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Prenen H, Deva S, Keam B, Lindsay CR, Lugowska I, Yang JC, Longo F, de Miguel M, Ponz-Sarvise M, Ahn MJ, Gumus M, Champiat S, Italiano A, Salas S, Perets R, Arslan C, Cho BC, Evers S, Boetsch C, Marbach D, Dejardin D, Sleiman N, Ardeshir C, Richard M, Charo J, Kraxner A, Keshelava N, Teichgräber V, Moreno V. Phase II study to determine the anti-tumor activity and safety of simlukafusp alfa (FAP-IL2v) combined with atezolizumab in esophageal cancer. Clin Cancer Res 2024:745192. [PMID: 38709220 DOI: 10.1158/1078-0432.ccr-23-2677] [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: 12/05/2023] [Revised: 02/29/2024] [Accepted: 05/01/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Reported here are results from the esophageal squamous cell carcinoma (SCC) cohort of a Phase II, non-comparative, basket study, evaluating the anti-tumor activity and safety of FAP-IL2v plus atezolizumab in patients with advanced/metastatic solid tumors (NCT03386721). EXPERIMENTAL DESIGN Eligible patients had an Eastern Cooperative Oncology Group performance status of 0-1; measurable metastatic, persistent, or recurrent esophageal SCC; progression on ≥1 prior therapy; and were checkpoint inhibitor naive. Patients received FAP-IL2v 10 mg plus atezolizumab 1200 mg intravenously every 3 weeks, or FAP-IL2v weekly for 4 weeks, then every 2 weeks, plus atezolizumab 840 mg intravenously every 2 weeks. Primary endpoint was investigator-assessed objective response rate (ORR). RESULTS In the response-evaluable population (N=34), best confirmed ORR was 20.6% (95% confidence interval [CI]: 10.4-36.8) with a complete response (CR) seen in one patient and partial responses (PR) in six patients. Disease control rate was 44.1% (CR=2.9%; PR=17.6%; stable disease [SD]=23.5%) and median duration of response was 10.1 months (95% CI: 5.6-26.7). Median progression-free survival was 1.9 months (95% CI: 1.8-3.7). Analysis of response by PD-L1 expression (Ventana SP263) resulted in an ORR of 26.7 % for patients with PD-L1-positive tumors (tumor area positivity [TAP] cut-off ≥1%; n=15) and 7.1% for patients with PD-L1-negative tumors (TAP cut-off <1%; n=14). Overall, the treatment combination was tolerable and adverse events were consistent with the known safety profiles of each drug. CONCLUSIONS FAP-IL2v plus atezolizumab demonstrated clinical activity and was tolerable in patients with previously treated esophageal SCC.
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Affiliation(s)
- Hans Prenen
- University Hospital Antwerp, Edegem, Belgium
| | | | - Bhumsuk Keam
- Seoul National University Hospital, Seoul, Korea (South), Republic of
| | - Colin R Lindsay
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Iwona Lugowska
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - James C Yang
- National Taiwan University Hospital and National Taiwan University Cancer Center, Taipei, Taiwan, Taipei, Taiwan
| | - Federico Longo
- Ramón y Cajal University Hospital, IRYCIS, Universidad Alcala, CIBERONC, Madrid, Madrid, Spain
| | - Maria de Miguel
- START-CIOCC Early Phase Clinical Trial Unit, HM Sanchinarro Hospital/San Pablo CEU University, Madrid, Spain
| | - Mariano Ponz-Sarvise
- Cancer Center Clinica Universidad de Navarra and solid tumor program, CIMA, Pamplona, Spain
| | - Myung-Ju Ahn
- Sungkyunkwan University School of Medicine, Seoul, Korea (South), Republic of
| | - Mahmut Gumus
- Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | | | | | | | - Ruth Perets
- Rambam Health Care Campus and Technion--Israel Institute of Technology, Haifa, Israel
| | - Cagatay Arslan
- Izmir Economy University Medical Point Medical Hospital, Izmir, Turkey
| | - Byoung C Cho
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | | | | | | | | | - Nassim Sleiman
- Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | | | - Muriel Richard
- Roche Pharma Research and Early Development, Discovery & Translational Area Oncology, Roche Innovation Center, Basel, Switzerland
| | - Jehad Charo
- Roche (Switzerland), Schlieren, Zurich, Switzerland
| | | | - Nino Keshelava
- Roche Pharma Research and Early Development, Discovery & Translational Area Oncology, Roche Innovation Center Zurich, Schlieren, Switzerland
| | | | - Victor Moreno
- START-Madrid-FJD, Hospital Fundación Jimenez Diaz, Madrid, Spain
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Blay JY, Penel N, Valentin T, Anract P, Duffaud F, Dufresne A, Verret B, Cordoba A, Italiano A, Brahmi M, Henon C, Amouyel T, Ray-Coquard I, Ferron G, Boudou-Rouquette P, Tlemsani C, Salas S, Rochwerger R, Faron M, Bompas E, Ducassou A, Gangloff D, Gouin F, Firmin N, Piperno-Neumann S, Rios M, Ropars M, Kurtz JE, Le Nail LR, Bertucci F, Carrere S, Llacer C, Watson S, Bonvalot S, Leroux A, Perrin C, Gantzer J, Pracht M, Narciso B, Monneur A, Lebbe C, Hervieu A, Saada-Bouzid E, Dubray-Longeras P, Fiorenza F, Chaigneau L, Nevieres ZM, Soibinet P, Bouché O, Guillemet C, Spano JP, Ruzic JC, Isambert N, Vaz G, Meeus P, Karanian M, Ngo C, Coindre JM, De Pinieux G, Le Loarer F, Ducimetiere F, Chemin C, Morelle M, Toulmonde M, Le Cesne A. Improved nationwide survival of sarcoma patients with a network of reference centers. Ann Oncol 2024; 35:351-363. [PMID: 38246351 DOI: 10.1016/j.annonc.2024.01.001] [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: 11/01/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND We investigated the impact of the implementation of a network of reference centers for sarcomas (NETSARC) on the care and survival of sarcoma patients in France since 2010. PATIENTS AND METHODS NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor boards (MDTBs), funded by the French National Cancer Institute (INCa) since 2010. Its aims are to improve the quality of diagnosis and care of sarcoma patients. Patients' characteristics, treatments, and outcomes are collected in a nationwide database. The objective of this analysis was to compare the survival of patients in three periods: 2010-2012 (non-exhaustive), 2013-2015, and 2016-2020. RESULTS A total of 43 975 patients with sarcomas, gastrointestinal stromal tumors (GISTs), or connective tissue tumors of intermediate malignancy were included in the NETSARC+ database since 2010 (n = 9266 before 2013, n = 12 274 between 2013 and 2015, n = 22 435 in 2016-2020). Median age was 56 years, 50.5% were women, and 13.2% had metastasis at diagnosis. Overall survival was significantly superior in the period 2016-2020 versus 2013-2015 versus 2010-2012 for the entire population, for patients >18 years of age, and for both metastatic and non-metastatic patients in univariate and multivariate analyses (P < 0.0001). Over the three periods, we observed a significantly improved compliance to clinical practice guidelines (CPGs) nationwide: the proportion of patients biopsied before surgery increased from 62.9% to 72.6%; the percentage of patients presented to NETSARC MDTBs before first surgery increased from 31.7% to 44.4% (P < 0.0001). The proportion of patients with R0 resection on first surgery increased (from 36.1% to 46.6%), while R2 resection rate decreased (from 10.9% to 7.9%), with a better compliance and improvement in NETSARC centers. CONCLUSIONS The implementation of the national reference network for sarcoma was associated with an improvement of overall survival and compliance to guidelines nationwide in sarcoma patients. Referral to expert networks for sarcoma patients should be encouraged, though a better compliance to CPGs can still be achieved.
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Affiliation(s)
- J Y Blay
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon.
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - T Valentin
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - P Anract
- Department of Orthopedics, Hôpital Cochin Saint Vincent de Paul, Paris
| | - F Duffaud
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - A Dufresne
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - B Verret
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - A Cordoba
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - M Brahmi
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Henon
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - T Amouyel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - I Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - G Ferron
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | | | - C Tlemsani
- Department of Orthopedics, Hôpital Cochin Saint Vincent de Paul, Paris
| | - S Salas
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - R Rochwerger
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - M Faron
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - E Bompas
- Department of Medical Oncology, Cochin Hospital, Paris; Department of Medical Oncology, Centre René Gauducheau, Nantes St. Herblain
| | - A Ducassou
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - D Gangloff
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - F Gouin
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Service Orthopedie, CHU Nantes, Nantes
| | - N Firmin
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - S Piperno-Neumann
- INSERM U1194, IRCM, Univ Montpellier, Montpellier; Department of Medical Oncology, Institut Curie, Paris; Department of Surgical Oncology, Institut Curie, Paris
| | - M Rios
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - M Ropars
- Department of Orthopedics, CHU Rennes, Rennes
| | | | | | - F Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - S Carrere
- Service Orthopedie, CHU Nantes, Nantes
| | - C Llacer
- Service Orthopedie, CHU Nantes, Nantes
| | - S Watson
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - S Bonvalot
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - A Leroux
- INSERM U1194, IRCM, Univ Montpellier, Montpellier
| | - C Perrin
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - J Gantzer
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - M Pracht
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - B Narciso
- Department of Orthopedic Surgery, Tours
| | - A Monneur
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - C Lebbe
- Department of Dermatology, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris; Department of CIC, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris
| | - A Hervieu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon
| | - E Saada-Bouzid
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice
| | - P Dubray-Longeras
- Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand
| | - F Fiorenza
- Department of Orthopedic Surgery, CHU Limoges, Limoges
| | - L Chaigneau
- Department of Medicine, CHU Besancon, Besancon
| | | | - P Soibinet
- Department of Medicine, Centre Francois Baclesse, Caen
| | - O Bouché
- Department of Gastroenterology, CHU Reims, Reims
| | - C Guillemet
- Department of Medical Oncology, Centre J Godinot Reims, Reims
| | - J P Spano
- Department of Oncology, Hôpital Pitié-Salpétriere, Paris
| | - J C Ruzic
- Departement d'oncologie, CHU, La Reunion
| | - N Isambert
- Service d'oncologie, CHU Poitiers, Poitiers, France
| | - G Vaz
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - P Meeus
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Karanian
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Ngo
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - J M Coindre
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | | | - F Le Loarer
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - F Ducimetiere
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Chemin
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Morelle
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - A Le Cesne
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
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Salas S, Economos G, Hugues D, Gilbert E, Gracia D, Poulain P, Mateus C, Collet E, Planchet-Barraud B, Colpaert A, Perceau-Chambard É, Calvel LY, Franck C, Mallet D, Baumstarck K, Evin A. Legalisation of euthanasia and assisted suicide: advanced cancer patient opinions - cross-sectional multicentre study. BMJ Support Palliat Care 2024; 13:e1335-e1341. [PMID: 37536753 PMCID: PMC10850827 DOI: 10.1136/spcare-2022-004134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/06/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES The French government voted a new law in February 2016 called the Claeys-Leonetti Law, which established the right to deep and continuous sedation, confirmed the ban on euthanasia and ruled out physician-assisted suicide. The aim of this work was to gather the opinion of patients on continuous sedation and the legalisation of medical assistance in dying and to explore determinants associated with favourable and unfavourable opinions. METHODS This was a French national prospective multicentre study between 2016 and 2020. RESULTS 331 patients with incurable cancer suffering from locally advanced or metastatic cancer in 14 palliative care units were interviewed. 48.6% of participants expressed a favourable opinion about physician-assisted suicide and 27.2% an unfavourable opinion about its legalisation. Regarding euthanasia, 52% of patients were in favour of its legalisation. In univariate analysis, the only factor determining opinion was belief in God. CONCLUSIONS While most healthy French people are in favour of legalising euthanasia, only half of palliative care patients expressed this opinion. Medical palliative care specialists were largely opposed to euthanasia. The only determining factor identified was a cultural factor that was independent of the other studied variables. This common factor was found in other studies conducted on cohorts from other countries. This study contributes to the knowledge and thinking about the impact of patients' personal beliefs and values regarding their opinions about euthanasia and assisted suicide. TRIAL REGISTRATION NUMBER NCT03664856.
