MD PhD, Gynecologic Oncologist, Gynecologic Oncology Unit, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Predictive biomarkers for immunotherapy response in ovarian cancer: the role of repair assisted damage detection (RADD) Ilary Ruscito, Giorgia Russo, Adriana Ionelia Apostol, Marica Marraffa, Amedeo Cefaliello, Serena Maria Boccia, Carolina Maria Sassu, Anna Fagotti, Claudia Marchetti Expert Review of Clinical Pharmacology, 2026 1. During the last 15 years, the international gynecologic oncology community recognized epithelial ovarian cancer (EOC) disease as a heterogeneous group of neoplasms with different molecular chara...
The impact of BRCA status on the efficacy of paclitaxel monotherapy in recurrent ovarian cancer Giorgia Russo, Adriana Ionelia Apostol, Ilary Ruscito, Carolina Maria Sassu, Claudia Diella, Fabiana Salvati, Filippo Maria Capomacchia, Serena Maria Boccia, Laura Vertechy, Christian Marth, Anna Fagotti, Claudia Marchetti International Journal of Gynecological Cancer, 2026 OBJECTIVE: In BRCA-mutated (BRCAmut) patients, while sensitivity to platinum has been assessed, the efficacy of other chemotherapy drugs, such as paclitaxel, in the recurrent setting is less defined. To this purpose, a single-center retrospective study was designed to evaluate the effects of paclitaxel monotherapy in patients with platinum-resistant ovarian cancer based on BRCA status. METHODS: We collected data on patients with recurrent high-grade epithelial ovarian cancer treated with paclitaxel monotherapy between November 2017 and October 2024. Only patients who received 2 to 4 previous lines of chemotherapy before paclitaxel were selected. BRCAmut patients were compared with BRCA wild-type (BRCAwt) patients. The primary outcome was the impact of paclitaxel monotherapy on overall survival in both groups separately. The secondary outcomes were progression-free survival, response rate, and toxicity profile. RESULTS: Of 175 patients who received paclitaxel, 155 met the inclusion criteria: 50 (32.3%) BRCAmut and 105 (67.7%) BRCAwt patients. Median progression-free survival was 5 months (95% confidence interval [CI] 3.58 to 6.42) in the BRCAwt group compared with 4 months (95% CI 2.29 to 5.71) in the BRCAmut group (p = .013). In BRCAmut patients, median overall survival was 11 months (95% CI 8.28 to 13.72) compared with 18 months for the BRCAwt group (95% CI 16.04 to 19.96) (p < .001). In the 93 patients who had previously received poly (ADP-ribose) polymerase (PARP) inhibitors, overall survival remained significantly longer in BRCAwt patients (p = .004), but not progression-free survival (p > .05). CONCLUSIONS: Treatment with paclitaxel monotherapy seems to be less effective in patients with recurrent platinum-resistant BRCAmut ovarian cancer compared with the BRCAwt population. Further clinical studies are needed to confirm these data and investigate potential mechanisms of paclitaxel resistance in BRCAmut carriers.
Mesothelin in solid tumors: biology, biomarker utility, and therapeutic targeting Ilary Ruscito, Elizaveta Baisheva, Eliane T. Taube, E. Ioana Braicu Current Opinion in Obstetrics and Gynecology, 2025 Purpose of review Mesothelin (MSLN) is a CA125-binding surface glycoprotein that mediates cell adhesion and peritoneal metastasis development in mesothelioma, high-grade serous ovarian cancer (HGSOC), pancreatic ductal adenocarcinoma, and cholangiocarcinoma. Recent findings Because of its tumor-restricted expression and functional role in dissemination, MSLN is represents an attractive molecule to target in solid tumors. Several antibody-based therapeutic agents, vaccine and chimeric antigen receptor therapy directed against MSLN are object of clinical evaluation. MSLN-targeted therapies are limited by antigen shedding and on-target/off-target effects. Summary MSLN is expressed in solid tumor patients, with no differences in expression among histologies. MSLN expression is associated with Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) stage and platinum sensitivity. Higher MSLN expression is detected among primary ovarian cancer patients and correlates with better survival data in HGSOC patients only. According to our data, treatment strategies targeting MSLN should be offered in first line setting rather than in relapse.
