Carmine Carapella - Academia.edu (original) (raw)

Papers by Carmine Carapella

Table S2. Raw RPPA data. (XLSX 126 kb)

Neuro-Oncology, Nov 1, 2017

NEURO-ONCOLOGY • NOVEMBER 2017 racy, precision, recall, and F1 measure were calculated for the NL... more NEURO-ONCOLOGY • NOVEMBER 2017 racy, precision, recall, and F1 measure were calculated for the NLP method. RESULTS: The manual review was completed in 27 days; mean discordance rate was 36.2%. The overall accuracy of the best logistic regression classifier was 84.6% on the training data and 82.8% on the hold-out test data. The precision and recall were both 83%, and the F1-score was 0.83. The algorithm required 28.9 minutes for training, after which it is able to classify the entire dataset in a less than 0.2 second. The model was incorporated into a user-friendly interface that allows for future report classification. CONCLUSION: NLP is a powerful method for the high-throughput evaluation of free-text radiology reports that can have high sensitivity and specificity. Use of NLP can accelerate retrospective clinical research with improved accuracy over manual chart review.

Flow cytometry characterization of cerebrospinal fluid (CSF) and peripheral blood (PB) lymphocyte... more Flow cytometry characterization of cerebrospinal fluid (CSF) and peripheral blood (PB) lymphocytes in patients with breast cancer leptomeningeal metastasis. (XLSX 11 kb)

Flow cytometry analysis of cerebospinal fluid (CSF) samples of patients with breast cancer leptom... more Flow cytometry analysis of cerebospinal fluid (CSF) samples of patients with breast cancer leptomeningeal metastasis. Representative dot plot and histogram for CSF breast cancer cells and tumor-associated leukocytes. (PPTX 2013 kb)

Journal of Experimental & Clinical Cancer Research, 2019

Table S1. Complete list of antibodies used for RPPA analysis and their main related information. ... more Table S1. Complete list of antibodies used for RPPA analysis and their main related information. (PDF 26 kb)

Figure S2. Clonogenic Assay. (PDF 440 kb)

Anticancer research, 2004

The extraneural diffusion of malignant gliomas is not frequent and some authors have reported sin... more The extraneural diffusion of malignant gliomas is not frequent and some authors have reported single or multiple bone metastases from glioblastoma contemporary to the time of primary cerebral tumor or accompanying relapse on the brain. We report the case of a man affected by a glioblastoma who had a lumbar spine metastases without any brain relapse after excision of cerebral glioblastoma multiforme and brain radiotherapy.

World Neurosurgery

BACKGROUND Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefo... more BACKGROUND Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefore, a proper understanding of the anatomy, physiology, and pathology is mandatory to achieve favorable outcomes. Accordingly, diagnostic tests and treatment guidelines should be determined and implemented. Thus, we decided to perform a multicenter study among Italian neurosurgical centers performing pituitary surgery to provide an actual depiction from the neurosurgical standpoint. METHODS On behalf of the SINch (Società Italiana di Neurochirurgia), a survey was undertaken with the participants to explore the activities in the field of pituitary surgery within 41 public institutions. RESULTS Of the 41 centers, 37 participated in the present study. The total number of neurosurgical procedures performed in 2016 was 1479. Most of the procedures were performed using the transsphenoidal approach (1320 transsphenoidal [1204 endoscopic, 53 microscopic, 53 endoscope-assisted microscopic] vs. 159 transcranial). A multidisciplinary tumor board is convened regularly in 32 of 37 centers, and a research laboratory is present in 18 centers. CONCLUSIONS Diagnosing pituitary/hypothalamus disorders and treating them is the result of teamwork, composed of several diverse experts. Regarding neurosurgery, our findings have confirmed the central role of the transsphenoidal approach, with preference toward the endoscopic technique. Better outcomes can be expected at centers with a multidisciplinary team and a full, or part of a, residency program, with a greater surgical caseload.

