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Penault-Llorca F, Dalenc F, Chabaud S, Cottu P, Allouache D, Cameron D, Grenier J, Venat Bouvet L, Jegannathen A, Campone M, Debled M, Hardy-Bessard AC, Giacchetti S, Barthelemy P, Kaluzinski L, Mailliez A, Mouret-Reynier MA, Legouffe E, Cayre A, Martinez M, Delbaldo C, Mollon-Grange D, Macaskill EJ, Sephton M, Stefani L, Belgadi B, Winter M, Orfeuvre H, Lacroix-Triki M, Bonnefoi H, Bliss J, Canon JL, Lemonnier J, Andre F, Bachelot T. Prognostic value of EndoPredict test in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative primary breast cancer screened for the randomized, double-blind, phase III UNIRAD trial. ESMO Open 2024; 9:103443. [PMID: 38692082 DOI: 10.1016/j.esmoop.2024.103443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/15/2024] [Accepted: 04/04/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the prognostic value of the multigene EndoPredict test in prospectively collected data of patients screened for the randomized, double-blind, phase III UNIRAD trial, which evaluated the addition of everolimus to adjuvant endocrine therapy in high-risk, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer. PATIENTS AND METHODS Patients were classified into low or high risk according to the EPclin score, consisting of a 12-gene molecular score combined with tumor size and nodal status. Association of the EPclin score with disease-free survival (DFS) and distant metastasis-free survival (DMFS) was evaluated using Kaplan-Meier estimates. The independent prognostic added value of EPclin score was tested in a multivariate Cox model after adjusting on tumor characteristics. RESULTS EndoPredict test results were available for 768 patients: 663 patients classified as EPclin high risk (EPCH) and 105 patients as EPclin low risk (EPCL). Median follow-up was 70 months (range 1-172 months). For the 429 EPCH randomized patients, there was no significant difference in DFS between treatment arms. The 60-month relapse rate for patients in the EPCL and EPCH groups was 0% and 7%, respectively. Hazard ratio (HR) supposing continuous EPclin score was 1.87 [95% confidence interval (CI) 1.4-2.5, P < 0.0001]. This prognostic effect remained significant when assessed in a Cox model adjusting on tumor size, number of positive nodes and tumor grade (HR 1.52, 95% CI 1.09-2.13, P = 0.0141). The 60-month DMFS for patients in the EPCL and EPCH groups was 100% and 94%, respectively (adjusted HR 8.10, 95% CI 1.1-59.1, P < 0.0001). CONCLUSIONS The results confirm the value of EPclin score as an independent prognostic parameter in node-positive, hormone receptor-positive, HER2-negative early breast cancer patients receiving standard adjuvant treatment. EPclin score can be used to identify patients at higher risk of recurrence who may warrant additional systemic treatments.
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Affiliation(s)
- F Penault-Llorca
- Centre de Lutte Contre le Cancer Jean Perrin, Imagerie Moléculaire et Stratégies Théranostiques, Université Clermont Auvergne, UMR 1240 INSERM-UCA, Clermont Ferrand.
| | - F Dalenc
- Oncopole Claudius Regaud, IUCT, Toulouse
| | | | | | | | - D Cameron
- Western General Hospital, Edinburg, UK
| | | | | | | | - M Campone
- Institut de cancérologie de l'Ouest, Saint-Herblain & Angers
| | | | | | | | - P Barthelemy
- Institut de Cancérologie Strasbourg Europe, Strasbourg
| | - L Kaluzinski
- Centre Hospitalier Cotentin, Cherbourg en Cotentin
| | | | - M-A Mouret-Reynier
- Centre de Lutte Contre le Cancer Jean Perrin, Imagerie Moléculaire et Stratégies Théranostiques, Université Clermont Auvergne, UMR 1240 INSERM-UCA, Clermont Ferrand
| | | | - A Cayre
- Centre de Lutte Contre le Cancer Jean Perrin, Imagerie Moléculaire et Stratégies Théranostiques, Université Clermont Auvergne, UMR 1240 INSERM-UCA, Clermont Ferrand
| | | | | | | | | | | | | | - B Belgadi
- Centre Hospitalier Montélimar, Montélimar, France
| | - M Winter
- Weston Park Hospital, Sheffield, UK
| | - H Orfeuvre
- Centre Hospitalier Fleyriat, Bourg-en-Bresse
| | | | | | - J Bliss
- The Institute of Cancer Research, London, UK
| | - J-L Canon
- Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | - F Andre
- Gustave Roussy, Villejuif, France
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Desramé J, Baize N, Anota A, Laribi K, Stefani L, Hjiej S, Nabirotchkina E, Zelek L, Choquet S. Fatigue visual analogue scale score correlates with quality of life in cancer patients receiving epoetin alfa (Sandoz) for chemotherapy-induced anaemia: The CIROCO study. Cancer Treat Res Commun 2023; 37:100781. [PMID: 38039763 DOI: 10.1016/j.ctarc.2023.100781] [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: 12/15/2022] [Revised: 03/25/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE Available tools to measure fatigue and health-related quality of life (HRQoL) in cancer patients are often difficult to use in clinical practice. The fatigue visual analogue scale (VAS) provides a simple method to assess fatigue. This study evaluated the correlation between HRQoL and fatigue perceived by cancer patients undergoing chemotherapy. METHODS This was a non-interventional prospective study of adult cancer patients in France presenting with chemotherapy-induced anaemia (CIA) treated with epoetin alfa (Sandoz). Data were collected using an electronic case report form at study inclusion (T0), after 2-3 chemotherapy cycles (T1) and after 4-6 cycles (T2). RESULTS The study included 982 patients from September 2015 to October 2017. Overall, there was a negative correlation between fatigue VAS and HRQoL. The overall haemoglobin (Hb) change between T0 and T2 was +17.8 % (± 18.1 %). Fatigue assessed by both patients and physicians showed a clinically significant improvement during the study. Global HRQoL also increased. CONCLUSION Treatment of CIA with epoetin alfa (Sandoz) improved Hb levels, fatigue, and HRQoL, with a correlation observed between fatigue VAS score and HRQoL. Fatigue VAS could act as a simple alternative to more complex methods to measure HRQoL; however, further analyses are required to confirm this association.
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Affiliation(s)
- Jerome Desramé
- Institut Privé de Cancérologie, Hôpital Privé Jean Mermoz, 55 Av. Jean Mermoz, 69373, Lyon 69008, France.
| | - Nathalie Baize
- Centre Hospitalier Départemental Vendée, Bd Stéphane Moreau, La Roche-sur-Yon 85000, France
| | - Amélie Anota
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France; French National Platform Quality of Life and Cancer, Besançon, France; Department of Biostatistics, Centre Léon Bérard, 28 Prom. Léa et Napoléon Bullukian, Lyon 69008, France
| | - Kamel Laribi
- Centre Hospitalier Le Mans, 194 Av. Rubillard, Le Mans 72037, France
| | - Laetitia Stefani
- Centre Hospitalier Annecy Genevois, 1 Av. De l'Hôpital, Epagny Metz-Tessy 74370, France
| | - Salim Hjiej
- Sandoz, 49 Av. Georges Pompidou, Levallois-Perret 92300, France
| | | | - Laurent Zelek
- Department of Medical Oncology, Hôpital Avicenne, Hôpitaux Universitaires Paris Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Université Sorbonne Paris Nord, 125, rue de Stalingrad 93000 Bobigny, Paris, France
| | - Sylvain Choquet
- Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris -Sorbonne Université, 83 Boulevard de l'Hôpital, Paris 75651, France
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Bachelot T, Jouannaud C, Verret B, Chabaud S, Petrau C, Stefani L, Ung M, Desmoulins I, Jacot W, Bailleux C, Marques S, Lemonnier J, Hardy-Bessard AC. Abstract OT1-10-01: Treatment with Tucatinib in addition to Pertuzumab and Trastuzumab in patients with HER2-positive metastatic breast cancer (HER2+ MBC) after local therapy of isolated brain progression: InTTercePT, a UCBG/GINECO study. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-ot1-10-01] [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: 03/06/2023]
Abstract
Abstract
Treatment with Tucatinib in addition to Pertuzumab and Trastuzumab in patients with HER2-positive metastatic breast cancer (HER2+ MBC) after local therapy of isolated brain progression: InTTercePT, a UCBG/GINECO study. Background HER2+ MBC patient on first line treatment with pertuzumab and trastuzumab have a 13% risk of developing brain metastasis (BM) as the first site of progression. For such patient with isolated brain progression, guidelines recommend to use central nervous system (CNS) directed therapy whenever possible (stereotactic radiosurgery or surgery or both). These patients will have a higher risk of subsequent brain and systemic progression after local treatment. Therefore, whether systemic treatment should be continued or changed remains an open question. The tyrosine kinase inhibitor tucatinib is an orally bioavailable HER2 inhibitor with validated antineoplastic activity and the ability to cross the blood brain barrier. The randomized HER2CLIMB study, demonstrated that adding tucatinib to trastuzumab/capecitabine improved both progression-free survival (PFS) and overall survival (OS) among HER2+ MBC patients previously treated with trastuzumab, pertuzumab and T-DM1. Particularly, this regimen demonstrated improved antitumor activity in patients with BM, in terms of CNS-PFS and OS. Exploratory analysis of HER2CLIMB and in a phase 1b study, showed patients who continued systemic treatment with tucatinib (in combination either with trastuzumab/capecitabine or TDM-1) after CNS-directed treatment had a better outcome compared with those that discontinued systemic tucatinib-based treatment. These results suggest that for patient in the first line metastatic setting who experience isolated brain progression, adding tucatinib to the trastuzumab/pertuzumab regimen could help control BM, improve PFS, OS and patients’ quality of life. Trial design InTTercePT is an open-label, single-arm, national, multicentric, phase II trial assessing the combination of tucatinib, pertuzumab and trastuzumab. Tucatinib will be administered orally twice daily at 300 mg. Pertuzumab and trastuzumab will be administered at the initial dose of 840 mg and 8 mg/kg respectively following by a maintenance dose of 420 mg and 6mg/kg respectively, 3-weekly. If indicated, hormone therapy is allowed in combination with HER2-directed therapy. Eligibility criteria include HER2+ MBC with isolated brain progression (new or progressive BM with stable or responding systemic disease) under pertuzumab/trastuzumab treatment (± taxane) after complete local treatment (surgery and/or radiation therapy). There is no limit to the number and size of BM. Specific aims To evaluate the efficacy, in terms of PFS rate (RECIST v1.1) of tucatinib in combination with pertuzumab/trastuzumab. Secondary endpoints include OS, brain PFS (RECIST v1.1) and BM response in patient not in complete remission at the brain level after local treatment and safety (NCI-CTCAE v5.0). Statistical methods Given the lack of safety data from this association, two interim safety analysis are planned: after 10 and 20 patients having received at least one dose of the treatments combination during at least one cycle. The number of patients to be included was calculated using Fleming’s single-stage procedure for phase II trials. The sample size calculation was based on a minimum success (non-progression rate at 6 months) considered of interest of p1 = 75% and an uninteresting rate of p0 = 60%. Assuming a unilateral type I error alpha of 10% and a power of 85%, 52 patients are needed. Considering 5% of the patients may be non-evaluable, 55 patients will be included. At the time of analysis, if at least 37 successes are observed, the treatment will be considered as interesting for further investigation. The study is recruiting. By July 1, 2022, 10 patients have been screened and 8 treated (NCT05041842). Funding SeaGen Contact information thomas.bachelot@lyon.unicancer.fr
Citation Format: Thomas Bachelot, Christelle Jouannaud, Benjamin Verret, Sylvie Chabaud, Camille Petrau, Laetitia Stefani, Mony Ung, Isabelle Desmoulins, William Jacot, Caroline Bailleux, Sandrine Marques, Jérôme Lemonnier, Anne-Claire Hardy-Bessard. Treatment with Tucatinib in addition to Pertuzumab and Trastuzumab in patients with HER2-positive metastatic breast cancer (HER2+ MBC) after local therapy of isolated brain progression: InTTercePT, a UCBG/GINECO study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT1-10-01.
