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Molinier O, Guguen C, Marcq M, Chene AL, Masson P, Bigot F, Denis F, Empereur F, Saulnier P, Urban T. A Comparative Multicenter Cohort Study Evaluating the Long-Term Influence of the Strict Lockdown during the First COVID-19 Wave on Lung Cancer Patients (ARTEMISIA Trial). Cancers (Basel) 2023; 15:5729. [PMID: 38136275 PMCID: PMC10742265 DOI: 10.3390/cancers15245729] [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: 11/09/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
The consequences of the strict health restrictions during the first wave of COVID-19 on lung cancer (LC) patients are not known. This cohort study evaluated the impact of the initial lockdown on management of and long-term outcome in LC patients. This exposed-unexposed-type study included two evaluation periods of 6 months each in non-selected patients; one began on the first day of lockdown in 2020, and the other in 2019 during the same calendar period. Various indicators were compared: clinical profiles, management delays and overall survival beyond 2 years. A total of 816 patients from 7 public or private centers were enrolled. The clinical characteristics of the patients in 2020 did not differ from those in 2019, except that the population was older (p = 0.002) with more non-smokers (p = 0.006). Delays for pre-therapeutic medical management were generally reduced after the first imaging in 2020 (1.28 [1.1-1.49]). In the multivariate analysis, being part of the 2020 cohort was correlated with better prognosis (HR = 0.71 [0.5-0.84], p < 0.001). The gain observed in 2020 mainly benefited non-smoking patients, along with ECOG PS 0-2 (p = 0.01), stage 4 (p = 0.003), squamous cell carcinoma (p = 0.03) and receiving systemic therapy (p = 0.03). In conclusion, the first lockdown did not exert any deleterious impact on LC patients.
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Affiliation(s)
- Olivier Molinier
- Respiratory Medicine Department, Hospital Center, 194 Avenue Rubillard, CEDEX 9, 72037 Le Mans, France
| | - Camille Guguen
- Respiratory Medicine Department, Hospital Center, 194 Avenue Rubillard, CEDEX 9, 72037 Le Mans, France
| | - Marie Marcq
- Respiratory Medicine Department, Hospital Center, 85925 La Roche-sur-Yon, France
| | - Anne-Laure Chene
- Respiratory Medicine Department, Thorax Institute, University Hospital Center, University of Nantes, 44093 Nantes, France
| | - Philippe Masson
- Respiratory Medicine Department, Hospital Center, 49300 Cholet, France
| | - Frédéric Bigot
- Oncology Department, Western Cancer Institute Paul Papin, 49105 Angers, France;
| | - Fabrice Denis
- Oncology Department, Clinique Victor Hugo, 72000 Le Mans, France;
| | | | - Philippe Saulnier
- Biostatistics Department, National Institute of Health and Medical Research, University of Angers, 49100 Angers, France
| | - Thierry Urban
- Respiratory Medicine Department, University Hospital Center, 49100 Angers, France;
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Dhamelincourt E, Descourt R, Rousseau-Bussac G, Doubre H, Decroisette C, Demontrond P, Le Garff G, Falchero L, Huchot E, Vieillot S, Corre R, Kazulinski L, Bizieux A, Bigay-Gamé L, Morel H, Molinier O, Chouaïd C, Guisier F. Clinical Characteristics of Patients with Advanced ALK-Translocated Non-small Cell Lung Cancers and Long-Term Responses to Crizotinib (CRIZOLONG GFPC 05-19 Study). Target Oncol 2023; 18:905-914. [PMID: 37966566 DOI: 10.1007/s11523-023-01014-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Accepted: 10/21/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Although ALK-translocated (ALK+) advanced non-small cell lung cancers (aNSCLCs) are currently treated with second- or third-generation ALK inhibitors (ALK-TKIs), some patients respond durably to the first-generation ALK-TKI crizotinib. OBJECTIVE This study aimed to describe the clinical characteristics of these long-term responders. PATIENTS AND METHODS This national, multicenter, retrospective, non-interventional study included patients with ALK+ aNSCLCs and long-term responses to first (L1)- or subsequent (≥ L2)-line crizotinib, defined, respectively, as treatments lasting > 18 and > 10 months. Median treatment duration (mDOT) was the primary endpoint. RESULTS A total of 85 patients (32 L1 and 53 ≥ L2 responders) from 23 centers were included (receiving crizotinib between 10/24/2011-10/02/2018): median age of 59 years, 83.6% non-smokers or ex-smokers, 85.9% performance status (PS) 0/1, 94.1% with adenocarcinomas, median of one metastatic site, and 22.4% with brain metastases (BMs). After median follow-up of 73.4 [95% confidence interval, 67.5-79.9] months, respective L1 and ≥ L2 mDOTs were 43.3 [26.7-56.8] and 29.6 [22.6-35.8] months, with overall survival (OS) not reached (NR) and 116.2 [83.4-NR] months. BM presence or absence did not affect mDOT (31.4 versus 32.9 months) but significantly impacted median OS (70.6 versus 158.6 months; p = 0.0008). Progression on crizotinib was paucisymptomatic (74.1%) and oligometastatic (34.8%), especially BMs (42.4%). After crizotinib discontinuation, 65 (76.5%) patients received subsequent systemic therapy: 57 (67.1%) with second-generation ALK-TKIs. Respective mDOTs of first- and second-line post-crizotinib ALK-TKIs lasted 19.4 [14.9-25.6] and 11.1 [4.8-17.9] months, respectively. CONCLUSIONS Most ALK+ aNSCLC patients with prolonged crizotinib efficacy had paucisymptomatic and oligometastatic disease without BMs. They subsequently benefited from a sequential strategy with other ALK-TKIs.
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Affiliation(s)
| | - Renaud Descourt
- Institut de Cancérologie, Hôpital Morvan, CHU de Brest, Brest, France
| | | | - Hélène Doubre
- Service d'Oncologie Thoracique, Hôpital Foch, Suresnes, France
| | | | | | | | - Lionel Falchero
- Service de Pneumologie, Hôpital Nord-Ouest de Villefranche-sur-Saône, Gleizé, France
| | - Eric Huchot
- Service de Pneumologie, CHU Saint-Pierre, La Réunion, France
| | - Sabine Vieillot
- Service d'Oncologie, Clinique Saint Pierre, Perpignan, France
| | - Romain Corre
- Service de Pneumologie, CH Quimper, Quimper, France
| | - Laure Kazulinski
- Service de Pneumologie, CH du Cotentin Cherbourg, Cherbourg, France
| | - Acya Bizieux
- Service de Pneumologie, CH La Roche-sur-Yon, La Roche-sur-Yon, France
| | | | - Hugues Morel
- Service de Pneumologie, CH Orléans, Orléans, France
| | | | - Christos Chouaïd
- Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France
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Levallet G, Dubois F, Elie N, Creveuil C, Brosseau S, Danel C, Scherpereel A, Lantuejoul S, Mazières J, Greillier L, Audigier-Valette C, Bergot E, Moro-Sibilot D, Molinier O, Léna H, Monnet I, Morin F, Gounant V, Zalcman G. VEGFR2 and CD34 expression associated with longer survival in patients with pleural mesothelioma in the IFCT-GFPC-0701 MAPS phase 3 trial. Lung Cancer 2023; 182:107287. [PMID: 37393757 DOI: 10.1016/j.lungcan.2023.107287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/19/2023] [Accepted: 06/24/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES VEGF/VEGFR autocrine loop is a hallmark of pleural mesothelioma (PM). We thus assayed the prognostic and predictive values of VEGFR-2 [vascular endothelial growth factor receptor 2 or Flk-1] and CD34, a marker of endothelial cells, in samples from patients accrued in the Mesothelioma Avastin Cisplatin Pemetrexed Study ('MAPS', NCT00651456). MATERIALS AND METHODS VEGFR2 and CD34 expression were assayed using immunohistochemistry in 333 MAPS patients (74.3%), and their prognostic value was evaluated in terms of overall survival (OS) and progression-free survival (PFS) in univariate and multivariate analyses, before validation by bootstrap methodology. RESULTS Positive VEGFR2 or CD34 staining was observed in 234/333 (70.2%) and 322/323 (99.6%) of tested specimens, respectively. VEGFR2 and CD34 staining correlated weakly, yet significantly, with each other (r = 0.36, p < 0.001). High VEGFR2 expression or high CD34 levels were associated with longer OS in PM patients in multivariate analysis (VEGFR2: adjusted [adj.] hazard ratio [HR]: 0.91, 95% confidence interval [CI] [0.88; 0.95], p < 0.001; CD34: adj. HR: 0.86, 95 %CI [0.76; 0.96], p = 0.010), with only high VEGFR2 expression resulting in significantly longer PFS (VEGFR2: adj. HR: 0.96, 95 %CI [0.92; 0.996], p = 0.032). Stability of these results was confirmed using bootstrap procedure. Nevertheless, VEGFR2 expression failed to specifically predict longer survival in bevacizumab-chemotherapy combination trial arm, regardless of whether the VEGFR2 score was combined or not with serum VEGF concentrations. CONCLUSION VEGFR2 overexpression independently correlated with longer OS or PFS in PM patients, such biomarker deserving prospective evaluation as stratification variable in future clinical trials.
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Affiliation(s)
- Guénaëlle Levallet
- Université de Caen-Normandie, CNRS, Normandie Univ, ISTCT UMR6030, GIP Cyceron, F-14000 Caen, France; Department of Pathology, Caen University Hospital, Caen, France
| | - Fatéméh Dubois
- Université de Caen-Normandie, CNRS, Normandie Univ, ISTCT UMR6030, GIP Cyceron, F-14000 Caen, France; Department of Pathology, Caen University Hospital, Caen, France
| | - Nicolas Elie
- Université de Caen-Normandie, Normandie Univ, Federative Structure 4207 "Normandie Oncologie", Service Unit PLATON, Virtual'His platform, Caen, France
| | - Christian Creveuil
- Université de Caen-Normandie, Normandie Univ, Biomedical Research Unit, University Hospital, Caen, France
| | - Solenn Brosseau
- Université Paris Cité, Thoracic Oncology Department & CIC1425, Hôpital Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; U830 INSERM "Cancer, Heterogeneity, Instability, Plasticity, A.R.T group", Curie Institute, Paris, France
| | - Claire Danel
- Université Paris Cité Department of Pathology, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Arnaud Scherpereel
- Department of Pulmonary and Thoracic Oncology, Centre Hospitalier Universitaire Lille, University of Lille, U1019 INSERM, Center of Infection and Immunity of Lille, Lille, France
| | - Sylvie Lantuejoul
- Department of Biopathology, Reference National Center MESOPATH, Centre Léon Bérard, Lyon, France
| | - Julien Mazières
- Grenoble Alpes University, Department of Pulmonology, Hôpital Larrey, University Hospital of Toulouse, Toulouse, France
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | | | - Emmanuel Bergot
- Université de Caen-Normandie, CNRS, Normandie Univ, ISTCT UMR6030, GIP Cyceron, F-14000 Caen, France; Normandie Univ, UNICAEN, Pulmonology and Thoracic Oncology Department, Caen University Hospital, Caen, France
| | - Denis Moro-Sibilot
- Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble, Grenoble, France
| | - Olivier Molinier
- Department of Pulmonology, Centre Hospitalier Le Mans, Le Mans, France
| | - Hervé Léna
- Department of Pulmonology, Ponchaillou University Hospital, Rennes, France
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - Valérie Gounant
- Université Paris Cité, Thoracic Oncology Department & CIC1425, Hôpital Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; Pulmonology and thoracic oncology Department, Tenon University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | - Gérard Zalcman
- Université Paris Cité, Thoracic Oncology Department & CIC1425, Hôpital Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; U830 INSERM "Cancer, Heterogeneity, Instability, Plasticity, A.R.T group", Curie Institute, Paris, France.
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Debieuvre D, Molinier O, Falchero L, Locher C, Templement-Grangerat D, Meyer N, Morel H, Duval Y, Asselain B, Letierce A, Trédaniel J, Auliac JB, Bylicki O, Moreau L, Fore M, Corre R, Couraud S, Cortot A. Lung cancer trends and tumor characteristic changes over 20 years (2000–2020): Results of three French consecutive nationwide prospective cohorts’ studies. Lancet Reg Health Eur 2022; 22:100492. [PMID: 36108315 PMCID: PMC9445429 DOI: 10.1016/j.lanepe.2022.100492] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Long-term changes in lung cancer (LC) patients are difficult to evaluate. We report results from the French KBP-2020 real-life cohort. Methods KBP-2020 was a prospective cohort that included all patients diagnosed with LC in 2020, in nonacademic public hospital in France. Patient and tumour characteristics were described and compared with similarly designed cohorts in 2000 and 2010. Findings In 2020, 82 centers included 8,999 patients diagnosed with LC. The proportion of women increased: 34·6% (3114/8999) compared to, 24·3% (1711/7051) and 16·0% (904/5667) in 2010 and 2000 (p<0·0001). The proportion of non-smokers was higher in 2020 (12·6%, 1129/8983) than in previous cohorts (10·9% (762/7008) in 2010; 7·2% (402/5586) in 2000, p<0·0001). In 2020, at diagnosis, 57·6% (4405/7648) of patients had a metastatic/disseminated stage non-small-cell lung cancer (NSCLC) (58·3% (3522/6046) in 2010; 42·6% (1879/4411) in 2000, p<0·0001). Compared with 2000 and 2010 data, early survival improved slightly. In 2020, 3-month mortality of NSCLC varied from 3·0% [2·2 – 3·8] for localized to 9·6% [8·1 – 11·0] for locally advanced to 29·2% [27·8 – 30·6] for metastatic and was 24·8% [22·3 – 27·3] for SCLC. Interpretation To our knowledge KBP cohorts have been the largest, prospective, real-world cohort studies involving LC patients conducted in worldwide. The trend found in our study shows an increase in LC in women and still a large proportion of patients diagnosed at metastatic or disseminated stage. Funding The study was promoted by the French College of General Hospital Pulmonologists with financial support of industrials laboratories.
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Affiliation(s)
- Didier Debieuvre
- Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Emile Muller, Mulhouse, France
- Corresponding author at: Service de Pneumologie, GHRMSA, Hôpital Emile Muller, 20 rue du Dr Laënnec, BP 1370, 68070 Mulhouse CEDEX, France.
| | - Olivier Molinier
- Respiratory Medicine Department, Centre Hospitalier Le Mans, Le Mans, France
| | - Lionel Falchero
- Respiratory Medicine Department, L'Hôpital Nord-Ouest, Villefranche-Sur-Saône, France
| | - Chrystèle Locher
- Respiratory Medicine Department, Grand Hôpital de l'Est Francilien (GHEF), Meaux, France
| | | | - Nicolas Meyer
- Biostatistician, Public Health Department, CHU de Strasbourg, GMRC, Strasbourg, France
| | - Hugues Morel
- Respiratory Medicine Department, Centre Hospitalier Régional D'Orléans Hôpital de La Source, Orléans, France
| | - Yannick Duval
- Respiratory Medicine Department, Hôpital de Cannes Simone Veil, Cannes, France
| | - Bernard Asselain
- Methodologist, Groupe Statistique, ARCAGY - GINECO, Paris, France
| | | | - Jean Trédaniel
- Department of Thoracic Oncology, Groupe hospitalier Paris-Saint Joseph, Paris, France
| | - Jean-Bernard Auliac
- Respiratory Medicine Department, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Olivier Bylicki
- Respiratory Medicine Department, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France
| | - Lionel Moreau
- Respiratory Medicine Department, Centre Hospitalier de Colmar, Colmar, France
| | - Mathieu Fore
- Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Emile Muller, Mulhouse, France
| | - Romain Corre
- Respiratory Medicine Department, Centre Hospitalier de Cornouaille, Quimper, France
| | - Sébastien Couraud
- Respiratory Medicine Department, Centre Hospitalier de Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Alexis Cortot
- Department of Thoracic Oncology, CHU de Lille, CNRS, Inserm, Institut Pasteur de Lille, UMR9020-U1277-CANTHER, Lille, France
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Wislez M, Mazieres J, Lavole A, Zalcman G, Carre O, Egenod T, Caliandro R, Dubos-Arvis C, Jeannin G, Molinier O, Massiani MA, Langlais A, Morin F, Le Pimpec Barthes F, Brouchet L, Assouad J, Milleron B, Damotte D, Antoine M, Westeel V. Neoadjuvant durvalumab for resectable non-small-cell lung cancer (NSCLC): results from a multicenter study (IFCT-1601 IONESCO). J Immunother Cancer 2022; 10:jitc-2022-005636. [PMID: 36270733 PMCID: PMC9594538 DOI: 10.1136/jitc-2022-005636] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [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] [Accepted: 09/26/2022] [Indexed: 11/07/2022] Open
Abstract
Background The IONESCO (IFCT-1601) trial assessed the feasibility of neoadjuvant durvalumab, for early-stage resectable non-small-cell lung cancer (NSCLC). Methods In a multicenter, single-arm, phase II trial, patients with IB (≥4 cm)-IIIA, non-N2, resectable NSCLC received three doses of durvalumab (750 mg every 2 weeks) and underwent surgery between 2 and 14 days after the last infusion. The primary endpoint was the complete surgical resection rate. Secondary endpoints included tumor response rate, major histopathological response (MPR: ≤10% remaining viable tumor cells), disease-free survival (DFS), overall survival (OS), durvalumab-related safety, and 90-day postoperative mortality (NCT03030131). Results Forty-six patients were eligible (median age 60.9 years); 67% were male, 98% were smokers, and 41% had squamous cell carcinoma. Regarding tumor response, 9% had a partial response, 78% had stable disease, and 13% had progressive disease. Among the operated patients (n=43), 41 achieved complete resection (89%, 95% CI 80.1% to 98.1%)), and eight achieved MPR (19%). The 12-month median OS and DFS rates were 89% (95% CI 75.8% to 95.3%) and 78% (95% CI 63.4% to 87.7%), respectively (n=46). The median follow-up was 28.4 months (12.8–41.1). All patients in whom MPR was achieved were disease-free at 12 months compared to only 11% of those with >10% residual tumor cells (p=0.04). No durvalumab-related serious or grade 3–5 events were reported. The unexpected 90-day postoperative mortality of four patients led to premature study termination. None of these four deaths was considered secondary to direct durvalumab-related toxicity. Conclusions Neoadjuvant durvalumab given as monotherapy was associated with an 89% complete resection rate and an MPR of 19%. Despite an unexpectedly high rate of postoperative deaths, which prevented us from completing the trial, we were able to show a significant association between MPR and DFS.
