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Bourien H, Lefevre LB, Mouret-Reynier MA, Asselain B, Lucas B, Gavoille C, Cornila C, Gavoille L, Colomba E, Patsouris A, Fabbro M, Chakiba C, Toussaint P, Simon H, Berton D, Garbay D, Tixidre CG, Coeffic D, Morvan A, Collard O, DE LA Motte Rouge T. Real-World Data on Olaparib in Relapsed BRCA-mutated Ovarian Cancer: A Multicenter GINECO RETROLA Cohort Study. Anticancer Res 2023; 43:653-662. [PMID: 36697069 DOI: 10.21873/anticanres.16202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/24/2022] [Accepted: 12/07/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND/AIM Olaparib was approved in 2014 by the European Medicines Agency (EMA) as maintenance treatment for patients with breast cancer gene (BRCA)-mutated platinum-sensitive relapsed high-grade epithelial ovarian cancer (EOC) following the results of the Study 19. We present the results of a national real-world study on the effectiveness of olaparib in relapsed BRCA-mutated EOC patients. PATIENTS AND METHODS Patients with EOC, peritoneal, and/or fallopian-tube cancer treated with olaparib in a French Center between May 2014 and March 2017 were included. The primary end-point of the study was progression-free survival. RESULTS Of the 128 patients analyzed, 89 were treated according to the EMA label. The median progression-free survival was 17.0 months. The most common treatment-related toxicity was fatigue. Treatment-related myelodysplastic syndrome (n=5) and a second cancer (n=1) were diagnosed. CONCLUSION In this real-life setting, olaparib confirmed its efficacy and safety profile, as previously shown in clinical trials.
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Affiliation(s)
| | | | | | | | | | - Celine Gavoille
- Institut de Cancérologie de Lorraine, Vandoeuvre Les Nancy, France
| | | | | | - Emeline Colomba
- Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | | | - Michel Fabbro
- ICM Regional Cancer Institute of Montpellier, Montpellier, France
| | | | | | - Helene Simon
- Hôpital Morvan - Centre Hospitalier Universitaire, Brest, France
| | - Dominique Berton
- Institut de Cancérologie de l'Ouest (ICO) René Gauducheau, Saint-Herblain, France
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Pautier P, Italiano A, Piperno-Neumann S, Chevreau C, Penel N, Firmin N, Boudou-Rouquette P, Bertucci F, Balleyguier C, Lebrun-Ly V, Ray-Coquard I, Kalbacher E, Bardet A, Bompas E, Collard O, Isambert N, Guillemet C, Rios M, Archambaud B, Duffaud F, ITALIANO A, PAUTIER P, LECESNE A, PIPERNO-NEUMANN S, CHEVREAU C, CUPISSOL D, PENEL N, ALEXANDRE J, BERTUCCI F, RAY-COQUARD I, LEBRUN-LY V, KALBACHER E, DUFFAUD F, DELCAMBRE C, BOMPAS E, COLLARD O, ISAMBERT N, GUILLEMET C, SOULIE P, RIOS M, SAADA-BOUZID E. Doxorubicin alone versus doxorubicin with trabectedin followed by trabectedin alone as first-line therapy for metastatic or unresectable leiomyosarcoma (LMS-04): a randomised, multicentre, open-label phase 3 trial. Lancet Oncol 2022; 23:1044-1054. [DOI: 10.1016/s1470-2045(22)00380-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/05/2022] [Accepted: 06/10/2022] [Indexed: 10/17/2022]
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3
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Fayet Y, Chevreau C, Decanter G, Dalban C, Meeus P, Carrère S, Haddag-Miliani L, Le Loarer F, Causeret S, Orbach D, Kind M, Le Nail LR, Ferron G, Labrosse H, Chaigneau L, Bertucci F, Ruzic JC, Le Brun Ly V, Farsi F, Bompas E, Noal S, Vozy A, Ducoulombier A, Bonnet C, Chabaud S, Ducimetière F, Tlemsani C, Ropars M, Collard O, Michelin P, Gantzer J, Dubray-Longeras P, Rios M, Soibinet P, Le Cesne A, Duffaud F, Karanian M, Gouin F, Tétreau R, Honoré C, Coindre JM, Ray-Coquard I, Bonvalot S, Blay JY. No Geographical Inequalities in Survival for Sarcoma Patients in France: A Reference Networks' Outcome? Cancers (Basel) 2022; 14:cancers14112620. [PMID: 35681600 PMCID: PMC9179906 DOI: 10.3390/cancers14112620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/15/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary As patients with rare cancers face specific problems, reference networks have been developed in several European countries and then at the European level to improve their management. In some cases, the specialized centers belonging to reference networks provide remote services (specialized diagnosis review, discussion in the Multidisciplinary Tumour Board, etc.) to increase access to these services. Using data from the national sarcoma reference network implemented in France (NETSARC+), the IGéAS research program assesses the potential of its organization to address the geographical inequalities in cancer management. We analyze the individual, clinical, and geographical determinants of the overall survival of sarcoma patients in France. We found no association between the overall survival of sarcoma patients and variables measuring their social deprivation, remoteness from reference centers, and geographical context. Following previous results from the research program, this study suggests that reference network organization should be considered to reduce cancer inequalities. Abstract The national reference network NETSARC+ provides remote access to specialized diagnosis and the Multidisciplinary Tumour Board (MTB) to improve the management and survival of sarcoma patients in France. The IGéAS research program aims to assess the potential of this innovative organization to address geographical inequalities in cancer management. Using the IGéAS cohort built from the nationwide NETSARC+ database, the individual, clinical, and geographical determinants of the 3-year overall survival of sarcoma patients in France were analyzed. The survival analysis was focused on patients diagnosed in 2013 (n = 2281) to ensure sufficient hindsight to collect patient follow-up. Our study included patients with bone (16.8%), soft-tissue (69%), and visceral (14.2%) sarcomas, with a median age of 61.8 years. The overall survival was not associated with geographical variables after adjustment for individual and clinical factors. The lower survival in precarious population districts [HR 1.23, 95% CI 1.02 to 1.48] in comparison to wealthy metropolitan areas (HR = 1) found in univariable analysis was due to the worst clinical presentation at diagnosis of patients. The place of residence had no impact on sarcoma patients’ survival, in the context of the national organization driven by the reference network. Following previous findings, this suggests the ability of this organization to go through geographical barriers usually impeding the optimal management of cancer patients.
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Affiliation(s)
- Yohan Fayet
- EMS Team–Human and Social Sciences Department, Centre Léon Bérard, 69008 Lyon, France
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France
- Correspondence:
| | | | - Gauthier Decanter
- Department of Surgical Oncology, Oscar Lambret Center, 59000 Lille, France;
| | - Cécile Dalban
- Department of Clinical Research and Innovation, Centre Léon Bérard, 69008 Lyon, France; (C.D.); (S.C.)
| | - Pierre Meeus
- Department of Surgery, Centre Léon Bérard, 69008 Lyon, France; (P.M.); (F.G.)
| | - Sébastien Carrère
- Institut de Recherche en Cancérologie Montpellier, INSERM U1194, 34000 Montpellier, France;
| | - Leila Haddag-Miliani
- Service D’imagerie Diagnostique, Institut Gustave Roussy, 94800 Villejuif, France;
| | - François Le Loarer
- Department of Pathology, Institut Bergonié, 33000 Bordeaux, France; (F.L.L.); (J.-M.C.)
| | | | - Daniel Orbach
- Centre Oncologie SIREDO (Soins, Innovation et Recherche en Oncologie de l’Enfant, de l’aDOlescents et de L’adulte Jeune), Institut Curie, Université de Recherche Paris Sciences et Lettres, 75005 Paris, France;
| | - Michelle Kind
- Radiologue, Département D’imagerie Médicale, Institut Bergonié, 33000 Bordeaux, France;
| | - Louis-Romée Le Nail
- Department of Orthopaedic Surgery, CHU de Tours, Faculté de Médecine, Université de Tours, 37000 Tours, France;
| | - Gwenaël Ferron
- INSERM CRCT19 ONCO-SARC (Sarcoma Oncogenesis), Institut Claudius Regaud-Institut Universitaire du Cancer, 31000 Toulouse, France;
| | - Hélène Labrosse
- CRLCC Léon Berard, Oncology Regional Network ONCO-AURA, 69008 Lyon, France; (H.L.); (F.F.)
| | - Loïc Chaigneau
- Department of Medical Oncology, CHRU Jean Minjoz, 25000 Besançon, France;
| | - François Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France;
| | | | | | - Fadila Farsi
- CRLCC Léon Berard, Oncology Regional Network ONCO-AURA, 69008 Lyon, France; (H.L.); (F.F.)
| | | | - Sabine Noal
- UCP Sarcome, Centre François Baclesse, 14000 Caen, France;
| | - Aurore Vozy
- Department of Medical Oncology, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Sorbonne University, 75013 Paris, France;
| | | | - Clément Bonnet
- Service d’Oncologie Médicale Hôpital Saint Louis, 75010 Paris, France;
| | - Sylvie Chabaud
- Department of Clinical Research and Innovation, Centre Léon Bérard, 69008 Lyon, France; (C.D.); (S.C.)
| | | | - Camille Tlemsani
- Service d’Oncologie Médicale, Hôpital Cochin, Institut du Cancer Paris CARPEM, Université de Paris, APHP Centre, 75014 Paris, France;
- INSERM U1016-CNRS UMR8104, Institut Cochin, Institut du Cancer Paris CARPEM, Université de Paris, APHP Centre, 75014 Paris, France
| | - Mickaël Ropars
- Orthopaedic and Trauma Department, Pontchaillou University Hospital, University of Rennes 1, 35000 Rennes, France;
| | - Olivier Collard
- Département d’Oncologie Médicale, Hôpital Privé de la Loire, 42100 Saint-Etienne, France;
| | - Paul Michelin
- Service D’imagerie Médicale, CHU Hopitaux de Rouen-Hopital Charles Nicolle, 76000 Rouen, France;
| | - Justine Gantzer
- Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), 67033 Strasbourg, France;
| | | | - Maria Rios
- Department of Medical Oncology, Cancer Institute of Lorraine-Alexis Vautrin, 54500 Vandoeuvre Les Nancy, France;
| | - Pauline Soibinet
- Department of Hepato-Gastroenterology and Digestive Oncology, Reims University Hospital, 51000 Reims, France;
| | - Axel Le Cesne
- Medical Oncology, Insitut Gustave Roussy, 94800 Villejuif, France;
| | - Florence Duffaud
- Department of Medical Oncology, CHU La Timone and Aix-Marseille Université (AMU), 13005 Marseille, France;
| | - Marie Karanian
- Department of Pathology, Lyon University Hospital, 69008 Lyon, France;
| | - François Gouin
- Department of Surgery, Centre Léon Bérard, 69008 Lyon, France; (P.M.); (F.G.)
| | - Raphaël Tétreau
- Medical Imaging Center, Institut du Cancer, 34000 Montpellier, France;
| | - Charles Honoré
- Department of Surgical Oncology, Gustave Roussy, Villejuif 94800, France;
| | - Jean-Michel Coindre
- Department of Pathology, Institut Bergonié, 33000 Bordeaux, France; (F.L.L.); (J.-M.C.)
| | | | - Sylvie Bonvalot
- Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, 75005 Paris, France;
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard, Lyon University, 69008 Lyon, France;
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Voute M, Riant T, Amodéo J, André G, Barmaki M, Collard O, Colomb C, Créac’h C, Deleens R, Delorme C, Montgazon G, Dixneuf V, Dy L, Gaillard J, Gov C, Kieffer X, Lanteri‐Minet M, Le Borgne J, Le Caër F, Maamar F, Maindet C, Marcaillou F, Plantevin F, Pluchon Y, Rioult B, Rostaing S, Salvat E, Sep Hieng V, Sorel M, Vergne‐Salle P, Morel V, Chazeron I, Pickering G. Ketamine in chronic pain: a Delphi survey. Eur J Pain 2022; 26:873-887. [DOI: 10.1002/ejp.1914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/04/2022] [Accepted: 01/23/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Marion Voute
- CHU Clermont‐Ferrand Plateforme d’Investigation Clinique/CIC Inserm 1405 France
| | - Thibault Riant
- Unité douleur, Le Confluent, Catherine de Sienne Center Nantes France
| | | | | | | | - Olivier Collard
- Centre d'Evaluation et de Traitement de la Douleur, Clinique Sainte Clotilde Ile de la Réunion France
| | | | - Christelle Créac’h
- Centre d'Evaluation et de Traitement de la Douleur, CHU Sainte Etienne Saint Etienne France
| | - Rodrigue Deleens
- Centre d'Evaluation et de Traitement de la Douleur, CHU Rouen France
| | - Claire Delorme
- Centre d'Evaluation et de Traitement de la Douleur, CH Bayeux Bayeux France
| | | | - Véronique Dixneuf
- Evaluation et de Traitement de la Douleur, Clinique Brétéché Nantes France
| | - Lénaïg Dy
- Evaluation et de Traitement de la Douleur, Clinique mutualiste de la porte de l’orient Lorient France
| | | | - Christian Gov
- Centre d'Evaluation et de Traitement de la Douleur, Hôpital neurologique France
| | - Xavier Kieffer
- Centre de la Douleur Chronique et Rebelle, CH Versailles Le Chesnay France
| | - Michel Lanteri‐Minet
- Département d’Evaluation et Traitement de la Douleur Hopital de Cimiez Nice France
| | | | | | | | - Caroline Maindet
- Centre de la Douleur, Hôpital Albert Michallon La Tronche France
| | - Fabienne Marcaillou
- Centre d'Evaluation et de Traitement de la Douleur, CHU Clermont‐Ferrand Clermont‐Ferrand France
| | - Frédéric Plantevin
- Centre d'Evaluation et de Traitement de la Douleur, CH Mâcon Mâcon France
| | - Yves‐Marie Pluchon
- Centre d'Evaluation et de Traitement de la Douleur, CHD Vendée La Roche sur Yon France
| | - Bruno Rioult
- Unité douleur, Le Confluent, Catherine de Sienne Center Nantes France
| | | | - Eric Salvat
- Centre d'Evaluation et de Traitement de la Douleur, Hôpital de Hautepierre Strasbourg France
| | | | - Marc Sorel
- Centre de la Douleur, CH Nemours Nemours France
| | | | - Véronique Morel
- CHU Clermont‐Ferrand Plateforme d’Investigation Clinique/CIC Inserm 1405 France
| | - Ingrid Chazeron
- Service de Psychiatrie B, CHU Clermont‐Ferrand Clermont‐Ferrand France
| | - Gisèle Pickering
- CHU Clermont‐Ferrand Plateforme d’Investigation Clinique/CIC Inserm 1405 France
- Inserm, CIC 1405 UMR Neurodol 1407 Clermont‐Ferrand France
- Clermont Université, Laboratoire de Pharmacologie, Faculté de médecine Clermont‐Ferrand France
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Ray-Coquard IL, Savoye AM, Mouret-Reynier MA, Chabaud S, Derbel O, Kalbacher E, Leheurteur M, Martinez A, Cornila C, Martinez M, Bengrine L, Priou F, Cloarec N, Venat-Bouvet L, Selle F, Berton D, Collard O, Joly F, Tredan O. Efficacy and safety results from neopembrov study, a randomized phase II trial of neoadjuvant chemotherapy (CT) with or without pembrolizumab (P) followed by interval debulking surgery and standard systemic therapy ± P for advanced high-grade serous carcinoma (HGSC): A GINECO study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.5500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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
5500 Background: To investigate whether adding Pembrolizumab (P) to neoadjuvant carboplatin-paclitaxel chemotherapy (CP) may increase the optimal debulking rate, assessed by Complete Resection Rate (CRR) after Interval Debulking Surgery (IDS) in patients (pts) with initially unresectable International Federation of Gynecology and Obstetrics (FIGO) stage IIIC/IV ovarian, tubal or peritoneal HGSC. Methods: Multicenter, open-label, non-comparative randomized phase II trial. Pts were randomized (2:1) to receive 4 cycles of CP ± P before IDS. After IDS, all patients received post-operative chemotherapy (2 to 4 cycles) and optional bevacizumab for 15 months in total ± P as maintenance therapy for up to 2 years. Randomization was stratified on center, FIGO stage, Bev planned after IDS and disease volume (<5cm/>5cm). Primary endpoint was the centrally reviewed CRR at IDS. 60 pts were planned in the CP+P arm (A'Hern's single-stage design P0=50%, P1=70%). Safety (particularly due to P addition), surgical morbidity, ORR, PFS and OS were secondary endpoints. Results: 91 pts were randomized from 02/18 to 04/19 with a median Peritoneal Cancer Index at 24 (range 7-39). 80 pts (88%) received Bev in combination with CP followed by bev ± P in maintenance. In the CP+P group (n=61), 58 (95%) pts had IDS and 78% achieved complete resection. The CRR in this group was 74%, statistically superior to the pre-defined hypothesis. In the CP group, CRR was 70% (29/30 pts underwent IDS). Complete resection after strictly 4 cycles of CP±P was obtained for 41 pts (71%) and 17 (58%) pts in CP+P and CP group, respectively (sensitivity analysis). For CP+P group, numerically higher ORRs were observed before IDS compared to CP group (76% vs 61%). Grade ≥3 adverse events (AE) occurred in 75% of the CP+P group and 67% in the CP group: mainly blood and lymphatic, gastrointestinal and vascular disorders. Postoperative AE (mainly infectious, vascular and gastrointestinal) occurred in 20% and 13% of the pts in CP+P and CP arm, respectively. No difference in the number of fatal events between the two arms: 2 in the experimental arm vs 1 in the control arm. Progression free survival rate at 18 months was 61% (95CI% [47-73]) and 57% (95CI% [37-72]) in CP+P and CP arm, respectively. Conclusions: P may be safely added to preoperative treatment in pts deemed non-optimally resectable. The primary objective was met with an improved CRR on CP+P arm. The CRR in the control group was higher than expected. Survival data and translational research including PDL1 status are ongoing to better define P as treatment option in this setting. Clinical trial information: 2016-004-163-39. Clinical trial information: NCT03275506.
