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Vanacker H, Treilleux I, Schiffler C, Bieche I, Campone M, Patsouris A, Arnedos M, Cottu PH, Jacquin JP, Dalenc F, Pinton A, Servant N, Attignon V, Rouleau E, Morel A, Legrand F, Jimenez M, Andre F, Bachelot T. p4EBP1 staining predicts outcome in ER-positive endocrine-resistant metastatic breast cancer patients treated with everolimus and exemestane. Br J Cancer 2024; 130:613-619. [PMID: 38182687 PMCID: PMC10876520 DOI: 10.1038/s41416-023-02549-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/07/2023] [Revised: 11/27/2023] [Accepted: 12/11/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND To identify patients most likely to respond to everolimus, a mammalian target of rapamycin (mTOR) inhibitor, a prospective biomarker study was conducted in hormone receptor-positive endocrine-resistant metastatic breast cancer patients treated with exemestane-everolimus therapy. METHODS Metastatic tumor biopsies were processed for immunohistochemical staining (p4EBP1, PTEN, pAKT, LKB1, and pS6K). ESR1, PIK3CA and AKT1 gene mutations were detected by NGS. The primary endpoint was the association between the p4EBP1 expression and clinical benefit rate (CBR) at 6 months of everolimus plus exemestane treatment. RESULTS Of 150 patients included, 107 were evaluable for the primary endpoint. p4EBP1 staining above the median (Allred score ≥6) was associated with a higher CBR at 6 months (62% versus 40% in high-p4EBP1 versus low-p4EBP1, χ2 test, p = 0.026) and a longer progression-free survival (PFS) (median PFS of 9.2 versus 5.8 months in high-p4EBP1 versus low-p4EBP1; p = 0.02). When tested with other biomarkers, only p4EBP1 remained a significant predictive marker of PFS in multivariate analysis (hazard ratio, 0.591; p = 0.01). CONCLUSIONS This study identified a subset of patients with hormone receptor-positive endocrine-resistant metastatic breast cancer and poor outcome who would derive less benefit from everolimus and exemestane. p4EBP1 may be a useful predictive biomarker in routine clinical practice. CLINICAL TRIAL REGISTRATION NCT02444390.
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Affiliation(s)
| | | | | | | | - Mario Campone
- Institut de cancérologie de l'ouest Pays de Loire Nantes-Angers, Saint-Herblain, France
| | - Anne Patsouris
- Institut de cancérologie de l'ouest Pays de Loire Nantes-Angers, Saint-Herblain, France
| | | | | | | | - Florence Dalenc
- ICR, Institut Universitaire du Cancer de Toulouse, Oncopole, Toulouse, France
| | | | | | | | | | - Alain Morel
- Institut de cancérologie de l'ouest Pays de Loire Nantes-Angers, Saint-Herblain, France
- Univ Angers, Nantes Université, Inserm, CNRS, CRCI2NA, SFR ICAT, F-49000, Angers, France
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Esnault V, Hoisnard L, Peiffer B, Fihman V, Fourati S, Angebault C, Champy C, Gallien S, Attias P, Morel A, Grimbert P, Melica G, Matignon M. Beyond the First Year: Epidemiology and Management of Late-Onset Opportunistic Infections After Kidney Transplantation. Transpl Int 2024; 37:12065. [PMID: 38468638 PMCID: PMC10926380 DOI: 10.3389/ti.2024.12065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024]
Abstract
Late opportunistic infections (OI) occurring beyond the first year after kidney transplantation (KT) are poorly described and not targeted by prophylactic strategies. We performed a ten-year retrospective monocentric cohort study describing epidemiology, risk factors and impact of late OI occurring 1 year after KT. We included clinically symptomatic OI requiring treatment besides BK virus nephropathy. Control groups included early OI occurring in the first year after KT, and KT recipients without OI since KT and alive with a functional allograft at 1 year. Among 1066 KT recipients, 185 (19.4%) presented a first episode of OI 21.0 (8.0-45.0) months after KT: 120 late OI (64.9%) and 65 early OI (35.1%). Late OI were mainly viral (N = 83, 69.2%), mostly herpes zoster (HZ) (N = 36, 43.4%). Pneumocystis represented most late fungal infections (N = 12/25, 48%). Compared to early OI, we reported more pneumocystis (p = 0.002) and less invasive aspergillosis (p = 0.01) among late OI. Patients with late OI were significatively younger at KT (54.0 ± 13.3 vs. 60.2 ± 14.3 years, p = 0.05). Patient and allograft survival rates between late OI and control groups were similar. Only age was independently associated with mortality. While late OI were not associated with higher mortality or graft loss, implementing prophylactic strategies might prevent such infections.
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Affiliation(s)
- V. Esnault
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Maladies Infectieuses et d’Immunologie Clinique, Centre Hospitalo-Universitaire (CHU) Henri Mondor, Créteil, France
| | - L. Hoisnard
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, AP-HP, Henri Mondor Hospital, Créteil, France
- INSERM, Centre d’Investigation Clinique 1430, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, Créteil, France
| | - B. Peiffer
- AP-HP, Département Médico-Universitaire Médecine, CHU Henri Mondor, Créteil, France
| | - V. Fihman
- AP-HP, Service de Microbiologie, Département de Prévention, Diagnostic et Traitement des Infections, CHU Henri Mondor, Créteil, France
| | - S. Fourati
- AP-HP, Service de Microbiologie, Département de Prévention, Diagnostic et Traitement des Infections, CHU Henri Mondor, Créteil, France
| | - C. Angebault
- AP-HP, Service de Microbiologie, Département de Prévention, Diagnostic et Traitement des Infections, CHU Henri Mondor, Créteil, France
- EA DYNAMiC 7380, Faculté de Santé, University Paris-Est Créteil (UPEC), Ecole Nationale Vétérinaire d’Alfort (ENVA), USC Anses, Créteil, France
| | - C. Champy
- AP-HP, Service d’Urologie, CHU Henri Mondor, Créteil, France
| | - S. Gallien
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Maladies Infectieuses et d’Immunologie Clinique, Centre Hospitalo-Universitaire (CHU) Henri Mondor, Créteil, France
- EA DYNAMiC 7380, Faculté de Santé, University Paris-Est Créteil (UPEC), Ecole Nationale Vétérinaire d’Alfort (ENVA), USC Anses, Créteil, France
| | - P. Attias
- AP-HP, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », CHU Henri Mondor, Créteil, France
| | - A. Morel
- AP-HP, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », CHU Henri Mondor, Créteil, France
| | - P. Grimbert
- AP-HP, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », CHU Henri Mondor, Créteil, France
- University of Paris-Est-Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Team 21, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - G. Melica
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Maladies Infectieuses et d’Immunologie Clinique, Centre Hospitalo-Universitaire (CHU) Henri Mondor, Créteil, France
| | - M. Matignon
- AP-HP, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », CHU Henri Mondor, Créteil, France
- University of Paris-Est-Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Team 21, Institut Mondor de Recherche Biomédicale, Créteil, France
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3
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Hofman P, Calabrese F, Kern I, Adam J, Alarcão A, Alborelli I, Anton NT, Arndt A, Avdalyan A, Barberis M, Bégueret H, Bisig B, Blons H, Boström P, Brcic L, Bubanovic G, Buisson A, Caliò A, Cannone M, Carvalho L, Caumont C, Cayre A, Chalabreysse L, Chenard MP, Conde E, Copin MC, Côté JF, D'Haene N, Dai HY, de Leval L, Delongova P, Denčić-Fekete M, Fabre A, Ferenc F, Forest F, de Fraipont F, Garcia-Martos M, Gauchotte G, Geraghty R, Guerin E, Guerrero D, Hernandez S, Hurník P, Jean-Jacques B, Kashofer K, Kazdal D, Lantuejoul S, Leonce C, Lupo A, Malapelle U, Matej R, Merlin JL, Mertz KD, Morel A, Mutka A, Normanno N, Ovidiu P, Panizo A, Papotti MG, Parobkova E, Pasello G, Pauwels P, Pelosi G, Penault-Llorca F, Picot T, Piton N, Pittaro A, Planchard G, Poté N, Radonic T, Rapa I, Rappa A, Roma C, Rot M, Sabourin JC, Salmon I, Prince SS, Scarpa A, Schuuring E, Serre I, Siozopoulou V, Sizaret D, Smojver-Ježek S, Solassol J, Steinestel K, Stojšić J, Syrykh C, Timofeev S, Troncone G, Uguen A, Valmary-Degano S, Vigier A, Volante M, Wahl SGF, Stenzinger A, Ilié M. Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe. ESMO Open 2023; 8:101628. [PMID: 37713929 PMCID: PMC10594022 DOI: 10.1016/j.esmoop.2023.101628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/13/2023] [Revised: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). MATERIALS AND METHODS To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. RESULTS TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. CONCLUSIONS These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe.
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Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J Adam
- Department of Pathology, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Alarcão
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - I Alborelli
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - N T Anton
- Department of Genetics, University Hospital Bichat-Claude Bernard, Paris University, Paris, France
| | - A Arndt
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - A Avdalyan
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - M Barberis
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - H Bégueret
- Department of Pathology, University Hospital of Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - B Bisig
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - H Blons
- Pharmacogenomics and Molecular Oncology Unit, Biochemistry Department, Assistance Publique-Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - L Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - G Bubanovic
- Laboratory for Molecular Pathology, Department of Pathology, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia
| | - A Buisson
- Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - A Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - M Cannone
- Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), MultiMedica, Milan, Italy
| | - L Carvalho
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - C Caumont
- Department of Tumor Biology, University Hospital of Bordeaux, Hospital Haut-Lévêque, Pessac, France
| | - A Cayre
- Department of Biopathology, Jean Perrin Centre, Clermont-Ferrand, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - M P Chenard
- Department of Pathology, University Hospital of Strasbourg, 67098 Strasbourg, France
| | - E Conde
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - M C Copin
- Department of Pathology, Université d'Angers, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - J F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - N D'Haene
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium
| | - H Y Dai
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - P Delongova
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A Fabre
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Ferenc
- Department of Pathology, University of Oradea, Oradea, Romania
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F de Fraipont
- Medical Unit of Molecular Genetic (Hereditary Diseases and Oncology), Grenoble University Hospital, Grenoble, France
| | - M Garcia-Martos
- Department of Pathology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - G Gauchotte
- Department of Biopathology, CHRU-ICL, CHRU Nancy, Vandoeuvre-lès-Nancy, France
| | - R Geraghty
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - E Guerin
- Department of Molecular Cancer Genetics, Laboratory of Biochemistry and Molecular Biology, University Hospital of Strasbourg, Strasbourg, France
| | - D Guerrero
- Biomedical Research Centre, Navarra Health Service, Pamplona, Navarra, Spain
| | - S Hernandez
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - P Hurník
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - B Jean-Jacques
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - K Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Kazdal
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - S Lantuejoul
- Department of Biopathology, Centre Leon Berard Unicancer and Pathology Research Platform, Cancer Research Center of Lyon (CRCL), Lyon, France
| | - C Leonce
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - A Lupo
- Department of Pathology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - U Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - R Matej
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - J L Merlin
- Department of Biopathology, Institut de Cancérologie de Lorraine, University of Lorraine, Vandoeuvre-Les-Nancy, France
| | - K D Mertz
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Morel
- Department of Innate Immunity and Immunotherapy, Institut de Cancérologie de l'Ouest - Centre Paul Papin, Angers, France
| | - A Mutka
- HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - N Normanno
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - P Ovidiu
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M G Papotti
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - E Parobkova
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - G Pasello
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - P Pauwels
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology, Clermont Auvergne University, "Molecular Imaging and Theranostic Strategies", Center Jean Perrin, Montalembert, Clermont-Ferrand, France
| | - T Picot
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - N Piton
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - A Pittaro
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - G Planchard
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - N Poté
- Department of Pathology, Hospital Bichat Bichat, Assistance Publique Hôpitaux de Paris; Université Paris Cité, Paris, France
| | - T Radonic
- Department of Pathology, Amsterdam University Medical Center, VUMC, University of Amsterdam, Amsterdam, Netherlands
| | - I Rapa
- Pathology Unit, San Luigi Hospital, Orbassano Turin, Italy
| | - A Rappa
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - C Roma
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - M Rot
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J C Sabourin
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium; CurePath, Jumet, Belgium
| | - S Savic Prince
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - A Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - E Schuuring
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - I Serre
- Department of Pathology, Gui de Chauliac Hospital, Montpellier University Medical Center, University of Montpellier, 80 Avenue Augustin Fliche, Montpellier, France
| | - V Siozopoulou
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - D Sizaret
- Department of Pathology, CHRU Tours - Hôpital Trousseau, Chambray-lès-Tours, France
| | - S Smojver-Ježek
- Division for Pulmonary Cytology, Department of Pathology and Cytology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - J Solassol
- Solid Tumour Laboratory, Pathology and Oncobiology Department, CHU Montpellier, University of Montpellier, Montpellier, France
| | - K Steinestel
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - J Stojšić
- Department of Thoracic Pathology, Section of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - C Syrykh
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - S Timofeev
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - G Troncone
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Uguen
- Department of Pathological Anatomy and Cytology, CHRU de Brest, Brest, France; LBAI, UMR1227, INSERM, University of Brest, CHU de Brest, Brest, France
| | - S Valmary-Degano
- Department of Pathology, Institute for Advanced Biosciences, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - A Vigier
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - M Volante
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - S G F Wahl
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Stenzinger
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
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Morel A, Prunaretty J, Trauchessec D, Ailleres N, Fenoglietto P, Azria D. Comprehensive commissioning and quality assurance validation of Ethos™ therapy. Cancer Radiother 2023; 27:355-361. [PMID: 37085341 DOI: 10.1016/j.canrad.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/22/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 04/23/2023]
Abstract
PURPOSE Adaptive radiotherapy with the Ethos® therapy Varian system has been recently implemented at the Montpellier Cancer Institute, France. This article details the commissioning performed before the implementation of this new treatment planning system (TPS). MATERIAL AND METHODS To validate the golden beam data of the machine (Halcyon linear accelerator), percentage depth doses (PDD) and profiles were measured for several field sizes and at different depths with a microdiamond chamber. The final doses calculated for different plan types with the Ethos Acuros XB algorithm and the Halcyon Eclipse Analytic Anisotropic Algorithm were compared using the gamma index method. Lastly, for the patient quality assurance (QA) process, the patient treatment plan results obtained with the Mobius3D QA platform (Varian) were compared with the portal dosimetry results obtained with Epiqa (Epidos). RESULTS Minor differences were observed for the PDD and profile curves (mean difference of 0.2% and 2%, respectively). The χ index pass rate was above 98% for all measures using the 1%/1mm and 2%/2mm criteria for PDD and profile evaluations. The Ethos AXB algorithm was validated for every configuration (fixed fields, standard IMRT and VMAT fields, and clinical plans) with 2D/3D gamma index values>99%. Seventy-three 3-arcs-VMAT QA plans and 27 9-fields-IMRT QA plans were evaluated. Both showed excellent agreement with the TPS calculations (mean gamma pass rate higher than 99%). No difference was observed between IMRT and VMAT. CONCLUSION The beam delivery, the Ethos AXB algorithm, and the patient QA were comprehensively validated using independent tools.