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Affiliation(s)
- Marie Wislez
- Université Paris Cité, Pneumology, Assistance Publique des Hôpitaux de Paris (APHP), Hôpital Cochin, Paris, France
| | - Julien Mazieres
- Pneumology, Centre Hospitalier Universitaire Toulouse - Hôpital Larrey, Toulouse, France
| | - Armelle Lavole
- Université Paris Cité, Pneumology, Hôpital Tenon, Paris, France
| | - Gérard Zalcman
- Université Paris Cité, Thoracic Oncology, Assistance Publique des Hôpitaux de Paris (APHP), Hôpital Bichat, Paris, France
| | | | - Thomas Egenod
- Thoracic Oncology, Hôpital Dupuytren, Limoges, France
| | | | | | - Gaelle Jeannin
- Thoracic Oncology, Hopital Gabriel Montpied, Clermont-Ferrand, France
| | | | - Marie-Ange Massiani
- Medical Oncology, Hôpital René Huguenin - Institut Curie, Saint Cloud, France
| | | | - Franck Morin
- Clinical Research Unit, French Cooperative Thoracic Intergroup, Paris, France
| | | | - Laurent Brouchet
- Thoracic Oncology, Centre Hospitalier Universitaire Toulouse - Hôpital Larrey, Toulouse, France
| | - Jalal Assouad
- Université Paris Cité, Thoracic Surgery, Assistance Publique des Hôpitaux de Paris (APHP), Hôpital Tenon, Paris, France
| | - Bernard Milleron
- Clinical Research Unit, French Cooperative Thoracic Intergroup, Paris, France
| | - Diane Damotte
- Université Paris Cité, Pathology, Assistance Publique des Hôpitaux de Paris (APHP), Hôpital Cochin, Paris, France
| | - Martine Antoine
- Université Paris Cité, Pathology, Hôpital Tenon, Paris, France
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Molinier O, Falchero L, Monnet I, Decroisette C, Neidhart AC, Redureau E, Chiappa AM, Bigot F, Bedossa A, Amrane K, Jeandeau S, Dujon C, Bugnet AS, Bonnefoy P, Alizon C, Meyer N, Couraud S, Cortot A, Letierce A, Debieuvre D. 509P COVID-19 disease among lung cancer (LC) patients: Data from a real-life prospective multicentric study. Ann Oncol 2022. [PMCID: PMC9472519 DOI: 10.1016/j.annonc.2022.07.637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Zalcman G, Madroszyk Flandin AC, Molinier O, Dayen C, Egenod T, Debieuvre D, Beaucaire-Danel S, Dixmier A, Pichon E, Galland Girodet S, Giroux-Leprieur E, Cloarec N, Cadranel J, Otto J, Romand P, Langlais A, Morin F, Antoine M, Westeel V, Toffart A. 972O Nivolumab (Nivo) plus ipilimumab (Ipi) 6-months treatment versus continuation in patients with advanced non-small cell lung cancer (aNSCLC): Results of the randomized IFCT-1701 phase III trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1100] [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: 11/01/2022] Open
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Barlesi F, Tomasini P, Karimi M, Michiels S, Raimbourg J, Daniel C, Janicot H, Madroszyk A, Audigier-Valette C, Quoix E, Mazieres J, Moro-Sibilot D, Dansin E, Molinier O, Morel H, Pichon E, Cortot A, Otto J, Chomy FO, Souquet PJ, Cloarec N, Giroux Leprieur E, Bieche I, Lacroix L, Boyault S, Attignon V, Soubeyran I, Morel A, Tran-Dien A, Jacquet A, Dall'Olio FG, Jimenez M, Soria JC, Besse B. Comprehensive genome profiling in patients with metastatic non-small cell lung cancer: the precision medicine phase 2 randomized SAFIR02-Lung trial. Clin Cancer Res 2022; 28:4018-4026. [PMID: 35802649 DOI: 10.1158/1078-0432.ccr-22-0371] [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] [Received: 02/06/2022] [Revised: 04/20/2022] [Accepted: 07/06/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Targeted therapies (TT) and immune checkpoint blockers (ICB) have revolutionized the approach to non-small cell lung cancer (NSCLC) treatment in the era of precision medicine. Their impact as switch maintenance therapy based on molecular characterization is unknown. EXPERIMENTAL DESIGN SAFIR02-Lung was an open-label, randomized, phase 2 trial, involving 33 centers in France. We investigated eight TT (substudy-1) and one ICB (substudy-2), compared to standard-of-care as a maintenance strategy in advanced EGFR, ALK wild-type (wt) NSCLC patients without progression after first line chemotherapy, based on high-throughput genome analysis. The primary outcome was progression-free survival (PFS). RESULTS Among the 175 patients randomized in substudy-1, 116 received TT (selumetinib, vistusertib, capivasertib, AZD4547, AZD8931, vandetanib, olaparib, savolitinib) and 59 standard-of-care. Median PFS was 2.7 months (95% CI 1.6-2.9) with TT vs. 2.7 months (1.6-4.1) with standard-of-care (HR 0.97, 0.7-1.36; p=0.87). There were no significant differences in PFS within any molecular subgroup. In substudy-2, 183 patients were randomized, 121 received durvalumab and 62 standard-of-care. Median PFS was 3.0 months (2.3-4.4) with durvalumab versus 3.0 months (2.0-5.1) with standard-of-care (HR=0.86; 0.62-1.20; p=0.38). Preplanned subgroup analysis showed an enhanced benefit with durvalumab in patients with PD-L1 Tumor Proportion Score (TPS) ≥ 1%, (n=29, HR=0.29; 0.11-0.75) as compared to PD-L1 <1% (n=31, HR=0.71, 0.31-1.60, interaction p= 0.036). CONCLUSIONS Molecular profiling can feasibly be implemented to guide treatment choice for the maintenance strategy in EGFR/ALK wt NSCLC; in the current study it did not lead to substantial treatment benefits beyond durvalumab for PD-L1 ≥ 1 patients.
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Affiliation(s)
- Fabrice Barlesi
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Pascale Tomasini
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | | | | | | | | | - Henri Janicot
- CHU - Hopital Gabriel Montpied, Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alain Morel
- Institut de Cancérologie de l'Ouest, Angers, France
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Maille E, Levallet J, Dubois F, Antoine M, Danel C, Creveuil C, Mazieres J, Margery J, Greillier L, Gounant V, Moro‐Sibilot D, Molinier O, Léna H, Monnet I, Bergot E, Langlais A, Morin F, Scherpereel A, Zalcman G, Levallet G. A Defect of Amphiregulin Release Predicted Longer Survival Independently of YAP Expression in Patients with Pleural Mesothelioma in the IFCT-0701 MAPS Phase 3 Trial. Int J Cancer 2022; 150:1889-1904. [PMID: 35262190 PMCID: PMC9545369 DOI: 10.1002/ijc.33997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/12/2022] [Accepted: 02/22/2022] [Indexed: 11/07/2022]
Abstract
The Hippo pathway effector YAP is dysregulated in malignant pleural mesothelioma (MPM). YAP's target genes include the secreted growth factor amphiregulin (AREG), which is overexpressed in a wide range of epithelial cancers and plays an elusive role in MPM. We assayed the expression of YAP and AREG in MPM pathology samples and that of AREG additionally in plasma samples of patients from the randomized phase 3 IFCT‐0701 Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS) using immunohistochemistry and ELISA assays, respectively. MPM patients frequently presented high levels of tumor AREG (64.3%), a high cytosolic AREG expression being predictive of a better prognosis with longer median overall and progression‐free survival. Surprisingly, tumor AREG cytosolic expression was not correlated with secreted plasma AREG. By investigating the AREG metabolism and function in MPM cell lines H2452, H2052, MSTO‐211H and H28, in comparison with the T47D ER+ breast cancer cell line used as a positive control, we confirm that AREG is important for cell invasion, growth without anchorage, proliferation and apoptosis in mesothelioma cells. Yet, most of these MPM cell lines failed to correctly execute AREG posttranslational processing by metalloprotease ADAM17/tumor necrosis factor‐alpha‐converting enzyme (TACE) and extracell secretion. The favorable prognostic value of high cytosolic AREG expression in MPM patients could therefore be sustained by default AREG posttranslational processing and release. Thus, the determination of mesothelioma cell AREG content could be further investigated as a prognostic marker for MPM patients and used as a stratification factor in future clinical trials.
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Affiliation(s)
- Elodie Maille
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
| | - Jérôme Levallet
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
| | - Fatéméh Dubois
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
- Department of PathologyCHU de CaenCaenFrance
| | | | - Claire Danel
- Department of PathologyHôpital Bichat‐Claude Bernard, AP‐HP, Université Paris‐DiderotParisFrance
| | - Christian Creveuil
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
- Biomedical Research UnitCHU de CaenCaenFrance
| | - Julien Mazieres
- Department of PulmonologyHôpital Larrey, CHU de ToulouseToulouseFrance
| | - Jacques Margery
- Department of Medical OncologyInstitut Gustave RoussyVillejuifFrance
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic InnovationsAssistance Publique Hôpitaux de Marseille, Université Aix‐Marseille UM015MarseilleFrance
| | - Valérie Gounant
- Department of PulmonologyHôpital Tenon, AP‐HPParisFrance
- Department of Thoracic Oncology & CIC 1425University Hospital Bichat‐Claude Bernard, AP‐HP, Université de ParisParisFrance
| | - Denis Moro‐Sibilot
- Pôle Thorax et Vaisseaux, University Hospital of Grenoble‐AlpesLa TroncheFrance
| | - Olivier Molinier
- Department of PulmonologyCentre Hospitalier Le MansLe MansFrance
| | - Hervé Léna
- Department of PulmonologyUniversity Hospital PontchaillouRennesFrance
| | - Isabelle Monnet
- Department of PulmonologyCentre Hospitalier Intercommunal de CréteilCréteilFrance
| | - Emmanuel Bergot
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
- Department of Pulmonology and Thoracic OncologyUniversity Hospital of CaenCaenFrance
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique (IFCT)ParisFrance
| | - Arnaud Scherpereel
- Department of Pulmonary and Thoracic OncologyCentre Hospitalier Universitaire Lille, University of Lille, U1019 INSERM, Center of Infection and Immunity of LilleLilleFrance
| | - Gérard Zalcman
- Department of Thoracic Oncology & CIC 1425University Hospital Bichat‐Claude Bernard, AP‐HP, Université de ParisParisFrance
- U830 INSERM, “Cancer, Hétérogénéité, Instabilité et Plasticité” Centre de Recherche, Institut CurieParisFrance
| | - Guénaëlle Levallet
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
- Department of PathologyCHU de CaenCaenFrance
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10
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Molinier O, Besse B, Barlesi F, Audigier-Valette C, Friard S, Monnet I, Jeannin G, Mazières J, Cadranel J, Hureaux J, Hilgers W, Quoix E, Coudert B, Moro-Sibilot D, Fauchon E, Westeel V, Brun P, Langlais A, Morin F, Souquet PJ, Girard N. IFCT-1502 CLINIVO: real-world evidence of long-term survival with nivolumab in a nationwide cohort of patients with advanced non-small-cell lung cancer. ESMO Open 2021; 7:100353. [PMID: 34953398 PMCID: PMC8764511 DOI: 10.1016/j.esmoop.2021.100353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/17/2021] [Accepted: 11/20/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Immunotherapy using inhibitors targeting immune checkpoint programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) is currently the standard of care in patients with advanced non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS We carried out a nationwide cohort retrospective study of consecutive patients with advanced, refractory NSCLC who received nivolumab as second to later lines of treatment as part of the expanded access program. Key objectives were to assess the efficacy and safety of nivolumab and the efficacy of first post-nivolumab treatment. RESULTS Nine hundred and two patients were enrolled: 317 (35%) with squamous cell carcinoma and 585 (65%) with non-squamous cell carcinoma. Median age was 64 years; there were 630 (70%) men, 795 (88%) smokers, 723 (81%) patients with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0/1, 197 (22%) patients with brain metastases, and 212 (27%) with liver metastases. Best response was partial response for 16.2% and stable disease (SD) for 30.5%. Progression-free survival and overall survival (OS) rates at 2, 3, and 5 years were 8% and 25%, 6% and 16%, and 4% and 10%, respectively. At multivariate analysis, ECOG PS ≥2 [hazard ratio (HR) = 2.13, 95% confidence interval (95% CI) 1.78-2.55, P < 0.001], squamous histology (HR = 1.17, 95% CI 1.01-1.36, P = 0.04), and presence of central nervous system metastases (HR = 1.29, 95% CI 1.08-1.54, P = 0.005) were significantly associated with lower OS. Four hundred and ninety-two patients received at least one treatment after discontinuation of nivolumab, consisting of systemic therapies in 450 (91%). Radiation therapy was delivered to 118 (24%) patients. CONCLUSION The CLINIVO cohort represents the largest real-world evidence cohort with the use of immune checkpoint inhibitor in advanced, metastatic NSCLC after failure of first-line chemotherapy, with long-term follow-up and analysis of subsequent therapies. Our data confirm the efficacy of nivolumab in a cohort larger than that reported in landmark clinical trials and identify prognostic factors, which reinforces the need for accurate selection of patients for treatment with immune checkpoint inhibitors. Our data indicate that oligoprogression is frequent after nivolumab exposure and provide a unique insight into the long-term survival.
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Affiliation(s)
- O Molinier
- Pneumology, Centre Hospitalier Du Mans, Le Mans, France
| | - B Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, France; Paris-Saclay University, Orsay, France
| | - F Barlesi
- Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France; Gustave Roussy Cancer Campus, Villejuif, France
| | - C Audigier-Valette
- Pneumology Department, Centre Hospitalier Toulon Sainte-Musse, Toulon, France
| | - S Friard
- Hopital Foch, Chest Department, Suresnes, France
| | - I Monnet
- Pneumology Service, CHI Créteil, Créteil, France
| | - G Jeannin
- Pneumology Service, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - J Mazières
- Pneumology Service, Centre Hospitalier Universitaire de Toulouse, Hôpital Larrey, Pôle Voies Respiratoires, Toulouse, France
| | - J Cadranel
- Pneumology Service, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, GRC n04, Theranoscan, Paris, France
| | - J Hureaux
- Pôle Hippocrate, CHU d'Angers, Angers, France
| | - W Hilgers
- Medical Oncology, Sainte Catherine Cancer Institute, Avignon Provence, France
| | - E Quoix
- Pneumology Service, Hôpitaux Universitaires de Strasbourg-Unistra, Strasbourg, France
| | - B Coudert
- Medical Oncology Department, Centre Georges-François Leclerc, Dijon, France
| | - D Moro-Sibilot
- Pneumology and Thoracic Oncology Department, CHU Grenoble-Alpes, La Tronche, France
| | - E Fauchon
- Pneumology Service, CHI, Saint-Julien-en-Genevois, France
| | - V Westeel
- Pneumology Service, Centre Hospitalier Régional Universitaire de Besançon, Hôpital Jean Minjoz, Besançon, France
| | - P Brun
- Pneumology Service, CH de Valence, Valence, France
| | - A Langlais
- Biostatistic Department, French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | - F Morin
- Clinical Research Unit, French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | - P J Souquet
- Pneumology Service, Centre hospitalier Lyon-Sud, Pierre-Bénite, France
| | - N Girard
- Paris-Saclay University, Orsay, France; Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France.
