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Leclercq A, Chatrenet A, Bourgeois H, Cojocarasu O, Mathie C, Martin T, Rahmani A, Morel B. Multidisciplinary analysis of cancer-related fatigue at the time of diagnosis: preliminary results of the BIOCARE FActory cohort. Support Care Cancer 2024; 32:319. [PMID: 38689167 DOI: 10.1007/s00520-024-08520-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a common side effect of cancer and cancer treatment that significantly impairs the quality of life and can persist for years after treatment completion. Although fatigue is often associated with cancer treatment, it is also a result of the disease itself, even before intervention. CRF at the time of diagnosis may affect treatment timing or completion and is a consistent predictor of post-treatment fatigue at any time. The mechanisms underlying CRF are multidimensional and not well understood, particularly at the time of diagnosis. METHODS Sixty-five breast cancer patients at the time of diagnosis were included. The participants completed self-assessment questionnaires about CRF, sleep disturbances, and emotional symptoms and wore an accelerometer to assess levels of spontaneous physical activity and sleep quality. During the experimental session, the participants underwent cognitive, neuromuscular, and exercise metabolism evaluations. RESULTS Using augmented backward elimination regression, this study found that emotional symptoms and perceived sleep disturbances were the strongest predictors of CRF (adjusted r2 = 0.51). Neuromuscular fatigability and sleep disturbance were also associated with physical dimensions, whereas cognitive performance was associated with cognitive dimensions. CONCLUSION At the time of diagnosis, emotional and cognitive dimensions are over-represented compared to the general population, and specific subdimensions have specific predictors that support the idea of distinct mechanisms. Evaluating CRF subdimensions and their potential mechanisms at the time of diagnosis would be particularly relevant for identifying high-risk patients and offering them appropriate interventions. TRIAL REGISTRATION This study was registered at ClinicalTrials.gov (NCT04391543) in May, 2020.
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Affiliation(s)
- A Leclercq
- Laboratoire Movement, Interactions, Performance, MIP-UR 4334, Le Mans Université Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France.
| | - A Chatrenet
- Laboratoire Movement, Interactions, Performance, MIP-UR 4334, Le Mans Université Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France
- APCoSS-Institute of Physical Education and Sports Sciences (IFEPSA), UCO, Angers, France
| | - H Bourgeois
- Elsan-Clinique Victor Hugo, Centre Jean Bernard, Le Mans, France
| | - O Cojocarasu
- Centre Hospitalier Le Mans (CHM), Le Mans, France
| | - C Mathie
- Centre Hospitalier Le Mans (CHM), Le Mans, France
| | - T Martin
- Laboratoire Movement, Interactions, Performance, MIP-UR 4334, Le Mans Université Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France
| | - A Rahmani
- Laboratoire Movement, Interactions, Performance, MIP-UR 4334, Le Mans Université Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France
| | - B Morel
- Laboratoire Interuniversitaire de Biologie de La Motricité, Université Savoie Mont Blanc, EA 7424, F-73000, Chambéry, France
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Ingrand I, Laurent E, Lecomte T, Cojocarasu O, Egreteau J, Aleba A, Hureaux J, Colombat P, Gyan E, Bourgeois H. The place of the relative at the time of the announcement of cancer progression: BABEL - a mixed-methods study. Palliat Support Care 2023:1-10. [PMID: 37357920 DOI: 10.1017/s1478951523000342] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
OBJECTIVES This study aims to explore the place of the relative in these triadic consultations and how this influences communication. METHODS A mixed-methods research strategy was used. Triadic consultations for the announcement of cancer progression were recorded and following the 3 participants completed questionnaires comprising mirror-items. Recordings and answers were further investigated in a few semi-structured interviews. Comparison of quantitative responses (questionnaires) used Wilcoxon's test for matched series. Qualitative analyses (consultations, interviews) used grounded theory. Patients were over 18, followed for cancer in palliative phase, excluding brain tumors and malignant hemopathies, and presented renewed disease progression. Relatives were over 18 and authorized by the patient to participate. RESULTS 47 consultations (audio-recordings, answers to questionnaires) and 12 interviews conducted separately with 4 triads were collected. Half the relatives, while remaining in the background, nevertheless contributed to the discussion. For patients, the presence of a relative was considered beneficial and for oncologists it facilitated the announcement. However, symptoms perceived as intimate or private appeared difficult to express for some patients, and for relatives, prognosis was a difficult subject to broach. Although their relationship with time and their expectations may differ, patients and relatives found consultations positive. Oncologists appeared to underestimate the patient's level of understanding (P<0.001) and perceptions of the seriousness of the disease (P=0.009) but not those of relatives. They did not evaluate the relative's state of health and check what the dyad had retained. SIGNIFICANCE OF RESULTS Training via simulation sessions should be adapted to communication involving relatives.
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Affiliation(s)
- Isabelle Ingrand
- INSERM, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Centre d'Investigation Clinique CIC 1402, Poitiers, France
| | - Estelle Laurent
- INSERM, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Centre d'Investigation Clinique CIC 1402, Poitiers, France
- GRESCO (EA 3815), Université de Poitiers, Poitiers, France
| | - Thierry Lecomte
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Oana Cojocarasu
- Service d'oncologie médicale, Centre Hospitalier du Mans, Le Mans, France
| | - Joëlle Egreteau
- Hôpital du Scorff, Groupe Hospitalier Bretagne Sud, Lorient, France
| | - Albert Aleba
- Service d'oncologie médicale, Centre Hospitalier de Niort, Niort, France
| | - José Hureaux
- Service de pneumologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Philippe Colombat
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Emmanuel Gyan
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours, Tours, France
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Gronnier C, Mariette C, Lepage C, Monterymard C, Jary M, Ferru A, Baconnier M, Adhoute X, Tavan D, Perrier H, Guerin-Meyer V, Lecaille C, Bonichon-Lamichhane N, Pillon D, Cojocarasu O, Egreteau J, D'journo XB, Dahan L, Locher C, Texereau P, Collet D, Michel P, Ben Abdelghani M, Guimbaud R, Muller M, Bouché O, Piessen G. Perioperative Cetuximab with Cisplatin and 5-Fluorouracil in Esogastric Adenocarcinoma: A Phase II Study. Cancers (Basel) 2023; 15:cancers15072188. [PMID: 37046849 PMCID: PMC10093434 DOI: 10.3390/cancers15072188] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
PURPOSE While perioperative chemotherapy provides a survival benefit over surgery alone in gastric and gastroesophageal junction (G/GEJ) adenocarcinomas, the results need to be improved. This study aimed to evaluate the efficacy and safety of perioperative cetuximab combined with 5-fluorouracil and cisplatin. PATIENTS AND METHODS Patients received six cycles of cetuximab, cisplatin, and simplified LV5FU2 before and after surgery. The primary objective was a combined evaluation of the tumor objective response (TOR), assessed by computed tomography, and the absence of major toxicities resulting in discontinuation of neoadjuvant chemotherapy (NCT) (45% and 90%, respectively). RESULTS From 2011 to 2013, 65 patients were enrolled. From 64 patients evaluable for the primary endpoint, 19 (29.7%) had a morphological TOR and 61 (95.3%) did not stop NCT prematurely due to major toxicity. Sixty patients (92.3%) underwent resection. Sixteen patients (/56 available, 28.5%) had histological responses (Mandard tumor regression grade ≤3). After a median follow-up of 44.5 months, median disease-free and overall survival were 24.4 [95% CI: 16.4-39.4] and 40.3 months [95% CI: 27.5-NA], respectively. CONCLUSION Adding cetuximab to the NCT regimen in operable G/GEJ adenocarcinomas is safe, but did not show enough efficacy in the present study to meet the primary endpoint (NCT01360086).
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Affiliation(s)
- Caroline Gronnier
- Department of Digestive Surgery, Magellan Center, Bordeaux University Hospital, 33600 Pessac, France
| | - Christophe Mariette
- Department of Digestive and Oncological Surgery, CHU Lille, Claude Huriez University Hospital, 59000 Lille, France
- UMR-S 1172-CANTHER Laboratory "Cancer Heterogeneity, Plasticity and Resistance to Therapies", University Lille, 59045 Lille, France
| | - Come Lepage
- FFCD EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche-Comté, 21000 Dijon, France
- Department of Digestive Oncology University Hospital Dijon, University of Burgundy and Franche Comté, 21000 Dijon, France
| | - Carole Monterymard
- Federation Francophone de Cancérologie Digestive (FFCD), EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, 21000 Dijon, France
| | - Marine Jary
- Department of Digestive Oncology, University Hospital, 63100 Clermont-Ferrand, France
| | - Aurélie Ferru
- Department of Oncology, University Hospital, 86000 Poitiers, France
| | - Mathieu Baconnier
- Department of Gastroenterology, General Hospital, 74960 Annecy, France
| | - Xavier Adhoute
- Department of Gastroenterology, St Joseph General Hospital, 13000 Marseille, France
| | - David Tavan
- Department of Gastroenterology, Lyon Protestant Infirmary Clinic, 69300 Lyon, France
| | - Hervé Perrier
- Department of Hepato-Gastroenterology, Saint Joseph Hospital, 13000 Marseille, France
| | | | - Cédric Lecaille
- Department of Hepato-Gastroenterology, Polyclinic Bordeaux Nord, 33000 Bordeaux, France
| | | | - Didier Pillon
- Department of Hepato-Gastroenterology, Centre Hospitalier de Bourg en Bresse, 01053 Bourg-en-Bresse, France
| | - Oana Cojocarasu
- Onco-Hematology Department, Centre Hospitalier du Mans, 72000 Le Mans, France
| | - Joëlle Egreteau
- Radiotherapy and Oncology Department, Centre Hospitalier Bretagne Sud, 56100 Lorient, France
| | - Xavier Benoit D'journo
- Department of Thoracic Surgery, North Hospital, Aix-Marseille University, 13000 Marseille, France
| | - Laétitia Dahan
- Service d'Oncologie Digestive, CHU Timone, 13000 Marseille, France
| | | | - Patrick Texereau
- Gastroenterology, Centre Hospitalier de Mont-de-Marsan, 40000 Mont-de-Marsan, France
| | - Denis Collet
- Department of Digestive Surgery, Magellan Center, Bordeaux University Hospital, 33600 Pessac, France
| | - Pierre Michel
- Iron Group, Normandy Centre for Genomic and Personalized Medicine and Department of Hepatogastroenterology, Rouen University Hospital, Normandie University, 76000 Rouen, France
| | | | - Rosine Guimbaud
- Centre Hospitalier Universitaire de Toulouse, 31400 Toulouse, France
| | - Marie Muller
- Department of Gastroenterology, CHU Nancy, 54500 Vandoeuvre-les-Nancy, France
| | - Olivier Bouché
- Department of Digestive Oncology, CHU Reims, 51100 Reims, France
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, CHU Lille, Claude Huriez University Hospital, 59000 Lille, France
- UMR-S 1172-CANTHER Laboratory "Cancer Heterogeneity, Plasticity and Resistance to Therapies", University Lille, 59045 Lille, France
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Gluszak C, Campion L, Seegers V, Cojocarasu O, Commer JM, Priou F, Rolland F, Terret C, Abadie-Lacourtoisie S. Geriatric Assessment Implementation before Chemotherapy in MEtastatic Prostate Cancer, Results from the Real-Life Study GAMERS. J Clin Med 2023; 12:jcm12041636. [PMID: 36836171 PMCID: PMC9961170 DOI: 10.3390/jcm12041636] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Geriatric assessment (GA) can predict and improve treatment tolerance and estimate overall survival in older patients with cancer. Several international organizations promote GA; however, data related to its implementation in daily clinical practice are still limited. We aimed to describe GA implementation in patients over 75 years old with metastatic prostate cancer treated with docetaxel as first-line treatment, and with positive G8 screening test or frailty criteria. This retrospective real-world study included 224 patients treated from 2014 to 2021 in four French centers, including 131 patients with a theoretical indication of GA. Among the latter, 51 (38.9%) patients had GA. The main barriers to GA were the lack of systematic screening (32/80, 40.0%), unavailability of geriatric physician (20/80, 25.0%), and absence of referral despite a positive screening test (12/80, 15.0%). With GA performed in only one-third of the patients with a theoretical indication in daily clinical practice, mostly due to an absence of screening test, the use of GA is currently sub-optimal.