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Affiliation(s)
- A Morel
- Institut du cancer de Montpellier (ICM), Montpellier, France
| | - J Prunaretty
- Institut du cancer de Montpellier (ICM), Montpellier, France.
| | - D Trauchessec
- Institut du cancer de Montpellier (ICM), Montpellier, France
| | - N Ailleres
- Institut du cancer de Montpellier (ICM), Montpellier, France
| | - P Fenoglietto
- Institut du cancer de Montpellier (ICM), Montpellier, France
| | - D Azria
- Institut du cancer de Montpellier (ICM), Montpellier, France
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FRENEL JS, Azzouz FB, Bigot F, Dauve J, Heymann MF, Gouraud W, Guette C, Lasla H, Michel B, Morel A, Patsouris A, Robert M, Siekaniec G, Colombie M, Jézéquel P, Campone M. Abstract P5-02-37: Multi-omics approach to identify markers of resistance to endocrine therapy + CDK4/6 inhibitors in first line HR+/HER2- metastatic breast cancer (MBC) patients. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-02-37] [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: 03/06/2023]
Abstract
Abstract
CONTEXT: Endocrine therapy combined with CDK4/6 inhibitor is the standard frontline treatment for the vast majority of HR+/HER2- MBC patients. Despite an overall survival benefit, patients eventually progress and mechanisms of resistance to this combination are not well identified. METHODS: EPICURE is an ongoing pilot prospective cohort study of heterogeneous and massive data integration, ie. multi-omics approach in MBC patients. The present study aims at identifying progression markers in patients with HR+/HER2- MBC receiving frontline endocrine therapy+iCDK4/6 by means of transcriptomics, genomics and proteomics data. All patients had a tumor biopsy at the entry in the study (B1) and a biopsy was repeated at progression if feasible (B2). Transcriptomic (RNAseq: NextSeq550, Illumina), genomic (whole exome sequencing: NextSeq550, Illumina) and proteomic (DIA mass spectrometry: TimsTOFPro2, Bruker) were performed on B1 and B2 according to available tumor tissue. RESULTS: Fifty-one patients matching inclusion criteria were included. B1 was done at inclusion for all patients (B1) (n = 51) and B2 was performed in 8 patients. (B2) (n = 8). Eight metastatic sites were biopsied: node (n = 17); liver (n = 16); bone (n = 8); breast local recurrence (n = 5); chest wall (n = 5); skin (n = 4); pleural (n = 3); ovary (n = 1). Transcriptomic, genomic and proteomic analysis of paired biopsies (B1 and B2) was performed in parallel and separately for 8, 7 and 2 patients, respectively. Exploratory data analysis of transcriptomic and proteomic data showed that liver biopsies clustered together. In order to eliminate this anatomic bias, specific genes and proteins of liver metastases were identified by means of DESeq2 analysis (12 liver vs 39 other sites) for transcriptomic data (n = 2654) and LIMMA (4 liver vs 14 other sites) for proteomic data (n = 227), and excluded for the rest of the analysis. Differential analyses (ie. gene expression, non-synonymous mutations and protein expression) between B1 and B2 were performed for each patient. These three kind of lists were finally submitted to ToppGene, DAVID and GOrilla for Gene Ontology terms enrichment analyses. Transcriptomic analyses of the 8 paired biopsies highlighted immune response (IR) in seven B1, IR in four B2 and neurogenesis in three B2. Genomics data evaluation between B1 and B2 pointed out “transposon integration” as an important pathway. Proteomic data of the 2 paired biopsies analysed underlined high immune response in B1, and muscle development/contraction and response to tumor necrosis factor in B2 for one patient. For the second one, liver metabolism in B1 and extracellular matrix and p38 MAPK cascade were emphasised. CONCLUSION: This preliminary study based on transcriptomic, genomic and proteomic data represents an encouraging first step of the EPICURE project. In a near future, additional paired biopsies and other kinds of omics data (epigenetics, radiomics, microbiomics, exposomics) will be available. Furthermore, omics data will be analysed in an integrated manner (ie. artificial intelligence), which will make it possible to detect synergies across the different omics data.
Citation Format: Jean Sebastien FRENEL, Fadoua Ben Azzouz, Frederic Bigot, Jonathan Dauve, Marie Francoise Heymann, Wilfried Gouraud, Catherine Guette, Hamza Lasla, Bertrand Michel, Alain Morel, Anne Patsouris, Marie Robert, Grégoire Siekaniec, Mathilde Colombie, Pascal Jézéquel, Mario Campone. Multi-omics approach to identify markers of resistance to endocrine therapy + CDK4/6 inhibitors in first line HR+/HER2- metastatic breast cancer (MBC) patients. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-02-37.
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Affiliation(s)
| | | | | | | | - Marie Francoise Heymann
- 5Institut de Cancérologie de l’Ouest site Saint-Herblain, Saint-Herblain, Pays de la Loire, France
| | - Wilfried Gouraud
- 6Institut de Cancérologie de l’Ouest, Saint Herblain, Pays de la Loire, France
| | | | | | | | - Alain Morel
- 10institut de cancerologie de l’ouest, ANGERS CEDEX 02, Pays de la Loire, France
| | | | - Marie Robert
- 12Institut de Cancérologie de l’Ouest, René Gauducheau, Saint-Herblain, France, Saint-Herblain, France
| | | | | | | | - Mario Campone
- 16Institut de Cancérologie de l’Ouest, René Gauducheau, Saint-Herblain, France, Saint-Herblain, France
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6
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Andre F, Filleron T, Kamal M, Mosele F, Arnedos M, Dalenc F, Sablin MP, Campone M, Bonnefoi H, Lefeuvre-Plesse C, Jacot W, Coussy F, Ferrero JM, Emile G, Mouret-Reynier MA, Thery JC, Isambert N, Mege A, Barthelemy P, You B, Hajjaji N, Lacroix L, Rouleau E, Tran-Dien A, Boyault S, Attignon V, Gestraud P, Servant N, Le Tourneau C, Cherif LL, Soubeyran I, Montemurro F, Morel A, Lusque A, Jimenez M, Jacquet A, Gonçalves A, Bachelot T, Bieche I. Genomics to select treatment for patients with metastatic breast cancer. Nature 2022; 610:343-348. [PMID: 36071165 DOI: 10.1038/s41586-022-05068-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 07/03/2022] [Indexed: 01/04/2023]
Abstract
Cancer progression is driven in part by genomic alterations1. The genomic characterization of cancers has shown interpatient heterogeneity regarding driver alterations2, leading to the concept that generation of genomic profiling in patients with cancer could allow the selection of effective therapies3,4. Although DNA sequencing has been implemented in practice, it remains unclear how to use its results. A total of 1,462 patients with HER2-non-overexpressing metastatic breast cancer were enroled to receive genomic profiling in the SAFIR02-BREAST trial. Two hundred and thirty-eight of these patients were randomized in two trials (nos. NCT02299999 and NCT03386162) comparing the efficacy of maintenance treatment5 with a targeted therapy matched to genomic alteration. Targeted therapies matched to genomics improves progression-free survival when genomic alterations are classified as level I/II according to the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT)6 (adjusted hazards ratio (HR): 0.41, 90% confidence interval (CI): 0.27-0.61, P < 0.001), but not when alterations are unselected using ESCAT (adjusted HR: 0.77, 95% CI: 0.56-1.06, P = 0.109). No improvement in progression-free survival was observed in the targeted therapies arm (unadjusted HR: 1.15, 95% CI: 0.76-1.75) for patients presenting with ESCAT alteration beyond level I/II. Patients with germline BRCA1/2 mutations (n = 49) derived high benefit from olaparib (gBRCA1: HR = 0.36, 90% CI: 0.14-0.89; gBRCA2: HR = 0.37, 90% CI: 0.17-0.78). This trial provides evidence that the treatment decision led by genomics should be driven by a framework of target actionability in patients with metastatic breast cancer.
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Affiliation(s)
- Fabrice Andre
- Department of Medical Oncology, Gustave Roussy, Villejuif, France. .,INSERM U981, Gustave Roussy, Villejuif, France. .,PRISM Center for personalized medicine, Gustave Roussy, Villejuif, France. .,Medical School, Université Paris Saclay, Kremlin Bicetre, France.
