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Baude J, Niogret J, Jacob P, Bardet F, Desmoulins I, Zanetta S, Kaderbhai C, Galland L, Mayeur D, Delattre B, Cormier L, Ladoire S. Carboplatin and Etoposide for the Treatment of Metastatic Prostate Cancer with or without Neuroendocrine Features: A French Single-Center Experience. Cancers (Basel) 2024; 16:280. [PMID: 38254771 PMCID: PMC10813788 DOI: 10.3390/cancers16020280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/17/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Chemotherapy using carboplatin and etoposide (CE) is frequently pragmatically proposed to treat metastatic prostate cancer (mPC), both primary small-cell neuroendocrine (PSC-NE) carcinoma and adenocarcinoma with or without neuroendocrine (NE) marker elevation. However, the real benefit of CE is poorly reported in the recent therapeutic context. METHODS We retrospectively analyzed the efficacy and tolerance of CE chemotherapy in these three different groups of mPC patients. Efficacy endpoints included radiological response, progression-free survival (PFS), and overall survival (OS), as well as PSA response and PFS2/PFS1 ratio in patients with adenocarcinoma. RESULTS Sixty-nine patients were included in this single-center study (N = 18 with PSC-NE carcinoma and 51 with adenocarcinoma with (N = 18) or without (N = 33) NE marker elevation). Patients with adenocarcinoma were highly pretreated with next-generation hormonal agents (NHAs) and taxanes. In patients with adenocarcinoma, a PSA response ≥50% was observed in six patients (15.8%), four of whom had NE marker elevation. The radiological response was higher in PSC-NE and tended to be higher in adenocarcinoma when NE marker elevation was present. Comparing patients with adenocarcinoma with vs. without NE marker elevation, the median PFS was 3.7 and 2.1 months and the median OS was 7.7 and 4.7 months, respectively. Overall, 62.3% of patients experienced grade 3-4 adverse events (mainly hematological), and three treatment-related deaths were recorded. CONCLUSION Reports of the clinical results of CE suggest that we should not mix PSC-NE and castration-resistant adenocarcinoma of the prostate. In patients with heavily pretreated adenocarcinoma, the benefit/risk ratio of CE chemotherapy seems unfavorable due to poor response and high toxicity.
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Affiliation(s)
- Jérémy Baude
- Department of Radiation Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France;
| | - Julie Niogret
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
| | - Pierre Jacob
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
| | - Florian Bardet
- Department of Urology, University Hospital François Mitterrand, 21000 Dijon, France; (F.B.)
| | - Isabelle Desmoulins
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
| | - Courèche Kaderbhai
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
| | - Loïck Galland
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
| | - Didier Mayeur
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
| | - Benjamin Delattre
- Department of Urology, University Hospital François Mitterrand, 21000 Dijon, France; (F.B.)
| | - Luc Cormier
- Department of Urology, University Hospital François Mitterrand, 21000 Dijon, France; (F.B.)
- UFR des Sciences de Santé, Université of Bourgogne Franche-Comté, 21000 Dijon, France
| | - Sylvain Ladoire
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
- UFR des Sciences de Santé, Université of Bourgogne Franche-Comté, 21000 Dijon, France
- Platform of Transfer in Biological Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France
- INSERM U1231 «Lipid, Nutrition, Cancer», 21000 Dijon, France
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2
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Roussot N, Fumet JD, Limagne E, Thibaudin M, Hervieu A, Hennequin A, Zanetta S, Dalens L, Fourrier T, Galland L, Jacob P, Bertaut A, Rederstorff E, Chevalier C, Ghirardi S, Gilbert E, Khoukaz A, Martin E, Nicolet C, Quivrin M, Thibouw D, Vulquin N, Truc G, Rouffiac M, Ghiringhelli F, Mirjolet C. A phase I study of the combination of atezolizumab, tiragolumab, and stereotactic body radiation therapy in patients with metastatic multiorgan cancer. BMC Cancer 2023; 23:1080. [PMID: 37946136 PMCID: PMC10633948 DOI: 10.1186/s12885-023-11534-6] [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: 02/24/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Immunotherapy targeting the PD-1/PD-L1 pathway is a standard of care in a number of metastatic malignancies, but less than a fifth of patients are expected to respond to ICIs (Immune Checkpoint Inhibitors). In a clinical trial, combining