetate (AA) is a potent, selective androgen (CYP17) biosynthesis inhibitor, which showed to improve overall survival in mCRPC pts progressing after docetaxel. Few data are available concerning the clinical outcome of AA treatment in mCRPC in terms of the duration of prior androgen deprivation therapy (ADT). In this retr...

Aromatase inhibitors (AIs) are standard hormone therapy (HT) for the adjuvant treatment of postmenopausal endocrine-sensitive early breast cancer. Treatment discontinuation due to toxicity is an important issue that may help clinicians identify effective clinical interventions to allow adequate treatment duration. We reviewed the main reasons for i...

Both Epithelial Na+ Channel (γENaC) and the Acid-Sensing Ion Channel 1 (ASIC1) belong to Degenerin/Epithelial Na+ channel family that represents a new class of cation channels [1]. Increasing evidences show an involvement of these channels in the control of bladder afferent excitability under physiological and pathological conditions [2]; however,...

Objective To investigate the expression of two types of cation channels such as the γEpithelial Na+ Channel (γENaC) and the Acid-Sensing Ion Channel1 (ASIC1) in the urothelium of controls and in patients affected by neurogenic detrusor overactivity (NDO). In parallel, the urodynamic parameters were collected and correlated to the immunohistochemica...

Unlabelled: Monoclonal antibodies bevacizumab and cetuximab both improve overall survival (OS), progression free survival (PFS) and overall response rate (ORR) when combined with irinotecan-containing regimens. The optimal sequence of these monoclonal antibodies in combination with chemotherapy is controversial. This study analysed the efficacy of...

Erlotinib is registered for treatment of all patients with advanced non-small-cell lung cancer (NSCLC). However, its efficacy for treatment of patients whose tumours are EGFR wild-type-which includes most patients-is still contentious. We assessed the efficacy of erlotinib compared with a standard second-line chemotherapy in such patients. We did t...

Objectives: To evaluate the efficacy and safety over a 10-year period of any urological operations required by female patients with spinal cord lesions (SCLs). Methods: Retrospective study of urological surgeries from our database performed on females with SCLs from 2001 to 2002. Surgery efficacy for neurogenic lower urinary tract dysfunctions (...

Objectives: To compare the efficacy of intravesical electrostimulation (IVES) versus sacral neuromodulation (SNM) in patients with incomplete spinal cord lesions (SCL) and neurogenic non-obstructive urinary retention (N-NOR). Methods: In this retrospective study, 77 N-NOR patients underwent IVES (minimum 28 sessions), then after returning to voi...

Background: We retrospectively evaluated the efficacy of first-line epirubicin and docetaxel in patients with metastatic, hormonal receptor (HR)-positive, and human epidermal growth factor receptor-2-negative breast cancer. A subgroup analysis evaluated the predictive value of immunohistochemistry-defined luminal subtype. Methods: We included pa...

The addition of bevacizumab to standard chemotherapy has improved progression-free survival (PFS) and overall survival (OS) in patients with metastatic colorectal cancer (mCRC) in both first- and second line treatment, but the role of maintenance bevacizumab remains controversial. The association of various clinical factor and survival was examined...

Objective: To evaluate the clinical and urodynamic impact of intravesical electrostimulation (IVES) on incomplete spinal cord injury (SCI) patients suffering from chronic neurogenic non-obstructive urinary retention (N-NOR). Methods: One-hundred and two patients underwent at least 28 consecutive daily IVES sessions because objective evidence of...

Background Dose-dense sequential chemotherapy including anthracyclines and taxanes has been well established in the adjuvant setting of high-risk operable breast cancer. However, the preferable taxane and optimal schedule of administration have not been defined, as yet.

e18065 Background: PEM plus platinum–based regimen is a standard of care in chemonaïve advanced non-squamous NSCLC pts. This retrospective multicenter analysis was performed to evaluate the predictive value of clinical variables for PFS in an unselected population. Methods: Data were obtained by reviewing the clinical data of pts affected with adva...

Background We evaluated the efficacy of gemcitabine and carboplatin for patients affected by pretreated metastatic breast cancer. A subgroup analysis was performed to evaluate the predictive value of immunohistochemically defined breast cancer subtypes. Methods We included human epidermal growth factor 2 (HER-2) negative metastatic breast cancer re...

Erectile dysfunction (ED) is reported in a high percentage of patients with central neurological disorders (CND).   An up-to-date review on oral phosphodiesterase 5 inhibitors (PDE5): sildenafil, tadalafil, and vardenafil for individuals with CND and ED. Various questionnaires on ED, such as the International Index of Erectile Function composed of...