| | - Thomas Filleron
- Department of Biostatistics, Institut Claudius Regaud, IUCT oncopole, Toulouse, France
| | - Maud Kamal
- Department of Drug Development and Innovation, Institut Curie, Saint Cloud, France
| | | | - Monica Arnedos
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Florence Dalenc
- Department of Medical Oncology, Institut Claudius-Regaud IUCT oncopole and University of Paul Sabatier, Toulouse, France
| | - Marie-Paule Sablin
- Department of Drug Development and Innovation, Institut Curie, Saint Cloud, France.,Department of Medical Oncology, Institut Curie, Paris, France
| | - Mario Campone
- Institut de Cancérologie de l'Ouest - René Gauducheau, Saint Herblain, University of Angers, Angers, France
| | - Hervé Bonnefoi
- Department of Medical Oncology, Institut Bergonié INSERM U1218 and Université of Bordeaux, Bordeaux, France
| | | | - William Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier, Institut de Recherche en Cancérologie de Montpellier INSERM U1194 and Montpellier University, Montpellier, France
| | - Florence Coussy
- Department of Medical Oncology, Institut Curie, Saint-Cloud, France
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, University Côte d'Azur, Nice, France
| | - George Emile
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | | | - Jean-Christophe Thery
- Department of Medical Oncology, Centre Hennri Becquerel, University of Medicine of Rouen, Rouen, France
| | - Nicolas Isambert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Alice Mege
- Institut Sainte Catherine, Avignon, France
| | | | - Benoit You
- Department of Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Nawale Hajjaji
- Department of Medical Oncology, Centre Oscar Lambret INSERM U1192 PRISM Laboratory and University of Lille, Lille, France
| | - Ludovic Lacroix
- Cancer Genetics Laboratory, Department of Pathology and Medical Biology, Gustave Roussy, Villejuif, France
| | - Etienne Rouleau
- Cancer Genetics Laboratory, Department of Pathology and Medical Biology, Gustave Roussy, Villejuif, France
| | - Alicia Tran-Dien
- INSERM U981, Gustave Roussy, Villejuif, France.,PRISM Center for personalized medicine, Gustave Roussy, Villejuif, France.,Bioinformatic Core Facility, UMS AMMICA, Gustave Roussy, Villejuif, France
| | - Sandrine Boyault
- Department of Translational Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Valery Attignon
- Department of Translational Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Pierre Gestraud
- Bioinformatics and Computational Systems Biology of Cancer, PSL Research University, Mines Paris Tech, INSERM U900, Paris, France
| | - Nicolas Servant
- Bioinformatics and Computational Systems Biology of Cancer, PSL Research University, Mines Paris Tech, INSERM U900, Paris, France
| | | | - Linda Larbi Cherif
- Department of Drug Development and Innovation, Institut Curie, Saint Cloud, France
| | - Isabelle Soubeyran
- Unit of Molecular Pathology - Department of Biopathology, Institut Bergonié, Bordeaux, France
| | | | - Alain Morel
- Department of Innate Immunity and Immunotherapy, Institut de Cancérologie de l'Ouest - Centre Paul Papin, Angers, France
| | - Amelie Lusque
- Department of Biostatistics, Institut Claudius Regaud, IUCT oncopole, Toulouse, France
| | | | | | - Anthony Gonçalves
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Thomas Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Ivan Bieche
- Department of Genetics, Institut Curie, INSERM U1016, Université Paris Cité, Paris, France
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7
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Barlesi F, Tomasini P, Karimi M, Michiels S, Raimbourg J, Daniel C, Janicot H, Madroszyk A, Audigier-Valette C, Quoix E, Mazieres J, Moro-Sibilot D, Dansin E, Molinier O, Morel H, Pichon E, Cortot A, Otto J, Chomy FO, Souquet PJ, Cloarec N, Giroux Leprieur E, Bieche I, Lacroix L, Boyault S, Attignon V, Soubeyran I, Morel A, Tran-Dien A, Jacquet A, Dall'Olio FG, Jimenez M, Soria JC, Besse B. Comprehensive genome profiling in patients with metastatic non-small cell lung cancer: the precision medicine phase 2 randomized SAFIR02-Lung trial. Clin Cancer Res 2022; 28:4018-4026. [PMID: 35802649 DOI: 10.1158/1078-0432.ccr-22-0371] [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] [Received: 02/06/2022] [Revised: 04/20/2022] [Accepted: 07/06/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Targeted therapies (TT) and immune checkpoint blockers (ICB) have revolutionized the approach to non-small cell lung cancer (NSCLC) treatment in the era of precision medicine. Their impact as switch maintenance therapy based on molecular characterization is unknown. EXPERIMENTAL DESIGN SAFIR02-Lung was an open-label, randomized, phase 2 trial, involving 33 centers in France. We investigated eight TT (substudy-1) and one ICB (substudy-2), compared to standard-of-care as a maintenance strategy in advanced EGFR, ALK wild-type (wt) NSCLC patients without progression after first line chemotherapy, based on high-throughput genome analysis. The primary outcome was progression-free survival (PFS). RESULTS Among the 175 patients randomized in substudy-1, 116 received TT (selumetinib, vistusertib, capivasertib, AZD4547, AZD8931, vandetanib, olaparib, savolitinib) and 59 standard-of-care. Median PFS was 2.7 months (95% CI 1.6-2.9) with TT vs. 2.7 months (1.6-4.1) with standard-of-care (HR 0.97, 0.7-1.36; p=0.87). There were no significant differences in PFS within any molecular subgroup. In substudy-2, 183 patients were randomized, 121 received durvalumab and 62 standard-of-care. Median PFS was 3.0 months (2.3-4.4) with durvalumab versus 3.0 months (2.0-5.1) with standard-of-care (HR=0.86; 0.62-1.20; p=0.38). Preplanned subgroup analysis showed an enhanced benefit with durvalumab in patients with PD-L1 Tumor Proportion Score (TPS) ≥ 1%, (n=29, HR=0.29; 0.11-0.75) as compared to PD-L1 <1% (n=31, HR=0.71, 0.31-1.60, interaction p= 0.036). CONCLUSIONS Molecular profiling can feasibly be implemented to guide treatment choice for the maintenance strategy in EGFR/ALK wt NSCLC; in the current study it did not lead to substantial treatment benefits beyond durvalumab for PD-L1 ≥ 1 patients.
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Affiliation(s)
- Fabrice Barlesi
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Pascale Tomasini
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | | | | | | | | | - Henri Janicot
- CHU - Hopital Gabriel Montpied, Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alain Morel
- Institut de Cancérologie de l'Ouest, Angers, France
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Cherifi F, Da Silva A, Johnson A, Blanc Fournier C, Broyelle A, Abramovici O, Morel A, Bertho M, Hrab I, Allouache D, Segura Djezzer C, Levy C, Boscher C, Villemin M, Rottier P, Lequesne J, Emile G. 104P HELENA: Study of HER2-low as a prEdictive factor of response to Neoadjuvant chemotherapy in eArly breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.120] [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: 11/01/2022] Open
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9
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André F, Gonçalves A, Filleron T, Dalenc F, Lusque A, Campone M, Sablin MP, Bonnefoi H, Bieche I, Lacroix L, Tran-Dien A, Jimenez M, Jacquet A, Wang Q, Rouleau E, Gentien D, Soubeyran I, Morel A, Arnedos M, Bachelot T. Abstract GS1-10: Clinical utility of molecular tumor profiling: Results from the randomized trial SAFIR02-BREAST. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-gs1-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: While studies have shown feasibility and reported preliminary evidence of utility, there is no evidence that multigene sequencing improves outcome in patients with metastatic cancer. The aim of the present study was to assess the clinical utility of multigene sequencing and DNA copy number analyses.. Methods: In SAFIR02-BREAST (NCT: 02299999) and SAFIR-PI3K (NCT: 03386162), open-label multicentric phase II randomized trials, patients were selected if they had a Her2-negative metastatic breast cancer eligible to 1st or 2nd line chemotherapy. Patients underwent a pre-treatment biopsy of metastatic disease when feasible, followed by genomic analysis by next generation sequencing and SNParray. After 6 to 8 cycles of induction chemotherapy, patients without progressive disease and presenting an actionable genomic alteration, were randomized between targeted therapies matched to genomic alterations or maintenance chemotherapy. The primary objective was to evaluate whether targeted therapies guided by genomics improves progression-free survival (PFS) as compared to maintenance chemotherapy, in a pooled analyses of SAFIR02-BREAST and SAFIR-PI3K populations. A hierarchical testing was applied. The efficacy of targeted therapies matched to genomic alterations was first tested in patients presenting an ESCAT I/II alteration (ESMO Scale of Actionability of Molecular Targets). If a p value <0.1 was observed in the first step, analyses were then performed in the Intent-to-treat population. Results: Out of the 1462 patients included, 238 (16%) were subsequently randomized between maintenance chemotherapy (n=81) and targeted therapy (n=157). In 115 patients presenting an ESCAT I/II genomic alteration, the median PFS was 9.1 months (90%CI: 7.1-9.8) and 2.8 (90%CI: 2.1-4.8) in matched targeted therapy and maintenance chemotherapy arms respectively (adjusted HR for stratification factors =0.41;90%CI: 0.27-0.61, p<0.001). In the overall population, there was no significant difference in the duration of PFS between the two arms (adjusted HR: 0.77 (95%CI: 0.56- 1.06, p=0.109). ESCAT classification was highly predictive for the benefit of targeted therapies matched to genomic alterations (interaction test, p= 0.004). Targeted therapies matched to genomic alterations were not effective in patients without ESCAT I/II alteration (HR: 1.15, 95%CI: 0.76-1.75). The SNP array analyses (n=926) identified 21 genes altered more frequently in metastases as compared to primary tumors (TCGA+ METABRIC). Of these, focal TERT amplifications were associated with a poor outcome. Focal CDK4 amplifications were observed after resistance to CDK4 inhibitors. Finally, high HRD was associated with longer PFS in patients with BRCA mutation treated with olaparib (HR: 0.32 [95%CI: 0.12;0.83], p=0.013).. Conclusion: SAFIR02/PI3K trials report that the clinical use of multigene sequencing must be driven by a framework of actionability, and identifies new genomic alterations associated with metastatic evolution and drug resistance or sensitivity.
Citation Format: Fabrice André, Anthony Gonçalves, Thomas Filleron, Florence Dalenc, Amélie Lusque, Mario Campone, Marie-Paule Sablin, Hervé Bonnefoi, Ivan Bieche, Ludovic Lacroix, Alicia Tran-Dien, Marta Jimenez, Alexandra Jacquet, Qing Wang, Etienne Rouleau, David Gentien, Isabelle Soubeyran, Alain Morel, Monica Arnedos, Thomas Bachelot. Clinical utility of molecular tumor profiling: Results from the randomized trial SAFIR02-BREAST [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr GS1-10.
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Affiliation(s)
- Fabrice André
- Gustave Roussy-Department of Medical Oncology, Villejuif, France
| | | | | | | | | | - Mario Campone
- Institut de Cancérologie de l’Ouest, ST-HERBLAIN, France
| | | | | | - Ivan Bieche
- Institut Curie and Paris-Descartes University-Department of Medical Oncology, Paris, France
| | - Ludovic Lacroix
- Gustave Roussy-Department of Medical Biology and Pathology, BMO Unit - AMMICa UMS3655/US23, Villejuif, France
| | - Alicia Tran-Dien
- Gustave Roussy Cancer Campus-Inserm UMR981 and Department of Medical Oncology, Villejuif, France
| | | | | | - Qing Wang
- Centre Léon Bérard-Département de Recherche Translationnelle et d’Innovation, Lyon, France
| | - Etienne Rouleau
- Gustave Roussy-Department of Medical Biology and Pathology, BMO Unit - AMMICa UMS3655/US23, Villejuif, France
| | - David Gentien
- Institut Curie-Genomics Platform, Translational Research Department. PSL University, Paris, France
| | - Isabelle Soubeyran
- Institut Bergonié-nité de Pathologie Moléculaire - Département de Biopathologie, Bordeaux, France
| | - Alain Morel
- ICO- Centre Paul Papin-Department of Innate Immunity and Immunotherapy, Angers, France
| | - Monica Arnedos
- Gustave Roussy-Department of Medical Oncology, Villejuif, France
| | - Thomas Bachelot
- Centre Léon Bérard-Department of Medical Oncology, Lyon, France
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Sourty B, Dardaud LM, Bris C, Desquiret-Dumas V, Boisselier B, Basset L, Figarella-Branger D, Morel A, Sanson M, Procaccio V, Rousseau A. Mitochondrial DNA copy number as a prognostic marker is age-dependent in adult glioblastoma. Neurooncol Adv 2022; 4:vdab191. [PMID: 35118384 PMCID: PMC8807107 DOI: 10.1093/noajnl/vdab191] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Glioblastoma (GBM) is the most common and aggressive form of glioma. GBM frequently displays chromosome (chr) 7 gain, chr 10 loss and/or EGFR amplification (chr7+/chr10-/EGFRamp). Overall survival (OS) is 15 months after treatment. In young adults, IDH1/2 mutations are associated with longer survival. In children, histone H3 mutations portend a dismal prognosis. Novel reliable prognostic markers are needed in GBM. We assessed the prognostic value of mitochondrial DNA (mtDNA) copy number in adult GBM. METHODS mtDNA copy number was assessed using real-time quantitative PCR in 232 primary GBM. Methylation of POLG and TFAM genes, involved in mtDNA replication, was assessed by bisulfite-pyrosequencing in 44 and 51 cases, respectively. RESULTS Median age at diagnosis was 56.6 years-old and median OS, 13.3 months. 153/232 GBM (66 %) displayed chr7+/chr10-/EGFRamp, 23 (9.9 %) IDH1/2 mutation, 3 (1.3 %) H3 mutation and 53 (22.8 %) no key genetic alterations. GBM were divided into two groups, "Low" (n = 116) and "High" (n = 116), according to the median mtDNA/nuclear DNA ratio (237.7). There was no significant difference in OS between the two groups. By dividing the whole cohort according to the median age at diagnosis, OS was longer in the "High" vs "Low" subgroup (27.3 vs 15 months, P = .0203) in young adult GBM (n = 117) and longer in the "Low" vs "High" subgroup (14.5 vs 10.2 months, P = .0116) in older adult GBM (n = 115). POLG was highly methylated, whereas TFAM remained unmethylated. CONCLUSION mtDNA copy number may be a novel prognostic biomarker in GBM, its impact depending on age.
