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Fabre M, Lamoureux A, Meunier L, Samaran Q, Lesage C, Girard C, Du Thanh A, Moulis L, Dereure O. Efficiency and tolerance of second-line triple BRAF inhibitor/MEK inhibitor/anti-PD1 combined therapy in BRAF mutated melanoma patients with central nervous system metastases occurring during first-line combined targeted therapy: a real-life survey. Melanoma Res 2024; 34:241-247. [PMID: 38546723 DOI: 10.1097/cmr.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Although current systemic therapies significantly improved the outcome of advanced melanoma, the prognosis of patient with central nervous system (CNS) metastases remains poor especially when clinically symptomatic. We aimed to investigate the efficiency of CNS targets and tolerance of second-line combined anti-PD1/dual-targeted anti-BRAF/anti-MEK therapy implemented in patients with CNS progression after initially efficient first-line combined targeted therapy in patients with BRAF-mutated melanoma in a real-life setting. A monocentric retrospective analysis including all such patients treated from January 2017 to January 2022 was conducted in our tertiary referral center. The response of CNS lesions to second-line triple therapy was assessed through monthly clinical and at least quarterly morphological (according to RECIST criteria) evaluation. Tolerance data were also collected. Seventeen patients were included with a mean follow-up of 2.59 (±2.43) months. Only 1 patient displayed a significant clinical and morphological response. No statistically significant difference was observed between patients receiving or not additional local therapy (mainly radiotherapy) as to response achievement. Immunotherapy was permanently discontinued in 1 patient owing to grade 4 toxicity. Mean PFS and OS after CNS progression were 2.59 and 4.12 months, respectively. In this real-life survey, the subsequent addition of anti-PD1 to combined targeted therapy in melanoma patients with upfront CNS metastases did not result in significant response of CNS targets in most BRAF mutated melanoma patients with secondary CNS progression after initially successful first-line combined targeted therapy.
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Affiliation(s)
- Marie Fabre
- Department of Dermatology, University of Montpellier
| | | | | | | | | | - Céline Girard
- Department of Dermatology, University of Montpellier
| | - Aurélie Du Thanh
- Department of Dermatology, University of Montpellier
- INSERM U1058 'Pathogenesis and Control of Chronic and Emerging Infections' University of Montpellier, Montpellier, France
| | - Lionel Moulis
- Department of Dermatology, University of Montpellier
| | - Olivier Dereure
- Department of Dermatology, University of Montpellier
- INSERM U1058 'Pathogenesis and Control of Chronic and Emerging Infections' University of Montpellier, Montpellier, France
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2
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Amini-Adle M, Arnault JP, Aubin F, Beneton N, Bens G, Brunet-Possenti F, Célerier P, Charles J, Crumbach L, Dalac S, Darras S, De Quatrebarbes J, Dinulescu M, Dutriaux C, Gaudy C, Gérard E, Giacchero D, Granel-Brocard F, Grange F, Jouary T, Kramkimel N, Lebbé C, Le Corre Y, Legoupil D, Lesage C, Lesimple T, Lorphelin JM, Mansard S, Martin L, Mary-Prey S, Maubec E, Meyer N, Mignard C, Montaudie H, Mortier L, Nardin C, Neidhardt Berard EM, Pagès Laurent C, Peuvrel L, Quereux G, Robert C, Saiag P, Saint-Jean M, Samimi M, Sassolas B, Scalbert C, Skowron F, Steff M, Stoebner PE, Trablesi S, Visseaux L, Zehou O, Boespflug A. The combination of ipilimumab and nivolumab is still not reimbursed for BRAF-mutated melanoma patients in France: An unacceptable medical situation that raises ethical concerns. Ann Dermatol Venereol 2024; 151:103243. [PMID: 38325268 DOI: 10.1016/j.annder.2023.103243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/06/2023] [Accepted: 09/05/2023] [Indexed: 02/09/2024]
Affiliation(s)
- M Amini-Adle
- Dermatology Department, Centre Léon Bérard, Lyon, France.
| | - J-P Arnault
- Dermatology Department, Centre Hospitalo-Universitaire, Amiens Picardie, France
| | - F Aubin
- Université de Bourgogne-Franche-Comté, Dermatology Department, Head of the Skin Cancer Unit, Centre Hospitalo-Universitaire de Besançon, Besançon, France; INSERM UMR RIGHT 1098, Besançon, France
| | - N Beneton
- Dermatology Department, Centre Hospitalier, Le Mans, France
| | - G Bens
- Dermatology Department, Centre Hospitalier, Orléans, France
| | - F Brunet-Possenti
- Dermatology Department, Centre Hospitalo-Universitaire Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - P Célerier
- Dermatology Department, Centre Hospitalier La Rochelle-Ré-Aunis, La Rochelle, France
| | - J Charles
- Dermatology Department, Centre Hospitalo-Universitaire, Grenoble, France
| | - L Crumbach
- Dermatology Department, Centre Léon Bérard, Lyon, France
| | - S Dalac
- Dermatology Department, Centre Hospitalo-Universitaire, Dijon, France
| | - S Darras
- Dermatology Department, Centre Hospitalier de Boulogne-sur-Mer, France
| | - J De Quatrebarbes
- Dermatology Department, Centre Hospitalier Annecy Genevois, Annecy, France
| | - M Dinulescu
- Dermatology Department, Centre Hospitalo-Universitaire, Rennes, France
| | - C Dutriaux
- Dermatology Department, Centre Hospitalo-Universitaire, Bordeaux, France
| | - C Gaudy
- Dermatology Department, Centre Hospitalo-Universitaire, Marseille, France
| | - E Gérard
- Dermatology Department, Centre Hospitalo-Universitaire, Bordeaux, France
| | | | - F Granel-Brocard
- Dermatology Department, Hôpitaux de Brabois Allée de Morvan, Vandoeuvre Les Nancy, France
| | - F Grange
- Dermatology Department, Centre Hospitalier, Valence, France
| | - T Jouary
- Dermatology Department, Hôpital François Mitterrand, Pau, France
| | - N Kramkimel
- Dermatology Department, Centre Hospitalo-Universitaire Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Lebbé
- Dermatology Department, Centre Hospitalo-Universitaire Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Y Le Corre
- Dermatology Department, Centre Hospitalo-Universitaire Angers, France
| | - D Legoupil
- Dermatology Department, Centre Hospitalo-Universitaire Régional, Brest, France
| | - C Lesage
- Dermatology Department, Hôpital Saint Eloi, Montpellier, France
| | | | - J-M Lorphelin
- Dermatology Department, Centre Hospitalo-Universitaire, Caen, France
| | - S Mansard
- Dermatology Department, Centre Hospitalo-Universitaire, Clermont Ferrand, France
| | - L Martin
- Dermatology Department, Centre Hospitalo-Universitaire, Angers, France; Groupe Ethique de la Société Française de Dermatologie, France
| | - S Mary-Prey
- Centre Hospitalo-Universitaire Saint André, Bordeaux, France
| | - E Maubec
- Dermatology Department, Centre Hospitalo-Universitaire Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - N Meyer
- Institut Universitaire du Cancer et Centre Hospitalo-Universitaire, Toulouse, France
| | - C Mignard
- Dermatology Department, Centre Hospitalo-Universitaire, Rouen, France
| | - H Montaudie
- Dermatology Department, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; INSERM U1065, Team 12, Centre Méditerranéen de Médecine Moléculaire, Université Nice Côte d'Azur, Nice, France
| | - L Mortier
- Dermatology Department, Centre Hospitalier Régional Universitaire, Lille, France
| | - C Nardin
- Université de Bourgogne-Franche-Comté et Centre Hospitalier Universitaire, Besançon, France; IINSERM UMR RIGHT 1098, Besançon, France
| | | | - C Pagès Laurent
- Institut Universitaire du Cancer et Centre Hospitalo-Universitaire, Toulouse, France
| | - L Peuvrel
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint Herblain, France
| | - Gaelle Quereux
- Dermatology Department, Centre Hospitalo-Universitaire, Nantes Université, Nantes, France; INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Nantes, France
| | - Caroline Robert
- Dermatology Department, Institut Gustave Roussy, Villejuif, France
| | - Philippe Saiag
- Dermatology Department, Centre Hospitalo-Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne Billancourt, France
| | - Mélanie Saint-Jean
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint Herblain, France
| | - M Samimi
- Dermatology Department, Centre Hospitalo-Universitaire, Tours, France
| | - B Sassolas
- Institute of Oncology & Hematology, Hôpital Morvan, Centre Hospitalier Régional Universitaire, Brest, France
| | - C Scalbert
- Dermatology Department, Centre Hospitalier Ouest Réunion, Saint Paul, Ile de la Réunion, France
| | - F Skowron
- Dermatology Department, Hôpitaux Drome Nord, Romans Sur Isère, France
| | - M Steff
- Dermatology Department, Centre Hospitalier Intercommunal Robert Ballanger, Aulnay sous-Bois, France
| | - P-E Stoebner
- Dermatology Department, Centre Hospitalo-Universitaire, Nîmes, France
| | - S Trablesi
- Dermatology Department, Centre Hospitalo-Universitaire, Grenoble, France
| | - L Visseaux
- Polyclinique Reims Bezannes, Bezannes, France
| | - O Zehou
- Dermatology Department, Centre Hospitalo-Universitaire Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - A Boespflug
- Dermatology Department, Centre Hospitalier Henri Mondor, Villejuif, France
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3
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Nardin C, Hennemann A, Diallo K, Funck-Brentano E, Puzenat E, Heidelberger V, Jeudy G, Samimi M, Lesage C, Boussemart L, Peuvrel L, Rouanet J, Brunet-Possenti F, Gerard E, Seris A, Jouary T, Saint-Jean M, Puyraveau M, Saiag P, Aubin F. Efficacy of Immune Checkpoint Inhibitor (ICI) Rechallenge in Advanced Melanoma Patients' Responders to a First Course of ICI: A Multicenter National Retrospective Study of the French Group of Skin Cancers (Groupe de Cancérologie Cutanée, GCC). Cancers (Basel) 2023; 15:3564. [PMID: 37509227 PMCID: PMC10377277 DOI: 10.3390/cancers15143564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/07/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The long-term effectiveness of immune checkpoint inhibitor (ICI) rechallenge for progressive or recurrent advanced melanoma following previous disease control induced by ICI has not been thoroughly described in the literature. PATIENTS AND METHODS In this retrospective multicenter national real-life study, we enrolled patients who had been rechallenged with an ICI after achieving disease control with a first course of ICI, which was subsequently interrupted. The primary objective was to evaluate tumor response, while the secondary objectives included assessing the safety profile, identifying factors associated with tumor response, and evaluating survival outcomes. RESULTS A total of 85 patients from 12 centers were included in the study. These patients had advanced (unresectable stage III or stage IV) melanoma that had been previously treated and controlled with a first course of ICI before undergoing rechallenge with ICI. The rechallenge treatments consisted of pembrolizumab (n = 44, 52%), nivolumab (n = 35, 41%), ipilimumab (n = 2, 2%), or ipilimumab plus nivolumab (n = 4, 5%). The best overall response rate was 54%. The best response was a complete response in 30 patients (35%), a partial response in 16 patients (19%), stable disease in 18 patients (21%) and progressive disease in 21 patients (25%). Twenty-eight adverse events (AEs) were reported in 23 patients (27%), including 18 grade 1-2 AEs in 14 patients (16%) and 10 grade 3-4 AEs in nine patients (11%). The median progression-free survival (PFS) was 21 months, and the median overall survival (OS) was not reached at the time of analysis. Patients who received another systemic treatment (chemotherapy, targeted therapy or clinical trial) between the two courses of ICI had a lower response to rechallenge (p = 0.035) and shorter PFS (p = 0.016). CONCLUSION Rechallenging advanced melanoma patients with ICI after previous disease control induced by these inhibitors resulted in high response rates (54%) and disease control (75%). Therefore, ICI rechallenge should be considered as a relevant therapeutic option.
