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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.
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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
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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.
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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
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Hanvic B, Lecuru F, Vanacker H, Pautier P, Narducci F, Cherifi F, Floquet A, Angeles M, Berton-Rigaud D, Pomel C, Kalbacher E, Provansal Gross M, Fernandez Y, De La Motte Rouge T, Selle F, Meeus P, Genestie C, Salleron J, Ray-Coquard I. 13O Impact of surgery and chemotherapy in ovarian sex cord-stromal tumors from the multicentric Salomé study including 469 patients: A TMRG and GINECO group study. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101034] [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
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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
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Banerjee S, Leary A, Stewart J, Dewan M, Lheureux S, Clamp A, Ray-Coquard I, Selle F, Gourley C, Glasspool R, Bowen R, Attygalle A, Vroobel K, Tunariu N, Wilkinson K, Toms C, Natrajan R, Bliss J, Lord C, Porta N. 34O ATR inhibitor alone (ceralasertib) or in combination with olaparib in gynaecological cancers with ARID1A loss or no loss: Results from the ENGOT/GYN1/NCRI ATARI trial. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100814] [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: 02/27/2023] Open
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Kurtz J, Pujade-Lauraine E, Oaknin A, Belin L, Tsibulak I, Cibula D, Vergote I, Rosengarten O, Rodrigues M, de Gregorio N, Martinez-Garcia J, Pautier P, Mouret Reynier M, Selle F, D'Hondt V, Lobbedez FJ, Boissier EB, Floquet A, Heudel PE, Heitz F. LBA30 Phase III ATALANTE/ov29 trial: Atezolizumab (Atz) versus placebo with platinum-based chemotherapy (Cx) plus bevacizumab (bev) in patients (pts) with platinum-sensitive relapse (PSR) of epithelial ovarian cancer (OC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.026] [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] Open
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Joly Lobbedez F, Ray-Coquard I, Lefevre Arbogast S, Grellard JM, Clarisse B, Floquet A, Selle F, Berton-Rigaud D, Frank S, De La Motte Rouge T, Kalbacher E, Provansal Gross M, A. lortholary, Orfeuvre H, Alexandre J, Augereau P, Kurtz J, Nadeau C, Pautier P, Gernier F. 535P Long term quality of life after chemotherapy among nonepithelial ovarian cancer survivors: The case-control vivrovaire rare tumours study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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O'Malley D, Oaknin A, Monk B, Leary A, Selle F, Alexandre J, Randall L, Rojas C, Neffa M, Kryzhanivska A, Gladieff L, Berton D, Meniawy T, Lugowska I, Bondarenko I, Moore K, Ortuzar Feliu W, Ancukiewicz M, Shapiro I, Ray-Coquard I. LBA34 Single-agent anti-PD-1 balstilimab or in combination with anti-CTLA-4 zalifrelimab for recurrent/metastatic (R/M) cervical cancer (CC): Preliminary results of two independent phase II trials. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2264] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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9
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Lecuru F, du Bois A, Sehouli J, Vergote I, Ferron G, Reuss A, Meier W, Greggi S, Jensen P, Selle F, Guyon F, Pomel C, Zang R, Avall-Lundqvist E, Kim JW, Ponce J, Raspagliesi F, Sadaf GM, Reinthaller A, Harter P. 816MO AGO DESKTOP III/ENGOT OV20: Impact of surgical characteristics and time to first subsequent therapy (TFST). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Derquin F, Floquet A, Hardy-Bessard AC, Edeline J, Lotz JP, Alexandre J, Pautier P, Angeles MA, Delanoy N, Lefeuvre-Plesse C, Cancel M, Treilleux I, Augereau P, Lavoue V, Kalbacher E, Berton Rigaud D, Selle F, Nadeau C, Gantzer J, Joly F, Guillemet C, Pomel C, Favier L, Abdeddaim C, Venat-Bouvet L, Provansal M, Fabbro M, Kaminsky MC, Lortholary A, Lecuru F, Coquard IR, de La Motte Rouge T. Need for risk-adapted therapy for malignant ovarian germ cell tumors: A large multicenter analysis of germ cell tumors' patients from French TMRG network. Gynecol Oncol 2020; 158:666-672. [PMID: 32624235 DOI: 10.1016/j.ygyno.2020.06.491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/15/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Malignant ovarian germ cell tumors are rare tumors, affecting young women with a generally favorable prognosis. The French reference network for Rare Malignant Gynecological Tumors (TMRG) aims to improve their management. The purpose of this study is to report clinicopathological features and long-term outcomes, to explore prognostic parameters and to help in considering adjuvant strategy for stage I patients. PATIENTS AND METHODS Data from patients with MOGCT registered among 13 of the largest centers of the TMRG network were analyzed. We report clinicopathological features, estimated 5-year event-free survival (5y-EFS) and 5-year overall survival (5y-OS) of MOGCT patients. RESULTS We collected data from 147 patients including 101 (68.7%) FIGO stage I patients. Histology identifies 40 dysgerminomas, 52 immature teratomas, 32 yolk sac tumors, 2 choriocarcinomas and 21 mixed tumors. Surgery was performed in 140 (95.2%) patients and 106 (72.1%) received first line chemotherapy. Twenty-two stage I patients did not receive chemotherapy. Relapse occurred in 24 patients: 13 were exclusively treated with upfront surgery and 11 received surgery and chemotherapy. 5y-EFS was 82% and 5y-OS was 92.4%. Stage I patients who underwent surgery alone had an estimated 5y-EFS of 54.6% and patients receiving adjuvant chemotherapy 94.4% (P < .001). However, no impact on estimated 5y-OS was observed: 96.3% versus 97.8% respectively (P = .62). FIGO stage, complete primary surgery and post-operative alpha fetoprotein level significantly correlated with survival. CONCLUSION Adjuvant chemotherapy does not seem to improve survival in stage I patients. Active surveillance can be proposed for selected patients with a complete surgical staging.
