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Pfister C, Gravis G, Flechon A, Chevreau C, Mahammedi H, Laguerre B, Guillot A, Joly F, Soulie M, Allory Y, Harter V, Culine S. Perioperative dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin in muscle-invasive bladder cancer (VESPER): survival endpoints at 5 years in an open-label, randomised, phase 3 study. Lancet Oncol 2024; 25:255-264. [PMID: 38142702 DOI: 10.1016/s1470-2045(23)00587-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The optimal perioperative chemotherapy for patients with muscle-invasive bladder cancer is not defined. The VESPER (French Genito-Urinary Tumor Group and French Association of Urology V05) trial reported improved 3-year progression-free survival with dose-dense methotrexate, vinblastine, doxorubicin and cisplatin (dd-MVAC) versus gemcitabine and cisplatin (GC) in patients who received neoadjuvant therapy, but not in the overall perioperative setting. In this Article, we report on the secondary endpoints of overall survival and time to death due to bladder cancer at 5-year follow-up. METHODS VESPER was an open-label, randomised, phase 3 trial done at 28 university hospitals or comprehensive cancer centres in France, in which adults (age ≤18 years and ≤80 years) with primary bladder cancer and histologically confirmed muscle-invasive urothelial carcinoma were randomly allocated (1:1; block size four) to treatment with dd-MVAC (every 2 weeks for a total of six cycles) or GC (every 3 weeks for a total of four cycles). Overall survival and time to death due to bladder cancer (presented as 5-year cumulative incidence of death due to bladder cancer) was analysed by intention to treat (ITT) in all randomly assigned patients. Overall survival was assessed by the Kaplan-Meier method with the treatment groups compared with log-rank test stratified for mode of administration of chemotherapy (neoadjuvant or adjuvant) and lymph node involvement. Time to death due to bladder cancer was analysed with an Aalen model for competing risks and a Fine and Gray regression model stratified for the same two covariates. Results were presented for the total perioperative population and for the neoadjuvant and adjuvant subgroups. The trial is registered with ClinicalTrials.gov, NCT01812369, and is complete. FINDINGS From Feb 25, 2013, to March 1, 2018, 500 patients were randomly assigned, of whom 493 were included in the final ITT population (245 [50%] in the GC group and 248 [50%] in the dd-MVAC group; 408 [83%] male and 85 [17%] female). 437 (89%) patients received neoadjuvant chemotherapy. Median follow-up was 5·3 years (IQR 5·1-5·4); 190 deaths at the 5-year cutoff were reported. In the perioperative setting (total ITT population), we found no evidence of association of overall survival at 5 years with dd-MVAC treatment versus GC treatment (64% [95% CI 58-70] vs 56% [50-63], stratified hazard ratio [HRstrat] 0·79 [95% CI 0·59-1·05]). Time to death due to bladder cancer was increased in the dd-MVAC group compared with in the GC group (5-year cumulative incidence of death: 27% [95% CI 21-32] vs 40% [34-46], HRstrat 0·61 [95% CI 0·45-0·84]). In the neoadjuvant subgroup, overall survival at 5 years was improved in the dd-MVAC group versus the GC group (66% [95% CI 60-73] vs 57% [50-64], HR 0·71 [95% CI 0·52-0·97]), as was time to death due to bladder cancer (5-year cumulative incidence: 24% [18-30] vs 38% [32-45], HR 0·55 [0·39-0·78]). In the adjuvant subgroup, the results were not conclusive due to the small sample size. Bladder cancer progression was the cause of death for 157 (83%) of the 190 deaths; other causes of death included cardiovascular events (eight [4%] deaths), deaths related to chemotherapy toxicity (four [2%]), and secondary cancers (four [2%]). INTERPRETATION Our results on overall survival at 5 years were in accordance with the primary endpoint analysis (3-year progression-free survival). We found no evidence of improved overall survival with dd-MVAC over GC in the perioperative setting, but the data support the use of six cycles of dd-MVAC over four cycles of GC in the neoadjuvant setting. These results should impact practice and future trials of immunotherapy in bladder cancer. FUNDING French National Cancer Institute.
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Affiliation(s)
- Christian Pfister
- Department of Urology, Charles Nicolle University Hospital, Rouen, France; Clinical Investigation Center, Onco-Urology, Inserm 1404, Rouen, France.
| | - Gwenaelle Gravis
- Department of Medical Oncology, Paoli-Calmette Institute, Marseille, France
| | - Aude Flechon
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | | | - Hakim Mahammedi
- Department of Medical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand, France
| | - Brigitte Laguerre
- Department of Medical Oncology, Eugène Marquis Cancer Center, Rennes, France
| | - Aline Guillot
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, St Priest, France
| | - Florence Joly
- Department of Medical Oncology, Baclesse Cancer Center, Caen, France
| | - Michel Soulie
- Department of Urology, Rangueil University Hospital, Toulouse, France
| | - Yves Allory
- Department of Pathology, Curie Institute, Saint-Cloud, France
| | - Valentin Harter
- North-West Canceropole Data Center, Baclesse Cancer Center, Caen, France
| | - Stéphane Culine
- Department of Medical Oncology, Saint-Louis Hospital, AP-HP, Université de Paris, Paris, France
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Guignand A, Bouleftour W, Vassal C, Tinquaut F, Rivoirard R, Guillot A. The Impact of an Enrolment in Clinical Trial on Tolerance and Pathological Response for Patients Treated by Neoadjuvant MVAC Against an Invasive Bladder Cancer. A Retrospective Comparative Study. Clin Genitourin Cancer 2024; 22:e14-e21.e3. [PMID: 37400296 DOI: 10.1016/j.clgc.2023.06.006] [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: 03/13/2023] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION MVAC (Methotrexate, Vinblastine, Adriamycin, and Cisplatin) neoadjuvant chemotherapy a standard treatment for invasive bladder cancer is associated with mainly haematological toxicities. Randomized clinical trials remain a gold standard for treatment outcomes and efficacy assessment. Patients enrolled in clinical trials are selected and tend to benefit from a stricter follow-up unlike everyday clinical practice patients. Conversely, real-life observational studies better define the effectiveness of treatments in clinical routine practice. The aim of this study is to analyse the impact of clinical trial monitoring on MVAC-related toxicities. MATERIAL AND METHODS Patients with an infiltrative localized bladder cancer treated by MVAC neoadjuvant chemotherapy between 2013 and 2019 were enrolled, and divided into 2 groups: patients included in a clinical trial namely "VESPER study" during their treatment and patients treated in clinical routine practice. RESULTS Out of 59 patients were enrolled in this retrospective study, 13 patients were included in a clinical trial. Clinical characteristics were similar between the 2 groups. Comorbidities were more frequent in the nonclinical trial group (NCTG). Completed 6 cures treatment proportion was higher in the clinical trial group (CTG) (69.2% vs. 50%). Yet, in this group, patients had more doses reduction (38.5% vs. 19.6%). The proportion of complete pathologic response was higher in patients enrolled in clinical trial (53.8% vs. 39.1%). Statistically, the expected stricter monitoring due to clinical trial enrolment had no impact on the complete pathologic response and clinically relevant toxicities. DISCUSSION When compared to conventional clinical practice, clinical trial enrolment induced no significant difference on the pathologic complete response or toxicity rate. Further large prospective studies are needed to confirm these data.
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Affiliation(s)
- Alexis Guignand
- Department of Medical Oncology, Saint-Etienne University Hospital-Etienne, Saint-Etienne, France
| | - Wafa Bouleftour
- Department of Medical Oncology, Saint-Etienne University Hospital-Etienne, Saint-Etienne, France.
| | - Cecile Vassal
- Oncology Department, Private Loire Hospital (HPL), Saint-Etienne, France
| | - Fabien Tinquaut
- Public Health and Medical Informatics Department, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Romain Rivoirard
- Oncology Department, Private Loire Hospital (HPL), Saint-Etienne, France
| | - Aline Guillot
- Oncology Department, Private Loire Hospital (HPL), Saint-Etienne, France
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Culine S, Harter V, Krucker C, Gravis G, Fléchon A, Chevreau C, Mahammedi H, Laguerre B, Guillot A, Joly F, Fontugne J, Allory Y, Pfister C. Refining the Characterization and Outcome of Pathological Complete Responders after Neoadjuvant Chemotherapy for Muscle-Invasive Bladder Cancer: Lessons from the Randomized Phase III VESPER (GETUG-AFU V05) Trial. Cancers (Basel) 2023; 15:cancers15061742. [PMID: 36980628 PMCID: PMC10046214 DOI: 10.3390/cancers15061742] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/15/2023] Open
Abstract
Neoadjuvant cisplatin-based chemotherapy (NAC) followed by radical cystectomy and pelvic lymph node dissection is the optimal treatment for patients with muscle-invasive bladder cancer. In recent years, the VESPER trial showed a statistically significant higher progression-free survival with dd-MVAC (dose dense methotrexate, vinblastine, doxorubicin, and cisplatin) compared to GC (gemcitabine and cisplatin). In the present report, we refine the characterization and outcome of patients whose cystectomy specimens were pathologically free of cancer (pathological complete response, pCR). We confirm that these patients portend a better outcome as compared to patients with invasive disease (≥pT1N0) at cystectomy. Nested variant and lymphovascular invasion were identified as adverse predictive factors of pCR. Progression-free survival probability three years after pCR on cystectomy was about 85%, regardless of the NAC regimen. A lower creatinine clearance and the delivery of less than four cycles were associated with a higher risk of relapse. Predicting the efficacy of NAC remains a major challenge. The planned analysis of molecular subtypes in the VESPER trial could help predict which patients may achieve complete response and better outcome.
