10 results on '"Gennaro Acanfora"'
Search Results
2. Tissue Microarray from Cell Block Material (cbTMA)—An Additional Shot for Cytology in the Predictive Pathology Era: The PD-L1 Experience
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Antonino Iaccarino, Gennaro Acanfora, Pasquale Pisapia, Umberto Malapelle, Claudio Bellevicine, Giancarlo Troncone, and Elena Vigliar
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TMA ,molecular cytopathology ,immunohistochemistry ,PD-L1 ,FNA ,Pathology ,RB1-214 - Abstract
Generally, predictive biomarker tests are clinically validated on histological formalin-fixed, paraffin-embedded (FFPE) samples. In addition to FFPE samples, cytological samples have also emerged as a useful approach to detect predictive biomarkers. However, as of today, despite the promising results reported in the recent literature, their full implementation in routine clinical practice is still lagging owing to a lack of standardized preparatory protocols, challenging assessments of cyto-histological correlation, and variable inter-observer agreement. The aim of this report was to explore the possibility of implementing a large-scale validation of predictive biomarker testing on cytological material. To this aim, we evaluated the technical feasibility of PD-L1 assessment on a cell block (CB)-derived tissue microarray (cbTMA). Consecutive and unselected CBs prepared from metastatic lymph node fine-needle cytology (FNC) samples were retrospectively collected and used for TMA construction. PD-L1 immunohistochemistry (IHC) was carried out on cbTMA sections with the companion diagnostic kit SP263 assay. TMA contained 33 CB-derived cores. A total of 20 sections were hematoxylin and eosin (H&E) stained. Overall, 29 (88%) samples were visible at least in one H&E-stained slide. Four cases out of five sections stained with the SP263 assay (4/29, 13.8%) showed PD-L1 positivity in neoplastic and/or immune cells; remarkably, no unspecific background was observed. Although our study was based on a limited and non-selected series, our findings do provide proof of concept for the use of cbTMA in predictive biomarker testing on cytological material in large-scale post-clinical trial validation studies, multicenter studies, and quality control programs.
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- 2022
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3. Evaluation of the Molecular Landscape in PD-L1 Positive Metastatic NSCLC: Data from Campania, Italy
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Pasquale Pisapia, Antonino Iaccarino, Caterina De Luca, Gennaro Acanfora, Claudio Bellevicine, Roberto Bianco, Bruno Daniele, Luisa Ciampi, Marco De Felice, Teresa Fabozzi, Luigi Formisano, Pasqualina Giordano, Cesare Gridelli, Giovanni Pietro Ianniello, Annamaria Libroia, Paolo Maione, Mariantonia Nacchio, Fabio Pagni, Giovanna Palmieri, Francesco Pepe, Gianluca Russo, Maria Salatiello, Antonio Santaniello, Rachele Scamarcio, Davide Seminati, Michele Troia, Giancarlo Troncone, Elena Vigliar, and Umberto Malapelle
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molecular oncology ,molecular pathology ,PD-L1 ,immune-checkpoint inhibitors ,biomarkers ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Background: Immune-checkpoint inhibitors (ICIs) have increased and improved the treatment options for patients with non-oncogene-addicted advanced stage non-small cell lung cancer (NSCLC). However, the role of ICIs in oncogene-addicted advanced stage NSCLC patients is still debated. In this study, in an attempt to fill in the informational gap on the effect of ICIs on other driver mutations, we set out to provide a molecular landscape of clinically relevant oncogenic drivers in programmed death-ligand 1 (PD-L1) positive NSCLC patients. Methods: We retrospectively reviewed data on 167 advanced stage NSCLC PD-L1 positive patients (≥1%) who were referred to our clinic for molecular evaluation of five driver oncogenes, namely, EGFR, KRAS, BRAF, ALK and ROS1. Results: Interestingly, n = 93 (55.7%) patients showed at least one genomic alteration within the tested genes. Furthermore, analyzing a subset of patients with PD-L1 tumor proportion score (TPS) ≥ 50% and concomitant gene alterations (n = 8), we found that n = 3 (37.5%) of these patients feature clinical benefit with ICIs administration, despite the presence of a concomitant KRAS gene alteration. Conclusions: In this study, we provide a molecular landscape of clinically relevant biomarkers in NSCLC PD-L1 positive patients, along with data evidencing the clinical benefit of ICIs in patient NSCLC PD-L1 positive alterations.
