2,037 research outputs found
Will the new stability and growth pact succeed? An economic and political perspective
No full textWhile the Maastricht Treaty establishes the entry conditions for Member States to join the single currency, the Stability and Growth Pact (SGP) aims to make budgetary discipline a permanent feature of EMU. Consequently, the Pact is commonly interpreted as a major building block of EMU's architecture: the SGP ‘must rank as one of the most remarkable pieces of policy coordination in world history. The purpose of this paper is to offer an initial evaluation of the SGP reform. Section Two reviews the main fiscal policy developments in the early years of EMU which were at the basis of the crisis of the SGP ‘mark I'. Section Three describes the reformed SGP and an assessment of its main features. Section Four presents some reflections on the political economy of the EU rules, comparing the new SGP with the Maastricht Treaty and the SGP ‘mark I'. The final section concludes.Stability and Growth Pact, Economic Monetary Union (EMU), Maastricht Treaty, Buti
Revisiting the Stability and Growth Pact: grand design or internal adjustment?
No full textThe Stability and Growth Pact is under fire. Problems have appeared in sticking to the rules. Proposals to reform the Pact or ditch it altogether abound. But is the Pact a flawed fiscal rule? Against established criteria for an ideal fiscal rule, its design and compliance mechanisms fare reasonably well. Where weaknesses are found, they tend to reflect trade-offs typical of supra-national arrangements. In the end, only a higher degree of fiscal integration would remove the inflexibility inherent in the recourse to predefined budgetary rules. This does not mean that the EU fiscal rules cannot be improved. However, given the existing degree of political integration in EMU, internal adjustment rather than attempting to re-design the rules from scratch appears a more suitable way to bring about progress. Redefining the medium term budgetary target, improving transparency, tackling the pro-cyclical fiscal bias in good times, moving towards non-partisan application of the rules and improving transparency in the data can achieve both stronger discipline and higher flexibility.sgp, stability and growth pact, Buti, Eijffinger, Franco
The Stability pact Pains: A Forward-Looking Assessment of the Reform Debate
No full textThe Stability and Growth Pact has been under fire ever since it was born.But is the Pact a flawed fiscal rule?Against established criteria for an ideal fiscal rule, its design and compliance mechanisms show strengths and weaknesses. The latter tend to reflect tradeoffs typical of supra-national arrangements.In the end, only a higher degree of fiscal integration would remove the inflexibility inherent in the recourse to predefined budgetary rules.No alternative solution put forward in the literature appears clearly superior.This does not mean that the original Pact of 1997 could not be improved.The debate on the SGP has shown that any reform should aim at overcoming the excessive uniformity of the rules, improving their transparency, correcting pro-cyclicality and strengthening enforcement.The reform of the Pact agreed in 2005 moves in this direction but leaves open a number of issues.EMS;fiscal policy;fiscal rules;Economic and Monetary Union;Stability and Growth Pact
Systemic adjuvant therapies in renal cell carcinoma
No full textRenal cell carcinoma (RCC) is one of the ten most frequent solid tumors worldwide. Recent innovations in the treatment of metastatic disease have led to new therapeutic approaches being investigated in the adjuvant setting. Observation is the only current standard of care after radical nephrectomy, although there is evidence of efficacy of adjuvant use of vaccine among all the strategies used. This article aims to collect published experiences with systemic adjuvant approaches in RCC and to describe the results of past and ongoing phase III clinical trials in this field. We explored all the systemic treatments, including chemotherapy, immunotherapy and targeted drugs while alternative approaches have also been described. Appropriate selection of patients who would benefit from adjuvant therapies remains a crucial dilemma. Although the international guidelines do not actually recommend any adjuvant treatment after radical surgery for RCC, no conclusions have yet been drawn pending the results of the promising ongoing clinical trials with the target therapies. The significant changes that these new drugs have made on advanced disease outcome could represent the key to innovation in terms of preventing recurrence, delaying relapse and prolonging survival after radical surgery for RCC. © Copyright S. Buti et al., 2012