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Affiliation(s)
- Stéphane Culine
- Department of Medical Oncology, Hôpital Saint-Louis, AP-HP, Nord, Université de Paris Cité, Avenue Claude Vellefaux, 75010 Paris, France
- Correspondence: ; Tel.: +33-142-494-247
| | - Valentin Harter
- North-West Canceropole Data Center, Baclesse Cancer Center, 14000 Caen, France
| | - Clémentine Krucker
- CNRS, UMR144, Molecular Oncology Team, Equipe Labellisée Ligue Contre le Cancer, PSL Research University, Institut Curie, 75005 Paris, France
| | - Gwenaelle Gravis
- Department of Medical Oncology, Paoli-Calmette Institute, 13009 Marseille, France
| | - Aude Fléchon
- Department of Medical Oncology, Léon Bérard Cancer Center, 69008 Lyon, France
| | - Christine Chevreau
- Department of Medical Oncology, ICR-IUCT Oncopole, 31100 Toulouse, France
| | - Hakim Mahammedi
- Department of Medical Oncology, Jean Perrin Cancer Center, 63011 Clermont-Ferrand, France
| | - Brigitte Laguerre
- Department of Medical Oncology, Eugène Marquis Cancer Center, 35042 Rennes, France
| | - Aline Guillot
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42270 St Priest en Jarez, France
| | - Florence Joly
- Department of Medical Oncology, Baclesse Cancer Center, 14000 Caen, France
| | - Jacqueline Fontugne
- CNRS, UMR144, Molecular Oncology Team, Equipe Labellisée Ligue Contre le Cancer, PSL Research University, Institut Curie, 75005 Paris, France
- Department of Pathology, Institut Curie, 92210 Saint-Cloud, France
- Université Paris-Saclay, UVSQ, 78180 Montigny-le-Bretonneux, France
| | - Yves Allory
- CNRS, UMR144, Molecular Oncology Team, Equipe Labellisée Ligue Contre le Cancer, PSL Research University, Institut Curie, 75005 Paris, France
- Department of Pathology, Institut Curie, 92210 Saint-Cloud, France
- Université Paris-Saclay, UVSQ, 78180 Montigny-le-Bretonneux, France
| | - Christian Pfister
- Department of Urology, Clinical Investigation Center, Inserm 1404, Charles Nicolle University Hospital, 76000 Rouen, France
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Pfister C, Gravis G, Fléchon A, Chevreau C, Mahammedi H, Laguerre B, Guillot A, Joly F, Soulié M, Allory Y, Harter V, Culine S. Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin or Gemcitabine and Cisplatin as Perioperative Chemotherapy for Patients With Nonmetastatic Muscle-Invasive Bladder Cancer: Results of the GETUG-AFU V05 VESPER Trial. J Clin Oncol 2022; 40:2013-2022. [PMID: 35254888 DOI: 10.1200/jco.21.02051] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The optimal perioperative chemotherapy regimen for patients with nonmetastatic muscle-invasive bladder cancer is not defined. PATIENTS AND METHODS Between February 2013 and March 2018, 500 patients were randomly assigned in 28 French centers and received either six cycles of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) once every 2 weeks or four cycles of gemcitabine and cisplatin (GC) once every 3 weeks before surgery (neoadjuvant group) or after surgery (adjuvant group). We report the primary end point of the GETUG-AFU V05 VESPER trial (ClinicalTrials.gov identifier: NCT01812369): progression-free survival (PFS) at 3 years. Secondary end points were time to progression and overall survival. RESULTS Four hundred thirty-seven patients (88%) received neoadjuvant chemotherapy; 60% of patients received the planned six cycles in the dd-MVAC arm, 84% received four cycles in the GC arm, and thereafter, 91% and 90% of patients underwent surgery, respectively. Organ-confined response (< ypT3N0) was observed more frequently in the dd-MVAC arm (77% v 63%, P = .001). In the adjuvant group, 40% of patients received six cycles in the dd-MVAC arm, and 81% of patients received four cycles in the GC arm. For all patients in the clinical trial, 3-year PFS was improved in the dd-MVAC arm, but the study did not meet its primary end point (3-year rate: 64% v 56%, hazard ratio [HR] = 0.77 [95% CI, 0.57 to 1.02], P = .066); nevertheless, the dd-MVAC arm was associated with a significantly longer time to progression (3-year rate: 69% v 58%, HR = 0.68 [95% CI, 0.50 to 0.93], P = .014). In the neoadjuvant group, PFS at 3 years was significantly higher in the dd-MVAC arm (66% v 56%, HR = 0.70 [95% CI, 0.51 to 0.96], P = .025). CONCLUSION In the VESPER trial, dd-MVAC improved 3-years PFS over GC. In the neoadjuvant group, a better bladder tumor local control and a significant improvement in 3-year PFS were observed in the dd-MVAC arm.
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Affiliation(s)
- Christian Pfister
- Department of Urology, Charles Nicolle University Hospital, Rouen, France.,Clinical Investigation Center, Onco-Urology, Inserm 1404, Rouen, France
| | - Gwenaelle Gravis
- Department of Medical Oncology, Paoli-Calmette Institute, Marseille, France
| | - Aude Fléchon
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | | | - Hakim Mahammedi
- Department of Medical Oncology, Jean Perrin Cancer Center, Clermont-Ferrand, France
| | - Brigitte Laguerre
- Department of Medical Oncology, Eugène Marquis Cancer Center, Rennes, France
| | - Aline Guillot
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, St Priest, France
| | - Florence Joly
- Department of Medical Oncology, Baclesse Cancer Center, Caen, France
| | - Michel Soulié
- Department of Urology, Rangueil University Hospital, Toulouse, France
| | - Yves Allory
- Department of Pathology, Curie Institute, Saint-Cloud, France
| | - Valentin Harter
- North-West Canceropole Data Center, Baclesse Cancer Center, Caen, France
| | - Stéphane Culine
- Department of Medical Oncology, Saint-Louis Hospital, AP-HP, Faculté de Paris, France
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Thiery-Vuillemin A, Gravis G, Schlürmann F, Bompas E, Rolland F, Gross-Goupil M, Vano YA, Guillot A, Barthélémy P, Joly C, Laramas M, Dourthe LM, Maurina T, Gauthier H, Taillandy K, Meurisse A, Vernerey D, Albiges L. Randomized phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen in anti-angiogenic naïve patients with metastatic renal cell carcinoma (mRCC): Final analysis of SURF study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.344] [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: 11/20/2022] Open
Abstract
344 Background: SUN is approved in mRCC setting at the dose of 50mg daily for 4 weeks followed by 2 weeks rest (4/2 schedule). The 4/2 schedule often requires dose modifications for toxicity. Current recommendation is to reduce the dose to 37.5mg per day. Alternative schedules (2 weeks of treatment followed by one-week rest (2/1 schedule) have shown promising results. SURF trial evaluated prospectively schedule 2/1 when toxicity occurs. Methods: SURF [NCT02689167] is a prospective, non-comparative randomized study. Patients (pts) with mRCC (clear cell) were included at SUN initiation. When a dose adjustment of SUN was required, patients were randomized between 4/2 schedule at 37.5mg daily and experimental 2/1 schedule at 50mg daily. Primary objective was to assess duration of SUN treatment among the 73 first evaluable pts. Overall 226 pts were enrolled with 133 randomized. All other analyses are shown for the 133 randomized patients. Results: Pts were 75.2% males, with a median age 63.7 years for 94% with a Karnofsky ≥ 80%. Of them, 54.9% had partial/total nephrectomy. IMDC risk score was favourable (45.1%), intermediate (46.6%) or poor (8.3%). Pts characteristics were well balanced between 2 arms. Metastatic sites were lungs (60.5%), bones (16.3%), lymph nodes (15.5%). At 6 months, 48 patients (65.8%) of the 2/1 schedule were still on treatment (above predefined threshold for positivity). Other data are listed on the table. No new safety signal was identified. Permanent SUN discontinuation due to toxicity was 22.2% in control arm vs 12.3% in experimental arm. Conclusions: SURF is the largest prospective randomised trial evaluating two different SUN schedules modifications in mRCC in case of toxicity. This positive trial confirms the role of adapting SUN to a 2/1 schedule rather than reducing SUN dose to the classical 4/2 schedule. Clinical trial information: NCT02689167. [Table: see text]
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Affiliation(s)
| | | | | | | | - Frederic Rolland
- Institut de Cancérologie de l'Ouest, Department of Medical Oncology, Saint-Herblain, France
| | - Marine Gross-Goupil
- Centre Hospitalier Universitaire de Bordeaux-Hôpital Saint-André, Bordeaux, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | | | - Charlotte Joly
- Oncology Department, Hôpital Henri Mondor, APHP, Créteil, France
| | | | | | | | | | | | - Aurelia Meurisse
- Methodology and Quality of Life Unit, Department of Oncology University Hospital, Besancon, France
| | - Dewi Vernerey
- Methodology and Quality of Life Unit in Oncology, Department of Oncology, University Hospital of Besancon, Besançon, France
| | - Laurence Albiges
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
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Bouleftour W, Guillot A, Magné N. The Anti-Nectin 4: A Promising Tumor Cells Target. A Systematic Review. Mol Cancer Ther 2022; 21:493-501. [PMID: 35131876 DOI: 10.1158/1535-7163.mct-21-0846] [Citation(s) in RCA: 2] [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] [Received: 10/19/2021] [Revised: 12/17/2021] [Accepted: 01/25/2022] [Indexed: 11/16/2022]
Abstract
The nectin cell adhesion protein 4 (Nectin-4) is overexpressed in multiple human malignancies. Such aberrant expression is correlated with cancer progression and poor prognostic. Nectin-4 has emerged as a potential biomarker and promising targeted therapy. This review aimed to gather the current state of the literature about Nectin-4 relevance in preclinical tumor models and to summarize its clinical relevance regarding cancer. A systematic assessment of literature articles was performed by searching in PUBMED (MEDLINE) from the database inception to May 2021, following PRISMA guidelines. Preclinical models unanimously demonstrated membrane and cytoplasmic location of the Nectin-4. Furthermore, Nectin-4 was overexpressed whatever the location of the solid tumors. Interestingly, a heterogeneity of Nectin-4 expression has been highlighted in bladder urothelial carcinoma. High serum Nectin-4 level was correlated with treatment efficiency and disease progression. Finally, generated Anti-drug-Conjugated targeting Nectin-4 induced cell death in multiple tumor cell lines. Nectin-4 emerge as a promising target for anti-cancer drugs development because of its central role in tumorigenesis, and lymphangiogenesis. Enfortumab vedotin targeting Nectin-4 demonstrated encouraging results and should be extended to other types of solid tumors.
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Affiliation(s)
- Wafa Bouleftour
- Medical oncology department, Institut de cancérologie de la loire
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Pfister C, Gravis G, Flechon A, Chevreau C, Mahammedi H, Laguerre B, Guillot A, Joly F, Soulié M, Allory Y, Harter V, Culine S. Dose dense methotrexate, vinblastine, doxorubicin et cisplatin (DD-MVAC) versus gemcitabine et cisplatin (GC) comme chimiothérapie péri-opératoire dans le cancer de vessie localisé infiltrant le muscle. résultats de la phase III GETUG/AFU vesper V05. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.111] [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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Pujalte Martin M, Borchiellini D, Thamphya B, Guillot A, Paoli JB, Besson D, Hilgers W, Priou F, El Kouri C, Hoch B, Deville JL, Schiappa R, Cheli S, Milano G, Tanti JF, Bost F, Ferrero JM. TAXOMET: A French Prospective Multicentric Randomized Phase II Study of Docetaxel Plus Metformin Versus Docetaxel Plus Placebo in Metastatic Castration-Resistant Prostate Cancer. Clin Genitourin Cancer 2021; 19:501-509. [PMID: 34629300 DOI: 10.1016/j.clgc.2021.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 06/15/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Docetaxel (DOCE) is a standard of care in metastatic castration-resistant prostate cancer (mCRPC). Several retrospective studies suggested a decrease in Prostate Cancer incidence and mortality with metformin (MET). MET has also demonstrated anti-tumor activity in Prostate Cancer preclinical models, with increased apoptosis when added to DOCE. We aimed at exploring the role of MET in combination with DOCE in mCRPC. PATIENTS AND METHODS Non-diabetic mCRPC patients were randomly assigned to receive DOCE 75 mg/m2 every 21 days + prednisone (5 mg. BID) with either MET 850 mg BID (D+M) or placebo (D+P) up to 10 cycles. Prostate-Specific Antigen (PSA) response ≥50% from baseline was the primary end point. Secondary end points included objective response rate (ORR), progression-free survival (PFS), overall survival (OS), toxicity and quality of life (QoL). RESULTS Out of 99 patients were randomized (D+M = 50; D+P = 49) in 10 French centers. The median follow-up was 86 (IQR 73-88) months. The PSA-response rate reached 66% in the D+M arm, but was not different from that observed in the D+P arm (63%, P = 0,94). In the D+M and D+P arms, the ORR was 28% and 24%, the median PFS was 7.8 and 6.0 months and the median OS was 27 and 20 months (ns), respectively. Diarrhea grade I to II was more frequent in the MET arm (66% vs. 43%). No impairment of QoL was observed. CONCLUSION MET addition failed to improve the standard DOCE regimen in mCRPC. Further research targeting tumor cell metabolism should be performed.
