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Bejarano-Quisoboni D, Panjo H, Fresneau B, El-Fayech C, Doz F, Surun A, de Vathaire F, Pelletier-Fleury N. Excess healthcare expenditure in adults treated for solid cancer in childhood: a cohort study in France. Eur J Health Econ 2024; 25:513-523. [PMID: 37344685 DOI: 10.1007/s10198-023-01606-6] [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] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Due to late effects, childhood cancer survivors (CCS) are more likely to have multiple chronic conditions than the general population. However, little is known about the economic burden of care of CCS in the long term. OBJECTIVES To estimate excess healthcare expenditure for long-term CCS in France compared to the general population and to investigate the associated factors. METHODS We included 5353 5-year solid CCS diagnosed before the age of 21 years before 2000 from the French CCS cohort and obtained a random reference sample from the general population for each CCS, matched on age, gender and region of residence. We used the French national health data system to estimate annual healthcare expenditure between 2011 and 2018 for CCS and the reference sample, and computed the excess as the net difference between CCS expenditure and the median expenditure of the reference sample. We used repeated-measures linear models to estimate associations between excess healthcare expenditure and CCS characteristics. RESULTS Annual mean (95% CI) excess healthcare expenditure was €3920 (3539; 4301), mainly for hospitalization (39.6%) and pharmacy expenses (17%). Higher excess was significantly associated with having been treated before the 1990s and having survived a central nervous system tumor, whereas lower excess was associated with CCS who had not received treatment with radiotherapy. CONCLUSIONS Of the variables that influence excess healthcare expenditure, a lever for action is the type of treatment administered. Future research should focus on addressing the long-term cost-effectiveness of new approaches, especially those related to radiotherapy.
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Affiliation(s)
- Daniel Bejarano-Quisoboni
- Radiation Epidemiology Team, CESP, Inserm, U1018, Villejuif, France.
- Primary Care and Prevention Team, CESP, Inserm, U1018, Villejuif, France.
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France.
- Department of Research, Gustave Roussy, Villejuif, France.
| | - Henri Panjo
- Primary Care and Prevention Team, CESP, Inserm, U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France
| | - Brice Fresneau
- Radiation Epidemiology Team, CESP, Inserm, U1018, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
- Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, France
| | - Chiraz El-Fayech
- Department of Research, Gustave Roussy, Villejuif, France
- Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, France
| | - François Doz
- SIREDO Center (Care, Research, Innovation in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France
- Université Paris Cité, Paris, France
| | - Aurore Surun
- SIREDO Center (Care, Research, Innovation in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France
- Université Paris Cité, Paris, France
| | - Florent de Vathaire
- Radiation Epidemiology Team, CESP, Inserm, U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
| | - Nathalie Pelletier-Fleury
- Primary Care and Prevention Team, CESP, Inserm, U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France
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2
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Barraud-Lange V, Boissel N, Gille AS, Jean C, Sitbon L, Schubert B, Yakouben K, Fahd M, Peycelon M, Paye-Jaouen A, Chalas C, Vanhaesebrouck A, Doz F, Surun A, Lemelle L, Sarnacki S, Neven B, Philippe-Chomette P, Dufour C, Rigaud C, Leverger G, Tabone MD, Irtan S, Pondarée C, Lezeau H, Lenaour G, Sibony M, Comperat E, Brocheriou I, Wolf JP, Dalle JH, Poirot C. A 10-year experience in testicular tissue cryopreservation for boys under 18 years of age: What can be learned from 350 cases? Andrology 2024; 12:385-395. [PMID: 37418281 DOI: 10.1111/andr.13493] [Citation(s) in RCA: 1] [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: 11/29/2022] [Revised: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND A growing number of centers worldwide are preserving testicular tissue (TT) of young boys at risk of fertility loss to preserve their fertility. Data in this regard are scarce and experience sharing is essential to the optimization of the process. OBJECTIVES This report of our 10-year activity of pediatric fertility preservation (FP) has the objective to (1) improve knowledge regarding the feasibility, acceptability, safety, and potential usefulness of the procedure; (2) analyze the impact of chemotherapy on spermatogonia in the cryopreserved TT. MATERIALS AND METHODS For this retrospective study of data prospectively recorded, we included all boys under 18 years of age referred to the FP consultation of our academic network between October 2009 and December 2019. Characteristics of patients and cryopreservation of testicular tissue (CTT) were extracted from the clinical database. Univariate and multivariate analyses were used to assess factors associated with the risk of absence of spermatogonia in the TT. RESULTS Three hundred and sixty-nine patients (7.2 years; 0.5-17.0) were referred to the FP consultation for malignant (70%) or non-malignant (30%) disease, of whom 88% were candidates for CTT, after a previous chemotherapy exposure (78%). The rate of recorded immediate adverse events was 3.5%, with painful episodes dominating. Spermatogonia were detected in the majority of TTs: 91.1% of those exposed to chemotherapy and 92.3% of those not exposed (p = 0.962). In multivariate analysis, the risk of absence of spermatogonia was almost three-fold higher in boys > 10 years of age ([OR] 2.74, 95% CI 1.09-7.26, p = 0.035) and four-fold higher in boys exposed to alkylating agents prior to CTT ([OR] 4.09, 95% CI 1.32-17.94, p = 0.028). DISCUSSION/CONCLUSION This large series of pediatric FP shows that this procedure is well accepted, feasible, and safe in the short term, strengthening its place in the clinical care pathway of young patients requiring a highly gonadotoxic treatment. Our results demonstrate that CTT post-chemotherapy does not impair the chance to preserve spermatogonia in the TT except when the treatment includes alkylating agents. More data on post-CTT follow-up are still required to ensure the long-term safety and usefulness of the procedure.
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Affiliation(s)
- Virginie Barraud-Lange
- Université Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Nicolas Boissel
- Université Paris Cité, Paris, France
- Department of Hematology, Adolescents and Young Adults Unit, AP-HP. North-Université Paris Cité. Saint-Louis Hospital, Paris, France
| | - Anne-Sophie Gille
- Université Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Camille Jean
- Université Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Leslie Sitbon
- Biomega-Bioclinic, Department Intercommunal Hospital of Créteil, Assisted Reproductive Biology, Créteil, France
| | - Benoit Schubert
- Eurofins Biomnis Laboratory, Institut Rhonalpin IVF Center, Clinique du Val d'Ouest, Ecully, France
| | - Karima Yakouben
- Department of Pediatric Immunology and Hematology, APHP. North-Université Paris Cité. Robert Debré Hospital, Paris, France
| | - Mony Fahd
- Department of Pediatric Immunology and Hematology, APHP. North-Université Paris Cité. Robert Debré Hospital, Paris, France
| | - Matthieu Peycelon
- Université Paris Cité, Paris, France
- Department of Pediatric Surgery and Urology, Centre de Référence des Malformations Rares des Voies Urinaires (MARVU), Inserm UMR 1141 NeuroDev, APHP. North-Université Paris Cité. Robert-Debré Hospital, Paris, France
| | - Annabel Paye-Jaouen
- Department of Pediatric Surgery and Urology, Centre de Référence des Malformations Rares des Voies Urinaires (MARVU), Inserm UMR 1141 NeuroDev, APHP. North-Université Paris Cité. Robert-Debré Hospital, Paris, France
| | - Céline Chalas
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Alexis Vanhaesebrouck
- Interdisciplinary Research Institute on Social issues (IRIS), UMR 8156-997, Sorbonne Paris North University, Aubervilliers, France
- Department of Legal and Social Medicine, AP-HP, Jean-Verdier Hospital, Bondy, France
- Department of Social Epidemiology, Sorbonne University, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - François Doz
- Université Paris Cité, Paris, France
- Curie Institute, SIREDO Center (Care, Innovation, Research in Pediatric, Adolescent and Young Adult Oncology, Paris, France
| | - Aurore Surun
- Curie Institute, SIREDO Center (Care, Innovation, Research in Pediatric, Adolescent and Young Adult Oncology, Paris, France
| | - Lauriane Lemelle
- Curie Institute, SIREDO Center (Care, Innovation, Research in Pediatric, Adolescent and Young Adult Oncology, Paris, France
| | - Sabine Sarnacki
- Université Paris Cité, Paris, France
- Department of Visceral and Urological Pediatric Surgery, AP-HP. Center-Université Paris Cité. Necker Hospital, Paris, France
| | - Bénédicte Neven
- Université Paris Cité, Paris, France
- Department of Immuno-Hematology and Pediatric Rheumatology, APHP. Center-Université Paris Cité. Necker-Enfant Malades Hospital, Paris, France
| | | | - Christelle Dufour
- Department of Pediatric Oncology, Gustave Roussy Institute, Villejuif, France
| | - Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Institute, Villejuif, France
| | - Guy Leverger
- Sorbonne University, Paris, France