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Affiliation(s)
- F Derquin
- Medical Oncology Department, Centre Hospitaliser Yves Le Foll, Saint Brieuc, France
| | - A Floquet
- Medical Oncology Department, Institut Bergonié, Bordeaux, France
| | | | - J Edeline
- Medical Oncology Department, Centre Eugène Marquis, Rennes, France
| | - J P Lotz
- Medical Oncology Department, Sorbonne University, APHP, Paris, France
| | - J Alexandre
- Medical Oncology Department, Hôpital Cochin, APHP, Paris, France
| | - P Pautier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - M A Angeles
- Surgical Oncology Department, Institut Claudius Regaud, Toulouse, France
| | - N Delanoy
- Medical Oncology Department, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | | | - M Cancel
- Medical Oncology Department, Centre Hospitalier Universitaire Bretonneau, Tours, France
| | - I Treilleux
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
| | - P Augereau
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Angers, France
| | - V Lavoue
- Gynecology Department, Centre Hospitalier Universitaire, Rennes, France
| | - E Kalbacher
- Medical Oncology Department, Centre Hospitalier Régional Universitaire, Besançon, France
| | - D Berton Rigaud
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Nantes, France
| | - F Selle
- Diaconnesses Hospital Group, Paris, France
| | - C Nadeau
- Gynecology Department, CHU de Poitiers, Poitiers, France
| | - J Gantzer
- Medical Oncology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F Joly
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - C Guillemet
- Medical Oncology Department, Centre Henri-Becquerel, Rouen, France
| | - C Pomel
- Medical Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - L Favier
- Medical Oncology Department, Centre Georges François Leclerc, Dijon, France
| | - C Abdeddaim
- Medical Oncology Department, Centre Oscar Lambret, Lille, France
| | - L Venat-Bouvet
- Medical Oncology Department, CHU Dupuytren, Limoges, France
| | - M Provansal
- Medical Oncology Department, Institut Paoli Calmettes, Marseille, France
| | - M Fabbro
- Medical Oncology Department, Institut régional du Cancer Montpellier, Montpellier, France
| | - M C Kaminsky
- Medical Oncology Department, Institut de Cancérologie de Lorraine - Alexis Vautrin, Vandoeuvre-Les-Nancy, France
| | - A Lortholary
- Medical Oncology Department, Hôpital Privé du Confluent, Nantes, France
| | - F Lecuru
- Medical Oncology Department, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - I Ray Coquard
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
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Fujiwara K, Harter P, Leary A, Perol D, Pignata S, González-Martín A, Petru E, van Nieuwenhuysen E, Colombo N, Mäenpää J, Selle F, de Gregorio N, Lorusso D, Guerra Alia E, Lefeuvre-Plesse C, Buderath P, Lortholary A, Burges A, Pujade-Lauraine E, Ray-Coquard I. Phase III PAOLA-1/ENGOT-ov25 trial: Olaparib plus bevacizumab (bev) as maintenance therapy in patients (pts) with newly diagnosed, advanced ovarian cancer (OC) treated with platinum-based chemotherapy (PCh) plus bev. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.009] [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: 11/13/2022] Open
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12
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Ray-Coquard I, Pautier P, Pignata S, Pérol D, González-Martín A, Sevelda P, Fujiwara K, Vergote I, Colombo N, Mäenpää J, Selle F, Sehouli J, Lorusso D, Alia EMG, Lefeuvre-Plesse C, Canzler U, Lortholary A, Marmé F, Pujade-Lauraine E, Harter P. Phase III PAOLA-1/ENGOT-ov25 trial: Olaparib plus bevacizumab (bev) as maintenance therapy in patients (pts) with newly diagnosed, advanced ovarian cancer (OC) treated with platinum-based chemotherapy (PCh) plus bev. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Berton-Rigaud D, Floquet A, Mollon-Grange D, Dechartres A, Lescaut W, Kaminsky-Forrett MC, Tredan O, Largillier R, Savoye A, Alexandre J, Delbaldo C, Malaurie E, Barletta H, Bosacki C, Tixidre CG, Follana P, Laharie-Mineur H, Levaché CB, Pujade-Lauraine E, Selle F. Use of bevacizumab (Bev) in real life for first-line (fl) treatment of ovarian cancer (OC)/ The GINECO ENCOURAGE cohort of 500 French patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.031] [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
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Montagner C, Bricou A, Selle F, Kafé H, Mauhin W, Fredeau L, Duval-Chopard L, Slama J, Durand P, Beal C, London J, Lidove O. [Glassy cell carcinoma of the uterine cervix: An aggressive type of cancer]. Rev Med Interne 2019; 40:754-757. [PMID: 31431320 DOI: 10.1016/j.revmed.2019.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/19/2019] [Accepted: 07/17/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cervical cancer is the twelfth most frequent cancer in women in France. Glassy cell carcinoma is a rare histological entity, rapidly aggressive, associated with a poor prognosis. CASE REPORT A 30-year-old woman was admitted in an internal medicine department for polyarthralgia with high grade fever, evolving for 3 weeks. There was an inflammatory syndrome. The 18-FDG-PET-scan showed inflammatory lymph nodes as well as disseminated osteolytic lesions, and a primitive pelvic tumor. A 3cm tumor of the cervix was found during the gynaecologic examination. Histological analysis elicited a high-index mitotic carcinoma, glassy cell carcinoma type. Despite chemotherapy, the outcome was poor, with early death occurring after three months of follow-up. CONCLUSION The glassy cell carcinoma of the cervix should be considered as an aetiology of bone metastases in young female patients.
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Affiliation(s)
- C Montagner
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France.
