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Carle X, Gastaud L, Salleron J, Tardy MP, Caujolle JP, Thyss A, Thariat J, Chevallier P. Optimizing the treatment of liver metastases from uveal melanomas with transarterial chemoembolization using melphalan and calibrated microspheres. Bull Cancer 2020; 107:1274-1283. [PMID: 33183739 DOI: 10.1016/j.bulcan.2020.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/14/2020] [Accepted: 09/27/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patients with liver metastasis from uveal melanoma have a poor prognosis. Efficacy and safety of hepatic transarterial chemoembolization (TACE) using melphalan and microspheres was evaluated. MATERIALS AND METHODS Monocentric retrospective study of all consecutive patients treated by TACE using melphalan and 250μm calibrated microspheres between 2004 and 2016. Radiological response was assessed according to RECIST 1.1, modified (m)-RECIST and EASL on contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The primary endpoint was overall survival (OS). Liver metastasis response, hepatic, extrahepatic and global progression free survival (PFS) complications were evaluated with the common terminology criteria for adverse events version 4.0 (CTCAE 4.0) and survival factors were secondary endpoints. RESULTS Thirty-four patients underwent 138 TACE (4; 4.1 sessions; range 1-9). Median OS was 16.5 months (mean 21.6 months). Liver metastasis response combining partial and complete response was 42.4%, 97%, 97% with RECIST 1.1, mRECIST, EASL, respectively. There were 58 severe (CTCAE≥3) but manageable complications in 28 patients, except for 1 toxic death. CONCLUSION For patients with liver metastases from uveal melanoma ineligible for local treatments, TACE using melphalan may be performed as first line therapy in metastatic miliary disease from uveal melanomas with careful supportive care.
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Affiliation(s)
- Xavier Carle
- University Hospital Archet 2, Department of Diagnostic and Interventional Radiology, 151 Route de Saint-Antoine, 06200 Nice, France
| | - Lauris Gastaud
- Antoine-Lacassagne Centre, Cancer Research Center, Department of Oncology, 133, avenue de Valombrose, 06189 Nice, France
| | - Julia Salleron
- Lorraine Institute of Oncology, Department of Biostatistics, 6 avenue de Bourgogne, 54519 Vandoeuvre-lès-Nancy, France
| | - Magali Pascale Tardy
- Antoine-Lacassagne Centre, Cancer Research Center, Department of Oncology, 133, avenue de Valombrose, 06189 Nice, France
| | - Jean-Pierre Caujolle
- University Hospital Pasteur 2, Department of Ophtalmology, 30, voie Romaine, 06001 Nice, France
| | - Antoine Thyss
- Antoine-Lacassagne Centre, Cancer Research Center, Department of Oncology, 133, avenue de Valombrose, 06189 Nice, France
| | - Juliette Thariat
- Francois-Baclesse Centre, Cancer Research Center, Department of Oncology, 3, avenue du Général Harris, 14000 Caen, France
| | - Patrick Chevallier
- University Hospital Archet 2, Department of Diagnostic and Interventional Radiology, 151 Route de Saint-Antoine, 06200 Nice, France.
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Schiano de Colella JM, Viviani S, Rapezzi D, PATTI CATERINA, Clement Filliatre L, Rossi A, Bijou F, Cantonetti M, Borel C, Thamphya B, Schiappa R, Chamorey E, Debaigt C, Gastaud L, Thyss A, Gallamini A. Brentuximab vedotin and bendamustine as first-line treatment of Hodgkin lymphoma in the elderly (HALO Trial). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.8029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8029 Background: Hodgkin Lymphoma (HL) treatment in the elderly is a challenge, as standard ABVD is able to cure no more than 60% of the patients (p.). Bendamustine (Be), and Brentuximab Vedotin (BV), are well-tolerated and effective drugs in relapsing HL, but only preliminary data exist in 1st line treatment of the elderly (Evens AM 2018). Methods: HALO is a prospective international multicenter open-label phase I/II study (NCT02467946) to assess the safety and efficacy of Be-BV in advanced-stage elderly HL p. Briefly, BV 1.2 mg/kg on D1, and Be 90 mg/m2 on D1-2 were administered Q3W for 6 cycles. The primary endpoint was the feasibility and the efficacy of Be-BV. Results: Between July 2015 and February 2019, 59/60 p. consecutive enrolled received at least 1 Be-BV cycle, and are valuable for primary endpoint. One p. was excluded because a histological review showing angioimmunoblastic T-Cell Lymphoma. The mean age was 70.32 (62-79), and M/F ratio 41/18. The Ann-Arbor stage was IIB in 12, III in 14 and IV in 33 patients, B-symptoms (y/n) 40/19. IPS was 0-2 in 19 and ≥ 3 in 40 p., P.S. (ECOG) was 0-1 in 53, 2 in 6 p., nonetheless most of them were frail, as ADL was ≥ 6 in 47 (79%) and IADL was ≥ 8 in 42 (71%) p. Most frequent co-morbidities were cardio-vascular disease (45) metabolism disorders (31) prostatic adenoma (11). 163 treatment-related adverse events (WHO 3-4) were recorded: neutropenia and lymphopenia, (134), infections (7), cutaneous reactions (5), liver toxicity (2). No case of grade > 2 peripheral neuropathy was recorded. Out of 59 p., 41 concluded and 18 interrupted the treatment for toxicity (8), progression (5), treatment failure (2), CMV reactivation (3). The latter was recorded in 17 p., 12/17 received valgancyclovir. 4 p. died with CMV viremia. After a mean follow-up of 20.6 (0.3-46.5) months, 37/59 (63%) were in CR, while 22 (37%) have progressed (5) or relapsed (17). The 2-y OS and PFS in ITT analysis were 83% (95% CI 71-96) and 54% (95% CI 41-72) and in PP 89% (95%CI 75-100) and 78% (95%CI 64-96), respectively. 22 p. had a PFS event: 5 progression (2 deaths), 17 relapse (8 deaths). 10 p. died for recurrent HL (5), sepsis (1), secondary malignancy (2), respiratory insufficiency (1) and unknown (1). Conclusions: The Be-BV combination, a novel anthracycline-free regiment for first line treatment of HL in elderly, proved effective in unselected, frail, poor-risk, HL p. aged more than 60 in daily hospital real life. The CMV reactivation is frequent and should be treated with preemptive antiviral therapy upon detection of CMV DNA in plasma. Clinical trial information: NCT02467946 .
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Affiliation(s)
| | | | | | | | | | - Andrea Rossi
- Asst Papa Giovanni XXIII Bergamo, Bergamo, Italy
| | | | | | - Cécile Borel
- Institut Universitaire du Cancer de Toulouse, Toulouse Cedex, France
| | | | - Renaud Schiappa
- Biostatistics’ Unite, Antoine Lacassagne Cancer Center, University of Cote d’Azur, Nice, France
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Duffaud F, Blay JY, Italiano A, Bompas E, Rios M, Penel N, Mir O, Piperno-Neumann S, Chevreau C, Delcambre C, Bertucci F, Boudou Rouquette P, Vegas H, Perrin C, Thyss A, Schiffler C, Monard L, Bouvier C, Vidal V, Chabaud S. Results of the randomized, placebo (PL)-controlled phase II study evaluating the efficacy and safety of regorafenib (REG) in patients (pts) with locally advanced (LA) or metastatic relapsed chondrosarcoma (CS), on behalf of the French Sarcoma Group (FSG) and UNICANCER. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pedrono M, Mir O, Chaltiel L, Brahmi M, Italiano A, Decanter G, Rouquette PB, Ropars M, Bompas E, Firmin N, Isambert N, Valentin T, Duffaud F, Gantzer J, Thyss A, Guillemet C, Blay JY, Cesne AL, Chevreau C, Perrin C. Outcome of 98 patients with epithelioid sarcoma treated in curative intent: A retrospective study from the French Sarcoma Group (GSF-GETO). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bertrand AS, Iannessi A, Peyrottes I, Lacout A, Thyss A, Marcy PY. Myoma Hot Spot: Tumor-to-Tumor Metastasis of Thyroid Origin into Uterine Leiomyoma. Eur Thyroid J 2019; 8:273-277. [PMID: 31768339 PMCID: PMC6873082 DOI: 10.1159/000501153] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/23/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Distant metastases of papillary thyroid cancers are rare. Most common metastatic sites include bone and lung, whereas metastases to brain, eye, breast, liver, kidney, muscle, and skin are infrequent and almost always appear in advanced-stage tumor disease. Metastases to ovary and/or uterus are even scarcer. We report herein a very exceptional case of asymptomatic malignant-to-benign tumor-to-tumor metastasis of thyroid origin into a uterine leiomyoma. CASE PRESENTATION We present the case of a 53-year-old female patient who had a previous history of pT1b N0 M0 R0 papillary carcinoma of the lower left thyroid lobe, treated by total thyroidectomy and central lymph node dissection and two successive administrations of radioactive treatment with iodine-131. Six years later, follow-up imaging disclosed an asymptomatic slow-growing 40-mm-long pedicled subserous heterogeneous uterine myoma including a 12-mm hypervascular nodule, which was suspicious for thyroid malignancy on MRI. DISCUSSION Histopathology of a hysterectomy specimen disclosed a hypervascular well-limited poorly differentiated trabecular carcinomatous infiltration within the uterine leiomyoma. The immunohistochemical profile of the suspicious nodule was compatible with a thyroid origin. CONCLUSION A hypervascular "hot spot" intramyoma nodule was the diagnostic clue in a clinical context of hematogenous tumor spread of thyroid origin (increased thyroglobulin level).
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Affiliation(s)
- Anne-Sophie Bertrand
- Department of Interventional Radiology Imaging, Antoine Lacassagne Cancer Research Center, Nice, France
- *Anne-Sophie Bertrand, MD, Department of Interventional Radiology Imaging, Antoine Lacassagne Cancer Research Center, 33 avenue de Valombrose, FR–06189 Nice (France), E-Mail
| | - Antoine Iannessi
- Department of Interventional Radiology Imaging, Antoine Lacassagne Cancer Research Center, Nice, France
| | - Isabelle Peyrottes
- Department of Anatomopathology, Antoine Lacassagne Cancer Research Center, Nice, France
| | - Alexis Lacout
- Department of Radiology, Centre médico-chirurgical ELSAN, Aurillac, France
| | - Antoine Thyss
- Department of Oncology, Antoine Lacassagne Cancer Research Center, Nice, France
| | - Pierre-Yves Marcy
- Department of Interventional Radiology and Diagnostic Imaging, Polyclinique Les Fleurs Groupe ELSAN, Ollioules, France
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Borra A, Morbelli S, Zwarthoed C, Bianchi A, Bergesio F, Chauvie S, Zaucha JM, Taszner M, Malkowski B, Biggi A, Thyss A, Darcourt J, Gallamini A. Dual-point FDG-PET/CT for treatment response assessment in Hodgkin lymphoma, when an FDG-avid lesion persists after treatment. Am J Nucl Med Mol Imaging 2019; 9:176-184. [PMID: 31328023 PMCID: PMC6627477] [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] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
FDG-PET/CT (PET) is now considered the standard imaging tool for Hodgkin Lymphoma (HL) staging and restaging. However a CT-detected residual mass at the end of therapy (EoT) is still a challenge for PET interpretation. The aim of our study was to improve the overall accuracy of EoT PET/CT by using a dynamic dual-point scanning at 60 and 120 after FDG injection (2P-PET/CT). Fifty-one HL patients showing a single residual FDG-avid mass (SFAM) at EoT PET/CT were included in the study in Italy and Poland. Treatment was ABVD, ABVD followed by BEACOPP or ABVD plus radiotherapy. Only patients with a SFAM and a Deauville score (DS) > 2 in EoT PET/CT were included in the study. Two independent nuclear medicine reviewed images with a semi-quantitative analysis (SUVMax and retention index, RI) and a visual scoring according to DS. Compared to standard PET, 2P-PET/CT showed only a modest increase in NPV and PPV, from 0.87 to 0.89 and of the PPV from 0.67 to 0.71, respectively. Increase of the overall accuracy became substantial upon including in the analysis only patients whose images were acquired in strict adhesion to original protocol of 2P-PET/CT scanning: (t 120'-6040 min): the sensitivity increased from 0.60 to 1.00, PPV from 0.75 to 0.83 and NPV from 0.89 to 1. This study, with caution for the small number of patients included, seems to suggest that 2P-PET/CT could increase the overall accuracy of EoT PET/CT in correctly classifying treatment response in HL with a persisting SFAM at EoT.
