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De Metz C, Hennart B, Aymes E, Cren P, Martignène N, Penel N, Barthoulot M, Carnot A. Complete DPYD genotyping combined with dihydropyrimidine dehydrogenase phenotyping to prevent fluoropyrimidine toxicity: A retrospective study. Cancer Med 2024; 13:e7066. [PMID: 38523525 PMCID: PMC10961597 DOI: 10.1002/cam4.7066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/19/2024] [Accepted: 02/18/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION In April 2019, French authorities mandated dihydropyrimidine dehydrogenase (DPD) screening, specifically testing uracilemia, to mitigate the risk of toxicity associated with fluoropyrimidine-based chemotherapy. However, this subject is still of debate as there is no consensus on a standardized DPD deficiency screening test. We conducted a real-life retrospective study with the aim of assessing the impact of DPD screening on the occurrence of severe toxicity and exploring the potential benefits of complete genotyping using next-generation sequencing. METHODS All adult patients consecutively treated with 5-fluorouracil (5-FU) or its oral prodrug at six cancer centers between March 2018 and February 2019 were considered for inclusion. Dihydropyrimidine dehydrogenase deficiency screening included gene encoding DPD (DPYD) genotyping using complete genome sequencing and DPD phenotyping (uracilemia or dihydrouracilemia/uracilemia ratio) or both tests. Associations between each DPD screening method and (i) severe (grade ≥3) early toxicity and (ii) fluoropyrimidine dose reduction in the second chemotherapy cycle were evaluated using multivariable logistic regression analysis. Furthermore, we assessed the concordance between DPD genotype and phenotype using Cohen's kappa. RESULTS A total of 551 patients were included. Most patients were tested for DPD deficiency (86%) including DPYD genotyping only (6%), DPD phenotyping only (8%), or both (72%). Complete DPD deficiency was not detected in the study population. Severe early toxicity events were observed in 73 patients (13%), with two patients (0.30%) presenting grade 5 toxicity. Despite the numerically higher toxicity rate in untested patients, the occurrence of severe toxicity was not significantly associated with the DPD screening method (p = 0.69). Concordance between the DPD genotype and phenotype was weak (Cohen's kappa of 0.14). CONCLUSION Due to insufficient numbers, our study was not able to demonstrate any added value of DPYD genotyping using complete genome sequencing to prevent 5-FU toxicity. The optimal strategy for DPD screening before fluoropyrimidine-based chemotherapy requires further clinical evaluation.
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Affiliation(s)
- Côme De Metz
- Department of Medical OncologyCentre Oscar LambretLilleFrance
| | - Benjamin Hennart
- Toxicology Unit, Biology and Pathology CentreLille University Medical CentreLilleFrance
| | - Estelle Aymes
- Department of BiostatisticsCentre Oscar LambretLilleFrance
| | - Pierre‐Yves Cren
- Department of Medical OncologyCentre Oscar LambretLilleFrance
- Department of BiostatisticsCentre Oscar LambretLilleFrance
| | | | - Nicolas Penel
- Department of Medical OncologyCentre Oscar LambretLilleFrance
- Univ. Lille, CHU Lille, ULR 2694 ‐ Metrics: Evaluation des technologies de santé et des pratiques médicalesLilleFrance
| | | | - Aurélien Carnot
- Department of Medical OncologyCentre Oscar LambretLilleFrance
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Coquan E, Penel N, Lequesne J, Leman R, Lavaud P, Neviere Z, Brachet PE, Meriaux E, Carnot A, Boutrois J, Castera M, Goardon N, Muller E, Leconte A, Thiery-Vuillemin A, Clarisse B, Joly F. Carboplatin in metastatic castration-resistant prostate cancer patients with molecular alterations of the DNA damage repair pathway: the PRO-CARBO phase II trial. Ther Adv Urol 2024; 16:17562872241229876. [PMID: 38425504 PMCID: PMC10903225 DOI: 10.1177/17562872241229876] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/08/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction DNA damage repair genes are altered in 20-35% of metastatic castration-resistant prostate cancer (mCRPC). Poly-ADP (Adénosine Diphosphate)-ribose polymerase inhibitors (PARPi) showed significant activity for these selected tumors, especially with homologous recombination repair (HRR) deficiency. These alterations could also predict platinum sensitivity. Although carboplatin was inconclusive in unselected mCRPC, the literature suggests an anti-tumoral activity in mCRPC with HHR gene alterations. We aimed to assess the efficacy of carboplatin monotherapy in mCRPC patients with HRR deficiency. Methods This prospective multicenter single-arm two-stage phase II addressed mCRPC men with HRR somatic and/or germline alterations, pretreated with ⩾2 taxane chemotherapy regimens and one androgen receptor pathway inhibitor. Prior PARPi treatment was allowed. Enrolled patients received intravenous carboplatin (AUC5) every 21 days for 6-9 cycles. The primary endpoint was the best response rate according to adapted PCWG3 guidelines: radiological response (RECIST 1.1 criteria) and/or biological response [⩾50% prostate-specific antigen (PSA) decline]. Results A total of 15 out of 16 enrolled patients started carboplatin treatment. Genomic alterations were identified for BRCA2 (n = 5), CDK12 (n = 3), ATM (n = 3) CHEK2 (n = 2), CHEK1 (n = 1), and BRCA1 (n = 1) genes. Objective response (partial biological response + stable radiological response) was achieved in one patient (6.7%), carrying a BRCA2 mutation and not pre-treated with PARPi; stable disease was observed for five patients (33.5%). Among seven patients (46.7%) with previous PARPi treatment, four patients (57.1%) had a stable disease. The median progression-free and overall survivals were 1.9 [95% confidence interval (95% CI), 1.8-9.5] and 8.6 months (95% CI, 4.3-19.5), respectively. The most common severe (grade 3-4) treatment-related toxicities were thrombocytopenia (66.7%), anemia (66.7%), and nausea (60%). Overall, 8 (53.3%) patients experienced a severe hematological event. Conclusion The study was prematurely stopped as pre-planned considering the limited activity of carboplatin monotherapy in heavily pre-treated, HHR-deficient mCRPC patients. Larger experience is needed in mCRPC with BRCA alterations. Trial registration NCT03652493, EudraCT ID number 2017-004764-35.
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Affiliation(s)
- Elodie Coquan
- Department of Medical Oncology, Centre François Baclesse, Caen, France
- Department of Clinical Research, Centre François Baclesse, Caen, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
- Université de Lille, CHU Lille, ULR 2694 – Metrics: Evaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Justine Lequesne
- Department of Clinical Research, Centre François Baclesse, 3 Avenue du Général Harris, F-14076 CAEN Cedex 05, France
| | - Raphaël Leman
- Genetic and Oncology Biology Department, Centre François Baclesse, Caen, France
- Inserm U1245, Cancer Brain and Genome, Normandie Univ, UNICAEN, FHU G4 Génomique, Rouen, France
| | - Pernelle Lavaud
- Department of Oncology, Institut Gustave Roussy, Villejuif, France
| | - Zoé Neviere
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Pierre-Emmanuel Brachet
- Department of Medical Oncology, Centre François Baclesse, Caen, France
- Department of Clinical Research, Centre François Baclesse, Caen, France
| | - Emeline Meriaux
- Department of Medical Oncology, Centre François Baclesse, Caen, France
- Department of Clinical Research, Centre François Baclesse, Caen, France
| | - Aurélien Carnot
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - Jérémy Boutrois
- Department of Clinical Research, Centre François Baclesse, Caen, France
| | - Marie Castera
- Department of Clinical Research, Centre François Baclesse, Caen, France
| | - Nicolas Goardon
- Genetic and Oncology Biology Department, Centre François Baclesse, Caen, France
- Inserm U1245, Cancer Brain and Genome, Normandie Univ, UNICAEN, FHU G4 Génomique, Rouen, France
| | - Etienne Muller
- Genetic and Oncology Biology Department, Centre François Baclesse, Caen, France
| | - Alexandra Leconte
- Department of Clinical Research, Centre François Baclesse, Caen, France
| | | | | | - Florence Joly
- Department of Medical Oncology, Centre François Baclesse, Caen, France
- Department of Clinical Research, Centre François Baclesse, Caen, France
- Normandie University, UNICAEN, INSERM U1086 “ANTICIPE” (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Centre François Baclesse, Caen, France
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Turpin A, Delliaux C, Parent P, Chevalier H, Escudero-Iriarte C, Bonardi F, Vanpouille N, Flourens A, Querol J, Carnot A, Leroy X, Herranz N, Lanel T, Villers A, Olivier J, Touzet H, de Launoit Y, Tian TV, Duterque-Coquillaud M. Fascin-1 expression is associated with neuroendocrine prostate cancer and directly suppressed by androgen receptor. Br J Cancer 2023; 129:1903-1914. [PMID: 37875732 PMCID: PMC10703930 DOI: 10.1038/s41416-023-02449-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/11/2023] [Accepted: 09/20/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Neuroendocrine prostate cancer (NEPC) is an aggressive form of prostate cancer, arising from resistance to androgen-deprivation therapies. However, the molecular mechanisms associated with NEPC development and invasiveness are still poorly understood. Here we investigated the expression and functional significance of Fascin-1 (FSCN1), a pro-metastasis actin-bundling protein associated with poor prognosis of several cancers, in neuroendocrine differentiation of prostate cancer. METHODS Differential expression analyses using Genome Expression Omnibus (GEO) database, clinical samples and cell lines were performed. Androgen or antagonist's cellular treatments and knockdown experiments were used to detect changes in cell morphology, molecular markers, migration properties and in vivo tumour growth. Chromatin immunoprecipitation-sequencing (ChIP-Seq) data and ChIP assays were analysed to decipher androgen receptor (AR) binding. RESULTS We demonstrated that FSCN1 is upregulated during neuroendocrine differentiation of prostate cancer in vitro, leading to phenotypic changes and NEPC marker expression. In human prostate cancer samples, FSCN1 expression is restricted to NEPC tumours. We showed that the androgen-activated AR downregulates FSCN1 expression and works as a transcriptional repressor to directly suppress FSCN1 expression. AR antagonists alleviate this repression. In addition, FSCN1 silencing further impairs in vivo tumour growth. CONCLUSION Collectively, our findings identify FSCN1 as an AR-repressed gene. Particularly, it is involved in NEPC aggressiveness. Our results provide the rationale for the future clinical development of FSCN1 inhibitors in NEPC patients.