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Affiliation(s)
- Marc Pujalte Martin
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France.
| | - Delphine Borchiellini
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Brice Thamphya
- Research Departement, Epidemiology and Bioinformatics Unit, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Aline Guillot
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | | | - Dominique Besson
- Department of Medical Oncology, Centre Cario-HPCA, Plérin, France
| | - Werner Hilgers
- Department of Medical Oncology, Sainte Catherine Cancer Institute, Avignon Provence, France
| | - Frank Priou
- Department of Medical Oncology, CHD Vendée, La Roche sur Yon, France
| | - Claude El Kouri
- Department of Medical Oncology, Centre Catherine de Sienne, Nantes, France
| | - Benjamin Hoch
- Department of Medical Oncology, Centre Azuréen de Cancérologie, Mougins
| | | | - Renaud Schiappa
- Research Departement, Epidemiology and Bioinformatics Unit, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Sandrine Cheli
- Clinical Research and Innovation Department, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Gérard Milano
- Oncopharmacology Unit, EA3836, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | | | - Frédéric Bost
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
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Pfister C, Gravis G, Flechon A, Chevreau C, Mahammedi H, Laguerre B, Guillot A, Joly F, Soulie M, Allory Y, Harter V, Culine S. 652O Dose-dense methotrexate, vinblastine, doxorubicin and cisplatin (dd-MVAC) or gemcitabine and cisplatin (GC) as perioperative chemotherapy for patients with muscle-invasive bladder cancer (MIBC): Results of the GETUG/AFU VESPER V05 phase III trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Blanchard P, Foulon S, Artignan X, Carles J, Ronchin P, Gizzi M, Villa Freixa S, Valdagni R, Sargos P, Marques Da Costa L, Duberge T, Guillot A, Latorzeff I, Gallardo E, Sáez M, Abadie-Lacourtoisie S, Bennamoun M, Hasbini A, Tantot F, Fizazi K. 646TiP A randomized phase III, factorial design, of cabazitaxel and pelvic radiotherapy in patients with localized prostate cancer and high-risk features of relapse: The PEACE 2 trial from Unicancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1159] [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] Open
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Bouleftour W, Boussoualim K, Sotton S, Vassal C, Thomas T, Magne N, Guillot A. Second-generation hormonotherapy in prostate cancer and bone microenvironment. Endocr Relat Cancer 2021; 28:T39-T49. [PMID: 33974558 DOI: 10.1530/erc-21-0118] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/07/2021] [Indexed: 11/08/2022]
Abstract
Prostate cancer (Pca) is the most commonly diagnosed cancer affecting men in France. Before the age of 75 years old, 1 in 8 French men will have Pca. Androgen deprivation therapies (ADT) remain the standard of care. Such therapies induce significant bone loss. The bone-remodelling cycle depends on the androgen synthesis signalling pathways. Furthermore, age-specific hormonal decline plays a key role in the decrease in bone mass. As a result, the older the patients, the more likely they are to have osteoporosis if they are treated with hormone therapy. Their risk of osteoporotic fracture has an impact on their quality of life and their capacity of independent living. In recent years, newer hormone therapies (acetate abiraterone, enzalutamide, apalutamide and darolutamide) have proved efficient in metastatic castration-resistant Pca (mCRPC) patients as well as in hormone naïve patients, and actually in nonmetastatic diagnosis. The combination of these treatments with ADT highly inhibit androgen production pathways. They are prescribed to aged patients undergoing bone density loss after first-generation antiandrogen treatment. Specific recommendations for bone health management in Pca patients are currently lacking. To date, bone mineral density in patients treated with second-generation hormone therapy has never been assessed in a prospective study. This review aims at reviewing what is known about the impact of second-generation hormonotherapy on bone microenvironment.
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Affiliation(s)
- Wafa Bouleftour
- Department of Medical Oncology, Lucien Neuwirth cancer institute, Saint Priest en Jarez, Rhône-Alpes, France
| | - Karima Boussoualim
- Department of rheumatology, North Hospital, university Hospital of Saint-Étienne, Saint-Priest-en-Jarez, Rhône-Alpes, France
| | - Sandrine Sotton
- Department of Radiotherapy, Lucien Neuwirth Cancerology Institute, Saint Priest en Jarez, Rhône-Alpes, France
| | - Cecile Vassal
- Department of Medical Oncology, Lucien Neuwirth cancer institute, Saint Priest en Jarez, Rhône-Alpes, France
| | - Thierry Thomas
- Department of rheumatology, North Hospital, university Hospital of Saint-Étienne, Saint-Priest-en-Jarez, Rhône-Alpes, France
| | - Nicolas Magne
- Department of Radiotherapy, Lucien Neuwirth Cancerology Institute, Saint Priest en Jarez, Rhône-Alpes, France
| | - Aline Guillot
- Department of Medical Oncology, Lucien Neuwirth cancer institute, Saint Priest en Jarez, Rhône-Alpes, France
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Bouleftour W, Muron T, Guillot A, Tinquaut F, Rivoirard R, Jacquin JP, Saban-Roche L, Boussoualim K, Tavernier E, Augeul-Meunier K, Collard O, Mery B, Pupier S, Oriol M, Bourmaud A, Fournel P, Vassal C. Effectiveness of a nurse-led telephone follow-up in the therapeutic management of patients receiving oral antineoplastic agents: a randomized, multicenter controlled trial (ETICCO study). Support Care Cancer 2021; 29:4257-4267. [DOI: 10.1007/s00520-020-05955-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/15/2020] [Indexed: 12/30/2022]
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13
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Thiery-Vuillemin A, Gravis G, Constans Schlurmann F, Bompas E, Rolland F, Gross-Goupil M, Vano Y, Guillot A, Barthélémy P, Joly C, Laramas M, Dourthe L, Maurina T, Gauthier Petithuguenin H, Taillandy K, Meurisse A, Vernerey D, Albiges L. 720P Randomised phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen in anti-angiogenic naïve patients with metastatic renal cell carcinoma (mRCC): Interim analysis (IA) of SURF study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.792] [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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14
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Delanoy N, Hardy-Bessard AC, Efstathiou E, Moulec SL, Basso U, Birtle A, Thomson A, Krainer M, Guillot A, Giorgi UD, Hasbini A, Daugaard G, Bahl A, Chowdhury S, Caffo O, Beuzeboc P, Spaeth D, Eymard JC, Fléchon A, Alexandre J, Helissey C, Butt M, Priou F, Lechevallier E, Deville JL, Gross-Goupil M, Morales R, Thiery-Vuillemin A, Gavrikova T, Barthélémy P, Sella A, Fizazi K, Ferrero JM, Laguerre B, Thibault C, Hans S, Oudard S. Erratum to ‘Clinical progression is associated with poor prognosis whatever the treatment line in metastatic castration-resistant prostate cancer: The CATS international database’ [European Journal of Cancer, Volume 125 (January 2020) Pages 153–163]. Eur J Cancer 2020; 137:290-291. [DOI: 10.1016/j.ejca.2020.06.013] [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]
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15
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Chanal E, Bouleftour W, Dridi M, Héritier P, Gagneux-Brunon A, Vassal C, Guillot A. [A complex case of miliary pulmonary tuberculosis following intravesical BCG therapy]. Rev Med Liege 2020; 75:518-520. [PMID: 32779902] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Bladder cancer (urothelial carcinoma in 90 % of cases) is the most common neoplasia of the urinary tract. Superficial carcinoma represents 70-80 % of bladder cancers. The treatment of these tumours includes, after transuretral resection, intravesical Bacillus Calmette-Guerin (BCG) instillation therapy. This treatment constitutes, by its immune-mediated anti-tumoral action, the first step of immunotherapy in cancer. Severe complications (granulomatosis, hypersensitivity pneumonitis or orchitis) are rare (0.5-2 %). Here we report a complex case of pulmonary granulomatosis secondary to BCG therapy. This is a 74-year-old male, treated for superficial bladder carcinoma by transuretral resection (pT1G3) and then endovesical instillations of BCG therapy for two months. Two years later, a new transuretral resection shows an infiltrating urothelial carcinoma pT2G3. The extension balance finds a persistent micro-nodular pulmonary infiltrate. A broncho-alveolar lavage is then realised but no mycobacteria was found. A surgical biopsy of a nodule is performed and revealed a histiocytic reaction without any neoplastic element. Detection of Mycobacterium tuberculosis by Polymerase Chain Reaction (PCR) was finally positive. In the absence of a secondary lesion, the patient had a cysto-prostatectomy and began a tritherapy against tuberculosis. Post-BCG therapy granulomatosis is a rare complication but should remain a differential diagnosis in front of the appearance of pulmonary nodes in patients who have received posttransuretral resection BCG instillations. Mycobacterial DNA PCR research remains the most sensitive examination.
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Affiliation(s)
- E Chanal
- Département d'Oncologie médicale, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - W Bouleftour
- Département d'Oncologie médicale, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - M Dridi
- Département d'Oncologie médicale, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - P Héritier
- Département de Chirurgie urologique, Clinique du Parc, Saint-Priest-en-Jarez, France
| | | | - C Vassal
- Département d'Oncologie médicale, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - A Guillot
- Département d'Oncologie médicale, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
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Thorey V, Guillot A, El Kanbi K, Harris M, Arnal PJ. 1211 Assessing the Accuracy of a Dry-EEG Headband for Measuring Brain Activity, Heart Rate, Breathing and Automatic Sleep Staging. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1205] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
The development of new sleep study devices, adapted for daily use, is necessary for diagnosis of sleep disorders. However, this requires to be both suitable for daily use and capable of recording accurate electrophysiological data. This study assesses the signal acquisition of a comfortable sleep headband, using dry electrodes, and the performance of its automatic sleep staging algorithms compared to the gold-standard clinical PSG scored by 4 sleep experts.
Methods
42 participants slept at a sleep center wearing both the Dreem headband (DH) and a PSG simultaneously. We measured 1) the EEG signal similarity between both devices, 2) heart rate, breathing frequency and respiration rate variability (RRV) agreement, and 3) the performance of the headband automatic sleep scoring compared to PSG sleep experts manual scoring.
Results
Results demonstrate a strong correlation between the EEG signals acquired by the headband and those from the PSG, and the signals acquired by the headband enable monitoring of alpha (r= 0.75 ± 0.11), beta (r= 0.74 ± 0.14), delta (r = 0.78 ± 0.16), and theta (r = 0.63 ± 0.15) frequencies during sleep. The mean absolute error for heart rate, breathing frequency, and RRV was 2.2 ± 0.8 bpm, 0.3 ± 0.2 cpm and 3.1 ± 0.4 %, respectively. Automatic Sleep Staging reached an overall accuracy of 84.1 ± 7.5% (F1 score: 83.0 ± 8.4) for the headband to be compared with an average of 86.4 ± 5.5% (F1 score: 86.5 ± 5.5) for the 4 sleep experts.
Conclusion
These results demonstrate the capacity of the headband to both precisely monitor sleep-related physiological signals and process them accurately into sleep stages. This device paves the way for high-quality, large-scale, longitudinal sleep studies.
Support
This Study has been supported by Dreem sas.
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Affiliation(s)
- V Thorey
- Dreem Algorithms Team, Paris, FRANCE
| | - A Guillot
- Dreem Algorithms Team, Paris, FRANCE
| | | | - M Harris
- Dreem Science Team, New York, NY
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Guillot A, Moutakanni T, Harris M, Arnal PJ, Thorey V. 0616 Validation of a Sleep Headband for Detecting Obstructive Sleep Apnea. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.613] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Polysomnography (PSG) is the gold-standard to diagnose obstructive sleep apnea (OSA). OSA severity diagnosis is defined by the apnea-hypopnea index (AHI) defined as the number of apnea and hypopnea events measured per hour of sleep. The Dreem2 headband (DH) is a self-administered, easy to use device that measure EEG, breathing frequency, heart rate and sound at-home. In our study, we assessed the performance of the DH to automatically detects OSA compared to 3 sleep’s experts scoring on PSG.