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Affiliation(s)
- Anna Borra
- Nuclear Medicine Department, University of GenoaItaly
- IRCCS Ospedale Policlinico San MartinoGenova, Italy
| | - Silvia Morbelli
- Nuclear Medicine Department, University of GenoaItaly
- IRCCS Ospedale Policlinico San MartinoGenova, Italy
| | - Colette Zwarthoed
- Nuclear Medicine Department, A. Lacassagne Cancer CentreNice, France
| | - Andrea Bianchi
- Nuclear Medicine Department S. Croce e Carle HospitalCuneo, Italy
| | | | - Stephane Chauvie
- Medical Physics Department, S. Croce e Carle HospitalCuneo, Italy
| | - Jan M Zaucha
- Hematology and Bone Marrow Transplantation Department, University of GdańskGdansk, Poland
| | - Michal Taszner
- Hematology and Bone Marrow Transplantation Department, University of GdańskGdansk, Poland
| | | | - Alberto Biggi
- Nuclear Medicine Department S. Croce e Carle HospitalCuneo, Italy
| | - Antoine Thyss
- Onco-hematology Department, A. Lacassagne Cancer CentreNice, France
| | - Jacques Darcourt
- Nuclear Medicine Department, A. Lacassagne Cancer CentreNice, France
| | - Andrea Gallamini
- Research and Clinical, Innovation Department, A. Lacassagne Cancer CentreNice, France
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Gallamini A, Schiano de Colella J, Viotti J, Bijou F, Rambaldi A, Perrot A, Patti C, Gastaud L, Sorasio R, Debaigt C, Schiappa R, Chamorey E, Viviani S, Thyss A. BRENTUXIMAB-VEDOTIN AND BENDAMUSTINE IS A FEASIBLE AND EFFECTIVE DRUG COMBINATION AS FIRST-LINE TREATMENT OF HODGKIN LYMPHOMA IN THE ELDERLY (HALO TRIAL). Hematol Oncol 2019. [DOI: 10.1002/hon.101_2630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A. Gallamini
- Clinical Research and Innovation; A. Lacassagne Cancer Center; Nice France
| | | | - J. Viotti
- Département d'Epidemiologie; de Biostatistiques et des Données de Santé, Centre Antoine Lacassagne; Nice France
| | - F. Bijou
- Oncologie Médicale; Institut Bergonié; Bordeaux France
| | - A. Rambaldi
- Ematologia; Ospedale Papa Giovanni XXII; Bergamo Italy
| | - A. Perrot
- Service Hématologie et Médecine Interne; CHU Nancy-Brabois; Vandoeuvre Les Nancy France
| | - C. Patti
- Ematologia; Ospedali Riuniti Villa Sofia e Cervello; Palermo Italy
| | - L. Gastaud
- Département d'Oncologie Médicale; Centre Antoine Lacassagne; Nice France
| | - R. Sorasio
- Ematologia; Ospedale Sante Croce e Carle; Cuneo Italy
| | - C. Debaigt
- Clinical Research and Innovation; A. Lacassagne Cancer Center; Nice France
| | - R. Schiappa
- Département d'Epidemiologie; de Biostatistiques et des Données de Santé, Centre Antoine Lacassagne; Nice France
| | - E. Chamorey
- Département d'Epidemiologie; de Biostatistiques et des Données de Santé, Centre Antoine Lacassagne; Nice France
| | - S. Viviani
- Dipartimento di Oncologia Medica; Istituto Nazionale Dei Tumori; Milano Italy
| | - A. Thyss
- Département d'Oncologie Médicale; Centre Antoine Lacassagne; Nice France
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Iannessi A, Bertrand AS, Peyrottes I, Thyss A, Machiavello JC, Liberatore M. One-bloc percutaneous large biopsy of soft-tissue tumours: feasibility study and possible indications. Clin Radiol 2019; 74:649.e11-649.e17. [PMID: 31178068 DOI: 10.1016/j.crad.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 05/02/2019] [Indexed: 11/26/2022]
Abstract
AIM To report the early results of the Intact lesion excision system (LES) regarding feasibility, tolerance and efficiency in obtaining soft-tissue tumour samples under ultrasound guidance. MATERIALS AND METHODS The feasibility and tolerance of Intact LES procedures under ultrasound guidance were studied prospectively in 15 patients. The procedure was performed on an outpatient basis under local anaesthesia by a single interventional radiologist with 6 years of experience and lasted around 30 min. RESULTS The feasibility of the Intact LES for soft-tissue masses was good except when lesions were hard and calcified. Tolerance was good, with median pain experienced during the procedure evaluated at 4.5/10 (SD 2.2) and median post-procedural pain at day 1 evaluated at 1.8/10 (SD 2.5). No major complications were observed; however, for vascularised lesions, one case of acute wound bleeding and two post-procedural haematomas led to delayed pain. CONCLUSION Percutaneous biopsy of suspected soft-tissue sarcoma using the LES device under ultrasound guidance is well tolerated and feasible. After a first non-contributing core biopsy, and especially, in the case of lipomatous lesions, it is a valuable option to consider, as is surgical incision biopsy.
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Affiliation(s)
- A Iannessi
- Interventional and Diagnostic Imaging Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France.
| | - A S Bertrand
- Interventional and Diagnostic Imaging Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France
| | - I Peyrottes
- Pathology Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France
| | - A Thyss
- Oncology Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France
| | - J C Machiavello
- Visceral Surgery Department, Cancer Center Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France
| | - M Liberatore
- Diagnostic Imaging Department, Princess Grace Hospital, 1 Avenue Pasteur, 98012 Monaco
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Basse C, Italiano A, Penel N, Mir O, Chemin C, Toulmonde M, Duffaud F, Le Cesne A, Chevreau C, Maynou C, Anract P, Gouin F, Rios M, Firmin N, Kurtz JE, Kerbrat P, Piperno-Neumann S, Bertucci F, Rosset P, Isambert N, Bompas E, Dubray-Longeras P, Fiorenza F, Le Maignan C, Chaigneau L, Thyss A, Bouché O, Eymard JC, Delcambre Lair C, Adam J, Karanian M, Lebbé C, Dupré A, Meeus P, Brahmi M, Dufresne A, Ducimetière F, Ray-Coquard I, Blay JY. Sarcomas in patients over 90: Natural history and treatment-A nationwide study over 6 years. Int J Cancer 2019; 145:2135-2143. [PMID: 30924137 PMCID: PMC6767526 DOI: 10.1002/ijc.32307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/15/2019] [Accepted: 03/11/2019] [Indexed: 11/16/2022]
Abstract
Soft tissue sarcomas (STS) are rare tumors accounting for less than 1% of human cancers. While the highest incidence of sarcomas is observed in elderly, this population is often excluded or poorly represented in clinical trials. The present study reports on clinicopathological presentation, and outcome of sarcoma patients over 90 recorded in the Netsarc.org French national database. NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor board (MDTB), funded by the French National Cancer Institute to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB, second pathological review, and collection of sarcoma patient characteristics and follow‐up are collected in a database Information of patients registered from January 1, 2010, to December 31, 2016, in NETSARC were collected, analyzed and compared to the younger population. Patients with sarcomas aged >90 have almost exclusively sarcomas with complex genomics (92.0% vs. 66.3%), are less frequently metastatic (5.3% vs. 14·7%) at diagnosis, have more often superficial tumors (39.8% vs. 14.7%), as well as limbs and head and neck sites (75.2% vs. 38.7%) (all p < 0.001). Optimal diagnostic procedures and surgery were less frequently performed in patients over 90 (p < 0.001). These patients were less frequently operated in NETSARC centers, as compared to those of younger age groups including aged 80–90. However, local relapse‐free survival, metastatic relapse‐free survival and relapse‐free survival were not significantly different from those of younger patients, in the whole cohort, as well as in the subgroup of operated patients. As expected overall survival was worse in patients over 90 (p < 0.001). Patients over 90 who were not operated had worse overall survival than younger patients (9.9 vs. 27.3 months, p < 0.001). Patients with STS diagnosed after 90 have distinct clinicopathological features, but comparable relapse‐free survival, unless clinical practice guidelines recommendations are not applied. Standard management should be proposed to these patients if oncogeriatric status allows. What's new? While the highest incidence of soft‐tissue sarcoma (STS) is observed in the elderly, this population is often excluded or poorly represented in clinical trials. Therefore, little is known about the characteristics, treatment, and outcomes of STS in these patients. In this study, the authors analyzed numerous clinical characteristics of patients with sarcoma diagnosed at age 91 or older. They conclude that standard STS management and clinical practice guidelines should be followed for these patients if possible.
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Affiliation(s)
- Clémence Basse
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | - Antoine Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, CHRU, Lille, France
| | - Olivier Mir
- Department of Orthopedic and Traumatology Surgery, University Hospital, Lille, France
| | - Claire Chemin
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | - Maud Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Florence Duffaud
- Department of Medical Oncology, Timone University Hospital, Marseille, France
| | - Axel Le Cesne
- Department of Medicine and Surgery, Gustave Roussy Cancer Campus, Paris, France
| | | | - Carlos Maynou
- Department of Medical Oncology, Centre Oscar Lambret, CHRU, Lille, France
| | - Philippe Anract
- Orthopaedic Department, Cochin University Hospital, Paris, France
| | - François Gouin
- Department of Orthopedic Surgery, Nantes University Hospital, Nantes, France
| | - Maria Rios
- Department of Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, France
| | - Nelly Firmin
- Department of Medicine, Val d'Aurelle Institute, Montpellier, France
| | - Jean-Emmanuel Kurtz
- Medical Oncology & Orthopedy Department, Strasbourg University Hospital, Rennes, France
| | | | | | - François Bertucci
- Département of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Philippe Rosset
- Department of Orthopedic and Traumatology Surgery, Tours University Hospital, Tours, France
| | | | - Emmanuelle Bompas
- Medical Oncology Department, René Gauducheau, Saint-Herblain, France
| | | | - Fabrice Fiorenza
- Department of Orthopedics Surgery and Traumatology, Limoges University Hospital, Limoges, France
| | - Christine Le Maignan
- Department of Dermatology and INSERM Unité 976, Saint Louis University Hospital, Paris, France
| | - Loïc Chaigneau
- Department of Medical Oncology, Jean Minjoz University Hospital, Besançon, France
| | - Antoine Thyss
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Olivier Bouché
- Institut Jean Godinot & Reims University Hospital, Reims, France
| | | | | | - Julien Adam
- Department of Medical Oncology, Timone University Hospital, Marseille, France
| | - Marie Karanian
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | - Céleste Lebbé
- Department of Dermatology and INSERM Unité 976, Saint Louis University Hospital, Paris, France
| | - Aurélien Dupré
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | - Pierre Meeus
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | - Mehdi Brahmi
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | - Armelle Dufresne
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | | | | | - Jean-Yves Blay
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
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Houillier C, Taillandier L, Dureau S, Lamy T, Laadhari M, Chinot O, Moluçon-Chabrot C, Soubeyran P, Gressin R, Choquet S, Damaj G, Thyss A, Abraham J, Delwail V, Gyan E, Sanhes L, Cornillon J, Garidi R, Delmer A, Tanguy ML, Al Jijakli A, Morel P, Bourquard P, Moles MP, Chauchet A, Gastinne T, Constans JM, Langer A, Martin A, Moisson P, Lacomblez L, Martin-Duverneuil N, Delgadillo D, Turbiez I, Feuvret L, Cassoux N, Touitou V, Ricard D, Hoang-Xuan K, Soussain C. Radiotherapy or Autologous Stem-Cell Transplantation for Primary CNS Lymphoma in Patients 60 Years of Age and Younger: Results of the Intergroup ANOCEF-GOELAMS Randomized Phase II PRECIS Study. J Clin Oncol 2019; 37:823-833. [DOI: 10.1200/jco.18.00306] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [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
PURPOSE To determine the efficacy and toxicity of chemoimmunotherapy followed by either whole-brain radiotherapy (WBRT) or intensive chemotherapy and autologous stem-cell transplantation (ASCT) as a first-line treatment of primary CNS lymphoma (PCNSL). PATIENTS AND METHODS Immunocompetent patients (18 to 60 years of age) with untreated PCNSL were randomly assigned to receive WBRT or ASCT as consolidation treatment after induction chemotherapy consisting of two cycles of R-MBVP (rituximab 375 mg/m2 day (D) 1, methotrexate 3 g/m2 D1; D15, VP16 100 mg/m2 D2, BCNU 100 mg/m2 D3, prednisone 60 mg/kg/d D1-D5) followed by two cycles of R-AraC (rituximab 375 mg/m2 D1, cytarabine 3 g/m2 D1 to D2). Intensive chemotherapy consisted of thiotepa (250 mg/m2/d D9; D8; D7), busulfan (8 mg/kg D6 through D4), and cyclophosphamide (60 mg/kg/d D3; D2). WBRT delivered 40 Gy (2 Gy/fraction). The primary end point was 2-year progression-free survival. Cognitive outcome was the main secondary end point. Analysis was intention to treat in a noncomparative phase II trial. RESULTS Between October 2008 and February 2014, 140 patients were recruited from 23 French centers. Both WBRT and ASCT met the predetermined threshold (among the first 38 patients in each group, at least 24 patients were alive and disease free at 2 years). The 2-year progression-free survival rates were 63% (95% CI, 49% to 81%) and 87% (95% CI, 77% to 98%) in the WBRT and ASCT arms, respectively. Toxicity deaths were recorded in one and five patients after WBRT and ASCT, respectively. Cognitive impairment was observed after WBRT, whereas cognitive functions were preserved or improved after ASCT. CONCLUSION WBRT and ASCT are effective consolidation treatments for patients with PCNSL who are 60 years of age and younger. The efficacy end points tended to favor the ASCT arm. The specific risk of each procedure should be considered.
