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Detroit M, Collier M, Beeker N, Willems L, Decroocq J, Deau-Fischer B, Vignon M, Birsen R, Moufle F, Leclaire C, Balladur E, Deschamps P, Chauchet A, Batista R, Limat S, Treluyer JM, Ricard L, Stocker N, Hermine O, Choquet S, Morel V, Metz C, Bouscary D, Kroemer M, Zerbit J. Predictive Factors of Response to Immunotherapy in Lymphomas: A Multicentre Clinical Data Warehouse Study (PRONOSTIM). Cancers (Basel) 2023; 15:4028. [PMID: 37627056 PMCID: PMC10452259 DOI: 10.3390/cancers15164028] [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: 07/10/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Immunotherapy (IT) is a major therapeutic strategy for lymphoma, significantly improving patient prognosis. IT remains ineffective for a significant number of patients, however, and exposes them to specific toxicities. The identification predictive factors around efficacy and toxicity would allow better targeting of patients with a higher ratio of benefit to risk. PRONOSTIM is a multicenter and retrospective study using the Clinical Data Warehouse (CDW) of the Greater Paris University Hospitals network. Adult patients with Hodgkin lymphoma or diffuse large-cell B lymphoma treated with immune checkpoint inhibitors or CAR T (Chimeric antigen receptor T) cells between 2017 and 2022 were included. Analysis of covariates influencing progression-free survival (PFS) or the occurrence of grade ≥3 toxicity was performed. In total, 249 patients were included. From this study, already known predictors for response or toxicity of CAR T cells such as age, elevated lactate dehydrogenase, and elevated C-Reactive Protein at the time of infusion were confirmed. In addition, male gender, low hemoglobin, and hypo- or hyperkalemia were demonstrated to be potential predictive factors for progression after CAR T cell therapy. These findings prove the attractiveness of CDW in generating real-world data, and show its essential contribution to identifying new predictors for decision support before starting IT.
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Affiliation(s)
- Marion Detroit
- Pharmacy Department, Pitié-Salpêtrière Hospital, Greater Paris University Hospitals (AP-HP), Sorbonne University, 75013 Paris, France; (M.D.); (C.M.)
| | - Mathis Collier
- Clinical Research Unit, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (M.C.); (N.B.); (J.-M.T.)
| | - Nathanaël Beeker
- Clinical Research Unit, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (M.C.); (N.B.); (J.-M.T.)
| | - Lise Willems
- Hematology Department, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (L.W.); (J.D.); (B.D.-F.); (M.V.); (R.B.); (D.B.)
| | - Justine Decroocq
- Hematology Department, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (L.W.); (J.D.); (B.D.-F.); (M.V.); (R.B.); (D.B.)
| | - Bénédicte Deau-Fischer
- Hematology Department, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (L.W.); (J.D.); (B.D.-F.); (M.V.); (R.B.); (D.B.)
| | - Marguerite Vignon
- Hematology Department, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (L.W.); (J.D.); (B.D.-F.); (M.V.); (R.B.); (D.B.)
| | - Rudy Birsen
- Hematology Department, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (L.W.); (J.D.); (B.D.-F.); (M.V.); (R.B.); (D.B.)
| | - Frederique Moufle
- Adult Department, Hospital at Home, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (F.M.); (C.L.); (E.B.)
| | - Clément Leclaire
- Adult Department, Hospital at Home, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (F.M.); (C.L.); (E.B.)
| | - Elisabeth Balladur
- Adult Department, Hospital at Home, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (F.M.); (C.L.); (E.B.)
| | - Paul Deschamps
- Hematology Oncology Department, André Mignot Hospital, 78157 Le Chesnay, France;
| | - Adrien Chauchet
- Hematology Department, University Hospital of Besançon, 25000 Besançon, France;
| | - Rui Batista
- Pharmacy Department, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France;
| | - Samuel Limat
- Pharmacy Department, University Hospital of Besançon, 25000 Besançon, France; (S.L.); (M.K.)
- French National Institute of Health and Medical Research (INSERM), Etablissement Français du Sang Bourgogne Franche-Comte (EFS BFC), UMR1098, RIGHT, University of Bourgogne Franche-Comté, 25000 Besançon, France
| | - Jean-Marc Treluyer
- Clinical Research Unit, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (M.C.); (N.B.); (J.-M.T.)
- Regional Pharmacovigilance Center, Pharmacology Department, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France
| | - Laure Ricard
- Hematology Department, Saint Antoine Hospital, AP-HP, INSERM UMRs 938, Sorbonne University, 75012 Paris, France; (L.R.); (N.S.)
| | - Nicolas Stocker
- Hematology Department, Saint Antoine Hospital, AP-HP, INSERM UMRs 938, Sorbonne University, 75012 Paris, France; (L.R.); (N.S.)
| | - Olivier Hermine
- Hematology Department, Necker Hospital, AP-HP, Centre Paris-Cité University, 75015 Paris, France;
| | - Sylvain Choquet
- Hematology Department, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, 75013 Paris, France; (S.C.); (V.M.)
| | - Véronique Morel
- Hematology Department, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, 75013 Paris, France; (S.C.); (V.M.)
| | - Carole Metz
- Pharmacy Department, Pitié-Salpêtrière Hospital, Greater Paris University Hospitals (AP-HP), Sorbonne University, 75013 Paris, France; (M.D.); (C.M.)
| | - Didier Bouscary
- Hematology Department, Cochin Hospital, AP-HP, Centre Paris-Cité University, 75014 Paris, France; (L.W.); (J.D.); (B.D.-F.); (M.V.); (R.B.); (D.B.)
| | - Marie Kroemer
- Pharmacy Department, University Hospital of Besançon, 25000 Besançon, France; (S.L.); (M.K.)
