151
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Enrico D, Lacroix L, Rouleau E, Scoazec JY, Loriot Y, Tselikas L, Jovelet C, Planchard D, Gazzah A, Mezquita L, Ngo M, Michiels S, Massard C, Facchinetti F, Chen J, Soria JC, André F, Vassal G, Friboulet L, Besse B. Multiple synchronous mechanisms may contribute to osimertinib resistance in non-small cell lung cancer (NSCLC) patients: Insights of the MATCH-R study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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152
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Ortiz-Cuaran S, Mezquita L, Swalduz A, Aldea M, Mazieres J, Jovelet C, Flores WC, Lacroix L, Loriot Y, Friboulet L, Westeel V, Ngocamus M, Pradines A, Tissot C, Duchene CC, Raynaud C, Quantin X, Gervais R, Brain E, Monnet I, Leprieur EG, Avrillon V, Mahier-Aït Oukhatar C, Hoog-Labouret N, De Kievit F, Howarth K, Guichou J, Morris C, Green E, Perol M, Besse B, Blay J, Saintigny P, Planchard D. MA21.07 Circulating Tumor DNA Analysis Depicts Potential Mechanisms of Resistance to BRAF-Targeted Therapies in BRAF+ Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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153
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Ortiz - Cuaran S, Mezquita L, Swalduz A, Aldea M, Mazieres J, Jovelet C, Lacroix L, Pradines A, Avrillon V, MahierAït Oukhatar C, Hoog-Labouret N, Howarth K, Guichou JF, Morris C, Green E, Perol M, Besse B, Blay JY, Saintigny P, Planchard D. Circulating tumour DNA (ctDNA) analysis depicts mechanisms of resistance and tumour response to BRAF inhibitors in BRAF-mutant non-small cell lung cancer (NSCLC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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154
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Varga A, Zalcman G, Gomez-Roca C, Ammari S, Caramella C, Gounant V, Rabeau A, Paoletti X, Baldini C, Martin-Romano P, Champiat S, Vuagnat P, Michot J, Mezquita L, Massard C, Besse B, Soria J, Marabelle A, Planchard D. MA05.11 Safety and Efficacy of Nintedanib in Combination with Pembrolizumab in Patients with Refractory/Relapsing Malignant Pleural Mesothelioma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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155
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Geraud A, Mezquita L, Auclin E, Combarel D, Delahousse J, Naltet C, Jovelet C, Lavaud P, Gazzah A, Lacroix L, Remon J, Caramella C, Planchard D, Mir O, Paci A, Besse B. MA21.09 Tyrosine Kinase Inhibitors' Plasma Concentration and Oncogene-Addicted Advanced Non-Small Lung Cancer (aNSCLC) Resistance. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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156
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Mezquita L, Preeshagul I, Auclin E, Saravia D, Hendriks L, Rizvi H, Planchard D, Park W, Nadal E, Ruffinelli J, Ponce S, Audigier-Valette C, Carnio S, Novello S, Zalcman G, Majem M, Mariniello A, Dingemans A, Lopes G, Rossoni C, Pignon J, Chaput N, Hellmann M, Arbour K, Besse B. MA07.02 Early Change of dNLR Is Correlated with Outcomes in Advanced NSCLC Patients Treated with Immunotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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157
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Malo J, Messaoudene M, Cauchois F, Belkaid W, Frizon-Peresa D, Ikene S, Rousseau L, Lattouf JB, Elkrief A, Mezquita L, Derosa L, Besse B, Blais N, Alameddine R, Tehfe M, Florescu M, Routy B. Cancer patient participation and compliance in microbiome sample collection: An oncology research nurse’s experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz277.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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158
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Ferrara R, Naigeon M, Auclin E, Duchemann B, Cassard L, Medhi J, Boselli L, Grivel J, Desnoyer A, Texier M, Mezquita L, Aboubakar F, Hendriks L, Planchard D, Caramella C, Remon J, Ngocamus M, Nicotra C, Proto C, Sangaletti S, Chaput N, Besse B. P1.04-31 Immunosenescence Correlates with Poor Outcome from PD-(L)1 Blockade but Not Chemotherapy in Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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159
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Gobbini E, Toffart A, Perol M, Assié J, Duruisseaux M, Coupez D, Gervais R, Westeel V, Delaunay M, Guisier F, Veillon R, Gounant V, Leprieur EG, Vanel F, Chaabane N, Dansin E, Babey H, Decroisette C, Barlesi F, Girard N, Fournel P, Mezquita L, Oulkhouir Y, Canellas A, Duchemann B, Molinier O, Moro-Sibilot D, Levra MG. MA07.05 Immune Checkpoint Inhibitor (ICPi) Re-Challenge: Outcomes Analysis in a French National Cohort of Non-Small-Cell Lung Cancer (NSCLC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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160
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Herrera Gomez R, Mezquita L, Auclin E, Heraudet L, Plana M, Salas S, Cristina V, Garcia Castano A, Arrazubi V, Grau J, Saleh K, Cirauqui Cirauqui B, Mesia Nin R, Even C, Taberna M, Daste A, Peters S, Besse B, Baste-Rotllan N. The head and neck lung immune prognostic index (HN-LIPI): A prognostic score for immune checkpoint inhibitors (ICI) in recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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161
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Lefebvre C, Martin E, Hendriks L, Veillon R, Filleron T, Puisset F, Mezquita L, Ferrara R, Sabatier M, Besse B, Dingemans A, Mazieres J. P1.01-120 Immune Checkpoint Inhibitors Versus Second Line Chemotherapy for Patients with Lung Cancer Refractory to First Line Chemotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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162
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Mezquita L, Auclin E, Ferrara R, Charrier M, Remon J, Planchard D, Ponce S, Ares LP, Leroy L, Audigier-Valette C, Felip E, Zerón-Medina J, Garrido P, Brosseau S, Zalcman G, Mazieres J, Caramela C, Lahmar J, Adam J, Chaput N, Soria JC, Besse B. Association of the Lung Immune Prognostic Index With Immune Checkpoint Inhibitor Outcomes in Patients With Advanced Non-Small Cell Lung Cancer. JAMA Oncol 2019; 4:351-357. [PMID: 29327044 DOI: 10.1001/jamaoncol.2017.4771] [Citation(s) in RCA: 549] [Impact Index Per Article: 109.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Derived neutrophils/(leukocytes minus neutrophils) ratio (dNLR) and lactate dehydrogenase (LDH) level have been correlated with immune checkpoint inhibitor (ICI) outcomes in patients with melanoma. Objective To determine whether pretreatment dNLR and LDH are associated with resistance to ICIs in patients with advanced non-small cell lung cancer (NSCLC). Design, Setting, and Participants Multicenter retrospective study with a test (n = 161) and a validation set (n = 305) treated with programmed death 1/programmed death ligand 1 (PD-1/PD-L1) inhibitors in 8 European centers, and a control cohort (n = 162) treated with chemotherapy only. Complete blood cell counts, LDH, and albumin levels were measured before ICI treatment. A lung immune prognostic index (LIPI) based on dNLR greater than 3 and LDH greater than upper limit of normal (ULN) was developed, characterizing 3 groups (good, 0 factors; intermediate, 1 factor; poor, 2 factors). Main Outcomes and Measures The primary end point was overall survival (OS). Secondary end points were progression-free survival (PFS) and disease control rate (DCR). Results In the pooled ICI cohort (N = 466), 301 patients (65%) were male, 422 (90%) were current or former smokers, and 401 (87%) had performance status of 1 or less; median age at diagnosis was 62 (range, 29-86) years; 270 (58%) had adenocarcinoma and 159 (34%) had squamous histologic subtype. Among 129 patients with PD-L1 data, 96 (74%) had PD-L1 of at least 1% by immunohistochemical analysis, and 33 (26%) had negative results. In the test cohort, median PFS and OS were 3 (95% CI, 2-4) and 10 (95% CI, 8-13) months, respectively. A dNLR greater than 3 and LDH greater than ULN were independently associated with OS (hazard ratio [HR] 2.22; 95% CI, 1.23-4.01 and HR, 2.51; 95% CI, 1.32-4.76, respectively). Median OS for poor, intermediate, and good LIPI was 3 months (95% CI, 1 month to not reached [NR]), 10 months (95% CI, 8 months to NR), and 34 months (95% CI, 17 months to NR), respectively, and median PFS was 2.0 (95% CI, 1.7-4.0), 3.7 (95% CI, 3.0-4.8), and 6.3 (95% CI, 5.0-8.0) months (both P < .001). Disease control rate was also correlated with dNLR greater than 3 and LDH greater than ULN. Results were reproducible in the ICI validation cohort for OS, PFS, and DCR, but were nonsignificant in the chemotherapy cohort. Conclusions and Relevance Pretreatment LIPI, combining dNLR greater than 3 and LDH greater than ULN, was correlated with worse outcomes for ICI, but not for chemotherapy, suggesting that LIPI can serve as a potentially useful tool when selecting ICI treatment, raising the hypothesis that the LIPI might be useful for identifying patients unlikely to benefit from treatment with an ICI.
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Affiliation(s)
- Laura Mezquita
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Edouard Auclin
- Medical and Gastrointestinal Oncology Department, Hôpital Européen Georges Pompidou, Paris, France
| | - Roberto Ferrara
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Melinda Charrier
- Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy, Villejuif, France
| | - Jordi Remon
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - David Planchard
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Santiago Ponce
- Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Luis Paz Ares
- Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Laura Leroy
- Medical Oncology Department, Institut Bergonie, Bordeaux, France
| | | | - Enriqueta Felip
- Medical Oncology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | | | - Pilar Garrido
- Medical Oncology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Solenn Brosseau
- Thoracic Oncology Department, CIC1425/CLIP2 Paris-Nord, Hôpital Bichat-Claude Bernard, Paris, France
| | - Gérard Zalcman
- Thoracic Oncology Department, CIC1425/CLIP2 Paris-Nord, Hôpital Bichat-Claude Bernard, Paris, France
| | - Julien Mazieres
- Medical Oncology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | | | - Jihene Lahmar
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Julien Adam
- Pathology Department, Gustave Roussy, Villejuif, France
| | - Nathalie Chaput
- Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy, Villejuif, France.,Faculty of Pharmacy, University Paris-Saclay, Chatenay-Malabry, France
| | - Jean Charles Soria
- Drug Development Department, Gustave Roussy, Villejuif, France.,Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre, France
| | - Benjamin Besse
- Medical Oncology Department, Gustave Roussy, Villejuif, France.,Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre, France
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163
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Rassy E, Mezquita L, Remon J, Besse B. Non-small-cell lung cancer: what are the benefits and challenges of treating it with immune checkpoint inhibitors? Immunotherapy 2019; 11:1149-1160. [DOI: 10.2217/imt-2019-0071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape of advanced non-small-cell lung cancer (NSCLC). It has improved the overall survival in the first- and second-line setting with manageable adverse events. Multiple challenges still impede the success of ICI in the whole population of NSCLC namely the lack of reliable predictive biomarkers, the scarcity of data regarding the optimal treatment duration with ICI and possibility of rechallenge with ICI as well as the efficacy of ICI in special subgroups of patients such as those with oncogenic addicted tumors or patients with brain metastases. In this framework, we review the benefits and challenges of ICI in NSCLC, in monotherapy and in combinations, in the advanced setting.