Is Adenomyosis Associated with Systemic Vascular Complications? Marwan Habiba, Ilary Ruscito, Paola Bianchi, Sun-Wei Guo, Giuseppe Benagiano Reproductive Medicine, 2025 We carried out a comprehensive literature search for publications on the range of vascular events that have been linked to adenomyosis. This covered vascular diseases, blood coagulation disorders, thrombosis, hypercoagulation, stroke (embolic, ischemic, thrombotic, hemorrhagic), cerebrovascular episodes, cerebral infarction, cerebral hemorrhage) and renal disease. This review covers 63 articles. Nineteen articles reported clinical manifestations of intravascular thrombosis in women with adenomyosis. Eleven publications were identified that reported on cerebral involvement and adenomyosis, including cases of ischemic stroke or infarction. Dysregulation primarily seems to occur via local factors leading to altered angiogenesis. Five case reports were identified that reported on various vascular complications attributed to the presence of adenomyosis. The search also identified reports of cerebral complications in women with adenomyosis. Through a secondary search, we identified publications dealing with a possible connection between cardiac complications and renal pathology, which the authors attributed to adenomyosis. Vascular involvement in adenomyosis is documented in rare cases by the presence of endometrial tissue in myometrial vessels both in menstrual and non-menstrual uteri. Women with adenomyosis have a higher platelet count, a shorter thrombin and prothrombin time and an activated partial thromboplastin time. These findings has been applied to attempts to identify therapies for adenomyosis based on targeting the vasculature, but the existence of a link between the two conditions is under question for several reasons: only case reports (or very small series) have been published; all published cases come from one region of the world (the Far East); the published literature does not contain objective proof of a causal relationship between the two pathologies, except for the elevation of some markers. In summary, it is not possible to conclude that the presence of adenomyosis has a pathogenetic role in causing vascular events, first and foremost because available evidence consists mostly of case reports.
Real-life observational study on niraparib in older patients with primary tubo-ovarian cancer: a focus on safety and efficacy Adriana Ionelia Apostol, Matteo Bruno, Carolina Maria Sassu, Serena Maria Boccia, Laura Vertechy, Giorgia Russo, Ilary Ruscito, Filippo Maria Capomacchia, Giovanni Scambia, Anna Fagotti, Claudia Marchetti International Journal of Clinical Oncology, 2025 Background Niraparib is approved for maintenance treatment of tubo-ovarian cancer patients, but data on older patients are limited. This retrospective study evaluated its safety and efficacy in primary advanced tubo-ovarian cancer, focusing on patients ≥ 75 years. Methods Women aged ≥ 50 years diagnosed with primary high-grade serous tubo-ovarian cancer, treated with niraparib between 2019–2023, were enrolled. Patients were stratified into three groups: A (50–64 years), B (65–74 years), and C (≥ 75 years). The primary outcome was progression-free survival. The secondary outcomes were toxicity and dose reduction. Results 127 patients were identified: 62 (48.8%) group A, 26 (20.5%) group B, and 39 (30.7%) group C. Baseline characteristics were comparable across groups, excluding a higher proportion of interval cytoreductive surgeries ( p = 0.001), residual tumor ( p = 0.01) and Eastern Cooperative Oncology Group (ECOG) > 1 ( p = 0.01) in group C. Most patients started niraparib at 200 mg/day with dose reductions primarily occurred within fourth cycle. Dose reductions were observed in 77.4%, 69.2% and 56.4% of patients in groups A, B, and C, respectively ( p = 0.08). In patients ≥ 75 years, 26 (66.7%) discontinued treatment due to disease progression (48.7%) or toxicity (17.9%). There were no significant differences in common or grade ≥ 3 adverse events between groups. Progression-free survival was 12 months (95%CI: 2.0–25.0) for group A, 29 months (95%CI: 11.0–52.0) for group B, and 16 months (95%CI: 1.0–31.0) for group C ( p = 0.78). Conclusions Our findings suggest that niraparib is safe and well-tolerated in aged ≥ 75 years. Concerns about toxicity should not preclude the enrollment of elderly patients in treatment regiments.