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Affiliation(s)
- Baptiste Sourty
- Department of Pathology, University Hospital of Angers, Angers, France
| | | | - Céline Bris
- Department of Genetics, University Hospital of Angers and Angers University, INSERM1083, CNRS6015, MITOVASC, Angers, France
| | - Valérie Desquiret-Dumas
- Department of Genetics, University Hospital of Angers and Angers University, INSERM1083, CNRS6015, MITOVASC, Angers, France
| | - Blandine Boisselier
- Department of Pathology, University Hospital of Angers, Angers, France
- Center for Research in Cancerology and Immunology Nantes/Angers, INSERM, University of Nantes, University of Angers, Angers, France
| | - Laëtitia Basset
- Department of Pathology, University Hospital of Angers, Angers, France
- Center for Research in Cancerology and Immunology Nantes/Angers, INSERM, University of Nantes, University of Angers, Angers, France
| | - Dominique Figarella-Branger
- Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
| | - Alain Morel
- Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France
| | - Marc Sanson
- Sorbonne University UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, F-75013, Groupe Hospitalier Pitié-Salpêtrière, Neurology Department 2, Paris, France
| | - Vincent Procaccio
- Department of Genetics, University Hospital of Angers and Angers University, INSERM1083, CNRS6015, MITOVASC, Angers, France
| | - Audrey Rousseau
- Department of Pathology, University Hospital of Angers, Angers, France
- Center for Research in Cancerology and Immunology Nantes/Angers, INSERM, University of Nantes, University of Angers, Angers, France
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11
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Adam C, Paolini L, Gueguen N, Mabilleau G, Preisser L, Blanchard S, Pignon P, Manero F, Le Mao M, Morel A, Reynier P, Beauvillain C, Delneste Y, Procaccio V, Jeannin P. Acetoacetate protects macrophages from lactic acidosis-induced mitochondrial dysfunction by metabolic reprograming. Nat Commun 2021; 12:7115. [PMID: 34880237 PMCID: PMC8655019 DOI: 10.1038/s41467-021-27426-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/09/2021] [Indexed: 01/01/2023] Open
Abstract
Lactic acidosis, the extracellular accumulation of lactate and protons, is a consequence of increased glycolysis triggered by insufficient oxygen supply to tissues. Macrophages are able to differentiate from monocytes under such acidotic conditions, and remain active in order to resolve the underlying injury. Here we show that, in lactic acidosis, human monocytes differentiating into macrophages are characterized by depolarized mitochondria, transient reduction of mitochondrial mass due to mitophagy, and a significant decrease in nutrient absorption. These metabolic changes, resembling pseudostarvation, result from the low extracellular pH rather than from the lactosis component, and render these cells dependent on autophagy for survival. Meanwhile, acetoacetate, a natural metabolite produced by the liver, is utilized by monocytes/macrophages as an alternative fuel to mitigate lactic acidosis-induced pseudostarvation, as evidenced by retained mitochondrial integrity and function, retained nutrient uptake, and survival without the need of autophagy. Our results thus show that acetoacetate may increase tissue tolerance to sustained lactic acidosis. Lactic acidosis is a metabolic state that occurs in injured tissues. Here the authors show that macrophages, in order to remain functional in acidosis, reduce their mitochondrial mass by mitophagy and rely on autophagy for survival, with mitochondrial integrity retained using acetoacetate as alternative fuel.
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Affiliation(s)
- Clément Adam
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France
| | - Léa Paolini
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France
| | - Naïg Gueguen
- Univ Angers, CHU d'Angers, INSERM, CNRS, MitoVasc, SFR ICAT, F-49000, Angers, France.,Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - Guillaume Mabilleau
- GEROM, Université d'Angers, Angers, France.,Département de Pathologie Cellulaire et Tissulaire, CHU d'Angers, Angers, France
| | - Laurence Preisser
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France
| | - Simon Blanchard
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France.,Laboratoire d'Immunologie et Allergologie, CHU d'Angers, Angers, France
| | - Pascale Pignon
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France
| | | | - Morgane Le Mao
- Univ Angers, CHU d'Angers, INSERM, CNRS, MitoVasc, SFR ICAT, F-49000, Angers, France
| | - Alain Morel
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France.,Institut de Cancérologie de l'Ouest, F-49000, Angers, France
| | - Pascal Reynier
- Laboratoire de Biochimie et biologie moléculaire, CHU d'Angers, Angers, France
| | - Céline Beauvillain
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France.,Laboratoire d'Immunologie et Allergologie, CHU d'Angers, Angers, France
| | - Yves Delneste
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France.,Laboratoire d'Immunologie et Allergologie, CHU d'Angers, Angers, France
| | - Vincent Procaccio
- Univ Angers, CHU d'Angers, INSERM, CNRS, MitoVasc, SFR ICAT, F-49000, Angers, France.,Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - Pascale Jeannin
- Univ Angers, Université de Nantes, INSERM, CRCINA, LabEx IGO, SFR ICAT, F-49000, Angers, France. .,Laboratoire d'Immunologie et Allergologie, CHU d'Angers, Angers, France.
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12
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Billaud A, Chevalier LM, Augereau P, Frenel JS, Passot C, Campone M, Morel A. Functional pre-therapeutic evaluation by genome editing of variants of uncertain significance of essential tumor suppressor genes. Genome Med 2021; 13:174. [PMID: 34749799 PMCID: PMC8576946 DOI: 10.1186/s13073-021-00976-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/23/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Targeted therapies in oncology are promising but variants of uncertain significance (VUS) limit their use for clinical management and necessitate functional testing in vitro. Using BRCA1 and BRCA2 variants, which have consequences on PARP inhibitor sensitivity, and POLE variants, potential biomarkers of immunotherapy response, we developed a rapid functional assay based on CRISPR-Cas9 genome editing to determine the functional consequences of these variants having potentially direct implications on patients' access to targeted therapies. METHODS We first evaluated the functional impact of 26 BRCA1 and 7 BRCA2 variants by editing and comparing NGS results between the variant of interest and a silent control variant. Ten of these variants had already been classified as benign or pathogenic and were used as controls. Finally, we extended this method to the characterization of POLE VUS. RESULTS For the 23 variants that were unclassified or for which conflicting interpretations had been reported, 15 were classified as functionally normal and 6 as functionally abnormal. Another two variants were found to have intermediate consequences, both with potential impacts on splicing. We then compared these scores to the patients' responses to PARP inhibitors when possible. Finally, to prove the application of our method to the classification of variants from other tumor suppressor genes, we exemplified with three POLE VUS. Among them, two were classified with an intermediate functional impact and one was functionally abnormal. Eventually, four POLE variants previously classified in databases were also evaluated. However, we found evidence of a discordance with the classification, variant p.Leu424Val being found here functionally normal. CONCLUSIONS Our new rapid functional assay can be used to characterize the functional implication of BRCA1 and BRCA2 variants, giving patients whose variants were evaluated as functionally abnormal access to PARP inhibitor treatment. Retrospective analysis of patients' responses to PARP inhibitors, where accessible, was consistent with our functional score evaluation and confirmed the accuracy of our protocol. This method could potentially be extended to the classification of VUS from all essential tumor suppressor genes and can be performed within a timeframe compatible with clinical applications, thereby having a direct theranostic impact.
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Affiliation(s)
- Amandine Billaud
- Université d'Angers, Inserm, CRCINA, SFR ICAT, F-49000, Angers, France
- Institut de Cancérologie de l'Ouest Nantes-Angers, F-49000, Angers, France
| | - Louise-Marie Chevalier
- Université d'Angers, Inserm, CRCINA, SFR ICAT, F-49000, Angers, France
- Institut de Cancérologie de l'Ouest Nantes-Angers, F-49000, Angers, France
| | - Paule Augereau
- Institut de Cancérologie de l'Ouest Nantes-Angers, F-49000, Angers, France
| | - Jean-Sebastien Frenel
- Institut de Cancérologie de l'Ouest Nantes-Angers, F-49000, Angers, France
- Université de Nantes, Inserm, CRCINA, F-44000, Nantes, France
| | - Christophe Passot
- Institut de Cancérologie de l'Ouest Nantes-Angers, F-49000, Angers, France
| | - Mario Campone
- Institut de Cancérologie de l'Ouest Nantes-Angers, F-49000, Angers, France
- Université de Nantes, Inserm, CRCINA, F-44000, Nantes, France
| | - Alain Morel
- Université d'Angers, Inserm, CRCINA, SFR ICAT, F-49000, Angers, France.
- Institut de Cancérologie de l'Ouest Nantes-Angers, F-49000, Angers, France.
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13
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Morel A, Ouamri Y, Canoui-Poitrine F, Ingels A, Audard V, Luciani A, Grimbert P, Pigneur F, Stehle T. La myostéatose comme facteur de risque indépendant de mortalité après transplantation rénale: une étude de cohorte rétrospective. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.128] [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: 10/20/2022]
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14
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Morel A, Hoisnard L, Dudreuilh C, Moktefi A, Kheav D, Attias P, Champy C, Remy P, Grimbert P, Matignon M. Conséquences à 3 ans de la conversion des inhibiteurs de la calcineurine au belatacept en thérapie de sauvetage chez les patients transplantés rénaux : une étude de cohorte retrospective. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.109] [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: 10/20/2022]
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15
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Pinquie F, Cortot AB, Chevalier LM, Morel A, Sandrini J, Guguen C, Morvan B, Molinier O. A Case Report of Successful Treatment With Crizotinib to Overcome Resistance to Osimertinib in an EGFR Mutated Non-Small-Cell Lung Cancer Patient Harboring an Acquired MET Exon 14 Mutation. Clin Lung Cancer 2021; 23:e131-e134. [PMID: 34548228 DOI: 10.1016/j.cllc.2021.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/29/2021] [Accepted: 06/03/2021] [Indexed: 11/03/2022]
Affiliation(s)
- François Pinquie
- Department of Respiratory Diseases, Le Mans Hospital Center, 72000 Le Mans, France
| | - Alexis B Cortot
- Department of Thoracic Oncology, Lille University Hospital, CNRS, Inserm, Institut Pasteur de Lille, Canther, F-59000, Lille, France
| | - Louise-Marie Chevalier
- Angers University, Inserm, 49000 Angers, France; Department of Oncogenomic, Cancer Center Paul Papin, 49000 Angers, France
| | - Alain Morel
- Angers University, Inserm, 49000 Angers, France; Department of Oncogenomic, Cancer Center Paul Papin, 49000 Angers, France
| | - Jérémy Sandrini
- Department of Pathology, Le Mans Hospital Center, 72000 Le Mans, France
| | - Camille Guguen
- Department of Respiratory Diseases, Le Mans Hospital Center, 72000 Le Mans, France
| | - Benjamin Morvan
- Department of Pathology, Le Mans Hospital Center, 72000 Le Mans, France
| | - Olivier Molinier
- Department of Respiratory Diseases, Le Mans Hospital Center, 72000 Le Mans, France.
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16
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Besse B, Karimi M, Tomasini P, Janicot H, Raimbourg J, Audigier-Valette C, Madroszyk A, Chomy F, Dansin E, Mazieres J, Cortot A, Bieche I, Lacroix L, Boyault S, Soubeyran I, Morel A, Tran-Dien A, Jacquet A, Soria JC, Barlesi F. Maintenance targeted therapy compared to standard of care (SoC) in patients (pts) with metastatic non-small cell lung cancer (NSCLC): Results from the phase II randomized UNICANCER/IFCT1301- SAFIR02-LUNG intergroup trial. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.9095] [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
9095 Background: Targeted therapies (TT) are approved in NSCLC based on a limited number of oncogenic drivers. Numerous additional TT can be matched to other molecular alterations found in comprehensive profiles. We investigated the effect of 8 TT compared to SoC as a maintenance strategy after chemotherapy in pts with metastatic NSCLC. Methods: In SAFIR02-LUNG trial (NCT: 02117167), open-label multicentric phase II randomized trials, PS 0-1 pts with ALK/EGFR WT NSCLC after a CR/PR/SD to 4 cycles of platinum-based chemotherapy were selected. All pts underwent a fresh biopsy, followed by targeted sequencing on 70 genes and SNP-array when > 30% cancer cells were present on HES slides. In case of genomic alteration (including KRAS, ERBB2, BRAF, BRCA mutations), pts were randomized 2:1 between 8 TT and SoC. TT allocation was decided during weekly national tumor board, based on predefined guidelines. The primary endpoint was Progression-Free Survival (PFS) and the secondary endpoint was Overall Survival (OS). Results: 999 patients were enrolled and 394 had a molecular alteration eligible for the study. Among the 175 randomized pts (between July 2014 and May 2019), 116 received TT (65 selumetinib, 18 vistusertib, 9 capivasertib, 8 AZD4547, 5 AZD8931, 5 vandetanib, 4 olaparib, 1 savolitinib) and 59 SoC (54 pemetrexed, 4 gemcitabine and 1 erlotinib). Median age was 60, 40.6% were female, 4.6% never-smoker, 44% were PS 0, 88.6% had a non-squamous NSCLC and 26.9% a PR to chemotherapy. At data cut-off, 168 pts had progressed or died. With a median follow-up of 42.0 months (mo), median PFS was 2.7 mo (95% confidence interval (CI) 1.6 to 2.7) with TT vs. 2.7 mo (95%CI 1.6-4.1) with SoC (HR for disease progression or death 1.00; 95%CI = 0.73 to 1.38; p = 0.978). There was no significant PFS differences among the molecular subgroups; in the cohort with KRAS or BRAF mutation without STK11 mutations the HR for disease progression or death was 0.76; 95%CI = 0.52 to 1.13; p = 0.17. Median OS was 14.3 mo (95%CI 11.0-18.3) with TT vs. 14.1 mo (95% CI 8.0-30.9) with SoC (HR for death 1.12; 95%CI = 0.75-1.65; p = 0.581). Grade 3 or 4 treatment-related adverse events occurred in 31 pts (26.7%) on TT (G3: 30 pts (25.9%), G4: 1 pt (0.8%)) and in 13 (22%) on SoC (G3 8 pts, G4 5 pts). Conclusions: The SAFIR02-LUNG trial demonstrated the feasibility of a routine precision medicine for advanced NSCLC. However, the monotherapy TT used as maintenance therapy after platinum-based chemotherapy failed to improve PFS or OS in this advanced ALK/EGFR WT NSCLC pts population. Newly available therapeutic options (ex. for KRASG12C, RET, NTRK, ERBB2, NRG1, etc) need to be evaluated. Clinical trial information: 2013-001653-27.