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Affiliation(s)
- Elie Rassy
- Department of Cancer Medicine, Gustave Roussy Institute, F-94805 Villejuif, France
- Department of Medical Oncology, Faculty of Medicine, Saint Joseph University, Lebanon
| | - Laura Mezquita
- Department of Cancer Medicine, Gustave Roussy Institute, F-94805 Villejuif, France
| | - Jordi Remon
- Centroi Integral Oncología Clara Campal Barcelona – HM Delfos, Barcelona, Spain
| | - Benjamin Besse
- Department of Cancer Medicine, Gustave Roussy Institute, F-94805 Villejuif, France
- Université Paris Sud, Université Paris-Saclay, F-94270 Le Kremlin-Bicêtre, France
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164
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Pailler E, Faugeroux V, Oulhen M, Mezquita L, Laporte M, Honoré A, Lecluse Y, Queffelec P, NgoCamus M, Nicotra C, Remon J, Lacroix L, Planchard D, Friboulet L, Besse B, Farace F. Acquired Resistance Mutations to ALK Inhibitors Identified by Single Circulating Tumor Cell Sequencing in ALK-Rearranged Non-Small-Cell Lung Cancer. Clin Cancer Res 2019; 25:6671-6682. [PMID: 31439588 DOI: 10.1158/1078-0432.ccr-19-1176] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/04/2019] [Accepted: 08/13/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Patients with anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) inevitably develop resistance to ALK inhibitors. New diagnostic strategies are needed to assess resistance mechanisms and provide patients with the most effective therapy. We asked whether single circulating tumor cell (CTC) sequencing can inform on resistance mutations to ALK inhibitors and underlying tumor heterogeneity in ALK-rearranged NSCLC. EXPERIMENTAL DESIGN Resistance mutations were investigated in CTCs isolated at the single-cell level from patients at disease progression on crizotinib (n = 14) or lorlatinib (n = 3). Three strategies including filter laser-capture microdissection, fluorescence activated cell sorting, and the DEPArray were used. One hundred twenty-six CTC pools and 56 single CTCs were isolated and sequenced. Hotspot regions over 48 cancer-related genes and 14 ALK mutations were examined to identify ALK-independent and ALK-dependent resistance mechanisms. RESULTS Multiple mutations in various genes in ALK-independent pathways were predominantly identified in CTCs of crizotinib-resistant patients. The RTK-KRAS (EGFR, KRAS, BRAF genes) and TP53 pathways were recurrently mutated. In one lorlatinib-resistant patient, two single CTCs out of 12 harbored ALK compound mutations. CTC-1 harbored the ALK G1202R/F1174C compound mutation virtually similar to ALK G1202R/F1174L present in the corresponding tumor biopsy. CTC-10 harbored a second ALK G1202R/T1151M compound mutation not detected in the tumor biopsy. By copy-number analysis, CTC-1 and the tumor biopsy had similar profiles, whereas CTC-10 harbored multiple copy-number alterations and whole-genome duplication. CONCLUSIONS Our results highlight the genetic heterogeneity and clinical utility of CTCs to identify therapeutic resistance mutations in ALK-rearranged patients. Single CTC sequencing may be a unique tool to assess heterogeneous resistance mechanisms and help clinicians for treatment personalization and resistance options to ALK-targeted therapies.
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Affiliation(s)
- Emma Pailler
- Gustave Roussy, Université Paris-Saclay, "Rare Circulating Cells" Translational Platform, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France.,INSERM, U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment," Villejuif, France.,Univ Paris Sud, Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Vincent Faugeroux
- Gustave Roussy, Université Paris-Saclay, "Rare Circulating Cells" Translational Platform, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France.,INSERM, U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment," Villejuif, France.,Univ Paris Sud, Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Marianne Oulhen
- Gustave Roussy, Université Paris-Saclay, "Rare Circulating Cells" Translational Platform, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France.,INSERM, U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment," Villejuif, France
| | - Laura Mezquita
- Gustave Roussy, Université Paris-Saclay, Department of Medicine, Villejuif, France
| | - Mélanie Laporte
- Gustave Roussy, Université Paris-Saclay, Genomic Platform and Biobank, Department of Medical Biology and Pathology, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France
| | - Aurélie Honoré
- Gustave Roussy, Université Paris-Saclay, Genomic Platform and Biobank, Department of Medical Biology and Pathology, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France
| | - Yann Lecluse
- Gustave Roussy, Université Paris-Saclay, "Flow Cytometry and Imaging" Platform, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France
| | - Pauline Queffelec
- Gustave Roussy, Université Paris-Saclay, "Rare Circulating Cells" Translational Platform, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France.,INSERM, U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment," Villejuif, France
| | - Maud NgoCamus
- Gustave Roussy, Université Paris-Saclay, Department of Medicine, Villejuif, France
| | - Claudio Nicotra
- Gustave Roussy, Université Paris-Saclay, Department of Medicine, Villejuif, France
| | - Jordi Remon
- Gustave Roussy, Université Paris-Saclay, Department of Medicine, Villejuif, France
| | - Ludovic Lacroix
- Gustave Roussy, Université Paris-Saclay, Genomic Platform and Biobank, Department of Medical Biology and Pathology, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France
| | - David Planchard
- Gustave Roussy, Université Paris-Saclay, Department of Medicine, Villejuif, France
| | - Luc Friboulet
- INSERM, U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment," Villejuif, France.,Univ Paris Sud, Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Benjamin Besse
- Univ Paris Sud, Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France.,Gustave Roussy, Université Paris-Saclay, Department of Medicine, Villejuif, France
| | - Françoise Farace
- Gustave Roussy, Université Paris-Saclay, "Rare Circulating Cells" Translational Platform, CNRS UMS3655 - INSERM US23 AMMICA, Villejuif, France. .,INSERM, U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment," Villejuif, France.,Univ Paris Sud, Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
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165
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Benitez JC, Mezquita L, Colle R, Tselikas L, Botticella A, Caramella C, Besse B. Hepatic Intra-Arterial Chemotherapy With Immunotherapy in NSCLC. J Thorac Oncol 2019; 14:e215-e216. [PMID: 31302233 DOI: 10.1016/j.jtho.2019.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/14/2019] [Accepted: 07/01/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Jose Carlos Benitez
- Medical Oncology Department, Hospital Universitari Mutua Terrassa, Barcelona, Spain
| | - Laura Mezquita
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Rapahël Colle
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | | | | | | | - Benjamin Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, France; Paris-Sud University, Orsay, France.
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166
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Leclerc M, Mezquita L, Guillebot De Nerville G, Tihy I, Malenica I, Chouaib S, Mami-Chouaib F. Recent Advances in Lung Cancer Immunotherapy: Input of T-Cell Epitopes Associated With Impaired Peptide Processing. Front Immunol 2019; 10:1505. [PMID: 31333652 PMCID: PMC6616108 DOI: 10.3389/fimmu.2019.01505] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/17/2019] [Indexed: 12/26/2022] Open
Abstract
Recent advances in lung cancer treatment are emerging from new immunotherapies that target T-cell inhibitory receptors, such as programmed cell death-1 (PD-1). However, responses to anti-PD-1 antibodies as single agents are observed in fewer than 20% of non-small-cell lung cancer (NSCLC) patients, and immune mechanisms involved in the response to these therapeutic interventions remain poorly elucidated. Accumulating evidence indicates that effective anti-tumor immunity is associated with the presence of T cells directed toward cancer neoepitopes, a class of major histocompatibility complex (MHC)-bound peptides that arise from tumor-specific mutations. Nevertheless, tumors frequently use multiple pathways to escape T-cell recognition and destruction. In this regard, primary and acquired resistance to immune checkpoint blockade (ICB) therapy was associated with alterations in genes relevant to antigen presentation by MHC-class I/beta-2-microglobulin (MHC-I/β2m) complexes to CD8 T lymphocytes. Among additional known mechanisms involved in tumor resistance to CD8 T-cell immunity, alterations in transporter associated with antigen processing (TAP) play a major role by inducing a sharp decrease in surface expression of MHC-I/β2m-peptide complexes, enabling malignant cells to evade cytotoxic T lymphocyte (CTL)-mediated killing. Therefore, development of novel immunotherapies based on tumor neoantigens, that are selectively presented by cancer cells carrying defects in antigen processing and presentation, and that are capable of inducing destruction of such transformed cells, is a major challenge in translational research for application in treatment of lung cancer. In this context, we previously identified a non-mutant tumor neoepitope, ppCT16−25, derived from the preprocalcitonin (ppCT) leader sequence and processed independently of proteasomes/TAP by a mechanism involving signal peptidase (SP) and signal peptide peptidase (SPP). We also provided in vitro and in vivo proof of the concept of active immunotherapy based on ppCT-derived peptides capable of controlling growth of immune-escaped tumors expressing low levels of MHC-I molecules. Thus, non-mutant and mutant neoepitopes are promising T-cell targets for therapeutic cancer vaccines in combination with ICB. In this review, we summarize current treatments for lung cancer and discuss the promises that conserved neoantigens offer for more effective immunotherapies targeting immune-escaped tumor variants.
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Affiliation(s)
- Marine Leclerc
- INSERM UMR 1186, Integrative Tumor Immunology and Genetic Oncology, Gustave Roussy, EPHE, PSL, Faculté de Médecine - Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Laura Mezquita
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Guillaume Guillebot De Nerville
- INSERM UMR 1186, Integrative Tumor Immunology and Genetic Oncology, Gustave Roussy, EPHE, PSL, Faculté de Médecine - Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Isabelle Tihy
- INSERM UMR 1186, Integrative Tumor Immunology and Genetic Oncology, Gustave Roussy, EPHE, PSL, Faculté de Médecine - Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Ines Malenica
- INSERM UMR 1186, Integrative Tumor Immunology and Genetic Oncology, Gustave Roussy, EPHE, PSL, Faculté de Médecine - Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Salem Chouaib
- INSERM UMR 1186, Integrative Tumor Immunology and Genetic Oncology, Gustave Roussy, EPHE, PSL, Faculté de Médecine - Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Fathia Mami-Chouaib
- INSERM UMR 1186, Integrative Tumor Immunology and Genetic Oncology, Gustave Roussy, EPHE, PSL, Faculté de Médecine - Université Paris-Sud, Université Paris-Saclay, Villejuif, France
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Recondo G, Mezquita L, Planchard D, Gazzah A, Facchinetti F, Bigot L, Rizvi AZ, Thiery JP, Scoazec JY, Frias RL, Sourisseau T, Mahjoubi L, Galissant J, Abou-Lovergne A, Vassal G, Bahleda R, Hollebecque A, Nicotra C, Ngocamus M, Michiels S, Lacroix L, Richon C, Auger N, Baere TD, Deschamps F, Solary E, Olaussen KA, Angevin E, Eggermont A, André F, Massard C, Soria JC, Besse B, Friboulet L. Abstract 311: Diverse biological mechanisms drive resistance to Lorlatinib in ALK-rearranged Lung Cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: ALK rearrangements occur in 3-6% of patients (pts) with lung adenocarcinoma. Lorlatinib, is a novel third generation ALK tyrosine kinase inhibitor (TKI) with proven efficacy for patients previously treated with second generation ALK TKI.