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11
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Guillemois S, Seegers V, Molinier O, Masson P, Capitain O, Bigot F. 70P Outcomes in patients treated with taxane regimen after immune checkpoint inhibitors failure in advanced or metastatic non-small cell lung cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.088] [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: 10/19/2022] Open
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12
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Souquet PJ, Audigier-Valette C, Molinier O, Cortot A, Margery J, Moreau L, Gervais R, Barlesi F, Pichon E, Zalcman G, Dumont P, Girard N, Poudenx M, Mazières J, Cadranel J, Debieuvre D, Dauba J, Langlais A, Morin F, Moro-Sibilot D, Westeel V, Pérol M. Tailoring maintenance chemotherapy upon response to induction chemotherapy as compared with pemetrexed continuation maintenance in advanced non-squamous NSCLC patients: Results of the IFCT-GFPC-1101 multicenter randomized phase III trial. Lung Cancer 2021; 164:84-90. [PMID: 35051725 DOI: 10.1016/j.lungcan.2021.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Benefit from maintenance in advanced non-squamous non-small cell lung cancer (NS-NSCLC) might favor switch maintenance after disease stabilization (SD) and continuation after objective response (OR). This trial assessed a maintenance strategy conditioned by response to cisplatin-gemcitabine (CG) with G continuation for patients with OR or switch to pemetrexed (P) for patients with SD as compared with a control arm based on the Paramount regimen. METHODS Eligibility criteria: age 18-70 years, ECOG PS 0-1, untreated stage IV NS-NSCLC without EGFR or ALK alteration, ineligibility to bevacizumab. Patients were randomized 1:1 to receive either CG (4 cycles) followed by G maintenance in case of OR followed by P at progression, or switch to P for patients with SD, or 4 cycles of CP followed by P (control arm). Primary endpoint: overall Survival. RESULTS Between 2012 and 2016, 932 patients were randomized (CG: 467, CP: 465) with well-balanced characteristics. 257 patients (56.7%) in the CG arm received maintenance (G: 142, P: 113) versus 277 patients (59.7%) in the CP arm. Median number of maintenance cycles was 5 for G and P (CG induction) and 4 for P (CP induction). OS adjusted HR was 0.97 (95% CI 0.84, 1.13; p = 0.71) with a median of 10.9 months (CG) versus 10.4 (CP). HR for PFS was 0.95 (95% CI 0.83, 1.09; p = 0.45) with a median of 4.8 months for CG versus 4.5 for CP. Safety profile was as expected. CONCLUSIONS Adapting maintenance strategy according to response to induction chemotherapy does not improve patient outcome. CLINICAL TRIAL INFORMATION NCT01631136.
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Affiliation(s)
| | | | - Olivier Molinier
- Service des Maladies Respiratoires, Centre Hospitalier Général - Le Mans, France
| | - Alexis Cortot
- Thoracic Oncology Department, CHU Lille, Univ. Lille, Siric ONCOLille, CNRS UMR8161, Lille F-59000, France
| | - Jacques Margery
- Department of Pneumology, Hôpital D'Instruction des Armées Percy, Clamart, France
| | - Lionel Moreau
- Department of Pneumology, Hôpital Louis Pasteur, Hôpitaux Civils de Colmar, Colmar, France
| | - Radj Gervais
- Department of Pneumology, Centre François Baclesse, Caen, France
| | - Fabrice Barlesi
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Campus Timone, CHU NORD, Chemin des Bourrely, Marseille 13915, France; Gustave Roussy cancer campus - Villejuif, France
| | - Eric Pichon
- Department of Pneumology, CHRU Bretonneau, Tours, France
| | - Gérard Zalcman
- University Hospital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Diderot University Paris, France
| | | | - Nicolas Girard
- Institut Curie Montsouris Thorax, Institut Curie, Paris, France
| | | | | | - Jacques Cadranel
- Department of Pneumology and Thoracic Oncology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris and GRC 04 Theranoscan Sorbonne Université, Paris, France
| | | | - Jérôme Dauba
- Departement of Oncology, Hôpital Mont de Marsan - Mont-de-Marsan, France
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique - Paris, France
| | - Denis Moro-Sibilot
- Thoracic Oncology Unit, PTV, CHU Grenoble-Alpes CS10217, 38043 Grenoble, France
| | - Virginie Westeel
- Université de Bourgogne-Franche Comté, INSERM UMR 1098, University Hospital Jean Minjoz, Department of Pneumology, Besançon, France
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13
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Peters S, Pujol JL, Dafni U, Dómine M, Popat S, Reck M, Andrade J, Becker A, Moro-Sibilot D, Curioni-Fontecedro A, Molinier O, Nackaerts K, Insa Mollá A, Gervais R, López Vivanco G, Madelaine J, Mazieres J, Faehling M, Griesinger F, Majem M, González Larriba JL, Provencio Pulla M, Vervita K, Roschitzki-Voser H, Ruepp B, Mitchell P, Stahel RA, Le Pechoux C, De Ruysscher D. Consolidation nivolumab and ipilimumab versus observation in limited-disease small-cell lung cancer after chemo-radiotherapy - results from the randomised phase II ETOP/IFCT 4-12 STIMULI trial. Ann Oncol 2021; 33:67-79. [PMID: 34562610 DOI: 10.1016/j.annonc.2021.09.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 04/27/2021] [Revised: 08/13/2021] [Accepted: 09/12/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Concurrent chemotherapy and thoracic radiotherapy followed by prophylactic cranial irradiation (PCI) is the standard treatment in limited-disease small-cell lung cancer (LD-SCLC), with 5-year overall survival (OS) of only 25% to 33%. PATIENTS AND METHODS STIMULI is a 1:1 randomised phase II trial aiming to demonstrate superiority of consolidation combination immunotherapy versus observation after chemo-radiotherapy plus PCI (protocol amendment-1). Consolidation immunotherapy consisted of four cycles of nivolumab [1 mg/kg, every three weeks (Q3W)] plus ipilimumab (3 mg/kg, Q3W), followed by nivolumab monotherapy (240 mg, Q2W) for up to 12 months. Patient recruitment closed prematurely due to slow accrual and the statistical analyses plan was updated to address progression-free survival (PFS) as the only primary endpoint. RESULTS Of the 222 patients enrolled, 153 were randomised (78: experimental; 75: observation). Among the randomised patients, median age was 62 years, 60% males, 34%/65% current/former smokers, 31%/66% performance status (PS) 0/1. Up to 25 May 2020 (median follow-up 22.4 months), 40 PFS events were observed in the experimental arm, with median PFS 10.7 months [95% confidence interval (CI) 7.0-not estimable (NE)] versus 42 events and median 14.5 months (8.2-NE) in the observation, hazard ratio (HR) = 1.02 (0.66-1.58), two-sided P = 0.93. With updated follow-up (03 June 2021; median: 35 months), median OS was not reached in the experimental arm, while it was 32.1 months (26.1-NE) in observation, with HR = 0.95 (0.59-1.52), P = 0.82. In the experimental arm, median time-to-treatment-discontinuation was only 1.7 months. CTCAE v4 grade ≥3 adverse events were experienced by 62% of patients in the experimental and 25% in the observation arm, with 4 and 1 fatal, respectively. CONCLUSIONS The STIMULI trial did not meet its primary endpoint of improving PFS with nivolumab-ipilimumab consolidation after chemo-radiotherapy in LD-SCLC. A short period on active treatment related to toxicity and treatment discontinuation likely affected the efficacy results.
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Affiliation(s)
- S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Lausanne University, Lausanne, Switzerland
| | - J-L Pujol
- Thoracic Oncology Unit, Hopital Arnaud de Villeneuve, Montpellier, France
| | - U Dafni
- National and Kapodistrian University of Athens, Athens, Greece; Frontier Science Foundation-Hellas, Athens, Greece
| | - M Dómine
- Hospital Universitario Fundacion Jimenez Díaz (IIS-FJD), Madrid, Spain
| | - S Popat
- Medicine, Royal Marsden Hospital, London, UK
| | - M Reck
- Thoracic Oncology, Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - J Andrade
- Medical Oncology, Hospital Virgen De La Salud, Toledo, Spain
| | - A Becker
- Department of Pulmonology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - D Moro-Sibilot
- Thoracic Oncology Unit, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - A Curioni-Fontecedro
- Department of Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
| | - O Molinier
- Department of Respiratory Disease, Centre Hospitalier - Le Mans, Le Mans, France
| | - K Nackaerts
- Department of Pulmonology, Respiratory Oncology Unit, KU Leuven, Leuven, Belgium
| | - A Insa Mollá
- Medical Oncology, Hospital Clínico Universitario De Valencia, Valencia, Spain
| | - R Gervais
- Medical Oncology, Centre François Baclesse, Caen, France
| | - G López Vivanco
- Medical Oncology, Hospital Universitario Cruces, Barakaldo, Spain
| | - J Madelaine
- Thoracic Oncology Unit, Centre Hospitalier Universitaire Caen Normandie, Caen, France
| | - J Mazieres
- Thoracic Oncology, Centre Hospitalier Universitaire Toulouse, Toulouse, France
| | | | | | - M Majem
- Hospital De La Santa Creu I Sant Pau, Barcelona, Spain
| | | | | | - K Vervita
- Frontier Science Foundation-Hellas, Athens, Greece
| | - H Roschitzki-Voser
- Coordinating Office, European Thoracic Oncology Platform, Bern, Switzerland
| | - B Ruepp
- Coordinating Office, European Thoracic Oncology Platform, Bern, Switzerland
| | - P Mitchell
- Olivia Newton-John Cancer Centre, Austin Hospital (VIC), Melbourne, Australia
| | - R A Stahel
- Coordinating Office, European Thoracic Oncology Platform, Bern, Switzerland.
| | - C Le Pechoux
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - D De Ruysscher
- Maastricht University Medical Center, Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht, Netherlands
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14
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Pinquie F, Cortot AB, Chevalier LM, Morel A, Sandrini J, Guguen C, Morvan B, Molinier O. A Case Report of Successful Treatment With Crizotinib to Overcome Resistance to Osimertinib in an EGFR Mutated Non-Small-Cell Lung Cancer Patient Harboring an Acquired MET Exon 14 Mutation. Clin Lung Cancer 2021; 23:e131-e134. [PMID: 34548228 DOI: 10.1016/j.cllc.2021.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/29/2021] [Accepted: 06/03/2021] [Indexed: 11/03/2022]
Affiliation(s)
- François Pinquie
- Department of Respiratory Diseases, Le Mans Hospital Center, 72000 Le Mans, France
| | - Alexis B Cortot
- Department of Thoracic Oncology, Lille University Hospital, CNRS, Inserm, Institut Pasteur de Lille, Canther, F-59000, Lille, France
| | - Louise-Marie Chevalier
- Angers University, Inserm, 49000 Angers, France; Department of Oncogenomic, Cancer Center Paul Papin, 49000 Angers, France
| | - Alain Morel
- Angers University, Inserm, 49000 Angers, France; Department of Oncogenomic, Cancer Center Paul Papin, 49000 Angers, France
| | - Jérémy Sandrini
- Department of Pathology, Le Mans Hospital Center, 72000 Le Mans, France
| | - Camille Guguen
- Department of Respiratory Diseases, Le Mans Hospital Center, 72000 Le Mans, France
| | - Benjamin Morvan
- Department of Pathology, Le Mans Hospital Center, 72000 Le Mans, France
| | - Olivier Molinier
- Department of Respiratory Diseases, Le Mans Hospital Center, 72000 Le Mans, France.
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15
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Cortot AB, Madroszyk A, Giroux-Leprieur E, Molinier O, Quoix E, Bérard H, Otto J, Rault I, Moro-Sibilot D, Raimbourg J, Amour E, Morin F, Hureaux J, Moreau L, Debieuvre D, Morel H, Renault A, Pichon E, Huret B, Charpentier S, Denis MG, Cadranel J. First-Line Afatinib plus Cetuximab for EGFR-Mutant Non-Small Cell Lung Cancer: Results from the Randomized Phase II IFCT-1503 ACE-Lung Study. Clin Cancer Res 2021; 27:4168-4176. [PMID: 34031056 DOI: 10.1158/1078-0432.ccr-20-4604] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/12/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Double inhibition of epidermal growth factor receptor (EGFR) using a tyrosine kinase inhibitor plus a monoclonal antibody may be a novel treatment strategy for non-small cell lung cancer (NSCLC). We assessed the efficacy and toxicity of afatinib + cetuximab versus afatinib alone in the first-line treatment of advanced EGFR-mutant NSCLC. PATIENTS AND METHODS In this phase II, randomized, open-label study, patients with stage III/IV EGFR-positive NSCLC were randomly assigned (1:1) to receive afatinib (group A) or afatinib + cetuximab (group A + C). Oral afatinib 40 mg was given once daily; cetuximab 250 mg/m² was administered intravenously on day 15 of cycle 1, then every 2 weeks at 500 mg/m² for 6 months. The primary endpoint was time to treatment failure (TTF) rate at 9 months. Exploratory analysis of EGFR circulating tumor DNA in plasma was performed. RESULTS Between June 2016 and November 2018, 59 patients were included in group A and 58 in group A + C. The study was ended early after a futility analysis was performed. The percentage of patients without treatment failure at 9 months was similar for both groups (59.3% for group A vs. 64.9% for group A + C), and median TTF was 11.1 (95% CI, 8.5-14.1) and 12.9 (9.2-14.5) months, respectively. Other endpoints, including progression-free survival and overall survival, also showed no improvement with the combination versus afatinib alone. There was a slight numerical increase in grade ≥3 adverse events in group A + C. Allele frequency of the EGFR gene mutation in circulating tumor DNA at baseline was associated with shorter PFS, regardless of the treatment received. CONCLUSIONS These results suggest that addition of cetuximab to afatinib does not warrant further investigation in treatment-naïve advanced EGFR-mutant NSCLC.
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Affiliation(s)
- Alexis B Cortot
- Univ. Lille, CHU Lille, Thoracic Oncology Department, CNRS, Inserm, Institut Pasteur de Lille, UMR9020, UMR-S 1277, Canther, Lille, France. .,Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - Anne Madroszyk
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Institut Paoli-Calmettes, Marseille, France
| | - Etienne Giroux-Leprieur
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Respiratory Diseases and Thoracic Oncology, APHP-AmbroiseParé Hospital and EA 4340 University Versailles-Saint Quentin en Yvelines, Boulogne, France
| | - Olivier Molinier
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service des Maladies Respiratoires, Centre Hospitalier, Le Mans, France
| | - Elisabeth Quoix
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, University Hospital, Strasbourg, France
| | - Henri Bérard
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie, hôpital d'instruction des armées Sainte-Anne, Toulon, France
| | - Josiane Otto
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Medicine, Centre Antoine Lacassagne, Nice, France
| | - Isabelle Rault
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, Amiens, France
| | - Denis Moro-Sibilot
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Thoracic Oncology Unit Teaching Hospital A Michallon, INSERM U823, Grenoble, France
| | - Judith Raimbourg
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,ICO René Gauducheau, Saint-Herblain, France
| | - Elodie Amour
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - José Hureaux
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie, pôle Hippocrate, CHU, Angers, France; MINT, UNIV Angers, Inserm 1066, CNRS 6021, université Bretagne Loire, Angers, France
| | - Lionel Moreau
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie, Hôpital Louis Pasteur, Hôpitaux Civils de Colmar, Colmar, France
| | - Didier Debieuvre
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,GHRMSA, Mulhouse, France
| | - Hugues Morel
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, CHR Orléans, Orléans, France
| | - Aldo Renault
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, Hospital, Pau, France
| | - Eric Pichon
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie, CHRU Bretonneau, Tours, France
| | - Benjamin Huret
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, Private Hospital, Ramsay Generale de Sante, Villeneuve d'Ascq, France
| | - Sandrine Charpentier
- Department of Biochemistry, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Marc G Denis
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Biochemistry, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Jacques Cadranel
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie et d'Oncologie Thoracique, hôpital Tenon, Assistance Publique Hôpitaux de Paris and GRC 04 Theranoscan Sorbonne Université, Paris, France
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16
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Vasseur D, Jovelet C, Cozic N, Mazieres J, Barlesi F, Bennouna J, Gervais R, Moreau L, Berard H, Molinier O, Moro-Sibilot D, Souquet PJ, Amour E, Morin F, Zalcman G, Soria JC, Westeel V, Lacroix L, Besse B. Minimal residual disease (MRD) in patients with resected stage I NSCLC: Results of the prospective adjuvant IFCT-0703 trial. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.8526] [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
8526 Background: MRD aims to detect circulating biomarkers of micrometastatic disease and ultimately predict recurrences. The IFCT-0703 randomized phase II trial failed to show a benefit of 6 months adjuvant pazopanib (P) vs. placebo after resection of stage I NSCLC (7th TNM edition). The outcome of pts based on their MRD status has been evaluated. Methods: Blood samples were collected in EDTA tubes (Becton Dickinson Company) after surgery (T0), after 3 months (T3) of P or placebo and at the end of treatment (T6). Plasmas were obtained after double centrifugation of total blood. Total nucleic acid was extracted using the Maxwell RSC LV plasma kit (Promega) according to the manufacturer’s protocol. Samples were quantified using the QuBit dsDNA HS Assay kit on a QuBit 3.0 flurometer (Thermo Fisher Scientific). Molecular analysis was performed by next generation sequencing using the Oncomine Lung cfDNA Assay (ThermoFisher Scientific). Two MRD definitions were tested : 1) high level of DNA in the blood or 2) any mutation detected by the standard bioinformatic pipeline was considered present, whatever the allelic fraction. Results: 143 pts were randomized in 29 centers between March 2009 and August 2012, 71 and 72 in the placebo and P arms respectively. Among the 119 pts with evaluable T0 samples, 27 pts recurred and 14 died. Median DNA concentration ([DNA]) was 6.6 ng/ml and an increase of [DNA] of 10 ng/ml was found prognostic of poor DFS and OS, HR=1.4, 95%CI [1.14-1.72], p=0.0016 and HR=1.62, 95%CI [1.15-2.30], p=0.0057 respectively. In 81 pts with available T0-T6 samples, [DNA] variation had no different impact on DFS and OS, in the P arm and the placebo arm. ctDNA mutations (ctDNA+) were detected in 31/119 pts. ctDNA+ were more frequent in samples with high DNA quantity (p=0.0002). Genes mutated at T0 were TP53 in 16, NRAS in 6, MAP2K1 in 2, KRAS in 1, EGFR in 5, BRAF in 1, ALK in 2. 29 pts had 1 mutation, 2 had 2 mutations. DFS and OS were similar between pts with or without ctDNA+ : HR= 1.038 (95%CI 0.438-2.456, p=0.93) and 1.193 (95% CI 0.367-3.882, p=0.77) respectively. Among 27 pts with ctDNA+ at T0 and available sample at T6, 23 had no more mutations at T6. Two pts had a ctDNA+ only at T6 (not at T3), one of them had a recurrence at 7 months. Conclusions: Post-operative ctDNA mutations are found in 26.0% of the pts but their positivity had no impact on DFS or OS. In contrast, DFS and OS were poorer in pts with increased plasma DNA concentration. ctDNA mutations status do not recapitulate the complexity of MRD characterization. NGS will be performed on matched tissues in order to refine MRD definition. Clinical trial information: NCT00775307.
