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Stratigos AJ, Sekulic A, Peris K, Bechter O, Prey S, Lewis KD, Basset-Seguin N, Chang ALS, Dalle S, Fernández Orland A, Licitra L, Robert C, Ulrich C, Hauschild A, Migden MR, Dummer R, Yoo SY, Okoye E, Bassukas I, Loquai C, De Giorgi V, Eroglu Z, Gutzmer R, Ulrich J, Puig S, Inocencio TJ, Chen CI, LaFontaine PR, Seebach F, Lowy I, Fury MG. Phase 2 open-label, multicenter, single-arm study of cemiplimab in patients with locally advanced basal cell carcinoma after hedgehog inhibitor therapy: Extended follow-up. J Am Acad Dermatol 2024; 90:414-418. [PMID: 37839734 DOI: 10.1016/j.jaad.2023.08.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/11/2023] [Accepted: 08/01/2023] [Indexed: 10/17/2023]
Affiliation(s)
- Alexander J Stratigos
- Department of Dermatology-Venereology, Andreas Sygros Hospital-National and Kapodistrian University of Athens, Athens, Greece.
| | | | - Ketty Peris
- Dipartimento di Scienze Mediche e Chirurgiche, UOC di Dermatologia, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Oliver Bechter
- Department of General Medical Oncology, University Hospitals, Leuven, Belgium
| | - Sorilla Prey
- Department of Dermatology, Bordeaux University Hospital, Bordeaux, France
| | - Karl D Lewis
- School of Medicine, University of Colorado, Aurora, Colorado
| | | | - Anne Lynn S Chang
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Stéphane Dalle
- Department of Dermatology, Centre Hospitalier Lyon-Sud, Lyon, France
| | | | - Lisa Licitra
- Medical Oncology Head and Neck Cancer Department, Fondazione IRCCS Istituto Nazionale dei Tumori and University of Milan, Milan, Italy
| | - Caroline Robert
- Dermatology Unit, Gustave Roussy Cancer Center and Paris-Saclay University, Villejuif, France
| | - Claas Ulrich
- Skin Cancer Centre, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Axel Hauschild
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - Michael R Migden
- Departments of Dermatology and Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | | | | | - Ioannis Bassukas
- Faculty of Medicine, Department of Skin and Venereal Diseases, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Carmen Loquai
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - Vincenzo De Giorgi
- Departments of Dermatology, Human Pathology, and Oncology, University of Florence, Florence, Italy
| | - Zeynep Eroglu
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Ralf Gutzmer
- Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany
| | - Jens Ulrich
- Academic Teaching Hospital of the University Otto von Guericke Magdeburg, Quedlinburg, Germany
| | - Susana Puig
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | | | - Chieh-I Chen
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York
| | | | | | - Israel Lowy
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York
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2
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Herms F, Basset-Seguin N. Response to " Hedgehog pathway inhibitor real-world treatment patterns in patients with basal cell carcinoma: a claims-based analysis". Future Oncol 2023; 19:2335-2336. [PMID: 37965712 DOI: 10.2217/fon-2022-1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Affiliation(s)
- Florian Herms
- Hôpital Saint-Louis, Paris, 75010, France
- Université Paris Diderot, Paris, 75010, France
| | - Nicole Basset-Seguin
- Hôpital Saint-Louis, Paris, 75010, France
- Université Paris Diderot, Paris, 75010, France
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3
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Bossi P, Ascierto PA, Basset-Seguin N, Dreno B, Dummer R, Hauschild A, Mohr P, Kaufmann R, Pellacani G, Puig S, Moreno-Ramírez D, Robert C, Stratigos A, Gutzmer R, Queirolo P, Quaglino P, Peris K. Long-term strategies for management of advanced basal cell carcinoma with hedgehog inhibitors. Crit Rev Oncol Hematol 2023; 189:104066. [PMID: 37442495 DOI: 10.1016/j.critrevonc.2023.104066] [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: 09/05/2022] [Revised: 04/12/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023] Open
Abstract
Basal cell carcinoma (BCC), the most common type of skin cancer, is characterized by aberrant activation of the hedgehog molecular pathway. Systemic therapy is indicated when local approaches, such as surgery and radiation, are inappropriate. In this article, a group of clinical experts recommends the long-term management strategy for advanced BCC patients treated with systemic therapy. The hedgehog inhibitors sonidegib and vismodegib are first-line treatments for advanced BCC with a long-lasting response, but long-term treatment with hedgehog inhibitors is often challenged by tolerability issues. However, several strategies for adverse effect management are available, such as dose interruptions, on-label alternate-day dosing and supportive medications. In conclusion, although BCC shows a high tumor mutational burden that favors a response to immunotherapy, experts recommend keeping patients on hedgehog inhibitors limiting immunotherapy to those who developed resistance during hedgehog inhibitor therapy or in case of persisting toxicity despite long-term management of adverse events.
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Affiliation(s)
- Paolo Bossi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - Paolo A Ascierto
- Department of Skin Cancers, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | | | - Brigitte Dreno
- Department of Dermato Oncology, University Hospital Nantes, Nantes, France
| | - Reinhard Dummer
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Axel Hauschild
- Department of Dermatology, University Hospital (UKSH), Campus Kiel, Kiel, Germany
| | - Peter Mohr
- Department of Dermatology, Elbe Kliniken Buxtehude, Buxtehude, Germany
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Germany
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Susana Puig
- Hospital Clinic de Barcelona, Universitat de Barcelona, Spain & Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - David Moreno-Ramírez
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Caroline Robert
- Gustave Roussy and INSERM U981, Villejuif, Paris Sud, France
| | - Alex Stratigos
- Dept of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Ralf Gutzmer
- Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum Campus Minden, Minden, Germany
| | | | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy and Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
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4
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Morton C, Baharlou S, Basset-Seguin N, Calzavara-Pinton P, Dirschka T, Gilaberte Y, Haedersdal M, Hofbauer G, Sapra S, Waalboer-Spuij R, Yip L, Szeimies RM. Expert Recommendations on Facilitating Personalized Approaches to Long-term Management of Actinic Keratosis: The Personalizing Actinic Keratosis Treatment (PAKT) Project. Acta Derm Venereol 2023; 103:adv6229. [PMID: 37289027 DOI: 10.2340/actadv.v103.6229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/25/2023] [Indexed: 06/09/2023] Open
Abstract
Actinic keratoses are pre-malignant skin lesions that require personalized care, a lack of which may result in poor treatment adherence and suboptimal outcomes. Current guidance on personalizing care is limited, notably in terms of tailoring treatment to individual patient priorities and goals and supporting shared decision-making between healthcare professionals and patients. The aim of the Personalizing Actinic Keratosis Treatment panel, comprised of 12 dermatologists, was to identify current unmet needs in care and, using a modified Delphi approach, develop recommendations to support personalized, long-term management of actinic keratoses lesions. Panellists generated recommendations by voting on consensus statements. Voting was blinded and consensus was defined as ≥ 75% voting 'agree' or 'strongly agree'. Statements that reached consensus were used to develop a clinical tool, of which, the goal was to improve understanding of disease chronicity, and the need for long-term, repeated treatment cycles. The tool highlights key decision stages across the patient journey and captures the panellist's ratings of treatment options for attributes prioritized by patients. The expert recommendations and the clinical tool can be used to facilitate patient-centric management of actinic keratoses in daily practice, encompassing patient priorities and goals to set realistic treatment expectations and improve care outcomes.
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Affiliation(s)
- Colin Morton
- Department of Dermatology, NHS Forth Valley, Stirling, United Kingdom.
| | - Samira Baharlou
- Department of Dermatology, Skin Immunology & Immune Tolerance (SKIN) Research Group, Vrije Universiteit Brussel, Brussels, Belgium; Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | | | | | - Yolanda Gilaberte
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Zaragoza, Spain
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg and Frederiksberg Hospitals, Copenhagen University Hospital, Copenhagen
| | - Günther Hofbauer
- University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Sheetal Sapra
- Oakville Trafalgar Memorial Hospital, Oakville, Canada; Institution of Cosmetic and Laser Surgery, Oakville, Canada
| | | | | | - Rolf-Markus Szeimies
- Department of Dermatology & Allergology, Klinikum Vest GmbH Academic Teaching Hospital, Recklinghausen, Germany
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5
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Moghadam P, Herms F, Baroudjian B, Tetu P, Delyon J, Jouenne F, Boisson M, Louveau B, Mourah S, Brunet-Possenti F, Duverger L, Gounant V, Lebbé C, Basset-Seguin N. Eruptive squamous cell carcinomas following an acute skin inflammatory disease: A series of four cases. J Eur Acad Dermatol Venereol 2023; 37:e119-e121. [PMID: 35993817 DOI: 10.1111/jdv.18559] [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: 05/02/2022] [Accepted: 08/08/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Parna Moghadam
- Dermatology Department, Université Paris-Cité, INSERM 976, Saint Louis Hospital, Paris, France
| | - Florian Herms
- Dermatology Department, Université Paris-Cité, INSERM 976, Saint Louis Hospital, Paris, France
| | - Barouyr Baroudjian
- Dermatology Department, Université Paris-Cité, INSERM 976, Saint Louis Hospital, Paris, France
| | - Pauline Tetu
- Dermatology Department, Université Paris-Cité, INSERM 976, Saint Louis Hospital, Paris, France
| | - Julie Delyon
- Dermatology Department, Université Paris-Cité, INSERM 976, Saint Louis Hospital, Paris, France
| | - Fanélie Jouenne
- Tumor Genomics and Pharmacology Department, Université Paris-Cité, INSERM UMR-S 976, Saint Louis Hospital, Paris, France
| | - Marie Boisson
- Tumor Genomics and Pharmacology Department, Université Paris-Cité, INSERM UMR-S 976, Saint Louis Hospital, Paris, France
| | - Baptiste Louveau
- Tumor Genomics and Pharmacology Department, Université Paris-Cité, INSERM UMR-S 976, Saint Louis Hospital, Paris, France
| | - Samia Mourah
- Tumor Genomics and Pharmacology Department, Université Paris-Cité, INSERM UMR-S 976, Saint Louis Hospital, Paris, France
| | - Florence Brunet-Possenti
- Virology Department, Université de Paris-Cité, INSERM UMR 1137 IAME, Bichat Hospital, Paris, France
| | - Lucie Duverger
- Pathology Department, Saint Louis Hospital, Paris, France
| | - Valérie Gounant
- Thoracic Oncology Department, Université de Paris-Cité, CIC-1425 Inserm, Bichat-Claude Bernard Hospital, Cancer Institute-AP-HP Nord, Paris, France
| | - Céleste Lebbé
- Dermatology Department, Université Paris-Cité, INSERM 976, Saint Louis Hospital, Paris, France
| | - Nicole Basset-Seguin
- Dermatology Department, Université Paris-Cité, INSERM 976, Saint Louis Hospital, Paris, France
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6
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Hughes B, Grob J, Bowyer S, Day F, Ladwa R, Stein B, Muñoz Couselo E, Basset-Seguin N, Guminski A, Mortier L, Hauschild A, Migden M, Schmults C, Yoo SY, Booth J, Seebach F, Lowy I, Fury M, Rischin D. 818P Phase II confirmatory study of cemiplimab (350mg IV Q3W) in patients with locally advanced or metastatic cutaneous squamous cell carcinoma (CSCC): Study 1540 Group 6. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.944] [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] Open
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7
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Garbe C, Amaral T, Peris K, Hauschild A, Arenberger P, Basset-Seguin N, Bastholt L, Bataille V, Del Marmol V, Dréno B, Fargnoli MC, Forsea AM, Grob JJ, Höller C, Kaufmann R, Kelleners-Smeets N, Lallas A, Lebbé C, Lytvynenko B, Malvehy J, Moreno-Ramirez D, Nathan P, Pellacani G, Saiag P, Stratigos AJ, Van Akkooi ACJ, Vieira R, Zalaudek I, Lorigan P. European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022. Eur J Cancer 2022; 170:236-255. [PMID: 35570085 DOI: 10.1016/j.ejca.2022.03.008] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 01/02/2023]
Abstract
Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed with dermatoscopy. If a melanoma is suspected, a histopathological examination is always required. Sequential digital dermatoscopy and full body photography can be used in high-risk patients to improve the detection of early melanoma. Where available, confocal reflectance microscopy can also improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the American Joint Committee on Cancer classification. Thin melanomas up to 0.8 mm tumor thickness do not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC onwards whole-body examinations with computed tomography (CT) or positron emission tomography CT (PET-CT) in combination with brain magnetic resonance imaging are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to define the frequency and extent of examinations. A stage-based follow-up scheme is proposed which, according to the experience of the guideline group, covers the optimal requirements, but further studies may be considered. This guideline is valid until the end of 2024.