- French National Institute of Health and Medical Research (INSERM), Etablissement Français du Sang Bourgogne Franche-Comte (EFS BFC), UMR1098, RIGHT, University of Bourgogne Franche-Comté, 25000 Besançon, France
| | - Jérémie Zerbit
- Cancer Treatment Unit, Pharmacy Department, Hospital at Home, AP-HP, Centre Paris-Cité University, 75014 Paris, France
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Zerbit J, Detroit M, Chevret S, Pene F, Luyt CE, Ghosn J, Eyvrard F, Martin-Blondel G, Sarton B, Clere-Jehl R, Moine P, Cransac A, Andreu P, Labruyère M, Albertini L, Huon JF, Roge P, Bernard L, Farines-Raffoul M, Villiet M, Venet A, Dumont LM, Kaiser JD, Chapuis C, Goehringer F, Barbier F, Desjardins S, Benzidi Y, Abbas N, Guerin C, Batista R, Llitjos JF, Kroemer M. Remdesivir for Patients Hospitalized with COVID-19 Severe Pneumonia: A National Cohort Study (Remdeco-19). J Clin Med 2022; 11:6545. [PMID: 36362773 PMCID: PMC9654065 DOI: 10.3390/jcm11216545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/15/2022] [Accepted: 10/29/2022] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Given the rapidly evolving pandemic of COVID-19 in 2020, authorities focused on the repurposing of available drugs to develop timely and cost-effective therapeutic strategies. Evidence suggested the potential utility of remdesivir in the framework of an early access program. REMDECO-19 is a multicenter national cohort study assessing the ability of remdesivir to improve the outcome of patients hospitalized with COVID-19. METHODS We conducted a retrospective real-life study that included all patients from the early access program of remdesivir in France. The primary endpoint was the clinical course evolution of critically ill and hospitalized COVID-19 patients treated with remdesivir. Secondary endpoints were the SOFA score evolution within 29 days following the admission and mortality at 29 and 90 days. RESULTS Eighty-five patients were enrolled in 22 sites from January to April 2020. The median WHO and SOFA scores were respectively reduced by two and six points between days 1 and 29. Improvement in the WHO-CPS and the SOFA score were observed in 83.5% and 79.3% of patients, respectively, from day 10. However, there was no effect of remdesivir on the 90-day survival based on the control cohort for hospitalized COVID-19 patients with invasive ventilation. CONCLUSIONS SOFA score appeared to be an attractive approach to assess remdesivir efficacy and stratify its utilization or not in critically ill patients with COVID-19. This study brings a new clinical benchmark for therapeutic decision making and supports the use of remdesivir for some hospitalized COVID-19 patients.
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Affiliation(s)
- Jeremie Zerbit
- Department of Pharmacy, Hospital at Home, University Hospitals of Paris, 75014 Paris, France
| | - Marion Detroit
- Department of Pharmacy, University Hospital of Besançon, 25056 Besançon, France
| | - Sylvie Chevret
- Department of Biostatistics, Saint-Louis Hospital, AP-HP, Universite Paris Diderot, INSERM S717, 75010 Paris, France
| | - Frederic Pene
- Institut Cochin, Université de Paris, INSERM U1016, CNRS UMR 8104, 75014 Paris, France
- Service de Médecine Intensive et Réanimation, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - Charles-Edouard Luyt
- Médecine Intensive Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
- INSERM, UMRS_1166-ICA, Sorbonne Universités, 75005 Paris, France
| | - Jade Ghosn
- Infectious Diseases Department, Bichat-Claude Bernard University Hospital, AP-HP, 75018 Paris, France
| | - Frederic Eyvrard
- Pharmacy Department, Toulouse University Hospital, 31300 Toulouse, France
| | - Guillaume Martin-Blondel
- Department of Infectious and Tropical Diseases, Toulouse University Hospital, 31300 Toulouse, France
- Inserm U1043—CNRS UMR 5282, Toulouse-Purpan Pathophysiology Center, 31300 Toulouse, France
| | - Benjamine Sarton
- Critical Care Unit, University Teaching Hospital of Purpan, Place du Dr Baylac, 31300 Toulouse, France
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, 31300 Toulouse, France
| | - Raphael Clere-Jehl
- Service de Médecine Intensive—Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaire de Strasbourg, 67091 Strasbourg, France
| | - Pierre Moine
- Intensive Care Unit, Raymond Poincaré Hospital, AP-HP, 92033 Garches, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et Inflammation, 78180 Montigny le Bretonneux, France
| | - Amelie Cransac
- Department of Pharmacy, Dijon University Hospital, 21231 Dijon, France
| | - Pascal Andreu
- Department of Intensive Care, Dijon Bourgogne University Hospital, 21231 Dijon, France
| | - Marie Labruyère
- Department of Intensive Care, Dijon Bourgogne University Hospital, 21231 Dijon, France
| | | | | | - Pauline Roge
- Pharmacie, CHRU Brest, Hôpital de La Cavale Blanche, 29200 Brest, France
