1
|
Pujade-Lauraine E, Selle F, Scambia G, Asselain B, Marmé F, Lindemann K, Colombo N, Mądry R, Glasspool R, Vergote I, Korach J, Lheureux S, Dubot C, Oaknin A, Zamagni C, Heitz F, Gladieff L, Rubio-Pérez MJ, Scollo P, Blakeley C, Shaw B, Ray-Coquard I, Redondo A. Maintenance olaparib rechallenge in patients with platinum-sensitive relapsed ovarian cancer previously treated with a PARP inhibitor (OReO/ENGOT-ov38): a phase IIIb trial. Ann Oncol 2023; 34:1152-1164. [PMID: 37797734 DOI: 10.1016/j.annonc.2023.09.3110] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/19/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Poly(ADP-ribose) polymerase (PARP) inhibitor maintenance therapy is the standard of care for some patients with advanced ovarian cancer. We evaluated the efficacy and safety of PARP inhibitor rechallenge. PATIENTS AND METHODS This randomized, double-blind, multicenter trial (NCT03106987) enrolled patients with platinum-sensitive relapsed ovarian cancer who had received one prior PARP inhibitor therapy for ≥18 and ≥12 months in the BRCA-mutated and non-BRCA-mutated cohorts, respectively, following first-line chemotherapy or for ≥12 and ≥6 months, respectively, following a second or subsequent line of chemotherapy. Patients were in response following their last platinum-based chemotherapy regimen and were randomized 2 : 1 to maintenance olaparib tablets 300 mg twice daily or placebo. Investigator-assessed progression-free survival (PFS) was the primary endpoint. RESULTS Seventy four patients in the BRCA-mutated cohort were randomized to olaparib and 38 to placebo, and 72 patients in the non-BRCA-mutated cohort were randomized to olaparib and 36 to placebo; >85% of patients in both cohorts had received ≥3 prior lines of chemotherapy. In the BRCA-mutated cohort, the median PFS was 4.3 months with olaparib versus 2.8 months with placebo [hazard ratio (HR) 0.57; 95% confidence interval (CI) 0.37-0.87; P = 0.022]; 1-year PFS rates were 19% versus 0% (Kaplan-Meier estimates). In the non-BRCA-mutated cohort, median PFS was 5.3 months for olaparib versus 2.8 months for placebo (HR 0.43; 95% CI 0.26-0.71; P = 0.0023); 1-year PFS rates were 14% versus 0% (Kaplan-Meier estimates). No new safety signals were identified with olaparib rechallenge. CONCLUSIONS In ovarian cancer patients previously treated with one prior PARP inhibitor and at least two lines of platinum-based chemotherapy, maintenance olaparib rechallenge provided a statistically significant, albeit modest, PFS improvement over placebo in both the BRCA-mutated and non-BRCA-mutated cohorts, with a proportion of patients in the maintenance olaparib rechallenge arm of both cohorts remaining progression free at 1 year.
Collapse
Affiliation(s)
- E Pujade-Lauraine
- Association de Recherche Cancers Gynécologiques (ARCAGY)-Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris; GINECO, Paris.
| | - F Selle
- GINECO, Paris; Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - G Scambia
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica, Rome; Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Milan, Italy
| | - B Asselain
- Association de Recherche Cancers Gynécologiques (ARCAGY)-Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris; GINECO, Paris
| | - F Marmé
- University Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Studiengruppe, Essen, Germany
| | - K Lindemann
- Department of Gynaecological Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo; Nordic Society of Gynecologic Oncology (NSGO), Oslo, Norway
| | - N Colombo
- University of Milan-Bicocca and IEO European Institute of Oncology IRCCS, Milan; Mario Negri Gynecologic Oncology Group (MANGO), Italy
| | - R Mądry
- Uniwersytet Medyczny im.K.Marcinkowskiego w Poznaniu, Poznań; Polish Gynecologic Oncology Group (PGOG), Poznan, Poland
| | - R Glasspool
- Beatson West of Scotland Cancer Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow; National Cancer Research Institute (NCRI), London; Scottish Gynaecological Cancer Trials Group (SGCTG), Edinburgh, UK
| | - I Vergote
- University Hospitals Leuven, Leuven Cancer Institute, Leuven; Belgian and Luxembourg Gynaecological Oncology Group (BGOG), Leuven, Belgium
| | - J Korach
- Sheba Medical Center, Tel Aviv University, Tel Hashomer, Ramat Gan; Israeli Society of Gynecologic Oncology (ISGO), Tel Aviv, Israel
| | - S Lheureux
- Princess Margaret Hospital, Department of Medical Oncology, Toronto; Princess Margaret Consortium, Toronto, Canada
| | - C Dubot
- GINECO, Paris; Oncologie Médicale, Institut Curie Saint Cloud, Paris, France
| | - A Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona; Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain
| | - C Zamagni
- Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Milan, Italy; IRCCS Azienda Ospedaliero-universitaria di Bologna, Bologna, Italy
| | - F Heitz
- Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen; Department for Gynecology with the Center for Oncologic Surgery Charité Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin; Berlin Institute of Health, Berlin; AGO Studiengruppe, Wiesbaden, Germany
| | - L Gladieff
- GINECO, Paris; Institut Claudius Regaud IUCT-Oncopole, Toulouse, France
| | - M J Rubio-Pérez
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain; Reina Sofia University Hospital, Cordoba, Spain
| | - P Scollo
- Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Milan, Italy; Kore University Enna, Enna; Dipartimento di Ginecologia e Ostetricia, Ospedale Cannizzaro, Catania, Italy
| | | | - B Shaw
- AstraZeneca, Cambridge, UK
| | - I Ray-Coquard
- GINECO, Paris; Medical Oncology Department, Centre Léon Bérard and University Claude Bernard Lyon, Lyon, France
| | - A Redondo
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain; La Paz University Hospital-IdiPAZ, Madrid, Spain
| |
Collapse
|
2
|
Ray-Coquard I, Leary A, Pignata S, Cropet C, González-Martin A, Marth C, Nagao S, Vergote I, Colombo N, Mäenpää J, Selle F, Sehouli J, Lorusso D, Alia EMG, Bogner G, Yoshida H, Lefeuvre-Plesse C, Buderath P, Mosconi AM, Lortholary A, Burges A, Medioni J, El-Balat A, Rodrigues M, Park-Simon TW, Dubot C, Denschlag D, You B, Pujade-Lauraine E, Harter P. Olaparib plus bevacizumab first-line maintenance in ovarian cancer: final overall survival results from the PAOLA-1/ENGOT-ov25 trial. Ann Oncol 2023:S0923-7534(23)00686-5. [PMID: 37211045 DOI: 10.1016/j.annonc.2023.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [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: 03/09/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND In the PAOLA-1/ENGOT-ov25 primary analysis, maintenance olaparib plus bevacizumab demonstrated a significant progression-free survival (PFS) benefit in newly diagnosed advanced ovarian cancer patients in clinical response after first-line platinum-based chemotherapy plus bevacizumab, irrespective of surgical status. Prespecified, exploratory analyses by molecular biomarker status showed substantial benefit in patients with a BRCA1/BRCA2 mutation (BRCAm) or homologous recombination deficiency (HRD; BRCAm and/or genomic instability). We report the prespecified final overall survival (OS) analysis, including analyses by HRD status. PATIENTS AND METHODS Patients were randomized 2:1 to olaparib (300 mg bid; up to 24 months) plus bevacizumab (15 mg/kg q3w; 15 months total) or placebo plus bevacizumab. Analysis of OS, a key secondary endpoint in hierarchical testing, was planned for ∼60% maturity or 3 years after the primary analysis. RESULTS After median follow-up of 61.7 and 61.9 months in the olaparib and placebo arms, respectively, median OS was 56.5 versus 51.6 months in the ITT (hazard ratio [HR]=0.92, 95% CI 0.76-1.12; P=0.4118). Subsequent poly(ADP-ribose) polymerase (PARP) inhibitor therapy was received by 105 (19.6%) olaparib patients versus 123 (45.7%) placebo patients. In the HRD-positive population, OS was longer with olaparib plus bevacizumab (HR=0.62, 95% CI 0.45-0.85; 5-year OS rate, 65.5% versus 48.4%); at 5 years, updated PFS also showed a higher proportion of olaparib plus bevacizumab patients without relapse (HR=0.41, 95% CI 0.32-0.54; 5-year PFS rate, 46.1% versus 19.2%). Myelodysplastic syndrome, acute myeloid leukemia, aplastic anemia, and new primary malignancy incidence remained low and balanced between arms. CONCLUSIONS Olaparib plus bevacizumab provided clinically meaningful OS improvement for first-line patients with HRD-positive ovarian cancer. These prespecified exploratory analyses demonstrated improvement despite a high proportion of patients in the placebo arm receiving PARP inhibitors post-progression, confirming the combination as one of the standards of care in this setting with the potential to enhance cure.