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Affiliation(s)
- Anthony Turpin
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
- Department of Medical Oncology, Lille University Hospital, F-59000, Lille, France
| | - Carine Delliaux
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
| | - Pauline Parent
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
- Department of Medical Oncology, Lille University Hospital, F-59000, Lille, France
| | - Hortense Chevalier
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
- Department of Medical Oncology, Centre Oscar Lambret, 3, rue Frederic Combemale, 59000, Lille, France
| | | | - Franck Bonardi
- University Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UAR 2014 - PLBS, F-59000, Lille, France
| | - Nathalie Vanpouille
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
| | - Anne Flourens
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
| | - Jessica Querol
- Vall d'Hebron Institute of Oncology (VHIO), 08035, Barcelona, Spain
| | - Aurélien Carnot
- Department of Medical Oncology, Centre Oscar Lambret, 3, rue Frederic Combemale, 59000, Lille, France
| | - Xavier Leroy
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
- Institut de Pathologie, CHU Lille, Avenue Oscar Lambret, F-59000, Lille, France
| | - Nicolás Herranz
- Vall d'Hebron Institute of Oncology (VHIO), 08035, Barcelona, Spain
| | - Tristan Lanel
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
- Institut de Pathologie, CHU Lille, Avenue Oscar Lambret, F-59000, Lille, France
| | - Arnauld Villers
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
- Department of Urology, Hospital Claude Huriez, CHU Lille, Lille, France
| | - Jonathan Olivier
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
- Department of Urology, Hospital Claude Huriez, CHU Lille, Lille, France
| | - Hélène Touzet
- University Lille, CNRS, Centrale Lille, UMR 9189 CRIStAL, F-59000, Lille, France
| | - Yvan de Launoit
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
| | - Tian V Tian
- Vall d'Hebron Institute of Oncology (VHIO), 08035, Barcelona, Spain
| | - Martine Duterque-Coquillaud
- University Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France.
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Strobbe G, Gaboriau L, Abelé M, Villain A, Aelbrecht-Meurisse C, Carnot A, Le Deley MC, Léguillette C, Feutry F, Sakji I, Marliot G. Impact of histamine-2 antagonist shortage on the incidence of hypersensitivity reactions to paclitaxel: a reconsideration of premedication protocols in France (PACLIREACT Study). Eur J Clin Pharmacol 2023; 79:1229-1238. [PMID: 37438439 DOI: 10.1007/s00228-023-03536-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE An international shortage of ranitidine led to adjustments in premedication regimens for paclitaxel-based chemotherapy in early October 2019. In this study, we implemented and evaluated an anti-allergic protocol without histamine-2 antagonists (H2As) and aimed to assess the risk of hypersensitivity reactions (HSRs) to the different premedication regimens used. METHODS We conducted a single-center observational retrospective study of paclitaxel administrations (7173 administrations in 831 patients). Between January 2019 and December 2020, all allergies reported were recorded. A mixed logistic regression model was implemented to predict the risk of allergy at each injection and to account for repeated administration per patient. RESULTS A total of 27 HSRs occurred in 24 patients. No protective effect was observed for H2A when comparing paclitaxel injections with H2A premedication versus without H2A (OR = 1.12, p = 0.84). There was also no significant difference in risk of HSR for famotidine versus ranitidine (OR = 0.79, p = 0.78). However, the risk of HSRs was significantly lower for paclitaxel injections with corticosteroids than for those without (OR = 0.08, p = 0.03). In addition, the risk of HSR was significantly higher for the first, second, or third paclitaxel injections than for the subsequent injections (OR = 10.1, p < 0.001). CONCLUSION We did not find substantial evidence of an increased risk of HSR due to the absence of H2A in the premedication protocols for paclitaxel. Thus, in contrary to the existing literature on paclitaxel, our findings support the use of a premedication protocol without H2A.