| | - A Bricou
- Service de chirurgie gynécologique et mammaire, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - F Selle
- Service d'oncologie, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron 75020 Paris, France
| | - H Kafé
- Centre de pathologie, 19, rue de Passy, 75016, France
| | - W Mauhin
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - L Fredeau
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - L Duval-Chopard
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - J Slama
- Paris Service de médecine nucléaire, Hôpital Beaujon, 100, boulevard du Général Leclerc, 92110 Clichy, France
| | - P Durand
- Service de radiologie, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - C Beal
- Service de rhumatologie, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - J London
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - O Lidove
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
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Ray-Coquard I, Harter P, Lorusso D, Dalban C, Vergote I, Fujiwara K, Gladieff L, Lueck HJ, Floquet A, Lesoin A, Schnelzer A, Pignata S, Selle F, Sehouli J, Brocard F, Mangili G, Pautier P, De Giorgi U, Provansal M, Heudel PE. Alienor/ENGOT-ov7 randomized trial exploring weekly paclitaxel (wP) + bevacizumab (bev) vs wP alone for patients with ovarian sex cord tumors (SCT) in relapse. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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De Giorgi U, Richard S, Badoglio M, Kanfer E, Bourrhis JH, Nicolas-Virelizier E, Vettenranta K, Lioure B, Martin S, Dreger P, Schuler MK, Thomson K, Scarpi E, Rosti G, Selle F, Mangili G, Lanza F, Bregni M. Salvage high-dose chemotherapy in female patients with relapsed/refractory germ-cell tumors: a retrospective analysis of the European Group for Blood and Marrow Transplantation (EBMT). Ann Oncol 2018; 28:1910-1916. [PMID: 28510616 DOI: 10.1093/annonc/mdx259] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background High-dose chemotherapy (HDC) with hematopoietic progenitor cell transplantation is a standard option for relapsed/refractory testicular germ-cell tumor (GCT), but only few data have been reported in female patients with GCT. We conducted a retrospective analysis of female patients with GCT treated with HDC and registered with the European Society for Blood and Marrow Transplantation. Patients and methods Between 1985 and 2013, 60 registered female patients with GCT, median age 27 years (range 15-48), were treated with salvage HDC. Forty patients (67%) had primary ovarian GCT, 8 (13%) mediastinal, 7 (12%) retroperitoneal and 5 (8%) other primary sites/unknown. Twenty-two patients (37%) received HDC as second-line therapy, 29 (48%) as third-line, and 9 (15%) as fourth- to sixth-line. Nine of 60 patients (15%) received HDC as late-intensification with no evidence of metastasis before HDC. The conditioning HDC regimens comprised carboplatin in 51 of 60 cases (85%), and consisted of a single HDC cycle in 31 cases (52%), a multi-cycle HDC regimen in 29 (48%). Results Nine cases who underwent late intensification HDC were not evaluable for response. Of the other 51 assessable patients, 17 (33%) achieved a complete response (CR), 8 (16%) a marker-negative partial remission (PRm-), 5 (10%) a marker-positive partial remission, 5 (10%) stable disease, and 13 (25%) progressive disease. There were 3 toxic deaths (6%). With an overall median follow-up of 14 months (range 1-219), 7 of 9 (78%) patients with late intensification and 18 of the 25 patients (72%) achieving a CR/PRm- following HDC were free of relapse/progression. In total, 25 of 60 patients (42%) were progression-free following HDC at a median follow-up of 87 months (range 3-219 months). Conclusions Salvage HDC based on carboplatin represents a therapeutic option for female patients with relapsed/refractory GCT.
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Affiliation(s)
- U De Giorgi
- Department of Medical Oncology and Hematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - S Richard
- Department of Medical Oncology, Hopital Tenon, Paris
| | | | - E Kanfer
- Department of Hematology, Imperial College, Hammersmith Hospital, London, UK
| | - J H Bourrhis
- Hematology-Marrow Transplant Service, Institute Gustave-Roussy, Villejuif
| | | | - K Vettenranta
- Department of Pediatrics, University of Helsinki, Helsinki, Finland
| | - B Lioure
- Department of Hematology/Oncology, Strasbourg University Hospital, Strasbourg, France
| | - S Martin
- Department of Internal Medicine II, Robert-Bosch-Hospital, Stuttgart
| | - P Dreger
- Department of Medicine V, University of Heidelberg, Heidelberg
| | - M K Schuler
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - K Thomson
- Department of Haematology, University College London Hospital, London, UK
| | - E Scarpi
- Biostatistics and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola
| | - G Rosti
- Department of Oncology, Policlinico San Matteo IRCCS, Pavia
| | - F Selle
- Department of Medical Oncology, Hopital Tenon, Paris
| | - G Mangili
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, Milan
| | - F Lanza
- Department of Onco-Hematology, Santa Maria delle Croci Hospital, Ravenna
| | - M Bregni
- Department of Medical Oncology, Busto Arsizio Hospital, Busto Arsizio, Italy
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Park SB, Kwok JB, Asher R, Lee CK, Beale P, Selle F, Friedlander M. Clinical and genetic predictors of paclitaxel neurotoxicity based on patient- versus clinician-reported incidence and severity of neurotoxicity in the ICON7 trial. Ann Oncol 2017; 28:2733-2740. [PMID: 29117336 DOI: 10.1093/annonc/mdx491] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [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: 11/14/2022] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity of paclitaxel, with no reliable method to identify at-risk patients. We investigated the incidence and risk factors including genetic polymorphisms associated with the development of CIPN based on clinician and patient reporting of neuropathic symptoms. PATIENTS AND METHODS Risk factors for the development of CIPN were examined in 454 patients treated with paclitaxel/carboplatin from the International Collaboration on Ovarian Neoplasms 7 (ICON7) trial. Neuropathy was graded by clinicians by standard adverse event reporting and by patients utilising OV28 questionnaire. Genetic risk factors were examined by selecting six single nucleotide polymorphisms in genes associated with microtubule function. Risk factors were assessed via dose-to-event cox regression models. RESULTS Grade >2 neuropathy was reported by clinicians in 28% of patients, while 67% of patients reported 'quite a bit' or 'very much' tingling or numbness. Agreement between clinicians and patients was poor (κ = 0.236, 95% confidence interval, 0.177-0.296, P < 0.001). Older age, bevacizumab treatment and bowel resection were associated with clinician reported CIPN, while older age and volume of residual disease were associated with patient-reported neuropathy. There were no significant associations between clinician-reported neuropathy or patient-reported neuropathy and TUBB2, CEP72 or individual MAPT or GSK3B SNPs, however MAPT additive polymorphisms were associated with patient-reported neuropathy and GSK3B additive polymorphisms were associated with clinician reported CIPN. CONCLUSIONS There was significant discordance between patient- and clinician-reported neurotoxicity. The lack of consensus regarding optimal outcome measures and whose opinion with regard to CIPN takes precedence is a limitation in the investigation of risk factors for CIPN. Care must be taken to select and include patient-reported outcome measures in CIPN assessment to enable accurate identification of genetic and other risk factors for neuropathy.