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Affiliation(s)
- Charlée Nardin
- Service de Dermatologie, Centre Hospitalier Universitaire, 25000 Besancon, France
- Université Franche Comté, Inserm 1098 RIGHT, 25020 Besancon, France
| | - Aymeric Hennemann
- Service de Dermatologie, Centre Hospitalier Universitaire, 25000 Besancon, France
| | - Kadiatou Diallo
- Centre de Méthodologie Clinique, Centre Hospitalier Universitaire, 25030 Besancon, France
| | - Elisa Funck-Brentano
- Université Paris-Saclay, UVSQ, EA4340-BECCOH, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Ambroise-Paré, Service de Dermatologie Générale et Oncologique, 92104 Boulogne-Billancourt, France
| | - Eve Puzenat
- Service de Dermatologie, Centre Hospitalier Universitaire, 25000 Besancon, France
| | | | - Géraldine Jeudy
- Service de Dermatologie, Centre Hospitalier Universitaire, Hôpital Le Bocage, 21079 Dijon, France
| | - Mahtab Samimi
- Service de Dermatologie, Centre Hospitalier Universitaire, BIP 1282, INRA-Université de Tours, 37020 Tours, France
| | - Candice Lesage
- Service de Dermatologie, Centre Hospitalier Universitaire, 34295 Montpellier, France
| | - Lise Boussemart
- Service de Dermatologie, Centre Hospitalier Universitaire, Université de Nantes, INSERM, Immunology and New Concepts in Immunotherapy, INCIT, UMR 1302, 44000 Nantes, France
| | - Lucie Peuvrel
- Institut de Cancérologie de l'Ouest, 44800 Saint-Herblain, France
| | - Jacques Rouanet
- Service de Dermatologie, Centre Hospitalier Universitaire, 63003 Clermont-Ferrand, France
| | | | - Emilie Gerard
- Service de Dermatologie, Centre Hospitalier Universitaire, 33075 Bordeaux, France
| | - Alice Seris
- Oncologie Médicale, Centre Hospitalier, 64046 Pau, France
| | - Thomas Jouary
- Oncologie Médicale, Centre Hospitalier, 64046 Pau, France
| | | | - Marc Puyraveau
- Centre de Méthodologie Clinique, Centre Hospitalier Universitaire, 25030 Besancon, France
| | - Philippe Saiag
- Université Paris-Saclay, UVSQ, EA4340-BECCOH, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Ambroise-Paré, Service de Dermatologie Générale et Oncologique, 92104 Boulogne-Billancourt, France
| | - François Aubin
- Service de Dermatologie, Centre Hospitalier Universitaire, 25000 Besancon, France
- Université Franche Comté, Inserm 1098 RIGHT, 25020 Besancon, France
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4
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Hountondji L, Ferreira De Matos C, Lebossé F, Quantin X, Lesage C, Palassin P, Rivet V, Faure S, Pageaux GP, Assenat É, Alric L, Zahhaf A, Larrey D, Witkowski Durand Viel P, Riviere B, Janick S, Dalle S, Maria ATJ, Comont T, Meunier L. Clinical pattern of checkpoint inhibitor-induced liver injury in a multicentre cohort. JHEP Rep 2023; 5:100719. [PMID: 37138674 PMCID: PMC10149360 DOI: 10.1016/j.jhepr.2023.100719] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 05/05/2023] Open
Abstract
Background & Aims Immune checkpoint inhibitors (ICIs) have changed the landscape of cancer therapy. Liver toxicity occurs in up to 25% of patients treated with ICIs. The aim of our study was to describe the different clinical patterns of ICI-induced hepatitis and to assess their outcome. Methods We conducted a retrospective observational study of patients with checkpoint inhibitor-induced liver injury (CHILI) discussed in multidisciplinary meetings between December 2018 and March 2022 in three French centres specialised in ICI toxicity management (Montpellier, Toulouse, Lyon). The hepatitis clinical pattern was analysed by the ratio of serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) (R value = (ALT/ULN)/(ALP/ULN)) for characterisation as cholestatic (R ≤2), hepatocellular (R ≥5), or mixed (2 <R <5). Results We included 117 patients with CHILI. The clinical pattern was hepatocellular in 38.5%, cholestatic in 36.8%, and mixed in 24.8% of patients. High-grade hepatitis severity (grade ≥3 according to the Common Terminology Criteria for Adverse Events system) was significantly associated with the hepatocellular hepatitis (p <0.05). No cases of severe acute hepatitis were reported. Liver biopsy was performed in 41.9% of patients: granulomatous lesions, endothelitis, or lymphocytic cholangitis were described. Biliary stenosis occurred in eight patients (6.8%) and was significantly more frequent in the cholestatic clinical pattern (p < 0.001). Steroids alone were mainly administered to patients with a hepatocellular clinical pattern (26.5%), and ursodeoxycholic acid was more frequently used in the cholestatic pattern (19.7%) than in the hepatocellular or mixed clinical pattern (p <0.001). Seventeen patients improved without any treatment. Among the 51 patients (43.6%) rechallenged with ICIs, 12 (23.5%) developed CHILI recurrence. Conclusions This large cohort indicates the different clinical patterns of ICI-induced liver injury and highlights that the cholestatic and hepatocellular patterns are the most frequent with different outcomes. Impact and Implications ICIs can induce hepatitis. In this retrospective series, we report 117 cases of ICI-induced hepatitis, mostly grades 3 and 4. We find a similar distribution of the different patterns of hepatitis. ICI could be resumed without systematic recurrence of hepatitis.
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Affiliation(s)
- Lina Hountondji
- Department of Liver Transplantation, Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | | | - Fanny Lebossé
- Department of Hepatology, Croix Rousse Hospital, Lyon Liver Institute, Hospices Civils of Lyon, Lyon, France
| | - Xavier Quantin
- Department of Medical Oncology, Montpellier Cancer Institute, Montpellier University Hospital, Montpellier, France
| | - Candice Lesage
- Department of Dermatology, Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Pascale Palassin
- Department of Medical Pharmacology and Toxicology, Lapeyronie Hospital, Montpellier University Hospital, Montpellier, France
| | - Valérian Rivet
- Department of Internal Medicine, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France
| | - Stéphanie Faure
- Department of Liver Transplantation, Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Georges-Philippe Pageaux
- Department of Liver Transplantation, Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Éric Assenat
- Department of Oncology, Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Laurent Alric
- Department of Internal Medicine and Digestive Diseases, Purpan Hospital, Toulouse University Hospital, Toulouse, France
| | - Amel Zahhaf
- Department of Liver Transplantation, Saint Eloi Hospital, Montpellier University Hospital, REFHEPS, Montpellier, France
| | - Dominique Larrey
- Department of Liver Transplantation, Saint Eloi Hospital, Montpellier University Hospital, REFHEPS, Montpellier, France
| | | | - Benjamin Riviere
- Department of Pathology, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | | | - Stéphane Dalle
- Department of Dermatology, Lyon Sud Hospital, Lyon Cancer Institute, Hospices Civils of Lyon, Lyon, France
| | - Alexandre Thibault Jacques Maria
- Internal Medicine & Immuno-Oncology (MedI2O), Institute for Regenerative Medicine and Biotherapy (IRMB), Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Thibaut Comont
- Department of Internal Medicine, IUCT-Oncopole, Toulouse University Hospital, Toulouse, France
| | - Lucy Meunier
- Department of Liver Transplantation, Saint Eloi Hospital, Montpellier University Hospital, REFHEPS, Montpellier, France
- Corresponding author. Address: Department of Liver Transplantation, Saint Eloi Hospital, Montpellier University Hospital, REFHEPS, 80 avenue Augustin Fliche, 34090 Montpellier, France. Tel: +33 4 67 33 02 24, Fax: +33 4 67 33 69 42.
