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Dreno B, Khosrotehrani K, De Barros Silva G, Wolf JR, Kerob D, Trombetta M, Atenguena E, Dielenseger P, Pan M, Scotte F, Krakowski I, Lacouture M. The role of dermocosmetics in the management of cancer-related skin toxicities: international expert consensus. Support Care Cancer 2023; 31:672. [PMID: 37925388 PMCID: PMC10625513 DOI: 10.1007/s00520-023-08116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/11/2023] [Indexed: 11/06/2023]
Abstract
Skin toxicities are very common in patients undergoing cancer treatment and have been found to occur with all types of cancer therapeutic interventions (cytotoxic chemotherapy, targeted therapies, immunotherapy, and radiotherapy). Further, skin toxicities can lead to interruption or even discontinuation of anticancer treatment in some patients, translating to suboptimal outcomes. Dermocosmetics (or cosmeceuticals)-defined as skincare solutions incorporating dermatologically active ingredients (beyond vehicle effects) that directly improve symptoms of various skin conditions-are increasingly being used in cancer care to prevent and manage skin toxicities. The active ingredients in these products have a measurable biological action in skin; they typically improve skin integrity (barrier function/hydration and other factors) while relieving skin symptoms. The Association Francophone des Soins Oncologiques de Support (AFSOS) and Multinational Association of Supportive Care in Cancer (MASCC) partnered to select a multidisciplinary group of healthcare professionals involved in the management of patients with cancer and skin toxicities. The group reviewed existing literature and created a summary of recommendations for managing these toxicities through online meetings and communication. In this publication, the group (1) reviews new skin toxicities seen with oncology drugs and (2) evaluates the role of dermocosmetics in improving patient outcomes and minimizing cancer treatment interruptions. We provide general recommendations for initiation and selection of skin care in all oncology patients as well as recommendations for what factors should be considered when using dermocosmetics in specific types of skin toxicities.
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Affiliation(s)
- Brigitte Dreno
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in Immunotherapy, INCIT, UMR 1302/EMR6001. F-44000, Nantes, France
| | - Kiarash Khosrotehrani
- Experimental Dermatology Group, University of Queensland Diamantina Institute, Brisbane, Australia
| | | | - Julie Ryan Wolf
- Departments of Dermatology and Radiation Oncology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Mark Trombetta
- Department of the Radiologic Sciences, Allegheny Health Network, Drexel University College of Medicine, Pittsburgh, PA, USA
| | - Etienne Atenguena
- Department of Internal Medicine, University of Yaoundé I, Yaoundé Hospital General, Yaoundé, Cameroon
| | - Pascale Dielenseger
- Research and Education for Paramedic Professionals Nursing Coordinator, Gustave Roussy, Villejuif, France
- École Des Sciences du Cancer, Université Paris Sud (XI), Paris, France
- Association Française Des Infirmières de Cancerologie (AFIC), Paris, France
| | - Meng Pan
- Department of Dermatology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Florian Scotte
- Interdisciplinary Patient Pathway Division, Gustave Roussy, Villejuif, France
- Multinational Association of Supportive Care in Cancer (MASCC), Aurora, Canada
| | - Ivan Krakowski
- Medical Oncologist, Bordeaux, France
- Association Francophone Des Soins Oncologiques de Support (AFSOS), Bègles, France
| | - Mario Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Orlando V, Drubay D, Lavaud P, Faivre L, Lesaunier F, Delva R, Gravis G, Rolland F, Priou F, Ferrero JM, Houede N, Mourey L, Theodore C, Krakowski I, Berdah JF, Baciuchka M, Laguerre B, Fléchon A, Grosse-Goupil M, Cojean-Zelek I, Oudard S, Labourey JL, Chinet-Charrot P, Legouffe E, Lagrange JL, Linassier C, Deplanque G, Beuzeboc P, Davin JL, Martin AL, Brihoum M, Culine S, Teuff GL, Fizazi K. Very Long-Term Complete Remission Can Be Achieved in Men With High-Risk Localized Prostate Cancer and a Very High PSA Value: An Analysis of the GETUG 12 Phase 3 Trial. Clin Genitourin Cancer 2023; 21:615.e1-615.e8. [PMID: 37263910 DOI: 10.1016/j.clgc.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Serum prostate specific antigen (PSA) is a well-known prognostic parameter in men with prostate cancer. The treatment of men with very high PSA values and apparently no detectable metastases is not fully established. PATIENTS AND METHODS Ancillary analysis from the GETUG 12 phase 3 trial. Patients with non-metastatic high-risk prostate cancer by bone and computerized tomography (CT) scan were randomly assigned to receive androgen deprivation therapy (ADT) and docetaxel plus estramustine or ADT alone. Relapse-free survival (RFS), clinical RFS, metastases-free survival (MFS), overall survival (OS), and prostate cancer-specific survival (PCSS) were estimated using the Kaplan-Meier method for different levels of PSA (50 ng/mL, 75 ng/mL, and 100 ng/mL). The relationship between PSA and outcomes was studied using residual-based approaches and spline functions. RESULTS The median follow-up was 12 years (range: 0-15.3). Baseline PSA (<50 ng/mL, n = 328; ≥50ng/mL, n = 85) was associated with improved RFS (P = .0005), cRFS (P = .0024), and MFS (P = .0068). The 12-year RFS rate was 46.33% (CI 40.59-51.86), 33.59% (CI 22.55-44.97), and 11.76% (1.96-31.20) in men with PSA values <50 ng/mL (n = 328), 50-100 ng/mL (n = 68), and ≥100 ng/mL (n = 17), respectively. Exploratory analyses revealed no deviation from the linear relationship assumption between PSA and the log hazard of events. CONCLUSIONS Men with apparently localized prostate cancer and a high baseline PSA value have a reasonable chance of being long-term disease-free when treated with curative intent combining systemic and local therapy.
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Affiliation(s)
| | - Damien Drubay
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - Pernelle Lavaud
- Department of cancer medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - Laura Faivre
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | | | - Remy Delva
- Institut de Cancérologie de l'Ouest, Angers, France
| | - Gwenaëlle Gravis
- Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | - Frédéric Rolland
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | - Frank Priou
- Department of Medical Oncology, Centre Hospitalier Départemental, La Roche-sur-Yon, France
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Nadine Houede
- Department of Medical Oncology, Centre Hospitalier de Nimes, Nimes, France
| | - Loic Mourey
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | | | - Ivan Krakowski
- Department of Medical Oncology, Centre Alexis Vautrin, Nancy, France
| | | | - Marjorie Baciuchka
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Brigitte Laguerre
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Aude Fléchon
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Isabelle Cojean-Zelek
- Department of Medical Oncology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Stéphane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris, France
| | | | | | - Eric Legouffe
- Department of Medical Oncology, Clinique Valdegour, Nîmes, France
| | - Jean-Léon Lagrange
- Department of Radiation Oncology, Hopital Henri Mondor, Université Paris Est Creteil, Créteil, France
| | - Claude Linassier
- Department of Medical Oncology, Hôpital Bretonneau, Tours, France
| | - Gaël Deplanque
- Department of Oncology, Lausanne University Hospital, Lausanne, Swiss
| | - Philippe Beuzeboc
- Oncology and Supportive Care Department, Foch Hospital, Suresnes, France
| | | | | | | | - Stéphane Culine
- Department of Medical Oncology, Hôpital Saint-Louis, Paris, France
| | - Gwénaël Le Teuff
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - Karim Fizazi
- Department of cancer medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
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Bouillet T, Joly F, Saghatchian M, Guéroult-Accolas L, Tahar JM, Descotes JM, Krakowski I. Activité Physique Adaptée et cancer métastatique : quels besoins et quelles attentes ? Bull Cancer 2022; 109:1287-1297. [DOI: 10.1016/j.bulcan.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/04/2022] [Accepted: 07/25/2022] [Indexed: 11/06/2022]
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Giacchero D, Buiret G, Bartolini-Grosjean C, Taieb C, Saghatchian M, Krakowski I. Creation of a tool to evaluate supportive care. Palliat Support Care 2022:1-8. [PMID: 35913037 DOI: 10.1017/s1478951522000918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
RATIONAL The absence of a specific tool to evaluate the impact of supportive care in general and socioesthetics (SE) in particular is undoubtedly at the origin of the lack of published research based on scientific standards. OBJECTIVE We developed a supportive-care, patient-reported outcome questionnaire using the multistep methods, following COSMIN recommendations. METHODS The Patient Centricity Questionnaire (PCQ) was developed using the standardized methodology for designing patient-reported outcome (PRO) questionnaires according to the following steps: elaboration of the questionnaire, measurement properties of the questionnaire, internal and external validation, test-retest validation and translation, cross-cultural adaptation, and cognitive debriefing. A multidisciplinary work group was designed including professionals, such as physicians, public health experts, sociologists, supportive-care experts, and socioestheticians. RESULTS Our questionnaire includes 11 items. It is scored by adding each Visual Analogue Scale [VAS], making it range from 0 to 110, with a higher benefit when the score is higher. The Cronbach's α coefficient is 0.88 for the entire questionnaire. As the questionnaire is a reflection of the patient's feelings, it is quite natural that the name "Patient Centricity Questionnaire" (PCQ) was retained and validated by the Scientific Committee. The PCQ correlated negatively and moderately with the Perceived Stress Scale [PSS], positively and moderately with the mental dimension of the Short Form-12, and poorly with the Well Beng 12 [WB12], the physical dimension of the SF-12, and the satisfaction VAS. CONCLUSION Constructed according to the recommendations, the PCQ meets the prerequisite for this type of questionnaire. Its short format and simplicity of use allow it to be used by a large number of people. The PCQ is a simple, reliable, easy-to-use, and validated tool for research teams, making it possible for randomized studies to prove the impact of supportive care in general and SE in particular, on the patient's quality of life.
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Affiliation(s)
- Damien Giacchero
- Department of Medical Oncology, University Côte d'Azur, Centre Antoine Lacassagne, Nice, France
| | - Guillaume Buiret
- Department of Otorhinolaryngology Surgery, Hospital of Valence, Valence, France
| | | | - Charles Taieb
- Patient Priority Department, European Market Maintenance Assessment, Fontenay-sous-Bois, France
| | - Mahasti Saghatchian
- Department of Oncology, American Hospital of Paris, Neuilly-sur-Seine, France
- Department of Medical Oncology, Gustave Roussy Institute, Villejuif, France
| | - Ivan Krakowski
- Association Francophone pour les Soins Oncologiques de Support, Bègles, France
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Denis F, Krakowski I. How Should Oncologists Choose an Electronic Patient-Reported Outcome System for Remote Monitoring of Patients With Cancer? J Med Internet Res 2021; 23:e30549. [PMID: 34499046 PMCID: PMC8461535 DOI: 10.2196/30549] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/08/2021] [Accepted: 08/02/2021] [Indexed: 01/22/2023] Open
Abstract
Electronic patient-reported outcome (ePRO) systems for symptom monitoring in patients with cancer have shown quality of life and survival benefits in controlled trials. They are beginning to be used in routine oncology practice. Many software developers provide software solutions for clinicians, but how should clinicians decide which system to use? We propose a synthesis of the main questions regarding the effectiveness, safety, and functionality of an ePRO system that a clinician should ask software providers to assist in the selection of a software product in order to obtain the best value tools for their patients and their practice.