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Affiliation(s)
| | | | - Nathalie Cozic
- Biostatistics Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | - Julien Mazieres
- Centre Hospitalier Universitaire de Toulouse–Hôpital Larrey, Toulouse, France
| | - Fabrice Barlesi
- Aix-Marseille University, CEPCM CLIP, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Jaafar Bennouna
- University Hospital of Nantes, Digestive Oncology, Nantes, France
| | | | - Lionel Moreau
- Centre Hospitalier Pneumologie Colmar, Colmar, France
| | - Henri Berard
- Hopital D'instruction Des Armes Sainte-Anne, Toulon, France
| | | | - Denis Moro-Sibilot
- Unité d’Oncologie Thoracique, Service Hospitalier Universitaire Pneumologie Physiologie Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Grenoble, France
| | | | | | - Franck Morin
- Clinical Research Unit, Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Gerard Zalcman
- Department of Thoracic Oncology, CIC INSERM 1425, Université de Paris, Hôpital Bichat, Paris, France
| | - Jean-Charles Soria
- Gustave Roussy Cancer Campus, Department of Drug Development (DITEP), Villejuif, France
| | | | - Ludovic Lacroix
- Cancer Genetics Laboratory, Departement of Pathology and Medical Biology, Gustave Roussy, Villejuif, France
| | - Benjamin Besse
- Department of Medicine and Thoracic Pathology Committee, Gustave Roussy, Villejuif, France
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17
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Sendur MN, Reck M, Rodriguez-Abreu D, Park K, Lee DH, Cicin I, Yumuk PF, Orlandi FJ, Leal TA, Molinier O, Soparattanapaisarn N, Langleben A, Califano R, Medgyasszay B, Hsia TC, Otterson GA, Xu L, Burke TA, Samkari A, Boyer MJ. Health-related quality of life for pembrolizumab (pembro) plus ipilimumab (ipi) versus pembro plus placebo in patients with metastatic NSCLC with PD-L1 tumor proportion score ≥ 50%: KEYNOTE-598. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.9038] [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
9038 Background: In the phase 3 KEYNOTE-598 study (NCT03302234), OS (HR, 1.08; 95% CI, 0.85–1.37; P = 0.74) and PFS (1.06; 95% CI, 0.86–1.30; P = 0.72) were not improved for pembro + ipi vs pembro + placebo in patients (pts) with previously untreated metastatic NSCLC with PD-L1 tumor proportion score (TPS) ≥50% and without EGFR/ALK genomic alterations. Incidence of treatment-related grade 3–5 AEs, fatal AEs, and AEs leading to discontinuation was higher with pembro + ipi vs pembro + placebo. We present prespecified patient-reported outcome (PRO) analyses from KEYNOTE-598. Methods: Pts (n = 568) with previously untreated stage IV NSCLC with PD-L1 TPS ≥50% were randomized 1:1 to pembro 200 mg Q3W for up to 35 cycles + ipi 1 mg/kg or placebo Q6W for up to 18 cycles. The EORTC QLQ-C30, QLQ-LC13, EQ-5D-5L, and NSCLC-SAQ were administered at cycles 1‒7, then every 3 cycles through cycle 19, and every 4 cycles until PD or a maximum of 35 cycles. Change from baseline in global health status (GHS)/quality of life (QoL) score from the QLQ-C30 and the time to true deterioration (TTD) in the composite endpoint of cough (LC13), chest pain (LC13), or dyspnea (C30) were secondary objectives in KEYNOTE-598. Change from baseline in GHS/QoL was analyzed using a constrained longitudinal data analysis model with missing at random assumption. Difference in TTD was evaluated using a Cox proportional hazards model and stratified log-rank test. PROs were analyzed in all pts who completed ≥1 PRO assessment and received ≥1 dose of study treatment. P values are two-sided and nominal. Results: As of data cutoff (Sept 1, 2020), PRO analyses included 280 pts in the pembro + ipi group and 280 pts in the pembro + placebo group. QLQ-C30 completion rates were 95.7% in the pembro + ipi group vs 96.1% in the pembro + placebo group at baseline and 63.6% vs 70.0% at week 18. QLQ-LC13 completion rates were 95.4% vs 96.4% at baseline and 63.6% vs 69.6% at week 18. Mean QLQ-C30 GHS/QoL scores at baseline were 62.8 in the pembro + ipi group and 64.2 in the pembro + placebo group and were similar between the groups across the follow-up period. Least squares (LS) mean (95% CI) change from baseline to week 18 in GHS/QoL scores was improved in both groups (pembro + ipi: 3.7 [0.9‒6.5]; pembro + placebo: 4.1 [1.4‒6.9]), with no significant difference between groups (LS mean difference −0.4 [−4.0 to 3.1], P = 0.82). Median TTD in composite of cough, chest pain, or dyspnea was not reached (NR; 95% CI, 13.0 mo–NR) in the pembro + ipi group vs 20.0 (95% CI, 12.7–NR) mo in the pembro + placebo group (hazard ratio, 0.98 [95% CI, 0.74‒1.30]; P = 0.91). Conclusions: There was no difference in health-related QoL or TTD in lung cancer symptoms between pembro + ipi and pembro + placebo in pts with previously untreated metastatic NSCLC with PD-L1 TPS ≥50%. Clinical trial information: NCT03302234.
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Affiliation(s)
- Mehmet Nahit Sendur
- Ankara Yıldırım Beyazıt University, Faculty of Medicine and Ankara City Hospital, Ankara, Turkey
| | - Martin Reck
- LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany
| | - Delvys Rodriguez-Abreu
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas De Gran Canaria, Spain
| | - Keunchil Park
- Samsung Medical Center at Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | | | | | | | | | | | | | - Adrian Langleben
- St. Mary’s Hospital–ODIM, McGill University Department of Oncology, Montreal, QC, Canada
| | - Raffaele Califano
- The Christie NHS Foundation Trust, and Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Te-Chun Hsia
- China Medical University and China Medical University Hospital, Taichung, Taiwan
| | | | - Lu Xu
- Merck & Co., Inc., Kenilworth, NJ
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18
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Gounant V, Duruisseaux M, Soussi G, Van Hulst S, Bylicki O, Cadranel J, Wislez M, Trédaniel J, Spano JP, Helissey C, Chouaid C, Molinier O, Dhalluin X, Doucet L, Hureaux J, Cazes A, Zalcman G. Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients. Cancers (Basel) 2021; 13:cancers13051040. [PMID: 33801285 PMCID: PMC7958129 DOI: 10.3390/cancers13051040] [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: 02/04/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Immunotherapies prolong survival of metastatic non-small-cell lung cancer patients. However, their efficacy in patients with very poor general condition is unknown. Best supportive care is the standard of care for these patients because chemotherapy is more toxic and less effective than for patients with good general condition. Most patients die within 1 to 4 months of diagnosis. Consecutive metastatic non-small-cell lung cancer patients with very poor general condition receiving compassionate immunotherapy were accrued by 12 French thoracic oncology departments, over 24 months. Tolerance was acceptable. Overall, 20% of patients were alive at 1 year, and 14% at 2 years. We feel that our study results might suggest that some patients with a very poor general condition (namely those without brain metastases or heavy smokers) could derive long-term benefit from immunotherapy as salvage therapy. We initiated such a prospective phase 2 trial based on these results, which is a cause for hope. Abstract Anti-PD-1 antibodies prolong survival of performance status (PS) 0–1 advanced non-small-cell lung cancer (aNSCLC) patients. Their efficacy in PS 3–4 patients is unknown. Conse- cutive PS 3–4 aNSCLC patients receiving compassionate nivolumab were accrued by 12 French thoracic oncology departments, over 24 months. Overall survival (OS) was calculated using the Kaplan-Meier method. Prognostic variables were assessed using Cox proportional hazards models. Overall, 35 PS 3–4 aNSCLC patients (median age 65 years) received a median of 4 nivolumab infusions (interquartile range [IQR], 1–7) as first- (n = 6) or second-line (n = 29) therapy. At a median of 52-month follow-up (95%CI, 41–63), 32 (91%) patients had died. Median progression-free survival was 2.1 months (95%CI, 1.1–3.2). Median OS was 4.4 months (95%CI, 0.5–8.2). Overall, 20% of patients were alive at 1 year, and 14% at 2 years. Treatment-related adverse events occurred in 8/35 patients (23%), mostly of low-grade. After adjustment, brain metastases (HR = 5.2; 95%CI, 9–14.3, p = 0.001) and <20 pack-years (HR = 4.8; 95%CI, 1.7–13.8, p = 0.003) predicted worse survival. PS improvement from 3–4 to 0–1 (n = 9) led to a median 43-month (95%CI, 0–102) OS. Certain patients with very poor general condition could derive long-term benefit from nivolumab salvage therapy.
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Affiliation(s)
- Valérie Gounant
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, France; (G.S.); (G.Z.)
- Correspondence:
| | - Michael Duruisseaux
- Respiratory Department, Louis Pradel Hospital, Hospices Civils de Lyon, 69002 Lyon, France;
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Ghassen Soussi
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, France; (G.S.); (G.Z.)
| | - Sylvie Van Hulst
- Department of Pneumology, University Hospital of Nîmes, 30900 Nîmes, France;
| | - Olivier Bylicki
- Respiratory Disease Unit, Hôpital d’Instruction des Armées Sainte-Anne, 83800 Toulon, France;
| | - Jacques Cadranel
- Department of Pneumology and Thoracic Oncology, Tenon Hospital, APHP, GRC Theranoscan and Curamus Sorbonne Université, 75020 Paris, France;
| | - Marie Wislez
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, INSERM, TeamInflammation, Complement, and Cancer, 75006 Paris, France;
- Oncology Thoracic Unit Pulmonology Department, AP-HP, Hôpital Cochin, 75014 Paris, France
| | - Jean Trédaniel
- Groupe Hospitalier Paris Saint-Joseph, Department of Pneumology, Université de Paris, Sorbonne Paris Cité, Unité INSERM UMR-S 1124, 75014 Paris, France;
| | - Jean-Philippe Spano
- Department of Medical Oncology, Pitié-Salpétrière Hospital, APHP, Sorbonne Université, 75013 Paris, France;
| | - Carole Helissey
- Clinical Research Unit, Hôpital d’Instruction des Armées Bégin, 94160 Saint-Mandé, France;
| | - Christos Chouaid
- Department of Pneumology, Centre Hospitalier Intercommunal de Créteil, University Paris–Est Créteil (UPEC), CEpiA (Clinical Epidemiology and Ageing), EA 7376-IMRB, 94000 Créteil, France;
| | - Olivier Molinier
- Department of Pneumology, Centre Hospitalier Le Mans, 72037 Le Mans, France;
| | - Xavier Dhalluin
- Department of Pneumology and Thoracic Oncology, Calmette Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, France;
| | - Ludovic Doucet
- Department of Oncology, Saint Louis Hospital, APHP, 75010 Paris, France;
| | - José Hureaux
- Department of Pneumology, Pόle Hippocrate, University Hospital of Angers, 49100 Angers, France;
| | - Aurélie Cazes
- Department of Pathology, Bichat Claude Bernard Hospital, APHP, Université de Paris, 75018 Paris, France;
| | - Gérard Zalcman
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, France; (G.S.); (G.Z.)
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19
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Boyer M, Sendur M, Rodríguez-Abreu D, Park K, Lee D, Cicin I, Yumuk P, Orlandi F, Leal T, Molinier O, Soparattanapaisam N, Langleben A, Califano R, Medgyasszay B, Hsia T, Otterson G, Xu L, Piperdi B, Samkari A, Reck M. PS01.09 Pembrolizumab Plus Ipilimumab vs Pembrolizumab Plus Placebo as 1L Therapy for Metastatic NSCLC of PD-L1 TPS ≥50%: KEYNOTE-598. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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20
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Boyer M, Şendur MAN, Rodríguez-Abreu D, Park K, Lee DH, Çiçin I, Yumuk PF, Orlandi FJ, Leal TA, Molinier O, Soparattanapaisarn N, Langleben A, Califano R, Medgyasszay B, Hsia TC, Otterson GA, Xu L, Piperdi B, Samkari A, Reck M. Pembrolizumab Plus Ipilimumab or Placebo for Metastatic Non-Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score ≥ 50%: Randomized, Double-Blind Phase III KEYNOTE-598 Study. J Clin Oncol 2021; 39:2327-2338. [PMID: 33513313 DOI: 10.1200/jco.20.03579] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [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 Pembrolizumab monotherapy is standard first-line therapy for metastatic non-small-cell lung cancer (NSCLC) with programmed death ligand 1 (PD-L1) tumor proportion score (TPS) ≥ 50% without actionable driver mutations. It is not known whether adding ipilimumab to pembrolizumab improves efficacy over pembrolizumab alone in this population. METHODS In the randomized, double-blind, phase III KEYNOTE-598 trial (ClinicalTrials.gov identifier: NCT03302234), eligible patients with previously untreated metastatic NSCLC with PD-L1 TPS ≥ 50% and no sensitizing EGFR or ALK aberrations were randomly allocated 1:1 to ipilimumab 1 mg/kg or placebo every 6 weeks for up to 18 doses; all participants received pembrolizumab 200 mg every 3 weeks for up to 35 doses. Primary end points were overall survival and progression-free survival. RESULTS Of the 568 participants, 284 were randomly allocated to each group. Median overall survival was 21.4 months for pembrolizumab-ipilimumab versus 21.9 months for pembrolizumab-placebo (hazard ratio, 1.08; 95% CI, 0.85 to 1.37; P = .74). Median progression-free survival was 8.2 months for pembrolizumab-ipilimumab versus 8.4 months for pembrolizumab-placebo (hazard ratio, 1.06; 95% CI, 0.86 to 1.30; P = .72). Grade 3-5 adverse events occurred in 62.4% of pembrolizumab-ipilimumab recipients versus 50.2% of pembrolizumab-placebo recipients and led to death in 13.1% versus 7.5%. The external data and safety monitoring committee recommended that the study be stopped for futility and that participants discontinue ipilimumab and placebo. CONCLUSION Adding ipilimumab to pembrolizumab does not improve efficacy and is associated with greater toxicity than pembrolizumab monotherapy as first-line treatment for metastatic NSCLC with PD-L1 TPS ≥ 50% and no targetable EGFR or ALK aberrations. These data do not support use of pembrolizumab-ipilimumab in place of pembrolizumab monotherapy in this population.