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Affiliation(s)
| | | | | | | | | | | | - Mony Ung
- 7Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | | | - William Jacot
- 9Institut du Cancer de Montpellier, Université de Montpellier, INSERM U1194, Montpellier, Languedoc-Roussillon, France
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Marmouset V, Decroocq J, Garciaz S, Etienne G, Belhabri A, Bertoli S, Gastaud L, Simand C, Chantepie S, Uzunov M, Genthon A, Berthon C, Chiche E, Dumas PY, Vargaftig J, Salmeron G, Lemasle E, Tavernier E, Delage J, Loirat M, Morineau N, Blanc-Durand F, Pautier P, Vergé V, Auger N, Thomas M, Stefani L, Lepelley M, Boyer T, Thepot S, Gourin MP, Bourquard P, Duchmann M, Morice PM, Michallet M, Adès L, Fenaux P, Récher C, Dombret H, Pagès A, Marzac C, Leary A, Micol JB. Therapy-related Myeloid Neoplasms Following PARP Inhibitors: Real-life Experience. Clin Cancer Res 2022; 28:5211-5220. [PMID: 36201165 DOI: 10.1158/1078-0432.ccr-22-1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/27/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE To provide insights into the diagnosis and management of therapy-related myeloid neoplasms (t-MN) following PARP inhibitors (PARPi). EXPERIMENTAL DESIGN In a French cancer center, we identified and described the profiles of 13 t-MN diagnosed among 37 patients with ovarian cancer referred to hematology consultation for cytopenia under PARPi. Next, we described these 13 t-MN post-PARPi among 37 t-MN post ovarian cancer according to PARPi exposure. Finally, we described 69 t-MN post-PARPi in a national cohort. RESULTS From 2016 to 2021, cumulative incidence of t-MN was 3.5% (13/373) among patients with ovarian cancer treated with PARPi. At time of hematologic consultation, patients with t-MN had a longer PARPi exposure (9 vs. 3 months, P = 0.01), lower platelet count (74 vs. 173 G/L, P = 0.0005), and more cytopenias (2 vs. 1, P = 0.0005). Compared with t-MN not exposed to PARPi, patients with t-MN-PARPi had more BRCA1/2 germline mutation (61.5% vs. 0%, P = 0.03) but similar overall survival (OS). In the national cohort, most t-MN post-PARPi had a complex karyotype (61%) associated with a high rate of TP53 mutation (71%). Median OS was 9.6 months (interquartile range, 4-14.6). In multivariate analysis, a longer time between end of PARPi and t-MN (HR, 1.046; P = 0.02), olaparib compared with other PARPi (HR, 5.82; P = 0.003) and acute myeloid leukemia (HR, 2.485; P = 0.01) were associated with shorter OS. CONCLUSIONS In a large series, we described a high incidence of t-MN post-PARPi associated with unfavorable cytogenetic and molecular abnormalities leading to poor OS. Early detection is crucial, particularly in cases of delayed cytopenia.
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Affiliation(s)
- Vincent Marmouset
- Department of Hematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Justine Decroocq
- Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
| | - Sylvain Garciaz
- Institut Paoli Calmettes, Marseille, France
- Cancer Research Center of Marseille, INSERM U1068, Aix-Marseille University, Marseille, France
| | | | - Amine Belhabri
- Department of Oncology, Centre Leon Berard, Lyon, France
| | - Sarah Bertoli
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
| | | | - Célestine Simand
- Department of Hematology, Institute for Cancer Strasbourg-Europe (ICANS), Strasbourg University, Strasbourg, France
| | - Sylvain Chantepie
- Department of Clinical Hematology, Caen University Hospital, Caen, France
| | - Madalina Uzunov
- Service d'hématologie adulte, Hôpital Pitié-Salpêtrière, Paris, France
| | - Alexis Genthon
- Department of Clinical Hematology, Saint Antoine Hospital, Sorbonne University, INSERM UMR-S 938, Paris, France
| | - Céline Berthon
- Department of Hematology, CHU Lille, Lille, France
- University of Lille, CNRS, Inserm, CHU Lille, IRCL, UMR9020 - UMR1277 - Canther - Cancer heterogeneity, plasticity and resistance to therapies, Lille, France
| | | | - Pierre-Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | | | | | - Emilie Lemasle
- Département d'hématologie, Hôpital Henri Becquerel, Rouen, France
| | - Emmanuelle Tavernier
- Hématologie, Institut de Cancérologie-Hématologie Universitaire de Saint Etienne, France
| | - Jérémy Delage
- Département d'hématologie clinique, Saint Eloi, Montpellier, France
| | - Marion Loirat
- Service d'hématologie, Hôpital Saint Nazaire, Saint-Nazaire, France
| | | | - Félix Blanc-Durand
- Department of Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM U981, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Patricia Pautier
- Department of Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM U981, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Véronique Vergé
- Department of Biology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Nathalie Auger
- Department of Biology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | - Marion Lepelley
- Centre Régional de Pharmacovigilance - Addictovigilance, CHU de Grenoble-Alpes, France
| | - Thomas Boyer
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | | | | | | | - Matthieu Duchmann
- Université de Paris, Génomes, Biologie Cellulaire et Thérapeutique Unité (U)944, INSERM, Centre National de la Recherche Scientifique (CNRS), Paris, France
| | - Pierre-Marie Morice
- Department of Clinical Hematology, Caen University Hospital, Caen, France
- UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancer Prevention and Treatment), Normandie University, Caen, France
| | | | - Lionel Adès
- Hématologie Sénior Hôpital Saint Louis, Assistance publique hôpitaux de paris, and Université de Paris Cité, Paris, France
| | - Pierre Fenaux
- Hématologie Sénior Hôpital Saint Louis, Assistance publique hôpitaux de paris, and Université de Paris Cité, Paris, France
| | - Christian Récher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Hervé Dombret
- Adult Hematology Department, Saint-Louis Hospital, APHP, URP3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Arnaud Pagès
- Bureau de Biostatistique et d'Épidémiologie - Gustave Roussy Équipe Oncostat - CESP U1018 - Inserm, France
| | - Christophe Marzac
- Department of Biology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alexandra Leary
- Department of Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM U981, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Jean-Baptiste Micol
- Department of Hematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM U1287, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Bidard FC, Hardy-Bessard AC, Dalenc F, Bachelot T, Pierga JY, de la Motte Rouge T, Sabatier R, Dubot C, Frenel JS, Ferrero JM, Ladoire S, Levy C, Mouret-Reynier MA, Lortholary A, Grenier J, Chakiba C, Stefani L, Plaza JE, Clatot F, Teixeira L, D'Hondt V, Vegas H, Derbel O, Garnier-Tixidre C, Canon JL, Pistilli B, André F, Arnould L, Pradines A, Bièche I, Callens C, Lemonnier J, Berger F, Delaloge S, PISTILLI B, DALENC F, BACHELOT T, DE LA MOTTE ROUGE T, SABATIER R, DUBOT C, FRENEL JS, FERRERO JM, LADOIRE S, LEVY C, MOURET-REYNIER MA, HARDY-BESSARD AC, LORTHOLARY A, GRENIER J, CHAKIBA C, STEFANI L, SOULIE P, JACQUIN JP, PLAZA JE, CLATOT F, TEIXEIRA L, D'HONDT V, VEGAS H, DERBEL O, GARNIER TIXIDRE C, DELBALDO C, MOREAU L, CHENEAU C, PAITEL JF, BERNARD-MARTY C, SPAETH D, GENET D, MOULLET I, BONICHON-LAMICHHANE N, DEIANA L, GREILSAMER C, VENAT-BOUVET L, DELECROIX V, MELIS A, ORFEUVRE H, NGUYEN S, LEGOUFFE E, ZANNETTI A, LE SCODAN R, DOHOLLOU N, DALIVOUST P, ARSENE O, MARQUES N, PETIT T, MOLLON D, DAUBA J, BONNIN N, MORVAN F, GARDNER M, MARTI A, LEVACHE CB, LACHAIER E, ACHILLE M, VALMAR C, BOUAITA R, MEDIONI J, FOA C, BERNARD-MARTY C, DEL PIANO F, GOZY M, ESCANDE A, LEDUC N, LUCAS B, MILLE D, AMMARGUELLAT H, NAJEM A, TROUBOUL F, BARTHELEMY P, DESCLOS H, MAYEUR D, LORCHEL F, GUINET F, LAURENTY AP, BOUDRANT A, GISSEROT O, ALLEAUME C, DE GRAMONT A. Switch to fulvestrant and palbociclib versus no switch in advanced breast cancer with rising ESR1 mutation during aromatase inhibitor and palbociclib therapy (PADA-1): a randomised, open-label, multicentre, phase 3 trial. Lancet Oncol 2022; 23:1367-1377. [PMID: 36183733 DOI: 10.1016/s1470-2045(22)00555-1] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND In advanced oestrogen receptor-positive, HER2-negative breast cancer, acquired resistance to aromatase inhibitors frequently stems from ESR1-mutated subclones, which might be sensitive to fulvestrant. The PADA-1 trial aimed to show the efficacy of an early change in therapy on the basis of a rising ESR1 mutation in blood (bESR1mut), while assessing the global safety of combination fulvestrant and palbociclib. METHODS We did a randomised, open-label, phase 3 trial in 83 hospitals in France. Women aged at least 18 years with oestrogen receptor-positive, HER2-negative advanced breast cancer and an Eastern Cooperative Oncology Group performance status of 0-2 were recruited and monitored for rising bESR1mut during first-line aromatase inhibitor (2·5 mg letrozole, 1 mg anastrozole, or 25 mg exemestane, orally once per day, taken continuously) and palbociclib (125 mg orally once per day on days 1-21 of a 28-day cycle) therapy. Patients with newly present or increased bESR1mut in circulating tumour DNA and no synchronous disease progression were randomly assigned (1:1) to continue with the same therapy or to switch to fulvestrant (500 mg intramuscularly on day 1 of each 28-day cycle and on day 15 of cycle 1) and palbociclib (dosing unchanged). The randomisation sequence was generated within an interactive web response system using a minimisation method (with an 80% random factor); patients were stratified according to visceral involvement (present or absent) and the time from inclusion to bESR1mut detection (<12 months or ≥12 months). The co-primary endpoints were investigator-assessed progression-free survival from random assignment, analysed in the intention-to-treat population (ie, all randomly assigned patients), and grade 3 or worse haematological adverse events in all patients. The trial is registered with Clinicaltrials.gov (NCT03079011), and is now complete. FINDINGS From March 22, 2017, to Jan 31, 2019, 1017 patients were included, of whom 279 (27%) developed a rising bESR1mut and 172 (17%) were randomly assigned to treatment: 88 to switching to fulvestrant and palbociclib and 84 patients to continuing aromatase inhibitor and palbociclib. At database lock on July 31, 2021, randomly assigned patients had a median follow-up of 35·3 months (IQR 29·2-41·4) from inclusion and 26·0 months (13·8-34·3) from random assignment. Median progression-free survival from random assignment was 11·9 months (95% CI 9·1-13·6) in the fulvestrant and palbociclib group versus 5·7 months (3·9-7·5) in the aromatase inhibitor and palbociclib group (stratified HR 0·61, 0·43-0·86; p=0·0040). The most frequent grade 3 or worse haematological adverse events were neutropenia (715 [70·3%] of 1017 patients), lymphopenia (66 [6·5%]), and thrombocytopenia (20 [2·0%]). The most common grade 3 or worse adverse events in step 2 were neutropenia (35 [41·7%] of 84 patients in the aromatase inhibitor and palbociclib group vs 39 [44·3%] of 88 patients in the fulvestrant and palbociclib group) and lymphopenia (three [3·6%] vs four [4·5%]). 31 (3·1%) patients had grade 3 or worse serious adverse events related to treatment in the overall population. Three (1·7%) of 172 patients randomly assigned had one serious adverse event in step 2: one (1·2%) grade 4 neutropenia and one (1·2%) grade 3 fatigue among 84 patients in the aromatase inhibitor and palbociclib group, and one (1·1%) grade 4 neutropenia among 88 patients in the fulvestrant and palbociclib group. One death by pulmonary embolism in step 1 was declared as being treatment related. INTERPRETATION PADA-1 is the first prospective randomised trial showing that the early therapeutic targeting of bESR1mut results in significant clinical benefit. Additionally, the original design explored in PADA-1 might help with tackling acquired resistance with new drugs in future trials. FUNDING Pfizer.
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Affiliation(s)
- François-Clément Bidard
- Department of Medical Oncology, Institut Curie, Université Versailles Saint-Quentin, Université Paris-Saclay, Saint-Cloud, France; Circulating Tumour Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, Paris, France.