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- 2022
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4. A Novel Approach to Classification and Reporting of Lymph Node Fine-Needle Cytology: Application of the Proposed Sydney System
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Elena Vigliar, Gennaro Acanfora, Antonino Iaccarino, Massimo Mascolo, Daniela Russo, Giulia Scalia, Roberta Della Pepa, Claudio Bellevicine, Marco Picardi, and Giancarlo Troncone
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lymph node ,fine-needle cytology ,reporting system ,Sydney system ,lymphoproliferative disorders ,metastasis ,Medicine (General) ,R5-920 - Abstract
Fine-needle cytology (FNC) is a useful diagnostic tool in the first line evaluation of lymphadenopathy of unknown aetiology. Nevertheless, considering the large number of conditions presenting as lymphadenopathy, lymph node cytology represents a challenging scenario. Recently, an expert panel published the proposal of the Sydney system for performing classification and reporting of lymph node cytopathology; the aim of the present study was to evaluate the applicability of this system. Thus, 300 lymph node FNCs performed over 1 year were reviewed and categorized according to the Sydney system classification. Overall, n = 20 cases (6.7%) were categorized as L1-inadequate/non-diagnostic; n = 104 (34.7%) as benign (L2); n = 25 (8.3%) as atypical (L3); n = 13 (4.3%) as suspicious (L4), and n = 138 (46%) as malignant (L5). FNC diagnoses were correlated with histopathologic and clinical follow-up to assess the diagnostic accuracy and the risk of malignancy (ROM) for each diagnostic category. Statistical analysis showed the following results: sensitivity 98.47%, specificity 95.33%, positive predictive value 96.27%, negative predictive value 98.08%, and accuracy 97.06%. The ROM was 50% for the category L1, 1.92% for L2, 58.3% for L3, and 100% for L4 and L5. In conclusion, FNC coupled with ancillary techniques ensures satisfactory diagnostic accuracy and the implementation of the Sydney system may improve the practice of cytopathologists.
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- 2021
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5. Multiple predictive biomarker testing in melanoma: Another challenge in identifying the optimal approach on cytological samples
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Antonino Iaccarino, Mariantonia Nacchio, Gennaro Acanfora, Pasquale Pisapia, Umberto Malapelle, Claudio Bellevicine, Giancarlo Troncone, and Elena Vigliar
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Histology ,General Medicine ,Pathology and Forensic Medicine - Published
- 2023
6. Multiple predictive biomarker testing in melanoma: another challenge for the optimal approach on cytological samples
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Antonino Iaccarino, Mariantonia Nacchio, Gennaro Acanfora, Pasquale Pisapia, Umberto Malapelle, Claudio Bellevicine, Giancarlo Troncone, Elena Vigliar, Iaccarino, Antonino, Nacchio, Mariantonia, Acanfora, Gennaro, Pisapia, Pasquale, Malapelle, Umberto, Bellevicine, Claudio, Troncone, Giancarlo, and Vigliar, Elena
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Background: The management of cutaneous melanoma has dramatically changed in recent years thanks to the development of tyrosine kinase and immune-checkpoint inhibitors (ICIs). Thus, multiple biomarker testing is becoming ever more important to identify patients potentially eligible for these treatments. One reliable approach for molecular evaluation of metastatic melanoma is fine-needle cytology (FNC). To examine the utility of this approach for PD-L1 assessment, we evaluated the cellular adequacy of residual cell block (CB) material from metastatic melanomas previously tested for BRAF and NRAS mutations. Methods: We retrieved from our internal archives a series of FNC samples of metastatic melanoma subjected to molecular testing on residual CB material or dedicated needle rinse, between January 2016 and July 2022. Briefly, RT-PCR was adopted to assess BRAF and NRAS status, and SP263 assay was employed to assess PD-L1 expression level. Results: Overall n=19 cases were selected. Of these, 11 (57,9%) cases revealed a BRAF exon 15 p.V600E mutation, one case (5,3%) revealed NRAS mutation, and seven cases (36,8%) showed no mutations. Regarding PD-L1 assessment, 16/19 (84,2%) cases were deemed adequate, containing at least 100 viable cells. Conclusions: We highlighted the feasibility of PD-L1 assessment on residual CB material from metastatic melanomas previously tested for BRAF and NRAS mutations. Moreover, we pointed out that FNC needle rinses may be an alternative sources of nucleic acids for molecular testing, preserving CB material for ICC evaluation.