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Affiliation(s)
| | - Mehmet A N Şendur
- Ankara Yıldırım Beyazıt University, Faculty of Medicine and Ankara City Hospital, Ankara, Turkey
| | - Delvys Rodríguez-Abreu
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Keunchil Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | | | | | | | - Ticiana A Leal
- University of Wisconsin Carbone Cancer Center, Madison, WI
| | | | | | - Adrian Langleben
- St Mary's Hospital - ODIM, McGill University Department of Oncology, Montreal, QC, Canada
| | - Raffaele Califano
- The Christie NHS Foundation Trust, and Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | | | - Te-Chun Hsia
- China Medical University and China Medical University Hospital, Taichung, Taiwan
| | - Gregory A Otterson
- The Ohio State University-James Comprehensive Cancer Center, Columbus, OH
| | - Lu Xu
- Merck & Co, Inc, Kenilworth, NJ
| | | | | | - Martin Reck
- LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany
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21
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Herbreteau G, Langlais A, Greillier L, Audigier-Valette C, Uwer L, Hureaux J, Moro-Sibilot D, Guisier F, Carmier D, Madelaine J, Otto J, Souquet PJ, Gounant V, Merle P, Molinier O, Renault A, Rabeau A, Morin F, Denis MG, Pujol JL. Circulating Tumor DNA as a Prognostic Determinant in Small Cell Lung Cancer Patients Receiving Atezolizumab. J Clin Med 2020; 9:E3861. [PMID: 33261056 PMCID: PMC7760916 DOI: 10.3390/jcm9123861] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The IFCT-1603 trial evaluated atezolizumab in small cell lung cancer (SCLC). The purpose of the present study was to determine whether circulating tumor DNA (ctDNA), prospectively collected at treatment initiation, was associated with the prognosis of SCLC, and whether it identified patients who benefited from atezolizumab. METHODS 68 patients were included in this study: 46 patients were treated with atezolizumab and 22 with conventional chemotherapy. Circulating DNA was extracted from plasma and NGS (Next Generation Sequencing) looked for mutations in the TP53, RB1, NOTCH1, NOTCH2, and NOTCH3 genes. ctDNA was detectable when at least one somatic mutation was identified, and its relative abundance was quantified by the variant allele fraction (VAF) of the most represented mutation. RESULTS We found that 49/68 patients (70.6%) had detectable baseline ctDNA. The most frequently identified mutations were TP53 (32/49; 65.3%) and RB1 (25/49; 51.0%). Patients with detectable ctDNA had a significantly lower disease control rate at week 6 compared with patients with no detectable ctDNA, regardless of the nature of the treatment. Detection of ctDNA was associated with a poor OS prognosis. The detection of ctDNA at a relative abundance greater than the median value was significantly associated with poor overall survival (OS) and progression free survival (PFS). Interestingly, the benefit in overall survival (OS) associated with low ctDNA was more pronounced in patients treated with atezolizumab than in patients receiving chemotherapy. Among patients whose relative ctDNA abundance was below the median, those treated with atezolizumab tended to have higher OS than those in the chemotherapy arm. CONCLUSION ctDNA is strongly associated with the prognosis of SCLC patients treated with second-line immunotherapy. Its analysis seems justified for future SCLC clinical trials.
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Affiliation(s)
- Guillaume Herbreteau
- Department of Biochemistry, Nantes University Hospital, 9 quai Moncousu, 44093 Nantes, France;
| | - Alexandra Langlais
- IFCT Intergroupe Francophone de Cancérologie Thoracique, 10 Rue de la Grange Batelière, 75009 Paris, France; (A.L.); (F.M.)
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique—Hôpitaux de Marseille, Aix Marseille University, 13015 Marseille, France;
| | - Clarisse Audigier-Valette
- Department of Thoracic Oncology, 54 Rue Henri Sainte Claire Deville, CHITS CH Sainte Musse, 83000 Toulon, France;
| | - Lionel Uwer
- Institut de Cancérologie de Lorraine Alexis Vautrin, 6 Avenue de Bourgogne, 54519 Vandoeuvre-les-Nancy, France;
| | - José Hureaux
- Pôle Hippocrate, Angers University Hospital, 49933 Angers, France;
| | | | - Florian Guisier
- Department of Pneumology, Thoracic Oncology and Respiratory Intensive Care, Rouen University Hospital, 76000 Rouen, France;
| | - Delphine Carmier
- Service de Pneumologie CHRU Hôpitaux de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France;
| | - Jeannick Madelaine
- Service de Pneumologie, CHU Caen Normandie, Av de La Côte de Nacre, 14000 Caen, France;
| | - Josiane Otto
- Pôle Médecine, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France;
| | - Pierre-Jean Souquet
- Service de Pneumologie Aiguë Spécialisée et Cancérologie Thoracique, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69310 Pierre-Benite, France;
| | - Valérie Gounant
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, 75018 Paris, France;
| | - Patrick Merle
- Service de Pneumologie, 58 Rue Montalembert, CHU G Montpied, 63000 Clermont Ferrand, France;
| | - Olivier Molinier
- Service de Pneumologie, Centre Hospitalier, 194 Avenue Rubillard, 72037 Le Mans, France;
| | - Aldo Renault
- Service de Pneumologie, Centre Hospitalier, 4 Boulevard Hauterive, 64000 Pau, France;
| | - Audrey Rabeau
- Service de Pneumologie, Centre Hospitalier, Université Paul Sabatier, 31300 Toulouse, France;
| | - Franck Morin
- IFCT Intergroupe Francophone de Cancérologie Thoracique, 10 Rue de la Grange Batelière, 75009 Paris, France; (A.L.); (F.M.)
| | - Marc G Denis
- Department of Biochemistry, Nantes University Hospital, 9 Quai Moncousu, 44093 Nantes, France;
| | - Jean-Louis Pujol
- Department of Thoracic Oncology, Montpellier Regional University Hospital, 34090 Montpellier, France
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Payen T, Trédaniel J, Moreau L, Larivé S, Le Treut J, Nocent C, Hominal S, Grangeon V, Bizec JL, Molinier O, Debieuvre D. Real world data of efficacy and safety of erlotinib as first-line TKI treatment in EGFR mutation-positive advanced non-small cell lung cancer: Results from the EGFR-2013-CPHG study. Respir Med Res 2020; 80:100795. [PMID: 34242973 DOI: 10.1016/j.resmer.2020.100795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/22/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Phase III clinical trials have demonstrated the merits of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKI) in the treatment of non-small cell lung cancer (NSCLC) patients with EGFR-activating mutations. Using a cohort of unselected patients treated with erlotinib, we sought to further describe patient and tumour characteristics, and to evaluate their progression-free survival (PFS) and overall survival (OS). METHODS Overall, 44 pulmonologists included patients with the required characteristics as follows: Stage IIIB-IV NSCLC, EGFR-activating mutation, age≥18 years, and having to start erlotinib therapy or receiving erlotinib therapy as the first-line TKI, regardless of treatment-line. The analyses were performed using R software, with survival rates calculated according to the Kaplan-Meier method. RESULTS A total of 177 patients, aged 72 years on average, were enrolled over a 2-year period. The cohort included 123 women (69.5%), 158 Caucasians (89.3%), 112 non-smokers (63.2%), and 167 adenocarcinomas (94.3%), at either stage IIIB (21) or IV (156), with a good performance status (PS 0-1, 127). Overall, 40 exhibited brain metastases at baseline (22.6%), while 75 had undergone earlier treatment (42.4%). Median PFS was 11.7 months and OS 25.8 months, with respectively a 1-year rate of 48.6% and 74%. The risk of death correlated with ECOG status (PS=2, HR=4.48, P<0.001) but not with brain metastasis (HR=1.67, P=0.278). CONCLUSIONS This study has confirmed erlotinib's efficacy and safety for unselected patients, with PFS and OS comparable to those obtained in phase III trials.
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Affiliation(s)
- T Payen
- Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Emile-Muller, 20, rue du Dr-Laënnec, BP 1370, 68070 Mulhouse cedex, France
| | - J Trédaniel
- Respiratory Medicine and Thoracic Oncology Department, Groupe Hospitalier Paris Saint-Joseph, Paris, France; Paris Descartes University, Sorbonne Paris cité, Paris, France; INSERM Unit UMR-S 1124, Toxicology, Pharmacology and Cell Signalling, Paris, France
| | - L Moreau
- Respiratory Medicine Department, Hôpitaux Civils de Colmar, 68024 Colmar, France
| | - S Larivé
- Respiratory Medicine Department, Centre hospitalier de Macon - site des Chanaux, 71018 Macon, France
| | - J Le Treut
- Respiratory Medicine Department, Hôpital Européen, 13003 Marseille, France
| | - C Nocent
- Respiratory Medicine Department, Centre Hospitalier de la Côte Basque, 64109 Bayonne, France
| | - S Hominal
- Respiratory Medicine Department, Centre Hospitalier Annecy-Genevois, 74000 Annecy, France
| | - V Grangeon
- Respiratory Medicine Department, Centre Hospitalier de Roanne, 42300 Roanne, France
| | - J-L Bizec
- Respiratory Medicine Department, Centre Hospitalier Bretagne-Atlantique, 56017 Vannes, France
| | - O Molinier
- Respiratory Medicine Department, Centre Hospitalier du Mans, 72 037 Le Mans, France
| | - D Debieuvre
- Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Emile-Muller, 20, rue du Dr-Laënnec, BP 1370, 68070 Mulhouse cedex, France.
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Quoix E, Audigier-Valette C, Lavolé A, Molinier O, Westeel V, Barlesi F, Le Treut J, Pichon E, Dauba J, Otto J, Moreau L, Madelaine J, Dumont P, Margery J, Debieuvre D, Renault PA, Pujol JL, Langlais A, Morin F, Moro-Sibilot D, Souquet PJ. Switch maintenance chemotherapy versus observation after carboplatin and weekly paclitaxel doublet chemotherapy in elderly patients with advanced non-small cell lung cancer: IFCT-1201 MODEL trial. Eur J Cancer 2020; 138:193-201. [PMID: 32898792 DOI: 10.1016/j.ejca.2020.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE Maintenance chemotherapy is a reasonable choice for patients with metastatic non-small cell lung carcinoma (NSCLC) not progressing after induction therapy with a platinum-based doublet. Nevertheless, there have been no studies dedicated to elderly patients. PATIENTS AND METHODS We conducted a randomised trial in patients aged 70-89 years, with advanced NSCLC (with neither EGFR mutation nor ALK rearrangement), who had not progressed after four cycles of monthly carboplatin and weekly paclitaxel in order to compare maintenance with either pemetrexed (500 mg/m2 d1, 22) in patients with non-squamous cell carcinoma or gemcitabine (1,150 mg/m2 d1, 8, 22) in squamous cell carcinoma to simple observation. The patients were required to have a performance status (PS) 0-2, mini-mental score >23, and creatinine clearance ≥45 mL/min. The primary end-point was overall survival (OS). RESULTS 632 patients were enrolled from May 2013 to October 2016. Of the 328 (52.3%) patients randomised after induction therapy, 166 patients were assigned to the observation arm, versus 162 to the switch maintenance arm, 119 of whom received pemetrexed and 43 gemcitabine. The median OS from randomisation was 14.1 months (95% confidence interval [CI]: 12.0-17.0) in the observation arm and 14 months (95% CI: 10.9-16.9) in the maintenance arm (p = 0.72). The median progression-free survival (PFS) from randomisation was 2.7 months (95% CI: 2.6-3.1) in the observation arm versus 5.7 months (95% CI: 4.8-7.1) in the maintenance arm (p < 0.001). CONCLUSION Switch maintenance therapy significantly prolonged PFS but not OS and, thus, should not be proposed to elderly patients with advanced NSCLC.
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Affiliation(s)
- Elisabeth Quoix
- Department of Pneumology, University Hospital of Strasbourg, Strasbourg, France.
| | | | | | | | - Virginie Westeel
- Department of Pneumology, University Hospital of Besançon, Besançon, France
| | - Fabrice Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Jacques Le Treut
- Department of Pneumology, Pays D'Aix Hospital, Aix-en-Provence, France
| | - Eric Pichon
- Department of Pneumology, University Hospital of Tours, Tours, France
| | - Jérôme Dauba
- Department of Medical Oncology, Hospital Layné, Mont-de-Marsan, France
| | | | - Lionel Moreau
- Department of Pneumology, Louis Pasteur Hospital, Colmar, France
| | - Jeannick Madelaine
- Department of Pneumology, University Hospital of Caen Normandie, Caen, France
| | - Patrick Dumont
- Department of Pneumology, Hospital of Chauny, Chauny, France
| | - Jacques Margery
- Department of Pneumology, Hôpital D'Instruction des Armées Percy, Clamart, France
| | - Didier Debieuvre
- Department of Pneumology, GHRMSA, Emile Miller Hospital, Mulhouse, France
| | | | - Jean-Louis Pujol
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Denis Moro-Sibilot
- Thoracic Oncology Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | - Pierre-Jean Souquet
- Department of Pneumology and Thoracic Oncology, Hospital of Lyon Sud, Lyon, France
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Peters S, Pujol JL, Dafni U, Dómine M, Becker A, Andrade J, Curioni-Fontecedro A, Molinier O, Moro-Sibilot D, Nackaerts K, Mollá AI, López Vivanco G, Madelaine J, Popat S, Reck M, Roschitzki-Voser H, Mitchell P, De Ruysscher D, Le Pechoux C, Stahel R. LBA84 Consolidation ipilimumab and nivolumab vs observation in limited stage SCLC after chemo-radiotherapy: Results from the ETOP/IFCT 4-12 STIMULI trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2326] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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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25
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Wislez M, Mazieres J, Lavole A, Zalcman G, Carre O, Egenod T, Caliandro R, Gervais R, Jeannin G, Molinier O, Massiani M, Langlais A, Morin F, Le Pimpec Barthes F, Brouchet L, Assouad J, Milleron B, Damotte D, Antoine M, Westeel V. 1214O Neoadjuvant durvalumab in resectable non-small cell lung cancer (NSCLC): Preliminary results from a multicenter study (IFCT-1601 IONESCO). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1416] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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26
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Barlesi F, Karimi M, Tomasini P, Daniel C, Raimbourg J, Quoix AE, Flandin ACM, Mazieres J, Molinier O, Audigier-Valette C, Moro-Sibilot D, Morel H, Souquet PJ, Bieche I, Tran-Dien A, Jacquet A, Adam J, Soria JC, Besse B. 1273P Durvalumab (D) compared to maintenance chemotherapy (SoC) in patients (pts) with metastatic non-small cell lung cancer (NSCLC): Results from the randomized SAFIR02 LUNG-IMMUNO trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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27
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Gobbini E, Toffart AC, Pérol M, Assié JB, Duruisseaux M, Coupez D, Dubos C, Westeel V, Delaunay M, Guisier F, Veillon R, Gounant V, Giroux Leprieur E, Vanel FR, Chaabane N, Dansin E, Babey H, Decroisette C, Barlesi F, Daniel C, Fournel P, Mezquita L, Oulkhouir Y, Canellas A, Duchemann B, Molinier O, Alcazer V, Moro-Sibilot D, Levra MG. Immune Checkpoint Inhibitors Rechallenge Efficacy in Non-Small-Cell Lung Cancer Patients. Clin Lung Cancer 2020; 21:e497-e510. [PMID: 32605892 DOI: 10.1016/j.cllc.2020.04.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/26/2020] [Accepted: 04/23/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Immune checkpoint inhibitor (ICPi) rechallenge could represent an attractive option in non-small-cell lung cancer (NSCLC), yet no sufficient data supporting this strategy are available. This retrospective observational multicenter national study explored the efficacy of anti-programmed cell death 1 (PD-1)/programmed death ligand 1 (PD-L1) rechallenge in advanced NSCLC patients, looking for potential clinical features associated with greater outcomes. PATIENTS AND METHODS We retrospectively collected data from 144 advanced NSCLC patients whose disease was rechallenged with ICPis after ≥ 12 weeks of discontinuation. The progression-free survival (PFS) and overall survival (OS) were calculated from first or second ICPi initiation to disease progression (PFS1 and PFSR, respectively), death, or last follow-up (OS1, OSR), respectively. RESULTS The median (interquartile range) age was 63 (58-70) years. Most patients were male (67%) and smokers (87%). Most had adenocarcinomas (62%) and/or stage IV disease at diagnosis (66%). The best response at rechallenge was not associated with that under the first ICPi (P = 1.10-1). The median (95% confidence interval) PFS1 and PFSR were 13 (10-16.5) and 4.4 (3-6.5) months, respectively. The median (95% confidence interval) OS1 and OSR were 3.3 (2.9-3.9) and 1.5 (1.0-2.1) years, respectively. Longer PFSR and OSR were found in patients discontinuing first ICPi because of toxicity or clinical decision, those not receiving systemic treatment between the two ICPis, and those with good Eastern Cooperative Oncology Group performance status at rechallenge. Only performance status proved to affect outcomes at multivariate analysis. CONCLUSION Patients discontinuing first ICPi because of toxicity or clinical decision, those able to maintain a treatment-free period, and those with good performance status may be potential candidates for rechallenge.