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Affiliation(s)
- Cassandre Gluszak
- Department of Medical Oncology, Integrated Center of Oncology (ICO) Paul Papin, 49055 Angers, France
- Correspondence: ; Tel.: +33-6-06-44-25-12
| | - Loïc Campion
- Department of Biostatistics, Integrated Center of Oncology (ICO) René Gauducheau, 44800 Saint-Herblain, France
| | - Valérie Seegers
- Department of Biostatistics, Integrated Center of Oncology (ICO) Paul Papin, 49055 Angers, France
| | - Oana Cojocarasu
- Department of Medical Oncology, Centre Hospitalier Le Mans, 72037 Le Mans, France
| | - Jean-Marie Commer
- Department of Supportive Care, Integrated Center of Oncology (ICO) Paul Papin, 49055 Angers, France
| | - Frank Priou
- Department of Medical Oncology, Centre Hospitalier La Roche-sur-Yon, 85000 La Roche-sur-Yon, France
| | - Frédéric Rolland
- Department of Medical Oncology, Integrated Center of Oncology (ICO) René Gauducheau, 44800 Saint-Herblain, France
| | - Catherine Terret
- Department of Medical Oncology, Leon Berard Institute, 69008 Lyon, France
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Chartogne M, Leclercq A, Beaune B, Boyas S, Forestier C, Martin T, Thomas-Ollivier V, Landry S, Bourgeois H, Cojocarasu O, Pialoux V, Zanna O, Messonnier LA, Rahmani A, Morel B. Building a biopsychosocial model of cancer-related fatigue: the BIOCARE FActory cohort study protocol. BMC Cancer 2021; 21:1140. [PMID: 34688272 PMCID: PMC8542307 DOI: 10.1186/s12885-021-08831-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/04/2021] [Indexed: 12/03/2022] Open
Abstract
Background Cancer-related fatigue (CRF) is the most common side effect of cancer and cancer treatment. CRF prevalence is up to 50% in breast cancer patients and can continue several years after cancer remission. This persistent subjective sense of exhaustion is multifactorial. Numerous parameters have been evidenced to be related to CRF across biological, physical, psychological, social and/or behavioral dimensions. Although CRF has been studied for many years, the majority of previous studies focused on only one dimension, i.e., physical function. Moreover, few studies investigated CRF longitudinally with repeated measures. These are the two main obstacles that limit the understanding of CRF mechanisms. The purpose of this study is to create a biopsychosocial model of CRF with simultaneous and longitudinal anthropometric, clinical, biological, physical, psychological and sociological parameters. Methods BIOCARE FActory is a multicentric prospective study that will consist of an 18-month follow-up of 200 women diagnosed with breast cancer. Four visits will be scheduled at diagnosis, after treatments, and 12 and 18 months after diagnosis. The same procedure will be followed for each visit. Each session will be composed of anthropometric data collection, a semi-structured interview, cognitive tests, postural control tests, neuromuscular fatigability tests and a cardiorespiratory fitness test. Clinical and biological data will be collected during medical follow-ups. Participants will also complete questionnaires to assess psychological aspects and quality of life and wear an actigraphy device. Using a structural equation modeling analysis (SEM), collected data will build a biopsychosocial model of CRF, including the physiological, biological, psychological, behavioral and social dimensions of CRF. Discussion This study aims to highlight the dynamics of CRF and its correlates from diagnosis to post treatment. SEM analysis could examine some relations between potential mechanisms and CRF. Thus, the biopsychosocial model will contribute to a better understanding of CRF and its underlying mechanisms from diagnosis to the aftermaths of cancer and its treatments. Trial registration This study is registered at ClinicalTrials.gov (NCT04391543), May 2020.
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Affiliation(s)
- M Chartogne
- Le Mans Université, Movement - Interactions - Performance, MIP, 4334, F-72000, Le Mans, EA, France.
| | - A Leclercq
- Le Mans Université, Movement - Interactions - Performance, MIP, 4334, F-72000, Le Mans, EA, France
| | - B Beaune
- Le Mans Université, Movement - Interactions - Performance, MIP, 4334, F-72000, Le Mans, EA, France
| | - S Boyas
- Le Mans Université, Movement - Interactions - Performance, MIP, 4334, F-72000, Le Mans, EA, France
| | - C Forestier
- Le Mans Université, Movement - Interactions - Performance, MIP, 4334, F-72000, Le Mans, EA, France
| | - T Martin
- Le Mans Université, Movement - Interactions - Performance, MIP, 4334, F-72000, Le Mans, EA, France
| | - V Thomas-Ollivier
- Nantes Université, Movement - Interactions - Performance, MIP, 4334, Nantes, EA, France
| | - S Landry
- Elsan-Clinique Victor Hugo, Centre Jean Bernard, Le Mans, France
| | - H Bourgeois
- Elsan-Clinique Victor Hugo, Centre Jean Bernard, Le Mans, France
| | - O Cojocarasu
- Centre Hospitalier Le Mans (CHM), Le Mans, France
| | - V Pialoux
- Univ Lyon, University Claude Bernard Lyon 1, Inter-University Laboratory of Human Movement Biology, Team Atherosclerosis Thrombosis & Physical Activity, EA7424, Lyon, France
| | - O Zanna
- Le Mans Université, VIPS2, EA4636, Le Mans, France
| | - L A Messonnier
- Laboratoire Interuniversitaire de Biologie de la Motricité, Univ. Savoie Mont Blanc, 7424, F-73000, Chambéry, EA, France
| | - A Rahmani
- Le Mans Université, Movement - Interactions - Performance, MIP, 4334, F-72000, Le Mans, EA, France
| | - B Morel
- Le Mans Université, Movement - Interactions - Performance, MIP, 4334, F-72000, Le Mans, EA, France.,Laboratoire Interuniversitaire de Biologie de la Motricité, Univ. Savoie Mont Blanc, 7424, F-73000, Chambéry, EA, France
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Metges JP, Douillard JY, Ramée JF, Dupuis O, Senellart H, Porneuf M, Deguiral P, Achour NE, Edeline J, Cumin I, Artignan X, Faroux R, Stampfli C, Cojocarasu O, Gourlaouen A, Bideau K, Meyer VG, Fichet A, Klein V, Touchefeu Y, Besson D, Desclos H, Barraya R, Alavi Z, Campion L, Lagadec DD, Marhuenda F, Grudé F. Efficacy and safety of panitumumab in a cohort of patients with metastatic colorectal cancer in France: PANI OUEST, a post-EMA-approval descriptive study with a geriatric oncology focus. Turk J Gastroenterol 2020; 31:695-705. [PMID: 33169707 DOI: 10.5152/tjg.2020.19219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIMS The Bretagne-Pays de la Loire cancer observatory, an oncology network created by the French Ministry of Health, is specifically dedicated to assess the use of new targeted anticancer therapies in routine practice. In line with the French National Cancer III program, our cancer network set up a real-life cohort, which is independent of the pharmaceutical industry, for patients with colorectal cancer to monitor patient safety and quality of care and promote pharmacovigilance. MATERIALS AND METHODS Panitumumab monotherapy was assessed in 243 patients with wild-type Kirsten rat sarcoma who were treated for metastatic colorectal cancer (mCRC) between July 2008 and December 2010 after prior chemotherapy using oxaliplatine and irinotecan. This was a post-European medicine agency marketing (EMA-M) study Results: This study shed light on the best practices, strategic adaptations, clinical results (treatment objective responses, 13%; progression free survival, 2.99 months [2.73-3.15]; and overall survival, 6.8 months [5.49-8.38]) as well as expected or unexpected (grade 3 or 4: 11.5%) secondary effects in the phase IV panitumumab treatment of mCRC. CONCLUSION Our results are similar to those by Amado whose phase III study led to obtaining EMA-M for panitumumab and tend to confirm the antitumor activity of this antiepidermal growth factor receptor antibody in the treatment of mCRC. In addition, our results opened avenues to further assessment of panitumumab use as monotherapy as well as its benefit-risk ratio while taking into account the patients' general and clinical characteristics. In 2012, the French National Authority for Health appended these data to the panitumumab transparency committee report.
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Affiliation(s)
- Jean-Philippe Metges
- Observatoire dédié au Cancer BPL, siège médical ICO site Paul Papin, France;C.H.R.U., Hôpital Morvan, Institut de cancérologie et d'hématologie, Brest, France
| | - Jean-Yves Douillard
- Observatory of Cancer BPL, Angers, France;West Institut of Cancer (ICO), René Gauducheau, Boulevard Jacques Monod, Saint-Herblain, France
| | | | - Olivier Dupuis
- Private Hospital Jean Bernard/Clinique Victor Hugo Le Mans, Le Mans, France
| | - Helene Senellart
- West Institut of Cancer (ICO), René Gauducheau, Boulevard Jacques Monod, Saint-Herblain, France
| | - Marc Porneuf
- Hospital Center of Yves le Foll, Saint-Brieuc, France;C.H. Lannion Trestel, Venelle de Kergomar, Lannion, France
| | | | - Nach Eddine Achour
- Private Hospital Pasteur-Lanroze, Brest, France;Private Hospital CMC de la Baie de Morlaix, Morlaix, France
| | - Julien Edeline
- C.R.L.C.C. Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, Rennes, France
| | | | - Xavier Artignan
- C.H.P, 6 Boulevard de la Boutière, Saint-Gregoire, France;Private Hospital Sévigné, Cesson Sevigne, France
| | - Roger Faroux
- Hospital Center of Vendée, La Roche Sur Yon, France
| | | | | | | | | | - Véronique Guérin Meyer
- West Institut of Cancer (ICO), Paul Papin, Angers, France;Hospital Center of Saumur, Saumur, France
| | | | - Vincent Klein
- Hospital Center of Vannes, Vannes, France;Private Hospital Océane, Vannes, France
| | - Yann Touchefeu
- University Hospital of. Nantes Hôtel Dieu, Nantes, France
| | | | | | | | | | - Loic Campion
- West Institut of Cancer (ICO), René Gauducheau, Boulevard Jacques Monod, Saint-Herblain, France
| | | | - Fanny Marhuenda
- Observatory of Cancer BPL, Angers, France;West Institut of Cancer (ICO), Paul Papin, Angers, France
| | - Francoise Grudé
- Observatory of Cancer BPL, Angers, France;West Institut of Cancer (ICO), Paul Papin, Angers, France
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7
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Reichling C, Taieb J, Derangere V, Klopfenstein Q, Le Malicot K, Gornet JM, Becheur H, Fein F, Cojocarasu O, Kaminsky MC, Lagasse JP, Luet D, Nguyen S, Etienne PL, Gasmi M, Vanoli A, Perrier H, Puig PL, Emile JF, Lepage C, Ghiringhelli F. Artificial intelligence-guided tissue analysis combined with immune infiltrate assessment predicts stage III colon cancer outcomes in PETACC08 study. Gut 2020; 69:681-690. [PMID: 31780575 PMCID: PMC7063404 DOI: 10.1136/gutjnl-2019-319292] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [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: 06/14/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Diagnostic tests, such as Immunoscore, predict prognosis in patients with colon cancer. However, additional prognostic markers could be detected on pathological slides using artificial intelligence tools. DESIGN We have developed a software to detect colon tumour, healthy mucosa, stroma and immune cells on CD3 and CD8 stained slides. The lymphocyte density and surface area were quantified automatically in the tumour core (TC) and invasive margin (IM). Using a LASSO algorithm, DGMate (DiGital tuMor pArameTErs), we detected digital parameters within the tumour cells related to patient outcomes. RESULTS Within the dataset of 1018 patients, we observed that a poorer relapse-free survival (RFS) was associated with high IM stromal area (HR 5.65; 95% CI 2.34 to 13.67; p<0.0001) and high DGMate (HR 2.72; 95% CI 1.92 to 3.85; p<0.001). Higher CD3+ TC, CD3+ IM and CD8+ TC densities were significantly associated with a longer RFS. Analysis of variance showed that CD3+ TC yielded a similar prognostic value to the classical CD3/CD8 Immunoscore (p=0.44). A combination of the IM stromal area, DGMate and CD3, designated 'DGMuneS', outperformed Immunoscore when used in estimating patients' prognosis (C-index=0.601 vs 0.578, p=0.04) and was independently associated with patient outcomes following Cox multivariate analysis. A predictive nomogram based on DGMuneS and clinical variables identified a group of patients with less than 10% relapse risk and another group with a 50% relapse risk. CONCLUSION These findings suggest that artificial intelligence can potentially improve patient care by assisting pathologists in better defining stage III colon cancer patients' prognosis.