Methods: The MATCH-R study is a prospective single-institution trial aiming to identify mechanisms of resistance to targeted agents and immunotherapy in pts with advanced cancer (NCT02517892). Patients that achieve an initial partial or complete response or stability of disease for at least 6 months with selected agents are included upon disease progression. Tumor biopsies are performed and serial blood samples are collected. Extensive molecular profiling with panel next-generation sequencing (NGS), whole exome sequencing (WES) and RNA sequencing (RNAseq) is performed on tumor samples. Patient-derived xenografts (PDX) in NOD scid gamma (NSG) or nude mice and patient-derived cell lines are developed. We report mechanisms of resistance in a cohort of pts with ALK-rearranged lung cancer treated with lorlatinib.
Results: From June 29th 2015 to November 15th 2018, 113 pts treated with a TKI were included in the MATCH-R study, of which 14 (12%) received treatment with ALK TKI, 6 pts treated with lorlatinib and with adequate tumor biopsies for molecular analysis were included. Tumor types studied were lung adenocarcinoma (n=4), anaplastic thyroid carcinoma (ATC, n=1) and myofibroblastic inflammatory tumor (MIT, n=1). An NF2 frame-shift deletion was detected by NGS in the ATC sample and a TNIK Q674 missense mutation was detected in the MIT sample. In the four pts with lung cancer treated with lorlatinib, we identified novel ALK G1202R/F1174L compound mutations from the tumor biopsy in one case and characterized them with Ba/F3 models (ctDNA analysis will be presented). Induction of epithelial mesenchymal transition (EMT) with lorlatinib exposure was responsible for resistance in one patient-derived model and susceptible to combined ALK/SRC inhibition. This cell line also had ALK C1156Y/G1269A compound mutations, not contributing to lorlatinib resistance. In a third case, double deleterious events in NF2 were identified in temporo-spatial distinct tumor biopsies on progression to lorlatinib. We further validated the effect of these events in patient-derived cell lines developed from two different biopsies. Downstream mTOR pathway activation conferred resistance to lorlatinib, and was reversible with mTOR inhibitors. We performed NF2 knockout in H3122 cells using Crispr-Cas9 gene editing to validate these findings. The resistance mechanism to lorlatinib treatment is yet to be elucidated in one patient-derived model.
Conclusions: Mechanisms of resistance to lorlatinib can be diverse and complex, involving compound mutations, EMT and bypass activation. The present evidence could provide new insights for the development of tailored treatments for patients.
Citation Format: Gonzalo Recondo, Laura Mezquita, David Planchard, Anas Gazzah, Francesco Facchinetti, Ludovic Bigot, Ahsan Z. Rizvi, Jean-Paul Thiery, Jean-Yves Scoazec, Rosa L. Frias, Tony Sourisseau, Linda Mahjoubi, Justine Galissant, Aurelie Abou-Lovergne, Gilles Vassal, Rastislav Bahleda, Antoine Hollebecque, Claudio Nicotra, Maud Ngocamus, Stefan Michiels, Ludovic Lacroix, Catherine Richon, Nathalie Auger, Thierry De Baere, Frederic Deschamps, Eric Solary, Ken A. Olaussen, Eric Angevin, Alexander Eggermont, Fabrice André, Christophe Massard, Jean-Charles Soria, Benjamin Besse, Luc Friboulet. Diverse biological mechanisms drive resistance to Lorlatinib in ALK-rearranged Lung Cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 311.
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Affiliation(s)
| | | | | | | | | | | | | | - Jean-Paul Thiery
- 2Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Hendriks LE, Bootsma G, Mourlanette J, Henon C, Mezquita L, Ferrara R, Audigier-Valette C, Mazieres J, Lefebvre C, Duchemann B, Cousin S, le Pechoux C, Botticella A, De Ruysscher D, Dingemans AMC, Besse B. Survival of patients with non-small cell lung cancer having leptomeningeal metastases treated with immune checkpoint inhibitors. Eur J Cancer 2019; 116:182-189. [DOI: 10.1016/j.ejca.2019.05.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/04/2019] [Accepted: 05/12/2019] [Indexed: 11/24/2022]
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169
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Mezquita L, Benito A, Ruano-Raviña A, Zamora J, Olmedo ME, Reguera P, Madariaga A, Villamayor M, Cortez SP, Gorospe L, Santón A, Mayoralas S, Hernanz R, Cabañero A, Auclin E, Carrato A, Garrido P. Indoor Radon in EGFR- and BRAF-Mutated and ALK-Rearranged Non-Small-Cell Lung Cancer Patients. Clin Lung Cancer 2019; 20:305-312.e3. [PMID: 31151782 DOI: 10.1016/j.cllc.2019.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/26/2019] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Radon gas is the leading cause of lung cancer in the nonsmoking population. The World Health Organization (WHO) recommends indoor concentrations of < 100 Bq/m³. Several molecular alterations have been described in non-small-cell lung cancer (NSCLC), mainly in nonsmokers, with no risk factors identified. We studied the role of indoor radon in NSCLC patients harboring specific driver alterations. PATIENTS AND METHODS We assessed the radon concentration from EGFR-, BRAF-mutated (m), and ALK-rearranged (r) NSCLC patients measured by an alpha-track detector placed in their homes between September 2014 and August 2015. Clinical characteristics were collected prospectively, and pathologic samples were reviewed retrospectively. RESULTS Forty-eight patients were included (36 EGFRm, 10 ALKr, 2 BRAFm). Median radon concentration was 104 Bq/m³ (IQR 69-160) overall, and was 96 Bq/m³ (42-915) for EGFRm, 116 (64-852) for ALKr, and 125 for BRAFm, with no significant differences. Twenty-seven patients (56%) had indoor radon above WHO recommendations, 8 (80%) of 10 ALKr, 2 (100%) of 2 BRAFm, and 17 (47%) of 36 EGFRm. CONCLUSION The median indoor radon concentration was above the WHO recommendations, with no differences between EGFR, ALK, and BRAF patients. Concentrations above the WHO recommendations were most common with ALKr and BRAFm. These findings should be validated in larger studies.
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Affiliation(s)
- Laura Mezquita
- Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain; Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
| | - Amparo Benito
- Pathology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Alberto Ruano-Raviña
- Public Health Department, School of Medicine Santiago de Compostela University, Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Javier Zamora
- CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain; Clinical Biostatistics Unit, Ramón y Cajal University Hospital, Research Institute Ramón y Cajal (IRYCIS), Madrid, Spain
| | | | - Pablo Reguera
- Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Ainhoa Madariaga
- Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - María Villamayor
- Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | | | - Luis Gorospe
- Radiology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Almudena Santón
- Pathology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | | | - Raúl Hernanz
- Radiotherapy Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Alberto Cabañero
- Thoracic Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Edouard Auclin
- Medical and Gastrointestinal Oncology Department, Georges Pompidou Hospital, Paris, France
| | - Alfredo Carrato
- Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain; Medicine Department, Universidad de Alcalá, Research Institute Ramón y Cajal (IRYCIS), CIBER Oncology (CIBERONC), Madrid, Spain
| | - Pilar Garrido
- Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain; Medicine Department, Universidad de Alcalá, Research Institute Ramón y Cajal (IRYCIS), CIBER Oncology (CIBERONC), Madrid, Spain.
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170
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Skoulidis F, Arbour KC, Hellmann MD, Patil PD, Marmarelis ME, Awad MM, Murray JC, Hellyer J, Gainor JF, Dimou A, Bestvina CM, Shu CA, Riess JW, Blakely CM, Pecot CV, Mezquita L, Tabbò F, Scheffler M, Papadimitrakopoulou V, Heymach J. Association of STK11/LKB1 genomic alterations with lack of benefit from the addition of pembrolizumab to platinum doublet chemotherapy in non-squamous non-small cell lung cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.102] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
102 Background: Addition of pembrolizumab (P) to platinum-doublet chemotherapy [carboplatin (or cisplatin) and pemetrexed (CP)] prolongs overall survival and is a standard of care (SOC) for the 1st line treatment of metastatic EGFR/ALK wild-type (wt) non-squamous non-small cell lung cancer (mnsNSCLC). Despite widespread adoption of the CPP regimen, molecular determinants of clinical benefit from the addition of P to CP remain poorly defined. We previously identified genomic alterations in STK11/LKB1 as a major driver of primary resistance to PD-1/PD-L1 blockade in mnsNSCLC. Here, we examine the impact of STK11/LKB1 alterations on clinical outcomes with CPP chemo-immunotherapy. Methods: 497 pts with mnsNSCLC and tumor genomic profiling encompassing STK11/LKB1 from 17 academic institutions in the US and Europe were included in this study. Clinical outcomes were collected for two distinct patient cohorts: a) 377 pts treated with first-line CPP (or > 1st line following FDA-approved TKIs) that were alive for 14 days thereafter and b) 120 STK11/LKB1-mt pts that received CP prior to regulatory approval of CPP. Results: Among 377 CPP-treated pts, STK11/LKB1 genomic alterations (N = 102) were associated with significantly shorter PFS (mPFS 4.8m vs 7.2m, HR 1.5, 95% CI 1.1 to 2.0; P = 0.0063) and shorter OS (mOS 10.6m vs 16.7m, HR 1.58, 95% CI 1.09 to 2.27; P = 0.0083) compared with STK11/LKB1-wt tumors (N = 275). ORR also differed significantly between the two groups (32.6% vs 44.7%, P = 0.049). Similar results were obtained when limiting the analysis to EGFR and ALK-wt tumors (N = 333). Importantly, in pts with STK11/LKB1-mt mnsNSCLC, addition of pembrolizumab to CP did not improve PFS (mPFS 4.8m vs 4.3m, HR 1.13, 95% CI 0.83 to 1.54, P = 0.75) or OS (mOS 10.6m vs 10.3m, HR 1.03, 95% CI 0.71 to 1.49, P = 0.79) compared to CP alone. Conclusions: In mnsNSCLC, STK11/LKB1 alterations define a subgroup of pts with inferior clinical outcomes with CPP and lack of benefit from the addition of pembrolizumab to CP chemotherapy. Novel therapeutic strategies are required to establish effective antitumor immunity in STK11/LKB1-mutant NSCLC.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Laura Mezquita
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Matthias Scheffler
- Lung Cancer Group Cologne, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Dept. I of Internal Medicine, Cologne, Germany
| | | | - John Heymach
- The University of Texas MD Anderson Cancer Center, Houston, TX
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Mezquita L, Swalduz A, Jovelet C, Ortiz-Cuaran S, Planchard D, Recondo G, Benitez JC, Howarth K, Morris CD, Green E, Lacroix L, Odier L, Rouleau E, Fournel P, Caramella C, Tissot C, Perol M, Friboulet L, Besse B, Saintigny P. Efficacy of tyrosine kinase inhibitors (TKIs) based on the ALK resistance mutations on amplicon-based liquid biopsy in ALK positive non-small cell lung cancer (NSCLC) patients (pts). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.3055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3055 Background: Acquired ALK resistance mutations (mut.) are the main mechanism of tyrosine kinase inhibitor (TKI) resistance (30-50%). While next-generation TKIs are more active on mut. than earlier TKIs, compound ALK resistance are associated with failure to next-generation TKIs. We evaluated the clinical utility of detecting ALK resistance mutations in blood to predict TKI efficacy. Methods: ALK positive advanced NSCLC pts were prospectively enrolled between Oct. 2015 and Aug. 2018 in 8 French institutions. Prospective samples were collected; ctDNA was analyzed by amplicon-based Inivata InVisionFirst-Lung. Results: A total of 101 pts with advanced ALK positive NSCLC were enrolled and 328 samples collected. In samples collected at TKI failure (N=74), we detected 9 single and 7 complex (≥2) ALK resistance mut. (22%), associated with EML4-ALK variant 3 (38%) vs. variant 2 (13%) vs. variant 1 (none); 30% had other somatic mut. (mainly TP53 and KRAS, PI3KCA, MET, etc.). No mutations were detected in 48% of samples (ctDNA neg). ALK mut. were more frequent after 2nd/3rd generation TKI (43% post-lorlatinib (7), 29% post-2nd gen. (31), 11% post-crizotinib (36)). ALKG1202R was the most common, as single (n=3) or complex mut. (n=4). The median overall survival (mOS) was 100.4 mo. (95% CI 41.9-158.9) and the median progression free-survival (mPFS) to subsequent line was 2.8 mo. (0.7-4.9). Patients with ctDNA neg had mOS of 105 mo. (39.3-172.1) vs. 58.5 mo. (33.1-84.0) if ≥1 ALK mut. vs. 44.1 mo. (20.0-68.2) if others ( P=0.001). Pts with the complex ALK mut. had worse OS compared to singles ALK mut. (mOS 26.9 mo. vs. 58.5 mo., P=0.001); ALK complex mut. were associated with poor efficacy to subsequent therapy (PFS <3 mo. in 57%; no cases with PFS >6 mo.) vs. single mut., with longer PFS (PFS >6 mo. in 56%). Detectable ALKG1202R mut. were associated with shorter median OS (58.3 mo.; 7.9-109.1) vs. overall population; 86% of cases developed rapid PD (PFS <3mo.) to subsequent therapy with only one durable response to lorlatinib (PFS >6mo.). Conclusions: The absence of ctDNA mutations at TKI failure was associated with prolonged OS, whereas complex ALK mutations at TKI failure may predict resistance to subsequent therapy. Larger and specifically designed studies should be performed to validate these findings.