The Relation between the Inner Myometrium and the Junctional Zone Marwan Habiba, Ilary Ruscito, Paola Bianchi, Sun-Wei Guo, Giuseppe Benagiano Gynecologic and Obstetric Investigation, 2025 Background: The nature and functions of the innermost layer of the myometrium, which is located immediately below the endometrium, coined the “junctional zone” (JZ), continue to be the subject of debate. The role and significance of the JZ have attracted little attention beyond its relation to the diagnosis of adenomyosis. Objectives: This review was conducted to update our current understanding of the role of the JZ as a specific uterine region. Methods: This is a comprehensive review of literature that was published in PubMed and MEDLINE platforms till April 2025 and that addresses the uterine JZ, excluding articles concerned with uterine adenomyosis. Outcome: It is not possible to reconcile JZ appearance on imaging with embryological or functional correlates. There are clear histological and immunohistological differences between the inner and outer myometrium, but the change is gradual with no demarcation of the transition. Whether the JZ has a different origin remains controversial because of the lack of supportive embryological evidence. There is evidence that JZ appearance on MRI is hormonally dependent, but it is not always recognizable and is often indistinct before puberty and after menopause. JZ seems to increase in thickness in the secretory and menstrual phases. Conclusion: While increased thickness is often considered a sign of adenomyosis, considerable uncertainty remains. We have not been able to identify studies that related features of the JZ per se to clinical outcomes. This supports the need for caution when interpreting the relevance of the JZ.
Precision oncology targeting FGFRs: A systematic review on pre-clinical activity and clinical outcomes of pemigatinib Ludovica Gnagni, Ilary Ruscito, Ilaria Grazia Zizzari, Marianna Nuti, Chiara Napoletano, Aurelia Rughetti Critical Reviews in Oncology Hematology, 2024 Fibroblast Growth Factor Receptors (FGFRs) are emerging as key factors involved in tumorigenesis, tumor microenvironment remodeling and acquired resistance to targeted therapies. Pemigatinib is a Tyrosine-Kinase Inhibitor that selectively targets aberrant FGFR1, FGFR2 and FGFR3. Pemigatinib is now approved for advanced-stage cholangiocarcinoma (CCA) but data suggests that other tumor histotypes exhibit FGFR alterations, thus hypothesizing its potential efficacy in other cancer settings. The present systematic review, based on PRISMA guidelines, aims to synthetize and critically interpret the results of all available preclinical and clinical evidence regarding Pemigatinib use in cancer. In April 2024, an extensive search was performed in PubMed, MEDLINE, and Scopus databases using the keyword "Pemigatinib". Twenty-seven studies finally met all inclusion criteria. The promising results emerging from Pemigatinib preclinical and clinical studies pave the way for Pemigatinib extension to multiple solid cancer settings. • FGFRs promote tumorigenesis, microenvironment remodeling, and immune modulation. • Pemigatinib is a potent anti-FGFRs TKI now approved in advanced cholangiocarcinoma. • Many clinical trials are ongoing to assess Pemigatinib efficacy in other cancers. • This is a systematic review performed following PRISMA guidelines in April 2024. • This study summaries all preclinical and clinical results on Pemigatinib in cancer.