Collapse
Affiliation(s)
- I Ray-Coquard
- Department of Medical Oncology, Centre Léon BERARD, Lyon, and GINECO, France;.
| | - A Leary
- Gynecological Cancer Unit, Department of Medicine, Institut Gustave Roussy, Villejuif, and GINECO, France
| | - S Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori 'Fondazione G Pascale', IRCCS, Napoli, and MITO, Italy
| | - C Cropet
- Department of Biostatistics Centre Léon BERARD, Lyon, and GINECO, France
| | - A González-Martin
- Department of Medical Oncology, Clínica Universidad de Navarra, Program in Solid Tumors (CIMA), Pamplona, and GEICO, Spain
| | - C Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, and AGO Austria, Austria
| | - S Nagao
- Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi, and GOTIC, Japan
| | - I Vergote
- Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven Cancer Institute, Leuven, and BGOG, Belgium, European Union
| | - N Colombo
- University of Milan-Bicocca and Istituto Europeo di Oncologia IRCCS Milan, and MANGO, Italy
| | - J Mäenpää
- Department of Obstetrics and Gynecology and Cancer Center, Tampere University and University Hospital, Tampere, and NSGO, Finland
| | - F Selle
- Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, and GINECO, France
| | - J Sehouli
- Charité - Department of Gynecology with Center of Oncological Surgery, Universitätsmedizin Berlin, Berlin, and AGO, Germany
| | - D Lorusso
- (3)Gynecologic Oncology Unit, Catholic University of Sacred Heart and Fondazione Policlinico Gemelli IRCCS, Rome, and MITO, Italy
| | - E M Guerra Alia
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, and GEICO, Spain
| | - G Bogner
- Department of Obstetrics and Gynecology, Paracelsus Medical University Salzburg, Salzburg, and AGO Austria, Austria
| | - H Yoshida
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, and GOTIC, Japan
| | - C Lefeuvre-Plesse
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, and GINECO, France
| | - P Buderath
- Universitätsklinikum Essen, University Hospital Essen, West German Cancer Center, Department of Gynecology and Obstetrics, Essen and AGO, Germany
| | - A M Mosconi
- S.C. di Oncologia Medica Osp. S. Maria della Misericordia - AO di Perugia, and MITO, Italy
| | - A Lortholary
- Centre Catherine de Sienne Hopital privé du Confluent, Nantes, and GINECO, France
| | - A Burges
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, and AGO, Germany
| | - J Medioni
- Hôpital Européen Georges Pompidou, Universite de Paris Cite, Paris, and GINECO, France
| | - A El-Balat
- Spital Uster, Frauenklinik, Uster, Switzerland, and Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, and AGO, Germany
| | - M Rodrigues
- Department of Medical Oncology, Institut Curie, Hopital Claudius Régaud, PSL Research University, Paris, France, and GINECO, France
| | - T-W Park-Simon
- Department of Gynaecology and Obstetrics, Hannover Medical School, Hannover, and AGO, Germany
| | - C Dubot
- Oncologie Médicale, Institut Curie, Hôpital René Huguenin, Saint Cloud, Paris, and GINECO, France
| | - D Denschlag
- Hochtaunuskliniken, Bad Homburg, and AGO, Germany
| | - B You
- HCL - Hospices Civils de Lyon IC-HCL, CITOHL, Université Claude Bernard Lyon 1, CICLY,Lyon, and GINECO, France
| | | | - P Harter
- Department of Gynaecology & Gynaecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, and AGO, Germany
| |
Collapse
|
3
|
Dubot C, Joly Lobbedez F, Ray Coquard I, Floquet A, Lefevre Arbogast S, Selle F, Berton-Rigaud D, Frank S, De La Motte Rouge T, Kalbacher E, Provansal Gross M, Lortholary A, Orfeuvre H, Alexandre J, Augereau P, Nadeau C, Kurtz J, Grellard JM, Pautier P, Gernier F. 19P Long term sexual disorders among rare ovarian cancer survivors: The national GINECO case-control Vivrovaire Rare Tumors study. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101040] [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: 04/05/2023] Open
|
4
|
Colombo N, Dubot C, Lorusso D, Cáceres V, Hasegawa K, Shapira-Frommer R, Tewari K, Salman P, Hoyos E, Yañez E, Gumus M, Olivera Hurtado de Mendoza M, Samouëlian V, Castonguay V, Arkhipov A, Toker S, Li K, Keefe S, Monk B. LBA2 Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for persistent, recurrent, or metastatic cervical cancer: Randomized, double-blind, phase III KEYNOTE-826 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
5
|
Fujiwara K, Shapira-Frommer R, Alexandre J, Monk B, Fehm T, Colombo N, Caceres M, Hasegawa K, Dubot C, Li J, Stein K, Keefe S, Tewari K. KEYNOTE-826: A phase III randomized study of chemotherapy with or without pembrolizumab for first-line treatment of persistent, recurrent, or metastatic cervical cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz426.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
6
|
Lecuru F, Pujade-Lauraine E, Hamizi S, Caumont-Prim A, Raban N, Malaurie E, Pautier P, Kaminsky-Forrett MC, Meunier J, Alexandre J, Berton-Rigaud D, Dohollou N, Dubot C, Floquet A, Favier L, Venat-Bouvet L, Fabbro M, Louvet C, Lortholary A, Ferron G. Surrogate endpoint of progression-free (PFS) and overall survival (OS) for advanced ovarian cancer (AOC) patients (pts) treated with neo-adjuvant chemotherapy (NACT): Results of the CHIVA randomized phase II GINECO study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
7
|
Robelin P, Tod M, Colomban O, Ray-Coquard I, De Rauglaudre G, Florence J, Chevalier A, combe P, Lortholary A, Hamizi S, Raban N, Ferron G, Meunier J, Berton-Rigaud D, Alexandre J, Kaminsky-Forrett MC, Dubot C, Leary A, Malaurie E, You B. Comparison of 11 circulating miRNAs and CA125 kinetics in ovarian cancer during first line treatment: Data from the randomized CHIVA trial (a GINECO-GCIG study). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
8
|
Bidard FC, Callens C, Pistilli B, Dalenc F, de La Motte Rouge T, Sabatier R, Frenel JS, Ladoire S, Dubot C, Ferrero JM, Clatot F, Nierges D, Everhard S, Lemonnier J, Bieche I, Pradines A, Pierga JY, Berger F, Bachelot T, Delaloge S. Emergence of ESR1 mutation in cell-free DNA during first line aromatase inhibitor and palbociclib: An exploratory analysis of the PADA-1 trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.002] [Citation(s) in RCA: 5] [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] [Indexed: 11/14/2022] Open
|
9
|
Kaczmarek E, Saint-Martin C, Pierga JY, Brain E, Rouzier R, Savignoni A, Mouret-Fourme E, Dieras V, Piot I, Dubot C, Carton M, Lerebours F. Long-term survival in HER2-positive metastatic breast cancer treated with first-line trastuzumab: results from the french real-life curie database. Breast Cancer Res Treat 2019; 178:505-512. [DOI: 10.1007/s10549-019-05423-5] [Citation(s) in RCA: 5] [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: 04/24/2019] [Accepted: 08/27/2019] [Indexed: 11/30/2022]
|
10
|
Pierga JY, Silveira A, Lorgis V, Tanguy ML, Tredan O, Dubot C, Jacot W, Goncalves A, Debled M, Levy C, Ferrero JM, Jouannaud C, Luporsi E, Mouret-Reynier MA, Dalenc F, Lemonnier J, Berger F, Proudon C, Bidard FC. Abstract PD2-03: Circulating tumor DNA (ctDNA) and circulating tumor cells (CTC) predictive value in HER2 negative metastatic breast cancer patients treated with first line weekly paclitaxel and bevacizumab: Results of a prospective cohort from the French Breast Cancer InterGroup Unicancer (UCBG): COMET study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd2-03] [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: Increased levels of CTC and a persistent elevated level after just one cycle of chemotherapy are very strong and independent markers of worse progression-free survival (PFS) and overall survival (OS) in patients (pts) with metastatic breast cancer (MBC) (Bidard et al, Lancet Oncol 2014). ctDNA can be used to detect mutation associated with resistance to treatment. It has also been shown that dynamic changes in ctDNA levels closely reflect changes in tumor burden. We prospectively monitored CTC and ctDNA early variations during first line chemotherapy for MBC.
Patients & methods: The French cohort COMET is a prospective study including first line HER2 negative patients (pts) receiving weekly paclitaxel and bevacizumab according to EMA approved combination. The aim of this cohort is to evaluate clinical, biological and radiological parameters associated with pts outcome (CTC, serum markers, ctDNA, pharmacogenomic polymorphisms, metabolomic parameters, visceral fat, serum estradiol level and quality of life). We present here the first planned analysis on pts evaluated for CTC (CellSearch) and ctDNA using targeted sequencing (Roche SeqCap technology) of a panel of 46 genes and 8 promoters, using unique molecular identifiers to increase ctDNA detection sensitivity. Blood samples were obtained at baseline (BL) and before the second cycle of chemotherapy (C2).