Methods
41 subjects (8 females, 42.6 ± 13.7 y.o.) having a suspicion of OSA performed a night at-home wearing both a PSG and the DH. Each PSG record was scored for apnea and hypopnea events by 3 independent trained sleep experts following AASM guidelines. The deep learning approach DOSED, was trained on the DH signals using the manual apnea scoring. 10-fold cross-validation was used to provide predictions for each of the 41 subjects with the DH.
Results
We observed an average AHI expert’s scoring of 13.6 ± 10.1 CI[10.5, 16.5] compared to 12.9 ± 10.3 CI[9.6, 15.8] for the DH. Both, the correlation between the 3 scorers (r= 0.88, p < 0.001) and the DH and the scorers (r=0.79, p< 0.001) were significant. The specificity and sensitivity to detect mild OSA (AHI ≤ 5) was 84.4 % and 96.4 % for the DH and 86.5 % and 86.0% for the scorers.
Conclusion
The results show that the DH using deep learning can detect OSA with an accuracy similar to the sleep experts. The use of DH paves the way for longitudinal monitoring of patients with a suspicion of OSA and its accessibility could lead to better screening of the general population.
Support
This Study has been supported by Dreem sas.
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Affiliation(s)
- A Guillot
- Dreem Algorithms Team, Paris, FRANCE
| | | | - M Harris
- Dreem Science Team, New York, NY
| | | | - V Thorey
- Dreem Algorithms Team, Paris, FRANCE
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18
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Mourey L, Flechon A, Tosi D, Abadie Lacourtoisie S, Joly F, Guillot A, Loriot Y, Dauba J, Roubaud G, Rolland F, Abraham C, Gauthier H, Barthelemy P, Gravis G, Nénan-Le Ficher S, Cabarrou B, Filleron T. Vefora, GETUG-AFU V06 study: Randomized multicenter phase II/III trial of fractionated cisplatin (CI)/gemcitabine (G) or carboplatin (CA)/g in patients (pts) with advanced urothelial cancer (UC) with impaired renal function (IRF)—Results of a planned interim analysis. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.461] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
461 Background: Standard treatment for advanced UC is chemotherapy (CT) combining CI and G. 70% of pts with UC are over 65 and 40% of them are unfit for CI because of IRF or comorbidities. CA replaces frequently CI, when creatinine clearance (Cr Cl) is < 60 ml/min according to Cockroft and Gault formula (CGF). However, CA tends to show a lower efficacy than CI, due to decreased dose intensity of CT. Methods: We performed a multicentre randomized phase II/III study in order to compare the activity and safety of a CT regimen with fractionated CI or CA for advanced UC in 1st line setting among pts unfit for standard CT because of IRF (40 ≤ Cr Cl ≤ 60ml/min) according to CGF. We report here the results of the interim analysis of phase II. Treatment: Arm A: CA AUC4,5 D1+ G 1000 mg/m² D1, [D1 = D21]; Arm B: fractionated CI 35 mg/m² D1D8 + G 1000 mg/m² D1D8, [D1 = D21] The co-primary objectives of the phase II were to evaluate activity (non-progression (RECIST V1.1) at (D21 C6)) and safety defined by the absence during treatment of: IRF: Cr Cl <35 mL/min or deterioration of Cr Cl >20%; delayed CT (≥ 2 weeks); decrease twice G dose on day 1 for: NCI CTC grade III or IV non-hematologic toxicity; hematologic toxicity; A two-stage Bryant and Day design was used. Results: A planned first step analysis was performed after randomization of 25 and 21 pts from April 2015 to January 2018. 23 and 19 of them were evaluable (resp. Arm A/B). 8 failures were reported for safety reason in experimental arm B, 7 for renal toxicity. Conclusions: According to our pre planned first step analysis, the trial met criteria for excessive toxicity in experimental arm (fractionated CI), predominantly renal toxicity. The study was therefore definitely stopped. Survival results will be available at the meeting. Clinical trial information: NCT02240017 . [Table: see text]
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Affiliation(s)
- Loic Mourey
- Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Aude Flechon
- Departement of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Diego Tosi
- Medical Oncology Department, Institut du Cancer de Montpellier, Montpellier, France
| | | | | | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | | | | | | | - Frederic Rolland
- Institut de Cancerologie de l'Ouest, René Gauducheau, St Herblain, France
| | | | | | | | | | | | | | - Thomas Filleron
- Institut Universitaire du Cancer - Oncopole, Toulouse, France
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Chanal E, Bousarsar A, Vallard A, Méry B, Vincent L, Flechon A, Chanelière AF, Daguenet E, Bouleftour W, Vassal C, Magné N, Guillot A. [Docetaxel for octogerian metastatic castration-resistant prostate cancer patient: A multicentric ten years' experience]. Bull Cancer 2019; 107:171-180. [PMID: 31901292 DOI: 10.1016/j.bulcan.2019.11.006] [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: 08/02/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION There is very few data about the management of elderly patients with metastatic castration-resistant prostate cancer (mCRPC). The aim of this study was to analyze the management of patients aged 80 and over treated with docetaxel for a mCRPC. METHODS AND MATERIALS Clinical and pathological characteristics of octogerians treated with docetaxel were collected retrospectively from 3 French centers from 2009 to 2019. Patient's outcome, treatments administered before and/or after docetaxel were also analyzed. RESULTS Data of 89 patients could be analyzed. A total of 20.2 % of patients received the standard regimen and 79.8 % received an adapted one. Patients in the adapted group were significantly older than in standard one. Other patient's characteristics - including the geriatric scales - were similar. Dose reductions for toxicity were more frequent in the standard group (P=0.04). The median overall survival of the total population was 13.3 months. It was longer in the standard group than in the adapted group (26.1 months vs 12.4 months=0.01). In multivariate analysis, the type of docetaxel regimen (standard versus adapted) was an independent predictor of survival. CONCLUSION This study suggests the benefit of the standard management even in oldest patients. A geriatric evaluation should certainly be processed in patients with poor oncogeriatric scale in order to select the sub-population able to receive the full dose standard docetaxel regimen.
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Affiliation(s)
- Edouard Chanal
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Amal Bousarsar
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Alexis Vallard
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Benoite Méry
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Lionel Vincent
- Centre hospitalier de Roanne, département d'oncologie, 28, rue de Charlieu, 42300 Roanne, France
| | - Aude Flechon
- Centre Léon-Bérard, département d'oncologie, 28, promenade Léa et Napoléon-Bullukian, 69008 Lyon, France
| | - Anne-Françoise Chanelière
- Centre hospitalo-universitaire Nord de Saint-Étienne, département de gériatrie, avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Elisabeth Daguenet
- Institut de cancérologie Lucien-Neuwirth, département universitaire de recherche et d'enseignement, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Wafa Bouleftour
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Cécile Vassal
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Nicolas Magné
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France.
| | - Aline Guillot
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France
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Thorey V, Harris M, Guillot A, Hernandez A, Arnal P. The dreem2 headband as an alternative to polysomnography for EEG signal acquisition, breathing and heart rate monitoring and sleep staging in healthy subjects. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1068] [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]
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Dridi M, Bouleftour W, Rivoirard R, Dal Col P, Langrand-Escure J, Vassal C, Guillot A. Leptomeningeal Metastases in Renal Cell Carcinoma at Initial Diagnosis: 2 Case Reports and Literature Review. Cancer Invest 2019; 37:501-505. [PMID: 31583922 DOI: 10.1080/07357907.2019.1662031] [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] [Indexed: 10/25/2022]
Abstract
Leptomeningeal metastasis (LM) in solid tumors are rare, even more in renal cell carcinoma (RCC). To date there is a lack of consensual treatment modalities of leptomeningeal metastasis. Furthermore, with the improvement of outcomes and more effective systemic targeted therapies, the management of leptomeningeal metastasis becomes a real challenge. We here report two cases of RCC with leptomeningeal metastasis at initial diagnosis. Both patients had concurrent adjacent skull bone metastasis. Therapeutic management of both patients consisted in surgical resection, followed by radiotherapy in one case. Systemic treatment was delayed according to current recommendations for the management of metastatic RCC. The aim of this work is to report the therapeutic approach and related outcomes and also provide a review of the currently available literature on leptomeningeal disease in renal cell carcinoma. Indeed, local treatment with curative outcome of meningeal location in RCC should be performed specially in LM at initial diagnosis.
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Affiliation(s)
- Manel Dridi
- Department of Medical Oncology, Institut de Cancérologie Lucien Neuwirth , Saint Priest en Jarez , France
| | - Wafa Bouleftour
- Department of Medical Oncology, Institut de Cancérologie Lucien Neuwirth , Saint Priest en Jarez , France
| | - Romain Rivoirard
- Department of Medical Oncology, Institut de Cancérologie Lucien Neuwirth , Saint Priest en Jarez , France
| | - Pierre Dal Col
- Anatomo-pathology Department, CHU de Saint Etienne , Saint-Etienne , France
| | - Julien Langrand-Escure
- Department of Radiotherapy, Institut de Cancérologie Lucien Neuwirth , Saint Priest en Jarez , France
| | - Cécile Vassal
- Department of Medical Oncology, Institut de Cancérologie Lucien Neuwirth , Saint Priest en Jarez , France
| | - Aline Guillot
- Department of Medical Oncology, Institut de Cancérologie Lucien Neuwirth , Saint Priest en Jarez , France
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22
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Chanal E, Bouleftour W, Guillot A, Rowinski E, Bernichon E, Tremeau L, Lardon R, Lacroix B, Lorin S, Delorme G, Perraud Y, Armand C, Levigne F, Vallard A, Langrand-Escure J, Fournel P, Benoite M, Vassal C. Current management of stage I testicular germ cell tumors in a French cancer institute. A practice analysis over the 10 past years. Bull Cancer 2019; 106:1086-1093. [PMID: 31582176 DOI: 10.1016/j.bulcan.2019.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/01/2019] [Accepted: 08/13/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Testicular Germ Cell Tumors (TGCTs) represent the most frequent malignant tumour among young male adults. Orchiectomy alone cure 80% of stage I. Standard options after orchiectomy include radiotherapy (RT), chemotherapy (CT) by 1 cycle of carboplatin AUC 7 or active surveillance (SV) for seminomatous GCTs (SGCT) and retroperitoneal lymphadenectomy (RPLND), CT by 1 or 2 cycles of Bleomycine Etoposide Cisplatine (BEP) or active surveillance for nonseminomatous GCTs (NSGCT). Adjuvant treatments decrease the relapse rate after orchiectomy with substantial toxicities without any benefit on overall survival. Recent guidelines accorded utmost importance on SV rather than adjuvants strategies. The main objective of this study was to describe our current practice over the 10 past years in regard of these recommendations. METHODS Data of 50 patients with stage I GCT treated in our institute were collected between 2006 and 2016. Demographic and anatomopathologic data were reported. Clinical practice in our center was analyzed during two periods [2006-2011] and [2012-2016] according to the European Association of Urology Guidelines in 2011. RESULTS Patient's median age was 35.3 years. The analysis of clinical practice during the last 10 years showed that in SGCT, main treatment was RT than SV and CT. This option declined over the years (89% between 2006-2010 versus 53% between 2011-2016) whereas SV was more often employed (27% between 2011-2016 versus none between 2006-2010). Surveillance was used for 64% of NSGCT. CONCLUSIONS In our center, RT was less used over the years for the benefit of SV which is recommended by guidelines.