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Affiliation(s)
| | | | - Damien Hugues
- Medicine, CHI Toulon - La Seyne sur Mer, Toulon, France
| | | | - Dominique Gracia
- Centre Hospitalier de Salon de Provence, Salon de Provence, France
| | | | - Christine Mateus
- Palliative Care Unit, Gustave Roussy Institute, Villejuif, France
| | - Elsa Collet
- Centre Hospitalier de Martigues, Martigues, France
| | | | | | | | - Laurent Yves Calvel
- Equipe mobile de Soins Palliatifs, Hop Hautepierre, Strasbourg, France
- unité de Soins Palliatifs, Hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Cecile Franck
- Centre Hospitalier de la Région de Saint-Omer, Saint-Omer, France
| | - Donatien Mallet
- Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | | | - Adrien Evin
- CHU Nantes, Nantes, France
- Nantes University, Nantes, France
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Tourneau CL, Takacsi-Nagy Z, Finzi L, Liem X, Calugaru V, Moreno V, Calvo E, Salas S, Doger B, Dubray-Vautrin A, Mirabel X, Badois N, Chilles A, Fakhry N, Kam SWH, Houdas L, Debard A, Vivar OI, Farber LA, Lesnik M. Novel Radioenhancer NBTXR3 Activated by Radiotherapy in Cisplatin-Ineligible Locally Advanced HNSCC Patients: Final Results of a Phase I Trial. Int J Radiat Oncol Biol Phys 2023; 117:S99. [PMID: 37784620 DOI: 10.1016/j.ijrobp.2023.06.435] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) New approaches are needed for frail or elderly patients with locally advanced head and neck squamous cell carcinoma (LA HNSCC) who are unfit to receive cisplatin with concurrent radiotherapy (RT). NBTXR3 is a first-in-class radioenhancer, composed of functionalized hafnium oxide nanoparticles, administered by a single intratumoral (IT) injection and activated by RT. NBTXR3 locally amplifies the anti-tumoral response of RT without adding toxicity to surrounding healthy tissue as shown in a randomized trial in soft tissue sarcoma. This two-part study: dose-escalation followed by the dose-expansion part reported here, evaluated the safety and preliminary efficacy for NBTXR3 activated by RT in elderly or frail patients ineligible to cisplatin. MATERIALS/METHODS This trial enrolled patients who had previously untreated AJCC 8th Stage III-IVA or T3, T4 SCC of the oral cavity or oropharynx (OPC) ineligible to cisplatin. Eligible patients received a single IT injection of NBTXR3 at the recommended dose (22% of the baseline tumor volume) followed by RT (IMRT 70 Gy in 35 fractions). The primary objectives of the dose expansion part were to test the recommended dose, to confirm its safety, and obtain preliminary evidence of efficacy. The secondary objectives included the evaluation of progression-free survival (PFS) and overall survival (OS). RESULTS Fifty-sixpatients in the dose expansion part were treated from April 2019-January 2022; 44 patients were evaluable for objective tumor response. In the all-treated population, median age was 71.9 years. 64.3% had age-adjusted Charlson Comorbidity Index scores ≥4, 55.4% had OPC (45.2% HPV+) and 80% had T3-4. Median injected volume of NBTXR3 was 13.6 [0.5-57.1] mL. Grade ≥ 3 adverse events reported as potentially related to NBTXR3 or to injection procedure were 1.2% and 0.4% of all AEs reported, respectively. In the evaluable population, the best objective response rate of the NBTXR3 injected lesion was 81.8% with a complete response rate of 63.6%. The best overall response rate (injected and non-injected lesions) was 79.5%. Final analyses on PFS and OS with long-term follow-up will be presented. CONCLUSION NBTXR3 IT injection followed by activation with RT was confirmed to be feasible and well tolerated in elderly or frail patients with LA HNSSC and significant comorbidities. The high rate of best overall response suggests that NBTXR3+RT is effective in this elderly population ineligible to cisplatin with a high unmet medical need. These results support our ongoing phase III study comparing NBTXR3/RT ± cetuximab vs. RT ± cetuximab in platinum-based chemotherapy ineligible elderly patients with LA-HNSCC: NANORAY 312 (NCIT04892173).
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Affiliation(s)
| | | | | | - X Liem
- Univesrite Montreal, Montreal, QC, Canada
| | - V Calugaru
- Department of Radiation Oncology-Institut Curie, Paris, France
| | - V Moreno
- Hospital Fundación Jimenez Diaz, Madrid, Spain
| | | | - S Salas
- Assistance Publique Hôpitaux de Marseille, Timone Hospital, Marseille, France
| | | | | | | | | | - A Chilles
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - N Fakhry
- Hôpital Timone, Marseille, France
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Vienne A, Collet L, Chevalier T, Borel C, Tardy M, Huguet F, Richard S, Salas S, Saada-Bouzid E, Fayette J, Daste A. Efficacy of second-line chemotherapy or immune checkpoint inhibitors for patients with a prolonged objective response (≥ 6 months) after first-line therapy for recurrent or metastatic head and neck squamous cell carcinoma: a retrospective study. BMC Cancer 2023; 23:663. [PMID: 37452287 PMCID: PMC10347750 DOI: 10.1186/s12885-023-11133-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M-HNSCC) have a poor prognosis and limited therapeutic options. Immune checkpoint inhibitors (ICIs) are effective in patients with tumor progression < 6 months following first-line, platinum-based chemotherapy (PBC), but data are missing for patients with progression ≥ 6 months after the last platinum dose. METHODS Retrospective analysis (six French centers, 2008-2019) of all consecutive R/M-HNSCC patients. treated first-line with PBC and tumor progression ≥ 6 months after the last platinum dose. PRIMARY ENDPOINT progression-free survival after second-line therapy (PFS2). Additional endpoints: overall survival from Day 1 of first-line (OS1) and second-line (OS2) therapy. RESULTS R/M-HNSCC patients (n = 144) received cisplatinum (n = 67, 47%) or carboplatinum (n = 77, 53%) first-line. Response after first-line: complete response (CR; n = 16, 11%); partial response (PR; n = 77, 53%); stable disease (n = 22, 15%). Second-line therapy: PBC (n = 95, 66%); platinum-free regimen (PFR) (n = 25, 17%); ICI (n = 24, 17%). Median [95% confidence interval] PFS (months): PBC 5.0 [3.8-6.2]; PFR 4.0 [1-7.0]; ICI 2.0 [0.4-3.6] (p = 0.16). For PBC, PFR, and ICI, respectively: OS1 30, 23, and 29 months (p = 1.02); OS2 14, 10, and 16 months (p = 0.25); PR, 26%, 16%, and 21% patients; CR, 0%, 8%, and 4% patients. For subsequent lines, ICIs were administered for PBC (n = 11, 12%) and PFR (n = 2, 8%). No predictive factor for efficacy (PFS, OS) was identified. CONCLUSIONS Our retrospective study suggests similar efficacy regarding OS2 for second-line chemotherapy or ICI in R/M-HNSCC patients with progression ≥ 6 months after the last first-line platinum dose.
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Affiliation(s)
- Agathe Vienne
- Department of Medical Oncology, Hôpital Saint-André, CHU Bordeaux-University of Bordeaux, 1 Rue Jean Burguet, Bordeaux, 33000, France
| | - Laetitia Collet
- Department of Medical Oncology, Léon Bérard Center, University of Lyon, Lyon, France
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium
| | - Thomas Chevalier
- Department of Medical Oncology, CHU la Timone, AP-HM, Marseille, France
| | - Christian Borel
- Department of Medical Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - Magalie Tardy
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Florence Huguet
- Department of Radiation Oncology, AP-HP, Tenon Hospital, Sorbonne University, Paris, France
| | - Sandrine Richard
- Department of Medical Oncology, Tenon Hospital, AP-HP Sorbonne University, Paris, France
| | - Sebastien Salas
- Department of Medical Oncology, CHU la Timone, AP-HM, Marseille, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Jerome Fayette
- Department of Medical Oncology, Léon Bérard Center, University of Lyon, Lyon, France
| | - Amaury Daste
- Department of Medical Oncology, Hôpital Saint-André, CHU Bordeaux-University of Bordeaux, 1 Rue Jean Burguet, Bordeaux, 33000, France.
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Yom S, Takacsi-Nagy Z, Liem X, Salas S, Debard A, Finzi L, Vivar O, Farber L, Gogishvili M, Kristesashvili G, Makharadze T, Hoffmann C, Tourneau CL. NANORAY-312: A Phase III Pivotal Study of NBTXR3 Activated by Investigator's Choice of Radiotherapy Alone or Radiotherapy in Combination with Cetuximab for Platinum-Based Chemotherapy-Ineligible Elderly Patients with Locally Advanced HNSCC. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1372] [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: 11/26/2022]
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Le Tourneau C, Salas S, Pointreau Y, Ceruse P, Babin E, Rondeau V, Guigay J, Rotarski M, Chehimi M, Toullec C, Marie G, Sire C, Darut Jouve A, Theron A, Calderon B, Houessinon A, Cotté FE, Lavignon M, Even C, Fayette J. 695P Effectiveness and quality-of-life (QoL) data from real-world study (ProNiHN) in patients (pts) with recurrent and/or metastatic squamous cell carcinoma of head and neck (R/M SCCHN) treated with nivolumab (nivo) in France. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.819] [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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8
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Penel N, Bonvalot S, Bimbai AM, Italiano A, Orbach D, Verret B, Toulmonde M, Dufresne A, Bay JO, Chaigneau L, Kurtz J, Bompas E, Salas S, Bertucci F, Guillemet C, Ryckewaert T, Thery J, Le Deley MC, Blay JY, Le Cesne A. 1512P Pain in patients with desmoid fibromatosis (DF). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1615] [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: 11/29/2022] Open
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9
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Marin C, Khoudour N, Millet A, Lebert D, Bros P, Thomas F, Ternant D, Guitton J, Hamimed M, Blanchet B, Salas S, Ciccolini J. Abstract 1144: A multiplex LC-MS/MS method for assaying mAbs in oncology: Application to the CETUXIMAX GPCO-Unicancer trial on cetuximab pharmacokinetics in head and neck cancer patients. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Implementing PK-guided dosing with monoclonal antibodies (mAbs) in oncology has been for long impaired by difficulties in developing appropriate (i.e., time- and cost-effective) bioanalytical methods suitable for routine Therapeutic Drug Monitoring, plus concerns regarding the exact PK/PD relationships of several biologics possibly blurred by the TMDD phenomenon. To help lifting these issues, we have developed and cross-validated a multiplex LC-MS/MS method allowing to assay simultaneously up to 8 mAbs in plasma, including several immune checkpoint inhibitors (i.e., atezolizumab, bevacizumab, cetuximab, ipilimumab, nivolumab, pembrolizumab, rituximab, trastuzumab). Using a ready-to-use kit (mAbXmise), the method proved to be simple and rapid - covering a concentration range of 2-100 µg/ml, in line with plasma concentrations usually expected with mAbs. Inter and intra-assay precision were both <15% and accuracy was comprised between 90.1 and 111.1%, thus meeting the requirements of current EMA guidelines for validating bioanalytical methods. Cross-validation using reference LC-MS/MS or ELISA methods was performed on 7 mAbs (excluding atezolizumab since no reference method was available) with a satisfactory mean absolute bias of 10.6% (3.0-19.9%). This LC-MS/MS method was next used as part of the Cetuximax trial (NCT-04218136), an open, non-randomized, single arm, multicentric study aiming at determining the PK/PD relationships of Cetuximab in Head-and-Neck cancer patients with monitoring of both Cmax and Cmin levels. Patients are all treated with the 250 mg/m² QW schedule. Previous works have suggested that Cetuximab trough levels < 34 µg/ml were associated with higher risk for treatment failure in Head-and-Neck patients. Patients were repeatedly sampled in a longitudinal fashion at their Cmax plus trough levels and individual PK parameters were derived using a pop-PK approach. Preliminary results on 90 samples collected from the first 25 out of the 110 patients to be included have confirmed the marked inter-individual variability in Cetuximab exposure (i.e., >56% on trough levels and >55% on Cmax values). Mean Cetuximab trough level was 54 ± 30 µg/ml (range: 12-104 µg/ml) and mean Cmax value was 211 ± 116 µg/ml (range: 75-418 µg/ml), with several individuals (8 out of 25, i.e., 32%) showing plasma exposure below the expected trough levels associated with efficacy. Although preliminary, our data confirm that PK variability is massive with mAbs. This observation suggests that Therapeutic Drug Monitoring, using appropriate LC-MS/MS method, could help appraising interpatient variability at bedside and detecting individuals with exposure levels out of the range usually observed.
Citation Format: Clemence Marin, Nihel Khoudour, Aurélien Millet, Dorothée Lebert, Pauline Bros, Fabienne Thomas, David Ternant, Jerôme Guitton, Mourad Hamimed, Benoit Blanchet, Sebastien Salas, Joseph Ciccolini. A multiplex LC-MS/MS method for assaying mAbs in oncology: Application to the CETUXIMAX GPCO-Unicancer trial on cetuximab pharmacokinetics in head and neck cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1144.