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Affiliation(s)
- Claus Garbe
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.
| | - Teresa Amaral
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Ketty Peris
- Institute of Dermatology, Università Cattolica, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Axel Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Nicole Basset-Seguin
- Université Paris Cite, AP-HP Department of Dermatology INSERM U 976 Hôpital Saint Louis Paris France
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | - Veronique Bataille
- Twin Research and Genetic Epidemiology Unit, School of Basic & Medical Biosciences, King's College London, London, SE1 7EH, UK
| | - Veronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Brigitte Dréno
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
| | - Maria C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ana-Maria Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy Bucharest, Romania
| | | | - Christoph Höller
- Department of Dermatology, Medical University of Vienna, Austria
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
| | - Nicole Kelleners-Smeets
- Department of Dermatology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Celeste Lebbé
- Université Paris Cite, AP-HP Department of Dermatology INSERM U 976 Hôpital Saint Louis Paris France
| | - Bohdan Lytvynenko
- Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine
| | - Josep Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - David Moreno-Ramirez
- Medical-&-Surgical Dermatology Service, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Paul Nathan
- Mount-Vernon Cancer Centre, Northwood United Kingdom
| | | | - Philippe Saiag
- University Department of Dermatology, Université de Versailles-Saint Quentin en Yvelines, APHP, Boulogne, France
| | - Alexander J Stratigos
- 1st Department of Dermatology, University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Alexander C J Van Akkooi
- Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
| | - Ricardo Vieira
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Paul Lorigan
- The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
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8
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Garbe C, Amaral T, Peris K, Hauschild A, Arenberger P, Basset-Seguin N, Bastholt L, Bataille V, Del Marmol V, Dréno B, Fargnoli MC, Forsea AM, Grob JJ, Hoeller C, Kaufmann R, Kelleners-Smeets N, Lallas A, Lebbé C, Lytvynenko B, Malvehy J, Moreno-Ramirez D, Nathan P, Pellacani G, Saiag P, Stratigos AJ, Van Akkooi ACJ, Vieira R, Zalaudek I, Lorigan P. European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2022. Eur J Cancer 2022; 170:256-284. [PMID: 35623961 DOI: 10.1016/j.ejca.2022.04.018] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [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] [Indexed: 11/26/2022]
Abstract
A unique collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on the systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with one to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumor thickness ≥1.0 mm or ≥0.8 mm with additional histological risk factors, although there is as yet no clear survival benefit for this approach. Therapeutic decisions in stage III/IV patients should be primarily made by an interdisciplinary oncology team ("tumor board"). Adjuvant therapies can be proposed in stage III/completely resected stage IV patients and are primarily anti-PD-1, independent of mutational status, or alternatively dabrafenib plus trametinib for BRAF mutant patients. In distant metastases (stage IV), either resected or not, systemic treatment is always indicated. For first-line treatment particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies shall be considered. In stage IV melanoma with a BRAF-V600 E/K mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy. In patients with primary resistance to immunotherapy and harboring a BRAF-V600 E/K mutation, this therapy shall be offered as second-line therapy. Systemic therapy in stage III/IV melanoma is a rapidly changing landscape, and it is likely that these recommendations may change in the near future.
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Affiliation(s)
- Claus Garbe
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.
| | - Teresa Amaral
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Ketty Peris
- Institute of Dermatology, Università Cattolica, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Axel Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Nicole Basset-Seguin
- Université Paris Cite, AP-HP, Department of Dermatology INSERM U 976 Hôpital, Saint Louis Paris France
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Veronique Bataille
- Twin Research and Genetic Epidemiology Unit, School of Basic & Medical Biosciences, King's College London, London, SE1 7EH, United Kingdom
| | - Veronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Brigitte Dréno
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
| | - Maria C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ana-Maria Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy Bucharest, Romania
| | | | | | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
| | | | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Celeste Lebbé
- Université Paris Cite, AP-HP, Department of Dermatology INSERM U 976 Hôpital, Saint Louis Paris France
| | - Bodhan Lytvynenko
- Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine
| | - Josep Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - David Moreno-Ramirez
- Medical-&-Surgical Dermatology Service, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Paul Nathan
- Mount-Vernon Cancer Centre, Northwood United Kingdom
| | | | - Philippe Saiag
- University Department of Dermatology, Université de Versailles-Saint Quentin en Yvelines, APHP, Boulogne, France
| | - Alexander J Stratigos
- First Department of Dermatology, University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Alexander C J Van Akkooi
- Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
| | - Ricardo Vieira
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Paul Lorigan
- The University of Manchester, Oxford Rd, Manchester, M13 9PL, United Kingdom
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9
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Herms F, Baroudjian B, Delyon J, Laly P, Tetu P, Lebbe C, Basset-Seguin N. Sonidegib in the Treatment of Locally Advanced Basal Cell Carcinoma: a Retrospective Study. Acta Derm Venereol 2022; 102:adv00740. [PMID: 35604234 PMCID: PMC9574683 DOI: 10.2340/actadv.v102.1995] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 01/15/2023] Open
Abstract
Sonidegib, a hedgehog pathway inhibitor, is indicated for treatment of locally advanced basal cell carcinoma, based on the results of the BOLT study. However, to date, no real-world study of sonidegib has been reported. An observational, retrospective, single-centre study (PaSoS study) was conducted. The primary objective was to evaluate the efficacy of sonidegib for treatment of locally advanced basal cell carcinoma in a real-world setting. Secondary objectives included modalities of use, tolerability, tumour evolution, and management after discontinuation. A total of 21 patients treated with sonidegib were included from March 2018 to January 2021. The median follow-up was 18.7 months and median exposure 7.0 months. Objective response (OR) rate was 81.0% (n = 17) including 6 (29%) patients with a complete response (CR). Disease control rate was 100%. First tumour response was rapid, with a median time of 2.3 months. Nine (43%) patients underwent surgery after sonidegib discontinuation, and no relapse was observed. All the patients experienced at least 1 adverse event (AE). Muscle spasms were the most frequent AE (n = 14; 67%), followed by dysgeusia (n = 8; 38%) and alopecia (n = 12; 57%). The efficacy and safety profile of sonidegib in this first-to-date real-life trial are consistent with prior results. Overall, real-world evidence corroborated sonidegib efficacy and tolerability as a first-line treatment for locally advanced basal cell carcinoma.
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Affiliation(s)
- Florian Herms
- AP-HP Department of Dermatology, Université de Paris, DMU ICARE, INSERM U976 HIPI, Team 1 Hôpital Saint-Louis, FR-75010 Paris, France.
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10
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Schlessinger DI, Reynolds KA, Dirr MA, Ibrahim SA, Yanes AF, Lazaroff JM, Godinez-Puig V, Chen BR, Kurta AO, Cotseones JK, Chiren SG, Furlan KC, Iyengar S, Behshad R, DeHoratius DM, Denes P, Drucker AM, Dzubow LM, Etzkorn JR, Harwood CA, Kim JYS, Lawrence N, Lee EH, Lissner GS, Marghoob AA, Matin RN, Mattox AR, Mittal BB, Thomas JR, Zhou XA, Zloty D, Schmitt J, Kirkham JJ, Armstrong AW, Basset-Seguin N, Billingsley EM, Bordeaux JS, Brewer J, Brown M, Brown M, Collins SAB, Fargnoli MC, De Azevedo SJ, Dummer R, Eggermont A, Goldman GD, Haedersdal M, Hale E, Hanlon A, Harms KL, Huang CC, Hurst EA, In GK, Kelleners-Smeets N, Kheterpal M, Leshin B, Mcdonald M, Miller SJ, Miller A, Mostow EN, Trakatelli M, Nehal KS, Ratner D, Rogers H, Sarin KY, Soon SL, Stasko T, Storrs PA, Tagliaferri L, Vidimos AT, Wong SL, Yu SS, Zalaudek I, Zeitouni NC, Zitelli JA, Poon E, Sobanko JF, Cartee TV, Maher IA, Alam M. Development of a Core Outcome Set for Basal Cell Carcinoma (BCC), Including Low-Risk and Advanced Tumors. J Am Acad Dermatol 2022; 87:573-581. [PMID: 35551965 DOI: 10.1016/j.jaad.2022.04.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/18/2022] [Accepted: 04/23/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is variation in the outcomes reported in clinical studies of basal cell carcinoma (BCC). This can prevent effective meta-analyses to answer important clinical questions. OBJECTIVE To identify a recommended minimum set of core outcomes for BCC clinical trials. METHODS Patient and professional Delphi process to cull a long-list, culminating in a consensus meeting. To be provisionally accepted, outcomes needed to be deemed 'important' (score: 7-9, of maximum of 9) by 70% of each stakeholder group. RESULTS 235 candidate outcomes identified via a systematic literature review and survey of key stakeholders were reduced to 74 that were rated by 100 health care professionals and patients in two Delphi rounds. 27 outcomes were provisionally accepted. The final core set of 5 agreed-upon outcomes after the consensus meeting was: complete response; persistent or serious adverse events; recurrence-free survival; quality of life; and patient satisfaction, including with cosmetic outcome. LIMITATIONS English-speaking patients and professionals rated outcomes extracted from English-language studies. CONCLUSIONS A core outcome set (COS) for basal cell carcinoma has been developed. Use of relevant measures may improve the utility of clinical research and the quality of therapeutic guidance available to clinicians.
