1
|
Troudi A, Tensaouti F, Cabarrou B, Arribarat G, Pollidoro L, Péran P, Sevely A, Roques M, Chaix Y, Bertozzi AI, Gambart M, Ducassou A, Baudou E, Laprie A. A Prospective Study of Arterial Spin Labelling in Paediatric Posterior Fossa Tumour Survivors: A Correlation with Neurocognitive Impairment. Clin Oncol (R Coll Radiol) 2024; 36:56-64. [PMID: 37805352 DOI: 10.1016/j.clon.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023]
Abstract
AIMS Posterior fossa tumours (PFTs), which account for two-thirds of paediatric brain tumours, are successfully treated in about 70% of patients, but most survivors experience long-term cognitive impairment. We evaluated arterial spin labelling (ASL), a common, non-invasive magnetic resonance imaging (MRI) technique, as a biomarker of cognitive impairment in a paediatric PFT survivor population. MATERIALS AND METHODS Sixty participants were prospectively analysed. PFT survivors were at least 5 years post-treatment and had been treated as appropriate for their age and type of tumour. Group 1 had received radiotherapy and Group 2 had not. Group 3 were healthy controls matched to Group 1 for age, sex and handedness. All participants underwent cognitive assessment and multimodal MRI, including an ASL perfusion sequence. We used semi-quantitative ASL methods to assess differences in mean perfusion in the thalamus, caudate, putamen and hippocampus. RESULTS Statistically, no significant associations between cognitive data and radiation doses were identified. Compared with healthy controls, Group 1 patients had significantly lower overall mean perfusion values (20-30% lower, depending on the cerebral structure) and Group 2 had slightly lower mean perfusion values (5-10% lower). Perfusion values did not correlate with total prescribed irradiation doses nor with doses received by different cerebral structures. Episodic and semantic memory test scores were significantly lower in Group 1 and correlated with lower mean absolute perfusion values in the hippocampus (P < 0.04). CONCLUSIONS These preliminary results indicate that radiotherapy affects the perfusion of specific cerebral structures and identify perfusion as a potential biomarker of hippocampus-dependent memory deficit.
Collapse
Affiliation(s)
- A Troudi
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - F Tensaouti
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France.
| | - B Cabarrou
- Biostatistics & Health Data Science Unit, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, Toulouse, France
| | - G Arribarat
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - L Pollidoro
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Radiology Department, Toulouse University Hospital, Toulouse, France
| | - P Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - A Sevely
- Radiology Department, Toulouse University Hospital, Toulouse, France
| | - M Roques
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Radiology Department, Toulouse University Hospital, Toulouse, France
| | - Y Chaix
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - A-I Bertozzi
- Pediatric Oncology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - M Gambart
- Pediatric Oncology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - A Ducassou
- Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - E Baudou
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - A Laprie
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Radiation Oncology Department, Institut Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| |
Collapse
|
2
|
Glemarec G, Lacaze J, Cabarrou B, Aziza R, Jouve E, Zerdoud S, De Maio E, Massabeau C, Loo M, Esteyrie V, Ung M, Dalenc F, Izar F, Chira C. PD-0749 Systemic treatment and ablative therapies in oligometastatic breast cancer: a single center analysis. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
3
|