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- 2023
7. A roadmap for a comprehensive diagnostic approach to fine needle cytology of lymph node metastases
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Gennaro Acanfora, Antonino Iaccarino, Filippo Dello Iacovo, Pasquale Pisapia, Caterina De Luca, Claudia Giordano, Claudio Bellevicine, Marco Picardi, Giancarlo Troncone, Elena Vigliar, Acanfora, Gennaro, Iaccarino, Antonino, Iacovo, Filippo Dello, Pisapia, Pasquale, De Luca, Caterina, Giordano, Claudia, Bellevicine, Claudio, Picardi, Marco, Troncone, Giancarlo, and Vigliar, Elena
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Histology ,Needles ,Cytodiagnosis ,Lymphatic Metastasis ,Biopsy, Fine-Needle ,Humans ,General Medicine ,Lymph Nodes ,Pathology and Forensic Medicine - Abstract
Fine needle cytology (FNC) is widely used as a first-line procedure in the diagnostic algorithm of lymphadenopathies. In a metastatic setting, a first-line diagnostic approach identifies non-haematopoietic malignancy; however, cytopathologists could also provide a second diagnostic level, identifying the origin of the primary tumour. This paper outlines a comprehensive and practical approach to the cytological diagnosis of lymph node metastases.Cytological diagnoses of lymph node metastases performed over a 10-year period were selected and divided into two groups. The first group, labelled "oncological," comprised patients with a previous history of malignancy; the second group, labelled "naïve," included patients with no relevant history. Pathology records were retrieved to record microscopic findings, namely, background appearance, group architecture, and specific cell features; data from cell block (CB) preparations were also collected.Overall, 982 cases were selected: 497 cases (50.61%) in the naïve group, and 485 (49.39%) in the oncological group. Overall, a second diagnostic level was achieved in 834/982 cases (84.92%); cases diagnosed as carcinoma not otherwise specified were more frequent in the naïve group than in the oncological group (17.51% vs. 8.04%, P lt; 0.01). Notably, although CB material was available in only 44.87% of the naïve cases, we were able to achieve a second diagnostic level thanks to the integration of clinical and cytomorphological findings, plus lymph node topography, in 82.49% of the cases.Our results confirmed that in a metastatic setting, FNC can reliably lead to the identification of the origin of the primary tumour.
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- 2022
8. A narrative review of predictive immuno-histo/cyto chemistry in lung cancer: focus on gene fusions and PD-L1 expression
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Pasquale Pisapia, Gennaro Acanfora, Caterina De Luca, Antonino Iaccarino, Giancarlo Troncone, Elena Vigliar, Pisapia, Pasquale, Acanfora, Gennaro, De Luca, Caterina, Iaccarino, Antonino, Troncone, Giancarlo, and Vigliar, Elena
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General Medicine - Published
- 2022
9. A Novel Approach to Classification and Reporting of Lymph Node Fine-Needle Cytology: Application of the Proposed Sydney System
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Roberta Della Pepa, Massimo Mascolo, Elena Vigliar, Claudio Bellevicine, Giancarlo Troncone, Marco Picardi, Daniela Russo, Gennaro Acanfora, Antonino Iaccarino, Giulia Scalia, Vigliar, E., Acanfora, G., Iaccarino, A., Mascolo, M., Russo, D., Scalia, G., Pepa, R. D., Bellevicine, C., Picardi, M., and Troncone, G.