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Affiliation(s)
| | - Ivan Krakowski
- Association Francophone pour les Soins Oncologiques de Support, Bègles, France
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Petrucci J, Huet I, Krakowski I, Fechner S, Touboul C. 1828P How cancer-related cognitive impairment affects quality of life? A large survey among women with breast cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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7
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Huet I, Touboul C, Petrucci J, Descoins S, Krakowski I. 1833P Chemobrain: Seldom studied or reported, but apparently very common. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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8
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Krakowski I, Bottai M, Habel H, Masucci G, Girnita A, Smedby KE, Eriksson H. Corrigendum: Impact of modern systemic therapies and clinical markers on treatment outcome for metastatic melanoma in a real-world setting. J Eur Acad Dermatol Venereol 2021; 35:1407. [PMID: 34004068 DOI: 10.1111/jdv.17209] [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: 11/29/2022]
Affiliation(s)
- I Krakowski
- Department of Dermatology/Theme inflammation, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - M Bottai
- Institute of Environmental Medicine, Karolinska Instinewtutet, Stockholm, Sweden
| | - H Habel
- Institute of Environmental Medicine, Karolinska Instinewtutet, Stockholm, Sweden
| | - G Masucci
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.,Skin Cancer Center, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology/Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - A Girnita
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.,Skin Cancer Center, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - K E Smedby
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Solna, Division of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - H Eriksson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.,Skin Cancer Center, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology/Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
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Jovenin N, De Boissieu P, Cailleux PÉ, Dohollou N, Stefani L, Bourbouloux E, Toledano A, Abadie-Lacourtousie S, Soffray F, Tual V, Dreno B, Farsi F, Krakowski I. Efficacité et tolérance d’une cure thermale sur la xérose cutanée cicatricelle post-chirurgie du cancer du sein suivie de radiothérapie : résultats d’un essai ouvert, randomisé et contrôlé. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.554] [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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10
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Krakowski I, Bottai M, Häbel H, Masucci G, Girnita A, Smedby KE, Eriksson H. Impact of modern systemic therapies and clinical markers on treatment outcome for metastatic melanoma in a real-world setting. J Eur Acad Dermatol Venereol 2020; 35:105-115. [PMID: 32455474 DOI: 10.1111/jdv.16678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/23/2020] [Accepted: 05/05/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The survival in metastatic melanoma has dramatically improved after the introduction of immune checkpoint- (ICIs) and MAPKinase inhibitors (MAPKis). OBJECTIVE Our aim was to describe therapy response and survival in a real-world population as well as to assess the associations between clinical variables and therapy outcome for patients with metastatic melanoma receiving first-line ICIs or MAPKis. METHODS A total of 252 patients with metastatic (stage IV) melanoma were prospectively followed between 1 January 2010 and 3 December 2017 with follow-up until 31 March 2019, at the Karolinska University Hospital, Sweden. Hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS) were analysed with Cox regression, and logistic regression was used to estimate odds ratios (ORs) for therapy response. RESULTS Patients receiving ICIs (n = 138) experienced longer PFS compared to patients that received MAPKis (n = 114; median PFS for ICIs was 6.8 months, and median PFS for MAPKis was 5.3 months). In the multivariable analyses of clinical markers, increasing M-stage (OR 0.65; 95% CI 0.45-0.94; P = 0.022) and male sex (OR 0.41; 95% CI 0.19-0.90; P = 0.027) were significantly associated with lower response to ICIs. Lower baseline albumin levels (OR 0.90; 95% CI 0.83-0.98; P = 0.019) and male sex (OR 0.33; 95% CI 0.12-0.93; P = 0.036) were related with lower response to MAPKis. For ICIs, increasing M-stage (HR 1.34; 95% CI 1.07-1.68; P = 0.010), increasing LDH (HR 1.73; 95% CI 1.19-2.50; P = 0.004) and decreasing albumin (HR 1.06; 95% CI 1.01-1.10; P = 0.011) were significantly associated lower PFS in the adjusted model. The corresponding markers for MAPKis were increasing LDH (HR 1.44; 95% CI 1.08-1.92; P = 0.013) and decreasing albumin (HR 1.05; 95% CI 1.02-1.09; P = 0.005) for PFS. CONCLUSION ICIs and MAPKis were effective in this real-world population, and we could confirm the importance of previously reported clinical prognostic markers. Albumin values may be associated with therapy outcome but need further validation.
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Affiliation(s)
- I Krakowski
- Department of Dermatology/Theme inflammation, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - M Bottai
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - H Häbel
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - G Masucci
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.,Skin Cancer Center, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology/Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - A Girnita
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.,Skin Cancer Center, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - K E Smedby
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Solna, Division of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - H Eriksson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.,Skin Cancer Center, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology/Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
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Grellety T, Ravaud A, Canivet A, Ganem G, Giraud P, Guimbaud R, Kaluzinski L, Krakowski I, Mayeur D, Lotz JP, You B. [SARS-CoV-2/COVID 19 Infection and Solid Cancers: Synthesis of Recommendations for Health Professionals]. Bull Cancer 2020; 107:400-402. [PMID: 32229048 PMCID: PMC7195419 DOI: 10.1016/j.bulcan.2020.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Thomas Grellety
- Service d'oncologie médicale, centre hospitalier de la Côte Basque, 13, avenue de l'Interne-Jacques-Loeb, 64100 Bayonne, France.
| | - Alain Ravaud
- CHU de Bordeaux, service d'oncologie médicale, Bordeaux, France
| | - Anne Canivet
- Centre Francois-Baclesse, service d'hygiène, Caen, France
| | - Gérard Ganem
- Clinique Victor Hugo-Centre Jean-Bernard, Le Mans, France
| | - Philippe Giraud
- Radiotherapy Department, hôpital Européen Georges-Pompidou, Société Française de Radiothérapie Oncologique, France
| | - Rosine Guimbaud
- CHU de Toulouse, oncologie médicale digestive, Toulouse, France
| | - Laure Kaluzinski
- Centre hospitalier public du Cotentin, service d'oncologie médicale, Cherbourg-en-Cotentin, France
| | - Ivan Krakowski
- AFSOS, centre de lutte contre le cancer institut Bergonié, Bordeaux, France
| | - Didier Mayeur
- Centre Georges-François-Leclerc, service d'oncologie médicale, Dijon, France
| | | | - Benoit You
- Institut de cancérologie des hospices civils de Lyon (IC-HCL), service d'oncologie médicale, Lyon, France
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12
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You B, Ravaud A, Canivet A, Ganem G, Giraud P, Guimbaud R, Kaluzinski L, Krakowski I, Mayeur D, Grellety T, Lotz JP. The official French guidelines to protect patients with cancer against SARS-CoV-2 infection. Lancet Oncol 2020; 21:619-621. [PMID: 32220659 PMCID: PMC7118635 DOI: 10.1016/s1470-2045(20)30204-7] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Benoit You
- Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon, Centre d'Investigation des Thérapeutiques en Oncologie et Hématologie de lyon, Université Claude Bernard Lyon 1, Lyon 69495, France.
| | - Alain Ravaud
- Medical Oncology, Bordeaux University Hospital, Bordeaux, France
| | - Anne Canivet
- Service d'hygiene, Centre de Lutte Contre le Cancer François Baclesse, Caen, France
| | - Gérard Ganem
- Clinique Victor Hugo-Centre Jean Bernard, Le Mans, France
| | - Philippe Giraud
- Radiotherapy Department, Hôpital Européen Georges Pompidou, Sociéré Francaise de Radiothérapie Oncologique, France
| | - Rosine Guimbaud
- Oncologie Médicale Digestive, CHU de Toulouse, Toulouse, France
| | - Laure Kaluzinski
- Centre Hospitalier Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Ivan Krakowski
- Centre de Lutte Contre le Cancer Institut Bergonié, Bordeaux, Association Francophone pour les Soins Oncologiques de Support (AFSOS), France
| | - Didier Mayeur
- Oncologie médicale, Centre Georges Francois Leclerc, Dijon, AFSOS, France
| | - Thomas Grellety
- Centre hospitalier de la Côte Basque, Service D'Oncologie Médicale, Bayonne, France
| | - Jean-Pierre Lotz
- Tenon Hospital, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
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13
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Oudard S, Latorzeff I, Caty A, Miglianico L, Sevin E, Hardy-Bessard AC, Delva R, Rolland F, Mouret L, Priou F, Beuzeboc P, Gravis G, Linassier C, Gomez P, Voog E, Muracciole X, Abraham C, Banu E, Ferrero JM, Ravaud A, Krakowski I, Lagrange JL, Deplanque G, Zylberait D, Bozec L, Houede N, Culine S, Elaidi R. Effect of Adding Docetaxel to Androgen-Deprivation Therapy in Patients With High-Risk Prostate Cancer With Rising Prostate-Specific Antigen Levels After Primary Local Therapy: A Randomized Clinical Trial. JAMA Oncol 2020; 5:623-632. [PMID: 30703190 DOI: 10.1001/jamaoncol.2018.6607] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Androgen-deprivation therapy (ADT) plus docetaxel is the standard of care in hormone-naive metastatic prostate cancer but is of uncertain benefit in a nonmetastatic, high-risk prostate cancer setting. Objective To assess the benefit of ADT plus docetaxel in patients presenting with rising prostate-specific antigen (PSA) levels after primary local therapy and high-risk factors but no evidence of metastatic disease. Design, Setting, and Participants This open-label, phase 3, randomized superiority trial comparing ADT plus docetaxel vs ADT alone enrolled patients from 28 centers in France between June 4, 2003, and September 25, 2007; final follow-up was conducted April 12, 2017, and analysis was performed May 2 to July 31, 2017. Patients had undergone primary local therapy for prostate cancer, were experiencing rising PSA levels, and were considered to be at high risk of metastatic disease. Stratification was by prior local therapy and PSA-level doubling time (≤6 vs >6 months), and intention-to-treat analysis was used. Interventions Patients were randomly assigned to receive ADT (1 year) plus docetaxel, 70 mg/m2 (every 3 weeks [6 cycles]), or ADT alone (1 year). Main Outcomes and Measures The primary outcome was PSA progression-free survival (PSA-PFS). Secondary end points were PSA response, radiologic PFS, overall survival, safety, and quality of life. Results Overall, 254 patients were randomized (1:1) to the trial; median age, 64 years in the ADT plus docetaxel arm, 66 years in the ADT alone arm. At a median follow-up of 30.0 months, the median PSA-PFS was 20.3 (95% CI, 19.0-21.6) months in the ADT plus docetaxel arm vs 19.3 (95% CI, 18.2-20.8) months in the ADT alone arm (hazard ratio [HR], 0.85; 95% CI, 0.62-1.16; P = .31). At a median follow-up of 10.5 years, there was no significant between-arm difference in radiologic PFS (HR, 1.03; 95% CI, 0.74-1.43; P = .88). Overall survival data were not mature. The most common grade 3 or 4 hematologic toxic effects in the ADT plus docetaxel arm were neutropenia (60 of 125 patients [48.0%]), febrile neutropenia (10 [8.0%]), and thrombocytopenia (4 [3.0%]). There was no significant between-arm difference in overall quality of life. Conclusions and Relevance Compared with ADT alone, combined ADT plus docetaxel therapy with curative intent did not significantly improve PSA-PFS in patients with high-risk prostate cancer and rising PSA levels and no evidence of metastatic disease. Trial Registration French Health Products Safety Agency identifier: 030591; ClinicalTrials.gov identifier: NCT00764166.