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Affiliation(s)
- Laura Mezquita
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Aurélie Swalduz
- Department of Thoracic Oncology, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France
| | - Cecile Jovelet
- Translational Reseach Laboratory, Gustave Roussy, Villejuif, France
| | - Sandra Ortiz-Cuaran
- INSERM U1052, CNRS UMR 5286, Cancer Research Center of Lyon, Université de Lyon, Centre Léon Bérard, Université Lyon 1, ISPB, Faculté de Pharmacie de Lyon, Lyon, France
| | - David Planchard
- Medical Oncology Department, Thoracic Group, Gustave Roussy, Villejuif, France
| | | | | | | | | | | | | | | | | | - Pierre Fournel
- GFPC (France), Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | | | - Claire Tissot
- Acute Respiratory Medicine and Thoracic Oncology Department Lyon Sud Hospital and Lyon University Cancer Institute, International Agency for Research on Cancer, Molecular Mechanisms and Biomarkers Group, Pierre Benite, France
| | - Maurice Perol
- Department of Thoracic Oncology, Centre Léon Bérard, Lyon, France
| | | | - Benjamin Besse
- Paris-Sud University, Orsay and Gustave Roussy, Villejuif, France
| | - Pierre Saintigny
- INSERM U1052, CNRS UMR 5286, Cancer Research Center of Lyon, Université de Lyon, Centre Léon Bérard, Université Lyon 1, ISPB, Faculté de Pharmacie de Lyon, Lyon, France
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Aldea M, Mezquita L, Hendriks L, Auclin E, Remon J, Planchard D, Jovelet C, Benitez JC, Gazzah A, Lavaud P, Naltet C, Lacroix L, Morris CD, Green E, Howarth K, Nicotra C, Besse B. Circulating tumor DNA analysis (ctDNA) for genomic testing in NSCLC patients with isolated CNS progression. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2015 Background: Genomic DNA profiles are mandatory in advanced, treatment naive non-small cell lung cancer (NSCLC) patients (pts) and strongly recommended at progression (PD) on personalized treatment. In pts with PD limited to central nervous system (CNS), tissue biopsy is difficult and the performance of ctDNA is unknown. Methods: Clinical, molecular, imaging data of NSCLC pts included in 2 prospective studies from 01.2016 to 11.2018 at Gustave Roussy were collected. Inclusion criteria were: stage IV disease and any known tissue genomic alteration (GA) EGFR, ALK, BRAF, KRAS, HER2, ROS1, MET, PIK3CA, TP53. Plasma ctDNA collected at baseline/PD were analyzed by next-generation sequencing (NGS-InVisionFirst™-Lung) in 3 groups: pts with isolated CNS (iCNS), extra-CNS only (noCNS) or both combined (cCNS) disease. iCNS was defined as any PD to CNS, while stable/absent extra-CNS metastases (mts). ctDNA was considered positive if ≥1 GA was found. ctDNA in cerebrospinal fluid (CSF) were also collected. Results: Out of 245 pts with ≥1 ctDNA: 56 had iCNS (66 samples), 97 noCNS (127 samples) and 92 cCNS (107 samples). In this cohort, 60% were female, median age 60 years, 47% smokers; 92% had adenocarcinoma. The median number of mts sites was 3 in noCNS/cCNS groups. Proportions of tissue GA at baseline were (iCNS vs noCNS/cCNS): EGFR (50% vs 44%), ALK (30% vs 11%), BRAF (4% vs 12%), KRAS (5% vs 15%), HER2 (2% vs 5%), ROS1 (5% vs 4%). Tyrosine kinase inhibitors were used in 73% iCNS vs 61% noCNS/cCNS. Local brain treatments were performed in 43% (n = 24) vs 32% (n = 29) and leptomeningeal mts (LM) detected in 34% (n = 19) vs 8% (n = 9), in iCNS and cCNS, respectively. CtDNA was positive (+) in 52% in iCNS vs 84% in noCNS and 92% in cCNS (p < 0.0001). In iCNS, there was a non-significantly higher proportion of + ctDNA in pts with LM vs only brain disease (59 vs 48%, P = 0.44). 12/56 pts of iCNS group had serial ctDNA, being collected also at time of cCNS. In 25% of cases, a negative ctDNA at time of iCNS shifted to + at time of cCNS. In 12 iCNS pts, ctDNA was + in 6 (50%) plasma and in 10 (83%) paired CSF (p = 0.193). Conclusions: Detection of GA by plasma ctDNA is lower in NSCLC pts with isolated CNS PD. Alternative strategies (as CSF analysis) should be explored.
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Affiliation(s)
- Mihaela Aldea
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Laura Mezquita
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Edouard Auclin
- Gastrointestinal Oncology Department, European Georges Pompidou Hospital, Paris, France
| | | | - David Planchard
- Medical Oncology Department, Thoracic Group, Gustave Roussy, Villejuif, France
| | - Cecile Jovelet
- Translational Reseach Laboratory, Gustave Roussy, Villejuif, France
| | | | - Anas Gazzah
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - Pernelle Lavaud
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Charles Naltet
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | | | | | | | - Claudio Nicotra
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - Benjamin Besse
- Paris-Sud University, Orsay and Gustave Roussy, Villejuif, France
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Ferrara R, Mezquita L, Texier M, Lahmar J, Audigier-Valette C, Tessonnier L, Mazieres J, Brosseau S, Leroy L, Duchemann B, Lefebvre C, Veillon R, Westeel V, Champiat S, Planchard D, Remon J, Gazzah A, Soria JC, Caramella C, Besse B. Fast-progression (FP), hyper-progression (HPD) and early deaths (ED) in advanced non-small cell lung cancer (NSCLC) patients (pts) upon PD-(L)-1 blockade (IO). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.9107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9107 Background: HPD was described in 13.8% of NSCLC pts upon single-agent IO and correlated with high metastatic burden and poor prognosis. Other progression (PD) patterns as FP and ED within 12 weeks have been reported respectively in 4.7% and 5.6% of atezolizumab treated NSCLC pts. Whether FP/ED and HPD are different or overlapping patterns is currently unknown. Methods: We analyzed FP, ED and HPD in a multicentric (8 centers) retrospective cohort of IO treated NSCLC pts (11/2012-04/2017). Eligibility criteria required 2 CT scans before and one after IO start. HPD was defined as RECIST v 1.1 PD at first CT scan and a variation per month of tumor growth rate (TGR upon IO – TGR before IO) > 50%. ED was defined as deaths due to disease PD within 12 wks of IO start. FP was defined as ≥ 50% increase in the sum of long diameters within 6 weeks (wks) from baseline. The associations between PD patterns and pts’ characteristics were performed using Fisher or t-student tests. Median overall survival (mOS) was estimated by Kaplan-Meier method and compared by log-rank test. Results: Out of 406 NSCLC pts, 46% were ≥65 years, 72% had non-squamous NSCLC, > 90% received single agent IO in ≥2 line. 56 (13.8%) were HPD by TGR analysis. Among 72 pts (18%) who performed a CT scan within 6 wks after IO start, 6 (8.3%) were FP. These 6 FP pts were also classified as HPD by TGR analysis, while the other 50 (89%) of 56 HPD pts were not FP. The rate of PD in ≥ 3 sites (54% vs 0%, p = 0.002), the rate of liver PD (62% vs 5%, p = 0.002), the baseline tumor burden (BTB) (mean 176± 26 mm vs 55 ± 6 mm, p < 0.0001) and the TGR upon IO (mean 439± 119% vs 216 ± 41%, p = 0.03) were significantly higher in FP pts compared to HPD pts who were not FP. At 4.4 months of median follow-up, FP pts had significantly worse mOS compared to HPD pts not FP [0.7 months (95% CI 0.6,0.8) vs 1.6 months (95% CI 1.1, 2.1); p = 0.02]. Of 406 IO treated pts, 46 (11%) were ED within 12 wks, and 21 (46%) of ED pts had also HPD by TGR analysis. Conclusions: FP and ED are not a surrogate of HPD. FP occurs in a small subgroup (11%) of HPD and correlates with more aggressive features (PD in ≥3 sites, liver-PD, high BTB, high TGR upon IO) and worse OS. ED within 12 wks overlapped with HPD for only 46% of pts.