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Affiliation(s)
- Daniel I Schlessinger
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Kelly A Reynolds
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL; University of Cincinnati College of Medicine, Cincinnati, OH
| | - McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Arianna F Yanes
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Jake M Lazaroff
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Victoria Godinez-Puig
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Brian R Chen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Jill K Cotseones
- Medical & Cosmetic Dermatology Service, Northwestern Medicine Regional Medical Group, Naperville, IL
| | - Sarah G Chiren
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karina C Furlan
- Department of Pathology, Rush University Medical Center, Chicago, IL
| | - Sanjana Iyengar
- Department of Dermatology, West Virginia University, Morgantown, WV
| | - Ramona Behshad
- Department of Dermatology, Saint Louis University, St. Louis, MO
| | - Danielle M DeHoratius
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Pablo Denes
- Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | | | - Jeremy R Etzkorn
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Catherine A Harwood
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK; Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - John Y S Kim
- Division of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Naomi Lawrence
- Division of Dermatologic Surgery, Department of Dermatology, Cooper University Hospital, Camden, NJ
| | - Erica H Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gary S Lissner
- Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Ashfaq A Marghoob
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York City, NY
| | - Rubeta N Matin
- Department of Dermatology, Churchill Hospital, Oxford, UK
| | - Adam R Mattox
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - Bharat B Mittal
- Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - J Regan Thomas
- Department of Otolaryngology- Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Xiaolong Alan Zhou
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - David Zloty
- Department of Dermatology & Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jochen Schmitt
- Center for Evidence-based Healthcare, Medical Faculty, Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jamie J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - April W Armstrong
- Keck School of Medicine, Department of Dermatology, University of Southern California Los Angeles
| | | | | | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, OH, USA
| | | | - Marc Brown
- Professor of Dermatology and Oncology; University of Rochester, MN, USA
| | - Mariah Brown
- Department of Dermatology, University of Colorado Hospital and School of Medicine
| | | | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Sergio Jobim De Azevedo
- Professor, Department of Medicine, Chief of Medical Oncology at Hospital de Clinicas de Porto Alegre, Brazil
| | - Reinhard Dummer
- University Hospital, Skin Cancer Center, Zurich, Switzerland
| | | | | | - Merete Haedersdal
- Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | | | | | - Kelly L Harms
- Department of Dermatology, the Comprehensive Cancer Center University of Michigan Medical School, Ann Arbor
| | - Conway C Huang
- Department of Dermatology, University of Alabama at Birmingham, AL, USA
| | - Eva A Hurst
- Distinctive Dermatology, Fairview Heights, IL, USA
| | - Gino K In
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | | | | | | | | | | | - Eliot N Mostow
- Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA
| | - Myrto Trakatelli
- Associate Professor of Dermatology, Papageorgiou Hospital, Aristotle University Department of Medicine, Thessaloniki, Greece
| | - Kishwer S Nehal
- Attending Physician, Memorial Sloan Kettering Cancer Center; Director, Mohs and Dermatological Surgery; Professor of Dermatology, Weill Cornell Medical College, NY, USA
| | | | | | | | | | - Thomas Stasko
- Professor and Chair, The University of Oklahoma Department of Dermatology, OK, USA
| | - Paul A Storrs
- University of Illinois Chicago, Department of Dermatology, IL, USA
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Italy
| | | | | | - Siegrid S Yu
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Iris Zalaudek
- Department of Dermatology and Venereology, University of Trieste, Italy
| | | | - John A Zitelli
- Clinical Associate Professor of Dermatology, Otolaryngology, Plastic Surgery, University of Pittsburgh Medical Center, PA, USA
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Joseph F Sobanko
- Department of Dermatology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA; Division of Dermatologic Surgery, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Todd V Cartee
- Department of Dermatology, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Otolaryngology- Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
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11
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Yurchenko AA, Pop OT, Ighilahriz M, Padioleau I, Rajabi F, Sharpe HJ, Poulalhon N, Dreno B, Khammari A, Delord M, Alberti A, Soufir N, Battistella M, Mourah S, Bouquet F, Savina A, Besse A, Mendez-Lopez M, Grange F, Monestier S, Mortier L, Meyer N, Dutriaux C, Robert C, Saiag P, Herms F, Lambert J, de Sauvage FJ, Dumaz N, Flatz L, Basset-Seguin N, Nikolaev SI. Frequency and Genomic Aspects of Intrinsic Resistance to Vismodegib in Locally Advanced Basal Cell Carcinoma. Clin Cancer Res 2022; 28:1422-1432. [PMID: 35078858 PMCID: PMC9365352 DOI: 10.1158/1078-0432.ccr-21-3764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/03/2021] [Accepted: 01/20/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Vismodegib is approved for the treatment of locally advanced basal cell carcinoma (laBCC), but some cases demonstrate intrinsic resistance (IR) to the drug. We sought to assess the frequency of IR to vismodegib in laBCC and its underlying genomic mechanisms. EXPERIMENTAL DESIGN Response to vismodegib was evaluated in a cohort of 148 laBCC patients. Comprehensive genomic and transcriptomic profiling was performed in a subset of five intrinsically resistant BCC (IR-BCC). RESULTS We identified that IR-BCC represents 6.1% of laBCC in the studied cohort. Prior treatment with chemotherapy was associated with IR. Genetic events that were previously associated with acquired resistance (AR) in BCC or medulloblastoma were observed in three out of five IR-BCC. However, IR-BCCs were distinct by highly rearranged polyploid genomes. Functional analyses identified hyperactivation of the HIPPO-YAP and WNT pathways at RNA and protein levels in IR-BCC. In vitro assay on the BCC cell line further confirmed that YAP1 overexpression increases the cell proliferation rate. CONCLUSIONS IR to vismodegib is a rare event in laBCC. IR-BCCs frequently harbor resistance mutations in the Hh pathway, but also are characterized by hyperactivation of the HIPPO-YAP and WNT pathways.
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Affiliation(s)
- Andrey A. Yurchenko
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Oltin T. Pop
- Institute of Immunobiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | - Ismael Padioleau
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Fatemeh Rajabi
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | | | - Nicolas Poulalhon
- Service de dermatologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Brigitte Dreno
- Department of Dermato-Oncology, CHU Nantes, Nantes Université, CIC 1413, Inserm UMR 1302/EMR6001 INCIT, F-44000 Nantes, France
| | - Amir Khammari
- Department of Dermato-Oncology, CHU Nantes, Nantes Université, CIC 1413, Inserm UMR 1302/EMR6001 INCIT, F-44000 Nantes, France
| | - Marc Delord
- Université de Paris, Hôpital Saint-Louis, Paris, France.,Department of Population Health Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | | | | | - Maxime Battistella
- INSERM U976, Hôpital Saint-Louis, Paris, France.,Université de Paris, Hôpital Saint-Louis, Paris, France.,Service d'anatomie pathologique, Hôpital Saint-Louis, Claude Vellefaux, Paris, France
| | - Samia Mourah
- INSERM U976, Hôpital Saint-Louis, Paris, France.,Université de Paris, Hôpital Saint-Louis, Paris, France.,Département de Génomique des Tumeurs Solides, Hôpital Saint-Louis, Claude Vellefaux, Paris, France
| | | | | | - Andrej Besse
- Institute of Immunobiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Max Mendez-Lopez
- Institute of Immunobiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Florent Grange
- Service de dermatologie, CHU Reims, Rue du general Koenig, Reims, France.,Service de Dermatologie, centre hospitalier de Valence, Valence, France
| | | | - Laurent Mortier
- Service de dermatologie, CHU Lille, Clin Dermato Hop Huriez, Rue Michel Polonovski, Lille, France
| | - Nicolas Meyer
- Service de dermatologie, Institut Univeristaire du Cancer et CHU de Toulouse, Hôpital Larrey, Toulouse, France
| | | | - Caroline Robert
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France.,Department of Medical Oncology, Gustave Roussy and Paris-Saclay University, Villejuif, France
| | - Philippe Saiag
- Department of General and Oncologic Dermatology, Ambroise-Paré hospital, APHP, and EA 4340 “Biomarkers in Cancerology and Hemato-oncology,” UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Florian Herms
- Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | - Jerome Lambert
- Université de Paris, Hôpital Saint-Louis, Paris, France.,Service de Biostatistique et Information Médicale, Hôpital Saint-Louis, Paris, France
| | | | | | - Lukas Flatz
- Institute of Immunobiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.,Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
| | - Nicole Basset-Seguin
- INSERM U976, Hôpital Saint-Louis, Paris, France.,Université de Paris, Hôpital Saint-Louis, Paris, France.,Service de dermatologie, Hôpital Saint-Louis, Paris, France.,Corresponding Authors: Sergey I. Nikolaev, U981 INSERM, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94800 Villejuif, France. Phone: 33-142115775; E-mail: ; and Nicole Basset-Seguin, Service de dermatologie, unité d'oncodermatologie, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010 Paris. Phone: 33-153722066; Fax: 33-142355310; E-mail:
| | - Sergey I. Nikolaev
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France.,Corresponding Authors: Sergey I. Nikolaev, U981 INSERM, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94800 Villejuif, France. Phone: 33-142115775; E-mail: ; and Nicole Basset-Seguin, Service de dermatologie, unité d'oncodermatologie, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010 Paris. Phone: 33-153722066; Fax: 33-142355310; E-mail:
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12
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Bassompierre A, Dalac S, Dreno B, Neidhardt EM, Maubec E, Capelle C, Andre F, Behal H, Dziwniel V, Bens G, Leccia MT, Meyer N, Granel-Brocard F, Beylot-Barry M, Dereure O, Basset-Seguin N, Mortier L. Efficacy of sonic hedgehog inhibitors rechallenge, after initial complete response in recurrent advanced basal cell carcinoma: a retrospective study from the CARADERM database. ESMO Open 2021; 6:100284. [PMID: 34689002 PMCID: PMC8551849 DOI: 10.1016/j.esmoop.2021.100284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Smoothened (SMO) inhibitors, blocking the sonic hedgehog pathway, have been approved for advanced basal cell carcinoma (aBCC). Safety analyses reveal a high rate of adverse events (AEs) and, most of the time, vismodegib is most commonly stopped when the best overall response is reached. The long-term evolution of aBCC after vismodegib discontinuation is poorly described. The aim of this study is to evaluate the efficacy and safety of the SMO inhibitors (SMOis) available (vismodegib and sonidegib) following rechallenge after complete response (CR) following an initial treatment by vismodegib. MATERIALS AND METHODS This real-life, retrospective, multicenter and descriptive study is based on an extraction from the CARADERM accredited database, including 40 French regional hospitals, of patients requiring BCC systemic treatment. RESULTS Of 303 patients treated with vismodegib, 110 achieved an initial CR. The vast majority of these patients (98.2%) stopped vismodegib, notably due to poorly tolerated AEs. The CARADERM database provided a median follow-up of 21 months (13.5-36.0 months) after CR. Of the 110 patients, 48.1% relapsed after a median relapse-free survival of 24 months (13.0-38.0 months). Among them, 35 patients were retreated by an SMOi and the overall response rate was 65.7% (34.3% of CR and 31.4% of partial response). The median duration of retreatment was 6.0 months (4.0-9.5 months). CONCLUSION Our real-life study, carried out on patients with complex clinical pictures, shows that after treatment discontinuation, 48.1% of patients achieved CR relapse within an average of 24 months (13.0-38.0 months). It emphasized that even though rechallenge can be considered as a therapeutic option, efficacy seems to decrease, suggesting the development of resistance mechanisms.