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Affiliation(s)
- Clemence Marin
- 1SMARTc COMPO CRCM Inserm U1068, Marseille Cedex 5, France
| | | | | | | | | | | | | | | | - Mourad Hamimed
- 1SMARTc COMPO CRCM Inserm U1068, Marseille Cedex 5, France
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10
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Couderc AL, Ninove L, Nouguerède E, Rey D, Rebroin M, Daumas A, Tomasini P, Greillier L, Salas S, Duffaud F, Dahan L, Duluc M, Garcia ME, Pluvy J, Chaléat S, Farnault L, Venton G, Fourié T, Nurtop E, de Lamballerie X, Villani P, Charrel R, Correard F. Acceptance, efficacy, and safety of COVID-19 vaccination in older patients with cancer. J Geriatr Oncol 2022; 13:850-855. [PMID: 35589542 PMCID: PMC9108027 DOI: 10.1016/j.jgo.2022.05.002] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 01/08/2023]
Abstract
Purpose The COVID-19 vaccination campaign began in December 2020, in France, and primarily targeted the oldest people. Our study aimed to determine the level of acceptance of vaccination in a population of older patients with cancer. Methods From January 2021, we offered vaccination with the BNT162b2 COVID-19 vaccine to all patients 70 years and older referred to our geriatric oncology center in Marseille University Hospital (AP-HM) for geriatric assessment before initiation of an oncological treatment. Objectives were to evaluate acceptance rate of COVID-19 vaccination and to assess vaccine safety, reactogenicity, and efficacy two months after the first dose. Results Between January 18, 2021 and May 7, 2021, 150 older patients with cancer were offered vaccination after a geriatric assessment. The majority were men (61.3%), with a mean age of 81 years. The two most frequent primary tumors were digestive (29.4%) and thoracic (18%). The vaccine acceptance rate was 82.6% and the complete vaccination rate (2 doses) reached 75.3%. Among the vaccinated patients, 15.9% reported mild side effects after the first dose and 23.4% after the second dose, mostly arm pain and fatigue. COVID-19 cases were observed in 5.1% of vaccinated patients compared with 16.7% in unvaccinated patients. Of the 22 vaccinated patients who agreed to have their serum tested, 15 had antibodies against the spike protein at day 21 after the first dose. Conclusion Our study showed a high acceptance rate of COVID-19 vaccination, with good tolerance in this frail population. These results highlight the benefits of organizing vaccination campaigns at the very beginning of oncological management in older patients. Clinical trial registration: This study was registered May 23, 2019 in ClinicalTrials.gov (NCT03960593).
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Affiliation(s)
- Anne-Laure Couderc
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille University, CNRS, EFS, ADES, Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France.
| | - Laetitia Ninove
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Emilie Nouguerède
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France
| | - Dominique Rey
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France
| | | | - Aurélie Daumas
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Pascale Tomasini
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Laurent Greillier
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | | | | | - Laetitia Dahan
- Hepato-Gastro-Enterolgy Unit, CHU Timone, AP-HM, Marseille, France
| | - Muriel Duluc
- Hepato-Gastro-Enterolgy Unit, CHU Timone, AP-HM, Marseille, France
| | - Marie-Eve Garcia
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Johan Pluvy
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Solène Chaléat
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Laure Farnault
- Haematology and Cellular Therapy Department, AP-HM, Marseille, France
| | - Geoffroy Venton
- Haematology and Cellular Therapy Department, AP-HM, Marseille, France
| | - Toscane Fourié
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Elif Nurtop
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Patrick Villani
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille University, CNRS, EFS, ADES, Marseille, France
| | - Remi Charrel
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
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11
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Penel N, Bonvalot S, Bimbai AM, Meurgey A, Le Loarer F, Salas S, Piperno-Neumann S, Chevreau C, Boudou-Rouquette P, Dubray-Longeras P, Kurtz JE, Guillemet C, Bompas E, Italiano A, Le Cesne A, Orbach D, Thery J, Le Deley MC, Blay JY, Mir O. Lack of prognostic value of CTNNB1 mutation profile in desmoid-type fibromatosis. Clin Cancer Res 2022; 28:4105-4111. [PMID: 35294527 DOI: 10.1158/1078-0432.ccr-21-4235] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE This prospective nationwide cohort study aimed to investigate desmoid-type fibromatosis (DF) outcomes, focusing on the prognostic value of CTNNB1 mutations. EXPERIMENTAL DESIGN ALTITUDES (NCT02867033) was a nationwide prospective cohort study of DF diagnosed between January 2016 and December 2020. At diagnosis, CTNNB1 molecular alterations were identified using next-generation sequencing or Sanger sequencing. The primary endpoint was event-free survival (EFS) (progression, relapse, or death). We enrolled 628 patients managed by active surveillance (AS), surgical resection (SR), or systemic treatment as front-line therapy. RESULTS Overall, 516 (82.2%) patients (368 females [71.3%], median age 40.3 years [range, 1-89]) were eligible for analysis. In 435 (84.3%) cases, there was one CTNNB1 molecular alteration: p.T41A, p.S45F, or p.S45P. The front-line management was AS in 352 (68.2%), SR in 120 (23.3%), and systemic treatments in 44 (8.5%) patients. CTNNB1 mutation distribution was similar across the three therapeutic groups. The median follow-up period was 24.7 (range, 0.4-59.7) months. The estimated 3-year EFS rate was 66.2% (95%CI, 60.5%-71.2%). DF harboring p.S45F was significantly associated with male sex (p=0.03), non-abdominal wall sites (p=0.05), pain (p=0.007), and large tumor size (p=0.025). CTNNB1 p.S45F mutation was not significantly associated with EFS, either in univariate (hazard ratio [HR]=1.06; 95% confidence interval [CI], 0.65-1.73; p=0.81), or in multivariate analysis (HR=0.91; 95% CI, 0.55-1.49; p=0.71). CONCLUSIONS We found that CTNNB1 mutation profile was associated with unfavorable prognostic factors but was not a prognostic factor for EFS.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jean-Yves Blay
- Centre Leon Bérard, Univ Claude Bernard, Unicancer, Lyon, France
| | - Olivier Mir
- Gustave Roussy Cancer Institute, Villejuif, France
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12
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Viprey M, Pauly V, Salas S, Baumstarck K, Orleans V, Llorca PM, Lancon C, Auquier P, Boyer L, Fond G. Palliative and high-intensity end-of-life care in schizophrenia patients with lung cancer: results from a French national population-based study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1571-1578. [PMID: 32876751 DOI: 10.1007/s00406-020-01186-z] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/20/2020] [Indexed: 11/28/2022]
Abstract
Schizophrenia is marked by inequities in cancer treatment and associated with high smoking rates. Lung cancer patients with schizophrenia may thus be at risk of receiving poorer end-of-life care compared to those without mental disorder. The objective was to compare end-of-life care delivered to patients with schizophrenia and lung cancer with patients without severe mental disorder. This population-based cohort study included all patients aged 15 and older who died from their terminal lung cancer in hospital in France (2014-2016). Schizophrenia patients and controls without severe mental disorder were selected and indicators of palliative care and high-intensity end-of-life care were compared. Multivariable generalized log-linear models were performed, adjusted for sex, age, year of death, social deprivation, time between cancer diagnosis and death, metastases, comorbidity, smoking addiction and hospital category. The analysis included 633 schizophrenia patients and 66,469 controls. The schizophrenia patients died 6 years earlier, had almost twice more frequently smoking addiction (38.1%), had more frequently chronic pulmonary disease (32.5%) and a shorter duration from cancer diagnosis to death. In multivariate analysis, they were found to have more and earlier palliative care (adjusted Odds Ratio 1.27 [1.03;1.56]; p = 0.04), and less high-intensity end-of-life care (e.g., chemotherapy 0.53 [0.41;0.70]; p < 0.0001; surgery 0.73 [0.59;0.90]; p < 0.01) than controls. Although the use and/or continuation of high-intensity end-of-life care is less important in schizophrenia patients with lung cancer, some findings suggest a loss of chance. Future studies should explore the expectations of patients with schizophrenia and lung cancer to define the optimal end-of-life care.
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Affiliation(s)
- Marie Viprey
- CEReSS-Health Services Research and Quality of Life Center, Faculté de Médecine, Secteur Timone, EA 3279, CEReSS -Centre D'Etude Et de Recherche Sur Les Services de Santé Et La Qualité de Vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Epidemiology and Health Economics, APHM, Marseille, France
| | - Vanessa Pauly
- CEReSS-Health Services Research and Quality of Life Center, Faculté de Médecine, Secteur Timone, EA 3279, CEReSS -Centre D'Etude Et de Recherche Sur Les Services de Santé Et La Qualité de Vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Medical Information, APHM, Marseille, France
| | | | - Karine Baumstarck
- CEReSS-Health Services Research and Quality of Life Center, Faculté de Médecine, Secteur Timone, EA 3279, CEReSS -Centre D'Etude Et de Recherche Sur Les Services de Santé Et La Qualité de Vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | | | | | - Christophe Lancon
- CEReSS-Health Services Research and Quality of Life Center, Faculté de Médecine, Secteur Timone, EA 3279, CEReSS -Centre D'Etude Et de Recherche Sur Les Services de Santé Et La Qualité de Vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Psychiatry, APHM, Marseille, France
| | - Pascal Auquier
- CEReSS-Health Services Research and Quality of Life Center, Faculté de Médecine, Secteur Timone, EA 3279, CEReSS -Centre D'Etude Et de Recherche Sur Les Services de Santé Et La Qualité de Vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Epidemiology and Health Economics, APHM, Marseille, France
| | - Laurent Boyer
- CEReSS-Health Services Research and Quality of Life Center, Faculté de Médecine, Secteur Timone, EA 3279, CEReSS -Centre D'Etude Et de Recherche Sur Les Services de Santé Et La Qualité de Vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Epidemiology and Health Economics, APHM, Marseille, France.,Department of Medical Information, APHM, Marseille, France
| | - Guillaume Fond
- CEReSS-Health Services Research and Quality of Life Center, Faculté de Médecine, Secteur Timone, EA 3279, CEReSS -Centre D'Etude Et de Recherche Sur Les Services de Santé Et La Qualité de Vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France. .,Department of Epidemiology and Health Economics, APHM, Marseille, France. .,Department of Medical Information, APHM, Marseille, France.
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13
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Le Tourneau C, Calugaru V, Moreno V, Calvo E, Liem X, Salas S, Doger B, Jouffroy T, Mirabel X, Rodriguez J, Chilles A, Bernois K, Fakhry N, Wong Hee Kam S, Hoffmann C. A phase I dose expansion study of NBTXR3, radiation enhancing hafnium oxide nanoparticles, for the treatment of cisplatin-ineligible locally advanced HNSCC patients. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00346-5] [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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Muratori L, Texier M, Mayache-Badis L, Bidault F, Iacob M, Daste A, Fayette J, Lefebvre G, Saada-Bouzid E, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminsky-Forrett MC, Johnson A, Ferrand F, Aupérin A, Guigay J, Raynard B, Even C. 916P Impact of sarcopenia (S) on efficacy and toxicity of nivolumab (N) in patients (pts) with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) in TOPNIVO (T) study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1326] [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: 11/29/2022] Open
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15
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Lasserre M, Muratori L, Esma S, Marret G, Salas S, Borel C, Delord JP, Le Nagat S, Clatot F, Evrard C, Rolland F, Even C, Le Tourneau C, Daste A. 896P Long-responders to ICI in R/M-HNSCC: A retrospective multicentric French cohort. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1306] [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: 10/20/2022] Open
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16
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Le Tourneau C, Calugaru V, Takacsi-Nagy Z, Liem X, Papai Z, Moreno V, Braña I, Salas S, Poissonnet G, Calvo E, Doger B, Choussy O, Mirabel X, Krhili S, Bernois K, Fakhry N, Wong Hee Kam S, Borcoman E, Hoffmann C. OC-0515 NBTXR3 activated by radiotherapy in cisplatin-ineligible locally advanced HNSCC patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06941-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Fond G, Pauly V, Duba A, Salas S, Viprey M, Baumstarck K, Orleans V, Llorca PM, Lancon C, Auquier P, Boyer L. End of life breast cancer care in women with severe mental illnesses. Sci Rep 2021; 11:10167. [PMID: 33986419 PMCID: PMC8119688 DOI: 10.1038/s41598-021-89726-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/16/2021] [Indexed: 11/30/2022] Open
Abstract
Little is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women without SPD. Study design, setting, participants. This population-based cohort study included all women aged 15 and older who died from breast cancer in hospitals in France (2014–2018). Key measurements/outcomes. Indicators of palliative care and high-intensity EOL care. Multivariable models were performed, adjusted for age at death, year of death, social deprivation, duration between cancer diagnosis and death, metastases, comorbidity, smoking addiction and hospital category. The analysis included 1742 women with SPD (287 with bipolar disorder, 1075 with major depression and 380 with schizophrenia) and 36,870 women without SPD. In multivariate analyses, women with SPD had more palliative care (adjusted odd ratio aOR 1.320, 95%CI [1.153–1.511], p < 0.001), longer palliative care follow-up before death (adjusted beta = 1.456, 95%CI (1.357–1.555), p < 0.001), less chemotherapy, surgery, imaging/endoscopy, and admission in emergency department and intensive care unit. Among women with SPD, women with bipolar disorders and schizophrenia died 5 years younger than those with recurrent major depression. The survival time was also shortened in women with schizophrenia. Despite more palliative care and less high-intensity care in women with SPD, our findings also suggest the existence of health disparities in women with bipolar disorders and schizophrenia compared to women with recurrent major depression and without SPD. Targeted interventions may be needed for women with bipolar disorders and schizophrenia to prevent these health disparities.