Lamy T, Cabarrou B, Planchard D, Quantin X, Schneider S, Bringuier M, Robain M, Besse B, Simon G, Baldini C. Molecular testing in older patients treated for an advanced or metastatic nonsquamous non-small-cell lung cancer. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00328-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
4
|
Chollet C, Malloizel-Delaunay J, Cabarrou B, Chantalat E, Leray H, Garmy-Susini B, Yannoutsos A, Chaput B, Vaysse C. Liposuction-assisted brachioplasty in breast cancer-related lymphedema: Impact on volume reduction and quality of life. J Plast Reconstr Aesthet Surg 2021; 74:1633-1701. [DOI: 10.1016/j.bjps.2020.11.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/30/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
|
5
|
Branco B, Bories P, Ysebaert L, Laurent C, Cabarrou B, Botin, Leveneur Y, Ghenim L, Gaspard M, Hess N, Vaillant W, Carreiro M, Oberic L. REAL WORLD OUTCOME IN MANTLE CELL LYMPHOMA: A FRENCH RETROSPECTIVE STUDY IN ELDERLY PATIENTS BETWEEN 2005 AND 2018. Hematol Oncol 2021. [DOI: 10.1002/hon.30_2881] [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: 11/11/2022]
Affiliation(s)
- B Branco
- IUCT‐Oncopole, Haematology Toulouse France
| | - P Bories
- IUCT‐Oncopole, Haematology Toulouse France
| | - L Ysebaert
- IUCT‐Oncopole, Haematology Toulouse France
| | - C Laurent
- IUCT‐Oncopole, Pathology Toulouse France
| | - B Cabarrou
- IUCT‐Oncopole, Biostatistics Toulouse France
| | - Botin
- Centre Hospitalier Intercommunal Castres‐Mazamet, Haematology Castres France
| | - Y Leveneur
- Centre Hospitalier de Bigorre, Internal Medicine Tarbes France
| | - L Ghenim
- Centre Hospitalier de Rodez, Oncology Rodez France
| | | | - N Hess
- Clinique du Pont de Chaume, Oncology Montauban France
| | - W Vaillant
- Centre Hospitalier de Auch, Haematology Auch France
| | - M Carreiro
- Centre Hospitalier de Montauban, Oncology Montauban France
| | - L Oberic
- IUCT‐Oncopole, Haematology Toulouse France
| |
Collapse
|
6
|
Tostivint V, Verhoest G, Cabarrou B, Gas J, Coloby P, Zgheib J, Thoulouzan M, Soulié M, Gamé X, Beauval JB, Pons-Tostivint E, Roumiguié M. Quality of life and functional outcomes after radical cystectomy with ileal orthotopic neobladder replacement for bladder cancer: a multicentre observational study. World J Urol 2020; 39:2525-2530. [PMID: 33067727 DOI: 10.1007/s00345-020-03484-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Ileal orthotopic neobladder (IONB) reconstruction is the preferred urinary diversion among selected patients who have undergone radical cystectomy (RC) for bladder cancer (BCa). There is insufficient data regarding patients' quality of life (QoL), sexual and urinary outcomes. Our objectives were to assess QoL in a multicentre cohort study, and to identify related clinical, oncological and functional factors. METHODS Patients who underwent RC with IONB reconstruction for BCa from 2010 to 2017 at one of the three French hospitals completed the following self-reported questionnaires: European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer specific instruments (QLQ-BLM30). To assess urinary symptoms, patients completed the Urinary Symptom Profile questionnaire (USP) and a three-day voiding diary. Univariate and multivariate analyses were computed to identify clinical, pathological, and functional predictors of global QoL score. RESULTS Seventy-three patients completed questionnaires. The median age was 64 years and 86.3% were men. The median interval between surgery and responses to questionnaires was 36 months (range 12-96). Fifty-five percent of patients presented a high global QoL (EORTC-QLQC30, median score 75). A pre-RC American Society of Anesthesiologists score > 2, active neoplasia, sexual inactivity, and stress urinary incontinence were associated with a worse QoL. After a multivariate analysis, sexual inactivity was the only independent factor related to an altered QoL. CONCLUSION Patients with IONB reconstruction after RC have a high global QoL. Sexual activity could independently impact the global QoL, and it should be assessed pre- and post-operatively by urologists.