the anti-TIGIT (T cell immunoreceptor with Ig and ITIM domains) Mab (monoclonal antibody) tiragolumab with atezolizumab improved outcomes in non-small cell lung cancer. In preclinical models, SBRT (Stereotactic Body Radiation Therapy) could increase expression levels of the inhibitory co-receptors TIGIT and PD-L1. We aim to assess the combination of tiragolumab with atezolizumab and SBRT in metastatic, previously treated by ICIs, non-small cell lung cancer, head and neck cancer, bladder cancer, and renal cell cancer. METHODS This phase I study (ClinicalTrials.gov NCT05259319) will assess the efficacy and safety of the combination of atezolizumab with tiragolumab and stereotactic body radiation therapy in patients with histologically proven metastatic non-small cell lung cancer, renal cell cancer, bladder cancer, and head and neck cancer previously treated. First part: 2 different schedules of SBRT in association with a fixed dose of atezolizumab and tiragolumab will be investigated only with metastatic non-small cell lung cancer patients (cohort 1). The expansion cohorts phase will be a multicentric, open-label study at the recommended scheme of administration and enroll additional patients with metastatic bladder cancer, renal cell cancer, and head and neck cancer (cohort 2, 3 and 4). Patients will be treated until disease progression, unacceptable toxicity, intercurrent conditions that preclude continuation of treatment, or patient refusal in the absence of progression or intolerance. The primary endpoint of the first phase is the safety of the combination in a sequential or concomitant scheme and to determine the expansion cohorts phase recommended scheme of administration. The primary endpoint of phase II is to evaluate the efficacy of tiragolumab + atezolizumab + SBRT in terms of 6-month PFS (Progression-Free Survival). Ancillary analyses will be performed with peripheral and intratumoral immune biomarker assessments. TRIAL REGISTRATION This study is registered on ClinicalTrials.gov: NCT05259319, since February 28th, 2022.
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Affiliation(s)
- Nicolas Roussot
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
- Cancer Biology Transfer Platform, Dijon, France
- University of Burgundy-Franche Comté, Dijon, France
- UMR INSERM 1231, Dijon, France
| | - Jean-David Fumet
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France.
- Cancer Biology Transfer Platform, Dijon, France.
| | - Emeric Limagne
- Cancer Biology Transfer Platform, Dijon, France
- GIMI Genetic and Immunology Medical Institute, Dijon, France
- University of Burgundy-Franche Comté, Dijon, France
- UMR INSERM 1231, Dijon, France
| | - Marion Thibaudin
- Cancer Biology Transfer Platform, Dijon, France
- GIMI Genetic and Immunology Medical Institute, Dijon, France
- UMR INSERM 1231, Dijon, France
| | - Alice Hervieu
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Audrey Hennequin
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Lorraine Dalens
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Théo Fourrier
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Loick Galland
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Pierre Jacob
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Aurélie Bertaut
- Department of Epidemiology and Biostatistics, Center GF Leclerc, Dijon, France
| | - Emilie Rederstorff
- Department of Epidemiology and Biostatistics, Center GF Leclerc, Dijon, France
| | | | - Sarah Ghirardi
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | - Elodie Gilbert
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | - Azzat Khoukaz
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | - Etienne Martin
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | | | - Magali Quivrin
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | - David Thibouw
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | - Noémie Vulquin
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | - Gilles Truc
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | - Magali Rouffiac
- Department of Radiotherapy, Center GF Leclerc, Dijon, France
| | - Francois Ghiringhelli
- Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, Dijon, 21000, France
- Cancer Biology Transfer Platform, Dijon, France
- GIMI Genetic and Immunology Medical Institute, Dijon, France
- University of Burgundy-Franche Comté, Dijon, France
- UMR INSERM 1231, Dijon, France
| | - Céline Mirjolet
- UMR INSERM 1231, Dijon, France
- Radiation Oncology Department, Preclinical Radiation Therapy and Radiobiology Unit, Center GF Leclerc, Unicancer, Dijon, France