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MESH Headings
- Adenocarcinoma, Clear Cell/complications
- Adenocarcinoma, Clear Cell/drug therapy
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Mucinous/complications
- Adenocarcinoma, Mucinous/drug therapy
- Adenocarcinoma, Mucinous/pathology
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents, Phytogenic/adverse effects
- Biomarkers, Tumor/genetics
- Cystadenocarcinoma, Serous/complications
- Cystadenocarcinoma, Serous/drug therapy
- Cystadenocarcinoma, Serous/pathology
- Endometrial Neoplasms/complications
- Endometrial Neoplasms/drug therapy
- Endometrial Neoplasms/pathology
- Female
- Follow-Up Studies
- Humans
- Incidence
- Middle Aged
- Neoplasm Invasiveness
- Neurotoxicity Syndromes/diagnosis
- Neurotoxicity Syndromes/epidemiology
- Neurotoxicity Syndromes/etiology
- Neurotoxicity Syndromes/genetics
- Outcome Assessment, Health Care
- Ovarian Neoplasms/complications
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/pathology
- Paclitaxel/adverse effects
- Patient Reported Outcome Measures
- Physicians
- Polymorphism, Single Nucleotide
- Prognosis
- Risk Factors
- Severity of Illness Index
- Surveys and Questionnaires
- Survival Rate
- Young Adult
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Affiliation(s)
- S B Park
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney; Prince of Wales Clinical School
| | - J B Kwok
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney; Neuroscience Research Australia, University of New South Wales, Sydney
| | - R Asher
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - C K Lee
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - P Beale
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney; Sydney Medical School, University of Sydney, Sydney, Australia
| | - F Selle
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Department of Medical Oncology, Alliance For Cancer Research, Hôpital Tenon, Paris, France
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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
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19
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Deurloo R, Colombo N, Mendiola C, Selle F, Korach J, Oestergaard M, Bylesjo M, Urban HJ, Ghazi Y, Oza A. Gene mutational analyses in 154 ovarian cancer (OC) samples from the ROSiA study of front-line bevacizumab (BEV)-containing therapy for OC. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.021] [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
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20
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Selle F, Heudel PE, Tazi Y, Pozet A, Hardy-Bessard AC, Meunier J, Gladieff L, Lotz JP, Provansal M, Augereau P, Frenel JS, Bonichon-Lamichhane N, Orfeuvre H, Pommeret F, Torres-Macque M, Kalbacher E, Roemer-Becuwe C. Outcomes of the combination trabectedin and pegylated liposomal doxorubicin (T-PLD) in recurrent platinum-sensitive ovarian cancer (OC): a GINECO cohort study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.037] [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: 11/14/2022] Open
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Pujade-Lauraine E, Colombo N, Glasspool R, Asselain B, Huzarski T, Korach J, Marme F, Mirza M, Redondo A, Scambia G, Blakeley C, Milner A, Selle F, Vergote I. OReO/ENGOT Ov-38: A phase IIIb trial of olaparib maintenance retreatment in patients with epithelial ovarian cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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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22
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Heudel PE, Devouassoux-Shisheboran M, Taieb S, Genestie C, Selle F, Morice P, Rouzier R, Ray-Coquard I. Multidisciplinary management of advanced ovarian cancer for an optimal therapeutic strategy. EUR J GYNAECOL ONCOL 2017; 38:175-180. [PMID: 29953774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The management of advanced ovarian cancer generally requires specialist multidisciplinary teamwork to achieve optimum outcomes. Preoperative computed tomography scans are the imaging modality of choice in determining the extent of disease and aiding in surgical planning. Histological classification is crucial to define various subtypes with their different behaviour and prognosis and to plan the best therapeutic strategy. Pathological prognostic factors, such as histological type, degree of differentiation, and FIGO stage must be described. To determine the ability to optimally cytoreduce advanced ovarian cancer, an experienced gynaecological oncologist needs to explore the entire upper abdomen and the pelvic and para-aortic lymph node regions to define the peritoneal cancer index (PCI). The final assessment is the completeness of cytoreduction (CC) score which is important in predicting prognosis and decision of post-surgical surgery. Ovarian cancer is the leading cause of death from gynaecologic cancers. Initial management is best provided by a specialist multidisciplinary team, including a radiologist, a pathologist, a gynaecologic oncologist, and a medical oncologist.
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Berton-Rigaud D, Selle F, Floquet A, Mollon D, Lescaut W, Kaminsky MC, Ray-Coquard I, Largillier R, Savoye AM, Barletta H, Pautier P, Orfeuvre H, Baron M, Marti A, Mouysset JL, Paoli JB, Cailleux PE, Cornea C, Pujade-Lauraine E. Use of bevacizumab (Bev) in real life for first-line (fl) treatment of ovarian cancer (OC). Part1: the ENCOURAGE cohort of 1158 patients (pts) by GINECO. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.42] [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: 11/14/2022] Open
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Rouzier R, Gouy S, Selle F, Lambaudie E, Guyon F, Fourchotte V, Pomel C, Colombo PE, Kalbacher E, Martin-Francoise S, Fauvet R, Follana P, Lesoin A, Lecuru F, Ghazi Y, Dupin J, Chereau E, Zohar S, Cottu P, Joly F. Complete resection rate at interval debulking surgery after bevacizumab containing neoadjuvant therapy: primary objective of the ANTHALYA trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.07] [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
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25
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Selle F, Soares DG, Lotz JP. A rational approach for salvage of testicular cancer patients. Ann Oncol 2015; 27:202. [PMID: 26483046 DOI: 10.1093/annonc/mdv492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- F Selle
- Department of Medical Oncology and Cellular Therapy, Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), APREC (Alliance Pour la Recherche En Cancérologie), Paris Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris, France
| | - D G Soares
- Department of Medical Oncology and Cellular Therapy, Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), APREC (Alliance Pour la Recherche En Cancérologie), Paris
| | - J P Lotz
- Department of Medical Oncology and Cellular Therapy, Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), APREC (Alliance Pour la Recherche En Cancérologie), Paris Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris, France
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Oza A, Selle F, Davidenko I, Korach J, Mendiola C, Gocze P, Pautier P, Chmielowska E, Bamias A, DeCensi A, Zvirbule Z, Gonzalez-Martin A, Hegg R, Joly F, Zamagni C, Gadducci A, Deurloo R, Revil C, Robb S, Colombo N. 2702 Safety and efficacy in ROSiA, a single-arm study of extended duration front-line (FL) bevacizumab (BEV)-containing therapy in 1021 women with ovarian cancer (OC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31470-8] [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: 11/29/2022]
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Chéreau E, Gouy S, Lambaudie E, Ballester M, Fourchotte V, Guyon F, Pomel C, Colombo P, Delroeux D, Martin-Francoise S, Bihan C, Leblanc E, Lecuru F, Fouche Y, Ghazi Y, Pau D, Selle F, Cottu P, Joly F, Rouzier R. 2740 Independent review committee assessment of Fagotti carcinomatosis score from 8 laparoscopic images: Ancillary analysis of ANTHALYA, a randomized, open-label, phase II study assessing the efficacy and safety of bevacizumab addition to neoadjuvant therapy for women with ovarian, tubal or peritoneal adenocarcinoma, initially unresectable. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31506-4] [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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Selle F, Gligorov J, Richard S, Khalil A, Alexandre I, Avenin D, Provent S, Soares DG, Lotz JP. Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer. ACTA ACUST UNITED AC 2014; 48:13-24. [PMID: 25493378 PMCID: PMC4288488 DOI: 10.1590/1414-431x20144214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/15/2014] [Indexed: 02/15/2023]
Abstract
Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis.