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Affiliation(s)
- Geoffrey Strobbe
- Pole produits de santé, Service de pharmacie, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59020, Cedex BP307, Lille, France.
| | - Louise Gaboriau
- Centre Régional de Pharmacovigilance, Service de pharmacologie, CHU, Lille, France
| | - Marie Abelé
- Pole produits de santé, Service de pharmacie, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59020, Cedex BP307, Lille, France
| | - Alexandre Villain
- Pole produits de santé, Service de pharmacie, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59020, Cedex BP307, Lille, France
| | | | - Aurélien Carnot
- Pole d'oncologie médicale, Centre Oscar Lambret, Lille, France
| | | | | | - Frédéric Feutry
- Pole produits de santé, Service de pharmacie, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59020, Cedex BP307, Lille, France
| | - Ilyes Sakji
- Pole produits de santé, Service de pharmacie, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59020, Cedex BP307, Lille, France
| | - Guillaume Marliot
- Pole produits de santé, Service de pharmacie, Centre Oscar Lambret, 3, rue Frédéric Combemale, 59020, Cedex BP307, Lille, France
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Fournier C, Leguillette C, Leblanc E, Le Deley MC, Carnot A, Pasquier D, Escande A, Taieb S, Ceugnart L, Lebellec L. Diagnostic Value of the Texture Analysis Parameters of Retroperitoneal Residual Masses on Computed Tomographic Scan after Chemotherapy in Non-Seminomatous Germ Cell Tumors. Cancers (Basel) 2023; 15:cancers15112997. [PMID: 37296963 DOI: 10.3390/cancers15112997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
After chemotherapy, patients with non-seminomatous germ cell tumors (NSGCTs) with residual masses >1 cm on computed tomography (CT) undergo surgery. However, in approximately 50% of cases, these masses only consist of necrosis/fibrosis. We aimed to develop a radiomics score to predict the malignant character of residual masses to avoid surgical overtreatment. Patients with NSGCTs who underwent surgery for residual masses between September 2007 and July 2020 were retrospectively identified from a unicenter database. Residual masses were delineated on post-chemotherapy contrast-enhanced CT scans. Tumor textures were obtained using the free software LifeX. We constructed a radiomics score using a penalized logistic regression model in a training dataset, and evaluated its performance on a test dataset. We included 76 patients, with 149 residual masses; 97 masses were malignant (65%). In the training dataset (n = 99 residual masses), the best model (ELASTIC-NET) led to a radiomics score based on eight texture features. In the test dataset, the area under the curve (AUC), sensibility, and specificity of this model were respectively estimated at 0.82 (95%CI, 0.69-0.95), 90.6% (75.0-98.0), and 61.1% (35.7-82.7). Our radiomics score may help in the prediction of the malignant nature of residual post-chemotherapy masses in NSGCTs before surgery, and thus limit overtreatment. However, these results are insufficient to simply select patients for surgery.
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Affiliation(s)
- Clémence Fournier
- Department of Medical Oncology, Centre Hospitalier de Roubaix, 59100 Roubaix, France
| | | | - Eric Leblanc
- Department of Surgical Oncology, Centre Oscar Lambret, 59000 Lille, France
| | | | - Aurélien Carnot
- Department of Medical Oncology, Centre Oscar Lambret, 59000 Lille, France
| | - David Pasquier
- Academic Department of Radiation Oncology, Centre Oscar Lambret, 59000 Lille, France
- Univ. Lille, CNRS, Centrale Lille, UMR 9189-CRIStAL, 59000 Lille, France
| | - Alexandre Escande
- Univ. Lille, CNRS, Centrale Lille, UMR 9189-CRIStAL, 59000 Lille, France
- Department of Radiotherapy, Clinique Léonard de Vinci, 59187 Dechy, France
| | - Sophie Taieb
- Department of Radiology, Centre Oscar Lambret, 59000 Lille, France
| | - Luc Ceugnart
- Department of Radiotherapy, Clinique Léonard de Vinci, 59187 Dechy, France
| | - Loïc Lebellec
- Department of Medical Oncology, Centre Oscar Lambret, 59000 Lille, France
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Polastro L, Kotecki N, Martins-Branco D, Delaroche D, Barthelemy P, Holbrechts S, Vergauwe P, Goemine JC, Demolin G, Prenen H, Clatot F, Roca CG, Kristanto P, Peasmans M, Awada A, hendlisz A, Carnot A, Sclafani F, Aftimos P. Abstract CT530: Multiorgan metabolic imaging response assessment of abemaciclib (MiMe-A): Oncodistinct 002. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-ct530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Abemaciclib (A) activity against breast cancer as monotherapy or combined with endocrine therapy warrants further investigations in other cancer types. However, its significant toxicity profile illustrates the challenge of defining more precisely the patients unlikely to benefit from it, sparing them from useless toxicities. FDG-PET/CT can identify treatment-refractory disease with high negative predictive value, soon after the treatment onset and before morphological changes are observed. MiMe-A was built on the assumption that a therapy that does not induce tumoral metabolic changes 14 days after its onset is unlikely to achieve a significant clinical benefit.