Results: From 09/2012 to 5/2014, 218 pts were included in this substudy. Median age was 55 years and 22% of pts had triple negative BC. At BL, 70% of pts had ≥1 detectable CTC per 7.5 ml of blood (median 4 CTC, range 1- 30,000) and 37% at C2. With a threshold of ≥5 CTC, 47% of pts were positive at BL and 22% at C2. For ctDNA, out of the first 141 pts analyzed, 105 had at least one somatic mutation detected in plasma (74%). The average number of mutations per pt was 2.7 and most commonly mutated genes were TP53 and PIK3CA. ESR1 was found mutated in 9% of all cases and restricted to the ER+ subgroup. Median Allelic Frequency was 10% (range 0.6-83%). Only 33% of pts had detectable ctDNA at C2. At BL, CTC and ctDNA levels were correlated (r=0.46, p<0.0001). Despite no complete overlap, 11% of pts had no CTC nor ctDNA detected. Median follow-up was 53 months and median OS was 32 months. Increased level of CTC and ctDNA were significantly associated with decreased PFS and OS. At C2, ≥5 CTC or still detectable ctDNA were strong markers of reduced OS: HR 4.6 (CI95 3.1-7) and HR 3.2 (CI95 1.8 – 5.5), respectively (both p< 0.0001). At multivariate analysis for PFS, detectable ctDNA at C2 and triple negative status were the only significant prognostic factors. None of serum marker level at BL or their early variations had prognostic value.
Conclusion: This is the largest prospective cohort assessing the respective prognostic values of early CTC and ctDNA changes in homogenously treated first line MBC patients. Analysis of mutations profile variations and comparison with primary tumor and metastasis biopsies are ongoing and may reveal early mechanisms of resistance.
Citation Format: Pierga J-Y, Silveira A, Lorgis V, Tanguy M-L, Tredan O, Dubot C, Jacot W, Goncalves A, Debled M, Levy C, Ferrero J-M, Jouannaud C, Luporsi E, Mouret-Reynier M-A, Dalenc F, Lemonnier J, Berger F, Proudon C, Bidard F-C. Circulating tumor DNA (ctDNA) and circulating tumor cells (CTC) predictive value in HER2 negative metastatic breast cancer patients treated with first line weekly paclitaxel and bevacizumab: Results of a prospective cohort from the French Breast Cancer InterGroup Unicancer (UCBG): COMET study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD2-03.
Collapse
Affiliation(s)
- J-Y Pierga
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - A Silveira
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - V Lorgis
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - M-L Tanguy
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - O Tredan
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - C Dubot
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - W Jacot
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - A Goncalves
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - M Debled
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - C Levy
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - J-M Ferrero
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - C Jouannaud
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - E Luporsi
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - M-A Mouret-Reynier
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - F Dalenc
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - J Lemonnier
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - F Berger
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - C Proudon
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| | - F-C Bidard
- Institut Curie, Paris & St Cloud, France; Centre Georges-François Leclerc, Dijon, France; Centre Leon Berard, Lyon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D UNICANCER, Paris, France
| |
Collapse
|
11
|
Lecerf C, Kamal M, Vacher S, Chemlali W, Dubot C, Jeannot E, Klijanienko J, Hoffmann C, Bieche I, Le Tourneau C. Prognostic value of immune gene’s expression in head and neck squamous cell carcinoma patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy314.029] [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: 11/12/2022] Open
|
12
|
Pierga JY, Proudon C, Tredan O, Decraene C, Dubot C, Lorgis V, Jacot W, Goncalves A, Debled M, Levy C, Ferrero JM, Jouannaud C, Luporsi E, Mouret-Reynier MA, Dalenc F, Lemonnier J, Berger F, Bidard FC. Abstract P2-01-02: Heterogeneity and variability of human epidermal growth factor receptor 2 (HER2) expression on circulating tumor cells (CTC) in HER2 negative metastatic breast cancer patients treated with first line weekly paclitaxel and bevacizumab in a prospective cohort from the French Breast Cancer InterGroup Unicancer (UCBG): COMET study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-01-02] [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: It has been reported in women with advanced estrogen-receptor (ER)-positive/(HER2)-negative breast cancer the acquisition of a HER2-positive CTC subpopulation during therapy (Jordan NV Nature 2016). The clinical significance of acquired HER2 heterogeneity during the evolution of metastatic breast cancer is unknown. We report here the analysis of HER2 status of CTC before and after one cycle of treatment in HER2 negative metastatic breast cancer patients treated with first line weekly paclitaxel and bevacizumab.
Patients & methods:The French cohort COMET is a prospective study including first line HER2 negative patients (pts) receiving weekly paclitaxel and bevacizumab according to EMA approved combination. The aim of this cohort is to evaluate clinical, biological and radiological parameters associated with pts outcome. We confirmed previously the outcome of patients with high CTC count at base line and after one cycle of treatment (Bidard et al, Lancet Oncol 2014). We present here the analysis on 203 pts evaluated for the expression of HER2 on CTC using the FDA cleared CellSearch method. The HER2 expression of CTCs (CB11 clone) was categorized (class 0–3) as described by Riethdorf et al.CCR2010.
Results: At base line, 144 out of 203 pts had at least one detectable CTC (71%), (median 4, and range 1- 30,000). Among them, 104 (72%) had one or more HER2 positive CTC (1-21,484). In 25 patients with HER2 2+ primary tumor with FISH or CISH non amplified, the incidence of CTC HER2+ cases (13/25, 52%) was similar than in pts with HER2 0 or HER2 1+ (51%) primary tumor. In each case, 3 to 100% of detectable CTC could be HER2+ stained (median 50% of CTC). Only 12 cases (8% of all CTC cases) had 2+ HER2 staining score on CTC and none 3+. After one cycle of treatment, the number of pts with detectable CTC dropped to 64, including 42 with HER2+ CTC (65%). Out of these cases, 14 were 3+ or 2+ HER2 score (22% of CTC+ cases). This was a significant increase compared to baseline (8%) (p<0.001), including 6 cases with 100% of HER2+ CTC. To note, 7 patients without HER2+ CTC at baseline, had detectable HER2+ CTC after one cycle of treatment. With a median follow-up of 2 years, correlation of CTC variations with pts outcome is planned.
Conclusion: HER2 staining on CTC was heterogeneous with HER2 positive and negative subpopulations in the same patient with primary HER2 negative breast cancer. We observe a variability of HER2 CTC status with an increased intensity or appearance of immunostaining in few cases during treatment. We hypothesize that these phenotypes changes within patient-derived circulating tumor cells could contribute to progression of breast cancer and acquisition of drug resistance.
Citation Format: Pierga J-Y, Proudon C, Tredan O, Decraene C, Dubot C, Lorgis V, Jacot W, Goncalves A, Debled M, Levy C, Ferrero J-M, Jouannaud C, Luporsi E, Mouret-Reynier M-A, Dalenc F, Lemonnier J, Berger F, Bidard F-C. Heterogeneity and variability of human epidermal growth factor receptor 2 (HER2) expression on circulating tumor cells (CTC) in HER2 negative metastatic breast cancer patients treated with first line weekly paclitaxel and bevacizumab in a prospective cohort from the French Breast Cancer InterGroup Unicancer (UCBG): COMET study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-01-02.
Collapse
Affiliation(s)
- J-Y Pierga
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - C Proudon
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - O Tredan
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - C Decraene
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - C Dubot
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - V Lorgis
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - W Jacot
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - A Goncalves
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - M Debled
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - C Levy
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - J-M Ferrero
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - C Jouannaud
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - E Luporsi
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - M-A Mouret-Reynier
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - F Dalenc
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - J Lemonnier
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - F Berger
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| | - F-C Bidard
- Institut Curie, Paris, France; Centre Leon Berard, Lyon; Centre Georges-François Leclerc, Dijon; Institut du Cancer de Montpellier, Montpellier; Institut Paoli Calmettes, Marseille; Institut Bergonié, Bordeaux; Centre François Baclesse, Caen; Centre Antoine Lacassagne, Nice; Institut Jean Godinot, Reims; ICL Alexis Vautrin, Vandoeuvre les Nancy; Centre Jean Perrin, Clermont-Ferrand; Institut Claudius Regaud, Toulouse; R&D UNICANCER, Paris
| |
Collapse
|
13
|
Frank S, Tchokothe C, Carton M, Mouret-Fourme E, Dubot C, Campone M, Pistilli B, Dalenc F, Mailliez A, Levy C, D'Hondt V, Debled M, Leheurteur M, Coudert B, Perrin C, Gonçalves A, Uwer L, Ferrero JM, Eymard JC, Petit T, Mouret-Reynier MA, Guesmia T, Bachelot T, Robain M, Cottu P. Abstract P6-08-10: Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life "ESME" cohort. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-08-10] [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
Young age is a known poor prognosis factor in early stage breast cancer (BC). Its value is less documented for metastatic BC (MBC). Guidelines state that age should not guide the treatment strategy. We used the ESME database to evaluate the impact of age at MBC diagnosis on overall survival (OS).
