21 results on '"Gregory, Kaltsas"'
Search Results
2. Hypophysitis (Including IgG4 and Immunotherapy)
- Author
-
Eva Kassi, Gregory Kaltsas, Anna Angelousi, Krystallenia I Alexandraki, and Marina Tsoli
- Subjects
medicine.medical_specialty ,Pediatrics ,Hypophysitis ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Hypopituitarism ,030218 nuclear medicine & medical imaging ,Pathogenesis ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Adrenal insufficiency ,Humans ,Immunologic Factors ,Endocrine and Autonomic Systems ,business.industry ,Autoantibody ,Immunotherapy ,medicine.disease ,Lymphoma ,Histiocytosis ,Immunoglobulin G ,business - Abstract
Hypophysitis is characterized by inflammation of the pituitary gland that can be primary (PH) or secondary (SH) to other diseases or following drug administration. It may also be classified according to anatomical and histopathological criteria, leading to variable degrees of hypopituitarism and/or compressive symptoms to nearby structures. There has recently been an increase in the number of hypophysitis cases, raising the interest on the spectrum of its pathogenesis, clinical, biochemical/endocrinological, and imaging features. However, the use of conventional biomarkers, including currently utilized pituitary autoantibodies, has relatively limited diagnostic accuracy. Lymphocytic hypophysitis (LH) is the commonest cause of PH, whereas IgG4-related hypophysitis is increasingly being recognized. Histiocytosis and granulomatous diseases are the most frequent causes of SH, although infections and lymphoma have also been reported. The increasing use of immune checkpoint inhibitors in oncology is associated with a high incidence of hypophysitis, providing further understanding of its pathogenesis. Hypophysitis can occur silently and be easily missed, potentially leading to substantial morbidity or mortality due to adrenal insufficiency, requiring a high index of clinical suspicion and timely initiation of appropriate treatment. In most cases of LH or drug-induced hypophysitis, active surveillance along with replacement of established hormonal deficiencies is needed. In the presence of compressive and/or evolving symptoms, treatment with glucocorticoids either alone or in combination with other immunosuppressive agents can be used. Surgical decompression is reserved for nonresponsive cases with threatened vital structures. Timely diagnosis and intervention are important to minimize disease-related morbidity and mortality. We aimed to review current concepts and recent developments in the pathogenesis, diagnosis, and management of hypophysitis.
- Published
- 2020
3. Authors’ Response to the Letter by Lamarca et al. Entitled 'Temozolomide-Capecitabine Chemotherapy for Neuroendocrine Neoplasms: The Dilemma of Treatment Duration' Regarding 'Activity and Safety of Standard and Prolonged Capecitabine/Temozolomide Administration in Patients with Advanced Neuroendocrine Neoplasms'
- Author
-
Anna Koumarianou, David J. Gross, Ewa Wachuła, Kosmas Daskalakis, Simona Grozinsky-Glasberg, Gregory Kaltsas, Amichay Meirovitz, Ofra Maimon, Eleftherios Chatzellis, Marina Tsoli, Anna Angelousi, Krystallenia I Alexandraki, and Beata Kos-Kudła
- Subjects
Oncology ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Treatment duration ,Dacarbazine ,medicine.medical_treatment ,Neuroendocrine tumors ,Capecitabine ,Cellular and Molecular Neuroscience ,Endocrinology ,Internal medicine ,Temozolomide ,medicine ,Humans ,In patient ,Chemotherapy ,Duration of Therapy ,Endocrine and Autonomic Systems ,business.industry ,medicine.disease ,Neuroendocrine Tumors ,stomatognathic diseases ,business ,medicine.drug - Abstract
Authors' Response to the Letter by Lamarca et al. Entitled "Temozolomide-Capecitabine Chemotherapy for Neuroendocrine Neoplasms : The Dilemma of Treatment Duration" Regarding "Activity and Safety of Standard and Prolonged Capecitabine/Temozolomide Administration in Patients with Advanced Neuroendocrine Neoplasms"
- Published
- 2019
4. Lung Metastases in Patients with Well-Differentiated Gastroenteropancreatic Neuroendocrine Neoplasms: An Appraisal of the Validity of Thoracic Imaging Surveillance
- Author
-
Eleftherios Chatzellis, Anna Angelousi, Raj Srirajaskanthan, Krystallenia I Alexandraki, Kosmas Daskalakis, Michail Pizanias, Harpal S. Randeva, Martin O. Weickert, Marina Tsoli, and Gregory Kaltsas
- Subjects
Adult ,Male ,medicine.medical_specialty ,Lung Neoplasms ,Thoracic imaging ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Gastroenterology ,Disease-Free Survival ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Stomach Neoplasms ,Internal medicine ,Intestinal Neoplasms ,medicine ,Humans ,In patient ,Lymph node ,Aged ,Aged, 80 and over ,Lung ,Endocrine and Autonomic Systems ,business.industry ,Middle Aged ,medicine.disease ,Well differentiated ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,medicine.anatomical_structure ,Concomitant ,Disease Progression ,Abdomen ,Female ,Lymph Nodes ,business ,Progressive disease - Abstract
Background/Aims: To evaluate the impact of lung metastases (LM) on overall survival (OS) in well-differentiated (WD) stage IV gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) patients along with developing surveillance strategies for thoracic imaging. Methods: Thirty-four patients with LM, from 3 centres, were identified (22 small intestine/12 pancreatic; 17 grade 1/15 grade 2/2 of unknown grade). For comparison, we used 106 stage IV WD, grade 1 and 2 GEP-NEN patients with metastatic disease confined in the abdomen. Results: LM prevalence was 4.9% (34/692). Eleven patients (32%) presented with synchronous LM whereas 23 (68%) developed metachronous LM at a median of 25 months (range 1–150 months). Patients with metachronous LM had already established liver and/or para-aortic lymph node metastases. Eighteen of 23 patients (78%) with metachronous LM exhibited concomitant progression in the abdomen. Median OS of WD GEP-NEN patients with LM was shorter than for those with stage IV disease without extra-abdominal metastases (56 [95% CI 40.6–71.6] vs. 122.7 [95% CI 70.7–174.8] months; log-rank p = 0.001). Among patients with progressive stage IV disease, the subset of patients with LM exhibited shorter OS (log-rank p = 0.005). LM were also confirmed as an independent prognostic factor for survival in multivariable analysis (HR 0.18; 95% CI 0.07–0.45; p < 0.0001). Conclusion: LM, although relatively rare in patients with WD stage IV GEP-NENs, may impact patients’ outcome. The development of metachronous LM is associated with concomitant disease progression in established abdominal metastases in most patients. These patient-related parameters could be utilized for a stratified surveillance approach, mainly reserving thoracic imaging for GEP-NEN patients with progressive disease in the abdomen.