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Affiliation(s)
- Cynthia Reichling
- Département d'hépato-gastroentérologie et en oncologie digestive, Hôpital du Bocage, Dijon, Bourgogne-Franche-Comté, France
| | - Julien Taieb
- Service d'hépato-gastroentérologie, Hopital Europeen Georges Pompidou, Paris, France
| | - Valentin Derangere
- Plateforme de recherche biologique en oncologie, Georges-Francois Leclerc Centre, Dijon, Bourgogne-Franche-Comté, France
| | - Quentin Klopfenstein
- Plateforme de recherche biologique en oncologie, Georges-Francois Leclerc Centre, Dijon, Bourgogne-Franche-Comté, France
| | - Karine Le Malicot
- Fédération Francophone de Cancérologie Digestive, Hôpital du Bocage, Dijon, Bourgogne-Franche-Comté, France
| | - Jean-Marc Gornet
- Département d'hépato-gastroentérologie, Hospital Saint-Louis, Paris, Île-de-France, France
| | - Hakim Becheur
- Département d'hépato-gastroentérologie, Hôpital Bichat Claude-Bernard, Paris, Île-de-France, France
| | - Francis Fein
- Département d'hépato-gastroentérologie, CHU Besancon, Besancon, France
| | - Oana Cojocarasu
- Département d'onco-hématologie, Le Mans Universite, Le Mans, Pays de la Loire, France
| | - Marie Christine Kaminsky
- Département d'oncologie médicale, Institut de Cancérologie de Lorraine, Vandoeuvre-les-Nancy, Lorraine, France
| | - Jean Paul Lagasse
- Département d'hépato-gastroentérologie et en oncologie digestive, Orleans University, Orleans, France
| | - Dominique Luet
- Département d'hépato-gastroentérologie et en oncologie digestive, CHU Angers, Angers, Pays de la Loire, France
| | - Suzanne Nguyen
- Service d'Oncologie Médicale, CH Pau, Pau, Aquitaine-Limousin-Poitou, France
| | - Pierre-Luc Etienne
- Service d'Oncologie Médicale, Hospital Centre Saint Brieuc, Saint Brieuc, Bretagne, France
| | - Mohamed Gasmi
- Département d'hépato-gastroentérologie, Assistance Publique Hopitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France
| | - Andre Vanoli
- Département d'oncologie médicale, Clinique Sainte Marthe, Dijon, Bourgogne, France
| | - Hervé Perrier
- service d'oncologie, Hopital Saint Joseph, Marseille, Provence-Alpes-Côte d'Azu, France
| | - Pierre-Laurent Puig
- pole biologie, Hospital European George Pompidou, Paris, Île-de-France, France
| | | | - Come Lepage
- Département d'hépato-gastroentérologie et en oncologie digestive, Hôpital du Bocage, Dijon, Bourgogne-Franche-Comté, France
| | - François Ghiringhelli
- Département d'oncologie médicale, Georges-Francois Leclerc Centre, Dijon, Bourgogne-Franche-Comté, France
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8
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Voog E, Campillo-Gimenez B, Elkouri C, Priou F, Rolland F, Laguerre B, Elhannani C, Merrer J, Pfister C, Sevin E, L'Haridon T, Hasbini A, Moise L, Le Rol A, Malhaire JP, Delva R, Vauléon E, Cojocarasu O, Deguiral P, Cumin I, Cheneau C, Schlürmann F, Delecroix V, Boughalem E, Mollon D, Ligeza-Poisson C, Abadie-Lacourtoisie S, Monpetit E, Chatellier T, Desclos H, Coquan E, Joly F, Tessereau JY, Dupuy S, Déniel Lagadec D, Marhuenda F, Grudé F. Long survival of patients with metastatic clear cell renal cell carcinoma. Results of real life study of 344 patients. Int J Cancer 2019; 146:1643-1651. [PMID: 31318983 DOI: 10.1002/ijc.32578] [Citation(s) in RCA: 5] [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: 01/16/2019] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 11/10/2022]
Abstract
The treatment landscape in metastatic renal cell carcinoma has changed fundamentally over the last decade by the development of antiangiogenic agents, mammalian target of rapamycin inhibitors and immunotherapy. Outside of the context of a clinical trial, the treatments are used sequentially. We describe results under real-life conditions of a sequential treatment strategy, before the era of immunotherapy. All patients were treated according to their prognostic score (either Memorial Sloan Kettering Cancer Center or International Metastatic Renal Cell Carcinoma Database Consortium) for advanced renal cell carcinoma. A treatment strategy involving 1 to 4 lines was determined including a rechallenge criterion for the repeat use of a treatment class. Three hundred forty-four patients were included over 3 years. Overall survival was 57 months in patients with good or intermediate prognosis and 19 months in patients with poor prognosis. In the former group, the proportions of patients treated with 2 to 4 treatment lines were 70%, 38% and 16%, respectively. The best objective response rates for lines 1 to 4 were 46%, 36%, 16% and 17%, respectively. Grade III/IV toxicity did not appear to be cumulative. The recommended strategy was followed in 68% of patients. A large proportion of patients with good or intermediate prognosis who progress after two lines of treatment still have a performance status good enough to receive a systemic treatment, which justifies such a strategy. Overall survival of patients with good and intermediate prognosis was long, suggesting a benefit from the applied approach. These results might be used as selection criterion for the treatment of patients in the era of immune checkpoint inhibitors.
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Affiliation(s)
- Eric Voog
- Clinique Victor Hugo, Le Mans, France
| | | | | | - Franck Priou
- Centre Hospitalier de La Roche/Yon, La Roche/Yon, France
| | | | | | | | | | | | | | | | | | | | - Annick Le Rol
- Centre Hospitalier Intercommunal de Cornouaille, Quimper, France
| | | | - Remy Delva
- Institut de Cancérologie de l'Ouest, Angers, Nantes, France
| | | | | | - Philippe Deguiral
- Clinique Mutualiste de l'Estuaire Saint-Nazaire, Saint-Nazaire, France
| | - Isabelle Cumin
- Centre Hospitalier Bretagne Sud Lorient, Lorient, France
| | - Caroline Cheneau
- Centre Hospitalier Universitaire Brest Morvan, Brest, France.,Centre Hospitalier Bretagne Sud Lorient, Lorient, France
| | - Friedrike Schlürmann
- Centre Hospitalier Intercommunal de Cornouaille, Quimper, France.,Centre Hospitalier Universitaire Brest Morvan, Brest, France
| | - Valérie Delecroix
- Clinique Mutualiste de l'Estuaire Saint-Nazaire, Saint-Nazaire, France
| | | | - Delphine Mollon
- Centre Hospitalier Intercommunal de Cornouaille, Quimper, France
| | | | | | | | | | | | | | | | - Jean Yves Tessereau
- Institut de Cancérologie de l'Ouest, Angers, Nantes, France.,Observatoire dédié au Cancer des Pays de la Loire, Angers, France
| | - Sandra Dupuy
- Institut de Cancérologie de l'Ouest, Angers, Nantes, France
| | - Delphine Déniel Lagadec
- Centre Hospitalier Universitaire Brest Morvan, Brest, France.,Observatoire dédié au Cancer des Pays de la Loire, Angers, France
| | - Fanny Marhuenda
- Institut de Cancérologie de l'Ouest, Angers, Nantes, France.,Observatoire dédié au Cancer des Pays de la Loire, Angers, France
| | - Francoise Grudé
- Institut de Cancérologie de l'Ouest, Angers, Nantes, France.,Observatoire dédié au Cancer des Pays de la Loire, Angers, France
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9
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Falandry C, Savoye AM, Stefani L, Tinquaut F, Lorusso D, Herrstedt J, Bourbouloux E, Floquet A, Brachet PE, Zannetti A, Mouret-Reynier MA, Sverdlin R, D'hondt V, Guillem O, Cojocarasu O, Venat-Bouvet L, Rousseau F, Lortholary A, Pujade-Lauraine E, Freyer G. EWOC-1: A randomized trial to evaluate the feasibility of three different first-line chemotherapy regimens for vulnerable elderly women with ovarian cancer (OC): A GCIG-ENGOT-GINECO study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5508] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5508 Background: The Geriatric Vulnerability Score (GVS) combining albumin, lymphocyte count, ADL, IADL and HADS scores has been reported (Falandry C Ann Oncol 2013) to identify vulnerable elderly OC patients (pts) as those with a GVS≥3. For such pts, Carboplatin (Cb) monotherapy or weekly Cb plus paclitaxel (Pa) are often proposed as an alternative to Cb-Pa given every 3 weeks. Methods: Pts ≥70 yrs with first line FIGO stage III/IV epithelial OC were screened for GVS. Those with GVS≥3 were randomized to receive either arm A: Cb AUC5-6 + Pa 175mg/m², d1q3week or arm B: Cb AUC5-6 d1q3week or arm C:weekly Cb AUC2 + Pa 60mg/m² d1-d8-d15 q4week. Primary endpoint is treatment feasibility defined as the ability to complete 6 chemotherapy courses without disease progression, early treatment stopping due to unacceptable toxicity or death. Inclusion of 240 pts was planned. Results: Among 444 screened pts, 120 were randomized from 12/2013 to 04/2017 (armA = B = C = 40). Pts characteristics were well balanced between arms A-B-C respectively: median age (79-82-80 yrs), FIGO stage IV (32-37-27%), primary surgery (65-72-70%), absence of macroscopic residuals (CC-0) (7-5-7%), ECOG≥2 (50-50-47%). Feasibility per protocol for arms A-B-C is 65%, 47% and 60% (p = 0.15). Main reasons for treatment arrest are treatment toxicity (A:20%; B:15%; C:22.5%; p = 0.771) and disease progression (A:7.5%; B:30%; C:2%; p = 0.004). Median PFS for arm A-B-C are 12.5 mos (95%CI 10.3-15.3), 4.8 (3.8-15.3) and 8.3 (6.6-15.3), respectively (p < 0.001) and median OS for arm A-B-C is not reached (NR) (21, NR), 7.4 (5.3-NR) and 17.3 (10.8-NR), respectively (p = 0.001). At the pre-planned intermediate analysis, the IDMC recommended to prematurely close the study as survival in armB was found significantly worse and the number of potential pts required to find a significant difference between both Cb-Pa regimens (arms A&C) was out of reach. Conclusions: Compared to 3-weekly and weekly Cb-Pa regimens, Cb single agent was reported to be less active with significant worse survival outcome in vulnerable elderly pts. In this population Cb-Pa combination remains a standard. Clinical trial information: NCT02001272.