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Affiliation(s)
- Benjamin Besse
- Department of Medicine and Thoracic Pathology Committee, Gustave Roussy, Villejuif, France
| | - Maryam Karimi
- Department of Biostatistics, Gustave Roussy; Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - Pascale Tomasini
- Aix-Marseille Université, APHM, INSERM, CNRS, CRCM, Hôpital Nord, Multidisciplinary Oncology and Therapeutic Innovations Department, Marseille, France
| | - Henri Janicot
- Department of Medical Oncology, Centre Hospitalier Universitaire de Clermont-Ferrand - Hôpital Gabriel Montpied, Clermont Ferrand, France
| | - Judith Raimbourg
- Department of Medical Oncology, ICO- Centre René Gauducheau, Nantes, France
| | | | - Anne Madroszyk
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Francois Chomy
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Eric Dansin
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - Julien Mazieres
- Centre Hospitalier Universitaire de Toulouse–Hôpital Larrey, Toulouse, France
| | | | - Ivan Bieche
- Department of Genetics, Institut Curie and University of Paris, Paris, France
| | - Ludovic Lacroix
- Cancer Genetics Laboratory, Departement of Pathology and Medical Biology, Gustave Roussy, Villejuif, France
| | - Sandrine Boyault
- Department of Translational Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Isabelle Soubeyran
- Molecular Pathology Unit-Department of Biopathology, Institut Bergonié, Bordeaux, France
| | - Alain Morel
- Department of Innate Immunity and Immunotherapy, ICO- Centre Paul Papin, Angers, France
| | - Alicia Tran-Dien
- Inserm UMR981 and Department of Medical Oncology, Gustave Roussy Cancer, Campus and Université Paris Saclay, Villejuif, France
| | | | - Jean-Charles Soria
- Gustave Roussy Cancer Campus, Department of Drug Development (DITEP), Villejuif, France
| | - Fabrice Barlesi
- Department of Medical Oncology, Gustave Roussy; Department of Medical Oncology, AP-HM - Hôpital Nord, Marseille, Villejuif and Marseille, France
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Diaz Gomez C, Morel A, Sedano I, Aubin HJ. The Efficacy of Primavera, a Prevention Programme on Alcohol and Tobacco Use among 10-12-Year-Old Schoolchildren: A Randomized Controlled Cluster Study. Int J Environ Res Public Health 2021; 18:3852. [PMID: 33916906 PMCID: PMC8067627 DOI: 10.3390/ijerph18083852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/21/2021] [Accepted: 04/01/2021] [Indexed: 11/26/2022]
Abstract
Alcohol and tobacco use is a major health problem and one of the first causes of the burden of disease and mortality. School-based alcohol and tobacco use prevention programmes that have demonstrated efficacy are most often based on psychosocial skill development, individuals' experiential learning strategies, and community resources. Furthermore, early and prolonged interventions have been recommended. Primavera is a pluri-annual, generic, multimodal, experiential-oriented prevention program. It runs over a three-year period from the last year of primary school to the second year of secondary school. This randomized controlled cluster study aimed at assessing the effects of the Primavera programme compared to a control prevention intervention among schoolchildren from 10 to 12 years in eight secondary schools in a particular French geographical area. The primary outcomes were lifetime tobacco use and past-month alcohol use. Data were collected at baseline and over three follow-up time points. In all, 287 and 266 questionnaires, respectively, were collected at baseline from the Primavera group and from the control group. Attrition was 45% and 41%, respectively. The SARS-COV2 pandemic crisis made it impossible for questionnaires to be collected during the final year. After adjustment, children from the Primavera group were less likely to report current alcohol use at the end of the first year (odds ratio = 0.39, 95% CI: 0.18-0.78) and past-month alcohol use at the end of the second year (odds ratio = 0.07, 95% CI: 0.01-0.66) compared to those from the control group. The results for psychosocial skills and alcohol and tobacco use denormalization were contrasted. Primavera is shown to be effective in reducing alcohol use among schoolchildren.
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Affiliation(s)
| | | | | | - Henri-Jean Aubin
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), French Institute of Health and Medical Research (INSERM) U 1018, University Paris-Saclay, Hopital Paul Brousse AP-HP, 94800 Villejuif, France
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18
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Schwarz C, Morel A, Rondeau E, Marie M, Dahan K, LUQUE Y. POS-768 Hepatitis B reactivation in kidney transplant recipients treated with belatacept. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.800] [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: 10/21/2022] Open
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19
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Raoul JL, Heymann MF, Dumont F, Morel A, Senellart H, Bertucci F. Case Report: Grade 2 Metastatic Pancreatic Neuroendocrine Tumor With Progression of One Metastasis After Pregnancy to Grade 3 Large-Cell Neuroendocrine Carcinoma: One Case Cured by Resection With Genomic Characterization of the Two Components. Front Oncol 2021; 11:646992. [PMID: 33954111 PMCID: PMC8092117 DOI: 10.3389/fonc.2021.646992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/28/2020] [Accepted: 03/16/2021] [Indexed: 12/14/2022] Open
Abstract
Temporal and spatial tumor heterogeneity can be observed in pancreatic neuroendocrine tumor. We report the case of a young woman with long term stabilization of a G2 metastatic pancreatic NET that, after pregnancy, suddenly progressed into one single liver metastasis corresponding to a transformation into G3 large-cell neuroendocrine cancer. The patient underwent liver resection (the progressive and one dormant metastasis). With a 45 months follow-up the patient is without evolutive disease. Exome sequencing of the two metastases revealed completely different genomic signatures and gene alterations: the dormant metastasis was MSS without any gene alteration; the poorly differentiated tumor was MSI, with gain of many mutations including MEN1, BCL2, MLH1 and TP53 corresponding to a mutational signature 11. Could temozolomide play a role in this transformation?
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Affiliation(s)
- Jean-Luc Raoul
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | | | - Frédéric Dumont
- Department of Surgery, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Alain Morel
- Department of Oncopharmacology, Institut de Cancérologie de l'Ouest, Angers, France
| | - Hélène Senellart
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - François Bertucci
- Predictive Oncology Laboratory, Department of Medical Oncology, CRCM, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
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Mezaache S, Carrieri P, Briand-Madrid L, Laporte V, Morel A, Castro DR, Roux P. Correction to: Individual and structural correlates of willingness for intravenous buprenorphine treatment among people who inject sublingual buprenorphine in France. Harm Reduct J 2021; 18:23. [PMID: 33607993 PMCID: PMC7893719 DOI: 10.1186/s12954-021-00465-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Salim Mezaache
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Sante & Traitement de L'information Medicale, Aix-Marseille Univ, Marseille, France. .,ORS PACA, Observatoire Regional de La Sante Provence-Alpes-Cote D'Azur, Marseille, France.
| | - Patrizia Carrieri
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Sante & Traitement de L'information Medicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Regional de La Sante Provence-Alpes-Cote D'Azur, Marseille, France
| | - Laelia Briand-Madrid
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Sante & Traitement de L'information Medicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Regional de La Sante Provence-Alpes-Cote D'Azur, Marseille, France
| | | | | | - Daniela Rojas Castro
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Sante & Traitement de L'information Medicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Regional de La Sante Provence-Alpes-Cote D'Azur, Marseille, France.,Laboratoire de Recherche Communautaire Coalition PLUS, Pantin, France
| | - Perrine Roux
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Sante & Traitement de L'information Medicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Regional de La Sante Provence-Alpes-Cote D'Azur, Marseille, France
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Chevalier LM, Billaud A, Fronteau S, Dauvé J, Patsouris A, Verriele V, Morel A. Somatic mRNA Analysis of BRCA1 Splice Variants Provides a Direct Theranostic Impact on PARP Inhibitors. Mol Diagn Ther 2021; 24:233-243. [PMID: 32124385 DOI: 10.1007/s40291-020-00452-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The identification of pretherapeutic somatic BRCA variants can have considerable clinical impact given that they affect response to the new poly (ADP-ribose) polymerase (PARP)-targeted therapy. One major issue with this type of testing is the identification of splicing variants of uncertain significance (VUS) on degraded somatic messenger RNA. It is therefore important to be able to quickly characterize these splice variants. OBJECTIVE As part of PARP inhibitor targeted therapy, we have investigated a method for the direct confirmation of potential pathogenic somatic splice variants of BRCA1 found in fixed tumor samples. Previously these VUS have commonly only been tested by in silico analysis. METHODS Five BRCA1 variants affecting splicing were characterized from formalin-fixed, paraffin-embedded (FFPE) ovarian carcinoma tissues by next-generation sequencing (NGS). Three patient samples had already been functionally characterized and were used as controls. Total somatic RNA from samples was extracted, reverse-transcribed, and amplified with several primer pairs encompassing the target exon. The polymerase chain reaction (PCR) products were analyzed by capillary gel electrophoresis to assess possible changes in size due to splicing alterations. Finally, we confirmed our results by cloning, followed by Sanger sequencing, and analyzed the expression of the aberrant forms. RESULTS Our molecular approach made it possible to visualize the splicing outcomes of three variants (c.5194-2A>G, c.5434C>G, and c.547+1G>A) already identified and present in databases and/or identified with prediction tools (ClinVar, UMD, ARUP Utah database, and Human Splice Finder splices sites prediction) and to confirm their exon skipping consequences, their expression in tumors, and thus their pathogenicity. The c.4484+5G>A variant was not found in databases and was predicted to have no impact on splicing, but was found to display altered processing in tumor tissue. This variant also had a major detrimental impact on transcriptional expression. CONCLUSION In a break from purely in silico approaches, we propose a simple and rapid pretherapeutic functional analysis of somatic BRCA1 variants potentially involved in splicing alterations. This approach will allow more ovarian cancer patients to benefit from new therapies targeting PARP.
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Affiliation(s)
- Louise-Marie Chevalier
- Université d'Angers, Inserm, CRCINA, 49000, Angers, France.,Institut de Cancérologie de l'Ouest - Paul Papin, 49000, Angers, France
| | - Amandine Billaud
- Université d'Angers, Inserm, CRCINA, 49000, Angers, France.,Institut de Cancérologie de l'Ouest - Paul Papin, 49000, Angers, France
| | - Sabrina Fronteau
- Institut de Cancérologie de l'Ouest - Paul Papin, 49000, Angers, France
| | - Jonathan Dauvé
- Institut de Cancérologie de l'Ouest - Paul Papin, 49000, Angers, France
| | - Anne Patsouris
- Institut de Cancérologie de l'Ouest - Paul Papin, 49000, Angers, France
| | | | - Alain Morel
- Université d'Angers, Inserm, CRCINA, 49000, Angers, France. .,Institut de Cancérologie de l'Ouest - Paul Papin, 49000, Angers, France.
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22
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Mezaache S, Carrieri P, Briand-Madrid L, Laporte V, Morel A, Rojas Castro D, Roux P. Individual and structural correlates of willingness for intravenous buprenorphine treatment among people who inject sublingual buprenorphine in France. Harm Reduct J 2021; 18:11. [PMID: 33468133 PMCID: PMC7814710 DOI: 10.1186/s12954-021-00460-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/18/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some people do not benefit from oral administration of opioid agonist treatment, and an intravenous (IV) formulation may be more suitable. Our objective was to evaluate the willingness of people who regularly inject sublingual buprenorphine to receive IV buprenorphine as a prescribed treatment, and to examine related correlates. METHODS We performed a secondary analysis of data from the cross-sectional study PrebupIV, conducted in France in 2015 among 557 people who inject opioids. The study comprised questionnaires completed either face to face or online and community-based workshops. We only included participants who reported buprenorphine as their main injected drug (n = 209). Willingness to receive IV buprenorphine treatment was measured on a scale from 0 to 10. Ordinal logistic regression identified correlates of willingness. Artworks and testimonies from participants in the workshops were also used to illustrate correlates of willingness. RESULTS Among the 209 participants, the mean score (SD) for willingness to receive IV buprenorphine was 8.0 (2.8). Multivariate analysis showed that participants who reported using non-prescribed buprenorphine (AOR = 4.82, p = 0.019), a higher daily dosage of buprenorphine (AOR (for 1 mg) = 1.05, p = 0.043), and a higher number of complications due to injection (AOR = 2.28, p = 0.037), were more willing to receive IV buprenorphine treatment. CONCLUSIONS Willingness to initiate IV buprenorphine treatment was high among people who regularly inject sublingual buprenorphine. A prescribed IV formulation could attract and retain more people into care and reduce harms associated with the injection of buprenorphine tablets.