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Affiliation(s)
- Roberto Ferrara
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Mezquita
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Jihene Lahmar
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Laurent Tessonnier
- Nuclear Medicine Department, Centre Hospitalier Toulon Sainte-Musse, Toulon, France
| | - Julien Mazieres
- Hôpital Larrey, Centre Hospitalier Universitaire Toulouse, Toulouse, France
| | - Solenn Brosseau
- Hôpital Bichat, Assistance Publique-Hôpitaux de Paris (Paris public hospitals), Paris, France
| | | | - Boris Duchemann
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
| | | | - Remi Veillon
- CHU Bordeaux, Service Des Maladies Respiratoires, Bordeaux, France
| | | | | | - David Planchard
- Medical Oncology Department, Thoracic Group, Gustave Roussy, Villejuif, France
| | - Jordi Remon
- Centro Integral Oncología Clara Campal Barcelona, HM-Delfos, Barcelona, Spain
| | - Anas Gazzah
- Department of Drug Development (DITEP), Gustave Roussy, Villejuif Cedex, France
| | | | | | - Benjamin Besse
- Paris-Sud University, Orsay and Gustave Roussy, Villejuif, France
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Flippot R, Biondani P, Auclin E, Xiao D, Hendriks L, Le Rhun E, Leduc C, Beau-Faller M, Gervais R, Remon J, Adam J, Planchard D, Lavaud P, Naltet C, Caramella C, Le Pechoux C, Lacroix L, Gazzah A, Mezquita L, Besse B. Activity of EGFR Tyrosine Kinase Inhibitors in NSCLC With Refractory Leptomeningeal Metastases. J Thorac Oncol 2019; 14:1400-1407. [PMID: 31108248 DOI: 10.1016/j.jtho.2019.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Leptomeningeal metastases (LMs) are associated with dismal prognosis in NSCLC. Optimal management remains unknown in patients with EGFR-mutated NSCLC after initial tyrosine kinase inhibitor (TKI) failure. METHODS We conducted a multicenter retrospective study including patients with EGFR-mutated NSCLC and LM. TKI failure was defined as diagnosis of LM on TKI, or progression of known LM on TKI. RESULTS Ninety-two patients were included, median age of 60 years, predominantly female (68%), never-smokers (74%). EGFR mutations included L858R (45%), exon 19 deletions (28%), or other mutations (14%). Median time to LM diagnosis was 18.5 months after initial diagnosis of advanced NSCLC. LM was diagnosed after a median of 2 (range: 0-9) systemic therapies. Median overall survival from LM diagnosis was 6.1 months (95% confidence interval [CI]: 4.2-7.6 months). Among 87 patients with TKI failure, patients rechallenged with TKI (n = 50) had a median LM overall survival of 7.6 months (95% CI: 5.7-10.9) compared to 4.2 months (95% CI: 1.6-6.7) in patients without further therapy. Overall, 60% of patients rechallenged with TKI experienced clinical benefit (clinical response or stable disease >2 months), and 23% were treatment failure-free at 6 months. Clinical benefit was reported in 11 of 20 (55%) patients treated with erlotinib after afatinib or gefitinib. Strategies based on increasing dose intensity (n = 17) yielded clinical benefit in 59% of patients. All four patients who received osimertinib after first- and second-generation TKI experienced clinical benefit. CONCLUSIONS TKI rechallenge strategies, including dosing intensification, may improve clinical outcomes of patients with LM from EGFR-mutated NSCLC after initial TKI failure.
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Affiliation(s)
- Ronan Flippot
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Pamela Biondani
- Department of Medical Oncology, Paul Brousse Hospital, Villejuif, France
| | - Edouard Auclin
- Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Paris, France
| | - Dingyu Xiao
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Lizza Hendriks
- Department of Medical Oncology, Gustave Roussy, Villejuif, France; Department of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, Netherlands
| | - Emilie Le Rhun
- University of Lille, Lille, France; Neuro-oncology, General and Stereotaxic Neurosurgery Department, Lille University Hospital, Lille, France; Breast Cancer Department, Oscar Lambret Center, Lille, France; Department of Neurology & Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Charlotte Leduc
- Department of Pneumology, Strasbourg University Hospital, Strasbourg, France
| | - Michèle Beau-Faller
- Department of Molecular Biology, Strasbourg University Hospital, Strasbourg, France
| | - Radj Gervais
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Jordi Remon
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Julien Adam
- Department of Pathology, Gustave Roussy, Villejuif, France
| | - David Planchard
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Pernelle Lavaud
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Charles Naltet
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | | | | | - Ludovic Lacroix
- Department of Molecular Biology, Gustave Roussy, Villejuif, France
| | - Anas Gazzah
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Laura Mezquita
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Benjamin Besse
- Department of Medical Oncology, Gustave Roussy, Villejuif, France; Paris-Sud University, Orsay, France.
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Mezquita L, Ruiz-Valero L, Martínez-Gómez N, Ibáñez MI, Ortet G. Development and Validation of the Marijuana Motives Measure Short Form. Adicciones 2019; 31:106-116. [PMID: 29353298 DOI: 10.20882/adicciones.979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Marijuana motives are a proximal variable to marijuana use. This research aimed to adapt and validate the short form of the Marijuana Motives Measure (MMM; Simons, Correia, Carey, y Borsari, 1998), the MMM SF, in Spanish. The sample comprised 232 participants (mean age = 25.11 (7.58), 50.43% males) who had tried marijuana at least once in their lifetime. Item and Rasch analyses were performed to choose the final pool of 15 items. Confirmatory Factor Analysis (CFA) showed an adequate 5-factor structure (S-BX2(80) = 121.30, p = .002; NNFI = .944; CFI = .958; IFI = .959; MFI = .915; RMSEA = .047(0.029, 0.063); AIC = -38.70), and the multi-group CFA between males and females showed acceptable fit indices (S-BX2(160) = 230.01, p = .000; NNFI = .900; CFI = .924; IFI = .927; MFI = .860; RMSEA = .062(.043, .078); AIC = -89.99). The questionnaire indicated metric (S-BX2diff (15) = 13.61, p = .556)), scalar (S-BX2diff (15) = 23.15, p = .081)) and error measurement invariance (S-BX2diff (15) = 8.65, p = .895)) between gender groups. The internal consistencies and ordinal omega of the scales were between .79 and .90. In the regression analysis, enhancement, coping and low conformity motives predicted frequency and quantity of marijuana smoked. The best predictor of frequency and quantity consumed during the heaviest smoking period was enhancement, while coping and, to a lesser extent, low conformity, were the only predictors of cannabis-related problems when marijuana frequency and quantity were controlled for. The MMM SF shows adequate psychometric properties and is a suitable instrument to assess marijuana motives, especially during time-limited sessions.
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Ferrara R, Naigeon M, Auclin E, Duchemann B, Cassard L, Medhi J, Boselli L, Grivel J, Desnoyer A, Mezquita L, Hendriks L, Planchard D, Caramella C, Remon-Masip J, Sangaletti S, Garassino M, Besse B, Chaput N. Immunosenescence (iSenescence) correlates with progression (PD) to PD-(L)1 inhibitors (IO) and not to platinum-chemotherapy (PCT) in advanced non-small cell lung cancer (aNSCLC) patients (pts). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz073.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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177
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Aldea M, Hendriks L, Mezquita L, Remon-Masip J, Planchard D, Jovelet C, Benitez J, Gazzah A, Naltet C, Lavaud P, Lacroix L, Howarth K, Morris C, Green E, Nicotra C, Besse B. Plasma circulating tumor DNA analysis (ctDNA) for molecular alteration detection in advanced non-small cell lung cancer (NSCLC) patients (pts) with isolated central nervous system (CNS) metastases (mts). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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178
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Remon J, Lacroix L, Jovelet C, Caramella C, Howarth K, Plagnol V, Rosenfeld N, Morris C, Mezquita L, Pannet C, Ngocamus M, Le Pechoux C, Adam J, Grecea AM, Planchard D, Vassal G, Benitez JC, Gazzah A, Green E, Soria JC, Besse B. Real-World Utility of an Amplicon-Based Next-Generation Sequencing Liquid Biopsy for Broad Molecular Profiling in Patients With Advanced Non-Small-Cell Lung Cancer. JCO Precis Oncol 2019; 3:PO.18.00211. [PMID: 32914037 PMCID: PMC7446523 DOI: 10.1200/po.18.00211] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2018] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To assess the feasibility and utility of circulating tumor DNA (ctDNA) by amplicon-based next-generation sequencing (NGS) analysis in the daily clinical setting in a cohort of patients with advanced non-small-cell lung cancer (NSCLC), as an alternative approach to tissue molecular profiling. PATIENTS AND METHODS In this single-center prospective study, treatment-naïve and previously treated patients with advanced NSCLC were enrolled. Clinical validation of ctDNA using amplicon-based NGS analysis (with a 36-gene panel) was performed against standard-of-care tissue molecular analysis in treatment-naïve patients. The feasibility, utility, and prognostic value of ctDNA as a dynamic marker of treatment efficacy was evaluated. Results of tissue molecular profile were blinded during ctDNA analysis. RESULTS Of 214 patients with advanced NSCLC who were recruited, 156 were treatment-naïve patients and 58 were pretreated patients with unknown tissue molecular profile. ctDNA screening was successfully performed for 91% (n = 194) of all patients, and mutations were detected in 77% of these patients. Tissue molecular analysis was available for 111 patients (52%), and tissue somatic mutations were found for 78% (n = 87) of patients. For clinically relevant variants, concordance agreement between ctDNA and tumor tissue analysis was 95% among 94 treatment-naïve patients who had concurrent liquid and tumor biopsy molecular profiles. Sensitivity and specificity were 81% and 97%, respectively. Of the 103 patients with no tissue available, ctDNA detected potential actionable mutations in 17% of patients; of these, 10% received personalized treatment. ctDNA kinetics correlated with response rate and progression-free survival in 31 patients treated with first-line platinum-based chemotherapy. CONCLUSION These real-world data from a prospective study endorse ctDNA molecular profile by amplicon-based NGS as an accurate and reliable tool to detect and monitor clinically relevant molecular alterations in patients with advanced NSCLC.
