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Reichert C, Baldini C, Mezghani S, Maubec E, Longvert C, Mortier L, Quereux G, Jannic A, Machet L, de Quatrebarbes J, Nardin C, Beneton N, Amini Adle M, Funck-Brentano E, Descamps V, Hachon L, Malissen N, Baroudjian B, Brunet-Possenti F. Combined Nivolumab and Ipilimumab in Octogenarian and Nonagenarian Melanoma Patients. Cancers (Basel) 2023; 15:4330. [PMID: 37686606 PMCID: PMC10486537 DOI: 10.3390/cancers15174330] [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: 07/16/2023] [Revised: 08/13/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Data regarding elderly melanoma patients treated with anti-PD-1 or anti-CTLA-4 antibodies are in favor of tolerability outcomes that are similar to those of younger counterparts. However, there are very few studies focusing on elderly patients receiving nivolumab combined with ipilimumab (NIVO + IPI). Here, we ask what are the current prescribing patterns of NIVO + IPI in the very elderly population and analyze the tolerance profile. This French multicenter retrospective study was conducted on 60 melanoma patients aged 80 years and older treated with NIVO + IPI between January 2011 and June 2022. The mean age at first NIVO + IPI administration was 83.7 years (range: 79.3-93.3 years). Fifty-five patients (92%) were in good general condition and lived at home. Two dosing regimens were used: NIVO 1 mg/kg + IPI 3 mg/kg Q3W (NIVO1 + IPI3) in 27 patients (45%) and NIVO 3 mg/kg + IPI 1 mg/kg Q3W (NIVO3 + IPI1) in 33 patients (55%). NIVO + IPI was a first-line treatment in 39 patients (65%). The global prevalence of immune-related adverse events was 63% (38/60), with 27% (16/60) being of grade 3 or higher. Grade ≥ 3 adverse events were less frequent in patients treated with NIVO3 + IPI1 compared with those treated with NIVO1 + IPI3 (12% versus 44%, p = 0.04). In conclusion, the prescribing patterns of NIVO + IPI in very elderly patients are heterogeneous in terms of the dosing regimen and line of treatment. The safety profile of NIVO + IPI is reassuring; whether or not the low-dose regimen NIVO3 + IPI1 should be preferred over NIVO1 + IPI3 in patients aged 80 years or older remains an open question.
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Affiliation(s)
- Constance Reichert
- Department of Dermatology, Hôpital Bichat AP-HP, Université Paris Cité, 75018 Paris, France; (C.R.); (V.D.)
| | - Capucine Baldini
- Drug Development Department, Institut Gustave Roussy, CNRS-UMS 3655 and INSERM US23, 94805 Villejuif, France;
| | - Sarah Mezghani
- Department of Imaging, Institut Curie, PSL Research University, 75005 Paris, France;
| | - Eve Maubec
- Department of Dermatology, Hôpital Avicenne AP-HP, Université Sorbonne Paris Nord—Campus de Bobigny, 93000 Bobigny, France;
| | - Christine Longvert
- Department of Dermatology, EA4340-BECCOH, Hôpital Ambroise Paré APHP, Université Paris-Saclay, 92100 Boulogne-Billancourt, France; (C.L.); (E.F.-B.)
| | - Laurent Mortier
- Department of Dermatology, Claude Huriez Hospital, Lille University, Inserm U1189, 59000 Lille, France;
| | - Gaëlle Quereux
- Department of Dermatology, Centre Hospitalier Universitaire de Nantes, CIC 1413, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Nantes University, 44000 Nantes, France;
| | - Arnaud Jannic
- Dermatology Department, Hôpital Henri Mondor AP-HP, 94000 Créteil, France;
| | - Laurent Machet
- Department of Dermatology, Tours University Hospital, 37000 Tours, France;
| | - Julie de Quatrebarbes
- Department of Dermatology, Centre Hospitalier Annecy-Genevois, 74370 Annecy, France;
| | - Charlée Nardin
- Université de Franche-Comté, CHU Besançon, EFS, INSERM, UMR RIGHT, 25000 Besançon, France;
| | - Nathalie Beneton
- Department of Dermatology, Centre Hospitalier du Mans, 72037 Le Mans, France;
| | - Mona Amini Adle
- Oncodermatology Department Centre Léon Bérard, 69008 Lyon, France;
| | - Elisa Funck-Brentano
- Department of Dermatology, EA4340-BECCOH, Hôpital Ambroise Paré APHP, Université Paris-Saclay, 92100 Boulogne-Billancourt, France; (C.L.); (E.F.-B.)
| | - Vincent Descamps
- Department of Dermatology, Hôpital Bichat AP-HP, Université Paris Cité, 75018 Paris, France; (C.R.); (V.D.)
| | - Lorry Hachon
- Department of Pharmacy, Hôpital Bichat, AP-HP, 75018 Paris, France;
| | - Nausicaa Malissen
- Dermatology and Skin Cancer Department, APHM, CRCM Inserm U1068, CNRS U7258, CHU Timone, Aix Marseille University, 13007 Marseille, France;
| | - Barouyr Baroudjian
- Department of Dermato-Oncology, Hôpital Saint-Louis AP-HP, Inserm U976, Université Paris Cité, 75010 Paris, France;
| | - Florence Brunet-Possenti
- Department of Dermatology, Hôpital Bichat AP-HP, Université Paris Cité, 75018 Paris, France; (C.R.); (V.D.)
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2
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Magen A, Hamon P, Fiaschi N, Soong BY, Park MD, Mattiuz R, Humblin E, Troncoso L, D'souza D, Dawson T, Kim J, Hamel S, Buckup M, Chang C, Tabachnikova A, Schwartz H, Malissen N, Lavin Y, Soares-Schanoski A, Giotti B, Hegde S, Ioannou G, Gonzalez-Kozlova E, Hennequin C, Le Berichel J, Zhao Z, Ward SC, Fiel I, Kou B, Dobosz M, Li L, Adler C, Ni M, Wei Y, Wang W, Atwal GS, Kundu K, Cygan KJ, Tsankov AM, Rahman A, Price C, Fernandez N, He J, Gupta NT, Kim-Schulze S, Gnjatic S, Kenigsberg E, Deering RP, Schwartz M, Marron TU, Thurston G, Kamphorst AO, Merad M. Intratumoral dendritic cell-CD4 + T helper cell niches enable CD8 + T cell differentiation following PD-1 blockade in hepatocellular carcinoma. Nat Med 2023; 29:1389-1399. [PMID: 37322116 PMCID: PMC11027932 DOI: 10.1038/s41591-023-02345-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 04/10/2023] [Indexed: 06/17/2023]
Abstract
Despite no apparent defects in T cell priming and recruitment to tumors, a large subset of T cell rich tumors fail to respond to immune checkpoint blockade (ICB). We leveraged a neoadjuvant anti-PD-1 trial in patients with hepatocellular carcinoma (HCC), as well as additional samples collected from patients treated off-label, to explore correlates of response to ICB within T cell-rich tumors. We show that ICB response correlated with the clonal expansion of intratumoral CXCL13+CH25H+IL-21+PD-1+CD4+ T helper cells ("CXCL13+ TH") and Granzyme K+ PD-1+ effector-like CD8+ T cells, whereas terminally exhausted CD39hiTOXhiPD-1hiCD8+ T cells dominated in nonresponders. CD4+ and CD8+ T cell clones that expanded post-treatment were found in pretreatment biopsies. Notably, PD-1+TCF-1+ (Progenitor-exhausted) CD8+ T cells shared clones mainly with effector-like cells in responders or terminally exhausted cells in nonresponders, suggesting that local CD8+ T cell differentiation occurs upon ICB. We found that these Progenitor CD8+ T cells interact with CXCL13+ TH within cellular triads around dendritic cells enriched in maturation and regulatory molecules, or "mregDC". These results suggest that discrete intratumoral niches that include mregDC and CXCL13+ TH control the differentiation of tumor-specific Progenitor exhasuted CD8+ T cells following ICB.
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Affiliation(s)
- Assaf Magen
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pauline Hamon
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nathalie Fiaschi
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Brian Y Soong
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew D Park
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raphaël Mattiuz
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Etienne Humblin
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leanna Troncoso
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Darwin D'souza
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Travis Dawson
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joel Kim
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven Hamel
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mark Buckup
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christie Chang
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexandra Tabachnikova
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hara Schwartz
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nausicaa Malissen
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yonit Lavin
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alessandra Soares-Schanoski
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bruno Giotti
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Samarth Hegde
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giorgio Ioannou
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edgar Gonzalez-Kozlova
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Clotilde Hennequin
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jessica Le Berichel
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zhen Zhao
- The Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen C Ward
- The Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Isabel Fiel
- The Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Baijun Kou
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Michael Dobosz
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Lianjie Li
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Christina Adler
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Min Ni
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Yi Wei
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Wei Wang
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Gurinder S Atwal
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Kunal Kundu
- VI NEXT, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Kamil J Cygan
- VI NEXT, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Alexander M Tsankov
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adeeb Rahman
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Namita T Gupta
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Seunghee Kim-Schulze
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sacha Gnjatic
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ephraim Kenigsberg
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raquel P Deering
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Myron Schwartz
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Thomas U Marron
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Gavin Thurston
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.
| | - Alice O Kamphorst
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Miriam Merad
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Institute for Thoracic Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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3
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Malissen N, Grob JJ. Treatment of Recurrent Melanoma Following Adjuvant Therapy. Am J Clin Dermatol 2023; 24:333-341. [PMID: 36890427 DOI: 10.1007/s40257-023-00762-y] [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] [Accepted: 01/31/2023] [Indexed: 03/10/2023]
Abstract
In the era of effective therapies in melanoma, notably the widespread use of two types of adjuvant treatments: anti-PD-1 immunotherapies and therapies targeting the mitogen-activated protein kinase pathway, for BRAF-mutant patients, an important question arises about how to treat these patients in case of recurrent melanoma following adjuvant therapy. Prospective data are lacking in this area and might be difficult to obtain due to the constant progress being made in the field. Therefore, we reviewed available data suggesting that the initial adjuvant treatment received and the following events provide information about the biology of the disease and the probability of response to following systemic treatments. Thus, in case of relapse during or just after adjuvant anti-PD-1, immune resistance is probable, an anti-PD-1 monotherapy rechallenge has a low likelihood of clinical benefit, and escalation with a combination of immunotherapies should be given priority. In case of relapse during treatment with BRAF plus MEK inhibitors, there may be a risk of lower efficacy of immunotherapy than in naïve patients since this relapse attests not only to a resistance to BRAF-MEK inhibition, but also the introduction of immunotherapy to rescue a progression on targeted therapy. In case of relapse long after adjuvant treatment cessation, whatever the treatment received, no conclusion can be drawn about the efficacy of these drugs, and these patients can be treated like naïve patients. Thus, a combination of anti-PD-1 and anti-CTLA4 is probably the best solution, and the following line can be BRAF-MEK inhibitors in BRAF-mutated patients. Finally, in case of recurrent melanoma following adjuvant therapy, given the promising upcoming strategies, inclusion in a clinical trial should be offered as frequently as possible.
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Affiliation(s)
- Nausicaa Malissen
- Dermatology and Skin Cancer Department, Aix Marseille University, APHM, CRCM Inserm U1068, CNRS U7258, CHU Timone, 13005, Marseille, France.
| | - Jean-Jacques Grob
- Dermatology and Skin Cancer Department, Aix Marseille University, APHM, CRCM Inserm U1068, CNRS U7258, CHU Timone, 13005, Marseille, France
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4
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Leader AM, Grout JA, Maier BB, Nabet BY, Park MD, Tabachnikova A, Chang C, Walker L, Lansky A, Le Berichel J, Troncoso L, Malissen N, Davila M, Martin JC, Magri G, Tuballes K, Zhao Z, Petralia F, Samstein R, D'Amore NR, Thurston G, Kamphorst AO, Wolf A, Flores R, Wang P, Müller S, Mellman I, Beasley MB, Salmon H, Rahman AH, Marron TU, Kenigsberg E, Merad M. Single-cell analysis of human non-small cell lung cancer lesions refines tumor classification and patient stratification. Cancer Cell 2021; 39:1594-1609.e12. [PMID: 34767762 PMCID: PMC8728963 DOI: 10.1016/j.ccell.2021.10.009] [Citation(s) in RCA: 130] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 01/25/2021] [Accepted: 10/18/2021] [Indexed: 12/15/2022]
Abstract
Immunotherapy is a mainstay of non-small cell lung cancer (NSCLC) management. While tumor mutational burden (TMB) correlates with response to immunotherapy, little is known about the relationship between the baseline immune response and tumor genotype. Using single-cell RNA sequencing, we profiled 361,929 cells from 35 early-stage NSCLC lesions. We identified a cellular module consisting of PDCD1+CXCL13+ activated T cells, IgG+ plasma cells, and SPP1+ macrophages, referred to as the lung cancer activation module (LCAMhi). We confirmed LCAMhi enrichment in multiple NSCLC cohorts, and paired CITE-seq established an antibody panel to identify LCAMhi lesions. LCAM presence was found to be independent of overall immune cell content and correlated with TMB, cancer testis antigens, and TP53 mutations. High baseline LCAM scores correlated with enhanced NSCLC response to immunotherapy even in patients with above median TMB, suggesting that immune cell composition, while correlated with TMB, may be a nonredundant biomarker of response to immunotherapy.