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Affiliation(s)
| | | | | | - Thierry Lamy
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | | | - Olivier Chinot
- Centre Hospitalier Universitaire de la Timone, Marseille, France
| | | | | | - Remy Gressin
- Centre Hospitalier Universitaire de Grenoble, La Tronche, France
| | - Sylvain Choquet
- Groupe Hospitalier Universitaire Pitié-Salpétrière, Paris, France
| | - Gandhi Damaj
- Centre Hospitalier Universitaire d’Amiens, Salouël, France
| | | | - Julie Abraham
- Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Vincent Delwail
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Emmanuel Gyan
- Centre Hospitalier Regional Universitaire de Tours, Tours, France
| | | | - Jérôme Cornillon
- Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France
| | - Reda Garidi
- Centre Hospitalier de Saint Quentin, Saint Quentin, France
| | - Alain Delmer
- Centre Hospitalier Universitaire de Reims, Reims, France
| | | | | | | | | | | | - Adrien Chauchet
- Centre Hospitalier Universitaire de Besançon, Besançon, France
| | | | | | | | | | | | | | | | | | | | - Loïc Feuvret
- Groupe Hospitalier Universitaire Pitié-Salpétrière, Paris, France
| | | | - Valérie Touitou
- Groupe Hospitalier Universitaire Pitié-Salpétrière, Paris, France
| | - Damien Ricard
- Hôpital d’Instruction des Armées Percy, Clamart, France
| | - Khê Hoang-Xuan
- Groupe Hospitalier Universitaire Pitié-Salpétrière, Paris, France
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Doyen J, Picard A, Naghavi AO, Thyss A, Passeron T, Lacour JP, Montaudié H. Clinical Outcomes of Metastatic Melanoma Treated With Checkpoint Inhibitors and Multisite Radiotherapy. JAMA Dermatol 2019; 153:1056-1059. [PMID: 28746710 DOI: 10.1001/jamadermatol.2017.2222] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Jérôme Doyen
- Department of Radiotherapy, Centre Antoine-Lacassagne, Nice, France
| | - Alexandra Picard
- Dermatology Department, Archet 2 Hospital, Nice University Hospital, Nice, France
| | - Arash O Naghavi
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Antoine Thyss
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Thierry Passeron
- Dermatology Department, Archet 2 Hospital, Nice University Hospital, Nice, France
| | - Jean-Philippe Lacour
- Dermatology Department, Archet 2 Hospital, Nice University Hospital, Nice, France
| | - Henri Montaudié
- Dermatology Department, Archet 2 Hospital, Nice University Hospital, Nice, France
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12
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Bertrand AS, Iannessi A, Natale R, Beaumont H, Patriti S, Xiong-Ying J, Baudin G, Thyss A. Focused ultrasound for the treatment of bone metastases: effectiveness and feasibility. J Ther Ultrasound 2018; 6:8. [PMID: 30519467 PMCID: PMC6267064 DOI: 10.1186/s40349-018-0117-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 11/01/2018] [Indexed: 12/25/2022] Open
Abstract
Background To evaluate the effectiveness and feasibility of high-intensity focused ultrasound (HIFU) for the treatment of bone metastases. Methods A single-center prospective study was made involving 17 consecutive patients with symptomatic bone metastases. Patients were treated by Focused Ultrasound (FUs) performed with magnetic resonance (MR) guidance. Surgical treatment or radiotherapy treatment was not indicated for patients who underwent FUs. Lesions were located in the appendicular and axial skeleton and consisted of secondary symptomatic lesions. The clinical course of pain was evaluated using the Visual Analog Scale (VAS) before treatment, at 1 week, and at 1 month after treatment and the Oral Morphine Equivalent Daily Dose (OMEDD) was also recorded. We used Wilcoxon signed rank test to assess change in patient pain (R CRAN software V 3.1.1). Results We observed a significant decrease in the pain felt by patients between pre- procedure and 1 week post-procedure (p = 2.9.10-4), and pre-procedure and 1 month post-procedure (p = 3.10-4). The proportion of responders according to the International Bone Metastases Consensus Working Party was: Partial Response 50% (8/16) and Complete Response 37.5% (6/16). Conclusions HIFU under MR-guidance seems to be an effective and safe procedure in the treatment of symptomatic bone lesions for patients suffering from metastatic disease. A significant decrease of patient pain was observed. Trial registration NCT01091883. Registered 24 March 2010. Level of evidence: Level 3.
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Affiliation(s)
- Anne-Sophie Bertrand
- Department of Interventional Radiology, Centre de Lutte contre le Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France
| | - Antoine Iannessi
- Department of Interventional Radiology, Centre de Lutte contre le Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France
| | - Romain Natale
- Department of Radiotherapy, Centre de Lutte contre le Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France
| | - Hubert Beaumont
- 3Department of Statistics, University of Nice Sophia Antipolis, 28 Avenue Valrose, 06000 NICE, France
| | - Sebastien Patriti
- Department of Interventional Radiology, Centre de Lutte contre le Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France
| | - Jiang Xiong-Ying
- Department of Interventional Radiology, Centre de Lutte contre le Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France
| | - Guillaume Baudin
- Department of Interventional Radiology, Centre de Lutte contre le Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France
| | - Antoine Thyss
- Department of Oncology, Centre de Lutte anti-Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France
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13
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Duffaud F, Blay JY, Mir O, Boudou-Rouquette P, Piperno-Neumann S, Penel N, Bompas E, Delcambre C, Kalbacher E, Italiano A, Collard O, Chevreau C, Thyss A, Isambert N, Delaye J, De Sousa Carvalho N, Schiffler C, Bouvier C, Vidal V, Chabaud S. Results of randomized, placebo (PL)-controlled phase II study evaluating efficacy and safety of regorafenib (REG) in patients (pts) with metastatic osteosarcoma (metOS), on behalf of the French Sarcoma Group (FSG) and Unicancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.11504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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)
| | | | - Olivier Mir
- Gustave Roussy Cancer Campus, Villejuif, France
| | | | | | | | | | | | | | | | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | | | | | - Nicolas Isambert
- Service d'oncologie médicale CLCC Georges-François Leclerc, Dijon, France
| | | | | | | | - Corinne Bouvier
- Assistance Publique - Hopitaux De Marseille, Marseille, France
| | - Vincent Vidal
- Assistance Publique - Hôpitaux de Marseille, Marseille, France
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14
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Toulmonde M, Ray-Coquard IL, Pulido M, Andre T, Isambert N, Chevreau C, Penel N, Bompas E, Thyss A, Bertucci F, Lebbe C, Domont J, Soulie P, Neumann SP, Cecchi F, Hembrough TA, Petitprez F, Bellera CA, Blay JY, Italiano A. DESMOPAZ pazopanib (PZ) versus IV methotrexate/vinblastine (MV) in adult patients with progressive desmoid tumors (DT) a randomized phase II study from the French Sarcoma Group. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.11501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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)
- Maud Toulmonde
- Institut Bergonié, Department of Medical Oncology, Bordeaux, France
| | | | | | | | - Nicolas Isambert
- Service d'oncologie médicale CLCC Georges-François Leclerc, Dijon, France
| | | | | | | | | | | | - Celeste Lebbe
- AP-HP Dermatology and CIC department, INSERM U976, Faculté Paris 7 Diderot, Saint-Louis hospital, AP-HP, Paris, France, Paris, France
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15
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Boudou-Rouquette P, Martin E, Kempf E, Penel N, Italiano A, Duffaud F, Bompas E, Firmin N, Bertucci F, Kurtz JE, Chaigneau L, Isambert N, Thyss A, Bay JO, Chevreau C, Blay JY, Piperno-Neumann S. Rare bone sarcoma: A retrospective analysis of 149 adult patients from the French Sarcoma Group. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.11523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Pascaline Boudou-Rouquette
- Department of Medical Oncology, ARIANE, Cochin Hospital, Paris Descartes University, AP-HP, CARPEM, Paris, France
| | | | - Emmanuelle Kempf
- Gustave-Roussy Institute, Oncology Department, Villejuif, France
| | | | | | | | | | - Nelly Firmin
- Institut du Cancer de Montpellier, Montpellier, France
| | | | | | - Loic Chaigneau
- Institut Regional du Cancer en Franche-Comté - University Hospital, Besançon, France
| | | | | | - Jacques-Olivier Bay
- Cellular Therapy and Clinic Hematology Unit for Adults, Clermont-Ferrand, France
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16
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Rodon P, Hulin C, Daley L, Dauriac C, Hacini M, Decaux O, Eisemann JC, Fitoussi O, Lioure B, Voillat L, Slama B, Al Jijakli A, Benramdane R, Chaleteix C, Costello R, Thyss A, Mathiot C, Eileen B, Maloisel F, Stoppa AM, Kolb B, Michallet M, Lamblin A, Natta P, Facon T, Elalamy I, Fermand JP, Moreau P, Leleu X. MELISSE, a large multicentric observational study to determine risk factors of venous thromboembolism in patients with multiple myeloma treated with immunomodulatory drugs. Thromb Haemost 2017; 110:844-51. [DOI: 10.1160/th13-02-0140] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 06/22/2013] [Indexed: 01/06/2023]
Abstract
SummaryImmunomodulatory drugs (IMiDs) are associated with an increased risk of venous thromboembolism (VTE) in multiple myeloma (MM) patients. We designed MELISSE, a multicentre prospective observational study, to evaluate VTE incidence and identify risk factors in IMiDstreated MM. Our objective was to determine the real-life practice of VTE prophylaxis strategy. A total of 524 MM patients were included, and we planned to collect information at baseline, at four and at 12 months, on MM therapy, on VTE risk factors and management. VTE incidence was 7% (n=31), including 2.5% pulmonary embolism (PE) (n=11), similar at four or 12 months. VTE was observed at all risk assessment levels, although the increased risk assessment level correlated to a lower rate of VTE, maybe due to the implemented thromboprophylaxis strategy. VTE occurred in 7% on aspirin vs 3% on lowmolecular- weight heparin (LMWH) prophylaxis, and none on vitamin K antagonists (VKA). New risk factors for VTE in IMiDs-treated MM were identified. In conclusion, VTE prophylaxis is compulsory in IMiDstreated MM, based on individualised VTE risk assessment. Anticoagulation prophylaxis with LMWH should clearly be prioritised in MM patients with high VTE risk, along with VKA. Further prospective studies will identify most relevant VTE risk factors in IMiDs-treated MM to select accurately which MM patients should receive LMWH prophylaxis and for which duration to optimise VTE risk reduction.
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Blay JY, Soibinet P, Penel N, Bompas E, Duffaud F, Stoeckle E, Mir O, Adam J, Chevreau C, Bonvalot S, Rios M, Kerbrat P, Cupissol D, Anract P, Gouin F, Kurtz JE, Lebbe C, Isambert N, Bertucci F, Toumonde M, Thyss A, Piperno-Neumann S, Dubray-Longeras P, Meeus P, Ducimetière F, Giraud A, Coindre JM, Ray-Coquard I, Italiano A, Le Cesne A. Improved survival using specialized multidisciplinary board in sarcoma patients. Ann Oncol 2017; 28:2852-2859. [PMID: 29117335 PMCID: PMC5834019 DOI: 10.1093/annonc/mdx484] [Citation(s) in RCA: 212] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Sarcomas are rare but aggressive diseases. Specialized multidisciplinary management is not implemented for all patients in most countries. We investigated the impact of a multidisciplinary tumor board (MDTB) presentation before treatment in a nationwide study over 5 years. PATIENTS AND METHODS NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized MDTB, funded by the French National Cancer Institute to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB and second pathological review are mandatory for sarcoma patients in France. Patients' characteristics and follow-up are collected in a database regularly monitored and updated. The management and survival of patients presented to these MDTB before versus after initial treatment were analyzed. RESULTS Out of the 12 528 patients aged ≥15 years, with a first diagnosis of soft tissue and visceral sarcoma obtained between 1 January 2010 and 31 December 2014, 5281 (42.2%) and 7247 (57.8%) were presented to the MDTB before and after the initiation of treatment, respectively. The former group had generally worse prognostic characteristics. Presentation to a MDTB before treatment was associated with a better compliance to clinical practice guidelines, for example, biopsy before surgery, imaging, quality of initial surgery, and less reoperations (all P < 0.001). Local relapse-free survival and relapse-free survival were significantly better in patients presented to a MDTB before initiation of treatment, both in univariate and multivariate analysis. CONCLUSION The compliance to clinical practice guidelines and relapse-free survival of sarcoma patients are significantly better when the initial treatment is guided by a pre-therapeutic specialized MDTB.
