1
|
Larroquette M, Lefort F, Heraudet L, Bernhard JC, Ravaud A, Domblides C, Gross-Goupil M. Therapeutic Management of Metastatic Clear Cell Renal Cell Carcinoma: A Revolution in Every Decade. Cancers (Basel) 2022; 14:6230. [PMID: 36551715 PMCID: PMC9777357 DOI: 10.3390/cancers14246230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Clear cell renal cell carcinoma (RCC) oncogenesis is mainly driven by VHL gene inactivation, leading to overexpression of vascular endothelial growth factor (VEGF). The use of tyrosine-kinase inhibitors (TKIs) directed against VEGF and its receptor (VEGFR) revolutionised the management of metastatic renal cancer in the 2000s. The more recent development of next-generation TKIs such as cabozantinib or lenvatinib has made it possible to bypass some of the mechanisms of resistance to first-generation anti-VEGFR TKIs. During the decade 2010-2020, the development of immune checkpoint blockade (ICB) therapies revolutionised the management of many solid cancers, including RCC, in first- and subsequent-line settings. Dual ICB or ICB plus anti-VEGFR TKI combinations are now the standard of care for patients with advanced clear cell RCC. To optimise these combination therapies while preserving patient quality of life, escalation and de-escalation strategies are being evaluated in prospective randomised trials, based on patient selection according to their prognosis risk. Finally, new therapeutic approaches, such as targeting hypoxia-inducible factor (HIF) and the development of innovative treatments using antibody-drug conjugates (ADCs), CAR-T cells, or radiopharmaceuticals, are all potential candidates to improve further patient survival.
Collapse
Affiliation(s)
- Mathieu Larroquette
- Department of Medical Oncology, University Hospital of Bordeaux, 33000 Bordeaux, France
- Faculty of Medicine, University of Bordeaux, 33000 Bordeaux, France
| | - Félix Lefort
- Department of Medical Oncology, University Hospital of Bordeaux, 33000 Bordeaux, France
| | - Luc Heraudet
- Department of Medical Oncology, University Hospital of Bordeaux, 33000 Bordeaux, France
- Faculty of Medicine, University of Bordeaux, 33000 Bordeaux, France
| | - Jean-Christophe Bernhard
- Faculty of Medicine, University of Bordeaux, 33000 Bordeaux, France
- Department of Urology, University Hospital of Bordeaux, 33000 Bordeaux, France
| | - Alain Ravaud
- Department of Medical Oncology, University Hospital of Bordeaux, 33000 Bordeaux, France
- Faculty of Medicine, University of Bordeaux, 33000 Bordeaux, France
| | - Charlotte Domblides
- Department of Medical Oncology, University Hospital of Bordeaux, 33000 Bordeaux, France
- Faculty of Medicine, University of Bordeaux, 33000 Bordeaux, France
| | - Marine Gross-Goupil
- Department of Medical Oncology, University Hospital of Bordeaux, 33000 Bordeaux, France
| |
Collapse
|
2
|
Heraudet L, Galtier J, Favre S, Peyraud F, Cazaubiel T, Leroy H, Mottal N, Gros FX, Forcade E, Clément L, Dumas PY, Pigneux A, Leguay T. VANDA regimen followed by blinatumomab leads to favourable outcome in patients with Philadelphia chromosome-negative B-precursor acute lymphoblastic leukaemia in first relapse. Br J Haematol 2022; 198:523-527. [PMID: 35524489 DOI: 10.1111/bjh.18218] [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] [Received: 03/19/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
Adults with relapsed or refractory B-precursor acute lymphoblastic leukaemia (R/R BCP-ALL) have very poor outcome. Blinatumomab as single agent has shown activity in R/R BCP-ALL. We aimed to assess the activity of blinatumomab in concomitant association with intensive chemotherapy. Seventeen patients with R/R BCP-ALL were treated with combination of blinatumomab and VANDA (etoposide, cytarabine, mitoxantrone, dexamethasone and asparaginase) regimen. Complete remission (CR) was achieved in 14/17 patient (82%) and 11/17 (65%) were transplanted. One-year leukaemia-free survival was 58.8% for the whole cohort and 90.9% for transplanted patients. These preliminary data suggest that the VANDA-blinatumomab salvage regimen leads to a very high rate of CR and HSCT in suitable patients.