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Affiliation(s)
- Salim Mezaache
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France. .,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France.
| | - Patrizia Carrieri
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France
| | - Laélia Briand-Madrid
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France
| | | | | | - Daniela Rojas Castro
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France.,Laboratoire de Recherche Communautaire Coalition PLUS, Pantin, France
| | - Perrine Roux
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France
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Billaud A, Chevalier LM, Campone M, Morel A, Bigot F. [Genetic instability, a factor limiting the efficiency of targeted therapies in solid oncology]. Bull Cancer 2020; 107:1161-1170. [PMID: 33070953 DOI: 10.1016/j.bulcan.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 04/16/2020] [Revised: 07/31/2020] [Accepted: 08/12/2020] [Indexed: 10/23/2022]
Abstract
Genomic instability is one of the main properties of tumour development, promoting first the acquisition of genetic alterations and thus carcinogenesis. Then, the chronic and anarchic proliferation of cancer cells also supports and contributes to this instability allowing a continuous evolution of the tumour. The accumulation of mutations resulting from that instability contributes to tumour heterogeneity that occurs in a specific environment. The resulting diversity of oncogenic drivers further complicates the characterization of the origin of cancer cells dysfunction and consequently therapeutic decision. However, the consideration of the molecular context in oncology has initiated the development of targeted therapies. Based on the concept of oncogene addiction and synthetic lethality, these new drugs require the characterization and identification of specific tumour biomarkers. Targeted therapies have thus considerably optimized patient management, improving efficiency and quality of life while limiting the side effects observed with conventional chemotherapies. However, despite significant clinical benefits, some major limitations to their administration remain. The study of the current issues related to these new therapeutic molecules is becoming crucial for patient management towards an improvement of personalized medicine.
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Affiliation(s)
- Amandine Billaud
- Université d'Angers, Inserm, CRCINA, 49000 Angers, France; Institut de cancérologie de l'Ouest, Angers, France
| | - Louise-Marie Chevalier
- Université d'Angers, Inserm, CRCINA, 49000 Angers, France; Institut de cancérologie de l'Ouest, Angers, France
| | - Mario Campone
- Université de Nantes, Inserm, CRCINA, 44000 Nantes, France; Institut de cancérologie de l'Ouest, Angers, France
| | - Alain Morel
- Université d'Angers, Inserm, CRCINA, 49000 Angers, France; Institut de cancérologie de l'Ouest, Angers, France.
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Valdenaire S, Debuire P, Aillères N, Morel A, Trauchessec D, Riou O, Azria D, Fenoglietto P. Acceptance mécanique et dosimétrique d’un dispositif de radiothérapie guidé par IRM. Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.08.018] [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: 11/24/2022]
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25
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Dupont C, Morel A, Martel B, Duval C, Divanon F, Levy C. 284P Interest of a multidisciplinary approach in the initiation of oral therapies in metastatic breast cancer (MBC): Experience of a French comprehensive cancer center. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.386] [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: 10/23/2022] Open
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26
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Billaud A, Verriele V, Dauvé J, Chevalier LM, Morel A. Non-Small-Cell Lung Cancer-Sensitive Detection of the p.Thr790Met EGFR Alteration by Preamplification before PNA-Mediated PCR Clamping and Pyrosequencing. Diagnostics (Basel) 2020; 10:diagnostics10080527. [PMID: 32751202 PMCID: PMC7460542 DOI: 10.3390/diagnostics10080527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/27/2020] [Revised: 07/19/2020] [Accepted: 07/27/2020] [Indexed: 12/24/2022] Open
Abstract
Targeted therapies and, more precisely, EGFR tyrosine kinase inhibitors (TKIs) have been a major improvement in the therapeutic management of EGFR-mutated non-small-cell lung cancers (NSCLCs). Earlier administration of these TKIs throughout tumor progression is imperative to improve patient outcomes. Consequently, studies have focused on refining the characterization of biomarkers, especially concerning the resistance mutation p.Thr790Met of EGFR. Herein, we developed peptide nucleic acid (PNA)-mediated PCR clamping followed by pyrosequencing, favoring enrichment of the mutated fraction. A preamplification step was first added to increase the amplifiable DNA fraction. Throughout the application of our method on DNA extracted from FFPE samples of 46 patients with NSCLC who had relapsed under first-generation EGFR TKI, we evaluated a sensitivity of 93.3% and a specificity of 100%. All 19 patients who were positive for the p.Thr790Met mutation with NGS were also found to be positive with our protocol. The only discordant case was a sample with no mutation detected with NGS, but which was positive with PNA. This protocol allows for the detection of the p.Thr790Met mutation with a sensitivity of 0.5% which will permit earlier detection and an improvement of therapeutic management.
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Affiliation(s)
- Amandine Billaud
- Université d’Angers, Inserm, CRCINA, F-49000 Angers, France; (A.B.); (L.-M.C.)
- Institut de Cancérologie de l’Ouest Nantes-Angers, 49000 Angers, France; (V.V.); (J.D.)
| | - Veronique Verriele
- Institut de Cancérologie de l’Ouest Nantes-Angers, 49000 Angers, France; (V.V.); (J.D.)
| | - Jonathan Dauvé
- Institut de Cancérologie de l’Ouest Nantes-Angers, 49000 Angers, France; (V.V.); (J.D.)
| | - Louise-Marie Chevalier
- Université d’Angers, Inserm, CRCINA, F-49000 Angers, France; (A.B.); (L.-M.C.)
- Institut de Cancérologie de l’Ouest Nantes-Angers, 49000 Angers, France; (V.V.); (J.D.)
| | - Alain Morel
- Université d’Angers, Inserm, CRCINA, F-49000 Angers, France; (A.B.); (L.-M.C.)
- Institut de Cancérologie de l’Ouest Nantes-Angers, 49000 Angers, France; (V.V.); (J.D.)
- Correspondence: ; Tel.: +33-241-352-717
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27
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Chevalier LM, Billaud A, Passot C, Renoult A, Bigot F, Verrièle V, Morel A. [EGFR molecular characterization in non-small cell bronchic cancer: comparative prospective study by NGS and Idylla platform technologies]. Ann Pathol 2020; 40:389-400. [PMID: 32081549 DOI: 10.1016/j.annpat.2020.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 06/27/2019] [Revised: 01/10/2020] [Accepted: 01/23/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Detection of genetic alterations in the EGFR tyrosine kinase domain is a major concern in the management of non-small cell lung cancer because it conditions access to tyrosine kinase inhibitors. In practice, it is possible to characterize only well-documented mutations or to sequence all relevant EGFR exons and also other targets of theranostic interest. This prospective study compares the targeted EGFR characterization on Idylla platform (Biocartis) and a more extensive one by next generation sequencing using Ion Torrent technology. MATERIAL AND METHODS A total of 100 formalin-fixed paraffin-embedded tumour samples were tested simultaneously by both techniques under the conditions recommended by the suppliers. The comparison covered all technical and practical aspects of the laboratory. RESULTS At least one EGFR mutation of interest for tyrosine kinase inhibitors for 9 and 7 samples was detected respectively by sequencing and by the Idylla system. For three samples, EGFR sensitive mutations to tyrosine kinase inhibitors were detected only by next-generation sequencing. In addition, for 37 samples, mutations of clinical interest outside EGFR were characterized by sequencing and communicated to the prescriber. CONCLUSION Idylla technology allows the rapid characterization of a majority of EGFR variants. The result can be optimized by careful analysis of the amplification curves with the Idylla Explore tool or by increasing the amount of initial material. A complementary new generation sequencing analysis for non-contributory results by Idylla should also be recommended.
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Affiliation(s)
- Louise-Marie Chevalier
- Département de Biopathologie, Institut de Cancérologie de l'Ouest, site Paul Papin, 15, rue André Boquel, 49 055 Angers cedex 02, France; CRCINA U1232, Inserm, Université de Nantes, Université d'Angers, 4, rue Larrey, Angers, France.
| | - Amandine Billaud
- Département de Biopathologie, Institut de Cancérologie de l'Ouest, site Paul Papin, 15, rue André Boquel, 49 055 Angers cedex 02, France; CRCINA U1232, Inserm, Université de Nantes, Université d'Angers, 4, rue Larrey, Angers, France.
| | - Christophe Passot
- Département de Biopathologie, Institut de Cancérologie de l'Ouest, site Paul Papin, 15, rue André Boquel, 49 055 Angers cedex 02, France.
| | - Adélaïde Renoult
- Département de Biopathologie, Institut de Cancérologie de l'Ouest, site Paul Papin, 15, rue André Boquel, 49 055 Angers cedex 02, France.
| | - Frédéric Bigot
- Département de Biopathologie, Institut de Cancérologie de l'Ouest, site Paul Papin, 15, rue André Boquel, 49 055 Angers cedex 02, France.
| | - Véronique Verrièle
- Département de Biopathologie, Institut de Cancérologie de l'Ouest, site Paul Papin, 15, rue André Boquel, 49 055 Angers cedex 02, France.
| | - Alain Morel
- Département de Biopathologie, Institut de Cancérologie de l'Ouest, site Paul Papin, 15, rue André Boquel, 49 055 Angers cedex 02, France; CRCINA U1232, Inserm, Université de Nantes, Université d'Angers, 4, rue Larrey, Angers, France.
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28
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Paolini L, Adam C, Beauvillain C, Preisser L, Blanchard S, Pignon P, Seegers V, Chevalier LM, Campone M, Wernert R, Verrielle V, Raro P, Ifrah N, Lavoué V, Descamps P, Morel A, Catros V, Tcherkez G, Lenaers G, Bocca C, Kouassi Nzoughet J, Procaccio V, Delneste Y, Jeannin P. Lactic Acidosis Together with GM-CSF and M-CSF Induces Human Macrophages toward an Inflammatory Protumor Phenotype. Cancer Immunol Res 2020; 8:383-395. [PMID: 31924656 DOI: 10.1158/2326-6066.cir-18-0749] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 07/12/2019] [Accepted: 01/03/2020] [Indexed: 11/16/2022]
Abstract
In established tumors, tumor-associated macrophages (TAM) orchestrate nonresolving cancer-related inflammation and produce mediators favoring tumor growth, metastasis, and angiogenesis. However, the factors conferring inflammatory and protumor properties on human macrophages remain largely unknown. Most solid tumors have high lactate content. We therefore analyzed the impact of lactate on human monocyte differentiation. We report that prolonged lactic acidosis induces the differentiation of monocytes into macrophages with a phenotype including protumor and inflammatory characteristics. These cells produce tumor growth factors, inflammatory cytokines, and chemokines as well as low amounts of IL10. These effects of lactate require its metabolism and are associated with hypoxia-inducible factor-1α stabilization. The expression of some lactate-induced genes is dependent on autocrine M-CSF consumption. Finally, TAMs with protumor and inflammatory characteristics (VEGFhigh CXCL8+ IL1β+) are found in solid ovarian tumors. These results show that tumor-derived lactate links the protumor features of TAMs with their inflammatory properties. Treatments that reduce tumor glycolysis or tumor-associated acidosis may help combat cancer.
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Affiliation(s)
- Léa Paolini
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France
| | - Clément Adam
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France
| | - Céline Beauvillain
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France.,Laboratoire d'Immunologie et Allergologie, CHU d'Angers, Angers, France
| | - Laurence Preisser
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France
| | - Simon Blanchard
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France.,Laboratoire d'Immunologie et Allergologie, CHU d'Angers, Angers, France
| | - Pascale Pignon
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France
| | - Valérie Seegers
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France.,Institut de Cancérologie de l'Ouest, Angers, France
| | - Louise-Marie Chevalier
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France.,Institut de Cancérologie de l'Ouest, Angers, France
| | - Mario Campone
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France.,Institut de Cancérologie de l'Ouest, Angers, France
| | | | | | - Pedro Raro
- Institut de Cancérologie de l'Ouest, Angers, France
| | - Norbert Ifrah
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France.,Service des Maladies du Sang, CHU d'Angers, Angers, France
| | - Vincent Lavoué
- Service de Gynécologie-obstétrique, CHU de Rennes, Rennes, France.,UMR INSERM 1242, Université de Rennes, Rennes, France
| | | | - Alain Morel
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France.,Institut de Cancérologie de l'Ouest, Angers, France
| | - Véronique Catros
- CHU de Rennes, Rennes, France; UMR INSERM 991, Rennes, France; CRB Santé de Rennes, Rennes, France
| | - Guillaume Tcherkez
- Research School of Biology, ANU Joint College of Sciences, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Guy Lenaers
- Université d'Angers, Inserm U1083, CNRS U6015, Institut MitoVasc, Angers, France
| | - Cinzia Bocca
- Université d'Angers, Inserm U1083, CNRS U6015, Institut MitoVasc, Angers, France
| | | | - Vincent Procaccio
- Université d'Angers, Inserm U1083, CNRS U6015, Institut MitoVasc, Angers, France.,Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - Yves Delneste
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France.,Laboratoire d'Immunologie et Allergologie, CHU d'Angers, Angers, France
| | - Pascale Jeannin
- Université d'Angers, CHU d'Angers, Inserm U1232, CRCINA, Angers, France. .,Laboratoire d'Immunologie et Allergologie, CHU d'Angers, Angers, France
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Cirella D, Prunaretty J, Debuire P, Aillères N, Morel A, Simeon S, Valdenaire S, Fenoglietto P. 76 First French clinical experience with the Calypso® system using the real-time tracking for the prostate treatment. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.157] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Cirella D, Prunaretty J, Debuire P, Aillères N, Morel A, Simeon S, Valdenaire S, Fenoglietto P. 21 Performance assessment of the Calypso® system. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.102] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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31
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Abstract
Auxetic materials have gained increasing interest in the last decades, fostered by auspicious applications in various fields. While the design of new auxetics has largely focused on meta-materials with deterministic, periodically arranged structures, we show here by theoretical and numerical analysis that pronounced auxetic behaviour with negative Poisson's ratios of very large magnitude can occur in random fibre networks with slender, reasonably straight fibre segments that buckle and deflect. We further demonstrate in experiments that such auxetic fibre networks, which increase their thickness by an order of magnitude and more than quintuple their volume when moderately extended, can be produced by electrospinning. Our results thus augment the class of auxetics by a large group of straightforwardly fabricable meta-materials with stochastic microstructure.