Patients and Methods
ESME is a unique national cohort, collecting retrospective data using clinical trial-like methodology. It included all consecutive MBC patients (pts) who initiated at least 1 treatment in one of the 18 participating French cancer centers between 01/01/2008 and 12/31/2014. The database was locked on 12/8/2016. Primary objective were the comparisons of MBC characteristics between age groups (<40, 40 to 60 and >60 years (y)) and the evaluation of the impact of age at MBC diagnosis on OS.
Interaction between age and tumor subtype was tested using a Cox regression model.
ResultsAmong 16 703 included pts, 1539 had no information on tumor receptors (ER/PR/HER2) and 682 had an exclusion criteria (unknown age, men or other cancer in the last 5y), leaving 14 482 for analysis. At the onset of MBC, 902 pts (6.2%), 6269 (43.3%) and 7311 (50.5%) were <40y, 40y to 60y and older than 60y respectively. Median follow-up was 54.8 months.
Pts <40 had significantly more aggressive presentations than other age groups: more HER2+ (26.5%), and triple negative (26.4%) subtypes, more visceral involvement (57.1%), and shorter time to metastasis (26.9% between 6 to 24 months) (all p-value vs other age groups <0.0001).
MBC characteristics according to age groups Age at MBC diagnosis (years)p-value <4040-60>60 Tumor subtype <0.0001HR+/HER2-425 (47.12)3816 (60.87)5262 (71.97) HR-/HER2-238 (26.39)1126 (17.96)884 (12.09) HER2+239 (26.5)1327 (21.17)1165 (15.93) Type of metastasis, N(%) <0.0001Bone only219 (24.31)1832 (29.23)2367 (32.41) Non visceral168 (18.65)1046 (16.69)1314 (17.99) Visceral514 (57.05)3389 (54.08)3623 (49.6) Time to first metastasis (months), N(%) <0.0001< 6304 (33.74)1882 (30.1)2107 (28.9) [6-12[65 (7.21)241 (3.85)209 (2.9) [12-24[177 (19.64)760 (12.15)564 (7.7) ≥24355 (39.4)3370 (53.89)4416 (60.53) Number of metastatic sites, N(%) 0.51 site709(78.6)4948 (78.93)5805 (79.4) 2 sites163(18.07)1130 (18.03)1313(17.96) ≥3 sites30(3.33)191 (3.05)193 (2.64)
Overall, median OS was identical in the different age groups: 39.1, 41.1 and 39.8 months for pts <40, 40-60 and >60, respectively (p=0.2).
Tumor subtype and age showed a significant interaction on OS (p<0.0001), especially among HER2+ MBC
Overall survival (months) according to tumor subtypes and age groups Age groups (years)p-value (log-rank)Tumor subtype<4040-60>60 HR+/HER2-46,4 (CI 95% 40.5-55.4)47,8 (CI 95% 46-50)44,2 (CI 95% 42.1-46.3)0.0023HER2+60,7 (CI 95% 45.6-76.4)50,4 (CI 95% 46.3-56.3)44 (CI 95% 38.8-48.9)<0.0001Triple negative14 (CI 95% 11.5-16.5)14,7 (CI 95% 13.7-15.9)15,7 (CI 95% 14.6-17.1)0.01
. Anti-HER2 with first-line treatment was given preferentially to young pts: 86.6, 81.9 and 74.9%for pts <40, 40-60 and >60, respectively (p<0.0001).
Conclusion
At onset of MBC, young age was associated with more aggressive presentations, however with no global impact on OS. Pts <40 with HER2+ disease carried a better prognosis, maybe related to therapy.
Citation Format: Frank S, Tchokothe C, Carton M, Mouret-Fourme E, Dubot C, Campone M, Pistilli B, Dalenc F, Mailliez A, Levy C, D'Hondt V, Debled M, Leheurteur M, Coudert B, Perrin C, Gonçalves A, Uwer L, Ferrero J-M, Eymard J-C, Petit T, Mouret-Reynier M-A, Guesmia T, Bachelot T, Robain M, Cottu P. Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life "ESME" cohort [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-08-10.
Collapse
Affiliation(s)
- S Frank
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - C Tchokothe
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - M Carton
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - E Mouret-Fourme
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - C Dubot
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - M Campone
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - B Pistilli
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - F Dalenc
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - A Mailliez
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - C Levy
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - V D'Hondt
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - M Debled
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - M Leheurteur
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - B Coudert
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - C Perrin
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - A Gonçalves
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - L Uwer
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - J-M Ferrero
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - J-C Eymard
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - T Petit
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - M-A Mouret-Reynier
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - T Guesmia
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - T Bachelot
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - M Robain
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| | - P Cottu
- Institut Curie, Paris/Saint Cloud, France; Institut de Cancérologie de l'Ouest - Paul Papin, Angers, France; Gustave Roussy, Villejuif, France; Institut Claudius Régaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre François Baclesse, Caen, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Bergonié, Bordeaux, France; Centre Henri Becquerel, Rouen, France; Centre Georges-François Leclerc, Dijon, France; Centre Eugène Marquis, Rennes, France; Institut Paoli-Calmettes, Marseille, France; Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandœuvre-lès-Nancy, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; Centre Paul Strauss, Strasbourg, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, France; Centre Léon Bérard, Lyon, France
| |
Collapse
|
14
|
Dubot C, Bernard V, Sablin MP, Vacher S, Chemlali W, Schnitzler A, Pierron G, Ait Rais K, Bessoltane N, Jeannot E, Klijanienko J, Mariani O, Jouffroy T, Calugaru V, Hoffmann C, Lesnik M, Badois N, Berger F, Le Tourneau C, Kamal M, Bieche I. Comprehensive genomic profiling of head and neck squamous cell carcinoma reveals FGFR1 amplifications and tumour genomic alterations burden as prognostic biomarkers of survival. Eur J Cancer 2018; 91:47-55. [PMID: 29331751 DOI: 10.1016/j.ejca.2017.12.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/25/2017] [Accepted: 12/09/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND We aimed at identifying deleterious genomic alterations from untreated head and neck squamous cell carcinoma (HNSCC) patients, and assessing their prognostic value. PATIENTS AND METHODS We retrieved 122 HNSCC patients who underwent primary surgery. Targeted NGS was used to analyse a panel of 100 genes selected among the most frequently altered genes in HNSCC and potential therapeutic targets. We selected only deleterious (activating or inactivating) single nucleotide variations, and copy number variations for analysis. Univariate and multivariate analyses were performed to assess the prognostic value of altered genes. RESULTS A median of 2 (range: 0-10) genomic alterations per sample was observed. Most frequently altered genes involved the cell cycle pathway (TP53 [60%], CCND1 [30%], CDKN2A [25%]), the PI3K/AKT/MTOR pathway (PIK3CA [12%]), tyrosine kinase receptors (EGFR [9%], FGFR1 [5%]) and cell differentiation (FAT1 [7%], NOTCH1 [4%]). TP53 mutations (p = 0.003), CCND1 amplifications (p = 0.04), CDKN2A alterations (p = 0.02) and FGFR1 amplifications (p = 0.003), correlated with shorter overall survival (OS). The number of genomic alterations was significantly higher in the HPV-negative population (p = 0.029) and correlated with a shorter OS (p < 0.0001). Only TP53 mutation and FGFR1 amplification status remained statistically significant in the multivariate analysis. CONCLUSION These results suggest that genomic alterations involving the cell cycle (TP53, CCND1, CDKN2A), as well as FGFR1 amplifications and tumour genomic alterations burden are prognostic biomarkers and might be therapeutic targets for patients with HNSCC.