- Published
- 2019
5. Unmet Medical Needs in Pulmonary Neuroendocrine (Carcinoid) Neoplasms
- Author
-
Baudin, Eric, Hayes, Aimee R., Scoazec, Jean-Yves, Filosso, Pier Luigi, Lim, Eric, Kaltsas, Gregory, Frilling, Andrea, Chen, Jie, Kos-Kudla, Beata, Gorbunova, Vera, Wiedenmann, Bertram, van Dijkum, Els Nieveen, Cwikla, Jaroslaw B., Falkerby, Jenny, Valle, Juan W., Kulke, Matthew H., Caplin, Martyn E., Detlef, Bartsch, Rudolf, Arnold, Eric, Baudin, Lisa, Bodei, Ivan, Borbath, Jaume, Capdevila, Martyn, Caplin, Jie, Chen, Frederico, Costa, Anne, Couvelard, Jaroslaw, Cwikla B., Philippa, Davies, de Herder, Wouter W., Massimo, Falconi, Jenny, Falkerby, Nicola, Fazio, Diego, Ferone, Andrea, Frilling, Rocio, Garcia-Carbonero, Simona, Glasberg, Vera, Gorbunova, Ashley, Grossman, Dieter, Hoech, Robert, Jensen, Gregory, Kaltsas, Guenter, Kloeppel, Peter, Knigge Ulrich, Beata, Kos-Kudla, Guenter, Krejs J., Eric, Krenning, Matthew, Kulke, Steven, Lamberts W. J., van Elisabeth, Nieveen Dijkum, Juan Manuel, O'Connor, Dermot, O'Toole, Ulrich-Frank, Pape, Stefano, Partelli, Ellen, Pavel Marianne, Peeters, Marc, John, Ramage, Simon, Reed Nicholas, Guido, Rindi, Anja, Rinke, Philippe, Ruszniewski, Halfdan, Sorbye, Anders, Sundin, Jean-Yves, Scoazec, Babs, Taal G., Eva, Tiensuu Janson, Christos, Toumpanakis, Juan, Valle, Marie-Pierre, Vullierme, Staffan, Welin, Bertram, Wiedenmann, ENETS 2016 Munich Advisory Board, Internal Medicine, Baudin, E, Hayes, A R, Scoazec, J-Y, Filosso, Pl, Lim, E, Kaltsas, G, Frilling, A, Chen, J, Kos-Kudla, B, Gorbunova, V, Wiedenmann, B, Nieveen, Van Dijkum E, Cwikla, J B, Falkerby, J, Valle, J W, Kulke, M H, Caplin, M E, on behalf The ENETS 2016 Munich Advisory Board, Participant, Partelli, S, Falconi, M, and Dr. Heinz-Horst Deichmann Stiftung
- Subjects
Oncology ,Biomedical Research ,Lung Neoplasms ,SOMATOSTATIN RECEPTORS ,Endocrinology, Diabetes and Metabolism ,CHROMOGRANIN-A ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Endocrinology ,PROGNOSTIC-FACTORS ,PROLIFERATIVE INDEX ,Prognosis ,Neuroendocrine Tumors ,Neuroendocrine Tumors/classification ,CUSHINGS-SYNDROME ,Tumour classification ,ENETS 2016 Munich Advisory Board Participants ,Life Sciences & Biomedicine ,medicine.medical_specialty ,Carcinoid Tumor/classification ,030209 endocrinology & metabolism ,Carcinoid Tumor ,ENETS CONSENSUS GUIDELINES ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Endocrinology & Metabolism ,Biomedical Research/trends ,Internal medicine ,Pulmonary carcinoids ,medicine ,Humans ,EUROPEAN ASSOCIATION ,Science & Technology ,Endocrine and Autonomic Systems ,CLINICAL-FEATURES ,Bronchial carcinoid tumour ,Neurosciences ,1103 Clinical Sciences ,ECTOPIC ACTH SYNDROME ,Lung Neoplasms/classification ,Clinical trial ,NET ,Neuroendocrine neoplasm ,Bronchial carcinoid tumours ,Ectopic ACTH syndrome ,Neuroendocrine neoplasms ,Neurosciences & Neurology ,RECEPTOR RADIONUCLIDE THERAPY ,Human medicine ,Management principles ,Atypical carcinoid ,1109 Neurosciences - Abstract
Pulmonary carcinoids (PCs) display the common features of all well-differentiated neuroendocrine neoplasms (NEN) and are classified as low- and intermediate-grade malignant tumours (i.e., typical and atypical carcinoid, respectively). There is a paucity of randomised studies dedicated to advanced PCs and management principles are drawn from the larger gastroenteropancreatic NEN experience. There is growing evidence that NEN anatomic subgroups have different biology and different responses to treatment and, therefore, should be investigated as separate entities in clinical trials. In this review, we discuss the existing evidence and limitations of tumour classification, diagnostics and staging, prognostication, and treatment in the setting of PC, with focus on unmet medical needs and directions for the future.