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Affiliation(s)
- Edouard Chanal
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Wafa Bouleftour
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France.
| | - Aline Guillot
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Elise Rowinski
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Emilie Bernichon
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | | | - Renaud Lardon
- Clinique mutualiste chirurgicale de Saint-Étienne, Urology department, Saint-Étienne, France
| | - Bertrand Lacroix
- Clinique mutualiste chirurgicale de Saint-Étienne, Urology department, Saint-Étienne, France
| | - Stephane Lorin
- Hôpital Privé de la Loire, Urology department, Loire, France
| | - Gregory Delorme
- Hôpital Privé de la Loire, Urology department, Loire, France
| | - Yves Perraud
- Hôpital Privé de la Loire, Urology department, Loire, France
| | - Corinne Armand
- Hôpital Privé de la Loire, Urology department, Loire, France
| | | | - Alexis Vallard
- Institut de cancérologie Lucien-Newirth, Department of Radiotherapy, Saint-Priest-en-Jarez, France
| | - Julien Langrand-Escure
- Institut de cancérologie Lucien-Newirth, Department of Radiotherapy, Saint-Priest-en-Jarez, France
| | - Pierre Fournel
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Mery Benoite
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Cecile Vassal
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
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Pujalte Martin MARC, Borchiellini D, Viotti J, Guillot A, Paoli JB, Besson D, Hilgers W, El Kouri C, Cavaglione G, Priou F, Lharidon T, Largillier R, Deville JL, Hoch B, Schiappa R, Tanti JF, Bost F, Ferrero JM. TAXOMET: A French prospective multicenter randomized controlled phase II study comparing docetaxel plus metformin versus docetaxel plus placebo in mCRPC. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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
5004 Background: Docetaxel (DOCE) is a standard of care in metastatic castration-resistant prostate cancer (mCRPC). Several retrospective cohort studies suggest a decrease in PC incidence and mortality with metformin (MET). MET has also demonstrated anti-tumor activity in PC preclinical models, with increase apoptosis when added to DOCE. The addition of MET could enhance DOCE efficacy in mCRPC patients (pts). Methods: TAXOMET is a phase II prospective multicentric randomized controlled trial. Non-diabetic mCRPC pts were assigned 1:1 to receive DOCE 75mg/m2 every 21 days + prednisone (P) 5 mg twice a day and either MET 850mg twice a day (arm A) or placebo (arm B), up to 10 cycles. The primary end point was PSA response rate (≥50% decrease). Main secondary endpoints included objective response rate (ORR, according to RECIST v1.1), clinical and biological progression-free survival (PFS), overall survival (OS), toxicity and quality of life (QoL). Comparisons between arm A and B were performed using Chi² test for qualitative data and Log-rank test for survival data. Results: From January 2013 to December 2015, 99 pts were randomized (50 pts in arm A and 49 pts in arm B) in 10 french centers, and 95 pts were evaluable. No difference was observed between arm A and arm B in PSA-response rate (72% in both arms), ORR (28% in both arms), clinical or biological mPFS (7.3 months vs 5.8 months p = 0.848) and mOS (24.2 months (95CI: 17.2 – 33.7) vs 19.7 months (95CI: 14.8 – 36.8), p = 0.53), respectively. There was no difference between arms in adverse events, except a trend for diarrhea to be more common with MET (70% in arm A vs 50% in arm B, p = 0.072), but few grade 3-4 events. There was no difference in QoL according to QLQ-C30 score between the two arms during the treatment period. Conclusions: This is the first prospective randomized controlled trial to evaluate the combination of MET with DOCE+P in mCRPC. The addition of MET has no meaningful clinical benefit in this setting. Clinical trial information: NCT01796028.
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Affiliation(s)
| | | | | | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | | | | | | | | | | | - Frank Priou
- Centre Hospitalier Departemental Vendee, La Roche-Sur-Yon, France
| | - Tifenn Lharidon
- GINECO-Centre Hospitalier Départemental Vendée Les Oudairies, La Roche-Sur-Yon, France
| | | | | | | | - Renaud Schiappa
- Biostatistics’ Unite, Antoine Lacassagne Cancer Center, University of Cote d’Azur, Nice, France
| | | | | | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
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Abstract
METASTATIC RENAL CELL CARCINOMA WHICH TREATMENTS IN FIRST-LINE SETTING?: The treatment of metastatic kidney cancer has radically changed during the past decade, notably with the development of tyrosin kinase inhibitors (TKI) and the rise of immunotherapy. Kidney cancer, especially clear cell renal cell carcinoma (CCRC) which regroups 80% of cases, is associated with increased angiogenesis and VEGF (vascular endothelial growth factor) dependent signaling pathways. Targeted therapies have therefore modified therapeutical strategies through direct inhibition of VEGF on its receptor or inhibition of the PI3K/AKT/mTOR pathway. Consequently, new anti-angiogenic molecules are now available as first line treatment and are to be prioritized depending on tumoral histology and prognostic groups. These new molecules have allowed increased patient survival. Immunotherapy is again currently transforming our first line therapeutical approach of metastatic kidney cancer with numerous ongoing therapeutical trials including combination of targeted therapies with immune checkpoint inhibitors or association of various immunotherapies. Beyond these major first line changes, difficulties still remain in the therapeutical sequence which is crucial in the care of these patients. This report aims to underline first line therapeutical recommendations in metastatic kidney cancer and expose results of recent assays.
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Affiliation(s)
- Benoîte Mery
- Département d'oncologie médicale, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - Samuel Jones
- Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse
| | - Alexis Vallard
- Département de radiothérapie, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - Elise Rowinski
- Département d'oncologie médicale, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - Aline Guillot
- Département d'oncologie médicale, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - Nicolas Magné
- Département de radiothérapie, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
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Guillot A, Joly C, Barthélémy P, Meriaux E, Negrier S, Pouessel D, Chevreau C, Mahammedi H, Houede N, Roubaud G, Gravis G, Tartas S, Albiges L, Vassal C, Oriol M, Tinquaut F, Espenel S, Bouleftour W, Culine S, Fizazi K. Denosumab Toxicity When Combined With Anti-angiogenic Therapies on Patients With Metastatic Renal Cell Carcinoma: A GETUG Study. Clin Genitourin Cancer 2018; 17:e38-e43. [PMID: 30279115 DOI: 10.1016/j.clgc.2018.08.006] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/10/2018] [Accepted: 08/26/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND About one-third of patients with renal cell carcinoma (RCC) have detectable metastases at diagnosis. Among them, bone is the second most frequent metastatic site. Treatment of metastatic RCC mostly relies on anti-angiogenic (AA) therapies and, more recently, immunotherapy. Skeletal-related events (SREs) can be prevented with bone-targeted therapies such as denosumab (Dmab), which has demonstrated superiority when compared with zoledronic acid in solid tumors. However, there is limited available data on Dmab toxicity in combination with AA therapies in patients with kidney cancer. The objective of this study was to retrospectively analyze the toxicity profile (mainly osteonecrosis of the jaw [ONJ] and hypocalcemia) in patients with metastatic renal cell carcinoma (mRCC) treated with Dmab and AA therapy combination. PATIENTS AND METHODS We conducted a multicenter retrospective study among centers from the French Groupe d'Etudes des Tumeurs Uro Genitales (GETUG). Patients with bone metastases who received concurrently or sequentially AA therapy and Dmab were included in this study. RESULTS A total of 41 patients with mRCC were enrolled. Although no patient presented with severe hypocalcemia, ONJ occurred in 7 (17%) of 41 patients. Interestingly, all patients with ONJ received the Dmab and AA combination in the first line of treatment; among these patients, 3 patients had no risk factor other than the Dmab and AA combination. CONCLUSION The incidence of ONJ was high in this real-life population of patients with mRCC treated with AA therapies combined with Dmab. This toxicity signal should warn physicians about this combination in the mRCC population.
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Affiliation(s)
- Aline Guillot
- Department of Medical Oncology, Institut de cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | | | | | | | | | | | | | - Hakim Mahammedi
- Centre Jean-Perrin, Medical Oncology, Clermont-Ferrand, France
| | | | | | | | | | | | - Cécile Vassal
- Department of Medical Oncology, Institut de cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Mathieu Oriol
- Department of Medical Oncology, Institut de cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Fabien Tinquaut
- Department of Biostatistics, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Sophie Espenel
- Department of Radiotherapy, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Wafa Bouleftour
- Department of Medical Oncology, Institut de cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France.
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Angelergues A, Efstathiou E, Gyftaki R, Wysocki PJ, Lainez N, Gonzalez I, Castellano DE, Ozguroglu M, Carbonero IG, Flechon A, Borrega P, Guillot A, Balea BC, Le Moulec S, Esteban E, Munarriz J, Rubio G, Birtle AJ, Delanoy N, Bellmunt J, Oudard S. Results of the FLAC European Database of Metastatic Castration-Resistant Prostate Cancer Patients Treated With Docetaxel, Cabazitaxel, and Androgen Receptor–Targeted Agents. Clin Genitourin Cancer 2018; 16:e777-e784. [DOI: 10.1016/j.clgc.2018.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/14/2018] [Accepted: 02/18/2018] [Indexed: 10/18/2022]
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27
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Delanoy N, Hardy-Bessard AC, Efstathiou E, Le Moulec S, Basso U, Birtle A, Thomson A, Krainer M, Guillot A, De Giorgi U, Hasbini A, Daugaard G, Bahl A, Chowdhury S, Caffo O, Beuzeboc P, Spaeth D, Eymard JC, Fléchon A, Alexandre J, Helissey C, Butt M, Priou F, Lechevallier É, Deville JL, Goupil MG, Morales R, Thiery-Vuillemin A, Gavrikova T, Barthelemy P, Sella A, Fizazi K, Baciarello G, Fererro JM, Laguerre B, Verret B, Hans S, Oudard S. Sequencing of Taxanes and New Androgen-targeted Therapies in Metastatic Castration-resistant Prostate Cancer: Results of the International Multicentre Retrospective CATS Database. Eur Urol Oncol 2018; 1:467-475. [PMID: 31158090 DOI: 10.1016/j.euo.2018.05.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/09/2018] [Accepted: 05/16/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The optimal sequence of life-extending therapies in metastatic castration-resistant prostate cancer (mCRPC) is unknown. OBJECTIVE To evaluate outcomes among mCRPC patients treated with docetaxel (DOC), cabazitaxel (CABA), and a novel androgen receptor-targeted agent (ART; abiraterone acetate or enzalutamide) according to three different sequences. DESIGN, SETTING, AND PARTICIPANTS Data from 669 consecutive mCRPC patients were retrospectively collected between November 2012 and October 2016. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary endpoint was the prostate-specific antigen (PSA) response (decrease ≥50% from baseline) to each therapy. Secondary endpoints included best clinical benefit, time to PSA progression, radiological progression-free survival (rPFS), overall survival (OS), and toxicity. RESULTS AND LIMITATIONS A total of 158 patients received DOC→CABA→ART (group 1), 456 received DOC→ART→CABA (group 2), and 55 received ART→DOC→CABA (group 3). At baseline, PSA progression only and Gleason <8 were more common in group 3. PSA response on DOC was lower in group 3 than in other groups (p=0.02) and PSA response on CABA was higher in the second than in the third line (p=0.001). In Group 3, rPFS on ART (6.6 mo) and DOC (9.2 mo) was also shorter than in the other groups. OS calculated from the first life-extending therapy reached 34.8, 35.8, and 28.9 mo in groups 1, 2 and 3, respectively (p=0.007). Toxicity was comparable between the arms. The main limitations of the trial are its retrospective design and the low number of patients in group 3. CONCLUSIONS In this retrospective trial, sequencing of DOC, CABA, and one ART, was associated with median OS of up to 35.8 mo. CABA seemed to retain its activity regardless of treatment sequence. DOC activity after ART appeared to be reduced, but the data are insufficient to conclude that cross-resistance occurs. PATIENT SUMMARY The order of drugs administered to patients with metastatic castration-resistant prostate cancer could impact their efficacy, with cabazitaxel appearing to retain its activity whatever the therapeutic sequence.