Methods: A multicenter phase II basket trial assessed the efficacy of A in 5 cancers types (cholangiocarcinoma, endometrial, urothelial carcinomas, oesophagal adeno- and squamous cell carcinomas). The primary endpoint is the ‘treatment success’, defined as metabolic response according to PERCIST at FDG-PET/CT performed during the first cycle (D14) and absence of disease progression per RECIST 1.1 after two cycles of A. A Simon’s 2-stage design was used in each cohort based on the null hypothesis that the treatment success rate will be ≤20%. An interim analysis for futility was performed on each cohort after accrual of 17 patients during the first stage.
Results: The baseline characteristics and the metabolic and morphologic evaluation of eligible patients are shown below.
*: stop treatment before the two months (due to progression or toxicities) IQR: interquartile range, PR: partial response, SD: stable disease, PD: progressive disease
The treatment success rate was 0% for each cancer type except for urothelial carcinoma (5,9% (1/17 treatment success). Toxicities were mainly graded 1 or 2, including diarrhea, nausea, fatigue and haematological.
Conclusion: A did not show significant anti-tumour activity in any of the five cohorts. But early metabolic response was noted in 29% of the oesophageal squamous cell carcinoma population, this finding did not translate in disease control at two months. This could be explained by an initial response rapidly followed by tumoral escape. A combination of A with other drugs should be explored in this cancer type.
Esophageal adenocarcinomaN=17 Esophageal Squamous cell carcinomaN=17 CholangiocarcinomaN=17 Endometrial carcinomaN=17 Urothelial CarcinomaN=17 Baselinecharacteristics Age range 36-83 56-77 50-85 57-84 46-80 Median age (IQR) 65 (55-68) 67 (63-71) 70 (67-74) 68(64-73) 67 (63-71) Median number of lines of prior treatments (IQR) 3 (2-4) 3 (2-4) 2 (1-2) 3 (2-3) 3 (2-3) Metabolic response (PERCIST) assessment Complete metabolic response 0/17 0/17 0/17 0/17 0/17 Partial metabolic response 2/17 5/17 1/17 0/17 2/17 Stable metabolic disease 8/17 4/17 5/17 8/17 7/17 Progressive metabolic disease 4/17 7/17 9/17 6/17 4/17 Not evaluable 3/17 1/17 2/17 3/17 4/17 % Complete or partial metabolic response (95% CI) 12% (2%-36%) 29% (10%-56%) 6% (0%-29%) 0% (0%-20%) 12% (1%-36%) Response by RECIST (after 2 cycles) PR 1/17 1/17 0/17 0/17 0/17 SD 3/17 2/17 5/17 5/17 8/17 PD 6/17 10/17 7/17 9/17 8/17 Not available* 7/17 4/17 5/17 3/17 1/17
Citation Format: Laura Polastro, Nuria Kotecki, Diogo Martins-Branco, Diane Delaroche, Philippe Barthelemy, Stephane Holbrechts, Philippe Vergauwe, JC Goemine, Gauthier Demolin, Hans Prenen, Florian Clatot, Carlos Gomez Roca, Paulus Kristanto, Marianne Peasmans, Ahmad Awada, Alain hendlisz, Aurélien Carnot, Fransceco Sclafani, Philippe Aftimos. Multiorgan metabolic imaging response assessment of abemaciclib (MiMe-A): Oncodistinct 002 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT530.