Brain metastases in breast cancer Maria Luisa Gasparri, Rosa Di Micco, Arianna Siconolfi, Ammad Ahmad Farooqi, Gabrielle Di Bartolomeo, Veronica Zuber, Donatella Caserta, Filippo Bellati, Ilary Ruscito, Andrea Papadia, Oreste D. Gentilini Unraveling the Complexities of Metastasis Transition from A Segmented View to A Conceptual Continuum, 2022
Impact of clinical factors and surgical outcome on long-term survival in high-grade serous ovarian cancer: A multicenter analysis Joanna Baum, Elena Ioana Braicu, Oliver Hunsicker, Ignace Vergote, Nicole Concin, Els Van Nieuwenhuysen, Aarne Feldheiser, Patriciu Achimas-Cadariu, Silvia Darb-Esfahani, Astrid Berger, Bogdan Fetica, Sven Mahner, Andrea Papadia, Linn Wölber, Maria Luisa Gasparri, Adriaan Vanderstichele, Pierluigi Benedetti Panici, Michael D Mueller, Ilary Ruscito, Hannah Woopen, Jalid Sehouli International Journal of Gynecological Cancer, 2021
Adjuvant vaginal interventional radiotherapy in early-stage non-endometrioid carcinoma of corpus uteri: A systematic review Francesca De Felice, Valentina Lancellotta, Lisa Vicenzi, Sara Costantini, Alfredo Antonacci, Valentina Cerboneschi, Daniela Cristino, Luca Tagliaferri, Annamaria Cerrotta, Andrea Vavassori, Sergio Gribaudo, Alessandro Colombo, Francesco Lucà, Raffaele Barbara, Monica Mangoni, Francesco Marampon, Daniela Musio, Filippo Bellati, Ilary Ruscito, Francesco Torcia, Vincenzo Tombolini, Mattia Osti, Vitaliana De Sanctis Journal of Contemporary Brachytherapy, 2021
BRCA1 Promoter Methylation and Clinical Outcomes in Ovarian Cancer: An Individual Patient Data Meta-Analysis Roshni D Kalachand, Britta Stordal, Stephen Madden, Benjamin Chandler, Julie Cunningham, Ellen L Goode, Ilary Ruscito, Elena I Braicu, Jalid Sehouli, Atanas Ignatov, Herbert Yu, Dionyssios Katsaros, Gordon B Mills, Karen H Lu, Mark S Carey, Kirsten M Timms, Jolanta Kupryjanczyk, Iwona K Rzepecka, Agnieszka Podgorska, Jessica N McAlpine, Elizabeth M Swisher, Sarah S Bernards, Ciaran O’Riain, Sharon O’Toole, John J O’Leary, David D Bowtell, David M Thomas, Katharina Prieske, Simon A Joosse, Linn Woelber, Parvesh Chaudhry, Norman Häfner, Ingo B Runnebaum, Bryan T Hennessy Journal of the National Cancer Institute, 2020
TK inhibitor pazopanib primes DCs by downregulation of the β-catenin pathway Ilaria Grazia Zizzari, Chiara Napoletano, Andrea Botticelli, Salvatore Caponnetto, Fabio Calabrò, Alain Gelibter, Aurelia Rughetti, Ilary Ruscito, Hassan Rahimi, Ernesto Rossi, Giovanni Schinzari, Paolo Marchetti, Marianna Nuti Cancer Immunology Research, 2018
Dynamics of the Intratumoral Immune Response during Progression of High-Grade Serous Ovarian Cancer Mandy Stanske, Stephan Wienert, Dan Cacsire Castillo-Tong, Caroline Kreuzinger, Ignace Vergote, Sandrijne Lambrechts, Hani Gabra, Charlie Gourley, Ram N. Ganapathi, Ivonne Kolaschinski, Jan Budczies, Jalid Sehouli, Ilary Ruscito, Carsten Denkert, Hagen Kulbe, Wolfgang Schmitt, Korinna Jöhrens, Ioana Braicu, Silvia Darb-Esfahani Neoplasia United States, 2018
Current knowledge of miRNAs as biomarkers in breast cancer Maria Luisa Gasparri, Zein Mersini Besharat, Aris Raad Besharat, Ilary Ruscito, Konstantinos Nirgianakis, Ammad Ahmad Farooqi, Andrea Papadia, Elisabetta Ferretti, Pierluigi Benedetti Panici, Michael David Mueller Recent Trends in Cancer Biology Spotlight on Signaling Cascades and Micrornas Cell Signaling Pathways and Micrornas in Cancer Biology, 2018
Cediranib in ovarian cancer: state of the art and future perspectives Ilary Ruscito, Maria Luisa Gasparri, Claudia Marchetti, Caterina De Medici, Carlotta Bracchi, Innocenza Palaia, Sara Imboden, Michael D. Mueller, Andrea Papadia, Ludovico Muzii, Pierluigi Benedetti Panici Tumor Biology, 2016