Collapse
Affiliation(s)
- V Tostivint
- Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France.
| | - G Verhoest
- Department of Urology, University Hospital, Rennes, France
| | - B Cabarrou
- Department of Biostatistics, Claudius Regaud Institute, Toulouse University Cancer Institute-Oncopole, Toulouse, France
| | - J Gas
- Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France
- Department of Urology, René Dubos Hospital, Pontoise, France
| | - P Coloby
- Department of Urology, René Dubos Hospital, Pontoise, France
| | - J Zgheib
- Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France
| | - M Thoulouzan
- Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France
| | - M Soulié
- Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France
| | - X Gamé
- Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France
| | - J B Beauval
- Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France
| | - E Pons-Tostivint
- Medical Oncology Department, Claudius Regaud Institute, Toulouse University Cancer Institute-Oncopole, Toulouse, France
| | - M Roumiguié
- Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France
| |
Collapse
|
7
|
Longué M, Cabarrou B, Wallet J, Brodowicz T, Roché H, Boher JM, Delord JP, Penel N, Filleron T. The importance of jointly analyzing treatment administration and toxicity associated with targeted therapies: a case study of regorafenib in soft tissue sarcoma patients. Ann Oncol 2019; 29:1588-1593. [PMID: 29722789 DOI: 10.1093/annonc/mdy168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Different methods have been proposed to analyze adverse events (AEs) associated with targeted therapies. While these AEs lead to dose adjustments for many patients, conventional reporting methods do not take drug administration into consideration. This paper underlines the importance of jointly reporting AEs and drug administration using prevalence, and proposes a complementary approach to reporting. Patients and methods The prevalence method estimates the probability of progression-free patients being in a particular health state (state 1: AEs with full dose; state 2: AEs with reduced dose; state 3: no AEs with reduced dose) at different time points. To take into account the impact of dose adjustments on efficacy, the weighted prevalence method can be used by assigning utility weights to the different health states. The benefit of these methods was illustrated using data from a phase II trial of regorafenib. Results Only 4.6% of progression-free patients developed mucositis/stomatitis (grade ≥2) at 3 months. The prevalence of patients not experiencing this AE but whose dose was reduced or treatment interrupted was 58.1%. The weighted prevalence of the regorafenib toxicity profile and dose reduction was higher in the control arm. Conclusion This case study confirms the importance of jointly analyzing AEs and drug administration. The weighted prevalence approach is an average score that incorporates the dimension of drug administration into AE assessment. This can be helpful for regulatory agencies as well as for clinicians to evaluate the benefit-risk ratio of therapies in their treatment choice. Clinical trial NCT01900743.
Collapse
Affiliation(s)
- M Longué
- Department of Biostatistics, Institut Claudius Regaud, IUCT-O, Toulouse, France
| | - B Cabarrou
- Department of Biostatistics, Institut Claudius Regaud, IUCT-O, Toulouse, France
| | - J Wallet
- Department of Biostatistics, Centre Oscar Lambret, Lille, France
| | - T Brodowicz
- Comprehensive Cancer Center Vienna - MusculoSkeletal Tumors, Medical University Vienna - General Hospital, Vienna, Austria
| | - H Roché
- Department of Medical Oncology, Institut Claudius Regaud, IUCT-O, Toulouse, France
| | - J M Boher
- Department of Biostatistics, Institut Paoli Calmette, Marseille, France
| | - J P Delord
- Department of Medical Oncology, Institut Claudius Regaud, IUCT-O, Toulouse, France
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - T Filleron
- Department of Biostatistics, Institut Claudius Regaud, IUCT-O, Toulouse, France.