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Affiliation(s)
| | | | | | - Sylvie Chabaud
- Departement of Clinical Research,Centre Léon-Bérard, Lyon, France
| | - Olfa Derbel
- Institut de Cancérologie, Hôpital Privé Jean Mermoz, Lyon, France
| | | | | | | | | | | | | | - Frank Priou
- CHD Vendee-Hopital Les Oudairies, La Roche-sur-Yon, France
| | | | | | - Frederic Selle
- Groupe Hospitalier Diaconesses Croix Saint-Simon, and GINECO, Paris, France
| | - Dominique Berton
- GINECO & Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | - Florence Joly
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Olivier Tredan
- Departement of Medical Oncology, Centre Léon Bérard, Lyon, France
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Duffaud F, Chabaud S, Gautier J, Ferlay C, Vizoso S, Brahmi M, Benezech S, Dufresne A, Marec-Berard P, Ray-Coquard IL, Kalbacher E, Collard O, Penel N, Rios M, Bompas E, Chevreau C, Mir O, Boudou-Rouquette P, Blay JY, Piperno-Neumann S. REGOSTA: A randomized, placebo-controlled, double-blinded, multicenter study evaluating the efficacy and safety of regorafenib (REGO) as maintenance therapy after first-line treatment in patients (pts) with osteosarcoma (OS) and non-osteosarcomas (non-OS) of bone (non-Ewing, non-chondrosarcomas and non-chordomas). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps11576] [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
TPS11576 Background: Pts with OS and non-OS of bone are treated with a multimodal sequence therapy of neoadjuvant chemotherapy (CT), surgery and adjuvant CT, followed by a close surveillance until recurrence. At recurrence, the prognosis remains poor with objective response rates of 3-29%, and a median Progression-Free Survival (PFS) of less than 4 months in OS. There is a clinical need to reduce the risk of recurrence after the initial treatment sequence. The REGOBONE study reported a significant clinical benefit of regorafenib compared to placebo in patients with relapsed OS (median PFS: 16.4 versus 4.1 weeks). Methods: This multicenter trial is ongoing to study the efficacy and safety of maintenance REGO in pts > = 16 years, with complete remission after initial treatment sequence of their bone sarcoma. 168 pts will be randomly allocated in a 1:1 ratio to receive either oral REGO or its matching placebo (control arm) at a daily dose of 120mg, continuously and for a maximum of 12 months. Randomization will be stratified according to the following risk factors: metastases (mets) at diagnosis and/or poor response to neoadjuvant CT versus no mets at diagnosis and good response to neoadjuvant CT. The primary objective is to compare the efficacy (Relapse-Free Survival) between the 2 arms. The expected 3-year RFS rates are 55% in the control arm and 74.6% in the REGO arm (HR = 0.5). 66 events will provide 80% power to show significant improvement in RFS, using a 2-sided log-rank test at a 5% level. Secondary endpoints include Time to Treatment Failure, Overall Survival, Quality of Life, safety profile, and compliance to treatment. Radiological endpoints will be evaluated using the RECIST 1.1. Translational objectives will be to identify predictive biomarkers for efficacy of REGO as maintenance therapy using liquid biopsies. As of Feb 1st, 2021, 3 patients have been randomized. 15 sites of the French Sarcoma Group will participate. Clinical trial information: NCT04055220.
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Affiliation(s)
| | - Sylvie Chabaud
- Departement of Clinical Research,Centre Léon-Bérard, Lyon, France
| | | | | | | | | | - Sarah Benezech
- Centre Léon Bérard, Institut d'Hématologie et Oncologie Pédiatrique, Lyon, France
| | | | | | | | | | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret and Lille University Hospital, Lille, France
| | | | | | | | - Olivier Mir
- Gustave Roussy Cancer Institute, Villejuif, France
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Penel N, Bonvalot S, Bimbai AM, Salas S, Le Loarer F, Meurgey A, Piperno-Neumann S, Collard O, Kurtz JE, Guillemet C, Chevreau C, Ryckewaert T, Italiano A, Boudou-Rouquette P, Orbach D, Le Cesne A, Thery J, Le Deley MC, Blay JY, Mir O. Prognosis value of S45F mutation of CTNNB1 in desmoid-type fibromatosis (DF): Prospective analysis of 500 consecutive patients (pts) from ALTITUDES trial. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.11510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11510 Background: DF rare locally aggressive fibroblastic non-metastasizing tumor, with an unpredictable course. Its management remains challenging, there is a current shift in standard of care from large surgical resection (SR) to active surveillance (AS). Most of DF display somatic mutation of CTNNB1, with three major hotpots: S45F, T41A and S45P. The poor prognosis of S45F is a matter of debate (Timbergen et al. Ann Surg 2019). Methods: ALTITUDES (NCT02867033) is a nationwide prospective registry of DF, diagnosed from January 2016 to December 2020 and confirmed by central pathological review. CTNNB1 mutations were identified by NGS. Primary endpoint was event-free survival (including disease progression or relapse). We have selected pts managed by AS, SR or systemic treatments as front-line. Pt undergoing R2 resection and then managed by follow-up were part of AS group. Prognostic factors were assessed using univariate and multivariate Cox Model. Results: From the 630-pts enrolled in ALTITUDES, 500 (79.3%) were eligible for the present analysis. Exclusion criteria were diagnosis before 2016 in 13 pts, multiple DF in 33 pts, 39 pts without CTNNB1 mutation analysis, and 45 pts receiving other treatments. The study population included 349 females (69.8%), the median age was 40 years (range 1-89). Abdominal wall was the predominant primary site: 161 pts (32.2%). In 430 (86.0%) cases, there was a CTNNB1 mutation, including, S45F in 56 cases (11.2%). In 70 cases (14.0%), we did not identify CTNNB1 mutation. The front-line managements were AS in 361 pts (72.2%), SR with R0/R1 margins in 57 cases (11.4%) and systemic treatments in 82 pts (16.5%). The median follow-up was 23 months (Range, 0.4-55). Overall, progression or relapse occurred in 128 pts (25.6%). We observed a significant EFS-difference between treatment groups, both in univariate and multivariate analysis with, compared to AS, a better outcome in patients with SR and worse outcome in patients who had received a systemic treatment (p = 0.01 in multivariate analysis). The risk of event was significantly associated with the tumor size, with a HR = 1.46 in tumors larger than 50 mm compared to smaller tumors (95%CI, 1.01-2.10, p = 0.04). We did not observe any significant association between the CTNNB1 mutational status and the outcome: compared to patients with another mutation, the hazard ratio associated with a S45F mutation was HR = 0.84 (95%CI, 0.48-1.46, p = 0.53) in multivariate analysis. Age, gender, location (abdominal wall versus other) were not associated with EFS. Conclusions: In this large prospective study, S45F was not an independent poor prognostic factor in DF. Size and front-line treatment drive both the outcome. The understanding and prediction of natural course of DF require further studies.
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Affiliation(s)
- Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret and Lille University Hospital, Lille, France
| | | | | | - Sébastien Salas
- CEPCM Assistance Publique des Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | | | | | | | - Olivier Collard
- Institut de Cancérologie Lucien Neuwirth, Saint Etienne, France
| | | | | | | | | | | | | | | | | | | | | | | | - Olivier Mir
- Gustave Roussy Cancer Institute, Villejuif, France
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8
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Thebault E, Piperno-Neumann S, Tran D, Pacquement H, Marec-Berard P, Lervat C, Castex MP, Cleirec M, Bompas E, Vannier JP, Plantaz D, Saumet L, Verite C, Collard O, Pluchart C, Briandet C, Monard L, Brugieres L, Le Deley MC, Gaspar N. Successive Osteosarcoma Relapses after the First Line O2006/Sarcome-09 Trial: What Can We Learn for Further Phase-II Trials? Cancers (Basel) 2021; 13:cancers13071683. [PMID: 33918346 PMCID: PMC8038261 DOI: 10.3390/cancers13071683] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/28/2022] Open
Abstract
Simple Summary Osteosarcoma is the most common primary malignant bone tumour in adolescents and young adults. The survival of osteosarcoma patients has not improved for four decades. The purpose was to describe first and subsequent relapses in patients from the OS2006/Sarcome-09 trial, to help future trial design. Among the 434 patients with a confirmed osteosarcoma who achieved CR1 during first line treatment, 157 patients experienced at least one relapse. The 3-year progression-free and overall survival rates were 21% and 37%, respectively. Only a quarter of the patients were included in clinical trials at first recurrence. We want to promote randomised phase-II trials in osteosarcoma relapses, with broad inclusion criteria at study entry in terms of age and disease status, and PFS as primary endpoint. Surgery/local treatment of all residual lesions should be allowed when feasible. Single-arm trial design could be used for subsequent relapses. Abstract The purpose was to describe first and subsequent relapses in patients from the OS2006/Sarcome-09 trial, to help future trial design. We prospectively collected and analysed relapse data of all French patients included in the OS2006/Sarcome-09 trial, who had achieved a first complete remission. 157 patients experienced a first relapse. The median interval from diagnosis to relapse was 1.7 year (range 0.5–7.6). The first relapse was metastatic in 83% of patients, and disease was not measurable according to RECIST 1.1 criteria in 23%. Treatment consisted in systemic therapy (74%) and surgical resection (68%). A quarter of the patients were accrued in a phase-II clinical trial. A second complete remission was obtained for 79 patients. Most of them had undergone surgery (76/79). The 3-year progression-free and overall survival rates were 21% and 37%, respectively. In patients who achieved CR2, the 3y-PFS and OS rates were 39% and 62% respectively. Individual correlation between subsequent PFS durations was poor. For osteosarcoma relapses, we recommend randomised phase-II trials, open to patients from all age categories (children, adolescents, adults), not limited to patients with measurable disease (but stratified according to disease status), with PFS as primary endpoint, response rate and surgical CR as secondary endpoints.
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Affiliation(s)
- Eric Thebault
- Department of Oncology for Child and Adolescent, Gustave Roussy, Paris-Saclay University, 94800 Villejuif, France; (E.T.); (L.B.)
| | | | - Diep Tran
- Biostatistics Department, Gustave Roussy Institute, 94800 Villejuif, France;
| | | | - Perrine Marec-Berard
- Department of Paediatric Oncology, Institut D’hématologie et D’oncologie Pédiatrique, 69008 Lyon, France;
| | - Cyril Lervat
- Department of Tumor Pediatrics, Centre Oscar Lambret, 59000 Lille, France;
| | - Marie-Pierre Castex
- Department of Pediatric and Adolescent Unity Oncology, Toulouse University Hospital, 31300 Toulouse, France;
| | - Morgane Cleirec
- Pediatric Onco-Hematology Department, University Hospital Center of Nantes, 44093 Nantes, France;
| | - Emmanuelle Bompas
- Department of Medicine, Institut Cancerologie de l’Ouest, 44093 Nantes, France;
| | - Jean-Pierre Vannier
- Pediatric Hematology, Centre Hospitalo-Universitaire Charles Nicolle, 76038 Rouen, France;
| | - Dominique Plantaz
- Department of Paediatric Oncology, University Hospital, 38700 Grenoble, France;
| | - Laure Saumet
- Department of Paediatric Onco-Haematology, Montpellier University Hospital, 34295 Montpellier, France;
| | - Cecile Verite
- Department of Pediatric and Adolescent Hematogy and Oncology, Pellegrin Hospital, 33000 Bordeaux, France;
| | - Olivier Collard
- Department of Medical Oncology, Institut de Cancérologie de la Loire, Lucien Neuwirth, 42270 St Priest en Jarez, France;
| | - Claire Pluchart
- Department of Paediatric Oncology, Centre Hospitalo-Universitaire, 51100 Reims, France;
| | - Claire Briandet
- Department of Paediatric Immuno-Hematology, Centre Hospitalo-Universitaire, 21079 Dijon, France;
| | | | - Laurence Brugieres
- Department of Oncology for Child and Adolescent, Gustave Roussy, Paris-Saclay University, 94800 Villejuif, France; (E.T.); (L.B.)
| | | | - Nathalie Gaspar
- Department of Oncology for Child and Adolescent, Gustave Roussy, Paris-Saclay University, 94800 Villejuif, France; (E.T.); (L.B.)
- Correspondence: ; Tel.: +33-1-42-11-41-66; Fax: +33-1-42-11-52-75
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Desage AL, Bouleftour W, Rivoirard R, Magne N, Collard O, Fournel P, Tissot C. Vaccination and Immune Checkpoint Inhibitors: Does Vaccination Increase the Risk of Immune-related Adverse Events? A Systematic Review of Literature. Am J Clin Oncol 2021; 44:109-113. [PMID: 33350679 DOI: 10.1097/coc.0000000000000788] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Immune checkpoint inhibitors (ICIs) have become part of cancer treatments. Their main side effects are immune-related adverse events (irAEs). So far, there has been no recommendation regarding routine vaccinations during ICIs treatment. Clinicians are aware of the risk of irAEs increases in this specific situation. The aim of this review of literature is to summarize the main studies about vaccination and ICIs interactions. METHODS A systematic assessment of literature articles was performed by searching in PubMed (MEDLINE), and major oncology meeting following PRISMA guidelines. RESULTS This review highlights the lack of literature. Indeed, most of the studies published were about influenza vaccination. Vaccination for patients under ICIs causes a humoral response and seems to be associated with an increase rate of seroconversion. Interestingly vaccination may provoke irAEs in ICIs-treated patients. So far, inactivated vaccines have not been contraindicated during ICI treatment. CONCLUSION Larger prospective studies are needed in order to define a consensus on the use of vaccines under immunotherapy.