- Department of Pediatric Onco-Hematology, AP-HP. Sorbonne University. Armand Trousseau Hospital, Paris, France
| | - Marie-Dominique Tabone
- Department of Pediatric Onco-Hematology, AP-HP. Sorbonne University. Armand Trousseau Hospital, Paris, France
| | - Sabine Irtan
- Sorbonne University, Paris, France
- Department of Pediatric Surgery, AP-HP. Sorbonne University. Armand Trousseau Hospital, Paris, France
| | - Corinne Pondarée
- Pediatric Department Sickle Cell Referral Center, Intercommunal Hospital of Créteil, Créteil, France
- University Paris XII, INSERM U 955, Créteil, France
| | - Harry Lezeau
- Department of Visceral, Urological and Traumatological Surgery, Intercommunal Hospital of Créteil, Créteil, France
| | | | - Mathilde Sibony
- Université Paris Cité, Paris, France
- Department of Pathology, AP-HP. Center-Université Paris Cité. Cochin Hospital, Paris, France
| | - Eva Comperat
- Sorbonne University, Paris, France
- Department of Pathology, AP-HP. Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Isabelle Brocheriou
- Sorbonne University, Paris, France
- Department of Pathology, AP-HP. Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Jean Philippe Wolf
- Université Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Jean-Hugue Dalle
- Université Paris Cité, Paris, France
- Department of Pediatric Immunology and Hematology, APHP. North-Université Paris Cité. Robert Debré Hospital, Paris, France
| | - Catherine Poirot
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
- Department of Hematology, Adolescents and Young Adults Unit, AP-HP. North-Université Paris Cité. Saint-Louis Hospital, Paris, France
- Sorbonne University, Paris, France
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3
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Charrier T, Haddy N, Schwartz B, Journy N, Fresneau B, Demoor-Goldschmidt C, Diallo I, Surun A, Aerts I, Doz F, Souchard V, Vu-Bezin G, Laprie A, Lemler S, Letort V, Rubino C, Chounta S, de Vathaire F, Latouche A, Allodji RS. Increased Cardiac Risk After a Second Malignant Neoplasm Among Childhood Cancer Survivors: A FCCSS Study. JACC CardioOncol 2023; 5:792-803. [PMID: 38205003 PMCID: PMC10774765 DOI: 10.1016/j.jaccao.2023.07.008] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 01/12/2024] Open
Abstract
Background Childhood cancer survivors (CCS) are at an elevated risk of developing both a second malignant neoplasm (SMN) and cardiac disease. Objectives This study sought to assess the excess of occurrence of cardiac disease after a SMN among CCS. Methods Analyses included 7,670 CCS from the French Childhood Cancer Survivors Study cohort diagnosed between 1945 and 2000. To account for the time dependence of the occurrence of a SMN, we employed a landmark approach, considering an additive regression model for the cumulative incidence of cardiac disease. We estimated the effect of a SMN on the instantaneous risk of cardiac disease using a proportional cause-specific hazard model, considering a SMN as a time-dependent exposure. In both models, we adjusted for demographic and treatment information and considered death as a competing event. Results In 7,670 CCS over a median follow-up of 30 years (IQR: 22-38 years), there were 378 cases of cardiac disease identified, of which 49 patients experienced a SMN. Patients who survived 25 years after their childhood cancer diagnosis and had a SMN in that time frame had a significantly increased cumulative incidence of cardiac disease, which was 3.8% (95% CI: 0.5% to 7.1%) higher compared with those without a SMN during this period. No SMN-induced excess of cardiac disease was observed at subsequent landmark times. SMNs were associated with a 2-fold increase (cause-specific HR: 2.0; 95% CI: 1.4-2.8) of cardiac disease. Conclusions The occurrence of a SMN among CCS is associated with an increased risk of cardiac disease occurrence and risk at younger ages.
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Affiliation(s)
- Thibaud Charrier
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
- U900, Institut National de la Santé et de la Recherche Médicale, PSL Research University, Institut Curie, Saint-Cloud, France
| | - Nadia Haddy
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Boris Schwartz
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Neige Journy
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Brice Fresneau
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Department of Pediatric Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Charlotte Demoor-Goldschmidt
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
- Department of Pediatric Oncology, Centre Hospitalier Universitaire, Angers, France
- Department of Radiotherapy, Centre François Baclesse, Caen, France
- Department of Supportive Care, Centre François Baclesse, Caen, France
| | - Ibrahima Diallo
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
- Radiothérapie Moléculaire et Innovation Thérapeutique, Institut National de la Santé et de la Recherche Médicale, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Aurore Surun
- SIREDO Oncology Center, Institut Curie, Paris, France
| | | | - François Doz
- SIREDO Oncology Center, Institut Curie, Paris, France
- Université Paris Cité, Paris, France
| | - Vincent Souchard
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Giao Vu-Bezin
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Anne Laprie
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Sarah Lemler
- Mathématiques et Informatique pour la Complexité et les Systèmes, CentraleSupélec, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Véronique Letort
- Mathématiques et Informatique pour la Complexité et les Systèmes, CentraleSupélec, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Carole Rubino
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Stéfania Chounta
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
- Mathématiques et Informatique pour la Complexité et les Systèmes, CentraleSupélec, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Florent de Vathaire
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Aurélien Latouche
- U900, Institut National de la Santé et de la Recherche Médicale, PSL Research University, Institut Curie, Saint-Cloud, France
- Conservatoire National des Arts et Métiers, Paris, France
| | - Rodrigue S. Allodji
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Université Paris-Saclay– Université Paris-Sud–Université de Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Cancer and Radiation Team, Centre de Research en Epidemiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
- Cancer and Radiation Team, Department of Clinical Research, Gustave Roussy, Villejuif, France
- Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
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4
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Bougas N, Allodji RS, Fayech C, Haddy N, Mansouri I, Journy N, Demoor C, Allard J, Thebault E, Surun A, Pacquement H, Pluchart C, Bondiau PY, Berchery D, Laprie A, Boussac M, Jackson A, Souchard V, Vu-Bezin G, Dufour C, Valteau-Couanet D, de Vathaire F, Fresneau B, Dumas A. Surveillance after childhood cancer: are survivors with an increased risk for cardiomyopathy regularly followed-up? Br J Cancer 2023; 129:1298-1305. [PMID: 37604931 PMCID: PMC10575933 DOI: 10.1038/s41416-023-02400-0] [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: 01/06/2023] [Revised: 07/13/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND We aimed to study adherence to cardiac screening in long-term childhood cancer survivors (CCS) at high risk of cardiomyopathy. METHODS This study involved 976 5-year CCS at high risk for cardiomyopathy from the French Childhood Cancer Survivor Study. Determinants of adherence to recommended surveillance were studied using multivariable logistic regression models. Association of attendance to a long-term follow-up (LTFU) visit with completion of an echocardiogram was estimated using a Cox regression model. RESULTS Among participants, 32% had an echocardiogram within the 5 previous years. Males (adjusted RR [aRR] 0.71, 95% CI 0.58-0.86), survivors aged 36-49 (aRR 0.79, 95% CI 0.64-0.98), Neuroblastoma (aRR 0.53, 95% CI 0.30-0.91) and CNS tumour survivors (aRR 0.43, 95% CI 0.21-0.89) were less likely to adhere to recommended surveillance. Attendance to an LTFU visit was associated with completion of an echocardiogram in patients who were not previously adherent to recommendations (HR 8.20, 95% CI 5.64-11.93). CONCLUSIONS The majority of long-term survivors at high risk of cardiomyopathy did not adhere to the recommended surveillance. Attendance to an LTFU visit greatly enhanced the completion of echocardiograms, but further interventions need to be developed to reach more survivors.
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Grants
- Institut National Du Cancer (French National Cancer Institute)
- This study was supported by the INCa/ARC foundation (CHART project). The FCCSS cohort is supported and funded by the French Society of Cancer in Children and adolescents (SFCE), the Gustave Roussy Foundation (Pediatric Program “Guérir le Cancer de l’Enfant”), the Foundation ARC (POPHarC program) and The French National Research Agency (ANR, HOPE-EPI project), the ‘Ligue Nationale Contre le Cancer’, and the ‘Programme Hospitalier de Recherche Clinique’.
- This work was supported by the INCa/ARC foundation (CHART project). The FCCSS cohort is supported and funded by the French Society of Cancer in Children and adolescents (SFCE), the Gustave Roussy Foundation (Paediatric Program “Guérir le Cancer de l’Enfant”), the Foundation ARC (POPHarC program) and The French National Research Agency (ANR, HOPE-EPI project), the ‘Ligue Nationale Contre le Cancer’, and the ‘Programme Hospitalier de Recherche Clinique’.