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Affiliation(s)
- Stéphane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris, France
| | - Igor Latorzeff
- Department of Oncology Radiotherapy, Clinique Pasteur, Toulouse, France
| | - Armelle Caty
- Department of Medical Oncology, Centre Galilée, Hôpital Privé la Louvière, Lille, France
| | - Laurent Miglianico
- Department of Oncology Radiotherapy, Centre Hospitalier Privé St Grégoire, Rennes, France
| | - Emmanuel Sevin
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | | | - Remy Delva
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Angers, France
| | - Frédéric Rolland
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, St Herblain, France
| | - Loic Mouret
- Department of Medical Oncology, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Franck Priou
- Department of Medical Oncology, Centre Hospitalier de Vendée, La Roche sur Yon, France
| | | | - Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Claude Linassier
- Department of Medical Oncology, Centre Hospitalier Bretonneau, Tours, France
| | - Philippe Gomez
- Department of Oncology Radiotherapy, Centre Joliot Curie, Rouen, France
| | - Eric Voog
- Department of Medical Oncology, Clinique Victor Hugo, Institut Inter-régional de Cancérologie, Le Mans, France
| | - Xavier Muracciole
- Department of Oncology Radiotherapy, Hôpital de la Timone, Marseille, France
| | - Christine Abraham
- Department of Medical Oncology, Centre Hospitalier Versailles André Mignot, Le Chesnay, France
| | - Eugeniu Banu
- Department of Medical Oncology, Cancer Institute Ion Chiricuta, Cluj-Napoca, Romania
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Alain Ravaud
- Department of Medical Oncology, Hôpital St Andre, Bordeaux, France
| | - Ivan Krakowski
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre Les Nancy, France
| | | | - Gaël Deplanque
- Department of Medical Oncology, Fondation Hopital St Joseph, Paris, France
| | - David Zylberait
- Department of Medical Oncology, Centre Hospitalier de Compiegne, Compiegne, France
| | - Laurence Bozec
- Department of Medical Oncology, Hôpital Foch, Suresnes, France
| | - Nadine Houede
- Department of Medical Oncology, Institut Bergonie, Bordeaux, France
| | - Stéphane Culine
- Department of Medical Oncology, Hôpital St Louis, Paris, France
| | - Reza Elaidi
- Association pour la Recherche sur les Thérapeutiques Innovantes en Cancérologie, Paris, France
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Antoun S, Morel H, Souquet PJ, Surmont V, Planchard D, Bonnetain F, Foucher P, Egenod T, Krakowski I, Gaudin H, Debieuvre D. Staging of nutrition disorders in non-small-cell lung cancer patients: utility of skeletal muscle mass assessment. J Cachexia Sarcopenia Muscle 2019; 10:782-793. [PMID: 30932365 PMCID: PMC6711412 DOI: 10.1002/jcsm.12418] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 02/04/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND An international consensus proposed in 2011 a definition and classification system for cachexia (CAX), mainly based on weight loss, sarcopenia [skeletal muscle mass (SMM) loss], inflammation, and anorexia. The aim of this study was to stage CAX in non-small-cell lung cancer (NSCLC) patients by using a classification based on the Fearon criteria and supported by quantifiable parameters. METHODS This was a cross-sectional and non-interventional multicentre study. SMM was assessed by analysing L3 computed tomography-scan images. Patients completed the anorexia/CAX subscale of the Functional Assessment of Anorexia/Cachexia Therapy, EORTC QLQ-C30 quality of life (QoL) and International Physical Activity Questionnaire (IPAQ). RESULTS Patients were recruited in 56 sites. The analysis population comprised 531 patients, and SMM was assessed in 312 patients. Male patients were 66.5%, with a mean (SD) age of 65.2 (10.0) years, 79.9% were PS 0-1, and the tumour stage was mainly IIIB-IV (87.3%). Overall, 38.7% of patients had CAX, 33.8% pre-CAX, and 0.9% refractory CAX. Molecular tumour profiles were significantly associated with the presence of CAX: 23.9% in EGFR, ALK, ROS1, BRAF, or HER2+ patients, 41.4% in K-RAS+, and 43.2% in patients with no molecular abnormality (P = 0.003). The more advanced the CAX stage, the poorer the scores of functional items of the QoL (P < 0.001) and International Physical Activity Questionnaire (P < 0.001). Sarcopenia was present in 66.7% of CAX and 68.5% of pre-CAX patients. Overall, 43.8% of pre-CAX patients had only sarcopenia with limited weight loss (≤2%) and no anorexia. CONCLUSIONS This is the first study to show the distribution of CAX in a population of NSCLC patients and an association between molecular abnormality in NSCLC and CAX. The original Fearon classification for CAX stages was supported by the associated functional QoL scores and physical activity levels, resulting in a clinically relevant system for detection of early stages of CAX.
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Affiliation(s)
- Sami Antoun
- Emergency Unit, Gustave Roussy, Paris Saclay University, Villejuif, France
| | - Hugues Morel
- Pneumology Department, Centre Hospitalier Régional d'Orleans, Orleans, France
| | | | - Veerle Surmont
- Thoracic Oncology Unit, Universitair Ziekenhuis Gent, Ghent, Belgium
| | - David Planchard
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit (EA 3181), Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - Pascal Foucher
- Department of Thoracic Oncology, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon Cedex, France
| | - Thomas Egenod
- Thoracic and Skin Oncology Unit, Centre Hospitalier Universitaire De Limoges Dupuytren, Limoges, France
| | - Ivan Krakowski
- Interdisciplinary Department of Supportive care in Oncology (DISSPO-CARE), French-Speaking Association of Supportive Care in Cancer (AFSOS), Institut Bergonié, Bordeaux, France
| | - Hélène Gaudin
- Chugai Pharma France, Tour Franklin - Arche Sud, Paris, France
| | - Didier Debieuvre
- GHRMSA, Pneumology Department, French College of General Hospital Respiratory Physicians (CPHG), Hôpital Emile Muller, Mulhouse, France
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Kerckhove N, Busserolles J, Stanbury T, Pereira B, Plence V, Bonnetain F, Krakowski I, Eschalier A, Pezet D, Balayssac D. Effectiveness assessment of riluzole in the prevention of oxaliplatin-induced peripheral neuropathy: RILUZOX-01: protocol of a randomised, parallel, controlled, double-blind and multicentre study by the UNICANCER-AFSOS Supportive Care intergroup. BMJ Open 2019; 9:e027770. [PMID: 31182448 PMCID: PMC6561607 DOI: 10.1136/bmjopen-2018-027770] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Most patients (>70%) experience acute neuropathic symptoms shortly after oxaliplatin infusions. These symptoms are not always resolved between infusions. Overall, 30%-50% of patients suffer from chronic oxaliplatin-induced peripheral neuropathy (OIPN). This cumulative and dose-dependent sensory neuropathy limits compliance or results in oxaliplatin-based chemotherapies to be substituted with less neurotoxic agents. These treatment changes impair clinical outcomes, and may be associated with comorbidities, such as distress, depression and anxiety. Currently, no drug used to prevent or treat OIPN is sufficiently effective to be used routinely in clinical practice. There is, thus, an unmet therapeutic need to reduce the intensity of and/or prevent OIPN. We hypothesised that riluzole would be an excellent candidate to address this public health issue. Riluzole is approved for treating amyotrophic lateral sclerosis. In animals, there is a beneficial effect on sensorimotor and pain disorders, as well as related comorbidities, after repeated administration of oxaliplatin. In humans, riluzole has shown neuroprotective, anxiolytic and antidepressive effects. METHODS AND ANALYSIS RILUZOX-01 trial was designed as a randomised, controlled, double-blind study to evaluate the efficacy of riluzole to prevent OIPN. Patients with colorectal cancer and initiating adjuvant oxaliplatin-based chemotherapy are eligible. Patients (n=210) will be randomly assigned to either riluzole or placebo, concomitantly with chemotherapy. The primary endpoint is the change in OIPN intensity, assessed by the sensory scale of the QLQ-CIPN20, after six 2-week cycles of chemotherapy. Secondary endpoints include incidence and severity of neuropathy, grade of sensory neuropathy, intensity and features of neuropathic pain, health-related quality of life, disease-free survival, overall survival and safety. ETHICS AND DESSIMINATION The study was approved by a French ethics committee (ref:39/18_1, 'Comité de Protection des Personnes' Ouest-IV, France) and plans to start enroling patients in September 2019. The trial is registered in EudraCT and clinicaltrials.gov. TRIAL REGISTRATION NUMBER N°2017-002320-25; NCT03722680.
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Affiliation(s)
- Nicolas Kerckhove
- Medical pharmacology, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
- Institut Analgesia, Faculty of medicine, Clermont-Ferrand, France
- INSERM 1107, NEURO-DOL Basic and Clinical Pharmacology of Pain, University Clermont Auvergne, Clermont-Ferrand, France
| | - Jérome Busserolles
- INSERM 1107, NEURO-DOL Basic and Clinical Pharmacology of Pain, University Clermont Auvergne, Clermont-Ferrand, France
| | | | - Bruno Pereira
- DRCI, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | | | - Alain Eschalier
- Institut Analgesia, Faculty of medicine, Clermont-Ferrand, France
- INSERM 1107, NEURO-DOL Basic and Clinical Pharmacology of Pain, University Clermont Auvergne, Clermont-Ferrand, France
| | - Denis Pezet
- INSERM 1107, NEURO-DOL Basic and Clinical Pharmacology of Pain, University Clermont Auvergne, Clermont-Ferrand, France
- University Hospital of Clermont-Ferrand, Digestive and hepatobiliary surgery, Clermont-Ferrand, France
| | - David Balayssac
- INSERM 1107, NEURO-DOL Basic and Clinical Pharmacology of Pain, University Clermont Auvergne, Clermont-Ferrand, France
- DRCI, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
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Jovenin N, Eche-Gass A, Chèze S, Launay-Vacher V, Mayeur D, Rey JB, Joly F, Krakowski I, Scotté F. Nausées-vomissements induits par les traitements anti-cancéreux (NVITAC) : quelle prise en charge en 2018 ? Mise à jour du référentiel AFSOS. Bull Cancer 2019; 106:497-509. [DOI: 10.1016/j.bulcan.2019.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/22/2019] [Accepted: 02/13/2019] [Indexed: 11/29/2022]
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Krakowski I, Morel H, Debieuvre D, Souquet PJ, Surmont V, Bonnetain F, Planchard D, Gaudin H, Antoun S. La mesure de la masse musculaire permet de préciser les différents stades de cachexie cancéreuse chez les patients (pts) suivis pour un cancer du poumon non à petites cellules (CPNPC). NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Fizazi K, Carmel A, Joly F, Delva R, Gravis G, Rolland F, Priou F, Ferrero JM, Houede N, Mourey L, Theodore C, Krakowski I, Berdah JF, Baciuchka Palmaro M, Laguerre B, Flechon A, Ravaud A, Brihoum M, Culine S, Le Teuff G. Updated results of GETUG-12, a phase III trial of docetaxel-based chemotherapy in high-risk localized prostate cancer, with a 12-year follow-up. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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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Saghatchian M, Bouleuc C, Naudet C, Arnaud S, Papazian P, Scotté F, Krakowski I. [Impact of beauty and well-being care assessed in a national survey including 1166 individuals]. Bull Cancer 2018; 105:671-678. [PMID: 30099993 DOI: 10.1016/j.bulcan.2018.05.012] [Citation(s) in RCA: 3] [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: 02/21/2018] [Revised: 05/15/2018] [Accepted: 05/25/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Research has suggested a high level of satisfaction following beauty and well-being care in oncology. We aimed to assess perception of beauty and well-being care in a large sample of patients affected by cancer. METHODS From June through August, 2017, a physical and online survey was conducted recruiting patients affected by cancer and their relatives. A questionnaire, established in a collaborative manner with healthcare providers and patients, collected general demographic and medical data, awareness and knowledge data, the experience of beauty and well-being care and perceived benefits. RESULTS At baseline, 1263 people were recruited (online, n=485; others, n=778) with 1254 usable replies. After excluding caregivers (n=88), the analysis was made on 1166 patients (mean age=51.7). This sample included 1080 women (92.6 %) and breast cancer was prominent (n=827; 70.9%). Among the 481 patients, who had received beauty and well-being care, 405 stated them as a relaxing time (84 %) and the average ranking was 8,1/10. Mean number of sessions was 2.8. A combined scheme of beauty and well-being care (individual and collective) and a greater number of sessions were statistically associated with a higher perceived benefit (P=0.02 and P<0.001) and a higher level of recommendation (P=0.039 and P=0.05). DISCUSSION This large national survey confirms the high level of satisfaction associated with beauty and well-being care. The type and number of sessions seem to be positively correlated with a greater benefit.