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Affiliation(s)
- F Selle
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - J Gligorov
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - S Richard
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - A Khalil
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - I Alexandre
- Medical Oncology Department, Hospital Centre of Bligny, Briis-sous-Forges, France
| | - D Avenin
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - S Provent
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - D G Soares
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - J P Lotz
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
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Selle F, Sevin E, Ray-Coquard I, Mari V, Berton-Rigaud D, Favier L, Fabbro M, Lesoin A, Lortholary A, Pujade-Lauraine E. A phase II study of lenalidomide in platinum-sensitive recurrent ovarian carcinoma. Ann Oncol 2014; 25:2191-2196. [DOI: 10.1093/annonc/mdu392] [Citation(s) in RCA: 10] [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: 11/12/2022] Open
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30
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Rouzier R, Chereau E, Floquet A, Selle F, Fourchotte V, Pomel C, Follana P, Martin-Françoise S, Fauvet R, Colombo P, Kalbacher E, Lesoin A, Lécuru F, Cottu P, Lobbedez FJ, Menguy V, Ghazi Y, Morice P. Neoadjuvant Therapy in Advanced Ovarian Cancer Patients: Efficiency of Screening By Laparoscopy for Clinical Trial Recruitment. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu338.22] [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
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31
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Launay-Vacher V, Janus N, Ray-Coquard I, Gligorov J, Selle F, Beuzeboc P, Daniel C, Spano J, Thery J, Goldwasser F, Mir O, Rey J, Jouannaud C, Morere J, Oudard S, Scotte F, Azizi M, Dorent R, Deray G. Hypertension, Proteinuria and Overall Survival in Elderly Cancer Patients Treated with Bevacizumab. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu356.69] [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: 11/14/2022] Open
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Berton-Rigaud D, Selle F, Ray-Coquard I, Floquet A, Largillier R, Hardy-Bessard A, Jaubert D, Roemer-Becuwe C, Venat-Bouvet L, Lesoin A, Guardiola E, Alexandre J, Provansal M, Blot E, Achour N, Pujade-Lauraine E. Encourage: the Use in Routine Practice of Bevacizumab in First-Line Therapy for Patients with Ovarian Cancer– a Gineco Prospective Cohort Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu338.66] [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: 11/14/2022] Open
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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.
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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
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Debrix I, Fillon J, Boukari Y, Selle F, Casagrande T, Lotz JP, Herve C. Évaluation des pratiques de prescription de chimiothérapies anticancéreuses à des stades métastatiques avancés : résultats d’une étude pilote. ONCOLOGIE 2013. [DOI: 10.1007/s10269-013-2262-1] [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: 11/28/2022]
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Pautier P, Floquet A, Gladieff L, Bompas E, Ray-Coquard I, Piperno-Neumann S, Selle F, Guillemet C, Weber B, Largillier R, Bertucci F, Opinel P, Duffaud F, Reynaud-Bougnoux A, Delcambre C, Isambert N, Kerbrat P, Netter-Pinon G, Pinto N, Duvillard P, Haie-Meder C, Lhommé C, Rey A. A randomized clinical trial of adjuvant chemotherapy with doxorubicin, ifosfamide, and cisplatin followed by radiotherapy versus radiotherapy alone in patients with localized uterine sarcomas (SARCGYN study). A study of the French Sarcoma Group. Ann Oncol 2012; 24:1099-104. [PMID: 23139262 DOI: 10.1093/annonc/mds545] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is no proven benefit of adjuvant treatment of uterine sarcoma (US). SARCGYN phase III study compared adjuvant polychemotherapy followed by pelvic radiotherapy (RT) (arm A) versus RT alone (arm B) conducted to detect an increase ≥ 20% of 3-year PFS. METHODS Patients with FIGO stage ≤ III US, physiological age ≤ 65 years; chemotherapy: four cycles of doxorubicin 50 mg/m² d1, ifosfamide 3 g/m²/day d1-2, cisplatin 75 mg/m² d3, (API) + G-CSF q 3 weeks. Study was stopped because of lack of recruitment. RESULTS Eighty-one patients were included: 39 in arm A and 42 in arm B; 52 stage I, 16 stage II, 13 stage III; 53 leiomyosarcomas, 9 undifferenciated sarcomas, 19 carcinosarcomas. Gr 3-4 toxicity during API (/37 patients): thrombopenia (76%), febrile neutropenia (22%) with two toxic deaths; renal gr 3 (1 patient). After a median follow-up of 4.3 years, 41/81 patients recurred, 15 in arm A, 26 in arm B. The 3 years DFS is 55% in arm A, 41% in arm B (P = 0.048). The 3-year overall survival (OS) is 81% in arm A and 69% in arm B (P = 0.41). CONCLUSION API adjuvant CT statistically increases the 3 year-DFS of patients with US.