- Published
- 2019
6. New Molecular, Biological, and Immunological Agents Inducing Hypophysitis
- Author
-
Anna Angelousi, Eleftherios Chatzellis, and Gregory Kaltsas
- Subjects
Drug ,medicine.medical_specialty ,Side effect ,Hypophysitis ,Endocrinology, Diabetes and Metabolism ,media_common.quotation_subject ,Antineoplastic Agents ,030209 endocrinology & metabolism ,Biology ,Biological Factors ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Humans ,Immunologic Factors ,media_common ,Endocrine and Autonomic Systems ,Cancer ,medicine.disease ,030220 oncology & carcinogenesis ,IMMUNOLOGICAL AGENTS ,Pituitary hormones ,Immunology ,Etiology ,Rare disease - Abstract
Hypophysitis is a relatively rare disease that exerts a strong autoimmune component encompassing different etiologies. Immunomodulatory drugs, such as interferon-α, are known to rarely induce hypophysitis. In recent years, a large number of new biological and immunomodulatory agents have been introduced into clinical practice. Although immune-suppressing agents used for the treatment of autoimmune disorders only rarely are associated with hypophysitis, it is commonly encountered with immunomodulatory agents used for the treatment of cancer. Hypophysitis related to anti-cytotoxic T-lymphocyte-associated antigen-4 antibodies (anti-CTLA-4 Abs) occurs with a prevalence ranging from 0 to 18% and is considered a distinctive side effect of anti-CTLA-4 Abs treatment. Hypophysitis due to the programmed cell death protein-1 antibodies and their ligand is less common, its frequency ranging from 0 to 0.8%. No cases of hypophysitis have been described with molecular targeted agents. Diagnosis of hypophysitis still remains clinical since anti-pituitary antibodies are not a sensitive marker and thus its true prevalence is probably underestimated. The pathophysiology of hypophysitis induced by anticancer agents is not fully clarified. In most cases, treatment requires dose adjustment of the offending drug and pituitary hormone replacement. This mini-review aims to present currently available information regarding hypophysitis related to new molecular, biological, and immunological agents.
- Published
- 2017
7. Contents Vol. 105, 2017
- Author
-
Sara Massironi, Clorinda Ciafardini, Jordan Goethel, Kazushige Kawai, Ida Rapa, Odile Viltart, Ophélia Le Thuc, Guillaume Cadiot, Thomas G. Papathomas, Teppei Morikawa, Marcel Smid, Yayoi Ikeda, Shigenobu Emoto, David Alexandre, Edward J. Wagner, Toshiaki Watanabe, Sara Zgheib, Ayako Tagami, Dermot O'Toole, Satz Mengensatzproduktion, Federica Cavalcoli, Tomomichi Kiyomatsu, Philippe Ruszniewski, Toshiaki Tanaka, Koji Murono, Mercedes Robledo, Wouter W. de Herder, Mifumi Takahashi, Massimo Mannelli, I. Fanetti, Susanna Bernasconi, Anne Couvelard, Marco Volante, Carole Rovère, Irene Felicetta, Holly A. Ingraham, Manabu Kaneko, William C. Krause, Takeshi Nishikawa, Dario Conte, Cindy Neuzillet, Jin Hur, Anna Angelousi, Ronald R. de Krijger, Daniel Fischer, Esther Korpershoek, Kimberly Kamp, Carolina Fabelo, Hiroaki Nozawa, Kensuke Otani, Kristie Conde, Louis de Mestier, Alessandra Zilli, Cecilia Meza, Jérôme Cros, Christophe Chauveau, Keisuke Hata, Gregory Kaltsas, Kazuhito Sasaki, Anne-Paule Gimenez-Roqueplo, Lindsey Oudijk, Maria Kaltsatou, Munekazu Komada, Mathieu Méquinion, Pascal Hammel, Nelly Muller, Druckerei Stückle, Axel Egal, Nicolas Chartrel, Maria Currás-Freixes, Olivia Hentic, Olivier Bouché, Judith Favier, Letizia Canu, Robert Propst, Pierre Hardouin, and Mauro Papotti
- Subjects
Cellular and Molecular Neuroscience ,medicine.medical_specialty ,Endocrinology ,Traditional medicine ,Endocrine and Autonomic Systems ,business.industry ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,medicine ,business - Published
- 2017
8. Activity and Safety of Standard and Prolonged Capecitabine/Temozolomide Administration in Patients with Advanced Neuroendocrine Neoplasms
- Author
-
David J. Gross, Amichay Meirovitz, Kosmas Daskalakis, Simona Grozinsky-Glasberg, Beata Kos-Kudła, Ewa Wachuła, Anna Angelousi, Krystallenia I Alexandraki, Eleftherios Chatzellis, Anna Koumarianou, Gregory Kaltsas, Ofra Maimon, and Marina Tsoli
- Subjects
Male ,medicine.medical_specialty ,Antimetabolites, Antineoplastic ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Treatment duration ,Labeling index ,030209 endocrinology & metabolism ,Gastroenterology ,030218 nuclear medicine & medical imaging ,Capecitabine ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Temozolomide ,Humans ,In patient ,Antineoplastic Agents, Alkylating ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chemotherapy ,Univariate analysis ,Endocrine and Autonomic Systems ,business.industry ,Middle Aged ,medicine.disease ,Prognosis ,Survival Analysis ,Progression-Free Survival ,Neuroendocrine Tumors ,Treatment Outcome ,Female ,business ,Progressive disease ,medicine.drug - Abstract
Background: Capecitabine and temozolomide combination (CAPTEM) is associated with high response rates in patients with advanced neuroendocrine neoplasms (NENs). We evaluated the real-world activity and safety of CAPTEM from 3 NEN centers. Methods: Clinicopathological characteristics and outcomes of patients treated with CAPTEM for bulky or progressive disease (PD) were retrospectively analyzed. Results: Seventy-nine patients with gastroenteropancreatic (grades 1–2 [n = 38], grade 3 [n = 24]) and lung/thymic (n = 17) NENs were included. Median treatment duration was 12.1 months (range 0.6–55.6). Overall, partial responses (PRs) occurred in 23 (29.1%), stable (SD) in 24 (30.4%), and PD in 28 (35.4%) patients. Median progression-free survival (PFS) and overall survival (OS) were 10.1 (6–14.2) and 102.9 months (43.3–162.5), respectively. On univariate analysis, NENs naive to chemotherapy and low Ki67 were associated with favorable responses (partial response [PR] + SD; p = 0.011 and 0.045), PFS (p < 0.0001 and 0.002) and OS (p = 0.005 and 0.001). Primary site (pancreas and lung/thymus) was also a significant prognostic factor for PFS (p < 0.0001) and OS (p < 0.0001). On multivariate analysis, gastrointestinal and unknown primary NENs (hazard ratio [HR] 0.3, 95% CI 0.1–0.8, p = 0.009 and p = 0.018) and prior surgery (HR 2.4, 95% CI 11–4.9, p = 0.021) were independent prognostic factors for PFS. Ki-67 was a poor predictor for favorable response in receiver operating characteristic analysis (area under the curve 0.678). Safety analysis of CAPTEM indicated rare events of serious (grades 3–4) toxicities (n = 4) and low discontinuation rates (n = 8) even in patients with prolonged administration (>12 months). Conclusions: CAPTEM treatment can be an effective and safe treatment even after prolonged administration for patients with NENs of various sites and Ki67 labeling index, associated with significant favorable responses and PFS.