| | | | - Florence Dalenc
- Department of Medical Oncology, Institut Claudius-Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Thomas Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Jean-Yves Pierga
- Circulating Tumour Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, Paris, France; Department of Medical Oncology, Institut Curie and Université de Paris, Paris, France
| | | | - Renaud Sabatier
- Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille Université, Marseille, France
| | - Coraline Dubot
- Department of Medical Oncology, Institut Curie, Université Versailles Saint-Quentin, Université Paris-Saclay, Saint-Cloud, France
| | | | - Jean Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Christelle Levy
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | | | - Alain Lortholary
- Department of Medical Oncology, Hopital Privé du Confluent, Nantes, France
| | - Julien Grenier
- Department of Medical Oncology, Institut Sainte Catherine, Avignon, France
| | - Camille Chakiba
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Laetitia Stefani
- Department of Medical Oncology, Centre Hospitalier Annecy Genvoi, Pringy-Metz-Tessy, France
| | - Jérôme Edouard Plaza
- Department of Medical Oncology, UNEOS Site Hôpital Robert Schuman, Vantoux, France
| | - Florian Clatot
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | - Luis Teixeira
- Department of Medical Oncology, Hôpital Saint Louis, Paris, France
| | - Véronique D'Hondt
- Department of Medical Oncology, Institut du Cancer de Montpellier Val d'Aurelle, Montpellier, France
| | - Hélène Vegas
- Department of Medical Oncology, Centre Hospitalier de Tours, Hôpital Bretonneau, Tours, France
| | - Olfa Derbel
- Department of Medical Oncology, Hôpital Privé Jean Mermoz, Lyon, France
| | - Claire Garnier-Tixidre
- Department of Medical Oncology, Institut Daniel Hollard, G H Mutualiste de Grenoble, Grenoble, France
| | - Jean-Luc Canon
- Department of Medical Oncology, Grand Hôpital de Charleroi, Charleroi, Belgique
| | | | - Fabrice André
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Laurent Arnould
- Department of Pathology, Centre Georges François Leclerc, Dijon, France
| | - Anne Pradines
- INSERM U1037 CNRS ERL5294 UPS, Cancer Research Center of Toulouse, Toulouse, France; Prospective Biology Unit, Medical Laboratory, Claudius Regaud Institute, Toulouse University Cancer Institute, Toulouse, France
| | - Ivan Bièche
- Pharmacogenomic Unit, Genetics Laboratory, Department of Diagnostic and Theranostic Medicine, Institut Curie, PSL University, Saint-Cloud, Paris, France
| | - Céline Callens
- Pharmacogenomic Unit, Genetics Laboratory, Department of Diagnostic and Theranostic Medicine, Institut Curie, PSL University, Saint-Cloud, Paris, France
| | | | - Frédérique Berger
- Biometry Unit, Institut Curie, PSL University, Saint-Cloud, Paris, France
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Falandry C, Pommeret F, Gladieff L, Tinquaut F, Lorusso D, Mouret-Reynier MA, D'Hondt V, Mollon-Grange D, Floquet A, Abadie-Lacourtoisie S, Brachet PE, Stefani L, Rousseau F, Frenel JS, Del Piano F, Komulainen M, Warkus T, Trédan O, Pujade-Lauraine E, Freyer G. Validation of the geriatric vulnerability score in older patients with ovarian cancer: an analysis from the GCIG-ENGOT-GINECO EWOC-1 study. Lancet Healthy Longev 2022; 3:e176-e185. [PMID: 36098291 DOI: 10.1016/s2666-7568(22)00002-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Older patients with ovarian cancer represent a heterogeneous population. The French National Group of Investigators for the Study of Ovarian and Breast Cancer developed the geriatric vulnerability score (GVS) to identify geriatric parameters predictive of poor outcomes. A prospective validation of the GVS was needed. METHODS The EWOC-1 study (NCT02001272) was an international, open-label, phase 2, three-arm trial designed according to a two-step process. Patients aged 70 years or older with newly diagnosed stage III or IV ovarian cancer were identified and the GVS determined. Those with a GVS of 3 or greater were randomly assigned to the EWOC-1 trial, stratified by country and surgical outcome, to receive three different carboplatin with or without paclitaxel regimens; those not included in the EWOC-1 trial were followed up in the EWOC-1 registry. External validation of the GVS was a secondary endpoint of the trial. Three validation cohorts were identified: the total population (validation cohort 1 [V1], n=447), the registry-only population (validation cohort 2 [V2], n=327), and the carboplatin-paclitaxel-treated population (validation cohort 3 [V3], n=320). FINDINGS From Dec 11, 2013, to Nov 16, 2018, 447 patients were included in 48 academic centres in six countries; 120 in the EWOC-1 trial and 327 in the EWOC-1 registry. Median follow-up was 19·7 (95% CI 8·5-29·7) months for the total cohort; missing values were low (<2%). According to the maximum likelihood analysis, the hazard ratio (HR) of death in V1 was 1·8 (95% CI 1·1-3·1, p=0·029) for those with a GVS of 1; 2·4 (1·4-4·0, p=0·0009) with a GVS of 2; 4·1 (2·5-7·0, p<0·0001) for a GVS of 3; 5·5 (3·3-9·3, p<0·0001) for a GVS of 4; and 9·1 (4·7-17·5, p<0·0001) for a GVS of 5 compared with a score of 0. Whatever the validation cohort, GVS of 3 or more significantly segregated two groups with different overall survival: V1 (median 13·2 [95% CI: 10·8-18·7] vs 40·8 [32·0-45·6] months; HR 2·8 [95% CI 2·2-3·7]; p<0·0001); V2 (11·9 [95% CI 8·8-18·1] vs 40·8 [32·0-45·6] months, HR 3·5 [2·5-4·9]; p<0·0001); and V3 (18·1 [95% CI 15·8-31·8] vs 43·0 [40·6-49·7] months, HR 2·6 [1·9 to 3·7]; p<0·0001). INTERPRETATION The GVS has high prognostic performance for overall survival in patients with advanced ovarian cancer, independently of geographic and historic effect (V1), as well as treatment patterns (V3), validated in an international population. Even though the GVS is time consuming it will allow the stratification of populations for clinical research and might permit the orientation of the geriatric intervention to specific domains. FUNDING French National Cancer Institute. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Claire Falandry
- GINECO, Paris, France; Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
| | - Fanny Pommeret
- GINECO, Paris, France; Institut Gustave Roussy, Villejuif, France
| | - Laurence Gladieff
- GINECO, Paris, France; Institut Claudius Regaud-IUCT Oncopole, Toulouse, France
| | - Fabien Tinquaut
- GINECO, Paris, France; Institut de Cancérologie de la Loire, St Priest en Jarez, France
| | - Domenica Lorusso
- MITO and IRCCS, Istituto Nazionale dei Tumori, Milan, Italy; Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | | | - Véronique D'Hondt
- GINECO, Paris, France; Institut du Cancer de Montpellier, Montpellier, France
| | | | - Anne Floquet
- GINECO, Paris, France; Institut Bergonié, Bordeaux, France
| | | | | | - Laetitia Stefani
- GINECO, Paris, France; Centre Hospitalier Annecy Genevois, Pringy, France
| | | | - Jean-Sébastien Frenel
- GINECO, Paris, France; Institut de Cancérologie de l'Ouest-site René Gauducheau, Nantes, France
| | | | | | | | | | | | - Gilles Freyer
- GINECO, Paris, France; Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
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Danaila V, Vaheisvaran P, Ferkh A, Emerson P, Stefani L, Duggins A, Evans A, Chong J, Denniss A, Kizana E, Thomas L. Demographics and Cardiovascular Risk Profile of Ischaemic Stroke in Western Sydney. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.494] [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: 10/16/2022]
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Trivedi S, Stefani L, Byth K, Brown P, Qian P, Kumar S, Thomas S, Thomas L. Left Ventricular Diastolic Dysfunction and Left Atrial Myopathy Independently Predict Atrial Fibrillation Recurrence Post Pulmonary Vein Isolation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ferkh A, Tjahjadi C, Geenty P, Stefani L, Boyd A, Richards D, Mollee P, Korczyk D, Taylor M, Kwok F, Kizana E, Ng A, Thomas L. Echocardiographic Deep Phenotyping of Hypertrophic Cardiomyopathies: Amyloid, Anderson-Fabry and Hypertensive Heart Disease. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.013] [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: 10/16/2022]
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Stefani L, Boyd A, Ferkh A, Zada M, Devine K, Trivedi S, Tchan M, Thomas L. Basal Segmental Strain as a Marker of Cardiac Involvement in Anderson-Fabry Disease. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.226] [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: 10/16/2022]
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11
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Trivedi S, Stefani L, Byth K, Brown P, Qian P, Kumar S, Thomas S, Thomas L. Medium-term Maintenance of Sinus Rhythm Post Pulmonary Vein Isolation Results in Significant Cardiac Reverse Remodelling. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Morice PM, Genthon A, Boyer T, Bihan K, Mahé J, Sourisseau A, Peyrouzet H, Miremont G, Lepelley M, Stefani L, Gaboriau L, Rocher F, Aquaronne D, Le Beller C, Allouchery M, Azzouz B, Massy N, Alt-Tebacher M, Simand C, Herbrecht R, Chrétien B, Dolladille C, Chantepie S, Alexandre J. Poly(ADP-ribose)polymerase inhibitors-associated myeloid neoplasms: a retrospective study from the French Network of Pharmacovigilance centres. Br J Haematol 2021; 196:787-793. [PMID: 34611896 DOI: 10.1111/bjh.17863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Pierre-Marie Morice
- UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Normandie Univ, Caen, France.,Department of Clinical Hematology, Caen University Hospital, Caen, France
| | - Alexis Genthon
- Department of Clinical Haematology, Saint Antoine Hospital, Sorbonne University, INSERM UMR-S 938, Paris, France
| | - Thomas Boyer
- Laboratory of Hematology, Amiens University Hospital, Amiens, France
| | - Kevin Bihan
- Regional Pharmacovigilance Center, Department of Pharmacology, Pitié-Salpêtrière University Hospital, Paris, France
| | - Julien Mahé
- Regional Pharmacovigilance Center, Department of Clinical Pharmacology, CHU of Nantes, Nantes, France
| | | | - Hélène Peyrouzet
- Public Health Unit, Department of Medical Pharmacology, Regional Pharmacovigilance Center, Bordeaux University Hospital, Bordeaux, France
| | - Ghada Miremont
- Public Health Unit, Department of Medical Pharmacology, Regional Pharmacovigilance Center, Bordeaux University Hospital, Bordeaux, France.,INSERM, BPH, U1219, Team Pharmacoepidemiology, Univ. Bordeaux, Bordeaux, France
| | - Marion Lepelley
- Regional Pharmacovigilance Center, Department of Public Health, Grenoble-Alpes University Hospital, Grenobles, France
| | - Laetitia Stefani
- Department of Medical Oncology, Annecy-Genevois Hospital, Epagny Metz-Tessy, France
| | - Louise Gaboriau
- Regional Pharmacovigilance Center, Department of Pharmacology, Lille University Hospital, Lille, France
| | - Fanny Rocher
- Regional Pharmacovigilance Center, Department of Pharmacology, Cimiez University Hospital, Nice, France
| | | | - Christine Le Beller
- Innovative Therapies in Hemostasis, INSERM, Pharmacovigilance Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris University, Paris, France
| | - Marion Allouchery
- Regional Pharmacovigilance Center, Department of Clinical Pharmacology, Poitiers University, Poitiers University Hospital, Poitiers, France
| | - Brahim Azzouz
- Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, Reims, France.,EA 3797, Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
| | - Nathalie Massy
- Regional Pharmacovigilance Center, Department of Pharmacology, Rouen University Hospital, Rouen, France
| | - Martine Alt-Tebacher
- Regional Pharmacovigilance Center, Cardiology Department, Strasbourg University Hospital, Strasbourg, France
| | - Célestine Simand
- Department of Hematology, Institute for Cancer Strasbourg-Europe (ICANS), Strasbourg University, Strasbourg, France
| | - Raoul Herbrecht
- Department of Hematology, Institute for Cancer Strasbourg-Europe (ICANS), Strasbourg University, Strasbourg, France
| | - Basile Chrétien
- Regional Pharmacovigilance Center, Department of Pharmacology, Caen University Hospital, Caen, France
| | - Charles Dolladille
- UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Normandie Univ, Caen, France.,Regional Pharmacovigilance Center, Department of Pharmacology, Caen University Hospital, Caen, France
| | - Sylvain Chantepie
- Department of Clinical Hematology, Caen University Hospital, Caen, France
| | - Joachim Alexandre
- UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Normandie Univ, Caen, France.,Regional Pharmacovigilance Center, Department of Pharmacology, Caen University Hospital, Caen, France
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Campa F, Mascherini G, Polara G, Chiodo D, Stefani L. Association of Regional Bioelectrical Phase Angle with Physical Performance: a Pilot Study in Elite Rowers. Muscles Ligaments Tendons J 2021. [DOI: 10.32098/mltj.03.2021.09] [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: 11/05/2022]
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Falandry C, Rousseau F, Mouret-Reynier MA, Tinquaut F, Lorusso D, Herrstedt J, Savoye AM, Stefani L, Bourbouloux E, Sverdlin R, D'Hondt V, Lortholary A, Brachet PE, Zannetti A, Malaurie E, Venat-Bouvet L, Trédan O, Mourey L, Pujade-Lauraine E, Freyer G. Efficacy and Safety of First-line Single-Agent Carboplatin vs Carboplatin Plus Paclitaxel for Vulnerable Older Adult Women With Ovarian Cancer: A GINECO/GCIG Randomized Clinical Trial. JAMA Oncol 2021; 7:853-861. [PMID: 33885718 DOI: 10.1001/jamaoncol.2021.0696] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Single-agent carboplatin is often proposed instead of a conventional carboplatin-paclitaxel doublet in vulnerable older patients with ovarian cancer. Such an approach could have a detrimental effect on outcomes for these patients. Objective To compare the feasibility, efficacy, and safety of single-agent carboplatin every 3 weeks, weekly carboplatin-paclitaxel, or conventional every-3-weeks carboplatin-paclitaxel in vulnerable older patients with ovarian cancer. Design, Setting, and Participants This international, open-label, 3-arm randomized clinical trial screened 447 women 70 years and older with newly diagnosed stage III/IV ovarian cancer by determining their Geriatric Vulnerability Score; 120 patients with a Geriatric Vulnerability Score of 3 or higher were stratified by country and surgical outcome. Enrollment took place at 48 academic centers in France, Italy, Finland, Denmark, Sweden, and Canada from December 11, 2013, to April 26, 2017. Final analysis database lock April 2019. Data analysis was performed from February 1 to December 31, 2019. Interventions Patients were randomized to receive 6 cycles of (1) carboplatin, area under the curve (AUC) 5 mg/mL·min, plus paclitaxel, 175 mg/m2, every 3 weeks; (2) single-agent carboplatin, AUC 5 mg/mL·min or AUC 6 mg/mL·min, every 3 weeks; or (3) weekly carboplatin, AUC 2 mg/mL·min, plus paclitaxel, 60 mg/m2, on days 1, 8, and 15 every 4 weeks. Main Outcomes and Measures The primary outcome was treatment feasibility, defined as the ability to complete 6 chemotherapy cycles without disease progression, premature toxic effects-related treatment discontinuation, or death. Results A total of 120 women were randomized. The mean and median age was 80 (interquartile range, 76-83; range, 70-94) years; 43 (36%) had a Geriatric Vulnerability Score of 4 and 13 (11%) had a Geriatric Vulnerability Score of 5; 40 (33%) had stage IV disease. During its third meeting, the independent data monitoring committee's recommendation led to the termination of the trial because single-agent carboplatin was associated with significantly worse survival. Six cycles were completed in 26 of 40 (65%), 19 of 40 (48%), and 24 of 40 (60%) patients in the every-3-weeks combination, single-agent carboplatin, and weekly combination groups, respectively. Treatment-related adverse events were less common with the standard every-3-weeks combination (17 of 40 [43%]) than single-agent carboplatin or weekly combination therapy (both 23 of 40 [58%]). Treatment-related deaths occurred in 4 patients (2 of 40 [5%] in each combination group). Conclusions and Relevance This randomized clinical trial shows that compared with every-3-weeks or weekly carboplatin-paclitaxel regimens, single-agent carboplatin was less active with significantly worse survival outcomes in vulnerable older patients with ovarian cancer. Trial Registration ClinicalTrials.gov Identifier: NCT02001272.