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5
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Coustal C, Vanoverschelde J, Quantin X, Lesage C, Michot JM, Lappara A, Ederhy S, Assenat E, Faure M, Issa N, Lambotte O, Puyade M, Dereure O, Tosi D, Rullier P, Serre I, Larcher R, Klouche K, Chanques G, Vernhet-Kovacsik H, Faillie JL, Agullo A, Roubille F, Guilpain P, Maria ATJ. Prognosis of immune checkpoint inhibitors-induced myocarditis: a case series. J Immunother Cancer 2023; 11:jitc-2022-004792. [PMID: 37258037 DOI: 10.1136/jitc-2022-004792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) have transformed cancer treatment over the last decade. Alongside this therapeutic improvement, a new variety of side effects has emerged, called immune-related adverse events (irAEs), potentially affecting any organ. Among these irAEs, myocarditis is rare but life-threatening. METHODS We conducted a multicenter cross-sectional retrospective study with the aim of better characterizing ICI-related myocarditis. Myocarditis diagnosis was based on the recent consensus statement of the International Cardio-Oncology Society. RESULTS Twenty-nine patients were identified, from six different referral centers. Most patients (55%) were treated using anti-programmed-death 1, rather than ICI combination (35%) or anti-programmed-death-ligand 1 (10%). Transthoracic echocardiography was abnormal in 52% of them, and cardiac magnetic resonance showed abnormal features in 14/24 patients (58%). Eleven patients (38%) were classified as severe. Compared with other patients, they had more frequently pre-existing systemic autoimmune disease (45% vs 6%, p=0.018), higher troponin level on admission (42-fold the upper limit vs 3.55-fold, p=0.001), and exhibited anti-acetylcholine receptor autoantibodies (p=0.001). Seven patients (24%) had myocarditis-related death, and eight more patients died from cancer progression during follow-up. Twenty-eight patients received glucocorticoids, 10 underwent plasma exchanges, 8 received intravenous immunoglobulins, and 5 other immunosuppressants. ICI rechallenge was performed in six patients, with only one myocarditis relapse. DISCUSSION The management of ICI-related myocarditis may be challenging and requires a multidisciplinary approach. Prognostic features are herein described and may help to allow ICI rechallenge for some patients with smoldering presentation, after an accurate evaluation of benefit-risk balance.
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Affiliation(s)
- Cyrille Coustal
- Department of Internal Medicine, CHRU de Montpellier, Montpellier, France
| | | | - Xavier Quantin
- Department of thoracic oncology, Regional Cancer Centre Val d'Aurelle - Paul Lamarque, Montpellier, France
| | - Candice Lesage
- Department of Dermatology, CHRU de Montpellier, Montpellier, France
| | | | | | - Stephane Ederhy
- Cardiology, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Eric Assenat
- Department of Oncology, CHRU de Montpellier, Montpellier, France
| | - Maxime Faure
- Department of Interventional Cardiology, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
| | - Nahema Issa
- Intensive Care Unit, CHU de Bordeaux, Bordeaux, France
| | - Olivier Lambotte
- Department of Internal Medicine, CHU Bicêtre, Le Kremlin-Bicetre, France
| | - Mathieu Puyade
- Medecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- CIC-1402, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Olivier Dereure
- Department of Dermatology, CHRU de Montpellier, Montpellier, France
| | - Diego Tosi
- Medical Oncology Department, Institut régional du Cancer de Montpellier, Montpellier, France
| | - Patricia Rullier
- Department of Internal Medicine, CHRU de Montpellier, Montpellier, France
| | - Isabelle Serre
- Department of Pathology, CHRU de Montpellier, Montpellier, France
| | - Romaric Larcher
- Department of Intensive Care Medicine, CHRU de Montpellier, Montpellier, France
| | - Kada Klouche
- Department of Intensive Care Medicine, CHRU de Montpellier, Montpellier, France
| | - Gérald Chanques
- Department of Anesthesiology and Critical Care Medicine, CHRU de Montpellier, Montpellier, France
| | | | - Jean-Luc Faillie
- Department of Medical Pharmacology and Toxicology, University Hospital Centre Montpellier, Montpellier, France
| | - Audrey Agullo
- Department of Cardiology, CHRU de Montpellier, Montpellier, France
| | | | - Philippe Guilpain
- Department of Internal Medicine, CHRU de Montpellier, Montpellier, France
- U1183, Institut national de la santé et de la recherche médicale, Paris, France
| | - Alexandre Thibault Jacques Maria
- Department of Internal Medicine, CHRU de Montpellier, Montpellier, France
- U1183, Institut national de la santé et de la recherche médicale, Paris, France
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6
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Leenhardt F, Mbatchi L, Evrard A, Cupissol D, Lesage C. [Unusual association of BRAF and MEK inhibitors: Clinical response of metastatic melanoma treated with dabrafenib-cobimetinib]. Bull Cancer 2023:S0007-4551(23)00137-6. [PMID: 36966054 DOI: 10.1016/j.bulcan.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/13/2023] [Accepted: 02/25/2023] [Indexed: 03/27/2023]
Abstract
Despite the efficacy of targeted therapies in melanoma, the management of adverse events with BRAFi and MEKi (inhibitors) is one of the limits of these treatments. Close monitoring is required to ensure efficacy and patient safety. In this case study, we report a patient treated for metastatic melanoma with an unusual and innovative combination of dabrafenib (BRAFi) and cobimetinib (MEKi), to manage pyrexia, and lead to complete remission for 19 months. This is the first case ever reported of metastatic melanoma treated with this off-label combination and characterized by the use of therapeutic drug monitoring.
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Affiliation(s)
- Fanny Leenhardt
- Institut du cancer de Montpellier, service de pharmacie, Montpellier, France; Université de Montpellier, faculté de pharmacie, laboratoire de pharmacocinétique, Montpellier, France; Université de Montpellier, institut de recherche en cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, France.