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Affiliation(s)
| | | | | | | | | | | | | | - JC Goemine
- 5Clinique Saint Elisabeth, Namur, Belgium
| | | | | | | | | | | | | | - Ahmad Awada
- 1Jules Bordet Institute, Anderlecht, Belgium
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Hautecloque-Rayz S, Albert-Thananayagam M, Martignene N, Le Deley MC, Carbonnelle G, Penel N, Carnot A. Long-Term Outcomes and Prognostic Factors of Patients with Metastatic Solid Tumors Admitted to the Intensive Care Unit. Oncology 2022; 100:173-181. [PMID: 35051928 DOI: 10.1159/000520097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/12/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Admission of metastatic cancer patients to the intensive care unit (ICU) poses medical and ethical challenges in the absence of reliable prognostic tools to guide decision-making. MATERIAL AND METHODS We retrospectively analyzed the medical charts of 129 consecutive patients with metastatic solid tumors admitted to the ICU between January and September 2014 and identified prognostic factors (PFs) using Cox models. RESULTS The mean patient age at ICU admission was 58.9 years (range, 25-81 years; males, 51%). Performance status (PS) was 0-1 and 2-3 in 61% and 39% of the patients, respectively. The most prevalent cancers were lung cancer (20%), sarcoma (17%), and breast cancer (16%). ICU admission was attributable to the cancer itself (53%), cancer treatment toxicity (43%), and comorbidities (37%). The median overall survival (OS) after ICU admission was 2.6 months; 15% of the patients died during the ICU stay. Poor PFs for OS were PS >1 before ICU admission (p = 0.007) and ICU admission for the cancer itself (p < 10-3). After ICU discharge, 58% and 42% of the patients received systemic treatment within 12 months and showed good PS recovery, respectively. Multiple organ failure and a multidisciplinary decision to limit therapeutic efforts were poor PFs for reinitiation of systemic treatment (p = 0.2 and 0.006, respectively), and the latter was also a poor PF for PS recovery (p = 0.004). DISCUSSION In the ICU, the OS of adult patients with solid tumors was similar to that of the noncancer population. For ICU admissions related to the cancer itself, the prognosis is poor.
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Affiliation(s)
- Ségolène Hautecloque-Rayz
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France.,Medical School, Lille University, Lille, France.,Department of Medical Oncology, Hôpital Duchesne de Boulogne, Boulogne-sur-mer, France
| | | | - Niels Martignene
- Department of Medical Oncology, Hôpital Duchesne de Boulogne, Boulogne-sur-mer, France.,Methology and Biostatistics Unit, Centre Oscar Lambret, Lille, France.,Medical Information Unit, Centre Oscar Lambret, Lille, France
| | - Marie-Cécile Le Deley
- Methology and Biostatistics Unit, Centre Oscar Lambret, Lille, France.,CESP, INSERM, Paris-Saclay University, Paris-Sud University, UVSQ, Villejuif, France
| | - Guillaume Carbonnelle
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France.,Supportive Care Unit, Centre Oscar Lambret, Lille, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France.,Medical School, Lille University, Lille, France
| | - Aurélien Carnot
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
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Martinez Chanza N, Soukane L, Barthelemy P, Carnot A, Gil T, Casert V, Vanhaudenarde V, Sautois B, Staudacher L, Van den Brande J, Culine S, Seront E, Gizzi M, Albisinni S, Tricard T, Fantoni JC, Paesmans M, Caparica R, Roumeguere T, Awada A. Avelumab as neoadjuvant therapy in patients with urothelial non-metastatic muscle invasive bladder cancer: a multicenter, randomized, non-comparative, phase II study (Oncodistinct 004 - AURA trial). BMC Cancer 2021; 21:1292. [PMID: 34856936 PMCID: PMC8638545 DOI: 10.1186/s12885-021-08990-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/10/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction Cisplatin-based neoadjuvant chemotherapy (NAC) followed by surgery is the standard treatment for patients with non-metastatic muscle invasive bladder cancer (MIBC). Unfortunately, many patients are not candidates to receive cisplatin due to renal impairment. Additionally, no predictive biomarkers for pathological complete response (pCR) are currently validated in clinical practice. Studies evaluating immune checkpoint inhibitors in the peri-operative setting are emerging with promising results. Clinical trials are clearly required in the neoadjuvant setting in order to improve therapeutic strategies. Methods and analysis Oncodistinct 004 – AURA is an ongoing multicenter phase II randomized trial assessing the efficacy and safety of avelumab single-agent or combined to different NAC regimens in patients with non-metastatic MIBC. Patients are enrolled in two distinct cohorts according to their eligibility to receive cisplatin-based NAC. In the cisplatin eligible cohort, patients are randomized in a 1:1 fashion to receive avelumab combined with cisplatin-gemcitabine or with dose-dense methotrexate-vinblastine-doxorubicin-cisplatin. In the cisplatin ineligible cohort, patients are randomized at a 1:1 ratio to paclitaxel-gemcitabine associated to avelumab or avelumab alone. Primary endpoint is pCR. Secondary endpoints are pathological response and safety. Ethics and dissemination The study is approved by ethics committee from all participating centers. All participants provide informed consent prior inclusion to the study. Once completed, results will be published in peer-reviewed journals. Trial registration number ClinicalTrials.gov (NCT03674424).