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Affiliation(s)
- Claire Falandry
- Groupe d'Investigateurs Nationaux pour l'Étude des Cancers de l'Ovaire et du sein (GINECO), Laboratoire CarMEN, INSERM U1060/INRA U1397, Université Lyon 1, INSA de Lyon, and Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | | | | | - Fabien Tinquaut
- GINECO and Institut de Cancérologie de la Loire, St Priest en Jarez, France
| | - Domenica Lorusso
- Multicentre Italian Trials in Ovarian cancer (MITO) and Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, and Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Jørn Herrstedt
- Nordic Society of Gynecologic Oncology (NSGO), Odense University Hospital, Odense, and Zealand University Hospital, Roskilde, Denmark
| | | | | | | | - Robert Sverdlin
- GINECO and Groupe Hospitalier Paris Saint Joseph, Paris, France
| | | | | | | | | | | | | | | | - Loïc Mourey
- GINECO and Institut Claudius Regaud, Toulouse, France
| | | | - Gilles Freyer
- GINECO and Centre Hospitalier Lyon-Sud, Lyon, France
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Roche M, Ravot C, Malapert A, Paget-Bailly S, Garandeau C, Pitiot V, Tomatis M, Riche B, Galamand B, Granger M, Barbavara C, Bourgeois C, Genest E, Stefani L, Haïne M, Castel-Kremer E, Morel-Soldner I, Collange V, Le Saux O, Dayde D, Falandry C. Feasibility of a prehabilitation programme dedicated to older patients with cancer before complex medical-surgical procedures: the PROADAPT pilot study protocol. BMJ Open 2021; 11:e042960. [PMID: 33811052 PMCID: PMC8023742 DOI: 10.1136/bmjopen-2020-042960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/20/2021] [Accepted: 02/26/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ageing is associated with an increased prevalence of comorbidities and sarcopenia as well as a decline of functional reserve of multiple organ systems, which may lead, in the context of the disease-related and/or treatment-related stress, to functional deconditioning. The multicomponent 'Prehabilitation & Rehabilitation in Oncogeriatrics: Adaptation to Deconditioning risk and Accompaniment of Patients' Trajectories (PROADAPT)' intervention was developed multiprofessionally to implement prehabilitation in older patients with cancer. METHODS The PROADAPT pilot study is an interventional, non-comparative, prospective, multicentre study. It will include 122 patients oriented to complex medical-surgical curative procedures (major surgery or radiation therapy with or without chemotherapy). After informed consent, patients will undergo a comprehensive geriatric assessment and will be offered a prehabilitation kit that includes an advice booklet with personalised objectives and respiratory rehabilitation devices. Patients will then be called weekly and monitored for physical and respiratory rehabilitation, preoperative renutrition, motivational counselling and iatrogenic prevention. Six outpatient visits will be planned: at inclusion, a few days before the procedure and at 1, 3, 6 and 12 months after the end of the procedure. The main outcome of the study is the feasibility of the intervention, defined as the ability to perform at least one of the components of the programme. Clinical data collected will include patient-specific and cancer-specific characteristics. ETHICS AND DISSEMINATION The study protocol was approved by the Ile de France 8 ethics committee on 5 June 2018. The results of the primary and secondary objectives will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03659123. Pre-results of the trial.
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Affiliation(s)
- Mélanie Roche
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Christine Ravot
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Amélie Malapert
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life Unit in Oncology, University Hospital Centre Besancon, Besancon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, Université Bourgogne Franche-Comté, Besancon, France
| | - Charlène Garandeau
- Direction à la Recherche Clinique et à l'Innovation, Hospices Civils de Lyon, Lyon, France
| | - Virginie Pitiot
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Mélanie Tomatis
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Riche
- Service de Biostatistique - Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive CNRS UMR 5558, Équipe Biostatistiques Santé, Université de Lyon, Lyon, France
| | - Béatrice Galamand
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Marion Granger
- Geriatrics Unit, Hospices Civils de Lyon, Lyon, France
- Centre Hospitalier de Chambery, Chambery, France
| | | | - Chrystelle Bourgeois
- Department of Medical Oncology, Centre Hospitalier Annecy Genevois, Pringy, France
| | | | - Laetitia Stefani
- Department of Medical Oncology, Centre Hospitalier Annecy Genevois, Pringy, France
| | - Max Haïne
- Pôle de gérontologie et Médecine de Réadaptation, Hôpital Nord-Ouest, Villefranche-sur-Saone, France
| | | | - Isabelle Morel-Soldner
- Geriatrics Unit, Centre Hospitalier de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Vincent Collange
- Département anesthésie réanimation, Medipole Lyon-Villeurbanne, Villeurbanne, France
| | - Olivia Le Saux
- Therapeutic targeting of the tumor cell and its immune microenvironment, Centre de Recherche en Cancerologie de Lyon, Lyon, France
| | - David Dayde
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Claire Falandry
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
- CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France
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Emerson P, Stefani L, Terluk A, Boyd A, Hui R, Thomas L. Left Atrial Strain Analysis in Breast Cancer Patients Post Anthracycline (AC). Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stefani L, Gan G, Trivedi S, Ferkh A, Altman M, Thomas L. LA Strain Mechanics are Altered in Hypertensive Patients vs Healthy Individuals. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.221] [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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Geenty P, Sivapathan S, Stefani L, Zada M, Taylor M, Kwok F, Thomas L. The Prognostic Value of Left Atrial Volume in AL Amyloidosis. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.110] [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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Ferkh A, Stefani L, Trivedi S, Brown P, Altman M, Thomas L. Comparison of 2-Dimensional Single Plane, Biplane and Triplane With 3-Dimensional Left Atrial Strain. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Trivedi S, Bennett R, Byth K, Campbell T, Turnbull S, Stefani L, Kumar S, Thomas L. Speckle Tracking Echocardiography Predicts Arrhythmia Recurrence in Patients With Structural Heart Disease Following Ventricular Tachycardia Ablation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.012] [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: 11/30/2022]
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21
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Fuster-López L, Izzo FC, Andersen CK, Murray A, Vila A, Picollo M, Stefani L, Jiménez R, Aguado-Guardiola E. Picasso’s 1917 paint materials and their influence on the condition of four paintings. SN Appl Sci 2020. [DOI: 10.1007/s42452-020-03803-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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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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Joly F, Lefeuvre-Plesse C, Garnier-Tixidre C, Helissey C, Menneveau N, Zannetti A, Salas S, Houede N, Abadie-Lacourtoisie S, Stefani L, Nenan S, Rieger I, Durand-Zaleski I, Descotes JM, Anota A. Feasibility and efficacy of a supervised home-based physical exercise program for metastatic cancer patients receiving oral targeted therapy: study protocol for the phase II/III - UNICANCER SdS 01 QUALIOR trial. BMC Cancer 2020; 20:975. [PMID: 33036567 PMCID: PMC7545839 DOI: 10.1186/s12885-020-07381-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/04/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Currently, oral targeted therapies are known to be effective and are frequently used to treat metastatic cancer patients, but fatigue is a frequently reported early side effect of these treatments. This fatigue may impact the patient's treatment adherence and result in a negative impact on quality of life. Physical exercise significantly improved the general well-being and quality of life of advanced cancer patients. However, there is no specific physical activity program adapted for patients with advanced disease. METHODS QUALIOR is a two-part, randomized, open-label, and multicenter with two arms phase II/III trial. Patients (phase II: n = 120; phase III: n = 312) with metastatic cancer (breast cancer, kidney cancer, lung cancer, and other cancers [including but not limited to colon cancer, melanoma, sarcoma, or hepatocarcinoma]) treated with a first- or second-line oral targeted therapy without chemotherapy will be included. Patients will be randomized (2:1) to a 3-month supervised home-based standardized physical activity program or to a recommended adapted physical activity (via a booklet). The primary objective of the phase II is to evaluate the feasibility of the supervised program. The primary objective of the phase III is the evaluation of the benefit of the supervised home-based program compare to the recommended program in terms of fatigue and quality of life at 3 months. The secondary objectives aim to evaluate the impact of the supervised program on fatigue over time, pain, physical capacities, psychosocial and cognitive functions, general quality of life, frequency of dose reduction and patients' adherence to the targeted therapy, overall survival, and progression-free survival. This study will also evaluate the medico-economic impact of supervised program compared to the recommended adapted physical activity program. DISCUSSION The aim of this study is to evaluate home-based physical exercise program for metastatic cancer patients treated with oral targeted therapies to help patients to cope with fatigue and improve quality of life. TRIAL REGISTRATION This trial was registered in ClinicalTrials.gov since May 2017 ( NCT03169075 ).
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Affiliation(s)
- Florence Joly
- Centre François Baclesse et CHU Côte de Nacre, Caen, France.
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Falandry C, Stefani L, Andre L, Granger M, Barbavara C, Habchi H, Bourgeois C, Cure H, Passot G, Gilbert T. Interventions to improve physical performances of older people with cancer before complex medico-surgical procedures: Protocol for an umbrella review of systematic reviews and meta-analyses. Medicine (Baltimore) 2020; 99:e21780. [PMID: 32991400 PMCID: PMC7523808 DOI: 10.1097/md.0000000000021780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Current demographics lead increasing older cancer patients to undergo complex medico-surgical procedures, with substantial risk of decompensations and deconditioning. The Prehabilitation & Rehabilitation in Oncology: Adaptation to Disease and Accompaniment of Patients' Trajectories (PROADAPT) project is currently being developed with the aim of improving care, through standardized care pathways guided by existing evidence and implementation programs. A working group will specifically focus on improvement of physical performances before such procedures. These interventions may have been developed in different contexts: before surgery in large, before carcinologic surgery or complex medical interventions (chemotherapy, radiotherapy), or in primary care for elderly patients to prevent sarcopenia and frailty. Post-surgical interventions are out of the scope of this review. The objective of this review is to summarize the level of evidence to support physical reconditioning interventions and identify areas where further work is required. METHODS This umbrella review will include moderate to high quality systematic reviews, meta-analysis, and pre-existing umbrella or meta-reviews. Two reviewers will independently search the following databases: PubMed/MedLine, Cochrane Library, Embase, and CINAHL. Research strategy will use diverse keywords used to refer to the concepts of "prehabilitation," "preoperative exercise," or "preoperative rehabilitation," with prespecified inclusion and exclusion criteria and only systematic reviews selection. The distinct types of interventions presented using PRISMA guidelines and a narrative reporting of results. A focus will be made on outcomes such as physical performances, quality of life, autonomy in everyday activities, or number of hospital bed days. ETHICS AND DISSEMINATION Ethical approval is not required for such an umbrella review. Our review will be submitted for publication in a peer-reviewed international journal using open access option if available. It will be complementary to reviews focused on hospital discharge of older people. PROSPERO REGISTRATION NUMBER CRD42020100110.
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Affiliation(s)
- Claire Falandry
- Geriatric Unit, Lyon-Sud Hospital
- CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Lyon University, Oullins
| | | | | | | | | | - Hocine Habchi
- Urology Department, University Hospital Jean Monnet, St. Etienne
| | | | - Hervé Cure
- Department of Medical Oncology, CHU de Grenoble, La Tronche
| | - Guillaume Passot
- Department of Surgical Oncology, CHU Lyon Sud, Hospices Civils de Lyon, University of Lyon
| | - Thomas Gilbert
- Geriatric Unit, Lyon-Sud Hospital
- Health Services and Performance Research (HESPER EA7425), Lyon, France
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Trivedi S, Stefani L, Brown P, Kizana E, Kumar S, Thomas S, Thomas L. P353 Structural, functional, and electromechanical alterations in patients with paroxysmal atrial fibrillation compared to healthy controls. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.204] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Methods
We sought to evaluate the clinical and echocardiographic differences between healthy controls and paroxysmal atrial fibrillation (AF) patients. Clinical and echocardiographic parameters (performed in sinus rhythm) in 46 paroxysmal AF patients were compared with a departmental database of 83 health controls.
Results
AF patients were older and had increased body size (Table 1). 39/46 (84%) of AF patients had hypertension and 23/46 (50%) had diabetes mellitus.