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Affiliation(s)
| | | | | | - Fabien Tinquaut
- GINECO Statistician - Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | - Domenica Lorusso
- MITO and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Jorn Herrstedt
- Nordic Society of Gynecologic Oncology (NSGO) and Odense University Hospital, Odense, Denmark
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10
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Reichling C, Taieb J, Derangere V, Le Malicot K, Emile JF, Gornet JM, Becheur H, Fein F, Cojocarasu O, Kaminsky MC, Lagasse JP, Luet D, Nguyen S, Etienne PL, Gasmi M, Vanoli A, Perrier H, Klopfenstein Q, Lepage C, Ghiringhelli F. Combination of tissues analysis and immune infiltrate in localized colon cancer using artificial intelligence in PETACC8 study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.3574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3574 Background: We used artificial intelligence to perform tissue classification and count CD3 and CD8 in each subclass and determined their role in outcome prediction in PETACC8 cohort of stage III colon cancer treated with FOLFOX or FOLFOX plus cetuximab. Methods: We developed artificial intelligence aimed to detect tumor, healthy mucosa, stroma and immune cells on whole slide of CD3 and CD8 staining. The invasive margin (IM) was also automatically determined. Using a lasso algorithm, the software was able to detect digital parameters within the tumor core (TC) which were related to patients’ outcome (variable called DGMate for DiGital tuMor pArameTErs). CD3 and CD8 lymphocytes density were also quantified automatically by the software in TC and at IM. Associations with disease-free survival (DFS) were evaluated by multivariable Cox regression adjusting for age, T/N stage, sidedness, KRAS/BRAF, DNA mismatch repair (MMR). Results: On 1220 samples collected, data could be generated for 1018 patients. We observed that a high IM stromal area and a high DGMate were associated with a poorer DFS [HR 5.65 (95% CI, 2.34, 13.67), p < 0.0001; HR 2.72 (95% IC, 1.92, 3.85), p<0.001 respectively for the continuous variable]. A higher density of CD3+ TC, CD3+ IM and CD8+ TC were significantly associated with a longer DFS (HR 0.75 (95% IC, .66, .87), p<0.0001; HR 0.78 (95% IC, .68, .88), p<0.0001; HR 0.83 (95% IC, .71, .96), p=0.01). All these immune variables were significantly correlated with each other. ANOVA test demonstrated that CD3+ TC gave a similar prognostic value compared to the classical CD3/CD8 immunoscore (p=0.44). The combination of IM stromal area, DGMate and CD3 outperformed the classical CD3/CD8 immunoscore to estimate patients’ prognosis (C-index= 0.601 vs 0.578, p-value=0.04). Adding this new variable to classical clinical prognostic parameters we generated a nomogram which predicted the risk of relapse of stage III colon cancer with a stronger predictive value compared to clinical parameters or the immunoscore. Conclusions: We propose a new fully automated method of whole slide analysis using a software based on artificial intelligence which classify tissue and determine tumor and immune parameters on one single slide stained with CD3 antibody. This valuable strategy outperforms immunoscore and clinical outcome prediction models.
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Affiliation(s)
| | - Julien Taieb
- Hôpital Européen Georges-Pompidou, Sorbonne Paris Cite/Paris Descartes University, Paris, France
| | - Valentin Derangere
- Research Platform in Biological Oncology, Center GF Leclerc, Dijon, France
| | | | - Jean Francois Emile
- Service d’Anatomie Pathologique Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | | | | | | | | | | | | | | | | | | | | | - Andr Vanoli
- Clinique Sainte Marie, Chalons Sur Saone, France
| | | | | | - Come Lepage
- Dijon University Hospital, INSERM U1231, Dijon, France
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11
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Romeo C, Joly F, Ray-Coquard I, El Kouri C, Mercier-Blas A, Berton-Rigaud D, Kalbacher E, Cojocarasu O, Fabbro M, Cretin J, Zannetti A, Abadie-Lacourtoisie S, Mollon D, Hardy-Bessard AC, Provansal M, Blot E, Delbaldo C, Lesoin A, Freyer G, You B. Non-pegylated liposomal doxorubicin (NPLD, Myocet®) + carboplatin in patients with platinum sensitive ovarian cancers: A ARCAGY-GINECO phase IB-II trial. Gynecol Oncol 2019; 152:68-75. [DOI: 10.1016/j.ygyno.2018.10.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022]
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12
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Cox DG, Curtit E, Romieu G, Fumoleau P, Rios M, Bonnefoi H, Bachelot T, Soulié P, Jouannaud C, Bourgeois H, Petit T, Tennevet I, Assouline D, Mathieu MC, Jacquin JP, Lavau-Denes S, Darut-Jouve A, Ferrero JM, Tarpin C, Lévy C, Delecroix V, Trillet-Lenoir V, Cojocarasu O, Meunier J, Pierga JY, Faure-Mercier C, Blanché H, Sahbatou M, Boland A, Bacq D, Besse C, Deleuze JF, Pauporté I, Thomas G, Pivot X. GWAS in the SIGNAL/PHARE clinical cohort restricts the association between the FGFR2 locus and estrogen receptor status to HER2-negative breast cancer patients. Oncotarget 2018; 7:77358-77364. [PMID: 27764800 PMCID: PMC5363591 DOI: 10.18632/oncotarget.12669] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 04/12/2016] [Accepted: 09/14/2016] [Indexed: 01/23/2023] Open
Abstract
Genetic polymorphisms are associated with breast cancer risk. Clinical and epidemiological observations suggest that clinical characteristics of breast cancer, such as estrogen receptor or HER2 status, are also influenced by hereditary factors. To identify genetic variants associated with pathological characteristics of breast cancer patients, a Genome Wide Association Study was performed in a cohort of 9365 women from the French nationwide SIGNAL/PHARE studies (NCT00381901/RECF1098). Strong association between the FGFR2 locus and ER status of breast cancer patients was observed (ER-positive n=6211, ER-negative n=2516; rs3135718 OR=1.34 p=5.46×10-12). This association was limited to patients with HER2-negative tumors (ER-positive n=4267, ER-negative n=1185; rs3135724 OR=1.85 p=1.16×10-11). The FGFR2 locus is known to be associated with breast cancer risk. This study provides sound evidence for an association between variants in the FGFR2 locus and ER status among breast cancer patients, particularly among patients with HER2-negative disease. This refinement of the association between FGFR2 variants and ER-status to HER2-negative disease provides novel insight to potential biological and clinical influence of genetic polymorphisms on breast tumors.
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Affiliation(s)
- David G Cox
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052 - Centre Léon Bérard, 69373 Lyon, France
| | - Elsa Curtit
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire, Boulevard Fleming, 25030 Besançon, France
| | - Gilles Romieu
- Oncologie Sénologie, ICM Institut Régional du Cancer, 34298 Montpellier Cedex, France
| | | | - Maria Rios
- Institut de Cancérologie de Lorraine - Alexis Vautrin, Département d'Oncologie Médicale, 54511 Vandœuvre-lès-Nancy Cedex, France
| | - Hervé Bonnefoi
- Institut Bergonié, Département d'Oncologie Médicale, 33000 Bordeaux, France
| | - Thomas Bachelot
- Centre Léon Bérard, Département de Cancérologie Médicale, Lyon Cedex 08, France
| | - Patrick Soulié
- Institut de Cancérologie de l'Ouest, Service Oncologie Médicale, 49993 Angers Cedex 09, France
| | | | - Hugues Bourgeois
- Clinique Victor Hugo-Centre Jean Bernard, 72015 Le Mans Cedex 2, France
| | - Thierry Petit
- Centre Paul Strauss, Service d'Oncologie Médicale, 67065 Strasbourg Cedex, France
| | | | - David Assouline
- Institut Daniel Hollard, Service Oncologie Médicale, 38028 Grenoble Cedex 01, France
| | | | - Jean-Philippe Jacquin
- Institut de Cancérologie Lucien Neuwirth, Service Oncologie Médicale, 42270 Saint Priest en Jarez, France
| | - Sandrine Lavau-Denes
- Centre Hospitalier de Limoges, Service d'Oncologie Médicale, 87042 Limoges Cedex, France
| | - Ariane Darut-Jouve
- Clinique Drévon, Centre d'Oncologie et de Radiothérapie du Parc, 21000 Dijon, France
| | - Jean-Marc Ferrero
- Centre Antoine Lacassagne, Département Oncologie Médicale, 06189 Nice Cedex 02, France
| | - Carole Tarpin
- Institut Paoli-Calmettes, Département d'Oncologie Médicale, 13009 Marseille, France
| | | | - Valérie Delecroix
- Pôle Mutualiste, Service Oncologie Médicale, 44606 Saint Nazaire, France
| | | | - Oana Cojocarasu
- Centre Hospitalier Le Mans, Service d'Onco-Hématologie et Médecine interne, 72037 Le Mans Cedex, France
| | - Jérôme Meunier
- Centre Hospitalier Régional d'Orléans, Service d'Oncologie Médicale, 45032 Orleans Cedex 1, France
| | - Jean-Yves Pierga
- Institut Curie, Department of Medical Oncology, 75248 Paris Cedex 05, France
| | - Céline Faure-Mercier
- Institut National du Cancer, Direction de la Recherche, 92513 Boulogne-Billancourt, France
| | - Hélène Blanché
- Fondation Jean Dausset, Centre d'Etudes du Polymorphisme Humain, 75010 Paris, France
| | - Mourad Sahbatou
- Fondation Jean Dausset, Centre d'Etudes du Polymorphisme Humain, 75010 Paris, France
| | - Anne Boland
- Centre National du Génotypage, Institut de Génomique, CEA, CP 5721, 91057 Evry Cedex, France
| | - Delphine Bacq
- Centre National du Génotypage, Institut de Génomique, CEA, CP 5721, 91057 Evry Cedex, France
| | - Céline Besse
- Centre National du Génotypage, Institut de Génomique, CEA, CP 5721, 91057 Evry Cedex, France
| | - Jean-François Deleuze
- Fondation Jean Dausset, Centre d'Etudes du Polymorphisme Humain, 75010 Paris, France.,Centre National du Génotypage, Institut de Génomique, CEA, CP 5721, 91057 Evry Cedex, France
| | - Iris Pauporté
- Institut National du Cancer, Direction de la Recherche, 92513 Boulogne-Billancourt, France
| | - Gilles Thomas
- Synergie Lyon Cancer, Centre Léon Bérard, Lyon Cedex 08, France
| | - Xavier Pivot
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire, Boulevard Fleming, 25030 Besançon, France
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13
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Aparicio T, Bennouna J, Le Malicot K, Boige V, Taieb J, Bouche O, Francois E, Phelip JM, Borel C, Faroux R, Dahan L, Bachet JB, Egreteau J, Kaminsky-Forrett MC, Gornet JM, Cojocarasu O, Gasmi M, Guerin-Meyer V, Ghiringhelli F, Lepage C. Predictive factors for early progression during induction chemotherapy (IC) and chemotherapy-free interval (CFI): Analysis from PRODIGE 9 trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.083] [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: 11/13/2022] Open
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14
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Curtit E, Pivot X, Henriques J, Paget-Bailly S, Fumoleau P, Rios M, Bonnefoi H, Bachelot T, Soulié P, Jouannaud C, Bourgeois H, Petit T, Tennevet I, Assouline D, Mathieu MC, Jacquin JP, Lavau-Denes S, Darut-Jouve A, Ferrero JM, Tarpin C, Lévy C, Delecroix V, Trillet-Lenoir V, Cojocarasu O, Meunier J, Pierga JY, Kerbrat P, Faure-Mercier C, Blanché H, Sahbatou M, Boland A, Bacq D, Besse C, Thomas G, Deleuze JF, Pauporté I, Romieu G, Cox DG. Assessment of the prognostic role of a 94-single nucleotide polymorphisms risk score in early breast cancer in the SIGNAL/PHARE prospective cohort: no correlation with clinico-pathological characteristics and outcomes. Breast Cancer Res 2017; 19:98. [PMID: 28830573 PMCID: PMC5568360 DOI: 10.1186/s13058-017-0888-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/04/2017] [Indexed: 12/17/2022] Open
Abstract
Background Genome-wide association studies (GWAS) have to date identified 94 genetic variants (single nucleotide polymorphisms (SNPs)) associated with risk of developing breast cancer. A score based on the combined effect of the 94 risk alleles can be calculated to measure the global risk of breast cancer. We aimed to test the hypothesis that the 94-SNP-based risk score is associated with clinico-pathological characteristics, breast cancer subtypes and outcomes in early breast cancer. Methods A 94-SNP risk score was calculated in 8703 patients in the PHARE and SIGNAL prospective case cohorts. This score is the total number of inherited risk alleles based on 94 selected SNPs. Clinical data and outcomes were prospectively registered. Genotyping was obtained from a GWAS. Results The median 94-SNP risk score in 8703 patients with early breast cancer was 77.5 (range: 58.1–97.6). The risk score was not associated with usual prognostic and predictive factors (age; tumor, node, metastasis (TNM) status; Scarff-Bloom-Richardson grade; inflammatory features; estrogen receptor status; progesterone receptor status; human epidermal growth factor receptor 2 (HER2) status) and did not correlate with breast cancer subtypes. The 94-SNP risk score did not predict outcomes represented by overall survival or disease-free survival. Conclusions In a prospective case cohort of 8703 patients, a risk score based on 94 SNPs was not associated with breast cancer characteristics, cancer subtypes, or patients’ outcomes. If we hypothesize that prognosis and subtypes of breast cancer are determined by constitutional genetic factors, our results suggest that a score based on breast cancer risk-associated SNPs is not associated with prognosis. Trial registration PHARE cohort: NCT00381901, Sept. 26, 2006 – SIGNAL cohort: INCa RECF1098, Jan. 28, 2009 Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0888-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elsa Curtit
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire, UMR 1098 INSERM-EFS-Université de Bourgogne Franche-Comté, Boulevard Fleming, 25000, Besançon, France. .,Department of Medical Oncology, University Hospital Jean Minjoz, 3, boulevard Alexandre Fleming, 25030, Besancon Cedex, France.