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Affiliation(s)
- P Pautier
- Department of Medical Oncology, Institut Gustave-Roussy, Villejuif, Cedex, France.
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Ray-Coquard I, Pautier P, Alexandre J, Vacher-Lavenu M, Fabbro M, Floquet A, Selle F, Ferron G, Chiannilkulchai N, Pujade-Lauraine E. From a Website to a National and Regional Reference Centre Network: the French Experience for Rare Ovarian Tumors. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33550-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: 10/25/2022] Open
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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
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Mendiola C, Davidenko I, Colombo N, Korach J, Selle F, Gocze P, Chmielowska E, Pautier P, Bollag D, Oza A. Rosia: A Single-Arm Study in More Than 1000 Patients (PTS) Receiving Front-Line Bevacizumab (BEV) + Chemotherapy (CT) for Ovarian Cancer (OC). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33534-1] [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: 11/29/2022] Open
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Poveda A, Selle F, Hilpert F, Reuss A, Pasic A, Savarese A, Vergote I, Witteveen P, Bamias A, Bollag D, Pujade-Lauraine E. Weekly Paclitaxel (PAC), Pegylated Liposomal Doxorubicin (PLD) or Topotecan (TOP) ± Bevacizumab (BEV) in Platinum (PT)-Resistant Recurrent Ovarian Cancer (OC): Analysis by Chemotherapy (CT) Cohort in the GCIG Aurelia Randomised Phase III Trial. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34331-3] [Citation(s) in RCA: 5] [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: 11/25/2022] Open
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Chéreau E, Ballester M, Selle F, Rouzier R, Daraï E. [Clues for paraaortic lymphadenectomy in patients older than 70 years with ovarian cancer]. Gynecol Obstet Fertil 2012; 40:327-329. [PMID: 22521983 DOI: 10.1016/j.gyobfe.2012.02.018] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- E Chéreau
- Service de gynécologie obstétrique, hôpital Tenon, Assistance publique des Hôpitaux de Paris, CancerEst, université Pierre et Marie Curie, Paris 6, 4 rue de la Chine, Paris, France.
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Ray-Coquard I, Selle F, Cottu P, Laurraine EP. Thérapies ciblées dans le traitement des carcinomes de l’ovaire. ONCOLOGIE 2012. [DOI: 10.1007/s10269-011-2101-1] [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: 11/29/2022]
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Chereau E, Lavoue V, Ballester M, Coutant C, Selle F, Cortez A, Daraï E, Leveque J, Rouzier R. External validation of a laparoscopic-based score to evaluate resectability for patients with advanced ovarian cancer undergoing interval debulking surgery. Anticancer Res 2011; 31:4469-4474. [PMID: 22199317] [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]
Abstract
AIM To evaluate the relevance of laparoscopic index of Fagotti et al during staging laparoscopy (S-LPS) to predict optimal cytoreduction during interval debulking surgery (IDS) after neoadjuvant chemotherapy for ovarian cancer. PATIENTS AND METHODS Fifty-two patients with stage III-IV ovarian cancer were retrospectively analyzed. We evaluated discrimination with a receiver operating characteristic (ROC) curve analysis and calibration of Fagotti et al's model among our population and compared this performance with their data. RESULTS A score >4 was associated with optimal resection with sensitivity and positive predictive value (PPV) of 95% and 82% respectively. The ROC curve analysis gave an area under the curve (AUC) of 0.72 (95% confidence interval (CI) 0.65-0.80) for our population compared to 0.88 (95% CI 0.84-0.91) in Fagotti et al's population. Percentages predicted in our population were unsatisfactory (p<0.01), illustrating the different rates of optimal cytoreduction between the centers (average error of 25%). CONCLUSION The laparoscopic index of Fagotti et al is relevant in prediction of optimal cytoreduction among women undergoing IDS.
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Affiliation(s)
- E Chereau
- Service de Gynécologie-Obstétrique, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France.
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Chéreau E, Ballester M, Selle F, Rouzier R, Daraï E. Ovarian cancer in the elderly: Impact of surgery on morbidity and survival. Eur J Surg Oncol 2011; 37:537-42. [DOI: 10.1016/j.ejso.2011.03.136] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/20/2011] [Accepted: 03/28/2011] [Indexed: 12/26/2022] Open
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Pautier P, Floquet A, Gladieff L, Berton-Rigaud D, Piperno-Neumann S, Selle F, Guillemet C, Ray-Coquard IL, Weber B, Duvillard P, Haie-Meder C, Rey A. A randomized clinical trial of adjuvant chemotherapy with doxorubicin, ifosfamide, and cisplatin in localized uterine sarcomas: Results from 81 randomized patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10022] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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Fajac A, Gligorov J, Rezai K, Lévy P, Lévy E, Selle F, Beerblock K, Avenin D, Saintigny P, Hugonin S, Bernaudin JF, Lokiec F. Effect of ABCB1 C3435T polymorphism on docetaxel pharmacokinetics according to menopausal status in breast cancer patients. Br J Cancer 2010; 103:560-6. [PMID: 20628376 PMCID: PMC2939787 DOI: 10.1038/sj.bjc.6605789] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background: It can be hypothesised that inherited polymorphisms in the drug-transporter ABCB1 gene may interfere with interindividual variations in drug response in breast cancer patients. Docetaxel is a substrate for ABCB1 whose function has been shown to be modulated by oestrogen and progesterone. Methods: Whether ABCB1 polymorphisms including T-129C, A61G, C1236T, G2677T/A and C3435T polymorphisms could account for variations in the disposition of docetaxel and whether menopausal status at the time of diagnosis might interact with this effect were analysed in women receiving neoadjuvant chemotherapy for breast cancer (n=86). Results: A highly significant association was observed, but restricted to premenopausal women (n=53), between the pharmacokinetics of docetaxel and C3435T polymorphism, as patients with CC genotype had lower mean values of the area under the plasma concentration-time curve (AUC) of docetaxel than patients with CT and TT genotypes (P<0.0001). Comparison between pre- and postmenopausal women with the same C3435T genotype yielded a significant difference in docetaxel AUC only for CC genotype (P<0.0001). Conclusion: These results suggest that C3435T polymorphism genotyping and menopausal status at the time of diagnosis might be useful when considering chemotherapy regimens including docetaxel in breast cancer patients.