Collapse
Affiliation(s)
- Luc Heraudet
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Jean Galtier
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Simon Favre
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Florent Peyraud
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Titouan Cazaubiel
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Harmony Leroy
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Nathan Mottal
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - François-Xavier Gros
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Edouard Forcade
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Laurence Clément
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Pierre-Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Arnaud Pigneux
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Thibaut Leguay
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| |
Collapse
|
3
|
Heraudet L, Delon T, Veillon R, Vergnenègre C, Lepetit H, Daste A, Ravaud A, Zysman M, Domblides C. Effect of prior immunotherapy on the efficacy of chemotherapy in advanced non‐small cell lung cancer: A retrospective study. Thorac Cancer 2022; 13:1391-1400. [PMID: 35434866 PMCID: PMC9058314 DOI: 10.1111/1759-7714.14403] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background The effect of the sequential combination of chemotherapy and immune checkpoint inhibitors (ICIs) remains unclear. Here, we evaluated the efficacy of different chemotherapy regimens administered after ICIs in advanced non‐small cell lung cancer (NSCLC), compared to the same regimens administered without previous ICIs. Methods We retrospectively included all patients treated between 2015 and 2019 for an advanced NSCLC, receiving a salvage chemotherapy just after ICI (CAI group) comparing them to ICI naive patients (CWPI group) undergoing the same chemotherapy at Bordeaux University Hospital. The primary outcome was the time to treatment discontinuation (TTD), and secondary endpoints were overall survival (OS) and overall response rate (ORR). Results A total of 152 patients were included, with 34/23 (CAI/CWPI) receiving paclitaxel/bevacizumab (PB), 24/11 paclitaxel (P), 27/12 gemcitabine (G) and 6/15 pemetrexed (PE). Characteristics were comparable, except for CAI treated with PB (more patients with an ECOG PS ≤1 [p <0.001]). Median number of lines received was higher in CAI for all groups. There was no difference between CAI and CWPI for TTD, OS and ORR. However, PB was associated with a nonsignificant increase in OS in the CAI group (HR = 0.65; 95% CI: 0.38–1.2, p = 0.17]. Conclusion Our data showed no difference in TTD, OS and ORR regardless of chemotherapy, but a trend towards an increased OS with PB when given after an ICI, while patients received chemotherapy later in the CAI group. This suggests that a sequential combination of ICI followed by chemotherapy could be an interesting strategy in advanced NSCLC for selected patients.
Collapse
Affiliation(s)
- Luc Heraudet
- Department of Medical Oncology, Hôpital Saint‐André Bordeaux University Hospital Bordeaux France
- Faculty of Medicine University of Bordeaux Bordeaux France
| | - Tara Delon
- Faculty of Medicine University of Bordeaux Bordeaux France
- Pulmonary Department, Pôle Cardio‐thoracique, Hôpital Haut‐Lévèque Bordeaux University Hospital Bordeaux France
| | - Rémi Veillon
- Pulmonary Department, Pôle Cardio‐thoracique, Hôpital Haut‐Lévèque Bordeaux University Hospital Bordeaux France
| | - Charlotte Vergnenègre
- Pulmonary Department, Pôle Cardio‐thoracique, Hôpital Haut‐Lévèque Bordeaux University Hospital Bordeaux France
| | - Hélène Lepetit
- Unité de soutien méthodologique à la recherche clinique et épidémiologique Bordeaux University Hospital Bordeaux France
| | - Amaury Daste
- Department of Medical Oncology, Hôpital Saint‐André Bordeaux University Hospital Bordeaux France
| | - Alain Ravaud
- Department of Medical Oncology, Hôpital Saint‐André Bordeaux University Hospital Bordeaux France
- Faculty of Medicine University of Bordeaux Bordeaux France
| | - Maéva Zysman
- Faculty of Medicine University of Bordeaux Bordeaux France
- Pulmonary Department, Pôle Cardio‐thoracique, Hôpital Haut‐Lévèque Bordeaux University Hospital Bordeaux France