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Jannin A, Giudici F, de la Fouchardière C, Al Ghuzlan A, Wassermann J, Chougnet CN, Drui D, Godbert Y, Ilouz F, Bardet S, Zanetta S, Roudaut N, Batisse Lignier M, Groussin L, Klein M, Zerdoud S, Lamartina L, Baudin E, Decaussin-Petrucci M, Leteurtre E, Borson Chazot F, Do Cao C, Borget I, Hadoux J. Factors Associated with Survival in Anaplastic Thyroid Carcinoma: A Multicenter Study from the ENDOCAN-TUTHYREF Network. Thyroid 2023; 33:1190-1200. [PMID: 37855745 DOI: 10.1089/thy.2023.0164] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: Anaplastic thyroid carcinoma (ATC) is a rare and frequently fatal type of thyroid cancer. The degree of heterogeneity in survival rates for ATC is incompletely studied. This study evaluated the factors associated with overall survival (OS) of patients with ATC using multicenter real-world data from a national tertiary care center network in France. Methods: In this multicenter, retrospective cohort study, all patients with ATC diagnosed between 2010 and 2020 were identified from the national database of the French ENDOCAN-TUTHYREF network. Factors associated with OS were examined in multivariable analyses using Cox proportional hazards models. Results: The study included 360 patients. Of these, 220 (61%) were female and the median age was 72 years (interquartile range: 62-80). The percentages of patients with pure and mixed (synchronously-transformed) ATC (p-ATC and st-ATC) were 62.5% and 26.7%, respectively. The median OS was 6.8 months [confidence interval, CI: 5.5-8.1]: not reached for stage IVa, 11.4 months [8.2-17.8] for IVb, and 4.6 months [3.5-5.7] for IVc. Surgery, radiation therapy to the neck, chemotherapy, and best supportive care were administered to 69 (19.2%), 214 (59.4%), 254 (70.6%), and 66 (18.3%) patients, respectively. In a multivariable analysis, including stage IVb-IVc patients, significantly higher OS was observed in patients with Eastern Cooperative Oncology Group performance-status of 0-1 (hazard ratio [HR], 0.6; [CI, 0.4-0.9], p < 0.02), stage IVb [HR, 0.5; CI, 0.4-0.8, p < 0.001], and multimodal treatment (surgery and chemoradiotherapy) [HR, 0.07; CI, 0.04-0.1, p < 0.001]. Variables associated with significantly worse OS included: p-ATC (vs. st-ATC) [HR, 1.83; CI, 1.33-2.51, p = 0.001] and a neutrophil-to-lymphocyte ratio (NLR) >5.05 [HR, 2.05, CI, 1.39-3.05, p < 0.001]. Conclusions: Factors independently associated with improved OS in ATC included: European Cooperative Oncology Group performance status, disease stage, multimodality treatment, synchronously transformed ATC, and lower NLR. Long-term OS was observed in selected patients with ATC who underwent multimodal treatment.
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Affiliation(s)
- Arnaud Jannin
- CHU Lille, Department of Endocrinology, Diabetology, and Metabolism, Lille, France
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277-CANTHER-Cancer-Heterogeneity Plasticity and Resistance to Therapies, Lille, France
| | - Fabiola Giudici
- Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France
- Oncostat, U1018, CESP, Inserm, Paris-Saclay University, "Ligue Contre le Cancer" labeled team, Villejuif, France
| | | | - Abir Al Ghuzlan
- Department of Biology and Pathology, Gustave Roussy Cancer Campus and University Paris-Saclay, Villejuif, France
| | - Johanna Wassermann
- Medical Oncology Department and Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière University Hospital, AP-HP, IUC, Sorbonne University, Paris, France
| | - Cecile N Chougnet
- Endocrine Oncology Department, Saint-Louis Hospital (AP-HP), Université Paris, Paris, France
| | - Delphine Drui
- Nantes Université, CHU Nantes, Service d'Endocrinologie-Diabétologie et Nutrition, l'institut du thorax, Nantes, France
| | - Yann Godbert
- Nuclear Medicine and Endocrine Oncology Department, Institute of Bergonié, Bordeaux, France
| | | | - Stéphane Bardet
- Department of Nuclear Medicine and Thyroid Unit, Center François Baclesse, Caen, France
| | - Sylvie Zanetta
- Nuclear Medicine Department, Center Georges François Leclerc, Dijon, France
| | - Nathalie Roudaut
- Department of Endocrinology, University Hospital of Brest, Brest, France
| | | | - Lionel Groussin
- Endocrine Department, AP-HP, Hôpital Cochin, Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | - Marc Klein
- Department of Endocrinology, CHU de Nancy, Hôpital de Brabois, Vandoeuvre-lès-Nancy, France
| | - Slimane Zerdoud
- Department of Nuclear Medicine, Institute Claudius Regaud, Oncology University Institute, IUCT Oncopole, Toulouse, France
| | - Livia Lamartina
- Département d'imagerie, Service d'Oncologie Endocrinienne, Gustave Roussy, Villejuif, France
| | - Eric Baudin