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Affiliation(s)
- J-Y Blay
- Department of Medical and Surgical Oncology, Centre Léon Bérard, Lyon; Department of Université Claude Bernard, Lyon.
| | - P Soibinet
- Department of Medical Oncology, Centre J Godinot, Reims
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - E Bompas
- Department of Medical Oncology, Centre René Gauducheau Nantes, St. Herblain
| | - F Duffaud
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - E Stoeckle
- Departments of Medical and Surgical Oncology, Institut BergoniéBordeaux
| | - O Mir
- Departments of Medicine and Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - J Adam
- Departments of Medicine and Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - C Chevreau
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse
| | - S Bonvalot
- Departments of Medicine and Surgery, Gustave Roussy Cancer Campus, Villejuif; Departments of Medical and Surgical Oncology, Institut Curie, Paris
| | - M Rios
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - P Kerbrat
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - D Cupissol
- Department of Medical Oncology, Centre Val d'Aurelle, Montpellier
| | - P Anract
- Department of Orthopedics, Hopital Cochin Saint Vincent de Paul, Paris
| | - F Gouin
- Department of Orthopedics, Centre Hospitalier et Universitaire, Nantes
| | - J-E Kurtz
- Department of Medical Oncology, Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - C Lebbe
- Department of Dermatology and CIC Department, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris
| | - N Isambert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon
| | - F Bertucci
- Department of Medical Oncology, Institut Paoli Calmettes, Marseille
| | - M Toumonde
- Departments of Medical and Surgical Oncology, Institut BergoniéBordeaux
| | - A Thyss
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice
| | | | - P Dubray-Longeras
- Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - P Meeus
- Department of Medical and Surgical Oncology, Centre Léon Bérard, Lyon; Department of Université Claude Bernard, Lyon
| | - F Ducimetière
- Department of Medical and Surgical Oncology, Centre Léon Bérard, Lyon; Department of Université Claude Bernard, Lyon
| | - A Giraud
- Departments of Medical and Surgical Oncology, Institut BergoniéBordeaux
| | - J-M Coindre
- Departments of Medical and Surgical Oncology, Institut BergoniéBordeaux
| | - I Ray-Coquard
- Department of Medical and Surgical Oncology, Centre Léon Bérard, Lyon; Department of Université Claude Bernard, Lyon
| | - A Italiano
- Departments of Medical and Surgical Oncology, Institut BergoniéBordeaux
| | - A Le Cesne
- Departments of Medicine and Surgery, Gustave Roussy Cancer Campus, Villejuif
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Tardy M, Viotti J, Boscagli Melaine A, Thyss A, Peyrade F, Gastaud L. Autologous stem cell transplantation (ASCT) is safe and effective for the treatment of non-hodgkin lymphoma (NHL) in an elderly population of patients over 65 years old: A single center experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pautier P, Penel N, Ray-Coquard I, Italiano A, Bompas E, Delcambre C, Bay JO, Bertucci F, Delaye J, Chevreau C, Cupissol D, Le Moal LB, Eymard JC, Thyss A, Isambert N, Guillemet C, Rios M, Piperno-Neumann S, Chenuc G, Duffaud F. Results of the LMS03 phase II study evaluating gemcitabine combined with pazopanib as a 2nd-line treatment for metastatic/relapsed leiomyosarcomas (uterine or soft tissue) after failure of anthracycline-based chemotherapy: The UNICANCER SARCOME 11 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.072] [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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20
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Verriere B, Gastaud L, Chamorey E, Peyrade F, Deletie E, Bouredji K, Quinsat D, Schiappa R, Thyss A, Re D. Description of late onset neutropenia in indolent lymphoma patients treated with bendamustine plus rituximab. Hematol Oncol 2017; 36:144-149. [PMID: 28685846 DOI: 10.1002/hon.2458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/26/2017] [Accepted: 06/05/2017] [Indexed: 11/11/2022]
Abstract
Bendamustine (B) associated with rituximab (R) is widely described in literature for the management of patients with chronic lymphoid leukaemia (CLL) and indolent non-Hodgkin lymphoma. Safety data regarding late hematotoxicity such as late onset neutropenia (LON) are scarce. The aim of our study was to assess the incidence and to identify risk factors for LON in patients with indolent non-Hodgkin lymphoma and CLL treated with B and R (B-R). One hundred forty five patients were treated with B-R as first or second line. Patients with neutropenia prior induction treatment, treated beyond second line and relapsing within 3 months after the end of induction treatment, were excluded. Patients receiving at least 1 cycle of B-R and having LON during follow-up period were included and considered as eligible for toxicity assessment. A complete blood count was performed 4 weeks after the last cycle of induction treatment and thereafter every 3 months for 1 year. Thirty six patients were identified in our cohort (incidence of 25%), mostly affected by CLL (n = 11) and follicular lymphoma (FL) (n = 15). During follow-up, 84 events of LON were recorded, 61% and 39% were of grades 1/2 and 3/4, respectively. No episode of febrile neutropenia was documented. Amongst 13 of the 15 patients with FL undergoing R maintenance, 8 had treatment discontinuation because of LON. Median time for LON (grade > 2) and time to recovery (grade < 3) were of 11.2 and 17.3 weeks, respectively. One year after B-R induction, LON persisted in 4 patients. The risk of LON was increased both in patients with FL or CLL and performance status >1. The LON in B-R treated patients is clinically relevant. Close clinical and biological follow-up and treatment prophylaxis (eg, valaciclovir and cotrimoxazole) especially for FL patients undergoing maintenance with R monotherapy seems relevant.
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Affiliation(s)
- B Verriere
- Pharmacy department, Antibes Hospital, Antibes, France
| | - L Gastaud
- Oncology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - E Chamorey
- Biostatistics and epidemiology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - F Peyrade
- Oncology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - E Deletie
- Pharmacy department, Antibes Hospital, Antibes, France
| | - K Bouredji
- Oncology and hemato oncology department, Antibes Hospital, Antibes, France
| | - D Quinsat
- Internal Medicine department, Antibes Hospital, Antibes, France
| | - R Schiappa
- Biostatistics and epidemiology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - A Thyss
- Oncology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - D Re
- Oncology department, Anticancer Center Antoine Lacassagne, Nice, France.,Oncology and hemato oncology department, Antibes Hospital, Antibes, France
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Fermé C, Thomas J, Brice P, Casasnovas O, Vranovsky A, Bologna S, Lugtenburg PJ, Bouabdallah R, Carde P, Sebban C, Eghbali H, Salles G, van Imhoff GW, Thyss A, Noordijk EM, Reman O, Lybeert MLM, Janvier M, Spina M, Audhuy B, Raemaekers JMM, Delarue R, Anglaret B, de Weerdt O, Marjanovic Z, Tersteeg RJHA, de Jong D, Brière J, Henry-Amar M. ABVD or BEACOPP baseline along with involved-field radiotherapy in early-stage Hodgkin Lymphoma with risk factors: Results of the European Organisation for Research and Treatment of Cancer (EORTC)-Groupe d'Étude des Lymphomes de l'Adulte (GELA) H9-U intergroup randomised trial. Eur J Cancer 2017; 81:45-55. [PMID: 28601705 DOI: 10.1016/j.ejca.2017.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 02/27/2017] [Revised: 04/25/2017] [Accepted: 05/02/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE For early-stage Hodgkin lymphoma (HL), optimal chemotherapy regimen and the number of cycles to be delivered remain to settle down. The H9-U trial compared three modalities of chemotherapy followed by involved-field radiotherapy (IFRT) in patients with stage I-II HL and risk factors (NCT00005584). PATIENTS AND METHODS Patients aged 15-70 years with untreated supradiaphragmatic HL with at least one risk factor (age ≥ 50, involvement of 4-5 nodal areas, mediastinum/thoracic ratio ≥ 0.35, erythrocyte sedimentation rate (ESR) ≥ 50 without B-symptoms or ESR ≥ 30 and B-symptoms) were eligible for the randomised, open label, multicentre, non-inferiority H9-U trial. The limit of non-inferiority was set at 10% for the difference between 5-year event-free survival (EFS) estimates. From October 1998 to September 2002, 808 patients were randomised to receive either the control arm 6-ABVD-IFRT (n = 276), or one of the two experimental arms: 4-ABVD-IFRT (n = 277) or 4-BEACOPPbaseline-IFRT (n = 255). RESULTS Results in the 4-ABVD-IFRT (5-year EFS, 85.9%) and the 4-BEACOPPbaseline-IFRT (5-year EFS, 88.8%) were not inferior to 6-ABVD-IFRT (5-year EFS, 89.9%): difference of 4.0% (90%CI, -0.7%-8.8%) and of 1.1% (90%CI,-3.5%-5.6%) respectively. The 5-year overall survival estimates were 94%, 93%, and 93%, respectively. Patients treated with combined modality treatment chemotherapeutic regimen comprising doxorubicin (Adriamycin), bleomycin, vincristine (Oncovin), cyclophosphamide, procarbazine, etoposide and prednisone (BEACOPP)baseline more often developed serious adverse events requiring supportive measures and hospitalisation compared with patients receiving the chemotherapeutic regimen comprising doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD). CONCLUSIONS The trial demonstrates that 4-ABVD followed by IFRT yields high disease control in patients with early-stage HL and risk factors responding to chemotherapy. Although non-inferior in terms of efficacy, four cycles of BEACOPPbaseline were more toxic than four or six cycles of ABVD.
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Affiliation(s)
- Christophe Fermé
- Gustave Roussy, 114 Rue Édouard Vaillant, 94805 Villejuif Cedex, France
| | - José Thomas
- University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - Pauline Brice
- Centre Hospitalier Universitaire, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Olivier Casasnovas
- Centre Hospitalier Universitaire, Hôpital du Bocage, 1 Boulevard Jeanne d'Arc, 21000 Dijon, France
| | - Andrej Vranovsky
- National Cancer Institute, Klenova 1, 83310 Bratislava, Slovakia
| | - Serge Bologna
- Centre Hospitalier Universitaire de Nancy, Hôpital Brabois, Rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | | | - Réda Bouabdallah
- Institut Paoli Calmettes, 232 Boulevard Sainte-Marguerite, BP156, 13273 Marseille Cedex 09, France
| | - Patrice Carde
- Gustave Roussy, 114 Rue Édouard Vaillant, 94805 Villejuif Cedex, France
| | | | - Houchingue Eghbali
- Institut Bergonié, 229 Cours de l'Argonne, CS 61283, 33076 Bordeaux Cedex, France
| | - Gilles Salles
- Centre Hospitalier Lyon Sud, Chemin du Grand Revoyet, 69310 Pierre-Bénite, France
| | - Gustaaf W van Imhoff
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Antoine Thyss
- Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice Cedex 2, France
| | - Evert M Noordijk
- Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Oumédaly Reman
- Centre Hospitalier Universitaire, Avenue de la Côte de Nacre, 14033 Caen, France
| | - Marnix L M Lybeert
- Catharina Ziekenhuis, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands
| | - Maud Janvier
- Institut Curie-Hôpital René-Huguenin, 35 Rue Dailly, 92210 Saint-Cloud, France
| | - Michele Spina
- Centro di Riferimento Oncologico, Via Franco Gallini, 2, 33081 Aviano, PN, Italy
| | - Bruno Audhuy
- Hôpitaux Civils de Colmar, Hôpital Pasteur, 39 Avenue de la Liberté, 68024 Colmar Cedex, France
| | - John M M Raemaekers
- Radboud University Nijmegen Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Richard Delarue
- Centre Hospitalier Universitaire, Hôpital Necker, 149 Rue de Sèvres, 75015 Paris, France
| | - Bruno Anglaret
- Centre Hospitalier de Valence, 179 Avenue du Maréchal Juin, 26953 Valence, France
| | - Okke de Weerdt
- St. Antonius Ziekenhuis Nieuwegein, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands
| | - Zora Marjanovic
- Centre Hospitalier Universitaire, Hôpital Saint-Antoine, 184 Rue du faubourg Saint-Antoine, 75012 Paris, France
| | | | - Daphne de Jong
- VU University Medical Center, Department of Pathology, De Boelelaan 1117, 1081HV Amsterdam, The Netherlands
| | - Josette Brière
- Centre Hospitalier Universitaire, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Michel Henry-Amar
- Centre de Traitement des Données du Cancéropôle Nord-Ouest, Centre François Baclesse, 3 Avenue Général Harris, 14076 Caen Cedex 05, France.