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Affiliation(s)
| | | | | | - Nicolas Magne
- Radiotherapy Department, Lucien Neuwirth Cancerology Institute, Saint Priest en Jarez, France
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10
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Bouleftour W, Muron T, Guillot A, Tinquaut F, Rivoirard R, Jacquin JP, Saban-Roche L, Boussoualim K, Tavernier E, Augeul-Meunier K, Collard O, Mery B, Pupier S, Oriol M, Bourmaud A, Fournel P, Vassal C. Effectiveness of a nurse-led telephone follow-up in the therapeutic management of patients receiving oral antineoplastic agents: a randomized, multicenter controlled trial (ETICCO study). Support Care Cancer 2021; 29:4257-4267. [DOI: 10.1007/s00520-020-05955-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/15/2020] [Indexed: 12/30/2022]
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11
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Fredeau L, Hober C, Pham-Ledard A, Boubaya M, Herms F, Celerier P, Aubin F, Beneton N, Dinulescu M, Jannic A, Meyer N, Duval Modeste AB, Cesaire L, Neidhardt EM, Archier E, Dreno B, Lesage C, Berthin C, Kramkimel N, Grange F, De Quatrebarbes J, Stoebner P, Poulalhon N, Arnault J, Abed S, Bonniaud B, Darras S, Heidelberger V, Devaux S, Moncourier M, Misery L, Mansard S, Etienne M, Brunet-Possenti F, Jacobzone C, Lesbazeilles R, Skowron F, Sanchez J, Catala S, Samimi M, Tazi Y, Spaeth D, Gaudy-Marqueste C, Collard O, Triller R, Pracht M, Dumas M, Peuvrel L, Combe P, Lauche O, Guillet P, Reguerre Y, Kupfer-Bessaguet I, Solub D, Schoeffler A, Bedane C, Dalac S, Mortier L, Maubec E. Cémiplimab et carcinomes épidermoïdes cutanés localement évolués ou métastatiques : premières données de vie réelle. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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de La Motte Rouge T, Bengrine Lefevre L, Mouret-Reynier MA, Asselain B, Lucas B, Gavoille C, Cornila C, Spaeth D, Colomba E, Patsouris A, Fabbro M, Chakiba C, Toussaint P, Simon H, Berton D, Garbay D, Garnier Tixidre C, Coeffic D, Collard O, Lefeuvre-Plesse C. 823P Extended follow-up of a real-world cohort of patients (pts) with BRCA mutation (BRCAm) relapsed epithelial ovarian cancer (EOC) receiving olaparib maintenance therapy: The GINECO RETROLA study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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13
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Blanc-Durand F, Lefeuvre-Plesse C, Ray-Coquard I, Chaltiel D, Floquet A, Meriaux É, Berton D, Bello-Roufai D, Guillemet C, Dupre PF, Faller É, Alexandre J, Hardy-Bressard AC, Collard O, Fabbro M, Provansal M, Kalbacher E, Genestie C, Pautier P. Dose-intensive regimen treatment for small-cell carcinoma of the ovary of hypercalcemic type (SCCOHT). Gynecol Oncol 2020; 159:129-135. [PMID: 32723678 DOI: 10.1016/j.ygyno.2020.07.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/11/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Small cell carcinoma of the ovary of hypercalcemic type (SCCOHT) is a rare and rapidly lethal disease affecting young women. Cytoreductive surgery associated with chemotherapy followed by a high dose chemotherapy regimen (HDC) demonstrated improved outcomes in a unique prospective and several retrospective studies, and this report aimed to confirm these results in an independent and larger cohort. METHODS Between 2006 and 2018, we conducted a multicentric prospective study on 44 women diagnosed with SCCOHT. Patients were treated homogeneously with optimal cytoreductive surgery and chemotherapy protocol for four to six cycles (PAVEP). In case of complete response, patients received HDC with stem-cell support, followed by pelvic radiotherapy. The primary endpoint was the event-free survival (EFS) in the per-protocol cohort. Secondary analysis explored the effect of HDC with outcomes. RESULTS Mean age at diagnosis was 33 years old (range 13.8-75.8). 14 patients presented with stage FIGO I, 21 with stage III and 9 with stage IV. Median follow-up was 53.4 months. 38 patients underwent optimal surgery with up to 6 cycles of PAVEP. 30 received HDC, and 21 pelvic radiotherapy. 21 relapses were reported leading to death for 18 patients. Median EFS in the per-protocol cohort was 18.2 months, and 2-year EFS rate was 40%. HDC was significantly associated with better overall survival (p < .001). Grades 3/4 adverse events were frequent but, in most cases, manageable, although one grade-5 adverse-event occurred during HDC. CONCLUSION Intensive regimen containing multidrug chemotherapy, HDC and pelvic radiotherapy, for the management of SCCOHT, demonstrated encouraging survival and should be proposed for all patients. However, the significant toxicity cost associated is of concern and it should be restricted to expert centers.
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Affiliation(s)
- Félix Blanc-Durand
- Gynecology Unit, Institut Gustave-Roussy, 114 rue Édouard-Vaillant, 94800 Villejuif, France
| | | | | | - Dan Chaltiel
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Anne Floquet
- Institut Bergonié, 229 cours de l'Argonne, 33000 Bordeaux, France
| | - Émeline Meriaux
- Centre François-Baclesse, 3 avenue du Général-Harris, 14000 Caen, France
| | - Dominique Berton
- Institut de Cancérologie de l'Ouest - René-Gauducheau, Boulevard Pr Jacques-Monod, 44800 Saint-Herblain, France
| | - Diana Bello-Roufai
- Institut Curie - Centre René-Huguenin, 35 rue Dailly, 92210 Saint-Cloud, France
| | | | - Pierre-François Dupre
- Centre hospitalier régional universitaire Morvan de Brest, 2 Avenue Foch, 29200 Brest, France
| | - Émilie Faller
- Hôpital de Hautepierre, 1 avenue Molière, 67200 Strasbourg, France
| | - Jérôme Alexandre
- Hôpital Cochin-Port Royal, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | | | - Olivier Collard
- Institut de Cancérologie de la Loire - Lucien-Neuwirth, 108 bis avenue Albert-Raimond, 42270 SaintPriest-en-Jarez, France
| | - Michel Fabbro
- Institut du Cancer de Montpellier, 208 rue des Apothicaires, 34298 Montpellier, France
| | - Magali Provansal
- Institut Paoli-Calmettes, 232 boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Elsa Kalbacher
- CHRU Jean-Minjoz, 3 boulevard Alexander-Fleming, 25030 Besançon, France
| | - Catherine Genestie
- Pathology Unit, Institut Gustave-Roussy, 114 rue Édouard-Vaillant, 94800 Villejuif, France
| | - Patricia Pautier
- Gynecology Unit, Institut Gustave-Roussy, 114 rue Édouard-Vaillant, 94800 Villejuif, France.
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14
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Joly F, Brachet PE, Abadie Lacourtoisie S, Asselain B, Floquet A, Collard O, Rodrigues M, Leroy K, Jeanne C, Leary A, Betrian S, You B, Fernandez Diez Y, Hardy-Bessard AC, Chevalier A, Kalbacher E, Cornila C, Foa C, Follana P, Alexandre J. Multicentre randomized phase II trial of olaparib as maintenance therapy in platinum-sensitive advanced endometrial carcinoma: The GINECO-UTOLA study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.tps6109] [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
TPS6109 Background: Advanced endometrial cancer (EC) patients relapse despite treatment with combination chemotherapy and have a short progression-free survival (PFS). Data from the TGCA suggest opportunities to targeting DNA repair in women with EC. Particularly type 4 (High copy number or serous like, with frequent TP53 mutations) and type 2 (microsatellite instability hypermutated) EC can be associated with defects in double strand break DNA repair by homologous recombination (HR) and could potentially be targeted by olaparib. We propose a placebo-controlled, multicenter, two-arm, phase II trial comparing olaparib versus placebo in maintenance therapy after chemotherapy in patients with advanced/metastatic EC. Methods: The primary objective of this trial is to evaluate the efficacy of maintenance olaparib in comparison to placebo after platinum based chemotherapy, defined by PFS according to Recist. Key eligibility criteria include: advanced/metastatic histologically confirmed EC (excepted carcino-sarcoma, small cells& neuroendocrine); prior surgery, adjuvant chemotherapy, radiation and hormonal therapy are permitted; objective or stable response after first-line chemotherapy is mandatory. 147 patients are randomized (2:1) after chemotherapy to receive Olaparib 300mg twice daily or placebo in maintenance after at least 4 cycles of platinum based chemotherapy. Olaparib/placebo is continued until disease progression, unacceptable toxicity, or withdrawal. Stratification is on IHC P53 and MMR status. Primary hypothesis is a 66.7% relative increase in the median PFS rate in the olaparib arm (from 4.5 to 7.5 months), corresponding to a 0.60 Hazard Ratio. Secondary endpoints include PFS according to P53, MMR and NGS HRD status, PFS2, disease specific survival, time to subsequent therapy, overall survival, objective response, disease control rate, patient reported outcomes (assessed via EORTC QLQ-C30 and EORTC QLQ-EN24, EORTC-FA, EQ5D) and safety. Trial is recruiting in France (in February n= 40 randomization). Conclusion: this will be the first study that evaluate the efficacy of olaparib in maintenace after chemotherapy in advanced/metastastic EC, stratified on molecular profil. Clinical trial information: NCT03745950.
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Affiliation(s)
- Florence Joly
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | | | | | | | - Anne Floquet
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, and Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens, Bordeaux, France
| | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | | | - Karen Leroy
- AP-HP.Centre, hôpital COCHIN, Paris Université Paris Descartes, faculté de médecine, Paris, France
| | | | | | - Sarah Betrian
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - Benoit You
- Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, EMR UCBL/HCL 3738, Lyon, GINECO & GINEGEPS, Lyon, France
| | | | - Anne-Claire Hardy-Bessard
- Medical Oncology Department, CARIO-HPCA and Cooperative Gynecological Cancer Research Group (GINECO), Plerin, France
| | - Annick Chevalier
- Département d’Oncologie Médicale, Centre Oscar-Lambret, Lille, France
| | | | | | - Cyril Foa
- Hôpital Saint Joseph-Service d'Oncocologie Médicale, Marseille, France
| | | | - Jerome Alexandre
- Cochin Port Royal Hospital, AP-HP, Paris Descartes University, CARPEM, Paris, France
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15
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Pautier P, Floquet A, Chevreau C, Penel N, Guillemet C, Delcambre C, Cupissol D, Selle F, Isambert N, Piperno-Neumann S, Saada-Bouzid E, Bertucci F, Bompas E, Boudou-Rouquette P, Collard O, Le Brun Ly V, Toulmonde M, Le Cesne A, Lacas B, Duffaud F. A single-arm multicenter phase II trial of doxorubicin (Doxo) in combination with trabectedin (Trab) given as first-line treatment to patients with metastatic/advanced uterine (U-LMS) and soft tissue leiomyosarcoma (ST-LMS): Final results of the LMS-02 study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.11506] [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
11506 Background: U-LMS and ST-LMS are rare tumors with poor prognosis when locally advanced or metastatic, and with moderate chemosensitivity. Overall response rates (ORR) given in the 1st-line setting do not exceed 50% for U-LMS and 35% for ST-LMS with a mean response duration of 3- 6 months without impact on overall survival (OS). In 2015 we reported very encouraging results of the LMS-02 study (NCT02131480) with ORR of 59.6% in U-LMS, and 39.3% in ST-LMS with manageable toxicity (Pautier; Lancet oncol 2015). Herein, we report the updated results of progression-free survival (PFS) and final results of overall survival (OS). Methods: Patients (pts) received 60 mg/m² intravenous Doxo followed by trabectedin 1.1 mg/m2 as a 3-hour infusion on Day 1 and pegfilgrastim on Day 2, repeated every 3 weeks for up to 6 cycles. Surgery for residual disease was permitted. Patients were stratified into U-LMS and ST-LMS groups. Results: Overall, 108 patients with LMS with a median age of 59 years and mostly metastatic disease (85%) were enrolled. Of those, 77 patients (71.3%) have received all 6 cycles of treatment, and 20 patients (18.5%) had metastasis resection. With a median follow-up of 7.2 years (95% CI: 6.9 - 8.2), the overall median PFS was 10.1 months (95% CI: 8.5 - 12.6), being 8.3 months (95 CI: 7.4 - 10.3) and 12.9 months (95% CI: 9.2 - 14.1) in U and ST group, respectively. Median OS was 34.4 months (95% CI: 26.9 - 42.7), being 27.5 months (95% CI: 17.9 - 38.2) in U-LMS and 38.7 months (95% CI: 31.0 - 52.9) in ST-LMS group. The median OS among the 20 pts with surgery was not reached vs 31.6 months in the population without surgery (95% IC: 23.9 - 35.4). Conclusions: The Doxo +Trab combination is an effective 1st-line therapy for pts with LMS, with promising PFS and OS results and an acceptable safety profile. Merely for comparison, the most recent results of Doxo alone in metastatic LMS, given in 1st-line setting in a phase III ANNOUNCE trial conducted during the same period, reported median PFS of 6.9 months, and median OS of 21.9 months (ASCO 2019 LBA3). Results of the LMS04 trial (NCT02997358), a randomized phase III study comparing this combination vs Doxo alone in 1st-line therapy in metastatic LMS are pending. Clinical trial information: NCT02131480 .
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Affiliation(s)
- Patricia Pautier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Anne Floquet
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France
| | | | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | | | | | | | | | | | | | | | | | | | | | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | | | - Maud Toulmonde
- Institut Bergonié, Department of Medical Oncology, Bordeaux, France
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Blanc F, Lefeuvre C, Floquet A, Chaltiel D, Ray-Coquard IL, Meriaux E, Berton D, Bello D, Guillemet C, Dupre PF, Faller E, Alexandre J, Hardy-Bessard AC, Collard O, Fabbro M, Provansal M, Kalbacher E, Genestie C, Pautier P. Effect of high-dose chemotherapy with autologous stem cell rescue (HDC-aSCR) on outcome in ovarian small-cell carcinoma, hypercalcemic type (SCCOHT): Prospective series from the French Rare Gynecologic Malignant Tumors Network (TMRG). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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
6023 Background: Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), is a rare and rapidly lethal disease affecting young women with over half dying within 2 years of diagnosis. We previously reported improved outcomes with cytoreductive surgery followed by HDC-aSCR in a prospective study, but these encouraging results needed to be confirmed in an independent and larger cohort. Methods: Between 2008 and 2019, out of 44 patients (pts) diagnosed with centrally confirmed SCCOHT in 16 referent centers of the TMRG network, 38 were treated prospectively according to the French recommendations of the network with complete surgery (primary or after neoadjuvant chemotherapy), 4 to 6 cycles of PAVEP chemotherapy (cisplatin, doxorubicin, vepeside, and cyclophosphamide), and for pts with complete response (CR), HDC-aSCR, followed by pelvic radiotherapy. The 6 patients who could not receive PAVEP (unfit or diagnostic delay) relapsed and died rapidly. The primary endpoint was the event-free survival (EFS) in the intention-to-treat cohort. Results: Median age at diagnosis was 33 years (14-76). 13 pts presented with FIGO stage I, 17 stage III and 6 stage IV, 2 unknown. Median follow-up was 55.5 months. 34 patients achieved CR with CT + surgery and 30 received HDC-aSCR (40%, 47% and 10% with stages I, III and IV diseases respectively) and 21 received also pelvic radiotherapy. Median overall and event-free survival was 36.4 and 15.9 months respectively, and 2-years event-free survival rate was 40% (CI95% 25-56). Median OS was respectively not reached, 18 and 9.6 months for FIGO I, III and IV patients. Among the pts (N = 14) who did not receive HDC-aSCR (rapid progression during or after PAVEP), the 2-yr EFS was 0% compared to 50.5% for the 30 patients receiving HDC. In multivariate analysis, HDC was significantly correlated with better outcomes (p < 0.001). For the 21 patients receiving also pelvic radiotherapy, 57% (12/21) are free of recurrence at 4 years. Grades 3/4 adverse events were frequent (78%) but, in most cases, manageable, although one toxic death (3%) occurred during HDC (fungal septic shock). Conclusions: Treatment of SCCOHT, with intensive multimodal therapy, is associated with a 40% 2-yr event-free survival. However, this protocol is associated with significant toxicity and should be restricted to good performance status patient and expert centers.
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Affiliation(s)
| | | | - Anne Floquet
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, and Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens, Bordeaux, France
| | | | | | | | - Dominique Berton
- Groupe d'Investigateurs Nationaux pour l'Étude des Cancers Ovariens (GINECO), Institut de Cancérologie de l'Ouest (ICO) Centre René Gauducheau, Saint Herblain, France
| | | | | | | | | | - Jérôme Alexandre
- Department of Oncology, Paris Descartes University, Cochin-Port-Royal Hospital, AP-HP, Paris, France
| | - Anne-Claire Hardy-Bessard
- GINECO-Centre Armoricain de Radiothérapie d'Imagerie Médicale et d'Oncologie-Hôpital Privé des Côtes d'Armor, Plérin, France
| | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | | | | | | | | | - Patricia Pautier
- GINECO, French Sarcoma Group and Gustave Roussy Cancer Center, Villejuif, France
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Marec-Berard P, Laurence V, Occean BV, Ray-Coquard I, Linassier C, Corradini N, Collard O, Chaigneau L, Cupissol D, Kerbrat P, Saada-Bouzid E, Delcambre C, Gouin F, Guillemet C, Jimenez M, Lervat C, Gaspar N, Le Deley MC, Brugieres L, Piperno-Neumann S. Methotrexate-Etoposide-Ifosfamide Compared with Doxorubicin-Cisplatin-Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18-25 Years. J Adolesc Young Adult Oncol 2019; 9:172-182. [PMID: 31702419 DOI: 10.1089/jayao.2019.0085] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Purpose: The French standard chemotherapy for osteosarcoma combines high-dose methotrexate (HDM) and etoposide-ifosfamide (EI) in children and adolescents, and API-AI (doxorubicin-cisplatin-ifosfamide) in adults. We herein present the results of M-EI and API-AI in 18- to 25-year-old patients. Methods: Patients, 18-25 years old, received either M-EI or API-AI regimens. M-EI comprised seven M and two EI doses preoperatively then M-EI in standard-risk patients (good histological response without metastasis) and five M-AP (methotrexate-doxorubicin-cisplatin) in high-risk patients (poor histological response, metastasis, and/or unresectable primary), postoperatively. API-AI comprised three API and two AI doses preoperatively, then two AI and two PI in standard-risk patients and five EI in high-risk patients, postoperatively. Results: We analyzed 95 patients 18-25 years of age: 55 received M-EI and 40 API-AI. The groups had similar baseline characteristics. Eighty-nine patients (94%) had surgery. Twenty-nine of 55 M-EI patients (60%) and 16/40 API-AI patients (41%) had good histological responses to preoperative chemotherapy. At 5 years, event-free survival was 50% (95% confidence interval [CI]: 39-60) and overall survival was 65% (95% CI: 54-74). Acute toxicity was similar, without treatment-related deaths. Conclusions: Survival outcomes with M-EI and API-AI were not significantly different. Tolerance was acceptable with both regimens. HDM is thus feasible for young adults. However, our study limitations preclude any definitive conclusions.