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Affiliation(s)
- Mahasti Saghatchian
- Institut Gustave-Roussy, comité de pathologie, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
| | - Carole Bouleuc
- Institut Curie, oncologie médicale, 26, rue d'Ulm, 75005 Paris 5, France
| | - Catherine Naudet
- Institut Curie, oncologie médicale, 26, rue d'Ulm, 75005 Paris 5, France
| | - Sylvie Arnaud
- Institut Curie, oncologie médicale, 26, rue d'Ulm, 75005 Paris 5, France
| | - Patrick Papazian
- Hôpital Bichat-Claude-Bernard, service de maladies infectieuses et tropicales, 46, rue Henri-Huchard, 75018 Paris 18, France
| | - Florian Scotté
- Hôpital Foch, soins de support, 40, rue Worth, 92150 Suresnes, France
| | - Ivan Krakowski
- Institut Bergonié, oncologie médicale, 229, cours de l'Argonne, 33076 Bordeaux, France
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Almont T, Farsi F, Krakowski I, El Osta R, Bondil P, Huyghe É. Sexual health in cancer: the results of a survey exploring practices, attitudes, knowledge, communication, and professional interactions in oncology healthcare providers. Support Care Cancer 2018; 27:887-894. [PMID: 30109489 DOI: 10.1007/s00520-018-4376-x] [Citation(s) in RCA: 18] [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: 02/19/2018] [Accepted: 07/24/2018] [Indexed: 01/31/2023]
Abstract
PURPOSE To assess, focusing on population of healthcare professionals providing oncosexology care to men with cancer, clinical practice, attitudes, knowledge, communication, and professional interaction. METHODS We performed a descriptive cross-sectional study with an online self-administered e-questionnaire addressed to all medical, paramedical, or administrative professionals attending the 4th "Cancer, Sexuality and Fertility" Meeting in Toulouse, France. Their participation was voluntary and totally anonymous. RESULTS The 165 respondents comprised 44% of physicians, 47% of paramedics, and 9% of other health professionals in oncology, from all French regions. Paramedics were significantly younger than physicians (p = .006). One third of respondents were degreed in sexology, but 75.8% were in demand of oncosexology-specific trainings, particularly paramedics (p = .029). Regarding the oncosexology network, respondents declared being linked to organ specialists (56.8%), psychologists (49.5%), oncologists (47.4%), nurses (31.5%), radiation therapists (27.4%), and general practitioners (25.3%). Compared to paramedics, physicians were more likely to be engaged in oncosexology care (p = .039) and couple counseling (p = .005), but the proportions of counseled patients or couple were identical (p = .430 and p = .252, respectively). Overall, 90% of respondents reported discussing sexuality issues with patients. Regarding the time for discussion, physicians reported communicating more at cancer announcement (p = .004) or after treatments (p = .015), while more paramedics reported discussing at another time (p = .005). Regarding the place for discussion, paramedics more frequently reported talking about sexuality in the hospital room (p = .001) or during a specific consult (p = .007). CONCLUSIONS Results emphasize various levels for improving existing oncosexology care, such as developing oncosexology-specific educational and practical training programs, particularly for paramedics; consolidating information, counseling, and therapeutic education with formal procedures like implementing medical and paramedical "oncosexology moments," or strengthening the community-hospital networks, from diagnosis to survivorship.
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Affiliation(s)
- Thierry Almont
- EA 3694 Human Fertility Research Group, CHU Toulouse, Paule de Viguier, Reproductive Medicine Department, 330 avenue de Grande- Bretagne TSA 70034, 31059, Toulouse cedex 9, France.
- French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Paule de Viguier University Hospital, Reproductive Medicine Department, 330 avenue de Grande- Bretagne TSA 70034, 31059, Toulouse cedex 9, France.
| | - Fadila Farsi
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, 33130, Bègles, France
| | - Ivan Krakowski
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, 33130, Bègles, France
| | - Rabih El Osta
- Urology Department of Brabois University Hospital, CHU de Nancy, Allée du Morvan, 54511, Vandoeuvre les Nancy, France
| | - Pierre Bondil
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, 33130, Bègles, France
| | - Éric Huyghe
- EA 3694 Human Fertility Research Group, CHU Toulouse, Paule de Viguier, Reproductive Medicine Department, 330 avenue de Grande- Bretagne TSA 70034, 31059, Toulouse cedex 9, France
- French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Paule de Viguier University Hospital, Reproductive Medicine Department, 330 avenue de Grande- Bretagne TSA 70034, 31059, Toulouse cedex 9, France
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, 33130, Bègles, France
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Pernot E, Antoun S, Debieuvre D, Morel H, Souquet PJ, Planchard D, Surmont V, Bonnetain F, Krakowski I, Gaudin H, Bazin F. Mesure de la masse musculaire pour l’évaluation des différents stades de la cachexie cancéreuse : une étude observationnelle chez 531 patients suivis pour un cancer du poumon non à petites cellules. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.038] [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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Lavaud P, Gravis G, Foulon S, Joly F, Oudard S, Priou F, Latorzeff I, Mourey L, Soulié M, Delva R, Krakowski I, Laguerre B, Théodore C, Ferrero JM, Beuzeboc P, Habibian M, Rolland F, Deplanque G, Pouessel D, Zanetta S, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Tubiana-Mathieu N, Machiels JP, Kouri CE, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Culine S, Boher JM, Tergemina-Clain G, Legoupil C, Fizazi K. Anticancer Activity and Tolerance of Treatments Received Beyond Progression in Men Treated Upfront with Androgen Deprivation Therapy With or Without Docetaxel for Metastatic Castration-naïve Prostate Cancer in the GETUG-AFU 15 Phase 3 Trial. Eur Urol 2018; 73:696-703. [DOI: 10.1016/j.eururo.2017.09.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/19/2017] [Indexed: 12/19/2022]
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Souquet P, Debieuvre D, Morel H, Surmont V, Bonnetain F, Krakowski I, Antoun S, Gaudin H, Planchard D. La masse musculaire (MM) est un paramètre intéressant à mesurer chez les patients pris en charge pour un cancer du poumon non à petites cellules (CPNPC). Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Falandry C, Krakowski I, Curé H, Carola E, Soubeyran P, Guérin O, Gaudin H, Freyer G. Impact of geriatric assessment for the therapeutic decision-making of breast cancer: results of a French survey. AFSOS and SOFOG collaborative work. Breast Cancer Res Treat 2017; 168:433-441. [PMID: 29243107 DOI: 10.1007/s10549-017-4607-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Cancer management in the elderly is often considered as suboptimal, highly variable, and rarely evidence-based. Data are needed to understand decision-making processes in this population. MATERIALS AND METHODS A survey was performed in France to describe decision-making in gynaecologic patients over 70. It followed a three-step method: (1) 101 representative physicians questioned about treatment decision criteria; (2) simplified individual data were collected; (3) as well as detailed data patients receiving chemotherapy. This analysis refers to breast cancer subgroup of patients. RESULTS Main decision criteria were performance status, comorbidities, and renal function. In adjuvant setting, the main concern was life expectancy, whereas it was quality of life in metastatic setting. Of the 631 patients entered in the simplified analysis, 41% had been evaluated by a geriatrician, 67% received chemotherapy. In the detailed analysis, patients older than 75 were more likely to receive a monochemotherapy and to be treated with weekly/divided dose. In adjuvant setting, respectively, 19, 55, and 26% of the patients were treated with regimen validated in the elderly, validated in a younger population, and not validated. A G-CSF was prescribed in 48% of the patients, as primary prophylaxis in 78 and in 41% of patients with a risk of febrile neutropenia < 10%. CONCLUSION Geriatric covariates become an increasing concern in the decision-making process. This survey also suggests an insufficient use of validated chemotherapy regimens. To date, age remains a risk factor for heterogeneity in oncologic practice justifying a persistent effort for elaborating and disclosing specific recommendations.
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Affiliation(s)
- Claire Falandry
- Geriatrics Unit, Lyon Sud University Hospital, Hospices Civils de Lyon and Lyon University, 165 chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France.
| | - Ivan Krakowski
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Hervé Curé
- Department of Medical Oncology, CHU de Grenoble, La Tronche, France
| | - Elisabeth Carola
- Department of Medical Oncology, Groupe Hospitalier Public du Sud de l'Oise, Senlis, France
| | - Pierre Soubeyran
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | | | | | - Gilles Freyer
- Department of Medical Oncology, Lyon Sud University Hospital, Hospices Civils de Lyon and Lyon University, Pierre-Bénite, France
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Poulain P, Michenot N, Rostaing S, Baron L, Krakowski I. Opioid switch and change of route of administration in palliative care cancer patients treated by morphine: Update of French guidelines. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.31_suppl.226] [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
226 Background: In 2002 guidelines for the treatment of cancer pain (National Federation of French Cancer Centers) were adapted to the availability of drugs in France. In 2015, a group of experts nominated by the 3 French Societies involved in cancer pain (AFSOS, SFAP, SFETD: Supportive Care, Palliative Care and Pain Societies), reviewed these guidelines and established new ratios for morphine switching and/or changing the route of administration in patients whose pain was not adequately controlled. Methods: A review of the literature via Pubmed (key words: morphine, oxycodone, fentanyl, hydromorphone, methadone, tapentadol, pain, cancer, palliative care, opioid rotation, opioid switching, equianalgesic ratios) plus a manual search, led us to retain 43 original works containing good scientific evidence (methodology French Health Authority).Final approval for publishing was obtained from each of the aforementioned three scientific committees of the societies. Results: Experts explained why the theory of opioid rotation using fixed ratios was no longer appropriate for a secure practice. In the light of recent publications enhancing our knowledge on the efficacy of new drug switching ratios and for changing the route of administration of morphine, the group of experts recommended to use reconsidered switching ratios favoring security over efficacy, to minimize overdosing and adverse effects. Consequently, after the new conversion ratio (using slow release opioids) was applied, a second titration should be done by using normal release rescue formulations for breakthrough pain episodes. Conclusions: This work can be apply to an international situation (despite different drug availability amongst countries). A smartphone app is available for rapid and secure dose conversions and will be translated into English. The adequate opioid dose is obtained from a theoretical dose calculation adapted to patient’s personal situation and needs (second titration). Continuous updating of good practice guidelines may provide security and adequacy of prescription for adequate and safe pain relief for our patients, limiting overconsumption and risk of misuse.