| | - Litaty Mbatchi
- Université de Montpellier, faculté de pharmacie, laboratoire de pharmacocinétique, Montpellier, France; Université de Montpellier, institut de recherche en cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, France
| | - Alexandre Evrard
- Université de Montpellier, faculté de pharmacie, laboratoire de pharmacocinétique, Montpellier, France; Université de Montpellier, institut de recherche en cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, France
| | - Didier Cupissol
- Institut du cancer de Montpellier, département d'oncologie médicale, Montpellier, France
| | - Candice Lesage
- Institut du cancer de Montpellier, département d'oncologie médicale, Montpellier, France
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Nardin C, Lesage C, Goubeau E, Aubriot-Lorton MH, Lacheretz-Szablewski V, Ortonne N, Saizonou I, Aubin F, Dereure O, Dalac-Rat S. Cutaneous vasculitis associated with mycosis fungoides. J Eur Acad Dermatol Venereol 2023; 37:e204-e206. [PMID: 36222460 DOI: 10.1111/jdv.18657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/03/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Charlée Nardin
- Service de Dermatologie, CHU, Besançon, France.,IMSERM UMR1098, Université de Bourgogne-Franche Comté, Besançon, France
| | - Candice Lesage
- Service de Dermatologie, Université de Montpellier, Montpellier, France
| | - Eléonore Goubeau
- Service de Dermatologie, Unité Médicale Ambulatoire de Cancérologie, CHU Dijon-Bourgogne, Dijon, France
| | | | | | | | - Ines Saizonou
- Service d'Anatomo-pathologie, Centre Léon Bérard, Lyon, France
| | - François Aubin
- Service de Dermatologie, CHU, Besançon, France.,IMSERM UMR1098, Université de Bourgogne-Franche Comté, Besançon, France
| | - Olivier Dereure
- Service de Dermatologie, Université de Montpellier, Montpellier, France
| | - Sophie Dalac-Rat
- Service de Dermatologie, Unité Médicale Ambulatoire de Cancérologie, CHU Dijon-Bourgogne, Dijon, France
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Skowron F, Mouret S, Seigneurin A, Montaudié H, Maubec E, Grange F, Quéreux G, Celerier P, Adle A, Dalac S, De Quatrebarbes J, Zehou O, Safia A, Muller P, Modiano P, Misery L, Litrowski N, Brunet Possenti F, Mortier L, Bens G, Hervieu A, Leduc N, Jouary T, Lesage C, Beneton N, Le Corre Y, Geoffrois L, Thomas-Beaulieu D, Khammari A, Wierzbicka-Hainaut E, Leccia M. La pandémie COVID-19 est associée à des mélanomes diagnostiqués à un stade plus avancé. Annales de Dermatologie et de Vénéréologie - FMC 2022. [PMCID: PMC9748166 DOI: 10.1016/j.fander.2022.09.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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9
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Nardin C, Hennemann A, Diallo K, Funck-Brentano E, Puzenat E, Heidelberger V, Jeudy G, Samimi M, Lesage C, Boussemart L, Peuvrel L, Mansard S, Brunet F, Gerard E, Seris A, Jouary T, Saint-Jean M, Saiag P, Puyraveau M, Aubin F. Efficacy of immune checkpoint inhibitor (ICI) rechallenge in advanced melanoma patients responders to a first course of ICI: A multicenter, national, retrospective study of the French group of skin cancers (GCC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.9529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9529 Background: The efficacy of ICI rechallenge for progressive/recurrent disease of advanced melanoma patients (pts) after a first course of ICI interrupted for disease control has not been systematically described. Methods: A retrospective observational multicenter national real-life study evaluated the efficacy and tolerance of ICI rechallenge (anti-PD1, anti-CTLA-4, or combination therapy) in melanoma pts who progressed after disease control with an ICI subsequently interrupted. Primary objective was to evaluate tumor response using RECIST version 1.1. Secondary objectives were the factors associated with tumor response, progression-free survival (PFS), overall survival (OS) and the tolerance of the rechallenge. Results: 85 pts from 12 French different centers rechallenged with an ICI between July 2014 and June 2021 were included. Median (IQR) age of pts was 72.00 (30–89) years. Most pts were male (n = 47, 55%) with an AJCC stage IV melanoma (n = 75, 88%). BRAFV600-mutant melanoma and elevated LDH were reported in 19 pts (22%). Pts were rechallenged with anti-PD1 (Pembrolizumab (n = 44, 52%), Nivolumab (n = 35, 41%)), anti-CTLA-4 (Ipilimumab (n = 2, 2%)) or the combination therapy (Ipilimumab + Nivolumab (n = 4, 5%)). Median follow-up after rechallenge was 13 months (1.1-76.2). All pts included had had disease control with the first course of ICI including complete response (CR) in 47 pts (55%), partial response (PR) in 28 pts (33%) and stable disease (SD) in 10 pts (12%). Adverse events (AEs) of the first course of ICI had occurred in 51% pts including grade 3-4 AEs (22%). Median time between ICI interruption and ICI rechallenge was 9,3 months (1.2-63,9). The response rates of ICI rechallenge (2nd course of ICI) were CR in 30 pts (35%), PR in 17 pts (20%) and SD in 17 pts (20%). Progression occurred in 21 pts (25%). The use of steroids for brain metastases was the only factor associated with a higher recurrence rate in multivariate analysis (p = 0,002) and tends to be associated with lower outcomes. There was no correlation between best overall response to the first course of ICI and response to ICI rechallenge. Median duration of response, PFS and OS after ICI rechallenge were not reached. At last follow-up, 23 pts have died. 28 AEs of ICI rechallenge occurred in 23 pts (27%) with a median time of 3 (0.4-36.2) months, including grade 1-2 and grade 3-4 AEs in 13 (15%) and 9 (11%) pts respectively. Conclusions: ICI rechallenge for progressive/recurrent disease was associated with high objective response rate (CR+PR = 55%) and disease control rate (CR+PR+SD = 75%) in melanoma pts with a previous disease control induced by ICI. Thus, ICI rechallenge should be considered as an attractive therapeutic option for melanoma pts with progressive/recurrent disease after ICI interruption.
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Affiliation(s)
- Charlee Nardin
- Université de Franche-Comté, Inserm 1098 RIGHT, Besançon, France
| | - Aymeric Hennemann
- Service de Dermatologie et Institut Régional Fédératif de Cancérologie, CHU, Besançon, France
| | | | - Elisa Funck-Brentano
- General & Oncologic Dermatology, CHU Ambroise Paré APHP & University of Versailles, Boulogne-Billancourt, France
| | | | - Valentine Heidelberger
- Service de Dermatologie, Hôpital Avicenne, Université Sorbonne Paris Nord, Bobigny, France
| | | | | | - Candice Lesage
- Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, France
| | - Lise Boussemart
- CNRS, IGDR (Institut de Génétique et Développement de Rennes) – UMR6290, University of Rennes 1, Rennes, France
| | - Lucie Peuvrel
- Service de Dermatologie, Institut de Cancérologie de l'Ouest, Nantes, France
| | - Sandrine Mansard
- Dermatology department, CHU Clermont-Ferrand, Clermont Ferrand, France
| | | | - Emilie Gerard
- Service de Dermatologie, CHU Bordeaux, Bordeaux, France
| | - Alice Seris
- Service d’Oncologie Médicale, CH, Pau, France
| | - Thomas Jouary
- Department of Medical Oncology, CH de Pau, Pau, France
| | - Mélanie Saint-Jean
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Philippe Saiag
- Dermatology Department, Ambroise Paré Hospital, APHP, Versailles University – Paris-Saclay, Boulogne-Billancourt, France
| | | | - François Aubin
- Université de Franche Comté, EA3181, IFR133, Besançon, France
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Hountondji L, Palassin P, Faure S, Iltache S, Dupuy M, Pageaux G, Faillie J, Lesage C, Negre E, Assenat E, Rullier P, Rivet V, Quantin X, Meunier L, Maria A. Hépatites auto-immunes induites par inhibiteurs de checkpoints : étude observationnelle CHILI. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Lesage C, Habib-Hadef S, Trétarre B, Lesage FX, Bessaoud F, Varey E, Guillot B, Satgé D. Melanoma and intellectual disability: do prognostic factors at diagnosis differ from general population? J Intellect Disabil Res 2022; 66:392-398. [PMID: 35137477 DOI: 10.1111/jir.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 11/21/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Few melanoma cases are reported in individuals with intellectual disability (ID), and prognostic factors at diagnosis are unknown in this population. This work was designed to investigate whether prognostic factors at diagnostic are different in patients with ID compared with a general population. METHODS Melanoma cases retrieved from Hérault's Tumour Registry (HTR) from 1995 to 2015 were cross-referenced against a list of adult patients with ID, living in Hérault. Major prognostic factors were compared with those in non-ID melanoma patients included in HTR and in patients followed by Montpellier University Hospital and included in the Réseau pour la Recherche et l'Investigation Clinique sur le Mélanome (RIC-Mel) database. RESULTS Ten melanoma cases in individuals with ID were identified and compared with 3804 non-ID melanoma cases in HTR and 1024 non-ID melanoma cases included in RIC-Mel. Mean Breslow thickness at diagnosis was 4.6 mm in melanoma cases among those with ID versus 1.89 mm in HTR (P = 0.109) and 2.36 mm in RIC-Mel (P = 0.156). Stage at diagnosis was superior to stage IIB in 42.9% of ID cases versus 11.4% of non-ID cases in HTR (P < 0.05) and 8.5% in RIC-Mel (P < 0.05). CONCLUSIONS Melanomas in patients with ID had less favourable prognostic factors at diagnosis, including higher Breslow thickness and more advanced stage, than melanomas in non-ID patients. These adverse prognostic factors indicate a later diagnosis in this population, leading to a poorer prognosis. This work underlines the need to improve melanoma screening among individuals with ID.
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Affiliation(s)
- C Lesage
- Department of Dermatology, University Hospital, Montpellier, France
| | | | - B Trétarre
- Registre des Tumeurs de l'Hérault, Montpellier, France
| | - F-X Lesage
- Department of Professional pathologies, University of Montpellier, University Hospital Montpellier, Montpellier, France
| | | | - E Varey
- Réseau pour la Recherche et l'Investigation Clinique sur le Mélanome, Nantes University Hospital, Nantes, France
| | - B Guillot
- Department of Dermatology, University Hospital, Montpellier, France
| | - D Satgé
- ONCODEFI, Montpellier, France
- Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM Univ. Montpellier, Montpellier, France
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12
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Coustal C, Quantin X, Lesage C, Michot J, Laparra A, Ederhy S, Assenat E, Faure M, Issa N, Lambotte O, Puyade M, Dereure O, Rullier P, Serre I, Klouche K, Vernhet H, Faillie J, Roubille F, Guilpain P, Maria A. Facteurs pronostiques des myocardites induites par les inhibiteurs du checkpoint immunologique. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Rivet V, Quantin X, Faillie J, Lesage C, Meunier L, Faure S, Hillaire-Buys D, Lesouder C, Fabre S, Assenat E, Rullier P, Guilpain P, Maria A. Gestion des toxicités induites par les inhibiteurs de checkpoint immunologique : données de la RCP « ToxImmun » en Occitanie Est. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Juzot C, Sibaud V, Amatore F, Mansard S, Seta V, Jeudy G, Pham-Ledard A, Benzaquen M, Peuvrel L, Le Corre Y, Lesage C, Viguier M, Baroudjian B, Dréno B, Quéreux G. Clinical, biological and histological characteristics of bullous pemphigoid associated with anti-PD-1/PD-L1 therapy: A national retrospective study. J Eur Acad Dermatol Venereol 2021; 35:e511-e514. [PMID: 33783881 DOI: 10.1111/jdv.17253] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- C Juzot
- Department of Dermatology, Nantes University Hospital, Nantes, France
| | - V Sibaud
- Oncodermatology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, France
| | - F Amatore
- Department of dermatology, Timone Hospital, Aix-Marseille University, Marseille, France
| | - S Mansard
- Department of Dermatology, University Hospital Estaing, Clermont Ferrand, France
| | - V Seta
- Department of Dermatology, Cochin University Hospital, Paris, France
| | - G Jeudy
- Department of Dermatology, Dijon University Hospital, Dijon, France
| | - A Pham-Ledard
- Inserm U1053, Department of Dermatology, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France
| | - M Benzaquen
- Department of Dermatology, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - L Peuvrel
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Y Le Corre
- Department of Dermatology, Angers University Hospital, Angers, France
| | - C Lesage
- Department of Dermatology, Montpellier University Hospital, Montpellier, France
| | - M Viguier
- Department of Dermatology, Robert Debré University Hospital, Reims University, Reims, France
| | - B Baroudjian
- Department of Dermatology, Saint-Louis University Hospital, Paris, France
| | - B Dréno
- Department of Dermatology, CIC 1413, CRCINA, Nantes University Hospital, Nantes, France
| | - G Quéreux
- Department of Dermatology, CIC 1413, CRCINA, Nantes University Hospital, Nantes, France
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Humbert S, Devers E, Lesage C, Legens C, Lemaitre L, Sorbier L, De Geuser F, Briois V. ASAXS study of the influence of sulfidation conditions and organic additives on sulfide slabs multiscale organization. J Catal 2021. [DOI: 10.1016/j.jcat.2021.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Secco LP, Lesage C, Lippi A, Maria A. Posterior cord syndrome associated with immune checkpoint inhibitors for metastatic melanoma. Ann Dermatol Venereol 2021; 148:193-194. [PMID: 33551213 DOI: 10.1016/j.annder.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/20/2020] [Accepted: 11/05/2020] [Indexed: 10/22/2022]
Affiliation(s)
- L-P Secco
- Department of Dermatology, Montpellier University Hospital, Hôpital Saint-Eloi, 80, Avenue Augustin-Fliche, 34090 Montpellier, France.