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Affiliation(s)
- A Bassompierre
- Department of Dermatology, Lille University, CHU Lille, Lille, France.
| | - S Dalac
- Department of Dermatology, Dijon University Hospital, Dijon, France
| | - B Dreno
- Department of Dermatology, Dieu Hospital, Nantes, France
| | - E M Neidhardt
- Department of Dermatology, Léon Bérard Center, Lyon, France
| | - E Maubec
- Department of Dermatology, AP-HP, Avicenne University Hospital, Bobigny, France
| | - C Capelle
- Department of Dermatology, Lille University, CHU Lille, Lille, France
| | - F Andre
- Department of Dermatology, Lille University, CHU Lille, Lille, France
| | - H Behal
- Health Technology and Medical Practice Assessment, ULR 2694-METRICS, Lille University Hospital, University of Lille, Lille, France
| | - V Dziwniel
- Department of Dermatology, Lille University, CHU Lille, Lille, France; Languages Department, Centrale Lille Institut, Villeneuve d'Ascq, France
| | - G Bens
- Department of Dermatology, Orleans Regional Hospital, Orleans, France
| | - M T Leccia
- Department of Dermatology, Grenoble University Hospital, Grenoble, France
| | - N Meyer
- Department of Dermatology, IUC and CHU de Toulouse, Toulouse, France
| | - F Granel-Brocard
- Department of Dermatology, Nancy University Hospital, Nancy, France
| | - M Beylot-Barry
- Department of Dermatology, Bordeaux University Hospital, Bordeaux, France
| | - O Dereure
- Department of Dermatology, University of Montpellier, Montpellier, France
| | - N Basset-Seguin
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris University Hospital, Paris, France
| | - L Mortier
- Department of Dermatology, Lille University, CHU Lille, Lille, France; INSERM U1189, CARADERM, CHU Lille, Lille, France
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13
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Monnet P, Herms F, Djermane M, Dalac S, Dereure O, Dréno B, Beylot-Barry M, Mortier L, Basset-Seguin N. Characterization of patients with advanced basal cell carcinoma progressing while receiving Hedgehog pathway inhibitors. Br J Dermatol 2021; 186:579-581. [PMID: 34817864 DOI: 10.1111/bjd.20808] [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: 09/05/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 11/30/2022]
Affiliation(s)
- P Monnet
- Dermatology Department, AP-HP, Saint-Louis Hospital, Paris, France
| | - F Herms
- Dermatology Department, AP-HP, Saint-Louis Hospital, Paris, France.,CARADERM (Cancers RAres en DERMatologie), Lille, France
| | - M Djermane
- Dermatology Department, AP-HP, Saint-Louis Hospital, Paris, France.,CARADERM (Cancers RAres en DERMatologie), Lille, France
| | - S Dalac
- CARADERM (Cancers RAres en DERMatologie), Lille, France.,Dermatology Department, Dijon Bourgogne University Hospital, Dijon, France
| | - O Dereure
- CARADERM (Cancers RAres en DERMatologie), Lille, France.,Dermatology Department, Montpellier University Hospital, Montpellier, France
| | - B Dréno
- CARADERM (Cancers RAres en DERMatologie), Lille, France.,Dermatology Department, Nantes University Hospital, Nantes, France
| | - M Beylot-Barry
- CARADERM (Cancers RAres en DERMatologie), Lille, France.,Dermatology Department, Saint-André Hospital, Bordeaux, France
| | - L Mortier
- CARADERM (Cancers RAres en DERMatologie), Lille, France.,Dermatology Department, Lille University Hospital, Lille, France
| | - N Basset-Seguin
- Dermatology Department, AP-HP, Saint-Louis Hospital, Paris, France.,CARADERM (Cancers RAres en DERMatologie), Lille, France
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14
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Hughes BGM, Mendoza RG, Basset-Seguin N, Vornicova O, Schachter J, Joshi A, Meyer N, Grange F, Piulats JM, Bauman JR, Chirovsky D, Zhang P, Gumuscu B, Swaby RF, Grob JJ. Health-Related Quality of Life of Patients with Recurrent or Metastatic Cutaneous Squamous Cell Carcinoma Treated with Pembrolizumab in KEYNOTE-629. Dermatol Ther (Heidelb) 2021; 11:1777-1790. [PMID: 34558040 PMCID: PMC8484388 DOI: 10.1007/s13555-021-00598-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/30/2021] [Accepted: 08/18/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Pembrolizumab provided durable responses and acceptable safety in recurrent or metastatic (R/M) cutaneous squamous cell carcinoma (cSCC) in the KEYNOTE-629 study. In this elderly, fragile population with disfiguring tumours, preservation of health-related quality of life (HRQoL) is critical. Here, we present pre-specified exploratory HRQoL analyses from the first interim analysis of KEYNOTE-629. METHODS Patients with R/M cSCC not amenable to surgery or radiation therapy received pembrolizumab 200 mg every 3 weeks for ≤ 24 months. HRQoL end points included change from baseline to week 12 in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) global health status (GHS)/QoL, functioning, symptom and European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) scores and change from baseline through week 48 in EORTC QLQ-C30 GHS/QoL and physical functioning scores. Improvement (≥ 10-point increase post-baseline with confirmation) was assessed using the exact binomial method. RESULTS Analyses included 99 patients for EORTC QLQ-C30 and 100 for EQ-5D-5L. Compliance was > 80% at week 12. Mean scores were stable from baseline to week 12 for GHS/QoL (4.95 points; 95% confidence interval, -1.00 to 10.90) and physical functioning (-3.38 points; 95% confidence interval, -8.80 to 2.04). EORTC-QLQ-C30 functioning, symptom, and EQ-5D-5L scores remained stable at week 12. Post-baseline scores were improved in 29.3% of patients for GHS/QoL, 17.2% for physical functioning, and in a numerically higher proportion of responders versus non-responders (GHS/QoL, 55.6% versus 16.1%; physical functioning, 36.1% versus 7.1%). CONCLUSIONS In elderly patients with R/M cSCC, the clinical efficacy of pembrolizumab translates into a benefit validated by HRQoL preservation or improvement during treatment. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03284424.
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Affiliation(s)
- Brett G M Hughes
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia. .,University of Queensland, Brisbane, QLD, Australia.
| | | | | | | | - Jacob Schachter
- The Chaim Sheba Medical Center at Tel HaShomer, Ramat Gan, Israel
| | - Abhishek Joshi
- Townsville University Hospital, Townsville, QLD, Australia
| | - Nicolas Meyer
- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Florent Grange
- Centre Hospitalier Universitaire de Reims-Hoˆpital Robert Debre, Reims, France.,Centre Hospitalier Universitaire de Reims Hôpital Robert Debré, Valence, France
| | - Josep M Piulats
- Hospital Duran i Reinals ICO de Hospitalet, Barcelona, Spain
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15
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Lear J, Hauschild A, Squittieri N, Basset-Seguin N, Dummer R. 26206 Effect of sonidegib on secondary tumor size endpoints through 12 weeks of treatment in patients with nevoid basal cell carcinoma syndrome. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.380] [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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16
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Grob JJ, Guminski A, Malvehy J, Basset-Seguin N, Bertrand B, Fernandez-Penas P, Kaufmann R, Zalaudek I, Gaudy-Marqueste C, Fargnoli MC, Tagliaferri L, Fertil B, Del Marmol V, Stratigos A, Garbe C, Peris K. Position statement on classification of basal cell carcinomas. Part 1: unsupervised clustering of experts as a way to build an operational classification of advanced basal cell carcinoma based on pattern recognition. J Eur Acad Dermatol Venereol 2021; 35:1949-1956. [PMID: 34432327 PMCID: PMC8518046 DOI: 10.1111/jdv.17466] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 05/18/2021] [Indexed: 12/01/2022]
Abstract
Background No simple classification system has emerged for ‘advanced basal cell carcinomas’, and more generally for all difficult‐to‐treat BCCs (DTT‐BCCs), due to the heterogeneity of situations, TNM inappropriateness to BCCs, and different approaches of different specialists. Objective To generate an operational classification, using the unconscious ability of experts to simplify the great heterogeneity of the clinical situations into a few relevant groups, which drive their treatment decisions. Method Non‐supervised independent and blinded clustering of real clinical cases of DTT‐BCCs was used. Fourteen international experts from different specialties independently partitioned 199 patient cases considered ‘difficult to treat’ into as many clusters they want (≤10), choosing their own criteria for partitioning. Convergences and divergences between the individual partitions were analyzed using the similarity matrix, K‐mean approach, and average silhouette method. Results There was a rather consensual clustering of cases, regardless of the specialty and nationality of the experts. Mathematical analysis showed that consensus between experts was best represented by a partition of DTT‐BCCs into five clusters, easily recognized a posteriori as five clear‐cut patterns of clinical situations. The concept of ‘locally advanced’ did not appear consistent between experts. Conclusion Although convergence between experts was not granted, this experiment shows that clinicians dealing with BCCs all tend to work by a similar pattern recognition based on the overall analysis of the situation. This study thus provides the first consensual classification of DTT‐BCCs. This experimental approach using mathematical analysis of independent and blinded clustering of cases by experts can probably be applied to many other situations in dermatology and oncology.
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Affiliation(s)
- J J Grob
- Dermatology and skin cancer Dpt APHM Timone, Aix-Marseille University, Marseille, France
| | - A Guminski
- Melanoma Institute Australia, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia
| | - J Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain
| | | | - B Bertrand
- Plastic, Reconstructive and Aesthetic Surgery Department, Aix-Marseille University, APHM Conception, Marseille, France
| | - P Fernandez-Penas
- Centre for Translational Skin Research, The University of Sydney, Westmead, NSW, Australia.,Department of Dermatology, Westmead Hospital, Westmead, NSW, Australia
| | - R Kaufmann
- Department of Dermatology, Venereology and Allergology, University Hospital, Frankfurt, Germany
| | - I Zalaudek
- Dermatology Clinic, University of Trieste, Trieste, Italy
| | - C Gaudy-Marqueste
- Dermatology and skin cancer Dpt APHM Timone, Aix-Marseille University, Marseille, France
| | - M C Fargnoli
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
| | - L Tagliaferri
- Dipartimento di Scienze Radiologiche, Radioterapiche Ed Ematologiche, UOC di Radioterapia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - B Fertil
- Anapix Medical, Meyreuil, France
| | - V Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - A Stratigos
- Department of Dermatology- Venereology, School of Medicine, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - C Garbe
- Department of Dermatology, Centre for Dermatooncology, Eberhard-Karls University, Tuebingen, Germany
| | - K Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Italy.,IRCCS, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
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17
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Grob JJ, Gaudy-Marqueste C, Guminski A, Malvehy J, Basset-Seguin N, Bertrand B, Fernandez-Penas P, Kaufmann R, Zalaudek I, Fargnoli MC, Tagliaferri L, Fertil B, Del Marmol V, Stratigos A, Garbe C, Peris K. Position statement on classification of basal cell carcinomas. Part 2: EADO proposal for new operational staging system adapted to basal cell carcinomas. J Eur Acad Dermatol Venereol 2021; 35:2149-2153. [PMID: 34424580 PMCID: PMC8597032 DOI: 10.1111/jdv.17467] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/07/2021] [Indexed: 11/30/2022]
Abstract
Background No simple staging system has emerged for basal cell carcinomas (BCCs), since they do not follow the TNM process, and practitioners failed to agree on simple clinical or pathological criteria as a basis for a classification. Operational classification of BCCs is required for decision‐making, trials and guidelines. Unsupervised clustering of real cases of difficult‐to‐treat BCCs (DTT‐BCCs; part 1) has demonstrated that experts could blindly agree on a five groups classification of DTT‐BCCs based on five patterns of clinical situations. Objective Using this five patterns to generate an operational and comprehensive classification of BCCs. Method Testing practitioner's agreement, when using the five patterns classification to ensure that it is robust enough to be used in the practice. Generating the first version of a staging system of BCCs based on pattern recognition. Results Sixty‐two physicians, including 48 practitioners and the 14 experts who participated in the generation of the five different patterns of DTT‐BCCs, agreed on 90% of cases when classifying 199 DTT‐BCCs cases using the five patterns classification (part 1) attesting that this classification is understandable and usable in practice. In order to cover the whole field of BCCs, these five groups of DTT‐BCCs were added a group representing the huge number of easy‐to‐treat BCCs, for which sub‐classification has little interest, and a group of very rare metastatic cases, resulting in a four‐stage and seven‐substage staging system of BCCs. Conclusion A practical classification adapted to the specificities of BCCs is proposed. It is the first tumour classification based on pattern recognition of clinical situations, which proves to be consistent and usable. This EADO staging system version 1 will be improved step by step and tested as a decision tool and a prognostic instrument.