- Published
- 2018
9. Lung Carcinoids: Long-Term Surgical Results and the Lack of Prognostic Value of Somatostatin Receptors and Other Novel Immunohistochemical Markers
- Author
-
Gregory Kaltsas, Apostolos V. Tsolakis, Kjell Öberg, and Kosmas Daskalakis
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Lung Neoplasms ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Disease ,Carcinoid Tumor ,Gastroenterology ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Predictive Value of Tests ,Internal medicine ,medicine ,Biomarkers, Tumor ,Humans ,Receptors, Somatostatin ,Stage (cooking) ,Aged ,Retrospective Studies ,Aged, 80 and over ,Lung ,Relative survival ,Endocrine and Autonomic Systems ,business.industry ,Somatostatin receptor ,Middle Aged ,Prognosis ,Immunohistochemistry ,Survival Analysis ,Subcarinal Lymph Node ,030104 developmental biology ,medicine.anatomical_structure ,Cross-Sectional Studies ,Treatment Outcome ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Female ,business ,Follow-Up Studies - Abstract
Background/Aims: Lung carcinoids (LCs) are often diagnosed at an early stage and surgical intervention becomes the next phase of treatment. To date, there is lack of long-term follow-up data after surgery and prognostication based on WHO classification criteria and evolving prognostic markers, particularly the expression of somatostatin receptors (SSR). Methods: We included 102 consecutive patients (72 women; age at baseline 51 ± 16 years [mean ± SD]) with LCs, who underwent thoracic surgery (n = 99) and/or laser treatment (n = 8). Hospital charts were reviewed for clinico-pathological parameters. Immunohistochemical (IHC) expression of SSR1–5 and other novel markers were studied with regard to their prognostic value. Results: Five- and 10-year overall survival (OS) was 96 and 83% respectively; relative survival (RS) was 101 and 93% respectively; and event-free survival (EFS) was 80 and 67% respectively. Independent prognostic factors for OS, RS and/or EFS were age at diagnosis, histopathological type and the presence of ipsilateral mediastinal subcarinal lymph node metastases. Macro-radicality of resective surgery and its extent were associated with increased OS and EFS. The IHC expression of SSR1–5 and other novel markers was not associated with OS or EFS. Conclusion: The long-term outcome of surgically treated patients with LCs is favourable. Age, histopathological type and ipsilateral mediastinal subcarinal lymph node status at baseline were independent prognostic factors for survival and disease recurrence or progression. The extent of surgery and operative macro-radicality also had an impact on prognosis. None of the IHC markers tested appeared to be associated with disease prognosis.
- Published
- 2018
10. Temozolomide in Advanced Neuroendocrine Neoplasms: Pharmacological and Clinical Aspects
- Author
-
Massimo Barberis, Alfredo Berruti, Salvatore Galdy, Francesca Spada, Nicola Fazio, Gregory Kaltsas, Kjell Öberg, Anna Koumarianou, Jonathan R. Strosberg, Matthew H. Kulke, and Caterina Fumagalli
- Subjects
medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Dacarbazine ,Drug resistance ,Neuroendocrine tumors ,Ki-67 labelling index ,Neuroendocrine carcinomas ,Neuroendocrine neoplasms ,Pancreatic neuroendocrine neoplasms ,Progression-free survival ,Endocrinology ,Endocrine and Autonomic Systems ,Cellular and Molecular Neuroscience ,Capecitabine ,Internal medicine ,Temozolomide ,medicine ,Humans ,Antineoplastic Agents, Alkylating ,business.industry ,medicine.disease ,Diabetes and Metabolism ,Streptozocin ,Neuroendocrine Tumors ,Toxicity ,business ,medicine.drug - Abstract
Alkylating agents, such as streptozocin and dacarbazine, have been reported as active in neuroendocrine neoplasms (NENs). Temozolomide (TMZ) is an oral, potentially less toxic derivative of dacarbazine, which has shown activity both as a single agent and in combination with other drugs. Nevertheless, its role in NENs has not been well defined. Several retrospective and prospective phase I-II studies have been published describing its use in a variety of NENs. In a retrospective series, the combination of capecitabine and TMZ was reported to be associated with a particularly high tumour response in pancreatic NENs as a first-line treatment. Although in NENs, determination of the O6-methylguanine-DNA methyltransferase (MGMT) status has been suggested as a predictive biomarker of response, its role still remains investigational, awaiting validation along with the establishment of the optimal detection method. Metronomic schedules have been reported to potentially overcome MGMT-related drug resistance. Toxicity is manageable if well monitored. We reviewed the literature regarding pharmacological and clinical aspects of TMZ, focusing on specific settings of NENs, different schedules, toxicity and safety profiles, and potential predictive biomarkers of response.
