Liquid dynamic medicine and N-of-1 clinical trials: a change of perspective in oncology research

Silvestris, Nicola; Ciliberto, Gennaro; Paoli, Paolo De; Apolone, Giovanni; Lavitrano, Marialuisa; Stanta, Giorgio

doi:10.1186/s13046-017-0598-x

Cited by 20 publications

(18 citation statements)

References 31 publications

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“…CfDNA has the advantage to serve as “liquid biopsy”, which may be used as cost-effective and non-invasive surrogates for tissue biopsies in cancer risk prediction and early detection [ 5 ]. Moreover, analysis of tumor-specific alterations in cfDNA may represent a tool for cancer detection and disease progression monitoring [ 6 ]. However, more studies are needed before liquid biopsies will be routinely used in the clinic.…”

Section: Introductionmentioning

confidence: 99%

Circulating cell-free DNA content as blood based biomarker in endometrial cancer

et al. 2017

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BackgroundAltered circulating cell-free DNA (cfDNA) levels are related to cancer development and aggressiveness. Up to now, very few studies have been performed for evaluating cfDNA content in endometrial cancer (EC).MethodsFirst, we measured cfDNA release in blood serum of EC cancer patients collected before surgery and before the beginning of any treatment by SYBR Gold assay and correlated it with tumor aggressiveness. We also assessed the relative mitochondrial cell-free DNA (cfmtDNA) content by qRT-PCR. Next, we correlated cfDNA levels with BMI, age, hypertension and inflammation markers.ResultsCfDNA levels are higher in G2 and G3 compared with G1 EC sera. A significant modulation of cfDNA content was detected in sera from patients with BMI>30 compared with those with BMI<30. We observed a further and significant alteration in cfDNA level in hypertensive patients with G2-G3, but not in G1 EC. Analysis of preoperative neutrophil-to-lymphocyte (NLR) and monocyte-to-lymphocyte (MLR) ratios suggests a contribution of the host response in the altered cfDNA levels in EC.ConclusionsOur data indicate that assessment of total and mitochondrial cfDNA levels in blood sera and the relative NLR and MLR in blood obtained from preoperative patients may help clinical management and prognosis in EC.

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Section: Introductionmentioning

confidence: 99%

Circulating cell-free DNA content as blood based biomarker in endometrial cancer

et al. 2017

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“…In conclusion, we can win this war only if we acknowledge the need for a strategy that includes what we learn from the research on both cancer and COVID-19. On these grounds, we endorse an approach similar to what we have called "liquid dynamic medicine", i.e., the matching of dynamic changes in the tumor and dynamic changes in the therapy [10]. Indeed, the management of cancer patients during the COVID-19 pandemic will require continuous adjustments as new knowledge becomes available.…”

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confidence: 96%

A moonshot approach toward the management of cancer patients in the COVID-19 time: what have we learned and what could the Italian network of cancer centers (Alliance Against Cancer, ACC) do after the pandemic wave?

Silvestris

Apolone

Botti

et al. 2020

J Exp Clin Cancer Res

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If we focus our attention on seven main features of COVID-19 infection (heterogeneity, fragility, lack of effective treatments and vaccines, "miraculous cures", psychological suffering, deprivation, and globalization), we may establish parallelism with the challenges faced in the steep road to the understanding and treatment of neoplastic diseases. How the similarities between these two conditions can help us cope with the emergency effort represented by the management of cancer patients in the COVID-19 era, today and in the future? In a manner similar to the Cancer Moonshot initiative in the United States, we can hypothesize a multinational moonshot project towards the management of cancer patients during COVID-19 pandemic. In particular, we believe that the main road to elaborate meaningful scientific evidence is represented by the collection of all the data on COVID-19 and cancer comorbidity that are and will become available in cancer centers, coupled with the design of large clinical studies. To address this goal, it is essential to identify the entity that can produce this scientific evidences and the potentially most successful research strategy to undertake. The largest Italian organization for cancer research, Alliance Against Cancer (Alleanza Contro il Cancro, ACC), is called to play a scientific leadership in addressing these challenges, which requires the coordination of oncology teams at regional, national, and international levels. To fulfill this commitment, ACC will create a liaison with health government agencies in order to develop "dynamic" indications able to fight such an unpredictable pandemic.

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“…I ant case, we are still far from obtaining a panel useful for clinical practice. The efforts must be to identify a score [27,70] able to include various variables useful for perfecting the therapeutic choice in HCC.…”

Section: Resultsmentioning

confidence: 99%

“…In the era of target therapy and liquid dynamic medicine [27], plasmatic and histological biomarkers have always been used as predictive markers of putative response to target therapy, also in HCC patients treated with sorafenib ( Figure 1).…”

Section: Biological Predictive Markersmentioning

confidence: 99%

Predictive and Prognostic Factors in HCC Patients Treated with Sorafenib

Brunetti¹,

Gaspar²,

Licchetta³

et al. 2019

Preprint

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Sorafenib is an oral kinase inhibitor that enhances survival in patients affected by advanced hepatocellular carcinoma (HCC). According to the results of two registrative trials, this drug represents a gold quality standard in the first line treatment of advanced HCC. Recently, lenvatinib showed similar results in terms of survival in a non-inferiority randomized trial study considering the same subset of patients. Unlike other targeted therapies, currently predictive and prognostic markers in HCC patients treated with sorafenib are lacking. Their identification could help clinicians in the daily management of these patients, mostly in light of the new therapeutic options available in the first.

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Liquid dynamic medicine and N-of-1 clinical trials: a change of perspective in oncology research

Cited by 20 publications

References 31 publications

Circulating cell-free DNA content as blood based biomarker in endometrial cancer

Circulating cell-free DNA content as blood based biomarker in endometrial cancer

A moonshot approach toward the management of cancer patients in the COVID-19 time: what have we learned and what could the Italian network of cancer centers (Alliance Against Cancer, ACC) do after the pandemic wave?

Predictive and Prognostic Factors in HCC Patients Treated with Sorafenib

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