| | - Lise Bernard
- Département de Pharmacie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | | | - Maxime Villiet
- Département de Pharmacie, Centre Hospitalier Universitaire de Montpellier, 34000 Montpellier, France
| | - Arnaud Venet
- Department of Pharmacy, Pellegrin Hospital, 33000 Bordeaux, France
| | - Louis Marie Dumont
- Medical Intensive Care Unit, Louis-Mourier Hospital, AP-HP, 92025 Colombes, France
| | - Jean-Daniel Kaiser
- Pharmacy Department, Hôpitaux Civils de Colmar, 68026 Colmar, France
- Clinical Research Unit, Hôpitaux Civils de Colmar, 68026 Colmar, France
| | - Claire Chapuis
- Unités Pharmacie Clinique et Médecine Intensive-Réanimation, Centre Hospitalier Universitaire de Grenoble Alpes, 38000 Grenoble, France
| | - François Goehringer
- Department of Infectious Diseases, University Hospital of Nancy, 54000 Nancy, France
| | - François Barbier
- Médecine Intensive—Réanimation, Centre Hospitalier Régional d’Orléans, 45000 Orléans, France
| | - Stephane Desjardins
- Département de Pharmacie, Centre Hospitalier Sud Francilien, 91100 Corbeil-Essonnes, France
| | - Younes Benzidi
- Critical Care Center, Ajaccio Hospital, 20000 Ajaccio, France
| | - Nora Abbas
- Department of Clinical Pharmacy, Cochin Hospital, AP-HP, 75014 Paris, France
| | - Corinne Guerin
- Department of Clinical Pharmacy, Cochin Hospital, AP-HP, 75014 Paris, France
| | - Rui Batista
- Department of Clinical Pharmacy, Cochin Hospital, AP-HP, 75014 Paris, France
| | - Jean-François Llitjos
- Service de Médecine Intensive et Réanimation, Hôpital Cochin, AP-HP, 75014 Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR 8104, 75014 Paris, France
| | - Marie Kroemer
- Department of Pharmacy, University Hospital of Besançon, 25056 Besançon, France
- INSERM, EFS BFC, UMR 1098 RIGHT, University of Bourgogne Franche-Comté, 25056 Besançon, France
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Zerbit J, Kroemer M, Fuchs B, Detroit M, Decroocq J, Vignon M, Willems L, Deau‐Fischer B, Franchi P, Deschamps P, Contejean A, Grignano E, Fouquet G, Birsen R, Mondesir J, Rocquet M, Huon J, Batista R, Marty‐Reboul J, Bouscary D. Pharmaceutical cancer care for haematology patients on oral anticancer drugs: Findings from an economic, clinical and organisational analysis. Eur J Cancer Care (Engl) 2022; 31:e13753. [DOI: 10.1111/ecc.13753] [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: 07/27/2022] [Revised: 09/26/2022] [Accepted: 10/09/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Jeremie Zerbit
- Pharmacy Department, Hospital at Home University Hospitals of Paris (AP‐HP) Paris France
| | - Marie Kroemer
- Pharmacy Department University Hospital of Besançon Besançon France
| | - Basile Fuchs
- Medical Information, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
| | - Marion Detroit
- Pharmacy Department University Hospital of Besançon Besançon France
| | - Justine Decroocq
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016 Paris France
- Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC) Paris France
| | - Marguerite Vignon
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
| | - Lise Willems
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
| | | | - Patricia Franchi
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
| | - Paul Deschamps
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016 Paris France
- Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC) Paris France
| | | | - Eric Grignano
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016 Paris France
- Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC) Paris France
| | - Guillemette Fouquet
- Hematology Department Centre Hospitalier Sud Francilien Corbeil‐Essonnes France
| | - Rudy Birsen
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016 Paris France
- Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC) Paris France
| | - Johanna Mondesir
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016 Paris France
- Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC) Paris France
| | - Mathieu Rocquet
- Hematology Department Necker Hospital, University Hospitals of Paris (AP‐HP) Paris France
| | - Jean‐François Huon
- INSERM, UMR 1246‐SPHERE, MethodS in Patients‐Centered Outcomes and HEalth ResEarch Nantes France
- Clinical Pharmacy Unit Nantes University Hospital Nantes France
| | - Rui Batista
- Clinical Pharmacy, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
| | - Jeanne Marty‐Reboul
- Medical Information, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
| | - Didier Bouscary
- Clinical Hematology, Cochin Hospital University Hospitals of Paris (AP‐HP) Paris France
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016 Paris France
- Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC) Paris France
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