| |
Collapse
|
8
|
Pouessel D, Mervoyer A, Larrieu-Ciron D, Cabarrou B, Robert M, Frenel J, Olivier P, Mounier M, Cohen-Jonathan Moyal E. OS4.4 Hypofractionated stereotactic radiotherapy and anti-PDL1 Durvalumab combination in recurrent glioblastoma: Results of the phase I part of the phase I/II STERIMGLI trial. Neuro Oncol 2019; 21:iii10-iii11. [PMCID: PMC6795045 DOI: 10.1093/neuonc/noz126.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023] Open
Abstract
Abstract
BACKGROUND
Glioblastoma (GBM) remains a lethal disease with inevitable local relapse and no standard treatment. Re-irradiation by hypofractionated stereotactic radiotherapy (hFSRT) is an option of treatment with tolerable safety, but needs improvement in term of efficacy. Radiotherapy (RT) causes immunogenic tumor cell death but also induces PDL1 and PD1 expression on tumors and immune cells, potentially evoking resistance to RT. Pre-clinical studies combining hFSRT with an anti-PD-1 antibody in GBM have shown increased efficacy of the combination. Clinical studies also show encouraging results when checkpoint inhibitors have been combined with high dose RT. We hypothesized that combining the anti PD-L1 Durvalumab (Durva) with hFSRT will be an effective regimen for patients with recurrent GBM. We designed a phase I/II clinical trial studying the combination of hFSRT with Durva for recurrent GBM≤35 mm diameter. Results of the phase I are presented.
MATERIAL AND METHODS
Patients were included from February 2017 to October 2017.
A standard 3 + 3 de-escalation design was used. Patients were treated by hFSRT 24 Gy, 8 Gy/fraction at 80% isodose, every other day, combined with Durva infusion 1500mg first dose (Level 1) or 750 mg (Level -1) delivered on the last hFSRT day followed by 1500 mg Durva infusion every four weeks until relapse. The schema was defined as safe if one patient or less among 6 presents a dose limiting toxicity (DLT). Brain MRI was performed before RT and then every 8 weeks until relapse. Tumor assessment was performed according to RANO criteria.
RESULTS
Among the 6 patients (3 methylated MGMT, 3 unmethylated MGMT; all wild type IDH) included at the level 1, all completed the hFSRT course, only one had a DLT which was an immune related grade 3 vestibular neuritis. At the time of analysis (24/01/19), all the patients had a local tumor progression, 4 were still alive. Local progression free interval (LPFI) ranges from 2.1 to 8.1 months. Interestingly the 2 patients who presented a pseudo-progression had a prolonged LPFI (5.7 and 8.1 months) compared to the other patients. All the patients except these 2 patients had a lymphopenia at inclusion. PDL-1 expression varied from 0 to 70% in the primary tumor.
CONCLUSION
Combining three 8 Gy fractions of hFSRT with 1500 mg Durvalumab on the 3rd fraction hFSRT and every 4 weeks for recurrent GBM is well tolerated justifying exploration of its efficacy in the phase II which is currently in interim analysis
Collapse
Affiliation(s)
- D Pouessel
- Institut Claudius Regaud-IUCT-O, Toulouse, France
| | - A Mervoyer
- Institut de Cancerologie de l’Ouest, Saint Herblain, France
| | | | - B Cabarrou
- Institut Claudius Regaud-IUCT-O, Toulouse, France
| | - M Robert
- Institut de Cancerologie de l’Ouest, Saint Herblain, France
| | - J Frenel
- Institut de Cancerologie de l’Ouest, Saint Herblain, France
| | - P Olivier
- Centre Régional de Pharmacovigilance, Toulouse, France
| | - M Mounier
- Institut Claudius Regaud-IUCT-O, Toulouse, France
| | | |
Collapse