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Affiliation(s)
- Guillaume Fond
- Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France. .,Department of Epidemiology and Health Economics, APHM, Marseille, France. .,Department of Medical Information, APHM, Marseille, France.
| | - Vanessa Pauly
- Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Medical Information, APHM, Marseille, France
| | - Audrey Duba
- Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Epidemiology and Health Economics, APHM, Marseille, France.,Department of Medical Information, APHM, Marseille, France
| | | | - Marie Viprey
- Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Epidemiology and Health Economics, APHM, Marseille, France
| | - Karine Baumstarck
- Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France
| | | | | | - Christophe Lancon
- Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Psychiatry, APHM, Marseille, France
| | - Pascal Auquier
- Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Epidemiology and Health Economics, APHM, Marseille, France
| | - Laurent Boyer
- Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France.,Department of Epidemiology and Health Economics, APHM, Marseille, France.,Department of Medical Information, APHM, Marseille, France
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Le Cesne A, Blay JY, Cupissol D, Italiano A, Delcambre C, Penel N, Isambert N, Chevreau C, Bompas E, Bertucci F, Chaigneau L, Piperno-Neumann S, Salas S, Rios M, Guillemet C, Bay JO, Ray-Coquard I, Haddag L, Bonastre J, Kapso R, Fraslin A, Bouvet N, Mir O, Foulon S. A randomized phase III trial comparing trabectedin to best supportive care in patients with pre-treated soft tissue sarcoma: T-SAR, a French Sarcoma Group trial. Ann Oncol 2021; 32:1034-1044. [PMID: 33932507 DOI: 10.1016/j.annonc.2021.04.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 02/16/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The French Sarcoma Group assessed the efficacy, safety, and quality of life (QoL) of trabectedin versus best supportive care (BSC) in patients with advanced soft tissue sarcoma (STS). PATIENTS AND METHODS This randomized, multicenter, open-label, phase III study included adults with STS who progressed after 1-3 prior treatment lines. Patients were randomized (1 : 1) to receive trabectedin 1.5 mg/m2 every 3 weeks or BSC, stratified into L-STS (liposarcoma/leiomyosarcoma) and non-L-STS groups (other histotypes). Patients from the BSC arm were allowed to cross over to trabectedin at progression. The primary efficacy endpoint was progression-free survival (PFS) confirmed by blinded central review and analyzed in the intention-to-treat population. RESULTS Between 26 January 2015 and 5 November 2015, 103 heavily pre-treated patients (60.2% with L-STS) from 16 French centers were allocated to receive trabectedin (n = 52) or BSC (n = 51). Median PFS was 3.1 months [95% confidence interval (CI) 1.8-5.9 months] in the trabectedin arm versus 1.5 months (0.9-2.6 months) in the BSC arm (hazard ratio = 0.39, 95% CI 0.24-0.64, P < 0.001) with benefits observed across almost all analyzed subgroups, but particularly in patients with L-STS (5.1 versus 1.4 months, P = 0.0001). Seven patients (13.7%) in the trabectedin arm (all with L-STS) achieved a partial response, while no objective responses were observed in the BSC arm (P = 0.004). The most common grade 3/4 adverse events were neutropenia (44.2% of patients), leukopenia (34.6%), and transaminase increase (32.7%). Health-related 30-item core European Organization for the Research and Treatment of Cancer Quality-of-Life Questionnaire evidenced no statistical differences between the arms for any domain and at any time point. After progression, 91.8% of patients crossed over from BSC to trabectedin. CONCLUSION Trabectedin demonstrates superior disease control to BSC without impairing QoL in patients with recurrent STS of multiple histologies, with greater impact in patients with L-STS.
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Affiliation(s)
- A Le Cesne
- Medical Oncology Department, Gustave Roussy, Villejuif, France.
| | - J-Y Blay
- Medical Oncology Department, Centre Léon Bérard and Claude Bernard University, Lyon, France
| | - D Cupissol
- Medical Oncology Department, Centre Val d'Aurelle, Montpellier, France
| | - A Italiano
- Medical Oncology Department, Institut Bergonié, Bordeaux, France
| | - C Delcambre
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - N Penel
- Medical Oncology Department, Centre Oscar Lambret and Lille University, Lille, France
| | - N Isambert
- Medical Oncology Department, Centre Georges-François Leclerc, Dijon, France
| | - C Chevreau
- Medical Oncology Department, Institut Claudius Regaud, Toulouse, France
| | - E Bompas
- Medical Oncology Department, Centre René Gauduchau, Nantes, France
| | - F Bertucci
- Medical Oncology Department, Institut Paoli-Calmettes, Marseille, France
| | - L Chaigneau
- Medical Oncology Department, Hôpital Jean Minjoz, Besancon, France
| | | | - S Salas
- Medical Oncology Department, Hôpital La Timone, Marseille, France
| | - M Rios
- Medical Oncology Department, Institut de Cancerologie de Lorraine, Nancy, France
| | - C Guillemet
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France
| | - J-O Bay
- Medical Oncology Department, Centre Jean Perrin, Clermont Ferrand, France
| | - I Ray-Coquard
- Medical Oncology Department, Centre Léon Bérard and Claude Bernard University, Lyon, France
| | - L Haddag
- Department of Radiology, Gustave Roussy, Villejuif, France
| | - J Bonastre
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - R Kapso
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - A Fraslin
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - N Bouvet
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France
| | - O Mir
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - S Foulon
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
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Donnette M, Ciccolini J, Pissier C, Costello R, Duffaud F, Salas S, Farnault L, Tichadou A, Arcani R, Jarrot PA, Ouafik LH, Venton G, Fanciullino R. High incidence of CDA deficiency in patients with hematological malignancies: perspectives and therapeutic implications. Ann Oncol 2021; 32:684-686. [PMID: 33529741 DOI: 10.1016/j.annonc.2021.01.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/30/2020] [Accepted: 01/17/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- M Donnette
- SMARTc, Centre de Recherche en Cancérologie de Marseille, Inserm U1068, Aix-Marseille University, Marseille, France
| | - J Ciccolini
- SMARTc, Centre de Recherche en Cancérologie de Marseille, Inserm U1068, Aix-Marseille University, Marseille, France.
| | - C Pissier
- Laboratoire de Transfert en Oncologie, University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - R Costello
- Hematology Unit, La Conception University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - F Duffaud
- Medical Oncology Unit, La Timone University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - S Salas
- Medical Oncology Unit, La Timone University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - L Farnault
- Hematology Unit, La Conception University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - A Tichadou
- Hematology Unit, La Conception University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - R Arcani
- Internal Medicine Unit, La Conception University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - P A Jarrot
- Internal Medicine Unit, La Conception University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - L H Ouafik
- Laboratoire de Transfert en Oncologie, University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - G Venton
- Hematology Unit, La Conception University Hospital of Marseille, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - R Fanciullino
- SMARTc, Centre de Recherche en Cancérologie de Marseille, Inserm U1068, Aix-Marseille University, Marseille, France
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20
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Fayette J, Bauman J, Salas S, Colevas D, Even C, Cupissol D, Posner M, Lefebvre G, Saada-Bouzid E, Bernadach M, Seiwert T, Pearson A, Messouak S, Cornen S, Andre P, Rotolo F, Boyer-Chammard A, Cohen R. 81P Monalizumab in combination with cetuximab post platinum and anti-PD-(L)1 in patients with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Updated results from a phase II trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.568] [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: 10/22/2022] Open
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21
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Le Tourneau C, Cassier P, Rolland F, Salas S, Limacher JM, Capitain O, Lantz O, Lalanne A, Ekwegbara C, Tavernaro A, Makhloufi H, Bendjama K, Delord JP. 63MO TG4001 therapeutic vaccination combined with PD-L1 blocker avelumab remodels the tumor microenvironement (TME) and drives antitumor responses in human papillomavirus (HPV)+ malignancies. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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22
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Debourdeau P, Belkacémi M, Economos G, Assénat E, Hilgers W, Coussirou J, Kouidri Uzan S, Vasquez L, Debourdeau A, Daures JP, Salas S. Identification of factors associated with aggressive end-of-life antitumour treatment: retrospective study of 1282 patients with cancer. BMJ Support Palliat Care 2020:bmjspcare-2020-002635. [PMID: 33154087 DOI: 10.1136/bmjspcare-2020-002635] [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: 08/14/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Antitumour treatment in the last 2 weeks of death (ATT-W2) and a new regimen of ATT within 30 days of death (NATT-M1) are considered as aggressive end-of-life (EOL) care. We aimed to assess factors associated with inappropriate use of antitumour treatment (ATT) at EOL. METHODS Data of patients with cancer who died in 2013, 2015, 2017 and 2019 in a single for-profit cancer centre were retrospectively analysed. ATT was divided into chemotherapy (CT), oral targeted therapy (OTT), hormonotherapy and immunotherapy (IMT). RESULTS A total of 1282 patients were included. NATT-M1 was given to 197 (15.37%) patients, and 167 (13.03%) had an ATT-W2. Patients with a performance status of <2 and treated with CT had more both ATT- W2 (OR=2.45, 95% CI 1.65 to 3.65, and OR=10.29, 95% CI 4.70 to 22.6, respectively) and NATT-M1 (OR=2.01, 95% CI 1.40 to 2.90, and OR=8.41, 95% CI 4.46 to 15.86). Predictive factors of a higher rate of ATT-W2 were treatment with OTT (OR=19.08, 95% CI 7.12 to 51.07), follow-up by a medical oncologist (OR=1.49, 95% CI 1.03 to 2.17), miscellaneous cancer (OR=3.50, 95% CI 1.13 to 10.85) and length of hospital stay before death of <13 days (OR=1.92, 95% CI 1.32 to 2.79). Urinary tract and male genital cancers received less ATT-W2 (OR=0.38, 95% CI 0.16 to 0.89, and OR=0.40, 95% CI 0.16 to 0.99) and patients treated by IMT or with age <69 years more NATT-M1 (OR=19.21, 95% CI 7.55 to 48.8, and OR=1.69, 95% CI 1.20 to 2.37). Patients followed up by the palliative care team (PCT) had fewer ATT-W2 and NATT-M1 (OR=0.49, 95% CI 0.35 to 0.71, and OR=0.42, 95% CI 0.30 to 0.58). CONCLUSIONS Most recent ATT and access to a PCT follow-up are the two most important potentially modifiable factors associated with aggressive EOL in patients with cancer. Early integrated palliative oncology care could help to decrease futile ATT at EOL.