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Affiliation(s)
- Andrew M Leader
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John A Grout
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara B Maier
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barzin Y Nabet
- Department of Oncology Biomarker Development, Genentech, South San Francisco, CA, USA
| | - Matthew D Park
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexandra Tabachnikova
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christie Chang
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laura Walker
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alona Lansky
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jessica Le Berichel
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leanna Troncoso
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nausicaa Malissen
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Dermatology and Skin Cancer, APHM, CHU Timone, Aix-Marseille University, Marseille, France
| | - Melanie Davila
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jerome C Martin
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nantes Université, CHU Nantes, Inserm, Centre de Recherche en Transplantation et Immunologie, UMR 1064, 44000 Nantes, France; CHU Nantes, Nantes Université, Laboratoire d'Immunologie, 44000 Nantes, France
| | - Giuliana Magri
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin Tuballes
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zhen Zhao
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francesca Petralia
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Samstein
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Natalie Roy D'Amore
- Immuno-oncology Drug Discovery Unit, Millennium Pharmaceuticals, Inc. a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Gavin Thurston
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Alice O Kamphorst
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea Wolf
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raja Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pei Wang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sören Müller
- Department of Bioinformatics and Computational Biology, Genentech, South San Francisco, CA, USA
| | - Ira Mellman
- Department of Cancer Immunology, Genentech, South San Francisco, CA, USA
| | - Mary Beth Beasley
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hélène Salmon
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adeeb H Rahman
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Thomas U Marron
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ephraim Kenigsberg
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Miriam Merad
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Thoracic Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Hamon P, Magen A, Kim J, Buckup M, Troncoso L, Hamel S, Berichel JL, Barboy O, David E, Tabachnikova A, Chang C, Zhao Z, Cohen M, Giladi A, Malissen N, Desland F, Amit I, Kenigsberg E, Schwartz M, Marron T, Merad M. 685 Characterization of molecular and spatial diversity of macrophages in hepatocellular carcinoma. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundHepatocellular carcinoma (HCC) has a dismal prognosis, and though checkpoint blocking antibodies have significantly improved patient outcome, many patients remain left out, highlighting the need to identify additional immune target to enhance therapeutic immunity. Macrophages (MF) are an abundant and heterogeneous population in the tumor microenvironment (TME), and are associated with a poor prognosis in multiple tumor types, including HCC, however, their molecular and functional diversity is still poorly understood.MethodsWe analyzed the molecular and spatial organization patterns of immune cells within the TME and adjacent tissue of 26 resected HCC lesions using single-cell RNA sequencing and multiplex immunohistochemistry (IHC).ResultsWe found that Kupffer cells, the self-renewing tissue-resident macrophages in liver tissue, are lacking from the TME, which is dominated by monocyte-derived macrophages. ScRNAseq followed by high-resolution clustering identified distinct MF molecular programs within the monocyte-derived macrophage compartment. One MF subset expressed a shared signature with monocytes including FCN1, S100A8 and T cell activation genes like CXCL9 and IL32. Conversely, one subset of MF expressed FOLR2, SEPP1 and genes of the complement (C1Qs), a program shared with KC in the adjacent tissue, and include another intratumoral subset enriched for the expression of TREM2 and GPNMB. Guided by these results, we are developing an IHC antibody panel that allows to visualize distinct MF localization in the TME. Intratumoral MF interface with, and potentially regulate, the T cell compartment within the TME. We are analyzing HCC tumor lesions in our treatment-naïve cohort and in patients treated with neoadjuvant anti-PD-1 therapy (NCT03916627) to study co-localization and direct interaction of MF and T cells using physically-interacting cell sequencing (PICseq). This analysis enables us to identify MF with direct cell-cell contact with T cells, and our preliminary analysis demonstrates an enrichment in MF with an immunosuppressive phenotype. We are also using spatial transcriptomic to map molecular programs of MF in the TME, that we will corroborated with additional patients.ConclusionsTaken together, our data provide a new understanding of intratumoral MF diversity and highlight the presence of specific immunoregulatory MF programs unique to tumor lesions, with subsets of these MF found to be directly interacting with T cells, potentially modulating anti-tumor responsiveness. Our analysis of resected tumor from anti-PD-1 treated patients, will allow us to correlate MF programs, and direct T cell interaction, with clinical response, and will inform therapeutic trials targeting specific MF populations so as to improve clinical efficacy of cancer immunotherapy.Trial RegistrationNCT03916627Ethics ApprovalSamples of tumor and non-involved liver were obtained from surgical specimens of patients undergoing resection at Mount Sinai Hospital (New York, NY) after obtaining informed consent in accordance with a protocol reviewed and approved by the Institutional Review Board at the Icahn School of Medicine at Mount Sinai (RUTH Human Subjects Electronic Submission System 18–00407 and 20–04150) and in collaboration with the Biorepository and Department of Pathology.
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6
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Malissen N, Ninove L, de Lamballerie X, André N, Gaudy-Marqueste C. Safety and immunogenicity after 2 doses of the BNT162b2 COVID-19 vaccine in an early-phase oncology trial centre population. Eur J Cancer 2021; 156:125-126. [PMID: 34438245 PMCID: PMC8352671 DOI: 10.1016/j.ejca.2021.07.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Nausicaa Malissen
- Centre d'Essais Précoces en Cancérologie de Marseille CLIP(2), Aix Marseille University, Assistance Publique Hôpitaux de Marseille, CNRS, INSERM, CRCM, Marseille, France; Department of Dermatology and Skin Cancer, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, CNRS, INSERM, CRCM, Marseille, France.
| | - Laetitia Ninove
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France
| | - Nicolas André
- Centre d'Essais Précoces en Cancérologie de Marseille CLIP(2), Aix Marseille University, Assistance Publique Hôpitaux de Marseille, CNRS, INSERM, CRCM, Marseille, France; Department of Pediatric Oncology, La Timone Children's Hospital, AP-HM, Marseille, France; Metronomics Global Health Initiative, Marseille, France
| | - Caroline Gaudy-Marqueste
- Centre d'Essais Précoces en Cancérologie de Marseille CLIP(2), Aix Marseille University, Assistance Publique Hôpitaux de Marseille, CNRS, INSERM, CRCM, Marseille, France; Department of Dermatology and Skin Cancer, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, CNRS, INSERM, CRCM, Marseille, France
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7
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Bichon A, Brue A, Godefroy R, Sallee M, Daniel L, Farnarier C, Gobin N, Abed S, Richard MA, Villani P, Malissen N, Daumas A. [Minimal change nephropathy and IgA deposits associated with a Sezary syndrome]. Rev Med Interne 2021; 43:48-53. [PMID: 34419323 DOI: 10.1016/j.revmed.2021.08.006] [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: 07/07/2021] [Revised: 07/19/2021] [Accepted: 08/01/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The Sézary syndrome (SS) is an aggressive form of cutaneous T-cell lymphoma (CTCL) requiring a rapid diagnosis due to its poor prognosis. CASE REPORT We report the first case of an eighty-nine-year-old woman who presented with concomitant Sezary syndrome and anasarca, revealing a nephrotic syndrome caused by a minimal change nephropathy associated with immunoglobulin A (IgA) deposits. Scarce literature described rare cases associating these two entities (nephrotic syndrome and nephropathy). However, the nephrotic syndrome was delayed from disease onset, secondary to immunosuppressive treatment of SS, or due to the weaning of SS therapy. Thus, the direct link between the glomerular lesion and the cutaneous lymphoma was difficult to establish. However, the synchronous occurrence of both SS and glomerulopathy in our patient, along with Sezary cells in both urines (urinary cytology) and biopsy, and resolution of nephropathy after treatment of SS, support the likely attributability of SS in glomerulopathy. CONCLUSION Practitioners must acknowledge the possible occurrence of glomerular involvement in SS.
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Affiliation(s)
- A Bichon
- Service de médecine interne, gériatrie et thérapeutique, Aix-Marseille Université, AP-HM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - A Brue
- Service de dermatologie et cancérologie cutanée, Hôpital de la Timone, Aix-Marseille Université, AP-HM, Marseille, France
| | - R Godefroy
- Service de néphrologie et de transplantation rénale, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France
| | - M Sallee
- Service de néphrologie et de transplantation rénale, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France
| | - L Daniel
- Laboratoire d'anatomie pathologique, Hôpital de la Timone, Aix-Marseille Université, AP-HM, Marseille, France
| | - C Farnarier
- Laboratoire d'immunologie, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France
| | - N Gobin
- Service de médecine interne, gériatrie et thérapeutique, Aix-Marseille Université, AP-HM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - S Abed
- Laboratoire d'immunologie, Hôpital de la Conception, Aix-Marseille Université, AP-HM, Marseille, France
| | - M A Richard
- Service de dermatologie et cancérologie cutanée, Hôpital de la Timone, Aix-Marseille Université, AP-HM, Marseille, France
| | - P Villani
- Service de médecine interne, gériatrie et thérapeutique, Aix-Marseille Université, AP-HM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - N Malissen
- Service de dermatologie et cancérologie cutanée, Hôpital de la Timone, Aix-Marseille Université, AP-HM, Marseille, France
| | - A Daumas
- Service de médecine interne, gériatrie et thérapeutique, Aix-Marseille Université, AP-HM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
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8
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Malissen N, Farvacque G, Duconseil P, Birnbaum DJ, Falque C, Macagno N, Grob JJ, Gaudy-Marqueste C, Moutardier V. Surgery of small bowel melanoma metastases in the era of efficient medical therapies: a retrospective cohort study. Melanoma Res 2021; 31:358-365. [PMID: 34039940 DOI: 10.1097/cmr.0000000000000737] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Surgery of small bowel melanoma metastases has to be reconsidered in the era of targeted treatments and immunotherapy. To retrospectively assess context and outcomes of small bowel melanoma metastases resections. All consecutive melanoma patients who underwent resection of small bowel metastases between 2011 and 2017, in a single referral center, were retrospectively analyzed through melanoma-specific survival (MSS). A total of 20 patients were included with a 47.8 months median follow-up. Before small bowel surgery, eight patients (40%) were asymptomatic while seven had anemia and five patients had abdominal pain. All resections were decided on tumor boards except for three surgeries performed in the emergency setting. In the whole cohort, MSS was 89.5 months with 50% of patients alive at the study endpoint. We classified surgical indications in three groups: (1) surgery as a pivotal treatment for mono- or oligo-metastases limited to the small bowel (n = 6); (2) salvage surgery for symptomatic patients in order to preserve their chances to switch to an active line of medical treatment (n = 8); and (3) surgery of small bowel dissociated metastatic progression for patients otherwise controlled (n = 6), aiming at keeping patients with the same treatment or active follow-up. In these three situations, the objective of surgery was usually met, and most patients had a long median MSS after surgery: 70.3 months, 89.5 months and 72.4 months, respectively. Although medical treatments have dramatically improved survival in metastatic melanoma, surgical control of life-threatening localization like small bowel metastases is often a condition for long survival.