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Affiliation(s)
- Perrine Marec-Berard
- Unité de Traitement de la Douleur de l'Enfant, Centre Léon Bérard, Institut d'Hématologie et d'Oncologie Pédiatrie, Lyon, France
| | | | - Bob-Valéry Occean
- Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France
| | | | - Claude Linassier
- Department of Cancer Medicine, Centre Hospitalo-Universitaire, Tours, France
| | - Nadège Corradini
- Department of Pediatric and Adolescent Hematology-Oncology, Hôpital Mère-Enfant, Nantes, France
| | - Olivier Collard
- Department of Medical Oncology, Institut de Cancérologie de la Loire, Lucien Neuwirth, St Priest en Jarez, France
| | - Loïc Chaigneau
- Department of Medical Oncology, CHRU Jean Minjoz, Besançon, France
| | - Didier Cupissol
- Department of Medical Oncology, Centre Val d'Aurelle, Montpellier, France
| | - Pierre Kerbrat
- Department of Medical Oncology, Centre Eugène-Marquis, Rennes, France
| | - Esma Saada-Bouzid
- Medical Oncology Department, Centre Antoine Lacassagne, Nice, France
| | | | - François Gouin
- CHU Nantes Hôtel-Dieu/Laboratoire UMR1238 Phyos, Faculté de Médecine de Nantes, Nantes, France
| | - Cécile Guillemet
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France
| | | | - Cyril Lervat
- Pediatric Oncology Unit-Adolescents and Young Adults, Centre Oscar Lambret, Lille, France
| | - Nathalie Gaspar
- Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France
| | | | - Laurence Brugieres
- Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France
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Deliens C, Bavais M, Pepersack T, Collard O, Bron D, Dal Lago L. ANALYSIS OF POTENTIAL INTERACTIONS BETWEEN DRUG TREATMENTS AND OVER-THE-COUNTER MEDICATIONS TAKEN BY OLDER PATIENTS WITH SOLID TUMORS OR HEMATOLOGICAL MALIGNANCIES. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31218-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Blay JY, Honoré C, Stoeckle E, Meeus P, Jafari M, Gouin F, Anract P, Ferron G, Rochwerger A, Ropars M, Carrere S, Marchal F, Sirveaux F, Di Marco A, Le Nail LR, Guiramand J, Vaz G, Machiavello JC, Marco O, Causeret S, Gimbergues P, Fiorenza F, Chaigneau L, Guillemin F, Guilloit JM, Dujardin F, Spano JP, Ruzic JC, Michot A, Soibinet P, Bompas E, Chevreau C, Duffaud F, Rios M, Perrin C, Firmin N, Bertucci F, Le Pechoux C, Le Loarer F, Collard O, Karanian-Philippe M, Brahmi M, Dufresne A, Dupré A, Ducimetière F, Giraud A, Pérol D, Toulmonde M, Ray-Coquard I, Italiano A, Le Cesne A, Penel N, Bonvalot S. Surgery in reference centers improves survival of sarcoma patients: a nationwide study. Ann Oncol 2019; 30:1407. [PMID: 31168580 PMCID: PMC6683855 DOI: 10.1093/annonc/mdz170] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Piperno-Neumann S, Ray-Coquard I, Occean BV, Laurence V, Cupissol D, Perrin C, Penel N, Bompas E, Rios M, Le Cesne A, Italiano A, Anract P, de Pinieux G, Collard O, Bertucci F, Duffaud F, Le Deley MC, Delaye J, Brugieres L, Blay JY. Results of API-AI based regimen in osteosarcoma adult patients included in the French OS2006/Sarcome-09 study. Int J Cancer 2019; 146:413-423. [PMID: 31246277 DOI: 10.1002/ijc.32526] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 12/27/2018] [Accepted: 05/28/2019] [Indexed: 02/02/2023]
Abstract
In the OS2006 study, patients younger than 18 years were treated with a methotrexate-based regimen (MTX), patients older than 25 years with a doxorubicin-cisplatin-ifosfamide-based regimen (API-AI), whereas patients aged 18-25 years received either API-AI or MTX. We herein report the prespecified subgroup analysis of the outcome of 106 patients treated with API-AI. Preoperative chemotherapy combined three doxorubicin-ifosfamide-cisplatin (API) and two doxorubicin-ifosfamide (AI) courses. Postoperative chemotherapy was assigned by risk group: localised patients with a good histological response (<10% viable cells) received two AI and two cisplatin-ifosfamide (PI) courses; patients with synchronous metastases, poor histological response or unresectable primary received five cycles of etoposide-ifosfamide (EI). Of the 106 patients, 61 were randomised to receive or not zoledronate. Median age was 30 years (range 18-67), 66 (62%) patients were >25 years. The primary tumours were axial in 28 patients (26%), and 28 (26%) presented with metastases. Ninety-six patients (91%) had surgery, conservative in 82 (85%); 36 patients (38%, 95% CI 28-48%) were good responders. Toxicity was manageable, with no significant difference in severe acute toxicity between patients aged >25 years and those younger. With a median follow-up of 4.8 years, the 5-year event-free survival and overall survival rates were 46% (95% CI 36-56) and 57% (95% CI 47-67), respectively. The primary tumour size and initial metastases correlated with a higher risk of event. In these 106 osteosarcoma adult patients, API-AI proved feasible with no excess of toxicity, and favourable activity despite poor-prognosis factors.
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Affiliation(s)
| | - Isabelle Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
| | | | | | - Didier Cupissol
- Department of Medicine, Val d'Aurelle Institute, Montpellier, France
| | - Christophe Perrin
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, CHRU, Lille, France
| | - Emmanuelle Bompas
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Maria Rios
- Department of Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, France
| | - Axel Le Cesne
- Department of Medicine and Surgery, Gustave Roussy, Villejuif, France
| | - Antoine Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Philippe Anract
- Orthopaedic Department, Cochin University hospital, Paris, France
| | | | - Olivier Collard
- Medical Oncology Department, Institut de Cancérologie de la Loire Lucien Neuwirth, St Priest en Jarez, France
| | - François Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Florence Duffaud
- Department of Medical Oncology, Timone University Hospital, Marseille, France
| | - Marie-Cécile Le Deley
- Biostatistics Unit, Gustave Roussy, Villejuif, France.,Paris-Saclay University, Paris-Sud University, CESP, INSERM, Villejuif, France
| | | | - Laurence Brugieres
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, France
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard, University Claude Bernard Lyon I, Lyon, France
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21
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Blay JY, Honoré C, Stoeckle E, Meeus P, Jafari M, Gouin F, Anract P, Ferron G, Rochwerger A, Ropars M, Carrere S, Marchal F, Sirveaux F, Di Marco A, Le Nail LR, Guiramand J, Vaz G, Machiavello JC, Marco O, Causeret S, Gimbergues P, Fiorenza F, Chaigneau L, Guillemin F, Guilloit JM, Dujardin F, Spano JP, Ruzic JC, Michot A, Soibinet P, Bompas E, Chevreau C, Duffaud F, Rios M, Perrin C, Firmin N, Bertucci F, Le Pechoux C, Le Loarer F, Collard O, Karanian-Philippe M, Brahmi M, Dufresne A, Dupré A, Ducimetière F, Giraud A, Pérol D, Toulmonde M, Ray-Coquard I, Italiano A, Le Cesne A, Penel N, Bonvalot S. Surgery in reference centers improves survival of sarcoma patients: a nationwide study. Ann Oncol 2019; 30:1143-1153. [PMID: 31081028 PMCID: PMC6637376 DOI: 10.1093/annonc/mdz124] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND NETSARC (netsarc.org) is a network of 26 sarcoma reference centers with specialized multidisciplinary tumor boards (MDTB) aiming to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB and expert pathological review are mandatory for sarcoma patients nationwide. In the present work, the impact of surgery in a reference center on the survival of sarcoma patients investigated using this national NETSARC registry. PATIENTS AND METHODS Patients' characteristics and follow-up are prospectively collected and data monitored. Descriptive, uni- and multivariate analysis of prognostic factors were conducted in the entire series (N = 35 784) and in the subgroup of incident patient population (N = 29 497). RESULTS Among the 35 784 patients, 155 different histological subtypes were reported. 4310 (11.6%) patients were metastatic at diagnosis. Previous cancer, previous radiotherapy, neurofibromatosis type 1 (NF1), and Li-Fraumeni syndrome were reported in 12.5%, 3.6%, 0.7%, and 0.1% of patients respectively. Among the 29 497 incident patients, 25 851 (87.6%) patients had surgical removal of the sarcoma, including 9949 (33.7%) operated in a NETSARC center. Location, grade, age, size, depth, histotypes, gender, NF1, and surgery outside a NETSARC center all correlated to overall survival (OS), local relapse free survival (LRFS), and event-free survival (EFS) in the incident patient population. NF1 history was one of the strongest adverse prognostic factors for LRFS, EFS, and OS. Presentation to an MDTB was associated with an improved LRFS and EFS, but was an adverse prognostic factor for OS if surgery was not carried out in a reference center. In multivariate analysis, surgery in a NETSARC center was positively correlated with LRFS, EFS, and OS [P < 0.001 for all, with a hazard ratio of 0.681 (95% CI 0.618-0.749) for OS]. CONCLUSION This nationwide registry of sarcoma patients shows that surgical treatment in a reference center reduces the risk of relapse and death.
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Affiliation(s)
- J-Y Blay
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth.
| | - C Honoré
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - E Stoeckle
- Department of Medical Oncology and Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - P Meeus
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - M Jafari
- Department of Medical Oncology and Department of Surgical Oncology, Centre Oscar Lambret, Lille; Department of Surgical Oncology, CHU, Lille
| | - F Gouin
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth; Department of Medical Oncology and Department of Surgical Oncology, Institut de Cancerologie Nantes, Nantes; Department of Orthopedics, CHU Nantes, Nantes
| | - P Anract
- Department of Orthopedics, Hôpital Cochin-Saint-Vincent de Paul, Paris
| | - G Ferron
- Department of Medical Oncology and Department of Surgical Oncology, Institut Universitaire de Cancerologie de Toulouse, Claudius Regaud, Toulouse
| | - A Rochwerger
- Department of Medical Oncology and Department of Orthopedics, La Timone University Hospital, Marseille
| | - M Ropars
- Medical Oncology Department, Eugene Marquis Comprehensive Cancer Center, Rennes; Department of Orthopedics, CHU, Rennes
| | - S Carrere
- Medical Oncology Department, Institut de Cancérologie de Montpellier, Montpellier
| | - F Marchal
- Department of Medical Oncology and Department of Surgical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - F Sirveaux
- Department of Medical Oncology and Department of Surgical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - A Di Marco
- Department of Surgical Oncology and Department of Medical Oncology, Centre Paul Strauss & CHU Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - L R Le Nail
- Department of Orthopedics, CHU de Tours, Tours
| | - J Guiramand
- Department of Medical Oncology and Department of Surgical Oncology, Institut Paoli Calmettes, Marseille
| | - G Vaz
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - J-C Machiavello
- Department of Medical Oncology and Department of Surgical Oncology, Centre Antoine-Lacassagne, Nice
| | - O Marco
- Oncology Unit, Saint Louis Hospital, Paris
| | - S Causeret
- Department of Surgery, Centre Georges François Leclerc, Dijon
| | - P Gimbergues
- Department of Surgery, Centre Jean Perrin/ERTICa EA, Clermont-Ferrand
| | - F Fiorenza
- Department of Medical Oncology and Department of Surgical Oncology, CHU Limoges, Limoges
| | - L Chaigneau
- Medical Oncology Department, CHU Besancon, Besançon
| | - F Guillemin
- Department of Medical Oncology and Department of Surgical Oncology, Institut J Godinot Reims
| | - J-M Guilloit
- Department of Surgical Oncology, Centre Francois Baclesse, Caen
| | - F Dujardin
- Department of Surgery, Centre Henri Becquerel, Rouen
| | - J-P Spano
- Medical Oncology Department, APHP La Pitié Salpetriere/Tenon/Bicetre, Paris
| | - J-C Ruzic
- Medical Oncology Department, CHU La Réunion, Saint-Pierre, La Réunion
| | - A Michot
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - P Soibinet
- Department of Medical Oncology and Department of Surgical Oncology, Institut J Godinot Reims
| | - E Bompas
- Department of Medical Oncology and Department of Surgical Oncology, Institut de Cancerologie Nantes, Nantes; Department of Orthopedics, CHU Nantes, Nantes
| | - C Chevreau
- Department of Medical Oncology and Department of Surgical Oncology, Institut Universitaire de Cancerologie de Toulouse, Claudius Regaud, Toulouse
| | - F Duffaud
- Department of Medical Oncology and Department of Orthopedics, La Timone University Hospital, Marseille
| | - M Rios
- Medical Oncology Department, Eugene Marquis Comprehensive Cancer Center, Rennes; Department of Orthopedics, CHU, Rennes
| | - C Perrin
- Medical Oncology Department, Eugene Marquis Comprehensive Cancer Center, Rennes; Department of Orthopedics, CHU, Rennes
| | - N Firmin
- Medical Oncology Department, Institut de Cancérologie de Montpellier, Montpellier
| | - F Bertucci
- Department of Medical Oncology and Department of Surgical Oncology, Institut Paoli Calmettes, Marseille
| | - C Le Pechoux
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - F Le Loarer
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - O Collard
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - M Karanian-Philippe
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - M Brahmi
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - A Dufresne
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - A Dupré
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - F Ducimetière
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - A Giraud
- Department of Orthopedics, Hôpital Cochin-Saint-Vincent de Paul, Paris
| | - D Pérol
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - M Toulmonde
- Department of Medical Oncology and Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - I Ray-Coquard
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - A Italiano
- Department of Medical Oncology and Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - A Le Cesne
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - N Penel
- Department of Medical Oncology and Department of Surgical Oncology, Centre Oscar Lambret, Lille; Department of Surgical Oncology, CHU, Lille
| | - S Bonvalot
- Surgery Department, Institut Curie, Paris, France
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Trédan O, Wang Q, Pissaloux D, Cassier P, de la Fouchardière A, Fayette J, Desseigne F, Ray-Coquard I, de la Fouchardière C, Frappaz D, Heudel PE, Bonneville-Levard A, Fléchon A, Sarabi M, Guibert P, Bachelot T, Pérol M, You B, Bonnin N, Collard O, Leyronnas C, Attignon V, Baudet C, Sohier E, Villemin JP, Viari A, Boyault S, Lantuejoul S, Paindavoine S, Treillleux I, Rodriguez C, Agrapart V, Corset V, Garin G, Chabaud S, Pérol D, Blay JY. Molecular screening program to select molecular-based recommended therapies for metastatic cancer patients: analysis from the ProfiLER trial. Ann Oncol 2019; 30:757-765. [PMID: 30865223 DOI: 10.1093/annonc/mdz080] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Antitumor activity of molecular-targeted agents is guided by the presence of documented genomic alteration in specific histological subtypes. We aim to explore the feasibility, efficacy and therapeutic impact of molecular profiling in routine setting. PATIENTS AND METHODS This multicentric prospective study enrolled adult or pediatric patients with solid or hematological advanced cancer previously treated in advanced/metastatic setting and noneligible to curative treatment. Each molecular profile was established on tumor, relapse or biopsies, and reviewed by a molecular tumor board (MTB) to identify molecular-based recommended therapies (MBRT). The main outcome was to assess the incidence rate of genomic mutations in routine setting, across specific histological types. Secondary objectives included a description of patients with actionable alterations and for whom MBRT was initiated, and overall response rate. RESULTS Four centers included 2579 patients from February 2013 to February 2017, and the MTB reviewed the molecular profiles achieved for 1980 (76.8%) patients. The most frequently altered genes were CDKN2A (N = 181, 7%), KRAS (N = 177, 7%), PIK3CA (N = 185, 7%), and CCND1 (N = 104, 4%). An MBRT was recommended for 699/2579 patients (27%), and only 163/2579 patients (6%) received at least one MBRT. Out of the 182 lines of MBRT initiated, 23 (13%) partial responses were observed. However, only 0.9% of the whole cohort experienced an objective response. CONCLUSION An MBRT was provided for 27% of patients in our study, but only 6% of patients actually received matched therapy with an overall response rate of 0.9%. Molecular screening should not be used at present to guide decision-making in routine clinical practice outside of clinical trials.This trial is registered with ClinicalTrials.gov, number NCT01774409.