AF patients had increased left ventricular (LV) mass, and reduced diastolic function (lower e’ and increased E/e’ ratio) when compared to healthy controls. Left atrial (LA) volumes were significantly increased in the AF group. All strain parameters – reservoir, conduit, and contractile strain – were impaired in AF patients compared to controls. LA mechanical dispersion (MD) was significantly increased in AF patients. A ratio of indexed LA volume/LA reservoir strain was significantly higher in AF patients over controls.
The duration of AF had an inverse correlation with LA reservoir strain (Fig 1) (r=–0.78; p < 0.001).
Conclusions
Compared to healthy controls, patients with paroxysmal AF have significant structural, functional and electromechanical alterations. LA strain is significantly impaired in paroxysmal AF and correlates with AF duration.
Table 1. Echocardiographic parameters Parameter Controls (mean ± SD) AF patients (mean ± SD) P value Age (years) 48 ± 18 58 ± 14 0.001 Body surface area (m2) 1.9 ± 0.2 2 ± 0.2 0.014 LV mass (g) 178 ± 48 223 ± 68 <0.001 Average e’ velocity (cms-1) 10.3 ±2.7 8.1 ± 2.2 <0.001 E/e’ 7.4 ± 1.9 9.3 ± 3.4 0.001 Indexed LA end systolic volume (ml/m2) 27.2 ± 7.1 39.0 ± 11.6 <0.001 LA ejection fraction 55.2 ± 10.4 48.5 ± 14.0 0.007 LA functional index 43.7 ± 14.6 29.8 ± 14.3 <0.001 LA reservoir strain (%) 34.3 ± 6.8 27.9± 8.1 <0.001 LA conduit strain (%) 18.4 ± 6.2 13.5 ± 4.7 <0.001 LA contractile strain (%) 15.9 ± 3.9 14.4 ± 5.5 0.007 LA mechanical dispersion (ms) 25.8 ± 9.6 30.9 ± 11.6 0.018 Indexed LA volume / Reservoir strain ratio 0.8 ± 0.3 1.6 ± 0.9 <0.001 LV = left ventricular; LA = left atrium; SD = standard deviation
Abstract P353 Figure. Fig 1. AF duration vs. Reservoir strain
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Affiliation(s)
- S Trivedi
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - L Stefani
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - P Brown
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - E Kizana
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - S Kumar
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - S Thomas
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - L Thomas
- Westmead Hospital, Department of Cardiology, Sydney, Australia
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Stefani L, Leone BL, Zappelli EZ, Toncelli LT, Galanti GG. P1534 Clinical feasibility of 4D myocardial speckle tracking strain analysis in soccer referee: comparison to 2D strain. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.956] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
no
OnBehalf
no
Background
Quantitative analysis of deformation parameters can provide evidence about the presence of disease . Speckle tracking (ST)strain is recently largely used in sports medicine, as an usefull tool to add value to the traditional echo information .Especially 4D echo-strain is emerging in this context despite not yet completely explored. The study aim to verify the feasibility of the 4D strain analysis , compared to the 2D ST strain data, in a class of international trained soccer referee. Materials and methods : a group of 25 soccer referee ( aged 45,5 ± 5) underwent to an EMT, conducted at the 85% of their effort to obtain the eligibility. An 2D echocardiographic evaluation was also performed with the measurements of the systolic-diastolic parameters . A specific investigation for the 2D and 4D strain analysis by X-Strain-Esaote software, was possible from the 2C,3C;4C apical view chambers, acquired as cine loop. The study was completed by the study of the circumferential strain calculated from short axis view, from the images of the basal and medium LV segments. Results : all 2D echo parameters were normal (LVDD: 50,56 ± 2 mm,68; LVSD: 35,4 ± 2,3 mm; EF: 65,76 ±1,78%; E/A:1,73 ± 0,35 ; RV:23,71 ± 1 mm) The 2D GLS ( -22,29 ± 2,64); Circumferential strain( Basal -22,29 ± 5,3; Apical -25,66 ± 5,8 ) were in the normal range. No statistical differences ( P:NS) were observed comparing the mean GLS(21,60 ± 2,68) to the LV 4D strain( -21,24 ± 2,75) Conclusions : 4D strain completes and strengthens the role of the 2D strain in evaluating the myocardial function contributing to exclude eventual undiscovered disease. Especially in athletes, often checked in a short time the combination of the two methods should be widely proposed .More studies will be necessary in future to confirm this hypothesis.
Abstract P1534 Figure. 4D strain
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Affiliation(s)
- L Stefani
- Sports Medicine Center - University of Florence, Florence, Italy
| | - B L Leone
- Sports Medicine Center - University of Florence, Florence, Italy
| | - E Z Zappelli
- Sports Medicine Center - University of Florence, Florence, Italy
| | - L T Toncelli
- Sports Medicine Center - University of Florence, Florence, Italy
| | - G G Galanti
- Sports Medicine Center - University of Florence, Florence, Italy
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Emerson P, Mahendran S, Deshmukh T, Stefani L, Trivedi S, Hogg M, Brown P, Altman M, Panicker S, Gottlieb D, Thomas L. 072 Altered LA Strain in Bone Marrow Transplant (BMT) Patients Previously Treated With Anthracyclines: A Marker of an Atrial Myopathy. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Stefani L, Koltar A, Altman M, Boyd A, Richards D, Thomas L. 340 Exercise Related Changes in LA Phasic Function as Determined by 2D Speckle Tracking. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.347] [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: 10/23/2022]
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Ferkh A, Stefani L, Trivedi S, O'Keefe E, Duggins A, Evans A, Robert Denniss A, Kizana E, Thomas L. 366 Left Atrial Mechanical Dispersion in Patients With Embolic Stroke: A Marker of Underlying Atrial Dysfunction. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.373] [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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Trivedi S, Claessen G, Stefani L, Flannery D, Brown P, Janssens K, Thomas L, La Gerche A. P970 Significant differences in atrial structural and functional parameters leading to differing mechanisms of atrial fibrillation in athletes compared to non-athletes. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.602] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction: There is an increased incidence of atrial fibrillation (AF) in endurance athletes. We sought to evaluate the likely mechanistic basis for this phenomenon.
Methods
36 endurance athletes in sinus rhythm, with a previous history of AF (ATH-AF) were compared to age and gender matched endurance athletes with no prior history of AF (ATH), non athletes with paroxysmal AF (NONATH-AF) and age and gender matched healthy controls (CONTROL). A detailed transthoracic echocardiogram was performed with all groups in sinus rhythm, with detailed left atrial (LA) and left ventricular (LV) measurements, including strain analysis.
Results
All athletes had increased LA and LV size when compared with healthy controls (Table 1). Non athletes with paroxysmal AF had increased LA size when compared with controls. However, indexed LA/LV ratio was preserved in athletes and similar to healthy individuals, whilst AF patients had significantly increased LA/LV ratio. Athletes with AF had higher e’ velocity and lower E/e’, whereas e’ was reduced and E/e’ elevated in non-athlete AF patients.
Athletes had impaired LA reservoir and contractile strain, and reduced LV global longitudinal strain (GLS) compared with healthy controls.
Conclusions
Compared to healthy controls, athletes have reduced LA and LV strain, with preserved LV diastolic function and LA/LV ratio. In contrast, altered diastolic function with differential increase in LA volume was observed in AF patients. The increased risk of AF in athletes is likely mediated by different mechanistic processes other than an atrial myopathy consequent to diastolic dysfunction as observed in non-athletes with AF.
Table 1. LA and LV parameters Parameter ATH-AF ATH NONATH-AF CONTROL P value LVEDV indexed (ml/m2) 84 ± 12 79 ± 14 57 ± 10 51 ± 13 <0.001 LVESV indexed (ml/m2) 35 ± 6 34 ± 7 25 ± 8 27 ± 33 0.02 LV ejection fraction (%) 58 ± 4 56 ± 4 56 ± 10 58 ± 8 0.586 LV global longitudinal strain (%) 19.2 ± 1.7 18.9 ± 2.1 21 ± 3.1 21.7 ± 2.9 <0.001 e’ vel (cm/s) 10 ± 2 10 ± 3 8 ± 2 9 ± 2 0.007 E/e’ 5.7 ± 1.3 5.9 ± 1.8 9.1 ± 3.3 7.5 ± 1.5 <0.001 LAV max indexed (ml/m2) 45 ± 11 43 ± 12 38 ± 11 27 ± 8 <0.001 Indexed LAV/LVEDV ratio 0.5 ± 0.1 0.6 ± 0.2 0.7 ± 0.2 0.5 ± 0.1 <0.001 LA reservoir strain (%) 27.2 ± 4.8 28.2 ± 3.7 27.9 ± 8.4 33.2 ± 7.0 <0.001 LA conduit strain (%) 14.2 ± 4.5 14.4 ± 4.0 14.9 ± 5.5 16.6 ± 6.3 0.182 LA contractile strain (%) 13.0 ± 3.1 13.8 ± 3.6 13.0 ± 5.1 16.6 ± 3.1 <0.001 LV = left ventricular, LAV = left atrial volume, LA = left atrial
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Affiliation(s)
- S Trivedi
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - G Claessen
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - L Stefani
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - D Flannery
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - P Brown
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - K Janssens
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - L Thomas
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia
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Ferkh A, Stefani L, Trivedi S, Brown P, Pathan F, Thomas L. P1504 Inter-vendor comparison of left atrial 2-dimensional strain using multilayer analysis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.928] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Left atrial strain (LAS) is increasingly being accepted as a marker of left atrial function. Different vendors utilise different techniques of measuring LAS in echocardiography.
AIMS
To determine the difference between multilayer endocardial and mid-myocardial measurements of LA strain on General Electric (GE) Echopac compared to the TOMTEC system which tracks endocardial strain.
METHODS
Peak reservoir left atrial strain (LAS) was measured on 50 healthy controls using the two different echocardiographic software packages. GE Echopac (v201) 2D-speckle tracking echocardiography technique (LV package) was used to measuremid-myocardial (GE-mid) and endocardial (GE-endo) LAS. This was compared to LAS measurement using TOMTEC (v4.6) which uses an endocardial tracking technique. LAS was measured in 4ch and 2ch views and average biplane strain measurement was obtained.
RESULTS
The mean of GE-mid LAS was 36.3 ± 6.3%, GE-endo LAS was higher with a mean of 44.1 ± 8.0%, while TOMTEC LAS was 42.1 ± 6.3 %. GE-mid and GE-endo LAS correlated well with TOMTEC LAS (r = 0.9, p < 0.001 for both). On Bland-Altman Analysis, GE-mid LAS measurements were systematically lower than TOMTEC LAS (mean difference -5.77), whereas GE-endo LAS had no systematic bias (mean difference 1.99).
CONCLUSIONS
Mid-myocardial peak reservoir left atrial strain, which is routinely measured using GE Echopac software, systematically underestimates LAS as compared to TOMTEC LAS or GE endocardial LAS. This suggests that serial follow up of LAS measurements for patients should be performed on the same software.
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Affiliation(s)
- A Ferkh
- University of Sydney, Sydney, Australia
| | - L Stefani
- University of Sydney, Sydney, Australia
| | - S Trivedi
- University of Sydney, Sydney, Australia
| | - P Brown
- Westmead Hospital, Sydney, Australia
| | - F Pathan
- University of Sydney, Sydney, Australia
| | - L Thomas
- University of Sydney, Sydney, Australia
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Stefani L, Trivedi S, Altman M, Thomas L. 335 Effects of Healthy Aging on Left Atrial Phasic Function Using Strain Analysis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Trivedi S, Campbell T, Stefani L, Kumar S, Thomas L. 031 Speckle-Tracking Strain Echocardiography in the Assessment of Myocardial Mechanics in Patients With Idiopathic Ventricular Arrhythmias: A Longitudinal Follow-Up Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.038] [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: 11/25/2022]
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Tinquaut F, Freyer G, Pommeret F, Gladieff L, Lorusso D, Reynier MAM, D’Hondt V, Mollon-Grange D, Floquet A, Lacourtoisie SA, Brachet P, Stefani L, Rousseau F, Frenel JS, De Piano F, Herrstedt J, Warkus T, Tredan O, Pujade-Lauraine E, Falandry C. Validation of the geriatric vulnerability score (GVS) in older ovarian cancer (oOC) patients: An analysis from the GCIG-ENGOT-GINECO EWOC-1 study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Heudel P, Arnaud A, Frenel JS, Chabaud S, You B, Stefani L, Garnier-Tixidre C, Simon H, Beal-Ardisson D, Jacquin JP, Del Piano F, Lortholary A, Cornea C, Lharidon T, Largillier R, Brocard F, Legouffe E, Atlassi M, Hardy-Bessard AC, Bachelot TD. A GINECO randomized phase II assessing addition of an aromatase inhibitor to oral vinorelbine in pretreated metastatic breast cancer patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1043] [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
1043 Background: For ER+/HER2- metastatic breast cancer (mBC), efficacy of endocrine therapy + chemotherapy combination remain an open question. We hypothesized that continuing ER targeted therapy after progression in combination with chemotherapy may improve disease control. The objective of the CHEOPS trial was to assess the benefit of adding aromatase inhibitor (AI) to metronomic chemotherapy,oral vinorelbine, 50mg/3 time a week (OV) for AI pre-treated, ER+/HER2- mBC patients. Methods: Eligible patients had to have progressed on endocrine therapy and one or two lines of chemotherapy. They were randomized between vinorelbine (OV) and vinorelbine + AI (OV+AI). Primary end point was progression-free survival (PFS). To show an increase of median PFS (from 3.5 to 5.5 month, HR 0.636), with alpha = 5% and power = 80%, 130 evaluable patients were needed. Results: 121 patients were Included (OV = 61; OV+AI = 60). Median age was 68 (range: 49-87), Median time from metastatic diagnosis was 3.2 years (range 0 - 16.9). 109 patients (90%) had visceral metastases. They all had previously received an AI and had been treated with one line (N = 66, 54.5%), or 2 lines (N = 55, 45.5%) of chemotherapy. Median PFS was increased from 2.3 months with OV to 3.7 months with OV+AI, but this difference was not significant (HR 0.73 [95 % CI 0.50-1.06], log-rank test: P = 0.09) 81 patients (67%) had at least one adverse event (AE) of grade ≥ 3 (40 (66%) for OV vs 41 (68%) for OV+AI). The most common grade ≥ 3 AE were: GT gammas (23%), neutropenia (18%), arterial hypertension and lymphopenia (17%). The occurrence of 3 toxic deaths (OV = 1; OV+AI = 2) secondary to febrile aplasia motivated the early cessation of this clinical trial. 9 patients (5 OV (10%) and 4 OV+AI (8%) presented an objective complete or partial response. Conclusions: The addition of AI to OV over OV alone in AI resistant mBC was associated with a non-significant improvement of PFS, but both PFS are lower than expected. Metronomic OV schedule, at 50 mg three times a week, requires close biological monitoring. The question of hormonal treatment and chemotherapy combination remains open. Clinical trial information: EudraCT Number: 2015-000401-39.