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Affiliation(s)
- J J Grob
- Aix-Marseille University, APHM, Marseille, France
| | | | - A Guminski
- Melanoma Institute Australia, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia
| | - J Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain
| | | | - B Bertrand
- Plastic, Reconstructive and Aesthetic Surgery Department, La Conception Hospital, Marseille, France
| | - P Fernandez-Penas
- Centre for Translational Skin Research, The University of Sydney, Westmead, NSW, Australia.,Department of Dermatology, Westmead Hospital, Westmead, NSW, Australia
| | - R Kaufmann
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt, Germany
| | - I Zalaudek
- Dermatology Clinic, University of Trieste, Trieste, Italy
| | - M C Fargnoli
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
| | - L Tagliaferri
- Dipartimento di Scienze Radiologiche, Radioterapiche Ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radioterapia, Rome, Italy
| | - B Fertil
- Anapix Medical, Meyreuil, France
| | - V Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - A Stratigos
- Department of Dermatology- Venereology, National and Kapodistrian University of Athens, School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
| | - K Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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18
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Bertrand N, Guerreschi P, Basset-Seguin N, Saiag P, Dupuy A, Dalac-Rat S, Dziwniel V, Depoortère C, Duhamel A, Mortier L. Vismodegib in neoadjuvant treatment of locally advanced basal cell carcinoma: First results of a multicenter, open-label, phase 2 trial (VISMONEO study): Neoadjuvant Vismodegib in Locally Advanced Basal Cell Carcinoma. EClinicalMedicine 2021; 35:100844. [PMID: 33997740 PMCID: PMC8093898 DOI: 10.1016/j.eclinm.2021.100844] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Surgery is the primary treatment for basal cell carcinoma (BCC). In locally advanced basal cell carcinoma (laBCC), surgery may cause functional or aesthetic damage. In laBCC, neoadjuvant administration of vismodegib, an inhibitor of the Hedgehog signaling pathway, may reduce tumor size, facilitate resection, and reduce functional and aesthetic consequences of surgery. The VISMONEO study assessed efficacy and safety of vismodegib in neoadjuvant treatment of laBCC. METHODS VISMONEO (NCT02667574) is an open-label, noncomparative, multicenter, phase 2 study. Patients with ≥1 histologically confirmed facial BCC, inoperable or operable with functional or major aesthetic sequelae risk, were included. Oral vismodegib 150 mg was administered once daily for 4 to 10 months before planned surgery, which was performed once the best response under vismodegib was observed. Primary endpoint was percentage of patients with BCC with tumor downstaging following surgical resection after neoadjuvant vismodegib. Downstaging was defined according to a 6-stage surgical classification related to the aesthetic and functional consequences of surgery. FINDINGS 55 patients (median age: 73 years) with laBCC were included from November 2014 to June 2015. At inclusion, 4 patients were inoperable, 15 were operable with a major functional risk, and 36 were operable with a minor functional risk or a major aesthetic risk. Mean size of target lesion was 47.3 mm (SD: 27.2 mm). 44 patients presented with downstaging after vismodegib treatment (80%; 95% confidence interval [CI], 67 to 90). Of these 44 patients, 27 had a complete response (25 proved by biopsy). Mean treatment duration was 6.0 months. Overall Response Rate according to RECIST 1.1 criteria was 71% (95% CI, 59 to 88). At 3-years of follow-up, 16/44 patients had known recurrence (36%; 95%CI, 22 to 51). INTERPRETATION Neoadjuvant vismodegib allows for a downstaging of the surgical procedure for laBCCs in functionally sensitive locations. FUNDING VISMONEO was funded by F. Hoffmann-La Roche Ltd.
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Affiliation(s)
| | - Pierre Guerreschi
- Univ. Lille, CHU Lille, Plastic and Reconstructive Surgery Department, Lille, France
| | | | - Philippe Saiag
- Hôpital Ambroise Paré AP-HP, Dermatology Department, Boulogne‐Billancourt, France
| | - Alain Dupuy
- CHU Rennes, Dermatology Department, Rennes, France
| | | | | | - César Depoortère
- Univ. Lille, CHU Lille, Plastic and Reconstructive Surgery Department, Lille, France
| | | | - Laurent Mortier
- Univ. Lille, INSERM U1189, CHU Lille, Dermatology Department, Lille, France
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19
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Ighilahriz M, Nikolaev S, Yurchenko AA, Battistella M, Mourah S, Jouenne F, Bourrat E, Basset-Seguin N. A Novel Case of Gorlin Syndrome Mosaicism Involving an SMO Gene Mutation: Clinical, Histological and Molecular Analysis of Basaloid Tumours. Acta Derm Venereol 2021; 101:adv00434. [PMID: 33846763 PMCID: PMC9364259 DOI: 10.2340/00015555-3797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
Introduction: Basal cell carcinoma (BCC) is the most frequent skin malignancy, with incidence increasing worldwide. Most BCC can be cured with local treatments (surgery or topical therapies), but advanced or recurrent forms require specific therapies. Significant developments targeting the sonic hedgehog signalization pathway have been made in the past years, paving the way for new therapies.Areas covered: This review details emerging drugs for BCC treatment, focusing on topical, intra-tumoral, and systemic therapies, such as new targeted therapies and immune checkpoint inhibitors. A literature search was conducted to identify ongoing studies using PudMed database and clinicaltrials.gov website.Expert opinion: Although surgery is and will probably remain the gold-standard therapy for BCC, treatment of recurrent, advanced, and metastatic tumors is evolving. Emergence of tumors resistant to targeted therapies lead the way to new approaches. Topical and intra-tumoral treatments represent alternatives to surgical morbidity, and many studies are ongoing. The first results of immune checkpoint inhibitors are encouraging in advanced and metastatic forms of the disease. New targeted therapies are needed to overcome or prevent the resistance to standard hedgehog pathway inhibitors.
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Affiliation(s)
- Florian Herms
- Department of Dermatology, Université De Paris, Hôpital Saint-Louis, Paris, France
| | - Nicole Basset-Seguin
- Department of Dermatology, Université De Paris, Hôpital Saint-Louis, Paris, France
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Dauendorffer JN, Herms F, Baroudjian B, Basset-Seguin N, Cavelier-Balloy B, Fouéré S, Bagot M, Lebbé C. Penoscrotal Paget's disease. Ann Dermatol Venereol 2021; 148:71-76. [PMID: 33461789 DOI: 10.1016/j.annder.2020.08.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/12/2020] [Accepted: 08/31/2020] [Indexed: 10/22/2022]
Abstract
Paget's disease (PD) denotes an initially intra-epidermal adenocarcinoma that can later invade the dermis and metastasise. Among the extramammary forms of PD (EMPD), penoscrotal presentations are rarer than the vulvar and perianal forms. Once diagnosis has been confirmed by histopathological examination, a search for associated neoplasia must be conducted, although penoscrotal EMPD is less frequently associated with underlying neoplasia than mammary PD (MPD). The associated cancer most often involves a neighbouring organ, with prostate cancer being the most common, or in some cases consists of underlying cutaneous adnexal tumours. First-line therapy consists of surgical excision. Alternatives to surgery (imiquimod, CO2 laser vaporisation, dynamic phototherapy) may be considered in certain cases.
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Affiliation(s)
| | - F Herms
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - B Baroudjian
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - N Basset-Seguin
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | | | - S Fouéré
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - M Bagot
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - C Lebbé
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
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Trager MH, Farmer K, Ulrich C, Basset-Seguin N, Herms F, Geskin LJ, Bouaziz JD, Lebbé C, de Masson A, Bagot M, Dobos G. Actinic cheilitis: a systematic review of treatment options. J Eur Acad Dermatol Venereol 2020; 35:815-823. [PMID: 33251620 DOI: 10.1111/jdv.16995] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/02/2020] [Indexed: 12/20/2022]
Abstract
Actinic cheilitis is a premalignant condition that can progress to squamous cell carcinoma with a higher propensity for metastasis than cutaneous squamous cell carcinoma. Optimal treatment for actinic cheilitis has not been established, and evidence-based estimates of clinical cure in the dermatology literature are limited. Here, we review and synthesize outcome data published for patients with actinic cheilitis after treatment with various modalities. A systematic review was conducted in MEDLINE, Embase and the Cochrane library for English, French and German-language studies and references of included articles from inception to 20 January 2020. Studies were included if they reported on at least six patients with biopsy-proven actinic cheilitis. After quality appraisal, results of studies with the strongest methodology criteria were synthesized. 18 studies of 411 patients (published 1985 to 2016) were included. The majority of the studies were case series. Carbon dioxide laser ablation and vermilionectomy were associated with the most favourable outcomes with fewest recurrences. Chemical peel and photodynamic therapy were associated with higher recurrence. Adverse effects generally resolved in the weeks following treatment and cosmetic outcomes were favourable overall. In conclusion, there is a lack of high-quality comparative studies evaluating different treatment options for actinic cheilitis. The included publications used various outcome measures; however, the majority reported on the recently defined core outcome sets. These results suggest that both carbon dioxide laser ablation and vermilionectomy are effective treatments for actinic cheilitis. Prospective head-to-head studies are needed to compare these treatment modalities and to assess patient preferences.