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Gallamini A, Bijou F, Viotti J, Rossi A, Perrot A, Patti C, Gastaud L, Sorasio R, Debaigt C, Chamorey E, Viviani S, Thyss A. BRENTUXIMAB-VEDOTIN AND BENDAMUSTINE IS A FEASIBLE AND EFFECTIVE DRUG COMBINATION AS FIRST-LINE TREATMENT OF HODGKIN LYMPHOMA IN THE ELDERLY (HALO TRIAL). Hematol Oncol 2017. [DOI: 10.1002/hon.2438_28] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Gallamini
- Research Innovation and statistics; Antoine Lacassagne Cancer Center; Nice France
| | - F. Bijou
- Hematologie; Institut Bergonié; Bordeaux France
| | - J. Viotti
- Unité de Epidemiologie et Biostatistique; Antoine Lacassagne Cancer Center; Nice France
| | - A. Rossi
- Hematology; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - A. Perrot
- Hematologie; CHU Nancy-Brabois; Nancy France
| | - C. Patti
- Ematologia; Ospedale V. Cervello e Villa Sofia; Palermo Italy
| | - L. Gastaud
- Hematologie Oncolologie; Antoine Lacassagne Cancer Center; Nice France
| | - R. Sorasio
- Ematologia; Azienda Ospedaliera S. Croce e Carle; Cuneo Italy
| | - C. Debaigt
- Research Innovation and statistics; Antoine Lacassagne Cancer Center; Nice France
| | - E. Chamorey
- Unité de Epidemiologie et Biostatistique; Antoine Lacassagne Cancer Center; Nice France
| | - S. Viviani
- Ematologia e trapianto MO; Istituto Nazionale Tumori; Milan Italy
| | - A. Thyss
- Hematologie Oncolologie; Antoine Lacassagne Cancer Center; Nice France
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23
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Dadone B, Fontaine D, Mondot L, Cristofari G, Jouvet A, Godfraind C, Varlet P, Ranchère‐Vince D, Coindre J, Gastaud L, Baudoin C, Peyron A, Thyss A, Coutts M, Michiels J, Pedeutour F, Burel‐Vandenbos F. Meningeal SWI/SNF related, matrix‐associated, actin‐dependent regulator of chromatin, subfamily B member 1 (SMARCB1)‐deficient tumours: an emerging group of meningeal tumours. Neuropathol Appl Neurobiol 2016; 43:433-449. [DOI: 10.1111/nan.12364] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/22/2016] [Accepted: 10/12/2016] [Indexed: 12/12/2022]
Affiliation(s)
- B. Dadone
- Central Laboratory of Pathology of Nice University Hospital France
- Laboratory of Solid Tumors Genetics Nice University Hospital France
| | - D. Fontaine
- Department of Neurosurgery Nice University Hospital France
| | - L. Mondot
- Department of Radiology Nice University Hospital France
| | - G. Cristofari
- Institute for Research on Cancer and Aging of Nice (IRCAN) CNRS UMR 7284/INSERM U1081 University of Nice Sophia‐Antipolis Nice France
| | - A. Jouvet
- Department of Pathology and Neuropathology Groupement Hospitalier Est Lyon Bron France
| | - C. Godfraind
- Department of Pathology University Hospital of Clermont‐Ferrand Clermont‐Ferrand France
| | - P. Varlet
- Department of Neuropathology Sainte‐Anne Hospital Paris France
| | | | - J.‐M. Coindre
- Department of Pathology Institut Bergonié Bordeaux France
| | - L. Gastaud
- Department of Oncology Centre Antoine Lacassagne Nice France
| | - C. Baudoin
- Institute for Research on Cancer and Aging of Nice (IRCAN) CNRS UMR 7284/INSERM U1081 University of Nice Sophia‐Antipolis Nice France
| | - A.‐C. Peyron
- Laboratory of Solid Tumors Genetics Nice University Hospital France
- Institute for Research on Cancer and Aging of Nice (IRCAN) CNRS UMR 7284/INSERM U1081 University of Nice Sophia‐Antipolis Nice France
| | - A. Thyss
- Department of Oncology Centre Antoine Lacassagne Nice France
| | - M. Coutts
- Department of Pathology West Kent Cancer Centre Maidstone UK
| | - J.‐F. Michiels
- Central Laboratory of Pathology of Nice University Hospital France
| | - F. Pedeutour
- Laboratory of Solid Tumors Genetics Nice University Hospital France
- Institute for Research on Cancer and Aging of Nice (IRCAN) CNRS UMR 7284/INSERM U1081 University of Nice Sophia‐Antipolis Nice France
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24
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Picard A, Doyen J, Thyss A, Giacchero D, Leysalle A, Bondiau PY, Passeron T, Lacour JP, Montaudié H. Tolérance et efficacité de l’association radiothérapie et immunothérapie chez les patients atteints de mélanome métastatique. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Kogay M, Thariat J, Benisvy D, Dufour M, Gastaud L, Saada E, Iannessi A, Thyss A. Évaluation de l’utilisation de la TEP au FDG pour le bilan des sarcomes de l’adulte en pratique quotidienne. Bull Cancer 2016; 103:735-42. [DOI: 10.1016/j.bulcan.2016.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 05/23/2016] [Accepted: 05/28/2016] [Indexed: 12/31/2022]
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26
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Tardy MP, Gastaud L, Boscagli A, Peyrade F, Gallamini A, Thyss A. Autoimmune hemolytic anemia after nivolumab treatment in Hodgkin lymphoma responsive to immunosuppressive treatment. A case report. Hematol Oncol 2016; 35:875-877. [PMID: 27539158 DOI: 10.1002/hon.2338] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [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: 04/09/2016] [Revised: 06/23/2016] [Accepted: 07/04/2016] [Indexed: 11/07/2022]
Abstract
The patients with refractory Hodgkin lymphoma have a poor prognosis. The nivolumab, an IgG4 monoclonal antibody inhibiting the program death 1 pathway has recently demonstrated its efficacy and its safety in patients with heavily pretreated refractory Hodgkin lymphoma. The side effects of this immunotherapy include autoimmune-like syndromes. A 75-year-old woman with no significant comorbidities was treated by nivolumab (3 mg/kg every 2 wk) as a third-line treatment for refractory Hodgkin lymphoma. A clinical response was observed with the first injection of nivolumab, with a reduction in superficial lymph nodes. After the second injection, the patient presented an authentic autoimmune hemolytic anemia with a profound anemia at 64 g/L and biologic characteristics of hemolysis (elevated unconjugated bilirubin, lactate dehydrogenase, and reticulocytes). The direct antiglobulin test was strongly positive for IgG antibodies, and the indirect antiglobulin test became positive with a very high level of autoantibodies. After 2 injections of nivolumab, the patient underwent a fluodeoxyglucose F 18 positron emission tomography-computed tomography, showing a partial response according to modified Cheson criteria. A treatment with prednisone (2 mg/kg), initiated after transfusion of 2 units of red blood cells, permitted the complete resolution of this autoimmune reaction after 3 months of corticotherapy. The fluodeoxyglucose F 18 positron emission tomography-computed tomography performed at the end of the corticotherapy showed a clear disease progression. Considering the very good response achieved after only 2 injections of nivolumab, the limited therapeutic resources for this old woman, and the complete resolution of the autoimmune hemolytic anemia, nivolumab was reintroduced at the same dose, with close clinical and biological monitoring. She received 6 more injections of nivolumab without recurrence of hemolysis.
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Affiliation(s)
- Magalie P Tardy
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Lauris Gastaud
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Annick Boscagli
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Frederic Peyrade
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Andrea Gallamini
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Antoine Thyss
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
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27
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Blay JY, Le Cesne A, Penel N, Bompas E, Duffaud F, Chevreau C, Rios M, Kerbrat P, Cupissol D, Anract P, Kurtz JE, Lebbe C, Isambert N, Bertucci F, Thyss A, Piperno-Neumann S, Dubray-Longeras P, Ducimetiere F, Coindre JM, Italiano A. Improved sarcoma management in a national network of reference centers: Analysis of the NetSarc network on 13,454 patients treated between 2010 and 2014. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.11013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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)
- Jean-Yves Blay
- Universite Claude Bernard & Centre Léon Bérard, Lyon, France
| | | | | | - Emmanuelle Bompas
- Department of Medical Oncology, Centre René Gauducheau, Nantes St. Herblain, France
| | | | | | - Maria Rios
- Centre Alexis Vautrin, Vandoeuvre-lès-Nancy, France
| | - Pierre Kerbrat
- Medical Oncology Eugene Marquis Comprehensive Cancer Center, Rennes, France
| | | | | | | | - Celeste Lebbe
- Dermatology Department, Saint Louis Hospital, Paris, France
| | | | | | | | | | | | | | | | - Antoine Italiano
- Institut Bergonié, Department of Medical Oncology, Bordeaux, France
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28
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Gastaud L, Rossignol B, Peyrade F, Ré D, Thariat J, Thyss A, Doyen J. Place de la radiothérapie dans la prise en charge des lymphomes malins non hodgkiniens. Cancer Radiother 2016; 20:236-47. [DOI: 10.1016/j.canrad.2016.01.011] [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] [Received: 05/25/2015] [Revised: 12/27/2015] [Accepted: 01/29/2016] [Indexed: 12/11/2022]
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29
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Gastaud L, Rossignol B, Peyrade F, Ré D, Thariat J, Thyss A, Doyen J. Place de la radiothérapie dans la prise en charge des lymphomes malins non hodgkiniens. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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30
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Trněný M, Lamy T, Walewski J, Belada D, Mayer J, Radford J, Jurczak W, Morschhauser F, Alexeeva J, Rule S, Afanasyev B, Kaplanov K, Thyss A, Kuzmin A, Voloshin S, Kuliczkowski K, Giza A, Milpied N, Stelitano C, Marks R, Trümper L, Biyukov T, Patturajan M, Bravo MLC, Arcaini L. Lenalidomide versus investigator's choice in relapsed or refractory mantle cell lymphoma (MCL-002; SPRINT): a phase 2, randomised, multicentre trial. Lancet Oncol 2016; 17:319-331. [PMID: 26899778 DOI: 10.1016/s1470-2045(15)00559-8] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/26/2015] [Accepted: 11/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lenalidomide, an immunomodulatory drug with antineoplastic and antiproliferative effects, showed activity in many single-group studies in relapsed or refractory mantle cell lymphoma. The aim of this randomised study was to examine the efficacy and safety of lenalidomide versus best investigator's choice of single-agent therapy in relapsed or refractory mantle cell lymphoma. METHODS The MCL-002 (SPRINT) study was a randomised, phase 2 study of patients with mantle cell lymphoma aged 18 years or older at 67 clinics and academic centres in 12 countries who relapsed one to three times, had Eastern Cooperative Oncology Group performance status of 0-2, at least one measurable lesion to be eligible, and who were ineligible for intensive chemotherpy or stem-cell transplantation. Using a centralised interactive voice response system, we randomly assigned (2:1) patients in a permuted block size of six to receive lenalidomide (25 mg orally on days 1-21 every 28 days) until progressive disease or intolerability, or single-agent investigator's choice of either rituximab, gemcitabine, fludarabine, chlorambucil, or cytarabine. Randomisation was stratified by time from diagnosis, time from last anti-lymphoma therapy, and previous stem-cell transplantation. Individual treatment assignment between lenalidomide and investigator's choice was open label, but investigators had to register their choice of comparator drug before randomly assigning a patient. Patients who progressed on investigator's choice could cross over to lenalidomide treatment. We present the prespecified primary analysis results in the intention-to-treat population for the primary endpoint of progression-free survival, defined as the time from randomisation to progressive disease or death, whichever occurred first. Patient enrolment is complete, although treatment and collection of additional time-to-event data are ongoing. This study is registered with ClinicalTrials.gov, number NCT00875667. FINDINGS Between April 30, 2009, and March 7, 2013, we enrolled 254 patients in the intention-to-treat population (170 [67%] were randomly assigned to receive lenalidomide, 84 [33%] to receive investigator's choice monotherapy). Patients had a median age of 68·5 years and received a median of two previous regimens. With a median follow-up of 15·9 months (IQR 7·6-31·7), lenalidomide significantly improved progression-free survival compared with investigator's choice (median 8·7 months [95% CI 5·5-12·1] vs 5·2 months [95% CI 3·7-6·9]) with a hazard ratio of 0·61 (95% CI 0·44-0·84; p=0·004). In the 167 patients in the lenalidomide group and 83 patients in the investigator's choice group who received at least one dose of treatment the most common grade 3-4 adverse events included neutropenia (73 [44%] of 167 vs 28 [34%] of 83) without increased risk of infection, thrombocytopenia (30 [18%] vs 23 [28%]), leucopenia (13 [8%] vs nine [11%]), and anaemia (14 [8%] vs six [7%]). INTERPRETATION Patients with relapsed or refractory mantle cell lymphoma ineligible for intensive chemotherapy or stem-cell transplantation have longer progression-free survival, with a manageable safety profile when treated with lenalidomide compared with monotherapy investigator's choice options. FUNDING Celgene Corporation.
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Affiliation(s)
- Marek Trněný
- Department of Hematology, Charles University Hospital, Prague, Czech Republic.
| | - Thierry Lamy
- Department of Hematology, Rennes University Hospital, Rennes, France
| | - Jan Walewski
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland
| | - David Belada
- Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic
| | - Jiri Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University Hospital, Brno, Czech Republic
| | - John Radford
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - Wojciech Jurczak
- Department of Haematology, Jagiellonian University, Krakow, Poland
| | - Franck Morschhauser
- Centre Hospitalier Universitaire Régional de Lille, Unité GRITA, Lille, France
| | | | - Simon Rule
- Department of Hematology, Derriford Hospital, Plymouth, UK
| | - Boris Afanasyev
- First Pavlov State Medical University of St Petersburg, St Petersburg, Russia
| | - Kamil Kaplanov
- Volgograd Regional Clinical Oncology Dispensary Number 1, Department of Hematology, Volgograd, Russia
| | - Antoine Thyss
- Medical Oncology Department, Centre Antoine Lacassagne, Nice, France
| | - Alexej Kuzmin
- Republican Clinical Oncology Dispensary, Kazan, Russia
| | - Sergey Voloshin
- Russian Research Institute of Hematology and Transfusion, St Petersburg, Russia
| | - Kazimierz Kuliczkowski
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Giza
- Department of Haematology, Jagiellonian University, Krakow, Poland
| | - Noel Milpied
- Service d'Hématologie et de Thérapie Cellulaire, CHU Haut-Lévêque, Bordeaux, France; University of Bordeaux, Bordeaux, France
| | | | - Reinhard Marks
- Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany
| | - Lorenz Trümper
- Department of Hematology and Oncology, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Germany
| | | | | | | | - Luca Arcaini
- Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo & Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Papadopoulos KP, Lopez-Jimenez J, Smith SE, Steinberg J, Keating A, Sasse C, Jie F, Thyss A. A multicenter phase II study of sepantronium bromide (YM155) plus rituximab in patients with relapsed aggressive B-cell Non-Hodgkin lymphoma. Leuk Lymphoma 2016; 57:1848-55. [PMID: 26857688 DOI: 10.3109/10428194.2015.1113275] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This phase II study evaluated YM155, a novel small-molecule survivin suppressant, in combination with rituximab in patients with relapsed aggressive B-cell non-Hodgkin lymphoma (NHL) who failed or were not candidates for autologous stem cell transplant (ASCT). During 14-day cycles, 41 patients received YM155 (5mg/m(2)/d) by continuous intravenous (IV) infusion for 168 hours (day 1-7), and rituximab (375mg/m(2)) IV on days 1 and 8 during cycles 1-4 and repeated for 4 cycles every 10 cycles. Forty patients (97.6%) had prior rituximab and 15 patients (36.6%) prior ASCT. Most frequent grade 3-4 adverse events were neutropenia (19.5%) and thrombocytopenia (12.2%). In the per-protocol set (n = 34), objective response rate was 50% and median progression-free survival 17.9 months. Median overall survival was not reached at study termination (median follow-up, 23 months). YM155 in combination with rituximab was tolerable with encouraging antitumor activity and durable responses in relapsed aggressive B-cell NHL patients.
