1
|
Trédan O, Wang Q, Pissaloux D, Cassier P, de la Fouchardière A, Fayette J, Desseigne F, Ray-Coquard I, de la Fouchardière C, Frappaz D, Heudel PE, Bonneville-Levard A, Fléchon A, Sarabi M, Guibert P, Bachelot T, Pérol M, You B, Bonnin N, Collard O, Leyronnas C, Attignon V, Baudet C, Sohier E, Villemin JP, Viari A, Boyault S, Lantuejoul S, Paindavoine S, Treillleux I, Rodriguez C, Agrapart V, Corset V, Garin G, Chabaud S, Pérol D, Blay JY. Molecular screening program to select molecular-based recommended therapies for metastatic cancer patients: analysis from the ProfiLER trial. Ann Oncol 2019; 30:757-765. [PMID: 30865223 DOI: 10.1093/annonc/mdz080] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Antitumor activity of molecular-targeted agents is guided by the presence of documented genomic alteration in specific histological subtypes. We aim to explore the feasibility, efficacy and therapeutic impact of molecular profiling in routine setting. PATIENTS AND METHODS This multicentric prospective study enrolled adult or pediatric patients with solid or hematological advanced cancer previously treated in advanced/metastatic setting and noneligible to curative treatment. Each molecular profile was established on tumor, relapse or biopsies, and reviewed by a molecular tumor board (MTB) to identify molecular-based recommended therapies (MBRT). The main outcome was to assess the incidence rate of genomic mutations in routine setting, across specific histological types. Secondary objectives included a description of patients with actionable alterations and for whom MBRT was initiated, and overall response rate. RESULTS Four centers included 2579 patients from February 2013 to February 2017, and the MTB reviewed the molecular profiles achieved for 1980 (76.8%) patients. The most frequently altered genes were CDKN2A (N = 181, 7%), KRAS (N = 177, 7%), PIK3CA (N = 185, 7%), and CCND1 (N = 104, 4%). An MBRT was recommended for 699/2579 patients (27%), and only 163/2579 patients (6%) received at least one MBRT. Out of the 182 lines of MBRT initiated, 23 (13%) partial responses were observed. However, only 0.9% of the whole cohort experienced an objective response. CONCLUSION An MBRT was provided for 27% of patients in our study, but only 6% of patients actually received matched therapy with an overall response rate of 0.9%. Molecular screening should not be used at present to guide decision-making in routine clinical practice outside of clinical trials.This trial is registered with ClinicalTrials.gov, number NCT01774409.
Collapse
Affiliation(s)
- O Trédan
- Departments of Medical Oncology, University Claude Bernard
| | - Q Wang
- Translational Research and Innovation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - B You
- Department of Medical Oncology, Lyon Sud Hospital Center, CITOHL, Institute of Cancerology, Hospices Civils de Lyon (IC-HCL), Lyon; Faculty of Medicine-Lyon Sud, EMR UCBL/HCL 3738, University of Lyon 1, Oullins
| | - N Bonnin
- Department of Medical Oncology, Lyon Sud Hospital Center, CITOHL, Institute of Cancerology, Hospices Civils de Lyon (IC-HCL), Lyon
| | - O Collard
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - C Leyronnas
- Department of Medical Oncology, Mutualist Hospital Group, Grenoble
| | | | - C Baudet
- Synergie Lyon Cancer, Bio-Informatics Platform
| | - E Sohier
- Synergie Lyon Cancer, Bio-Informatics Platform
| | | | - A Viari
- Synergie Lyon Cancer, Bio-Informatics Platform
| | - S Boyault
- Translational Research and Innovation
| | | | | | | | - C Rodriguez
- BioPathology, Léon Bérard Cancer center, Lyon
| | - V Agrapart
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - V Corset
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - G Garin
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - S Chabaud
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - D Pérol
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - J-Y Blay
- Departments of Medical Oncology, University Claude Bernard.
| |
Collapse
|
2
|
Donzel M, Zidane-Marinnes M, Paindavoine S, Breheret R, de la Fouchardière A. Clear cell sarcoma of the soft palate mimicking unclassified melanoma. Pathology 2019; 51:331-334. [PMID: 30837084 DOI: 10.1016/j.pathol.2018.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 09/30/2018] [Accepted: 10/19/2018] [Indexed: 11/18/2022]
Affiliation(s)
- M Donzel
- Département of Biopathology, Centre Leon Bérard, Lyon, France
| | - M Zidane-Marinnes
- Département de Pathologie Cellulaire et Tissulaire, CHU Angers, Angers, France
| | - S Paindavoine
- Département of Biopathology, Centre Leon Bérard, Lyon, France
| | - R Breheret
- Service ORL-CCF, CHU Angers, Angers, France
| | - A de la Fouchardière
- Département of Biopathology, Centre Leon Bérard, Lyon, France; UMR Inserm 1052 CNRS 5286, Centre Léon Bérard, Lyon, France.
| |
Collapse
|