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Affiliation(s)
- M H Trager
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - K Farmer
- Skin Cancer Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Ulrich
- Skin Cancer Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - N Basset-Seguin
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,U976, INSERM, Saint-Louis Hospital, Paris, France.,Université de Paris, Paris, France
| | - F Herms
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France
| | - L J Geskin
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - J-D Bouaziz
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,U976, INSERM, Saint-Louis Hospital, Paris, France.,Université de Paris, Paris, France
| | - C Lebbé
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,U976, INSERM, Saint-Louis Hospital, Paris, France.,Université de Paris, Paris, France
| | - A de Masson
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,U976, INSERM, Saint-Louis Hospital, Paris, France.,Université de Paris, Paris, France
| | - M Bagot
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,U976, INSERM, Saint-Louis Hospital, Paris, France.,Université de Paris, Paris, France
| | - G Dobos
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,U976, INSERM, Saint-Louis Hospital, Paris, France.,Université de Paris, Paris, France
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Benajiba L, Lambert J, La Selva R, Cochereau D, Baroudjian B, Roux J, Le Goff J, Basset-Seguin N, Pages C, Battistella M, Delyon J, Lebbé C. Évolution clinique et prise en charge thérapeutique du sarcome de Kaposi classique et endémique. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.197] [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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Maubec E, Boubaya M, Petrow P, Beylot-Barry M, Basset-Seguin N, Deschamps L, Grob J, Dréno B, Scheer-Senyarich I, Bloch-Queyrat C, Leccia MT, Stefan A, Saiag P, Grange F, Meyer N, de Quatrebarbes J, Dinulescu M, Legoupil D, Machet L, Dereure O, Zehou O, Montaudié H, Wierzbicka-Hainaut E, Le Corre Y, Mansard S, Guegan S, Arnault JP, Dalac S, Aubin F, Alloux C, Lopez I, Cherbal S, Tibi A, Dalac S, Levy V. Étude de phase II de l’administration de pembrolizumab (MK-3475) en monothérapie et en première ligne chez des patients présentant un carcinome épidermoïde cutané non opérable. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.033] [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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25
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Tetu P, Sirven-Villaros L, Cuzzubbo S, Ursu R, Baroudjian B, Delyon J, Nataf F, De Margerie-Mellon C, Basset-Seguin N, Allayous C, Lefevre W, Carpentier A, Lebbé C. Impact des nouveaux traitements systémiques et de la radiothérapie cérébrale concomitante dans la prise en charge des patients présentant un mélanome avec atteinte leptoméningée. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.486] [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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Tetu P, Baroudjian B, Delyon J, Basset-Seguin N, Allayous C, Oriano B, Lebbé C. Facteurs pronostiques et prédictifs associés au traitement par nivolumab et ipilimumab chez les patients présentant un mélanome métastatique. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Soufir N, Benfodda M, Descamps V, Gazal S, Madjlessi-Ezra N, Colomb M, Baccard M, Archimbaud A, Renard F, Fite C, Grange A, Levy-Sitbon C, Vuong V, Jehou J, Arnoult-Coudoux E, Bachoud A, Massart-Manil S, Nicaise-Bergere C, Machuel B, Schernberg C, Lami MC, Basset-Seguin N, Lebbe C, Dupin N, Wolkenstein P, Bagot M, Saiag P, Fraitag S, Bensussan A, Marinho E, Nagore E, Kumar R, Grange F. L’algorithme MELAPRED apparaît comme un outil clef du dépistage ciblé du mélanome. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.015] [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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Duverger L, Cavelier-Balloy B, Basset-Seguin N, Lebbé C, Battistella M. Reproductibilité intra- et inter-observateurs des critères histopronostiques dans les carcinomes épidermoïdes cutanés. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.294] [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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29
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Duverger L, Cavelier-Balloy B, Basset-Seguin N, Lebbé C, Battistella M. Étude anatomo-clinique et pronostique des carcinomes épidermoïdes cutanés de type folliculaire. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.295] [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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30
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Nikolaev S, Yurchenko A, Ighilahriz M, Tiberiu Pop O, Delord M, Sharpe H, De Sauvage F, Dumaz N, Alberti A, Basset-Seguin N. Caractérisation génomique de la résistance primaire au vismodegib dans les carcinomes basocellulaires avancés. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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Haddad N, Delyon J, Trabelsi Messai S, Herms F, Leccia MT, Lebbe C, Whitney J, Bhatia S, Basset-Seguin N. Clinical response to immune checkpoint inhibition in patients with advanced skin cancers receiving concurrent ruxolitinib therapy for haematological malignancy. Br J Dermatol 2020; 184:564-566. [PMID: 33058221 DOI: 10.1111/bjd.19604] [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: 12/27/2019] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 11/30/2022]
Affiliation(s)
- N Haddad
- Department of Dermatology, AP-HP Saint-Louis Hospital, Paris, France
| | - J Delyon
- Department of Dermatology, AP-HP Saint-Louis Hospital, Paris, France.,Department of Dermatology, Université de Paris VII Diderot, Sorbonne Université Cité, Paris, France.,INSERM HIPI, Université de Paris VII Diderot, Sorbonne Université Cité, Paris, France
| | | | - F Herms
- Department of Dermatology, AP-HP Saint-Louis Hospital, Paris, France
| | - M T Leccia
- Dermatology Department, CHU de Grenoble, Grenoble, France
| | - C Lebbe
- Department of Dermatology, AP-HP Saint-Louis Hospital, Paris, France.,Department of Dermatology, Université de Paris VII Diderot, Sorbonne Université Cité, Paris, France.,INSERM HIPI, Université de Paris VII Diderot, Sorbonne Université Cité, Paris, France
| | - J Whitney
- Department of Medicine/Medical Oncology, University of Washington, Seattle, WA, USA
| | - S Bhatia
- Department of Medicine/Medical Oncology, University of Washington, Seattle, WA, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - N Basset-Seguin
- Department of Dermatology, AP-HP Saint-Louis Hospital, Paris, France.,Department of Dermatology, Université de Paris VII Diderot, Sorbonne Université Cité, Paris, France.,INSERM HIPI, Université de Paris VII Diderot, Sorbonne Université Cité, Paris, France
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32
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Stratigos A, Sekulic A, Peris K, Bechter O, Dutriaux C, Kaatz M, Lewis K, Basset-Seguin N, Chang A, Dalle S, Fernandez-Orland A, Licitra L, Robert C, Ulrich C, Hauschild A, Migden M, Dummer R, Li S, Bowler T, Fury M. LBA47 Primary analysis of phase II results for cemiplimab in patients (pts) with locally advanced basal cell carcinoma (laBCC) who progress on or are intolerant to hedgehog inhibitors (HHIs). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2277] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Grob JJ, Gonzalez R, Basset-Seguin N, Vornicova O, Schachter J, Joshi A, Meyer N, Grange F, Piulats JM, Bauman JR, Zhang P, Gumuscu B, Swaby RF, Hughes BGM. Pembrolizumab Monotherapy for Recurrent or Metastatic Cutaneous Squamous Cell Carcinoma: A Single-Arm Phase II Trial (KEYNOTE-629). J Clin Oncol 2020; 38:2916-2925. [PMID: 32673170 PMCID: PMC7460151 DOI: 10.1200/jco.19.03054] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Treatment options are limited for patients with recurrent and/or metastatic (R/M) cutaneous squamous cell carcinoma (cSCC); mortality rates exceed 70% in patients with distant metastases. Here, we present the first interim analysis of the R/M cSCC cohort from the 2-cohort-locally advanced and R/M-phase II KEYNOTE-629 study. PATIENTS AND METHODS Patients with R/M cSCC not amenable to surgery or radiation received pembrolizumab 200 mg every 3 weeks. The primary end point was objective response rate per RECIST v1.1. Secondary end points were duration of response, disease control rate, progression-free survival, overall survival, and safety. RESULTS At data cutoff (April 8, 2019), median follow-up of 105 enrolled patients in the R/M cohort was 11.4 months (range, 0.4 to 16.3 months). Objective response rate was 34.3% (95% CI, 25.3% to 44.2%; 4 complete responses, 32 partial responses), and disease control rate was 52.4% (95% CI, 42.4% to 62.2%). Median duration of response was not reached (range, 2.7 to 13.1+ months; '+' refers to ongoing response at data cutoff). Median progression-free survival was 6.9 months (95% CI, 3.1 months to 8.5 months). Median overall survival was not reached (95% CI, 10.7 months to not reached). Treatment-related adverse events occurred in 66.7% of patients (n = 70), the most common of which were pruritus (n = 15; 14.3%), asthenia (n = 14; 13.3%), and fatigue (n = 13; 12.4%). Grade 3 to 5 treatment-related adverse events occurred in 5.7% (n = 6) of patients. One patient died of treatment-related cranial nerve neuropathy. CONCLUSION Pembrolizumab demonstrated effective antitumor activity; clinically meaningful, durable responses; and acceptable safety in primarily elderly patients with R/M cSCC, supporting its use in clinical practice. Pembrolizumab adverse events in this study were consistent with its established safety profile.
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Affiliation(s)
| | - Rene Gonzalez
- Centro Estatal de Cancerologiade Chihuahua, Chihuahua, Mexico
| | | | | | - Jacob Schachter
- Chaim Sheba Medical Center at Tel HaShomer, Ramat Gan, Israel
| | - Abhishek Joshi
- Townsville University Hospital, Townsville, QLD, Australia
| | - Nicolas Meyer
- Institut Universitaire du Cancer and CHU de Toulouse, Toulouse, France
| | - Florent Grange
- Centre Hospitalier Universitaire de Reims-Hôpital Robert Debre, Reims, France
| | - Josep M Piulats
- Hospital Duran i Reinals L'Institut Català d'Oncologia de Hospitalet, Idibell, Oncobell, Ciberonc, Barcelona, Spain
| | | | | | | | | | - Brett G M Hughes
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
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34
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Maubec E, Boubaya M, Petrow P, Beylot-Barry M, Basset-Seguin N, Deschamps L, Grob JJ, Dréno B, Scheer-Senyarich I, Bloch-Queyrat C, Leccia MT, Stefan A, Saiag P, Grange F, Meyer N, de Quatrebarbes J, Dinulescu M, Legoupil D, Machet L, Dereure O, Zehou O, Montaudié H, Wierzbicka-Hainaut E, Le Corre Y, Mansard S, Guégan S, Arnault JP, Dalac S, Aubin F, Alloux C, Lopez I, Cherbal S, Tibi A, Lévy V. Phase II Study of Pembrolizumab As First-Line, Single-Drug Therapy for Patients With Unresectable Cutaneous Squamous Cell Carcinomas. J Clin Oncol 2020; 38:3051-3061. [PMID: 32730186 DOI: 10.1200/jco.19.03357] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To evaluate first-line pembrolizumab monotherapy efficacy and safety in patients with unresectable cutaneous squamous cell carcinomas (CSCCs). PATIENTS AND METHODS Patients, predominantly men, with their CSSCs' immunohistochemically determined programmed cell death-ligand 1 (PD-L1) status determined (tumor proportion score threshold, 1%), received pembrolizumab (200 mg every 3 weeks). The primary endpoint was the 39-patient primary cohort's objective response rate at week 15 (ORRW15). Secondary objectives were best ORR, overall survival (OS), progression-free survival (PFS), duration of response (DOR), safety, ORR according to PD-L1 status and health-related quality of life using Functional Assessment of Cancer Therapy-General (FACT-G) score. An 18-patient expansion cohort, recruited to power the study to evaluate the ORRW15 difference between PD-L1+ and PD-L1- patients, was assessed for ORR, disease control rate, and safety, but not survival. RESULTS Median age of all patients was 79 years. The primary cohort's ORRW15 was 41% (95% CI, 26% to 58%), including 13 partial and 3 complete responses. Best responses were 8 partial and 8 complete responses. At a median follow-up of 22.4 months, respective median PFS, DOR, and OS were 6.7 months, not reached, and 25.3 months, respectively. Pembrolizumab-related adverse events affected 71% of the patients, and 4 (7%) were grade ≥ 3. One death was related to rapid CSCC progression; another resulted from a fatal second aggressive head and neck squamous cell carcinoma diagnosed 15 weeks postinclusion. ORRW15 for the entire population was 42%; it was significantly higher for PD-L1+ patients (55%) versus PD-L1- patients (17%; P = .02). Responders' W15 total FACT-G score had improved (P = .025) compared with nonresponders. CONCLUSION First-line pembrolizumab monotherapy exhibited promising anti-CSCC activity, with durable responses and manageable safety. PD-L1 positivity appears to be predictive of pembrolizumab efficacy.