612 Background: Maintenance treatment with B is considered an option for mCRC pts in responding pts after a first line CT + B, but few data are available on its real benefit on PFS. Methods: We collected data from a cohort of mCRC pts consecutively treated in five oncologic centers of Lazio. One-hundred-ninety-nine mCRC pts treated with first line...

Our aim was to locate research and communicate the evidence found from scientific studies pertaining to the treatment of neurogenic detrusor overactivity (NDO) in the chronic stage of spinal cord injury (SCI). To address the controversy over the traditional (antimuscarinics) and the 'new' treatments for NDO and try to offer an insight on the ration...

To assess the concomitant clinical improvement in incomplete spinal cord injury patients (SCIPs) suffering from neurogenic bowel symptoms (NBSs), neurogenic lower urinary tract symptoms (NLUTSs) and neurogenic erectile dysfunction (NED) using sacral neuromodulation (SNM) for NBSs and NLUTSs. Seventy-five SCIPs were selected. Before and during the f...

e14603 Background: The role of the excision repair cross-complementing 1 (ERCC1) is well documented in a large number of tumor types with cisplatin-based chemotherapy. The aim of this study was to determine whether ERCC1 expression predict clinical outcome in patients affected by metastatic gastric cancer (MGC) treated with cisplatin (P), epirubici...

Sildenafil citrate is currently used on demand in the treatment of erectile failure, regardless of etiology. Nevertheless, recent data suggest a significant improvement in nocturnal penile erections in potent and impotent men taking a single dose at bedtime. The present study analyzes whether continuous use of sildenafil positively correlates with...

This study was designed to evaluate the predictive value of early specific toxicities on efficacy of weekly irinotecan/cetuximab administered as salvage therapy in patients with metastatic colorectal cancer (CRC) refractory to oxaliplatin and irinotecan. Seventy patients received a regimen composed of weekly irinotecan 125 mg/m2 as a 1-hour intrave...

Complete surgical resection of gastric cancer is potentially curative, but long-term survival is poor. Patients with histologically proven adenocarcinoma of the stomach of stages IB, II, IIIA and B, or IV (T4N2M0) and treated with potentially curative surgery were randomly assigned to follow-up alone or to intravenous treatment with four cycles (re...

Brain metastases are the most common intracranial tumors, occurring in 15–40% of cancer patients with an estimated incidence of 170,000 new cases a year in the United States (Davey, 2002). Lung cancer is the most common primary source of metastases to the central nervous system (CNS), causing brain metastases in 10–64% of patients. Non-small-cell l...

15502 Background: A randomized phase III trial comparing PG vs OBS in muscle-invasive TTC of the bladder is currently ongoing. ERCC1 and RRM1 genes are involved in the nucleotide excision repair pathways, and their up-regulation by tumor has been clearly related to resistance of cisplatin and gemcitabine, respectively. Preliminary correlations in p...

An 84-year-old patient presented with partial extrusion of a semirigid penile prosthesis, implanted 20 years earlier following a diagnosis of erectile dysfunction refractory to oral and injection therapy. Four years previously, the patient was diagnosed with bilateral obliterans arteriopathy limited to the iliac arteries and, two years later, with...

The purpose of this pilot study was to determine the safety and feasibility of a complete integrated approach, including induction chemotherapy with carboplatin/paclitaxel followed by accelerated hyperfractionated radiotherapy with concurrent chemotherapy, and then by consolidation chemotherapy for locally advanced stage III non-small cell lung car...

For patients with stage IV nonsmall cell lung cancer (NSCLC) who present with brain metastasis (BMs), standard platinum-based chemotherapy regimens have challenged the role of up-front whole-brain radiotherapy (WBRT). In this survey, the authors analyzed the decision tree by which 6 oncologic centers guided the pattern of care in an unselected popu...

To evaluate feasibility and safety of induction three-drugs combination chemotherapy and concurrent radio-chemotherapy in stage IIIB NSCLC. Patients with stage IIIB NSCLC were treated with three courses of induction chemotherapy, cisplatin 50 mg/m(2), paclitaxel 125 mg/m(2) and gemcitabine 1000 mg/m(2) on days 1,8 of every 21 day cycle. Patients wi...

18548 Background: Direct comparison of EA vs EB vs DE has never been performed. In order to define the efficacy, impact on quality of life (QL) and pt’s preference, a prospective observational comparison of erythropoietic agents has been carried out. Methods: Anemic pts (hgb <11 gr/dL) scheduled to receive at least 3 cycles of CT were stratified ac...

The development and use of new radiotherapy techniques, especially 3D conformal radiotherapy or intensity-modulated radiotherapy, has allowed the safe application of high doses of external beam radiotherapy without increasing toxicity. The aim of this analysis was to describe the acute and when possible late toxicity and the feasibility on using in...