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Affiliation(s)
| | | | - Sylvie Rostaing
- Centre Hospitalier Universitaire, L’hôpital Saint-Antoine, Paris, France
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26
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Debieuvre D, Morel H, Souquet PJ, Surmont V, Planchard D, Bonnetain F, Krakowski I, Gaudin H, Antoun S. Cancer cachexia (CAX), anorexia and muscle wasting (sarcopenia) assessment in non-small cell lung cancer (NSCLC): an observational study in 531 patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx382] [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: 11/14/2022] Open
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27
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Krakowski I, Joly F, Louvet C, Malka D, Seitz JF. Hommage à Franck Bonnetain. ONCOLOGIE 2017. [DOI: 10.1007/s10269-017-2717-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: 11/28/2022]
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28
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Joly Lobbedez F, Vanlemmens L, Descotes JM, Abadie-Lacourtoisie S, Boiron C, Garnier-Tixidre C, Girre V, Helissey C, Houede N, Lefeuvre-Plesse C, Mastroianni B, Meneveau N, Oudard S, Plence V, Priou F, Salas SB, Stefani L, Zannetti A, Bonnetain F, Krakowski I. A phase II-III, multicenter, randomized, open study evaluating the feasibility and efficacy of a supervised home-based standard physical exercise program for metastatic cancer patients receiving oral targeted therapy: The UNICANCER SdS 01 QUALIOR study (ID-RCB: 2015-A01922-47). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.tps10126] [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
TPS10126 Background: Fatigue is a frequent side effect with oral targeted therapies (OTT). Physical activity has been reported to improve fatigue and quality of life (QoL). However, few studies focused on metastatic cancer patients and mainly among patients treated with chemotherapy. Furthermore, recent guidelines recommend evaluation and optimization of standardized exercise programs. The aim of our study is to evaluate home-based standard physical exercise program (SPEP) for metastatic cancer patients treated with OTT. Methods: This phase II-III study will randomize (2:1) patients starting first-line OTT for metastatic cancer between an individualized SPEP supervised by a personal coach, and recommended physical exercises via a booklet. Eligible patients will have received ≤2 lines of metastatic chemotherapy, ECOG PS ≤2, controlled pain (VAS < 3/10), and life expectancy ≥3 months. The phase II part (120 patients) will evaluate the feasibility of a 3-month SPEP using the rate of patients performing ≥50% of SPEP (2-stage Fleming: one-sided α = 5%; β = 85%). An interim analysis is planned after the phase II. The phase III will compare the efficacy of an SPEP as opposed to recommendations to reduce fatigue and/or improve physical well-being (PWB) dimensions of QoL (evaluated with FACT-G and FACT-F questionnaires). To show a difference of ≥5 points in PWB and 2.5 for fatigue (α = 2.5%; β = 80%), 312 patients are required in the phase III trial. . Secondary objectives include: PFS, OS, other dimensions of QoL, tolerability and observance of OTT, change in body composition, physical benefits, and a medico-economic study. The SPEP was developed by specialized coaches involved in physical activity and cancer. The study has Ethic committee approval and accrual is planned in 18 French centers in April 2017, for 30 months. This is the first randomized trial dedicated to patients with metastatic cancer treated with OTT evaluating the feasibility and the efficacy of a well design home based SPEP on fatigue and physical well-being.
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Affiliation(s)
| | | | | | | | - Claude Boiron
- Department of Supportive Care, Institut Curie, Saint-Cloud, France
| | | | - Veronique Girre
- Centre Hospitalier Departemental Vendee, La Roche-Sur-Yon, France
| | | | - Nadine Houede
- Centre Hospitalier Régional Universitaire, Nîmes, France
| | | | - Benedicte Mastroianni
- Hospices Civils De Lyon, Cancer Research Center of Lyon, Claude Bernard University Lyon, Bron, France
| | - Nathalie Meneveau
- Institut Regional du Cancer en Franche-Comté - University Hospital, Besançon, France
| | - Stephane Oudard
- Department of Medical Oncology, Hopital Europeen Georges Pompidou, AP-HP, Paris, France
| | | | - Frank Priou
- Centre Hospitalier Departemental Vendee, La Roche-Sur-Yon, France
| | | | - Laetitia Stefani
- Department of Medical Oncology CH Annecy Genevois, Pringy, France
| | | | - Franck Bonnetain
- Methodology and Quality of Life Unit, Department of Oncology, INSERM UMR 1098, University Hospital of Besancon; French National Platform Quality of Life and Cancer, Besançon, France
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Rajpar S, Carmel A, Merabet Z, Vielh P, Foulon S, Lesaunier F, Delva R, Rolland F, Priou F, Ferrero JM, Houede N, Mourey L, Theodore C, Krakowski I, Faivre L, Habibian M, Culine S, Chauchereau A, Gravis G, Fizazi K. The benefit of combining docetaxel to androgen deprivation therapy in localized and metastatic castration-sensitive prostate cancer as predicted by ERG status: An analysis of two GETUG phase III trials. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.5012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5012 Background: Combining docetaxel to androgen deprivation therapy (ADT) improves survival in metastatic castration-sensitive prostate cancer (CSPC) (Vale C, Lancet Oncol 2016; 17: 243-56) and it also improves relapse-free survival (RFS) in high-risk localized CSPC (Fizazi K, Lancet Oncol 2015; 16: 787-94). However it is unlikely that all patients (pts) derive a benefit from docetaxel treatment and identifying predictive biomarkers remains a major unmet need. A subset of prostate cancers contains TMPRSS2-ERG gene fusions leading to ERG overexpression. Methods: Pre-treatment prostate core biopsies were collected from 255/413 pts and 79/385 pts enrolled respectively in the GETUG 12 and GETUG 15 (Gravis G, Eur Urol 2016; 70: 256-62) phase 3 trials testing early docetaxel in high-risk localized and metastatic CSPC. ERG, PTEN, Ki67 and Rb expression was assessed using immunohistochemistry. RFS curves were compared using the Logrank test. Results: The median age was 63 years (46-77) and 62 years (49-76) in GETUG 12 and GETUG 15. ERG staining was positive in 88/191 (46%) and 33/79 (42%) pts with available tissue, respectively. In GETUG 12, docetaxel-based chemotherapy was associated with improved RFS in pts with ERG+ expression (HR = 0.55 [0.29-1.03]; 6-year RFS : 80% ADT+docetaxel vs 68% ADT alone), but not in pts with ERG- (HR = 1.10 [0.66-1.85]; 6-year RFS 55% ADT+docetaxel vs 60% ADT alone), interaction test: p = 0.02. Similar findings were observed in GETUG 15, which was used as a validation set: the median RFS was 10.7 (6.5-14.3) and 18.8 (9.8-41) months in pts with ERG+ cancers receiving ADT alone and ADT+docetaxel, and 10.6 (4.8-25.3) and 13.2 (9.4-24) months in pts with ERG- cancers. In contrast, no difference in patient outcome by docetaxel treatment was observed by PTEN, Ki67 and Rb expression. Conclusions: Docetaxel-related benefit in men with CSPC is predicted by ERG expression. This biomarker may help better select pts for docetaxel treatment.
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Affiliation(s)
| | | | | | | | | | | | | | - Frederic Rolland
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | - Frank Priou
- Centre Hospitalier Departemental Vendee, La Roche-Sur-Yon, France
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Nadine Houede
- Centre Hospitalier Régional Universitaire, Nîmes, France
| | - Loic Mourey
- Institut Claudius Regaud, IUCT-Oncopole, CRCT, Inserm, Toulouse, France
| | | | | | | | - Muriel Habibian
- Federation Nationale des Centres de Lutte Contre le Cancer, Paris, France
| | - Stephane Culine
- Medical Oncology Department, Hospital Saint-Louis, Paris, France
| | | | | | - Karim Fizazi
- Gustave Roussy Cancer Campus and University Paris-Sud, Villejuif, France
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Scotté F, Hervé C, Leroy P, Tourani JM, Bensadoun RJ, Bugat ME, Farsi F, Jovenin N, Namer M, Tournigand C, Morin S, Brami C, Oudard S, Saadi A, Krakowski I. Supportive Care Organization in France: a national in-depth survey among patients and oncologists. Support Care Cancer 2017; 25:2111-2118. [DOI: 10.1007/s00520-017-3615-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 02/06/2017] [Indexed: 12/01/2022]
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31
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Joly F, Orsini C, Bonnetain F, Krakowski I. Les thématiques de recherche et les axes portés par le groupe de recherche en soins de support Afsos–Unicancer. ONCOLOGIE 2017. [DOI: 10.1007/s10269-017-2689-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: 10/20/2022]
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32
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Scotte F, Pechard M, Krakowski I, Tournigand C, Viallard ML. Decision of palliative chemotherapy in late-stage cancer: The doctor-patient relationship and the decision-making process as seen by an oncologist. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.26_suppl.48] [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
48 Background: We conducted a literature review on the administration of palliative chemotherapy in cancer patients at advanced stage. We wondered about ethical tensions encountered by the oncologists during the decision process to meet or not the patients' demand to have access to a palliative chemotherapy at a late stage of the disease. Methods: We conducted a multicenter, qualitative study of senior oncologists in university hospitals and cancer centers in France, by carrying out interviews with eleven oncologists. Results: The study are consistent with the literature showing that factors are in favor of treatment continuation: the patient's age, his desire to continue treatment and his life expectancy. The decision making process of chemotherapy discontinuation is marked by uncertainties, personal representations of the doctor and subjectivity in front of the objective facts that could make this decision difficult. The working conditions in cancer care and the valuation of the chemotherapy prescription can impact the decision. The constant medical progress in oncology make more complex the decision of stopping specific treatments. This study showed the singularity of the doctor-patient relationship in oncology. This can explain the difficulty to stop chemotherapy. Conclusions: The oncologist can use the collegiality which are necessary for decision to limit specific treatment. The objective is to propose the adequate care to the patient in all its dimensions. Some actions can be proposed to improve our practice: early use of palliative care for patients, analysis of practices and training to deal with uncertainty and the limits of possibilities in clinical practice.