|
9
|
Desrousseaux J, Cabarrou B, Modesto A, Rives M, Parent L, Brun T, Tournier A, Arnaud F, Meyer N, Sibaud V, Pages C, Boulinguez S, Gangloff D, Chira C. Electronic Brachytherapy for Skin Carcinomas of the Face : Practical Considerations from a Retrospective Series of 53 Lesions. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
Tostivint V, Roumiguié M, Cabarrou B, Verhoest G, Gas J, Coloby P, Soulié M, Thoulouzan M, Beauval JB. [Orthotopic neobladder reconstruction for bladder cancer: robotic-assisted versus open-radical cystectomy for perioperative outcomes, functional results and quality of life]. Prog Urol 2019; 29:440-448. [PMID: 31239101 DOI: 10.1016/j.purol.2019.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/28/2019] [Accepted: 05/18/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Open radical cystectomy (ORC) is the gold standard technique for carcinologic cystectomies. Robotic-assisted radical cystectomy (RARC) was introduced in 2003 and its development is booming. OBJECTIVE To compare ORC and RARC with totally intracorporal (IC) orthotopic neobladder (ONB) reconstruction, in terms of perioperative outcomes, morbidity, functional results and quality of life (Qol). PATIENTS AND METHODS From February 2010 to February 2017, a French multicentric, prospective study on patients who had a RC and ONB reconstruction for bladder cancer was performed. All patients completed the following questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and the bladder cancer specific instruments (QLQ-BLM30). To assess urinary symptoms, patients also completed the Urinary Symptom Profile questionnaire (USP) and a three-day voiding diary. Patients were divided in two groups: ORC and RARC. RESULTS We included 72 patients: 55 in the ORC group (76,4%) and 17 (33,6%) in the RARC group. Operative time was longer in RARC group (median 360 vs 300min; P<0.001) but length of stay was 5 days shorter (median 12 vs 17 days; P<0,05). Patients in RARC group had less blood transfusion (0 vs 23.6%; P<0.05), but a higher rate of uretero-ileal anastomosis stenosis and eventration at long term (respectively 25.5 vs 3.6% et 23 vs 2%; P<0.05). No statistical differences were found concerning quality of life items and functional results between the groups. CONCLUSION RARC with totally IC ONB reconstruction lead to less perioperative morbidity with a reduced rate of blood transfusion and a reduced hospital length of stay. At long term, RARC could provide higher rates of uretero-ileal stenosis and eventration. RARC and ORC do not have any differences in terms of functional outcomes and Qol at long term after ONB reconstruction. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- V Tostivint
- Département d'urologie, CHU de Toulouse Rangueil, 31400 Toulouse, France.
| | - M Roumiguié
- Département d'urologie, CHU de Toulouse Rangueil, 31400 Toulouse, France.
| | - B Cabarrou
- Institut Claudius-Regaud, IUCT, 31100 Toulouse, France.
| | - G Verhoest
- Département d'urologie CHU de Rennes-Pontchaillou, 35000 Rennes, France.
| | - J Gas
- Département d'urologie, centre hospitalier Pontoise, 95303 Pontoise, France.
| | - P Coloby
- Département d'urologie, centre hospitalier Pontoise, 95303 Pontoise, France.
| | - M Soulié
- Département d'urologie, CHU de Toulouse Rangueil, 31400 Toulouse, France.
| | - M Thoulouzan
- Département d'urologie, CHU de Toulouse Rangueil, 31400 Toulouse, France.
| | - J-B Beauval
- Département d'urologie, CHU de Toulouse Rangueil, 31400 Toulouse, France.