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Affiliation(s)
- A Fajac
- Service d'Histologie-Biologie Tumorale, hôpital Tenon, AP-HP, ER2 UPMC Université Pierre et Marie Curie, 4 rue de la Chine, Paris 75020, France.
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Rouzier R, Bergzoll C, Brun JL, Dubernard G, Selle F, Uzan S, Pomel C, Daraï E. The role of lymph node resection in ovarian cancer: analysis of the surveillance, epidemiology, and end results (SEER) database. BJOG 2010; 117:1451-8. [DOI: 10.1111/j.1471-0528.2010.02633.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Alexandre J, Ray-Coquard I, Selle F, Floquet A, Cottu P, Weber B, Falandry C, Lebrun D, Pujade-Lauraine E. Mucinous advanced epithelial ovarian carcinoma: clinical presentation and sensitivity to platinum-paclitaxel-based chemotherapy, the GINECO experience. Ann Oncol 2010; 21:2377-2381. [PMID: 20494964 DOI: 10.1093/annonc/mdq257] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Advanced mucinous epithelial ovarian carcinoma (mEOC) has been associated with a worse prognosis than the more common serous epithelial ovarian carcinomas (sEOC), but it remains unclear whether this observation reflects a more aggressive clinical presentation and/or chemoresistance. PATIENTS AND METHODS Data from four randomized phase III and one phase II advanced epithelial ovarian carcinoma (EOC) first-line clinical trials were retrospectively collected, yielding 1118 patients with advanced EOC (International Federation of Gynecology and Obstetrics stages IIB-IV), 85% of whom were treated with paclitaxel (Taxol)-carboplatin-based chemotherapy. RESULTS Based on 786 patients with sEOC and 54 (5%) with mEOC, peritoneal carcinomatosis were more limited in mEOC, which was more frequently stages IIB-IIIB (32% versus 19%, P = 0.001) and had more frequently macroscopic complete resection after initial surgery (50% of stages II-III versus 30%, P = 0.02). In contrast, visceral metastases (stage IV) were more frequent in mEOC (30% versus 15%, P = 0.004). mEOC had a lower response rate to carboplatin-paclitaxel, and shorter progression-free and overall survival rates, for both stage IV and optimally debulked stages II-III patients. CONCLUSIONS Advanced mEOC appears to be highly chemoresistant and complete resection of peritoneal metastases is unable to reverse its poor prognosis. New therapeutic options are needed.
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Affiliation(s)
- J Alexandre
- Medical Oncology Unit, Université Paris-Descartes, Hôtel-Dieu, Paris.
| | - I Ray-Coquard
- Medical Oncology Department, Centre Léon Bérard, Lyon
| | - F Selle
- Medical Oncology Department, Hôpital Tenon, Paris
| | - A Floquet
- Medical Oncology Department, Institut Bergonié, Bordeaux
| | - P Cottu
- Medical Oncology Department, Institut Curie, Paris
| | - B Weber
- Medical Oncology Department, Centre Alexis Vautrin, Nancy
| | - C Falandry
- Medical Oncology Department, CHU Lyon Sud, Pierre-Bénite
| | - D Lebrun
- Medical Oncology Department, Centre Jean Godinot, Reims, France
| | - E Pujade-Lauraine
- Medical Oncology Unit, Université Paris-Descartes, Hôtel-Dieu, Paris
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Gligorov J, Cals L, Tournigand C, Merad Z, Dutel J, Selle F, Zeghib N, Chibaudel B, Cvitkovic F. Gemcitabine-oxaliplatin combination (SEGEMOX) in anthracycline (A) and taxanes (T) pretreated metastatic breast cancer (MBC): Results from the GERCOR-SEGEMOX phase II trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1108] [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
1108 Objectives: To evaluate efficacy and safety of SEGEMOX regimen for previously A and T pre-treated MBC patients. Methods: Forty-five women with MBC not eligible for A and/or T chemotherapy were enrolled on SEGEMOX study. SEGEMOX was delivered as follows: Gemcitabine was given at 1000 mg/m2/100min on day 1, followed by oxaliplatin at 100 mg/m2/120min iv on day 2 every 2 weeks. Efficacy results were analyzed and are presented in an intention to treat analysis and toxicity according to the total number of cycles regimen. Results: Forty-four of the 45 patients received at least 1 cycle of SEGEMOX. Fifty-eight perccent of the patients have received previous adjuvant chemo, 36% 1st line and 42% 2nd line for MBC before the protocol inclusion. Visceral metastases were dominant site of disease (44% liver; 36% lung; 44% bone). Median age of the population was 55.8 years (36–73). After a median of 7.7 cycles (3.5 months of treatment); the overall response rate (ORR) is 38% [95%CI; 23%-51%] [1 CR (2.2%) and 16 PR (35.6%)]; 33% of stable disease [95%CI; 17%-43%], 24.4% progressive disease with a clinical benefit (CB) of 71% [95%CI; 57%-85%]. The median progression free survival (PFS) is 7.1 months for responders and 4.8 months for patients with stable disease. The all population median overall survival (OS) is 21.4 months with 22.7 months MOS for responders. Concerning toxicity analysis: 339 cycles of gemcitabine and 312 of oxaliplatinum were delivered. Respectively, grade 3–4 neutropenia occurred in 43% of patients (febrile neutropenia in 7%), grade 3–4 thrombocytopenia in 41%, and anemia in 2.3%. The most frequent non hematologic toxicities were represented by grade 3 peripheral neuropathy (Levi Scale) in 11.4% of the patients and grade 2 alopecia in 11.4%. For the subgroup of hormone receptor negative MBC (n = 12) the ORR is 33% [95%CI; 2%-64%], CB 50% [95%CI; 16%-73%], PFS of 2.8 months and MOS of 12 months. Conclusions: The SEGEMOX combination has relevant activity in A and T not eligible MBC patients, with a manageable toxicity profile. In the limited number of patients with HRN MBC even if the response rate is close to the overall population the prognosis seems still worse. No significant financial relationships to disclose.