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Affiliation(s)
- Philippe Debourdeau
- Supportive care unit, Institut sainte Catherine, Avignon, Provence Alpes Côte d'Azur, France
| | - Mohamed Belkacémi
- EA 2415, LBERC, Laboratoire de Biostatistiques, Epidémiologie et Recherche Clinique, Université Montpellier 1, Montpellier, Languedoc-Roussillon, France
| | - Guillaume Economos
- EA3738, Centre d'Investigation en Cancérologie de Lyon, Universite Claude Bernard Lyon 1, Pierre-Bénite, Auvergne-Rhône-Alpes, France
| | - Eric Assénat
- Medical Oncology, Hospital Saint-Eloi, Montpellier, Languedoc-Roussillon, France
| | - Werner Hilgers
- Medical Oncology, Institut Sainte Catherine, Avignon, Provence-Alpes-Côte d'Azu, France
| | - Julie Coussirou
- Pharmacy, Institut Sainte Catherine, Avignon, Provence Alpes Côte d'Azur, France
| | - Sfaya Kouidri Uzan
- Department of Medical Information, Institut Sainte Catherine, Avignon, Provence-Alpes-Côte d'Azu, France
| | - Léa Vasquez
- Department of Medical Information, Institut Sainte Catherine, Avignon, Provence-Alpes-Côte d'Azu, France
| | - Antoine Debourdeau
- Medical Oncology, Hospital Saint-Eloi, Montpellier, Languedoc-Roussillon, France
| | - Jean Pierre Daures
- EA 2415, LBERC, Laboratoire de Biostatistiques, Epidémiologie et Recherche Clinique, Université Montpellier 1, Montpellier, Languedoc-Roussillon, France
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Joly F, Lefeuvre-Plesse C, Garnier-Tixidre C, Helissey C, Menneveau N, Zannetti A, Salas S, Houede N, Abadie-Lacourtoisie S, Stefani L, Nenan S, Rieger I, Durand-Zaleski I, Descotes JM, Anota A. Feasibility and efficacy of a supervised home-based physical exercise program for metastatic cancer patients receiving oral targeted therapy: study protocol for the phase II/III - UNICANCER SdS 01 QUALIOR trial. BMC Cancer 2020; 20:975. [PMID: 33036567 PMCID: PMC7545839 DOI: 10.1186/s12885-020-07381-4] [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: 07/16/2020] [Accepted: 09/04/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Currently, oral targeted therapies are known to be effective and are frequently used to treat metastatic cancer patients, but fatigue is a frequently reported early side effect of these treatments. This fatigue may impact the patient's treatment adherence and result in a negative impact on quality of life. Physical exercise significantly improved the general well-being and quality of life of advanced cancer patients. However, there is no specific physical activity program adapted for patients with advanced disease. METHODS QUALIOR is a two-part, randomized, open-label, and multicenter with two arms phase II/III trial. Patients (phase II: n = 120; phase III: n = 312) with metastatic cancer (breast cancer, kidney cancer, lung cancer, and other cancers [including but not limited to colon cancer, melanoma, sarcoma, or hepatocarcinoma]) treated with a first- or second-line oral targeted therapy without chemotherapy will be included. Patients will be randomized (2:1) to a 3-month supervised home-based standardized physical activity program or to a recommended adapted physical activity (via a booklet). The primary objective of the phase II is to evaluate the feasibility of the supervised program. The primary objective of the phase III is the evaluation of the benefit of the supervised home-based program compare to the recommended program in terms of fatigue and quality of life at 3 months. The secondary objectives aim to evaluate the impact of the supervised program on fatigue over time, pain, physical capacities, psychosocial and cognitive functions, general quality of life, frequency of dose reduction and patients' adherence to the targeted therapy, overall survival, and progression-free survival. This study will also evaluate the medico-economic impact of supervised program compared to the recommended adapted physical activity program. DISCUSSION The aim of this study is to evaluate home-based physical exercise program for metastatic cancer patients treated with oral targeted therapies to help patients to cope with fatigue and improve quality of life. TRIAL REGISTRATION This trial was registered in ClinicalTrials.gov since May 2017 ( NCT03169075 ).
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Affiliation(s)
- Florence Joly
- Centre François Baclesse et CHU Côte de Nacre, Caen, France.
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Bouttefroy S, Penel N, Minard-Colin V, Orbach D, Le Cesne A, Blay JY, Marec Berard P, Verité C, Laurence V, Piperno-Neumann S, Defachelles AS, Bompas E, Chevreau C, Duffaud F, Salas S, Morelle M, Jean Denis M, Italiano A, Bonvalot S, Corradini N. 1650P Desmoid type fibromatosis in patients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Saada E, Koudou Y, Daste A, Fayette J, Lefebvre G, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminsky-Forrett MC, Johnson A, Vauleon E, Ebran N, Schmidt M, Texier M, Peyrade F, Milano G, Guigay J, Even C, Etienne-Grimaldi MC. 946P Germinal immunogenetics and response to nivolumab in recurrent/metastatic head and neck squamous cell carcinoma (RM HNSCC) patients (pts): TopNIVO ancillary study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1061] [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: 11/29/2022] Open
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Vienne A, Collet L, Chevalier T, Borel C, Tardy M, Huguet F, Richard S, Salas S, Saada-Bouzid E, Fayette J, Daste A. 925P Efficacy of 2nd line treatment with chemotherapy (CT) or immune checkpoint inhibitors (ICIs) for patients (pts) with a prolonged objective response (>6 months) after 1st line therapy for recurrent or metastatic head & neck squamous cell carcinoma (R/M-HNSCC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1040] [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: 11/26/2022] Open
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27
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Even C, Daste A, Fayette J, Lefebvre G, Saada-Bouzid E, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminski M, Johnson A, Vauleon E, Le Tourneau C, Sire C, Prevost A, Jallut I, Bourhis J, Guigay J, Aupérin A, Texier M. 917MO TOPNIVO - A safety study of nivolumab in patients with recurrent and/or metastatic platinum-refractory squamous cell carcinoma of head and neck (R/M SCCHN): Final analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1032] [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: 10/23/2022] Open
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Le Tourneau C, Calugaru V, Borcoman E, Moreno V, Calvo E, Liem X, Salas S, Doger B, Choussy O, Lesnik M, Mirabel X, Badois N, Krhili S, Blomkvist J, Fakhry N, Wong-Hee-Kam S, Hoffmann C. Phase I trial of hafnium oxide nanoparticles activated by radiotherapy in cisplatin-ineligible locally advanced HNSCC patients. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6573] [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
6573 Background: The standard of care non-surgical approach for locally advanced head and neck squamous cell carcinoma (LA HNSCC) patients (pts) is concurrent chemoradiation with high dose cisplatin or cetuximab in case of contra-indication. Older age is a contra-indication to cisplatin, and cetuximab might not improve survival in older pts. It is therefore urgently needed to develop new treatment options for elderly pts with LA HNSCC. NBTXR3 are hafnium oxide nanoparticles that can enhance the efficacy of radiotherapy (RT) by increasing locally the deposited dose. In this phase I clinical trial we aimed to evaluate the feasibility and safety of NBTXR3 administered as intratumoral (IT) injection prior to RT in LA HNSCC elderly pts. Methods: Pts with stage III-IV LA HNSCC of the oropharynx or oral cavity ineligible for platinum-based chemoradiation received a single IT injection of NBTXR3 into a selected primary tumor and intensity modulated RT (IMRT; 70 Gy/35 fractions/7 weeks) [NCT01946867]. A 3+3 dose escalation design, tested NBTXR3 dose levels equivalent to 5, 10, 15, and 22% of baseline tumor volume, followed by a dose expansion at the Recommended Phase II Dose (RP2D). Primary endpoints included RP2D determination, and early dose limiting toxicities (DLT). NBTXR3 intratumoral bioavailability and anti-tumor activity (RECIST 1.1) were also evaluated. Results: Enrollment was completed at all dose escalation levels: 5% (3 pts), 10% (3 pts), 15% (5 pts), and 22% (8 pts). No early DLT or SAE related to NBTXR3 or injection were observed. The median follow-up from NBTXR3 administration is 7.6 months. One AE (Grade 1) related to NBTXR3 and four AEs (Grade 1-2) related to the injection were observed. RT-related toxicity was as expected with IMRT. CT-scan assessment showed a good dispersion of NBTXR3 throughout the injected tumor and not in surrounding healthy tissues. The RP2D was determined to be 22%. Preliminary efficacy was evaluated in pts who received the intended dose of NBTXR3 and RT. A complete response of the injected lesion was observed in 9/13 (69%) evaluable pts at doses ≥10% (2 unconfirmed) and an overall complete response in 5/13 (38%) evaluable pts at doses ≥10%. Preliminary safety and efficacy data of the dose expansion cohort at the RP2D will also be presented. Conclusions: NBTXR3 activated by RT was well tolerated at all tested doses and demonstrated promising preliminary anti-tumor activity. Recruitment is ongoing in the dose expansion cohort. These results demonstrate that further testing of NBTXR3 in this population is warranted. Clinical trial information: NCT01946867 .
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Affiliation(s)
| | | | | | - Victor Moreno
- START Madrid-FJD, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | | | | | - Sebastien Salas
- CEPCM Assistance Publique des Hôpitaux de Marseille, Marseille, France
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Cohen RB, Bauman JR, Salas S, Colevas AD, Even C, Cupissol D, Posner MR, Lefebvre G, Saada-Bouzid E, Bernadach M, Seiwert TY, Pearson AT, Calmels F, Zerbib R, Andre P, Rotolo F, Boyer-chammard A, Fayette J. Combination of monalizumab and cetuximab in recurrent or metastatic head and neck cancer patients previously treated with platinum-based chemotherapy and PD-(L)1 inhibitors. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6516] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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
6516 Background: Monalizumab is a first-in-class immune checkpoint inhibitor targeting Natural Killer Group 2A (NKG2A), which is expressed on subsets of Natural Killer (NK), gd T and tumor-infiltrating CD8+T cells. NKG2A blockade promotes innate anti-tumor immunity mediated by NK and CD8+T cells and enhances NK cell antibody-dependent cell-mediated cytotoxicity induced by cetuximab. In a Phase I study, the combination of monalizumab and cetuximab was well tolerated. In an initial expansion cohort 1 of 40 patients (pts) who had progressed after platinum-based therapy, we reported an overall response rate (ORR) of 27.5%, a 4.5 month median PFS and an 8.5 month median OS. In a subset of patients (n=18) previously treated with PD-(L)1 inhibitors (IO), corresponding results were 17%, 5.1, and 14.1 months, respectively (ESMO 2019). Here we present data from a second expansion cohort 2 (n=40) conducted specifically in the post-IO setting to independently confirm the cohort 1 results. Methods: Eligible patients had R/M SCCHN previously treated with platinum and a PD-(L)1 inhibitor. Pts received monalizumab 750 mg q2weeks and cetuximab according to the label until progression or toxicity. Cohort 2 was designed as a confirmatory multicenter single arm phase II study, with a pre-planned total of 40 patients. The primary endpoint was ORR assessed per RECIST 1.1. Results: As of January 31, 2020, 40 pts have been treated in cohort 2. Median follow-up is 7.3 months (range, 1.9-13.6+). Eight (8) pts have a confirmed partial response (PR); ORR is 20% [95% confidence interval: 11-35]. Median time to response is 1.6 months [1.6-5.3]. At the time of data analysis, 3 pts were still in PR and 3 pts had stable disease continue on treatment. PFS and OS are still immature. Conclusions: In pts previously treated with platinum and PD-(L)1 inhibitors, the combination of monalizumab and cetuximab demonstrated promising activity. The second extension cohort confirmed prospectively the ORR reported in cohort 1. A randomized phase III trial of monalizumab and cetuximab is planned in this platinum and IO-pretreated SCCHN population. Clinical trial information: NCT02643550 .
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Affiliation(s)
- Roger B. Cohen
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | | | - Sebastien Salas
- CEPCM Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | | | | | | | - Marshall R. Posner
- Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | | | - Alexander T. Pearson
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL
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Le Tourneau C, Calugaru V, Borcoman E, Moreno V, Calvo E, Liem X, Salas S, Doger B, Jouffroy T, Mirabel X, Rodriguez J, Chilles A, Bernois K, De Rink M, Baskin-Bey E, Fakhry N, Hee Kam SW, Hoffmann C. Hafnium oxide nanoparticles (NBTXR3) activated by radiotherapy for the treatment of frail and/or elderly patients with locally advanced HNSCC: a phase I/II study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.207] [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: 11/25/2022]
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Fond G, Baumstarck K, Auquier P, Fernandes S, Pauly V, Bernard C, Orleans V, Llorca PM, Lançon C, Salas S, Boyer L. Recurrent major depressive disorder's impact on end-of-life care of cancer: A nationwide study. J Affect Disord 2020; 263:326-335. [PMID: 31969262 DOI: 10.1016/j.jad.2019.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/28/2019] [Accepted: 12/04/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE We still don't know if recurrent major depressive disorder (RMDD) may impact the quality of the end-of-life (EOL) cancer care in France. To tackle this knowledge gap, we explored EOL care in RMDD subjects who died from cancer compared to subjects without psychiatric disorder in a 4-year nationwide cohort study. DESIGN Nationwide cohort study. SETTING National hospital database, France. PARTICIPANTS All patients aged ≥15 years who died from cancer in hospital: 4070 RMDD subjects and 222,477 controls, 2013-2016, France. MAIN OUTCOME MEASURES Palliative care in the last 31 days of life and high-intensity EOL care including chemotherapy in the last 14 days of life, artificial nutrition, tracheal intubation, mechanical ventilation, gastrostomy, cardiopulmonary resuscitation, dialysis, transfusion, surgery, endoscopy, imaging, intensive care unit and emergency department admission in the last 31 days of life. Multivariate generalized mixed models with log-normal distribution was used to compare RMDD subjects and controls. RESULTS Compared to the controls, the RMDD subjects died 3 years younger, had more comorbidities, more thoracic cancers, less metastases and longer time from cancer diagnosis to death. After matching and adjustment, subjects with RMDD were found to receive more palliative care and less high-intensity EOL care, had fewer iterative admissions to acute care unit, and died less often in the intensive care unit and emergency department. CONCLUSIONS RMDD subjects were more likely to receive palliative care associated with less high-intensity EOL care. Yet the interpretation may be discussed, resulting from either patients'/families' wishes or difficulties for providers in offering personalized care to RMDD.