- Published
- 2015
11. Contents Vol. 101, 2015
- Author
-
Ashley B. Grossman, Ilona Michałowska, Anouk N A van der Horst-Schrivers, Satz Mengensatzproduktion, Hironobu Sasano, Andrzej Cichocki, Francesca Spada, Jadwiga Janas, Nicola Fazio, Thamara E. Osinga, Simona Grozinsky-Glasberg, David J. Gross, Jonathan R. Strosberg, Silvia Giatti, Andrzej Januszewicz, Wojciech Michalski, Saulo J.A. Felizola, Anna Koumarianou, Piotr Pęczkowski, Larissa C. Faustino, Caterina Fumagalli, Gregory Kaltsas, Druckerei Stückle, Maciej Otto, Kjell Öberg, Thera P. Links, Barbara Viviani, Marek Kabat, Roberta Rigolio, Anna Lewczuk, Angelica Malinoc, Małgorzata Szperl, Aleksander Prejbisz, Alfredo Berruti, Ronald R. de Krijger, Mika Watanabe, Ido P. Kema, Andrzej Kawecki, Yasuhiro Nakamura, Michiaki Unno, Simone Romano, Hiroko Ogata, Guido Cavaletti, Bernard F. A. M. van der Laan, Hartmut P. H. Neumann, Massimo Barberis, Dariusz Moczulski, Grażyna Bednarek-Tupikowska, Esther Korpershoek, Mariola Pęczkowska, Yoshiaki Onodera, J. R. Buscombe, Tania M. Ortiga-Carvalho, Samaneh Yazdani, Nico Mitro, Katarzyna Przybyłowska, Jolanta Antoniewicz, Luis M. Garcia-Segura, Matthew H. Kulke, Salvatore Galdy, Jarosław B. Ćwikła, Robin P. F. Dullaart, Donald W. Pfaff, Michiel N. Kerstens, Donatella Caruso, Zbigniew Szutkowski, Mariusz I. Furmanek, Khatuna Gagnidze, Atsuko Kasajima, Hanna Janaszek-Sitkowska, Roberto Cosimo Melcangi, and Fuyuhiko Motoi
- Subjects
Cellular and Molecular Neuroscience ,medicine.medical_specialty ,Endocrinology ,Traditional medicine ,Endocrine and Autonomic Systems ,business.industry ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,medicine ,business - Published
- 2015
12. Sequential Everolimus and Sunitinib Treatment in Pancreatic Metastatic Well-Differentiated Neuroendocrine Tumours Resistant to Prior Treatments
- Author
-
Dermot O'Toole, Gregory Kaltsas, Maria Kaltsatou, Kimberly Kamp, Wouter W. de Herder, Anna Angelousi, and Internal Medicine
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Indoles ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Antineoplastic Agents ,Kaplan-Meier Estimate ,Neuroendocrine tumors ,Severity of Illness Index ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Renal cell carcinoma ,Internal medicine ,medicine ,Clinical endpoint ,Sunitinib ,Humans ,Pyrroles ,Everolimus ,Adverse effect ,Retrospective Studies ,Endocrine and Autonomic Systems ,business.industry ,Hazard ratio ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,Treatment Outcome ,Tolerability ,030220 oncology & carcinogenesis ,Female ,business ,medicine.drug - Abstract
Objective: Alternating treatment with sunitinib and everolimus has been shown to be efficacious in renal cell carcinoma. However, no data currently exist for the role of alternate sequence administration of these agents in well-differentiated pancreatic neuroendocrine tumours (pNETs). Methods: Thirty-one patients were administered one compound and upon progression were switched to the other. All patients had grade 1 or 2 tumours and stage IV disease with similar metastatic load. The primary end point included estimation of the median overall progression-free survival (mPFS) along with each drug's mPFS as a first-line (mPFS1) and a second-line treatment (mPFS2); tolerability and serious adverse events were also evaluated. Secondary end points included overall survival (OS), 2-year mortality rate, and incidence of disease progression. Results: Overall, mPFS did not differ between the everolimus to sunitinib group (36.5 months) and the sunitinib to everolimus group (31.6 months) with a hazard ratio of 0.94 ([95% CI, 0.45-1.97], p = 0.7). Although mPFS1 after first-line everolimus was longer (16.3 months) compared to sunitinib (9 months), this was not statistically significant (p = 0.15). Sequential second-line treatment showed no difference in the mPFS2 (p = 0.3). No difference in OS between the 2 groups was observed. Tolerability was better for everolimus compared to sunitinib. Conclusions: Treatment with sequential molecular target agents was well tolerated and associated with similar overall mPFS in both schemes of administration. Larger prospective studies are required to investigate the long-term efficacy and sequence of administration of alternate therapy with molecular targeting agents in metastatic pNETs and their effect on OS.
- Published
- 2016
13. Contents Vol. 91, 2010
- Author
-
Ola Nilsson, Kazuyoshi Taya, Dik J. Kwekkeboom, David J. Gross, Ursula B. Kaiser, Reza Kianmanesh, Beata Kos-Kudła, Günther Klöppel, José C. Garrido-Gracia, Thomas Steinmüller, Federica Cioppi, Paul Komminoth, Yuan-Jia Chen, Rudolf Arnold, Ursula Plöckinger, José E. Sánchez-Criado, Ashley B. Grossman, Martyn Caplin, Frank Sundler, Wouter W. de Herder, John R. Buscombe, Nils Wierup, Mohandes Mallath, Ana Gordon, Mauro Papotti, Kalle Landerholm, Guido Rindi, Rafaela Aguilar, Matthew H. Kulke, Satz Mengensatzproduktion, John Ramage, Noboru Manabe, Magnus Nordenskjöld, Philippe Ruszniewski, Isabel Sevilla Garcia, Tomohiro Yonezawa, Keitaro Yamanouchi, Mickael Lesurtel, José Manuel Lopes, Masugi Nishihara, Aurel Perren, Dermot O'Toole, Nicola Fazio, Gen Watanabe, Johannes Järhult, Juana Martín de las Mulas, Peter Lind, Yolanda Millán, Eric Van Custem, Silvia Guil-Luna, Raquel Sánchez Cespedes, Jean-Yves Scoazec, Hironobu Sasano, Jyothis T. George, Ryuji Sako, Marianne Pavel, Sture Falkmer, Gregory Kaltsas, Kjell Öberg, Barbro Eriksson, Druck Reinhardt Druck Basel, Anders Sundin, Robert P. Millar, Ana Paula Abreu, Ana Claudia Latronico, Ulrich-Frank Pape, Kazutaka Mogi, Richard A. Anderson, Massimo Falconi, Jun You Li, Bertram Wiedenmann, and George Nikou
- Subjects
Cellular and Molecular Neuroscience ,medicine.medical_specialty ,Endocrinology ,Traditional medicine ,Endocrine and Autonomic Systems ,business.industry ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,Medicine ,business - Published
- 2010
14. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Somatostatin Receptor Imaging with 111In-Pentetreotide
- Author
-