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Affiliation(s)
- J. Gligorov
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
| | - L. Cals
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
| | - C. Tournigand
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
| | - Z. Merad
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
| | - J. Dutel
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
| | - F. Selle
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
| | - N. Zeghib
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
| | - B. Chibaudel
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
| | - F. Cvitkovic
- AP-HP, Tenon Cancer Est APREC, Paris, France; CH Toulon-La Seyne, Toulon, France; AP-HP, St Antoine CancerEst, Paris, France; CH Boulogne sur Mer, Boulogne sur Mer, France; CH Beauvais, Beauvais, France; GERCOR, Paris, France; Centre René Huguenin, Saint- Cloud, France
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Joly F, Weber B, Pautier P, Fabbro M, Selle F, Krieger S, Leconte A, Bourgeois H, Henry-Amar M. Combined topotecan and lapatinib in patients with early recurrent ovarian or peritoneal cancer after first line of platinum-based chemotherapy: A French FEDEGYN-FNCLCC phase II trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5555] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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
5555 Background: High HER1 expression is associated with poor prognosis. Preliminary data have shown links between HER1 expression and topotecan efficacy. The objective of the trial was to evaluate the efficacy of the association of topotecan and lapatinib in non-HER screened patients who failed first line platinum-based chemotherapy within 12 months. Methods: Chemotherapy consisted of 4-week course of topotecan (d1, d8, d15, 3.2 mg/m2 IV) and lapatinib (1250 mg/d PO). Response was assessed using RECIST or RUSTIN criteria. The primary objective was global response (GR, i.e. CR, PR, and SD). Biomarker profiles were evaluated according treatment response. A two-step phase II trial was designed to include 54 patients assuming a GR rate of 75% for the combination compared to 55% for topotecan alone. Results: From March to September 2008, 39 patients (37 ovarian and 2 peritoneal carcinomas), median age 60 (18 to 80), were included in 16 institutions. Patients presented with FIGO stage I (n = 1), II (n = 2), III (n = 29), and IV (n = 7) disease. Twenty and 19 patients had disease relapse occurring < 6 and 6–12 months after initial chemotherapy respectively. 2 patients were non evaluable. After 1 to 8 cycles (median 2) of topotecan-lapatinib there were 0/2 PR, 7/9 SD, 12/7 progressions in patients who failed <6 or 6–12 months respectively. The GR rate was 46% (35 and 58%; 95% confidence limits, 30–63%) and the trial was prematurely stopped. Three patients developed toxicity leading to treatment discontinuation after 3 cycles. Biological data will be presented at meeting. Conclusions: Combined topotecan and lapatinib is associated with modest GR rate. Biological profiles of responders are pending. No significant financial relationships to disclose.
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Affiliation(s)
- F. Joly
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
| | - B. Weber
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
| | - P. Pautier
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
| | - M. Fabbro
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
| | - F. Selle
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
| | - S. Krieger
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
| | - A. Leconte
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
| | - H. Bourgeois
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
| | - M. Henry-Amar
- Centre François Baclesse, Caen, France; Centre Alexis Vautrin, Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; AP-HP, Hôpital Tenon, Paris, France; Centre Jean Bernard, Le Mans, France
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50
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Lotz J, Selle F, Fizazi K, Gravis G, Bui B, Delva R, Bay J, Baron A, Robain M, Biron P. A phase II trial of high-dose chemotherapy (HDCT) supported by haematopoietic stem cell transplantation (HSCT) in patients (pts) with disseminated germ-cell tumors (GCTs) failing chemotherapy and with adverse prognostic factors: The TAXIF II protocol. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5028] [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
5028 Background: HDCT using the etoposide-carboplatin ± ifosfamide regimen is able to circumvent resistance in GCT pts, even when used as third-line or later therapy (Lotz, Ann Onco.l 2005 / Einhorn, N Eng J Med. 2007). Pts whose relapses occur more than 4 w after CDDP-based CT are probably the best candidates for HDCT. Epirubicine (E) and paclitaxel (P) possess interesting activity in GCTs. Thiotepa (TTP) and P can be safely combined at HD with good efficacy. The ICE regimen is a well-known worldwide used regimen. Methods: Non-resistant/refractory GCTs pts failing CT and with adverse prognostic factors were planned to receive 2 cycles combining (mg/m2) E (100) and P (250), given on day 1 and 14 supported by filgrastim (F), followed by 3 consecutive HDCTs [1 course combining a 3-d combination of P (360) + TTP (720), followed by 2 ICE regimens (IFM, 12 g/m2, CBDCA, AUC 20, VP16, 1,500 mg/m2), given on 5 days with HSCT and F]. Inclusion criterias were mainly: radiologically and/or biologically mesurable disease, seminomatous GCT in relapse after 2 lines of CT (BEP/VeIP), non-seminomatous GCT in relapse after 1 or 2 lines of CT or in PR after 1 line of CT, primary mediastinal GCT in first relapse. Resistant / refractory pts were excluded. PBSC were collected after the first ± the second courses of EP (aim: 9x10E6 CD34+/kg BW). We report herein on the preliminary results of this multicentric study. Results: From 09/04 to 12/07, 45 pre-treated (BEP ± VeIP) pts with gonadal (89%) or extra-gonadal T (11%) were treated in second-line (27%), 3rd-line (44 %) or more (29 %). Thirty-five pts received 1 HDCT, 29 two HDCTs and 21 pts could receive the whole protocol. At the time of analysis (12/08), the final overall response rate was 47%, 10 pts were in continuous CR (median time, 8 m; range, 1–18), and 37 pts (82%) were alive at a median F/U of 9 m (range, 1–26). The 1-y survival rate was 90%. The 1-y PFS rate was 62%. One pt died of multi-organ failure and 7 died of disease progression. Conclusions: This HDCT program preceded by 2 semi-intensive cycles of E-P is highly effective in non-resistant/refractory pts with disseminated GCTS failing CT and with adverse prognostic factors. No significant financial relationships to disclose.
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Affiliation(s)
- J. Lotz
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - F. Selle
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - K. Fizazi
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - G. Gravis
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - B. Bui
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - R. Delva
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - J. Bay
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - A. Baron
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - M. Robain
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - P. Biron
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
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