Biography:

Arianna Calcinotto is Group Leader of the Cancer Immunotherapy group at the Institute of Oncology Research in Switzerland. She received her PhD in Molecular Medicine with honors from Università Vita-Salute San Raffaele, Milan in 2015. She completed her Post Doc training before at San Raffaele Institute in Milan, then in the lab of Prof. Bergsagel at Mayo Clinic (Arizona, USA) and then in the lab of Prof. Alimonti in Switzerland. She has studied cancer cell-immune cell interactions in the tumor microenvironment during different phases of cancer development and progression in both solid tumors and hematological malignancies developing novel immunotherapies for cancer. Her major scientific contributions have been the identification of an unexpected link between the presence of specific bugs in the gut microbiota in patients affected by multiple myeloma and prostate cancer and the identification of the role played by IL23 producing myeloid cells promoting therapy-resistance in castration resistance prostate cancer patients.

Abstract:

The well-established dependency of cancer cells on the tumour microenvironment suggests that the non-cancer-cell component of the tumour may have an important role in controlling breast cancer progression and the emergence of therapy resistance. We are interested in understanding the liaison between tumor-infiltrating myeloid cells and cancer cells to identify new molecular mechanisms that regulate cancer progression, tumor evasion, and androgen insensitivity. Our research demonstrates that the breast tumor microenvironment is comprised of Myeloid-Derived Suppressor Cells (MDSCs) that favours tumour cell proliferation and therapy resistance in hormone-dependent cancers. These studies have helped provide significantly novel insights into designing novel immune therapies to target MDSCs that are now under clinical evaluation. Recent results will be presented on original and unexpected role of MDSCs in the neoplastic tissue, where they directly activate crucial pathways in the breast cancer cell. I will discuss that novel combination therapies tested in pre-clinical studies modulate the tumor microenvironment increasing the efficacy of currently available endocrine therapies.

Biography:

Gianluca Franceschini is an Associate Professor of General Surgery – Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University in Rome, Italy. He is a Coordinator of integrated therapies for breast cancer at the Department of Women and Children’s Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome - Italy. He worked as a Senior Staff Surgeon at Breast Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome - Italy. He is a Breast Surgeon with expertise in the surgical treatment of breast tumors and oncoplastic techniques; over 4.000 surgical procedures for breast cancer from 1 January 2010 to 31 October 2020. He is also an author of over 200 scientific papers in international journals and 15 textbook chapters (Orcid ID 0000-0002-2950-339; Scopus Author ID 23027478400). Professor at the School of Specialization in General Surgery, Plastic Surgery and Oncology at the Catholic University of Rome, Italy, from 2013.

Abstract:

Immediate Prosthetic Breast Reconstruction (IPBR) is considered as an integral part of the surgical treatment of patients undergoing Nipple-Sparing Mastectomy (NSM) for breast cancer, as it positively affects psychological health, sexuality, body image, and self-esteem.

Traditionally, IPBR has been performed by placement of the prosthetic implant in a Sub Muscular (SM) pocket created beneath the pectoralis major muscle, in order to protect the integrity of the implant and reduce its visibility and palpability. Although this technique has shown increasingly good results, it still yields a higher risk of undesirable outcomes such as significant postoperative pain, injury-induced muscular deficit, breast animation deformity, lateral deviation of the breast mound with poor inframammary fold definition, and insufficient lower pole fullness.

In recent years, placement of the implant in a prepectoral (PP) plane has been increasingly employed. When this technique is performed, the implant is usually covered with an Acellular Dermal Matrix (ADM) to shield it in the subcutaneous space underneath the skin flaps; however, the use of ADM has been reported to increase risks of seroma, infection, and skin/nipple-areola complex (NAC) necrosis, and associated with higher medical costs. To limit these inconveniences, the use of implants with a special micropolyurethane-foam-coated shell surface (microthane) that does not require ADM coverage has recently been proposed.

The aim of this study was to compare outcomes between traditional SM-IPBR and a PP technique using microthane implants without ADMs in patients undergoing NSM.

Biography:

Terri Crudup is a researcher with a passion for helping cancer patients finds their path to wellness. After her second bout with breast cancer in 2019, she returned to work as a market research consultant with a desire to quantify what many providers and patients know qualitatively: that combining conventional cancer medical treatments with complementary and lifestyle therapies positively affects patient survival. With her first two papers now published, Terri speaks at events for cancer patients, is part of an integrative oncology learning collaborative with the Samueli Foundation, and partners with Unite for HER, a US-based charity with the mission of educating and funding complementary therapies for those experiencing breast and ovarian cancers.

Abstract:

Integrative oncology is widely used by patients with breast cancer. This study aims to investigate the relationship between survival outcomes of breast cancer patients and the level of involvement in integrative oncology at the institutions treating them. Claims-based data were used to find 4,815 newly diagnosed breast cancer patients treated between January 2013 and December 2014, for survival analysis. A scoring system was developed asking oncologists about their institutions’ efforts to educate, support and provide funding for 12 complementary and lifestyle approaches. Cohort analysis using two-tailed chi square and a separate multivariate model using SMOTE and lasso regression were used. Nine variables across patient and institutional profiles were included. The model coefficients were exponentiated and presented as odds ratios. 173 patients mapped to 103 institutions and 103 oncologists.

Median patient age was 51 and 8% were metastatic. Institutions were scored for integrative oncology involvement and placed into four cohorts. Low-scoring institutions showed less effort to educate, support and provide integrative therapies compared to others. 5-year survival of patients in the low cohort was directionally but not significantly lower than others. In the multivariate model, a composite integrative oncology score was shown to increase 5-year survival odds three times for institutions in the low-mid cohort and 48% in the mid-high, compared to the low. Crossing the threshold beyond ‘low’ involvement in integrative oncology represents a new path to incremental survival benefit for many cancer patients. Entities invested in the survival of breast cancer patients should increase education, access and funding for a core set of six therapies: nutrition and exercise counselling, patient support groups, spiritual services, meditation and psycho-oncology support.