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Affiliation(s)
- O Trédan
- Departments of Medical Oncology, University Claude Bernard
| | - Q Wang
- Translational Research and Innovation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - B You
- Department of Medical Oncology, Lyon Sud Hospital Center, CITOHL, Institute of Cancerology, Hospices Civils de Lyon (IC-HCL), Lyon; Faculty of Medicine-Lyon Sud, EMR UCBL/HCL 3738, University of Lyon 1, Oullins
| | - N Bonnin
- Department of Medical Oncology, Lyon Sud Hospital Center, CITOHL, Institute of Cancerology, Hospices Civils de Lyon (IC-HCL), Lyon
| | - O Collard
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - C Leyronnas
- Department of Medical Oncology, Mutualist Hospital Group, Grenoble
| | | | - C Baudet
- Synergie Lyon Cancer, Bio-Informatics Platform
| | - E Sohier
- Synergie Lyon Cancer, Bio-Informatics Platform
| | | | - A Viari
- Synergie Lyon Cancer, Bio-Informatics Platform
| | - S Boyault
- Translational Research and Innovation
| | | | | | | | - C Rodriguez
- BioPathology, Léon Bérard Cancer center, Lyon
| | - V Agrapart
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - V Corset
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - G Garin
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - S Chabaud
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - D Pérol
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - J-Y Blay
- Departments of Medical Oncology, University Claude Bernard.
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Duffaud F, Mir O, Boudou-Rouquette P, Piperno-Neumann S, Penel N, Bompas E, Delcambre C, Kalbacher E, Italiano A, Collard O, Chevreau C, Saada E, Isambert N, Delaye J, Schiffler C, Bouvier C, Vidal V, Chabaud S, Blay JY. Efficacy and safety of regorafenib in adult patients with metastatic osteosarcoma: a non-comparative, randomised, double-blind, placebo-controlled, phase 2 study. Lancet Oncol 2018; 20:120-133. [PMID: 30477937 DOI: 10.1016/s1470-2045(18)30742-3] [Citation(s) in RCA: 194] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Regorafenib has proven activity in patients with pretreated gastrointestinal stromal tumours and colorectal and hepatocellular carcinoma. We designed REGOBONE to assess the efficacy and safety of regorafenib for patients with progressive metastatic osteosarcoma and other bone sarcomas. This trial comprised four parallel independent cohorts: osteosarcoma, Ewing sarcoma, chondrosarcoma, and chordoma. In this Article, we report the results of the osteosarcoma cohort. METHODS In this non-comparative, double-blind, placebo-controlled, phase 2 trial, patients aged 10 years or older with histologically confirmed osteosarcoma whose disease had progressed after treatment with one to two previous lines of chemotherapy for metastatic disease and an Eastern Cooperative Oncology Group performance status of 0 or 1 were enrolled. Patients were randomly assigned (2:1) to receive either oral regorafenib (160 mg/day, for 21 of 28 days) or matching placebo. Patients in both groups also received best supportive care. Randomisation was done using a web-based system and was stratified (permuted block) by age at inclusion (<18 vs ≥18 years old). Investigators and patients were masked to treatment allocation. Patients in the placebo group, after centrally confirmed progressive disease, could cross over to receive regorafenib. The primary endpoint was the proportion of patients without disease progression at 8 weeks. Analyses were done by modified intention to treat (ie, patients without any major entry criteria violation who initiated masked study drug treatment were included). All participants who received at least one dose of study drug were included in the safety analyses. This study is registered with ClinicalTrials.gov, number NCT02389244, and the results presented here are the final analysis of the osteosarcoma cohort (others cohorts are ongoing). FINDINGS Between Oct 10, 2014, and April 4, 2017, 43 adult patients were enrolled from 13 French comprehensive cancer centres. All patients received at least one dose of assigned treatment and were evaluable for safety; five patients were excluded for major protocol violations (two in the placebo group and three in the regorafenib group), leaving 38 patients who were evaluable for efficacy (12 in the placebo group and 26 in the regorafenib group). 17 of 26 patients (65%; one-sided 95% CI 47%) in the regorafenib group were non-progressive at 8 weeks compared with no patients in the placebo group. Ten patients in the placebo group crossed over to receive open-label regorafenib after centrally confirmed disease progression. 13 treatment-related serious adverse events occurred in seven (24%) of 29 patients in the regorafenib group versus none of 14 patients in the placebo group. The most common grade 3 or worse treatment-related adverse events during the double-blind period of treatment included hypertension (in seven [24%] of 29 patients in the regorafenib group vs none in the placebo group), hand-foot skin reaction (three [10%] vs none), fatigue (three [10%] vs one [3%]), hypophosphataemia (three [10%] vs none), and chest pain (three [10%] vs none). No treatment-related deaths occurred. INTERPRETATION Regorafenib demonstrated clinically meaningful antitumour activity in adult patients with recurrent, progressive, metastatic osteosarcoma after failure of conventional chemotherapy, with a positive effect on delaying disease progression. Regorafenib should be further evaluated in the setting of advanced disease as well as potentially earlier in the disease course for patients at high risk of relapse. Regorafenib might have an important therapeutic role as an agent complementary to standard cytotoxic chemotherapy in the therapeutic armamentarium against osteosarcoma. FUNDING Bayer HealthCare.
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Affiliation(s)
- Florence Duffaud
- Medical Oncology Unit, Aix Marseille University, APHM Hôpital La Timone, Marseille, France.
| | - Olivier Mir
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | | | - Nicolas Penel
- Medical Oncology Department, Centre Oscar Lambret and Lille University Hospital, Lille, France
| | - Emanuelle Bompas
- Medical Oncology Department, Centre René Gauduchau, Saint Herblain, France
| | | | - Elsa Kalbacher
- Medical Oncology Department, CHRU Jean Minjoz, Besançon, France
| | - Antoine Italiano
- Medical Oncology Department, Institut Bergonié, Bordeaux, France
| | - Olivier Collard
- Medical Oncology Department, Institut de Cancérologie de la Loire Lucien Neuwirth, St Priest en Jarez, France
| | - Christine Chevreau
- Medical Oncology Department, Institut Universitaire de Cancérologie de Toulouse, Oncopole, Toulouse, France
| | - Esma Saada
- Medical Oncology Department, Centre Antoine Lacassagne, Nice, France
| | | | | | | | - Corinne Bouvier
- Pathology Department, Aix Marseille University, APHM Hôpital La Timone, Marseille, France
| | - Vincent Vidal
- Radiology Department, Aix Marseille University, APHM Hôpital La Timone, Marseille, France
| | - Sylvie Chabaud
- Department of Statistics, Centre Léon Bérard, Lyon, France
| | - Jean-Yves Blay
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
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Passildas J, Collard O, Savoye AM, Dohou J, Ginzac A, Thivat E, Durando X, Kwiatkowski F, Penault-Llorca F, Abrial C, Mouret-Reynier MA. Impact of Chemotherapy-induced Menopause in Women of Childbearing Age With Non-metastatic Breast Cancer - Preliminary Results From the MENOCOR Study. Clin Breast Cancer 2018; 19:e74-e84. [PMID: 30448088 DOI: 10.1016/j.clbc.2018.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/26/2018] [Accepted: 10/14/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Young patients with breast cancer treated with chemotherapy can experience ovarian failure, which can lead to chemotherapy-induced menopause (CIM) impacting the quality of life (QoL). A prospective study was set out to evaluate the impact of CIM on QoL in women of childbearing age with non-metastatic breast cancer, and this article reports results of the interim analysis conducted to evaluate feasibility and to see preliminary results. PATIENTS AND METHODS A total of 58 women (age, 18-46 years) with newly diagnosed breast cancer and treated with chemotherapy were eligible. QoL was assessed by self-administered questionnaires (Quality of Life Questionnaire-Core 30 [QLQ-C30], Quality of Life Questionnaire-Breast 23 [QLQ-BR23], and Kupperman index) and hormonal variations (anti-Müllerian hormone [AMH], follicle-stimulating hormone, and estradiol) were explored. We compared patients with ≥ 12 months amenorrhea (CIM) (n = 41) to patients with < 12 months of amenorrhea (non-CIM) (n = 17). RESULTS A good inclusion rate (approximately 4/month) and sufficient data enabled us to perform this analysis. QLQ-C30 failed to show any difference between CIM and non-CIM patients (P = .5). In contrast, at 6 months post-chemotherapy, CIM patients tended to have lower QoL as shown by QLQ-BR23 (P = .16) and more severe climacteric symptoms (P = .01). Regarding hormonal variations, AMH pre-treatment level was higher in non-CIM patients (P = .0032). We also noted that CIM patients were older (P = .00013), had shorter menstruation cycle (P = .082), and experienced faster amenorrhea (P = .088). CONCLUSIONS The study is technically feasible, and our preliminary results underline that age in association with pre-treatment AMH level could be helpful to predict ovarian function. QLQ-BR23 seemed to be stronger, more precise, and appropriate to evaluate QoL changes in patients with breast cancer than the QLQ-C30.
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Affiliation(s)
- Judith Passildas
- Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France.
| | - Olivier Collard
- Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez, France
| | | | - Joyce Dohou
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Angeline Ginzac
- Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Emilie Thivat
- Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Xavier Durando
- Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Fabrice Kwiatkowski
- Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Frédérique Penault-Llorca
- Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Catherine Abrial
- Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Marie-Ange Mouret-Reynier
- Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
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Callejo Goena A, Faouzi S, Bouche O, Chevalier T, Isambert N, Duffaud F, Collard O, Mir O, Terrier P, Blay JY, Le Cesne A. Multicentric retrospective analysis of patients with KIT exon 9 mutated GIST. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.016] [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: 11/15/2022] Open
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Bouché O, Cesne AL, Rios M, Chaigneau L, Italiano A, Duffaud F, Lecomte T, Arsène D, Manfredi S, Aparicio T, Remy S, Isambert N, Collard O, Priou F, Bertucci F, Sambuc R, Bisot-Locard S, Bourges O, Chabaud S, Blay JY. EPIGIST: An observational real-life study on patients with metastatic gastrointestinal stromal tumors receiving imatinib. PLoS One 2018; 13:e0204117. [PMID: 30226855 PMCID: PMC6143255 DOI: 10.1371/journal.pone.0204117] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 09/04/2018] [Indexed: 11/30/2022] Open
Abstract
Background Gastrointestinal stromal tumors (GISTs) are rare, but represent the most common mesenchymal neoplasms of the gastrointestinal tract. EPIdemiology GIST, is an observational multicenter longitudinal follow-up cohort study reporting the prescribing patterns of imatinib in patients with GIST and the impact of the treatment in a real-world (standard clinical) setting. Methods Eligible patients had a confirmed diagnosis of unresectable or metastatic KIT-positive GIST and started treatment with imatinib for the first time between May 24, 2002, and June 30, 2010. During routine visits, annual collection of clinical characteristics was requested, i.e., age, GIST stage at diagnosis, history, imatinib treatment duration and dosage, adherence, and concomitant medications. Survival outcomes were estimated using the Kaplan-Meier method. Other data were analyzed using descriptive statistics. Results Of 151 patients enrolled, imatinib was initiated for 126 patients before enrollment and for 25 patients on the day of enrollment or soon after. The patient characteristics were similar to those in published prospective trials. The estimated 1-, 2-, 3-, and 4-year overall survival rates were 90.4% (95% confidence interval [CI; 84.8%-94.0%]), 84.7% (95% CI [78.1%-89.4%]), 73.0% (95% CI [65.0%-79.4%]), and 60.7% (95% CI [51.4%-68.8%]), respectively. The most common adverse events (AEs) were diarrhea (39%), asthenia (39%), eyelid or periorbital edema (32%), abdominal pain (23%), and anemia (21%). Eight of 126 serious AEs were possibly related to the treatment as assessed by investigators. Conclusions Study results showed that patients in real-life populations are generally treated in accordance with national and international clinical recommendations and have outcomes comparable to those of patients in clinical trials.
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Affiliation(s)
- Olivier Bouché
- Department of Digestive Oncology, University Hospital, Reims, France
- * E-mail:
| | - Axel Le Cesne
- Department of Cancer Medicine, Institut Gustave Roussy, Villejuif, France
| | - Maria Rios
- Department of Medical Oncology, Institut de Cancérologie de Lorraine—Alexis Vautrin, Nancy, France
| | - Loic Chaigneau
- Department of Medical Oncology, Centre J. Minjoz Universitary Hospital Center, Besançon, France
| | - Antoine Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Florence Duffaud
- Department of Medical Oncology, La Timone University Hospital, Marseille and Aix -Marseille University (AMU), Marseille, France
| | - Thierry Lecomte
- Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital Trousseau, Tours, France
| | - Dominique Arsène
- Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital Caen Normandy, Caen, France
| | - Sylvain Manfredi
- Department of Gastroenterology Oncology, University Hospital Dijon, Dijon, France
| | - Thomas Aparicio
- Department of Medical Oncology, University Hospital Saint Louis, Paris, France
| | - Stéphane Remy
- Department of Medical Oncology, Clinique Paulmy, Bayonne, France
| | - Nicolas Isambert
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Olivier Collard
- Department of Medical Oncology, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Frank Priou
- Department of Medical Oncology, Les Oudairies hospital CHD Vendée, La Roche sur Yon, France
| | - François Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Roland Sambuc
- Department of Public Health, La Conception Hospital, Marseille, France
| | | | - Olivier Bourges
- Oncology Business Unit, Novartis Pharma S.A.S., Rueil-Malmaison, France
| | | | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
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Duffaud F, Blay JY, Mir O, Boudou-Rouquette P, Piperno-Neumann S, Penel N, Bompas E, Delcambre C, Kalbacher E, Italiano A, Collard O, Chevreau C, Thyss A, Isambert N, Delaye J, De Sousa Carvalho N, Schiffler C, Bouvier C, Vidal V, Chabaud S. Results of randomized, placebo (PL)-controlled phase II study evaluating efficacy and safety of regorafenib (REG) in patients (pts) with metastatic osteosarcoma (metOS), on behalf of the French Sarcoma Group (FSG) and Unicancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.11504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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)
| | | | - Olivier Mir
- Gustave Roussy Cancer Campus, Villejuif, France
| | | | | | | | | | | | | | | | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest En Jarez, France
| | | | | | - Nicolas Isambert
- Service d'oncologie médicale CLCC Georges-François Leclerc, Dijon, France
| | | | | | | | - Corinne Bouvier
- Assistance Publique - Hopitaux De Marseille, Marseille, France
| | - Vincent Vidal
- Assistance Publique - Hôpitaux de Marseille, Marseille, France
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Garcia MA, Kalecinski J, Oriol M, Bonne A, Lofti M, Espenel S, Tinquaut F, Fournel P, Collard O, Vassal C, Rivoirard R, Regnier V, Chauvin F, Bourmaud A. Cancer patients treated with intravenous chemotherapy for the first time. What are their needs? What do they lack? A qualitative-quantitative mixed approach. Patient Prefer Adherence 2018; 12:1853-1861. [PMID: 30288026 PMCID: PMC6159784 DOI: 10.2147/ppa.s169810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION The announcement of cancer coupled with initiation of its treatment impacts patients' psychological and physical states as well as their lifestyles. The objective of this study was to identify and confirm the needs of patients starting off on anticancer chemotherapy treatment. METHODS This study was based on a qualitative-quantitative mixed method. In 2009, a qualitative study was conducted at the Lucien Neuwirth Cancer Institut for cancer patients undergoing intravenous chemotherapy for the first time. Exploratory and semi-directed interviews were carried out by a sociologist. In 2014, a questionnaire was hetero-administered to 100 patients starting off on chemotherapy. RESULTS Forty patients were interviewed in 2009. Ninety-seven patients answered the questionnaire in 2014. Food was a theme that was identified by a majority of patients in 2009 (13/40) and confirmed in 2014: 63% needed help in identifying favorable food and 67% in identifying those that had to be avoided. The other needs identified were those linked to better understanding of the treatment, of how it may affect the couple, its side effects, hygiene and beauty, and knowledge about other treatments. These needs were confirmed in 2014. New needs were elicited in 2014: activities and leisure (33%), psychological needs (32.6%), and family relations (29.9%). CONCLUSION This study enabled us to identify, confirm, and enrich our knowledge of the needs of cancer patients starting off on intravenous chemotherapy. These results led to the modification of an existing patient education program for these patients, in order to fulfill their needs in an updated and tailored manner.