| | - Xavier Pivot
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire, UMR 1098 INSERM-EFS-Université de Bourgogne Franche-Comté, Boulevard Fleming, 25000, Besançon, France
| | - Julie Henriques
- Centre Hospitalier Universitaire, Unité de Méthodologie et de Qualité de Vie en Cancérologie, 2 place St Jacques, 25000, Besançon, France
| | - Sophie Paget-Bailly
- Centre Hospitalier Universitaire, Unité de Méthodologie et de Qualité de Vie en Cancérologie, 2 place St Jacques, 25000, Besançon, France
| | - Pierre Fumoleau
- Georges-François Leclerc, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Maria Rios
- Institut de Cancérologie de Lorraine - Alexis Vautrin, département d'Oncologie Médicale, 6, avenue de Bourgogne, 54511, Vandoeuvre Les Nancy Cedex, France
| | - Hervé Bonnefoi
- Institut Bergonié, Département d'Oncologie Médicale, 229 Cours de l'Argonne, 33000, Bordeaux, France
| | - Thomas Bachelot
- Centre Léon Bérard, Département de Cancérologie Médicale, 28 rue Laënnec, Lyon Cedex 08, France
| | - Patrick Soulié
- Institut de Cancérologie de l'Ouest, Service Oncologie Médicale, 2 rue Moll, 49993, Angers Cedex 09, France
| | - Christelle Jouannaud
- Institut Jean Godinot, Service Oncologie Médicale, 1 rue du Général Koenig, 51056, Reims cedex, France
| | - Hugues Bourgeois
- Clinique Victor Hugo-Centre Jean Bernard, 18 rue Victor Hugo, 72015, Le Mans Cedex 2, France
| | - Thierry Petit
- Centre Paul Strauss, Service d'Oncologie Médicale, 3 rue de la Porte de l'Hôpital, 67065, Strasbourg Cedex, France
| | | | - David Assouline
- Institut Daniel Hollard, Service Oncologie Médicale, 8 rue du Docteur Calmette, 38028, Grenoble Cedex 01, France
| | - Marie-Christine Mathieu
- Institut Gustave Roussy, Comité de Pathologie mammaire, 39 rue Camille Desmoulins, 94805, Villejuif Cedex, France
| | - Jean-Philippe Jacquin
- Institut de Cancérologie Lucien Neuwirth, Service Oncologie Médicale, 108 bis avenue Albert Raimond, 42270, Saint Priest en Jarez, France
| | - Sandrine Lavau-Denes
- Centre Hospitalier de Limoges, Service d'Oncologie Médicale, 2 avenue Martin Luther King, 87042, Limoges Cedex, France
| | - Ariane Darut-Jouve
- Clinique Drévon, Centre d'oncologie et de radiothérapie du Parc, 18 cours du général de Gaulle, 21000, Dijon, France
| | - Jean-Marc Ferrero
- Centre Antoine Lacassagne, Département Oncologie Médicale, 33 avenue de Valombrose, 06189, Nice Cedex 02, France
| | - Carole Tarpin
- Institut Paoli-Calmettes, Département d'Oncologie Médicale, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France
| | - Christelle Lévy
- Centre François Baclesse, 3 avenue du Général Harris, 14076, Caen Cedex 5, France
| | - Valérie Delecroix
- Centre Etienne Dolet, Pôle Mutualiste, Service Oncologie Médicale, 11 boulevard Georges Charpak, 44606, Saint Nazaire, France
| | - Véronique Trillet-Lenoir
- Centre Hospitalier Lyon Sud, Service d'Oncologie Médicale, 165 chemin du Grand Revoyet, 69495, Pierre-Benite Cedex, France
| | - Oana Cojocarasu
- Centre Hospitalier Le Mans, Service d'Onco-Hématologie et Médecine interne, 194 avenue Rubillard, 72037, Le Mans Cedex, France
| | - Jérôme Meunier
- Centre Hospitalier Régional d'Orléans, Service d'Oncologie médicale, 1 rue Porte Madeleine, 45032, Orleans Cedex 1, France
| | - Jean-Yves Pierga
- Institut Curie, Department of Medical Oncology, 26 rue d'Ulm, 75248, Paris Cedex 05, France
| | - Pierre Kerbrat
- Centre Eugène Marquis, Service Oncologie médicale, Rue de la Bataille Flandres-Dunkerque, CS 44229, 35042, Rennes Cedex, France
| | - Céline Faure-Mercier
- Institut National du Cancer, Direction de la Recherche, 52 avenue Morizet, 92513, Boulogne-Billancourt, France
| | - Hélène Blanché
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, 75010, Paris, France
| | - Mourad Sahbatou
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, 75010, Paris, France
| | - Anne Boland
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, 91057, Evry Cedex, France
| | - Delphine Bacq
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, 91057, Evry Cedex, France
| | - Céline Besse
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, 91057, Evry Cedex, France
| | - Gilles Thomas
- Synergie Lyon Cancer, Centre Léon Bérard, 28 rue Laënnec, Lyon Cedex 08, France
| | - Jean-François Deleuze
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, 75010, Paris, France.,Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, 91057, Evry Cedex, France
| | - Iris Pauporté
- Institut National du Cancer, Direction de la Recherche, 52 avenue Morizet, 92513, Boulogne-Billancourt, France
| | - Gilles Romieu
- Oncologie Sénologie, ICM Institut Régional du Cancer, 34298, Montpellier Cedex, France
| | - David G Cox
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052 - Centre Léon Bérard, 28 rue Laennec, 69373, Lyon, France
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Bourgeois H, Grudé F, Solal-Céligny P, Dupuis O, Voog E, Ganem G, Denis F, Zinger M, Juhel-Voog L, Lafond C, Maillart P, Capitain O, Delva R, Soulié P, Abadie-Lacourtoisie S, Guérin-Meyer V, Morin-Meschin M, Commer J, Gangler A, d’Aillières B, Zannetti A, Bourbouloux E, Berton-Rigault D, Lebouvier-Sadot S, Kaassis M, Baudon J, Lam Y, Bizieux A, Marcq M, Edeline J, Le Du F, Lefeuvre C, Deguiral P, Delecroix V, Blot E, Egreteau J, Goudier M, Lamy R, Ferec M, Artignan X, Corbinais S, Morel H, Hardy-Bessard A, Alleaume C, Naudeix E, Cojocarasu O, Metges J, Riché C, Gamelin E, Déniel-Lagadec D, Marhuenda F, Ingrand P, Douillard J. Clinical validation of a prognostic tool in a population of outpatients treated for incurable cancer undergoing anticancer therapy: PRONOPALL study. Ann Oncol 2017; 28:1612-1617. [DOI: 10.1093/annonc/mdx172] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Indexed: 12/25/2022] Open
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16
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Pivot X, Romieu G, Fumoleau P, Rios M, Bonnefoi H, Bachelot T, Soulié P, Jouannaud C, Bourgeois H, Petit T, Tennevet I, Assouline D, Mathieu MC, Jacquin JP, Lavau-Denes S, Darut-Jouve A, Ferrero JM, Tarpin C, Lévy C, Delecroix V, Trillet-Lenoir V, Cojocarasu O, Meunier J, Pierga JY, Agostini C, Kerbrat P, Faure-Mercier C, Blanché H, Sahbatou M, Boland A, Bacq D, Besse C, Calvo F, Renaud A, Deleuze JF, Pauporté I, Thomas G, Cox DG. Constitutional variants are not associated with HER2-positive breast cancer: results from the SIGNAL/PHARE clinical cohort. NPJ Breast Cancer 2017. [PMID: 28649644 PMCID: PMC5445615 DOI: 10.1038/s41523-017-0005-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Human epidermal growth factor receptor 2-positive breast cancer is a subtype of interest regarding its outcome and the impressive impact of human epidermal growth factor receptor 2 targeted therapy. Constitutional variants may be involved in the aetiology of human epidermal growth factor receptor 2-positive breast cancer, and we propose a case–case study to test the hypothesis that single nucleotide polymorphisms may be associated with human epidermal growth factor receptor 2 status. A Genome-Wide Association Study was used in a cohort of 9836 patients from the SIGNAL/PHARE study (NCT00381901-RECF1098). The main goal was to identify variants specifically related to human epidermal growth factor receptor 2-positive breast cancer. A two-staged genotyping strategy was carried out to cover as large a proportion of the genome as possible. All subjects were genotyped using the Illumina HumanCore Exome chip set. Principal Components Analysis and k-means were then used to characterize the ancestry of the participants. A random sample of subjects from the main “European” cluster was genotyped with the Omni5 chip set. These data were then used to impute missing genotypes from the remaining subjects genotyped only using the HumanCore Exome array. From the 9836 patients, a total of 8703 cases including 3230 patients with human epidermal growth factor receptor 2-positive breast cancer were analyzed. Despite having 80% power to detect an odds ratio of 1.23 in this population, no variant achieved genome-wide significance for association with the occurrence of human epidermal growth factor receptor 2–positive breast cancer vs. any other subtype of breast tumour. Our study was unable to identify constitutional polymorphisms that are strongly associated with human epidermal growth factor receptor 2-positive status among breast cancer patients. A large gene-finding study failed to identify any hereditary factors linked to HER2 expression among women with breast cancer. A team in France led by Xavier Pivot from the University Hospital Center of Besançon, France, analyzed more than 500,000 single DNA letters from a cohort of 8703 patients with breast cancer, 3230 of whom had tumors with high expression of human epidermal growth factor receptor 2 (HER2) and are thus treated with for anti-HER2 targeted therapies. The researchers searched for DNA variants associated with HER2 status, but none reached the threshold for statistical significance. The findings reveal a high level of genetic diversity in women with HER2-positive breast cancer and suggest that HER2 amplification may have more to do with the intrinsic nature of the tumor than with the genetics of the patient.