| |
Collapse
|
11
|
Mourey L, Ravaud A, Digue L, Cabarrou B, Gomez-Roca C, Valentin T, Olivier P, Fabre A, Mounier M, Balardy L, Filleron T. VOTRAGE study pazopanib in a population of “frail” elderly patients after geriatric assessment: A phase I study with geriatric criteria. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
12
|
Larrieu-Ciron D, Peyraga G, Pouessel D, Mervoyer A, Cabarrou B, Attal J, Robert M, Olivier P, Mounier M, Cohen-Jonathan Moyal E. P01.094 Hypofractionnated Stereotactic Radiation Therapy and Durvalumab combination in recurrent Glioblastoma (GBM): Results of the phase I part of the phase I/II STERIMGLI trial. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.136] [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: 11/13/2022] Open
Affiliation(s)
| | - G Peyraga
- Institut Claudius Régaud, Toulouse, France
| | - D Pouessel
- Institut Claudius Régaud, Toulouse, France
| | - A Mervoyer
- Institut René Gauducheau, Nantes, France
| | | | - J Attal
- Institut Claudius Régaud, Toulouse, France
| | - M Robert
- Institut René Gauducheau, Nantes, France
| | | | - M Mounier
- Institut Claudius Régaud, Toulouse, France
| | | |
Collapse
|
13
|
Cabarrou B, Sfumato P, Leconte E, Boher JM, Filleron T. Designing phase II clinical trials to target subgroup of interest in a heterogeneous population: A case study using an R package. Comput Biol Med 2018; 100:239-246. [PMID: 30055524 DOI: 10.1016/j.compbiomed.2018.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/21/2018] [Accepted: 06/27/2018] [Indexed: 11/19/2022]
Abstract
Phase II trials that evaluate target therapies based on a biomarker must be well designed in order to assess anti-tumor activity as well as clinical utility of the biomarker. Classical phase II designs do not deal with this molecular heterogeneity and can lead to an erroneous conclusion in the whole population, whereas a subgroup of patients may well benefit from the new therapy. Moreover, the target population to be evaluated in a phase III trial may be incorrectly specified. Alternative approaches are proposed in the literature that make it possible to include two subgroups according to biomarker status (negative/positive) in the same study. Jones, Parashar and Tournoux et al. propose different stratified adaptive two-stage designs to identify a subgroup of interest in a heterogeneous population that could possibly benefit from the experimental treatment at the end of the first or second stage. Nevertheless, these designs are rarely used in oncology research. After introducing these stratified adaptive designs, we present an R package (ph2hetero) implementing these methods. A case study is provided to illustrate both the designs and the use of the R package. These stratified adaptive designs provide a useful alternative to classical two-stage designs and may also provide options in contexts other than biomarker studies.
Collapse
Affiliation(s)
- B Cabarrou
- Institut Claudius Regaud-IUCT-O. Biostatistics Unit, Toulouse, France
| | - P Sfumato
- Institut Paoli Calmettes. Biostatistics Unit, Marseille, France
| | | | - J M Boher
- Institut Paoli Calmettes. Biostatistics Unit, Marseille, France; Aix Marseille University, INSERM, IRD, SESSTIM, Marseille, France
| | - T Filleron
- Institut Claudius Regaud-IUCT-O. Biostatistics Unit, Toulouse, France.
| |
Collapse
|
14
|
Cabarrou B, Sfumato P, Mourey L, Leconte E, Balardy L, Delord J, Boher J, Filleron T. Comment prendre en compte l’hétérogénéité dans le schéma des essais cliniques de phase II en oncogériatrie ? Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
15
|
Cabarrou B, Boher JM, Bogart E, Tresch-Bruneel E, Penel N, Ravaud A, Escudier B, Mahier Ait-Oukhatar C, Delord JP, Roché H, Filleron T. How to report toxicity associated with targeted therapies? Ann Oncol 2016; 27:1633-8. [PMID: 27217543 DOI: 10.1093/annonc/mdw218] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 05/17/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the era of personalized medicine, molecularly targeted therapies (MTT) have modified the outcome of some cancer types. The price of tumor control needs to be balanced with toxicity since these new therapies are administered continuously for several months or sometimes for several years. For cytotoxic drugs, the incidence of adverse event (AE) was traditionally reported as frequency and intensity. This simple measure is not sufficient to capture the recurrent nature and duration of AE. This paper presents two methods to better describe the toxicity burden across the time: prevalence and Q-TWiST. PATIENTS AND METHODS Limitation of worst-grade method and advantages of prevalence and Q-TWiST in the analysis of toxicity were illustrated using data from a phase II trial and a hypothetically simulated clinical trial. RESULTS Prevalence integrates the recurrent nature of AE. Using prevalence, it is possible to obtain a time profile of AE. Q-TWiST method evaluates the weighted time spent in each health state and also considers the recurrent nature of side-effects in order to assess the 'risk-benefit' ratio of a treatment. When interpreting Q-TWiST results, it is necessary to take into account overall survival and progression-free survival and to define a clinically relevant difference according to the setting. CONCLUSION The two methods presented here capture different effects. They are helpful for physicians in their treatment choice (balance benefit risk), to counsel patients and to optimize supportive care. In order to ensure consistency and provide critical information required for medical decision-making, it is important to encourage the use of alternative statistical methods in the analysis of toxicities associated with MTT. CLINICAL TRIAL NCT00541008.