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Affiliation(s)
- Eve Maubec
- Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France.,Université Paris 13, Bobigny, France
| | - Marouane Boubaya
- Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France
| | - Peter Petrow
- Association de Cabinet de Radiologie et d'Imagérie Médicale, Service de Radiologie, Polyclinique Saint-Côme, Compiègne, France.,Institut Curie, Service de Radiodiagnostic, Paris, France
| | | | | | - Lydia Deschamps
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Paris, France
| | | | - Brigitte Dréno
- Service Oncodermatologie, Centre Hospitalier Universitaire Nantes, Centre d'Investigation Clinique 1413, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, Université de Nantes, Nantes, France
| | | | | | | | | | - Philippe Saiag
- Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise-Paré, Boulogne, France
| | - Florent Grange
- Centre Hospitalier Universitaire Reims, Hôpital Robert-Debré, Reims, France
| | - Nicolas Meyer
- Institut Universitaire du Cancer and Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | | | | | | | - Laurent Machet
- Centre Hospitalier Régional Universitaire de Tours, Chambray-les-Tours, France
| | | | - Ouidad Zehou
- Assistance Publique-Hôpitaux de Paris, Hôpital Henri-Mondor, Créteil, France
| | - Henri Montaudié
- Hôpital Archet 2, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | | | - Sandrine Mansard
- Centre Hospitalier Universitaire Estaing, Clermont-Ferrand, Clermont-Ferrand, France
| | - Sarah Guégan
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | | | - Sophie Dalac
- Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - François Aubin
- Centre Hospitalier Régional Universitaire Besançon, France
| | - Céline Alloux
- Assistance Publique-Hôpitaux de Paris, Agence Générale des Equipements et Produits de Santé, Paris, France
| | - Isabelle Lopez
- Association de Cabinet de Radiologie et d'Imagérie Médicale, Service de Radiologie, Polyclinique Saint-Côme, Compiègne, France
| | - Soufian Cherbal
- Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France
| | - Annick Tibi
- Assistance Publique-Hôpitaux de Paris, Agence Générale des Equipements et Produits de Santé, Paris, France
| | - Vincent Lévy
- Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France.,Université Paris 13, Bobigny, France
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35
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Morton CA, Szeimies RM, Basset-Seguin N, Calzavara-Pinton P, Gilaberte Y, Haedersdal M, Hofbauer GFL, Hunger RE, Karrer S, Piaserico S, Ulrich C, Wennberg AM, Braathen LR. European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications - actinic keratoses, Bowen's disease and basal cell carcinomas. J Eur Acad Dermatol Venereol 2020; 33:2225-2238. [PMID: 31779042 DOI: 10.1111/jdv.16017] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/04/2019] [Indexed: 12/29/2022]
Abstract
Topical photodynamic therapy (PDT) is a widely approved therapy for actinic keratoses, Bowen's disease (squamous cell carcinoma in situ), superficial and certain thin basal cell carcinomas. Recurrence rates when standard treatment protocols are used are typically equivalent to existing therapies, although inferior to surgery for nodular basal cell carcinoma. PDT can be used both as lesional and field therapies and has the potential to delay/reduce the development of new lesions. A protocol using daylight to treat actinic keratoses is widely practised, with conventional PDT using a red light after typically a 3-h period of occlusion employed for other superficial skin cancer indications as well as for actinic keratoses when daylight therapy is not feasible. PDT is a well-tolerated therapy although discomfort associated with conventional protocol may require pain-reduction measures. PDT using daylight is associated with no or minimal pain and preferred by patient. There is an emerging literature on enhancing conventional PDT protocols or combined PDT with another treatment to increase response rates. This guideline, published over two parts, considers all current approved and emerging indications for the use of topical PDT in dermatology, prepared by the PDT subgroup of the European Dermatology Forum guidelines committee. It presents consensual expert recommendations reflecting current published evidence.
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Affiliation(s)
- C A Morton
- Department of Dermatology, Stirling Community Hospital, Stirling, UK
| | - R-M Szeimies
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany.,Department of Dermatology & Allergology, Klinikum Vest GmbH, Recklinghausen, Germany
| | - N Basset-Seguin
- Department of Dermatology, Hôpital Saint Louis, Paris, France
| | | | - Y Gilaberte
- Department of Dermatology, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, Spain
| | - M Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - G F L Hofbauer
- Department of Dermatology, Zurich University Hospital, Zürich, Switzerland
| | - R E Hunger
- Department of Dermatology Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - S Karrer
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - S Piaserico
- Unit of Dermatology, Department of Medicine, University of Padova, Padova, Italy
| | - C Ulrich
- Skin Cancer Centre, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - A-M Wennberg
- Department of Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden
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36
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Dauendorffer JN, Baroudjian B, Herms F, Cavelier-Balloy B, Fouéré S, Bagot M, Lebbé C, Basset-Seguin N. [Penile squamous cell carcinoma]. Ann Dermatol Venereol 2020; 147:482-489. [PMID: 32247634 DOI: 10.1016/j.annder.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 01/24/2020] [Accepted: 02/07/2020] [Indexed: 10/24/2022]
Affiliation(s)
- J-N Dauendorffer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - B Baroudjian
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - F Herms
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | | | - S Fouéré
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Bagot
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - C Lebbé
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - N Basset-Seguin
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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37
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Hughes B, Gonzalez RM, Basset-Seguin N, Vornicova O, Schachter J, Joshi A, Meyer N, Grange F, Piulats J, Bauman J, Chirovsky D, Zhang P, Gumuscu B, Swaby R, Grob J. Health-Related Quality of Life of Pembrolizumab for Recurrent or Metastatic Cutaneous Squamous Cell Carcinoma in KEYNOTE-629. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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38
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Basset-Seguin N, Herms F. [New therapies for skin cancers]. Ann Dermatol Venereol 2020; 147:255-257. [PMID: 32087982 DOI: 10.1016/j.annder.2020.01.017] [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: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 10/25/2022]
Affiliation(s)
| | - F Herms
- Hôpital Saint-Louis, 75010 Paris, France
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39
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Lear JT, Hauschild A, Stockfleth E, Squittieri N, Basset-Seguin N, Dummer R. Efficacy and Safety of Sonidegib in Adult Patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome): Results from a Phase 2, Double-Blind, Randomized Trial. Clin Cosmet Investig Dermatol 2020; 13:117-121. [PMID: 32104037 PMCID: PMC7008063 DOI: 10.2147/ccid.s233097] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 10/01/2019] [Accepted: 01/08/2020] [Indexed: 11/23/2022]
Affiliation(s)
| | - Axel Hauschild
- Klinik Für Dermatologie, Venerologie Und Allergologie Universitätsklinikum Schleswig-Holstein, Kiel, Germany
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40
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Maubec E, Boubaya M, Petrow P, Basset-Seguin N, Grob JJ, Dréno B, Beylot-Barry M, Scheer-Senyarich I, Helfen S, Deschamps L, Leccia MT, Stefan A, Saiag P, De Quatrebarbes J, Meyer N, Alloux C, Lopez I, Cherbal S, Tibi A, Levy V. Étude de phase II de l’administration de pembrolizumab (MK-3475) en monothérapie et en première ligne chez des patients présentant un carcinome épidermoïde cutané non opérable. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.092] [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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41
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Herms F, Delyon J, Baroudjian B, De Masson A, Bagot M, Lebbé C, Basset-Seguin N. Traitement des carcinomes épidermoïdes cutanés métastatiques et localement avancés par cémiplimab : étude prospective monocentrique. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.093] [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: 10/25/2022]
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42
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Soufir N, Benfodda M, Grange F, Basset-Seguin N, Descamps V, Thomas L, Grandchamp B. Test MELAPRED : une nouvelle indication chez les patients atteints de maladie de Parkinson. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.513] [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: 10/25/2022]
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43
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Herms F, Lambert J, Grob JJ, Haudebourg L, Bagot M, Dalac S, Dutriaux C, Guillot B, Jeudy G, Mateus C, Monestier S, Mortier L, Poulalhon N, Prey S, Robert C, Vabres P, Lebbe C, Meyer N, Basset-Seguin N. Follow-Up of Patients With Complete Remission of Locally Advanced Basal Cell Carcinoma After Vismodegib Discontinuation: A Multicenter French Study of 116 Patients. J Clin Oncol 2019; 37:3275-3282. [PMID: 31609670 DOI: 10.1200/jco.18.00794] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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
PURPOSE Vismodegib is a hedgehog pathway inhibitor indicated for the treatment of locally advanced basal cell carcinoma (laBCC), with an objective response rate of 65%, including a 32% complete response (CR). However, adverse effects often lead to drug discontinuation. The objective of our study was to evaluate long-term responses, predictive factors, and management of relapse after vismodegib discontinuation. METHODS An observational retrospective study was conducted in nine French oncodermatology units. We included patients with laBCC with CR on vismodegib who discontinued treatment between March 2012 and January 2016; we reviewed charts up to June 2016. The primary objective was to evaluate median relapse-free survival (RFS). Secondary objectives were risk factors associated with RFS, relapse, and death and treatment modalities after relapse and their efficacy. RESULTS One hundred sixteen patients with laBCC were included. The median RFS was 18.4 months (95% CI, 13.5 to 24.8 months). The RFS rate at 36 months was 35.4% (95% CI, 22.5% to 47.9%) for the total population and 40.0% (95% CI, 25.7% to 53.7%) for patients without Gorlin syndrome. LaBCC to the limbs and trunk was the only variable independently associated with a higher risk of relapse (hazard ratio, 2.77; 95% CI, 1.23 to 6.22; P = .019). Twenty-seven patients (50%) who experienced relapse during follow-up were retreated with vismodegib, with an objective response in 23 (objective response rate, 85%; CR rate, 37%; partial response rate, 48%) and eligibility for surgery in 24 (42%). CONCLUSION Long-term response after vismodegib discontinuation is frequent. Most patients who experience a relapse still respond to vismodegib rechallenge.
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Affiliation(s)
- Florian Herms
- Hôpital Saint-Louis, Paris, France.,Université Paris Diderot, Paris, France
| | - Jerome Lambert
- Hôpital Saint-Louis, Paris, France.,Université Paris Diderot, Paris, France
| | | | - Luc Haudebourg
- Hôpital Saint-Louis, Paris, France.,Université Paris Diderot, Paris, France
| | - Martine Bagot
- Hôpital Saint-Louis, Paris, France.,Université Paris Diderot, Paris, France
| | | | - Caroline Dutriaux
- University of Bordeaux, Bordeaux, France.,CHU Bordeaux, Bordeaux, France
| | | | | | | | | | | | | | - Sorilla Prey
- University of Bordeaux, Bordeaux, France.,CHU Bordeaux, Bordeaux, France
| | | | | | - Celeste Lebbe
- Hôpital Saint-Louis, Paris, France.,Université Paris Diderot, Paris, France
| | - Nicolas Meyer
- Institut Universitaire du Cancer et CHU de Toulouse, Toulouse, France
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44
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Chapalain M, Baroudjian B, Dupont A, Lhote R, Lambert J, Bagot M, Lebbe C, Basset-Seguin N. Stage IV cutaneous squamous cell carcinoma: treatment outcomes in a series of 42 patients. J Eur Acad Dermatol Venereol 2019; 34:1202-1209. [PMID: 31587382 DOI: 10.1111/jdv.16007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 08/28/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND The prevalence and incidence of cutaneous squamous cell carcinoma (cSCC) are increasing due to the ageing of the population and sun exposure. Advanced cSCC forms (locally advanced and/or locoregional metastatic and/or distant metastatic) account for approximately 3% of cSCC and can result in death. OBJECTIVE Analysis of the clinical characteristics and treatment outcomes in stage IV cSCC with unresectable locoregional extension and/or the presence of metastases. METHODS A retrospective study was conducted at a single-centre university hospital for stage IV cSCC patients followed between 1 January 2008 and 31 December 2015. Descriptive analyses (demographic, anatomo-clinical characteristics, treatment sequences, response to treatment and survival analysis) were performed. RESULTS The study included 42 patients (median age = 75.5 years) with a diagnosis of stage IV cSCC who were treated with at least one line of chemotherapy and/or cetuximab. At the time of diagnosis, 85.7% of the patients had locoregional extension (19% of locally advanced and 67% of locoregional metastatic) and 14.3% had distant metastatic disease. Regarding treatment, 40% and 36% of patients received no more than 1 and 2 systemic treatment lines, respectively. The 4-year overall survival was 6%, and the median follow-up was 18.6 months. The objective response rate was 55% after the first line of treatment with a median progression-free survival (PFS) of 6.18 months and 12% after the second line with a median PFS of 6.51 months. Grade 3 and 4 adverse events were observed for 33% of patients. CONCLUSION Our study confirms a very poor prognosis of stage IV cSCC and a poor response to conventional therapies, indicating that the stage IV cSCC patient population remains with unmet medical needs.