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Affiliation(s)
- Max-Adrien Garcia
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
| | - Julie Kalecinski
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
| | - Mathieu Oriol
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
- Jean Monnet University, Saint Etienne, France
| | - Armand Bonne
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
| | - Mohamed Lofti
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
| | - Sophie Espenel
- Radiotherapy Department, Lucien Neuwirth Cancer Institut, Saint Priest en Jarez, France
| | - Fabien Tinquaut
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
| | - Pierre Fournel
- Medical Oncology Department, Lucien Neuwirth Cancer Institut, Saint Priest en Jarez, France
| | - Olivier Collard
- Medical Oncology Department, Lucien Neuwirth Cancer Institut, Saint Priest en Jarez, France
| | - Cécile Vassal
- Medical Oncology Department, Lucien Neuwirth Cancer Institut, Saint Priest en Jarez, France
| | - Romain Rivoirard
- Medical Oncology Department, Lucien Neuwirth Cancer Institut, Saint Priest en Jarez, France
| | - Véronique Regnier
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
- Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France,
| | - Franck Chauvin
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
- Jean Monnet University, Saint Etienne, France
- Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France,
| | - Aurélie Bourmaud
- Hygee Center, Lucien Neuwirth Cancer Institut, INSERM - CIC-EC, CIC 1408, Saint Priest en Jarez, France,
- Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France,
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Bourmaud A, Rousset V, Regnier-Denois V, Collard O, Jacquin JP, Merrouche Y, Lapoirie J, Tinquaut F, Lataillade L, Chauvin F. Improving Adherence to Adjuvant Endocrine Therapy in Breast Cancer Through a Therapeutic Educational Approach: A Feasibility Study
. Oncol Nurs Forum 2017; 43:E94-E103. [PMID: 27105205 DOI: 10.1188/16.onf.e94-e103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To develop and test the feasibility of a tailored therapeutic educational program, with the aim of improving adherence to oral endocrine adjuvant chemotherapy in women with breast cancer.
. DESIGN A qualitative study to identify educational needs and a feasibility study assessing the efficacy of the program.
. SETTING A comprehensive cancer center, the Lucien Neuwirth Cancer Institute in Saint-Priest-en-Jarez, France.
. SAMPLE Two consecutive samples (N = 11, N = 6) of women taking adjuvant oral endocrine chemotherapy for breast cancer.
. METHODS A mixed qualitative and quantitative method was used. The participants' representations of disease and treatment were explored through one-on-one interviews and then translated into educational needs, which were used to develop a tailored therapeutic education program. The pilot study evaluated the reach and efficacy using before-and-after comparisons.
. MAIN RESEARCH VARIABLES Educational objectives, knowledge, trust in the treatment, and anxiety.
. FINDINGS Five educational objectives (acquiring knowledge, improving communication skills, managing anxiety, managing side effects, and improving adherence) were identified through 11 interviews. A three-session program was developed. Eight of the 23 patients invited to participate in a pilot study accepted, and six completed the intervention. Knowledge improved from 38.9 of 100 preintervention to 69.4 of 100 postintervention (p = 0.045). Trust in treatment showed a trend to improvement from 5.5 of 10 to 8 of 10 (p = 0.14), but anxiety did not change significantly; anxiety went from 6 to 7 (p = 0.88).
. CONCLUSIONS Results from the feasibility study showed promising efficacy for the educational objectives and provided information about how the program could be improved.
. IMPLICATIONS FOR NURSING Tailored educational programs conducted by trained nurses may help patients to adhere to and live with the effects of endocrine therapy.
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Duffaud F, Auclin E, Italiano A, Mancini J, Bertucci F, Penel N, Pracht M, Vogin G, Collard O, Bompas E, Landi B, Valentin T, Chaigneau L, Toulmonde M, Adenis A, Ray-Coquard IL, Rios M, Salas SB, Le Cesne A, Blay JY. Long-term survival (over 10 years) of inoperable/metastatic GISTs: A retrospective series of 141 patients (pts) of the french sarcoma group (FSG). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.11041] [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
11041 Background: A subset of metastatic GIST exhibit very long-term survival after imatinib (IM) introduction. The aim of this study was to analyse the clinico-biological characteristics of GIST pts alive > 10 years (yrs) after diagnosis (dx) of metastases (mets) and identify possible factors associated with long-term survival. Methods: Pts were identified from 2 sarcoma databases; NetSarc and ConticaGIST. Clinical data prospectively registered in the databases were supplemented with retrospective review of medical records. Results: We identified 141 pts (75 men, 66 women) with median age 54 (17-84) yrs and median ECOG 0 (0-2). Primary tumors (T) were all CD117+, and mainly gastric or intestinal (64 & 45 pts), with median size 10 (2-40) cm, CD34+ (82 pts), mitoses/50 HPF ≤ 5 (n = 36), or > 5 (n = 81). Genotype was documented in 82 (58%) pts with 73 (89%) KIT mutations (in exons 11,9 and 12 of 69, 3, and 1 pts respectively) and 9 WT KIT. 129 (91%) T were resected, 124 upfront, 5 post IM, with R0/R1/R2 resections in 61, 11, and 10 pts. Mets were mainly hepatic or peritoneal (78 & 51 respectively). 1st line TKI was given to 139 pts: 130 received IM; 88 (63%) within a clinical trial (CT), 41 (29%) had mets resection. Second, 3d and 4th line TKI were given to 81, 51 and 37 pts respectively, comprising 27, 7 and 10 from CT. Median number of TKIs was 2 (0-7), but 60 (44%) pts received only 1st line with no GIST progression within or after 10 yrs. 2 pts never received TKI but had mets resection. After median FU of 14.3 yrs (10-34.5), 104 remain alive, 37 died. Mean and Median OS from initial dx are 24 yrs (CI95% 21.6-27) and 20,8 yrs. Median PFS on TKIs are 127, 29, 21 and 22 mos on 1st, 2d, 3d and 4th line of TKI. In univariate analysis no factor is significantly associated with OS, but T size (≤ 10 vs > 10 cm) and oligometastatic disease (≤5 vs > 5 mets) are borderline significant (p = 0.056 and 0.07), and good PS (ECOG ≤ 1) at 2dline TKI initiation is associated with better PFS (p = 0.03). Conclusions: This large series of long-term ( > 10 yrs) survivors of metastatic GIST shows a high proportion of mets resection and a longer duration of PFS for TKI at any line. In this selected population, no prognostic factor is associated with long OS.
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Affiliation(s)
| | - Edouard Auclin
- Medical and Gastrointestinal Oncology Department, Georges Pompidou Hospital; Methodology and Quality of Life Unit in Oncology (INSERM UMR 1098), University Hospital of Besançon, Paris, France
| | | | | | | | | | - Marc Pracht
- Service d'Oncologie Médicale, Centre Eugene Marquis, Rennes, France
| | - Guillaume Vogin
- Institut de Cancérologie de Lorraine, Département de Radiothérapie, Vandoeuvre-Les-Nancy, France
| | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest en Jarez, France
| | | | - Bruno Landi
- Hospital European Georges Pompidou, Clamart, France
| | | | - Loic Chaigneau
- Institut Regional du Cancer en Franche-Comté - University Hospital, Besançon, France
| | - Maud Toulmonde
- Institut Bergonié, Department of Medical Oncology, Bordeaux, France
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Lebellec L, Bertucci F, Tresch-Bruneel E, Ray-Coquard IL, Le Cesne A, Bompas E, Piperno-Neumann S, Italiano A, Chevreau C, Cupissol D, Bay JO, Collard O, Saada-Bouzid E, Isambert N, Delcambre C, Blay JY, Goncalves A, Penel N. Weekly paclitaxel (WP) +/- bevacizumab (B) in angiosarcoma (AS) patients (pts): Analysis of prognostic/predictive factors from a randomized phase 2 trial. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.11024] [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
11024 Background: WP is an active regimen for treatment of AS pts (Ray-Coquard JCO 2015). We report here the correlative analysis conducted during a phase 2 trial assessing WP +/- B. Methods: Circulating pro/anti-angiogenic factors (FGF, PlGF, SCF, Selectin, thrombospondin, VEGF, VEGF-C) were collected at D1 and D8. Prognostic value for PFS was assessed using Cox model (biomarkers as continuous variables). We attempt to identify subgroups of pts benefiting from adding B using interaction tests (predictive factors). Results: Among the 51 pts enrolled in this trial, 45 were analyzable: 20 in Arm A (WP without B) and 25 in Arm B (with B). Median PFS was 5.5 and 6.1 months, respectively (p = 0.84). Samples were collected in 45 pts at D1 and 42 pts at D1 and 8. Baseline biomarkers were similar in both arms (excluding Selectin, significantly lower in arm A: median of 25 vs. 35 ng/mL, p = 0.03). In arm A, there was no significant difference between values at D1 and D8. In arm B, there were a significant decrease in VEGF (from a median of 0.49 to 0.08 ng/mL; p < 0.01) and selectin (from a median of 35.3 to 31.7 ng/mL; p < 0.01), and a significant increase in PlGF (from a median of 16.1 to 30.0 pg/mL; p < 0.01). In univariate analysis, factors associated with PFS were: de novo vs. radiation-induced AS (HR = 2.39 (p < 0.01), visceral vs. superficial AS (HR = 2.04; p < 0.03), VEGF-C at D1 (HR = 0.77; p < 0.03), FGF at D8 (HR = 1.17; p < 0.01), difference in FGF D8-D1 (HR = 1.24; p < 0.01), and PlGF value at D1 (HR = 1.02; p < 0.05). In multivariate analysis, factors associated with PFS were: de novo AS (HR = 2.39; p = 0.03), VEGF-C at D1 (HR = 0.73; p < 0.02) and FGF difference between D8 and D1 (HR = 1.16; p < 0.02). None of these factors were associated with benefit of adding B. Conclusions: Baseline VEGF-C levels and change in FGF were independent prognostic factors in pts with or without B. Addition of B significantly decreased the level of circulating VEGF and selectin and increased the level of circulating PlGF in AS patients. We did not identify subgroup of pts benefiting from adding of B to WP. Clinical trial information: NCT01303497.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Didier Cupissol
- Institut de Cancérologie de Montpellier, Montpellier, France
| | - Jacques-Olivier Bay
- Cellular Therapy and Clinic Hematology Unit for Adults, Clermont-Ferrand, France
| | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest en Jarez, France
| | | | | | | | | | - Anthony Goncalves
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
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Ray-Coquard I, Collard O, Ducimetiere F, Laramas M, Mercier F, Ladarre N, Manson S, Tehard B, Clippe S, Suchaud JP, Stefani L, Blay JY. Treatment patterns and survival in an exhaustive French cohort of pazopanib-eligible patients with metastatic soft tissue sarcoma (STS). BMC Cancer 2017; 17:111. [PMID: 28173774 PMCID: PMC5297166 DOI: 10.1186/s12885-017-3057-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/11/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The French EMS study prospectively collected exhaustive data from STS patients diagnosed in the Rhone-Alpes region from 2005 to 07. METHODS The database included diagnosis/histology, surgery, radiotherapy, systemic treatments and treatment response. Treatment patterns and outcomes of patients with metastatic disease, excluding adipocytic sarcoma and GIST were analyzed. RESULTS Of 888 total patients, 145 were included based on having metastatic disease and appropriate subtypes. All patients received treatment with systemic therapy being most common (74%, n = 107), followed by radiotherapy (30%, n = 44) and surgery (23%, n = 33). Doxorubicin, alone or in combination, was the most common first line systemic therapy (65%, n = 46). Drugs without license in sarcoma were used in 38-83% of treatments depending on treatment line. 24% of frontline patients demonstrated an objective response, decreasing to 11% objective responses in second line but no responses were documented beyond second line, with median PFS declining with each additional line. Median PFS also declined in patients receiving surgery compared to those receiving no surgery (8-15 m vs 5 m). Median OS from metastatic diagnosis for patients receiving systemic therapy was double that of patients without systemic treatment (24 m vs 12 m, p = 0.007). CONCLUSIONS Outcomes in this population were poor and declined with successive treatment. However, results suggest that further anticancer therapies in recurrent sarcoma might be beneficial.
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Affiliation(s)
- Isabelle Ray-Coquard
- Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France. .,Service D'oncologie Médicale, Centre Léon Bérard, 28, rue Laennec, 69008, Lyon, France.
| | - Olivier Collard
- Institut de Cancérologie de la Loire Lucien Neuwirth, 108 Bis av. Albert Raimond, 42270, Saint-Priest en Jarez, France
| | - Françoise Ducimetiere
- Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France
| | - Mathieu Laramas
- CHU de Grenoble, Avenue Maquis du Grésivaudan, 38700, La Tronche, France
| | | | - Nadine Ladarre
- Novartis, 2-4, rue Lionel Terray, Boite postale 308, F-92506, Rueil-Malmaison Cedex, France
| | - Stephanie Manson
- Novartis, Park View, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK
| | - Bertrand Tehard
- Novartis, 2-4, rue Lionel Terray, Boite postale 308, F-92506, Rueil-Malmaison Cedex, France
| | - Sébastien Clippe
- Centre Marie Curie, 137 Avenue de Romans, 26000, Valence, France
| | - Jean-Philippe Suchaud
- Service de Radiothérapie, Centre Hospitalier de Roanne, 28 Rue de Charlieu, 42300, Roanne, France
| | - Laetitia Stefani
- Centre Hospitalier Annecy-Genevois, 1 Avenue de l'Hôpital, 74370, Metz-Tessy, France
| | - Jean-Yves Blay
- Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France
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Derbel O, Heudel PE, Cropet C, Meeus P, Vaz G, Biron P, Cassier P, Decouvelaere AV, Ranchere-Vince D, Collard O, De Laroche E, Thiesse P, Farsi F, Cellier D, Gilly FN, Blay JY, Ray-Coquard I. Survival impact of centralization and clinical guidelines for soft tissue sarcoma (A prospective and exhaustive population-based cohort). PLoS One 2017; 12:e0158406. [PMID: 28158190 PMCID: PMC5291382 DOI: 10.1371/journal.pone.0158406] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 06/15/2016] [Indexed: 12/15/2022] Open
Abstract
Purpose The outcome of sarcoma has been suggested in retrospective and non-exhaustive studies to be better through management by a multidisciplinary team of experts and adherence to clinical practice guidelines (CPGs). The aim of this prospective and exhaustive population based study was to confirm the impact of adherence to CPGs on survival in patients with localized sarcoma. Experimental design Between 2005 and 2007, all evaluable adult patients with a newly diagnosis of localized sarcoma located in Rhone Alpes region (n = 634), including 472 cases of soft-tissue sarcoma (STS), were enrolled. The prognostic impact of adherence to CPGs on progression-free survival (PFS) and overall survival (OS) was assessed by multivariate Cox model in this cohort. Results The median age was 61 years (range 16–92). The most common subtypes were liposarcoma (n = 133, 28%), unclassified sarcoma (n = 98, 20.7%) and leiomyosarcoma (n = 69, 14.6%). In the initial management phase, from diagnosis to adjuvant treatment, the adherence to CPGs for patients with localized STS was 36% overall, corresponding to 56%, 85%, 96% and 84% for initial surgery, radiation therapy, chemotherapy and follow-up, respectively. Adherence to CPGs for surgery was the strongest independent prognostic factor of PFS, along with age, gender, grade, and tumor size. For OS, multivariate analysis adherence to CPGs for surgery was a strong independent prognostic factor, with an important interaction with a management in the regional expert centers. Conclusions This study demonstrates impact of CPGs and treatment within an expert center on survival for STS patients in a whole population-based cohort.