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Affiliation(s)
- Nicolas Bougas
- Université Paris Cité, Inserm, ECEVE UMR 1123, F-75010, Paris, France.
| | - Rodrigue S Allodji
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Department of Clinical Research, F-94805, Villejuif, France
| | - Chiraz Fayech
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Nadia Haddy
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Department of Clinical Research, F-94805, Villejuif, France
| | - Imene Mansouri
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Department of Clinical Research, F-94805, Villejuif, France
| | - Neige Journy
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Department of Clinical Research, F-94805, Villejuif, France
| | - Charlotte Demoor
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Julie Allard
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Eric Thebault
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
- Department of Tumor Pediatrics, Centre Oscar Lambret, 59000, Lille, France
| | - Aurore Surun
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Hélène Pacquement
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Claire Pluchart
- Institut de Cancérologie Jean Godinot, F-51100, Reims, France
| | | | - Delphine Berchery
- Department of Radiation Oncology, University Institute of Cancer Toulouse-Oncopôle, Toulouse, France
| | - Anne Laprie
- Department of Radiation Oncology, University Institute of Cancer Toulouse-Oncopôle, Toulouse, France
| | - Marjorie Boussac
- Santé publique France, the National Public Health Agency, Saint-Maurice, France
- French National Health Insurance (Cnam), Paris, France
| | - Angela Jackson
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Department of Clinical Research, F-94805, Villejuif, France
| | - Vincent Souchard
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Department of Clinical Research, F-94805, Villejuif, France
| | - Giao Vu-Bezin
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Department of Clinical Research, F-94805, Villejuif, France
| | - Christelle Dufour
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Dominique Valteau-Couanet
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Florent de Vathaire
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Department of Clinical Research, F-94805, Villejuif, France
| | - Brice Fresneau
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Agnès Dumas
- Université Paris Cité, Inserm, ECEVE UMR 1123, F-75010, Paris, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, F-94805, France
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5
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Chounta S, Lemler S, Haddy N, Fresneau B, Mansouri I, Bentriou M, Demoor-Goldschmidt C, Diallo I, Souchard V, Do TD, Veres C, Surun A, Doz F, Llanas D, Vu-Bezin G, Rubino C, de Vathaire F, Letort V, Allodji RS. The risk of valvular heart disease in the French Childhood Cancer Survivors' Study: Contribution of dose-volume histogram parameters. Radiother Oncol 2023; 180:109479. [PMID: 36657724 DOI: 10.1016/j.radonc.2023.109479] [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: 05/25/2022] [Revised: 11/17/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE Valvular Heart Disease (VHD) is a known complication of childhood cancer after radiotherapy treatment. However, the dose-volume-effect relationships have not been fully explored. MATERIALS AND METHODS We obtained individual heart Dose Volume Histograms (DVH) for survivors of the French Childhood Cancer Survivors Study (FCCSS) who had received radiotherapy. We calculated the Mean Dose to the Heart (MHD) in Gy, as well as the heart DVH parameters (Vd Gy, which represents the percentage of heart volume receiving at least d Gy), fixing the thresholds to 0.1 Gy, 5 Gy, 20 Gy, and 40 Gy. We analyzed them furtherly in the subpopulation of the cohort that was treated with a dose lower than 5 Gy (V0.1Gy|V5Gy=0%), 20 Gy (V5Gy|V20Gy=0%), and 40 Gy (V20Gy|V40Gy=0%), respectively. We investigated their role in the occurrence of a VHD in this population-based observational cohort study using the Cox proportional hazard model, adjusting for age at cancer diagnosis and chemotherapy exposure. RESULTS Median follow-up was 30.6 years. Eighty-one patients out of the 7462 (1 %) with complete data experienced a severe VHD (grade ≥ 3). The risk of VHD increased along with the MHD, and it was associated with high doses to the heart (V40Gy < 50 %, hazard ratio (HR) = 7.96, 95 % CI: 4.26-14.88 and V20Gy|V40Gy=0% >50 %, HR = 5.03, 95 % CI: [2.35-10.76]). Doses 5-20 Gy to more than 50 % (V5Gy|V20Gy=0% >50 %) of the heart induced a marginally non-significant estimated risk. We also observed a remarkable risk increase with attained age. CONCLUSIONS Our results provide new insight into the VHD risk that may impact current treatments and long-term follow-up of childhood cancer survivors.
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Affiliation(s)
- Stefania Chounta
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France; Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, 91190, Gif-sur-Yvette, France
| | - Sarah Lemler
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, 91190, Gif-sur-Yvette, France
| | - Nadia Haddy
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Brice Fresneau
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric oncology, Villejuif, F-94805, France
| | - Imene Mansouri
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France; EPI-PHARE Scientific Interest Group, Saint-Denis, France; French National Agency for the Safety of Medicines and Health Products (ANSM), Saint-Denis, France
| | - Mahmoud Bentriou
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, 91190, Gif-sur-Yvette, France
| | - Charlotte Demoor-Goldschmidt
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France; Chu de Nantes, Pediatric Oncology, 38 Bd Jean Monnet, Nantes 44093, France
| | - Ibrahima Diallo
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Paris, France; Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France
| | - Vincent Souchard
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Thi-Duyen Do
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Cristina Veres
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Paris, France; Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France
| | - Aurore Surun
- SIREDO Oncology Center (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France
| | - François Doz
- SIREDO Oncology Center (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France; Université Paris Cité, Paris, France
| | - Damien Llanas
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Giao Vu-Bezin
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Carole Rubino
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Florent de Vathaire
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Véronique Letort
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, 91190, Gif-sur-Yvette, France
| | - Rodrigue Setcheou Allodji
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, Villejuif, France; INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France; Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France; Polytechnic School of Abomey-Calavi (EPAC), University of Abomey-Calavi, 01 P.O. Box 2009, Cotonou, Benin.
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6
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Mansouri I, Schwartz B, Vu-Bezin G, Bejarano-Quisoboni D, Fresneau B, El-Fayech C, Dufour C, Bolle S, Surun A, Orbach D, Allodji RS, Diallo I, Demoor-Goldschmidt C, de Vathaire F, Haddy N. Risk of renal or urinary related hospitalisation in survivors of childhood cancer: Results from the French Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev 2023; 32:572-581. [PMID: 36692978 DOI: 10.1158/1055-9965.epi-22-0925] [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: 08/25/2022] [Revised: 10/21/2022] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Hospitalisation rates can be used as an indirect indicator of the burden and severity of adverse health outcomes in childhood cancer survivors. We aimed to determine the long-term risks of hospitalisation related to renal and urinary diseases. METHODS The French Childhood Cancer Survivor Study cohort was linked with data from the French National Healthcare System database, which enabled the identification of hospitalisations related to renal or urinary diseases. Clinical and detailed treatment data were collected from medical records. Dose-volume histograms were estimated for patients treated with radiotherapy. Relative Risks (RRs) were estimated using Poisson regression. RESULTS A total of 5498 survivors were followed for 42118 person-years. Survivors experience 2.9 times more renal hospitalisations than expected in the general population. Exposing more than 10% of the kidneys' volume to at least 20 Gray increases the risk of being hospitalised for renal causes by 2.2 (95%CI=1.3-3.6). Nephrectomised survivors treated with high doses of ifosfamide (>60g/m²) have an extremely high risk of hospitalisation for renal causes. In the case of hospitalisation for urinary causes, treatment by anthracycline administration was found to be associated with an almost 2-fold higher risk of hospitalisation compared to the general population. CONCLUSION These results support the need for careful monitoring of long-term renal diseases in survivors who have undergone nephrectomy, those treated with high doses of radiation (≥20Gy) even to small volumes of the kidneys, and those with predisposing risk factors. IMPACT This study provides new evidence with potential impact on surveillance guidelines related to dose-volume indicators associated with renal toxicity.
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Affiliation(s)
- Imene Mansouri
- INSERM / Gustave Roussy / Univ. Paris-Sud, Villejuif, France
| | - Boris Schwartz
- INSERM / Gustave Roussy / Univ. Paris-Sud, Villejuif, France
| | - Giao Vu-Bezin
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France., France
| | | | - Brice Fresneau
- Gustave Roussy / INSERM / Univ. Paris-Sud, Villejuif, France
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7
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Hoffmann C, Noël F, Grandclaudon M, Massenet-Regad L, Michea P, Sirven P, Faucheux L, Surun A, Lantz O, Bohec M, Ye J, Guo W, Rochefort J, Klijanienko J, Baulande S, Lecerf C, Kamal M, Tourneau CL, Guillot-Delost M, Soumelis V. Abstract 2105: PD-L1 high ICOSL low Secretory dendritic cells infiltrate human solid tumors. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2105] [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: Human conventional dendritic cells (cDC) are essential for the anti-tumor immune response. Their immunogenic and tolerogenic states in cancer remain controversial. Our objective was to define the range of DC activation states in vitro and to determine their relevance ex vivo in cancer.