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Affiliation(s)
- M Chapalain
- Dermatology Department, Hôpital Saint-Louis, AP-HP, Paris, France.,Inserm Unité 976, Hôpital Saint-Louis, Paris, France.,Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France
| | - B Baroudjian
- Dermatology Department, Hôpital Saint-Louis, AP-HP, Paris, France.,Inserm Unité 976, Hôpital Saint-Louis, Paris, France.,Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France
| | - A Dupont
- Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France.,Department of Biostatistics, Hôpital Saint-Louis, AP-HP, Paris, France
| | - R Lhote
- Dermatology Department, Hôpital Saint-Louis, AP-HP, Paris, France.,Inserm Unité 976, Hôpital Saint-Louis, Paris, France.,Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France
| | - J Lambert
- Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France.,Department of Biostatistics, Hôpital Saint-Louis, AP-HP, Paris, France
| | - M Bagot
- Dermatology Department, Hôpital Saint-Louis, AP-HP, Paris, France.,Inserm Unité 976, Hôpital Saint-Louis, Paris, France.,Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France
| | - C Lebbe
- Dermatology Department, Hôpital Saint-Louis, AP-HP, Paris, France.,Inserm Unité 976, Hôpital Saint-Louis, Paris, France.,Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France
| | - N Basset-Seguin
- Dermatology Department, Hôpital Saint-Louis, AP-HP, Paris, France.,Inserm Unité 976, Hôpital Saint-Louis, Paris, France.,Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France
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Beaziz J, Battistella M, Delyon J, Maignan CL, Marco O, Kérob D, Laurent CP, Da Meda L, Farges C, Basset-Seguin N, Lebbe C, Baroudjian B. Long-term outcome of neoadjuvant tyrosine kinase inhibitors (TKI) in locally advanced dermatofibrosarcoma protuberans (DFSP). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Grob J, Gonzalez Mendoza R, Basset-Seguin N, Vornicova O, Schachter J, Joshi A, Meyer N, Grange F, Piulats J, Bauman J, Zhang P, Gumuscu B, Swaby R, Hughes B. Pembrolizumab for recurrent/metastatic cutaneous squamous cell carcinoma (cSCC): Efficacy and safety results from the phase II KEYNOTE-629 study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Benajiba L, Lambert J, La Selva R, Cochereau D, Baroudjian B, Roux J, Basset-Seguin N, Laurent CP, Battistella M, Delyon J, Lebbe C. Clinical course and therapeutic management of classical and endemic Kaposi’s Sarcoma (C/E KS). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.018] [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: 11/12/2022] Open
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Grob JJ, Mendoza RG, Basset-Seguin N, Schachter J, Vornicova O, Bauman J, Grange F, Meyer N, Piulats J, Zhang P(E, Gumuscu B, Swaby R, Hughes BGM. Abstract CT170: KEYNOTE-629: Phase II study of pembrolizumab for recurrent/metastatic or locally advanced unresectable cutaneous squamous cell carcinoma. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-ct170] [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: 11/16/2022]
Abstract
Abstract
Background: Findings from Phase I and II clinical trials suggest that treatment with an anti-programmed death 1 (PD-1) antibody is well tolerated and provides durable antitumor activity in patients with local/regionally advanced or metastatic cutaneous squamous cell carcinoma (cSCC). Encouraging efficacy and safety findings have also been reported from an expansion cohort in the phase 1 KEYNOTE-012 trial with the PD-1 inhibitor pembrolizumab. KEYNOTE-012 demonstrated that pembrolizumab 200 mg administered once every 3 weeks was well tolerated and yielded a clinically meaningful overall response rate with evidence of durable responses in patients with recurrent and/or metastatic head and neck cSCC. To test the clinical activity of pembrolizumab, the open-label, single-arm, phase 2 KEYNOTE-629 trial (NCT03284424) will be carried out in patients with locally advanced, unresectable, and recurrent or metastatic cSCC.
Trial design: Patients will receive intravenous pembrolizumab 200 mg every 3 weeks for up to 35 infusions (≤24 months) or until protocol-specified treatment discontinuation. Treatment will not be stratified in this study. Eligibility criteria include age ≥18 years; locally advanced cSCC that is ineligible for surgical resection or radiotherapy (RT) or that previously underwent RT to the index site or systemic therapy for curative intent; presence of measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1; and Eastern Cooperative Oncology Group performance status 0 or 1. Treatment will be discontinued for progressive disease, unacceptable toxicity, intercurrent illness preventing study treatment administration, investigator’s decision, patient withdrawal of consent, pregnancy, or cessation for administrative reasons. Response will be assessed by computed tomography or magnetic resonance imaging 6 weeks after treatment initiation, every 6 weeks through year 1, then every 9 weeks thereafter or more frequently if clinically indicted. After a patient experiences disease progression or starts new anticancer therapy, the patient will be followed up and contacted every 12 weeks until death, consent withdrawal, or study end, whichever occurs first. Safety will be monitored throughout the study treatment and for 30 days after treatment end and for 90 days for serious adverse events after the end of treatment. The primary end point is objective response rate (RECIST v1.1). Secondary end points include duration of response, disease control rate, progression-free survival, overall survival, and safety. Recruitment is ongoing in 10 countries and will continue until approximately 50 additional patients with locally advanced unresectable cSCC are enrolled.
Citation Format: Jean-Jacques Grob, Rene Gonzalez Mendoza, Nicole Basset-Seguin, Jacob Schachter, Olga Vornicova, Jessica Bauman, Florent Grange, Nicolas Meyer, Josep Piulats, Pingye (Eric) Zhang, Burak Gumuscu, Ramona Swaby, Brett GM Hughes. KEYNOTE-629: Phase II study of pembrolizumab for recurrent/metastatic or locally advanced unresectable cutaneous squamous cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT170.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Josep Piulats
- 9Hospital Duran I Reinals ICO de Hospitalet, Barcelona, Spain
| | | | | | | | - Brett GM Hughes
- 11Royal Brisbane & Women’s Hospital, Herston, and University of Queensland, Queensland, Australia
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Ighilahriz M, Benfodda M, Sharpe H, Soufir N, Mourah S, Dumaz N, Battistella M, Savina A, Bouquet F, Nikolaev S, Basset-Seguin N. Vismodegib resistant mutations are not selected in multifocal relapses of locally advanced basal cell carcinoma after vismodegib discontinuation. J Eur Acad Dermatol Venereol 2019; 33:e422-e424. [PMID: 31187903 DOI: 10.1111/jdv.15741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/09/2019] [Accepted: 05/29/2019] [Indexed: 11/29/2022]
Affiliation(s)
- M Ighilahriz
- Institute of Skin Research, INSERM U 976, Saint Louis Hospital, Paris, France
| | - M Benfodda
- Institute of Skin Research, INSERM U 976, Saint Louis Hospital, Paris, France.,Département de Génétique, AP-HP, Hôpital Bichat Claude Bernard, Paris, France
| | - H Sharpe
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - N Soufir
- Institute of Skin Research, INSERM U 976, Saint Louis Hospital, Paris, France.,Département de Génétique, AP-HP, Hôpital Bichat Claude Bernard, Paris, France.,Sorbonne Paris Cité, Université Paris-Diderot, Paris, France
| | - S Mourah
- Institute of Skin Research, INSERM U 976, Saint Louis Hospital, Paris, France.,Sorbonne Paris Cité, Université Paris-Diderot, Paris, France.,Pharmacology-Biologic Laboratory, AP-HP, Saint Louis University Hospital, Paris, France
| | - N Dumaz
- Institute of Skin Research, INSERM U 976, Saint Louis Hospital, Paris, France.,Sorbonne Paris Cité, Université Paris-Diderot, Paris, France
| | - M Battistella
- Department of Dermatology, AP-HP, Hôpital Saint-Louis, Paris, France
| | - A Savina
- Institut Roche, Boulogne-Billancourt, France
| | - F Bouquet
- Institut Roche, Boulogne-Billancourt, France
| | - S Nikolaev
- Institute of Skin Research, INSERM U 976, Saint Louis Hospital, Paris, France.,Sorbonne Paris Cité, Université Paris-Diderot, Paris, France
| | - N Basset-Seguin
- Institute of Skin Research, INSERM U 976, Saint Louis Hospital, Paris, France.,Sorbonne Paris Cité, Université Paris-Diderot, Paris, France.,Department of Dermatology, AP-HP, Hôpital Saint-Louis, Paris, France
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Duverger L, Osio A, Cribier B, Mortier L, De Masson A, Basset-Seguin N, Lebbé C, Battistella M. Heterogeneity of PD-L1 expression and CD8 tumor-infiltrating lymphocytes among subtypes of cutaneous adnexal carcinomas. Cancer Immunol Immunother 2019; 68:951-960. [PMID: 30953116 PMCID: PMC11028315 DOI: 10.1007/s00262-019-02334-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 03/28/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Adnexal carcinomas are rare and heterogeneous skin tumors, for which no standard treatments exist for locally advanced or metastatic tumors. AIM OF THE STUDY To evaluate the expression of PD-L1 and CD8 in adnexal carcinomas, and to study the association between PD-L1 expression, intra-tumoral T cell CD8+ infiltrate, and metastatic evolution. MATERIALS AND METHODS Eighty-three adnexal carcinomas were included. Immunohistochemistry using anti-PD-L1 monoclonal antibodies (E1L3N and 22C3) and CD8 was performed. PD-L1 expression in tumor and immune cells, and CD8+ tumor-infiltrating lymphocyte (TIL) density were analyzed semi-quantitatively. RESULTS Among the 60 sweat gland, 18 sebaceous and 5 trichoblastic carcinomas, 11% expressed PD-L1 in ≥ 1% tumor cells, more frequently sweat gland carcinomas (13%, 8/60) including apocrine carcinoma (40%, 2/5) and invasive extramammary Paget disease (57%, 4/7). Immune cells expressed significantly more PD-L1 than tumor cells (p < 0.01). Dense CD8+ TILs were present in 60% trichoblastic, 43% sweat gland, and 39% sebaceous carcinomas. CD8+ TILs were associated with PD-L1 expression by tumor cells (p < 0.01). Thirteen patients out of 47 developed metastases (27%) with a median follow-up of 30.5 months (range 7-36). Expression of PD-L1 by tumor cells was associated with the development of metastasis in univariate analysis (HR 4.0, 95% CI 1.1-15, p = 0.0377) but not in multivariate analysis (HR 4.1, 95% CI 0.6-29, p = 0.15). CONCLUSION PD-L1 expression is highly heterogeneous among adnexal carcinoma subtypes, higher in apocrine carcinoma and invasive extramammary Paget disease, and associated with CD8+ TILs. Our data suggest the interest of evaluating anti-PD1 immunotherapy in advanced or metastatic cutaneous adnexal carcinoma.
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Affiliation(s)
- Lucie Duverger
- Pathology Department, INSERM UMR_S1165, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (APHP), 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - Amélie Osio
- Pathology Department, INSERM UMR_S1165, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (APHP), 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - Bernard Cribier
- Dermatology Department, Hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Laurent Mortier
- Dermatology Department, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille, France
| | - Adèle De Masson
- INSERM, Unité mixte de recherche (UMR)_S976, University Paris Diderot, Paris, France
- Dermatology Department, Hôpital St Louis, APHP, Paris, France
| | - Nicole Basset-Seguin
- INSERM, Unité mixte de recherche (UMR)_S976, University Paris Diderot, Paris, France
- Dermatology Department, Hôpital St Louis, APHP, Paris, France
| | - Céleste Lebbé
- INSERM, Unité mixte de recherche (UMR)_S976, University Paris Diderot, Paris, France
- Dermatology Department, Hôpital St Louis, APHP, Paris, France
| | - Maxime Battistella
- Pathology Department, INSERM UMR_S1165, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (APHP), 1 Avenue Claude Vellefaux, 75010, Paris, France.
- INSERM, UMR_S1165, University Paris Diderot, Paris, France.
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