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Affiliation(s)
| | - Marie Pechard
- Hopital René Huguenin, Institut Curie, Saint Cloud, France
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33
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Lavaud P, Gravis G, Legoupil C, Foulon S, Joly F, Oudard S, Priou F, Soulié M, Mourey L, Latorzeff I, Delva R, Krakowski I, Laguerre B, Theodore C, Ferrero JM, Beuzeboc P, Habibian M, Boher J, Tergemina-Clain G, Fizazi K. How should we treat castration-resistant prostate cancer patients who have received androgen deprivation therapy (ADT) plus docetaxel upfront for hormone-sensitive diseae? Mature analysis of the GETUG-AFU 15 phase III trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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34
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Vicier C, Faivre L, Lesaunier F, Delva R, Gravis G, Rolland F, Priou F, Ferrero JM, Houede N, Mourey L, Theodore C, Krakowski I, Berdah JF, Baciuchka M, Laguerre B, Flechon A, Oudard S, Habibian M, Culine S, Fizazi K. Modelling relapse in patients with high-risk localised prostate cancer treated randomly in the GETUG 12 phase III trial reveals two populations of relapsing patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.07] [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: 11/13/2022] Open
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35
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Krakowski I, Badinand Ep Van Den Bussche D, Benabed K, Burlacu D, Corbinais S, Diab R, El Weshi A, Fabre E, Gardner M, Hacini M, Janoray P, Jovenin N, Mouysset JL, Sakek N, Laribi K. Filgrastim prophylaxis in elderly cancer patients: A French multicenter observational study (TULIP). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e21530] [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: 11/20/2022] Open
Affiliation(s)
| | | | | | - Daniela Burlacu
- Centre Hospitalier Henri Mondor d'Aurillac, Aurillac, France
| | | | - Rafik Diab
- CHI Emile Durkheim Site Epinal, Epinal, France
| | - Amr El Weshi
- CH du Cotentin Site de Cherbourg, Cherbourg Octeville, France
| | - Elizabeth Fabre
- Hôpital Européen Georges Pompidou (HEGP), Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | - Miriam Gardner
- Hôpital Clinique Claude Bernard - Centre, Privé de Radiothérapie, Metz, France, Metz, France
| | | | | | | | | | - Nacera Sakek
- Hôpital Nord Franche Comté Site Le Mittan, Montbeliard, France
| | - Kamel Laribi
- Department of Hematology, Centre Hospitalier Le Mans, Le Mans, France
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Lavaud P, Gravis G, Legoupil C, Joly F, Oudard S, Priou F, Mourey L, Soulie M, Latorzeff I, Delva R, Krakowski I, Laguerre B, Theodore C, Ferrero JM, Beuzeboc P, Habibian M, Foulon S, Boher JM, Tergemina-Clain G, Fizazi K. Efficacy and tolerance of treatments received beyond progression in men with metastatic hormone-naive prostate cancer treated with androgen deprivation therapy (ADT) with or without docetaxel in the GETUG-AFU 15 phase III trial. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Gwenaelle Gravis
- Medical Oncology, Institut Paoli Calmette, Hôpital de Jour, Marseille, France
| | | | | | - Stephane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris, France
| | - Franck Priou
- Centre Hospitalier Departemental Les Oudairies, La Roche sur Yon, France
| | - Loic Mourey
- Institut Claudius Regaud, IUCT-O, Toulouse, France
| | - Michel Soulie
- Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | | | | | | | | | | | | | | | | | | | | | | | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Sud, Villejuif, France
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Gravis G, Boher JM, Joly F, Soulié M, Albiges L, Priou F, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Théodore C, Deplanque G, Ferrero JM, Culine S, Mourey L, Beuzeboc P, Habibian M, Oudard S, Fizazi K. Androgen Deprivation Therapy (ADT) Plus Docetaxel Versus ADT Alone in Metastatic Non castrate Prostate Cancer: Impact of Metastatic Burden and Long-term Survival Analysis of the Randomized Phase 3 GETUG-AFU15 Trial. Eur Urol 2015. [PMID: 26610858 DOI: 10.1016/j.eururo.2015.11.005.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The role of chemotherapy in metastatic non castrate prostate cancer (mNCPC) is debated. Survival benefits of docetaxel (D) added to androgen-deprivation therapy (ADT) were shown in the CHAARTED trial in patients with metastatic high-volume disease (HVD). OBJECTIVE To assess the impact of metastatic burden and to update overall survival (OS) data of the GETUG-AFU15 study. DESIGN, SETTING, AND PARTICIPANTS Randomized phase 3 trial of ADT plus D versus ADT alone in 385 mNCPC patients; median follow-up of 7 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Primary end point was OS. Secondary end points were biochemical progression-free survival (bPFS) and radiographic progression-free survival (rPFS). Retrospective analysis was by tumor volume. RESULTS AND LIMITATIONS After a median follow-up of 83.9 mo, median OS in the overall population was 62.1 mo (95% confidence interval [CI], 49.5-73.7) and 48.6 mo (95% CI, 40.9-60.6) for ADT plus D and ADT arms, respectively (hazard ratio [HR]: 0.88 [95% CI, 0.68-1.14]; p=0.3). Median OS in ADT plus D and ADT arms, respectively, was for HVD patients: 39.8 mo (95% CI, 28.0-53.4) versus 35.1 mo (95% CI, 29.9-43.6) (HR: 0.78 [95% CI, 0.56-1.09]; p=0.14), for low-volume disease (LVD) patients; median was not reached (NR; 95% CI, 69.5-NR) and 83.4 mo (95% CI, 61.8-NR) (HR: 1.02 [95% CI, 0.67-1.55]; p=0.9). For upfront metastatic patients, OS was 52.6 mo (95% CI, 43.3-66.8) and 41.5 mo (95% CI, 36.3-54.5), respectively (HR: 0.93 [95% CI, 0.69-1.25]; p=0.6). The bPFS (HR: 0.73 [95% CI, 0.56-0.94]; p=0.014) and rPFS (HR: 0.75 [95% CI, 0.58-0.97]; p=0.030) were significantly longer in the ADT plus D arm. Limitations included the retrospective analysis of metastatic extent and the lack of statistical power to detect a significant difference in subgroups. CONCLUSIONS The post hoc analyses of the GETUG-AFU15 study demonstrated a nonsignificant 20% reduction in the risk of death in the HVD subgroup. Patients with LVD had no survival improvement with early D. PATIENT SUMMARY In this study, docetaxel added to castration did not improve survival in patients with metastatic hormone-sensitive prostate cancer, partly due to methodological issues. However, early chemotherapy should be discussed with all patients, given the data of three randomized trials including GETUG-AFU15.
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Affiliation(s)
| | - Jean-Marie Boher
- Biostatistics, Institut Paoli-Calmettes, Marseille, France; Aix-Marseille Université, UMR_S 912 (SESSTIM), IRD, Marseille, France; INSERM, UMR_S 912 (SESSTIM), Marseille, France
| | - Florence Joly
- Medical Oncology, Centre François Baclesse - CHU Côte de Nacre, Caen, France
| | - Michel Soulié
- Urology Department, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Laurence Albiges
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | - Franck Priou
- Medical Oncology, Centre Hospitalier Les Oudairies, La Roche-sur-Yon, France
| | - Igor Latorzeff
- Radiotherapy Department, Clinique Pasteur, Toulouse, France
| | - Remy Delva
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - Ivan Krakowski
- Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France
| | | | - Frédéric Rolland
- Medical Oncology, Centre René Gauducheau, Saint-Herblain, France
| | | | - Gael Deplanque
- Medical Oncology, Groupe Hospitalier Saint Joseph, Paris, France
| | | | | | | | | | | | - Stéphane Oudard
- Medical Oncology Department, Georges Pompidou Hospital and René Descartes University, Paris, France
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
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38
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Gravis G, Boher JM, Joly F, Soulié M, Albiges L, Priou F, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Théodore C, Deplanque G, Ferrero JM, Culine S, Mourey L, Beuzeboc P, Habibian M, Oudard S, Fizazi K. Androgen Deprivation Therapy (ADT) Plus Docetaxel Versus ADT Alone in Metastatic Non castrate Prostate Cancer: Impact of Metastatic Burden and Long-term Survival Analysis of the Randomized Phase 3 GETUG-AFU15 Trial. Eur Urol 2015; 70:256-62. [PMID: 26610858 DOI: 10.1016/j.eururo.2015.11.005] [Citation(s) in RCA: 300] [Impact Index Per Article: 33.3] [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: 07/18/2015] [Accepted: 11/02/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The role of chemotherapy in metastatic non castrate prostate cancer (mNCPC) is debated. Survival benefits of docetaxel (D) added to androgen-deprivation therapy (ADT) were shown in the CHAARTED trial in patients with metastatic high-volume disease (HVD). OBJECTIVE To assess the impact of metastatic burden and to update overall survival (OS) data of the GETUG-AFU15 study. DESIGN, SETTING, AND PARTICIPANTS Randomized phase 3 trial of ADT plus D versus ADT alone in 385 mNCPC patients; median follow-up of 7 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Primary end point was OS. Secondary end points were biochemical progression-free survival (bPFS) and radiographic progression-free survival (rPFS). Retrospective analysis was by tumor volume. RESULTS AND LIMITATIONS After a median follow-up of 83.9 mo, median OS in the overall population was 62.1 mo (95% confidence interval [CI], 49.5-73.7) and 48.6 mo (95% CI, 40.9-60.6) for ADT plus D and ADT arms, respectively (hazard ratio [HR]: 0.88 [95% CI, 0.68-1.14]; p=0.3). Median OS in ADT plus D and ADT arms, respectively, was for HVD patients: 39.8 mo (95% CI, 28.0-53.4) versus 35.1 mo (95% CI, 29.9-43.6) (HR: 0.78 [95% CI, 0.56-1.09]; p=0.14), for low-volume disease (LVD) patients; median was not reached (NR; 95% CI, 69.5-NR) and 83.4 mo (95% CI, 61.8-NR) (HR: 1.02 [95% CI, 0.67-1.55]; p=0.9). For upfront metastatic patients, OS was 52.6 mo (95% CI, 43.3-66.8) and 41.5 mo (95% CI, 36.3-54.5), respectively (HR: 0.93 [95% CI, 0.69-1.25]; p=0.6). The bPFS (HR: 0.73 [95% CI, 0.56-0.94]; p=0.014) and rPFS (HR: 0.75 [95% CI, 0.58-0.97]; p=0.030) were significantly longer in the ADT plus D arm. Limitations included the retrospective analysis of metastatic extent and the lack of statistical power to detect a significant difference in subgroups. CONCLUSIONS The post hoc analyses of the GETUG-AFU15 study demonstrated a nonsignificant 20% reduction in the risk of death in the HVD subgroup. Patients with LVD had no survival improvement with early D. PATIENT SUMMARY In this study, docetaxel added to castration did not improve survival in patients with metastatic hormone-sensitive prostate cancer, partly due to methodological issues. However, early chemotherapy should be discussed with all patients, given the data of three randomized trials including GETUG-AFU15.