- Département d'imagerie, Service d'Oncologie Endocrinienne, Gustave Roussy, Villejuif, France
| | - Myriam Decaussin-Petrucci
- Research on Healthcare Performance (RESHAPE), INSERM U1290, EA 3738 CICLY, Université Lyon 1, Claude Bernard, Lyon, France
- Service d'Anatomopathologie, Hospices Civils de Lyon, Groupement Hospitalier Sud, Pierre Bénite, France
| | - Emmanuelle Leteurtre
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277-CANTHER-Cancer-Heterogeneity Plasticity and Resistance to Therapies, Lille, France
| | - Francoise Borson Chazot
- Research on Healthcare Performance (RESHAPE), INSERM U1290, EA 3738 CICLY, Université Lyon 1, Claude Bernard, Lyon, France
- Endocrinology Department, Hospice Civils de Lyon, Hospital Louis-Pradel, Bron, France
| | - Christine Do Cao
- CHU Lille, Department of Endocrinology, Diabetology, and Metabolism, Lille, France
| | - Isabelle Borget
- Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France
- Oncostat, U1018, CESP, Inserm, Paris-Saclay University, "Ligue Contre le Cancer" labeled team, Villejuif, France
| | - Julien Hadoux
- Département d'imagerie, Service d'Oncologie Endocrinienne, Gustave Roussy, Villejuif, France
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Fumet JD, Isambert N, Hervieu A, Zanetta S, Guion JF, Hennequin A, Rederstorff E, Bertaut A, Ghiringhelli F. Corrigendum to "Phase Ib/II trial evaluating the safety, tolerability and immunological activity of durvalumab (MEDI4736) (anti-PD-L1) plus tremelimumab (anti-CTLA-4) combined with FOLFOX in patients with metastatic colorectal cancer": [ESMO Open 3 (2018) e000375]. ESMO Open 2023; 8:101185. [PMID: 36868156 PMCID: PMC10006516 DOI: 10.1016/j.esmoop.2023.101185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Affiliation(s)
- Jean-David Fumet
- Department of Medical, Oncology, Center Georges Francois Leclerc, Dijon, France; Research Platform in Biological Oncology, Georges Francois Leclerc Center, Dijon, France; University of Burgundy-Franche Comté, Dijon, France.
| | - Nicolas Isambert
- Department of Medical, Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Alice Hervieu
- Department of Medical, Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Sylvie Zanetta
- Department of Medical, Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Jean-Florian Guion
- Department of Medical, Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Audrey Hennequin
- Department of Medical, Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Emilie Rederstorff
- Department of Epidemiology and Biostatistics, Georges, François Leclerc Center, Dijon, France
| | - Aurélie Bertaut
- Department of Epidemiology and Biostatistics, Georges, François Leclerc Center, Dijon, France
| | - Francois Ghiringhelli
- Department of Medical, Oncology, Center Georges Francois Leclerc, Dijon, France; Research Platform in Biological Oncology, Georges Francois Leclerc Center, Dijon, France; University of Burgundy-Franche Comté, Dijon, France; INSERM UMR1231, Dijon, France; GIMI Genetic and Immunology, Medical Institute, Dijon, France
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Dufresne A, Huillard O, Dalban C, Geier M, Wassermann J, Zanetta S, Cabourg M, Catargi B, El Kouri C, Hrab I, Laramas M, Moreira A, Saada E, Tournigand C, Valentin T, Vauleon E, Mayet R, Perol D, Blay JY. 465P Larotracking: Real-life study of locally advanced/metastatic solid tumor treated with larotrectinib in French expanded access program. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.594] [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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Ladoire S, Rederstorff E, Goussot V, Parnalland S, Briot N, Ballot E, Truntzer C, Ayati S, Bengrine-Lefevre L, Bremaud N, Coudert B, Desmoulins I, Favier L, Fraisse C, Fumet JD, Hennequin A, Hervieu A, Ilie S, Kaderbhai C, Lagrange A, Martin N, Mazilu I, Mayeur D, Palmier R, Simonet-Lamm AL, Vincent J, Zanetta S, Arnould L, Coutant C, Bertaut A, Ghiringhelli F. Parallel evolution and differences in seroprevalence of SARS-CoV-2 antibody between patients with cancer and health care workers in a tertiary cancer centre during the first and second wave of COVID-19 pandemic: canSEROcov-II cross-sectional study. Eur J Cancer 2022; 165:13-24. [PMID: 35189537 PMCID: PMC8806022 DOI: 10.1016/j.ejca.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 12/12/2022]
Abstract