Methods: First, in vitro, we activated healthy donor cDC with 16 different stimuli and measured cDC and T cells cytokine and chemokine secretion upon co-culture (n = 130 individual experiments) to define new maturation archetypes. Second, we established the relevance of these archetypes in cancer, ex vivo in human. We performed in depth analysis of cDC infiltrating head and neck cancer (HNSCC) by flow cytometry (n = 22 patients), transcriptomic analysis (n = 6 patients), and cDC-enriched single-cell transcriptomics (ScRNAseq) (n = 10503 cells from 2 patients). Then we performed a merged analysis of cDC from in house and public ScRNAseq datasets (n = 36 tumor samples from HNSCC, Lung, and Breast cancer, and, as comparator, n = 33 blood and juxtatumor samples, n = 19 healthy donor samples, and n = 23 samples from inflammatory diseases).
Results: In vitro, we identified two archetypes of cDC activation: (i) PD-L1highICOSLlow cDC that produce large amounts of inflammatory cytokines and chemokines, labeled Secretory cDC; (ii)PD-L1lowICOSLhigh cDC that induce a broad range of Th cytokines, labeled Helper cDC. This functional dichotomy of cDC was mutually exclusive and not receptor specific. In cancer, we identified Secretory cDC, and these cells aligned with mature LAMP3+cDC. Helper cDC were not found ex vivo. Secretory cDC simultaneously expressed stimulatory (CD40, TNFRSF9 (4-1BB)), inhibitory (CD274, CD200, IDO1), and mixed (PVR) checkpoints. Secretory cDC were associated with T cell inflammation in HNSCC, triple-negative breast cancer (TNBC), and melanoma (all p < 1.10-15), with improved overall survival in HNSCC and TNBC (all p < 0.01), and with response to checkpoint blockade in 2 melanoma cohorts (all p < 0.01).
Conclusion: We identify and characterize Secretory cDC in several solid cancers. This novel phenotypic and functional dichotomy of human cDC activation states has broad implications for all types of immunotherapies and provides rational for drug combinations.
Citation Format: Caroline Hoffmann, Floriane Noël, Maximilien Grandclaudon, Lucile Massenet-Regad, Paula Michea, Philemon Sirven, Lilith Faucheux, Aurore Surun, Olivier Lantz, Mylene Bohec, Jian Ye, Weihua Guo, Juliette Rochefort, Jerzy Klijanienko, Sylvain Baulande, Charlotte Lecerf, Maud Kamal, Christophe Le Tourneau, Maude Guillot-Delost, Vassili Soumelis. PD-L1 high ICOSL low Secretory dendritic cells infiltrate human solid tumors [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 2105.
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8
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Hoffmann C, Noel F, Grandclaudon M, Massenet-Regad L, Michea P, Sirven P, Faucheux L, Surun A, Lantz O, Bohec M, Ye J, Guo W, Rochefort J, Klijanienko J, Baulande S, Lecerf C, Kamal M, Le Tourneau C, Guillot-Delost M, Soumelis V. PD-L1 and ICOSL discriminate human Secretory and Helper dendritic cells in cancer, allergy and autoimmunity. Nat Commun 2022; 13:1983. [PMID: 35418195 PMCID: PMC9008048 DOI: 10.1038/s41467-022-29516-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/07/2022] [Indexed: 11/22/2022] Open
Abstract
Dendritic cells (DC) are traditionally classified according to their ontogeny and their ability to induce T cell response to antigens, however, the phenotypic and functional state of these cells in cancer does not necessarily align to the conventional categories. Here we show, by using 16 different stimuli in vitro that activated DCs in human blood are phenotypically and functionally dichotomous, and pure cultures of type 2 conventional dendritic cells acquire these states (termed Secretory and Helper) upon appropriate stimuli. PD-L1highICOSLlow Secretory DCs produce large amounts of inflammatory cytokines and chemokines but induce very low levels of T helper (Th) cytokines following co-culturing with T cells. Conversely, PD-L1lowICOSLhigh Helper DCs produce low levels of secreted factors but induce high levels and a broad range of Th cytokines. Secretory DCs bear a single-cell transcriptomic signature indicative of mature migratory LAMP3+ DCs associated with cancer and inflammation. Secretory DCs are linked to good prognosis in head and neck squamous cell carcinoma, and to response to checkpoint blockade in Melanoma. Hence, the functional dichotomy of DCs we describe has both fundamental and translational implications in inflammation and immunotherapy. Phenotypic and functional states of dendritic cells critically influence the outcome of cancer and inflammation. Authors here show by single cell transcriptomics and in vitro validation assays that dichotomous PD-L1 and ICOSL expression assign dendritic cells to secretory and helper functions, with respective predominance of inflammatory cytokine expression or T helper cytokine induction.
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Affiliation(s)
- Caroline Hoffmann
- Institut Curie, INSERM U932, Immunity and Cancer, Paris, France. .,Institut Curie, Department of Surgical Oncology, Paris & Saint-Cloud, France. .,Université Paris Sciences Lettres (PSL), Paris, France.
| | - Floriane Noel
- Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, 75010, Paris, France
| | - Maximilien Grandclaudon
- Institut Curie, INSERM U932, Immunity and Cancer, Paris, France.,Université Paris Sciences Lettres (PSL), Paris, France
| | - Lucile Massenet-Regad
- Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, 75010, Paris, France.,Université Paris-Saclay, Orsay, France
| | - Paula Michea
- Institut Paoli Calmette, INSERM U1068-CNRS UMR7258-AMU UM105, Marseille, France.,Université Aix-Marseille, Marseille, France
| | - Philemon Sirven
- Institut Curie, INSERM U932, Immunity and Cancer, Paris, France.,Université Paris Sciences Lettres (PSL), Paris, France
| | - Lilith Faucheux
- Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, 75010, Paris, France.,Statistic and Epidemiologic Research Center Sorbonne Paris Cité, INSERM UMR-1153, ECSTRRA team, Paris, France
| | - Aurore Surun
- Institut Curie, SIREDO Cancer Center, Paris, France
| | - Olivier Lantz
- Institut Curie, INSERM U932, Immunity and Cancer, Paris, France.,Université Paris Sciences Lettres (PSL), Paris, France.,CIC IGR-Curie 1428, Center of Clinical Investigation, Paris, France
| | - Mylene Bohec
- Université Paris Sciences Lettres (PSL), Paris, France.,Institut Curie, NGS platform, Paris, France
| | - Jian Ye
- City of Hope Comprehensive Cancer Center, Department of Immuno-Oncology, Duarte, CA, USA
| | - Weihua Guo
- City of Hope Comprehensive Cancer Center, Department of Immuno-Oncology, Duarte, CA, USA
| | - Juliette Rochefort
- Cimi Paris, INSERM U1135, and Hospital Pitié Salpêtrière, Odontology department, Université de Paris, Paris, France
| | - Jerzy Klijanienko
- Université Paris Sciences Lettres (PSL), Paris, France.,Institut Curie, Department of pathology, Paris, France
| | - Sylvain Baulande
- Université Paris Sciences Lettres (PSL), Paris, France.,Institut Curie, NGS platform, Paris, France
| | - Charlotte Lecerf
- Université Paris Sciences Lettres (PSL), Paris, France.,Institut Curie, Department of Drug Development, and Innovation (D3i), Paris & Saint-Cloud, France
| | - Maud Kamal
- Université Paris Sciences Lettres (PSL), Paris, France.,Institut Curie, Department of Drug Development, and Innovation (D3i), Paris & Saint-Cloud, France
| | - Christophe Le Tourneau
- Université Paris-Saclay, Orsay, France.,Institut Curie, Department of Drug Development, and Innovation (D3i), Paris & Saint-Cloud, France.,Institut Curie, INSERM U900, Saint-Cloud, France
| | - Maude Guillot-Delost
- Institut Curie, INSERM U932, Immunity and Cancer, Paris, France.,Université Paris Sciences Lettres (PSL), Paris, France.,CIC IGR-Curie 1428, Center of Clinical Investigation, Paris, France
| | - Vassili Soumelis
- Institut Curie, INSERM U932, Immunity and Cancer, Paris, France. .,Université Paris Sciences Lettres (PSL), Paris, France. .,Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, 75010, Paris, France. .,Institut Curie, Clinical immunology department, Paris, France. .,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, Laboratoire d'Immunologie, F-75010, Paris, France. .,Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, 75010, Paris, France.