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Affiliation(s)
- Guillaume Fond
- Aix-Marseille Univ., CEReSS - Health Service Research and Quality of Life Center, Marseille, France; Department of Medical Information, APHM, Marseille, France; Department of Epidemiology and Health Economics, APHM, Marseille, France.
| | - Karine Baumstarck
- Aix-Marseille Univ., CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Pascal Auquier
- Aix-Marseille Univ., CEReSS - Health Service Research and Quality of Life Center, Marseille, France; Department of Epidemiology and Health Economics, APHM, Marseille, France
| | - Sara Fernandes
- Aix-Marseille Univ., CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Vanessa Pauly
- Aix-Marseille Univ., CEReSS - Health Service Research and Quality of Life Center, Marseille, France; Department of Medical Information, APHM, Marseille, France
| | - Cecile Bernard
- Aix-Marseille Univ., CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | | | | | - Christophe Lançon
- Aix-Marseille Univ., CEReSS - Health Service Research and Quality of Life Center, Marseille, France; Department of Psychiatry, APHM, Marseille, France
| | | | - Laurent Boyer
- Aix-Marseille Univ., CEReSS - Health Service Research and Quality of Life Center, Marseille, France; Department of Medical Information, APHM, Marseille, France; Department of Epidemiology and Health Economics, APHM, Marseille, France
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Estienne L, Dany L, Dudoit E, Duffaud F, Salas S. Spirituality and Cancer: a Qualitative Study. PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2019-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aims: Patients suffering from cancer are often confronted with an awareness of their own finiteness and with the fact that their life is now ruled by the cancer. This existential upheaval can be accompanied by spiritual “work” which contributes to the adjustment to the disease and to the conditions of the end of life. Spirituality can be defined as a process through which individuals seek for and give meaning to their life, feel connected to the self, to others, at the present moment and in what is sacred. Few studies in France have studied spirituality in the context of cancer. So, the aim of our research was to identify and to study the role of spiritual components in the experience of cancer.
Procedure: We carried out 15 semi-directed interviews with patients at the medical oncology and palliative care department at the CHU in Timone (Marseille). A double analysis was performed: 1) a lexicographical analysis and 2) a thematic content analysis of the most typical interviews from the lexicographical analysis.
Results: The lexicographical analysis highlighted three lexical classes. Class 1 represented the illness of cancer as a personal transformation (40.5%), Class 2 concerned the biographical disruption experience (13.4%) and Class 3 corresponded to daily life with the illness (46.1%). Moreover, the thematic content analysis revealed different themes testifying to spirituality in the lived experience of cancer, in particular the experience of and the relationship with the sacred, the relationship with transcendence and the role of spirituality in the lived experience of patients who are suffering from cancer.
Conclusion: The two analyses of the interviews allowed us to identify the expression of spirituality. Spirituality was expressed as a resource, an “invisible spring,” allowing people to adjust to the extreme experience of the disease of cancer. Both “secular” and “central” dimensions of spirituality: the transcendence and the relationship with the sacred open perspectives for the integration of spirituality into the care of patients suffering from cancer, without threatening the principle of secularism in French hospitals.
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Le Tourneau C, Garcia V, Doger B, Urban A, Bernois K, Liem X, Salas S, Wong S, Fakhry N, Dimitriu M, Calugaru V, Hoffmann C. PHASE I STUDY OF HAFNIUM OXIDE NANOPARTICLES ACTIVATED BY INTENSITY MODULATED RADIATION THERAPY (IMRT) AS A NEW THERAPEUTIC OPTION FOR ELDERLY OR FRAIL HNSCC PATIENTS. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31169-5] [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: 12/01/2022]
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Cohen R, Lefebvre G, Posner M, Bauman J, Salas S, Even C, Saada-Bouzid E, Seiwert T, Colevas D, Calmels F, Zerbib R, André P, Boyer-Chammard A, Fayette J. Monalizumab in combination with cetuximab in patients (pts) with recurrent or metastatic (R/M) head and neck cancer (SCCHN) previously treated or not with PD-(L)1 inhibitors (IO): 1-year survival data. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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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Ryckewaert T, Penel N, Le Deley M, Thery J, Decoupigny E, Vanseymortier M, Dufresne A, Corradini N, Blay JY, Orbach D, Salas S. National clinical-biological prospective cohort of incident cases of aggressive fibromatosis, AF (ALTITUDES). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.068] [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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Herrera Gomez R, Mezquita L, Auclin E, Heraudet L, Plana M, Salas S, Cristina V, Garcia Castano A, Arrazubi V, Grau J, Saleh K, Cirauqui Cirauqui B, Mesia Nin R, Even C, Taberna M, Daste A, Peters S, Besse B, Baste-Rotllan N. The head and neck lung immune prognostic index (HN-LIPI): A prognostic score for immune checkpoint inhibitors (ICI) in recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Le Tourneau C, Moreno V, Salas S, Mirabel X, Calvo E, Doger B, Florescu C, Thariat J, Fijuth J, Rutkowski T, Magné N, Liem X, Fakhry N, Wong-Hee-Kam S, Calugaru V, Hoffmann C. Hafnium oxide nanoparticles NBTXR3 activated by radiotherapy as a new therapeutic option for elderly/frail HNSCC patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.6069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6069 Background: New therapeutic approaches are needed for elderly or frail head and neck squamous cell carcinoma (HNSCC) patients (pts) ineligible for standard of care treatment. NBTXR3, a crystalline solution of hafnium oxide nanoparticles may represent such an option. Injected intratumorally, NBTXR3 enters tumor cells and yields an increased cell-localized energy deposit upon exposure to radiotherapy (RT), leading to increased tumor cell death compared to the same dose of RT alone. Methods: Phase I study of NBTXR3 activated by RT in pts ≥70 years old or ≥65 years old and unable to receive cisplatin, eligible for exclusive RT with stage III or IV HNSCC of the oral cavity or oropharynx [NCT01946867]. A 3+3 dose escalation design was implemented with dose levels corresponding to 5%, 10%, 15% and 22% of baseline tumor volume, followed by an expansion phase. Pts received an intratumoral (IT) injection of NBTXR3 and intensity modulated RT (IMRT; 70 Gy/35 fractions/7 weeks). Determination of Recommended Phase 2 Dose (RP2D) and Dose Limiting Toxicities (DLT) were primary endpoints of phase I. Absence of NBTXR3 leakage and preliminary efficacy using RECIST 1.1 principles were also evaluated. Results: The dose-escalation is complete. Nineteen pts were enrolled: 3 at 5%, 3 at 10%; 5 at 15% and 8 at 22% with no observed DLT or SAE related to NBTXR3 or IT injection. One grade 1 NBTXR3-related AE (asthenia at 22%) and four IT injection-related AE (grade 2 oral pain; grade 1 tumor hemorrhage; grade 1 asthenia, and grade 1 injection site hemorrhage) were reported. RT-related toxicity was as expected with IMRT. RP2D has been determined to be 22%. CT-scan assessment between 24h and 7 weeks post-IT injection demonstrated absence of NBTXR3 leakage in the surrounding tissues. Among 13 evaluable pts treated at doses ≥10%, 9 achieved a complete response of the injected lesion. Conclusions: These results show that NBTXR3 activated by RT is safe and well tolerated at all doses with preliminary encouraging efficacy results. It thus represents a promising future treatment for frail and elderly pts with locally advanced HNSCC with limited therapeutic options. Expansion phase has started at the RP2D. Clinical trial information: NCT01946867.
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Affiliation(s)
| | | | - Sebastien Salas
- CEPCM Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | | | | | | | | | | | | | | | - Nicolas Magné
- Medical Oncology Department, AP-HP, Salpetriere Hospital, University Paris VI, Paris, France
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Even C, Daste A, Saada-Bouzid E, Lefebvre G, Fayette J, Zanetta S, Kaminsky MC, Cupissol D, Prevost A, Vauleon E, Johnson AC, Salas S, Rolland F, Timar David M, Jallut I, Delaye J, Bourhis J, Guigay J, Texier M, Auperin A. A safety study of nivolumab in patients with recurrent and/or metastatic platinum-refractory squamous cell carcinoma of the head and neck (R/M SCCHN): Interim analysis on 199 patients—The TOPNIVO study on behalf of the GORTEC and the Unicancer Head & Neck Group. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.6032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6032 Background: In the randomized phase III Study CA209141, Nivolumab (N) demonstrated significant overall survival (OS) benefit with favorable safety profile for platinum refractory R/M SCCHN and is now approved for these patients (pts). The objectives of the study are to provide additional insight into the frequency of high-grade AEs related to N and the efficacy of N in real life. Methods: Between August and December 2017, 203 pts were included in the multicenter, non-controlled phase II TOPNIVO. The main inclusion criteria were patients with platinum refractory R/M SCCHN with progressive disease, ECOG 0-2. Pts received N 3mg/kg every 2 weeks intravenously over 30 minutes. Four pts did not receive N. We report here the safety during the first 6 months (mo) after inclusion and OS results on the first 199 treated pts. Results: Median age was 62 yr, 83% were male, 84% were ECOG 0-1, 16% 2. The primary site of cancer was oral cavity 26%, oropharynx 38%, larynx 16%, hypopharynx 21%. 33% had loco regional relapse, 32% metastatic disease and 35% both. 49% had received one prior line of chemotherapy and 30% two prior lines. 157 (79%) pts ended their treatment within the first six mo: 5 for AE related to N (pneumonitis 3 pts, hepatitis 1 pt, diarrhea 1 pt), 107 for progression, 33 for death (24 related to progression, 9 to intercurrent disease), 12 other. 132 pts (66%) experienced at least 1 AE grade ≥3. On the 226 AEs grade 3-4, 21 (mainly pneumopathy, lipase increase and asthenia) were related to N and occurred in 18 pts. On the 51 AEs grade 5, 3 were considered related to N (2 pneumonitis, 1 cardiac arrest). The median OS was 7.7 mo (CI 95% [6.0; 9.5]) in the whole population; 9.2 mo [6.8; 12.1] in the 167 pts with ECOG 0-1, 3.0 mo [1.1; 6.0] in the 32 pts with ECOG 2; 12.1 mo [7.6; NR] in the 64 pts with metastatic disease, 7.7 mo [5.0; 9.6] in the 66 pts with locoregional disease and 4.6 mo [3.1; 7.9] in the 69 pts with both. OS was similar in pts older or younger 70 yr. Conclusions: The interim analysis of the TOPNIVO study shows no additional toxicities of N compared to what has been described previously, confirms the previous results of OS and provides new survival data in subgroups of pts. Clinical trial information: NCT03226756.
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Affiliation(s)
| | - Amaury Daste
- Hôpital Saint André, University of Bordeaux-CHU, Bordeaux, France
| | | | | | | | | | | | | | | | | | | | | | - Frederic Rolland
- Institut de Cancérologie de l'Ouest, Department of Medical Oncology, St Herblain, France
| | | | | | | | - Jean Bourhis
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Joel Guigay
- Centre Antoine Lacassagne, FHU OncoAge, Université Côte d'Azur, Nice, France
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Penel N, Blay JY, Wallet J, Ray-Coquard IL, Le Cesne A, Ryckewaert T, Italiano A, Salas S, Delcambre C, Bompas E, Bertucci F, Saada-Bouzid E, Chaigneau L, Chevreau C, Thery J, Decoupigny E, Vanseymortier M, Le Deley MC, Mir O. A double-blind placebo-controlled randomized phase II trial assessing the activity and safety of regorafenib (REG) in patients (pts) with nonadipocytic soft tissue sarcoma (STS) previously treated with pazopanib (PAZ). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.11021] [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
11021 Background: After we demonstrated the activity of REG in pts with advanced non-adipocytic STS (MirTLO 2016), we conducted a dedicated study in pts previously treated with PAZ+chemo. Methods: We report here the 5th cohort of a double-blind randomized phase 2 trial (NCT01900743). Pts were treated with regorafenib (160mg/d, 21/28d) or placebo (PB). Pts receiving placebo were offered optional cross-over in case of centrally confirmed disease progression. The primary endpoint was centrally-reviewed RECIST-based progression-free survival (PFS), evaluated on the intent-to-treat dataset. A total of 24 events was required to ensure a 90%-power for HR = 0.33 (median PFS, 3·6 vs 1·2 months), with a 1-sided α = 0·1. Overall survival (OS) was a secondary endpoint. Results: From 12/2015 to 10/2017, 37 pts were randomized (18 REG vs 19 PB) and included in the final analysis. The median age was 60 (36-76). There were 28 women (76%). All pts had a performance status 0 or 1. Histological subtypes included 24 leiomyosarcoma (11 vs 13, in REG and PB, respectively), 1 synovial sarcoma (REG), 12 other sarcoma (7 vs 5). All pts had previously been treated with PAZ +chemo (including doxorubicin: 19 vs 17; ifosfamide: 11 vs 3; trabectedin: 11 vs 9; and dacarbazine: 7 vs 6), with 2-6 prior lines. The median relative dose intensity of REG was 0·86, range 0·41-1. Out of 19 pts assigned to placebo, 13 switched to REG after progression. There was no reported objective response. We observed a significant benefit of REG compared to PB in terms of PFS (HR = 0·38; 95%CI, 0·19-0·76; p = 0·007; median PFS = 2·1 vs 1·1 months, respectively), and OS despite the cross-over (HR = 0·41; 95%CI, 0·17-0·98; p = 0·04; median OS = 18·6 vs 8·2 months). Before cross-over, the most common clinically significant grade 3 or higher adverse events were diarrhea (4 vs 0), dyspnea (3 vs 1), arterial hypertension (2 vs 0), hand-foot skin reaction (2 vs 0). Conclusions: The present study demonstrates that regorafenib has a clinically meaningful anti-tumor activity in pts with non-adipocytic soft tissue sarcoma pretreated by both chemotherapy and pazopanib, improving PFS and OS. Clinical trial information: NCT01900743.