The treatment of muscle-invasive bladder carcinoma should include both the eradication of local disease and the elimination of potential micrometastases. To date, the 'gold standard' treatment for muscle invasive bladder carcinoma has been recognized to be radical cystectomy. Adjuvant chemotherapy (AC) has the advantage of being administered to pat...

Several improvements in the treatment of advanced transitional cell malignancies have been provided by clinical trials in the past 10 years. Nonetheless, there are conflicting results regarding the effect of perioperative chemotherapy of muscle-invasive disease and new cytotoxic agents in the metastatic setting. The authors will discuss the results...

Background. A nurse Symptoms Assessment Chart (SAC) may represent a valuable tool to better address the clinical problems of cancer patients and to evaluate the needs related to both symptoms and adverse events of treatments. This retrospective survey was conducted to evaluate the usefulness of SAC in comparison with both medical records and QLQ-C3...

The aim of the study was to describe in detail the impact of aging and comorbidities on safety and efficacy of gemcitabine-cisplatin in the subset of elderly with advanced NSCLC. We report the results of our study which enrolled patients aged over 65 years or older. This study included 46 patients consecutively admitted to our Department. Treatment...

Anaplastic thyroid carcinoma is a rare disease with a poor prognosis. Surgery represents the curative treatment for limiting the disease. In the presence of locoregional disease, not suitable for surgery, and for metastastic disease, chemotherapy represents the treatment option. Single agents chemotherapy can produce some responses; doxorubicin is...

The objective of this study was to evaluate the activity and toxicity of combined cisplatin, etoposide, and gemcitabine (PEG) and combined cisplatin plus gemcitabine (PG) in previously untreated patients with extensive-stage and poor-prognosis limited-stage small-cell lung carcinoma. One hundred forty patients (70 patients in two arms) were randomi...

Metastatic involvement of the extrahepatic digestive system is rare. We here report the case of a 62-year-old woman who presented with a bowel obstruction related to a metastasis of breast cancer occurring 12 years after a mastectomy for lobular carcinoma. No other distant metastases were detected except for two nodules of 20 and 5 mm on the right...

Docetaxel was proven to be effective as second-line therapy for patients with advanced NSCLC after failure of platinum-based front-line chemotherapy. We designed this phase I/II study to define the Maximum Tolerated Dose of weekly docetaxel combined with weekly vinorelbine, and subsequently evaluate tolerability and activity of this schedule in NSC...

7100 Background: The incidence of cutaneous adverse effect during therapy with ZD1839, usually dose-dependent, is reported from 48% to 65% with the dose of 250 mg/day. Despite neither dose reduction nor treatment discontinuation are suggested in case of grade 1–2 adverse events, however the extension of abnormalities to face and extremities, and so...

7365 Background: Phase III trials evaluating platinum-based chemotherapy (CT) have recently challenged the standard option of radiotherapy (WBRT) in the treatment of NSCLC pts presenting with brain metastases. Although the current options are often driven by the clinical status (e.g. BM symptoms) and the local practice (e.g. referred specialist and...

Our objective was to determine the activity in terms of response rate, surgical resectability, and the tolerability of the new three-drug combination gemcitabine-cisplatin-paclitaxel (GCP) in unresectable stage IIIA(N2) and IIIB non-small cell lung cancer (NSCLC). Forty-two chemo-naive patients with stage IIIA(N2)-IIIB NSCLC, median age of 59 years...

The objective of the current study was to define the activity and tolerability, as well as the influence on resectability, of the combination of gemcitabine, paclitaxel, and cisplatin (GTP) as induction chemotherapy for patients with Stage IIIA(N2) nonsmall cell lung carcinoma (NSCLC). Forty-nine chemotherapy-naïve patients (median age, 61 years; W...

The objective of this trial was to evaluate the activity and safety of one of the newer platinum-based doublets as a neoadjuvant regimen in patients with unresectable Stage IIIA-bulky N2 and Stage IIIB nonsmall cell lung carcinoma (NSCLC). From June 1996 to April 2000, 129 consecutive patients with locally advanced NSCLC were treated with gemcitabi...

The objectives of this phase I/II study were to define the maximum tolerated dose (MTD), safety, and activity of cisplatin, etoposide, and gemcitabine (PEG) in the treatment of previously untreated patients with small-cell lung cancer (SCLC). Chemonaive patients received fixed doses of gemcitabine (1000 mg/m(2) on days 1 and 8) and cisplatin (70 mg...

Our aim was to explore the activity and feasibility of gemcitabine plus cisplatin as induction chemotherapy in patients with Stage IIIA N(2) and selected IIIB non-small cell lung cancer (NSCLC). From September 1997 to July 2000, 70 chemonaive patients with Stage III NSCLC, median age of 64 years, World Health Organization performance status 0, 1, o...