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Affiliation(s)
| | | | | | | | | | | | - Fei Jie
- d Astellas Pharma , Northbrook , IL , USA
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32
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Penel-Page M, Ray-Coquard I, Larcade J, Girodet M, Bouclier L, Rogasik M, Corradini N, Entz-Werle N, Brugieres L, Domont J, Lervat C, Piperno-Neumann S, Pacquement H, Bay JO, Gentet JC, Thyss A, Chaigneau L, Narciso B, Cornille H, Blay JY, Marec-Bérard P. Off-label use of targeted therapies in osteosarcomas: data from the French registry OUTC'S (Observatoire de l'Utilisation des Thérapies Ciblées dans les Sarcomes). BMC Cancer 2015; 15:854. [PMID: 26541413 PMCID: PMC4635968 DOI: 10.1186/s12885-015-1894-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 11/01/2015] [Indexed: 12/15/2022] Open
Abstract
Background The objective of this study is to explore the off-label use of targeted therapies (TTs) for patients with osteosarcoma registered within the French Sarcoma Group – Bone Tumor Study Group (GSF-GETO) national registry. Methods All patients with an osteosarcoma, registered between January 1, 2009 and July 15, 2013 were analyzed. Results Twenty-nine patients with refractory relapsed osteosarcomas received 33 treatment lines of TTs. The median age at the beginning of treatment was 19 years (range 9–72). The median number of previous lines of chemotherapy was 3 (range 1–8). Before inclusion, 3 patients were in second complete remission, 26 were in progression for metastatic relapse. Twenty-three patients received sirolimus (in combination with cyclophosphamide for 18); 5, sunitinib; 4, sorafenib; and one, pazopanib. Stable disease was observed for 45.5 % of patients (95 % Confidence Interval (CI) [20–52.8]). The median Progression-Free Survival (PFS) was 3 months (95 % CI [2–5.4]) for patients treated by sirolimus and 1.8 months (95 % CI [1.3–2.8]) for patients receiving multi-targeted tyrosine kinase inhibitors; 6-month PFS 15 %. The median Overall Survival (OS) was 6.8 months (95 % CI [4.7–12.1]), and one-year OS was 24 %. In a multivariate analysis, PFS was superior for patients receiving sirolimus compared to other TTs (Hazard Ratio (HR) = 2.7, 95 % CI [1.05–7.1]). No toxic death was reported. Grade 3 and 4 toxicities were observed in 27 and 6 % of cases respectively. Conclusion Off-label TTs, especially sirolimus, reported benefit in the treatment of refractory osteosarcomas with an acceptable toxicity profile, including in pediatric population.
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Affiliation(s)
- Mathilde Penel-Page
- Department of Pediatric Oncology, Léon Bérard Cancer Center, 28, rue Laennec, 69008, Lyon, France. .,Université Claude Bernard Lyon 1, Lyon, France.
| | - Isabelle Ray-Coquard
- Department of Pediatric Oncology, Léon Bérard Cancer Center, 28, rue Laennec, 69008, Lyon, France. .,Université Claude Bernard Lyon 1, Lyon, France.
| | - Julie Larcade
- Department of Pediatric Oncology, Léon Bérard Cancer Center, 28, rue Laennec, 69008, Lyon, France. .,Université Claude Bernard Lyon 1, Lyon, France.
| | - Magali Girodet
- Department of Pediatric Oncology, Léon Bérard Cancer Center, 28, rue Laennec, 69008, Lyon, France.
| | - Laure Bouclier
- Department of Pediatric Oncology, Léon Bérard Cancer Center, 28, rue Laennec, 69008, Lyon, France.
| | - Muriel Rogasik
- Department of Pediatric Oncology, Léon Bérard Cancer Center, 28, rue Laennec, 69008, Lyon, France.
| | | | | | | | - Julien Domont
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, Villejuif, France.
| | - Cyril Lervat
- Centre Oscar Lambret, 3 rue Frédéric Combemale, Lille, France.
| | | | | | | | | | - Antoine Thyss
- Centre Antoine Lacassagne, 33 Avenue Valombrose, Nice, France.
| | | | | | - Helène Cornille
- CHU Raymond Poincaré, 104 Bd Raymond Poincaré, Garches, France.
| | - Jean-Yves Blay
- Department of Pediatric Oncology, Léon Bérard Cancer Center, 28, rue Laennec, 69008, Lyon, France. .,Université Claude Bernard Lyon 1, Lyon, France.
| | - Perrine Marec-Bérard
- Department of Pediatric Oncology, Léon Bérard Cancer Center, 28, rue Laennec, 69008, Lyon, France. .,Université Claude Bernard Lyon 1, Lyon, France.
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Tardy MP, Gastaud L, Ojeda-Uribe M, Boscagli A, Caruso S, Skaf R, Gutnecht J, Thyss A, Peyrade F. Z-BeEAM (Ibritumomab tiuxetan, Bendamustine, Etoposide, Cytarabine, Melphalan) before autologous stem cell transplantation is safe and efficient for refractory large B-cell lymphoma. Exp Hematol Oncol 2015; 4:18. [PMID: 26185733 PMCID: PMC4504161 DOI: 10.1186/s40164-015-0013-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/23/2015] [Indexed: 11/21/2022] Open
Abstract
Background Refractory or relapsed large B-cells lymphoma are usually treated with a high dose chemotherapy regimen followed by an autolougous stem cells transplantation. BEAM (carmustine, etoposide, cytarabine, melphalan) or more recently Z-BEAM (ibritumomab tiuxetan and BEAM) are commonly used regimens, but recently carmustine availability became difficult. The purpose of this study was to evaluate the feasibility and the safety of replacing carmustine by bendamustine in a new Z-BeEAM regimen (ibritumomab tiuxetan, bendamustine, etoposide, cytarabine, melphalan) prior to autologous stem cell transplantation. Findings This study was a retrospective analyze of six patients, with a median age of 60, treated by Z-BeEAM before autologous stem cell transplantation. We did not put in evidence any additional toxicities compared to conventional induction chemotherapy. The main toxicities were mucositis (3 grade III among 6 patients), gastrointestinal (2 grade III vomiting and 2 grade III diarrhea) and neutropenia (6 grade IV). Engraftment was successfully achieved for all patients. At the time of analysis of this study all patients were alive and in complete response based on the PET-CT evaluation. Conclusions BeEAM plus ibritumomab tiuxetan combined regimen before autologous stem cell transplantation is feasible and safe in aggressive relapsing large B-cell lymphoma.
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Affiliation(s)
- Magalie P Tardy
- Department of Oncology, Antoine-Lacassagne Center, Nice, France
| | - Lauris Gastaud
- Department of Oncology, Antoine-Lacassagne Center, Nice, France
| | | | - Annick Boscagli
- Department of Oncology, Antoine-Lacassagne Center, Nice, France
| | | | - Richard Skaf
- Department of Oncology, Saint-Georges Clinic, Nice, France
| | - Jean Gutnecht
- Department of Oncology, Frejus-Saint Raphael Hospital, Frejus, France
| | - Antoine Thyss
- Department of Oncology, Antoine-Lacassagne Center, Nice, France
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Falk AT, Thyss A, Thariat J. Metastatic Ablation for Sarcomas: Methodological and Ethical Dilemmas for Prospective Studies. Clin Oncol (R Coll Radiol) 2015; 27:429-30. [PMID: 25869259 DOI: 10.1016/j.clon.2015.03.009] [Citation(s) in RCA: 3] [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] [Received: 03/09/2015] [Accepted: 03/17/2015] [Indexed: 11/27/2022]
Affiliation(s)
- A T Falk
- Centre Antoine Lacassagne, Nice, France
| | - A Thyss
- Centre Antoine Lacassagne, Nice, France
| | - J Thariat
- Centre Antoine Lacassagne, Nice, France
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Pautier P, Floquet A, Chevreau C, Penel N, Guillemet C, Delcambre C, Cupissol D, Selle F, Isambert N, Piperno-Neumann S, Thyss A, Bertucci F, Bompas E, Alexandre J, Collard O, Lavau-Denes S, Soulié P, Toulmonde M, Le Cesne A, Lacas B, Duffaud F. Trabectedin in combination with doxorubicin for first-line treatment of advanced uterine or soft-tissue leiomyosarcoma (LMS-02): a non-randomised, multicentre, phase 2 trial. Lancet Oncol 2015; 16:457-64. [PMID: 25795402 DOI: 10.1016/s1470-2045(15)70070-7] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Metastatic leiomyosarcomas of uterine or soft-tissue origin have poor prognosis and moderate chemosensitivity. Trabectedin has shown activity in pretreated leiomyosarcoma. We did a single-group, multicentre, phase 2 trial (LMS-02) to assess the effect of first-line doxorubicin and trabectedin combination on disease control and survival. METHODS Adults (18 years to physiological age ≤70 years) with measurable metastatic or unresectable uterine leiomyosarcoma or soft-tissue leiomyosarcoma who had not received any previous chemotherapy were enrolled at 19 centres in France. Treatment consisted of 60 mg/m(2) intravenous doxorubicin followed by 1·1 mg/m(2) trabectedin in a 3 h intravenous infusion on day 1, both by the central venous route, and 6 mg subcutaneous pegfilgrastim on day 2, repeated every 3 weeks for up to six cycles. Surgery for residual disease was permitted. The primary endpoint was the proportion of patients achieving disease control, defined as complete or partial response or stable disease. Stratification was done by anatomical site and analyses were per protocol. This study is registered with ClinicalTrials.gov, number NCT02131480. FINDINGS Between July 28, 2010, and May 10, 2013, 109 patients were enrolled and treated, of whom 108 were assessable for response: 47 in the uterine leiomyosarcoma group and 61 in the soft-tissue leiomyosarcoma group. 32 (68%) patients in the uterine leiomyosarcoma group and 45 (74%) in the soft-tissue leiomyosarcoma group received all six cycles of treatment. Of 47 patients with uterine leiomyosarcoma, 28 (59·6%, 95% CI 44·3-73·6) achieved a partial response and 13 (27·7%, 15·6-42·6) stable disease; 41 (87·2%, 74·3-95·2) patients achieved disease control. Of 61 patients with soft-tissue leiomyosarcoma, two (3·3%, 95% CI 0·4-11·7) achieved a complete response, 22 (36·1%, 25·0-50·8) had a partial response, and 32 (52·5%, 40·8-67·3) had stable disease; 56 (91·8%, 81·9-97·3) of patients achieved disease control. The most common grade 3-4 treatment-associated adverse events were neutropenia (84 [78%] of 108 patients), increased alanine aminotransferase concentration (42 [39%]), thrombocytopenia (40 [37%]), anaemia (29 [27%]), febrile neutropenia (26 [24%]), and fatigue (21 [19%]). INTERPRETATION Despite expected but manageable toxic effects, these results support the activity of doxorubicin plus trabectedin as first-line treatment for uterine leiomyosarcoma and soft-tissue leiomyosarcoma. This combination should be developed further in a phase 3 trial against the present standard of care. FUNDING Pharmamar and Amgen.
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Affiliation(s)
- Patricia Pautier
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France.
| | - Anne Floquet
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Christine Chevreau
- Department of Medical Oncology, Institut Claudius-Regaud, Toulouse, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar-Lambret, Lille, France
| | - Cécile Guillemet
- Department of Medical Oncology, Centre Henri-Becquerel, Rouen, France
| | - Corinne Delcambre
- Department of Medical Oncology, Centre François-Baclesse, Caen, France
| | - Didier Cupissol
- Department of Medical Oncology, Centre Val d'Aurelle, Montpellier, France
| | - Frédéric Selle
- Department of Medical Oncology, Hôpital Tenon, Paris, France
| | - Nicolas Isambert
- Department of Medical Oncology, Centre GF Leclerc, Dijon, France
| | | | - Antoine Thyss
- Department of Medical Oncology Centre Antoine Lacassagne, Nice, France
| | - François Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Emmanuelle Bompas
- Department of Medical Oncology, Centre René Gauducheau, Saint Herblain, France
| | | | - Olivier Collard
- Department of Medical Oncology, Institut de Cancérologie de la Loire, Saint Priest en Jarez, France
| | - Sandrine Lavau-Denes
- Department of Medical Oncology, Centre Hospitalo-Universitaire Dupuytren, Limoges, France
| | - Patrick Soulié
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - Maud Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Axel Le Cesne
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Benjamin Lacas
- Department of Biostatistics, Institut Gustave Roussy, Villejuif, France
| | - Florence Duffaud
- Department of Medical Oncology, La Timone University Hospital, Marseille, France
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Stève-Dumont M, Baldin B, Legros L, Thyss A, Re D, Rocher F, Ajmia F, Spreux A, Drici MD. Are nilotinib-associated vascular adverse events an under-estimated problem? Fundam Clin Pharmacol 2015; 29:204-8. [PMID: 25619238 DOI: 10.1111/fcp.12102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 12/29/2014] [Accepted: 01/21/2015] [Indexed: 01/19/2023]
Abstract
Vascular adverse events have been reported with nilotinib, a tyrosine kinase inhibitor prescribed for chronic myeloid leukaemia. However, few data specify their incidence, or whether they occur in predisposed patients. Hence, we prospectively studied 30 consecutive patients to assess the frequency of such adverse reactions and determine whether the patients presenting with these adverse events bear predisposing factors. From 3 to 73 months after nilotinib initiation, 10 of the 30 patients experienced vascular events. Three patients of these 10 were devoid of any patent cardiovascular risk factor, except for age. This study points out an occurrence more frequent than expected of vascular adverse events associated with nilotinib (> 30% vs. < 1% in summary of product characteristics), and particularly of vascular events of late onset in patients with no pre-existing risk factors.