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Affiliation(s)
- Elisa Gobbini
- Thoracic Oncology Unit SHUPP, CHU Grenoble-Alpes, Grenoble, France; Cancer Research Center Lyon, Center Léon Bérard, Lyon, France.
| | | | - Maurice Pérol
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | | | - Michaël Duruisseaux
- Unité de Recherche Commune en Oncologie Thoracique (URCOT), Hospices Civils de Lyon Cancer Institute, Lyon, France; Anticancer Antibodies Laboratory, Cancer Research Center of Lyon, Inserm 1052, CNRS 5286, Lyon, France; Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Dahna Coupez
- Thoracic Oncology Unit, CHU Nantes, Nantes, France
| | - Catherine Dubos
- Thoracic Oncology Unit, Center François Baclesse, Caen, France
| | | | | | - Florian Guisier
- Pneumology, Thoracic Oncology, and Respiratory Intensive Care Unit, CHU Rouen, Rouen, France
| | - Rémi Veillon
- Respiratory Diseases Department, F-33000, CHU Bordeaux, Bordeaux, France
| | - Valérie Gounant
- Thoracic Oncology Department, CIC 1425 INSERM, Center Bichat, Paris, France
| | - Etienne Giroux Leprieur
- Department of Respiratory Diseases and Thoracic Oncology, APHP-Hôpital Ambroise Pare, Paris, France
| | | | - Nouha Chaabane
- Pulmonology Service, AP-HP Paris Center University Hospitals, Cochin Hospital, Paris, France
| | - Eric Dansin
- Thoracic Oncology Unit, Center Oscar Lambret, Lille, France
| | - Hélène Babey
- Thoracic Oncology Unit, CHRU Brest, Brest, France
| | | | - Fabrice Barlesi
- Aix-Marseille Université, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Catherine Daniel
- Thoracic Oncology Unit, Institute Curie, Paris/Saint Cloud, France
| | - Pierre Fournel
- Medical Oncology Department, Institut de Cancérologie de la Loire, Saint, France
| | - Laura Mezquita
- Department of Medical Oncology, Thoracic Group, Gustave Roussy, Villejuif, France
| | | | - Anthony Canellas
- Pulmonology Unit, APHP Hôpital Tenon and GRC 04 Theranoscan Sorbonne University, Paris, France
| | | | | | - Vincent Alcazer
- Cancer Research Center Lyon, Center Léon Bérard, Lyon, France
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Domblides C, Leroy K, Monnet I, Mazières J, Barlesi F, Gounant V, Baldacci S, Mennecier B, Toffart AC, Audigier-Valette C, Doucet L, Giroux-Leprieur E, Guisier F, Ricordel C, Molinier O, Perol M, Pichon E, Robinet G, Templement-Grangerat D, Ruppert AM, Rabbe N, Antoine M, Wislez M. Efficacy of Immune Checkpoint Inhibitors in Lung Sarcomatoid Carcinoma. J Thorac Oncol 2020; 15:860-866. [PMID: 31991225 DOI: 10.1016/j.jtho.2020.01.014] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/21/2020] [Accepted: 01/21/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Immune checkpoint inhibitors (ICIs) have improved cancer prognosis but have not been evaluated specifically in sarcomatoid carcinoma (SC), a rare lung cancer subtype with poor prognosis. As such, our study sought to retrospectively assess the efficacy of ICI in SC. METHODS All consecutive patients with centrally confirmed SC treated using ICI as a second-line treatment or beyond between 2011 and 2017 were enrolled. Programmed death-ligand 1 (PD-L1) tumor expression was assessed using immunohistochemistry (SP263 clone) and the tumor mutational burden (TMB) with the Foundation One panel. TMB was considered high if it was greater than or equal to 10 mutations per megabase. RESULTS Overall, 37 patients with SC were evaluated, predominantly men (73%) with a median age of 63.2 years (36.8-79.7) and who were current or former smokers (94.6%). Immunotherapy (nivolumab, 86.5% of cases) was given as a second-line treatment in 54% of the patients and as third-line treatment or beyond in 46% of the patients. The objective response rate was 40.5% and disease control rate was 64.8%, regardless of PD-L1 status. Median overall survival was 12.7 months (range: 0.3-45.7). One-third of patients exhibited early progression. The median PD-L1 expression was 70% (0-100). There was a trend toward higher PD-L1 expression in responsive diseases, with an objective response rate of 58.8% in patients with PD-L1+ and 0% in the one patient with PD-L1- (p = 0.44). The median TMB was 18 (4-39) mutations per megabase, with 87.5% of the cases displaying a high TMB. There was a trend toward higher TMB in responders versus stable or progressive diseases (p = 0.2). CONCLUSIONS Patients with SC exhibited high response rates and prolonged overall survival under ICI treatment. These data support the prospective investigation of ICI in patients with SC who are under first-line treatment.
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Affiliation(s)
- Charlotte Domblides
- Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, Bordeaux, France; ImmunoConcEpt, CNRS UMR 5164, University of Bordeaux, Bordeaux, France
| | - Karen Leroy
- Genetic and Molecular Biology Department, AP-HP, Groupe Hospitalier HUPC, Hôpital Cochin, Paris, France
| | | | - Julien Mazières
- Department of Pneumology, Hôpital Larrey, Université Paul Sabatier, Toulouse, France
| | - Fabrice Barlesi
- Multidisciplinary Oncology & Therapeutic Innovations Department, Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | | | - Simon Baldacci
- Thoracic Oncology Department, Lille University Hospital, Lille, France
| | | | | | | | - Ludovic Doucet
- Department of Medical Oncology, Hôpital Saint-Louis, Paris, France
| | | | - Florian Guisier
- Department of Pneumology, Hôpital Charles Nicolle, Rouen, France
| | | | | | - Maurice Perol
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Eric Pichon
- Department of Pneumology, CHRU Bretonneau, Tours, France
| | | | | | - Anne-Marie Ruppert
- Sorbonne Université, GRC n°04, Theranoscan, Paris, France; Department of Pneumology, AP-HP, Groupe Hospitalier HUEP, Hôpital Tenon, Paris, France
| | - Nathalie Rabbe
- Department of Thoracic Oncology, AP-HP, Groupe Hospitalier HUPC, Hôpital Cochin, Paris, France; Centre de Recherche des Cordeliers, Université Paris Descartes, Complement, Inflammation and Cancer, Paris, France
| | - Martine Antoine
- Pathology Department, AP-HP, Groupe Hospitalier HUEP, Hôpital Tenon, Paris, France
| | - Marie Wislez
- Department of Thoracic Oncology, AP-HP, Groupe Hospitalier HUPC, Hôpital Cochin, Paris, France; Centre de Recherche des Cordeliers, Université Paris Descartes, Complement, Inflammation and Cancer, Paris, France.
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29
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Cortot AB, Audigier-Valette C, Molinier O, Le Moulec S, Barlesi F, Zalcman G, Dumont P, Pouessel D, Poulet C, Fontaine-Delaruelle C, Hiret S, Dixmier A, Renault PA, Becht C, Raffy O, Dayen C, Mazieres J, Pichon E, Langlais A, Morin F, Moro-Sibilot D, Besse B. Weekly paclitaxel plus bevacizumab versus docetaxel as second- or third-line treatment in advanced non-squamous non-small-cell lung cancer: Results of the IFCT-1103 ULTIMATE study. Eur J Cancer 2020; 131:27-36. [PMID: 32276179 DOI: 10.1016/j.ejca.2020.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Second-line chemotherapy regimens have demonstrated poor benefit after failure of platinum-based chemotherapy in advanced non-squamous non-small-cell lung cancer (nsNSCLC). METHODS In this multicentre, open-label phase III trial, patients with advanced nsNSCLC treated with one or two prior lines, including one platinum-based doublet, were centrally randomised to receive 90 mg/m2 of paclitaxel (D1, D8, D15) plus 10 mg/kg of bevacizumab (D1, D15) every 28 days or docetaxel (75 mg/m2) every 21 days; crossover was allowed after disease progression. Primary end-point was progression-free survival (PFS). ClinicalTrials.gov registration number: NCT01763671. RESULTS One hundred sixty six patients were randomised (paclitaxel plus bevacizumab: 111, docetaxel: 55). The median PFS was longer in patients receiving paclitaxel plus bevacizumab than in patients receveing docetaxel [5·4 months versus 3·9 months, adjusted hazard ratio (HR) 0·61 (95% confidence interval [CI]: 0·44-0·86); p = 0·005]. Objective response rates (ORRs) were 22·5% (95% CI: 14·8-30·3) and 5·5% (95% CI: 0·0-11·5) (p = 0·006), respectively. Median overall survivals were similar (adjusted HR 1·17; p = 0·50). Crossover occurred in 21 of 55 (38·2%) docetaxel-treated patients. Grade III-IV adverse events (AEs) were reported in 45·9% and 54·5% of patients treated with paclitaxel and bevacizumab or docetaxel, respectively (p = NS), including neutropenia (19·3% versus 45·4%), neuropathy (8·3% versus 0·0%) and hypertension (7·3% versus 0·0%). Three patients died due to treatment-related AEs (1·8% in each group). CONCLUSION Weekly paclitaxel plus bevacizumab as second- or third-line improves PFS and ORR compared with docetaxel in patients with nsNSCLC, with an acceptable safety profile. These results place weekly paclitaxel plus bevacizumab as a valid option in this population. CLINICAL TRIALS REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT01763671.
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Affiliation(s)
- Alexis B Cortot
- Univ. Lille, CHU Lille, Thoracic Oncology Dept, CNRS, Inserm, Institut Pasteur de Lille, UMR9020 - UMR-S 1277, Canther, F-59000, Lille, France.
| | | | - Olivier Molinier
- Service des Maladies Respiratoires, Centre Hospitalier Général, Le Mans, France.
| | | | - Fabrice Barlesi
- Aix Marseille University, Assistance Public Hôpitaux de Marseille. Multidisciplinary Oncology & Therapeutic Innovations Dpt, Marseille, France.
| | - Gérard Zalcman
- Service D'oncologieThoracique, Hopital Bichat Claude Bernard, Paris, France.
| | | | - Damien Pouessel
- Service D'Oncologie Médicale, Hôpital Saint-Louis, Paris, France.
| | - Claire Poulet
- Service de Pneumologie, CHU - Groupe Hospitalier Sud, Amiens, France.
| | | | - Sandrine Hiret
- Institut de Cancérologie de L'Ouest - René Gauducheau-Saint Herblain, France.
| | - Adrien Dixmier
- Service de Pneumologie, Centre Hospitalier Régional, Orléans, France.
| | | | - Catherine Becht
- Oncologie Médicale, Clinique de Clémentville, Montpellier, France.
| | - Olivier Raffy
- Service de Pneumologie, CH Louis Pasteur, Chartres, France.
| | - Charles Dayen
- Service de Pneumologie, Centre Hospitalier, Saint Quentin, France.
| | | | - Eric Pichon
- Service de Pneumologie, CHRU Bretonneau, Tours, France.
| | - Alexandra Langlais
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.
| | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.
| | - Denis Moro-Sibilot
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France; Thoracic Oncology Unit, PTV, CHU Grenoble-Alpes CS10217, 38043, Grenoble, France.
| | - Benjamin Besse
- Cancer Medecine Department, Gustave Roussy, Villejuif, France; Paris-Saclay University, Orsay, France.
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Mazieres J, Barlesi F, Rouquette I, Molinier O, Besse B, Monnet I, Audigier-Valette C, Toffart AC, Renault PA, Fraboulet S, Hiret S, Mennecier B, Debieuvre D, Westeel V, Masson P, Madroszyk-Flandin A, Pichon E, Cortot AB, Amour E, Morin F, Zalcman G, Moro-Sibilot D, Souquet PJ. Randomized Phase II Trial Evaluating Treatment with EGFR-TKI Associated with Antiestrogen in Women with Nonsquamous Advanced-Stage NSCLC: IFCT-1003 LADIE Trial. Clin Cancer Res 2020; 26:3172-3181. [DOI: 10.1158/1078-0432.ccr-19-3056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/16/2019] [Accepted: 03/02/2020] [Indexed: 11/16/2022]
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Negre E, Coffy A, Langlais A, Daures JP, Lavole A, Quoix E, Molinier O, Greillier L, Audigier-Valette C, Moro-Sibilot D, Westeel V, Morin F, Roch B, Pujol JL. Development and Validation of a Simplified Prognostic Score in SCLC. JTO Clin Res Rep 2020; 1:100016. [PMID: 34589918 PMCID: PMC8474253 DOI: 10.1016/j.jtocrr.2020.100016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 01/16/2023] Open
Abstract
Introduction This study aimed at generating a new simplified prognostic score (SPS) using common clinical and biological variables to discriminate a limited number of subgroups of patients with SCLC differing by their overall survival (OS). Methods The SPS was developed exploring the Montpellier University Hospital retrospective database of 401 patients over a 16-year period. All patients had received etoposide - platinum-based chemotherapy as first-line treatment. The SPS development took into account significant determinants of OS in the Cox model, weighted by their regression β coefficients. Validation of the consequent SPS has been done separately in a combined population of 213 patients accrued from two different published trials (NCT03059667 and NCT00930891). Results The significant independent determinants of OS included the following: (1) American Joint Committee on Cancer TNM stage IV (hazard ratio [HR]: 2.52; 95% confidence interval [CI]: 1.91–3.33); (2) Eastern Cooperative Oncology Group performance status greater than 1 (HR: 2.27; 95% CI: 1.79–2.87); (3) the presence of liver metastases (HR: 1.66; 95% CI: 1.29–2.15); and (4) neutrophil-to-lymphocyte ratio greater than 4 (HR: 1.39; 95% CI: 1.11–1.92). The SPS generated with these four variables, segregated three groups (good, intermediate, and poor prognosis) with respective median OS of 26.9 months (95% CI: 20.1–38.9), 11.5 months (95% CI: 9.8–13.0), and 6.8 months (95% CI: 5.8–8.3; log-rank p < 10–4). Harrell's C statistic estimate was 0.68 ± 0.012, suggesting goodness of calibration. In the validation cohort, the SPS segregated the aforementioned three subgroups in a nearly similar manner, with respective median OS: 27.2, 12.3, and 8.6 months (log-rank p < 10–3; Harrell’s C statistic: 0.58 ± 0.02). Conclusions The SPS is easy to calculate in real-life practice and efficiently discriminates three populations with different prognoses. This study deserves further validation of this score in patients with SCLC receiving immunochemotherapy.
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Affiliation(s)
- Elodie Negre
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France
| | - Amandine Coffy
- Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier University, Montpellier, France
| | | | - Jean-Pierre Daures
- Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier University, Montpellier, France
| | | | - Elisabeth Quoix
- Department of Pneumology, University Hospital, Strasbourg, France
| | - Olivier Molinier
- Department of Pneumology, Centre Hospitalier Le Mans, Le Mans, France
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique-Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | | | | | - Virginie Westeel
- Department of pneumology, Hopital Universitaire, Besançon, France
| | - Franck Morin
- French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | - Benoît Roch
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France.,Montpellier Cancer Research Institute, INSERM U1194, Montpellier, France
| | - Jean-Louis Pujol
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France.,Montpellier Cancer Research Institute, INSERM U1194, Montpellier, France
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Bennouna J, Girard N, Audigier-Valette C, le Thuaut A, Gervais R, Masson P, Marcq M, Molinier O, Cortot A, Debieuvre D, Cadranel J, Lena H, Moro-Sibilot D, Chouaid C, Mennecier B, Urban T, Sagan C, Perrier L, Barlesi F, Denis MG. Phase II Study Evaluating the Mechanisms of Resistance on Tumor Tissue and Liquid Biopsy in Patients With EGFR-mutated Non-pretreated Advanced Lung Cancer Receiving Osimertinib Until and Beyond Radiologic Progression: The MELROSE Trial. Clin Lung Cancer 2020; 21:e10-e14. [PMID: 31648999 DOI: 10.1016/j.cllc.2019.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/03/2019] [Accepted: 09/23/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Osimertinib, a third-generation tyrosine kinase inhibitor, is a new therapeutic option in epidermal growth factor receptor (EGFR)-mutated non-pretreated advanced non-small-cell lung cancer (NSCLC). The tumor escape mechanisms after first-line treatment with osimertinib are partially known; most of the data being obtained by analysis of circulating tumor DNA (ctDNA) from the FLAURA phase III trial. STUDY DESIGN The MELROSE study, a French multicentric, open label, phase II trial (ClinicalTrials.govNCT03865511) plans to enroll 150 patients with treatment-naive advanced EGFR-mutated (L858R or exon 19 deletion) NSCLC, age ≥ 18 years, with an Eastern Cooperative Oncology Group performance status 0 or 1. All patients will receive osimertinib at the dose of 80 mg/d. Tumor assessment according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria will be performed every 3 months, with brain and thoracoabdominal computed tomographic scan. The continuation of osimertinib is at the discretion of the referring physician, particularly if clinical benefit is observed. The primary objective is the genetic tumor profile, both on tissue biopsy and ctDNA analyses, at the time of disease progression. Other endpoints include kinetic studies of ctDNA, biological progression-free survival (bPFS) (time from first study dose to first biological event on ctDNA), median PFS according to RECIST criteria 1.1 (called radiological [r] PFS), and median clinical (c) PFS (time from the first study dose to off-osimertinib). This study started in April 2019, and 18 centers in France are participants.