Beata Kos-Kudła, Klemens Scheidhauer, Jean-Yves Scoazec, Gregory Kaltsas, Ashley B. Grossman, Marie Pierre Vullierme, Kjell Öberg, Günter Klöppel, Barbro Eriksson, Bertram Wiedenmann, Guido Rindi, Diego Ferone, Dermot O'Toole, Anne Couvelard, D. Ivan, Anders Sundin, Paul Komminoth, Mauro Papotti, David J. Gross, Rudolf Arnold, Eric P. Krenning, Pavel Marianne, Babs Taal, Göran Åkerström, Ursula Plöckinger, Waldemar Szpak, Aurel Perren, Emilio Bajetta, Aldo Scarpa, Yuan Jia Chen, Marco Platania, Bjorn I. Gustafsson, Emmanuel Mitry, Val Lewington, Rudolf Hyrdel, Dirk Jan Kwekkeboom, Jaroslava Barkmanova, Ulrich Knigge, Ramon Salazar, Reza Kianmanesh, Joseph Davar, Anne Marie McNicol, Bruno Annibale, Massimo Falconi, Rachida Lebtahi, Frederico Costa, Ola Nilsson, Ulrich Frank Pape, Gianfranco Delle Fave, Juan Manuel O'Connor, Pavel Vítek, Philippe Ruszniewski, and Wouter W. de Herder
- Subjects
endocrine system ,medicine.medical_specialty ,medicine.diagnostic_test ,Endocrine and Autonomic Systems ,Somatostatin receptor ,business.industry ,Endocrinology, Diabetes and Metabolism ,Computer assisted tomography ,Diagnostic accuracy ,Neuroendocrine tumors ,Scintigraphy ,medicine.disease ,Cellular and Molecular Neuroscience ,Endocrinology ,Internal medicine ,Medical imaging ,medicine ,Nuclear medicine ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors : Somatostatin Receptor Imaging with In-111-Pentetreotide
- Published
- 2009
15. Aggressive pituitary tumors
- Author
-
Ioannis I. Androulakis, Krystallenia I Alexandraki, Eleftherios Chatzellis, and Gregory Kaltsas
- Subjects
Adenoma ,medicine.medical_specialty ,Pathology ,Endocrine and Autonomic Systems ,business.industry ,Endocrinology, Diabetes and Metabolism ,Pituitary tumors ,MEDLINE ,food and beverages ,medicine.disease ,Cellular and Molecular Neuroscience ,Endocrinology ,Text mining ,Internal medicine ,medicine ,Humans ,Pituitary Neoplasms ,business - Abstract
Pituitary adenomas are common intracranial tumors that are mainly considered as benign. Rarely, these tumors can exhibit an aggressive behavior, characterized by gross invasion of the surrounding tissues, resistance to conventional treatment leading to early and frequent recurrences. Even more rarely, pituitary tumors can give rise to cerebrospinal or systemic metastases qualifying as pituitary carcinomas according to the latest WHO definition. In the same classification, a subset of tumors with relatively distinct histopathological features was identified and defined as atypical adenomas designated to follow a more aggressive clinical course. This classification, although clinically useful, does not provide an accurate correlation between histopathological findings and the clinical behavior of these tumors, neither is it adequate to convey the precise features of ‘aggressive' tumors. Thus, ‘aggressive' pituitary adenomas need to be properly defined with clinical, radiological, histological and molecular markers in order to identify patients at increased risk of early recurrence or subsequent tumor progression. At present, no single marker or classification system of pituitary tumor aggressiveness exists, and clinically useful information in the literature is insufficient to guide diagnostic and therapeutic decisions. Treatment of patients with aggressive pituitary tumors is challenging since conventional treatments often fail, necessitating multiple surgical procedures with additional radiotherapy. Although traditional chemotherapy applied in other neuroendocrine tumors has not been shown to be efficacious, newer agents, particularly temozolomide, have shown promising results and are currently used despite the lack of data from a randomized prospective trial. Molecular targeted therapies such as mTOR and epidermal growth factor inhibitors have also been applied and might prove to be useful in the management of these patients. In the present review, we provide information regarding the epidemiology and clinical, histopathological and molecular features of aggressive pituitary tumors using recent employed definitions. In addition, we review currently employed therapeutic means providing a therapeutic algorithm and highlight the need to identify more specific disease-related and prognostic markers and the necessity for central registration of these tumors.
- Published
- 2014
16. Expression of Somatostatin Receptors 1-5 and Dopamine Receptor 2 in Lung Carcinoids: Implications for a Therapeutic Role
- Author
-
Apostolos V. Tsolakis, George Z. Rassidakis, Rodoula Tringidou, Gregory Kaltsas, Kjell Öberg, Athanasios Spathis, Lars Grimelius, and George Kanakis
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Lung Neoplasms ,Endocrinology, Diabetes and Metabolism ,Receptor expression ,chemical and pharmacologic phenomena ,Carcinoid Tumor ,Biology ,Neuroendocrine tumors ,Cellular and Molecular Neuroscience ,Endocrinology ,Internal medicine ,medicine ,Humans ,Somatostatin receptor 1 ,Receptors, Somatostatin ,Receptor ,Retrospective Studies ,Endocrine and Autonomic Systems ,Somatostatin receptor ,Receptors, Dopamine D2 ,Middle Aged ,medicine.disease ,Neoplasm Proteins ,Somatostatin ,Dopamine receptor ,Immunohistochemistry ,Female - Abstract
Objective: The expression of somatostatin receptors (SSTRs) and dopamine receptor 2 (DR2) in neuroendocrine tumors is of clinical importance as somatostatin analogues and dopamine agonists can be used for their localization and/or treatment. The objective of this study is to examine the expression of the five SSTR subtypes and DR2 in lung carcinoids (LCs). Methods: We conducted a retrospective study of 119 LCs from 106 patients [typical carcinoids (TCs): n = 100, and atypical carcinoids (ACs): n = 19]. The expression of all five SSTR subtypes and DR2 was evaluated immunohistochemically and correlated to clinicopathological data. In a subgroup of cases, receptor expression was further analyzed using semiquantitative RT-PCR. Results: SSTR2A was the SSTR subtype most frequently expressed immunohistochemically (72%), followed by SSTR1 (63%), SSTR5 (40%), and SSTR3 (20%), whereas SSTR4 was negative. DR2 was expressed in 74% and co-expressed with SSTR1 in 56%, with SSTR2A in 59%, with SSTR3 in 19%, and with SSTR5 in 37% of the tumors. Receptor expression was not related to the histological subtype, tumor aggressiveness (disease extent/grading) or functionality; however, DR2 was expressed more frequently in ACs than TCs (95 vs. 70%, p = 0.017). In a subset of patients, RT-PCR findings highly suggested that the expression of SSTR2A, SSTR3, DR2, and to a lesser extent that of SSTR1 and SSTR5 is the outcome of increased gene transcription. Conclusions: The high and variable immunohistochemical expression of the majority of SSTRs along with their co-expression with DR2 in LCs provides a rationale for their possible treatment with agents that target these receptors.