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Affiliation(s)
| | - Ludovic Lacroix
- Laboratoire de Recherche Translationnelle, AMMICA, Institut National de la Santé et de la Recherche Médicale US23/CNRS UNS3655, Gustave Roussy, Villejuif, France
| | - Cecile Jovelet
- Laboratoire de Recherche Translationnelle, AMMICA, Institut National de la Santé et de la Recherche Médicale US23/CNRS UNS3655, Gustave Roussy, Villejuif, France
| | | | | | | | - Nitzan Rosenfeld
- Inivata, Granta Park, Cambridge, United Kingdom
- Cancer Research UK, Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | | | | | | | | | | | | | | | | | - Gilles Vassal
- Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Orsay, France
| | | | | | - Emma Green
- Inivata, Granta Park, Cambridge, United Kingdom
| | | | - Benjamin Besse
- Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Orsay, France
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179
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Cabañero A, Gorospe L, Olmedo ME, Mezquita L. Pseudoprogresión en una paciente con adenocarcinoma pulmonar metastásico tratada con nivolumab. Arch Bronconeumol 2019; 55:168-169. [DOI: 10.1016/j.arbres.2018.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/06/2018] [Accepted: 06/06/2018] [Indexed: 11/28/2022]
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180
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Hendriks LEL, Henon C, Auclin E, Mezquita L, Ferrara R, Audigier-Valette C, Mazieres J, Lefebvre C, Rabeau A, Le Moulec S, Cousin S, Duchemann B, le Pechoux C, Botticella A, Ammari S, Gazzah A, Caramella C, Adam J, Lechapt E, Planchard D, De Ruysscher D, Dingemans AM, Besse B. Outcome of Patients with Non-Small Cell Lung Cancer and Brain Metastases Treated with Checkpoint Inhibitors. J Thorac Oncol 2019; 14:1244-1254. [PMID: 30780002 DOI: 10.1016/j.jtho.2019.02.009] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/01/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Although frequent in NSCLC, patients with brain metastases (BMs) are often excluded from immune checkpoint inhibitor (ICI) trials. We evaluated BM outcome in a less-selected NSCLC cohort. METHODS Data from consecutive patients with advanced ICI-treated NSCLC were collected. Active BMs were defined as new and/or growing lesions without any subsequent local treatment before the start of ICI treatment. Objective response rate (ORR), progression-free survival, and overall survival (OS) were evaluated. Multivariate analyses were performed by using a Cox proportional hazards model and logistic regression. RESULTS A total of 1025 patients were included; the median follow-up time from start of ICI treatment was 15.8 months. Of these patients, 255 (24.9%) had BMs (39.2% active, 14.3% symptomatic, and 27.4% being treated with steroids). Disease-specific Graded Prognostic Assessment (ds-GPA) score was known for 94.5% of patients (35.7% with a score of 0-1, 58.5% with a score of 1.5-2.5, and 5.8% with a score of 3). The ORRs with BM versus without BM were similar: 20.6% (with BM) versus 22.7% (without BM) (p = 0.484). The intracranial ORR (active BM with follow-up brain imaging [n = 73]) was 27.3%. The median progression-free survival times were 1.7 (95% confidence interval [CI]: 1.5-2.1) and 2.1 (95% CI: 1.9-2.5) months, respectively (p = 0.009). Of the patients with BMs, 12.7% had a dissociated cranial-extracranial response and two (0.8%) had brain pseudoprogression. Brain progression occurred more in active BM than in stable BM (54.2% versus 30% [p < 0.001]). The median OS times were 8.6 months (95% CI: 6.8-12.0) with BM and 11.4 months (95% CI: 8.6-13.8) months with no BM (p = 0.035). In the BM subgroup multivariate analysis, corticosteroid use (hazard ratio [HR] = 2.37) was associated with poorer OS, whereas stable BMs (HR = 0.62) and higher ds-GPA classification (HR = 0.48-0.52) were associated with improved OS. CONCLUSION In multivariate analysis BMs are not associated with a poorer survival in patients with ICI-treated NSCLC. Stable patients with BM without baseline corticosteroids and a good ds-GPA classification have the best prognosis.
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Affiliation(s)
- Lizza E L Hendriks
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Department of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands.
| | - Clemence Henon
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Edouard Auclin
- Gastrointestinal and Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France
| | - Laura Mezquita
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Roberto Ferrara
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Julien Mazieres
- Department of Pulmonary Diseases, Centre Hospitalier Universitaire de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Corentin Lefebvre
- Department of Pulmonary Diseases, Centre Hospitalier Universitaire de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Audrey Rabeau
- Department of Pulmonary Diseases, Centre Hospitalier Universitaire de Toulouse, Université Paul Sabatier, Toulouse, France
| | | | - Sophie Cousin
- Department of Medical Oncology, Institut Bergonie, Bordeaux, France
| | - Boris Duchemann
- Department of Pulmonary Diseases, Hopital Avicenne, Paris, France
| | - Cecile le Pechoux
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Angela Botticella
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Samy Ammari
- Department of Radiology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France; Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Anas Gazzah
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France
| | - Caroline Caramella
- Department of Radiology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Julien Adam
- Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Emmanuèle Lechapt
- Department of Pathology, Centre Hospitalier Sainte Anne, Paris, France
| | - David Planchard
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Dirk De Ruysscher
- Department of Radiation Oncology, MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Anne-Marie Dingemans
- Department of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Benjamin Besse
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Paris-Sud University, Orsay, France
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Madic J, Jovelet C, Lopez J, André B, Fatien J, Miran I, Honoré A, Mezquita L, Besse B, Lacroix L, Droniou M. Correction: EGFR C797S, EGFR T790M and EGFR sensitizing mutations in non-small cell lung cancer revealed by six-color crystal digital PCR. Oncotarget 2019; 10:1345. [PMID: 30863495 PMCID: PMC6407683 DOI: 10.18632/oncotarget.26686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
[This corrects the article DOI: 10.18632/oncotarget.26446.].
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Affiliation(s)
- Jordan Madic
- Stilla Technologies, 1 Mail du Professeur Georges Mathé, Villejuif, France
| | - Cécile Jovelet
- Plateforme de Génomique, Module de Biopathologie Moléculaire et Centre de Ressources Biologiques, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - Julien Lopez
- Stilla Technologies, 1 Mail du Professeur Georges Mathé, Villejuif, France
| | - Barbara André
- Stilla Technologies, 1 Mail du Professeur Georges Mathé, Villejuif, France
| | - Jean Fatien
- Ecole Polytechnique, Route de Saclay, Palaiseau, France
| | - Isabelle Miran
- Plateforme de Génomique, Module de Biopathologie Moléculaire et Centre de Ressources Biologiques, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - Aurélie Honoré
- Plateforme de Génomique, Module de Biopathologie Moléculaire et Centre de Ressources Biologiques, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - Laura Mezquita
- Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Benjamin Besse
- Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Ludovic Lacroix
- Plateforme de Génomique, Module de Biopathologie Moléculaire et Centre de Ressources Biologiques, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France.,Département de Biologie et Pathologie Médicales, Institut Gustave Roussy, Villejuif, France
| | - Magali Droniou
- Stilla Technologies, 1 Mail du Professeur Georges Mathé, Villejuif, France
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182
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Bravo AJ, Pilatti A, Pearson MR, Read JP, Mezquita L, Ibáñez MI, Ortet G. Cross-cultural examination of negative alcohol-related consequences: Measurement invariance of the Young Adult Alcohol Consequences Questionnaire in Spain, Argentina, and USA. Psychol Assess 2019; 31:631-642. [PMID: 30667265 DOI: 10.1037/pas0000689] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The present study examined measurement invariance of the 48-item, 8-factor, Young Adult Alcohol Consequences Questionnaire (YAACQ) across nationality in college students from the United States, Spain, and Argentina. We also compared latent mean differences and criterion-related validity (i.e., correlation with other alcohol-related outcomes) across countries. Last month drinkers (1,511) from the United States (n = 774, 70.5% female), Argentina (n = 439, 50.6% female), and Spain (n = 298, 72.1% female) completed an online survey measuring alcohol use, drinking motives, college alcohol beliefs, and negative alcohol-related consequences. Multigroup confirmatory factor analyses supported configural and scalar invariance of a 47-item, 8-factor YAACQ across countries. Overall, the correlation analysis supported criterion-related validity (i.e., strong bivariate correlations between the 8 subscales and alcohol consumption, drinking motives and college alcohol beliefs) across countries. Some nonsignificant bivariate correlations and differences in the magnitude of the correlations across countries are discussed. Our findings expand previous work, mostly focused on U.S. samples, by supporting the YAACQ as an adequate measure to assess alcohol-related consequences in youths across countries marked by unique cultural traditions, attitudes, and policies pertaining to alcohol. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Adrian J Bravo
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico
| | - Angelina Pilatti
- Facultad de Psicología and Instituto de Investigaciones Psicológicas, Universidad Nacional de Córdoba
| | - Matthew R Pearson
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico
| | | | - Laura Mezquita
- Manuel I. Ibáñez, and Generós Ortet, Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I
| | - Manuel I Ibáñez
- Manuel I. Ibáñez, and Generós Ortet, Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I
| | - Generós Ortet
- Manuel I. Ibáñez, and Generós Ortet, Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I
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Charrier M, Mezquita L, Lueza B, Dupraz L, Planchard D, Remon J, Caramella C, Cassard L, Boselli L, Reiners KS, Pogge von Strandmann E, Rusakiewicz S, Ferrara R, Duchemann B, Naigeon M, Pignon JP, Besse B, Chaput N. Circulating innate immune markers and outcomes in treatment-naïve advanced non-small cell lung cancer patients. Eur J Cancer 2019; 108:88-96. [PMID: 30648633 DOI: 10.1016/j.ejca.2018.12.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Innate immunity represents the first step of activation of the immune system and dictates the quality of adaptive immune responses. Studies have reported links between systemic inflammatory or innate immune markers and prognosis in patients with lung cancer. To our knowledge, the prospective and concomitant study of these systemic markers has never been performed. METHODS Advanced treatment-naive non-small cell lung cancer (NSCLC) patients eligible for first-line platinum-based chemotherapy were prospectively included from December 2012 to July 2015 (N = 148). Blood samples of patients were collected before the first cycle for fresh NK cell phenotyping. Peripheral blood mononuclear cells were cryopreserved for natural cytotoxicity receptor (NCR) genotyping as well as sera for NCR's ligand quantification. Data on leukocytes, neutrophils and monocyte counts and lactate dehydrogenase (LDH) levels were extracted from electronic medical records. RESULTS Among all studied markers, monocytosis, neutrophilia, leucocytosis, high LDH and sBAG6 levels and reduced levels of NCR3 transcripts were associated with poor overall survival (OS) in univariate analysis. The levels of NCR3 transcripts was linked to age, number of metastatic sites, monocyte counts, LDH and sBAG6 levels. Neutrophilia was associated to high sBAG6 levels. NCR3 was the unique innate immune parameter that remained as an independent factor associated with both OS (P = 0.003) and progression-free survival (P = 0.009) in the multivariate analysis. CONCLUSION This study brought evidence that these biomarkers are entangled; parameters associated with an inflammatory process were related to reduced levels of NCR3 transcripts. Finally, the level of NCR3 transcripts was independently associated with outcomes in treatment-naive patients with advanced NSCLC.