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Affiliation(s)
| | | | - Jean-Sebastien Frenel
- GINECO-Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - Sylvie Chabaud
- Statistician - GINECO - Centre Léon-Bérard, Lyon, France
| | - Benoit You
- GINECO-Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | | | | | - Helene Simon
- GINECO-Hôpital Morvan Centre Hospitalier Universitaire, Brest, France
| | | | - Jean-Philippe Jacquin
- GINECO-Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest-En-Jarez, France
| | | | | | - Claudiu Cornea
- GINECO-Centre Hospitalier Jean Bernard, Valenciennes, France
| | - Tifenn Lharidon
- GINECO-Centre Hospitalier Départemental Vendée Les Oudairies, La Roche-Sur-Yon, France
| | | | - Fabien Brocard
- GINECO-Oracle-Centre d'Oncologie de Gentilly, Nancy, France
| | - Eric Legouffe
- GINECO-Institut de Cancérologie du Gard Centre ONCOGARD, Nimes, France
| | | | - Anne-Claire Hardy-Bessard
- GINECO-Centre Armoricain de Radiothérapie d'Imagerie Médicale et d'Oncologie-Hôpital Privé des Côtes d'Armor, Plérin, France
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Falandry C, Savoye AM, Stefani L, Tinquaut F, Lorusso D, Herrstedt J, Bourbouloux E, Floquet A, Brachet PE, Zannetti A, Mouret-Reynier MA, Sverdlin R, D'hondt V, Guillem O, Cojocarasu O, Venat-Bouvet L, Rousseau F, Lortholary A, Pujade-Lauraine E, Freyer G. EWOC-1: A randomized trial to evaluate the feasibility of three different first-line chemotherapy regimens for vulnerable elderly women with ovarian cancer (OC): A GCIG-ENGOT-GINECO study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5508] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5508 Background: The Geriatric Vulnerability Score (GVS) combining albumin, lymphocyte count, ADL, IADL and HADS scores has been reported (Falandry C Ann Oncol 2013) to identify vulnerable elderly OC patients (pts) as those with a GVS≥3. For such pts, Carboplatin (Cb) monotherapy or weekly Cb plus paclitaxel (Pa) are often proposed as an alternative to Cb-Pa given every 3 weeks. Methods: Pts ≥70 yrs with first line FIGO stage III/IV epithelial OC were screened for GVS. Those with GVS≥3 were randomized to receive either arm A: Cb AUC5-6 + Pa 175mg/m², d1q3week or arm B: Cb AUC5-6 d1q3week or arm C:weekly Cb AUC2 + Pa 60mg/m² d1-d8-d15 q4week. Primary endpoint is treatment feasibility defined as the ability to complete 6 chemotherapy courses without disease progression, early treatment stopping due to unacceptable toxicity or death. Inclusion of 240 pts was planned. Results: Among 444 screened pts, 120 were randomized from 12/2013 to 04/2017 (armA = B = C = 40). Pts characteristics were well balanced between arms A-B-C respectively: median age (79-82-80 yrs), FIGO stage IV (32-37-27%), primary surgery (65-72-70%), absence of macroscopic residuals (CC-0) (7-5-7%), ECOG≥2 (50-50-47%). Feasibility per protocol for arms A-B-C is 65%, 47% and 60% (p = 0.15). Main reasons for treatment arrest are treatment toxicity (A:20%; B:15%; C:22.5%; p = 0.771) and disease progression (A:7.5%; B:30%; C:2%; p = 0.004). Median PFS for arm A-B-C are 12.5 mos (95%CI 10.3-15.3), 4.8 (3.8-15.3) and 8.3 (6.6-15.3), respectively (p < 0.001) and median OS for arm A-B-C is not reached (NR) (21, NR), 7.4 (5.3-NR) and 17.3 (10.8-NR), respectively (p = 0.001). At the pre-planned intermediate analysis, the IDMC recommended to prematurely close the study as survival in armB was found significantly worse and the number of potential pts required to find a significant difference between both Cb-Pa regimens (arms A&C) was out of reach. Conclusions: Compared to 3-weekly and weekly Cb-Pa regimens, Cb single agent was reported to be less active with significant worse survival outcome in vulnerable elderly pts. In this population Cb-Pa combination remains a standard. Clinical trial information: NCT02001272.
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Affiliation(s)
| | | | | | - Fabien Tinquaut
- GINECO Statistician - Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | - Domenica Lorusso
- MITO and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Jorn Herrstedt
- Nordic Society of Gynecologic Oncology (NSGO) and Odense University Hospital, Odense, Denmark
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Affiliation(s)
- L. Stefani
- Sports Medicine Center, Clinical and Experimental Department, Florence, Italy
| | - G. Galanti
- Sports Medicine Center, Clinical and Experimental Department, Florence, Italy
| | - S. Lorini
- Sports Medicine Center, Clinical and Experimental Department, Florence, Italy
| | - G. Beni
- Child and Woman Health Department, University of Florence, Italy
| | - M. Dei
- Child and Woman Health Department, University of Florence, Italy
| | - N. Maffulli
- Department of Musculoskeletal Disorders Faculty of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy; Centre for Sports and Exercise Medicine Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Ferkh A, Trivedi S, Stefani L, Brown P, Pathan F, Thomas L. Multivendor Analysis of Left Atrial Strain using Multilayer Analysis. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.293] [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: 11/30/2022]
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Aparicio T, Ducreux M, Faroux R, Barbier E, Manfredi S, Lecomte T, Etienne PL, Bedenne L, Bennouna J, Phelip JM, François E, Michel P, Legoux JL, Gasmi M, Breysacher G, Rougier P, De Gramont A, Lepage C, Bouché O, Seitz JF, Adenis A, Alessio A, Aouakli A, Azzedine A, Bedjaoui A, Bidault A, Blanchi A, Botton A, Cadier-Lagnes A, Fatisse A, Gagnaire A, Gilbert A, Gueye A, Hollebecque A, Lemaire A, Mahamat A, Marre A, Patenotte A, Rotenberg A, Roussel A, Thirot-Bidault A, Votte A, Weber A, Zaanan A, Dupont-Gossart A, Villing A, Queuniet A, Coudert B, Denis B, Garcia B, Lafforgue B, Landi B, Leduc B, Linot B, Paillot B, Rhein B, Winkfield B, Barberis C, Becht C, Belletier C, Berger C, Bineau C, Borel C, Brezault C, Buffet C, Cornila C, Couffon C, De La Fouchardière C, Giraud C, Lecaille C, Lepere C, Lobry C, Locher C, Lombard-Bohas C, Paoletti C, Platini C, Rebischung C, Sarda C, Vilain C, Briac-Levaché C, Auby D, Baudet-Klepping D, Bechade D, Besson D, Cleau D, Festin D, Gargot D, Genet D, Goldfain D, Luet D, Malka D, Peré-Vergé D, Pillon D, Sevin-Robiche D, Smith D, Soubrane D, Tougeron D, Zylberait D, Carola E, Cuillerier E, Dorval Danquechin E, Echinard E, Janssen E, Maillard E, Mitry E, Norguet-Monnereau E, Suc E, Terrebonne E, Zrihen E, Pariente E, Almaric F, Audemar F, Bonnetain F, Desseigne F, Dewaele F, Di Fiore F, Ghiringhelli F, Husseini F, Khemissa F, Kikolski F, Morvan F, Petit-Laurent F, Riot F, Subtil F, Zerouala-Boussaha F, Caroli-Bosc F, Boilleau-Jolimoy G, Bordes G, Cavaglione G, Coulanjon G, Deplanque G, Gatineau-Saillant G, Goujon G, Medinger G, Roquin G, Brixi-Benmansour H, Castanie H, Lacroix H, Maechel H, Perrier H, Salloum H, Senellart H, Baumgaertner I, Cumin I, Graber I, Trouilloud I, Boutin J, Butel J, Charneau J, Cretin J, Dauba J, Deguiral J, Egreteau J, Ezenfis J, Forestier J, Goineau J, Lacourt J, Lafon J, Martin J, Meunier J, Moreau J, Provencal J, Taieb J, Thaury J, Tuaillon J, Vergniol J, Villand J, Vincent J, Volet J, Bachet J, Barbare J, Souquet J, Grangé J, Dor J, Paitel J, Jouve J, Raoul J, Cheula J, Gornet J, Sabate J, Vantelon J, Vaillant J, Aucouturier J, Barbieux J, Herr J, Lafargue J, Lagasse J, Latrive J, Plachot J, Ramain J, Robin J, Spano J, Douillard J, Beerblock K, Bouhier-Leporrier K, Slimane Fawzi K, Cany L, Chone L, Dahan L, Gasnault L, Rob L, Stefani L, Wander L, Baconnier M, Ben Abdelghani M, Benchalal M, Blasquez M, Carreiro M, Charbit M, Combe M, Duluc M, Fayolle M, Gignoux M, Giovannini M, Glikmanas M, Mabro M, Mignot M, Mornet M, Mousseau M, Mozer M, Pauwels M, Pelletier M, Porneuf M, Ramdani M, Schnee M, Tissot M, Zawadi M, Clavero-Fabri M, Gouttebel M, Kaminsky M, Galais M, Abdelli N, Barrière N, Bouaria N, Bouarioua N, Delas N, Gérardin N, Hess-Laurens N, Stremsdoerfer N, Berthelet O, Boulat O, Capitain O, Favre O, Amoyal P, Bergerault P, Burtin P, Cassan P, Chatrenet P, Chiappa P, Claudé P, Couzigou P, Feydy P, Follana P, Geoffroy P, Godeau P, Hammel P, Laplaige P, Lehair P, Martin P, Novello P, Pantioni P, Pienkowski P, Pouderoux P, Prost P, Ruszniewski P, Souillac P, Texereau P, Thévenet P, Haineaux P, Benoit R, Coriat R, Lamy R, Mackiewicz R, Beorchia S, Chaussade S, Hiret S, Jacquot S, Lavau Denes S, Montembault S, Nahon S, Nasca S, Nguyen S, Oddou-Lagraniere S, Pesque-Penaud S, Fratte S, Chatellier T, Mansourbakht T, Morin T, Walter T, Boige V, Bourgeois V, Derias V, Guérin-Meyer V, Hautefeuille V, Jestin Le Tallec V, Lorgis V, Quentin V, Sebbagh V, Veuillez V, Adhoute X, Coulaud X, Becouarn Y, Coscas Y, Courouble Y, Le Bricquir Y, Molin Y, Rinaldi Y, Lam Y, Ladhib Z. Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials. Eur J Cancer 2018; 98:1-9. [DOI: 10.1016/j.ejca.2018.03.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 02/07/2023]
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Bidard FC, Sabatier R, Berger F, Pistilli B, Dalenc F, De La Motte Rouge T, Frenel JS, Dubot C, Ladoire S, Ferrero JM, Stefani L, Lortholary A, Hardy-Bessard AC, Grenier J, Everhard S, Jeannot E, Proudhon C, Lemonnier J, Delaloge S, Bachelot TD. PADA-1: A randomized, open label, multicentric phase III trial to evaluate the safety and efficacy of palbociclib in combination with hormone therapy driven by circulating DNA ESR1 mutation monitoring in ER-positive, HER2-negative metastatic breast cancer patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps1105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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)
| | - Renaud Sabatier
- Dpt of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | | | | | - Florence Dalenc