Collapse
Affiliation(s)
- C Dubot
- Department of Medical Oncology, Institut Curie, Paris, Saint-Cloud, France; Unit of Pharmacogenomics, Department of Genetics, Institut Curie, Paris, France.
| | - V Bernard
- Unit of Bioinformatics, Next Generation Sequencing Platform-ICGex, Institut Curie, Paris, France
| | - M P Sablin
- Department of Medical Oncology, Institut Curie, Paris, Saint-Cloud, France
| | - S Vacher
- Unit of Pharmacogenomics, Department of Genetics, Institut Curie, Paris, France
| | - W Chemlali
- Unit of Pharmacogenomics, Department of Genetics, Institut Curie, Paris, France
| | - A Schnitzler
- Unit of Pharmacogenomics, Department of Genetics, Institut Curie, Paris, France
| | - G Pierron
- Unit of Somatic Genomics, Department of Genetics, Institut Curie, Paris, France
| | - K Ait Rais
- Unit of Somatic Genomics, Department of Genetics, Institut Curie, Paris, France
| | - N Bessoltane
- Unit of Bioinformatics, Next Generation Sequencing Platform-ICGex, Institut Curie, Paris, France
| | - E Jeannot
- Department of Biopathology, Institut Curie, Paris, France
| | - J Klijanienko
- Department of Biopathology, Institut Curie, Paris, France
| | - O Mariani
- Department of Biopathology, Institut Curie, Paris, France
| | - T Jouffroy
- Department of Surgery, Institut Curie, Paris, France
| | - V Calugaru
- Department of Radiotherapy, Institut Curie, Paris, France
| | - C Hoffmann
- Department of Surgery, Institut Curie, Paris, France
| | - M Lesnik
- Department of Surgery, Institut Curie, Paris, France
| | - N Badois
- Department of Surgery, Institut Curie, Paris, France
| | - F Berger
- Department of Biostatistics, Institut Curie, Paris, France
| | - C Le Tourneau
- Department of Medical Oncology, Institut Curie, Paris, Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud, France
| | - M Kamal
- Department of Medical Oncology, Institut Curie, Paris, Saint-Cloud, France
| | - I Bieche
- Unit of Pharmacogenomics, Department of Genetics, Institut Curie, Paris, France; EA7331, Paris Descartes University, Faculty of Pharmaceutical and Biological Sciences, Paris, France
| |
Collapse
|
15
|
de La Motte Rouge T, Cottu P, Pautier P, Provansal M, Floquet A, Selle F, Fabbro M, Kalbacher E, Follana P, Lesoin A, Medioni J, Dupin J, Ferri RM, Bidard FC, Dubot C, Rouzier R, Joly Lobbedez F. Circulating tumor cells as prognostic marker in ovarian carcinoma: Results from the ANTHALYA study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
16
|
Bidard FC, cottu P, Dubot C, Venat-Bouvet L, Lortholary A, Bourgeois H, Bollet M, Servent Hanon V, Luporsi-Gely E, Espie M, Guiu S, D'Hondt V, Diéras V, Sablin M, Neffati S, Berger F, Pierga JY, Jacot W. Anti-HER2 therapy efficacy in HER2-negative metastatic breast cancer with HER2-amplified circulating tumor cells: results of the CirCe T-DM1 trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.033] [Citation(s) in RCA: 7] [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] [Indexed: 11/13/2022] Open
|
17
|
Belin L, Kamal M, Mauborgne C, Plancher C, Mulot F, Delord JP, Gonçalves A, Gavoille C, Dubot C, Isambert N, Campone M, Trédan O, Ricci F, Alt M, Loirat D, Sablin MP, Paoletti X, Servois V, Le Tourneau C. Randomized phase II trial comparing molecularly targeted therapy based on tumor molecular profiling versus conventional therapy in patients with refractory cancer: cross-over analysis from the SHIVA trial. Ann Oncol 2017; 28:590-596. [DOI: 10.1093/annonc/mdw666] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
18
|
Pierga JY, Tredant O, Chevrier M, Dubot C, Lorgis V, Romieu G, Goncalves A, Debled M, Levy C, Ferrero JM, Jouannaud C, Luporsi E, Mouret-Reynier MA, Dalenc F, Berger F, Lemonnier J, Proudhon C, Bidard FC. Abstract P1-01-02: Circulating tumor cells (CTC) and endothelial cells (CEC) prognostic value in HER2 negative metastatic breast cancer patients treated with first line weekly paclitaxel and bevacizumab: First results of a prospective cohort from the French Breast Cancer InterGroup Unicancer (UCBG): COMET study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-01-02] [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: increased levels of circulating tumor cells (CTC) are associated with worse progression-free survival (PFS) and overall survival (OS) in patients (pts) with metastatic breast cancer (MBC). It has been hypothesized that bevacizumab could modify CTC prognostic value. CEC variations to predict benefit of anti-angiogenic treatment is still controversial. Predictive markers for response to bevacizumab combined to chemotherapy in MBC remains a clinical unmet need.
Patients & methods: The French cohort COMET is a prospective study including first line HER2 negative patients (pts) receiving weekly paclitaxel and bevacizumab according to EMA approved combination. The aim of this cohort is to evaluate clinical, biological and radiological parameters associated with pts outcome (CTC, CEC, serum markers, ctDNA, pharmacogenomic polymorphisms, metabolomic parameters, visceral fat assessed by initial CTscan, serum estradiol level, and quality of life). We present here the first planned analysis on 203 pts evaluated for CTC and CEC using the FDA cleared CellSearch method.
Results: For CTC substudy, 211 patients were included from 09/2012 to 5/2014. Median follow-up is 24 months. Median PFS was 10 months (CI95 9-12) and response rate was 57%. Median OS was not reached. 203 patients were evaluable for both CTC and CEC at baseline and first day of second cycle of CT (D1C2). At baseline, 97/203 (48%) pts had ≥ 5 CTC (median 4 (range 0-30,000). Median number CEC was 21 (0-2231) at baseline and 22 (1-881) at D1C2. LDH, CEA, CA15.3 and CYFRA 21 were above normal at baseline in 44%, 46%, 73% and 71% of the cases respectively. CTC level was not correlated with any patients' characteristics except a number of metastatic site >3. After one cycle of chemotherapy (D1C2) 37 pts (22%) had still ≥ 5 CTC: 36 pts with initial high level and only one patient with low CTC at baseline had increased CTC above 5. Prognostic factors for PFS at univariate analysis were visceral disease, number of metastatic sites (> 3), triple negative status, LDH, CTC level at baseline and CTC level after one cycle of chemotherapy (D1C2). None of serum marker nor CEC level at baseline or any variations had prognostic value. In multivariate analysis for PFS, CTC level after one cyle of chemotherapy predicts poor outcome
Table 1 Multivariate analysis for PFSPts' characteristicsnRRCI 95%p-valueNumber of metastatic sites <3 sites971 >=3 sites1001.65[1.13 ; 2.41]0.010CTC D1C2 < 51321 >= 5372.17[1.43 ; 3.29]<0.001Hormonal status Luminal (HR+)1531 Triple negative372.86[1.85 ; 4.54]<0.001
Conclusion: We confirm in a large prospective series the lack of clinical validity of CEC to predict response to an antiangiogenic based treatment in MBC. A persistent elevated level of CTC after just one cycle of chemotherapy is a very strong and independent marker of poor outcome in a homogeneously bevacizumab-treated cohort of MBC patients. This marker could be used to stopped earlier an inefficient and costly treatment.
Citation Format: Pierga J-Y, Tredant O, Chevrier M, Dubot C, Lorgis V, Romieu G, Goncalves A, Debled M, Levy C, Ferrero J-M, Jouannaud C, Luporsi E, Mouret-Reynier M-A, Dalenc F, Berger F, Lemonnier J, Proudhon C, Bidard F-C. Circulating tumor cells (CTC) and endothelial cells (CEC) prognostic value in HER2 negative metastatic breast cancer patients treated with first line weekly paclitaxel and bevacizumab: First results of a prospective cohort from the French Breast Cancer InterGroup Unicancer (UCBG): COMET study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-01-02.
Collapse
Affiliation(s)
- J-Y Pierga
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - O Tredant
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - M Chevrier
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - C Dubot
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - V Lorgis
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - G Romieu
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - A Goncalves
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - M Debled
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - C Levy
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - J-M Ferrero
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - C Jouannaud
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - E Luporsi
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - M-A Mouret-Reynier
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - F Dalenc
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - F Berger
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - J Lemonnier
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - C Proudhon
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| | - F-C Bidard
- Institut Curie, Paris, France; Institut Curie, Saint Cloud, France; Centre Leon Berard, Lyon, France; Centre Georges-François Leclerc, Dijon, France; Institut du Cancer de Montpellier, Montpellier, France; Institut Paoli Calmettes, Marseille, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Antoine Lacassagne, Nice, France; Institut Jean Godinot, Reims, France; ICL Alexis Vautrin, Vandoeuvre les Nancy, France; Centre Jean Perrin, Clermont-Ferrand, France; Institut Claudius Regaud, Toulouse, France; R&D Unicancer, Paris, France
| |
Collapse
|
19
|
Rouzier R, Bonneau C, Cayre A, Hequet D, Gentien D, Bonhomme A, Mouret-Reynier MA, Dubot C, Cottu P, Roulot A, Morel P, Salomon A, Callens C, Guinebretiere JM, Penault-Llorca F. Abstract P2-05-04: Evaluation of intra-tumor heterogeneity, test reproducibility and their impact in breast cancer samples assessed by Prosigna™: Results from a decision impact prospective study and a matched case-control study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-05-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Recent molecular biology technologies reveals insight into tumor heterogeneity but quantification and impact on reproducibility of tests is not well known. The objective of this study was to assess the extent to which tumor heterogeneity may affect the prognosis of patients assessed by Prosigna™ (PAM50) gene signature assay compared to test reproducibility.