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Medicine (General) ,medicine.medical_specialty ,Sydney system ,Risk of malignancy ,First line ,Clinical Biochemistry ,030209 endocrinology & metabolism ,Metastasi ,Article ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Cytology ,fine-needle cytology ,medicine ,metastasis ,Statistical analysis ,Medical diagnosis ,Lymph node ,reporting system ,lymphoproliferative disorders ,business.industry ,lymph node ,Predictive value ,medicine.anatomical_structure ,Lymphoproliferative disorder ,Cytopathology ,030220 oncology & carcinogenesis ,Radiology ,business - Abstract
Fine-needle cytology (FNC) is a useful diagnostic tool in the first line evaluation of lymphadenopathy of unknown aetiology. Nevertheless, considering the large number of conditions presenting as lymphadenopathy, lymph node cytology represents a challenging scenario. Recently, an expert panel published the proposal of the Sydney system for performing classification and reporting of lymph node cytopathology, the aim of the present study was to evaluate the applicability of this system. Thus, 300 lymph node FNCs performed over 1 year were reviewed and categorized according to the Sydney system classification. Overall, n = 20 cases (6.7%) were categorized as L1-inadequate/non-diagnostic, n = 104 (34.7%) as benign (L2), n = 25 (8.3%) as atypical (L3), n = 13 (4.3%) as suspicious (L4), and n = 138 (46%) as malignant (L5). FNC diagnoses were correlated with histopathologic and clinical follow-up to assess the diagnostic accuracy and the risk of malignancy (ROM) for each diagnostic category. Statistical analysis showed the following results: sensitivity 98.47%, specificity 95.33%, positive predictive value 96.27%, negative predictive value 98.08%, and accuracy 97.06%. The ROM was 50% for the category L1, 1.92% for L2, 58.3% for L3, and 100% for L4 and L5. In conclusion, FNC coupled with ancillary techniques ensures satisfactory diagnostic accuracy and the implementation of the Sydney system may improve the practice of cytopathologists.
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- 2021
10. PD-L1 expression on routine samples of non-small cell lung cancer: results and critical issues from a 1-year experience of a centralised laboratory
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Gennaro Acanfora, Antonino Iaccarino, Eduardo Clery, Elena Vigliar, Caterina De Luca, Claudio Bellevicine, Giancarlo Troncone, Umberto Malapelle, Pasquale Pisapia, Vigliar, E., Malapelle, U., Iaccarino, A., Acanfora, G., Pisapia, P., Clery, E., De Luca, C., Bellevicine, C., and Troncone, G.
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0301 basic medicine ,Oncology ,Male ,medicine.medical_specialty ,Lung Neoplasms ,Reproducibility of Result ,Predictive Value of Test ,Clinical Laboratory Technique ,B7-H1 Antigen ,Regional Health Planning ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,molecular pathology ,Predictive Value of Tests ,Internal medicine ,Carcinoma, Non-Small-Cell Lung ,medicine ,Biomarkers, Tumor ,Humans ,Sampling (medicine) ,Prospective Studies ,Lung cancer ,Referral and Consultation ,Pathology, Clinical ,Molecular pathology ,business.industry ,Clinical Laboratory Techniques ,Significant difference ,Reproducibility of Results ,General Medicine ,medicine.disease ,Immunohistochemistry ,Lung Neoplasm ,lung cancer ,Prospective Studie ,030104 developmental biology ,Italy ,030220 oncology & carcinogenesis ,Pd l1 expression ,Female ,Non small cell ,business ,Clinical record ,Human ,Programmed death - Abstract
AimsOur laboratory is a centralised centre receiving routine non-small cell lung cancer (NSCLC) samples for programmed death ligand-1 (PD-L1) immunohistochemical (IHC) evaluation. Since literature data are not concordant here we review our clinical records to assess the rate of PD-L1 positive and negative NSCLC cases in real-world practice.MethodsPD-L1 expression was evaluated by a validated 22C3 IHC laboratory developed test on 211 prospectively collected routine NSCLC samples, received from 10 outside institutions. PD-L1 expression was assessed by the tumour proportion score (TPS) and reported by using a three cut-point system: TPSResultsOverall, 193 out of 211 samples (91.5%) meet the criteria for adequacy (more than 100 viable neoplastic cells). In 62.7% (121/193) of samples TPS was 50%. There was no significant difference in PD-L1 expression rates between different histotypes and site of sampling. Instead, a statistically significant difference was associated to the type of samples: in fact, cytological samples were more frequently negative for PD-L1 expression (TPS50%) than surgical resections and biopsies.ConclusionsWe present a referral laboratory experience on IHC PD-L1 expression of prospectively collected routine NSCLC samples. Data from the real-world practice can better clarify the percentage of PD-L1 positive and negative cases, to establish benchmarks for good practice standards.
- Published
- 2019
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