Background: The excellent results of phase 3 randomized trials have rendered cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine treatment (ET) as the new standard of care for both endocrine-sensitive and -resistant patients (pts). We performed a single institution retrospective review of pts with metastatic hormone receptor positive (HR+) HER2 negative (HER2-) breast cancer (MBC) receiving CDK4/6i in I line setting.

presence of opportunistic pathogens such as Fusobacterium nucleatum, which in turn could be responsible, at least in part, of the higher levels of inflammation found in these patients.These data point out the importance that gut microbiota could have in the appearance and develpment of CRC-associated to obesity and could give new clues for the development of new diagnostic tools for CRC prevention.

Background: Breast cancer (BC) is commonly diagnosed at early stage and more than 80% of patients (pts) are long-term survivors. Most cancer society guidelines recommend a non-intensive follow-up, that, after 5 years from diagnosis, consists of annual medical history, physical examination and surveillance mammogram. The role of family physician in the management of BC follow-up is still under discussion. Material and methods: Since 2013, we have launched a shared BC survivor follow up program involving family physicians working in the Province of Lecco. Pts with diagnosis of early BC have been referred to their family physician to continue surveillance with annual physical examination and mammogram at the completion of adjuvant treatment and after at least 5 years of follow-up, if no clinical evidence of disease recurrence was present. In case of suspicious disease recurrence, a direct access to our oncology unit has been offered. Results: From May 2013 to March 2017, 643 women have been enrolled in our program. All pts were disease free (as per clinical assessment), had completed adjuvant treatment and at least 5 years of follow-up at the time of enrollment. 11% of pts had ductal carcinoma in situ, 66% invasive ductal carcinoma, 7% invasive lobular carcinoma and 16% other histologic subtypes. 11% was hormonal receptor negative and 7% was HER2 positive. 44% was G2 and 34% G3. 25% received chemotherapy followed by hormonal treatment, 9% received adjuvant chemotherapy alone and 61% received hormonal treatment alone. Median follow up time was 8 years (range 5-23 years). 10/643 (1,6%) pts experienced BC recurrence: 3 had distant metastasis, 4 unilateral breast recurrence and 3 contralateral. Those with local recurrence underwent breast surgery followed by adjuvant chemotherapy in 1 case, chemotherapy and hormonal treatment in 1 and hormonal treatment alone in 5. Pts with distant metastasis are still alive and currently on treatment (1 with chemotherapy, 2 with hormonal treatment). Conclusion: This preliminary analysis has shown the feasibility of our program with a significant number of pts referred to their family physicians, reducing the need for specialist follow-up. Only a small proportion of pts experienced subsequent relapse requiring reassessment by the treating oncologist. Further analysis is planned to define the adherence to the shared follow-up.

AIM:Alopecia still remains one of the most untreatable side-effects induced by cancer chemotherapy. According to the phytotherapeutic tradition, Panicum Miliaceum has been proven to be effective in the prevention of hair loss for different reasons. At present, however, there are no data about its possible efficacy in the treatment of cancer chemotherapy-induce alopecia. The aim of this study was to analyze the efficacy of Panicum Miliaceum in cancer patients treated with the most potent chemotherapeutic drugs in terms of hair loss, consisting of cisplatin (CDDP) and anthracyclines.METHODS:This case-control study included 28 cancer patients concomitantly treated with Panicum Miliaceum and 56 patients receiving the same combinations of chemotherapy alone as a control group. Panicum Miliaceum was given orally at 300 mg (daily dose) 3 times per day, every day until the end of chemotherapy. The grade of hair loss was assessed by World Health Organization (WHO) criteria.RESULTS:The percentage of alopecia of third grade observed in patients concomitantly treated with Panicum Miliaceum in association with CDDP-containing regimens was significantly lower than that found in those who received the chemotherapy only. The percentage was also lower under anthracycline-containing schedules, without, however, statistically significant differences. Panicum Miliaceum therapy was substantially well tolerated in all patients.RESULTS:This preliminary study would suggest that the concomitant treatment with Panicum Miliaceum may be effective in preventing hair loss induced by CDDP-containing chemotherapies, whereas the benefit was lower in patients treated with anthracyclines. Future randomized studies will be necessary to confirm these preliminary

AIM:The recent rediscovery of the natural traditional medical sciences has contributed to improve the treatment of the human diseases and, in particular, it has been shown that the pharmacological approach is not the only possible strategy in the treatment of nausea and vomiting, since bioenergetic approaches, such as acupressure and acupuncture, may also counteract the onset of vomiting due to different causes. Previous preliminary clinical studies had already suggested a possible efficacy of acupressure also in the treatment of chemotherapy-induced vomiting resistant to the classical antiemetic drugs. The aim of this study was to confirm these preliminary data.METHODS:The study was performed in 100 consecutive metastatic solid tumour patients, who underwent chemotherapy for their advanced neoplastic disease, and who had no benefit from the standard antiemetic agents, including corticosteroids, antidopaminergics and 5-HT 3R-antagonists. Acupressure was made by a stimulation of PC6 acupoint.RESULTS:The emetic symptomatology was reduced by acupressure in 68/100 (68%) patients, without significant differences in relation to tumour histotype. The lowest efficacy was observed in patients treated by anthracycline-containing regimens, without, however, statistically significant differences with respect to the other chemotherapeutic combinations.CONCLUSION:This study confirms previous preliminary clinical results, which had already suggested the potential efficacy of acupressure in the treatment of vomiting due to cancer chemotherapy. Therefore, acupressure may be successfully included within the therapeutic strategies of cancer chemotherapy-induced vomiting.