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Affiliation(s)
- Nieves Martinez Chanza
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium. .,Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
| | - Louisa Soukane
- Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Thierry Gil
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Vinciane Casert
- Centre Hospitalier Universitaire de Ambrois Paré, Mons, Belgium
| | | | - Brieuc Sautois
- University Hospital of Liege (CHU Sart Tilman), Liège, Belgium
| | | | | | | | | | - Marco Gizzi
- Grand Hopital de Charleroi, Charleroi, Belgium
| | - Simone Albisinni
- Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Thibault Tricard
- Institut de Cancérologie Strasbourg Europe ICANS, Strasbourg, France
| | | | - Marianne Paesmans
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Rafael Caparica
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Thierry Roumeguere
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.,Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Ahmad Awada
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
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Martinez Chanza N, Carnot A, Barthelemy P, Casert V, Sautois B, Van den Brande J, Vanhaudenarde V, Staudacher L, Seront E, Culine S, Gizzi M, Gil T, Paesmans M, Kotecki N, Ignatiadis M, Albisinni S, Fantoni J, Tricard T, Roumeguere T, Awada A. 659MO Avelumab (A) as the basis of neoadjuvant chemotherapy (NAC) regimen in platinum eligible and ineligible patients (pts) with non-metastatic muscle invasive bladder cancer (NM-MIBC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.055] [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] Open
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Luporsi E, Turpin A, Massard V, Morin S, Chauffert B, Carnot A, Cacoub P. Iron deficiency in patients with cancer: a prospective cross-sectional study. BMJ Support Palliat Care 2021:bmjspcare-2021-002913. [PMID: 34330792 DOI: 10.1136/bmjspcare-2021-002913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/30/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Despite the deleterious consequences of iron deficiency (ID) in patients with cancer, underdiagnosis is frequent. The CARENFER study aimed to assess the prevalence of ID using both serum ferritin concentration and transferrin coefficient saturation (iron-saturation of transferrin, TSAT) index, as well as ID anaemia in patients with cancer. METHODS This prospective cross-sectional study was conducted in 15 oncology units in France in 2019. All patients present in the medical unit during the 2-week study period, regardless of the type of tumour (solid or haematological) and treatment, were eligible. Serum ferritin concentration, TSAT index and haemoglobin level were determined. ID and ID-associated anaemia were defined according to European Society of Medical Oncology 2018 Guidelines: ID was defined either as ferritin <100 µg/L (absolute ID) or as ferritin ≥100 µg/L and TSAT <20% (functional ID). RESULTS A total of 1221 patients with different types of solid malignant tumours were analysed: median age 64 years; 89.4% under treatment for their cancer, mainly by chemotherapy (75.4%). Overall, ID was found in 57.9% (55.1-60.6) of patients. Among them, functional ID accounted for 64% of cases. ID anaemia was reported in 21.8% (19.6-24.2) of all patients with cancer. ID was highly prevalent in untreated (75/130, 57.4%) and non-anaemic (419/775, 54.1%) patients. CONCLUSION This study highlights the high prevalence of ID in patients with cancer, whether or not associated with anaemia or treatment. These results emphasise the need to a better detection and management of ID in cancer, thereby optimising overall patient care. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT03924271.