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Affiliation(s)
- M Charrier
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Medicine, F-94270, Le Kremlin-Bicêtre, France
| | - L Mezquita
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Department of Cancer Medicine, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - B Lueza
- Biostatistics and Epidemiology Department, University Paris Saclay, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Oncostat CESP, INSERM, University Paris-Saclay, France; UVSQ, University Paris-Sud, F-94085, Villejuif, France
| | - L Dupraz
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - D Planchard
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Department of Cancer Medicine, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - J Remon
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Department of Cancer Medicine, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - C Caramella
- Radiology Department, Gustave Roussy, Cancer Campus, F-94085, Villejuif, France
| | - L Cassard
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - L Boselli
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - K S Reiners
- Institute for Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
| | - E Pogge von Strandmann
- Experimental Tumor Research, Center for Tumor Biology and Immunology, Clinic for Hematology, Oncology and Immunology, Philipps University, 35043 Marburg, Germany
| | - S Rusakiewicz
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Center of Clinical Investigations in Biotherapies of Cancer (CICBT) 1428, Villejuif, France
| | - R Ferrara
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - B Duchemann
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Medicine, F-94270, Le Kremlin-Bicêtre, France
| | - M Naigeon
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Medicine, F-94270, Le Kremlin-Bicêtre, France
| | - J P Pignon
- Biostatistics and Epidemiology Department, University Paris Saclay, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Oncostat CESP, INSERM, University Paris-Saclay, France; UVSQ, University Paris-Sud, F-94085, Villejuif, France
| | - B Besse
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Medicine, F-94270, Le Kremlin-Bicêtre, France; Department of Cancer Medicine, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - N Chaput
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Pharmacy, Chatenay-Malabry, F-92296, France.
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Madic J, Jovelet C, Lopez J, André B, Fatien J, Miran I, Honoré A, Mezquita L, Besse B, Lacroix L, Droniou M. EGFR C797S, EGFR T790M and EGFR sensitizing mutations in non-small cell lung cancer revealed by six-color crystal digital PCR. Oncotarget 2018; 9:37393-37406. [PMID: 30647840 PMCID: PMC6324771 DOI: 10.18632/oncotarget.26446] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 11/26/2018] [Indexed: 12/31/2022] Open
Abstract
Background Detection of EGFR sensitizing and p.T790M and p.C797S resistance mutations is particularly important for non-small cell lung cancer (NSCLC) patient therapy management. Non-invasive blood-based monitoring of these mutations may pave the way to a fine-tuned personalized treatment. Digital PCR has emerged as an extremely sensitive method to detect rare mutations, however its major limitation is the number of hotspots that can be simultaneously differentiated. Methods We developed a 6-color digital PCR assay for the detection and quantification of 19 most prevalent EGFR sensitizing and resistance mutations and evaluated this assay on 82 tumor and plasma samples from NSLC patients. Results Limits of detection (LOD) for the 6-color digital PCR assay were assessed on serial dilutions of DNA standards. We found that the 6-color assay enabled detection of mutant fractions as low as 1 mutant in 1025 wild-type molecules, depending on the mutation targeted, when assayed in a background of 10 000 wild-type DNA copies. EGFR mutant allelic fraction was also measured on tumor and plasma samples by 6-color digital PCR, and displayed a highly significant correlation with next generation sequencing and 3-color digital PCR. Lastly, the 6-color digital PCR assay was performed on several longitudinal plasma samples from four patients and revealed levels of sensitizing and resistance EGFR mutations that reflected well the course of the disease. Conclusion This 6-color Crystal digital PCR assay could represent a robust solution using digital PCR for the monitoring of EGFR mutations.
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Affiliation(s)
- Jordan Madic
- Stilla Technologies, 1 Mail du Professeur Georges Mathé, Villejuif, France
| | - Cécile Jovelet
- Plateforme de Génomique, Module de Biopathologie Moléculaire et Centre de Ressources Biologiques, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - Julien Lopez
- Stilla Technologies, 1 Mail du Professeur Georges Mathé, Villejuif, France
| | - Barbara André
- Stilla Technologies, 1 Mail du Professeur Georges Mathé, Villejuif, France
| | - Jean Fatien
- Ecole Polytechnique, Route de Saclay, Palaiseau, France
| | - Isabelle Miran
- Plateforme de Génomique, Module de Biopathologie Moléculaire et Centre de Ressources Biologiques, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - Aurélie Honoré
- Plateforme de Génomique, Module de Biopathologie Moléculaire et Centre de Ressources Biologiques, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - Laura Mezquita
- Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Benjamin Besse
- Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Ludovic Lacroix
- Plateforme de Génomique, Module de Biopathologie Moléculaire et Centre de Ressources Biologiques, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France.,Département de Biologie et Pathologie Médicales, Institut Gustave Roussy, Villejuif, France
| | - Magali Droniou
- Stilla Technologies, 1 Mail du Professeur Georges Mathé, Villejuif, France
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185
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Moya-Higueras J, Cuevas A, Marques-Feixa L, Mezquita L, Mayoral M, Fañanás L, Ortet G, Ibáñez MI. Recent Stressful Life Events (SLE) and Adolescent Mental Health: Initial Validation of the LEIA, a New Checklist for SLE Assessment According to Their Severity, Interpersonal, and Dependent Nature. Assessment 2018; 27:1777-1795. [PMID: 30539643 DOI: 10.1177/1073191118817648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The main aim of the present study was to develop and validate a checklist for adolescents, the Life Events Inventory for Adolescents (LEIA), for screening stressful life events (SLEs) of different nature (major-minor, dependent-independent, and personal-interpersonal). The LEIA was administered together with another SLE checklist (Escala de Acontecimientos Vitales [Life Events Scale], EAV), and with measures of life satisfaction and externalizing and internalizing symptoms. The results showed that the kappa and the percentage agreement reliability indices were adequate. Regarding validity evidences, the correlations found between the LEIA and the EAV ranged from .65 to .69, and between the LEIA and the psychopathological symptoms ranged from .26 to .38. Specifically, major dependent noninterpersonal SLEs were the best predictors of externalizing psychopathology; while major independent noninterpersonal SLEs were the best predictors of internalizing symptoms and low life satisfaction. To conclude, the LEIA could be considered an adequate checklist to screen for SLEs in adolescents.
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Affiliation(s)
- Jorge Moya-Higueras
- Universitat de Lleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Laia Marques-Feixa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Laura Mezquita
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
| | - María Mayoral
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Lourdes Fañanás
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Generós Ortet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
| | - Manuel I Ibáñez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
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186
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Abstract
INTRODUCTION Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), specifically designed to inhibit EGFR sensitizing and T790M acquired mutations, minimizing exposure in EGFR-wild-type tissues. Areas covered: Osimertinib use in EGFR-mutated non-small cell lung cancer patients is described, focusing on safety and tolerability from studies supporting its approval. Expert opinion: Osimertinib demonstrated greater efficacy, including CNS activity, compared to chemotherapy, with a manageable safety profile in pretreated T790M+ EGFR-mutated patients, leading to FDA approval in 2015 within record time in the oncology field. However, the therapeutic strategy in the EGFR-mutated population is changing, following the FLAURA study in untreated EGFR-mutated patients, in which osimertinib improved progression-free survival compared to other TKIs, with a similar toxicity profile but a lower serious adverse event rate. In April 2018, the FDA and EMA approved osimertinib as first-line therapy for EGFR-mutated patients. Long-term survival data will ultimately establish the true benefit of upfront versus sequential strategies guided by T790M status. These studies favor osimertinib for tolerability and safety, except for the slightly higher rate of interstitial lung disease, but which was nonetheless manageable. In the coming years, osimertinib will be consolidated as standard therapy in the EGFR population and in naïve and pretreated patients, based on mature survival data and the toxicity profile.
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Affiliation(s)
- Laura Mezquita
- a Medical Oncology Department , Gustave Roussy , Villejuif , France
| | - Andreea Varga
- b Early Drug Development Department , Gustave Roussy , Villejuif , France
| | - David Planchard
- a Medical Oncology Department , Gustave Roussy , Villejuif , France
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187
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Ferrara R, Mezquita L, Texier M, Lahmar J, Audigier-Valette C, Tessonnier L, Mazieres J, Zalcman G, Brosseau S, Le Moulec S, Leroy L, Duchemann B, Lefebvre C, Veillon R, Westeel V, Koscielny S, Champiat S, Ferté C, Planchard D, Remon J, Boucher ME, Gazzah A, Adam J, Bria E, Tortora G, Soria JC, Besse B, Caramella C. Hyperprogressive Disease in Patients With Advanced Non-Small Cell Lung Cancer Treated With PD-1/PD-L1 Inhibitors or With Single-Agent Chemotherapy. JAMA Oncol 2018. [PMID: 30193240 DOI: 10.1001/jamaoncol.2018.3676.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Hyperprogressive disease (HPD) is a new pattern of progression recently described in patients with cancer treated with programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors. The rate and outcome of HPD in advanced non-small cell lung cancer (NSCLC) are unknown. Objectives To investigate whether HPD is observed in patients with advanced NSCLC treated with PD-1/PD-L1 inhibitors compared with single-agent chemotherapy and whether there is an association between treatment and HPD. Design, Setting, and Participants In this multicenter retrospective study that included patients treated between August 4, 2011, and April 5, 2017, the setting was pretreated patients with advanced NSCLC who received PD-1/PD-L1 inhibitors (8 institutions) or single-agent chemotherapy (4 institutions) in France. Measurable disease defined by Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) on at least 2 computed tomographic scans before treatment and 1 computed tomographic scan during treatment was required. Interventions The tumor growth rate (TGR) before and during treatment and variation per month (ΔTGR) were calculated. Hyperprogressive disease was defined as disease progression at the first evaluation with ΔTGR exceeding 50%. Main Outcomes and Measures The primary end point was assessment of the HPD rate in patients treated with IO or chemotherapy. Results Among 406 eligible patients treated with PD-1/PD-L1 inhibitors (63.8% male), 46.3% (n = 188) were 65 years or older, 72.4% (n = 294) had nonsquamous histology, and 92.9% (n = 377) received a PD-1 inhibitor as monotherapy in second-line therapy or later. The median follow-up was 12.1 months (95% CI, 10.1-13.8 months), and the median overall survival (OS) was 13.4 months (95% CI, 10.2-17.0 months). Fifty-six patients (13.8%) were classified as having HPD. Pseudoprogression was observed in 4.7% (n = 19) of the population. Hyperprogressive disease was significantly associated with more than 2 metastatic sites before PD-1/PD-L1 inhibitors compared with non-HPD (62.5% [35 of 56] vs 42.6% [149 of 350]; P = .006). Patients experiencing HPD within the first 6 weeks of PD-1/PD-L1 inhibitor treatment had significantly lower OS compared with patients with progressive disease (median OS, 3.4 months [95% CI, 2.8-7.5 months] vs 6.2 months [95% CI, 5.3-7.9 months]; hazard ratio, 2.18 [95% CI, 1.29-3.69]; P = .003). Among 59 eligible patients treated with chemotherapy, 3 (5.1%) were classified as having HPD. Conclusions and Relevance Our study suggests that HPD is more common with PD-1/PD-L1 inhibitors compared with chemotherapy in pretreated patients with NSCLC and is also associated with high metastatic burden and poor prognosis in patients treated with PD-1/PD-L1 inhibitors. Additional studies are needed to determine the molecular mechanisms involved in HPD.