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9
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Malterre A, Cohen-Gogo S, Kriegel I, d'Avout Fourdinier P, Bouleuc C, Lemelle L, Surun A, Cordero C, Pacquement H, Orbach D. Subcutaneous implantable pleural port catheter in the management of malignant pleural effusions in young patients with solid tumors: A new option in the armamentarium of symptomatic treatment. Pediatr Blood Cancer 2021; 68:e29109. [PMID: 34048136 DOI: 10.1002/pbc.29109] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 11/05/2022]
Abstract
The contribution of subcutaneous implantable pleural port catheter (SIPP) for malignant pleural effusions (MPE) management in young patients with cancer, in a palliative care setting is not well explored. This monocentric series analyzed 38 patients, median age 18 years (range 3-25) with significant pleural effusion. SIPP were considered efficient for eight of 12 evaluable patients (67%) and allowed MPE outpatient management in five cases. SIPPs are safe and efficient device to manage MPE patients with solid tumors, in the palliative care setting. This original tool could help health care providers for thoracic symptom management in alternative to iterative pleural punctures.
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Affiliation(s)
- Aline Malterre
- Institut Curie, SIREDO Oncology Center Care, PSL Research University, Paris, France
| | - Sarah Cohen-Gogo
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Irène Kriegel
- Department of Anesthesiology, Institut Curie, Paris, France
| | | | - Carole Bouleuc
- Inter-Disciplinary Supportive Care Department for the Oncology Patient, Institut Curie, Paris, France
| | - Lauriane Lemelle
- Institut Curie, SIREDO Oncology Center Care, PSL Research University, Paris, France
| | - Aurore Surun
- Institut Curie, SIREDO Oncology Center Care, PSL Research University, Paris, France
| | - Camille Cordero
- Institut Curie, SIREDO Oncology Center Care, PSL Research University, Paris, France
| | - Hélène Pacquement
- Institut Curie, SIREDO Oncology Center Care, PSL Research University, Paris, France
| | - Daniel Orbach
- Institut Curie, SIREDO Oncology Center Care, PSL Research University, Paris, France
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10
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Ben-Ami T, Kontny U, Surun A, Brecht IB, Almaraz RL, Dragomir M, Pourtsidis A, Casanova M, Fresneau B, Bisogno G, Schneider DT, Reguerre Y, Bien E, Stachowicz-Stencel T, Österlundh G, Wygoda M, Janssens GO, Zsiros J, Jehanno N, Brisse HJ, Gandola L, Christiansen H, Claude L, Ferrari A, Rodriguez-Galindo C, Orbach D. Nasopharyngeal carcinoma in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations. Pediatr Blood Cancer 2021; 68 Suppl 4:e29018. [PMID: 33844410 DOI: 10.1002/pbc.29018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/17/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 01/25/2023]
Abstract
Nasopharyngeal carcinoma (NPC) is a rare pediatric tumor. Collaborative studies performed over the last decades showed improved results compared to historical data, but standardized guidelines for diagnosis and management of pediatric NPC are still unavailable. This study presents a European consensus guideline for the diagnosis and treatment of pediatric NPC developed by the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT). Main recommendations include induction chemotherapy with cisplatin and 5-flurouracil, concomitant chemoradiotherapy in advanced disease, and to consider maintenance treatment with interferon beta (IFN-β) for selected high-risk patients. Dose adjustments of radiotherapy based on response to induction chemotherapy may decrease the rates of long-term treatment-related complications that affect most of the survivors.
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Affiliation(s)
- Tal Ben-Ami
- Pediatric Hematology-Oncology Unit, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Udo Kontny
- Division of Pediatric Hematology Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Aurore Surun
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Ines B Brecht
- Pediatric Hematology and Oncology, University Children's Hospital, Eberhard-Karls-Universitaet, Tuebingen, Germany
| | - Ricardo López Almaraz
- Pediatric Hematology and Oncology Unit, Hospital Universitario de Cruces, Barakaldo-Bizkaia, Spain
| | - Monica Dragomir
- Department of Pediatric Oncology, Oncology Institute "Prof. Dr. Al. Trestioreanu,", Bucharest, Romania
| | - Apostolos Pourtsidis
- Pediatric and Adolescents Oncology Clinic Children's Hospital MITERA, Athens, Greece
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Brice Fresneau
- Gustave Roussy, Department of Pediatric Oncology, Université Paris-Saclay, Villejuif, France.,Paris-Saclay University, Paris-Sud University, Paris, France
| | - Gianni Bisogno
- Hematology Oncology Division, Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | | | - Yves Reguerre
- Department of Pediatric Hematology and Oncology, Félix Guyon University Hospital, St. Denis, Réunion Island, France
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | | | - Gustaf Österlundh
- Department of Pediatric Hematology and Oncology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marc Wygoda
- Department of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Geert O Janssens
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - József Zsiros
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Nina Jehanno
- Department of Nuclear Medicine, Institut Curie, Paris, France
| | - Herve J Brisse
- Department of Radiology, Institut Curie, Paris University, Paris, France
| | - Lorenza Gandola
- Pediatric Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Hans Christiansen
- Department of Radiation Oncology, Hannover Medical School, Hanover, Germany
| | - Line Claude
- Department of Radiation Oncology, Léon Bérard Center, Lyon, France
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
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11
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Orbach D, Ferrari A, Schneider DT, Reguerre Y, Godzinski J, Bien E, Stachowicz-Stencel T, Surun A, Almaraz RL, Dragomir M, Jani D, Ami TB, Roganovic J, Brecht IB, Ladenstein R, Bisogno G. The European Paediatric Rare Tumours Network - European Registry (PARTNER) project for very rare tumors in children. Pediatr Blood Cancer 2021; 68 Suppl 4:e29072. [PMID: 33913610 DOI: 10.1002/pbc.29072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 02/10/2021] [Revised: 03/18/2021] [Accepted: 04/03/2021] [Indexed: 01/15/2023]
Abstract
The PARTNER project (Paediatric Rare Tumours Network - European Registry) was launched in 2016. PARTNER aims to create a European Registry dedicated to children and adolescents with very rare tumors (VRT). It links existing national registries and provides a registry for those countries in which a VRT registry has not yet been created. This consortium is composed of the various national cooperative groups and their respective member institutions. The strategic value of this project is based on the Europe-wide data collection concerning the treatment of VRTs. These data are provided to experts and constitute the basis for new clinical practice guidelines for use by ERN (European Reference Network) and non-ERN institutions. The proposed tasks and milestones will increase collaboration in the field of pediatric oncology among member states and will also facilitate the inclusion of low health expenditure average rate (LHEAR) countries in this process. In addition, this project creates a platform for VRTs that may represent a model on how to elaborate a comprehensive approach (case registration, international case consultation and treatment recommendations, and website to provide information for parents/patients) for rare diseases.
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Affiliation(s)
- Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - Yves Reguerre
- Pediatric Hematology-Oncology Department, Centre Hospitalier Universitaire, Saint Denis, Réunion Island, France
| | - Jan Godzinski
- Department of Pediatric Surgery, Marciniak Hospital, Wroclaw, Poland
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland
| | | | - Aurore Surun
- Pediatric Surgery, Department of Pediatrics, Padova University Hospital, Padua, Italy
| | | | - Monica Dragomir
- Pediatric Oncology Unit, Oncology Institute "Prof. Dr. Al. Trestioreanu", Bucharest, Romania
| | - Dragana Jani
- Department of Hematology and Oncology, University Children's Hospital, University of Belgrade, Belgrade, Serbia
| | - Tal Ben Ami
- Pediatric Hematology Unit, Kaplan Medical Center, Rehovot, Israel
| | - Jelena Roganovic
- Department of Pediatrics, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Ines B Brecht
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard-Karls-Universitaet Tuebingen, Tübingen, Germany
| | - Ruth Ladenstein
- Department for Studies and Statistics and Integrated Research, St. Anna Children's Hospital, Children's Cancer Research Institute, Vienna, Austria
| | - Gianni Bisogno
- Hematology-Oncology Division, Department of Women's and Children's Health, Padova University Hospital, Padua, Italy
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12
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Surun A, Schneider DT, Ferrari A, Stachowicz-Stencel T, Rascon J, Synakiewicz A, Agaimy A, Martinova K, Kachanov D, Roganovic J, Bien E, Bisogno G, Brecht IB, Kolb F, Thariat J, Moya-Plana A, Orbach D. Salivary gland carcinoma in children and adolescents: The EXPeRT/PARTNER diagnosis and treatment recommendations. Pediatr Blood Cancer 2021; 68 Suppl 4:e29058. [PMID: 34174160 DOI: 10.1002/pbc.29058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 01/13/2023]
Abstract
Salivary gland carcinomas (SGCs) are rare during childhood and adolescence. Consequently, no standardized recommendations for the diagnosis and therapeutic management of pediatric SGC are available, and pediatric oncologists and surgeons generally follow adult guidelines. Complete surgical resection with adequate margins constitutes the cornerstone of treatment. However, the indications and modalities of adjuvant therapy remain controversial and may be challenging in view of the potential long-term toxicities in the pediatric population. This paper presents the consensus recommendations for the diagnosis and treatment of children and adolescents with SGCs, established by the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) within the EU-funded PARTNER project (Paediatric Rare Tumours Network - European Registry).