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Affiliation(s)
| | - Jean-Marie Boher
- Biostatistics, Institut Paoli-Calmettes, Marseille, France; Aix-Marseille Université, UMR_S 912 (SESSTIM), IRD, Marseille, France; INSERM, UMR_S 912 (SESSTIM), Marseille, France
| | - Florence Joly
- Medical Oncology, Centre François Baclesse - CHU Côte de Nacre, Caen, France
| | - Michel Soulié
- Urology Department, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Laurence Albiges
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | - Franck Priou
- Medical Oncology, Centre Hospitalier Les Oudairies, La Roche-sur-Yon, France
| | - Igor Latorzeff
- Radiotherapy Department, Clinique Pasteur, Toulouse, France
| | - Remy Delva
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - Ivan Krakowski
- Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France
| | | | - Frédéric Rolland
- Medical Oncology, Centre René Gauducheau, Saint-Herblain, France
| | | | - Gael Deplanque
- Medical Oncology, Groupe Hospitalier Saint Joseph, Paris, France
| | | | | | | | | | | | - Stéphane Oudard
- Medical Oncology Department, Georges Pompidou Hospital and René Descartes University, Paris, France
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
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Blanchard P, Faivre L, Lesaunier F, Salem N, Mesgouez-Nebout N, Deniau-Alexandre E, Rolland F, Ferrero JM, Houédé N, Mourey L, Théodore C, Krakowski I, Berdah JF, Baciuchka M, Laguerre B, Davin JL, Habibian M, Culine S, Laplanche A, Fizazi K. Outcome According to Elective Pelvic Radiation Therapy in Patients With High-Risk Localized Prostate Cancer: A Secondary Analysis of the GETUG 12 Phase 3 Randomized Trial. Int J Radiat Oncol Biol Phys 2015; 94:85-92. [PMID: 26576711 DOI: 10.1016/j.ijrobp.2015.09.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/04/2015] [Accepted: 09/15/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The role of pelvic elective nodal irradiation (ENI) in the management of prostate cancer is controversial. This study analyzed the role of pelvic radiation therapy (RT) on the outcome in high-risk localized prostate cancer patients included in the Groupe d'Etude des Tumeurs Uro-Genitales (GETUG) 12 trial. METHODS AND MATERIALS Patients with a nonpretreated high-risk localized prostate cancer and a staging lymphadenectomy were randomly assigned to receive either goserelin every 3 months for 3 years and 4 cycles of docetaxel plus estramustine or goserelin alone. Local therapy was administered 3 months after the start of systemic treatment. Performance of pelvic ENI was left to the treating physician. Only patients treated with primary RT were included in this analysis. The primary endpoint was biochemical progression-free survival (bPFS). RESULTS A total of 413 patients treated from 2002 to 2006 were included, of whom 358 were treated using primary RT. A total of 208 patients received pelvic RT and 150 prostate-only RT. Prostate-specific antigen (PSA) concentration, Gleason score, or T stage did not differ according to performance of pelvic RT; pN+ patients more frequently received pelvic RT than pN0 patients (P<.0001). Median follow-up was 8.8 years. In multivariate analysis, bPFS was negatively impacted by pN stage (hazard ratio [HR]: 2.52 [95% confidence interval [CI]: 1.78-3.54], P<.0001), Gleason score 8 or higher (HR: 1.41 [95% CI: 1.03-1.93], P=.033) and PSA higher than 20 ng/mL (HR: 1.41 [95% CI: 1.02-1.96], P=.038), and positively impacted by the use of chemotherapy (HR: 0.66 [95% CI: 0.48-0.9], P=.009). There was no association between bPFS and use of pelvic ENI in multivariate analysis (HR: 1.10 [95% CI: 0.78-1.55], P=.60), even when analysis was restricted to pN0 patients (HR: 0.88 [95% CI: 0.59-1.31], P=.53). Pelvic ENI was not associated with increased acute or late patient reported toxicity. CONCLUSIONS This unplanned analysis of a randomized trial failed to demonstrate a benefit of pelvic ENI on bPFS in high-risk localized prostate cancer patients.
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Affiliation(s)
- Pierre Blanchard
- Radiation Oncology, Gustave Roussy Cancer Center, Villejuif, France; University of Paris-Sud, Cancer Campus, Villejuif, France.
| | - Laura Faivre
- Biostatistics, Gustave Roussy Cancer Center, Villejuif, France
| | | | - Naji Salem
- Radiation Oncology, Institut Paoli Calmette, Marseille, France
| | | | | | - Frédéric Rolland
- Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | | | - Nadine Houédé
- Medical Oncology, Institut Bergonié, Bordeaux, France
| | | | | | | | | | | | | | | | | | - Stéphane Culine
- Department of Medical Oncology, Hopital Saint-Louis, APHP, Paris, France
| | - Agnès Laplanche
- Biostatistics, Gustave Roussy Cancer Center, Villejuif, France
| | - Karim Fizazi
- University of Paris-Sud, Cancer Campus, Villejuif, France; Department of Cancer Medicine, Gustave Roussy Cancer Center, Villejuif, France
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Fizazi K, Faivre L, Lesaunier F, Delva R, Gravis G, Rolland F, Priou F, Ferrero JM, Houede N, Mourey L, Theodore C, Krakowski I, Berdah JF, Baciuchka M, Laguerre B, Fléchon A, Ravaud A, Cojean-Zelek I, Oudard S, Labourey JL, Chinet-Charrot P, Legouffe E, Lagrange JL, Linassier C, Deplanque G, Beuzeboc P, Davin JL, Martin AL, Habibian M, Laplanche A, Culine S. Androgen deprivation therapy plus docetaxel and estramustine versus androgen deprivation therapy alone for high-risk localised prostate cancer (GETUG 12): a phase 3 randomised controlled trial. Lancet Oncol 2015; 16:787-94. [DOI: 10.1016/s1470-2045(15)00011-x] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/06/2015] [Accepted: 05/08/2015] [Indexed: 12/18/2022]
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Affiliation(s)
- Vincent Massard
- 1 Department of Medical Oncology, Institut de Cancérologie de Lorraine , Vandoeuvre-lès-Nancy, France
| | - Julia Salleron
- 2 Unit of Biostatistics, Institut de Cancérologie de Lorraine , Vandoeuvre-lès-Nancy, France
| | - Ivan Krakowski
- 1 Department of Medical Oncology, Institut de Cancérologie de Lorraine , Vandoeuvre-lès-Nancy, France .,3 Palliative Care Department, Institut de Cancérologie de Lorraine , Vandoeuvre-lès-Nancy, France
| | - Thierry Conroy
- 1 Department of Medical Oncology, Institut de Cancérologie de Lorraine , Vandoeuvre-lès-Nancy, France
| | - Béatrice Weber
- 1 Department of Medical Oncology, Institut de Cancérologie de Lorraine , Vandoeuvre-lès-Nancy, France
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Gravis G, Boher JM, Joly F, Oudard S, Albiges L, Priou F, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Theodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Habibian M, Soulie M, Fizazi K. Androgen deprivation therapy (ADT) plus docetaxel (D) versus ADT alone for hormone-naïve metastatic prostate cancer (PCa): Long-term analysis of the GETUG-AFU 15 phase III trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.7_suppl.140] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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
140 Background: ADT is standard treatment for metastatic PCa. Recently, the E3805 trial reported a survival benefit for (ADT+D) in high volume disease (HVD) patients, whereas the GETUG-15 trial did not demonstrate a survival improvement among a less selected group of patients (pts) with hormone-naïve metastatic PCa. We report an updated analysis of overall survival (OS) of the GETUG 15 trial and aligned the definition of HVD and low volume disease (LVD) subgroups. Methods: Long-termOS was analyzed in the intention-to-treat population (n=385 pts). Additionally, we retrospectively assessed the tumor volume as defined per E3805criteria in all patients enrolled in GETUG 15. Results: See Table. With a median follow-up of 82.9 months (95%CI [80.5-84.3]) (vs 50 months (95%CI [80.5-84.3] in the original analysis), 212 patients (55%) have died. The median OS is 46.5 [39.1-60.6] and 60.9 months [46.1-71.4] in the ADT and in the ADT + D arms, respectively (HR: 0.9 [95%CI: 0.7-1.2]). In HVD patients (n=183, 47.5%), median OS rates were 35.1 months [29.9-44.2] in the ADT alone arm and 39 months [28-52.6] in the ADT+D arm (HR: 0.8 [0.6-1.2]). Conclusions: With longer follow-up, the addition of docetaxel to ADT did not significantly improve OS in patients with hormone-naïve metastatic prostate cancer. In the retrospective analysis using aligned definition of volume of metastasis as E3805, the HVD outcomes were similar to E3805 for ADT alone and there was a non-significant 4 months increase in OS with ADT+D, in this underpowered subset. Clinical trial information: 00104715. [Table: see text]
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Affiliation(s)
- Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | - Jean-Marie Boher
- Biostatistic, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - Florence Joly
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Stephane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, René Descartes University, Paris, France
| | - Laurence Albiges
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Franck Priou
- Centre Hospitalier Departemental Les Oudairies, La Roche sur Yon, France
| | | | - Remy Delva
- Institut de Cancérologie de l'Ouest, Angers, France
| | | | | | | | | | | | - Jean-Marc Ferrero
- Department d'Oncologie Medicale, Centre Antoine Lacassagne, Nice, France
| | - Damien Pouessel
- Department of Medical Oncolgy, Hopital Saint-Louis, Paris, France
| | | | | | | | - Michel Soulie
- Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Sud, Villejuif, France
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Fogliarini A, Chvetzoff G, Guesdon G, Krakowski I. Evolution of palliative care in the French Cancer Centers-Unicancer. World Hosp Health Serv 2015; 51:33-34. [PMID: 26867345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The French Cancer Centers (FCC) have a threefold mission, care research and education. Their specificity is multidisciplinary and comprehensive patient support at all stages of cancer. Innovation and research are at the heart of FCC action, but the care of patients in the palliative phase is a major and long-time concern. In each center there is an autonomous or integrated structure of palliative care in a service or Interdisciplinary Department of Support Care for the Patient in Oncology. These include, besides the hospice activity, chronic pain, psychooncology, social support, nutrition, functional rehabilitation, etc. Furthermore, the FCC have, in accordance with a secondary regulatory text to National Plans for palliative care, identified beds of palliative care (IBPC) in oncology day hospitals and in palliative care. In 2006 a Unicancer FCC group was established. One of the group's goals is to promote "early palliative care" together with other FCC teams. A common research dynamic has been implemented, ensuring the development of organizations and palliative culture.