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Affiliation(s)
- Jaafar Bennouna
- Thoracic Oncology Unit, Centre Hospitalier Universitaire Nantes, Nantes, France.
| | | | | | - Aurélie le Thuaut
- Direction de la Recherche, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Radj Gervais
- Medical Oncology, Centre François Baclesse, Caen, France
| | - Philippe Masson
- Department of Pneumology, Centre Hospitalier Cholet, Cholet, France
| | - Marie Marcq
- Department of Pneumology, CHD Vendée, La Roche sur Yon, France
| | - Olivier Molinier
- Department of Pneumology, Centre Hospitalier Le Mans, Le Mans, France
| | - Alexis Cortot
- Thoracic Oncology Department, Centre Hospitalier Universitaire Lille, Lille, France
| | - Didier Debieuvre
- Department of Pneumology, GHRMSA - Hôpital Emile Miller, Mulhouse, France
| | - Jacques Cadranel
- Department of Pneumology, APHP, Hôpital Tenon and GRC 04 Theranoscan, Sorbonne Université, Paris, France
| | - Hervé Lena
- Department of Pneumology, Hôpital Pontchaillou, Rennes, France
| | - Denis Moro-Sibilot
- Thoracic Oncology Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | | | - Bertrand Mennecier
- Department of Pneumology, Centre Hospitalier Universitaire Strasbourg, Strasbourg, France
| | - Thierry Urban
- Department of Pneumology, Centre Hospitalier Universitaire Angers, Angers, France
| | - Christine Sagan
- Department of Anatomopathology, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Ludivine Perrier
- Direction de la Recherche, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Fabrice Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Marc G Denis
- Department of Biochemistry, Centre Hospitalier Universitaire Nantes, Nantes, France
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Molinier O, Goupil F, Debieuvre D, Auliac JB, Jeandeau S, Lacroix S, Martin F, Grivaux M. Five-year survival and prognostic factors according to histology in 6101 non-small-cell lung cancer patients. Respir Med Res 2019; 77:46-54. [PMID: 32036284 DOI: 10.1016/j.resmer.2019.10.001] [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] [Received: 02/06/2019] [Revised: 10/14/2019] [Accepted: 10/20/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To estimate five-year survival in non-small-cell lung cancer (NSCLC) patients according to histology and to identify independent prognostic factors by histology. METHODS Data were obtained during the KBP-2010-CPHG study, which included all new cases of primary lung cancer diagnosed in 2010 in 104 non-academic hospitals. RESULTS In all, 3199 patients had adenocarcinoma (ADC), 1852 squamous cell carcinoma (SCC), 754 large cell carcinoma (LCC). Five-year survival was 13.3% [12.1%-14.5%] for ADC, 14.3% [12.7%-16.0%] for SCC, 9.6% [7.6%-11.9%] for LCC (P<0.001). Performance status, weight loss prior to diagnosis and tumour stage were consistently significant independent prognostic factors. Age (>70 years; P=0.004), male gender (P<0.001), and smoking (P<0.001) were independent negative prognostic factors for ADC. Epidermal Growth Factor Receptor (EGFR)-mutation tests, performed in 1638 ADC patients, were positive for 186. Five-year survival was 14.7% [10.3%-21%] and 10.9% [9.4%-12.6%] for mutated and wild-type EGFR, respectively (P<0.001). EFGR mutation was an independent positive prognostic factor (HR=0.5 [0.4-0.6], P<0.001); however, the proportional hazards assumption was not fulfilled and hazards were inverted after 35 months. CONCLUSIONS Five-year survival in patients managed in French non-academic hospitals for primary NSCLC in 2010 remained poor (<15%), whatever the histologic type. The independent negative prognostic factors for five-year survival were: weight, particularly weight loss prior to diagnosis; smoking (active or former) at diagnosis in ADC and LCC and smoking level at diagnosis in smoker patients with SCC. The independent positive prognostic factors were young age and female gender for ADC.
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Affiliation(s)
- O Molinier
- Respiratory medicine department, hospital, avenue Rubillard, 72037 Le Mans, France.
| | - F Goupil
- Respiratory medicine department, hospital, avenue Rubillard, 72037 Le Mans, France.
| | - D Debieuvre
- Pneumology department, Regional Hospital Group Mulhouse-Sud Alsace, Emile Muller hospital, 20 Avenue du Docteur René Laennec, 68070 Mulhouse, France.
| | - J-B Auliac
- Respiratory medicine department, François Quesnay hospital, 2, boulevard Sully, 78200 Mantes-la-Jolie, France.
| | - S Jeandeau
- Respiratory medicine department, National Medical Center MGEN, 4, Les Bains, 23006 Sainte-Feyre, France.
| | - S Lacroix
- Respiratory medicine department, Périgueux hospital, 80, avenue Georges-Pompidou, 24000 Périgueux, France.
| | - F Martin
- Pneumology and sleep disorders department, Compiègne-Noyon, Intercommunal Hospital, 8, avenue Henri Adnot, BP 50029, 60321 Compiègne cedex, France.
| | - M Grivaux
- Respiratory medicine department, hospital, 6-8, rue Saint Fiacre, BP 218, 77104 Meaux cedex, France.
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Zalcman G, Toffart A, Madroszyk Flandin AC, Molinier O, Dayen C, Egenod T, Dixmier A, Giroux Leprieur E, Masson P, Cloarec N, Thibonnier L, Favier L, Debieuvre D, Mazieres J, Van Hulst S, Pichon E, Amour E, Morin F, Souquet PJ. IFCT-1701 DICIPLE: A randomized phase III trial comparing continuation nivolumab-Ipilimumab doublet immunotherapy until progression versus observation in patients with PDL1-positive stage IV non-small cell lung cancer (NSCLC) after nivolumab-ipilimumab induction treatment. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zalcman G, Mazieres J, Greillier L, Brosseau S, Lantuejoul S, Do P, Bylicki O, Monnet I, Corre R, Audigier-Valette C, Locatelli-Sanchez M, Molinier O, Guisier F, Urban T, Planchard D, Ligeza-Poisson C, Amour E, Morin F, Moro-Sibilot D, Scherpereel A. Second/third-line nivolumab vs nivo plus ipilimumab in malignant pleural mesothelioma: Long-term results of IFCT-1501 MAPS2 phase IIR trial with a focus on hyperprogression (HPD). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Zalcman G, Brosseau S, Mazieres J, Margery J, Greillier L, Audigier-Valette C, Moro-Sibilot D, Molinier O, Corre R, Monnet I, Gounant V, Rivière F, Gervais R, Janicot H, Locher C, Langlais A, Parienti J, Morin F, Scherpereel A. MA05.05 Post-Discontinuation Treatments in IFCT-GFPC-0701 MAPS Trial: Real-World Effectiveness of 2nd-Line (2L) Treatments for Mesothelioma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.532] [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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Debieuvre D, Tredaniel J, Moreau L, Larivé S, Le Treut J, Nocent C, Hominal S, Grangeon V, Bizec J, Molinier O, Payen T. EP1.01-05 EGFR-2013-CPHG, a Real-World Study of EGFR Mutant Advanced Non-Small-Cell Lung Cancer Patients Treated with Erlotinib. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1988] [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: 11/27/2022]
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Gobbini E, Toffart A, Perol M, Assié J, Duruisseaux M, Coupez D, Gervais R, Westeel V, Delaunay M, Guisier F, Veillon R, Gounant V, Leprieur EG, Vanel F, Chaabane N, Dansin E, Babey H, Decroisette C, Barlesi F, Girard N, Fournel P, Mezquita L, Oulkhouir Y, Canellas A, Duchemann B, Molinier O, Moro-Sibilot D, Levra MG. MA07.05 Immune Checkpoint Inhibitor (ICPi) Re-Challenge: Outcomes Analysis in a French National Cohort of Non-Small-Cell Lung Cancer (NSCLC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.550] [Citation(s) in RCA: 5] [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] [Indexed: 10/25/2022]
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Eberst G, Anota A, Scherpereel A, Mazieres J, Margery J, Greillier L, Audigier-Valette C, Moro-Sibilot D, Molinier O, Léna H, Rivière F, Monnet I, Gounant V, Janicot H, Gervais R, Locher C, Charton E, Morin F, Zalcman G, Westeel V. Health-Related Quality of Life Impact from Adding Bevacizumab to Cisplatin-Pemetrexed in Malignant Pleural Mesothelioma in the MAPS IFCT-GFPC-0701 Phase III Trial. Clin Cancer Res 2019; 25:5759-5765. [DOI: 10.1158/1078-0432.ccr-18-2860] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/18/2019] [Accepted: 06/04/2019] [Indexed: 11/16/2022]
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Ganga Debieuvre D, Duval Y, Morel H, Baranzelli A, Falchero L, Romand P, Ganga E, Bizieux A, Locher C, Molinier O. ALK-2016-CPHG : caractéristiques des patients présentant un CBNPC ALK+/ROS1+ traités par crizotinib en vie réelle indépendamment de la ligne de traitement. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.04.028] [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: 10/26/2022] Open
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Cortot AB, Madroszyk A, Giroux Leprieur E, Molinier O, Quoix EA, Berard H, Otto J, Rault I, Raimbourg J, Hureaux J, Moreau L, Debieuvre D, Morel H, Denis MG, Amour E, Morin F, Moro-Sibilot D, Cadranel J. Phase II randomized trial of afatinib with or without cetuximab as first-line treatment for EGFR mutated non-small cell lung cancer (NSCLC) patients (IFCT-1503 ACE-Lung). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.9079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9079 Background: First-line treatment of metastatic EGFR-mutated NSCLC relies on EGFR-TKIs. However, all patients (pts) eventually develop progression. Dual inhibition of EGFR with afatinib (A), an irreversible pan-erbB TKI, and cetuximab (C), an EGFR monoclonal antibody, has shown activity in EGFR-mutated pts with acquired resistance to TKIs, regardless of the T790M status. Methods: We conducted a phase II randomized trial in advanced NSCLC pts harboring an activating EGFR mutation, who had not received prior therapy. Pts were treated with A (40 mg/d) until progression alone or with C 500 mg/m² every 2 weeks during 6 months (mos) (beginning at D15 at 250 mg/m²). Primary endpoint was time-to-treatment failure (TTF) at 9 mos for pts with del19 and L858R mutations. Secondary endpoints include safety, progression-free survival (PFS), overall survival (OS). Prospective monitoring of the T790M mutation was performed on circulating tumoral DNA (ctDNA) by digital PCR. Results: Trial was stopped early due to futility analysis after 118 pts were enrolled (59 in each arm). Baseline characteristics were balanced between the 2 arms, and especially for the types of EGFR mutation (del19, 55.9 vs 50.8%; L858R, 39 vs 40.7%; others, 5.1 vs 8.5% in AC and A arms, respectively). Treatment-related AEs of any grades were similar, although there was an excess of grade 3 AEs in the AC arm (50 vs 37.3%), but no of grade 5. The excess in grade 3-5 AEs was essentially due to cutaneous (96.6 vs 81.4%), eyes (32.8 vs 27.1%), hematological (22.4 vs 15.3%) but not to digestive toxicities (89.7 vs 98.3%). Among the 117 pts included in the efficacy analysis, 9-months TTF was 63.3% (47.5-75.6) in arm A and 65.8% (50.1-77.66) in arm AC. Median TTF was 11.1 mos (8.3-not reached [NR]) and 10.8 mos (9.2-13.7) in arms A and AC, respectively. Median PFS was 11.1 mos (8.3-NR) and 12.8 mos (9.2-13.7), respectively. Median OS was 20.8 mos (17.5-NR) and NR (17-NR), respectively. Conclusions: Efficacy of AC was similar to that of A alone. These results don’t support further evaluation of this combination in this setting. Results of ctDNA monitoring will be reported during the meeting. Clinical trial information: NCT02716311.
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Affiliation(s)
| | | | | | | | | | - Henri Berard
- Hopital D'instruction Des Armes Sainte-Anne, Toulon, France
| | | | | | | | | | - Lionel Moreau
- Centre Hospitalier Pneumologie Colmar, Colmar, France
| | | | | | | | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | | | - Jacques Cadranel
- Hôpital Tenon, AP-HP and Faculté de Médecine Pierre et Marie Curie, Université Paris VI, Paris, France
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Levy B, Paz-Ares L, Bennouna J, Felip E, Abreu DR, Isla D, Barlesi F, Molinier O, Madelaine J, Audigier-Valette C, Kim SW, Kim HR, Ozguroglu M, Erman M, Badin FB, Mekhail TM, Scheff R, Chisamore MJ, Sadrolhefazi B, Riess JW. Afatinib With Pembrolizumab for Treatment of Patients With Locally Advanced/Metastatic Squamous Cell Carcinoma of the Lung: The LUX-Lung IO/KEYNOTE 497 Study Protocol. Clin Lung Cancer 2019; 20:e407-e412. [PMID: 30808583 DOI: 10.1016/j.cllc.2018.12.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/31/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Afatinib is a selective, irreversible ErbB family blocker that has shown survival benefit in lung squamous-cell carcinoma (SCC) patients. Pembrolizumab, a humanized immunoglobulin G4 monoclonal antibody to the programmed cell death 1 (PD-1) receptor, has also shown survival benefit in lung SCC. Concurrent inhibition of the PD-1 and epidermal growth factor receptor (EGFR) pathways represents a rational approach to improve responses and delay the onset of treatment resistance in lung SCC. TRIAL DESIGN This phase II, open-label, single-arm study (NCT03157089) is designed to assess the efficacy and safety of afatinib in combination with pembrolizumab in patients with stage IIIB/IV lung SCC that has progressed during/after first-line platinum-based chemotherapy. Eligible patients must have ≥1 target lesion (as per Response Evaluation Criteria in Solid Tumors version 1.1) and must have not received previous immune checkpoint inhibitor/EGFR-targeted therapy. The recommended phase II dose (RP2D) and safety profile will be determined during a safety run-in with oral afatinib (starting dose, 40 mg/d) with intravenous pembrolizumab (200 mg every 3 weeks). In the main study, all patients will receive afatinib at the RP2D with pembrolizumab until disease progression, unacceptable toxicity, or for up to 35 cycles. The primary end point is objective response (complete + partial response). Other end points include disease control, duration of objective response, progression-free survival, overall survival, tumor shrinkage, RP2D, and pharmacokinetics. Exploratory biomarker analysis will be performed. This study is being conducted in the United States, Spain, France, South Korea, and Turkey. Enrollment commenced in September 2017, with a target of 50 to 62 patients.
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Affiliation(s)
- Benjamin Levy
- Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital, Washington, DC.
| | - Luis Paz-Ares
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jaafar Bennouna
- Department of Pneumology, Thoracic Oncology, University Hospital-Nantes, Nantes, France
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Delvys Rodríguez Abreu
- Department of Medical Oncology, Gran Canaria University Hospital, Las Palmas de Gran Canaria, Spain
| | - Dolores Isla
- Department of Medical Oncology, University Hospital Lozano Blesa, Zaragoza, Spain
| | - Fabrice Barlesi
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | | | | | | | - Hye Ryun Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Mustafa Erman
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | | | | | - Ronald Scheff
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell College of Medicine, New York, NY
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Denis MG, Lafourcade MP, Le Garff G, Dayen C, Falchero L, Thomas P, Locher C, Oliviero G, Licour M, Reck M, Normanno N, Molinier O. Circulating free tumor-derived DNA to detect EGFR mutations in patients with advanced NSCLC: French subset analysis of the ASSESS study. J Thorac Dis 2019; 11:1370-1378. [PMID: 31179079 DOI: 10.21037/jtd.2019.03.95] [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: 11/06/2022]
Abstract
Background The non-interventional ASSESS study (NCT01785888) evaluated the utility of circulating free tumor-derived DNA (ctDNA) from plasma for epidermal growth factor receptor (EGFR) mutation testing in patients with advanced non-small-cell lung cancer (NSCLC), in a real-world setting across 56 centers in Europe and Japan. The high mutation status concordance between 1162 matched tissue/cytology and plasma samples (89%, sensitivity =46%, specificity =97%) suggested that ctDNA is a feasible sample for EGFR mutation analysis. We report data for the French subset of patients (pre-planned analysis). Methods Eligible patients (stage IIIA/B/IV locally advanced/metastatic treatment-naive advanced NSCLC) provided diagnostic tissue/cytology and plasma samples. DNA extracted from tissue/cytology samples was subjected to EGFR mutation testing as per local practice; a designated laboratory performed ctDNA extraction/mutation testing of plasma samples. The primary outcome was EGFR mutation status concordance between matched tumor and plasma samples. Results Of the 1,311 patients enrolled in the ASSESS trial, 145 were recruited from 9 centers in France. Tumor samples from 130 patients were collected and 126 were evaluable for EGFR mutation analysis. Activating EGFR mutations were identified in 13 of the 126 patient tumor samples (EGFR mutation frequency 10.3%). For plasma testing, 10 of the 145 samples tested were positive for EGFR mutations (EGFR mutation frequency 6.9%). EGFR mutation rate was significantly higher in never- versus ever-smokers (stepwise logistic regression: tumor, P<0.0001; plasma, P=0.0008). Mutation status concordance between 126 matched patient samples was 96.0% [121/126; 95% confidence intervals (CI), 91.0-98.7]. Of the 113 EGFR mutation-negative patient tissue samples, one tested plasma-positive; reanalysis of plasma via two different techniques confirmed the presence of a L858R mutation, indicating a tissue false-negative result. Based on these data, sensitivity of plasma testing was 64.3% (9/14; 95% CI, 35.1-87.2%) and its specificity was 100.0% (112/112; 95% CI, 96.8-100.0%). Conclusions Data confirm ctDNA as an alternative sample for EGFR mutation analysis in patients with advanced NSCLC.