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Affiliation(s)
| | - Georges Farvacque
- Department of Digestive Surgery, INSERM, CRCM, APHM, CHU Nord, Hôpital Nord
| | - Pauline Duconseil
- Department of Digestive Surgery, INSERM, CRCM, APHM, CHU Nord, Hôpital Nord
| | | | | | - Nicolas Macagno
- Department of Pathology, Aix Marseille University, INSERM, MMG, APHM, CHU Timone, CHU la Timone, Marseille, France
| | | | | | - Vincent Moutardier
- Department of Digestive Surgery, INSERM, CRCM, APHM, CHU Nord, Hôpital Nord
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9
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Hamon P, Magen A, Cohen M, Tabachnikova A, Chang C, Buckup M, Troncoso L, Zhao Z, Kim J, Giladi A, Malissen N, Desland F, Berichel JL, Amit I, Kenigsberg E, Schwartz M, Marron T, Merad M. Abstract 64: Characterization of molecular and spatial diversity of macrophages in hepatocellular carcinoma. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-64] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Hepatocellular carcinoma (HCC) has a dismal prognosis, and though checkpoint blocking antibodies have significantly improved patient outcome, many patients remain left out highlighting the need to identify additional immune target to enhance therapeutic immunity. Macrophages (MΦ) are an abundant and heterogeneous population in the tumor microenvironment (TME), and are associated with a poor prognosis in multiple tumor types, including HCC, however, their molecular and functional diversity is still poorly understood. We analyzed the molecular and spatial organization patterns of immune cells within the TME and adjacent tissue of 23 resected HCC lesions using single-cell RNA sequencing and multiplex immunohistochemistry (IHC). Strikingly, we found that Kupffer cells (KC), the self-renewing tissue-resident macrophages in liver tissue, are lacking from the TME, which is dominated by monocyte-derived macrophages. ScRNAseq followed by high-resolution clustering identified distinct MΦ molecular programs within the monocyte-derived macrophage compartment. One MΦ subset expressed a shared signature with monocytes including FCN1 and S100A8 in addition to T cell activation genes like CXCL9 and IL32. Conversely, one subset of MΦ expressed FOLR2, SEPP1 and genes of the complement (C1Qs), a program shared with KC in the adjacent uninvolved tissue, and include another intratumoral subset enriched for the expression of TREM2 and GPNMB. Guided by these results, we are developing an IHC antibody panel that allows to visualize distinct MΦ localization in the TME. Intratumoral MΦ interface with, and potentially regulate, the T cell compartment within the TME. We are analyzing HCC tumor lesions in our treatment-naïve cohort and in patients treated with neoadjuvant anti-PD-1 therapy (NCT03916627) to study direct interaction of MΦ and T cells using an innovative technology of physically-interacting cell sequencing (PICseq). This analysis enables us to identify MΦ with direct cell-cell contact with T cells, and our preliminary analysis demonstrates an enrichment in MΦ with a highly immunosuppressive phenotype. We are also using PICseq to map the molecular program of MΦ that are interacting with T cells and that we will corroborated with additional patients. Taken together, our data provide a new understanding of intratumoral MΦ diversity and highlight the presence of specific immunoregulatory MΦ programs unique to tumor lesions, with subsets of these MΦ found to be directly interacting with T cells, potentially modulating anti-tumor responsiveness. Our analysis of resected tumor from anti-PD-1 treated patients, will allow us to correlate MΦ programs, and direct T cell interaction, with clinical response, and will inform therapeutic trials targeting specific MΦ populations so as to improve clinical efficacy of cancer immunotherapy.
Citation Format: Pauline Hamon, Assaf Magen, Merav Cohen, Alexandra Tabachnikova, Christie Chang, Mark Buckup, Leanna Troncoso, Zhen Zhao, Joel Kim, Amir Giladi, Nausicaa Malissen, Fiona Desland, Jessica Le Berichel, Ido Amit, Ephraim Kenigsberg, Myron Schwartz, Thomas Marron, Miriam Merad. Characterization of molecular and spatial diversity of macrophages in hepatocellular carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 64.
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Affiliation(s)
- Pauline Hamon
- 1Icahn School of Medicine at Mount Sinai, New York, NY
| | - Assaf Magen
- 1Icahn School of Medicine at Mount Sinai, New York, NY
| | - Merav Cohen
- 2Weizmann Institute of Science, Rehovot, Israel
| | | | | | - Mark Buckup
- 1Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Zhen Zhao
- 1Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joel Kim
- 1Icahn School of Medicine at Mount Sinai, New York, NY
| | - Amir Giladi
- 2Weizmann Institute of Science, Rehovot, Israel
| | | | - Fiona Desland
- 1Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Ido Amit
- 2Weizmann Institute of Science, Rehovot, Israel
| | | | | | - Thomas Marron
- 1Icahn School of Medicine at Mount Sinai, New York, NY
| | - Miriam Merad
- 1Icahn School of Medicine at Mount Sinai, New York, NY
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10
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Gondois-Rey F, Paul M, Alcaraz F, Bourass S, Monnier J, Malissen N, Grob JJ, Bruger AM, Van Der Bruggen P, Gaudy-Marqueste C, Olive D. Identification of an Immature Subset of PMN-MDSC Correlated to Response to Checkpoint Inhibitor Therapy in Patients with Metastatic Melanoma. Cancers (Basel) 2021. [PMID: 33802925 DOI: 10.3390/cancers13061362.pmid:33802925;pmcid:pmc8002694] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
PMN-MDSCs support tumor progression and resistance to ICI therapy through their suppressive functions but their heterogeneity limits their use as biomarkers in cancer. Our aim was to investigate the phenotypic and functional subsets of PMN-MDSCs to identify biomarkers of response to ICI therapy. We isolated low-density CD15+ PMNs from patients with metastatic melanoma and assessed their immune-suppressive capacities. Expression of CD10 and CD16 was used to identify mature and immature subsets and correlate them to inhibition of T cell proliferation or direct cytotoxicity. Frequencies of the PMN-MDSCs subsets were next correlated to the radiological response of 36 patients receiving ICI therapy. Mature activated cells constituted the major population of PMN-MDSCs. They were found in a higher proportion in the pre-treatment blood of patients non responders to ICI. A subset of immature cells characterized by intermediate levels of CD10 and CD16, the absence of expression of SIRPα and a strong direct cytotoxicity to T cells was increased in patients responding to ICI. The paradoxical expansion of such cells during ICI therapy suggests a role of PMNs in the inflammatory events associated to efficient ICI therapy and the usefulness of their monitoring in patients care.
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Affiliation(s)
- Françoise Gondois-Rey
- Immunity and Cancer Team, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, CNRS, UMR7258, Institut Paoli-Calmettes, Aix Marseille University, UM105, 13009 Marseille, France
| | - Magali Paul
- Immunity and Cancer Team, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, CNRS, UMR7258, Institut Paoli-Calmettes, Aix Marseille University, UM105, 13009 Marseille, France
| | - Florence Alcaraz
- Immunity and Cancer Team, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, CNRS, UMR7258, Institut Paoli-Calmettes, Aix Marseille University, UM105, 13009 Marseille, France
| | - Sarah Bourass
- Immunity and Cancer Team, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, CNRS, UMR7258, Institut Paoli-Calmettes, Aix Marseille University, UM105, 13009 Marseille, France
| | - Jilliana Monnier
- Service de Dermatologie et de Cancérologie Cutanée, Hôpital de la Timone, 13005 Marseille, France
| | - Nausicaa Malissen
- Service de Dermatologie et de Cancérologie Cutanée, Hôpital de la Timone, 13005 Marseille, France
| | - Jean-Jacques Grob
- Immunity and Cancer Team, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, CNRS, UMR7258, Institut Paoli-Calmettes, Aix Marseille University, UM105, 13009 Marseille, France
- Service de Dermatologie et de Cancérologie Cutanée, Hôpital de la Timone, 13005 Marseille, France
| | - Annika M Bruger
- De Duve Institute, Université Catholique de Louvain, 1200 Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), 1200 Brussels, Belgium
| | - Pierre Van Der Bruggen
- De Duve Institute, Université Catholique de Louvain, 1200 Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), 1200 Brussels, Belgium
| | - Caroline Gaudy-Marqueste
- Immunity and Cancer Team, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, CNRS, UMR7258, Institut Paoli-Calmettes, Aix Marseille University, UM105, 13009 Marseille, France
- Service de Dermatologie et de Cancérologie Cutanée, Hôpital de la Timone, 13005 Marseille, France
| | - Daniel Olive
- Immunity and Cancer Team, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, CNRS, UMR7258, Institut Paoli-Calmettes, Aix Marseille University, UM105, 13009 Marseille, France
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Weill A, Delyon J, Descamps V, Deschamps L, Dinulescu M, Dupuy A, Célérier P, Nardin C, Aubin F, Le Corre Y, Heidelberger V, Maubec E, Malissen N, Longvert C, Machet L, Gounant V, Brosseau S, Bonniaud B, Jeudy G, Psimaras D, Doucet L, Lebbe C, Zalcman G, De Masson A, Baroudjian B, Leonard-Louis S, Hervier B, Brunet-Possenti F. Treatment strategies and safety of rechallenge in the setting of immune checkpoint inhibitors-related myositis: A national multicenter study. Rheumatology (Oxford) 2021; 60:5753-5764. [PMID: 33725115 DOI: 10.1093/rheumatology/keab249] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 10/21/2020] [Accepted: 03/04/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The occurrence of immune-related myositis (irM) is increasing, yet there are no therapeutic guidelines. We sought to analyze the current therapeutic strategies of irM and evaluate the outcomes of immune checkpoint inhibitors (ICI) rechallenge. METHODS We conducted a nationwide retrospective study between April 2018 and March 2020 including irM without myocardial involvement. Depending on the presence of cutaneous signs or unusual histopathological features, patients were classified into two groups: typical or atypical irM. Therapeutic strategies were analyzed in both groups. The modalities and outcomes of ICI rechallenge were reviewed. RESULTS Among the 20 patients, 16 presented typical irM. Regardless of severity, most typical irM were treated with steroid monotherapy (n = 14/16) and all had a complete response within ≤ 3 weeks. The efficacy of oral steroids for non-severe typical irM (n = 10) was the same with low-dose (≤ 0.5 mg/kg/day) or high-dose (1 mg/kg/day). Severe typical irM were successfully treated with intravenous methylprednisolone. Atypical irM (n = 4) had a less favorable evolution, including one irM-related death, and required heavy immunosuppression. ICI were safely reintroduced in 9 patients presenting a moderate (n = 6) or a severe (n = 3) irM. CONCLUSION Our data highlight that steroid monotherapy is an effective treatment for typical irM, either with prednisone or with intravenous methylprednisone pulses depending on the severity. The identification of unusual features is important in determining the initial therapeutic strategy. The outcomes of rechallenged patients are in favor of a safe reintroduction of ICI following symptom resolution and CK normalization in moderate and severe forms of irM.