| | - C Lesage
- Department of Dermatology, Montpellier University Hospital, Hôpital Saint-Eloi, 80, Avenue Augustin-Fliche, 34090 Montpellier, France
| | - A Lippi
- Department of Neurology, Montpellier University Hospital, Hôpital Gui de Chauliac, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - A Maria
- Department of Internal Medicine: Multi-Organic Diseases, Local Referral Center for Systemic Autoimmune Diseases, Montpellier University Hospital, Hôpital Saint-Eloi, 80 Avenue Augustin Fliche, 34090 Montpellier, France; IRMB Institute for Regenerative Medicine and Biotherapy, INSERM U1183, University of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France
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Rivet V, Quantin X, Faillie JL, Lesage C, Meunier L, Faure S, Hillaire-Buys D, Lesouder C, Fabre S, Assenat E, Rullier P, Guilpain P, Maria ATJ. [Management of immune-related toxicities associated with immune checkpoints inhibitors: Data from the multidisciplinary meeting « ToxImmun » in Eastern Occitania]. Rev Med Interne 2021; 42:310-319. [PMID: 33485701 DOI: 10.1016/j.revmed.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 12/06/2020] [Accepted: 01/01/2021] [Indexed: 10/22/2022]
Abstract
Immune checkpoint inhibitors (ICIs) can cause numerous and complex immune-related adverse events whose management need a multidisciplinary approach. Herein, we investigated 114 requests, mostly concerning patients suffering from lung cancer, that were submitted to the « ToxImmun » multidisciplinary meeting in Eastern Occitania between December the 17th 2018 and January the 20th 2020. The leading reasons for the request concerned the putative causal link between immunotherapy and immune-toxicity and its management, followed by possible retreatment after temporary withdrawn because of adverse event, and finally the possibility to initiate ICIs in patients with pre-existing autoimmunity. Colitis, hepatitis and myocarditis were the most frequent immune-related adverse events (IRAEs), both all grade and grade 3-4. Sicca syndrome (with or without Sjogren criteria) was also frequent (26% of cases) and seems to be associated with severe toxicity and multi-toxicity. The mean time to first IRAE was 3.8 months, a time shortened with the use of anti-PD-L1 agents or ICI combination. A majority of requests came from initial evaluation by the internist confirming the early and main role of this specialty in the management of immunotoxicity. Expansion of this regional multidisciplinary meeting, coordinated by internists and medical oncologists, could improve management of immune-related adverse events for the patients' benefits.
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Affiliation(s)
- V Rivet
- Service de médecine interne : maladies multi-organiques de l'adulte, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Faculté de médecine, université de Montpellier, Montpellier, France
| | - X Quantin
- Faculté de médecine, université de Montpellier, Montpellier, France; Service d'oncologie médicale-oncologie thoracique, institut du cancer de Montpellier, Val d'Aurelle, Montpellier, France
| | - J L Faillie
- Faculté de médecine, université de Montpellier, Montpellier, France; Département de pharmacologie médicale et toxicologie, centre régional de pharmacovigilance, hôpital Lapeyronie, CHRU de Montpellier, Montpellier, France
| | - C Lesage
- Service de dermatologie clinique, hôpital Saint-Éloi, CHRU de Montpellier, Montpellier, France
| | - L Meunier
- Faculté de médecine, université de Montpellier, Montpellier, France; Service d'hépato-gastro-entérologie, hôpital Saint-Éloi, CHRU de Montpellier, Montpellier, France
| | - S Faure
- Service d'hépato-gastro-entérologie, hôpital Saint-Éloi, CHRU de Montpellier, Montpellier, France
| | - D Hillaire-Buys
- Faculté de médecine, université de Montpellier, Montpellier, France; Département de pharmacologie médicale et toxicologie, centre régional de pharmacovigilance, hôpital Lapeyronie, CHRU de Montpellier, Montpellier, France
| | - C Lesouder
- Département de pharmacologie médicale et toxicologie, centre régional de pharmacovigilance, hôpital Lapeyronie, CHRU de Montpellier, Montpellier, France
| | - S Fabre
- Service de médecine interne, clinique Beau-Soleil, Montpellier, France
| | - E Assenat
- Faculté de médecine, université de Montpellier, Montpellier, France; Service d'oncologie médicale, hôpital Saint-Éloi, CHRU de Montpellier, Montpellier, France
| | - P Rullier
- Service de médecine interne : maladies multi-organiques de l'adulte, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - P Guilpain
- Service de médecine interne : maladies multi-organiques de l'adulte, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Faculté de médecine, université de Montpellier, Montpellier, France; IRMB Institute for regenerative medicine and biotherapy, Inserm U1183, hôpital Saint-Éloi, Montpellier, France
| | - A T J Maria
- Service de médecine interne : maladies multi-organiques de l'adulte, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Faculté de médecine, université de Montpellier, Montpellier, France; IRMB Institute for regenerative medicine and biotherapy, Inserm U1183, hôpital Saint-Éloi, Montpellier, France.
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Fredeau L, Hober C, Pham-Ledard A, Boubaya M, Herms F, Celerier P, Aubin F, Beneton N, Dinulescu M, Jannic A, Meyer N, Duval Modeste AB, Cesaire L, Neidhardt EM, Archier E, Dreno B, Lesage C, Berthin C, Kramkimel N, Grange F, De Quatrebarbes J, Stoebner P, Poulalhon N, Arnault J, Abed S, Bonniaud B, Darras S, Heidelberger V, Devaux S, Moncourier M, Misery L, Mansard S, Etienne M, Brunet-Possenti F, Jacobzone C, Lesbazeilles R, Skowron F, Sanchez J, Catala S, Samimi M, Tazi Y, Spaeth D, Gaudy-Marqueste C, Collard O, Triller R, Pracht M, Dumas M, Peuvrel L, Combe P, Lauche O, Guillet P, Reguerre Y, Kupfer-Bessaguet I, Solub D, Schoeffler A, Bedane C, Dalac S, Mortier L, Maubec E. Cémiplimab et carcinomes épidermoïdes cutanés localement évolués ou métastatiques : premières données de vie réelle. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.036] [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]
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19
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Juzot C, Sibaud V, Amatore F, Mansard S, Seta V, Jeudy G, Pham-Ledard A, Benzaquen M, Dinulescu M, Le Corre Y, Lesage C, Viguier M, Baroudjian B, Clerc CJ, Funck-Brentano E, Giacchero D, Mortier L, Peuvrel L, Machet L, Duvert-Lehembre S, Viarnaud A, Joachim C, Bara C, Baubion E, Bergeret B, Brunet-Possenti F, Debarbieux S, Hébert V, Konstantinou MP, Marzouki-Zerouali A, Moreau-Huguen J, Phan C, Templier I, Celerier P, Aubin F, Modiano P, Poinas A, Vibet MA, Dréno B, Quéreux G. Pemphigoïdes bulleuses associées aux anti-PD-1/PDL-1 : étude nationale de 85 cas. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hober C, Fredeau L, Ledard AP, Boubaya M, Herms F, Aubin F, Benetton N, Dinulescu M, Jannic A, Cesaire L, Meyer N, Modeste AD, Archier E, Lesage C, Kramkimel N, Arnault J, Grange F, Dalac S, Mortier L, Maubec E. 1086P Cemiplimab for advanced cutaneous squamous cell carcinoma: Real life experience. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1210] [Citation(s) in RCA: 4] [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: 10/23/2022] Open
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Dalle S, Varey E, Nguyen JM, Dupuy A, Montaudie H, Lesage C, Mortier L, Leccia MT, Skowron F, Celerier P, Meyer N, Dutriaux C, Dalac-Rat S, Khammari A, Lebbe C, Dréno B. Management of adjuvant settings for Stage III melanoma patients in France prior to checkpoint inhibitors: epidemiological data from the RIC-Mel database. Eur J Dermatol 2020; 30:389-396. [PMID: 32815816 DOI: 10.1684/ejd.2020.3848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Targeted therapies such as BRAF and MEK inhibitors and immunotherapies have been made available to treat melanoma. OBJECTIVES To provide an overview of the management of the French Stage III melanoma population after complete lymph node resection prior to new adjuvant therapies. MATERIALS AND METHODS A subgroup data analysis. RESULTS Data from 1,835 patients were analysed (15.58% Stage IIIA, 39.24% Stage IIIB, 43.92% Stage IIIC and 1.25% Stage IIID). Superficial spreading melanoma was the most frequent (70.98% in Stage IIIA for whom mutation analysis was performed; BRAF mutation was identified in up to 62% Stage IIIA patients). Sentinel lymph node biopsy was performed in 88.46% of Stage IIIA patients, 42.36% of Stage IIIB, 53.97% of Stage IIIC and 34.78% of Stage IIID. Up to 80% of Stage IIIA patients had no adjuvant treatment follow-up. Ulceration (p = 0.004; RR: 2.98; 95% CI: 1.4-6.3) and age at diagnosis (p = 0.0002; RR: 1.04; 95% CI: 1.02-1.06) were significant predictive factors for survival. Adjuvant interferon-α was administered in up to 13.04% of Stage IIID patients. CONCLUSION Only a small number of Stage III melanoma patients were treated with interferon-α in adjuvant settings. New adjuvant therapies are currently having an effect on clinical practice in France, increasing survival and decreasing cost.