- Published
- 2014
17. Predictive value of gastrin levels for the diagnosis of gastric enterochromaffin-like cell hyperplasia in patients with Hashimoto's thyroiditis
- Author
-
Krystallenia I Alexandraki, Apostolos V. Tsolakis, Argyro Nicolaou, Gregory Kaltsas, Stavros Sougioultzis, and Dimitrios Thomas
- Subjects
Adult ,Male ,endocrine system ,medicine.medical_specialty ,Enterochromaffin-like Cells ,Atrophic gastritis ,Endocrinology, Diabetes and Metabolism ,Enolase ,Stomach Diseases ,Hashimoto Disease ,Sensitivity and Specificity ,Thyroiditis ,Cellular and Molecular Neuroscience ,Endocrinology ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Gastrins ,medicine ,Humans ,Vitamin B12 ,Longitudinal Studies ,Prospective Studies ,Gastrin ,Aged ,Hyperplasia ,biology ,Endocrine and Autonomic Systems ,business.industry ,Stomach ,Chromogranin A ,Middle Aged ,medicine.disease ,Diabetes Mellitus, Type 1 ,ROC Curve ,biology.protein ,Enterochromaffin cell ,Female ,business ,hormones, hormone substitutes, and hormone antagonists ,Biomarkers - Abstract
Aim: Gastrin and chromogranin A (CgA) levels have been tested for the diagnosis of enterochromaffin-like cell hyperplasia (ECLH) in patients with type 1 diabetes and autoimmune atrophic gastritis but not for patients with Hashimoto's thyroiditis (HT). The aim of the study was to develop receiver operating characteristic (ROC) curves for gastrin and CgA levels and other clinical and biochemical parameters, as means for pretest probability of gastric ECLH in patients with HT. Methods: A total of 115 patients with HT were prospectively studied for a median period of 4 (2-7) years. Gastrin, CgA, vitamin B12, anti-parietal cell antibodies, free thyroxine, thyrotropin, and neuron-specific enolase levels were measured. Their predictive values were calculated according to the histological findings for ECLH diagnosis from esophagogastroduodenoscopy-obtained biopsies. Results: Thirteen patients (11.3%) had ECLH. The areas under the curve for gastrin and CgA level were 0.898 (p < 0.001) and 0.853 (p < 0.001), respectively. The product sensitivity × specificity was 0.803 and 0.653 for gastrin and CgA levels >89.5 and >89.1 ng/ml, respectively. Two and 4 patients with ECLH had normal gastrin and CgA levels, respectively. The most specific combined parameters predicting ECLH were gastrin >89.5 ng/ml with concomitant low B12 levels (96.1% specificity). Conclusion: Gastrin levels have high diagnostic accuracy for ECLH identification in patients with HT, and are highly specific when combined with low B12 levels. However, they should be interpreted with caution, as some patients may harbor gastric ECLH even if gastrin levels are not increased, necessitating further follow-up.
- Published
- 2014
18. Current size criteria for the management of neuroendocrine tumors of the appendix: are they valid? Clinical experience and review of the literature
- Author
-
David J Gross, Simona Grozinsky-Glasberg, Krystallenia I Alexandraki, Gregory Kaltsas, Dganit Barak, Petachia Reissman, and V Doviner
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Neuroendocrine tumors ,Cellular and Molecular Neuroscience ,Young Adult ,Endocrinology ,Internal medicine ,medicine ,Humans ,In patient ,Hemicolectomy ,Pathological ,Tumor size ,Endocrine and Autonomic Systems ,business.industry ,Disease Management ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Primary tumor ,Appendix ,Neuroendocrine Tumors ,medicine.anatomical_structure ,Appendiceal Neoplasms ,Female ,business ,Right hemicolectomy ,Follow-Up Studies - Abstract
We evaluated the latest pathological criteria for completion right hemicolectomy (RHC) in patients with appendiceal neuroendocrine tumors (ANETs) with emphasis on the size of the primary tumor. Data of 28 consecutive patients who underwent RHC for ANETs in three tertiary hospitals were reviewed retrospectively to assess the indications for completion RHC. 10/28 patients were found to have residual disease (36%). In 8/28 patients (29%), the tumor diameter was
- Published
- 2012
19. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: biotherapy
- Author
-
Massimo Falconi, Bruno Annibale, Beata Kos-Kudła, Paul Komminoth, Rudolf Arnold, Bertram Wiedenmann, Philippe Ruszniewski, Diego Ferone, Jean-Yves Scoazec, D. Ivan, Jaroslava Barkmanova, Rachida Lebtahi, Guido Rindi, David J. Gross, Marie Pierre Vullierme, Reza Kianmanesh, Anne Marie McNicol, Ramon Salazar, Gianfranco Delle Fave, Joseph Davar, Wouter W. de Herder, Ulrich Frank Pape, Mauro Papotti, Frederico Costa, Waldemar Szpak, Anders Sundin, Ursula Plöckinger, Ola Nilsson, Juan Manuel O'Connor, Marianne Pavel, Klemens Scheidhauer, Babs Taal, Pavel Vítek, Dermot O'Toole, Gregory Kaltsas, Ashley B. Grossman, Marco Platania, Günter Klöppel, Kjell Öberg, Barbro Eriksson, Göran Åkerström, Aurel Perren, Val Lewington, Rudolf Hyrdel, Dirk Jan Kwekkeboom, Anne Couvelard, Yuan Jia Chen, Bjorn I. Gustafsson, Emilio Bajetta, Aldo Scarpa, Emmanuel Mitry, Ulrich Knigge, Internal Medicine, K., Oberg, D., Ferone, G., Kaltsa, U., Knigge, B., Taal, U., Plöckinger, and Falconi, M