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Affiliation(s)
- Amandine Weill
- Department of Dermatology, Hôpital Bichat, AP-HP, Université de Paris, Paris, France
| | - Julie Delyon
- Department of Dermatology, Hôpital Saint Louis, AP-HP, Université de Paris, Paris, France
| | - Vincent Descamps
- Department of Dermatology, Hôpital Bichat, AP-HP, Université de Paris, Paris, France
| | - Lydia Deschamps
- Department of Pathology, Hôpital Bichat, AP-HP, Université de Paris, Paris, France
| | - Monica Dinulescu
- Department of Dermatology, CHU de Rennes, Université de Rennes, Rennes, France
| | - Alain Dupuy
- Department of Dermatology, CHU de Rennes, Université de Rennes, Rennes, France
| | | | - Charlee Nardin
- Department of Dermatology, CHU de Besançon, Université de Franche Comté, Besançon, France
| | - François Aubin
- Department of Dermatology, CHU de Besançon, Université de Franche Comté, Besançon, France
| | - Yannick Le Corre
- Department of Dermatology, CHU d'Angers, Université LUNAM, Angers, France
| | - Valentine Heidelberger
- Department of Dermatology, Hôpital Avicenne, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | - Eve Maubec
- Department of Dermatology, Hôpital Avicenne, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | - Nausicaa Malissen
- Department of Dermatology, Hôpital La Timone, AP-HM, Université d'Aix-Marseille, Marseille, France
| | - Christine Longvert
- Department of Dermatology, Hôpital Ambroise-Paré, AP-HP, Boulogne-Billancourt, France
| | - Laurent Machet
- Dermatology Department, CHRU de Tours, Université de Tours, Tours, France
| | - Valérie Gounant
- Department of Thoracic Oncology, Hôpital Bichat, AP-HP, Université de Paris, Paris, France
| | - Solenne Brosseau
- Department of Thoracic Oncology, Hôpital Bichat, AP-HP, Université de Paris, Paris, France
| | - Bertille Bonniaud
- Department of Dermatology, Hôpital universitaire de Dijon, Dijon, France
| | - Géraldine Jeudy
- Department of Dermatology, Hôpital universitaire de Dijon, Dijon, France
| | - Dimitri Psimaras
- Department of Neurology, Hôpital La Pitié Salpétrière, AP-HP, Université Sorbonne Paris Centre, Paris, France
| | - Ludovic Doucet
- Department of Oncology, Hôpital Saint Louis, AP-HP, Université 7, Paris, France
| | - Céleste Lebbe
- Department of Dermatology, Hôpital Saint Louis, AP-HP, Université de Paris, Paris, France
| | - Gérard Zalcman
- Department of Thoracic Oncology, Hôpital Bichat, AP-HP, Université de Paris, Paris, France
| | - Adèle De Masson
- Department of Dermatology, Hôpital Saint Louis, AP-HP, Université de Paris, Paris, France
| | - Barouyr Baroudjian
- Department of Dermatology, Hôpital Saint Louis, AP-HP, Université de Paris, Paris, France
| | - Sarah Leonard-Louis
- Department of Neuropathology, Hôpital La Pitié Salpétrière, AP-HP, Université Sorbonne Paris Centre, Paris, France
| | - Baptiste Hervier
- Department of Internal Medicine, Hôpital Saint Louis, AP-HP, Université de Paris, Paris, France
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Funck-Brentano E, Malissen N, Roger A, Lebbé C, Deilhes F, Frénard C, Dréno B, Meyer N, Grob JJ, Tétu P, Saiag P. Which adjuvant treatment for patients with BRAF V600-mutant cutaneous melanoma? Ann Dermatol Venereol 2021; 148:145-155. [PMID: 33579557 DOI: 10.1016/j.annder.2020.11.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/22/2020] [Accepted: 11/05/2020] [Indexed: 12/21/2022]
Abstract
Treatment of patients with melanoma has considerably improved over the past decade and more recently with adjuvant therapies for patients with American Joint Committee on Cancer (AJCC) stage III (loco-regional metastases) or IV (distant metastases) totally resected melanoma, in order to prevent recurrence. In the adjuvant setting, two options are available to patients with BRAFV600-mutant AJCC stage III totally resected melanoma: anti-PD-1 blockers (nivolumab or pembrolizumab) or BRAF plus MEK inhibitors (dabrafenib plus trametinib). In the absence of comparative studies, it is difficult to determine which of these options is best. Our aim was to review published studies focusing on the management of patients with BRAFV600-mutant melanoma in the adjuvant setting. We also reviewed the main clinical trials of BRAF plus MEK inhibitors and immunotherapy in advanced (i.e. unresectable metastatic) BRAF-mutant melanoma in an attempt to identify results potentially affecting the management of patients on adjuvants. More adverse events are observed with targeted therapy, but all resolve rapidly upon drug discontinuation, whereas with immune checkpoint blockers some adverse events may persist. New therapeutic strategies are emerging, notably neoadjuvant therapies for stage III patients and adjuvant therapies for stage II patients; the place of the adjuvant strategy amidst all these options will soon be re-evaluated. The choice of adjuvant treatment could influence the choice of subsequent treatments in neo-adjuvant or metastatic settings. This review will lead clinicians to a better understanding of the different adjuvant treatments available for patients with totally resected AJCC stage III and IV BRAFV600-mutant melanoma before considering subsequent treatment strategies.
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Affiliation(s)
- E Funck-Brentano
- Department of General and Oncologic Dermatology, Ambroise-Paré hospital, AP-HP, Boulogne-Billancourt, France; Research unit EA4340 "Biomarkers and clinical trials in oncology and onco-hematology", Versailles-Saint-Quentin-en-Yvelines University, Paris-Saclay University, France.
| | - N Malissen
- Department of Dermatology and Skin Cancer, Aix-Marseille University, AP-HM, Hôpital Timone, Marseille, France
| | - A Roger
- Department of General and Oncologic Dermatology, Ambroise-Paré hospital, AP-HP, Boulogne-Billancourt, France; Research unit EA4340 "Biomarkers and clinical trials in oncology and onco-hematology", Versailles-Saint-Quentin-en-Yvelines University, Paris-Saclay University, France
| | - C Lebbé
- Inserm U976, Department of Dermatology, Dermatology, Paris University, Hôpital Saint-Louis, AP-HP, Paris, France
| | - F Deilhes
- Dermatology Department, CHU de Toulouse, Toulouse, France
| | - C Frénard
- Department of Dermatology, CRCINA, CIC1413, CHU de Nantes, université de Nantes, Nantes, France
| | - B Dréno
- Department of Dermatology, CRCINA, CIC1413, CHU de Nantes, université de Nantes, Nantes, France
| | - N Meyer
- Dermatology Department, CHU de Toulouse, Toulouse, France
| | - J-J Grob
- Department of Dermatology and Skin Cancer, Aix-Marseille University, AP-HM, Hôpital Timone, Marseille, France
| | - P Tétu
- Department of Dermatology, CRCINA, CIC1413, CHU de Nantes, université de Nantes, Nantes, France
| | - P Saiag
- Department of General and Oncologic Dermatology, Ambroise-Paré hospital, AP-HP, Boulogne-Billancourt, France; Research unit EA4340 "Biomarkers and clinical trials in oncology and onco-hematology", Versailles-Saint-Quentin-en-Yvelines University, Paris-Saclay University, France
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13
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Radulesco T, Mancini J, Penicaud M, Grob JJ, Richard MA, Dessi P, Malissen N, Michel J. Cross-cultural adaptation into French and validation of the SCAR-Q questionnaire. Qual Life Res 2021; 30:1225-1231. [PMID: 33389488 DOI: 10.1007/s11136-020-02719-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Most questionnaires designed to evaluate patient-reported outcomes regarding scarring are available in English. The objective was to generate a validated French version of the SCAR-Q questionnaire. METHODS The SCAR-Q questionnaire (including Appearance, Symptom and Psychological impact scales) was translated into French using a translation-back-translation process in accordance with international guidelines (ISPOR and WHO). For validation, two hundred patients consulting in our tertiary center completed the questionnaire. We tested scale reliability (Cronbach's α), floor/ceiling effects and item redundancy (inter-item correlations). Structural validity was tested using confirmatory factor analysis (CFA) with the robust weighted least squares (WLSMV) estimator and Delta parameterization. Model fit was examined using the root mean square error of approximation (RMSEA), the comparative fit index (CFI) and the Tucker-Lewis index (TLI). Correlations between scales and scale repeatability were tested (Spearman coefficient, Intra-class-coefficient). RESULTS Four steps were required to obtain a translation consistent with the original version. Two hundred patients completed the questionnaire for validation. Internal consistency analysis found Cronbach's alphas > 0.7 for all scales (0.90 < α < 0.97). No floor or ceiling effect was found for all items (max = 85%). A ceiling effect was observed for all scales. Appearance and psychosocial impact scale items showed redundancy, with many inter-item correlations above 0.7. The CFA of the original structure displayed a reasonable fit, with RMSEA = 0.065, CFI = 0.974 and TLI = 0.972. Scales were positively correlated (0.45 < ρ < 0.65; p < 0.001). Test-retest intra-class correlation coefficients ranged from 0.94 to 0.99 for all scales. CONCLUSION A French version of the SCAR-Q questionnaire is validated, ready for use.
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Affiliation(s)
- Thomas Radulesco
- Aix Marseille Univ, APHM, IUSTI, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, Marseille, France.
| | - Julien Mancini
- Department of Public Health (BIOSTIC), Aix-Marseille Univ, INSERM, IRD, APHM, UMR1252, SESSTIM, Aix-Marseille University, Hôpital de la Timone, Marseille, France
| | - Martin Penicaud
- APHM, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, 13385, Marseille Cedex, France
| | - Jean-Jacques Grob
- Department of Dermatology and Skin Cancer, INSERM, CRCM, APHM, CHU Timone, Aix Marseille University, Marseille, France
| | - Marie-Aleth Richard
- Dermatology Department, CEReSS-EA 3279, Research Centrer in Health Services and Quality of Life Aix Marseille University, Universitary Hospital Timone, Assistance Publique Hôpitaux de Marseille, APHM, 13385, Marseille, France
| | - Patrick Dessi
- APHM, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, 13385, Marseille Cedex, France
| | - Nausicaa Malissen
- Department of Dermatology and Skin Cancer, INSERM, CRCM, APHM, CHU Timone, Aix Marseille University, Marseille, France
| | - Justin Michel
- Aix Marseille Univ, APHM, IUSTI, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, Marseille, France
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14
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Demarez B, Amatore F, Malissen N, Gaudy C, Grob JJ, Richard MA. Facteurs de risque de pneumocystose chez les patients traités par inhibiteurs de checkpoint immunitaire et corticostéroïdes. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.103] [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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15
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Sarles C, Amatore F, Malissen N, Gaudy-Marqueste C, Grob JJ, Macagno N, Richard MA. Les dermatoses eczématiformes chroniques idiopathiques du sujet âgé : description clinique et place du méthotrexate dans leur prise en charge. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.334] [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: 12/01/2022]
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16
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Malissen N, Abed S, Macagno N, Amatore F, Loundou A, Grange F, Gaudy-Marqueste C, Grob JJ. Early Phase of Primary Melanoma Growth from the Patient Point of view: A Prospective Cross Sectional Study on Melanoma over 1 mm in Thickness. Acta Derm Venereol 2020; 100:adv00222. [PMID: 32618351 PMCID: PMC9199911 DOI: 10.2340/00015555-3591] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Most melanomas are diagnosed by the patients themselves or by their partners or relatives; they alone can describe its history. We designed a prospective cross-sectional study to describe patients’ perception of morphology, growth pattern and kinetics of their primary melanoma over 1 mm in thickness before resection. Patients were interviewed with a questionnaire, a grid representing 9 possible scenarios of melanoma growth, and a set of 87 photographs of potential aspects of melanomas and precursors. Most patients were able to describe the growth of their melanoma and select pictures representative of its successive aspects before resection. Among 453 patients, 60% reported a preexisting lesion present for years. Growth pattern scenarios concurred with tumor kinetics but with no statistical difference between nodular and superficial spreading subtypes. These subjective patient-reported indicators about melanoma growth over time could dynamically complement its objective pathological analysis otherwise static at a single time point.
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Affiliation(s)
- Nausicaa Malissen
- Department of Dermatology and Skin Cancer, CHU Timone, APHM, Aix Marseille University, INSERM, CRCM, FR-13885 Marseille, France
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17
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Amatore F, Devey S, Tabelé C, Troin L, Monestier S, Malissen N, Gaudy‐Marqueste C, Grob J, Richard M. Comparison of complementary and alternative medicine use between patients with skin cancer and inflammatory skin diseases. J Eur Acad Dermatol Venereol 2020; 34:e182-e183. [DOI: 10.1111/jdv.16142] [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: 12/01/2022]
Affiliation(s)
- F. Amatore
- Department of Dermatology and Oncodermatology Timone Hospital Marseille France
| | - S. Devey
- Department of Dermatology and Oncodermatology Timone Hospital Marseille France
| | - C. Tabelé
- Department of Pharmacy Timone Hospital Marseille France
| | - L. Troin
- Department of Dermatology and Oncodermatology Timone Hospital Marseille France
| | - S. Monestier
- Department of Dermatology and Oncodermatology Timone Hospital Marseille France
| | - N. Malissen
- Department of Dermatology and Oncodermatology Timone Hospital Marseille France
| | - C. Gaudy‐Marqueste
- Department of Dermatology and Oncodermatology Timone Hospital Marseille France
| | - J.‐J. Grob
- Department of Dermatology and Oncodermatology Timone Hospital Marseille France
| | - M.‐A. Richard
- Department of Dermatology and Oncodermatology Timone Hospital Marseille France
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18
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Guichard G, Malissen N, Amatore F, Monestier S, Richard MA, Gaudy-Marqueste C, Grob JJ. Syndromes de relargage cytokinique chez des patients traités pour un mélanome métastatique. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.110] [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: 11/28/2022]
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19
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Malissen N, Macagno N, Granjeaud S, Granier C, Moutardier V, Gaudy-Marqueste C, Habel N, Mandavit M, Guillot B, Pasero C, Tartour E, Ballotti R, Grob JJ, Olive D. HVEM has a broader expression than PD-L1 and constitutes a negative prognostic marker and potential treatment target for melanoma. Oncoimmunology 2019; 8:e1665976. [PMID: 31741766 PMCID: PMC6844309 DOI: 10.1080/2162402x.2019.1665976] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 06/05/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 10/27/2022] Open
Abstract
HVEM (Herpes Virus Entry Mediator) engagement of BTLA (B and T Lymphocyte Attenuator) triggers inhibitory signals in T cells and could play a role in evading antitumor immunity. Here, HVEM expression levels in melanoma metastases were analyzed by immunohistochemistry, correlated with overall survival (OS) in 116 patients, and validated by TCGA transcriptomic data. Coincident expression of HVEM and its ligand BTLA was studied in tumor cells and tumor-infiltrating lymphocytes (TILs) by flow cytometry (n = 21) and immunofluorescence (n = 5). Candidate genes controlling HVEM expression in melanoma were defined by bioinformatics studies and validated by siRNA gene silencing. We found that in patients with AJCC stage III and IV melanoma, OS was poorer in those with high HVEM expression on melanoma cells, than in those with a low expression, by immunohistochemistry (p = .0160) or TCGA transcriptomics (p = .0282). We showed a coincident expression of HVEM at the surface of melanoma cells and of BTLA on TILs. HVEM was more widely expressed than PD-L1 in melanoma cells. From a mechanistic perspective, in contrast to PDL1, HVEM expression did not correlate with an IFNγ signature but with an aggressive gene signature. Interestingly, this signature contained MITF, a key player in melanoma biology, whose expression correlated strongly with HVEM. Finally, siRNA gene silencing validated MITF control of HVEM expression. In conclusion, HVEM expression seems to be a prognosis marker and targeting this axis by checkpoint-inhibitors may be of interest in metastatic melanoma.