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Affiliation(s)
- Xavier Pivot
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire INSERM 1098, Boulevard Fleming, Besançon, 25030 France
| | - Gilles Romieu
- Oncologie Sénologie, ICM Institut Régional du Cancer, Montpellier, CEDEX 34298 France
| | - Pierre Fumoleau
- Georges-François Leclerc, 1 Rue du Professeur Marion, Dijon, 21000 France
| | - Maria Rios
- Département d'Oncologie Médicale, Institut de Cancérologie de Lorraine-Alexis Vautrin, 6, avenue de Bourgogne, VANDOEUVRE LES NANCY, CEDEX 54511 France
| | - Hervé Bonnefoi
- Département d'Oncologie Médicale, Institut Bergonié, 229 Cours de l'Argonne, Bordeaux, 33000 France
| | - Thomas Bachelot
- Département de Cancérologie Médicale, Centre Léon Bérard, 28 rue Laënnec, Lyon, CEDEX 08 France
| | - Patrick Soulié
- Institut de Cancérologie de l'Ouest, Service Oncologie Médicale, 2 rue Moll, Angers, CEDEX 09 49993 France
| | - Christelle Jouannaud
- Institut Jean Godinot, Service Oncologie Médicale, 1 rue du Général Koenig, Reims, CEDEX 51056 France
| | - Hugues Bourgeois
- Clinique Victor Hugo-Centre Jean Bernard, 18 rue Victor Hugo, Le Mans, CEDEX 2 72015 France
| | - Thierry Petit
- Centre Paul Strauss, Service d'Oncologie Médicale, 3 rue de la Porte de l'Hôpital, Strasbourg, CEDEX 67065 France
| | | | - David Assouline
- Institut Daniel Hollard, Service Oncologie Médicale, 8 rue du Docteur Calmette, Grenoble, CEDEX 01 38028 France
| | - Marie-Christine Mathieu
- Institut Gustave Roussy, Comité de Pathologie mammaire, 39 rue Camille Desmoulins, Villejuif, CEDEX 94805 France
| | - Jean-Philippe Jacquin
- Institut de Cancérologie Lucien Neuwirth, Service Oncologie Médicale, 108 bis avenue Albert Raimond, Saint Priest en Jarez, 42270 France
| | - Sandrine Lavau-Denes
- Centre Hospitalier de Limoges, Service d'Oncologie Médicale, 2 avenue Martin Luther King, Limoges, CEDEX 87042 France
| | - Ariane Darut-Jouve
- Clinique Drévon, Centre d'oncologie et de radiothérapie du Parc, 18 cours du général de Gaulle, Dijon, 21000 France
| | - Jean-Marc Ferrero
- Département Oncologie Médicale, Centre Antoine Lacassagne, 33 avenue de Valombrose, Nice, CEDEX 02 06189 France
| | - Carole Tarpin
- Département d'Oncologie Médicale, Institut Paoli-Calmettes, 232 Boulevard de Sainte-Marguerite, Marseille, 13009 France
| | - Christelle Lévy
- Centre François Baclesse, 3 avenue du Général Harris, Caen, CEDEX 5 14076 France
| | - Valérie Delecroix
- Centre Etienne Dolet, Pôle Mutualiste, Service Oncologie Médicale, 11 boulevard Georges Charpak, Saint Nazaire, 44606 France
| | - Véronique Trillet-Lenoir
- Centre Hospitalier Lyon Sud, Service d'Oncologie Médicale, 165 chemin du Grand Revoyet, Pierre-Benite cedex, 69495 France
| | - Oana Cojocarasu
- Centre Hospitalier Le Mans, Service d'Onco-Hématologie et Médecine interne, 194 avenue Rubillard, Le Mans, CEDEX 72037 France
| | - Jérôme Meunier
- Centre Hospitalier Régional d'Orléans, Service d'Oncologie médicale, 1 rue Porte Madeleine, ORLEANS, CEDEX 1 45032 France
| | - Jean-Yves Pierga
- Department of Medical Oncology, Institut Curie, 26 rue d'Ulm, Paris, CEDEX 05 75248 France
| | - Cécile Agostini
- Centre Hospitalier de Chambéry, Service Oncologie médicale, Place du Docteur François Chiron, Chambéry, 73000 France
| | - Pierre Kerbrat
- Centre Eugène Marquis, Service Oncologie médicale, Rue de la Bataille Flandres-Dunkerque, CS 44229, Rennes, CEDEX 35042 France
| | - Céline Faure-Mercier
- Institut National du Cancer, Direction de la Recherche, 52 avenue Morizet, Boulogne-Billancourt, 92513 France
| | - Hélène Blanché
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, Paris, 75010 France
| | - Mourad Sahbatou
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, Paris, 75010 France
| | - Anne Boland
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, Evry, CEDEX 91057 France
| | - Delphine Bacq
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, Evry, CEDEX 91057 France
| | - Céline Besse
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, Evry, CEDEX 91057 France
| | - Fabien Calvo
- Institut Gustave Roussy, Comité de Pathologie mammaire, 39 rue Camille Desmoulins, Villejuif, CEDEX 94805 France
| | - Alexia Renaud
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052-Centre Léon Bérard, 28 rue Laennec, Lyon, 69373 France
| | - Jean-François Deleuze
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, Paris, 75010 France.,Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, Evry, CEDEX 91057 France
| | - Iris Pauporté
- Institut National du Cancer, Direction de la Recherche, 52 avenue Morizet, Boulogne-Billancourt, 92513 France
| | - Gilles Thomas
- Synergie Lyon Cancer, Centre Léon Bérard, 28 rue Laënnec, Lyon, CEDEX 08 France
| | - David G Cox
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052-Centre Léon Bérard, 28 rue Laennec, Lyon, 69373 France
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17
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Boisdron-Celle M, Capitain O, Faroux R, Borg C, Philippe Metges J, Galais MP, Kaassis M, Bennouna J, Bouhier-Leporrier K, Francois E, Baumgaertner I, Guerin-Meyer V, Cojocarasu O, Roemer-Becuwe C, Stampfli C, Rosenfeld L, Lecompte T, Berger V, Morel A, Gamelin E. In reply. Semin Oncol 2017; 44:161. [DOI: 10.1053/j.seminoncol.2017.08.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Voog E, Campillo-Gimenez B, El Kouri C, Priou F, Rolland F, Laguerre B, Elhannani C, Merrer J, Joly F, Pfister C, Malhaire JP, Delva R, Cojocarasu O, Cumin I, Ligeza-poisson C, Schlurmann F, Monpetit E, Deniel Lagadec D, Marhuenda F, Grude F. IVOIRE: Results of a prospective multicentre cohort study in advanced renal carcinoma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
451 Background: Sequential targeted therapy is standard in patients (pts) with clear-cell renal carcinoma (CCRCC). Clinical Practice Guidelines exists only for first and second lines (ESMO recommendations). Exploratory recommendations for next treatments (ttt) have been proposed according to their MSKCSS risk. In 3rd line, pts without prior everolimus were proposed to receive it. Pts who have failed 2nd line ttt with everolimus were proposed to rechallenge Tyrosine Kinase Inhibitor only if they experimented a disease control ≤ 6 months in 1st line. For 4thline, TKI or everolimus were rechallenged according to the previously quoted criteria. Poor risk pts are not presented here. Methods: IVOIRE was a prospective multicentric study including pts treated according to these guidelines. Objectives were overall survival (OS) and for each line Best Objective Response (BOR - RECIST 1.1) and Disease Control Time (DCT: time from day 1 of ttt to the day before the next one). Results: 301 locally advanced/metastatic RCC pts have been included in 17 French centers between Sept 2011 and Sept 2014: 71% men; median age 66 years [35-90]; CCRCC: 89%; grade III-IV Führmann: 68%; tumor resection: 90%. Pts received between 2 and 8 ttt lines, including mainly TK and mTOR inhibitors, or rarely (< 5%) immunotherapies in 1st line (IFN, IL-2 and bévacizumab only). Median OS was 57 [51-70] months. Results are summarized in table. Important clinical benefit (L1: 79%; L2: 65%; L3: 59%; L4 : 38%; L5: 39%) and DCT could be observed until ttt line 5. A long DCT in 1st line was predictive of a best OS (p=0.001). Indeed, pts with short 1stline DCT (11 to 54 weeks) had a shorter median OS (32 months [23-61]] while pts with long DCT (>54 weeks) had a longer median OS: 79 months [65-100]. Conclusions: Our results confirm that clinical benefit remained important to beyond the first lines and that DCT in the first line was predictive of the global OS. Ttt sequence analysis and tolerance will be shown at the meeting. [Table: see text]
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Affiliation(s)
- Eric Voog
- Centre Jean Bernard Clinique Victor Hugo, Le Mans, France
| | | | | | - Frank Priou
- Centre Hospitalier Departemental Vendee, La Roche-Sur-Yon, France
| | | | | | | | | | | | | | | | - Remy Delva
- Institut de Cancerologie de l'Ouest, Angers, France
| | | | | | | | | | | | | | - Fanny Marhuenda
- Observatoire dedie au Cancer Bretagne Pays de la Loire, Angers, France
| | - Francoise Grude
- Observatoire dedie au Cancer Bretagne Pays de la Loire, Angers, France
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Boisdron-Celle M, Capitain O, Faroux R, Borg C, Metges JP, Galais MP, Kaassis M, Bennouna J, Bouhier-Leporrier K, Francois E, Baumgaertner I, Guerin-Meyer V, Cojocarasu O, Roemer-Becuwe C, Stampfli C, Rosenfeld L, Lecompte T, Berger V, Morel A, Gamelin E. Prevention of 5-fluorouracil-induced early severe toxicity by pre-therapeutic dihydropyrimidine dehydrogenase deficiency screening: Assessment of a multiparametric approach. Semin Oncol 2017; 44:13-23. [DOI: 10.1053/j.seminoncol.2017.02.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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You B, Joly F, Ray-Coquard I, El Kouri C, Mercier-Blas A, Berton-Rigaud D, Kalbacher E, Cojocarasu O, Fabbro M, Cretin J, Zannetti A, Abadie-Lacourtoisie S, Mollon D, Hardy-Bessard AC, Provansal M, Freyer G. Non pegylated liposomal doxorubicin (npld, myocettm) + carboplatin (cb) in patients (pts) with ovarian cancer in late relapse (oclr): a phase 2 gineco study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.10] [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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Voog E, Campillo-Gimenez B, El Kouri C, Priou F, Laguerre B, Joly F, Merrer J, Delecroix V, Le Rol A, Delva R, Malhaire JP, Elhannani C, Pfister C, Rolland F, Cojocarasu O, Cumin I, Monpetit E, Deniel Lagadec D, Marhuenda F, Grude F. Third- and fourth-line treatment in patients with RCC: Results of a prospective multicentric non-randomised study (IVOIRE study). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.4567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Eric Voog
- Clinique Victor Hugo, Le Mans, France
| | | | | | - Frank Priou
- Centre Hospitalier Départemental Vendée, La Roche-Sur-Yon, France
| | | | | | | | - Valérie Delecroix
- Clinique Mutualiste de l'Estuaire - Cité Sanitaire, Saint Nazaire, France
| | | | - Remy Delva
- Institut de Cancérologie de l'Ouest, Angers, France
| | | | | | | | | | | | | | | | | | - Fanny Marhuenda
- Observatoire dédié au Cancer Bretagne Pays de la Loire, Angers, France
| | - Francoise Grude
- Observatoire dédié au Cancer Bretagne Pays de la Loire, Angers, France
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22
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Metges JP, Lebot MA, Faroux R, Riaud F, Gamelin E, Capitain O, Guérin Meyer V, Leynia P, Douillard JY, Senellart H, Rochard S, Louvigné C, Campion L, Dupuis O, Grollier C, Achour NA, Person B, Raoul JL, Boucher E, Bertrand C, Ramée JF, Guivarch L, Etienne PL, Roussel S, Desclos H, Julien MN, Labarre MI, Klein V, Bessard R, Stampfli C, Royet F, Faycal J, Gouva S, Le Bihan G, Couturier M, Gourlaouen A, Bertholom C, Porneuf M, Jobard E, Peguet E, Grasset D, Bouret JF, Bicheler V, Ulvoas A, Miglianico L, Chouzenoux C, Deguiral P, Derenne L, Martin D, Langlet PM, Bodin C, Rossi V, Barré S, Cojocarasu O, Naveau Ploux C, Vidal AM, Cumin I, Egreteau J, Brouard A, Matysiak Budnik T, Thomaré P, Le Bris Michel AS, Piriou G, Largeau R, Elhannani C, Crespeau E, Suberville F, Bourgeois H, Riche C, Lagadec DD, Marhuenda F, Grudé F. Evaluation in usual practice of the bevacizumab-FOLFIRI combination for the first-line treatment of patients with unresectable metastatic colorectal cancer treated in 2006: focus on resected patients and oncogeriatrics: AVASTIN OUEST cohort of the Observatory of Cancer of the Brittany and Pays de la Loire Areas ( Observatoire dédié au Cancer Bretagne / Pays de la Loire). ONCOLOGIE 2014; 16:267-276. [PMID: 26190928 PMCID: PMC4496868 DOI: 10.1007/s10269-014-2391-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 04/07/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND In 2006, bevacizumab, a targeted therapy agent was combined with FOLFIRI for the firstline treatment of patients with unresectable metastatic colorectal cancer. METHODS/RESULTS A study on a homogenous series of 111 patients from the Brittany and Pays de la Loire areas who received bevacizumab-FOLFIRI as first-line treatment in 2006 showed the following results: 51 responses, 29 stabilisations, 21 progressions and 10 cases of toxicity prior to assessment. Median overall survival (OS) was 25.1 months and median progression-free survival was 10.2 months. Surgery secondary to treatment tripled median OS which reached 59.2 months in resected patients versus 18.8 months in unresected patients. Comparison of patients aged more or less than 70 years showed no differences in terms of benefits or risks. CONCLUSION Bevacizumab-FOLFIRI could be administered as part of a routine care protocol to elderly patients previously evaluated by a geriatric assessment and validated by a multidisciplinary staff.