Methods: Reproducibility was measured by testing replicate tissue sections from 186 FFPE breast tumor blocks across 2 sites (Institut Curie, Centre Jean Perrin) following independent pathology review at each site. Consecutive slides came from blocks of patients included in the Decision Impact prospective study which examined whether the Prosigna™ test influences adjuvant treatment decision (Clinical trial information: NCT02395575). To evaluate heterogeneity and its impact in terms of outcome, we selected among T1N0 patients treated in Institut Curie between 2003 and 2008, 32 patients who did recur and 28 matched control group who did not (2 'controls' recurred during the study). Analyses were performed on two parts of each tumor. NanoString's Prosigna™ outputs (risk of recurrence (ROR) score, 10 year probability of distant recurrence, risk category, and intrinsic subtype (Luminal A/B, HER2-enriched, Basal-like)) were measured and compared to evaluate heterogeneity (defined as difference in terms of subtype and/or risk category between the two parts) and reproducibility. Correlation between heterogeneity and outcome was performed. Impact was assessed by tumor board analysis.
Results: Pearson correlation coefficients for ROR score and probability of distant recurrence predicted were .95 and .97, respectively in the reproducibility study and .82 and .86, in the tumor heterogeneity study. The measured standard deviation (SD) was 5.4 and 8.1 ROR units corresponding to 1.6% and 2.8% in terms of risk of distant metastasis free survival within the reproducibility study and the tumor heterogeneity study, respectively. Kappa coefficients for intrinsic subtype and risk category agreement were 0.88 and 0.87 in the reproducibility study, and 0.67 and 0.58 in the tumor heterogeneity study. Tumor board analysis of discordant cases showed that the impact, in terms of decision of chemotherapy administration, concerns 3% of patients because of reproducibility and 8% because of tumor heterogeneity, comparing favorably with the discordance between Prosigna™ and immunohistochemistry (27%). Probability of distant recurrence was higher in the cases (15%) compared to control (9%) (p=.001) in the tumor heterogeneity study confirming the performance of the Prosigna™ test.
Conclusion: We validated in the prospective Decision Impact study the analytical performance of NanoString's Prosigna™ assay across multiple clinical testing laboratories. We showed in these two studies that tumor heterogeneity has more impact than reproducibility performance. The clinical impact on the decision making based on tumor heterogeneity is however limited, since it does not correlate to outcomes, whereas the Prosigna™ ROR score has been shown to correlate very well to outcomes.
Citation Format: Rouzier R, Bonneau C, Cayre A, Hequet D, Gentien D, Bonhomme A, Mouret-Reynier M-A, Dubot C, Cottu P, Roulot A, Morel P, Salomon A, Callens C, Guinebretiere J-M, Penault-Llorca F. Evaluation of intra-tumor heterogeneity, test reproducibility and their impact in breast cancer samples assessed by Prosigna™: Results from a decision impact prospective study and a matched case-control study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-05-04.
Collapse
Affiliation(s)
- R Rouzier
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - C Bonneau
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - A Cayre
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - D Hequet
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - D Gentien
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - A Bonhomme
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - M-A Mouret-Reynier
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - C Dubot
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - P Cottu
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - A Roulot
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - P Morel
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - A Salomon
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - C Callens
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - J-M Guinebretiere
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| | - F Penault-Llorca
- Institut Curie, Saint-Cloud, France; Centre Jean Perrin, Clermont Ferrand, France; Nanostring
| |
Collapse
|
20
|
López-Miranda E, Brain E, Saura C, Gligorov J, Dubot C, Dieras V, Suter TM, Aguirre E, Perez-García JM, Llombart A, Cortés J. Abstract OT1-02-03: Phase I multicenter clinical trial evaluating the combination of trastuzumab emtansine (T-DM1) and non-pegylated liposomal doxorubicin (NPLD) in HER2-positive metastatic breast cancer (MBC) (MEDOPP038 study). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-02-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND:
Clinical efficacy and safety of T-DM1 for the treatment of HER2-positive MBC has been assessed in several phase II and III trials and is now considered the standard of care in taxane-and trastuzumab-progressing patients. However, although T-DM1 has shown encouraging antitumor activity in the advanced setting, several strategies to improve T-DM1 efficacy are currently evaluated, including the combination with non-pegylated liposomal doxorubicin (NPLD), considering that: i) doxorubicin is one of the most active chemotherapeutic agents against HER2-positive breast cancer; ii) the combination of doxorubicin and trastuzumab induces synergistic antitumor activity in HER2-overexpressing preclinical models; and iii) liposomal formulations of doxorubicin have a reduced risk of developing cardiac toxicity.
OBJECTIVES:
The primary objective of this trial is to determine the maximum tolerated dose (MTD) of the combination of T-DM1 and NPLD in patients with HER2-positive MBC naïve of anthracyclines and previously treated with trastuzumab and a taxane. The secondary objectives include 1) safety, with special emphasis on cardiac safety evaluated by left ventricular ejection fraction, high-sensitivity troponin I and B-type natriuretic peptide (BNP) levels, 2) pharmacokinetics, 3) antitumor activity, and the 4) role of single nucleotide polymorphisms of HER2 gene for developing cardiotoxicity.
TRIAL DESIGN:
This is a dose-finding, open-label, non-randomized and multicenter phase I clinical trial of T-DM1 at a fixed dose of 3.6 mg/kg IV in combination with three different dose levels (DL) of NPLD (45, 50, and 60 mg/m2) IV administered on Day 1 every three weeks. The trial follows a modified dose escalation scheme with a 3+3 design.A total of three patients will be included in the first cohort and observed for dose-limiting toxicities (DLTs) during the first two cycles of treatment. If none of these patients experiences a DLT, three other patients will be treated at the next DL. However, in case of at least one patient experiences a DLT, three more patients will be treated at the same DL. The MTD will be defined as the highest DL at which ≤1 of six patients experiences a DLT during the first two cycles of treatment. An expansion cohort of six additional patients at the MTD will be included.
ELIGIBILITY:
Anthracycline-naïve patients with HER2-positive MBC and up to two prior chemotherapy regimens in the advanced setting who previously were treated with trastuzumab and a taxane. ECOG performance status of 0-1. Adequate organ and cardiovascular function with LVEF ≥ 55%. RECIST v1.1 evaluable disease.
ACCRUAL:
A total of 12-24 patients will be enrolled at four sites in Spain and France. Recruitment was opened on September 2015. To date, four patients (three at DL1 and one at DL2) have been recruited.
Citation Format: López-Miranda E, Brain E, Saura C, Gligorov J, Dubot C, Dieras V, Suter TM, Aguirre E, Perez-García JM, Llombart A, Cortés J. Phase I multicenter clinical trial evaluating the combination of trastuzumab emtansine (T-DM1) and non-pegylated liposomal doxorubicin (NPLD) in HER2-positive metastatic breast cancer (MBC) (MEDOPP038 study) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-02-03.
Collapse
Affiliation(s)
- E López-Miranda
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - E Brain
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - C Saura
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - J Gligorov
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - C Dubot
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - V Dieras
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - TM Suter
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - E Aguirre
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - JM Perez-García
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - A Llombart
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| | - J Cortés
- Ramón y Cajal University Hospital, Madrid, Spain; Institut Curie / Hôpital René Huguenin, St Cloud, France; Vall d´Hebrón University Hospital, Vall d'Hebrón Institute of Oncology (VHIO), Barcelona, Spain; APHP Tenon, IUC-UPMC, Sorbonne University, Paris, France; Institut Curie, Paris, France; Bern University Hospital, Cardiology, Bern, Switzerland; Medica Scientia Innovation Research – MedSIR ARO, Barcelona, Spain; Baselga Institute of Oncology, Quiron University Hospital, Barcelona, Spain; Hospital Arnau i Vilanova, Valencia, Spain
| |
Collapse
|
21
|
Bacrie J, Laurans M, Iorio P, Fourme E, Pierga J, Béthune Volters A, Benzidane B, Bozec L, Lerebours F, Dubot C, Bensaoula O, Lefeuvre D. Febrile neutropenia in adjuvant and neoadjuvant chemotherapy for breast cancer: a retrospective study in routine clinical practice from a single institution. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30629-9] [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: 10/20/2022]
|
22
|
Bidard FC, Brain E, Jacot W, Bachelot T, Ladoire S, Bourgeois H, Gonçalves A, Naman H, Gligorov J, Dalenc F, Levy C, Espie M, Ferrero JM, Luporsi E, Sablin MP, Dubot C, Chevrier M, Berger F, Alix-Panabieres C, Pierga JY. First line hormone therapy vs chemotherapy for HR+ HER2- metastatic breast cancer in the phase III STIC CTC trial: clinical choice and validity of CTC count. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
23
|
Lerebours F, Hequet D, Guinebretière JM, Roulot A, Callens C, Gentien D, Penault-LLorca F, Zilberman S, Salmon R, Foa C, Berseneff H, Huchon C, Katz G, MacDonald M, Morel P, Bieche I, Dubot C, Rouzier R. Abstract OT2-03-02: DI study: Decision impact of the NanoString® Technologies Prosigna™ in early breast cancers. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot2-03-02] [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
Backgrounds: More than a decade of research, clinical studies, and peer reviewed publications support the value of molecular subtyping based on gene expression analyses to assess prognosis and treatment options for patients with early-stage breast cancer. Therefore, genomic assays are now being introduced to supplement the conventional diagnostic tools. Prosigna is a standardized test that measures the expression levels of 50 classifier genes in formalin-fixed, paraffin-embedded (FFPE) breast tumor tissue samples and provide a subtype classification based on the fundamental biology of individual patient's tumor (referred to as molecular subtyping), as well as a prognostic score (referred to as risk of recurrence (ROR) score) that predicts the probability of cancer recurrence over 10 years.