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Affiliation(s)
- Nausicaa Malissen
- Tumor Immunology Team, IBISA Immunomonitoring platform, Cancer Research Center of Marseille, INSERM U1068, CNRS U7258, Aix-Marseille University, Institut Paoli-Calmettes, Marseille, France.,INSERM, CRCM, APHM, CHU Timone, Department of Dermatology and Skin Cancer, Aix Marseille University, Marseille, France
| | - Nicolas Macagno
- INSERM, MMG, APHM, CHU Timone, Department of Pathology, Aix Marseille University, Marseille, France
| | - Samuel Granjeaud
- Tumor Immunology Team, IBISA Immunomonitoring platform, Cancer Research Center of Marseille, INSERM U1068, CNRS U7258, Aix-Marseille University, Institut Paoli-Calmettes, Marseille, France
| | - Clémence Granier
- UMR_S970, HEGP, Centre de recherche cardio-vasculaire, Paris, France
| | - Vincent Moutardier
- APHM, CHU Nord, Department of Digestive surgery, Aix Marseille University, Marseille, France
| | - Caroline Gaudy-Marqueste
- Tumor Immunology Team, IBISA Immunomonitoring platform, Cancer Research Center of Marseille, INSERM U1068, CNRS U7258, Aix-Marseille University, Institut Paoli-Calmettes, Marseille, France.,INSERM, CRCM, APHM, CHU Timone, Department of Dermatology and Skin Cancer, Aix Marseille University, Marseille, France
| | - Nadia Habel
- INSERM U 1065, Team 1 Nice, Centre Méditerranéen de Médecine Moléculaire, Nice, France
| | - Marion Mandavit
- UMR_S970, HEGP, Centre de recherche cardio-vasculaire, Paris, France
| | - Bernard Guillot
- Department of Dermatology, CHU Montpellier, Montpellier, France
| | - Christine Pasero
- Tumor Immunology Team, IBISA Immunomonitoring platform, Cancer Research Center of Marseille, INSERM U1068, CNRS U7258, Aix-Marseille University, Institut Paoli-Calmettes, Marseille, France
| | - Eric Tartour
- UMR_S970, HEGP, Centre de recherche cardio-vasculaire, Paris, France
| | - Robert Ballotti
- INSERM U 1065, Team 1 Nice, Centre Méditerranéen de Médecine Moléculaire, Nice, France
| | - Jean-Jacques Grob
- Tumor Immunology Team, IBISA Immunomonitoring platform, Cancer Research Center of Marseille, INSERM U1068, CNRS U7258, Aix-Marseille University, Institut Paoli-Calmettes, Marseille, France.,INSERM, CRCM, APHM, CHU Timone, Department of Dermatology and Skin Cancer, Aix Marseille University, Marseille, France
| | - Daniel Olive
- Tumor Immunology Team, IBISA Immunomonitoring platform, Cancer Research Center of Marseille, INSERM U1068, CNRS U7258, Aix-Marseille University, Institut Paoli-Calmettes, Marseille, France
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20
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Abstract
The prognosis of patients with metastatic melanoma has dramatically improved in recent years with the introduction of two new therapeutic strategies. BRAF and MEK inhibitors are small molecules that are able to block the mitogen-activated protein kinase (MAPK) pathway, which is constitutively activated by recurrent BRAF V600 mutations in 45% of melanoma patients. These agents were shown to provide a rapid and strong response but are often limited by a high rate of secondary resistance. Monoclonal antibodies against the immune checkpoints cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and programmed death 1 (PD-1) can restore an efficient and durable anti-tumor immunity, even following treatment discontinuation. Anti-PD-1 antibodies were shown to prolong survival of metastatic melanoma patients and a real cure seems to be obtainable in some patients. Many more therapies are currently under investigation, given that 50% of patients still do not have long-term benefits from approved treatments. The main goal is to avoid or circumvent primary or secondary immune resistance to anti-PD-1 therapy not only by targeting other players in the tumor microenvironment but also by optimizing treatment sequencing and combining anti-PD-1 with other treatments, especially with BRAF and MEK inhibitors. The unexpected major successes of immunotherapies in melanoma have opened the way for the development of these treatments in other cancers. In this review, we describe the different available treatments, their toxicities, and the key components of our decisional algorithms, and give an overview of what we expect to be the near future of melanoma treatment.
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Affiliation(s)
- Nausicaa Malissen
- Dermatology and Skin Cancer Department, Aix-Marseille University, 264, rue Saint-Pierre, 13385, Marseille, France
| | - Jean-Jacques Grob
- Dermatology and Skin Cancer Department, Aix-Marseille University, 264, rue Saint-Pierre, 13385, Marseille, France.
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21
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Escudier M, Cautela J, Malissen N, Ancedy Y, Orabona M, Pinto J, Monestier S, Grob JJ, Scemama U, Jacquier A, Lalevee N, Barraud J, Peyrol M, Laine M, Bonello L, Paganelli F, Cohen A, Barlesi F, Ederhy S, Thuny F. Clinical Features, Management, and Outcomes of Immune Checkpoint Inhibitor-Related Cardiotoxicity. Circulation 2019; 136:2085-2087. [PMID: 29158217 DOI: 10.1161/circulationaha.117.030571] [Citation(s) in RCA: 312] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Marion Escudier
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France (M.E., J.C., M.O., J.P., F.T.)
| | - Jennifer Cautela
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France (M.E., J.C., M.O., J.P., F.T.).,Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP), Marseille, France (J.C., F.B., F.T.)
| | - Nausicaa Malissen
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Department of Dermatology, Hôpital Timone, Marseille, France (N.M. S.M., J.J.G.)
| | - Yann Ancedy
- Hôpitaux Universitaires Paris-Est, Hôpital Saint Antoine, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Unité mixte de recherche, INSERM 856, Université Pierre et Marie Curie (Paris VI), France (Y.A., A.C., S.E.)
| | - Morgane Orabona
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France (M.E., J.C., M.O., J.P., F.T.)
| | - Johan Pinto
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France (M.E., J.C., M.O., J.P., F.T.)
| | - Sandrine Monestier
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Department of Dermatology, Hôpital Timone, Marseille, France (N.M. S.M., J.J.G.)
| | - Jean-Jacques Grob
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Department of Dermatology, Hôpital Timone, Marseille, France (N.M. S.M., J.J.G.)
| | - Ugo Scemama
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Department of Radiology and Cardiovascular Imaging, Hopital Nord, Marseille, France (U.S., A.J.)
| | - Alexis Jacquier
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Department of Radiology and Cardiovascular Imaging, Hopital Nord, Marseille, France (U.S., A.J.)
| | - Nathalie Lalevee
- Aix-Marseille University, Technological Advances for Genomics and Clinics (TAGC), Unité mixte de recherche/INSERM 1090, Marseille, France (N.L.)
| | - Jeremie Barraud
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.)
| | - Michael Peyrol
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.)
| | - Marc Laine
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.)
| | - Laurent Bonello
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Aix-Marseille University, Unité mixte de recherche, INSERM 1076, Marseille, France (L.B., F.P.)
| | - Franck Paganelli
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Aix-Marseille University, Unité mixte de recherche, INSERM 1076, Marseille, France (L.B., F.P.)
| | - Ariel Cohen
- Hôpitaux Universitaires Paris-Est, Hôpital Saint Antoine, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Unité mixte de recherche, INSERM 856, Université Pierre et Marie Curie (Paris VI), France (Y.A., A.C., S.E.)
| | - Fabrice Barlesi
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center (MEDI-CO Center), Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.).,Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP), Marseille, France (J.C., F.B., F.T.).,Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Multidisciplinary Oncology & Therapeutic Innovations Department, Hôpital Nord, Marseille, France (F.B.)
| | - Stephane Ederhy
- Hôpitaux Universitaires Paris-Est, Hôpital Saint Antoine, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Unité mixte de recherche, INSERM 856, Université Pierre et Marie Curie (Paris VI), France (Y.A., A.C., S.E.)
| | - Franck Thuny
- Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), France (M.E., J.C., M.O., J.P., J.B., M.P., M.L., L.B., F.P., F.T.) .,Groupe Méditerranéen de Cardio-Oncologie (gMEDICO), France (M.E., J.C., M.O., J.P., F.T.).,Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Oncosaftey Network of the Early Phases Cancer Trials Center (CLIP), Marseille, France (J.C., F.B., F.T.)
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22
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Delteil C, Malissen N, Appay R, Magis Q, Aubert S, Bouvier C, Richard MA, Macagno N. [Chordoma cutis, an unusual clinical presentation of a rare neoplasm: Chordoma]. Ann Pathol 2018; 38:126-130. [PMID: 29449046 DOI: 10.1016/j.annpat.2018.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/08/2017] [Revised: 12/06/2017] [Accepted: 01/08/2018] [Indexed: 11/26/2022]
Abstract
Chordoma cutis represents an unusual clinical presentation of a rare neoplasm. The involvement of skin or sub-cutaneous soft tissues can be the consequence of local infiltration or metastasis; the latter may occur several years following the initial diagnosis of chordoma and therefore, may pose a diagnosis challenge when the clinical history of the patient is unknown. The clinical forms, morphology, immuno-histochemical profile and the main differential diagnoses of chordoma cutis are presented here through an anatomoclinical case.