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Affiliation(s)
- Stephane Dalle
- Department of Dermatology, Université de Lyon, Institut de Cancérologie des HCL, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Emilie Varey
- Department of Oncodermatology, Université de Nantes, CHU Nantes, CIC 1413, CRCINA, Nantes, France
| | - Jean-Michel Nguyen
- Department of Epidemiology and Biostatistics, CHU Nantes, CRCINA, INSERM 1232, Université de Nantes, Nantes, France
| | - Alain Dupuy
- Department of Dermatology, Centre d'Onco-Dermatologie, CHU-CLCC de Rennes, Rennes, France
| | - Henri Montaudie
- Department of Dermatology, CHU de Nice, Hôpital l'Archet, Nice, France
| | - Candice Lesage
- Department of Dermatology, CHRU de Montpellier, Groupe Hospitalier Saint Eloi, Montpellier, France
| | - Laurent Mortier
- Department of Dermatology, Université de Lille, Inserm U 1189, CHRU de Lille, Lille, France
| | - Marie-Thérèse Leccia
- Department of Dermatology, CHU de Grenoble, Hôpital Albert Michalon, La Tronche, France
| | | | - Philippe Celerier
- Department of Dermatology, Groupe Hospitalier La Rochelle-Ré-Aunis, La Rochelle, France
| | - Nicolas Meyer
- Department of Dermatology, Institut Universitaire du Cancer de Toulouse et CHU de Toulouse, Toulouse, France
| | | | | | - Amir Khammari
- Department of Oncodermatology, Université de Nantes, CHU Nantes, CIC 1413, CRCINA, Nantes, France
| | - Céleste Lebbe
- Department of Dermatology, AP-HP Hôpital Saint-Louis, INSERM U976, Faculté Paris 7 Diderot, Paris, France
| | - Brigitte Dréno
- Department of Oncodermatology, Université de Nantes, CHU Nantes, CIC 1413, CRCINA, Nantes, France
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Nguyễn T, Maria ATJ, Ladhari C, Palassin P, Quantin X, Lesage C, Taïeb G, Ayrignac X, Rullier P, Hillaire-Buys D, Lambotte O, Guilpain P, Faillie JL. Rheumatic disorders associated with immune checkpoint inhibitors: what about myositis? An analysis of the WHO’s adverse drug reactions database. Ann Rheum Dis 2020; 81:e32. [DOI: 10.1136/annrheumdis-2020-217018] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 01/22/2020] [Indexed: 12/31/2022]
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Duplay Q, Riou J, Lesage C, Legrand E, Rodien P, Mucci S, Hamy A. Can postoperative calcemia kinetics predict the risk of hypocalcemia for the management of parathyroid adenoma in ambulatory surgery? J Visc Surg 2019; 157:175-182. [PMID: 31866268 DOI: 10.1016/j.jviscsurg.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The goal of this study was to analyse the kinetics of corrected calcemia levels (Cac) after parathyroid excision and to determine the percentage of variation (ΔCa) in the initial hours after surgery, in order to entertain an early discharge. POPULATION AND METHODS Were included in this study, patients undergoing operation for parathyroid adenoma responsible for primary hyperparathyroidism (PHP). The Cac was measure preoperatively and four hours after surgery, and then every day until patient discharge. Group A included patients for whom the Cac was inferior to 2.2mmol/L at least once postoperatively while group B included patients for whom the Cac was always equal or superior to 2.2mmol/L. The ΔCa represented the percentage of the fall in postoperative Cac with respect to preoperative Cac. RESULTS Between 2010 and 2017, 156 patients fulfilled the inclusion criteria (women 80.8%, [sex ratio 1:4], median age 64 years old). Preoperative Cac was statistically significantly lower in group A compared to group B (2.67 vs. 2.82mmol/L; P<0.0001). In total, 9.6% of patients had calcium supplementation for hypocalcemia, symptomatic or not. Postoperative Cac reached its nadir value on postoperative day 2. At four hours postoperative, the risk of postoperative calcelmia falling below 2.2mmol/L appeared when the ΔCa was superior to 6% with a sensitivity of 92.9% and a negative predictive value of 97.4%. CONCLUSION After excision of a parathyroid adenoma for PHP, the Cac falls rapidly and reaches its nadir value on day 2. If the fall in calcemia is less than 6% four hours after surgery (vs. preoperative level), early discharge within the framework of ambulatory surgery is possible.
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Affiliation(s)
- Q Duplay
- Digestive and endocrine surgery department, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
| | - J Riou
- MINT UMR Inserm 1066, CNRS 6021, Université d'Angers, 40, rue de Rennes, 49035 Angers, France
| | - C Lesage
- Digestive and endocrine surgery department, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - E Legrand
- Rheumatology department, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - P Rodien
- Endocrinology department, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - S Mucci
- Digestive and endocrine surgery department, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - A Hamy
- Digestive and endocrine surgery department, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
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Coustal C, Quantin X, Roubille F, Adda J, Tosi D, Ayrignac X, Hillaire-Buys D, Ladhari C, Lesage C, Faillie J, Guilpain P, Maria A. Myocardites aiguës sous inhibiteurs du check-point immunologique : expérience du groupe Montpellier-Oncologie-Immunologie (MONCIMMUN). Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Lesage C, Devers E, Legens C, Fernandes G, Roudenko O, Briois V. High pressure cell for edge jumping X-ray absorption spectroscopy: Applications to industrial liquid sulfidation of hydrotreatment catalysts. Catal Today 2019. [DOI: 10.1016/j.cattod.2019.01.081] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Maria A, Palassin P, Quantin X, Roubille F, Boissin C, Lesage C, Ladhari C, Hillaire-Buys D, Micallef J, Guillot B, Guilpain P, Faillie J. Hypertension artérielle pulmonaire sous inhibiteurs du checkpoint immunologique. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nguyen T, Ladhari C, Palassin P, Quantin X, Lesage C, Guillot B, Ayrignac X, Hillaire-Buys D, Lambotte O, Guilpain P, Faillie J, Maria A. Myosites induites par les inhibiteurs du checkpoint immunologique : analyse de la base de pharmacovigilance de l’organisation mondiale de la santé. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.051] [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: 11/28/2022]
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Lesage C, Longvert C, Prey S, Maanaoui S, Dréno B, Machet L, Zehou O, Kramkimel N, Jeudy G, Skowron F, Aubin F, Visseaux L, Mansard S, Dereure O, Lesage FX, Guillot B. Incidence and Clinical Impact of Anti-TNFα Treatment of Severe Immune Checkpoint Inhibitor-induced Colitis in Advanced Melanoma: The Mecolit Survey. J Immunother 2019; 42:175-179. [PMID: 31090656 DOI: 10.1097/cji.0000000000000268] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Immune checkpoint inhibitors (ICI) significantly improve overall survival (OS) in patients with advanced melanoma, but immune-related colitis may occur and warrant anti-tumor necrosis factor α (TNFα) treatment in severe forms. A nationwide, multicenter retrospective survey was conducted to assess both, the real-life incidence of grade 3/4 ICI-induced colitis treated with anti-TNFα, in patients with advanced melanoma, and the consequence of this therapeutic strategy on disease outcome. All patients with advanced melanoma treated with anti-TNFα agents for severe ICI-related colitis in the participating centers were included. Relative incidence was calculated according to the total number of patients treated with ICI in network centers during the period of inclusion. The possible impact of anti-TNFα treatment on disease outcome was evaluated through comparison of objective response rate, progression-free survival, and OS with pivotal literature data. Twenty-seven patients from 13 tertiary referral centers were included. Overall, severe ICI-related colitis treated with anti-TNFα occurred in 1% of patients with advanced melanoma, mostly with ipilimumab. Infliximab was successfully used in all patients but 1, mostly after 1 infusion. OS and progression-free survival of 12 and 3 months, respectively, were observed in these patients, along with an objective response rate of 41% at 12 months. This survey shows a low real-life incidence of severe colitis requiring anti-TNFα. Response rates to immunotherapy and survival data do not appear to significantly differ from those observed in pivotal studies. Severe ICI-induced colitis requiring anti-TNFα treatment appears to be a rare event in advanced melanoma, and infliximab does not seem to adversely affect disease outcome.