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Affiliation(s)
| | | | - Eleni Efstathiou
- Alexandra Hospital, University of Athens, Athens, Greece; Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - Alison Birtle
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK; University Hospitals of Morecombe Bay, NHS Foundation Trust, Lancaster, UK
| | | | | | - Aline Guillot
- Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | | | - Amit Bahl
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | | | | | | | | | | | | | - Carole Helissey
- Hôpital d'Instruction des armées, Bégin, Saint Mandé, France
| | - Mohamed Butt
- Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - Frank Priou
- CHD Vendee-Hopital Les Oudairies, La Roche Sur Yon, France
| | | | | | | | | | | | | | | | | | - Karim Fizazi
- Gustave Roussy, University of Paris Sud, Villejuif, France
| | | | | | | | | | - Sophie Hans
- European Georges Pompidou Hospital, Paris, France
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Oudard S, Hardy-Bessard AC, Le Moulec S, Basso U, Birtle AJ, Thomson AH, Guillot A, De Giorgi U, Hasbini A, Gedske Daugaard K, Chowdhury S, Caffo O, Beuzeboc P, Spaeth D, Flechon A, Alexandre J, Morales Barrera R, Thiery-Vuillemin A, Fizazi K, Efstathiou E. Association of clinical progression at initiation of a life-extending therapy (LET) in metastatic castration-resistant prostate cancer (mCRPC) with poor prognosis: Results of the CATS database. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e17007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Stephane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, René Descartes University, Paris, France
| | | | - Sylvestre Le Moulec
- Institut Bergonié Centre Régional de Lutte Contre Le Cancer de Bordeaux et Sud Ouest, Bordeaux, France
| | - Umberto Basso
- Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | | | | | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | | | | | - Simon Chowdhury
- Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | | | | | | | | | - Jerome Alexandre
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, AP-HP, Paris, France
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Vallat R, Combrisson E, Eichenlaub JB, O'Reilly C, Lajnef T, Guillot A, Ruby P, Jerbi K. Sleep: a python open-source software for visualizing and scoring sleep data. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.979] [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: 11/27/2022]
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Oudard S, Mejean A, Topart D, Thuret R, Tournigand C, Salomon L, Thiery-Vuillemin A, Guichard G, Le Moulec S, Houlgatte A, Guillot A, Mottet N, Cessot A, Barry-Delongchamps N, Elaidi R, Turajlic S, Swanton C, Escudier B, Patard J, Albiges L. Biomarkers before and after nephrectomy of locally advanced or metastatic renal cell carcinoma (RCC) treated with everolimus: Neorad phase 2 trial (PREDICT consortium). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Joly F, Guillot A, Vano YA, Spaeth D, Topart D, Roffet P, El Amarti R, Hasbini A, Fléchon A. [French national survey on incoming phone calls in oncology departments]. Bull Cancer 2017; 104:565-573. [PMID: 28391984 DOI: 10.1016/j.bulcan.2017.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/28/2016] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Oral therapies have shifted the follow-up of patients with cancer from hospital to home. As a consequence, the number of incoming calls has increased. To understand the source, reasons, management and burden of calls, we underwent a French national survey. The objective was to describe the way calls are managed in oncology departments. METHODS The study was a prospective survey in a representative sample of French oncology specialists using oral therapies. RESULTS Among 51 participating onco/radiotherapy departments, 86 % of specialists were oncologists or hematologists and 14 % radiation oncologists. Eighty percent were from public centers and 20 % from private ones. The median number of calls/week was 110. Sixty-six percent of calls were from patients and families and 23 % from general practitioners. Upon calls reception by the secretaries, half of them corresponded to a medical question. Sixty-five percent of centers did not have an established specific procedure and 70 % of responders did not specifically train their teams to address the management of calls. Sixty-five percent of the specialists spent more than 30min/day. Most of them considered it disturbing medical activities. Sixty-six percent of patients calls were related to adverse effects of treatments. Twenty-two percent of specialists declared at least one severe adverse effect linked to misinterpretation of a call. DISCUSSION With the increase of oral therapies, incoming phone calls represent an important burden of work. To improve calls management, adaptations of organizations are needed.
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Affiliation(s)
- Florence Joly
- Centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
| | - Aline Guillot
- Institut de cancérologie Lucien-Neuwirth, 108 bis, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | | | - Dominique Spaeth
- Centre d'oncologie de Gentilly, 2, rue Marie-Margingt, 54000 Nancy, France
| | - Delphine Topart
- Hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - Pascal Roffet
- Pfizer, 23-25, avenue du Dr-Lannelongue, 75014 Paris, France
| | - Rachid El Amarti
- CHI du Pays de Cognac, 65, avenue d'Angoulême, 16112 Cognac cedex, France
| | - Ali Hasbini
- Clinique Pasteur-Lanroze, 32, rue Auguste-Kervern, 29200 Brest, France
| | - Aude Fléchon
- Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
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Saimpont A, Richard O, Chabaud P, Jackson P, Guillot A, Collet C. P252 Does anodal tDCS of the premotor cortex enhance the effects of motor imagery on motor sequence learning? Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.366] [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: 11/25/2022]
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Tardy B, Picard S, Guirimand F, Chapelle C, Danel Delerue M, Celarier T, Ciais JF, Vassal P, Salas S, Filbet M, Gomas JM, Guillot A, Gaultier JB, Merah A, Richard A, Laporte S, Bertoletti L. Bleeding risk of terminally ill patients hospitalized in palliative care units: the RHESO study. J Thromb Haemost 2017; 15:420-428. [PMID: 28035750 DOI: 10.1111/jth.13606] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 07/15/2016] [Indexed: 12/25/2022]
Abstract
Essentials Bleeding incidence as hemorrhagic risk factors are unknown in palliative care inpatients. We conducted a multicenter observational study (22 Palliative Care Units, 1199 patients). At three months, the cumulative incidence of clinically relevant bleeding was 9.8%. Cancer, recent bleeding, thromboprophylaxis and antiplatelet therapy were independent risk factors. SUMMARY Background The value of primary thromboprophylaxis in patients admitted to palliative care units is debatable. Moreover, the risk of bleeding in these patients is unknown. Objectives Our primary aim was to assess the bleeding risk of patients in a real-world practice setting of hospital palliative care. Our secondary aim was to determine the incidence of symptomatic deep vein thrombosis and to identify risk factors for bleeding. Patients/Methods In this prospective, observational study in 22 French palliative care units, 1199 patients (median age, 71 years; male, 45.5%), admitted for the first time to a palliative care unit for advanced cancer or pulmonary, cardiac or neurologic disease were included. The primary outcome was adjudicated clinically relevant bleeding (i.e. a composite of major and clinically relevant non-major bleeding) at 3 months. The secondary outcome was symptomatic deep vein thrombosis. Results The most common reason for palliative care was cancer (90.7%). By 3 months, 1087 patients (91.3%) had died and 116 patients had presented at least one episode of clinically relevant bleeding (fatal in 23 patients). Taking into account the competing risk of death, the cumulative incidence of clinically relevant bleeding was 9.8% (95% confidence interval [CI], 8.3-11.6). Deep vein thrombosis occurred in six patients (cumulative incidence, 0.5%; 95% CI, 0.2-1.1). Cancer, recent bleeding, antithrombotic prophylaxis and antiplatelet therapy were independently associated with clinically relevant bleeding at 3 months. Conclusions Decisions regarding the use of thromboprophylaxis in palliative care patients should take into account the high risk of bleeding in these patients.
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Affiliation(s)
- B Tardy
- Inserm, CIC 1408, FCRIN-INNOVTE, Saint-Etienne, France
- UMR1059 SAINBIOSE, Université Jean Monnet, PRES de Lyon, Saint-Etienne, France
- Service de Soins Intensifs Médicaux, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
| | - S Picard
- Unité de Soins Palliatifs, Hôpital les Diaconesses, Paris, France
| | - F Guirimand
- Pôle Recherche SPES "soins palliatifs en société", Maison Médicale Jeanne Garnier, Paris, France
| | - C Chapelle
- Inserm, CIC 1408, FCRIN-INNOVTE, Saint-Etienne, France
- UMR1059 SAINBIOSE, Université Jean Monnet, PRES de Lyon, Saint-Etienne, France
| | - M Danel Delerue
- Unité de Soins Palliatifs, Centre Hospitalier Saint Vincent de Paul, Lille, France
| | - T Celarier
- Fédération de Soins Palliatifs, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
| | - J-F Ciais
- Unité de Soins Palliatifs, Centre Hospitalo-Universitaire de Nice, Nice, France
| | - P Vassal
- Fédération de Soins Palliatifs, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
| | - S Salas
- Service d'Oncologie Médicale, Assistance Publique des Hôpitaux de Marseille, Marseille, France
- CRO2, Aix Marseille Université, Marseille, France
- INSERM U911, Marseille, France
| | - M Filbet
- Centre de Soins Palliatifs, Centre Hospitalier Lyon Sud, Hospices Civiles de Lyon, Pierre-Bénite, France
| | - J-M Gomas
- Unité de Soins Palliatifs, Hôpital Sainte Perine, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - A Guillot
- Service d'Oncologie Médicale, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | - J-B Gaultier
- Service de Médecine Interne, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
| | - A Merah
- Inserm, CIC 1408, FCRIN-INNOVTE, Saint-Etienne, France
| | - A Richard
- Fédération de Soins Palliatifs, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
| | - S Laporte
- UMR1059 SAINBIOSE, Université Jean Monnet, PRES de Lyon, Saint-Etienne, France
- Unité de Recherche Clinique, Innovation et Pharmacologie, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
| | - L Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
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Culine S, Flechon A, Gravis G, Roubaud G, Loriot Y, Joly F, Barthelemy P, Assaf E, Mahammedi H, Beuzeboc P, Van Hulst S, Rolland F, Guillot A, Gross-Goupil M, Kayat D, Tartas S, Deblock M, Habibian M, Thezenas S, Allory Y. Results of the GETUG-AFU 19 trial: A randomized phase II study of dose dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) with or without anti-epidermal growth factor receptor (EGF-R) monoclonal antibody panitumumab (PANI) in advanced transitional cell carcinoma (ATCC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
307 Background: Frequent overexpression and correlation with stage and survival has been reported with the EGF-R pathway in ATCC. Methods: 93 patients (pts) with locally advanced or metastatic bladder or upper urinary tract (UUT) transitional cell carcinoma were planned with a 1:2 randomisation ratio. Patients with K-Ras or H-Ras mutations were excluded. dd-MVAC included M 30 mg/m2d1, V 3 mg/m2d2, D 30 mg/m2d2 and cisplatin 70 mg/m2d2 (d1 = d14) with G-CSF support. PANI 6 mg/kg was given on d2. The number of pts was determined from the 9-month median progression-free survival (PFS) rate reported with dd-MVAC. Using a one stage Fleming design, the dd-MVAC+PANI combination will be considered to be active if at least 37 patients among 70 do not show tumor progression at 9 months (p0 = 0.50, p1 = 0.70, alpha = 0.08 and beta = 0.03). As basal-like subtype might be related to Anti-EGFR treatment response, the phenotype was determined using a Keratin 5/6 and GATA3 double immunostaining (8 basal like among 58 cases tested). Results: From September 2010 to November 2015, 96 patients (bladder 68, UUT 21, both 8) received dd-MVAC (33) or dd-MVAC+PANI (63). No significant difference was observed among baseline characteristics and prognostic factors. The median number of cycles was 6 (1-6) in both arms. At least one grade > 2 toxicity was observed in 79% and 76% of patients in the dd-MVAC and PANI arms, respectively. More dermatological adverse events were observed in the PANI arm. Objective responses were reported in 23 (70%) pts in the dd-MVAC arm and 30 pts (48%) in the PANI arm. With a median follow-up of 27 months, PFS was 6.8 months and 5.7 months in the dd-MVAC and PANI arms respectively; OS was 20.2 months and 12.5 months in the dd-MVAC and PANI arms, respectively. No association was observed between PFS and basal-like feature for patients treated by MVAC+PANI. Molecular subtyping is in progress to confirm this observation at mRNA level. Conclusions: When combined with dd-MVAC, PANI does not seem to improve efficacy in pts with ATCC. Clinical trial information: NCT02818725.