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Affiliation(s)
- Clémence Delteil
- Service d'anatomie pathologique et neuropathologie, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille cedex 5, France.
| | - Nausicaa Malissen
- Service de cancérologie cutanée, CHU Timone, Assistance publique hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - Romain Appay
- Service d'anatomie pathologique et neuropathologie, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille cedex 5, France
| | - Quentin Magis
- Service de cancérologie cutanée, CHU Timone, Assistance publique hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | | | - Corinne Bouvier
- Service d'anatomie pathologique et neuropathologie, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille cedex 5, France
| | - Marie-Aleth Richard
- Service de cancérologie cutanée, CHU Timone, Assistance publique hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - Nicolas Macagno
- Service d'anatomie pathologique et neuropathologie, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille cedex 5, France
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23
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Guichard G, Grange F, Saiag P, Charles J, Dreno B, Guillot B, Lacour JP, Gaudy C, Monestier S, Hesse S, Khammari A, Visseaux L, Kramkimel N, Finet A, Picard A, Malissen N, Troin L, Magis Q, Richard MA, Grob JJ. Il n’y a pas de surtoxicité des BRAF-MEK inhibiteurs lorsqu’ils sont prescrits immédiatement après l’arrêt des anti-PD1. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.063] [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: 10/18/2022]
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24
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Berniolles P, Abed S, Macagno N, Monestier S, Mallet S, Gaudy-Marqueste C, Grob JJ, Richard MA, Malissen N. Éruption urticarienne annulaire et ecchymotique révélant une infection à Capnocytophaga. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.479] [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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25
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Malissen N, Magis Q, Macagno N, Monestier S, Troin L, Mallet S, Gaudy-Marqueste C, Grob JJ, Richard MA. Réactions granulomateuses sur tatouage sous anti-BRAF + anti-MEK révélatrices de fausses progressions. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.165] [Citation(s) in RCA: 3] [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: 10/18/2022]
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26
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Tabélé C, Monestier S, Malissen N, Gaudy C, Mallet S, Correard F, Honoré S, Bertault-Peres P, Grob JJ, Richard MA. Intérêt des consultations pharmaceutiques de thérapies ciblées en onco-dermatologie. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.522] [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: 10/18/2022]
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27
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Malissen N, Macagno N, Monestier S, Magis Q, Troin L, Mallet S, Gaudy-Marqueste C, Grob JJ, Richard MA. Localisation élective de lentigines sur des plaques de psoriasis : pigmentation kératinocytaire basale plutôt qu’effet secondaire des traitements. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.353] [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: 10/18/2022]
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28
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Devey S, Tabelé C, Troin L, Monestier S, Gaudy C, Magis Q, Malissen N, Grob JJ, Richard MA. Traitements alternatifs en dermatologie : enquête dans un service hospitalo-universitaire. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.563] [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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29
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Magis Q, Gaudy-Marqueste C, Beliard S, Basire A, Loundou A, Malissen N, Troin L, Monestier S, Richard MA, Grob JJ. Diabète et déséquilibre glycémique sous anti-PD1. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.098] [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: 10/18/2022]
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30
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Nollet M, Stalin J, Moyon A, Traboulsi W, Essaadi A, Robert S, Malissen N, Bachelier R, Daniel L, Foucault-Bertaud A, Gaudy-Marqueste C, Lacroix R, Leroyer AS, Guillet B, Bardin N, Dignat-George F, Blot-Chabaud M. A novel anti-CD146 antibody specifically targets cancer cells by internalizing the molecule. Oncotarget 2017; 8:112283-112296. [PMID: 29348825 PMCID: PMC5762510 DOI: 10.18632/oncotarget.22736] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 07/20/2017] [Accepted: 11/14/2017] [Indexed: 12/20/2022] Open
Abstract
CD146 is an adhesion molecule present on many tumors (melanoma, kidney, pancreas, breast, ...). In addition, it has been shown to be expressed on vascular endothelial and smooth muscle cells. Generating an antibody able to specifically recognize CD146 in cancer cells (designated as tumor CD146), but not in normal cells, would thus be of major interest for targeting tumor CD146 without affecting the vascular system. We thus generated antibodies against the extracellular domain of the molecule produced in cancer cells and selected an antibody that specifically recognizes tumor CD146. This antibody (TsCD146 mAb) was able to detect CD146-positive tumors in human biopsies and in vivo, by PET imaging, in a murine xenograft model. In addition, TsCD146 mAb antibody was able to specifically detect CD146-positive cancer microparticles in the plasma of patients. TsCD146 mAb displayed also therapeutic effects since it was able to reduce the growth of human CD146-positive cancer cells xenografted in nude mice. This effect was due to a decrease in the proliferation and an increase in the apoptosis of CD146-positive cancer cells after TsCD146-mediated internalization of the cell surface CD146. Thus, TsCD146 mAb could be of major interest for diagnostic and therapeutic strategies against CD146-positive tumors in a context of personalized medicine.
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Affiliation(s)
- Marie Nollet
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | - Jimmy Stalin
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | - Anaïs Moyon
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France.,CERIMED, European Center of Research in Medical Imaging, Aix-Marseille University, Marseille, France
| | - Waël Traboulsi
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | - Amel Essaadi
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | - Stéphane Robert
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | - Nausicaa Malissen
- Department of Dermatology, Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Inserm UMR-S 911, Aix-Marseille University, Marseille, France
| | - Richard Bachelier
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | - Laurent Daniel
- Service d'anatomie Pathologique, Aix-Marseille University, Timone Hospital, Marseille, France
| | | | - Caroline Gaudy-Marqueste
- Department of Dermatology, Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Inserm UMR-S 911, Aix-Marseille University, Marseille, France
| | - Romaric Lacroix
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | - Aurélie S Leroyer
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | - Benjamin Guillet
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France.,CERIMED, European Center of Research in Medical Imaging, Aix-Marseille University, Marseille, France
| | - Nathalie Bardin
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
| | | | - Marcel Blot-Chabaud
- INSERM UMR-S 1076, Aix-Marseille University, UFR Pharmacy, Marseille, France
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31
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Delteil C, Malissen N, Magis Q, Ranque S, Richard MA, Macagno N. [Pseudo-cutaneous tumor in a renal transplant patient]. Ann Pathol 2017; 37:500-502. [PMID: 29169837 DOI: 10.1016/j.annpat.2017.10.007] [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: 09/16/2017] [Revised: 10/08/2017] [Accepted: 10/10/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Clémence Delteil
- Institut médico-légal de Marseille, CHU Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), 264, rue St-Pierre, 13005 Marseille cedex 5, France; Service d'anatomie pathologique et neuropathologie, CHU Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), 13005 Marseille, France.
| | - Nausicaa Malissen
- Service de cancérologie cutanée, CHU Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - Quentin Magis
- Service de cancérologie cutanée, CHU Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - Stéphane Ranque
- Laboratoire de parasitologie et mycologie, LBM, CHU Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - Marie-Aleth Richard
- Service de cancérologie cutanée, CHU Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - Nicolas Macagno
- Service d'anatomie pathologique et neuropathologie, CHU Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
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32
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Gaudy-Marqueste C, Dussouil AS, Carron R, Troin L, Malissen N, Loundou A, Monestier S, Mallet S, Richard MA, Régis JM, Grob JJ. Survival of melanoma patients treated with targeted therapy and immunotherapy after systematic upfront control of brain metastases by radiosurgery. Eur J Cancer 2017; 84:44-54. [PMID: 28783540 DOI: 10.1016/j.ejca.2017.07.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [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: 04/06/2017] [Revised: 06/16/2017] [Accepted: 07/11/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Targeted therapy (TT) and immunotherapies (ITs) have dramatically improved survival in metastatic melanoma (MM). However, their efficacy on brain metastasis (BM) remains limited and poorly documented. PATIENTS AND METHODS Retrospective cohort of consecutive MM patients (pts) with BMs, all systematically upfront treated by Gamma-Knife (GK) at first BM and retreated in case of new BMs, from 2010 to 2015 at the time when ipilimumab BRAF ± MEK inhibitors and anti-PD1 were introduced in practice. Survival after 1st GK (OSGK1) according to prognostic factors and treatment. RESULTS Among 179 consecutive pts treated by GK, 109 received IT and/or TT after the 1st GK. Median OSGK1 was 10.95 months and 1- and 2-year survival rates were 49.5% and 27.4%, respectively, versus a median overall survival (OS) of 2.29 months (p < .001) in those who did not receive IT or TT. In pts who initially had a single BM, median OS and 1- and 2-year survival rates were 14.46 months, 66.7% and 43.4%, respectively; in pts with 2-3 BMs: 8.85 months, 46.4% and 31%, respectively; in pts with >3 BMs: 7.25 months, 37.2% and 11.9%, respectively. Multivariate analysis for OSGK1 confirmed that IT and TT were significantly and highly protective. Best OSGK1 was observed in BRAF-wild-type pts receiving anti-PD1 or in BRAF-mutated pts receiving BRAF-inhibitors and anti-PD1 (12.26 and 14.82 months, respectively). CONCLUSION In real-life MM pts with BMs, a strategy aiming at controlling BM with GK together with TT and/or TT seems to achieve unprecedented survival rates.
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Affiliation(s)
- C Gaudy-Marqueste
- Dermatology and Skin Cancers Department, UMR911 CRO2, Aix-Marseille University, APHM, Marseille, France
| | - A S Dussouil
- Dermatology and Skin Cancers Department, UMR911 CRO2, Aix-Marseille University, APHM, Marseille, France
| | - R Carron
- Department of Stereotaxic and Functional Neurosurgery, Gamma-knife Unit, Inserm U751, Aix-Marseille University, APHM, Marseille, France
| | - L Troin
- Dermatology and Skin Cancers Department, UMR911 CRO2, Aix-Marseille University, APHM, Marseille, France
| | - N Malissen
- Dermatology and Skin Cancers Department, UMR911 CRO2, Aix-Marseille University, APHM, Marseille, France
| | - A Loundou
- Public Health Department, Aix-Marseille University, APHM, Marseille, France
| | - S Monestier
- Dermatology and Skin Cancers Department, UMR911 CRO2, Aix-Marseille University, APHM, Marseille, France
| | - S Mallet
- Dermatology and Skin Cancers Department, UMR911 CRO2, Aix-Marseille University, APHM, Marseille, France
| | - M A Richard
- Dermatology and Skin Cancers Department, UMR911 CRO2, Aix-Marseille University, APHM, Marseille, France
| | - J M Régis
- Department of Stereotaxic and Functional Neurosurgery, Gamma-knife Unit, Inserm U751, Aix-Marseille University, APHM, Marseille, France
| | - J J Grob
- Dermatology and Skin Cancers Department, UMR911 CRO2, Aix-Marseille University, APHM, Marseille, France.
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33
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Gaudy Marqueste C, Troin L, Malissen N, Loundou A, Monestier S, Mallet S, Hesse S, Magis Q, Richard MA, Grange F, Grob JJ. Risk factors of fast growing melanomas in a French prospective cohort. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e21042] [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
e21042 Background: Rate of growth (ROG) of the primary tumor is a known prognostic factor in melanoma (MM). Fast growing melanomas (FGMM) could account for an important part of the thick tumors which still exist despite earlier and earlier detection. Methods: All patients referred for a primary mm to two French Dermatology Department from the period 2012-2016 were prospectively enrolled in an observational case control study. ROG was calculated as the ratio of Breslow thickness to time to mm development according to patient, following a well-established process. FGMM were defined as those with a ROG > 0.5 mm/month and MMs with a ROG ≤05mm/month were used as controls. Differences in epidemiological, clinical and pathological features were evaluated with univariate and multivariate analysis. Results: 464 patients were enrolled. 149 mm (32.1%) were FGMM. Factors associated with FGMM in univariate analysis were age > 70 years (p = 0.006), tumor location (p = 0.032), histological subtype (p = 0.021), median thickness (p < 0.001), ulceration (p < 0.001), high mitotic rate ( > 1/mm2 )(p = 0.002), sentinel node involvement (p = 0.008), hair color at the age of 20 (p = 0.011), lower NSAIDS consumption (p = 0.012) and lower number of sunburns (p = 0.002). Age > 70 years (OR 1.88 95%CI 1.19-2.98, p = 0.007), ulceration (OR 3.70 95%CI 2.05-6.61) p < 0.001), sentinel node involvement (OR 1.93 95%CI 1.01-3.69 p = 0.046), regression (OR 0.37 95%CI 0.15-0.94) p = 0.037) and NSAIDS exposure (OR 0.29 95%CI 0.11-0.78, p = 0.014) remained associated with FGMM in multivariate analysis. OS and PFS were significantly lower in the FGMM group (HR 1.98 (95%CI 1.11-3.54, p = 0.02) and HR 1.79 (95%CI 1.17-2.73, p = 0.007), respectively). Conclusions: Fast growth characterizes a subset of primary mm which are intrinsically more aggressive and have different risk factors than other MM, namely more frequent in the elderly and with no association with skin type, nevus count or sun exposure. Association with ulceration could reflect a specific immune context. Negative association with NSAIDS exposure warrants more investigation, since it may have therapeutic implications.