- Subjects
medicine.medical_specialty ,Cancer chemotherapy ,Endocrine and Autonomic Systems ,CYANOCOBALAMIN DEFICIENCY ,business.industry ,Endocrinology, Diabetes and Metabolism ,Cancer therapy ,Alpha interferon ,Interferon-alpha ,Antineoplastic Agents ,Neuroendocrine tumors ,University hospital ,medicine.disease ,Cellular and Molecular Neuroscience ,Neuroendocrine Tumors ,Endocrinology ,Internal medicine ,Cyclosporin a ,Cancer centre ,medicine ,Humans ,Somatostatin ,business - Abstract
aDepartment of Internal Medicine, Endocrine Unit, Uppsala University Hospital, Uppsala, Sweden; bDepartments of Internal Medicine and Endocrinological and Metabolic Sciences, University of Genoa, Genoa, Italy; cG. Genimatas Hospital, Athens, Greece; dDepartment of Surgery, Rigshospitalet, Copenhagen, Denmark; eNetherlands Cancer Centre, Amsterdam, The Netherlands; fDepartment of Hepatology and Gastroenterology, Campus Virchow-Klinikum, Charite-Universitatsmedizin Berlin, Berlin, Germany
- Published
- 2008
20. Subject Index Vol. 91, 2010
- Author
-
Keitaro Yamanouchi, Paul Komminoth, David J. Gross, Dermot O'Toole, Yolanda Millán, Noboru Manabe, Ursula Plöckinger, Thomas Steinmüller, Druck Reinhardt Druck Basel, Günther Klöppel, Ana Gordon, Sture Falkmer, Johannes Järhult, Anders Sundin, Rudolf Arnold, Dik J. Kwekkeboom, Jean-Yves Scoazec, Federica Cioppi, Ana Claudia Latronico, Gen Watanabe, José Manuel Lopes, Mauro Papotti, Hironobu Sasano, Frank Sundler, Ryuji Sako, Wouter W. de Herder, Nils Wierup, Raquel Sánchez Cespedes, Marianne Pavel, Mickael Lesurtel, Matthew H. Kulke, Magnus Nordenskjöld, Eric Van Custem, Masugi Nishihara, Peter Lind, Ashley B. Grossman, Tomohiro Yonezawa, Juana Martín de las Mulas, Mohandes Mallath, Beata Kos-Kudła, José C. Garrido-Gracia, John R. Buscombe, Kalle Landerholm, Yuan-Jia Chen, Guido Rindi, Satz Mengensatzproduktion, Philippe Ruszniewski, Nicola Fazio, Silvia Guil-Luna, Isabel Sevilla Garcia, Ursula B. Kaiser, José E. Sánchez-Criado, Martyn Caplin, Reza Kianmanesh, Aurel Perren, Jun You Li, Bertram Wiedenmann, Jyothis T. George, Rafaela Aguilar, Richard A. Anderson, Robert P. Millar, Ana Paula Abreu, Massimo Falconi, Ulrich-Frank Pape, George Nikou, Ola Nilsson, Kazutaka Mogi, Kazuyoshi Taya, John Ramage, Gregory Kaltsas, Kjell Öberg, and Barbro Eriksson
- Subjects
Cellular and Molecular Neuroscience ,medicine.medical_specialty ,Endocrinology ,Index (economics) ,Endocrine and Autonomic Systems ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,medicine ,Subject (documents) ,Medical physics ,Psychology - Published
- 2010
21. Subject Index Vol. 92, 2010
- Author
-
Manuela Albertelli, Gloria Appolloni, Satz Mengensatzproduktion, Maria Grazia Redaelli, Valentina Piccini, Alberto Rebora, Alia Munir, Bernard Conte-Devolx, Wouter W. de Herder, Andrea Laurenzi, Miryam Talco, Anne-Sophie Thonnard, Maria Cristina De Martino, Leo J. Hofland, Elisa Borgogni, Gabriella Nesi, Piero Picozzi, Steven W. J. Lamberts, Philippe Chanson, Carla Scaroni, Viviana Daidone, Monica Mangoni, Michaela Luconi, Jens Otto Lunde Jørgensen, Yona Greenman, Renata S. Auriemma, Thierry Brue, Patrick Petrossians, Ann Mosegaard Bak, L.J. Hofland, Elena Nazzari, M.C. De Martino, Annamaria Colao, Elena Rapizzi, Richard A Feelders, Umberto Goglia, Diego Ferone, Daniela Esposito, Kristine Zøylner Rubeck, Pasquale Vitale, Marco Boscaro, Alberto M. Pereira, R.N. Clayton, Silvia Vandeva, Sabina Zacharieva, Ashley B. Grossman, Sven Schlaffer, Charlotte Steffensen, Alessia Cozzolino, Alberto M Pedroncelli, Tonino Ercolino, Chiara Simeoli, Adrian F. Daly, Giada Poli, Mara Boschetti, Krystallenia I Alexandraki, Marco Losa, Gregory Kaltsas, Sylvie Salenave, Marina Cardinaletti, P. M. van Koetsveld, Giorgio Arnaldi, Johannes A. Romijn, Federico Gatto, Alessandra Casonato, Massimo Mannelli, Gaetano Lombardi, Druck Reinhardt Druck Basel, Polyzois Makras, Letizia Canu, Franco Mantero, Maria Verena Cicala, John Newell-Price, Jitske Tiemensma, Marica Arvigo, Albert Beckers, Laura Trementino, Monica De Leo, Pietro Mortini, Valerio Mattia Scandali, Maria Yaneva, Frederic Castinetti, Giulia Cantini, R. Pivonello, Francesco Minuto, Michael Buchfelder, and Rosario Pivonello
- Subjects
Gerontology ,Cellular and Molecular Neuroscience ,Endocrinology ,Index (economics) ,Endocrine and Autonomic Systems ,Endocrinology, Diabetes and Metabolism ,Subject (documents) ,Psychology - Published
- 2010
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.