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Affiliation(s)
- Stephane Culine
- Department of Medical Oncology, Hopital Saint-Louis, Paris, France
| | | | - Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | - Guilhem Roubaud
- Department of Medical Oncology, Institut Bergonie, Bordeaux, France
| | - Yohann Loriot
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Paris-Sud University, Villejuif, France
| | - Florence Joly
- Dept. of Medical Oncology, Centre Francois Baclesse, Caen, France
| | | | - Elias Assaf
- Oncology Department, Hopital Henri Mondor, APHP, Creteil, France
| | | | | | | | | | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | | | - David Kayat
- La Pitie Salpetriere Hospital, Paris, France
| | - Sophie Tartas
- University of Lyon, Centre Hospitalier Lyon Sud, Pierre-Benite, France
| | - Mathilde Deblock
- Institut de Cancerologie de Lorraine, VandUvre-Les-Nancy, France
| | | | - Simon Thezenas
- Institut Regional du Cancer Montpellier, Montpellier, France
| | - Yves Allory
- Department of Pathology, Hopital Henri Mondor, Creteil, France
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Delanoy N, Angelergues A, Efstathiou E, Gyftaki R, Wysocki PJ, Lainez N, Gonzalez I, Castellano DE, Ozguroglu M, Garcia Carbonero I, Flechon A, Borrega P, Guillot A, Campos Balea B, Le Moulec S, Esteban E, Munarriz J, Barker C, Birtle AJ, Oudard S. Sequencing in metastatic castration-resistant prostate cancer (mCRPC): Updated results of the FLAC International Database. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.267] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
267 Background: Optimal sequencing of new androgen-receptor targeted agents (ART) abiraterone and enzalutamide with docetaxel (DOC) and cabazitaxel (CABA) is unknown. In this large retrospective cohort of mCRPC patients (pts) treated with CABA after docetaxel (DOC), we evaluated the impact of 3 different sequences: DOC → CABA (group 1, n = 267) Or DOC → ART → CABA (group 2, n = 183) Or DOC → CABA → ART (group 3, n = 124). Methods: Records of 574 consecutive mCRPC patients were retrospectively collected in 44 centres in 6 European countries (France, Spain, UK, Greece, Poland, Turkey) from August 2012 to July 2016. Disease history and clinical characteristics at initiation of DOC therapy and outcomes were collected. Factors influencing OS were evaluated using multivariate stepwise logistic regression. Results: At DOC initiation, median age was 67 years, 83% of pts were ECOG 0-1, 45.1% had pain and 10.8% had visceral metastases. Median number of DOC cycles was 7 (6 in group 2, 7 in groups 1 and 3). Median number of CABA cycles was 6 (6 in groups 1 and 2, 7 in group 3). Median duration of ART treatment was 5.9 and 4.4 mths in groups 2 and 3, retrospectively. Median OS from first DOC cycle were 30.1, 37.1 and 40.1 mths in groups 1, 2 and 3, respectively. Factors influencing OS are summarized in the table below. Conclusions: Results of this retrospective cohort suggest that patients receiving DOC → CAB → ART show the greatest OS. High baseline PSA, short response to first-ADT and clinical progression of pts are major prognostic factors of OS at DOC initiation. The window of opportunity for chemotherapy should not be missed. [Table: see text]
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Affiliation(s)
- Nicolas Delanoy
- Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France
| | - Antoine Angelergues
- Department of Medical Oncology, Hopital Europeen Georges Pompidou, Paris, France
| | - Eleni Efstathiou
- Alexandra General Hospital of Athens, University of Athens, Athens, Greece
| | - Revekka Gyftaki
- Oncology Department, Department of Clinical Therapeutics, Alexandra General Hospital of Athens, Athens, Greece
| | | | - Nuria Lainez
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Iria Gonzalez
- University Hospital del Mar - IMIM, Barcelona, Spain
| | | | | | | | | | | | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | | | | | - Emilio Esteban
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Claire Barker
- Rosemere Cancer Center, Royal Preston Hospital, Preston, United Kingdom
| | - Alison J. Birtle
- Rosemere Cancer Centre, Royal Preston Hospital, Preston, United Kingdom
| | - Stephane Oudard
- Department of Medical Oncology, Hopital Europeen Georges Pompidou, Paris, France
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Joly F, Eymard JC, Albiges L, Nguyen T, Guillot A, Rolland F, Spaeth D, Laguerre B, Lebret T, Kelkouli N, Slimane K, Ravaud A. A prospective observational study on the evaluation of everolimus-related adverse events in metastatic renal cell carcinoma after first-line anti-vascular endothelial growth factor therapy: the AFINITE study in France. Support Care Cancer 2017; 25:2055-2062. [DOI: 10.1007/s00520-017-3594-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/23/2017] [Indexed: 11/29/2022]
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Guillot A, Stoeckli F, Bauguil Y. The Microporosity of Activated Carbon Fibre KF1500 Assessed by Combined CO2 Adsorption and Calorimetry Techniques and by Immersion Calorimetry. ADSORPT SCI TECHNOL 2016. [DOI: 10.1260/0263617001493233] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The microporous structure of the activated carbon fibre KF1500 was investigated by applying a new technique as presented here. This was based on a combination of high-pressure CO2 adsorption measurements between 253 K and 353 K with direct measurement of the differential heats of adsorption at 298 K at low and medium coverages. The validity of this approach was tested by using two activated carbons which has been characterized previously by a variety of techniques, including immersion calorimetry. It appears that a combination of high-pressure adsorption and calorimetry with CO2 alone is a useful tool for the characterization of the whole range of microporosity. This approach confirms earlier observations, according to which the initial stage of adsorption by strongly activated carbons corresponds to adsorption on the walls of large micropores rather than to the primary filling of small micropores.
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Affiliation(s)
- A. Guillot
- CNRS-IMP, Université de Perpignan, Avenue de Villeneuve, 66860 Perpignan, France
| | - F. Stoeckli
- Chemistry Department of the University, Bellevaux 51, CH-2000 Neuchâtel, Switzerland
| | - Y. Bauguil
- CNRS-IMP, Université de Perpignan, Avenue de Villeneuve, 66860 Perpignan, France
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Guillot A, Joly C, Barthelemy P, Meriaux E, Negrier S, Pouessel D, Chevreau C, Mahammedi H, Houede N, Roubaud G, Gravis G, Tartas S, Albiges L, Vassal C, Oriol M, Tinquaut F, Espenel S, Culine S, Fizazi K. Denosumab in patients with bone metastases from renal-cell carcinoma treated with anti-angiogenic therapy: a retrospective study from the GETUG (Groupe Etude des Tumeurs Uro Genitales). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.56] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Angelergues A, Birtle A, Hardy-Bessard A, Caffo O, Moulec S, Krainer M, Guillot A, Hasbini A, Daugaard G, Chowdhury S, Spaeth D, Beuzeboc P, Eymard JC, Flechon A, Alexandre J, Priou F, Delanoy N, El Awadly N, Braychenko E, Oudard S. Efficacy of cabazitaxel, abiraterone, enzalutamide and docetaxel sequence in men with metastatic castration-resistant prostate cancer (mCRPC) in real life practice: The multinational, retrospective, observational CATS study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.28] [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] [Indexed: 11/12/2022] Open
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40
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Lobbedez FJ, Guillot A, Vano Y, Spaeth D, Topart D, Roffet P, El Amarti R, Hasbini A, Flechon A. Impact of incoming phone calls on oncology departments in oral therapies era: a large national prospective survey. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Houédé N, Locker G, Lucas C, Parra HS, Basso U, Spaeth D, Tambaro R, Basterretxea L, Morelli F, Theodore C, Lusuardi L, Lainez N, Guillot A, Tonini G, Bielle J, Del Muro XG. Epicure: a European epidemiological study of patients with an advanced or metastatic Urothelial Carcinoma (UC) having progressed to a platinum-based chemotherapy. BMC Cancer 2016; 16:752. [PMID: 27664126 PMCID: PMC5035464 DOI: 10.1186/s12885-016-2782-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 05/10/2016] [Accepted: 09/14/2016] [Indexed: 01/31/2023] Open
Abstract
Background Platinum-based systemic chemotherapy is considered the backbone for management of advanced urothelial carcinomas. However there is a lack of real world data on the use of such chemotherapy regimens, on patient profiles and on management after treatment failure. Methods Fifty-one randomly selected physicians from 4 European countries registered 218 consecutive patients in progression or relapse following a first platinum-based chemotherapy. Patient characteristics, tumor history and treatment regimens, as well as the considerations of physicians on the management of urothelial carcinoma were recorded. Results A systemic platinum-based regimen had been administered as the initial chemotherapy in 216 patients: 15 in the neoadjuvant setting, 61 in adjuvant therapy conditions, 137 in first-line advanced setting and 3 in other conditions. Of these patients, 76 (35 %) were initially considered as cisplatin-unfit, mainly because of renal impairment (52 patients). After platinum failure, renal impairment was observed in 44 % of patients, ECOG Performance Status ≥ 2 in 17 %, hemoglobinemia < 10 g/dL in 16 %, hepatic metastases in 13 %. 80 % of these patients received further anticancer therapy. Immediately after failure of adjuvant/neoadjuvant chemotherapy, most subsequent anticancer treatments were chemotherapy doublets (35/58), whereas after therapy failure in the advanced setting most patients receiving further anticancer drugs were treated with a single agent (80/114). After first progression to chemotherapy, treatment decisions were mainly driven by Performance Status and prior response to chemotherapy (>30 % patients). The most frequent all-settings second anticancer therapy regimen was vinflunine (70 % of single-agent and 42 % of all subsequent treatments), the main reasons evoked by physicians (>1 out of 4) being survival benefit, safety and phase III evidence. Conclusion In this daily practice experience, a majority of patients with urothelial carcinoma previously treated with a platinum-based therapy received a second chemotherapy regimen, most often a single agent after an initial chemotherapy in the advanced setting and preferably a cytotoxic combination after a neoadjuvant or adjuvant chemotherapy. Performance Status and prior response to chemotherapy were the main drivers of further treatment decisions.