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Affiliation(s)
| | - Anthony Turpin
- Medical Oncology Department, CHU Lille, Lille, France
- UMR9020 - UMR-S 1277 Canther, University of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France
| | - Vincent Massard
- Oncology Unit, Institut de Cancérologie de Lorraine, Vandoeuvre-les-Nancy, France
| | - Sophie Morin
- Oncology Unit, Institut Bergonié, Bordeaux, France
| | | | - Aurélien Carnot
- Medical Oncology Department, Oscar Lambret Cancer Centre, Lille, France
| | - Patrice Cacoub
- Department of Internal Medicine and Clinical Immunology, Hopital Universitaire AP HP Pitie Salpetriere, Paris, France
- UPMC Univ Paris 06, INSERM, UMR S 959, Immunology-Immunopathology- Immunotherapy (I3), Sorbonne Université, Paris, France
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Gehenne L, Christophe V, Eveno C, Carnot A, Turpin A, Pannier D, Piessen G, Lelorain S. Creating scripted video-vignettes in an experimental study on two empathic processes in oncology: Reflections on our experience. Patient Educ Couns 2021; 104:654-662. [PMID: 32938562 DOI: 10.1016/j.pec.2020.08.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 08/10/2020] [Accepted: 08/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The aims were to: (1) apply the guidelines to develop and test the validity of video-vignettes manipulating empathy and context in oncology; (2) compare lay people's and patients' assessments of validity; (3) reflecting on our experiment METHODS: Guidelines were followed: (1) deciding whether video-vignettes were appropriate; (2) developing a valid script; (3) designing valid manipulations; (4) converting the scripted consultations into videos. One hundred sixteen lay people and 46 cancer patients filled in the Video Engagement Scale, the CARE, and ad hoc questionnaires on realism and emotions. RESULTS The video-vignettes are valid for experimental use. Differences appeared in the emotions participants reported. The empathic processes were successfully manipulated and perceived. Lay people's and patients' assessments were equivalent, except for video-vignettes in neutral consultations. Participants' comments on nonverbal behavior, camera perspective, scripts and empathy assessment were reported. CONCLUSION Patients' assessments are impacted by their personal experiences. Researchers should control for this in analogue patient studies. PRACTICE IMPLICATIONS Based on this experience, we reflect on: (1) adopting congruent nonverbal behavior throughout the video-vignettes; (2) alternating camera perspectives; (3) avoiding the sole use of written scripts; (4) using quantitative and qualitative analysis to validate scripts and video-vignettes.
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Affiliation(s)
- Lucie Gehenne
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.
| | - Véronique Christophe
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France; Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France
| | - Clarisse Eveno
- Department of Digestive and Oncological Surgery, University of Lille, Claude Huriez University Hospital, Lille, France
| | - Aurélien Carnot
- Department of General Oncology, Centre Oscar Lambret, Lille, France
| | - Anthony Turpin
- Department of Medical Oncology, University of Lille, Claude Huriez University Hospital, Lille, France; University of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000, Lille, France
| | - Diane Pannier
- Department of General Oncology, Centre Oscar Lambret, Lille, France
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, University of Lille, Claude Huriez University Hospital, Lille, France; Jean-Pierre Aubert Research Center, Neurosciences and Cancer, University of Lille, IMR-S 1172-JPArc, Lille, France
| | - Sophie Lelorain
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.
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Dansin E, Carnot A, Servent V, Daussay D, Robin YM, Surmei-Pintilie E, Lauridant G, Descarpentries C, Révillion F, Delattre C. EGFR-Mutated Breast Metastasis of Lung Adenocarcinoma: A Case Report. Case Rep Oncol 2015; 8:164-8. [PMID: 25873885 PMCID: PMC4386146 DOI: 10.1159/000381014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Breast metastasis from other primary carcinoma is very rare and could be difficult to identify despite immunohistochemistry analysis. Breast metastasis from lung adenocarcinoma can mimic triple-negative breast cancer. Given the prognosis and therapeutic challenges, a correct diagnosis appears essential, and molecular biomarkers could be useful. We report the case of a 52-year-old woman with a breast mass initially diagnosed as primary breast cancer and secondarily attached to breast metastasis from an EGFR-mutated lung adenocarcinoma. The same activating EGFR mutations were identified in both the primary lung carcinoma and the breast metastasis.
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Affiliation(s)
- Eric Dansin
- Département de Cancérologie Générale, France
| | | | | | | | | | | | - Géraldine Lauridant
- Département de Cancérologie Générale, France ; Département de Sénologie, France
| | | | - Françoise Révillion
- Unité d'Oncologie Moléculaire Humaine, CLCC Oscar Lambret, France ; Plateforme Régionale CHRU-COL de Génétique Moléculaire des Cancers, France
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Moser L, Neusser E, Carnot A, Faktor F. Die Bestimmung der Metallsulfide durch Erhitzen im Schwefelwasserstofstrom. Anal Bioanal Chem 1923. [DOI: 10.1007/bf01472965] [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: 10/25/2022]
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Carnot A. Neue Trennungsmethoden f�r Kupfer, Zink, Kadmium, Nickel und Kobalt. Anal Bioanal Chem 1918. [DOI: 10.1007/bf01443782] [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: 12/01/2022]
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Nihoul E, Vortmann G, Meineke C, Lunge G, Naef P, Salzer T, Kock E, Younger W, Norton LM, Rosenbaum M, Spring W, Bourgeois E, Sokolow N, Maltschewski P, Otto R, Friedheim C, Stolba F, Linossier G, Lignon M, Gathorne Young W, Kayser R, Offermann H, Carnot A, Gasselin V, Petersen T. Zur Bestimmung der Halogene. Anal Bioanal Chem 1896. [DOI: 10.1007/bf01415394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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