Journal of Experimental & Clinical Cancer Research, 2016

Background: Brain stereotactic biopsy (SB) followed by conventional histopathology and immunohist... more Background: Brain stereotactic biopsy (SB) followed by conventional histopathology and immunohistochemistry (IHC) is the gold standard approach for primary central nervous system lymphoma (PCNSL) diagnosis. Flow cytometry (FCM) characterization of fine-needle aspiration cytology and core needle biopsies are increasingly utilized to diagnose lymphomas however, no biological data have been published on FCM characterization of fresh single cell suspension from PCNSL SB. The aim of this study was to establish the feasibility and utility of FCM for the diagnosis and characterization of brain lymphomas from a tissue samples obtained by a single SB disaggregation. Methods: Twenty-nine patients with a magnetic resonance suggestive for PCNSL entered the study. A median of 6 SB were performed for each patient. A cell suspension generated from manual tissue disaggregation of a single, unfixed, brain SB, was characterized by FCM. The FCM versus standard approach was prospectively compared. Results: FCM and IHC showed an high degree of agreement (89 %) in brain lymphoma identification. By FCM, 16 out of 18 PCNSL were identified within 2 h from biopsy. All were of B cell type, with a heterogeneous CD20 mean fluorescence intensity (MFI), CD10 positive in 3 cases (19 %) with surface Ig light chain restriction documented in 11 cases (69 %). No false positive lymphomas cases were observed. Up to 38 % of the brain leukocyte population consisted of CD8 reactive T cells, in contrast with the CD4 positive lymphocytes of the peripheral blood samples (P < 0.001). By histopathology, 18 B-PCNSL, only one CD10 positive (5 %), 1 primitive neuroectodermal tumor (PNET) and 10 gliomas were diagnosed. A median of 6 days was required for IHC diagnosis. Conclusion: Complementary to histopathology FCM can contribute to a better characterization of PCNSL, although necrosis and previous steroid treatment can represent a pitfall of this approach. A single brain SB is a valid source for accurate FCM characterization of both lymphoma and reactive lymphocyte population, routinely applicable for antigen intensity quantification and consistently documenting an active mechanism of reactive CD8 T-lymphocytes migration in brain lymphomas. Moreover, FCM confirmed to be more sensitive than IHC for the identification of selected markers.

Future Oncology

Background: Eribulin shows some activity in controlling brain metastasis in breast cancer. Method... more Background: Eribulin shows some activity in controlling brain metastasis in breast cancer. Methods: This observational, multicenter study evaluated brain disease control rates, survival and safety in patients with brain metastatic breast cancer treated with eribulin in clinical practice. Results: A total of 34 patients were enrolled (mean age 49 years, 91% with visceral metastases) and 29 were evaluable for brain disease. Fourteen achieved disease control and showed a longer time without progression: 10 months (95% CI: 2.3–17.7) versus 4 months (95% CI: 3.3–4.7) in the control group (p = 0.029). Patients with clinical benefits at 6 months had longer survival. Leukopenia and neutropenia were the most frequent grade 3–4 toxicities. Conclusion: Eribulin confirms its effectiveness in patients with brain metastatic breast cancer. Further studies on larger cohorts are needed to confirm the results.

Current Opinion in Oncology

Neuro-Oncology

Low-grade glioma patients have relatively long life expectancy for gliomas, but once they recur i... more Low-grade glioma patients have relatively long life expectancy for gliomas, but once they recur in malign, their prognosis can be poor. We analyzed factors corresponding to malignant recurrence by uni-and multi-variate analysis applying their treatment backgrounds. SUBJECTS: 261 newly diagnosed WHO grade 2 adults gliomas in 2004 to 2014. Malignant recurrence was determined by pathological diagnosis if the patient had a surgery (69% of the recurrent patients), otherwise contrast T1WI or 11C-methionine PET images if the patient was unable to undergo any surgery or biopsy. RESULTS: Age average 41 years old, the 10-year survival rate in all patients was 75%, and the mean of progression-free survival time was 7.8 years. Relapse event occurred in 115 cases (44%), and 67 % of them developed malignant glioma sometime. The 10-year survival rate for the patients who relapsed in malign was 37%, on the contrary, the patients who had recurrence but staying in low grade was 71% (p=0.0389). When they were categorized by 1p19q deletion and IDH1 mutation status, IDH wild type diffuse astrocytoma patients had significantly developed malignant glioma compared to oligodendroglioma and IDH mutant type diffuse astrocytoma (p<0.0001). The factors related to malignant progression were extracted as; recurrence in 2 years, 6% and over in MIB-1 index, no intervention longer than 18 months since the disease revealed, 1p19q non-co-deletion, less than 90% of tumor resection rate, and IDH wild type. In the 1p19q non-deletion patients, who were provisionally defined as diffuse astrocytoma patients here, the factors were resection rate, MIB-1 index, and duration between discovered the disease and the first surgery, but not the IDH mutant status (p＜0.0001, p=0.0015, p=0.0478 respectively). CONCLUSION: Recurrence in malign form low-grade glioma can be avoided by early intervention in 18 months from diagnosis and resection over 90% of volume of the tumor.