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Affiliation(s)
- Marie Stève-Dumont
- Department of Pharmacology, Regional Pharmacovigilance Center, Nice, France
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Martin N, Borchiellini D, Coso D, Gastaud L, Boscagli A, Saudes L, Re D, Gutnecht J, Garnier G, Petit E, Barriere J, Naman H, Rossignol B, Thyss A, Peyrade F. High-dose chemotherapy with carmustine, etoposide, cytarabine and melphalan followed by autologous stem cell transplant is an effective treatment for elderly patients with poor-prognosis lymphoma. Leuk Lymphoma 2015; 56:2379-87. [PMID: 25563428 DOI: 10.3109/10428194.2014.1001987] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Autologous stem cell transplant (ASCT) after high-dose chemotherapy (HDT) increases overall survival when used in relapsed non-Hodgkin lymphoma (NHL) in patients under 65 years old. Limited experience is available for older patients. We present a retrospective analysis of 73 consecutive patients aged over 65 years treated for aggressive or relapsed lymphoma by HDT with carmustine, etoposide, cytarabine and melphalan (BEAM) at full dosage followed by ASCT. Patient data were obtained from medical charts from two institutions. Median age was 67 years (65-74). Significant comorbidities were present in 24.7% of patients. The median number of days for grade 4 neutropenia was 9 (5-18). The early treatment-related mortality rate (<100 days) was 2.7%. The estimated 2-year progression-free survival and overall survival rates were 67.2% and 78.5%, respectively. In conclusion, the full-dose HDT-ASCT regimen is feasible, safe and efficient in selected patients over 65 years old.
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Affiliation(s)
- Nicolas Martin
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | | | - Diane Coso
- b Department of Hematology , Paoli-Calmettes Institute , Marseille , France
| | - Lauris Gastaud
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | - Annick Boscagli
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | | | - Daniel Re
- d Department of Oncology , Antibes-Juan-les-Pins Hospital , France
| | - Jean Gutnecht
- e Department of Oncology , Frejus-Saint Raphael Hospital , France
| | - Georges Garnier
- f Department of Oncology , Princesse Grace Hospital Center , Monaco
| | - Emmanuel Petit
- g Department of Oncology , Oxford Clinic , Cannes , France
| | - Jèrôme Barriere
- h Department of Oncology , St-Jean Polyclinic , Cagnes-sur-Mer , France
| | - Hervé Naman
- i Azurean Center of Oncology , Mougins , France
| | | | - Antoine Thyss
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | - Frederic Peyrade
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
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Falk AT, Moureau-Zabotto L, Ouali M, Penel N, Italiano A, Bay JO, Olivier T, Sunyach MP, Boudou-Roquette P, Salas S, Le Maignan C, Ducassou A, Isambert N, Kalbacher E, Pan C, Saada E, Bertucci F, Thyss A, Thariat J. Effect on survival of local ablative treatment of metastases from sarcomas: a study of the French sarcoma group. Clin Oncol (R Coll Radiol) 2015; 27:48-55. [PMID: 25300878 DOI: 10.1016/j.clon.2014.09.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [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: 05/18/2014] [Revised: 07/31/2014] [Accepted: 09/04/2014] [Indexed: 01/08/2023]
Abstract
AIMS Recent data suggest that patients with pulmonary metastases from sarcomas might benefit from ablation of their metastases. Some data are available regarding osteosarcomas/angiosarcomas and lung metastases. The purpose of this study was to assess the efficacy of local ablative treatment on the survival of patients with oligometastases (one to five lesions, any metastatic site, any grade/histology) from sarcomas. MATERIALS AND METHODS A multicentric retrospective study of the French Sarcoma Group was conducted in sarcoma patients with oligometastases who were treated between 2000 and 2012. Survival was analysed using multivariate sensitivity analyses with propensity scores to limit bias. RESULTS Of the 281 patients evaluated, 164 patients received local treatment for oligometastases between 2000 and 2012. The groups' characteristics were similar in terms of tumour size and remission of the primary tumours. The median follow-up was 25.7 months; 129 (45.9%) patients had died at this point. The median overall survivals were 45.3 (95% confidence interval = 34-73) months for the local treatment group and 12.6 for the other group (95% confidence interval = 9.33-22.9). Survival was better among patients who received local treatment (hazard ratio = 0.47; 95% confidence interval = 0.29-0.78; P < 0.001). Subgroup analyses revealed similar findings in the patients with single oligometastases (hazard ratio = 0.48; 95% confidence interval = 0.28-0.82; P = 0.007); a significant benefit was observed for grade 3, and a trend was observed for grade 2. CONCLUSION Local ablative treatment seemed to improve the overall survival of the patients who presented with oligometastatic sarcomas, including soft tissue and bone sarcomas. The survival benefit remained after repeated local treatments for several oligometastatic events. Surgery yielded the most relevant results, but alternative approaches (i.e. radiofrequency ablation and radiotherapy) seemed to be promising. The relevance of these results is strengthened by our analysis, which avoided biases by restricting the population to patients with oligometastatic disease and used propensity scores.
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Affiliation(s)
- A T Falk
- Centre Antoine Lacassagne, Nice, France
| | | | - M Ouali
- Centre Claudius Regaud, Toulouse, France
| | - N Penel
- Centre Oscar Lambret, Lille, France
| | | | - J-O Bay
- Centre Jean Perrin, Clermont Ferrand, France; Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - T Olivier
- Institut régional du cancer de Montpellier, Montpellier, France
| | | | | | - S Salas
- Paris Descartes University, Paris, France
| | | | | | - N Isambert
- Centre Georges-François Leclerc, Dijon, France
| | - E Kalbacher
- Centre Hospitalier Universitaire, Besançon, France
| | - C Pan
- CHU Henri Mondor, Creteil, France
| | - E Saada
- Centre Antoine Lacassagne, Nice, France
| | - F Bertucci
- Institut Paoli-Calmettes, Marseille, France
| | - A Thyss
- Centre Antoine Lacassagne, Nice, France
| | - J Thariat
- Centre Antoine Lacassagne, Nice, France.
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Taieb S, Saada-Bouzid E, Tresch E, Ryckewaert T, Bompas E, Italiano A, Guillemet C, Peugniez C, Piperno-Neumann S, Thyss A, Maynou C, Clisant S, Penel N. Comparison of response evaluation criteria in solid tumours and Choi criteria for response evaluation in patients with advanced soft tissue sarcoma treated with trabectedin: a retrospective analysis. Eur J Cancer 2014; 51:202-9. [PMID: 25499439 DOI: 10.1016/j.ejca.2014.11.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 11/05/2014] [Accepted: 11/11/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND To assess the additional value of density measurement using contrast-enhancement sequences (Choi assessment) in a real-life cohort of adult soft tissue sarcoma patients treated with trabectedin. METHODS Eligibility criteria included adults (age ⩾18) treated between 01/2007 and 12/2011, with at least two trabectedin cycles after failure or intolerance to doxorubicin/ifosfamide. Baseline and first computed tomography (CT)-scans were centrally reviewed by an experienced radiologist. RESULTS The retrospective cohort consists of 134 (73 female) patients treated with trabectedin 1.5 mg/m(2) given as a 24-h infusion every 3 weeks. Patients received a median of five trabectedin cycles (range: 2-33) and the main cause of discontinuation was progressive disease (PD) (n = 105, 78.4%). Response Evaluation Criteria in Solid Tumours (RECIST) assessment was feasible in 128 (95.5%) patients, with Choi assessment performed in 92 (68.7%) patients, generally due to inadequate sequences or exclusive lung metastases. Concordance between both methods was fair (Kappa = 0.290). We identified five patients with false PD (i.e. PD according to RECIST but stable disease/partial response as per Choi). Univariate analysis did not identify any predictive factors for false PD. Median overall survival (OS) of patients with PD as per RECIST but stable disease/partial response (SD/PR) according to Choi was better than for patients with PD according to both RECIST and Choi (14 months versus 8 months; p = 0.052). CONCLUSIONS Choi assessment may identify patients with false PD who achieved improved efficacy outcomes, suggesting that trabectedin may delay tumour progression even in the case of non-dimensional response. Dual size and tumour density assessment may be more suitable to evaluate responses to trabectedin in sarcoma patients as well as to improve the decision-making strategies for the continuation of trabectedin therapy.
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Affiliation(s)
- Sophie Taieb
- Radiology Department, Centre Oscar Lambret, 3 rue Combemale, 59020 Lille cedex, France.
| | - Esma Saada-Bouzid
- Medical Oncology Department, Centre Antoine Lacassagne, 33 Avenue Valombrose, 06100 Nice, France.
| | - Emmanuelle Tresch
- Biostatistics and Methodology Unit, Centre Oscar Lambret, 3 rue Combemale, 59020 Lille cedex , France.
| | - Thomas Ryckewaert
- Medical Oncology Department, Centre Oscar Lambret, 3 rue Combemale, 59020 Lille cedex, France.
| | - Emmanuelle Bompas
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Boulevard Jacques Monod, 44805 Saint Herblain cedex, France.
| | - Antoine Italiano
- Medical Oncology Department, Institut Bergonié, 229 Cours de l'Argonne, 33000 Bordeaux, France.
| | - Cécile Guillemet
- Medical Oncology Department, Centre Henri Becquerel, Rue d'Amiens, 76000 Rouen, France.
| | - Charlotte Peugniez
- Medical Oncology Department, Centre Oscar Lambret, 3 rue Combemale, 59020 Lille cedex, France.
| | | | - Antoine Thyss
- Medical Oncology Department, Centre Antoine Lacassagne, 33 Avenue Valombrose, 06100 Nice, France.
| | - Carlos Maynou
- Orthopedics Unit A, University Hospital, Hôpital Roger Salengro, 59035 Lille cedex, France.
| | - Stéphanie Clisant
- Clinical Research Unit, Centre Oscar Lambret, 3 rue Combemale, 59020 Lille cedex, France; Clinical Resarch and Methodological Platform, SIRIC OncoLille, Lille, France.
| | - Nicolas Penel
- Medical Oncology Department, Centre Oscar Lambret, 3 rue Combemale, 59020 Lille cedex, France; Clinical Resarch and Methodological Platform, SIRIC OncoLille, Lille, France.
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Eberst L, Cropet C, Le Cesne A, Pautier P, Penel N, Adenis A, Chevreau C, Bay JO, Collard O, Cupissol D, Duffaud F, Gentet JC, Piperno-Neumann S, Marec-Berard P, Bompas E, Thyss A, Chaigneau L, Cassier P, Bertucci F, Blay JY, Ray-Coquard I. The off-label use of targeted therapies in sarcomas: the OUTC'S program. BMC Cancer 2014; 14:870. [PMID: 25420707 PMCID: PMC4289372 DOI: 10.1186/1471-2407-14-870] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 10/30/2014] [Indexed: 12/21/2022] Open
Abstract
Background Few targeted therapies (TTs) are registered for sarcoma treatment despite numerous phase II studies and yet there are potential treatment options for patients after standard treatment escape. The French Sarcoma Group - Bone Tumor Study Group (GSF-GETO) created a national registry to evaluate the outcome of patients treated with off-label TTs. Methods Every consecutive sarcoma-patient receiving an off-label TT outside a clinical trial was included. The objective was to describe this patient efficacy and safety data in routine practice. Results From October 2008 to October 2011, 249 patients in 24 centers received 278 treatment lines with TTs. Twenty-five histological subtypes were included: most frequent were leiomyosarcoma (n = 48, receiving sorafenib in 63%, and sunitinib in 27%), GIST (n = 39, receiving sorafenib in 79%), and angiosarcoma (n =18, receiving sorafenib in 78%). The overall response rate to TTs was 15% (95% CI [10,6-20,2]), the disease control rate at 2 months was 59%. The median progression-free survival was 4,1 months (IC 95% [3,2-4,8]). Three complete responses were observed. No toxic death occurred, grade 3 and 4 toxicities were reported in 74 (27%) and 14 patients (5%) respectively. Conclusion Off-label TTs can be used for sarcoma patients in routine practice with an acceptable toxicity profile and efficacy similar to that reported in non-randomized clinical trials. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-870) contains supplementary material, which is available to authorized users.