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Affiliation(s)
- J. P. Metges
- />CHU Brest Morvan, Brest, France
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
| | | | - R. Faroux
- />CH La Roche-Sur-Yon, La Roche-sur-Yon, France
| | - F. Riaud
- />CH La Roche-Sur-Yon, La Roche-sur-Yon, France
| | - E. Gamelin
- />ICO Paul Papin, Angers, France
- />Fondateur de l’Observatoire dédié au
cancer, Bretagne Pays de la Loire (ex-OMIT B PL), Rennes, France
| | | | | | | | - J. Y. Douillard
- />ICO René Gauducheau, Nantes, France
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
| | | | | | | | | | - O. Dupuis
- />Centre Jean Bernard/Clinique Victor-Hugo, Le Mans, France
| | - C. Grollier
- />Centre Jean Bernard/Clinique Victor-Hugo, Le Mans, France
| | | | | | | | | | | | - J. F. Ramée
- />Centre Catherine-de-Sienne, Nantes, France
| | - L. Guivarch
- />Centre Catherine-de-Sienne, Nantes, France
| | - P. L. Etienne
- />Clinique Armoricaine de Radiologie, Saint-Brieuc, France
- />Polyclinique Trégor-Lannion, Lannion, France
| | - S. Roussel
- />Clinique Armoricaine de Radiologie, Saint-Brieuc, France
| | | | | | | | - V. Klein
- />Hôpital Privé Océane/Centre Saint Yves
Vannes, Vannes, France
| | - R. Bessard
- />Hôpital Privé Océane/Centre Saint Yves
Vannes, Vannes, France
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
| | | | | | | | - S. Gouva
- />CH Landerneau, Landerneau, France
| | | | | | | | | | | | - E. Jobard
- />CH Saint-Brieuc, Saint-Brieuc, France
| | - E. Peguet
- />CH Saint-Brieuc, Saint-Brieuc, France
| | | | | | | | | | | | | | - P. Deguiral
- />Clinique Mutualiste de l’Estuaire, Saint-Nazaire, France
| | - L. Derenne
- />Clinique Mutualiste de l’Estuaire, Saint-Nazaire, France
| | - D. Martin
- />Polyclinique du Maine/Centre Mallet Proux Laval, Laval, France
| | | | - C. Bodin
- />Polyclinique du Maine/Centre Mallet Proux Laval, Laval, France
| | - V. Rossi
- />CH Haut Anjou Château Gontier, Château Gontier,
France
| | - S. Barré
- />CH Haut Anjou Château Gontier, Château Gontier,
France
| | | | | | - A. M. Vidal
- />CH Le Mans, Le Mans, France
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
| | - I. Cumin
- />CH Sud Lorient Hennebont, Hennebont, France
| | - J. Egreteau
- />CH Sud Lorient Hennebont, Hennebont, France
| | - A. Brouard
- />CH Sud Lorient Hennebont, Hennebont, France
| | | | | | | | | | | | | | - E. Crespeau
- />Polyclinique du Parc Cholet, Cholet, France
| | | | - H. Bourgeois
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
| | - C. Riche
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
| | - D. Déniel Lagadec
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
| | - F. Marhuenda
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
| | - F. Grudé
- />Observatoire dédié au Cancer de l’OMEDIT
Bretagne et de l’OMEDIT Pays de la Loire, Rennes, France
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23
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Joly F, Delva R, Mourey L, Sevin E, Bompas E, Vedrine L, Ravaud A, Eymard JC, Tubiana-Mathieu N, Linassier C, Houede N, Guillot A, Ringensen F, Cojocarasu O, Valenza B, Leconte A, Lheureux S, Clarisse B, Oudard S. Clinical benefits of non-taxane chemotherapies in unselected patients with symptomatic metastatic castration-resistant prostate cancer after docetaxel: the GETUG-P02 study. BJU Int 2014; 115:65-73. [DOI: 10.1111/bju.12552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Florence Joly
- Medical Oncology-Clinical Research Department; Centre François Baclesse - CHU Côte de Nacre; Caen France
- Universite Basse Normandie; Caen France
| | - Remy Delva
- Medical Oncology; Institut de Cancérologie de l'Ouest Centre Paul Papin; Angers France
| | - Loïc Mourey
- Medical Oncology; Institut Claudius Régaud; Toulouse France
| | - Emmanuel Sevin
- Medical Oncology-Clinical Research Department; Centre François Baclesse - CHU Côte de Nacre; Caen France
| | | | | | - Alain Ravaud
- Medical Oncology; Hôpital Saint-André; Bordeaux France
| | | | | | | | - Nadine Houede
- Medical Oncology; Institut Bergonié; Bordeaux France
| | - Aline Guillot
- Institut de Cancérologie de la Loire; Saint-Etienne France
| | | | | | - Bruno Valenza
- Oncology-Hematology; Centre Hospitalier; Frejus France
| | | | - Stéphanie Lheureux
- Medical Oncology-Clinical Research Department; Centre François Baclesse - CHU Côte de Nacre; Caen France
| | | | - Stéphane Oudard
- Medical Oncology Department; Georges Pompidou Hospital; Paris France
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24
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Bourgeois HP, Solal-Celigny P, Capitain O, Bourbouloux E, Baudon J, Marcq M, Boucher E, Delecroix V, Blot E, Ferec MARC, Egreteau J, Artignan X, Corbinais S, Alleaume C, Cojocarasu O, Hardy-Bessard AC, Naudeix E, Berger V, Ingrand P, Grude F. Assessing 2-month clinical prognosis in patients with solid tumors: Final results of PRONOPALL study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.9558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | - Marie Marcq
- Centre Hospitalier, La Roche-sur-Yon, France
| | | | - Valérie Delecroix
- Pôle Hospitalier Mutualiste de St Nazaire Polyclinique de l'Océan, SAINT NAZAIRE, France
| | | | | | | | | | | | | | | | | | | | | | | | - Francoise Grude
- Observatory of Cancer Bretagne Pays de la Loire, Angers, France
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25
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Metges JP, Ramée JF, Douillard JY, Boucher E, Faroux R, Guerin-Meyer V, Cumin I, Miglianico L, Le Roux C, Dupuis O, Porneuf M, Lam YH, Achour N, Etienne PL, Cojocarasu O, Corbinais S, Deguiral P, Geslin G, Campion L, Grude F. Efficacy and safety of FOLFIRINOX in patients with metastatic pancreatic cancer. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.3_suppl.305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
305 Background: FOLFIRINOX, one of the gold standard in metastatic pancreatic cancer as first-line therapy for patients under 76 years with PS 0-1, good haematological and renal function and a subnormal bilirubin level (Prodige 4 criteria), was analysed in Brittany (B) and Pays de la Loire (PL) in routine clinical practice. Methods: Our aim is to evaluate the use of Folfirinox between July 2010 and December 2012 in B/PL. Results: Data of 340 patients have been studied (198 men, median age 63 years [29-81]). 208 patients were metastatic at diagnosis (liver 67%). 62 primary tumors were resected and 51 patients had received previous adjuvant chemotherapy (gemcitabine, n=48). The median progression free survival PFS and overall survival OS were respectively 6.80 months IC95% [6.18-7.43] and 10.97 months IC 95% [9.56-11.83]. Patients could be divided into 4 groups : Group 1 composed of patients treated according to Prodige 4 trial (n=242), Group 2 1st line metastatic patients with at least one Prodige 4 non-eligibility criterion (n=25), Group 3 locally advanced patients (n=59) and Group 4 by Folfirinox in 2ndline (n=14). The median number of cycles was 9 [1-27] in Group 1 and 6 [1-12] in Group 2. Clinical benefit was 65% (group 1) vs 56% (group 2). During treatment, 81% of patients had a dose adjustment (Group 1) vs 72% (Group 2) and 32% vs 40% presented grade III/IV toxicity (mostly neuro- or haematotoxicity). Median PFS were respectively in Group 1 vs Group 2 : 6.54 months IC95% [5.98-7.29] vs 4.14 [1.68-6.21] (p=0.0107) and median OS :10.91 months IC 95% [8.94-12.02] vs 7.0 IC95% [4.01-11.20] (p=0.0166). For Group 3 and 4, median OS were respectively 11.24 months [10.0-15.01] vs 11.50 [4.83-14.09]. Others results will be shown at the meeting. For Group 1, stopping treatment before progression induced significatively better median PFS and OS than going on treatment until progression : PFS : 8.25 IC95[7.52-8.74] vs 3.48. IC95 [3.09-4.44] (p<0.0001) and OS : 12.78 months IC95 [11.60-15.54] vs 7.62 IC95 [6.44-9.49] (p<0.0001). Conclusions: Our results for Group 1 are relatively consistent with those of Prodige 4: objective response rate (39% vs 32%), PFS (6.5 vs 6.4 months) and OS (10.9 vs 11.1 months). Non eligibity for Prodige 4’s criteria decreases PFS and OS significantly.