- Institut Claudius Regaud, IUCT-Oncopole, CRCT, Inserm, Toulouse, France
| | | | | | | | - Sylvain Ladoire
- Dpt of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Laetitia Stefani
- Department of Medical Oncology CH Annecy Genevois, Pringy, France
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Decousus H, Bertoletti L, Fournel P, Bourmaud A, Labruyère C, Presles E, Merah A, Laporte S, Stefani L, Landry G, Chauvin F, Meyer G. In patients with cancer, prognostic factors of catheter-related thrombosis (CRT) are different than prognostic factors of VTE. A prospective cohort study in 3032 cancer patients with central venous catheter (ONCOCIP). Thromb Res 2018. [DOI: 10.1016/j.thromres.2018.02.080] [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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Bocci G, Kundisova L, Guadagni G, Stefani L, Cepollaro C, Nante N, Dei S, D'Amato MG. Blaylock risk assessment screening score as a predictor of length of hospital stay. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.446] [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: 11/12/2022] Open
Affiliation(s)
- G Bocci
- Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - L Kundisova
- Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - G Guadagni
- Post Graduate School of General Medicine, University of Siena, Siena, Italy
| | - L Stefani
- Local Health Unit “Tuscany Southeast”, Siena, Italy
| | - C Cepollaro
- Local Health Unit “Tuscany Southeast”, Siena, Italy
| | - N Nante
- Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - S Dei
- Local Health Unit “Tuscany Southeast”, Siena, Italy
| | - MG D'Amato
- Local Health Unit “Tuscany Southeast”, Siena, Italy
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Gligorov J, Ataseven B, Verrill M, De Laurentiis M, Jung K, Azim H, Al-Sakaff N, Lauer S, Shing M, Pivot X, Koroveshi D, Bouzid K, Casalnuovo M, Cascallar D, Korbenfeld EP, Bastick P, Beith J, Colosimo M, Friedlander M, Ganju V, Green M, Patterson K, Redfern A, Richardson G, Ceric T, Gordana K, Beato CA, Ferrari M, Hegg R, Helena V, Ismael GF, Lessa AE, Mano M, Morelle A, Nogueira JA, Timcheva K, Tomova A, Tsakova M, Zlatareva-Petrova A, Asselah J, Assi H, Brezden-Masley C, Chia S, Freedman O, Harb M, Joy AA, Kulkarni S, Prady C, Gaete AAA, Matamala L, Torres R, Yanez E, Franco S, Urrego M, Gugić D, Vrbanec D, Melichar B, Prausová J, Vyzula R, Pilarte RG, León MI, Muñoz R, Ramos G, Azeem HA, Aziz AA, El Zawahry H, Osegueda FR, Alexandre J, Artignan X, Barletta H, Beguier E, Berdah JF, Marty CB, Bollet M, Bourgeois H, Bressac C, Burki F, Campone M, Coeffic D, Cojocarasu OZ, Dagada C, Dalenc F, Del Piano F, Desauw C, Desmoulins I, Dohollou N, Egreteau J, Ferrero JM, Foa C, Garidi R, Gasnault L, Gligorov J, Guardiola E, Hamizi S, Jarcau R, Jacquin JP, Jaubert D, Jolimoy G, Mineur HL, Largillier R, Leduc B, Martin P, Melis A, Monge J, Moullet I, Mousseau M, Nguyen S, Orfeuvre H, Petit T, Pivot X, Priou F, Bach IS, Simon H, Stefani L, Uwer L, Youssef A, Aktas B, von der Assen A, Augustin D, Balser C, Bauer LE, Bechtner C, Beyer G, Brucker C, Bückner U, Busch S, Christensen B, Deryal M, Farrokh A, Faust E, Friedrichs K, Graf H, Griesshammer M, Grischke EM, Hänle C, Heider A, Henschen S, Hesse T, Jackisch C, Kisro J, Köhler A, Kuemmel S, Lampe D, Lantzsch T, Latos K, Lex B, Liedtke C, Luedders D, Maintz C, Müller V, Overkamp F, Park-Simon TW, Paul M, Prechtl A, Ringsdorf U, Runnebaum I, Ruth S, Salat C, Scheffen I, Schilling J, Schmatloch S, Schmidt M, Schneeweiss A, Schrader I, Seipelt G, Simon E, Stefek A, Stickeler E, Thill M, Tio J, Tuczek A, Warm M, Weigel M, Wischnik A, Wojcinski S, Ziegler-Löhr K, Aravantinos G, Ardavanis A, Fountzilas G, Gogas H, Kakolyris S, Mavroudis D, Papadimitriou C, Papandreou C, Papazisis K, Castro H, Hernandez-Monroy CE, Ngan R, Yeo W, Bittner N, Boer K, Csejtei A, Horvath Z, Kocsis J, Mangel LC, Mezei K, Nagy Z, Szanto J, Atmakusuma D, Fadjari H, Kurnianda D, Prayogo N, Tanggo EH, Coate L, Hennessy B, Kelly C, Martin M, Nasim S, O'Connor M, Aieta M, Allegrini G, Amadori D, Bidoli P, Biti G, Bordonaro R, Bottini A, Carterni G, Cavanna L, Cazzaniga M, Cognetti F, Contu A, Cruciani G, Donadio M, Falcone A, Farci D, Forcignanò RC, Frassoldati A, Gaion F, Gamucci T, Giotta F, de Laurentiis M, Livi L, Lorusso V, Maiello E, Marchetti P, Mariani G, Mion M, Moscetti L, Musolino A, Pazzola A, Pedrazzoli P, Pigi A, de Placido S, Caremoli ER, Santoro A, Tienghi A, Ahn JS, Jung KH, Lee KS, Lee SH, Seo JH, Sohn JH, Cesas A, Juozaityte E, Cheah NLC, Chong FLT, Devi BC, Phua V, Teoh D, Ching LW, Yusof M, Corona J, Dominguez A, Mendoza RLG, Hernandez CA, Ramiro AJ, Santos JM, Espinosa PM, Villarreal Garza CM, Errihani H, Bakker S, van den Berkmortel F, Blaisse R, Huinink DTB, van den Bosch J, Braun J, Dercksen M, Droogendijk H, Erdkamp F, Haringhuizen A, de Jongh F, Kok T, Los M, Madretsma S, Terwogt JMM, van der Padt A, van Rossum-Schornagel QC, Smilde T, de Valk B, van der Velden A, van Warmerdam L, van de Wouw A, North R, Kersten C, Mjaaland I, Wist E, Aziz Z, Masood N, Rashid K, Shah M, Alcedo JC, Aleman D, Neciosup S, Reategui R, Valdiviezo N, Vera L, Fernando G, Roque F, Strebel HM, Krzemieniecki K, Litwiniuk M, Mruk A, Pienkowski T, Sawrycki P, Slomian G, Tomczak P, Afonso N, Cardoso F, Damasceno M, Nave M, Badulescu F, Ciule L, Curescu S, Eniu A, Filip D, Grecea D, Jinga DC, Lungulescu D, Oprean CM, Stanculeanu DL, Turdean M, Dvornichenko V, Emelyanov S, Lichinitser M, Manikhas A, Sakaeva D, Shirinkin V, Stroyakovskiy D, Abulkhair O, Zekri J, Filipovic S, Kovcin V, Nedovic J, Pesic J, Vasovic S, Ng R, Bystricky B, Leskova J, Mardiak J, Mišurová E, Wagnerova M, Takač I, Demetriou GS, Dreosti L, Govender P, Jordaan JP, Veersamy P, Romero JLA, Lopez NB, Arias CC, Chacon J, Aramburo AF, Morales LAF, Garcia M, Estevez LG, Garcia-Palomo Perez A, Garcia Saenz JA, Garcia Sanchis L, Cubells LG, Cortijo LG, Santiago SG, De Aranguiz BHF, Mañas JJI, Gallego PJ, Cussac AL, Ferrandiz CL, Garrido ML, Alvarez PL, Vega JML, Del Prado PM, Jañez NM, Murillo SM, Rosales AM, Jaso LM, Fernandez IP, Martorell AP, Carrion RP, Simon SP, Alcibar AP, Lorenzo JP, Garcia VQ, Asensio TRYC, Maicas MDT, Villanueva Silva MJ, Killander F, Svensson JH, Fehr M, Hauser N, Müller A, Pagani O, Passmann-Kegel H, Popescu R, Rabaglio M, Rauch D, Schlatter C, Zaman K, Chang TW, Huang CS, Wang HC, Yu JC, Bandidwattanawong C, Maneechavakajorn J, Seetalarom K, Dejthevaporn T(S, Somwangprasert A, Vongsaisuwon M, Akbulut H, Altundag K, Arican A, Bozcuk H, Eralp Y, Idris M, Isikdogan A, Senol CH, Sevinc A, Uygun K, Yucel E, Yucel I, Yumuk F, Shparyk Y, Voitko N, Jaloudi M, Adams J, Agrawal R, Ahmed S, Alhasso A, Allerton R, Anwar S, Archer C, Ashford R, Barraclough L, Bertelli G, Bishop J, Branson T, Butt M, Chakrabarti A, Chakraborti P, Churn M, Crowley C, Davis R, Dhadda A, Eldeeb H, Fraser J, Hall J, Hickish T, Hogg M, Howe T, Joffe J, Kelleher M, Kelly S, Kendall A, Kristeleit H, Lumsden G, Macmillan C, MacPherson I, Malik Z, Mithal N, Neal A, Panwar U, Proctor A, Proctor SJ, Raj S, Rehman S, Sandri I, Scatchard K, Sherwin E, Sims E, Singer J, Smith S, Tahir S, Taylor W, Tsalic M, Verrill M, Wardley A, Waters S, Wheatley D, Wright K, Yuille F, Alonso I, Artagaveytia N, Rodriguez R, Arbona E, Garcia Y, Lion L, Marcano D, Van Thuan T. Safety and tolerability of subcutaneous trastuzumab for the adjuvant treatment of human epidermal growth factor receptor 2-positive early breast cancer: SafeHer phase III study's primary analysis of 2573 patients. Eur J Cancer 2017. [DOI: 10.1016/j.ejca.2017.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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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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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Ray-Coquard I, Collard O, Ducimetiere F, Laramas M, Mercier F, Ladarre N, Manson S, Tehard B, Clippe S, Suchaud JP, Stefani L, Blay JY. Treatment patterns and survival in an exhaustive French cohort of pazopanib-eligible patients with metastatic soft tissue sarcoma (STS). BMC Cancer 2017; 17:111. [PMID: 28173774 PMCID: PMC5297166 DOI: 10.1186/s12885-017-3057-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/11/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The French EMS study prospectively collected exhaustive data from STS patients diagnosed in the Rhone-Alpes region from 2005 to 07. METHODS The database included diagnosis/histology, surgery, radiotherapy, systemic treatments and treatment response. Treatment patterns and outcomes of patients with metastatic disease, excluding adipocytic sarcoma and GIST were analyzed. RESULTS Of 888 total patients, 145 were included based on having metastatic disease and appropriate subtypes. All patients received treatment with systemic therapy being most common (74%, n = 107), followed by radiotherapy (30%, n = 44) and surgery (23%, n = 33). Doxorubicin, alone or in combination, was the most common first line systemic therapy (65%, n = 46). Drugs without license in sarcoma were used in 38-83% of treatments depending on treatment line. 24% of frontline patients demonstrated an objective response, decreasing to 11% objective responses in second line but no responses were documented beyond second line, with median PFS declining with each additional line. Median PFS also declined in patients receiving surgery compared to those receiving no surgery (8-15 m vs 5 m). Median OS from metastatic diagnosis for patients receiving systemic therapy was double that of patients without systemic treatment (24 m vs 12 m, p = 0.007). CONCLUSIONS Outcomes in this population were poor and declined with successive treatment. However, results suggest that further anticancer therapies in recurrent sarcoma might be beneficial.