The primary objective of this study is to assess the extent to which Prosigna affects the medical oncologist's treatment recommendations regarding adjuvant chemotherapy and actual treatments received for patients with early-stage breast cancer. Changes will include hormonal therapy alone, hormonal therapy plus chemotherapy, and changes in types of chemotherapy if chemotherapy was recommended before and after the test. Secondary objectives will be to elicit information on investigators' confidence in the recommendations before and after the test, and by cancer recurrence risk groups, rate of chemotherapy related adverse events stratified by administration of chemotherapy, and patients' decisional conflict status, anxiety levels, and functional status before and after Prosigna results.
Multicentric prospective study. Prosigna will be performed on operative piece for all consecutively postmenopausal women matching the inclusion criteria and having signed an informed consent. Data on patient demographics, disease status, intended cancer-specific postoperative management before and after the test, tests results, investigators and patients' confidence in the treatment and in the test, will be recorded in the inclusion visit, after the tests results and 6 month post-assay.
Inclusion criteria: Postmenopausal patients with resected node-negative, estrogen-receptor-positive, HER2-negative (by the local laboratory) early-stage invasive breast cancer (T1-T2, N0, pN0 (i+), pN1 (micrometastatic), M0), able to give consent, eligible for treatment of breast cancer with adjuvant chemotherapy and with ECOG performance status of 0 or 1.
Statistical methods: The clinical and demographic characteristics of the study sample will be described using mean, median, standard deviation, and range for continuous/ordinal variables and frequency and proportion for categorical variables. Bivariate plots and crosstabs will be performed to inspect bivariate associations between variables. The proportion of patients for whom the physicians' choice of treatment changed from baseline to follow-up will be calculated along with the 95% confidence interval. The change in investigator confidence in treatment recommendations before and after Prosigna results were known will be analyzed by calculating the mean and 95% CI for the question regarding whether a physician is more confidence in treatment recommendation after ordering Prosigna.
47 patients have been included on 200 scheduled.
Citation Format: Lerebours F, Hequet D, Guinebretière J-M, Roulot A, Callens C, Gentien D, Penault-LLorca F, Zilberman S, Salmon R, Foa C, Berseneff H, Huchon C, Katz G, MacDonald M, Morel P, Bieche I, Dubot C, Rouzier R. DI study: Decision impact of the NanoString® Technologies Prosigna™ in early breast cancers. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT2-03-02.
Collapse
Affiliation(s)
- F Lerebours
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - D Hequet
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - J-M Guinebretière
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - A Roulot
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - C Callens
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - D Gentien
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - F Penault-LLorca
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - S Zilberman
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - R Salmon
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - C Foa
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - H Berseneff
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - C Huchon
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - G Katz
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - M MacDonald
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - P Morel
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - I Bieche
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - C Dubot
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| | - R Rouzier
- Institut Curie-Centre René Huguenin, St Cloud, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont-Ferrand, France; Tenon Hospital, Paris, France; Private Hospital Les Peupliers, Paris, France; Private Hospital Clairval, Marseille, France; René Dubos Hospital, Pontoise, France; Poissy-St Germain Hospital, Poissy, France; Groupe Général de Santé, Paris, France; NanoString Technologies, Seattle, WA; Equipe d'Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Montigny-le-Bretonneux, France
| |
Collapse
|
24
|
Dubot C, Donnadieu A, Houzard S, Fridmann S, Dehghani C, Dagousset I, Missey-Kolb H, Hassoun D. [Good reasons to develop the out-of-hospital follow-up after breast cancer]. J Gynecol Obstet Hum Reprod 2016; 45:98-99. [PMID: 26705607 DOI: 10.1016/j.jgyn.2015.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/24/2015] [Indexed: 06/05/2023]
Affiliation(s)
- C Dubot
- Service d'oncologie médicale, institut Curie/Site Paris, 5, rue Dailly, 92210 Saint-Cloud, France
| | - A Donnadieu
- Service de radiothérapie, institut Curie/Site Paris, 26, rue d'Ulm, 75005 Paris, France
| | - S Houzard
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France.
| | - S Fridmann
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France
| | - C Dehghani
- Service de chirurgie gynécologique, groupe hospitalier Diaconesses - Croix-Saint-Simon, 18, rue du Sergent-Bauchat, 75012 Paris, France
| | - I Dagousset
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France
| | - H Missey-Kolb
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France
| | - D Hassoun
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France
| |
Collapse
|
25
|
Sablin M, Dubot C, Kamal M, Rodriguez J, Jouffroy T, Girod A, Calugaru V, Klijanienko J, Caly M, Sastre-Garau X, Lappartient E, Mariani O, Berger F, Vacher S, Biáche I, Tourneau CL. 2878 Identification of actionable genes in head and neck squamous cell carcinoma (HNSCC) using gene expression analyses. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31615-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]
|
26
|
Philip C, Pelissier A, Bonneau C, Dubot C, Rouge TDLM, Nicolas P, Roman R. 2742 Impact of bowel resection on overall survival after neoadjuvant chemotherapy in advanced epithelial ovarian cancer. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31508-8] [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: 11/17/2022]
|
27
|
Dubot C, Bourbouloux E, Mir O, Kirscher S, Rigal O, Ferrero JM, Curé H, Blot E, Allouache D, Cottu P, Romieu G, Lefeuvre C, Malaurie E, Tubiana-Mathieu N, Lacroix-Triki M, Rollot F, Peyro-Saint-Paul H, Orsini C, Bonnetain F, Brain E. ASTER 70s UNICANCER phase III Trial: Can a genomic prognosticator help tailoring adjuvant systemic treatment for luminal breast carcinoma in elderly women? J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
28
|
Dubot C, Tazi Y, Bourbouloux E, Kirscher S, Rigal O, Abadie-Lacourtoisie S, Ferrero J, Curé H, Blot E, Allouache D, Romieu G, Cottu P, Malaurie E, Terret C, Lacroix MT, Rollot F, Paul HPS, Orsini C, Bonnetain F, Brain E. Aster 70S Unicancer Phase III Trial : Adjuvant Treatment for Women Over 70 with Luminal Breast Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.75] [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: 11/15/2022] Open
|
29
|
Selle F, Wittnebel S, Biron P, Gravis G, Roubaud G, Bui BN, Delva R, Bay JO, Fléchon A, Geoffrois L, Caty A, Soares DG, de Revel T, Fizazi K, Gligorov J, Micléa JM, Dubot C, Provent S, Temby I, Gaulet M, Horn E, Brindel I, Lotz JP. A phase II trial of high-dose chemotherapy (HDCT) supported by hematopoietic stem-cell transplantation (HSCT) in germ-cell tumors (GCTs) patients failing cisplatin-based chemotherapy: the Multicentric TAXIF II study. Ann Oncol 2014; 25:1775-1782. [PMID: 24894084 DOI: 10.1093/annonc/mdu198] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND High-dose chemotherapy (HDCT) is an effective salvage treatment of germ-cell tumors (GCTs) patients. In the first salvage setting, 30%-70% of patients may achieve durable remissions. Even when HDCT is administered as subsequent salvage treatment, up to 20% of patients may still be definitively cured. However, patients with refractory/relapsed disease still have a very poor long-term prognosis, requiring earlier intervention of HDCT. PATIENTS AND METHODS This phase II trial was addressed to nonrefractory patients failing Cisplatin-based chemotherapy. Inclusion criteria included seminomatous GCT in relapse after two lines of chemotherapy, nonseminomatous GCT in relapse after first or second lines, partial remission after first line, primary mediastinal GCT in first relapse. Patients received two cycles combining Epirubicin and Paclitaxel (Epi-Tax), followed by three consecutive HDCT, one using a Paclitaxel/Thiotepa (Thio-Tax) association and two using the 5-day Ifosfamide-Carboplatin-Etoposide regimen. The main objective was to determine the complete response rate. RESULTS Forty-five patients were included between September 2004 and December 2007: 44 received the first HDCT cycle, 39 two HDCT cycles, 29 could receive the whole protocol. Sixteen patients did not receive the entire protocol, including eight (17.7%) for toxic side-effects. Two patients (4.4%) died of toxicities, and 17 (37.7%) of disease progression. With a median follow-up time of 26 months (range, 4-51), the final overall response rate was 48.8% (including a complete response rate of 15.5% and a partial response/negative serum markers rate of 26.6%) in an intent-to-treat analysis. The median progression-free survival (PFS) and overall survival (OS) times were 22 months [95% confidence interval (CI) 2-not reached] and 32 months (95% CI 4-49), respectively. The 2-year PFS was a plateau setup at 50% (95% CI 32-67) and the 2-year OS was 66% (95% CI 44-81). CONCLUSION The TAXIF II protocol was effective in nonrefractory GCT patients failing Cisplatin-based chemotherapy. The toxic death rate remained acceptable in the field of HDCT regimens. TRIAL REGISTRATION NUMBER NCT00231582.