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Affiliation(s)
- Roberto Ferrara
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Laura Mezquita
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Matthieu Texier
- Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif, France
| | - Jihene Lahmar
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | | | - Laurent Tessonnier
- Nuclear Medicine Department, Centre Hospitalier Toulon Sainte-Musse, Toulon, France
| | - Julien Mazieres
- Pneumology Department, Centre Hospitalier Universitaire de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Gerard Zalcman
- Thoracic Oncology Department, Hôpital Bichat-Claude Bernard, Université Paris-Diderot, Paris, France
| | - Solenn Brosseau
- Thoracic Oncology Department, Hôpital Bichat-Claude Bernard, Université Paris-Diderot, Paris, France
| | | | - Laura Leroy
- Medical Oncology Department, Institute Bergonié, Bordeaux, France
| | - Boris Duchemann
- Medical Oncology Department, Hôpital Avicenne, Bobigny, France
| | - Corentin Lefebvre
- Service des Maladies Respiratoires, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Remi Veillon
- Service des Maladies Respiratoires, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Virginie Westeel
- Pneumology Department, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Serge Koscielny
- Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif, France
| | - Stephane Champiat
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - Charles Ferté
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - David Planchard
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Jordi Remon
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | | | - Anas Gazzah
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - Julien Adam
- Pathology Department, Gustave Roussy, Villejuif, France
| | - Emilio Bria
- Medical Oncology, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy
| | | | | | - Benjamin Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, France.,Paris-Sud University, Orsay, France
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Mezquita L, Bravo AJ, Ortet G, Pilatti A, Pearson MR, Ibáñez MI. Cross-cultural examination of different personality pathways to alcohol use and misuse in emerging adulthood. Drug Alcohol Depend 2018; 192:193-200. [PMID: 30268069 DOI: 10.1016/j.drugalcdep.2018.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Previous research has identified different, but not mutually exclusive, etiological pathways (i.e., the positive affect regulation pathway, the negative affect regulation pathway and the deviance proneness pathway) to alcohol use and misuse in which personality characteristics play a key role. OBJECTIVES The present study aimed to simultaneously and cross-culturally examine all these personality pathways to alcohol use in a large sample of young adult drinkers (N = 1280) from the US, Argentina, and Spain. METHOD Structural equation modeling was conducted to test the models. Multi-group models were conducted to test model invariance across countries and gender groups. RESULTS In the whole sample, low conscientiousness and extraversion were related to alcohol outcomes through enhancement drinking motives (i.e., positive affect regulation pathway), low emotional stability was related through coping drinking motives (i.e., negative affect regulation pathway), and low conscientiousness and low agreeableness were related through antisocial behavior (i.e., deviance proneness pathway). The model was invariant between gender groups. Some minor, yet significant, differences across countries arose. Specifically, antisocial behavior was a significant mediator of the association between agreeableness and alcohol use, but only in the US subsample. CONCLUSIONS The present findings suggest that risky-personality pathways for alcohol use and alcohol-related problems may be generalized across gender groups and cultures in young adults.
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Affiliation(s)
- Laura Mezquita
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Castellón, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Castellón de la Plana, Spain.
| | - Adrian J Bravo
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, United States
| | - Generós Ortet
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Castellón, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Castellón de la Plana, Spain
| | - Angelina Pilatti
- Facultad de Psicología, Universidad Nacional de Córdoba, Argentina; Instituto de Investigaciones Psicológicas, IIPSI, Unidad Ejecutora CONICET, Córdoba, Argentina
| | - Matthew R Pearson
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, United States
| | - Manuel I Ibáñez
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Castellón, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Castellón de la Plana, Spain
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189
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Schernberg A, Mezquita L, Boros A, Botticella A, Caramella C, Besse B, Escande A, Planchard D, Le Péchoux C, Deutsch E. Neutrophilia as prognostic biomarker in locally advanced stage III lung cancer. PLoS One 2018; 13:e0204490. [PMID: 30304046 PMCID: PMC6179235 DOI: 10.1371/journal.pone.0204490] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 09/10/2018] [Indexed: 01/06/2023] Open
Abstract
Objective To study the prognostic value of baseline leukocytosis or neutrophiliain two retrospective cohorts of stage III Non-Small Cell Lung Cancer (NSCLC) patients. Materials and methods Clinical records of consecutive previously untreated NSCLC patients in our Institution between June 2001 and September 2016 for stage III NSCLC were collected. The prognostic value of pretreatment leucocyte disorders was examined, with focus on patterns of relapse and survival. Leukocytosis and neutrophilia were defined as a leukocyte count or a neutrophil count exceeding 10 and 7 G/L, respectively. Results We identified 238 patients, displaying baseline leukocytosis or neutrophilia in 39% and 40% respectively. Most were diagnosed with adenocarcinoma (48%), and stage IIIB NSCLC (58%). 3-year actuarial overall survival (OS) and progression-free survival (PFS) were 35% and 27% respectively. Local relapses were reported in 100 patients (42%), and distant metastases in 132 patients (55%). In multivariate analysis, leukocytosis, neutrophilia, and induction chemotherapy regimen based on carboplatin/paclitaxel were associated with worse OS and PFS (p<0.05). Neutrophilia independently decreased Locoregional Control (LRC) (HR = 2.5, p<0.001) and Distant Metastasis Control (DMC) (HR = 2.1, p<0.001). Neutrophilia was significantly associated with worse brain metastasis control (p = 0.004), mostly in adenocarcinoma patients (p<0.001). Conclusion In stage III NSCLC patients, treated with concurrent cisplatin-based chemoradiation, baseline leukocytosis and neutrophilia were associated with worse OS, PFS, LRC, and DMC. In addition with previously available markers, this independent cost-effective biomarker could help to stratify stage III NSCLC population with more accuracy.
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Affiliation(s)
- Antoine Schernberg
- Radiation oncology department, Gustave Roussy Cancer Campus, Villejuif, France
- INSERM 1030, Gustave Roussy Cancer Campus, Villejuif, France
| | - Laura Mezquita
- Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Angela Boros
- Radiation oncology department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Angela Botticella
- Radiation oncology department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Caroline Caramella
- Department of Radiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Benjamin Besse
- Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- Université Paris Sud, Université Paris Saclay, Faculté de médecine du Kremlin-Bicetre, Le Kremlin-Bicetre, France
| | - Alexandre Escande
- Radiation oncology department, Gustave Roussy Cancer Campus, Villejuif, France
| | - David Planchard
- Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Cécile Le Péchoux
- Radiation oncology department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Eric Deutsch
- Radiation oncology department, Gustave Roussy Cancer Campus, Villejuif, France
- INSERM 1030, Gustave Roussy Cancer Campus, Villejuif, France
- Department of Radiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- Université Paris Sud, Université Paris Saclay, Faculté de médecine du Kremlin-Bicetre, Le Kremlin-Bicetre, France
- * E-mail:
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190
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Ferrara R, Naigeon M, Auclin E, Duchemann B, Cassard L, Medhi J, Boselli L, Grivel J, Desnoyer A, Mezquita L, Aboubakar F, Hendriks L, Planchard D, Caramella C, Remon J, Ngocamus M, Nicotra C, Besse B, Chaput N. Immunosenescence (iSenescence) correlates with disease progression in advanced non-small cell lung cancer (aNSCLC) patients treated with PD-(L)1 inhibitors (IO). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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191
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Swalduz A, Mezquita L, Ortiz-Cuaran S, Jovelet C, Avrillon V, Planchard D, Marteau S, Recondo G, Martinez S, Howarth K, Plagnol V, Morris C, Green E, Odier L, Lacroix L, Hominal S, Rouleau E, Tissot C, Caramella C, Fournel P, Friboulet L, Pérol M, Besse B, Saintigny P. MA16.09 Feasibility, Clinical Relevance of ALK/ROS1 Fusion Variant Detection by Liquid Biopsy in Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Remon J, Jovelet C, Lacroix L, Planchard D, Mezquita L, Howarth K, Green E, Plagnol V, Morris C, Rosenfeld N, Caramella C, Lepéchoux C, Aboubakar Nana F, Botticella A, Adam J, Ferrara R, Gazzah A, Ngocamus M, Soria J, Besse B. P2.13-24 Prospective Efficacy of Osimertinib in Circulating Tumour DNA (ctDNA) T790M-Mutant NSCLC Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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193
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Flippot R, Auclin E, Biondani P, Le Rhun E, Adam J, Planchard D, Caramella C, Le Pechoux C, Lacroix L, Gazzah A, Mezquita L, Besse B. P1.01-19 Efficacy of Tyrosine Kinase Inhibitors in EGFR Mutated Non-Small Cell Lung Cancer with Leptomeningeal Metastases. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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194
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Herrera Gomez R, Mezquita L, Auclin E, Saleh K, Baste Rotllan N, Iacobs M, Bursuc S, Mayache Badis L, Ferrand F, Casiraghi O, Temam S, Breuskin I, Tao Y, Besse B, Even C. Association of LIPI score with immune checkpoint inhibitors (ICI) outcomes in recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) patients (pts). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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195
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Vozy A, Simonaggio A, Auclin E, Mezquita L, Baldini C, Martin-Romano P, Pistilli B, Gazzah A, Bahleda R, Ribrag V, Postel-Vinay S, Champiat S, Soria JC, André F, Massard C, Besse B, Delaloge S, Varga A. Applicability of the lung immune prognostic index (LIPI) to metastatic triple negative breast cancer (mTNBC) patients treated with immune checkpoint targeted monoclonal antibodies (ICT mAbs). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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196
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Mezquita L, Arbour K, Auclin E, Saravia D, Rizvi H, Hendriks L, Planchard D, Park W, Nadal E, Ruffinelli Rodriguez J, Ponce S, Audigier-Valette C, Marilniello A, Zalcman G, Majem M, Schiavone G, Dingemans AM, Lopes G, Hellmann M, Besse B. Derived neutrophil-to lymphocyte ratio (dNLR) change between baseline and cycle 2 is correlated with benefit during immune checkpoint inhibitors (ICI) in advanced non-small cell lung cancer (NSCLC) patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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197
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Flippot R, Auclin E, Biondani P, Le Rhun E, Adam J, Planchard D, Caramella C, Le Pechoux C, Lacroix L, Gazzah A, Mezquita L, Besse B. Management of leptomeningeal metastases in EGFR mutated non-small cell lung cancer: Analysis of tyrosine kinase inhibitors sequence. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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198
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Hendriks L, Henon C, Auclin E, Mezquita L, Ferrara R, Audigier Valette C, Mazieres J, Lefebvre C, Le Moulec S, Duchemann B, Le Pechoux C, Botticella A, Ammari S, Gazzah A, Caramella C, Adam J, Planchard D, De Ruysscher D, Dingemans AM, Besse B. Prognostic factors in non-small cell lung cancer (NSCLC) patients (pts) with brain metastases (BM) treated with immune checkpoint inhibitors (ICI). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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199
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Recondo G, Mezquita L, Bigot L, Galissant J, Frias R, André F, Massard C, Soria JC, Besse B, Friboulet L. Preliminary results on mechanisms of resistance to ALK inhibitors: A prospective cohort from the MATCH-R study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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200
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Remon J, Mezquita L, Planchard D, Jovelet C, Lacroix L, Rouleau E, Howarth K, Plagnol V, Morris C, Green E, Le Pechoux C, Caramella C, Adam J, Besse B. Clinical validation and utility of InVision ctDNA in advanced non-small cell lung cancer (NSCLC) patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy318.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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