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Affiliation(s)
- N Houédé
- Institut de Cancérologie du Gard - CHU Caremeau, 30029, Nîmes, Cedex 9, France.
| | - G Locker
- Department of Internal Medicine I, Währinger Gürtel.18-20, 1090, Vienne, Austria
| | - C Lucas
- Institut de Recherche Pierre Fabre, 45 place Abel Gance, 92100, Boulogne-Billancourt, France
| | - H Soto Parra
- Oncologia Medica, P.O Gaspare Rodolico, Via Santa Sofia 78, 95123, Catania, Italy
| | - U Basso
- Istituto Oncologico Veneto IOV-IRCCS, Dipartmento di Oncologia Clinica e Sperimentale, Oncologia Medica 1, via Gattamelata 64, 35128, Padova, Italy
| | - D Spaeth
- Centre d'Oncologie de Gentilly, 2 rue Marie Marvingt, 54100, Nancy, France
| | - R Tambaro
- Istituto Nazionale Tumori IRCCS Fondazione Pascale, Via Mariano Semmola, 80131, Napoli, Italy
| | - L Basterretxea
- Hospital Universitario Donostia, Begiristain Doktorea Pasealekua 117-20080, Donostia, Gipuzkoa - San Sebastián, Spain
| | - F Morelli
- Fondazione Casa Sollievo della Sofferenza Oncologia, Viale Cappuccini 1, San Giovanni Rotondo, Foggia, Italy
| | - C Theodore
- Hopital Foch, 40 rue Worth, 92150, Suresnes, France
| | - L Lusuardi
- Reparto di Urologia - Ospedale di Bressanone, Via Dante 51, 39042, Bressanone, Italy
| | - N Lainez
- Hospital de Navarra - Virgen del Camino, Oncología Médica, Calle de Irunlarrea, 4 planta baja, 31008, Pamplona, Spain
| | - A Guillot
- Institut de cancérologie de la Loire, 108 bis avenue Albert Raimond, 42271, Saint Priest en Jarez, Cedex, France
| | - G Tonini
- Policlinico Universitario Campus Bio-medico Oncologia Medica, Via Alvaro del Portillo 200, 00128, Roma, Italy
| | - J Bielle
- Institut de Recherche Pierre Fabre, 45 place Abel Gance, 92100, Boulogne-Billancourt, France
| | - X Garcia Del Muro
- ICO L'Hospitalet, Avinguda Granvia, 199-203, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
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Legendre A, Guillot A, Ladouceur M, Bonnet D. Usefulness of stroke volume monitoring during upright ramp incremental cycling in young patients with Fontan circulation. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30550-x] [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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Méry B, Vallard A, Espenel S, Badie N, Thiermant M, Lambert V, Soulier V, Piqueres S, Del Santo K, Ben Mrad M, Wang G, Diao P, Langrand-Escure J, Rivoirard R, Guy JB, Guillot A, Chanelière AF, Gonthier R, Achour E, Fournel P, Magné N. Cancer de prostate des sujets âgés : place et rôle de l’évaluation gériatrique. Prog Urol 2016; 26:524-31. [DOI: 10.1016/j.purol.2016.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 06/13/2016] [Accepted: 07/22/2016] [Indexed: 11/30/2022]
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Oudard S, Geoffrois L, Guillot A, Chevreau C, Deville JL, Falkowski S, Boyle H, Baciuchka M, Gimel P, Laguerre B, Laramas M, Pfister C, Topart D, Rolland F, Legouffe E, Denechere G, Amela EY, Abadie-Lacourtoisie S, Gross-Goupil M. Clinical activity of sunitinib rechallenge in metastatic renal cell carcinoma—Results of the REchallenge with SUnitinib in MEtastatic RCC (RESUME) Study. Eur J Cancer 2016; 62:28-35. [DOI: 10.1016/j.ejca.2016.04.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/30/2016] [Accepted: 04/04/2016] [Indexed: 01/31/2023]
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Keïta A, Huneau-Salaün A, Guillot A, Galliot P, Tavares M, Puterflam J. A multi-pronged approach to the search for an alternative to formaldehyde as an egg disinfectant without affecting worker health, hatching, or broiler production parameters. Poult Sci 2016; 95:1609-1616. [DOI: 10.3382/ps/pew058] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 01/25/2016] [Indexed: 11/20/2022] Open
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Joly F, El Amarti MD R, Guillot A, Hasbini A, EL Sayadi MD B, Spaeth D, Topart D, Vano YA, Flechon A. Impact of incoming phone calls on oncology departments in oral therapies era: a large national prospective survey. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e18210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Aline Guillot
- Institut de Cancérologie de la Loire, Saint-Etienne, France
| | | | | | | | | | - Yann Alexandre Vano
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris, France
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Médioni J, Di Palma M, Guillot A, Spaeth D, Théodore C. Efficacy and safety of Vinflunine for advanced or metastatic urothelial carcinoma in routine practice based on the French multi-centre CURVE study. BMC Cancer 2016; 16:217. [PMID: 26975779 PMCID: PMC4792100 DOI: 10.1186/s12885-016-2262-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 03/09/2015] [Accepted: 03/09/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To retrospectively assess the efficacy and safety of Vinflunine (VFL) under routine conditions and identify overall survival (OS) prognostic factors. METHODS Twenty centres participated in the retrospective study (minimum 4 patients undergoing VFL treatment for advanced/metastatic UC after platinum-based regimen progression. Primary endpoint was OS. Secondary endpoints: progression-free survival (PFS), radiological response rate (RR) RECIST criteria and toxicity (CTC NCI v3). RESULTS These centres enrolled 134 patients. Prior chemotherapy (CT) lines (≥ 1 palliative): 1 and ≥ 2 in 69% and 26% of patients, respectively. Performance status (PS): 0, 1, 2 in 25%, 46% and 23% of patients. Median OS = 8.2 months [6.5-9.4], PFS = 4.2 months and RR 22%, median number of 5 cycles. In risk groups based on 0-3 presence of adverse prognostic factors (PS ≥ 1, haemoglobin ≤ 10 g/dl and liver metastasis), median OS: 13.2, 9.9, 3.6, and 2.4 months (P < .0001), respectively; 3.3 months (1.9-5.6) in PS ≥ 2 subgroup. CONCLUSION This study reflects routine UC management and confirmed VFL patient efficacy. The drug is safe with gastro-intestinal and haematological prophylaxis. Analysis of prognostic factors for OS is consistent with pivotal trials.
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Affiliation(s)
- Jacques Médioni
- />Medical Oncology Department, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Mario Di Palma
- />Department of Medicine, Gustave Roussy Institute, 114 Rue Édouard Vaillant, 94805 Villejuif, France
| | - Aline Guillot
- />Lucien Neuwirth Institute of Cancerology, 108 B Avenue Albert Raimond, 42270 Saint-Priest-en-Jarez, France
| | - Dominique Spaeth
- />Gentilly Oncology Centre, 2 rue Marie Marvingt, 54100 Nancy, France
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Moriceau G, Guillot A, Pacaut C, Méry B, Falk AT, Trone JC, Collard O, De Laroche G, Fournel P, Merrouche Y, Magné N. Translating Clinical Evidence-Based Medicine into the Real World: Single-Center Experience with Cabazitaxel in Metastatic Prostate Cancer Patients. Chemotherapy 2016; 61:127-33. [DOI: 10.1159/000441379] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/28/2015] [Indexed: 11/19/2022]
Abstract
Background: We studied the efficacy and safety of cabazitaxel in unselected real-life patients. Patients and Methods: We retrospectively investigated all patients with metastatic prostate cancer (mPC) treated with cabazitaxel 25 mg/m2 i.v. every 3 weeks combined with oral prednisolone (10 mg once daily) after first-line docetaxel chemotherapy. Study issues were to report patient characteristics and cabazitaxel data in terms of tolerance and efficacy. Overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method. All data were compared with TROPIC results. Results: From 2011 to 2014, 41 patients received cabazitaxel; 15 patients (37%) had a performance status (PS) ≥2 versus 7% (p < 0.0001) in TROPIC, and 38 patients (93%) presented a Gleason score ≥7 at baseline (vs. 60%; p < 0.0001). All patients had metastatic disease at baseline. Previous therapies were radiotherapy in 17 patients (41 vs. 61%; p = 0.01) and surgery in 24 patients (59 vs. 52%; p = 0.4). The median number of cabazitaxel cycles was 5 (1-10) versus 6 (3-10) in TROPIC. Five patients completed 10 cycles of cabazitaxel (12%) versus 28% in TROPIC (p = 0.03). Toxicities were anemia (12 patients, 29%), diarrhea (9 patients, 22%), nausea (7 patients, 17%), pain (6 patients, 15%), sepsis (4 patients, 10%), neutropenia (3 patients, 7%) and urinary tract infection (1 patient, 2%). The tumor response rate was 19.5 versus 14.4% in TROPIC (nonsignificant). PFS was 4.5 months (95% CI 3.3-6.4) in our analysis and 2.8 months (95% CI 2.4-3.0) in TROPIC. OS was 12.1 months (95% CI 9.2 to not reached) and 15.1 months (95% CI 14.1-16.3), respectively. Conclusion: In our unselected mPC patients with poorer baseline clinical conditions and aggressive disease, cabazitaxel seems efficient and not more toxic than in the TROPIC study.
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Thiery- Vuillemin A, Guillot A, Steiner T, Herrmann E, Syrigos KN, Kelkouli N, Cattaneo A, Nguyen T. Efficacy and safety of sequential use of everolimus in patients with metastatic renal cell carcinoma previously treated by bevacizumab with or without interferon therapy: Results from pooled analysis of AVATOR, CHANGE, and TRAIN studies. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.2_suppl.585] [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
585 Background: Everolimus is a mammalian target of rapamycin (mTOR) inhibitor. It gained approval based on the results of the RECORD-1 trial, which included patients with metastatic renal cell carcinoma (mRCC) whose disease progressed after receiving vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs). Bevacizumab is a monoclonal antibody targeting angiogenesis that is approved in patients (pts) with mRCC. AVATOR was the 1st study to explore the sequential use of bevacizumab followed by everolimus but with limited number of pts. Methods: In order to further explore this sequence pooled data from the AVATOR, CHANGE and TRAIN studies were analysed retrospectively. All pts had mRCC and were previously or currently treated with everolimus after failure of bevacizumab ± IFN. The primary end point was everolimus time to progression (TTP). Secondary end points were related to the overall survival (OS) of patients receiving the drug sequence, everolimus treatment and safety. Results: 89 pts were included in the analysis. Median age was 68 years [18-90]. At everolimus initiation ECOG was 0-1 for 72% pts and 16% were classified as poor prognosis from Heng classification. Exploring the duration of second-line everolimus treatment, 32% of patients received less than 3 months of everolimus and 35% received at least 6 months of treatment. At the time of data analysis, 20 pts (24%) were still receiving everolimus. Pts receiving everolimus after bevacizumab experienced a median TTP of 6 months [95%CI 4 - 14]. Median OS was not reached for everolimus second-line therapy. At 36 months after the start of first-line therapy, 60.4% of pts were still alive. All grades of common adverse events were consistent with the known safety profile of everolimus. Conclusions: The larger size of this cohort confirms the signal previously seen with AVATOR that the sequence of bevacizumab followed by everolimus displays interesting efficacy with not unexpected toxicity from everolimus and compares favourably with RECORD-1.
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Affiliation(s)
| | - Aline Guillot
- Institut de Cancérologie de la Loire, Saint-Etienne, France
| | - Thomas Steiner
- Helios-Klinikum Erfurt, Klinik für Urologie, Erfurt, Germany
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Di Rienzo F, Blache Y, Kanthack T, Monteil K, Collet C, Guillot A. Short-term effects of integrated motor imagery practice on muscle activation and force performance. Neuroscience 2015; 305:146-56. [DOI: 10.1016/j.neuroscience.2015.07.080] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/24/2015] [Accepted: 07/30/2015] [Indexed: 11/17/2022]
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