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Affiliation(s)
- Olfa Derbel
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
- * E-mail:
| | | | - Claire Cropet
- Department of Biostatistics, Centre Léon Bérard, Lyon, France
| | - Pierre Meeus
- Department of Surgery, Centre Léon Bérard, Lyon, France
- Groupe Sarcome Français, Groupe d’Etude des Tumeurs Osseuses (GSF-GETO), Lyon France
| | - Gualter Vaz
- Department of Surgery, Centre Léon Bérard, Lyon, France
- Groupe Sarcome Français, Groupe d’Etude des Tumeurs Osseuses (GSF-GETO), Lyon France
- Department of Orthopedic Surgery, Clinique des IRIS, Lyon, France
| | - Pierre Biron
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Philippe Cassier
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Dominique Ranchere-Vince
- Groupe Sarcome Français, Groupe d’Etude des Tumeurs Osseuses (GSF-GETO), Lyon France
- Department of Pathology, Centre Léon Bérard, Lyon, France
| | - Olivier Collard
- Groupe Sarcome Français, Groupe d’Etude des Tumeurs Osseuses (GSF-GETO), Lyon France
- Institut de Cancérologie Lucien Neuwirth, Saint-Priest en Jarez, France
| | - Eric De Laroche
- Institut de Cancérologie Lucien Neuwirth, Saint-Priest en Jarez, France
| | | | | | - Dominic Cellier
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
- Groupe Sarcome Français, Groupe d’Etude des Tumeurs Osseuses (GSF-GETO), Lyon France
- Réseau Espace Santé Cancer, Rhône-Alpes, France
- Claude Bernard University, Lyon, France
- Laboratoire HESPER EA 7425, Lyon 1 University, Lyon, France
| | - Isabelle Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
- Groupe Sarcome Français, Groupe d’Etude des Tumeurs Osseuses (GSF-GETO), Lyon France
- Réseau Espace Santé Cancer, Rhône-Alpes, France
- Claude Bernard University, Lyon, France
- Laboratoire HESPER EA 7425, Lyon 1 University, Lyon, France
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Affiliation(s)
- Georgia Karpathiou
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
| | - Fabrice Guy Barral
- Department of Radiology, North Hospital, University Hospital of St-Etienne, France
| | - Cyril Habougit
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
| | - Vanessa Da Cruz
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
| | - Fabien Forest
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
| | | | - Michel Peoc'h
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
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Mir O, Brodowicz T, Italiano A, Wallet J, Blay JY, Bertucci F, Chevreau C, Piperno-Neumann S, Bompas E, Salas S, Perrin C, Delcambre C, Liegl-Atzwanger B, Toulmonde M, Dumont S, Ray-Coquard I, Clisant S, Taieb S, Guillemet C, Rios M, Collard O, Bozec L, Cupissol D, Saada-Bouzid E, Lemaignan C, Eisterer W, Isambert N, Chaigneau L, Cesne AL, Penel N. Safety and efficacy of regorafenib in patients with advanced soft tissue sarcoma (REGOSARC): a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Oncol 2016; 17:1732-1742. [DOI: 10.1016/s1470-2045(16)30507-1] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/22/2016] [Accepted: 08/23/2016] [Indexed: 12/19/2022]
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Mery B, Moriceau G, Rivoirard R, Collard O. [Not Available]. Rev Prat 2016; 66:e291-e297. [PMID: 30512312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Benoîte Mery
- Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France
| | - Guillaume Moriceau
- Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France
| | - Romain Rivoirard
- Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France
| | - Olivier Collard
- Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France
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Mery B, Moriceau G, Rivoirard R, Collard O. [Not Available]. Rev Prat 2016; 66:e298. [PMID: 30512313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Benoîte Mery
- Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France
| | - Guillaume Moriceau
- Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France
| | - Romain Rivoirard
- Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France
| | - Olivier Collard
- Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France
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Méry B, Ndong SM, Guy JB, Assouline A, Falk AT, Valeille A, Trone JC, Rivoirard R, Auberdiac P, Vallard A, Espenel S, Moriceau G, Collard O, Bosacki C, Jacquin JP, de Laroche G, Fournel P, Chargari C, Magné N. Radiotherapy for gynecologic cancer in nonagenarian patients: a framework for new paradigms. Chin J Cancer 2016; 35:43. [PMID: 27160517 PMCID: PMC4862062 DOI: 10.1186/s40880-016-0104-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 04/18/2016] [Indexed: 11/10/2022]
Abstract
No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients. We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer (6 endometrial cancers, 6 cervical cancers, 4 vulvar cancers, and 3 vaginal cancers) who were treated with radiotherapy. Radiotherapy was performed mainly in a palliative setting (n = 12; 63.2%), with a median dose of 45 Gy (range, 6-76 Gy). Infrequent major acute or late toxicities were reported. Among 19 patients, 9 (47.4%) experienced tumor progression, 5 (26.3%) experienced complete response, 2 (10.5%) experienced stable disease and/or partial response. At last follow-up, 12 patients (63.2%) had died; most deaths (n = 9) occurred because of the cancer. These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.
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Affiliation(s)
- Benoîte Méry
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Sylvie Mengue Ndong
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Jean-Baptiste Guy
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Avi Assouline
- Department of Radiotherapy, Porte De Saint Cloud Clinical Center, 92100, Boulogne-Billancourt, France
| | - Alexander T Falk
- Department of Radiation Oncology, Antoine Lacassagne Center, 06100, Nice, France
| | - Anaïs Valeille
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Jane-Chloé Trone
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Romain Rivoirard
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Pierre Auberdiac
- Department of Radiotherapy, Claude Bernard Private Hospital, 81000, Albi, France
| | - Alexis Vallard
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Sophie Espenel
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Guillaume Moriceau
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Olivier Collard
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Claire Bosacki
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Jean-Philippe Jacquin
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Guy de Laroche
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Pierre Fournel
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France
| | - Cyrus Chargari
- Department of Radiotherapy, Val-De-Grâce Military Hospital, 75230, Paris, France
| | - Nicolas Magné
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
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Molins E, Tinquaut F, Oriol M, Rousset V, Okala J, Fournel P, Collard O, Chauvin F, Bourmaud A. Pourquoi les patients refusent-ils de participer à l’éducation thérapeutique ? Une approche mixte pour expliquer le biais d’auto-sélection. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.03.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bouchet S, Poulette S, Titier K, Moore N, Lassalle R, Abouelfath A, Italiano A, Chevreau C, Bompas E, Collard O, Duffaud F, Rios M, Cupissol D, Adenis A, Ray-Coquard I, Bouché O, Le Cesne A, Bui B, Blay JY, Molimard M. Relationship between imatinib trough concentration and outcomes in the treatment of advanced gastrointestinal stromal tumours in a real-life setting. Eur J Cancer 2016; 57:31-8. [PMID: 26851399 DOI: 10.1016/j.ejca.2015.12.029] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 12/30/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND Imatinib has dramatically improved the prognosis of advanced gastrointestinal stromal tumours (GISTs). Clinical trial data showed that patients with trough imatinib plasma concentrations (Cmin) below 1100 ng/ml (quartile 1) had shorter time to progression, but no threshold has been defined. The main objective of this study was to investigate in advanced GIST whether a Cmin threshold value associated with a longer progression-free survival (PFS) could be specified. This would be the first step leading to therapeutic drug monitoring of imatinib in GIST. PATIENTS AND METHODS Advanced GIST patients (n=96) treated with imatinib 400 mg/d (41 stomach, 34 small bowel, and 21 other primary site localisations) were prospectively included in this real-life setting study. Routine plasma level testing imatinib (Cmin) and clinical data of were recorded prospectively. RESULTS Small bowel localisation was associated with an increased relative risk of progression of 3.09 versus stomach localisation (p=0.0255). Mean Cmin (±standard deviation) was 868 (±536) ng/ml with 75% inter-individual and 26% intra-patient variability. A Cmin threshold of 760 ng/ml defined by log-rank test was associated with longer PFS for the whole population (p=0.0256) and for both stomach (p=0.043) and small bowel (p=0.049) localisations when analysed separately. Multivariate Cox regression analysis found that Cmin above 760 ng/ml was associated with 65% reduction risk of progression (p=0.0271) in the whole population independently of the anatomical localisation. CONCLUSION Concentration of imatinib significantly influences duration of tumour control treatment in GIST patients with a Cmin threshold of 760 ng/ml associated with prolonged PFS in real-life setting.
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Affiliation(s)
- Stéphane Bouchet
- Univ. de Bordeaux, Bordeaux, F-33000, France; INSERM, U1219, Bordeaux, F-33000, France; CHU de Bordeaux, Bordeaux, F-33000, France
| | | | - Karine Titier
- Univ. de Bordeaux, Bordeaux, F-33000, France; INSERM, U1219, Bordeaux, F-33000, France; CHU de Bordeaux, Bordeaux, F-33000, France
| | - Nicholas Moore
- Univ. de Bordeaux, Bordeaux, F-33000, France; INSERM, U1219, Bordeaux, F-33000, France; CHU de Bordeaux, Bordeaux, F-33000, France
| | - Régis Lassalle
- Univ. de Bordeaux, Bordeaux, F-33000, France; INSERM CIC Bordeaux CIC1401 Pharmaco-épidemiologie, Bordeaux, F-33000, France
| | - Abdelilah Abouelfath
- Univ. de Bordeaux, Bordeaux, F-33000, France; INSERM CIC Bordeaux CIC1401 Pharmaco-épidemiologie, Bordeaux, F-33000, France
| | | | - Christine Chevreau
- Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, F-31300, France
| | | | - Olivier Collard
- Institut de Cancérologie Lucien Neuwirth, Saint Priest-en-Jarez, F-42270, France
| | - Florence Duffaud
- CHU La Timone, Marseille, F-13385, France; Aix Marseille Université (AMU), France
| | - Maria Rios
- Institut de Cancérologie de Lorraine - Alexis Vautrin, Nancy, F-54500, France
| | | | | | - Isabelle Ray-Coquard
- Centre Léon Bérard, Lyon, F-69008, France; Université Claude Bernard Lyon 1, France
| | | | | | - Binh Bui
- Institut Bergonié, Bordeaux, F-33000, France
| | - Jean-Yves Blay
- Centre Léon Bérard, Lyon, F-69008, France; Université Claude Bernard Lyon 1, France
| | - Mathieu Molimard
- Univ. de Bordeaux, Bordeaux, F-33000, France; INSERM, U1219, Bordeaux, F-33000, France; CHU de Bordeaux, Bordeaux, F-33000, France.
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Moriceau G, Guillot A, Pacaut C, Méry B, Falk AT, Trone JC, Collard O, De Laroche G, Fournel P, Merrouche Y, Magné N. Translating Clinical Evidence-Based Medicine into the Real World: Single-Center Experience with Cabazitaxel in Metastatic Prostate Cancer Patients. Chemotherapy 2016; 61:127-33. [DOI: 10.1159/000441379] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/28/2015] [Indexed: 11/19/2022]
Abstract
Background: We studied the efficacy and safety of cabazitaxel in unselected real-life patients. Patients and Methods: We retrospectively investigated all patients with metastatic prostate cancer (mPC) treated with cabazitaxel 25 mg/m2 i.v. every 3 weeks combined with oral prednisolone (10 mg once daily) after first-line docetaxel chemotherapy. Study issues were to report patient characteristics and cabazitaxel data in terms of tolerance and efficacy. Overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method. All data were compared with TROPIC results. Results: From 2011 to 2014, 41 patients received cabazitaxel; 15 patients (37%) had a performance status (PS) ≥2 versus 7% (p < 0.0001) in TROPIC, and 38 patients (93%) presented a Gleason score ≥7 at baseline (vs. 60%; p < 0.0001). All patients had metastatic disease at baseline. Previous therapies were radiotherapy in 17 patients (41 vs. 61%; p = 0.01) and surgery in 24 patients (59 vs. 52%; p = 0.4). The median number of cabazitaxel cycles was 5 (1-10) versus 6 (3-10) in TROPIC. Five patients completed 10 cycles of cabazitaxel (12%) versus 28% in TROPIC (p = 0.03). Toxicities were anemia (12 patients, 29%), diarrhea (9 patients, 22%), nausea (7 patients, 17%), pain (6 patients, 15%), sepsis (4 patients, 10%), neutropenia (3 patients, 7%) and urinary tract infection (1 patient, 2%). The tumor response rate was 19.5 versus 14.4% in TROPIC (nonsignificant). PFS was 4.5 months (95% CI 3.3-6.4) in our analysis and 2.8 months (95% CI 2.4-3.0) in TROPIC. OS was 12.1 months (95% CI 9.2 to not reached) and 15.1 months (95% CI 14.1-16.3), respectively. Conclusion: In our unselected mPC patients with poorer baseline clinical conditions and aggressive disease, cabazitaxel seems efficient and not more toxic than in the TROPIC study.
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Moriceau G, Vallard A, Méry B, Rivoirard R, Langrand-Escure J, Espenel S, Ben Mrad M, Wang G, Diao P, Fournel P, Collard O, Magné N. What makes real world outcomes in soft tissue sarcomas? A mono-institutional trabectedin experience. Bull Cancer 2015; 102:814-22. [PMID: 26384694 DOI: 10.1016/j.bulcan.2015.07.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 07/08/2015] [Accepted: 07/21/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Trabectedin proved its efficacy in relapsed advanced soft tissue sarcomas (STS) in 3 multicenter phase II studies with selected patients. The aim of the present study is to investigate trabectedin efficacy and tolerance in a cohort of "real-life" unselected patients with sarcoma. METHODS A single-center analysis was carried out on all consecutive patients with histologically proven unresectable advanced or metastatic STS, who received at least one cycle of trabectedin. Data on efficacy and tolerance were retrospectively reported. RESULTS From 2004 to 2014, data of 59 patients were reviewed. Median age was 62 years (from 23 to 87). A total of 317 cycles of trabectedin were administered. Twenty-five patients (42%) suffered grade 3-4 hematological toxicity, mainly with neutropenia (22 patients, 37%). Disease control rate was 24%, mainly with stable disease, and 45 patients (76%) experienced disease progression. Median overall survival was 6.6 months (95%CI [4.9-12.6]). CONCLUSION Trabectedin might be an option for patients without any other validated alternative, but phase III study evaluating trabectedin+best supportive care (BSC) versus BSC is necessary.
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Affiliation(s)
- Guillaume Moriceau
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 42270 Saint-Priest-en-Jarez, France
| | - Alexis Vallard
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 42270 Saint-Priest-en-Jarez, France
| | - Benoîte Méry
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 42270 Saint-Priest-en-Jarez, France
| | - Romain Rivoirard
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 42270 Saint-Priest-en-Jarez, France
| | - Julien Langrand-Escure
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 42270 Saint-Priest-en-Jarez, France
| | - Sophie Espenel
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 42270 Saint-Priest-en-Jarez, France
| | - Majed Ben Mrad
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 42270 Saint-Priest-en-Jarez, France
| | - Guoping Wang
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 42270 Saint-Priest-en-Jarez, France
| | - Peng Diao
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 42270 Saint-Priest-en-Jarez, France
| | - Pierre Fournel
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 42270 Saint-Priest-en-Jarez, France
| | - Olivier Collard
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 42270 Saint-Priest-en-Jarez, France
| | - Nicolas Magné
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 42270 Saint-Priest-en-Jarez, France.
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Ray-Coquard IL, Domont J, Tresch-Bruneel E, Bompas E, Cassier PA, Mir O, Piperno-Neumann S, Italiano A, Chevreau C, Cupissol D, Bertucci F, Bay JO, Collard O, Saada-Bouzid E, Isambert N, Delcambre C, Clisant S, Le Cesne A, Blay JY, Penel N. Paclitaxel Given Once Per Week With or Without Bevacizumab in Patients With Advanced Angiosarcoma: A Randomized Phase II Trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.60.8505] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The aim of this randomized, phase II trial was to explore the activity and safety of adding bevacizumab to paclitaxel once per week in treatment of angiosarcomas (AS). Methods Patients were treated with paclitaxel alone (90 mg/m2 per week for six cycles of 28 days each; arm A) or with paclitaxel combined with bevacizumab (10 mg/kg once every 2 weeks; arm B). In the combination treatment arm, bevacizumab was administered after the six cycles of chemotherapy as maintenance therapy (15 mg/kg once every 3 weeks) until intolerance or progression occurred. Stratification factors were superficial versus visceral AS and de novo versus radiation-induced AS. The primary end point was the 6-month progression-free survival (PFS) rate, which was based on RECIST, version 1.1. Statistical assumptions were P0 = 20%, P1 = 40%, a = 10%, and b = 20%. P0 was the PFS rate at 6 months defining inactive drug, and P1 was the PFS rate at 6 months defining promising drug. Results A total of 52 patients were enrolled, and 50 were randomly assigned in 14 centers. The most common primary sites were the breast (49%) and skin (12%). There were 17 (34%) visceral and 24 (49%) radiation-induced AS. The performance status was 0 in 24 patients (49%) and 1 in the remaining 25 patients (51%). The median follow-up time was 14.5 months. Both treatment regimens were considered active, with 6-month PFS rates of 54% (14 of 26) in arm A and 57% (14 of 24) in arm B. The median overall survival rates were 19.5 months in arm A and 15.9 months in arm B. Toxicity was higher with the combination arm and included one fatal drug-related toxicity (intestinal occlusion). Conclusion The primary objective was met in both treatment arms. However, the present data do not support additional clinical investigation of combined paclitaxel/bevacizumab for the treatment of advanced AS.