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Affiliation(s)
| | | | | | | | | | | | | | - Sebastien Salas
- CEPCM Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | | | | | | | | | - Loic Chaigneau
- Department of Medical Oncology, Besançon University Hospital, Besançon, France
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Bron G, Scemama U, Villes V, Fakhry N, Salas S, Chagnaud C, Bendahan D, Varoquaux A. A new CT dynamic maneuver "Mouth Opened with Tongue Extended" can improve the clinical TNM staging of oral cavity and oropharynx squamous cell carcinomas. Oral Oncol 2019; 94:41-46. [PMID: 31178211 DOI: 10.1016/j.oraloncology.2019.04.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/06/2018] [Revised: 04/12/2019] [Accepted: 04/27/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Cross sectional imaging is mandatory for oral cavity and oropharynx head and neck squamous cell carcinoma's (ooSCC) local extension and TNM staging. However a complex anatomy and frequent dental metallic artifacts make it difficult. This study assesses the clinical benefit of "Mouth Open with Tongue Extended" dynamic maneuver at CT (CTmote) as compared to the conventional CT (CTconv) and MRI. MATERIAL Retrospectively, 58 patients with histologically proven ooSCC (oral cavity: 34; oropharynx: 24) were included in the study. All had endoscopy with biopsies, MRI, CTconv and an CTmote acquisitions. Data were splitted in 3 datasets and 2 independent radiologists performed readings blindly. Gold standard was pTNM in 31% of cases; otherwise cTNM obtained at multidisciplinary team meeting with endoscopy and mapping biopsies were used. RESULTS CTmote was feasible for all patients including those already treated by surgery or radiotherapy. Exact TNM staging was obtained in 68%, 83%, 83% for CTconv, CTmote and MRI respectively. The best exam ratings at paired wise comparisons were 3%, 47%, 50% for CTconv, CTmote and MRI respectively. CTmote and MRI observer agreements, image quality and confidence ratings, were comparable and higher compared to CTconv (p < 0.001). CONCLUSIONS CTmote improves oral cavity and oropharynx tumour stage assessment compared to CTconv with performances close to those of MRI examination. In clinical practice, combining both CT with MOTE maneuver and MRI seems to be the optimal imaging strategy for local staging.
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Affiliation(s)
- Guillaume Bron
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille University, Marseille, France.
| | - Ugo Scemama
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille University, Marseille, France
| | - Virginie Villes
- Department of Public Healthcare EA 3279, Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
| | - Nicolas Fakhry
- Department of Otorhinolaryngology-Head and Neck Surgery, Conception Hospital, Aix-Marseille University, Marseille, France.
| | - Sebastien Salas
- Department of Oncology, Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
| | - Christophe Chagnaud
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille University, Marseille, France; Biophysics and Nuclear Medicine, European Center for Research in Medical Imaging, UMR 7339, La Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
| | - David Bendahan
- Biophysics and Nuclear Medicine, European Center for Research in Medical Imaging, UMR 7339, La Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
| | - Arthur Varoquaux
- Department of Medical Imaging, Conception University Hospital, Aix-Marseille University, Marseille, France; Biophysics and Nuclear Medicine, European Center for Research in Medical Imaging, UMR 7339, La Timone University Hospital, Aix-Marseille University, 264, Rue Saint-Pierre, 13385 Marseille, France.
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de Nonneville A, Barbolosi D, Andriantsoa M, El-Cheikh R, Duffaud F, Bertucci F, Salas S. Validation of Neutrophil Count as An Algorithm-Based Predictive Factor of Progression-Free Survival in Patients with Metastatic Soft Tissue Sarcomas Treated with Trabectedin. Cancers (Basel) 2019; 11:E432. [PMID: 30917620 PMCID: PMC6468511 DOI: 10.3390/cancers11030432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 03/04/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 01/21/2023] Open
Abstract
Introduction: Based on a mathematical model of trabectedin-induced neutropenia, we assessed the predictive value of absolute neutrophil count (ANC) on progression-free survival (PFS) in an independent validation cohort of patients treated with trabectedin. Methods: We collected data from 87 patients in two expert centers who received at least two cycles of trabectedin for soft tissue sarcomas (STS) treatment. Correlations between ANC, patients' characteristics, and survival were assessed, and a multivariate model including tumor grade, performance status, ANC, and hemoglobin level was developed. Results: Therapeutic ANC ≥ 7.5 G/L level was associated with shorter PFS: 3.22 months (95% confidence interval (CI), 1.57⁻4.87) in patients with ANC ≥ 7.5 G/L vs. 5.78 months (95% CI, 3.95⁻7.61) in patients with ANC < 7.5 G/L (p = 0.009). Age, primary localization, lung metastases, dose reduction, hemoglobin, and albumin rates were also associated with PFS. In multivariate analysis, ANC ≥ 7.5 G/L was independently associated with poor PFS and overall survival. Conclusion: We validated increased pre-therapeutic ANC as a predictive factor of short PFS in patients starting trabectedin for STS. ANC appears to have an impact on survival rates and may be used as a decision-making tool for personalizing second-line strategies in patients with metastatic STS.
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Affiliation(s)
- Alexandre de Nonneville
- CRCM, Department of Medical Oncology, Institut Paoli-Calmettes, INSERM, CNRS, Aix-Marseille University, 13009 Marseille, France.
| | - Dominique Barbolosi
- SMARTc Unit, CRCM Inserm U1068, Aix-Marseille Université, 13005 Marseille, France.
| | - Maeva Andriantsoa
- Department of Medical Oncology, Hôpital de la Timone, APHM, INSERM U910, Aix-Marseille University, 13005 Marseille, France.
| | - Raouf El-Cheikh
- SMARTc Unit, CRCM Inserm U1068, Aix-Marseille Université, 13005 Marseille, France.
| | - Florence Duffaud
- Department of Medical Oncology, Hôpital de la Timone, APHM, INSERM U910, Aix-Marseille University, 13005 Marseille, France.
| | - François Bertucci
- CRCM, Department of Medical Oncology, Institut Paoli-Calmettes, INSERM, CNRS, Aix-Marseille University, 13009 Marseille, France.
| | - Sebastien Salas
- Department of Medical Oncology, Hôpital de la Timone, APHM, INSERM U910, Aix-Marseille University, 13005 Marseille, France.
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Hoffmann C, Calugaru V, Garcia VM, Mirabel X, de Spéville BD, Calvo E, Jouffroy T, Rodrigez J, Chilles-Wang A, Yemi M, Lesnik M, Badois N, Liem X, Salas S, Fakhri N, Khanà SWH, Le Tourneau C. OC-043 HNSCC in elderly frail patients treated by hafnium oxide nanoparticles activated by IMRT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30209-9] [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: 11/29/2022]
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Meurer M, Floquet A, Ray-Coquard I, Bertucci F, Auriche M, Cordoba A, Piperno-Neumann S, Salas S, Delannes M, Chevalier T, Italiano A, Blay JY, Mancini J, Pautier P, Duffaud F. Localized high grade endometrial stromal sarcoma and localized undifferentiated uterine sarcoma: a retrospective series of the French Sarcoma Group. Int J Gynecol Cancer 2019; 29:691-698. [PMID: 30772825 DOI: 10.1136/ijgc-2018-000064] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE High grade endometrial stromal sarcoma and undifferentiated uterine sarcomas are associated with a very poor prognosis. Although large surgical resection is the standard of care, the optimal adjuvant strategy remains unclear. METHODS A retrospective analysis of patients with localized high grade endometrial stromal sarcoma and undifferentiated uterine sarcomas (stages I-III) treated in 10 French Sarcoma Group centers was conducted. RESULTS 39 patients with localized high grade endometrial stromal sarcoma and undifferentiated uterine sarcomas treated from 2008 to 2016 were included. 24/39 patients (61.5%) were stage I at diagnosis. 38/39 patients underwent surgical resection, with total hysterectomy and bilateral oophorectomy completed in 26/38 (68%). Surgeries were mostly resection complete (R0, 23/38, 60%) and microscopically incomplete resection (R1, 6/38, 16%). 22 patients (58%) underwent postoperative radiotherapy (including brachytherapy in 11 cases), and 11 (29%) underwent adjuvant chemotherapy. After a median follow-up of 33 months (range 2.6-112), 17/39 patients were alive and 21/39 (54%) had relapsed (9 local relapses and 16 metastases). The 3 year and 5 year overall survival rates were 49.8% and 31.1%, respectively, and 3 year and 5 year disease free survival rates were 42.7% and 16.0%, respectively. Median overall survival and disease free survival were 32.7 (95% CI 16.3-49.1) and 23 (4.4-41.6) months, respectively. Medians were, respectively, 46.7 months and 39.0 months among those who underwent adjuvant radiotherapy and 41.0 months and 10.3 months for those who underwent adjuvant chemotherapy. In multivariate analysis, adjuvant radiotherapy was an independent prognostic factor for overall survival (P=0.012) and disease free survival (P=0.036). Chemotherapy, International Federation of Gynecology and Obstetrics I-II stages, and Eastern Cooperative Oncology Group-performance status 0 correlated with improved overall survival (P=0.034, P=0.002, P=0.006), and absence of vascular invasion (P=0.014) was associated with better disease free survival. CONCLUSIONS The standard treatment of primary localized high grade endometrial stromal sarcoma and undifferentiated uterine sarcomas is total hysterectomy and bilateral oophorectomy. The current study shows that adjuvant radiotherapy and adjuvant chemotherapy appear to improve overall survival. A prospective large study is warranted to validate this therapeutic management.
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Affiliation(s)
- Marie Meurer
- Department of Medical Oncology, CHU Timone, AP-HM, Marseille, France .,Aix-Marseille University, Marseille, France
| | - A Floquet
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - I Ray-Coquard
- Department of Adult Medical Oncology, Centre Leon Berard and Claude Bernard University, Lyon, France
| | - F Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - M Auriche
- Department of Medicine, Gynecology Unit, Gustave Roussy, Villejuif, France
| | - A Cordoba
- Department of General Cancerology, Oscar Lambret Center, Lille, France
| | | | - S Salas
- Department of Medical Oncology, CHU Timone, AP-HM, Marseille, France.,Aix-Marseille University, Marseille, France
| | - M Delannes
- Department of Radiotherapy, Institut Claudius Regaud, Toulouse, France
| | - T Chevalier
- Department of Medical Oncology, CHU Timone, AP-HM, Marseille, France.,Aix-Marseille University, Marseille, France
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - J Y Blay
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Julien Mancini
- Aix-Marseille Univ, INSERM, IRD, UMR 1252, SESSTIM, 'Cancers, Biomedicine and Society Group', Marseille, France.,APHM, Timone Hospital, Public Health Department (BIOSTIC), Marseille, France
| | - P Pautier
- Department of Medicine, Gynecology Unit, Gustave Roussy, Villejuif, France
| | - F Duffaud
- Department of Medical Oncology, CHU Timone, AP-HM, Marseille, France.,Aix-Marseille University, Marseille, France
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Vitale C, de Nonneville A, Fichaux M, Salas S. Medical staff opposition to a deep and continuous palliative sedation request under Claeys-Leonetti law. BMC Palliat Care 2019; 18:2. [PMID: 30621684 PMCID: PMC6325863 DOI: 10.1186/s12904-018-0384-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 12/05/2018] [Indexed: 11/11/2022] Open
Abstract
Background For the year 2018, the French government plans a revision of bioethics laws, including certainly the recent Claeys-Leonetti law introducing the right to deep and continuous sedation at the request of palliative patients and prohibiting euthanasia for end-of-life patients. Because there is no published data on medical staff opposition to a deep and continuous palliative sedation request under Claeys-Leonetti law, we believe this report may give insight into physicians’ decision making, into the role of criteria for prudent practice, and thus contribute to the bioethical debate. Case presentation We report a 70-year-old patient with squamous cell carcinoma of the hypopharyngeal region, who categorically refused any treatment since one year and asked for deep and continuous palliative sedation until death after attempting suicide. The patient’s request was examined and denied by palliative multidisciplinary board, in accordance with by the French Oncology Coordination Centre guidelines. This situation did not fulfil the criteria requested by Claeys-Leonetti law. Conclusions As highlighted by the present case-report, patient’s expectation regarding palliative sedation can be ambivalent with properly so called euthanasia or assisted suicide. This ambivalent perception was part of the controversy surrounding the parliamentary debate, which is still relevant. This case report supports that deep and continuous sedation under Claeys-Leonetti law need to meet specific criteria defined by the law and documented in the medical files as a safeguard against inappropriate practice. In fact, one of the shortcomings of the current arrangements of Claeys-Leonetti law is a lack of objective medical-based criteria. So it is necessary that scientific peer-reviews papers be published quickly in order to deepen the bioethical debate on the end of life.