Journal of Clinical Oncology

Journal of Clinical Oncology

European Journal of Cancer Supplements

Neuro-Oncology

BACKGROUND: A growing number of studies demonstrated that awake surgery for lower-grade glioma re... more BACKGROUND: A growing number of studies demonstrated that awake surgery for lower-grade glioma results in both good functional and oncological outcome. However, indication of awake surgery for glioblastoma (GBM) has not been defined. Here, we intend to determine the indication of awake surgery for GBM based on the functional data at chronic phase. METHODS: A total of 29 patients with GBM who underwent awake surgery between May 2012 and March 2018 were included (age: mean, 52.7; standard deviation [SD], 11.5). Additionally, 41 GBM patients (age, 65.4; SD, 11.4) who underwent surgery with general anesthesia (GA) were included as historical control. The Karnofsky Performance Status (KPS) of both groups were collected at pre-and postoperative 3 month (chronic phase). Moreover, to investigate factors relating to KPS score at chronic phase, multivariate analysis with following explanatory variables were performed: age, preoperative KPS score, genetic mutation, eloquent area, resected volume, laterality, and time of surgery. RESULTS: The rate of KPS score preservation was significantly higher in awake surgery group (72.4%) than that of GA group (51.2%, p=0.03). Factors that influence the KPS score at chronic phase were age and preoperative KPS score (p=0.014, p. CONCLUSIONS: Awake surgery for GBM patients is useful to preserve independence level at chronic phase. In the view of preservation of preoperative independence level, indication of awake surgery is KPS ≥ 90 and age ≤ 64.

Table S2. Raw RPPA data. (XLSX 126 kb)

Neuro-Oncology, Nov 1, 2017

NEURO-ONCOLOGY • NOVEMBER 2017 racy, precision, recall, and F1 measure were calculated for the NL... more NEURO-ONCOLOGY • NOVEMBER 2017 racy, precision, recall, and F1 measure were calculated for the NLP method. RESULTS: The manual review was completed in 27 days; mean discordance rate was 36.2%. The overall accuracy of the best logistic regression classifier was 84.6% on the training data and 82.8% on the hold-out test data. The precision and recall were both 83%, and the F1-score was 0.83. The algorithm required 28.9 minutes for training, after which it is able to classify the entire dataset in a less than 0.2 second. The model was incorporated into a user-friendly interface that allows for future report classification. CONCLUSION: NLP is a powerful method for the high-throughput evaluation of free-text radiology reports that can have high sensitivity and specificity. Use of NLP can accelerate retrospective clinical research with improved accuracy over manual chart review.

Flow cytometry characterization of cerebrospinal fluid (CSF) and peripheral blood (PB) lymphocyte... more Flow cytometry characterization of cerebrospinal fluid (CSF) and peripheral blood (PB) lymphocytes in patients with breast cancer leptomeningeal metastasis. (XLSX 11 kb)

Flow cytometry analysis of cerebospinal fluid (CSF) samples of patients with breast cancer leptom... more Flow cytometry analysis of cerebospinal fluid (CSF) samples of patients with breast cancer leptomeningeal metastasis. Representative dot plot and histogram for CSF breast cancer cells and tumor-associated leukocytes. (PPTX 2013 kb)

Journal of Experimental & Clinical Cancer Research, 2019

Table S1. Complete list of antibodies used for RPPA analysis and their main related information. ... more Table S1. Complete list of antibodies used for RPPA analysis and their main related information. (PDF 26 kb)

Figure S2. Clonogenic Assay. (PDF 440 kb)

Anticancer research, 2004

The extraneural diffusion of malignant gliomas is not frequent and some authors have reported sin... more The extraneural diffusion of malignant gliomas is not frequent and some authors have reported single or multiple bone metastases from glioblastoma contemporary to the time of primary cerebral tumor or accompanying relapse on the brain. We report the case of a man affected by a glioblastoma who had a lumbar spine metastases without any brain relapse after excision of cerebral glioblastoma multiforme and brain radiotherapy.