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Affiliation(s)
- Aurore Surun
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | | | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Jelena Rascon
- Center for Pediatric Oncology and Hematology, Vilnius University Hospital, Vilnius, Lithuania
| | - Anna Synakiewicz
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Kata Martinova
- Department of Hematology and Oncology, University Clinic for Children's Diseases, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Denis Kachanov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Jelena Roganovic
- Department of Pediatrics, Clinical Hospital Center, Rijeka, Croatia
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Gianni Bisogno
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padua, Italy
| | - Ines B Brecht
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard-Karls-Universitaet Tuebingen, Tübingen, Germany
| | - Frédéric Kolb
- Department of Surgery, Division of Plastic Surgery, University of California, San Diego, California, USA
| | - Juliette Thariat
- Radiation Oncology Department, Baclesse Cancer Center, Caen, France
| | - Antoine Moya-Plana
- Head and Neck Surgery Department, Gustave-Roussy Cancer Campus, Villejuif, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
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13
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Virgone C, Roganovic J, Vorwerk P, Redlich A, Schneider DT, Janic D, Bien E, López-Almaraz R, Godzinski J, Osterlundh G, Stachowicz-Stencel T, Brugières L, Brecht IB, Thomas-Teinturier C, Fresneau B, Surun A, Ferrari A, Bisogno G, Orbach D. Adrenocortical tumours in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations. Pediatr Blood Cancer 2021; 68 Suppl 4:e29025. [PMID: 34174161 DOI: 10.1002/pbc.29025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/09/2021] [Revised: 03/02/2021] [Accepted: 03/07/2021] [Indexed: 11/12/2022]
Abstract
Adrenocortical tumours (ACTs) are rare during childhood. A complete surgical resection provides the best chance of cure, but the role and efficacy of the adjuvant therapy are still controversial. Various histologic criteria of malignancy for ACTs adopted in children do not facilitate comparative studies and are not completely shared. Therefore, a sharp demarcation between benign and malignant lesions has not been recognised, making it difficult to identify who potentially needs perioperative therapy. This manuscript presents the internationally harmonised recommendations for the diagnosis and treatment of ACTs in children and adolescents, established by the European Cooperative Study Group for Paediatric Rare Tumours (EXPeRT) group within the EU-funded project PARTNER (Paediatric Rare Tumours Network - European Registry).
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Affiliation(s)
- Calogero Virgone
- Pediatric Surgery, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy
| | - Jelena Roganovic
- Department of Pediatrics, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Peter Vorwerk
- Pediatric Oncology Department, Otto von Guericke University Children´s Hospital, Magdeburg, Germany
| | - Antje Redlich
- Pediatric Oncology Department, Otto von Guericke University Children´s Hospital, Magdeburg, Germany
| | | | - Dragana Janic
- Department of Hematology and Oncology, University Children's Hospital, University of Belgrade, Belgrade, Serbia
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland
| | - Ricardo López-Almaraz
- Pediatric Hematology and Oncology Unit, Hospital Universitario de Cruces, Barakaldo-Bizkaia, Spain
| | - Jan Godzinski
- Department of Pediatric Surgery, Marciniak Hospital, Wroclaw, Poland.,Department of Pediatric Traumatology and Emergency Medicine, Medical University, Wroclaw, Poland
| | - Gustaf Osterlundh
- Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden
| | | | - Laurence Brugières
- Gustave Roussy Cancer Center, Department of Children and Adolescents Oncology, Paris-Saclay University, Villejuif, France
| | - Ines B Brecht
- Pediatric Oncology and Hematology, University Children's Hospital, Tuebingen, Germany
| | - Cécile Thomas-Teinturier
- Assistance Publique Hôpitaux de Paris (APHP), Department of Endocrinology and Diabetes for Children, Bicêtre Paris-Sud, Le Kremlin Bicêtre, Paris, France
| | - Brice Fresneau
- Gustave Roussy Cancer Center, Department of Children and Adolescents Oncology, Paris-Saclay University, Villejuif, France.,Paris-Saclay University, Paris-Sud University, Paris, France
| | - Aurore Surun
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Gianni Bisogno
- Hematology-Oncology Division, Department of Women's and Children's Health, University Hospital, Padua, Italy
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
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14
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Surun A, Varlet P, Brugières L, Lacour B, Faure-Conter C, Leblond P, Bertozzi-Salomon AI, Berger C, André N, Sariban E, Raimbault S, Prieur F, Desseigne F, Zattara H, Guimbaud R, Polivka M, Delisle MB, Vasiljevic A, Maurage CA, Figarella-Branger D, Coulet F, Guerrini-Rousseau L, Alapetite C, Dufour C, Colas C, Doz F, Bourdeaut F. Medulloblastomas associated with an APC germline pathogenic variant share the good prognosis of CTNNB1-mutated medulloblastomas. Neuro Oncol 2021; 22:128-138. [PMID: 31504825 DOI: 10.1093/neuonc/noz154] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Medulloblastomas may occur in a predisposition context, including familial adenomatosis polyposis. Medulloblastomas related to a germline pathogenic variant of adenomatous polyposis coli (APC) remain rare and poorly described. Their similarities with sporadic WNT medulloblastomas still require description. METHODS We performed a multicentric retrospective review of 12 patients treated between 1988 and 2018 for medulloblastoma with an identified or highly suspected (personal or familial history) APC germline pathogenic variant. We report personal and familial history APC gene pathogenic variants whenever available: clinical and histologic characteristics of the medulloblastoma, treatments, and long-term outcome, including second tumor and late sequelae. RESULTS Medulloblastomas associated with APC pathogenic variants are mainly classic (11/11 patients, 1 not available), nonmetastatic (10/12 patients) medulloblastomas, with nuclear immunoreactivity for ß-catenin (9/9 tested cases). Ten of 11 assessable patients are disease free with a median follow-up of 10.7 years (range, 1-28 y). Secondary tumors included desmoid tumors in 7 patients (9 tumors), 1 thyroid carcinoma, 2 pilomatricomas, 1 osteoma, 1 vertebral hemangioma, and 1 malignant triton in the radiation field, which caused the only cancer-related death in our series. CONCLUSIONS Medulloblastomas associated with an APC pathogenic variant have an overall favorable outcome, even for metastatic tumors. Yet, long-term survival is clouded by second tumor occurrence; treatment may play some role in some of these second malignancies. Our findings raise the question of applying a de-escalation therapeutic protocol to treat patients with APC germline pathogenic variants given the excellent outcome, and reduced intensity of craniospinal irradiation may be further evaluated.