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Affiliation(s)
- S Domaschke
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Experimental Continuum Mechanics, 8600, Dübendorf, Switzerland
- ETH Zurich, Institute for Mechanical Systems, 8092, Zürich, Switzerland
| | - A Morel
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, 9014, St. Gallen, Switzerland
| | - G Fortunato
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, 9014, St. Gallen, Switzerland
| | - A E Ehret
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Experimental Continuum Mechanics, 8600, Dübendorf, Switzerland.
- ETH Zurich, Institute for Mechanical Systems, 8092, Zürich, Switzerland.
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De Vries-brilland M, Menand E, Seegers V, Dauvé J, Passot C, Marion JM, Chauvet P, Morel A, Gross-Goupil M, Ravaud A, Boughalem E, Escudier B, Albiges L. Are immune checkpoint inhibitors a valid option for papillary renal cell carcinoma? Transcriptomic characterization of the immune infiltrate. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.066] [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: 11/14/2022] Open
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33
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Roux P, Morel A, Wolfe D, Carrieri P. Methadone in primary care in France: Using evidence for action against hepatitis C. Int J Drug Policy 2019; 71:91-92. [PMID: 31238180 DOI: 10.1016/j.drugpo.2019.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 06/12/2019] [Accepted: 06/15/2019] [Indexed: 10/26/2022]
Affiliation(s)
- P Roux
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
| | | | - D Wolfe
- Open Society Institute, New York, USA
| | - P Carrieri
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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Couraud S, Barlesi F, Fontaine-Deraluelle C, Debieuvre D, Merlio JP, Moreau L, Beau-Faller M, Veillon R, Mosser J, Al Freijat F, Bringuier PP, Léna H, Ouafik L, Westeel V, Morel A, Audigier-Valette C, Missy P, Langlais A, Morin F, Souquet PJ, Planchard D. Clinical outcomes of non-small-cell lung cancer patients with BRAF mutations: results from the French Cooperative Thoracic Intergroup biomarkers France study. Eur J Cancer 2019; 116:86-97. [PMID: 31181537 DOI: 10.1016/j.ejca.2019.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 11/15/2018] [Revised: 03/17/2019] [Accepted: 04/10/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Patients with stage IV non-small-cell lung cancer (NSCLC) and BRAF V600 mutations may benefit from targeted therapies. Chemotherapy outcomes are little known in this population. METHODS The French Cooperative Thoracic Intergroup (IFCT) Biomarkers France study was a national prospective cohort study aiming to describe the molecular characteristics and clinical outcome of all consecutive NSCLC patients (N = 17,664) screened for molecular alterations. We used this data set to set up a case-control analysis. Cases had stage IV BRAF-mutated (BRAF-MT) NSCLC, whereas controls had NSCLC that was wild-type for EGFR, KRAS, HER2, BRAF, PIK3CA and ALK. Each case was matched for sex, age at diagnosis and smoking status to two controls randomly selected. RESULTS Overall, 83 cases with BRAF mutant disease (66.3% V600E) were matched to 166 controls. Five cases received tyrosine kinase inhibition in the first-line and 16 in the second-line. All others were treated with standard chemotherapy. There was no significant difference in first-line and second-line progression-free survival (PFS) between the groups, as well as in the disease control rate, BRAF mutation was not found to be prognostic of overall survival. We found no significant difference in outcome between the treatment types used in first-line or second-line in patients with BRAF-MT disease compared with controls nor between BRAF V600E or non-V600E compared with controls. CONCLUSIONS BRAF mutation is not a strong prognostic factor in NSCLC. Although taxan-based therapy shows poorest PFS in first-line, no chemotherapy regimen was associated with prognosis.
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Affiliation(s)
- Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France; EMR3738 Ciblage Thérapeutique en Oncologie, Programme CIRCAN (CIRculating CANcer), Faculté de Médecine et de Maïeutique Lyon Sud - Charles Mérieux, Université Lyon 1, Université de Lyon, Oullins, France
| | - Fabrice Barlesi
- Aix Marseille University, Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR1068, CNRS UMR7258, Marseille France; Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology & Therapeutic Innovations Dpt, Marseille, France
| | - Clara Fontaine-Deraluelle
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Didier Debieuvre
- Chest Department, Hôpital Emile Muller - GHRMSA, Mulhouse, France
| | - Jean-Philippe Merlio
- CHU and University Bordeaux, Hôpital Haut-Lévêque, Department of Pathology and Tumor Biology, Pessac, France
| | - Lionel Moreau
- Service de Pneumologie, Hôpital Louis Pasteur, Hôpitaux Civils de Colmar, Colmar, France
| | - Michèle Beau-Faller
- Laboratoire de Biochimie et de Biologie Moléculaire, Hôpitaux Universitaires de Strasbourg, Plate-forme de Génomique des Cancers d'Alsace, Laboratoire d'Onco-biologie, Institut Régional du Cancer d'Alsace, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; INSERM IRFAC UMR-S1113, Université de Strasbourg, Strasbourg, France
| | - Rémi Veillon
- Service des Maladies Respiratoires, CHU Bordeaux, Hôpital du Haut Lévêque, Pessac, France
| | - Jean Mosser
- Centre Hospitalier Universitaire de Rennes, Département de Génomique et Génétique Moléculaire, Rennes, France
| | - Faraj Al Freijat
- Centre Hospitalier de Belfort-Montbéliard, Service de Pneumologie, Belfort, France
| | - Pierre-Paul Bringuier
- Department of Biology and Pathology, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Hervé Léna
- Hôpital Pontchaillou, Service de Pneumologie, Centre Hospitalier Universitaire, Rennes, France
| | - L'Houcine Ouafik
- Aix Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, Marseille, France; Faculté de Médecine Secteur Nord, Service de Transfert d'Oncologie Biologique, Marseille, France
| | - Virginie Westeel
- Service de Pneumologie, Centre Hospitalier Régional Universitaire de Besançon, Hôpital Jean Minjoz, Besançon, France
| | - Alain Morel
- CRCINA, INSERM, Université d'Angers et Institut de Cancérologie de l'Ouest, Nantes Angers, France
| | | | - Pascale Missy
- French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | | | - Franck Morin
- French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | - Pierre-Jean Souquet
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - David Planchard
- Department of Medical Oncology, Thoracic Unit, Gustave Roussy, Villejuif, France.
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Bachelot TD, Treilleux I, Schiffler C, Bieche I, Campone M, Patsouris A, Arnedos M, Cottu PH, Jacquin JP, Dalenc F, Attignon V, Rouleau E, Morel A, Legrand F, Jimenez M, Andre F. mTORC1 activation assessed in metastatic sample to predict outcome in patients with metastatic breast cancer treated with everolimus-exemestan: Results from the SAFIRTOR study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1024] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1024 Background: Using samples from TAMRAD study (Treilleux, Ann Oncol, 2015), we previously reported that p4EBP1, a downstream protein of mTOR, was associated with higher benefit to everolimus (eve). SAFIRTOR study was designed to validate clinical utility of this biomarker. Methods: Patients (pts) with ER+, HER2 negative, AI resistant MBC were prospectively included (NCT02444390). All pts had a biopsy of a metastatic site and were then treated with standard eve + exemestane (exe) combination. The primary end point was to validate that p4EBP1 expression is associated with longer PFS in patients treated with eve. 120 evaluable pts were needed for the pre planed statistical analysis. All samples were collected and processed in a standardized procedure in order to allow phophoproteins IHC staining. In addition to p4EBP1, we explored prognostic value of pS6K, pAkt, PTEN and LKB1, together with genomic alterations assessed by NGS and CGH arrays. Results: 150 pts were included, 30 pts had no adequate sample, and further 13 had missing clinical data, 107 were evaluable for primary objective. Median age was 62, they had previously progressed on AI treatment, either in the adjuvant (22 pts) or the metastatic setting (83 pts). 20 were considered as primary hormone resistant, 87 as secondary resistant. The median Allread score for p4EBP1 was 5.5 (range: 0-6.5). Analysis of the primary endpoint showed that p4EBP1 staining above the median is associated with a longer PFS on eve+exe. (median PFS: 9.3 months, 95CI 6.3-13.1 for high p4EBP1 versus 5.8 months, 95CI 3.7-7.8 for low p4EBP1, p = 0.02). Prognostic value of high pEBP1 remained significant when assessed in a multivariate analysis along classical clinico-biological prognostic factors for MBC (HR 0.57, 95%CI 0.38-0.88, p = 0.01). In this AI resistant population, the tumor of 42 (46%), 33 (35%) and 5 (5.3%) pts carried an activating mutation for ESR1, PIK3CA and AKT1, respectively. None of these mutational statuses were correlated to outcome. Conclusions: This prospective study validates p4EBP1 expression analysis to select patients most likely to benefit from everolimus + exemestane. Clinical trial information: NCT02444390.
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Affiliation(s)
| | | | | | | | - Mario Campone
- Institut de Cancérologie de l'Ouest, René Gauducheau, St Herblain, France
| | - Anne Patsouris
- Institute of West Cancerology Paul Papin, Angers, France
| | | | | | - Jean-Philippe Jacquin
- GINECO-Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest-En-Jarez, France
| | - Florence Dalenc
- Department of Medicalo Oncology, Institut Claudius Regaud, IUCT-Oncopole, CRCT, Inserm, Toulouse, France
| | | | | | - Alain Morel
- CRLCC Paul Papin, CRNA INSERM 892, Angers, France
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Prunaretty J, Cirella D, Debuire P, Ailleres N, Morel A, Simeon S, Valdenaire S, Fenoglietto P. EP-1946 First french clinical experience using the Calypso tracking system for the prostate treatment. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32366-7] [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: 11/26/2022]
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Morel A, Domaschke S, Urundolil Kumaran V, Alexeev D, Sadeghpour A, Ramakrishna S, Ferguson S, Rossi R, Mazza E, Ehret A, Fortunato G. Correlating diameter, mechanical and structural properties of poly(l-lactide) fibres from needleless electrospinning. Acta Biomater 2018; 81:169-183. [PMID: 30273744 DOI: 10.1016/j.actbio.2018.09.055] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/16/2018] [Accepted: 09/27/2018] [Indexed: 10/28/2022]
Abstract
The development and application of nanofibres requires a thorough understanding of the mechanical properties on a single fibre level including respective modelling tools for precise fibre analysis. This work presents a mechanical and morphological study of poly-l-lactide nanofibres developed by needleless electrospinning. Atomic force microscopy (AFM) and micromechanical testing (MMT) were used to characterise the mechanical response of the fibres within a diameter range of 200-1400 nm. Young's moduli E determined by means of both methods are in sound agreement and show a strong increase for thinner fibres below a critical diameter of 800 nm. Similar increasing trends for yield stress and hardening modulus were measured by MMT. Finite element analyses show that the common practice of modelling three-point bending tests with either double supported or double clamped beams is prone to significant bias in the determined elastic properties, and that the latter is a good approximation only for small diameters. Therefore, an analytical formula based on intermediate boundary conditions is proposed that is valid for the whole tested range of fibre diameters, providing a consistently low error in axial Young's modulus below 10%. The analysis of fibre morphology by differential scanning calorimetry and 2D wide-angle X-ray scattering revealed increasing polymer chains alignment in the amorphous phase and higher crystallinity of fibres for decreasing diameter. The combination of these observations with the mechanical characterisation suggests a linear relationship between Young's modulus and both crystallinity and molecular orientation in the amorphous phase. STATEMENT OF SIGNIFICANCE: Fibrous membranes have rapidly growing use in various applications, each of which comes with specific property requirements. However, the development and production of nanofibre membranes with dedicated mechanical properties is challenging, in particular with techniques suitable for industrial scales such as needleless electrospinning. It is therefore a key step to understand the mechanical and structural characteristics of single nanofibres developed in this process, and to this end, the present work presents changes of internal fibre structure and mechanical properties with diameter, based on dedicated models. Special attention was given to the commonly used models for analyzing Young's modulus of single nanofibers in three-point bending tests, which are shown to be prone to large errors, and an improved robust approach is proposed.
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Le Hello C, Trombert B, Morel A, Chieh A, Brouard B, Boissier C. Performance analysis of walking of 10,000 regular users of a connected activity tracker. J Med Vasc 2018; 43:231-237. [PMID: 29981731 DOI: 10.1016/j.jdmv.2018.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/20/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND According to the World Health Organization, individuals should walk 10,000 per day. Our aim was to determine the factors influencing this objective by using connected activity trackers. METHODS Anonymized data of 10,000 regular users of the Withings pulse Ox over a 3-month period. RESULTS Ratio men/women was 2.2, mean age 44.9±10.6 years, mean BMI 27.0±5.3kg/m2, proportion of individuals living in big towns 21.4%, proportion of physical activity<2 METs 66%. The frequency of achieving 10,000 daily steps was similar for work days, weekends and whole weeks. Mean number of daily steps, mean daily covered distances and slopes were higher during work days (P<0.0001); mean speed was higher during the weekends (P<0.0001). According to a quartile-repartition (percentages of use-days with 10,000 steps), the goal was more often achieved during work days (P<0.0001), if BMI<25kg/m2 (P<0.001), in individuals living in big towns (P<0.001) or having≥2 acquaintances to take up challenges (P<0.001). CONCLUSION Connected activity trackers represent a valuable tool for evaluating the number of daily steps and for providing feedback to promote walking.