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Affiliation(s)
- Caroline Gaudy Marqueste
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Laura Troin
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Nausicaa Malissen
- Dermatology and Skin Cancer Department, Aix-Marseille University, Marseille, France
| | - Anderson Loundou
- Public Health Department Aix-Marseille University, AP-HM, Marseille, France
| | | | | | - Sylvie Hesse
- Hopital Timone, Aix-Marseille University, Marseille, France
| | - Quentin Magis
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Marie-Aleth Richard
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | | | - Jean-Jacques Grob
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
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34
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Magis Q, Gaudy Marqueste C, Monestier S, Loundou A, Richard MA, Malissen N, Beliard S, Grob JJ. Glycemic disorders in melanoma patients treated with anti-PD1. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.9525] [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
9525 Background: Anti-PD1 are now the backbone of immunotherapy (IT) of metastatic melanoma (MM). Although they are overall well- tolerated, a number of severe immune-related adverse events (IRAE) have been described, among which type 1 diabetes. We observed 3 cases of fulminant diabetes (FD) in our center, and also had the impression that diabetics patients became more difficult to manage when receiving anti-PD1. Methods: Retrospective analysis of blood glucose samples collected before, during and after anti-PD1 treatment (trt ) in all mm patients (pts) receiving anti-PD1 in our department over a 36-month period. Study of FD cases observed. Results: A total of 163 pts were treated with 1920 cures of anti-PD1 including 27 treated within clinical trials. Anti-PD1 was the 1st line of IT in 70% of cases. As a whole, 1470 glycaemia were available. There was no significant difference between the median pre and post-trt glycaemia (5.37 +/-1.6 vs 5.6 +/-1.3 mmol/L (p = 0.033)). In the 28 pts with a type I (n = 0) or II (n = 28) diabetes prior to trt, there was very slight drift toward an increase of glycaemia along with the successive trt infusions (+0.05mmol/L/Cure, p = 0.004 with linear regression tendency test) .Three pts (1.84%) developed a FD revealed by a severe episode of ketosis with acute polyuria polydipsia, hyperglycaemia until 50mmol/L and weight loss. Two additional cases of FD were observed in pts treated within clinical trial comparing anti-PD1 with anti-CTLA4 in adjuvant and metastatic situation (imputability of anti-PD1 likely but uncertain until unblinding). None of these pts had any glucose increase in weeks prior to FD diagnosis. Four out of 5 FD cases had an HLA group at risk for type 1 diabetes development (HLA DRB3/4), a rare group in general population (1%). Conclusions: We could not document any systematic tendency to glycemic disorder in mm pts treated by anti-PD1. In diabetic pts prior to trt, a slight drift toward increase of glycaemia may be explained by other interfering factors (diet, metastatic disease itself, corticosteroids, anxiety etc). FD is not exceptional (2% of patients in our series) and does not seem to be announced by any minor preliminary glycemic disorder. Despite apparently stochastic onset, FD may be associated with HLA DRB3/4 subgroup.
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Affiliation(s)
- Quentin Magis
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Caroline Gaudy Marqueste
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | | | | | - Marie-Aleth Richard
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Nausicaa Malissen
- Dermatology and Skin Cancer Department, Aix-Marseille University, Marseille, France
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Malissen N, Macagno N, Granjeaud S, Granier C, Moutardier V, Gaudy Marqueste C, Habel N, Mandavit M, Guillot B, Pasero C, Tartour E, Ballotti R, Grob JJ, Olive D. HVEM: A novel cosignaling molecule of major interest in melanoma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e14591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14591 Background: Herpes Virus Entry Mediator (HVEM) is a member of the TNF superfamily, its ligation of the immunoglobulin family member B-lymphocyte and T-lymphocyte attenuator (BTLA) activates inhibitory signaling in T-cells and could play a role in evading host anti-tumor immunity. Ectopic overexpression of HVEM is associated with poor survival in some solid tumors. Our objectives were: -to evaluate HVEM expression in melanoma (MM) -to explore potential link of its overexpression with clinical outcomes -to understand the mechanisms by which HVEM was ectopically expressed in MM, and how HVEM-BTLA may play a role in MM. Methods: HVEM expression was analyzed by IHC in formalin-fixed samples of mm metastases and was correlated with OS in 130 patients. To better understand how HVEM could interfere with prognosis, relation of HVEM with its ligand BTLA was studied in the tumor and tumor microenvironment on 15 fresh metastases by flow cytometry after tumor dissociation. Bioinformatic studies based on TCGA and CCLE data combined to targeting of candidate genes by siRNA were used to investigate HVEM regulation on MM. Results: Patients with high HVEM expression on mm cells in their metastases have a significantly (p = 0.0142) poorer overall survival than those with a low expression. TCGA transcriptomic data support these results. From the mechanistic point of view, we could show that 1-HVEM expressed at the tumor cell surface interacts with BTLA expressed by tumor-infiltrated lymphocytes. 2-HVEM expression is neither linked to the mm mutational status nor inducible by IFN 3-Genes co-regulated with HVEM are associated with an aggressive gene signature 4- HVEM strongly correlate with MITF expression, MITF binds HVEM promoter, and its downregulation by siRNA results in a decrease in HVEM expression. Conclusions: A high expression of HVEM by mm metastases seems to be a pejorative prognostic marker. HVEM-BTLA interaction is a co-signaling system similar to the PD1-PDL1 one, but seem to be constitutive rather than inducible. HVEM and its co-regulated genes may constitute a signature of aggressiveness associated to MITF. High HVEM expression on mm cells may dampen anti-tumor immune responses, making HVEM and BTLA potential new targets for “checkpoint blockade” therapy.
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Affiliation(s)
| | | | | | | | | | - Caroline Gaudy Marqueste
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Nadia Habel
- Université Nice Côte d’Azur, Inserm U1065, C3M, Team 1, Biology and pathologies of melanocytes, Nice, France
| | | | | | | | - Eric Tartour
- Unité d'Immunologie Biologique, Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | - Robert Ballotti
- Université Nice Côte d’Azur, Inserm U1065, C3M, Team 1, Biology and pathologies of melanocytes, Nice, France
| | - Jean Jacques Grob
- Aix-Marseille University and APHM Hospital CHU Timone, Marseille, France
| | - Daniel Olive
- Institut Paoli-Calmettes CRCM U1068, Marseille, France
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Gaudy Marqueste C, Carron R, Amatore F, Malissen N, Muracciole X, Loundou A, Troin L, Monestier S, Mallet S, Richard MA, Regis J, Grob JJ. Safety and results of anti-PD1 combined with radiosurgery for the treatment of melanoma brain metastases. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.9552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9552 Background: Anti-PD1 are now pivotal in the treatment of metastatic melanoma (MM). Some concerns have emerged regarding the risk/benefit ratio of their combination with stereotactic radiosurgery. Methods: Retrospective assessment of the interaction between Gamma-Knife radiosurgery (GKRS) and anti-PD1 in terms of toxicity and OS in mm patients (pts) with BM. Patients were included if they were under anti-PD1 (PRE) at time of GKRS, or if they had started anti-PD1 concomitantly with GKRS (CO), or had received anti-PD1 within 3 months after GKRS (POST). Results: Among 47 pts who received GKRS and anti-PD1 during their disease course, 35 fulfilled PRE or CO or POST criteria (anti PD1 1st line therapy in 10 pts and 2d or more in 25 pts). One pt died before radiological evaluation. GKRS targeted a single BM in 10 pts and multiple BMs in 24 (max 19 BMs). Out of the 128 BMs treated, 6 cases of increase of preexisting edema (4.7%) and 8 hemorrhages (6.25%) occurred in 12 pts, but only 5 events (5%) were regarded as Adverse Radiation effects (ARE), being symptomatic in 3 pts (8% of pts). One BM had to be resected because of the occurrence of a symptomatic hemorrhage with hemiparesis 9 month after treatment. Median follow- up from GKRS was 13.7 mths. Median overall survival (OS) from GKRS and 1st BM were 14.8 and 26.5 mths respectively, with 6 and 12 mths 0S rates from GKRS of 65.7% and 57%, respectively. Local failure was observed in 5 pt. Median time to new BM was 12.6 mths. There was no significant difference in outcomes in pts, depending on PRE, CO and POST conditions. Conclusions: In this series, the largest to date of pts with BMs treated by GKRS and anti-PD1,ARE were within the expected range and survival rates appear promising. Given the natural propensity of MM-BMs for bleeding and edema our data do not support an increased risk with the combination of GKRS and anti-PD1. Regarding the timing between anti-PD1 administration and GKRS our data do not support a higher efficacy or higher toxicity among the 3 following potential mechanisms: immuno- sensitization to radiation (PRE), immuno-radio direct synergy (CO) or radiosensitization to immunotherapy (POST).
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Affiliation(s)
- Caroline Gaudy Marqueste
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Romain Carron
- Department of Stereotaxic and Functional Neurosurgery, Gammaknife Unit, Inserm U751, Aix-Marseille University, APHM, Marseille, France
| | - Florent Amatore
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Nausicaa Malissen
- Dermatology and Skin Cancer Department, Aix-Marseille University, Marseille, France
| | | | - Anderson Loundou
- Public Health Department Aix-Marseille University, AP-HM, Marseille, France
| | - Laura Troin
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | | | | | - Marie-Aleth Richard
- Dermatology and Skin Cancers Department, UMR911 CRO2 Timone Hospital, Aix-Marseille University, Marseille, France
| | - Jean Regis
- Department of Stereotaxic and Functional Neurosurgery, Gammaknife Unit, Inserm U751, Aix-Marseille University, APHM, Marseille, France
| | - Jean Jacques Grob
- Aix-Marseille University and APHM Hospital CHU Timone, Marseille, France
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Malissen N, Vergely L, Simon M, Roubertie A, Malinge MC, Bessis D. Long-term treatment of cutaneous manifestations of tuberous sclerosis complex with topical 1% sirolimus cream: A prospective study of 25 patients. J Am Acad Dermatol 2017; 77:464-472.e3. [PMID: 28502378 DOI: 10.1016/j.jaad.2017.04.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/04/2017] [Accepted: 04/05/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Data on long-term topical sirolimus treatment of the cutaneous manifestations of tuberous sclerosis complex are rare. OBJECTIVE To evaluate the long-term benefit and tolerance of topical 1% sirolimus in tuberous sclerosis complex. METHODS In this 18-month prospective single-center study, 1% sirolimus cream was applied daily to facial angiofibromas (FAs), fibrous cephalic plaques (FCPs), shagreen patches, hypomelanotic macules, and ungual fibromas. After complete clearance (CC) of FAs, we evaluated a maintenance protocol of 3 applications weekly. RESULTS Twenty-five patients were enrolled. Fifty percent obtained CC of FAs within 9 months. Of 7 patients with CC (58%) who were following the maintenance protocol, 6 relapsed within 7 months and 1 was still responding at 1 year. Of 16 patients with FCPs, 7 (44%) remained stable at 12 months and 9 (56%) improved after 3 to 9 months of treatment. Only 1 of 5 patients treated for shagreen patches showed improvement at 12 months. Treatment was well tolerated with no serious adverse events. LIMITATIONS The small number of patients was a limitation. CONCLUSIONS Topical 1% sirolimus applied daily produced positive responses in treatment of FAs, FCPs, and facial hypomelanotic macules and was well tolerated. A 3-times-weekly maintenance protocol did not prevent FA relapses.
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Affiliation(s)
- Nausicaa Malissen
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - Laurence Vergely
- Department of Clinical Pharmacy and Oncology, Lapeyronie Hospital, Montpellier, France
| | - Marguerite Simon
- Department of Clinical Pharmacy and Oncology, Lapeyronie Hospital, Montpellier, France
| | - Agathe Roubertie
- Department of Neuropediatric and Regional Center of Competence of Tuberous Sclerosis, Gui de Chauliac Hospital, Montpellier, France
| | | | - Didier Bessis
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1058, Montpellier, France; Regional Center of Competence for Rare Skin Disorders, Montpellier, France.