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Affiliation(s)
| | | | - Jean-Yves Douillard
- L'Institut de Cancérologie de l'Ouest Centre René Gauducheau, Saint-Herblain, France
| | | | - Roger Faroux
- Centre Hospitalier Départemental Les Oudairies, La Roche sur Yon, France
| | | | | | | | | | - Olivier Dupuis
- Service de Radiothérapie, Clinique Victor Hugo, Le Mans, France
| | | | | | | | | | | | | | | | | | - Loic Campion
- L'Institut de Cancérologie de l'Ouest René Gauducheau, Nantes Saint Herblain, France
| | - Francoise Grude
- Observatoire dédié au Cancer B PL - ICO Centre Paul Papin, Angers, France
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26
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Boisdron-Celle M, Capitain O, Metges JP, Faroux R, Borg C, Galais MP, Kaassis M, Bennouna J, Bouhier Leporrier K, Francois E, Baumgaertner I, Guerin-Meyer V, Cojocarasu O, Roemer-Becuwe C, Stampfli C, Rosenfeld L, Lecomte T, Berger V, Morel A, Gamelin E. Prevention of 5-FU-induced health-threatening toxicity by pretherapeutic DPD deficiency screening: Medical and economic assessment of a multiparametric approach. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.3601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3601 Background: While 5-FU is the foundation of many in GI oncology treatments, pts with DPD deficiency can experience early-onset severe (5%) even fatal (0.3%) toxicities. This study aimed to confirm the pharmaco-economic benefits of pre-therapeutic screening for DPD deficiency using a multiparametric approach in a multicenter prospective cohort study (NCT01547923). Methods: Two parallel cohorts of pts treated with 5-FU-based chemotherapy for colorectal carcinoma were compared: Group A: initial DPD deficiency screening; Group B: no evaluation. Enrollment was based on 5-FU administration guidelines of each institution. DPD deficiency screening combined genotyping and phenotyping (ODPM Tox) (1,2,3). The 2 groups were to be compared in terms of early 5-FU-induced toxicity grade, toxicity cost and DPD screening cost. The enrollment was to be immediately closed in the case of proven 5-FU-related toxic death. Results: 1,130 pts were included from 06/01/2008 to 07/31/2012. Group A: no severe toxicity despite 1 pt with complete deficiency (pt not treated with 5-FU), 20 pts with partial deficiency had safe PK-monitored 5-FU (ODPM Protocol) with only one hospitalization due to toxicity. Group B: One death due to complete DPD deficiency, confirmed retrospectively. Enrollment prematurely closed after experts’ unanimous decision citing ethical concerns. 21 pts with partial DPD deficiency. 5 reported toxicity-related hospitalizations. Data treatment is ongoing. Conclusions: One complete deficiency occurred in both groups: Group A pt had safe treatment whereas Group B pt died due to 5-FU toxicity. Pre-therapeutic DPD deficiency screening using this multi-parametric approach should be performed before 5-FU-based treatment and PK-guided dose adaptation allows for safe treatment of even partially DPD deficient patients. Clinical trial information: NCT01547923. [Table: see text]
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Affiliation(s)
- Michele Boisdron-Celle
- Institut de Cancérologie de l'Ouest Paul Papin, Département d'Oncopharmacologie, INSERM U892, Angers, France
| | | | | | - Roger Faroux
- Centre Hospitalier Départemental Les Oudairies, La Roche sur Yon, France
| | | | | | | | | | | | - Eric Francois
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | | | | | | | | | | | | | | | - Virginie Berger
- Institut de Cancérologie de l'Ouest Paul Papin, Angers, France
| | - Alain Morel
- Institut de Cancérologie de l'Ouest Paul Papin, Département d'Oncopharmacologie, INSERM U892, Angers, France
| | - Erick Gamelin
- Institut de Cancérologie de l'Ouest Paul Papin, Département d'Oncopharmacologie, INSERM U892, Angers, France
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27
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Boisdron-Celle M, Capitain O, Faroux R, Borg C, Metges JP, Galais MP, Kaassis M, Bennouna J, Bouhier Leporrier K, Francois E, Baumgaertner I, Guerin-Meyer V, Cojocarasu O, Roemer-Becuwe C, Stampfli C, Rosenfeld L, Lecomte T, Berger V, Morel A, Gamelin E. Prevention of 5-FU-induced toxicities using pretherapeutic DPD deficiency screening: Medical and economic assessment of a multiparametric approach. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
351 Background: 5-FU is the backbone of most chemotherapy regimens in GI oncology. Patients with DPD deficiency can experience early onset severe (5%) even fatal (0.3%) toxic side-effects. We decided to confirm the medical and economic interest of pre-therapeutic screening of DPD deficiency using a multiparametric approach in a multicenter prospective cohort study (Eudract n°2008-000026-39). Methods: Two parallel cohorts of patients treated with 5-FU-based chemotherapy for colorectal carcinoma were compared: Group A: initial DPD activity evaluation; Group B: no evaluation. Enrollment in either group was based on 5-FU administration guidelines at each institution. DPD deficiency screening combined genotyping and phenotyping (ODPM Tox) as well as other patient characteristics (1,2,3). The 2 groups were compared in terms of early 5-FU-induced toxicity grade, toxicity cost and DPD screening cost. The enrollment was to be immediately closed if 5-FU-induced toxic death occurred. Results: 1,130 patients were included from to 16/06/2008 to 07/31/2012. Group A: no severe toxicity despite 1 patient with complete deficiency (5-FU replaced by another TS inhibitor), 17 patients with partial deficiency safely received PK-monitored 5-FU (ODPM Protocol). Group B: 1 death: 65 y.o. patient, adjuvant FOLFOX 4, 5-FU-induced SAE at day 6: grade 4 febrile neutropenia, septicemia, diarrhoea, mucositis and secondary dehydration, renal failure, then death. 5-FU imputable Grade 5 SAE declared by investigator. Complete DPD deficiency retrospectively confirmed. The enrollment was prematurely closed after unanimous experts’ decision for ethical reasons. Data treatment is ongoing. Conclusions: One complete deficiency occurred in both groups: Group A patient had safe treatment whereas Group B patient died due to 5-FU grade 5 toxicity. DPD deficiency screening by a multiparametric approach (ODPM Tox) should be performed before 5-FU treatments. Clinical trial information: 2008-000026-39. [Table: see text]
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Affiliation(s)
- Michele Boisdron-Celle
- Institut de Cancérologie de l'Ouest Paul Papin \(ICO\) Département d'Oncopharmacologie, INSERM U892, Angers, France
| | - Olivier Capitain
- Institut de Cancérologie de l’Ouest Paul Papin \(ICO\), Angers, France
| | - Roger Faroux
- Centre Hospitalier Départemental Les Oudairies, La Roche sur Yon, France
| | | | | | | | | | - Jaafar Bennouna
- Institut de Cancerologie de l’Ouest-site René Gauducheau, Nantes, France
| | | | - Eric Francois
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | | | | | | | | | | | | | | | - Virginie Berger
- Institut de Cancérologie de l’Ouest Paul Papin \(ICO\), Angers, France
| | - Alain Morel
- Institut de Cancérologie de l'Ouest Paul Papin \(ICO\) Département d'Oncopharmacologie, INSERM U892, Angers, France
| | - Erick Gamelin
- Institut de Cancérologie de l'Ouest Paul Papin \(ICO\) Département d'Oncopharmacologie, INSERM U892, Angers, France
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28
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Falandry C, Horard B, Alexandre J, Deplanque G, Cojocarasu O, Salvat J, Legouffe E, Cretin J, Meunier J, Maraval-Gaget R, Micheau-Bonnier D, Gilson E, Freyer G. Correlation of short telomeres (ST) with vulnerability, toxicity, and early death in elderly AOC patients receiving carboplatin: A multicenter GINECO trial. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.9011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9011 Background: Age induces a progressive decline in the functional reserve and interferes with cancer treatments. As aging is heterogeneous, this decline has to be assessed individually. Telomere attrition leads to tissue senescence. We tested the hypothesis that telomere lenght (TL) could predict pts vulnerability and outcome during cancer treatment. Methods: This study was performed in the “Elderly women” GINECO trial designed to evaluate the impact of geriatric covariates on survival in AOC pts over 70 receiving 6 courses of carboplatin. TL was estimated in duplicate using standard Terminal Restriction Fragment analysis from peripheral blood cells at inclusion and tested for its correlation with geriatric covariates and pts outcomes (TC and tolerance, overall survival: OS). Results: TL (in base pair) was estimated for 109/111 pts (median 5997; extremes [4517-8333]). No significant correlation was found with any pts characteristics. With a cutoff of 5770 bp, TL discriminated two groups with significantly different Treatment Completion (TC) rates: 0.80 (95CI[0.71-0.89]) and 0.59 (95CI[0.41-0.76]), OR=2.8, p=0.02 for long telomere (LT) and short telomere groups, respectively . ST pts were at higher risk of severe adverse events (SAE, OR=2.7; p<0.02) and tended to have more unplanned hospital admissions (OR=2.1; p<0.08). Considering OS, after adjustment on FIGO stage, TL shorter than the median was a nearly significant risk factor of premature death (HR=1.57; p=0.06. Finally, we addressed if TL correlated with our previously validated geriatric vulnerability score (GVS)c including ADL score<6, IADL score<25, albuminemia<35g/l, lymphopenia<1G/L, HADS score£15 as risk factors of poorer survival. Despite no significant correlation with any of these factors, GVS³3) and ST tended to be correlated (OR=2.1; p=0.08). Conclusions: This exploratory study identifies TL as predictive factor of decreased TC, SAE risk, unplanned hospital admissions and OS after adjustment on FIGO stage.
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Affiliation(s)
| | - Béatrice Horard
- Université Lyon1 - UMR CNRS 5534 - Centre de Génétique et de Physiologie Moléculaires et Cellulaires, Villeurbanne, France
| | - Jerome Alexandre
- Université Paris Descartes, Oncologie, GH Cochin - Hôtel Dieu, Paris, France
| | | | | | - Jacques Salvat
- Centre Hospitalier de Thonon-les-Bains, Thonon-Les-Bains, France
| | | | | | - Jérome Meunier
- Centre Hospitalier Régional d'Orléans Service Oncologie Médicale, Orleans, France
| | | | | | - Eric Gilson
- Institut for Research on Cancer and Aging, Nice (IRCAN), University of Nice-Sophia Antipolis, CNRS UMR7284, INSERM U1081, Nice, France
| | - Gilles Freyer
- Oncologie Médicale, Centre Hospitalier Lyon-Sud, Lyon, France
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Medioni J, Cojocarasu O, Belcaceres JL, Halimi P, Oudard S. Complete cerebral response with sunitinib for metastatic renal cell carcinoma. Ann Oncol 2007; 18:1282-3. [PMID: 17675397 DOI: 10.1093/annonc/mdm275] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Berhoune M, Fabre-Guillevin E, Banu E, Scotte F, Bonan B, Medioni J, Cojocarasu O, Rideller K, Ayllon J, Levy E. What is the place of clinical variables in advanced non-small cell lung cancer (NSCLC) patients treated with chemotherapy? J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18197 Background: Chemotherapy (CT) has shown its effectiveness in symptom control and quality of life improvement in advanced NSCLC patients. The therapeutic strategy and some clinical variables could have a major impact on outcome. Methods: Our retrospective analysis evaluated the impact on overall survival (OS) of the clinical benefit (CB), ECOG performance status (PS) and toxicity, function of treatment. CB was defined as disease-related symptoms improvement according to hospitalization report. Only grade III-IV CTC-NCI version 2 toxicities have been considered. OS was calculated between start of CT and death or last follow-up. Multivariate Cox regression analysis including CB, PS, toxicity and age, stratified by AJCC initial stage was used. Results: Data of 68 consecutive stage IIIB-IV patients treated in a single French centre were analyzed. Chemotherapy was platinum-salt based in 88, 45 and 25% of pts for the first, second and third-line, respectively. Median age was 61 years, 37% were women. More than half (66%) were metastatic and 14% were previously irradiated. Median survival was 14 months (95% CI, 6.1–21.8), 53 % of patients are dead. The risk of death PS-related was multiplied by 2.3, 2.4 and 5.3 for the first, second and third-line of CT, respectively. PS and CB were initially associated with OS (first and second-line CT), but after the third-line of CT only PS was significantly related with OS. The risk of death reduction induced by a CB was 59, 82 and 29%, respectively. Less toxicities during CT were associated with a better OS (an unsignificant 20- 30% risk of death reduction), independently of the chronology of CT. Older pts >70 years have a higher risk of death (HR=1.87), independently of the CB and treatment-related toxicities in the multivariate analysis (P=0.18), sex-adjusted. Conclusions: No matter how many lines of CT are used for a specified patient, the ECOG PS was a patient-related variable with a dominant impact on the outcome. CT must be less toxic in order to achieve a CB and ameliorate the PS. No significant financial relationships to disclose.
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Affiliation(s)
- M. Berhoune
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - E. Fabre-Guillevin
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - E. Banu
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - F. Scotte
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - B. Bonan
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - J. Medioni
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - O. Cojocarasu
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - K. Rideller
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - J. Ayllon
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
| | - E. Levy
- Pitie Salpetriere Hospital, Paris, France; Georges Pompidou European Hospital, Paris, France
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31
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Oudard S, Banu E, Medioni J, Dionysopoulos D, Cojocarasu O, Banu A. What is the real impact of bone pain on survival of hormone-refractory prostate cancer (HRPC) patients treated with docetaxel? J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5149 Background: Docetaxel is currently the standard of care for HRPC patients (pts). The moment of docetaxel initiation according to the presence or absence of the bone pain was less explored. Methods: Eligible HRPC pts were required to have a baseline bone pain evaluation using the rank-scores as follows: no pain or minimal pain (0), mild (1), moderate and severe pain (2), respectively. The main endpoint was to explore the overall survival (OS) impact of the bone pain (presence and intensity) using the Cox regression analysis, stratified by chemotherapy regimen. OS was calculated between start of chemotherapy and death or last follow-up for censored pts. Secondary endpoint was to evaluate the relationship between PSA doubling time (DT) and survival of pts with minimal or no pain. Results: Data of 145 consecutive HRPC pts treated in a single French center were analyzed. Chemotherapy was docetaxel (67%) or mitoxantrone-based. The median age was 68 years and 93% of pts had bone metastases, 55% with minimal or no pain at baseline. Median OS was 17.3 months (95% CI, 14.6–20) and 93% of pts died. There were OS differences between pain categories ( Table ). Pain intensity was significantly related with OS: hazard ratio=1.50 (95% CI, 1.20–1.88), P=0.0001 at the univariate analysis. Multivariate analysis adjusted by ECOG PS, hemoglobin and number of metastatic sites showed a 16% rise of the risk of death for pts with severe and mild pain. Pts with minimal or no pain at baseline have a different outcome depending of PSA DT (≥ 45 and < 45 days): median OS 32.4 months (95% CI, 16.2–48.7) and 16.5 months (95% CI, 10–22.9), respectively. Conclusions: Our results suggest that HRPC pts with minimal or without bone pain can experience a better OS with docetaxel-based therapy. This motivates the use of docetaxel early, before bone pain apparition. The OS benefit was even higher for asymptomatic pts with a longer PSA DT. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- S. Oudard
- Georges Pompidou Eoropean Hospital, Paris, France
| | - E. Banu
- Georges Pompidou Eoropean Hospital, Paris, France
| | - J. Medioni
- Georges Pompidou Eoropean Hospital, Paris, France
| | | | | | - A. Banu
- Georges Pompidou Eoropean Hospital, Paris, France
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