World Neurosurgery

BACKGROUND Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefo... more BACKGROUND Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefore, a proper understanding of the anatomy, physiology, and pathology is mandatory to achieve favorable outcomes. Accordingly, diagnostic tests and treatment guidelines should be determined and implemented. Thus, we decided to perform a multicenter study among Italian neurosurgical centers performing pituitary surgery to provide an actual depiction from the neurosurgical standpoint. METHODS On behalf of the SINch (Società Italiana di Neurochirurgia), a survey was undertaken with the participants to explore the activities in the field of pituitary surgery within 41 public institutions. RESULTS Of the 41 centers, 37 participated in the present study. The total number of neurosurgical procedures performed in 2016 was 1479. Most of the procedures were performed using the transsphenoidal approach (1320 transsphenoidal [1204 endoscopic, 53 microscopic, 53 endoscope-assisted microscopic] vs. 159 transcranial). A multidisciplinary tumor board is convened regularly in 32 of 37 centers, and a research laboratory is present in 18 centers. CONCLUSIONS Diagnosing pituitary/hypothalamus disorders and treating them is the result of teamwork, composed of several diverse experts. Regarding neurosurgery, our findings have confirmed the central role of the transsphenoidal approach, with preference toward the endoscopic technique. Better outcomes can be expected at centers with a multidisciplinary team and a full, or part of a, residency program, with a greater surgical caseload.

Journal of Experimental & Clinical Cancer Research, 2016

Background: Brain stereotactic biopsy (SB) followed by conventional histopathology and immunohist... more Background: Brain stereotactic biopsy (SB) followed by conventional histopathology and immunohistochemistry (IHC) is the gold standard approach for primary central nervous system lymphoma (PCNSL) diagnosis. Flow cytometry (FCM) characterization of fine-needle aspiration cytology and core needle biopsies are increasingly utilized to diagnose lymphomas however, no biological data have been published on FCM characterization of fresh single cell suspension from PCNSL SB. The aim of this study was to establish the feasibility and utility of FCM for the diagnosis and characterization of brain lymphomas from a tissue samples obtained by a single SB disaggregation. Methods: Twenty-nine patients with a magnetic resonance suggestive for PCNSL entered the study. A median of 6 SB were performed for each patient. A cell suspension generated from manual tissue disaggregation of a single, unfixed, brain SB, was characterized by FCM. The FCM versus standard approach was prospectively compared. Results: FCM and IHC showed an high degree of agreement (89 %) in brain lymphoma identification. By FCM, 16 out of 18 PCNSL were identified within 2 h from biopsy. All were of B cell type, with a heterogeneous CD20 mean fluorescence intensity (MFI), CD10 positive in 3 cases (19 %) with surface Ig light chain restriction documented in 11 cases (69 %). No false positive lymphomas cases were observed. Up to 38 % of the brain leukocyte population consisted of CD8 reactive T cells, in contrast with the CD4 positive lymphocytes of the peripheral blood samples (P < 0.001). By histopathology, 18 B-PCNSL, only one CD10 positive (5 %), 1 primitive neuroectodermal tumor (PNET) and 10 gliomas were diagnosed. A median of 6 days was required for IHC diagnosis. Conclusion: Complementary to histopathology FCM can contribute to a better characterization of PCNSL, although necrosis and previous steroid treatment can represent a pitfall of this approach. A single brain SB is a valid source for accurate FCM characterization of both lymphoma and reactive lymphocyte population, routinely applicable for antigen intensity quantification and consistently documenting an active mechanism of reactive CD8 T-lymphocytes migration in brain lymphomas. Moreover, FCM confirmed to be more sensitive than IHC for the identification of selected markers.