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Affiliation(s)
- Aurore Surun
- Curie Institute, SIREDO Cancer Center (Care, Innovation and Research in Pediatric, Adolescents, and Young Adults Oncology), Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Pascale Varlet
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Sainte Anne Hospital, Department of Neuropathology, Paris, France
| | - Laurence Brugières
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Paris-Saclay University, Villejuif, France
| | - Brigitte Lacour
- CRESS Equipe 7 UMRS 1153, INSERM, Paris Descartes University, Paris, and National Registry of Solid Tumors, Nancy University Hospital, Vandoeuvre-les-Nancy, France
| | - Cécile Faure-Conter
- Centre Leon Berard, Pediatric Hemato-oncology Institute (IHOP), Lyon, France
| | - Pierre Leblond
- Centre Oscar Lambret, Pediatric Oncology Department, Lille, France
| | | | - Claire Berger
- Saint-Etienne University Hospital, Pediatric Hemato-oncology Department, Saint-Etienne, France
| | - Nicolas André
- Aix Marseille University, La Timone, Pediatric Hemato-oncology Department, AP-HM, Marseille, France
| | - Eric Sariban
- Hôpital des Enfants, Unité Cancer, Bruxelles, Belgique
| | - Sandra Raimbault
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Paris-Saclay University, Villejuif, France
| | - Fabienne Prieur
- Saint-Etienne University Hospital, Genetic Department, Saint-Etienne, France
| | | | - Hélène Zattara
- Marseille University, La Timone, Genetic Department, Marseille, France
| | - Rosine Guimbaud
- Centre Claudius Regaud, Oncogenetic Department, Toulouse, France
| | - Marc Polivka
- University Hospital Lariboisière, Department of Pathology, Paris, France
| | | | | | | | | | - Florence Coulet
- Pitié Salpêtrière hospital, Genetic Department, Paris, France
| | - Léa Guerrini-Rousseau
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Paris-Saclay University, Villejuif, France
| | - Claire Alapetite
- Curie Institute, Department of Radiation Oncology, Paris, France
| | - Christelle Dufour
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Paris-Saclay University, Villejuif, France
| | | | - François Doz
- Curie Institute, SIREDO Cancer Center (Care, Innovation and Research in Pediatric, Adolescents, and Young Adults Oncology), Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Franck Bourdeaut
- Curie Institute, SIREDO Cancer Center (Care, Innovation and Research in Pediatric, Adolescents, and Young Adults Oncology), Paris, France
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15
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Hoffmann C, Vacher S, Sirven P, Lecerf C, Massenet L, Moreira A, Surun A, Schnitzler A, Klijanienko J, Mariani O, Jeannot E, Badois N, Lesnik M, Choussy O, Le Tourneau C, Guillot-Delost M, Kamal M, Bieche I, Soumelis V. MMP2 as an independent prognostic stratifier in oral cavity cancers. Oncoimmunology 2020; 9:1754094. [PMID: 32934875 PMCID: PMC7466851 DOI: 10.1080/2162402x.2020.1754094] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 03/25/2020] [Indexed: 12/16/2022] Open
Abstract
Background Around 25% of oral cavity squamous cell carcinoma (OCSCC) are not controlled by the standard of care, but there is currently no validated biomarker to identify those patients. Our objective was to determine a robust biomarker for severe OCSCC, using a biology-driven strategy. Patients and methods Tumor and juxtatumor secretome were analyzed in a prospective discovery cohort of 37 OCSCC treated by primary surgery. Independent biomarker validation was performed by RTqPCR in a retrospective cohort of 145 patients with similar clinical features. An 18-gene signature (18 G) predictive of the response to PD-1 blockade was evaluated in the same cohort. Results Among 29 deregulated molecules identified in a secretome analysis, including chemokines, cytokines, growth factors, and molecules related to tumor growth and tissue remodeling, only soluble MMP2 was a prognostic biomarker. In our validation cohort, high levels of MMP2 and CD276, and low levels of CXCL10 and STAT1 mRNA were associated with poor prognosis in univariate analysis (Kaplan-Meier). MMP2 (p = .001) and extra-nodal extension (ENE) (p = .006) were independent biomarkers of disease-specific survival (DSS) in multivariate analysis and defined prognostic groups with 5-year DSS ranging from 36% (MMP2highENE+) to 88% (MMP2lowENE-). The expression of 18 G was similar in the different prognostic groups, suggesting comparable responsiveness to anti-PD-1. Conclusion High levels of MMP2 were an independent and validated prognostic biomarker, surpassing other molecules of a large panel of the tumor and immune-related processes, which may be used to select poor prognosis patients for intensified neoadjuvant or adjuvant regimens.
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Affiliation(s)
- Caroline Hoffmann
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Sophie Vacher
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Genetics, Institut Curie, Paris, France
| | - Philémon Sirven
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
| | - Charlotte Lecerf
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
| | - Lucile Massenet
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
| | - Aurélie Moreira
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
| | - Aurore Surun
- SIREDO Cancer Center (Care, Innovation and Research in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France
- Paris Descartes University, Paris, France
| | - Anne Schnitzler
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Genetics, Institut Curie, Paris, France
| | - Jerzy Klijanienko
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Pathology, Institut Curie, Paris, France
| | - Odette Mariani
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Pathology, Institut Curie, Paris, France
- Biological Resources Center, Institut Curie, Paris, France
| | - Emmanuelle Jeannot
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Pathology, Institut Curie, Paris, France
| | - Nathalie Badois
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Maria Lesnik
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Olivier Choussy
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Christophe Le Tourneau
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
- INSERM U900 Research Unit, Saint-Cloud, France
| | - Maude Guillot-Delost
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
- Center of Clinical Investigation, CIC IGR-Curie, Paris, France
| | - Maud Kamal
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
| | - Ivan Bieche
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Genetics, Institut Curie, Paris, France
- Faculty of Pharmaceutical and Biological Sciences, INSERM U1016 Research Unit, Paris Descartes University, Paris, France
| | - Vassili Soumelis
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
- Clinical Immunology Department, Institut Curie, Paris, France
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16
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Hoffmann C, Surun A, Noel F, Michea P, Grandclaudon M, Faucheux L, Sirven P, Klijanienko J, Badois N, Lesnik M, Choussy O, Kamal M, Lecerf C, Le Tourneau C, Guillot-Delost M, Soumelis V. Use of PD-L1 and ICOSL to discriminate innate and adaptive dendritic cells in the head and neck cancer microenvironment. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14184] [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
e14184 Background: Inflamed head and neck squamous cell carcinomas (HNSCC), have a better prognosis independently of the treatment modalities, and have an increased response rate to PD(L)1 blockade. Dendritic cells (DC) infiltration is associated to T cell infiltration and DC are critical in the immune response to cancer, but little is known on HNSCC infiltrating DC. The objectives were to determine the differences between DC infiltrating inflamed vs non inflamed tumors, to understand which mechanisms modulate DC phenotypes and which are the associated functions. Methods: 22 untreated HNSCC were characterized by flow cytometry for their immune infiltrate. RNA sequencing of sorted tumor infiltrating myeloid subsets and blood DC were analyzed for differentially expressed genes. The TMod database (Grandclaudon et al.), testing the effect of various stimuli on DC and subsequently on co-cultured T cells, was used to decipher DC and T cell modulation. Results: The level of CD3 infiltration was positively associated to the level of DC infiltration and PDL1 expression on myeloid cells, and negatively to the level neutrophils and of ICOSL expression on myeloid cells. PDL1high ICOSLneg DC from inflamed tumors were matched with the “innate DC” phenotype described in vitro, highly efficient at secreting cytokines and chemokines but poorly activating naïve CD4 T cells. DC from non-inflamed tumor resembled immature medium DC. A third type of DC, “adaptive DC”, expressing high levels of ICOSL and low of PDL1, poorly efficient at cytokine and chemokine secretion, but highly efficient at activating T cells is was described in vitro, but not found in tumors. RNAseq analysis confirmed this innate polarization and highlighted that those cells present a mature and NFkB activated phenotype. Conclusions: Inflamed HNSCC contain stimuli able to induce the recruitment and the differentiation of DC into mature, NFkB activated “innate” DC, highly efficient at secreting cytokines and chemokines but poorly activating naïve CD4 T cells. These data partly explain the superiority of CPS over TPS for the prediction of response to PD(L)1 blockade. More importantly, the stimuli identified here may be used as adjuvants to induce this DC « innate » maturation in non-inflamed tumors, but should only be used in combination with anti-PD(L)1 immunotherapy.