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Affiliation(s)
- Claire Vitale
- Department of Oncology and palliative care, Timone Hospital, Marseille, France. .,Paul Valéry University, Montpellier, France. .,Service Oncologie médicale et Soins Palliatifs, C.H.U. Timone, 264 rue Saint Pierre, 13005, Marseille, France. .,Université Paul Valéry, Route de Mende, 34090, Montpellier, France.
| | - Alexandre de Nonneville
- Aix-Marseille University, Marseille, France.,Faculté de Médecine - Timone 27, Aix-Marseille Université, Boulevard Jean Moulin, 13385, Marseille, France
| | - Marie Fichaux
- Department of Oncology and palliative care, Timone Hospital, Marseille, France.,Service Oncologie médicale et Soins Palliatifs, C.H.U. Timone, 264 rue Saint Pierre, 13005, Marseille, France
| | - Sebastien Salas
- Department of Oncology and palliative care, Timone Hospital, Marseille, France.,Aix-Marseille University, Marseille, France.,Service Oncologie médicale et Soins Palliatifs, C.H.U. Timone, 264 rue Saint Pierre, 13005, Marseille, France.,Faculté de Médecine - Timone 27, Aix-Marseille Université, Boulevard Jean Moulin, 13385, Marseille, France
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Terlizzi M, Rapeaud E, Le Pechoux C, Salas S, Lerouge D, Sunyach M, Vogin G, Sole C, Zilli T, Myroslav L, Mampuya A, Calvo F, Attal J, De Bari B, Ozsahin M, Sargos P, Thariat J. Radiation Therapy in Extracranial Chondrosarcomas: A Multicenter French Sarcoma Group and Rare Cancer Network Study. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1105] [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: 11/26/2022]
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46
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Fayette J, Lefebvre G, Posner M, Bauman J, Salas S, Even C, Saada-Bouzid E, Seiwert T, Colevas D, Calmels F, Zerbib R, Boyer Chammard A, Cohen R. Results of a phase II study evaluating monalizumab in combination with cetuximab in previously treated recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.005] [Citation(s) in RCA: 14] [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] [Indexed: 11/12/2022] Open
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Cho B, Daste A, Ravaud A, Salas S, Isambert N, McClay E, Awada A, Borel C, Gulley J, Ojalvo L, Helwig C, Rolfe P, Penel N. M7824 (MSB0011359C), a bifunctional fusion protein targeting PD-L1 and TGF-β, in patients (pts) with advanced SCCHN: Results from a phase I cohort. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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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48
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Terlizzi M, Rapeaud E, Le Péchoux C, Salas S, Lerouge D, Sunyach MP, Vogin G, Solé C, Zilli T, Myroslav L, Mampuya A, Calvo F, Attal J, De Bari B, Ozsahin M, Sargos P, Thariat J. Radiothérapie des chondrosarcomes extracrâniens : étude multicentrique du Groupe sarcome français et du Rare Cancer Network. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.111] [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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49
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Balar AV, Mahipal A, Grande E, Villalobos VM, Salas S, Kang TW, Kim SH, Powles T, Tsai F, Naing A, Razak A, Loriot Y, Lee JY, Shin SJ, Morales-Barrera R, Angra N, Xiao F, Abdullah S, Heijden MSVD. Abstract CT112: Durvalumab + tremelimumab in patients with metastatic urothelial cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-ct112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: PD-L1 blockade with durvalumab (D) is approved as second-line therapy in platinum-refractory metastatic urothelial cancer (mUC). Adding CTLA-4 blockade with tremelimumab (T) may improve responses, particularly in pts with low PD-L1 expression. Here we report safety and efficacy in the mUC cohort of the dose-expansion phase of a phase I, multicenter, open-label study of D+T in pts with advanced solid tumors (NCT02261220).
Methods: Pts with platinum-refractory mUC received D 20 mg/kg + T 1 mg/kg Q4W for 4 months, followed by D 10 mg/kg Q2W for a total of 12 months of treatment. The primary objectives were safety in the mUC cohort and antitumor activity in the subgroup with tumor cell and immune cell PD-L1 expression <25% (assessed by SP263 IHC assay). Secondary objectives included antitumor activity per RECIST v1.1 in other subgroups.
Results: As of Oct 20 2017, 168 pts received treatment and had ≥24 weeks' follow-up. Median age was 65.5 yr (range, 35-85), 78.0% were male, 81.0% had visceral metastases (32.1% liver metastases) and 32.1% had received >1 prior line of chemotherapy. Median duration of follow-up was 11.6 mo. Treatment-related AEs occurred in 75.6% of pts and were Grade 3-4 in 28.6%. One pt died due to a treatment-related AE (pulmonary hemorrhage). Treatment-related AEs led to discontinuation of therapy in 11.9% of pts. Confirmed objective response rate (ORR) was 35/168 (20.8%) including 4 CRs. Responses occurred early (median 1.8 mo) and are durable (median DOR not reached, range 1.9-24.9 mo). At 6 months, the PFS rate was 25.4% and the OS rate was 60.9%. Median PFS was 1.9 mo and median OS was 9.5 mo. Clinical activity was seen regardless of PD-L1 status, but patients with either tumor or immune cell expression ≥25% had numerically higher response rates (29.4% vs 15.1%) and 6-month OS rates than those with <25% expression (Table).
Conclusions: D+T had a manageable safety profile and encouraging antitumor activity and survival rate in previously treated mUC regardless of PD-L1 status.
Response and survivalPD-L1 ≥25% (n=68)PD-L1 <25% (n=86)PD-L1 unknown (n=14)Total (N=168)Confirmed ORR (CR+PR)(95% CI), %29.4 (19.0-41.7)15.1 (8.3-24.5)14.3 (1.8-42.8)20.8 (15.0-27.8)Ongoing ORR, %60.092.310074.3Disease control rate (CR+PR+SD≥24 weeks) (95% CI), %32.4 (21.5-44.8)24.4 (15.8-34.9)42.9 (17.7-71.1)29.2 (22.4-36.7)Median PFS, months (95% CI)3.5 (1.9-3.7)1.8 (1.8-1.9)4.9 (1.8-NE)1.9 (1.8-3.4)PFS 6-month rate, %26.122.638.525.4Median OS, months (95% CI)*18.9 (8.1-NE)8.0 (4.8-10.0)16.4 (7.3-16.4)9.5 (8.1-18.9)OS 6-month rate, %66.451.991.760.9NE, not estimable *Should be interpreted with caution due to limited follow-up at data cutoff Citation Format: Arjun V. Balar, Amit Mahipal, Enrique Grande, Victor M. Villalobos, Sebastien Salas, Taek Won Kang, Se Hyun Kim, Thomas Powles, Frank Tsai, Aung Naing, Albiruni Razak, Yohann Loriot, Ji Youl Lee, Sang Joon Shin, Rafael Morales-Barrera, Natasha Angra, Feng Xiao, Shaad Abdullah, Michiel S. Van der Heijden. Durvalumab + tremelimumab in patients with metastatic urothelial cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr CT112.
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Affiliation(s)
- Arjun V. Balar
- 1Perlmutter Cancer Center at NYU Langone Health, New York, NY
| | | | | | | | - Sebastien Salas
- 5Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Taek Won Kang
- 6Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Se Hyun Kim
- 7Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | | | - Frank Tsai
- 9Pinnacle Oncology Hematology, Scottsdale, AZ
| | - Aung Naing
- 10University of Texas MD Anderson Cancer Center, Houston, TX
| | - Albiruni Razak
- 11Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | | | - Ji Youl Lee
- 13Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Joon Shin
- 14Yonsei University Severance Hospital, Seoul, Republic of Korea
| | - Rafael Morales-Barrera
- 15Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
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50
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Chaigneau L, Patrikidou A, Ray-Coquard I, Valentin T, Linassier C, Bay JO, Moureau Zabotto L, Bompas E, Piperno-Neumann S, Penel N, Alcindor T, Laigre M, Guillemet C, Salas S, Hugli A, Domont J, Sunyach MP, Lecesne A, Blay JY, Nerich V, Isambert N. Brain Metastases from Adult Sarcoma: Prognostic Factors and Impact of Treatment. A Retrospective Analysis from the French Sarcoma Group (GSF/GETO). Oncologist 2018; 23:948-955. [PMID: 29934413 DOI: 10.1634/theoncologist.2017-0136] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/09/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Brain metastases (BM) from adult soft tissue or bone sarcomas are rare, and sparse data exist on their prognostic factors and management. SUBJECTS, MATERIALS AND METHODS A retrospective study was conducted in 15 centers of the French Sarcoma Group, plus one Canadian and one Swiss center, to report on clinical, histological, and treatment characteristics and to identify predictive factors of outcome. RESULTS Between 1992 and 2012, 246 patients with a median age of 50 years (range: 16-86) were managed for BM. BM included 221 cerebral and cerebellar metastases and 40 cases of meningeal sarcomatosis. The most frequent histopathological subtype was leiomyosarcoma (18.7%). Histological grade was high in 118 (48%) cases. Surgery of BM was carried out for 38 (15.5%) patients. Radiotherapy and chemotherapy were administered in 168 (68.3%) and 91 (37.0%) patients, respectively. Irrespective of treatment modality, BM were controlled in 113 patients (45.9%), including 31 partial responses (12.6%) and 18 complete responses (7.3%). The median overall survival from diagnosis of brain metastasis was 2.7 months (range: 0-133). In the multivariate analysis, the following parameters influenced overall survival: chemotherapy (hazard ratio [HR] = 0.38; 95% confidence interval [CI]: 0.26-0.48), surgery (HR = 0.40; 95% CI: 0.22-0.72), stereotactic radiotherapy (HR = 0.41; 95% CI: 0.19-0.90), whole-brain radiotherapy (HR = 0.51; 95% CI: 0.35-0.76), and grade (HR = 0.65; 95% CI: 0.43-0.98). CONCLUSION BM of sarcomas are rare and associated with a dismal outcome. Multidisciplinary management with chemotherapy, radiation therapy, and surgery is associated with a better survival. IMPLICATIONS FOR PRACTICE The incidence of brain and meningeal metastasis in bone and soft tissue sarcomas is estimated between 1% and 8%. Published data are derived from small retrospective case series, often in the pediatric population. A prognostic index is important to guide both clinical decision-making and outcomes research, but one such is lacking for adult sarcoma patients with brain metastases. The current study describes brain metastasis in a large cohort of sarcoma patients. This study, conducted within the French Sarcoma Group, describes the natural history of sarcoma brain metastasis and enables the proposal of strategic recommendations for subsequent clinical trials and for the management of such patients.
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Affiliation(s)
- Loïc Chaigneau
- Department of Medical Oncology, University Hospital Jean Minjoz, Besançon, France
| | - Anna Patrikidou
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | | | | | - Claude Linassier
- Department of Medical Oncology, University Hospital, Tours, France
| | - Jacques Olivier Bay
- Department of Medical Oncology, University Hospital, Clermont-Ferrand, France
| | | | - Emmanuelle Bompas
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | | | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - Thierry Alcindor
- Departments of Oncology and Medicine, McGill University, Montreal, Quebec, Canada
| | - Maryline Laigre
- Department of Oncology, Centre Val D'Aurelle II, Montpelier, France
| | - Cecile Guillemet
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | - Sebastien Salas
- Department of Medical Oncology, CH La Timone, Marseille, France
| | | | - Julien Domont
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | | | - Axel Lecesne
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Jean Yves Blay
- Department of Medical Oncology, Centre Leon Berard, Lyon, France
| | - Virginie Nerich
- Department of Pharmacy, University Hospital Jean Minjoz, Besançon, France
| | - Nicolas Isambert
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
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