Spotlight on cabozantinib for previously untreated advanced renal cell carcinoma: evidence to date
No full textMelissa Bersanelli, Francesco Leonardi, Sebastiano Buti University Hospital of Parma, Medical Oncology Unit, Parma, Italy Background: In the past few years, new drugs made their appearance in the first-line setting of treatment for metastatic renal cell carcinoma (mRCC), and cabozantinib is one among them. The present systematic review aims to point out any evidence published to date about first-line treatment with cabozantinib for mRCC patients, describing their outcome in all end points explored by the literature. Methods: PRISMA guidelines were followed. A systematic assessment of literature and peer-reviewed presentations was performed by searching PubMed and major oncology meeting resources, from the database inception until June 25, 2018. The following keywords were used: “cabozantinib or cabozantinib-s-malate or XL184” and “renal cell carcinoma or kidney cancer or clear cell renal carcinoma or renal cancer” and “first-line or untreated or treatment-naïve or primary treatment”. All types of original clinical studies were included, evaluating either cabozantinib monotherapy or any systemic drug combination containing cabozantinib for previously untreated patients with mRCC. Results: From potential 75 titles and abstracts, seven publications were selected. One was the main report of a randomized clinical trial (the CABOSUN study); four papers reported updated results, secondary or subgroup analyses from the same study population; and further two reports consisted of network meta-analyses. From the additional search for ongoing clinical trials, six studies currently in progress were reported. Conclusion: According to the reported evidence, cabozantinib may be a viable first-line option in mRCC patients with intermediate or poor risk according to International Metastatic Renal Cell Carcinoma Database Consortium model. It offers an undoubtful advantage in terms of progression-free survival, despite quite high rates of G3–4 toxicity, modest objective response rate, and no survival advantage. Nevertheless, given the availability of an immunotherapy combination that significantly improved overall survival for the same population in a Phase III trial and the indisputable efficacy of cabozantinib as second-line treatment, this drug may be devoted as a rescue option in patients progressive to primary therapy. Keywords: cabozantinib, renal cell carcinoma, first-line treatment, CABOSU
Fiscal policy in EMU: Rules, discretion and political incentives
No full textThe fiscal philosophy of EMU's budgetary rules is to bring deficits close to balance and then let automatic stabilisers play freely. Given the large tax and benefit systems in Europe, relying mainly on automatic stabilisation would allow a relatively high degree of cyclical smoothing while avoiding the typical pitfalls of fiscal activism. While this is, in most circumstances, good economic policy, it is evidently not regarded as good politics. The current difficulties of EMU's fiscal policy framework have little to do with its alleged fault lines and much to do with the resurgence of electoral budget cycles amid a weak system of incentives to abide by the agreed rules.EMU, economic and monetary union, fiscal policy, taxation, budgetary regulation, Marco Buti, van den Noord
Clinical use of lenvatinib in combination with everolimus for the treatment of advanced renal cell carcinoma
No full textAlessandro Leonetti, Francesco Leonardi, Melissa Bersanelli, Sebastiano Buti Medical Oncology Unit, University Hospital of Parma, Parma, Italy Introduction: Renal cell carcinoma (RCC) represents 2%–3% of all cancers in adults, and its pathogenesis is mainly related to altered cellular response to hypoxia. Lenvatinib, a novel multitarget tyrosine kinase inhibitor (TKI), represents a therapeutic option, in combination with mammalian target of rapamycin (mTOR) inhibitor everolimus, for the treatment of metastatic RCC (mRCC).Aim: The objective of this article is to review the evidence about the treatment of mRCC with combination of lenvatinib plus everolimus.Evidence review: Phase I studies supported clinical activity of lenvatinib in mRCC. A randomized, Phase II, open-label, multicenter trial demonstrated the clinical efficacy of combination treatment with lenvatinib plus everolimus in patients with progressive mRCC after prior therapy with TKI. Median progression-free survival was improved by 9 months with the combination therapy compared to the single-agent everolimus, with an overall response rate of 43% for the experimental regimen. Lenvatinib