Future Oncology

Background: Eribulin shows some activity in controlling brain metastasis in breast cancer. Method... more Background: Eribulin shows some activity in controlling brain metastasis in breast cancer. Methods: This observational, multicenter study evaluated brain disease control rates, survival and safety in patients with brain metastatic breast cancer treated with eribulin in clinical practice. Results: A total of 34 patients were enrolled (mean age 49 years, 91% with visceral metastases) and 29 were evaluable for brain disease. Fourteen achieved disease control and showed a longer time without progression: 10 months (95% CI: 2.3–17.7) versus 4 months (95% CI: 3.3–4.7) in the control group (p = 0.029). Patients with clinical benefits at 6 months had longer survival. Leukopenia and neutropenia were the most frequent grade 3–4 toxicities. Conclusion: Eribulin confirms its effectiveness in patients with brain metastatic breast cancer. Further studies on larger cohorts are needed to confirm the results.

Current Opinion in Oncology

Neuro-Oncology

Low-grade glioma patients have relatively long life expectancy for gliomas, but once they recur i... more Low-grade glioma patients have relatively long life expectancy for gliomas, but once they recur in malign, their prognosis can be poor. We analyzed factors corresponding to malignant recurrence by uni-and multi-variate analysis applying their treatment backgrounds. SUBJECTS: 261 newly diagnosed WHO grade 2 adults gliomas in 2004 to 2014. Malignant recurrence was determined by pathological diagnosis if the patient had a surgery (69% of the recurrent patients), otherwise contrast T1WI or 11C-methionine PET images if the patient was unable to undergo any surgery or biopsy. RESULTS: Age average 41 years old, the 10-year survival rate in all patients was 75%, and the mean of progression-free survival time was 7.8 years. Relapse event occurred in 115 cases (44%), and 67 % of them developed malignant glioma sometime. The 10-year survival rate for the patients who relapsed in malign was 37%, on the contrary, the patients who had recurrence but staying in low grade was 71% (p=0.0389). When they were categorized by 1p19q deletion and IDH1 mutation status, IDH wild type diffuse astrocytoma patients had significantly developed malignant glioma compared to oligodendroglioma and IDH mutant type diffuse astrocytoma (p<0.0001). The factors related to malignant progression were extracted as; recurrence in 2 years, 6% and over in MIB-1 index, no intervention longer than 18 months since the disease revealed, 1p19q non-co-deletion, less than 90% of tumor resection rate, and IDH wild type. In the 1p19q non-deletion patients, who were provisionally defined as diffuse astrocytoma patients here, the factors were resection rate, MIB-1 index, and duration between discovered the disease and the first surgery, but not the IDH mutant status (p＜0.0001, p=0.0015, p=0.0478 respectively). CONCLUSION: Recurrence in malign form low-grade glioma can be avoided by early intervention in 18 months from diagnosis and resection over 90% of volume of the tumor.

Journal of Clinical Oncology

Journal of Clinical Oncology

European Journal of Cancer Supplements

Neuro-Oncology

BACKGROUND: A growing number of studies demonstrated that awake surgery for lower-grade glioma re... more BACKGROUND: A growing number of studies demonstrated that awake surgery for lower-grade glioma results in both good functional and oncological outcome. However, indication of awake surgery for glioblastoma (GBM) has not been defined. Here, we intend to determine the indication of awake surgery for GBM based on the functional data at chronic phase. METHODS: A total of 29 patients with GBM who underwent awake surgery between May 2012 and March 2018 were included (age: mean, 52.7; standard deviation [SD], 11.5). Additionally, 41 GBM patients (age, 65.4; SD, 11.4) who underwent surgery with general anesthesia (GA) were included as historical control. The Karnofsky Performance Status (KPS) of both groups were collected at pre-and postoperative 3 month (chronic phase). Moreover, to investigate factors relating to KPS score at chronic phase, multivariate analysis with following explanatory variables were performed: age, preoperative KPS score, genetic mutation, eloquent area, resected volume, laterality, and time of surgery. RESULTS: The rate of KPS score preservation was significantly higher in awake surgery group (72.4%) than that of GA group (51.2%, p=0.03). Factors that influence the KPS score at chronic phase were age and preoperative KPS score (p=0.014, p. CONCLUSIONS: Awake surgery for GBM patients is useful to preserve independence level at chronic phase. In the view of preservation of preoperative independence level, indication of awake surgery is KPS ≥ 90 and age ≤ 64.