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Fénichel P, Rouzier C, Butori C, Chevallier P, Poullot AG, Thyss A, Mouroux J. Extragestational βHCG secretion due to an isolated lung epithelioid trophoblastic tumor: microsatellite genotyping of tumoral cells confirmed their placental origin and oriented specific chemotherapy. J Clin Endocrinol Metab 2014; 99:3515-20. [PMID: 25029419 DOI: 10.1210/jc.2014-1460] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
CONTEXT Persistent secretion of β-human chorionic gonadotropin (βHCG) in the absence of an ongoing or recent pregnancy and without persistent uterine gestational disease is a rare but challenging situation that requires locating the extrauterine secreting tumor and distinguishing between extragestational choriocarcinoma and gestational trophoblastic neoplasms. CASE PRESENTATION An unexplained, persistent extragestational βHCG secretion occurring in a 29-year-old, nonsmoking woman with abnormal uterine bleeding 4 years after a normal pregnancy and without persistent gestational disease led to the discovery by whole-body computed tomography/positron emission tomography of an isolated pulmonary tumor. OBJECTIVE Characterization of paternal alleles in tumoral cells in order to establish their fetal origin, which may be helpful for the diagnosis and treatment of such tumors. METHODS AND RESULTS After the surgical procedure, clinical, histological, and immunocytochemical analysis ruled out primary or metastatic bronchopulmonary carcinoma or choriocarcinoma and supported the diagnosis of an isolated, primary, epithelioid trophoblastic tumor. Microsatellite genotyping of tumoral cells identifying paternal alleles confirmed their placental origin and their migration to the lungs, with likely secondary malignant transformation, and guided the choice of postsurgical chemotherapy needed to completely eradicate βHCG secretion. CONCLUSION Persistent extragestational secretion of βHCG in a young nonsmoking woman with a precedent pregnancy and an isolated lung tumor suggests the diagnosis of epithelioid trophoblastic tumor, a very rare malignant tumor for which placental origin needs to be confirmed, especially when occurring several years after the patient's last pregnancy. Simple microsatellite genotyping of tumoral cells will allow this confirmation of diagnosis and help in personalizing chemotherapy.
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Affiliation(s)
- Patrick Fénichel
- Department of Reproductive Endocrinology (P.F., A.-G.P.), University Hospital of Nice, 06200 Nice, France; Inserm U1065 C3M (P.F.), University of Nice Sophia-Antipolis, 06202 Nice, France; Laboratory of Medical Genetics and Molecular Biology (C.R.), Laboratory of Clinical and Experimental Pathology (C.B.), and Department of Medical Imaging (P.C.), Centre Hospitalier Universitaire (CHU) de Nice, 06202 Nice, France; Department of Medical Oncology (A.T.), Centre Antoine Lacassagne, 06100 Nice, France; and Department of Thoracic Surgery (J.M.), CHU Nice, 06002 Nice, France
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Taieb S, Saada E, Tresch E, Ryckewaert T, Bompas E, Italiano A, Guillemet C, Peugniez C, Piperno-Neumann S, Thyss A, Clisant S, Cassar A, Nommay D, Penel N. Choi Vs. Recist Assessment of Tumor Response in a Retrospective Analysis of Patients (Pts) Receiving Trabectedin (T) for Advanced Soft Tissue Sarcomas (Asts). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mouriaux F, Servois V, Piperno-Neumann S, Lesimple T, Thyss A, Jouary T, Neidhardt EM, Penel N, Delcambre C, Parienti JJ, Serre-Henry C, Joly F. O-mel-sora: A national multicenter phase II trial of sorafenib in metastatic uveal melanoma. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e20004] [Citation(s) in RCA: 2] [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)
| | | | | | | | - Antoine Thyss
- Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Thomas Jouary
- Saint André Hospital CHU de Bordeaux, Dermatology, Bordeaux, France
| | | | | | | | | | | | - Florence Joly
- Comite Uro-Gynecologie, Centre François Baclesse, Caen, France
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Thariat J, Clément-Colmou K, Vogin G, Beckendorf V, Ducassou A, Ali AM, Salas S, Saada E, Thyss A, Lapeyre M, Isambert N. [Radiation therapy of cardiac sarcomas]. Cancer Radiother 2014; 18:125-31. [PMID: 24637021 DOI: 10.1016/j.canrad.2014.02.003] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/23/2013] [Accepted: 02/05/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE Primary cardiac sarcomas represent less than 10 yearly cases in France. Their median survival is approximately 18 months. The treatment consists of surgery when possible. The role of chemotherapy and radiation therapy is controversial, especially with respect to limiting cardiac radiation dose that is theoretically incompatible with the requirement of a tumoricidal dose for sarcoma. A recent series of 124 cases of the French Sarcoma Group suggested a benefit of radiation therapy on progression-free survival. PATIENTS AND METHODS The dosimetric data of 12 patients were analyzed. RESULTS There was variety in radiotherapy modalities and definition of target volumes, doses and techniques are evolving more conformal plans. Irradiation appeared feasible with conventional fractionation with respect to toxicities (although probably underestimated due to short follow-up and dismal prognosis) and previously demonstrated benefit of radiotherapy for primitive cardiac sarcomas. CONCLUSION A scheme of 45Gy in 1.8Gy per fraction to a preoperative volume with an additional dose of 14Gy in 7 fractions on areas at risk or residual disease and margins 1cm, may be proposed based on the preliminary data of this study. Intensity modulated radiotherapy with daily cone-beam CT-scanner should be evaluated.
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Affiliation(s)
- J Thariat
- Département d'oncologie-radiothérapie, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France; Université Nice Sophia-Antipolis, 06200 Nice, France.
| | - K Clément-Colmou
- Oncologie-radiothérapie, centre René-Gauducheau, institut de cancérologie de l'Ouest, 44805 Saint-Herblain, France
| | - G Vogin
- Oncologie-radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - V Beckendorf
- Oncologie-radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - A Ducassou
- Oncologie-radiothérapie, centre Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31300 Toulouse, France
| | - A M Ali
- Clinical oncology, Sohag University, Sohag, Égypte
| | - S Salas
- Oncologie médicale, CHU la Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France
| | - E Saada
- Oncologie médicale, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
| | - A Thyss
- Oncologie médicale, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
| | - M Lapeyre
- Oncologie-radiothérapie, centre Jean-Perrin, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - N Isambert
- Oncologie médicale, centre Georges-Francois-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
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Iannessi A, Doyen J, Leysalle A, Thyss A. Magnetic resonance guided focalised ultrasound thermo-ablation: A promising oncologic local therapy. Diagn Interv Imaging 2014; 95:339-43. [DOI: 10.1016/j.diii.2013.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Cerda T, Sun XS, Cazorla A, Laurent C, Floret F, Haudebourg J, Thyss A, Thariat J. [Follicular dendritic cell sarcoma in head and neck region]. Cancer Radiother 2014; 18:59-63. [PMID: 24373643 DOI: 10.1016/j.canrad.2013.10.010] [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: 05/27/2013] [Revised: 10/14/2013] [Accepted: 10/22/2013] [Indexed: 10/25/2022]
Abstract
Follicular dendritic cell sarcomas are a recently described entity, with biphenotypic characteristics of lymphomas and sarcomas. The treatment is hardly consensual in the literature. We report two head and neck cases, of favorable outcome after surgery and radiotherapy. Histopathology and differential diagnoses are discussed as well as the therapeutic strategies used.
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Affiliation(s)
- T Cerda
- Département de radiothérapie, centre hospitalier régional universitaire de Besançon, hôpital Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France; Département de radiothérapie, centre hospitalier de Belfort-Montbéliard, boulevard du Maréchal-Juin, 25209 Montbéliard cedex, France
| | - X S Sun
- Département de radiothérapie, centre hospitalier régional universitaire de Besançon, hôpital Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France; Département de radiothérapie, centre hospitalier de Belfort-Montbéliard, boulevard du Maréchal-Juin, 25209 Montbéliard cedex, France.
| | - A Cazorla
- Service d'anatomopathologie, centre hospitalier régional universitaire de Besançon, hôpital Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France
| | - C Laurent
- Laboratoire d'anatomie et cytologie pathologiques, CHU Purpan, place du Dr-Baylac, 31059 Toulouse, France; Université Paul-Sabatier, 31062 Toulouse cedex 9, France
| | - F Floret
- Service d'ORL, centre hospitalier régional universitaire de Besançon, hôpital Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon, France
| | - J Haudebourg
- Service d'anatomie et cytologie pathologiques, centre Antoine-Lacassagne, institut universitaire de la face et du cou, université de Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice, France
| | - A Thyss
- Service d'oncologie médicale, centre Antoine-Lacassagne, institut universitaire de la face et du cou, université de Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice, France
| | - J Thariat
- Département de radiothérapie, centre Antoine-Lacassagne, institut universitaire de la face et du cou, université de Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice, France
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Falk A, Moureau-Zabotto L, Penel N, Italiano A, Bay J, Sunyach M, Ducassou M, Olivier T, Thyss A, Thariat J. Improved Outcomes With Iterative Local Treatments of Oligometastases in Sarcomas: A French Sarcoma Group Study. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Natale R, Thariat J, Vedrine PO, Bozec A, Peyrottes I, Marcy PY, Haudebourg J, Pedeutour F, Saâda E, Thyss A. Conservative multimodal management of a primitive neuroectodermal tumor of the thyroid. Rare Tumors 2013; 5:75-8. [PMID: 23888220 PMCID: PMC3719115 DOI: 10.4081/rt.2013.e20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 03/30/2013] [Accepted: 04/08/2013] [Indexed: 11/23/2022] Open
Abstract
Abstract Primitive neuroectodermal tumors (PNET) represent 1% of sarcomas. Head and neck peripheral PNETs have an intermediate prognosis between abdominopelvic disease and extremities. We here report the case of a 40-year old male who presented with primitive neuroectodermal tumor of the thyroid and was treated by multimodal treatment, including surgery, chemotherapy and intermediate dose radiotherapy. The patient is alive and fit with a functional larynx at 27 months. Multimodal treatments yield five-year survival rates of about 60%. Major drug regimens use vincristine, doxorubicin, ifosfamide or cyclophosphamide, dactinomycin and/or etoposide. Complete surgical excision is undertaken whenever possible to improve long-term survival. However, the relative radiosensitivity of tumors of the Ewing family, suggest multimodal treatment including adjuvant conformal radiotherapy in case of positive margins or poor response to chemotherapy rather than resection with 2-3 cm margins, which would imply laryngeal sacrifice for thyroid tumors. The role of expert rare tumor networks is crucial for optimal decision-making and management of such rare tumors on a case by case basis.
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Affiliation(s)
- Romain Natale
- Centre Antoine Lacassagne, Institut Universitaire de la Face et du Cou , Nice
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Papai Z, Tolcher AW, Italiano A, Cupissol D, Lopez-Pousa A, Chawla SP, Bompas E, Penel N, Isambert N, Staddon AP, Thyss A, Santoro A, Franke FA, Cohen P, Le-Guennec S, Demetri GD, Blay JY. A randomized, double-blind, placebo (Pbo)-controlled phase III study of ombrabulin plus cisplatin in patients (pts) with advanced-stage soft-tissue sarcoma after failure of anthracycline and ifosfamide chemotherapies. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.10506] [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
10506 Background: Ombrabulin (AVE8062) is a vascular disrupting agent that damages established tumor vasculature and has demonstrated synergistic antitumor activity with cisplatin in vivo. In a phase I study, ombrabulin 25 mg/m² plus cisplatin 75 mg/m² was identified as the recommended dose in pts with solid tumors (AACR 2008; Abs 08-AB-4925). This phase III study evaluated the efficacy and safety of ombrabulin plus cisplatin in pts with advanced soft-tissue sarcoma (NCT00699517). Methods: Pts (aged ≥18 yrs, ECOG PS ≤2) with metastatic soft-tissue sarcoma who had received prior anthracycline and ifosfamide, with ≤2 prior chemotherapies for advanced disease, were randomized (1:1) to receive either ombrabulin 25 mg/m² or Pbo plus cisplatin 75 mg/m² every 3 weeks. The primary objective was to compare progression-free survival (PFS) between arms; secondary objectives included overall survival (OS) and safety. Results: Overall, 355 pts (median age 52 yrs; 51.5% male) were randomized (176 ombrabulin, 179 Pbo) in 44 centers worldwide. Median duration of follow-up was 27.9 and 30.5 months in Pbo and ombrabulin arms, respectively. PFS analysis showed a statistically significant improvement with ombrabulin (median 1.54 vs 1.41 months Pbo; HR=0.76, 95% CI 0.59–0.98; p=0.0302), with 3- and 6-month rates in favor of ombrabulin vs Pbo: 35.4% vs 24.9% and 19.3% vs 10.6%, respectively. A trend for an improvement with ombrabulin was observed in 3 of the 4 prespecified histology strata: liposarcoma, leiomyosarcoma, and “other”, but not for pleomorphic. Analysis of OS did not show statistically significant improvement with ombrabulin (median 11.43 vs 9.33 months Pbo, HR=0.85, 95% CI 0.67–1.09). OS rates at 1 year were in favor of ombrabulin (48.6% vs 42.4% Pbo). Grade 3/4 TEAEs more frequently seen with ombrabulin included neutropenia (19.2% vs 7.9% Pbo) and thrombocytopenia (8.5% vs 3.4% Pbo). Conclusions: Although this trial met its primary efficacy endpoint, the combination of ombrabulin and cisplatin did not demonstrate sufficient clinical benefit in pts with advanced soft-tissue sarcoma to warrant further study. Clinical trial information: NCT00699517.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - George D. Demetri
- Ludwig Center at Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
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Delarue R, Tilly H, Mounier N, Petrella T, Salles G, Thieblemont C, Bologna S, Ghesquières H, Hacini M, Fruchart C, Ysebaert L, Fermé C, Casasnovas O, Van Hoof A, Thyss A, Delmer A, Fitoussi O, Molina TJ, Haioun C, Bosly A. Dose-dense rituximab-CHOP compared with standard rituximab-CHOP in elderly patients with diffuse large B-cell lymphoma (the LNH03-6B study): a randomised phase 3 trial. Lancet Oncol 2013; 14:525-33. [DOI: 10.1016/s1470-2045(13)70122-0] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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