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Affiliation(s)
| | - Aurore Surun
- SIREDO Oncology Center, Institut Curie, Paris, France
| | | | | | | | | | | | | | | | | | | | | | - Charlotte Lecerf
- Department of Drug Development and Innovation, Institut Curie, Paris, France
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17
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Carceller F, Bautista F, Castañeda A, Surun A, Wasti A, Revon-Riviere G, Cortes M, Bergamaschi L, Juan Ribelles A, Millen G, Campbell Hewson Q, Amoroso L, Van der Lugt J, Fagioli F, Zwaan M, Marshall LV, Vassal G, Pearson ADJ, Geoerger B, Moreno L. Mortality and survival rates in children and adolescents enrolled in early phase trials with a dose-finding/dose-confirmation component: An innovative therapies for children with cancer (ITCC) study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e21509] [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
e21509 Background: Participation of children with advanced solid cancers in phase I trials raises ethical and logistic dilemmas. Life-expectancy beyond 8-12 weeks is a common inclusion criterion, but it can be difficult to gauge. This multicentric European study assessed the mortality and survival rates in pediatric phase I trials. Methods: Retrospective study of patients aged < 18 years with solid tumors enrolled in phase I trials in ITCC centres between 2015-2017. Outcome variables were described and prognostic factors analysed. Results: 256 patients across 12 centres in 5 countries were eligible. Median age 11.8 years (range, 0.5-17.9). Female:Male ratio 1:1.9. Tumor location: central nervous system (CNS) 66% vs extra-CNS 34%. Main diagnoses: 22% soft tissue sarcomas, 13% high grade gliomas, 11% osteosarcomas. Most frequent therapy: single targeted agent (63%). Ten cases (4%) were not evaluable for response and 128 (50%) had progressive disease at first evaluation. Best responses were complete in 12 cases (5%), partial in 29 (11%) and stable disease in 77 (30%). Median follow-up 7 months (range, 0.5-42.4). Median Time On Study (TOS) 2.1 months (range, 0.2-38.1). The 30 and 90-day mortality on trial were 3% (8/256) and 21% (54/256), respectively. The 90-day survival (95%CI) for patients with CNS vs extra-CNS tumors was 88% (78-93) vs 76% (68-82), respectively. One-year Overall Survival (95%CI) for the whole sample was 40% (33-46). No toxic deaths on trial were reported. Twenty-five cases (10%) survived ≥365 days on trial. Median TOS 21.5 months (range, 12.3-38.1). Compared to patients who died within 365 days from Cycle1-Day1, those on trial ≥365 days had lower rates of metastatic disease (74% vs 28%, respectively, p < 0.001), higher objective response rates (13% vs 44%, respectively, p < 0.001) and higher disease stabilization (27% vs 56%, respectively, p < 0.001). Conclusions: Currently few patients die within the first cycle of treatment. However a fifth of all patients died within 3 months from trial initiation. Patients with CNS tumors have comparable survival rates to those with extra-CNS and should not be excluded from phase I trials solely because of their diagnosis. The survival rates beyond one year remain modest.
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Affiliation(s)
| | | | | | - Aurore Surun
- SIREDO Oncology Center, Institut Curie, Paris, France
| | - Ajla Wasti
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Gabriel Revon-Riviere
- Paediatric Hematology-Oncology Unit, Hôpital d’Enfants de la Timone, Marseille, France
| | | | | | | | - Gerard Millen
- Department of Paediatric Oncology, Birmingham Children’s Hospital, Birmingham, United Kingdom
| | - Quentin Campbell Hewson
- The Great North Children's Hospital, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom
| | | | | | | | | | | | | | - Andrew DJ Pearson
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | | | - Lucas Moreno
- Hospital Universitario Niño Jesús, Madrid, Spain
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18
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Surun A, Brugières L, Guerrini-Rousseau L, Varlet P, Lacour B, Faure-Conter C, Leblond P, Bertozzi-Salomon AI, Berger C, Andre N, Sariban E, Prieur F, Desseigne F, Zattara-Cannoni H, Polivka M, Delisle MB, Vasiljevic A, Colas C, Doz F, Bourdeaut F. MBCL-38. MEDULLOBLASTOMAS ASSOCIATED WITH APC GERMLINE MUTATION: A MULTICENTRIC FRENCH AND BELGIAN REVIEW. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.434] [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: 11/12/2022] Open
Affiliation(s)
| | | | | | | | - Brigitte Lacour
- French National Childhood Solid Cancer Registry, CHU Nancy, Nancy, France
| | | | | | | | | | | | - Eric Sariban
- Université Libre de Bruxelles, Bruxelles, Belgium
| | | | | | | | | | | | | | | | - François Doz
- Institut Curie, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Franck Bourdeaut
- Institut Curie, Paris, France
- INSERM U830, Translational Research in Pediatric Oncology Team, Paris, France
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19
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Surun A, Dujaric MÉ, Aerts I, Orbach D, Jiménez I, Pacquement H, Schleiermacher G, Bourdeaut F, Michon J, Dupont JCK, Doz F. Enrollment in early-phase clinical trials in pediatric oncology: The experience at Institut Curie. Pediatr Blood Cancer 2018; 65:e26916. [PMID: 29334194 DOI: 10.1002/pbc.26916] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 10/28/2017] [Accepted: 11/06/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND The European Paediatric Regulation was introduced in 2007 to facilitate access to new medicines for children. Our study explored accessibility of early-phase trials in pediatric oncology, in line with the European Paediatric Regulation, to identify the reasons for not inviting patients to participate, parents' refusal, or inclusion failure. PROCEDURE We conducted a retrospective chart review at Institut Curie, Paris, for all pediatric patients whose cancer progressed despite known effective treatments between July 2010 and December 2013. RESULTS Out of 100 patients in the palliative phase, 52 received one or more invitations to participate in early-phase trials. Twenty parents declined the invitation, mainly prioritizing quality of life or fearing constraints. Fourteen inclusions failed despite parental approval, mostly due to rapid clinical deterioration. Five patients received no invitations because no early-phase trials were available. Major reasons for noninclusion in the 43 remaining patients were presence of exclusion criteria or other physical factors, preference for conventional treatment, constraints, psychological factors, and follow-up in another hospital after moving. CONCLUSIONS The Paediatric Regulation has led to increased availability of early-phase trials. Better timing of the proposal, designing less constraining early-phase trials, reducing waiting lists, and improving information for parents and children would facilitate pediatric access to new medicines.
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Affiliation(s)
- Aurore Surun
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France
| | | | - Isabelle Aerts
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France
| | - Daniel Orbach
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France
| | - Irène Jiménez
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France
| | - Hélène Pacquement
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France
| | - Gudrun Schleiermacher
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France.,INSERM U830, Translational Research in Pediatric Oncology Team, Institut Curie Research Center, Paris, France
| | - Franck Bourdeaut
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France.,INSERM U830, Translational Research in Pediatric Oncology Team, Institut Curie Research Center, Paris, France
| | - Jean Michon
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France
| | - Jean-Claude K Dupont
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France.,Hospinnomics, Paris School of Economics, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Doz
- Department of Pediatric Oncology, Oncology Center SIREDO (Care, Innovation, Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France.,Pediatrics, University Paris Descartes, Sorbonne Paris Cité, Paris, France
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20
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Gaudichon J, Toscani S, Cohen-Gogo S, Saulpic J, Surun A, Sakiroglu O, Doz F, Michon J, Orbach D. Care management for foreign children, adolescents, young adults with cancer, and their families. Pediatr Blood Cancer 2017; 64. [PMID: 27905679 DOI: 10.1002/pbc.26336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/28/2016] [Accepted: 10/10/2016] [Indexed: 11/05/2022]
Abstract
BACKGROUND Little is known about care management for foreign patients in pediatric oncology in European centers. We aimed to describe care given to children, adolescents, and young adults who came to France for cancer treatment, and to determine whether their geographical origin had an influence on decision making. PROCEDURE We conducted a monocentric retrospective study on all foreign patients aged 0-25 years and hospitalized for at least one night in Institut Curie (Paris, France) from 2009 to 2013. We analyzed the potential advantages of receiving treatment in France as well as their social and familial consequences. RESULTS A total of 93 foreign patients' files were retrieved. Most of these patients came from Africa (70%). In accord with the specific expertise of the institution, retinoblastoma was the most frequent tumor type (39%). An antitumor treatment had already been administrated in the native country in 44% of patients. We considered that 66% of patients received a significant medical advantage from care in our institution. The treatment provided in France was considered impossible in the native country in 44% of cases. The social and familial impact on the patients' families was high (59%). Almost all patients (96%) received the treatment that would have been proposed to their French counterparts. CONCLUSIONS There were notable medical advantages for foreign patients who come to France for their oncologic treatment despite important familial consequences. Patients' geographical origin did not have an influence on medical decisions.
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Affiliation(s)
- Jérémie Gaudichon
- Institute of Genetics and Development of Rennes, University of Rennes 1, Rennes, France.,Pediatric Onco-Immuno-Hematology, University Hospital of Caen, Caen, France.,Pediatric, Adolescent, Young Adult Department, Institut Curie, Paris, France
| | - Sandra Toscani
- Pediatric, Adolescent, Young Adult Department, Institut Curie, Paris, France
| | - Sarah Cohen-Gogo
- Pediatric, Adolescent, Young Adult Department, Institut Curie, Paris, France
| | - Juliette Saulpic
- Pediatric Onco-Hematology Follow-Up Care Department, Edouard Rist Medical and Educational Clinic, Paris, France
| | - Aurore Surun
- Pediatric, Adolescent, Young Adult Department, Institut Curie, Paris, France
| | - Oya Sakiroglu
- Pediatric Onco-Hematology Department, Margency Children Hospital, Margency, France
| | - François Doz
- Pediatric, Adolescent, Young Adult Department, Institut Curie, Paris, France
| | - Jean Michon
- Pediatric, Adolescent, Young Adult Department, Institut Curie, Paris, France
| | - Daniel Orbach
- Pediatric, Adolescent, Young Adult Department, Institut Curie, Paris, France
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