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Affiliation(s)
| | - Christine Longvert
- Department of Dermatology, Ambroise-Paré Hospital, APHP, Boulogne-Billancourt
| | - Sorilla Prey
- CHU, Bordeaux, Department of Dermatology
- Inserm U-1035, University of Bordeaux, Bordeaux
| | | | | | - Laurent Machet
- Department of Dermatology, CHRU Tours and Inserm U1253, University of Tours, Tours
| | - Ouidad Zehou
- Department of Dermatology, University Hospital Henri Mondor, Créteil
| | - Nora Kramkimel
- Department of Dermatology, University Hospital Cochin, Paris
| | | | | | - François Aubin
- Department of Dermatology, University Hospital, Besançon
| | | | - Sandrine Mansard
- Department of Dermatology, University Hospital Estaing, Clermont Ferrand, France
| | | | - François-Xavier Lesage
- Epsylon, University Montpellier, Paul Valéry University Montpellier 3, University Hospital, Montpellier
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Le Donne M, Bodard AG, Lesage C, Fleury B. Oral manifestations of a sinus melanoma: case report and literature review. J Oral Med Oral Surg 2019. [DOI: 10.1051/mbcb/2019020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Mucosal melanoma (MM) is a rare malignancy of the head and neck. Sinonasal melanomas are the most frequent, followed by oral melanomas. Observation: A 67-year-old patient with a known left sinus melanoma initially treated with immunotherapy was referred for consultation concerning mobile teeth. A pigmented lesion infiltrating the left maxillary arch in the molar area was detected. The malignancy had invaded the oral mucosa. Despite many proposed treatments (immunotherapy, chemotherapy, and radiotherapy), the patient showed metastatic progression, which resulted in death. Discussion: Sinus MMs are malignancies with poor prognosis because these are often diagnosed in the late stages of disease progression. As these tumors are rare, there is no treatment consensus and surgery remains the best option. Diagnosis of pigmented lesions of the oral mucosa is sometimes complicated because of various implied etiologies. Conclusion: This case report shows that sinus MMs can induce pigmentation in the oral mucosa. These are rare malignancies with poor prognosis, for which no treatment consensus exists to date.
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Bourquin M, Visseaux L, Stien S, Condamina M, Hourbeigt K, Lesage C, Sanchez J, Barbe-Da Cunha C, Grange F. Rôle des traumatismes dans les mélanomes des paumes, des plantes et des ongles : première étude cas-témoin basée sur la population. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Mignard C, Deschamps-Huvier A, Duval-Modeste AB, Dutriaux C, Khammari A, Avril MF, Mortier L, Lesimple T, Gaudy-Marqueste C, Lesage C, Machet L, Aubin F, Meyer N, Beneton Benhard N, Jeudy G, Montaudié H, Arnault JP, Leccia MT, Joly P, Oncology Research Group Of The French Society Of Dermatology S. Efficacy of immunotherapy in patients with metastatic mucosal or uveal melanoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Becquart O, Girard C, Lesage C, Guillot B. Angiosarcomes cutanés de la tête et du cou inopérables traités par bevacizumab et paclitaxel. Ann Dermatol Venereol 2018; 145:451-453. [DOI: 10.1016/j.annder.2018.02.008] [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] [Received: 08/07/2017] [Revised: 11/04/2017] [Accepted: 02/13/2018] [Indexed: 10/17/2022]
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Garval E, Plee J, Lesage C, Grange-Prunier A, Bernard P, Perceau G. [Frequency of contact sensitization to modern dressings used to treat chronic leg ulcer]. Ann Dermatol Venereol 2018; 145:339-346. [PMID: 29673752 DOI: 10.1016/j.annder.2018.01.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 09/03/2017] [Accepted: 01/15/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Allergic contact dermatitis around chronic leg ulcers (CLU) is a common complication in patients presenting CLU and prolongs healing times. The aim of this study was to describe the rate of sensitization to modern dressings (MD) used in these patients and to assess whether there is a relation between the number of sensitizations and ulcer type, the time from onset of the ulcer, and patient age and gender. PATIENTS AND METHODS We conducted a retrospective study at Reims University Hospital between 2010 and 2014 that included all patients with CLU of vascular etiology surrounded by eczematous lesions, and who had one of the patch-tests in the following 3 series: European baseline±leg ulcers±corticosteroids. RESULTS Among the 73 patients included, 43 % were polysensitized. Thirty-three patients (45 %) were sensitized to MD (38 % to hydrocolloids, 18 % to hydrogels, 7 % to hydrocellular dressings, 7 % to hydrofiber dressings, 5 % to contact layers and 3 % to alginates). Median age and sex did not differ between "polysensitized" patients and "non-polysensitized" patients (P=0.84 and P=0.25, respectively). Polysensitization was more frequent among patients presenting ulcers for more than 5 years (P=0.032). CONCLUSION Practically half of all patients presenting CLU with surrounding contact dermatitis had sensitization to modern dressings (mostly hydrocolloids and hydrogels). The rate of sensitization increased with the length of presence of CLU.
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Affiliation(s)
- E Garval
- Service de dermatologie, CHU, avenue du Général-Koenig, 51100 Reims, France.
| | - J Plee
- Service de dermatologie, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - C Lesage
- Service de dermatologie, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - A Grange-Prunier
- Service de dermatologie, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - P Bernard
- Service de dermatologie, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - G Perceau
- Service de dermatologie, CHU, avenue du Général-Koenig, 51100 Reims, France
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Lesage C, Longvert C, Prey S, Maanaoui S, Dréno B, Machet L, Zehou O, Kramkimel N, Jeudy G, Skowron F, Aubin F, Visseaux L, Mansard S, Guillot B. Incidence et impact du traitement par anti-TNFα des colites sévères sous immunothérapie du mélanome : étude MECOLIT. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.533] [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: 11/27/2022]
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35
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Baeke A, Goulart DM, Yachouh J, Frison L, Lesage C, Girard C, Guillot B, Dereure O. Analyse du ganglion sentinelle dans les carcinomes épidermoïdes cutanés à haut risque de la tête et du cou : quelle pertinence clinique ? Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.222] [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]
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Garval E, Plee J, Lesage C, Grange Prunier A, Bernard P, Perceau G. Fréquence des sensibilisations de contact aux dispositifs médicaux utilisés pour le traitement des ulcères de jambe. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sobocinski V, Duvert-Lehembre S, Bubenheim M, Lesage C, Bernard P, Bénichou J, Joly P. Assessment of adherence to topical corticosteroids in patients with bullous pemphigoid. Br J Dermatol 2016; 174:919-21. [PMID: 26556709 DOI: 10.1111/bjd.14285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- V Sobocinski
- Department of Dermatology, INSERM U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Rouen, Rouen, France.
| | - S Duvert-Lehembre
- Department of Dermatology, INSERM U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Rouen, Rouen, France
| | - M Bubenheim
- Department of Biostatistics, INSERM U 657, Rouen University Hospital, Rouen, France
| | - C Lesage
- Department of Dermatology, Reims University Hospital, Reims, France
| | - P Bernard
- Department of Dermatology, Reims University Hospital, Reims, France
| | - J Bénichou
- Department of Biostatistics, INSERM U 657, Rouen University Hospital, Rouen, France
| | - P Joly
- Department of Dermatology, INSERM U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Rouen, Rouen, France
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Becquart O, Girard C, Lesage C, Guillot B. Angiosarcomes cutanés avancés traités par paclitaxel et bevacizumab. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.212] [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: 11/27/2022]
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Dabouz F, Barbe C, Lesage C, Le Clainche A, Arnoult G, Hibon E, Bernard P, Grange F. Clinical and histological features of head and neck melanoma: a population-based study in France. Br J Dermatol 2015; 172:707-15. [DOI: 10.1111/bjd.13489] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2014] [Indexed: 11/29/2022]
Affiliation(s)
- F. Dabouz
- Service de Dermatologie; Hôpital Robert Debré; CHU de Reims Reims France
| | - C. Barbe
- Unité d'Aide Méthodologique; CHU de Reims; Reims France
| | - C. Lesage
- Service de Dermatologie; Hôpital Robert Debré; CHU de Reims Reims France
| | | | - G. Arnoult
- Centre de Recherche et d'Investigation Clinique; Hôpital Maison Blanche; CHU de Reims; Reims France
| | - E. Hibon
- Laboratoire de Pathologie; Centre de Regroupement Informatique des Statistiques Anatomo-pathologiques de Champagne; Reims France
| | - P. Bernard
- Service de Dermatologie; Hôpital Robert Debré; CHU de Reims Reims France
| | - F. Grange
- Service de Dermatologie; Hôpital Robert Debré; CHU de Reims Reims France
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Leroux-Kozal V, Lévêque N, Brodard V, Lesage C, Dudez O, Makeieff M, Kanagaratnam L, Diebold MD. Merkel cell carcinoma: histopathologic and prognostic features according to the immunohistochemical expression of Merkel cell polyomavirus large T antigen correlated with viral load. Hum Pathol 2014; 46:443-53. [PMID: 25623078 DOI: 10.1016/j.humpath.2014.12.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 11/29/2014] [Accepted: 12/03/2014] [Indexed: 12/19/2022]
Abstract
Merkel cell carcinoma (MCC) is a neuroendocrine skin malignancy frequently associated with Merkel cell polyomavirus (MCPyV), which is suspected to be oncogenic. In a series of MCC patients, we compared clinical, histopathologic, and prognostic features according to the expression of viral large T antigen (LTA) correlated with viral load. We evaluated the LTA expression by immunohistochemistry using CM2B4 antibody and quantified viral load by real-time polymerase chain reaction. We analyzed formalin-fixed, paraffin-embedded (FFPE) tissue samples (n = 36) and corresponding fresh-frozen biopsies when available (n = 12), of the primary tumor and/or metastasis from 24 patients. MCPyV was detected in 88% and 58% of MCC patients by real-time polymerase chain reaction and immunohistochemistry, respectively. The relevance of viral load measurements was demonstrated by the strong consistency of viral load level between FFPE and corresponding frozen tissues as well as between primary tumor and metastases. From FFPE samples, 2 MCC subgroups were distinguished based on a viral load threshold defined by the positivity of CM2B4 immunostaining. In the LTA-negative subgroup with no or low viral load (nonsignificant), tumor cells showed more anisokaryosis (P = .01), and a solar elastosis around the tumor was more frequently observed (P = .03). LTA-positive MCCs with significant viral load had a lower proliferation index (P = .03) and a longer survival of corresponding patients (P = .008). Depending on MCPyV involvement, 2 MCC subgroups can be distinguished on histopathologic criteria, and the CM2B4 antibody is able to differentiate them reliably. Furthermore, the presence of a significant viral load in tumors is predictive of better prognosis.