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Hartung N, Huynh CTK, Gaudy-Marqueste C, Flavian A, Malissen N, Richard-Lallemand MA, Hubert F, Grob JJ. Study of metastatic kinetics in metastatic melanoma treated with B-RAF inhibitors: Introducing mathematical modelling of kinetics into the therapeutic decision. PLoS One 2017; 12:e0176080. [PMID: 28472075 PMCID: PMC5417482 DOI: 10.1371/journal.pone.0176080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 04/05/2017] [Indexed: 01/09/2023] Open
Abstract
Background Evolution of metastatic melanoma (MM) under B-RAF inhibitors (BRAFi) is unpredictable, but anticipation is crucial for therapeutic decision. Kinetics changes in metastatic growth are driven by molecular and immune events, and thus we hypothesized that they convey relevant information for decision making. Patients and methods We used a retrospective cohort of 37 MM patients treated by BRAFi only with at least 2 close CT-scans available before BRAFi, as a model to study kinetics of metastatic growth before, under and after BRAFi. All metastases (mets) were individually measured at each CT-scan. From these measurements, different measures of growth kinetics of each met and total tumor volume were computed at different time points. A historical cohort permitted to build a reference model for the expected spontaneous disease kinetics without BRAFi. All variables were included in Cox and multistate regression models for survival, to select best candidates for predicting overall survival. Results Before starting BRAFi, fast kinetics and moreover a wide range of kinetics (fast and slow growing mets in a same patient) were pejorative markers. At the first assessment after BRAFi introduction, high heterogeneity of kinetics predicted short survival, and added independent information over RECIST progression in multivariate analysis. Metastatic growth rates after BRAFi discontinuation was usually not faster than before BRAFi introduction, but they were often more heterogeneous than before. Conclusions Monitoring kinetics of different mets before and under BRAFi by repeated CT-scan provides information for predictive mathematical modelling. Disease kinetics deserves more interest
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Affiliation(s)
- Niklas Hartung
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Cécilia T.-K. Huynh
- Aix-Marseille Université, APHM, Dermatology and skin cancers Department, Marseille, France
| | - Caroline Gaudy-Marqueste
- Aix-Marseille Université, APHM, Dermatology and skin cancers Department, Marseille, France
- Aix-Marseille Université, UMR_S 911 CRO2, Marseille, France
- * E-mail:
| | - Antonin Flavian
- APHM, Hopital Timone, Radiology department, Marseille, France
| | - Nausicaa Malissen
- Aix-Marseille Université, APHM, Dermatology and skin cancers Department, Marseille, France
| | - Marie-Aleth Richard-Lallemand
- Aix-Marseille Université, APHM, Dermatology and skin cancers Department, Marseille, France
- Aix-Marseille Université, UMR_S 911 CRO2, Marseille, France
| | - Florence Hubert
- Aix-Marseille Université, I2M, UMR 7373, CNRS, Centrale Marseille, Marseille, France
| | - Jean-Jacques Grob
- Aix-Marseille Université, APHM, Dermatology and skin cancers Department, Marseille, France
- Aix-Marseille Université, UMR_S 911 CRO2, Marseille, France
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Malissen N, Lacotte J, Du-Thanh A, Gaudy-Marqueste C, Guillot B, Grob JJ. Macrophage activation syndrome: A new complication of checkpoint inhibitors. Eur J Cancer 2017; 77:88-89. [PMID: 28365531 DOI: 10.1016/j.ejca.2017.02.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 02/22/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Nausicaa Malissen
- Dermatology and Skin Cancer Department, Aix-Marseille University, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - Julie Lacotte
- Dermatology Department, Montpellier University Hospital, 80 Avenue Augustin Fliche, 34090 Montpellier, France
| | - Aurélie Du-Thanh
- Dermatology Department, Montpellier University Hospital, 80 Avenue Augustin Fliche, 34090 Montpellier, France.
| | - Caroline Gaudy-Marqueste
- Dermatology and Skin Cancer Department, Aix-Marseille University, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - Bernard Guillot
- Dermatology Department, Montpellier University Hospital, 80 Avenue Augustin Fliche, 34090 Montpellier, France.
| | - Jean-Jacques Grob
- Dermatology and Skin Cancer Department, Aix-Marseille University, 264, rue Saint-Pierre, 13385 Marseille, France.
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Malissen N, Monestier S, Mallet S, Huynh C, Gaudy C, Richard MA, Grob JJ. Deux cas de syndrome d’activation macrophagique sous traitement inhibant la voie PD-1/PD-L1 et rationnel physiopathologique. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Amatore F, Macagno N, Loundou A, Baumstarck K, Monestier S, Malissen N, Gaudy C, Mallet S, Hesse S, Grob JJ, Richard MA. Facteurs de risque de récidive des carcinomes épidermoïdes du vertex : importance de la prise en charge initiale. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.225] [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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Malissen N, Troin L, Macagno N, Abed S, Huynh C, Gaudy C, Richard MA, Grob JJ. Dermatomyosite retardée et fatale sous anti-PD1 malgré une réponse complète : une nouvelle complication des anti-PD1. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Malissen N, Macagno N, Abed S, Huynh C, Chambelland A, Gaudy C, Richard MA, Grob JJ. Exploration immunologique d’une toxidermie lichénoïde et bulleuse sévère sous anti-PD1. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Amatore F, Clévy C, Gaudy-Marqueste C, Malissen N, Monestier S, Mallet S, Hesse S, Grob JJ, Richard MA. Prise en charge de la fièvre chez les patients traités par combinaison dabrafenib-trametinib pour un mélanome métastatique muté BRAF V600E/K. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.267] [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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Malissen N, Bourrain JL, Chiriac A, Montet A, Vincent L, Dereure O, Du-Thanh A. Symmetrical Intertriginous and Flexural Exanthema due to Bortezomib (a Proteasome Inhibitor) Given for Myeloma. Acta Derm Venereol 2016; 96:995-996. [PMID: 27001285 DOI: 10.2340/00015555-2415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nausicaa Malissen
- Department of Dermatology, Montpellier University Hospital, FR-34295 Montpellier, France
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Bessis D, Bigorre M, Malissen N, Captier G, Chiaverini C, Abasq C, Barbarot S, Boccara O, Bourrat E, El Fertit H, Eschard C, Hubiche T, Lacour JP, Leboucq N, Mahé E, Mallet S, Marque M, Martin L, Mazereeuw-Hautier J, Milla N, Phan A, Plantin P, Picot MC, Puzenat E, Rigau V, Vabres P, Fraitag S, Boralevi F. The scalp hair collar and tuft signs: A retrospective multicenter study of 78 patients with a systematic review of the literature. J Am Acad Dermatol 2016; 76:478-487. [PMID: 27742172 DOI: 10.1016/j.jaad.2016.08.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/27/2016] [Accepted: 08/21/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hair collar sign (HCS) and hair tuft of the scalp (HTS) are cutaneous signs of an underlying neuroectodermal defect, but most available data are based on case reports. OBJECTIVE We sought to define the clinical spectrum of HCS and HTS, clarify the risk for underlying neurovascular anomalies, and provide imaging recommendations. METHODS A 10-year multicenter retrospective and prospective analysis of clinical, radiologic, and histopathologic features of HCS and HTS in pediatric patients was performed. RESULTS Of the 78 patients included in the study, 56 underwent cranial and brain imaging. Twenty-three of the 56 patients (41%) had abnormal findings, including the following: (1) cranial/bone defect (30.4%), with direct communication with the central nervous system in 28.6%; (2) venous malformations (25%); or (3) central nervous system abnormalities (12.5%). Meningeal heterotopia in 34.6% (9/26) was the most common neuroectodermal association. Sinus pericranii, paraganglioma, and combined nevus were also identified. LIMITATIONS The partial retrospective design and predominant recruitment from the dermatology department are limitations of this study. CONCLUSIONS Infants with HCS or HTS are at high risk for underlying neurovascular anomalies. Magnetic resonance imaging scans should be performed in order to refer the infant to the appropriate specialist for management.
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Affiliation(s)
- Didier Bessis
- Department of Dermatology, Saint-Eloi Hospital, Montpellier, France; Montpellier University Hospital and Institut National de la Santé et de la Recherche Médicale (INSERM) U1058, Montpellier, France.
| | - Michèle Bigorre
- Department of Infantile Plastic Surgery, Lapeyronie Hospital, Montpellier, France
| | | | - Guillaume Captier
- Department of Infantile Plastic Surgery, Lapeyronie Hospital, Montpellier, France
| | | | - Claire Abasq
- Department of Dermatology, Brest University Hospital, Brest, France
| | | | - Olivia Boccara
- Department of Pediatric Dermatology, Necker-Enfants Malades Hospital, Paris, France
| | - Emmanuelle Bourrat
- Department of Pediatric Dermatology, Robert-Debré Hospital, Paris, France
| | - Hassan El Fertit
- Department of Infantile Neurosurgery, Caremeau Hospital, Nîmes, France
| | | | - Thomas Hubiche
- Department of Dermatology and Infectious Diseases, Fréjus Hospital, Fréjus, France
| | | | - Nicolas Leboucq
- Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France
| | - Emmanuel Mahé
- Department of Dermatology, Argenteuil Hospital, Argenteuil, France
| | | | - Myriam Marque
- Department of Dermatology, Caremeau Hospital, Nîmes, France
| | - Ludovic Martin
- Department of Dermatology, Angers University Hospital, Angers, France
| | | | - Nathalie Milla
- Department of Dermatology, Saint-Eloi Hospital, Montpellier, France
| | - Alice Phan
- Department of Pediatric Dermatology, Femme-Mère-Enfant Hospital and Claude-Bernard Lyon 1 University, Lyonm, France
| | - Patrice Plantin
- Department of Dermatology, Quimper Hospital, Quimper, France
| | - Marie-Christine Picot
- Unit of Clinical Research and Epidemiology, Department of Medical Information, Antonin Balmes Hospital, Montpellier, France
| | - Eve Puzenat
- Department of Dermatology, Besançon University Hospital, Besançon, France
| | - Valérie Rigau
- Department of Pathology, Montpellier University Hospital, Montpellier, France
| | - Pierre Vabres
- Department of Dermatology, Bocage Hospital and Bourgogne Medical University, Dijon, France
| | - Sylvie Fraitag
- Department of Pathology, Necker-Enfants Malades University Hospital, Paris, France
| | - Franck Boralevi
- Department of Pediatric Dermatology, National Center for Rare Skin Disorders-Institut National de la Santé et de la Recherche Médicale (INSERM) U1035, Bordeaux, France
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Malissen N, Marque M, Pallure V, Bessis D. Troubles pigmentaires segmentaires (Metzker) : étude multicentrique de 36 cas. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.095] [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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Malissen N, Szablewski V, Eberst E, Merlet-Albrand S, Jeziorski E, Dereure O. Manifestations cutanées associées à un syndrome lymphoprolifératif avec auto-immunité : 1er cas rapporté. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.363] [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: 10/22/2022]
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Malissen N, Vergely L, Simon M, Roubertie A, Bessis D. Traitement par rapamycine topique à 1 % des angiofibromes faciaux de la sclérose tubéreuse de Bourneville : étude prospective monocentrique de 24 patients. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.071] [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: 10/22/2022]
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Malissen N, Fabre C, Joujoux JM, Bourquard P, Dandurand M, Marque M, Stoebner P, Meunier L. [Multiple primary cutaneous plasmacytoma]. Ann Dermatol Venereol 2014; 141:364-8. [PMID: 24835649 DOI: 10.1016/j.annder.2014.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 10/09/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Primary cutaneous plasmacytoma is a rare form of cutaneous B-cell lymphoma. PATIENTS AND METHODS A 51 year-old male with an unremarkable history gradually presented erythematous papulonodular lesions that had appeared gradually over the whole body throughout a two-year period and showing histologic and immunohistochemical features of cutaneous plasmacytoma. Staging investigations confirmed the primary character of the disease, and because of this and the absence of functional impairment, we opted for therapeutic abstention. No progression was noted after 4 years of regular monitoring. DISCUSSION Primary cutaneous plasmacytoma (PCP) is characterized by clonal proliferation of plasma cells in skin. Multiple PCPs are extremely rare and to date have been treated in most cases by chemotherapy, either with or without radiotherapy. The prognosis is poor, with 2-year survival of only 25%. The present case is original, being the only one to our knowledge in which therapeutic abstention was followed by a lack of progression after 4 years of regular follow-up. Consequently, certain indolent forms of PCP do not warrant automatic institution of chemotherapy.
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Affiliation(s)
- N Malissen
- Service de dermatologie, CHU de Nîmes, place du Pr R. Debré, 30029 Nîmes cedex 9, France.
| | - C Fabre
- Service de dermatologie, CHU de Nîmes, place du Pr R. Debré, 30029 Nîmes cedex 9, France
| | - J-M Joujoux
- Service d'anatomopathologie, CHU de Nîmes, place du Pr R. Debré, 30029 Nîmes cedex 9, France
| | - P Bourquard
- Service d'hématologie et oncologie médicale, CHU de Nîmes, place du Pr R. Debré, 30029 Nîmes cedex 9, France
| | - M Dandurand
- Service de dermatologie, CHU de Nîmes, place du Pr R. Debré, 30029 Nîmes cedex 9, France
| | - M Marque
- Service de dermatologie, CHU de Nîmes, place du Pr R. Debré, 30029 Nîmes cedex 9, France
| | - P Stoebner
- Service de dermatologie, CHU de Nîmes, place du Pr R. Debré, 30029 Nîmes cedex 9, France
| | - L Meunier
- Service de dermatologie, CHU de Nîmes, place du Pr R. Debré, 30029 Nîmes cedex 9, France
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