Collapse
Affiliation(s)
- F Selle
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris; Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris.
| | - S Wittnebel
- Department of Medicine, Institut Gustave Roussy, Villejuif
| | - P Biron
- Department of Medical Oncology, Centre Léon Bérard, Lyon
| | - G Gravis
- Department of Medical Oncology, Institut Paoli Calmette, Marseille
| | - G Roubaud
- Department of Medicine, Institut Bergonié, Bordeaux
| | - B N Bui
- Department of Medicine, Institut Bergonié, Bordeaux
| | - R Delva
- Department of Chemotherapy, Centre Paul Papin, Angers
| | - J O Bay
- Department of Medicine, Centre Hospitalier Universitaire, Clermont-Ferrand
| | - A Fléchon
- Department of Medical Oncology, Centre Léon Bérard, Lyon
| | - L Geoffrois
- Department of Medicine, Centre Alexis Vautrin, Nancy
| | - A Caty
- Department of Medicine, Centre Oscar Lambret, Lille
| | - D G Soares
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris
| | - T de Revel
- Department of Hematology, Hôpital D'Instruction des Armées Percy, Clamart
| | - K Fizazi
- Department of Medicine, Institut Gustave Roussy, Villejuif
| | - J Gligorov
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris; Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris
| | - J M Micléa
- Cytapheresis and Cell Therapy Unit, Hôpital St Louis (AP-HP), Paris
| | - C Dubot
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris
| | - S Provent
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris
| | - I Temby
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris
| | - M Gaulet
- Statistic, 3ES-Cegedim Strategic Data, Boulogne, France
| | - E Horn
- Department of Internal Medicine, Brown University, Rhode Island Hospital, Providence, Rhode Island, USA
| | - I Brindel
- Department of Clinical Research, Hôpital St Louis (AP-HP), Paris, France
| | - J P Lotz
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris; Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris
| |
Collapse
|
30
|
Dubot C, Bourbouloux E, Tazi Y, Cure H, Ferrero JM, Romieu G, Rigal O, Allouache D, Abadie-Lacourtoisie S, Kirscher S, Ladoire S, Malaurie E, Blot E, Rollot F, Terret C, Baffert S, Lacroix-Triki M, Falandry C, Poggionovo C, Peyro Saint Paul HP, Orsini C, Latouche A, Bonnetain F, Girre V, Brain E. Abstract OT3-1-10: ASTER 70s (UNICANCER phase III trial): Is personalized adjuvant treatment for women over 70 with luminal breast cancer the way to go? Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-ot3-1-10] [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
The question of the additional benefit of adjuvant chemotherapy (CT) compared to hormonal therapy alone (HT) for women >70 with ER+ / HER2- breast cancer (BC) and aggressive characteristics is still unsolved. This trial compares the impact of both strategies on overall survival (OS).
Trial design
Following surgery, ∼2,000 patients will have a Genomic Grade (GG) centrally performed on FFPE specimens. Those with a high or equivocal GG will be randomized HT alone vs HT+CT. Patients with low GG will be followed as an observational cohort. The study, on-going in France since April 2012, has been recently activated in Belgium.
Eligibility criteria
Any ER+ HER2- BC after complete surgery, M0, any pT or pN. Normal organ functions. No specific BC treatment before surgery. Contralateral BC, invasive BC after ductal carcinoma in situ and isolated local invasive relapse when adjuvant systemic treatment is considered are all eligible. Multifocal or bilateral are eligible according to focus with worst GG. The G8 screening tool is used as stratification criteria for randomization.
Specific aims
OS (all deaths) is the primary endpoint. Secondary objectives include competing events, cost-effectiveness and Q-TWiST analysis, geriatric dimension, acceptability/willingness and health-related quality of life including specific ELD15. The Lee's 4-year mortality score is calculated. Translational research will focus on prognostic biomarkers and pharmacogenetic, investigating also the impact of treatments on putative ageing biomarkers as CRAMP, stathmin, EF-1α and chitinase and telomeres length.
Statistical methods
Sample size based on 4-year OS (87.5 vs 80%), bilateral test, α = 0.05, β = 0.20 and HR = 0.60.
In total, 129 events are expected, requiring 340 patients/arm. Considering those lost to follow-up, ∼700 patients in total should be included (5 extra patients/year).
Present accrual and target accrual
As of May 2013, 43 centres have included 406 Patients aged 70-88.
Only 14 GG evaluations were not performed for the following reasons: Patients consent withdrawal (n = 3), tumour block not available for the GG test (n = 5), CT not a treatment option anymore (patients or investigator's decision) (n = 2) or tumour status (ER+/HER2-) not confirmed by central review (n = 4). 8 GG evaluations are on-going.
Of 384 cases with GG report, 160 (42%), 151 (39%) and 65 (17%) were respectively GG-1 (low risk), GG-3 (high risk) and GG-EQ (equivocal); 8 (2%) tests failed for technical reasons. The proportion of high GG in the study (53%) is similar to those observed in previous studies in general BC populations (40% to 60%).
Of 216 GG-3/-EQ cases, 4 were not randomized because of distant metastases detected during extensive work-up (n = 3) and Patient refusal of CT treatment before randomization (n = 1). Five randomizations are on-going.
GG determination was obtained in 384 leading to randomization in 207, totalizing so far 30% of the projected recruitment for the primary objective. This confirms the feasibility of such multicentre strategic program with an innovative prognostic signature in the elderly BC population.
Contact information
c-orsini@unicancer.fr.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT3-1-10.
Collapse
Affiliation(s)
- C Dubot
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - E Bourbouloux
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - Y Tazi
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - H Cure
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - J-M Ferrero
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - G Romieu
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - O Rigal
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - D Allouache
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - S Abadie-Lacourtoisie
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - S Kirscher
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - S Ladoire
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - E Malaurie
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - E Blot
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - F Rollot
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - C Terret
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - S Baffert
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - M Lacroix-Triki
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - C Falandry
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - C Poggionovo
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - HP Peyro Saint Paul
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - C Orsini
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - A Latouche
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - F Bonnetain
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - V Girre
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| | - E Brain
- Hôpital René Huguenin / Institut Curie, Saint-Cloud, France; ICO - Centre René Gauducheau, Nantes, France; Institut Gustave Roussy, Villejuif, France; Institut Jean Godinot, Reims, France; Centre Antoine-Lacassagne, Nice, France; Institut Régional du Cancer Montpellier/Val d'Aurelle - Paul Lamarque, Montpellier, France; Centre Henri Becquerel, Rouen, France; Centre François Baclesse, Caen, France; Institut de Cancérologie de L'Ouest -site Paul Papin, Angers, France; Institut Sainte Catherine, Avignon, France; Centre Georges-François Leclerc, Dijon, France; CHI de Créteil, Creteil, France; CH Bretagne Atlantique, Vannes, France; Centre Saint-Yves, Vannes, France; Institut Curie - Hôpital Claudius Regaud, Paris, France; Centre Léon Bérard, Lyon, France; Institut Claudius Regaud, Toulouse, France; Centre Hospitalier Lyon Sud, Lyon, France; Qiagen Marseille SA, Marseille, France; UNICANCER, Paris, France; CNAM, Paris, France; CHU Besançon, Besancon, France; CHD de Vendée, La Roche sur Yon, France
| |
Collapse
|
31
|
Selle F, Fizazi K, Biron P, Gravis-Mescam G, Bui B, Bay J, Flechon A, Dubot C, Caty A, Burcoveanu D, Delva R, de Revel T, Miclea J, Gaulet M, Horn E, Provent S, Temby I, Brindel I, Khalil J, Gligorov J, Lotz JP. The TAXIF II Protocol Final Results: A Phase II Trial of High-Dose Chemotherapy Supported by Haematopoietic Stem Cell Transplantation in Patients with Disseminated Germ-Cell Tumors Failing Chemotherapy and with Adverse Prognostic Factors. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33414-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
32
|
Dubot C, Emile G, Lhomme C, Asmane I, Pautier P, Alexandre J, Goldwasser F, Lauraine EP, Coquard IR, Seile F. 8003 ORAL Experience With Bevacizumab in the Management of Relapsed Ovarian Cancer – a Retrospective Observational Study in Five French Hospitals. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72091-3] [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: 12/01/2022]
|