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Affiliation(s)
- Valérie Leroux-Kozal
- Department of Pathology, Faculty of Medicine, Robert Debré University Hospital, 51092 Reims, France.
| | - Nicolas Lévêque
- Clinical and Molecular Virology Unit, University Hospital, 51092 Reims, France; Faculty of Medicine, EA-4684 Cardiovir SFR-CAP Santé, 51092 Reims, France
| | - Véronique Brodard
- Clinical and Molecular Virology Unit, University Hospital, 51092 Reims, France
| | - Candice Lesage
- Department of Dermatology, Robert Debré University Hospital, 51092 Reims, France
| | - Oriane Dudez
- Department of Pathology, Faculty of Medicine, Robert Debré University Hospital, 51092 Reims, France
| | - Marc Makeieff
- Department of Otolaryngology-Head and Neck Surgery, Robert Debré University Hospital, 51092 Reims, France
| | - Lukshe Kanagaratnam
- Department of Research and Innovation, Robert Debré University Hospital, 51092 Reims, France
| | - Marie-Danièle Diebold
- Department of Pathology, Faculty of Medicine, Robert Debré University Hospital, 51092 Reims, France
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Anuset D, Quinquenel A, Lesage C, Durlach A, Delmer A, Bernard P, Grange F. Lymphoprolifération cutanée plasmocytoïde d’évolution fulgurante satellite d’un carcinome spinocellulaire chez un patient greffé rénal. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.213] [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: 11/28/2022]
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Sobocinski V, Duvert-Lehembre S, Lesage C, Bernard P, Joly P. Évaluation de l’observance de la corticothérapie locale et des traitements systémiques dans la pemphigoïde bulleuse. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lesage C, Vergier B, Diebold MD, de la Fouchardière A, Fraitag S, Mérol JC, Grange F. Nævus bleu cellulaire atypique temporal de l’enfant : un diagnostic rare. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.248] [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: 11/25/2022]
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Grange F, Barbe C, Aubin F, Arnoult G, Le Clainche A, Dufour V, Lesage C, Woronoff AS. Mélanomes des mains et des pieds : une étude française basée sur la population. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.043] [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: 10/27/2022]
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Decors A, Lesage C, Jourdain E, Giraud P, Houbron P, Vanhem P, Madani N. Outbreak of tularaemia in brown hares (Lepus europaeus) in France, January to March 2011. Euro Surveill 2011; 16:19913. [PMID: 21794224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
We report an outbreak of tularaemia in brown hares (Lepus europaeus) in France, which occurred from January to March 2011 and was characterised by a high mortality rate in the local hare population. In France, hare tularaemia is usually sporadic and does not significantly affect hare populations. The epizootic form of the outbreak reported here led us to reconsider the potential associated risks for hare populations and public health.
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Affiliation(s)
- A Decors
- National hunting and wildlife agency, Studies and research department, Auffargis, France. anouk.decors@
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Decors A, Lesage C, Jourdain E, Giraud P, Houbron P, Vanhem P, Madani N. Outbreak of tularaemia in brown hares (Lepus europaeus) in France, January to March 2011. Euro Surveill 2011. [DOI: 10.2807/ese.16.28.19913-en] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report an outbreak of tularaemia in brown hares (Lepus europaeus) in France, which occurred from January to March 2011 and was characterised by a high mortality rate in the local hare population. In France, hare tularaemia is usually sporadic and does not significantly affect hare populations. The epizootic form of the outbreak reported here led us to reconsider the potential associated risks for hare populations and public health.
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Affiliation(s)
- A Decors
- National hunting and wildlife agency, Studies and research department, Auffargis, France
| | - C Lesage
- National hunting and wildlife agency, Studies and research department, Auffargis, France
| | - E Jourdain
- Institut Scientifique de Recherche Agronomique (INRA), UR 346, Saint Genès Champanelle, France
| | - P Giraud
- Veterinary laboratory of Pas-de-Calais, Arras, France
| | - P Houbron
- Departmental Federation of Pas-de-Calais’s hunters, Arras, France
| | - P Vanhem
- National hunting and wildlife agency, Departmental Service, Bergueneuse, France
| | - N Madani
- French Agency for Food, Environmental and Occupational Health Safety, National Reference Laboratory, Animal Health Laboratory, Maisons-Alfort, France
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Daragon A, Krzanowska K, Vittecoq O, Ménard JF, Hau I, Jouen-Beades F, Lesage C, Bertho JM, Tron F, Le Loët X. Prospective X-ray densitometry and ultrasonography study of the hand bones of patients with rheumatoid arthritis of recent onset. Joint Bone Spine 2001; 68:34-42. [PMID: 11235778 DOI: 10.1016/s1297-319x(00)00227-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Bone demineralization observed in early rheumatoid arthritis is not easily measured. To measure bone loss and to discriminate between rheumatoid arthritis and other rheumatic diseases, we used two methods: dual-energy X-ray absorptiometry and ultrasonography. METHODS From a population-based recruitment, 32 patients with early peripheral polyarthritis (median disease duration: 4 months) were studied. Clinical, laboratory, functional, hand-bone assessments were made at the entry an at months 6 and 12. Bone X-ray densitometry measurements were made on 16 areas of the hand. Speed of sound was measured across the proximal phalanges of the four fingers. X-rays of both hands were scored according to the modified Sharp's score. At 12 months, patients were classified as rheumatoid arthritis (N = 15; 9 F) or as other rheumatic diseases. RESULTS We found: 1) significantly decreased bone mineral density (BMD) of the whole hand, in the rheumatoid arthritis group versus the other rheumatic diseases group, at 6 and 12 months (P < 0.05); 2) no significant decrease of bone mineral density (BMD) in other areas in the rheumatoid arthritis group; 3) no significant change of ultrasounds in either group; and 4) no significant correlation between the decrease of BMD in the rheumatoid arthritis group and clinical, biological or radiologic parameters, except for IFNgamma, whose production in whole blood cell culture was lower at entry in the rheumatoid arthritis group. CONCLUSION DEXA bone assessment in rheumatoid arthritis was able t detect bone loss in the whole hand at 6 months.
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Affiliation(s)
- A Daragon
- Rheumatology department, INSERM U-519 and IFR 23, Centre Hospitalier Universitaire de Rouen, France.
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Lesage C. [Women of letters in 16th- and 17th-century Venice: Moderata Fonte, Lucrezia Marinella, Arcangela Tarabotti]. Clio (Toulouse) 2001:135-144. [PMID: 19530390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Abstract
PURPOSE Corneal thinning disorders weaken the mechanical strength of affected corneas, suggesting that photorefractive procedures may be contraindicated in keratoconus. Few cases have been reported to confirm this hypothesis. METHODS A 45-year-old man had two laser in situ keratomileusis (LASIK) procedures and one photorefractive keratectomy (PRK) performed on his left eye, and three LASIK procedures on his right eye. After these surgeries, a dramatic corneal ectasia and grade III haze occurred in both eyes, with a clinical diagnosis of keratoconus. The changes in his corneas were followed with videokeratography and slit-lamp microscopy. RESULTS Preoperative videokeratograph of both eyes suggested keratoconus. After multiple refractive procedures, the best spectacle-corrected visual acuity was as low as 20/1200 bilaterally. Both eyes displayed dramatic corneal protrusion with corneal scarring. CONCLUSIONS This case emphasizes the need for preoperative corneal thickness measurement and detailed analysis of videokeratographs. Thinning corneal disorders such as keratoconus, keratoconus suspects, or pellucid marginal degeneration are a contraindication for excimer laser ablative refractive procedures.
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Braillon P, Lesage C, Bost M. Minéralisation osseuse au cours du traitement des syndromes de Turner. Arch Pediatr 1997. [DOI: 10.1016/s0929-693x(97)83437-9] [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: 11/24/2022]
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