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Culine S, Gligorov J, Krakowski I, Marti P, Metges JP, Serin D, Schneider M, Spielmann M. Une première collaboration entre Oncologie et la Fédération Française de Cancérologie Digestive (FFCD) ! ONCOLOGIE 2014. [DOI: 10.1007/s10269-014-2476-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: 11/24/2022]
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Scotte F, Herve C, Tourani JM, Bugat R, Farsi F, Jovenin N, Namer M, Tournigand C, Leroy P, Oudard S, Krakowski I. Supportive care organization: Patients and oncologist national survey comparison. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.31_suppl.202] [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
202 Background: The medical doctor's (MD) perspective of supportive care in cancer (SCC) in France was previously assessed on a national survey. However, the opinion of patients (P) has never been evaluated nor compared to MD’s perception.Wepromoted and compared P and MD awareness via national surveys to monitor implementation and information delivered to patients on SCC. Methods: The French Speaking Association for SCC (AFSOS) conducted two observational studies, analyzed with a Chi2 test: S1: a 30 points questionnaire sent to 2,263 physicians caring for cancer P (oncologists, radiotherapists, haematologists, gastroenterologists); and S2: a 40 points questionnaire performed by physicians to P, using a face-to-face method. Results: 711 MDs returned S1 and S2 was conducted with 1,562 P. In S1, MDs declared relying on SCC organization (81%) but 19% of P declared they were offered to benefit from an organization called SCC (54% at diagnosis, 35% after complication). The name SCC was known by 34% of P, most frequently described as complementary care to specific treatments (55%). Palliative Care word had been previously heard by 80% P, mostly considered as care to improve quality of life during cancer treatment for 59%. In S2, professional resources identified outside the hospital were: general practitioners (84%), nurses (58%), pharmacists (52%). According to P, the top 3 supportive care consultations proposed were psychology (61%), nutrition (55%) and announcement organization (55%), while MDs mentioned palliative care (98%), psychological care (98%), social care (98%), S2 showed that supportive treatment was prescribed to 63% of P, mostly by their oncologist (74%), and 64% of those P received information on side-effects. Epoetin was prescribed to 25% and analgesics to 73%, with discussion on adverse events respectively for 38% and 53%. MDs declared delivering information on adverse events to 49% of P receiving epoetin and to 74% of P running for analgesic treatment. Conclusions: Oncologist is the cornerstone of SCC organization. Information as well as treatment must be developed to further enhance SCC and patient quality of care.
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Affiliation(s)
- Florian Scotte
- Supportive Care Unit, Medical Oncology Department, Georges Pompidou European Hospital, Paris, France
| | | | - Jean Marc Tourani
- Department of Oncology, Poitiers University Hospital, Poitiers, France
| | | | | | | | | | | | - Pauline Leroy
- Supportive Care Unit, Medical Oncology Department, Georges Pompidou European Hospital, Paris, France
| | - Stephane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris, France
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Gravis G, Boher JM, Fizazi K, Joly F, Priou F, Marino P, Latorzeff I, Delva R, Krakowski I, Laguerre B, Walz J, Rolland F, Théodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Habibian M, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Labourey JL, Machiels JP, El Kouri C, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Soulie M, Oudard S. Prognostic Factors for Survival in Noncastrate Metastatic Prostate Cancer: Validation of the Glass Model and Development of a Novel Simplified Prognostic Model. Eur Urol 2014; 68:196-204. [PMID: 25277272 DOI: 10.1016/j.eururo.2014.09.022] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 09/15/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Glass model developed in 2003 uses prognostic factors for noncastrate metastatic prostate cancer (NCMPC) to define subgroups with good, intermediate, and poor prognosis. OBJECTIVE To validate NCMPC risk groups in a more recently diagnosed population and to develop a more sensitive prognostic model. DESIGN, SETTING, AND PARTICIPANTS NCMPC patients were randomized to receive continuous androgen deprivation therapy (ADT) with or without docetaxel in the GETUG-15 phase 3 trial. Potential prognostic factors were recorded: age, performance status, Gleason score, hemoglobin (Hb), prostate-specific antigen, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), metastatic localization, body mass index, and pain. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS These factors were used to develop a new prognostic model using a recursive partitioning method. Before analysis, the data were split into learning and validation sets. The outcome was overall survival (OS). RESULTS AND LIMITATIONS For the 385 patients included, those with good (49%), intermediate (29%), and poor (22%) prognosis had median OS of 69.0, 46.5 and 36.6 mo (p=0.001), and 5-yr survival estimates of 60.7%, 39.4%, and 32.1%, respectively (p=0.001). The most discriminatory variables in univariate analysis were ALP, pain intensity, Hb, LDH, and bone metastases. ALP was the strongest prognostic factor in discriminating patients with good or poor prognosis. In the learning set, median OS in patients with normal and abnormal ALP was 69.1 and 33.6 mo, and 5-yr survival estimates were 62.1% and 23.2%, respectively. The hazard ratio for ALP was 3.11 and 3.13 in the learning and validation sets, respectively. The discriminatory ability of ALP (concordance [C] index 0.64, 95% confidence interval [CI] 0.58-0.71) was superior to that of the Glass risk model (C-index 0.59, 95% CI 0.52-0.66). The study limitations include the limited number of patients and low values for the C-index. CONCLUSION A new and simple prognostic model was developed for patients with NCMPC, underlying the role of normal or abnormal ALP. PATIENT SUMMARY We analyzed clinical and biological factors that could affect overall survival in noncastrate metastatic prostate cancer. We showed that normal or abnormal alkaline phosphatase at baseline might be useful in predicting survival.
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Affiliation(s)
- Gwenaelle Gravis
- Medical Oncology Department, Institut Paoli-Calmettes, Marseille, France.
| | - Jean-Marie Boher
- Biostatistics Department, Institut Paoli-Calmettes, and Aix-Marseille Université, UMR_S 912 (SESSTIM), Marseille, France
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | - Florence Joly
- Medical Oncology Department, Centre François Baclesse-CHU Côte de Nacre, Caen, France
| | - Franck Priou
- Medical Oncology Department, Centre Hospitalier Les Oudairies, La Roche-sur-Yon, France
| | - Patricia Marino
- Institut Paoli-Calmettes, and Aix-Marseille Université, UMR_S912 (SESSTIM), Marseille, France
| | - Igor Latorzeff
- Radiotherapy Department, Clinique Pasteur, Toulouse, France
| | - Remy Delva
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - Ivan Krakowski
- Medical Oncology Department, Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France
| | | | - Jochen Walz
- Surgical Urology Department, Institut Paoli-Calmettes, Marseille, France
| | - Fréderic Rolland
- Medical Oncology Department, Centre René Gauducheau, Saint-Herblain, France
| | | | - Gael Deplanque
- Medical Oncology Department, Groupe Hospitalier Saint Joseph, Paris, France
| | - Jean-Marc Ferrero
- Medical Oncology Department, Centre Antoine Lacassagne, Nice, France
| | - Damien Pouessel
- Medical Oncology Department, Centre Val d'Aurelle-Paul Lamarque, Montpellier, France
| | - Loïc Mourey
- Medical Oncology Department, Institut Claudius Régaud, Toulouse, France
| | | | - Sylvie Zanetta
- Medical Oncology Department, Centre Georges François Leclerc, Dijon, France
| | | | | | - Jerome Dauba
- Medical Oncology Department, Hôpital Layné, Mont de Marsan, France
| | - Marjorie Baciuchka
- Medical Oncology Department, Centre Hospitalier La Timone, Marseille, France
| | - Christian Platini
- Medical Oncology Department, Centre Régional Hospitalier, Metz-Thionville, France
| | | | - Jean-Luc Labourey
- Medical Oncology Department, Centre Hospitalier Dupuytren, Limoges, France
| | - Jean Pascal Machiels
- Medical Oncology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Claude El Kouri
- Medical Oncology Department, Centre Catherine de Sienne, Nantes, France
| | - Alain Ravaud
- Medical Oncology Department, Hôpital Saint-André, Bordeaux, France
| | - Etienne Suc
- Medical Oncology Department, Clinique Saint-Jean Languedoc, Toulouse, France
| | | | - Ali Hasbini
- Medical Oncology Department, Clinique Armoricaine de Radiologie, Saint-Brieux, France
| | | | - Michel Soulie
- Urology Department, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Stéphane Oudard
- Medical Oncology Department, Georges Pompidou Hospital and Rene Descartes University, Paris, France
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Falandry C, Krakowski I, Curé H, Carola E, Soubeyran P, Guérin O, Freyer G. Granulocyte-colony-stimulating factor in elderly patients receiving chemotherapy for breast and gynaecological cancers: results of a French survey. Anticancer Res 2014; 34:5007-5015. [PMID: 25202084] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Age is a risk factor for chemo-induced febrile neutropenia (FN). According to ASCO guidelines, granulocyte colony-stimulating factor (G-CSF) use should be considered for regimens leading to a 10- to 20-percent risk of FN. PATIENTS AND METHODS A survey was undertaken describing the prescription of G-CSF in routine practices by 101 French physicians for 791 patients ≥70 years, having breast or gynaecological cancers, and receiving chemotherapy. RESULTS G-CSF was prescribed in 51% of the cases. A primary prophylaxis was prescribed in 90%, 59% and 36% of patients receiving regimens presenting a FN-risk of ≥20%, 10-20% and <10%, respectively. Covariates associated with the use of G-CSF were adjuvant chemotherapy, 3- or 4-weekly regimens, and geriatric assessment. Validated risk factors of FN were rarely considered. CONCLUSION The prescription of G-CSF was multi-factorial. The estimation of FN risk was mainly based on physician's experience, explaining differences between guidelines and routine practice.
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Affiliation(s)
- Claire Falandry
- Department of Geriatrics, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - Ivan Krakowski
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France
| | - Hervé Curé
- Department of Medical Oncology, Centre Jean Godinot, Reims, France
| | - Elisabeth Carola
- Department of Medical Oncology, Centre Hospitalier Général, Senlis, France
| | - Pierre Soubeyran
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | | | - Gilles Freyer
- Department of Medical Oncology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
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Scotte F, Herve C, Tourani J, Bugat R, Rouge-Bugat M, Farsi F, Jovenin N, Namer M, Tournigand C, Leroy P, Oudard S, Krakowski I. Supportive Care Organization Compared Between Patients and Oncologist National Survey. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu352.8] [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: 11/14/2022] Open
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Poulain P, Michenot N, Delorme T, Filbet M, Hubault P, Jovenin N, Rostaing S, Colin E, Chvetsoff G, Ammar D, Delorme C, Diquet B, Krakowski I, Magnet M, Minello C, Morere JF, Serrie A. Mise au point sur l’utilisation pratique de la méthadone dans le cadre des douleurs en oncologie. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.douler.2014.06.001] [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: 10/24/2022]
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Rajpar S, Vielh P, Laplanche A, Lesaunier F, Delva R, Gravis G, Rolland F, Priou F, Ferrero JM, Houede N, Mourey L, Theodore C, Krakowski I, Berdah JF, Baciuchka M, Habibian M, Culine S, Faivre L, Chauchereau A, Fizazi K. A study of ERG, PTEN, and ki-67 in a phase III trial assessing docetaxel and estramustine in high-risk localized prostate cancer (GETUG 12). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.5063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Philippe Vielh
- Department of Biopathology, Gustave Roussy, Cancer Campus, Grand Paris, Villejuif, France
| | | | | | | | - Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | | | - Frank Priou
- Centre Hospitalier La Roche sur Yon, La Roche sur Yon, France
| | - Jean-Marc Ferrero
- Centre Antoine Lacassagne, Department d'Oncologie Medicale, Nice, France
| | | | | | | | | | | | | | - Muriel Habibian
- Federation Nationale des Centres de Lutte Contre le Cancer, Paris, France
| | - Stephane Culine
- Department of Medical Oncology - Hopital Saint-Louis - APHP, Paris, France
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