- Centre de Recherche Cardio‐Thoracique de Bordeaux (CRCTB), INSERM U1045 Bordeaux France
| | - Charlotte Domblides
- Department of Medical Oncology, Hôpital Saint‐André Bordeaux University Hospital Bordeaux France
- Faculty of Medicine University of Bordeaux Bordeaux France
- CNRS UMR5164, ImmunoConcEpT Site de Carreire, University of Bordeaux Bordeaux France
| |
Collapse
|
4
|
Heraudet L, Delon T, Veillon R, Vergnenègre C, Lepetit H, Daste A, Ravaud A, Zysman M, Domblides C. 1314P Preliminary results of sequential combination of immunotherapy followed by chemotherapy in advanced non-small cell lung cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
5
|
Heraudet L, Domblides C, Daste A, Gross-Goupil M, Ravaud A. Adaptation of multidisciplinary meeting decisions in a medical oncology department during the COVID epidemic in a less affected region of France: a prospective analysis from Bordeaux University Hospital. Eur J Cancer 2020; 135:98-100. [PMID: 32559628 PMCID: PMC7298500 DOI: 10.1016/j.ejca.2020.04.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Luc Heraudet
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital, Bordeaux, France
| | - Charlotte Domblides
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital, Bordeaux, France; Bordeaux University, France
| | - Amaury Daste
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital, Bordeaux, France
| | - Marine Gross-Goupil
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital, Bordeaux, France
| | - Alain Ravaud
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital, Bordeaux, France; Bordeaux University, France.
| |
Collapse
|
6
|
Heraudet L, Domblides C, Daste A, Lefort F, Bernhard JC, Ravaud A, Gross-Goupil M. Safety of sunitinib in patients with renal cell carcinoma following nephrectomy. Expert Opin Drug Saf 2020; 19:799-806. [PMID: 32521179 DOI: 10.1080/14740338.2020.1774551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The safety profile characteristics of sunitinib were evaluated in patients who underwent nephrectomy for kidney cancer. AREAS COVERED In this literature review, safety data were evaluated from phase III trials investigating sunitinib following nephrectomy, either in the more recent adjuvant setting after nephrectomy or in the metastatic setting, with a focus on new data from the CARMENA and SURTIME trials. In particular, the aim was to determine the specificity of toxicity in the adjuvant setting. EXPERT OPINION In the adjuvant setting, even if the toxicity profile of sunitinib does not differ significantly from that in the metastatic setting, the importance of the dose intensity and, thus, exposure has been emphasized. Consequently, as described mainly in the metastatic setting, management of the adverse effects of sunitinib remains critical.
Collapse
Affiliation(s)
- Luc Heraudet
- Department of Medical Oncology, Bordeaux University Hospital , Saint-André, France
| | - Charlotte Domblides
- Department of Medical Oncology, Bordeaux University Hospital , Saint-André, France.,University of Bordeaux , Bordeaux, France
| | - Amaury Daste
- Department of Medical Oncology, Bordeaux University Hospital , Saint-André, France
| | - Félix Lefort
- Department of Medical Oncology, Bordeaux University Hospital , Saint-André, France
| | | | - Alain Ravaud
- Department of Medical Oncology, Bordeaux University Hospital , Saint-André, France.,University of Bordeaux , Bordeaux, France
| | - Marine Gross-Goupil
- Department of Medical Oncology, Bordeaux University Hospital , Saint-André, France
| |
Collapse
|
7
|
Herrera Gomez R, Mezquita L, Auclin E, Heraudet L, Plana M, Salas S, Cristina V, Garcia Castano A, Arrazubi V, Grau J, Saleh K, Cirauqui Cirauqui B, Mesia Nin R, Even C, Taberna M, Daste A, Peters S, Besse B, Baste-Rotllan N. The head and neck lung immune prognostic index (HN-LIPI): A prognostic score for immune checkpoint inhibitors (ICI) in recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
8
|
Martin M, Bacci M, Coulibaly S, Dupin C, Heraudet L, Lafon M, Trouette R, Vendrely V. Efficacité et tolérance de la radiothérapie stéréotaxique des lésions primitives et secondaires hépatiques au CHU de Bordeaux. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.096] [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]
|