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Affiliation(s)
- Isabelle L. Ray-Coquard
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Julien Domont
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Emmanuelle Tresch-Bruneel
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Emmanuelle Bompas
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Philippe A. Cassier
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Olivier Mir
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Sophie Piperno-Neumann
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Antoine Italiano
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Christine Chevreau
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Didier Cupissol
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - François Bertucci
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Jacques-Olivier Bay
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Olivier Collard
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Esma Saada-Bouzid
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Nicolas Isambert
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Corinne Delcambre
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Stéphanie Clisant
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Axel Le Cesne
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Jean-Yves Blay
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
| | - Nicolas Penel
- Isabelle L. Ray-Coquard, Philippe A. Cassier, and Jean-Yves Blay, Centre Léon Bérard and Claude Bernard University, Lyon; Julien Domont, Olivier Mir, and Axel Le Cesne, Gustave Roussy, Villejuif; Emmanuelle Tresch-Bruneel and Stéphanie Clisant, Centre Oscar Lambret; Nicolas Penel, Centre Oscar Lambret and Lille-Nord-de-France Medical School, Lille; Emmanuelle Bompas, Centre René Gauducheau, Nantes; Sophie Piperno-Neumann, Institut Curie, Paris; Antoine Italiano, Institut Bergonié, Bordeaux; Christine
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Bompas E, Le Cesne A, Tresch-Bruneel E, Lebellec L, Laurence V, Collard O, Saada-Bouzid E, Isambert N, Blay JY, Amela EY, Salas S, Chevreau C, Bertucci F, Italiano A, Clisant S, Penel N. Sorafenib in patients with locally advanced and metastatic chordomas: a phase II trial of the French Sarcoma Group (GSF/GETO). Ann Oncol 2015. [PMID: 26202596 PMCID: PMC4576908 DOI: 10.1093/annonc/mdv300] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is no consensual treatment of locally advanced or metastatic chordomas. PATIENTS AND METHODS We conducted a multicenter, open-label, uncontrolled phase II trial of sorafenib (800 mg/day). The primary end point was the 9-month progression-free rate according to RECIST 1.1. All patients had documented progressive disease at the time of study entry. RESULTS Twenty-seven patients were enrolled between May 2011 and January 2014. The median age was 64 (range, 30-86) years. There were 17 men and 10 women. Twelve patients had been previously treated with chemotherapy and molecularly targeted agents. The maximum toxicity grade per patient was grade 3 in 21 cases (77.8%) and grade 4 in 4 cases (14.8%). Sorafenib provided an intent-to-treat best objective response of 1/27 [3.7%; 95% confidence interval (CI) 0.1% to 19.0%], a 9-month progression-free rate of 73.0% (95% CI 46.1-88.0) and a 12-month overall survival rate of 86.5% (95% CI 55.8-96.5). Survival curves were similar in pretreated and not pretreated patients. DISCUSSION Additional clinical trials further exploring sorafenib as a treatment of locally advanced or metastatic chordomas are warranted.
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Affiliation(s)
- E Bompas
- Department of Medical Oncology, Centre René Gauducheau, Nantes
| | - A Le Cesne
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif
| | | | - L Lebellec
- Department of General Oncology, Centre Oscar Lambret, Lille
| | - V Laurence
- Department of Medical Oncology, Institut Curie, Paris
| | - O Collard
- Department of Medical Oncology, Institut de Cancérologie de la Loire, Lucien Neuwirth, Saint Priest en Jarez
| | - E Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice
| | - N Isambert
- Department of Medical Oncology, Centre GF Leclerc, Dijon
| | - J Y Blay
- Department of Medical Oncology, Centre Léon Bérard, Lyon
| | - E Y Amela
- Department of General Oncology, Centre Oscar Lambret, Lille
| | - S Salas
- Department of Medical Oncology, Hopital La Timone, Marseille
| | - C Chevreau
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse
| | - F Bertucci
- Department of Medical Oncology, Institut Paoli Calmette, Marseille
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux
| | - S Clisant
- Clinical Research Unit, Centre Oscar Lambret, Lille
| | - N Penel
- Department of General Oncology, Centre Oscar Lambret, Lille Clinical Research and Methodology Platform, SIRIC OncoLille Consortium, Lille, France
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Moriceau G, Vallard A, Rivoirard R, Méry B, Espenel S, Langrand-Escure J, Ben Mrad M, Wang G, Diao P, Pacaut C, Guillot A, Collard O, Fournel P, Magné N. Real-World Vinflunine Outcomes in Bladder Cancer in a Single-Institution Study: Moving Beyond Clinical Trials. Clin Genitourin Cancer 2015; 13:588-92. [PMID: 26117277 DOI: 10.1016/j.clgc.2015.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 05/29/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Intravenous vinflunine 320 mg/m(2) every 3 weeks plus best supportive care resulted in better overall survival in comparison with best supportive care alone for eligible patients with failure of prior therapy with locally advanced or metastatic transitional cell cancer of urothelial tract (TCCU). The objective of the present study was to describe our real-life experience of vinflunine for treatment of patients with TCCU. PATIENTS AND METHODS We retrospectively investigated all patients with TCCU who received at least 1 cycle of vinflunine. RESULTS Nineteen patients were treated between May 2010 and March 2014 in a compassionate-use program. Performance status was poor in our real-life cohort, with 6 patients (32%) with an Eastern Cooperative Oncology Group performance status of 2. Median duration of vinflunine treatment was 2.4 months (range, 0-4.3 months), and median number of cycles was 3 (range, 1-6). Total response rate was 32%, with partial responses only. Disease control rate was 53%, with a median duration of 7.7 months (range, 6.0-9.4 months). Median progression-free survival was 87 days, or 2.9 months (range, 0.7-11.7 months). After vinflunine treatment, 42% of patients received from 1 to 3 additional lines of chemotherapy. The most frequent grade 4 toxicities were constipation (26%), with 3 intestinal obstructions (16%) and 1 mechanical ileus (5%); and asthenia and fatigue (21%). CONCLUSION Vinflunine, as a TCCU second-line chemotherapy, brings benefits, particularly in cases where there is no alternative treatment.
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Affiliation(s)
- Guillaume Moriceau
- Medical Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Alexis Vallard
- Radiation Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Romain Rivoirard
- Medical Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Benoîte Méry
- Medical Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Sophie Espenel
- Radiation Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Julien Langrand-Escure
- Radiation Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Majed Ben Mrad
- Radiation Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Guoping Wang
- Radiation Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Peng Diao
- Radiation Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Cécile Pacaut
- Medical Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Aline Guillot
- Medical Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Olivier Collard
- Medical Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Pierre Fournel
- Medical Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Nicolas Magné
- Radiation Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France.
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Méry B, Trone JC, Moriceau G, Falk AT, Guillot A, Pacaut C, Collard O, Magné N. The Combination of 80 Years of Age and Metastatic Castration-Resistant Prostate Cancer Remain an Uphill Battle: A Case Report with Cabazitaxel as a Double-Edged Sword. Chemotherapy 2015; 60:300-1. [PMID: 25997418 DOI: 10.1159/000377620] [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] [Received: 12/12/2014] [Accepted: 02/02/2015] [Indexed: 11/19/2022]
Abstract
We report the case of an 80-year-old patient who presented with a progressive prostate metastatic cancer with poor performance status. The patient had already benefitted from docetaxel and abiraterone. A new line of chemotherapy by cabazitaxel was started with good response, and there was a dramatic improvement in general status and pain symptoms. Age and performance status alone should not be limiting decision factors for elderly cancer patients.
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Affiliation(s)
- Benoite Méry
- Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
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Amela E, Bompas E, Le Cesne A, Tresch E, Italiano A, Piperno-Neumann S, Collard O, Vansteene D, Domont J, Saada E, Isambert N, Salas S, Chevreau C, Bertucci F, DELAINE SCLISANT, Blay JY, Penel N. A phase II trial of sorafenib (SO) in advanced chordoma patients (pt). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.10520] [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)
| | - Emmanuelle Bompas
- Department of Medical Oncology, Centre René Gauducheau, Nantes St. Herblain, France
| | | | | | | | | | - Olivier Collard
- Institut de Cancérologie de la Loire, St. Priest en Jarez, France
| | - Damien Vansteene
- Institut de Cancerologie de l’Ouest – René Gauducheau, Nantes, France
| | | | | | | | | | | | | | | | - Jean-Yves Blay
- Centre Léon Bérard, Department of Medicine, Lyon, France
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Pautier P, Floquet A, Chevreau C, Penel N, Guillemet C, Delcambre C, Cupissol D, Selle F, Isambert N, Piperno-Neumann S, Thyss A, Bertucci F, Bompas E, Alexandre J, Collard O, Lavau-Denes S, Soulié P, Toulmonde M, Le Cesne A, Lacas B, Duffaud F. Trabectedin in combination with doxorubicin for first-line treatment of advanced uterine or soft-tissue leiomyosarcoma (LMS-02): a non-randomised, multicentre, phase 2 trial. Lancet Oncol 2015; 16:457-64. [PMID: 25795402 DOI: 10.1016/s1470-2045(15)70070-7] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Metastatic leiomyosarcomas of uterine or soft-tissue origin have poor prognosis and moderate chemosensitivity. Trabectedin has shown activity in pretreated leiomyosarcoma. We did a single-group, multicentre, phase 2 trial (LMS-02) to assess the effect of first-line doxorubicin and trabectedin combination on disease control and survival. METHODS Adults (18 years to physiological age ≤70 years) with measurable metastatic or unresectable uterine leiomyosarcoma or soft-tissue leiomyosarcoma who had not received any previous chemotherapy were enrolled at 19 centres in France. Treatment consisted of 60 mg/m(2) intravenous doxorubicin followed by 1·1 mg/m(2) trabectedin in a 3 h intravenous infusion on day 1, both by the central venous route, and 6 mg subcutaneous pegfilgrastim on day 2, repeated every 3 weeks for up to six cycles. Surgery for residual disease was permitted. The primary endpoint was the proportion of patients achieving disease control, defined as complete or partial response or stable disease. Stratification was done by anatomical site and analyses were per protocol. This study is registered with ClinicalTrials.gov, number NCT02131480. FINDINGS Between July 28, 2010, and May 10, 2013, 109 patients were enrolled and treated, of whom 108 were assessable for response: 47 in the uterine leiomyosarcoma group and 61 in the soft-tissue leiomyosarcoma group. 32 (68%) patients in the uterine leiomyosarcoma group and 45 (74%) in the soft-tissue leiomyosarcoma group received all six cycles of treatment. Of 47 patients with uterine leiomyosarcoma, 28 (59·6%, 95% CI 44·3-73·6) achieved a partial response and 13 (27·7%, 15·6-42·6) stable disease; 41 (87·2%, 74·3-95·2) patients achieved disease control. Of 61 patients with soft-tissue leiomyosarcoma, two (3·3%, 95% CI 0·4-11·7) achieved a complete response, 22 (36·1%, 25·0-50·8) had a partial response, and 32 (52·5%, 40·8-67·3) had stable disease; 56 (91·8%, 81·9-97·3) of patients achieved disease control. The most common grade 3-4 treatment-associated adverse events were neutropenia (84 [78%] of 108 patients), increased alanine aminotransferase concentration (42 [39%]), thrombocytopenia (40 [37%]), anaemia (29 [27%]), febrile neutropenia (26 [24%]), and fatigue (21 [19%]). INTERPRETATION Despite expected but manageable toxic effects, these results support the activity of doxorubicin plus trabectedin as first-line treatment for uterine leiomyosarcoma and soft-tissue leiomyosarcoma. This combination should be developed further in a phase 3 trial against the present standard of care. FUNDING Pharmamar and Amgen.
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Affiliation(s)
- Patricia Pautier
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France.
| | - Anne Floquet
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Christine Chevreau
- Department of Medical Oncology, Institut Claudius-Regaud, Toulouse, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar-Lambret, Lille, France
| | - Cécile Guillemet
- Department of Medical Oncology, Centre Henri-Becquerel, Rouen, France
| | - Corinne Delcambre
- Department of Medical Oncology, Centre François-Baclesse, Caen, France
| | - Didier Cupissol
- Department of Medical Oncology, Centre Val d'Aurelle, Montpellier, France
| | - Frédéric Selle
- Department of Medical Oncology, Hôpital Tenon, Paris, France
| | - Nicolas Isambert
- Department of Medical Oncology, Centre GF Leclerc, Dijon, France
| | | | - Antoine Thyss
- Department of Medical Oncology Centre Antoine Lacassagne, Nice, France
| | - François Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Emmanuelle Bompas
- Department of Medical Oncology, Centre René Gauducheau, Saint Herblain, France
| | | | - Olivier Collard
- Department of Medical Oncology, Institut de Cancérologie de la Loire, Saint Priest en Jarez, France
| | - Sandrine Lavau-Denes
- Department of Medical Oncology, Centre Hospitalo-Universitaire Dupuytren, Limoges, France
| | - Patrick Soulié
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - Maud Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Axel Le Cesne
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Benjamin Lacas
- Department of Biostatistics, Institut Gustave Roussy, Villejuif, France
| | - Florence Duffaud
- Department of Medical Oncology, La Timone University Hospital, Marseille, France
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Eberst L, Cropet C, Le Cesne A, Pautier P, Penel N, Adenis A, Chevreau C, Bay JO, Collard O, Cupissol D, Duffaud F, Gentet JC, Piperno-Neumann S, Marec-Berard P, Bompas E, Thyss A, Chaigneau L, Cassier P, Bertucci F, Blay JY, Ray-Coquard I. The off-label use of targeted therapies in sarcomas: the OUTC'S program. BMC Cancer 2014; 14:870. [PMID: 25420707 PMCID: PMC4289372 DOI: 10.1186/1471-2407-14-870] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 10/30/2014] [Indexed: 12/21/2022] Open
Abstract
Background Few targeted therapies (TTs) are registered for sarcoma treatment despite numerous phase II studies and yet there are potential treatment options for patients after standard treatment escape. The French Sarcoma Group - Bone Tumor Study Group (GSF-GETO) created a national registry to evaluate the outcome of patients treated with off-label TTs. Methods Every consecutive sarcoma-patient receiving an off-label TT outside a clinical trial was included. The objective was to describe this patient efficacy and safety data in routine practice. Results From October 2008 to October 2011, 249 patients in 24 centers received 278 treatment lines with TTs. Twenty-five histological subtypes were included: most frequent were leiomyosarcoma (n = 48, receiving sorafenib in 63%, and sunitinib in 27%), GIST (n = 39, receiving sorafenib in 79%), and angiosarcoma (n =18, receiving sorafenib in 78%). The overall response rate to TTs was 15% (95% CI [10,6-20,2]), the disease control rate at 2 months was 59%. The median progression-free survival was 4,1 months (IC 95% [3,2-4,8]). Three complete responses were observed. No toxic death occurred, grade 3 and 4 toxicities were reported in 74 (27%) and 14 patients (5%) respectively. Conclusion Off-label TTs can be used for sarcoma patients in routine practice with an acceptable toxicity profile and efficacy similar to that reported in non-randomized clinical trials. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-870) contains supplementary material, which is available to authorized users.
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Perrier L, Buja A, Mastrangelo G, Baron PS, Ducimetière F, Pauwels PJ, Rossi CR, Gilly FN, Martin A, Favier B, Farsi F, Laramas M, Baldo V, Collard O, Cellier D, Blay JY, Ray-Coquard I. Transferability of health cost evaluation across locations in oncology: cluster and principal component analysis as an explorative tool. BMC Health Serv Res 2014; 14:537. [PMID: 25399725 PMCID: PMC4241216 DOI: 10.1186/s12913-014-0537-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 10/17/2014] [Indexed: 11/10/2022] Open
Abstract
Background The transferability of economic evaluation in health care is of increasing interest in today’s globalized environment. Here, we propose a methodology for assessing the variability of data elements in cost evaluations in oncology. This method was tested in the context of the European Network of Excellence “Connective Tissues Cancers Network”. Methods Using a database that was previously aimed at exploring sarcoma management practices in Rhône-Alpes (France) and Veneto (Italy), we developed a model to assess the transferability of health cost evaluation across different locations. A nested data structure with 60 final factors of variability (e.g., unit cost of chest radiograph) within 16 variability areas (e.g., unit cost of imaging) within 12 objects (e.g., diagnoses) was produced in Italy and France, separately. Distances between objects were measured by Euclidean distance, Mahalanobis distance, and city-block metric. A hierarchical structure using cluster analysis (CA) was constructed. The objects were also represented by their projections and area of variability through correlation studies using principal component analysis (PCA). Finally, a hierarchical clustering based on principal components was performed. Results CA suggested four clusters of objects: chemotherapy in France; follow-up with relapse in Italy; diagnosis, surgery, radiotherapy, chemotherapy, and follow-up without relapse in Italy; and diagnosis, surgery, and follow-up with or without relapse in France. The variability between clusters was high, suggesting a lower transferability of results. Also, PCA showed a high variability (i.e. lower transferability) for diagnosis between both countries with regard to the quantities and unit costs of biopsies. Conclusion CA and PCA were found to be useful for assessing the variability of cost evaluations across countries. In future studies, regression methods could be applied after these methods to elucidate the determinants of the differences found in these analyses. Electronic supplementary material The online version of this article (doi:10.1186/s12913-014-0537-x) contains supplementary material, which is available to authorized users.
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