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Affiliation(s)
- Isabelle Ray-Coquard
- Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France. .,Service D'oncologie Médicale, Centre Léon Bérard, 28, rue Laennec, 69008, Lyon, France.
| | - Olivier Collard
- Institut de Cancérologie de la Loire Lucien Neuwirth, 108 Bis av. Albert Raimond, 42270, Saint-Priest en Jarez, France
| | - Françoise Ducimetiere
- Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France
| | - Mathieu Laramas
- CHU de Grenoble, Avenue Maquis du Grésivaudan, 38700, La Tronche, France
| | | | - Nadine Ladarre
- Novartis, 2-4, rue Lionel Terray, Boite postale 308, F-92506, Rueil-Malmaison Cedex, France
| | - Stephanie Manson
- Novartis, Park View, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Bertrand Tehard
- Novartis, 2-4, rue Lionel Terray, Boite postale 308, F-92506, Rueil-Malmaison Cedex, France
| | - Sébastien Clippe
- Centre Marie Curie, 137 Avenue de Romans, 26000, Valence, France
| | - Jean-Philippe Suchaud
- Service de Radiothérapie, Centre Hospitalier de Roanne, 28 Rue de Charlieu, 42300, Roanne, France
| | - Laetitia Stefani
- Centre Hospitalier Annecy-Genevois, 1 Avenue de l'Hôpital, 74370, Metz-Tessy, France
| | - Jean-Yves Blay
- Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France
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Trédan O, Follana P, Moullet I, Cropet C, Trager-Maury S, Dauba J, Lavau-Denes S, Diéras V, Béal-Ardisson D, Gouttebel M, Orfeuvre H, Stefani L, Jouannaud C, Bürki F, Petit T, Guardiola E, Becuwe C, Blot E, Pujade-Lauraine E, Bachelot T. A phase III trial of exemestane plus bevacizumab maintenance therapy in patients with metastatic breast cancer after first-line taxane and bevacizumab: a GINECO group study. Ann Oncol 2016; 27:1020-1029. [DOI: 10.1093/annonc/mdw077] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 02/15/2016] [Indexed: 11/12/2022] Open
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Mazzoni F, Petreni P, Lunghi A, Vannini A, Brugia M, Mela M, Stefani L, Mascherini G, Galanti G, Di Costanzo F. Physical exercise and eating habits in cancer survivors. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.41] [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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Petreni P, Lunghi A, Mazzoni F, Vannini A, Rispoli A, Brugia M, Stefani L, Petri C, Galanti G, Di Costanzo F. Fast Walking And Resistance Exercise Program In Breast Cancer Survivors. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.64] [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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Heudel PE, Van Praagh I, Duvert B, Cauvin I, Hardy-Bessard AC, Jacquin JP, Stefani L, Belliere A, Vincent L, Dramais D, Guastalla JP, Blanc E, Belleville A, Lavergne E, Pérol D. Can a homeopathic medicine complex reduce hot flashes induced by adjuvant endocrine therapy in localized breast cancer patients? Results of a randomized placebo-controlled phase III trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.9627] [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)
| | - Isabelle Van Praagh
- ERTICA EA 4677, Université d'Auvergne, Centre Jean Perrin, Centre d'investigation Clinique, Clermont-Ferrand, France
| | | | | | | | - Jean-Philippe Jacquin
- Department of Oncology, Institut de Cancérologie de la Loire, Saint-Priest-En-Jarez, France
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Turco A, Duchenne J, Nuyts J, Gheysens O, Voigt JU, Claus P, Vunckx K, Muhtarov K, Ozer N, Turk G, Sunman H, Karakulak U, Sahiner L, Kaya B, Yorgun H, Hazirolan T, Aytemir K, Warita S, Kawasaki M, Tanaka R, Houle H, Yagasaki H, Nagaya M, Ono K, Noda T, Watanabe S, Minatoguchi S, Kyle A, Dauphin C, Lusson JR, Dragoi Galrinho R, Rimbas R, Ciobanu A, Marinescu B, Cinteza M, Vinereanu D, Dragoi Galrinho R, Ciobanu A, Rimbas R, Marinescu B, Cinteza M, Vinereanu D, Aparina O, Stukalova O, Butorova E, Makeev M, Bolotova M, Parkhomenko D, Golitsyn S, Zengin E, Hoffmann BA, Ramuschkat M, Ojeda F, Weiss C, Willems S, Blankenberg S, Schnabel RB, Sinning CR, Schubert U, Suhai FI, Toth A, Kecskes K, Czimbalmos C, Csecs I, Maurovich-Horvat P, Simor T, Merkely B, Vago H, Slawek D, Chrzanowski L, Krecki R, Binkowska A, Kasprzak JD, Palombo C, Morizzo C, Kozakova M, Charisopoulou D, Koulaouzidis G, Rydberg A, Henein M, Kovacs A, Olah A, Lux A, Matyas C, Nemeth B, Kellermayer D, Ruppert M, Birtalan E, Merkely B, Radovits T, Henri C, Dulgheru R, Magne J, Kou S, Davin L, Nchimi A, Oury C, Pierard L, Lancellotti P, Sahin ST, Cengiz B, Yurdakul S, Altuntas E, Aytekin V, Aytekin S, Bajraktari G, Ibrahimi P, Bytyci I, Ahmeti A, Batalli A, Elezi S, Henein M, Pavlyukova E, Tereshenkova E, Karpov R, Barbier P, Mirea O, Guglielmo M, Savioli G, Cefalu C, Maltagliati M, Tumasyan L, Adamyan K, Chilingaryan A, Tunyan L, Kowalik E, Klisiewicz A, Biernacka E, Hoffman P, Park C, Yi J, Cho J, Ihm S, Kim H, Cho E, Jeon H, Jung H, Youn H, Mcghie J, Menting M, Vletter W, Roos-Hesselink J, Geleijnse M, Van Der Zwaan H, Van Den Bosch A, Spethmann S, Baldenhofer G, Stangl V, Baumann G, Stangl K, Laule M, Dreger H, Knebel F, Erdei T, Edwards J, Braim D, Yousef Z, Fraser A, Keramida K, Kouris N, Kostopoulos V, Kostakou P, Petrogiannos C, Olympios C, Bajraktari G, Berisha G, Bytyci I, Ibrahimi P, Rexhepaj N, Henein M, Wdowiak-Okrojek K, Shim A, Wejner-Mik P, Szymczyk E, Michalski B, Kasprzak J, Lipiec P, Tarr A, Stoebe S, Pfeiffer D, Hagendorff A, Haykal M, Ryu S, Park J, Kim S, Choi J, Goh C, Byun Y, Choi J, Sonoko M, Onishi T, Fujimoto W, Yamada S, Taniguchi Y, Yasaka Y, Kawai H, Okura H, Sakamoto Y, Murata E, Kanai M, Kataoka T, Kimura T, Watanabe N, Kuriyama N, Nakama T, Furugen M, Sagara S, Koiwaya H, Ashikaga K, Matsuyama A, Shibata Y, Meimoun P, Abouth S, Martis S, Boulanger J, Elmkies F, Zemir H, Tzvetkov B, Luycx-Bore A, Clerc J, Galli E, Oger E, Guirette Y, Daudin M, Fournet M, Donal E, Galli E, Guirette Y, Mabo P, Donal E, Keramida K, Kouris N, Kostopoulos V, Psarrou G, Petrogiannos C, Hatzigiannis P, Olympios C, Igual Munoz B, Erdociain Perales M, Maceira Gonzalez Alicia A, Vazquez Sanchez A, Miro Palau V, Alonso Fernandez P, Donate Bertolin L, Estornell Erill J, Cervera A, Montero Argudo Anastasio A, Okura H, Koyama T, Maehama T, Imai K, Yamada R, Kume T, Neishi Y, Caballero Jimenez L, Garcia-Navarro M, Saura D, Oliva M, Gonzalez-Carrillo J, Espinosa M, Valdes M, De La Morena G, Venkateshvaran A, Sola S, Dash PK, Annappa C, Manouras A, Winter R, Brodin L, Govind SC, Laufer-Perl L, Topilsky Y, Stugaard M, Koriyama H, Katsuki K, Masuda K, Asanuma T, Takeda Y, Sakata Y, Nakatani S, Marta L, Abecasis J, Reis C, Dores H, Cafe H, Ribeiras R, Andrade M, Mendes M, Goebel B, Hamadanchi A, Schmidt-Winter C, Otto S, Jung C, Figulla H, Poerner T, Kim DH, Sun B, Jang J, Choi H, Song JM, Kang DH, Song JK, Zakhama L, Slama I, Boussabah E, Antit S, Herbegue B, Annabi M, Jalled A, Ben Ameur W, Thameur M, Ben Youssef S, O' Grady H, Gilmore M, Delassus P, Sturmberger T, Ebner C, Aichinger J, Tkalec W, Eder V, Nesser H, Caggegi AM, Scandura S, Capranzano P, Grasso C, Mangiafico S, Ronsivalle G, Dipasqua F, Arcidiacono A, Cannata S, Tamburino C, Chapman M, Henthorn R, Surikow S, Zoontjens J, Stocker B, Mclean T, Zeitz CJ, Fabregat Andres O, Estornell-Erill J, Ridocci-Soriano F, De La Espriella R, Albiach-Montanana C, Trejo-Velasco B, Perdomo-Londono D, Facila L, Morell S, Cortijo-Gimeno J, Kouris N, Keramida K, Kostopoulos V, Psarrou G, Kostakou P, Olympios C, Kuperstein R, Blechman I, Freimatk D, Arad M, Ochoa JP, Fernandez A, Vaisbuj F, Salmo F, Fava A, Casabe H, Guevara E, Fernandes A, Cateano F, Almeida I, Silva J, Trigo J, Botelho A, Sanches C, Venancio M, Goncalves L, Schnell F, Daudin M, Oger E, Bouillet P, Mabo P, Carre F, Donal E, Petrella L, Fabiani D, Paparoni S, De Remigis F, Tomassoni G, Prosperi F, Napoletano C, Marchel M, Serafin A, Kochanowski J, Steckiewicz R, Madej-Pilarczyk A, Filipiak K, Opolski G, Abid L, Ben Kahla S, Charfeddine S, Kammoun S, Monivas Palomero V, Mingo Santos S, Goirigoizarri Artaza J, Rodriguez Gonzalez E, Restrepo Cordoba A, Rivero Arribas B, Garcia Lunar I, Gomez Bueno M, Sayago Silva I, Segovia Cubero J, Zengin E, Radunski UK, Klusmeier M, Ojeda F, Rybczynski M, Barten M, Muellerleile K, Reichenspurner H, Blankenberg S, Sinning CR, Romano G, Licata P, Tuzzolino F, Clemenza F, Di Gesaro G, Hernandez Baravoglia C, Scardulla C, Pilato M, Hashimoto G, Suzuki M, Yoshikawa H, Otsuka T, Isekame Y, Iijima R, Hara H, Nakamura M, Sugi K, Melnikova M, Krestjyaninov M, Ruzov V, Magnino C, Omede' P, Avenatti E, Presutti D, Moretti C, Ravera A, Sabia L, Gaita F, Veglio F, Milan A, Magda S, Mincu R, Soare A, Mihai C, Florescu M, Mihalcea D, Cinteza M, Vinereanu D, Chatzistamatiou E, Mpampatseva Vagena I, Manakos K, Moustakas G, Konstantinidis D, Memo G, Mitsakis O, Kasakogias A, Syros P, Kallikazaros I, Petroni R, Acitelli A, Cicconetti M, Di Mauro M, Altorio S, Romano S, Petroni A, Penco M, Apostolovic S, Stanojevic D, Jankovic-Tomasevic R, Salinger-Martinovic S, Pavlovic M, Djordjevic-Radojkovic D, Tahirovic E, Dungen H, Jung IH, Byun YS, Goh CW, Kim BO, Rhee KJ, Lee DS, Kim MJ, Seo HS, Kim HY, Tsverava M, Tsverava D, Zaletova T, Shamsheva D, Parkhomenko O, Bogdanov A, Derbeneva S, Leotescu A, Tudor I, Gurghean A, Bruckner I, Plaskota K, Trojnarska O, Bartczak A, Grajek S, Sharma P, Sharma D, Garg S, Vazquez Lopez-Ibor J, Monivas Palomero V, Solano-Lopez J, Zegri Reiriz I, Dominguez Rodriguez F, Gonzalez Mirelis J, Mingo Santos S, Sayago I, Garcia Pavia P, Segovia Cubero J, Florescu M, Mihalcea D, Magda S, Radu E, Chirca A, Acasandrei A, Jinga D, Mincu R, Enescu O, Vinereanu D, Saura Espin D, Caballero Jimenez L, Oliva Sandoval M, Gonzalez Carrillo J, Garcia Navarro M, Espinosa Garcia M, Valdes Chavarri M, De La Morena Valenzuela G, Abul Fadl A, Mourad M, Campanale CM, Di Maria S, Mega S, Nusca A, Marullo F, Di Sciascio G, Pardo Gonzalez L, Delgado M, Ruiz M, Rodriguez S, Hidalgo F, Ortega R, Mesa D, Suarez De Lezo Cruz Conde J, Bengrid TM, Zhao Y, Henein M, Kenjaev S, Alavi A, Kenjaev M, Mendes L, Lima S, Dantas C, Melo I, Madeira V, Balao S, Alves H, Baptista E, Mendes P, Santos J, Scali M, Mandoli G, Simioniuc A, Massaro F, Di Bello V, Marzilli M, Dini F, Cifra B, Dragulescu A, Friedberg M, Mertens L, Scali M, Bayramoglu A, Tasolar H, Otlu Y, Hidayet S, Kurt F, Dogan A, Pekdemir H, Stefani L, Galanti G, De Luca A, Toncelli L, Pedrizzetti G, Gopal AS, Saha S, Toole R, Kiotsekoglou A, Cao J, Reichek N, Ho SJ, Hung SC, Chang FY, Liao JN, Niu DM, Yu WC, Nemes A, Kalapos A, Domsik P, Forster T, Siarkos M, Sammut E, Lee L, Jackson T, Carr-White G, Rajani R, Kapetanakis S, Jarvinen V, Sipola P, Madeo A, Piras P, Evangelista A, Giura G, Dominici T, Nardinocchi P, Varano V, Chialastri C, Puddu P, Torromeo C, Sanchis Ruiz L, Montserrat S, Obach V, Cervera A, Bijnens B, Sitges M, Charisopoulou D, Banner NR, Rahman-Haley S, Imperadore F, Del Greco M, Jermendy A, Horcsik D, Horvath T, Celeng C, Nagy E, Bartykowszki A, Tarnoki D, Merkely B, Maurovich-Horvat P, Jermendy G, Whitaker J, Demir O, Walton J, Wragg A, Alfakih K, Karolyi M, Szilveszter B, Raaijmakers R, Giepmans W, Horvath T, Merkely B, Maurovich-Horvat P, Koulaouzidis G, Charisopoulou D, Mcarthur T, Jenkins P, Henein M, Silva T, Ramos R, Oliveira M, Marques H, Cunha P, Silva M, Barbosa C, Sofia A, Pimenta R, Ferreira R, Al-Mallah M, Alsaileek A. Poster session 5: Friday 5 December 2014, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu257] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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