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Affiliation(s)
- C Le Hello
- Therapeutic and Vascular Medicine Department, North University Hospital of Saint-Étienne, Jean-Monnet University of Saint-Etienne, Health and Innovations Campus, 42270 St-Priest-en-Jarez, France.
| | - B Trombert
- Public Health Department, North University Hospital of Saint-Etienne - EA4607 SNA-EPIS Laboratory (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean-Monnet University of Saint-Étienne, COMUE Lyon (Education and Research Cluster), 42270 St-Priest-en-Jarez, France
| | - A Morel
- Therapeutic and Vascular Medicine Department, North University Hospital of Saint-Étienne, Jean-Monnet University of Saint-Etienne, Health and Innovations Campus, 42270 St-Priest-en-Jarez, France
| | - A Chieh
- Withings, Medical Research and Health Department, 92130 Issy-les-Moulineaux, France
| | - B Brouard
- Withings, Medical Research and Health Department, 92130 Issy-les-Moulineaux, France
| | - C Boissier
- Therapeutic and Vascular Medicine Department, North University Hospital of Saint-Étienne, Jean-Monnet University of Saint-Etienne, Health and Innovations Campus, 42270 St-Priest-en-Jarez, France
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Boisdron-Celle M, Metges J, Capitain O, Faroux R, Stampfli C, Ferec M, Laplaige P, Lecomte T, Matysiak-Budnik T, Senellart H, Campone M, Morel A, Gamelin E. Primum non nocere: Screening patients for fluoropyrimidine-related toxicity risk: The most effective method. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.215] [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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Morel A. [Addictology, promoting users' power to act]. Rev Infirm 2018; 67:19-21. [PMID: 29331186 DOI: 10.1016/j.revinf.2017.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The notion of risk reduction applies to all uses, drinking of alcohol and smoking including, addictions without drugs likewise. With regard to drugs, mentalities change. We now talk more of risks than fault or deviance. Following, collaboration between health professionals and users, sharing and cooperation are the conditions necessary to develop a modern humanist and social addictology approach.
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Affiliation(s)
- Alain Morel
- Association Oppelia, 20 avenue Daumesnil, 75012 Paris, France.
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Pottier P, Cohen Aubart F, Steichen O, Desprets M, Pha M, Espitia A, Georgin-Lavialle S, Morel A, Hardouin JB. [Validity and reproducibility of two direct observation assessment forms for evaluation of internal medicine residents' clinical skills]. Rev Med Interne 2017; 39:4-9. [PMID: 29157753 DOI: 10.1016/j.revmed.2017.10.424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/22/2017] [Revised: 09/05/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The revision of the French medical studies' third cycle ought to be competency-based. In internal medicine, theoretical and practical knowledge will be assessed online with e-learning and e-portfolio. In parallel, a reflection about clinical skills assessment forms is currently ongoing. In this context, our aim was to assess the reproducibility and validity of two assessment forms based on direct clinical observation. METHOD A prospective and multicentric study has been conducted from November 2015 to October 2016 aiming at evaluating the French translations of the MINI-Clinical Examination Exercice (MINI-CEX) and the Standardized Patient Satisfaction Questionnaire (SPSQ). Included residents have been assessed 2 times over a period of 6 months by the same binoma of judges. RESULTS Nineteen residents have been included. The inter-judge reproducibility was satisfactory for the MINI-CEX: intraclass coefficients (ICC) between 0.4 and 0.8 and moderate for the SPSQ: ICC between 0.2 and 0.7 with a good internal coherence for both questionnaires (Cronbach between 0.92 and 0.94). Significant differences between the distributions of the scores given by the judges and a significant inter-center variability have been found. CONCLUSION If the absolute value of the scores should not be taken into account in the evaluation process given its high variability, it could be of interest for the follow-up of the progression in the competencies. These forms could support the residents' debriefing based on the general trends given by the scores.
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Affiliation(s)
- P Pottier
- Service de médecine interne, Hôtel-Dieu, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes, France; SPHERE U1246, Inserm, université de Nantes-université de Tours, 44000 Nantes, France.
| | - F Cohen Aubart
- Service de médecine interne 2, hôpital de la Pitié-Salpêtrière, université Paris-VI - Pierre-et-Marie-Curie, Assistance publique-Hôpitaux de Paris, 75013 Paris, France
| | - O Steichen
- Service de médecine interne, hôpital Tenon, UPMC université Paris 06, Sorbonne universités, AP-HP, 75970 Paris, France
| | - M Desprets
- Service de médecine interne, Hôtel-Dieu, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes, France
| | - M Pha
- Service de médecine interne 2, hôpital de la Pitié-Salpêtrière, université Paris-VI - Pierre-et-Marie-Curie, Assistance publique-Hôpitaux de Paris, 75013 Paris, France
| | - A Espitia
- Service de médecine interne, Hôtel-Dieu, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes, France
| | - S Georgin-Lavialle
- Service de médecine interne, hôpital Tenon, UPMC université Paris 06, Sorbonne universités, AP-HP, 75970 Paris, France
| | - A Morel
- SPHERE U1246, Inserm, université de Nantes-université de Tours, 44000 Nantes, France
| | - J B Hardouin
- SPHERE U1246, Inserm, université de Nantes-université de Tours, 44000 Nantes, France
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Morel A, Demily C. Cognition sociale dans les troubles neuro-génétiques de l’enfant : revue de la littérature. Arch Pediatr 2017; 24:757-765. [DOI: 10.1016/j.arcped.2017.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 01/15/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
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Nordmann S, Vilotitch A, Lions C, Michel L, Mora M, Spire B, Maradan G, Bendiane MK, Morel A, Roux P, Carrieri P. Pain in methadone patients: Time to address undertreatment and suicide risk (ANRS-Methaville trial). PLoS One 2017; 12:e0176288. [PMID: 28520735 PMCID: PMC5435132 DOI: 10.1371/journal.pone.0176288] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 04/07/2017] [Indexed: 12/21/2022] Open
Abstract
Background Pain in opioid-dependent patients is common but data measuring the course of pain (and its correlates) using validated scales in patients initiating methadone treatment are sparse. We aimed to assess pain and its interference in daily life, associated correlates, and undertreatment before and during methadone treatment. Methods This is a secondary analysis using longitudinal data of a randomized trial comparing two methadone initiation models. We assessed the effect of methadone initiation and other correlates on pain intensity and interference (using the Brief Pain Inventory) at months 0, 6 and 12 using a mixed multinomial logistic regression model. Results The study group comprised 168 patients who had data for either pain intensity or interference for at least one visit. Moderate to severe pain was reported in 12.9% of patients at M0, 5.4% at M6 and 7.3% at M12. Substantial interference with daily functioning was reported in 36.0% at M0, 14.5% at M6 and 17.1% at M12. Of the 98 visits where patients reported moderate to severe pain or substantial interference, 55.1% reported no treatment for pain relief, non-opioid analgesics were reported by 34.7%, opioid analgesics by 3.1% and both opioid and non-opioid analgesics by 7.1%. Methadone was associated with decreased pain intensity at 6 months (OR = 0.29, p = 0.04) and 12 months (OR = 0.30, p = 0.05) of follow-up and tended to be associated with substantial pain interference. Suicide risk was associated with both pain intensity and pain interference. Conclusions Methadone in opioid-dependent patients can reduce pain. However, undertreatment of pain in methadone patients remains a major clinical concern. Patients with pain are at higher risk of suicide. Adequate screening and management of pain in this population is a priority and needs to be integrated into routine comprehensive care.
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Affiliation(s)
- Sandra Nordmann
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Antoine Vilotitch
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Caroline Lions
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Laurent Michel
- INSERM, UMR-S 669, Paris, France
- Université Paris-Sud and Université Paris Descartes, UMR-S 669, Paris, France
- Centre Pierre Nicole, Paris, France
| | - Marion Mora
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Bruno Spire
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Gwenaelle Maradan
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marc-Karim Bendiane
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | | | - Perrine Roux
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Patrizia Carrieri
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- * E-mail:
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Obeid L, Prunaretty J, Ailleres N, Bedos L, Morel A, Simeon S, Fenoglietto P. EP-1675: Influence of CT contrast agent on head and neck VMAT dose distributions. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32207-7] [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: 10/19/2022]
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Boisdron-Celle M, Capitain O, Faroux R, Borg C, Philippe Metges J, Galais MP, Kaassis M, Bennouna J, Bouhier-Leporrier K, Francois E, Baumgaertner I, Guerin-Meyer V, Cojocarasu O, Roemer-Becuwe C, Stampfli C, Rosenfeld L, Lecompte T, Berger V, Morel A, Gamelin E. In reply. Semin Oncol 2017; 44:161. [DOI: 10.1053/j.seminoncol.2017.08.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Poli C, Augusto JF, Dauvé J, Adam C, Preisser L, Larochette V, Pignon P, Savina A, Blanchard S, Subra JF, Chevailler A, Procaccio V, Croué A, Créminon C, Morel A, Delneste Y, Fickenscher H, Jeannin P. IL-26 Confers Proinflammatory Properties to Extracellular DNA. J I 2017; 198:3650-3661. [DOI: 10.4049/jimmunol.1600594] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 02/24/2017] [Indexed: 12/12/2022]
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de Boissieu P, Kanagaratnam L, Mahmoudi R, Morel A, Dramé M, Trenque T. Adjudication of osteonecrosis of the jaw in phase III randomized controlled trials of denosumab: a systematic review. Eur J Clin Pharmacol 2017; 73:517-523. [PMID: 28188332 DOI: 10.1007/s00228-017-2210-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/09/2016] [Accepted: 01/30/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE Denosumab (an anti RANKL antibody) is known to be associated with an increased risk for osteonecrosis of the jaw (ONJ). Due to the variety of clinical presentation, many ONJ definitions are used. Evaluation of ONJ's frequency during phase III randomized controlled trials (RCTs) is crucial to assess benefit-risk ratio. We verified that phase III RCTs involving denosumab reported the definition of ONJ used. METHODS We systematically searched in Central, Medline, Cochrane, and Scopus, until 31 August 2015. We included original phase III RCTs, involving denosumab. Post hoc analysis and trial extension were excluded. Articles that did not mention ONJ in their methods or results were excluded. The primary outcome was the prevalence of a complete definition of ONJ. When no definition was provided, ONJ adjudication process was analyzed. RESULTS Of 313 articles found, 13 RCTs were included. A definition of ONJ was detailed in two RCTs (15%). For the remaining 11 RCTs, adjudication process was mentioned for nine. In those processes, "blinded," "expert," and "independent" were the most used words. CONCLUSION Most of the published phase III RCTs involving denosumab did not specify the definition of ONJ used to adjudicate events in the study. Instead of definition, non-scientific and non-reproducible expressions were used. Because the chosen definition could impact the ONJ estimated frequency, it should be mandatory to give the precise definition used in each RCT publication involving denosumab.
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Affiliation(s)
- Paul de Boissieu
- Regional Center for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, Avenue du Général Koenig, 51100, Reims, France. .,Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, France.
| | - L Kanagaratnam
- Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, France.,Department of Research and Innovation, Reims University Hospital, Reims, France
| | - R Mahmoudi
- Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, France.,Department of Geriatrics and Internal Medicine, Reims University Hospital, Reims, France
| | - A Morel
- Regional Center for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, Avenue du Général Koenig, 51100, Reims, France
| | - M Dramé
- Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, France.,Department of Research and Innovation, Reims University Hospital, Reims, France
| | - T Trenque
- Regional Center for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, Avenue du Général Koenig, 51100, Reims, France.,Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, France
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Boisdron-Celle M, Capitain O, Faroux R, Borg C, Metges JP, Galais MP, Kaassis M, Bennouna J, Bouhier-Leporrier K, Francois E, Baumgaertner I, Guerin-Meyer V, Cojocarasu O, Roemer-Becuwe C, Stampfli C, Rosenfeld L, Lecompte T, Berger V, Morel A, Gamelin E. Prevention of 5-fluorouracil-induced early severe toxicity by pre-therapeutic dihydropyrimidine dehydrogenase deficiency screening: Assessment of a multiparametric approach. Semin Oncol 2017; 44:13-23. [DOI: 10.1053/j.seminoncol.2017.02.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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50
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Boisdron-Celle M, Metges JP, Capitain O, Adenis A, Raoul JL, Lecomte T, Lam YH, Faroux R, Masliah C, Poirier AL, Berger V, Morel A, Gamelin E. A multicenter phase II study of personalized FOLFIRI-cetuximab for safe dose intensification. Semin Oncol 2017; 44:24-33. [DOI: 10.1053/j.seminoncol.2017.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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