Collapse
Affiliation(s)
- B Cabarrou
- Department of Biostatistics, Institut Claudius Regaud, IUCT-O Toulouse, Toulouse
| | - J M Boher
- Department of Biostatistics, Institut Paoli Calmette, Marseille
| | | | | | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - A Ravaud
- Department of Medical Oncology, Bordeaux University Hospital, Bordeaux
| | - B Escudier
- Department of Medical Oncology, Gustave Roussy, Villejuif
| | | | - J P Delord
- Department of Medical Oncology, Institut Claudius Regaud, IUCT-O Toulouse, Toulouse, France
| | - H Roché
- Department of Medical Oncology, Institut Claudius Regaud, IUCT-O Toulouse, Toulouse, France
| | - T Filleron
- Department of Biostatistics, Institut Claudius Regaud, IUCT-O Toulouse, Toulouse
| |
Collapse
|
16
|
Laurenty A, Selves J, Bonnet D, Staub A, Herve C, Danjoux M, Chipoulet E, Toulas C, Cabarrou B, Filleron T, Guimbaud R. 2019 Morphological, molecular and genetic study of mismatch repair-deficient colorectal cancer: Contribution of somatic tools in diagnosis of Lynch syndrome. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30942-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
17
|
Sfumato P, Boher JM, Cabarrou B, Blaise D, Filleron T, Kramar A. Estimation de la prévalence d’un état à partir d’un modèle de Markov, comparaison avec la méthode de référence. Rev Epidemiol Sante Publique 2015. [DOI: 10.1016/j.respe.2015.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
18
|
Cabarrou B, Jouin A, Boher JM, Kramar A, Filleron T. Assessment of health status over time by Prevalence and Weighted Prevalence functions: Interface in R. Comput Methods Programs Biomed 2015; 118:298-308. [PMID: 25622568 DOI: 10.1016/j.cmpb.2014.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/10/2014] [Accepted: 12/30/2014] [Indexed: 06/04/2023]
Abstract
The importance of evaluating complications and toxicity during and following treatment has been stressed in many publications. In most studies, these endpoints are presented descriptively and summarized by numbers and percentages but descriptive methods are rarely sufficient to evaluate treatment-related complications. Pepe and Lancar developed Prevalence and Weighted Prevalence functions which take into account the duration and the severity of complication unlike conventional methods of survival analysis or competing risks which are limited to the time to first event. The purpose of this paper is to describe features and use of two R functions, main.preval.func and main.wpreval.func, which were designed for the analysis of survival adjusted for quality of life. These functions compute descriptive statistics, survival and competing risks analysis and especially Prevalence and Weighted Prevalence estimations with confidence intervals and associated test statistics. The use of these functions is illustrated by several examples.
Collapse
Affiliation(s)
- B Cabarrou
- Institut Claudius Regaud, IUCT-O, Bureau des Essais Cliniques, Cellule Biostatistique, Toulouse F-31059, France
| | - A Jouin
- Centre Oscar Lambret, Lille, France
| | - J M Boher
- Institut Paoli Calmettes, Marseille, France
| | - A Kramar
- Centre Oscar Lambret, Lille, France
| | - T Filleron
- Institut Claudius Regaud, IUCT-O, Bureau des Essais Cliniques, Cellule Biostatistique, Toulouse F-31059, France.
| |
Collapse
|