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Affiliation(s)
- Marc G Denis
- Department of Biochemistry and INSERM U1232, Nantes University Hospital, 9 quai Moncousu, F-44093 Nantes Cedex, France
| | | | - Gwenaëlle Le Garff
- Centre Hospitalier Hôpital Yves Le Foll, 10 r Marcel Proust, 22027 St Brieuc, France
| | - Charles Dayen
- Centre Hospitalier De Saint Quentin, 1 av Michel de l'Hôpital, Saint-Quentin, France
| | - Lionel Falchero
- Centre Hospitalier Villefranche-Sur-Saône, 69655 Villefranche-sur-Saône Cedex, France
| | - Pascal Thomas
- Centre Hospitalier Intercommunal des Alpes du Sud, 1 pl Auguste Muret, 05007 Gap, France
| | - Chrystèle Locher
- Centre Hospitalier de Meaux, 6-8 r Saint Fiacre, 77104 Meaux, France
| | - Gérard Oliviero
- Centre Hospitalier de Longjumeau, 159 r Prés François Mitterrand, 91160 Longjumeau, France
| | - Muriel Licour
- AstraZeneca, Tour Carpe Diem, 31 place des Corolles, 92400 Courbevoie, France
| | - Martin Reck
- Department of Thoracic Oncology, LungenClinic Grosshansdorf GmbH, Airway Research Centre North, Member of the German Centre for Lung Research (DZL), Grosshansdorf, Germany
| | - Nicola Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione Pascale", IRCCS, Naples, Italy
| | - Olivier Molinier
- Centre Hospitalier Du Mans, 194 av Rubillard, 72037 Le Mans, France
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Debieuvre D, Locher C, Asselain B, Dayen C, Molinier O, Falchero L, Dujon C, Delclaux B, Grivaux M. Evidence of slight improvement in five-year survival in non-small-cell lung cancer over the last 10 years: Results of the French KBP-CPHG real-world studies. Bull Cancer 2019; 106:283-292. [PMID: 30803715 DOI: 10.1016/j.bulcan.2019.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/06/2018] [Accepted: 01/07/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Although improved during the last decades, the prognosis of lung cancer is poor. In 2000, the French College of general hospital respiratory physicians, conducted KBP-2000-CPHG, a prospective multicenter epidemiological study including all volunteer adult patients diagnosed for primary lung cancer; with the five-year survival as primary endpoint. The primary objective of KBP-2010-CPHG was to compare overall five-year survival data with KBP-2000-CPHG ones. MATERIAL AND METHODS All consecutive patients≥18 years of age with primary lung cancer diagnosed between 1st January and 31st December 2010 were included. The KBP-2010-CPHG protocol was approved by the advisory committee on research information processing in the health field (CCTIRS) on November 19, 2009. RESULTS Respectively, 5667 and 7051 patients were included in KBP-2000-CPHG and KBP-2010-CPHG. Five-year survival was improved: 12.7% [11.9%-13.5%] in 2010 versus 10.0% [9.2%-10.9%] in 2000 (P<0.001). Non-small-cell lung cancer showed improvement (13.8% [13.0%-14.8%] in 2010 versus 11.4% [10.5%-12.4%] in 2000; P<0.001); but not small-cell lung cancer (5.7% [4.4%-7.4%] in 2010 versus 3.3% [2.3%-4.7%] in 2000; P=0.56). The KBP-2010-CPHG study showed an overall 6% reduction in risk of death (HR=0.94 [0.89-0.98]; P=0.004). CONCLUSIONS Survival of patients with lung cancer improved over a 10-year period. This improvement was slight and limited to non-small-cell lung cancer, possibly partly because of 2010 advances in diagnosis and targeted therapy.
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Affiliation(s)
- Didier Debieuvre
- Groupe hospitalier de la région Mulhouse Sud-Alsace, hôpital Emile Muller, respiratory medicine department, 20, avenue du Dr Laënnec, BP 1370, 68070 Mulhouse cedex, France.
| | - Chrystèle Locher
- Hôpital de Meaux, respiratory medicine department, 6-8, rue Saint-Fiacre, BP 218, 77104 Meaux cedex, France
| | - Bernard Asselain
- Hôpital Hôtel-Dieu, service d'oncologie médicale, 1, place du Parvis-de-Notre-Dame, 75004 Paris, France
| | - Charles Dayen
- Centre hospitalier de Saint-Quentin, respiratory medicine department, 1, avenue Michel de l'hospital, 02321 Saint-Quentin, France
| | - Olivier Molinier
- Centre hospitalier du Mans, respiratory medicine department, avenue Rubillard, 72037 Le Mans, France
| | - Lionel Falchero
- Centre hospitalier de Villefranche-Sur-Saône, respiratory medicine department, 39, rue des Pavillons, 69400 Gleize, France
| | - Cécile Dujon
- Centre hospitalier de Versailles André Mignot, respiratory medicine department, 177, rue de Versailles, 78150 Le Chesnay, France
| | - Bertrand Delclaux
- Centre hospitalier de Troyes, respiratory medicine department, 101, avenue Anatole France, 10000 Troyes, France
| | - Michel Grivaux
- Hôpital de Meaux, respiratory medicine department, 6-8, rue Saint-Fiacre, BP 218, 77104 Meaux cedex, France
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Pujol JL, Greillier L, Audigier-Valette C, Moro-Sibilot D, Uwer L, Hureaux J, Guisier F, Carmier D, Madelaine J, Otto J, Gounant V, Merle P, Mourlanette P, Molinier O, Renault A, Rabeau A, Antoine M, Denis MG, Bommart S, Langlais A, Morin F, Souquet PJ. A Randomized Non-Comparative Phase II Study of Anti-Programmed Cell Death-Ligand 1 Atezolizumab or Chemotherapy as Second-Line Therapy in Patients With Small Cell Lung Cancer: Results From the IFCT-1603 Trial. J Thorac Oncol 2019; 14:903-913. [PMID: 30664989 DOI: 10.1016/j.jtho.2019.01.008] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [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: 12/05/2018] [Revised: 01/02/2019] [Accepted: 01/09/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This randomized phase II trial aimed at evaluating the engineered programmed cell death ligand 1 (PD-L1) antibody atezolizumab in SCLC progressing after first-line platinum-etoposide chemotherapy. METHODS Patients were randomized 2:1 to atezolizumab (1200 mg intravenously every 3 weeks) until progression or unacceptable toxicity, or conventional chemotherapy (up to 6 cycles of topotecan or re-induction of initial chemotherapy). Patients were not selected based on PD-L1 tissue expression. The primary endpoint was objective response rate at 6 weeks. A two-stage design with 2:1 randomization and O'Brien-Fleming stopping rules was used. The null hypothesis was rejected if more than 12 of 45 patients were responders. RESULTS Overall, 73 patients were randomized (atezolizumab n = 49; chemotherapy n = 24). At 6 weeks, 1 of 43 eligible atezolizumab patients achieved an objective response (2.3%, 95% confidence interval [CI]: 0.0-6.8), whereas 8 others had stable disease (20.9% disease control rate; 95% CI: 8.8-33.1). Among eligible chemotherapy patients (n = 20), 10% achieved an objective response (65% disease control rate). Median progression-free survival was 1.4 months (95% CI: 1.2-1.5) with atezolizumab and 4.3 months (95% CI: 1.5-5.9) with chemotherapy. Overall survival did not significantly differ between groups. Median overall survival was 9.5 months versus 8.7 months for the atezolizumab and the chemotherapy group, respectively (adjusted hazard ratioatezolizumab : 0.84, 95% CI: 0.45-1.58; p = 0.60). Two atezolizumab patients (4.2%) experienced grade 3 fatigue, and two others grade 1 dysthyroidism. Among 53 evaluable specimens, only 1 (2%) had positive immunohistochemical PD-L1 staining (SP142 clone). CONCLUSIONS Atezolizumab monotherapy in relapsed SCLC failed to show significant efficacy. No unexpected safety concerns were observed.
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Affiliation(s)
- Jean-Louis Pujol
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France.
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique - Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | | | | | - Lionel Uwer
- Institut de Cancerologie de Lorraine Alexis Vautrin. 6 Avenue de Bourgogne, Vandoeuvre-les-Nancy, France
| | - José Hureaux
- Pôle Hippocrate, Angers University Hospital, Angers, France
| | - Florian Guisier
- Service de Pneumologie, Oncologie Thoracique et soins Intensifs Respiratoires, CHU de Rouen, Rouen, France
| | - Delphine Carmier
- Service de Pneumologie CHRU Hôpitaux de Tours, Hôpital Bretonneau, Tours, France
| | | | - Josiane Otto
- Pôle Médecine, Centre Antoine Lacassagne, Nice, France
| | - Valérie Gounant
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, Paris, France
| | - Patrick Merle
- Service de Pneumologie, Chu Gabriel-Montpied, Clermont-Ferrand, France
| | | | - Olivier Molinier
- Service de Pneumologie, Centre Hospitalier du Mans, Le Mans, France
| | - Aldo Renault
- Service de Pneumologie, Centre Hospitalier de Pau, Pau, France
| | - Audrey Rabeau
- Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - Martine Antoine
- Service d'Anatomo-pathologie, Hôpitaux Universitaires Est Parisien Site Tenon, Paris, France
| | - Marc G Denis
- Department of Biochemistry, Nantes University Hospital, Nantes, France
| | - Sebastien Bommart
- Department of radiology, Montpellier Regional University Hospital, Montpellier, France
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Pierre-Jean Souquet
- Service de Pneumologie Aiguë Spécialisée et Cancérologie Thoracique, Centre Hospitalier Lyon, Lyon, France
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Scherpereel A, Mazieres J, Greillier L, Lantuejoul S, Dô P, Bylicki O, Monnet I, Corre R, Audigier-Valette C, Locatelli-Sanchez M, Molinier O, Guisier F, Urban T, Ligeza-Poisson C, Planchard D, Amour E, Morin F, Moro-Sibilot D, Zalcman G. Nivolumab or nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma (IFCT-1501 MAPS2): a multicentre, open-label, randomised, non-comparative, phase 2 trial. Lancet Oncol 2019; 20:239-253. [PMID: 30660609 DOI: 10.1016/s1470-2045(18)30765-4] [Citation(s) in RCA: 299] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/08/2018] [Accepted: 10/10/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is no recommended therapy for malignant pleural mesothelioma that has progressed after first-line pemetrexed and platinum-based chemotherapy. Disease control has been less than 30% in all previous studies of second-line drugs. Preliminary results have suggested that anti-programmed cell death 1 (PD-1) monoclonal antibody could be efficacious in these patients. We thus aimed to prospectively assess the anti-PD-1 monoclonal antibody alone or in combination with anti-cytotoxic T-lymphocyte protein 4 (CTLA-4) antibody in patients with malignant pleural mesothelioma. METHODS This multicentre randomised, non-comparative, open-label, phase 2 trial was done at 21 hospitals in France. Eligible patients were aged 18 years or older with an Eastern Cooperative Oncology Group performance status of 0-1, histologically proven malignant pleural mesothelioma progressing after first-line or second-line pemetrexed and platinum-based treatments, measurable disease by CT, and life expectancy greater than 12 weeks. Patients were randomly allocated (1:1) to receive intravenous nivolumab (3 mg/kg bodyweight) every 2 weeks, or intravenous nivolumab (3 mg/kg every 2 weeks) plus intravenous ipilimumab (1 mg/kg every 6 weeks), given until progression or unacceptable toxicity. Central randomisation was stratified by histology (epithelioid vs non-epithelioid), treatment line (second line vs third line), and chemosensitivity to previous treatment (progression ≥3 months vs <3 months after pemetrexed treatment) and used a minimisation method with a 0·8 random factor. The primary outcome was the proportion of patients who achieved 12-week disease control, assessed by masked independent central review; the primary endpoint would be met if disease control was achieved in at least 40% of patients. The primary endpoint was assessed in the first 108 eligible patients. Efficacy analyses were also done in the intention-to-treat population and safety analyses were done in all patients who received at least one dose of their assigned treatment. This trial is registered at ClinicalTrials.gov, number NCT02716272. FINDINGS Between March 24 and August 25, 2016, 125 eligible patients were recruited and assigned to either nivolumab (n=63) or nivolumab plus ipilimumab (n=62). In the first 108 eligible patients, 12-week disease control was achieved by 24 (44%; 95% CI 31-58) of 54 patients in the nivolumab group and 27 (50%; 37-63) of 54 patients in the nivolumab plus ipilimumab group. In the intention-to-treat population, 12-week disease control was achieved by 25 (40%; 28-52) of 63 patients in the nivolumab group and 32 (52%; 39-64) of 62 patients in the combination group. Nine (14%) of 63 patients in the nivolumab group and 16 (26%) of 61 patients in the combination group had grade 3-4 toxicities. The most frequent grade 3 adverse events were asthenia (one [2%] in the nivolumab group vs three [5%] in the combination group), asymptomatic increase in aspartate aminotransferase or alanine aminotransferase (none vs four [7%] of each), and asymptomatic lipase increase (two [3%] vs one [2%]). No patients had toxicities leading to death in the nivolumab group, whereas three (5%) of 62 in the combination group did (one fulminant hepatitis, one encephalitis, and one acute kidney failure). INTERPRETATION Anti-PD-1 nivolumab monotherapy or nivolumab plus anti-CTLA-4 ipilimumab combination therapy both showed promising activity in relapsed patients with malignant pleural mesothelioma, without unexpected toxicity. These regimens require confirmation in larger clinical trials. FUNDING French Cooperative Thoracic Intergroup.
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Affiliation(s)
- Arnaud Scherpereel
- Department of Pulmonary and Thoracic Oncology, University of Lille, University Hospital (CHU) of Lille, Lille, France; French National Network of Clinical Expert Centers for Malignant Pleural Mesothelioma Management (MESOCLIN), Lille, France.
| | - Julien Mazieres
- Department of Pneumology, University Hospital of Toulouse, Université Paul Sabatier, Toulouse, France
| | - Laurent Greillier
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Sylvie Lantuejoul
- Department of BioPathology, MESOPATH, Centre de Lutte Contre le Cancer Léon Bérard, Lyon, France; University Grenoble Alpes, Grenoble, France
| | - Pascal Dô
- Department of Pneumology, Centre de Lutte Contre le Cancer Baclesse, Caen, France
| | - Olivier Bylicki
- Department of Pneumology, Hôpital d'instruction des Armées, Percy, Clamart, France
| | - Isabelle Monnet
- Department of Pneumology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Romain Corre
- Department of Pneumology, University Hospital of Rennes, Rennes, France
| | | | | | - Olivier Molinier
- Department of Pneumology, Le Mans Regional Hospital, Le Mans, France
| | - Florian Guisier
- Department of Pneumology, University Hospital of Rouen, Rouen, France
| | - Thierry Urban
- Department of Pneumology, University Hospital of CHU Angers, Angers, France
| | | | - David Planchard
- Department of Thoracic Oncology, Institut Gustave Roussy, Villejuif, France
| | - Elodie Amour
- Intergroupe Francophone de Cancérologie Thoracique IFCT, Paris, France
| | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique IFCT, Paris, France
| | - Denis Moro-Sibilot
- Department of Pneumology, University Hospital of Grenoble, Grenoble, France
| | - Gérard Zalcman
- University Hospital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris-Diderot University Paris, Paris, France
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Pujol J, Greillier L, Audigier-Valette C, Moro-Sibilot D, Uwer L, Hureaux J, Thiberville L, Carmier D, Madelaine J, Otto J, Gounant V, Merle P, Mourlanette P, Molinier O, Renault P, Mazieres J, Antoine M, Langlais A, Morin F, Souquet P. Étude de phase II randomisée non comparative de l’anti-PD-L1 atézolizumab versus chimiothérapie comme traitement de deuxième ligne chez les patients atteints d’un cancer du poumon à petites cellules (CBPC) : résultats de l’essai IFCT-1603. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Domblides C, Monnet I, Mazières J, Barlési F, Gounant V, Baldacci S, Mennecier B, Toffart A, Audigier-Valette C, Doucet L, Giroux-Leprieur E, Guisier F, Ricordel C, Molinier O, Pérol M, Pichon E, Robinet G, Templement-Grangerat D, Ruppert A, Rabbe N, Antoine M, Wislez M. Efficacité des inhibiteurs de checkpoint immunitaire dans le carcinome sarcomatoïde du poumon : données issues d’une cohorte française multicentrique. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.040] [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: 10/27/2022]
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Domblides C, Monnet I, Mazieres J, Barlesi F, Gounant V, Baldacci S, Mennecier B, Toffart A, Audigier Valette C, Doucet L, Giroux-Leprieur E, Guisier F, Molinier O, Perol M, Pichon E, Robinet G, Templement Grangerat D, Ruppert AM, Wislez M. Efficacy of immune checkpoint inhibitors in lung sarcomatoid carcinoma: Data from a French multicentric cohort. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Quoix E, Audigier Valette C, Lavolé A, Molinier O, Westeel V, Barlesi F, Le Treut J, Pichon E, Dauba J, Otto J, Dumont P, Moreau L, Madelaine J, Margery J, Debieuvre D, Renault P, Langlais A, Morin F, Moro-Sibilot D, Souquet PJ. Maintenance chemotherapy versus follow-up after carboplatin and weekly paclitaxel doublet chemotherapy in elderly patients with advanced non-small cell lung cancer (NSCLC): IFCT-1201 MODEL randomised phase III trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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