plus everolimus appeared to be slightly less toxic than single-agent lenvatinib and more toxic than single-agent everolimus; grade 3–4 adverse events occurred in 71% of patients. Currently, lenvatinib plus everolimus has US Food and Drug Administration approval for its use in mRCC after failure of previous treatment with TKI.Conclusion: The combination therapy with lenvatinib plus everolimus might be a promising choice for second-line treatment of mRCC patients. Based on the results of the Phase II trial, it is possible to speculate that the combination therapy could be appropriate for patients with high disease burden or strongly symptomatic patients. Keywords: lenvatinib, everolimus, evidence-based review, renal cell carcinoma, RC
Profile of atezolizumab in the treatment of metastatic non-small-cell lung cancer: patient selection and perspectives
No full textFrancesco Facchinetti, Paola Bordi, Alessandro Leonetti, Sebastiano Buti, Marcello Tiseo Medical Oncology Unit, University Hospital of Parma, Parma, Italy Abstract: Programed cell death-1/programed death ligand-1 (PD-1/PD-L1) blockade represents an affirmed reality in the treatment of advanced non-small-cell lung cancer (NSCLC) patients. Atezolizumab, an anti-PD-L1 agent, figures among the drugs that provide previously unenvisaged outcomes in the pretreated setting of metastatic NSCLC. Increasing evidence vouches for the early administration of PD-1/PD-L1 blockers in untreated patients, encompassing atezolizumab combinations with chemotherapy and the anti-angiogenic agent bevacizumab. Moreover, the development of atezolizumab allowed to derive several hints regarding clinical and immunological factors predictive of its activity and efficacy, some of them exclusive among this class of drugs. This review provides an overview of atezolizumab development throughout clinical trials toward its applicability in the routine practice, with a particular focus on patient selection based on clinical and immune-related factors. Keywords: non-small cell lung cancer, NSCLC, immune checkpoint blockers, ICB, PD-1, PD-L1, atezolizumab development, biomarker
What is the impact of tax and welfare reforms on fiscal stabilisers? A simple model and an application to EMU
No full textReforms aiming at lowering the tax burden and cutting social benefits may boost efficiency and output, and improve market adjustment to shocks, but, by reducing the size of automatic stabilisers, may also imply less cyclical smoothing. This would be problematic in EMU given the loss of national monetary autonomy. This paper argues that the alleged trade-off between efficiency/flexibility and stabilisation depends on the typology of shocks affecting the economy.taxation, tax reforms, fiscal policy, social welfare, social benefits, fiscal stabilisers, automatic stabilisers, economic and monetary union, EMU, shocks, Buti, Van den Noord
Francesco Buti, poesia e drammaturgia.
No full textThe first part of this essay explains the poetry features for music of abbot Francesco Buti from Narni. The second one contains the modern edition of poems for Li Fiori, a group of polyphonic “villanelle” set to music and published in 1632 by the German nobleman Girolamo Kapsperger. Performed in a private concert in Rome, probably under the patronage of Cardinal Francesco Barberini, this work is the unique example of a music collection of 16th-century Italy entirely devoted to flowers.
Buti’s poetry resumed the ancient Greek legends of the jasmine, violet, rose, purple anemone, hyacinth, narcissus and iris aiming at transforming them as means to enhance the catholic ethic. In some cases, e.g. in reference to the jasmine, Buti was inspired by the contemporaneous iconography, in particular Guido Reni’s, Guercino’s and Cartari’s pictures (cf. the “Aurora” at Rospigliosi-Pallavicini Palace, another “Aurora” at Ludovisi Casino, the treatise of Vincenzo Cartari “Le imagini dei dei degli antichi”, 1626). The core meaning of “Li Fiori” metaphors, which establish close ties with the Counter-Reformation mentality, is the slogan “talking/painting” drawn from Horace’s “Ars poetica” and Marino’s “Dicerie sacre” (1614).
The poems, taken from the score of Kapsperger’s music, are conceived in an unusual structure. They intermingle different kinds of verse to which Buti adds a refrain. The absence or the ambiguous use of rhymes, and the irregular length of verses, in some cases increase the difficulty to establish the authentic form of the lines. Regarding the lexicon, some terms are retraceable also in the libretti written by the poet twenty years later for the French Royal Opera House at the time of Louis XIV’s reign
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