Background Patients with cancer are a population at high risk of severe infection from SARS-CoV-2. Patients with cancer regularly attend specialised healthcare centres for management and treatment, where they are in contact with healthcare workers (HCWs). Numerous recommendations target both patients with cancer and HCWs to minimise the spread of SARS-CoV-2 during these interactions. Objective To investigate the parallel evolution of the COVID-19 epidemic in these 2 populations over time, we studied the seroprevalence of anti-SARS-CoV-2 antibodies after both the first and second waves of the pandemic, and in both cancer patients and HCWs from a single specialised anti-cancer centre. Factors associated with seropositivity were identified in both populations. Methods We conducted a cross-sectional study after the second wave of the COVID pandemic in France. All participants were invited to undergo serological testing for SARS-CoV-2 and complete a questionnaire collecting data about their working conditions (for HCWs) or medical management (for patients) during this period. Results after the second wave were compared to those of a previous study among 1011 patients with cancer and 663 HCWs performed in the same centre after the first wave, using the same evaluations. Findings We included 502 HCWs and 507 patients with cancer. Seroprevalence of anti-SARS-CoV-2 antibodies was higher after the second wave than after the first wave in both HCWs (15.1% versus 1.8%; p < 0.001), and patients (4.1% versus 1.7%; p = 0.038). By multivariate analysis, the factors found to be associated with seropositivity after the second wave for HCWs were: working in direct patient care (p = 0.050); having worked in a dedicated COVID-19 unit (p = 0.0036); contact with a person with COVID-19-positive in the workplace (p = 0.0118) or outside of the workplace (p = 0.0297). Among patients with cancer, only a contact with someone who tested positive for COVID-19 was found to be significantly associated with positive serology. The proportion of reported contacts with individuals with COVID-19-positive was significantly lower among patients with cancer than among HCWs (7.6% versus 40.7%, respectively; p < 0.0001) Interpretation Between the first and second waves of the epidemic in France, the seroprevalence of anti-SARS-CoV-2 antibodies increased to a lesser extent among patients with cancer than among their HCWs, possibly due to better self-protection, notably social distancing. The risk factors for infection identified among HCWs plead in favour of numerous intra-hospital contaminations, especially for HCWs in contact with high-risk patients. This underlines the compelling need to pursue efforts to implement strict hygiene and personal protection measures (including vaccination) to protect HCWs and patients with cancer.
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Affiliation(s)
- Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France; Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; University of Burgundy-Franche Comté, France.
| | - Emilie Rederstorff
- Clinical Research Center (CRC), Centre Georges François Leclerc, Dijon, France
| | - Vincent Goussot
- Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
| | - Sophie Parnalland
- Clinical Research Center (CRC), Centre Georges François Leclerc, Dijon, France
| | - Nathalie Briot
- Methodology and Biostatistics Unit, Centre Georges François Leclerc, Dijon, France
| | - Elise Ballot
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; Bioinformatic Core Facility Georges-François Leclerc Cancer Center, Dijon, France
| | - Caroline Truntzer
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; Bioinformatic Core Facility Georges-François Leclerc Cancer Center, Dijon, France
| | - Siavoshe Ayati
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | - Nathalie Bremaud
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Bruno Coudert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Isabelle Desmoulins
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Laure Favier
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Cléa Fraisse
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Jean-David Fumet
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Audrey Hennequin
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Alice Hervieu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Silvia Ilie
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Courèche Kaderbhai
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Aurélie Lagrange
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Nils Martin
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Irina Mazilu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Didier Mayeur
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Rémi Palmier
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | - Julie Vincent
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Laurent Arnould
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
| | - Charles Coutant
- University of Burgundy-Franche Comté, France; Department of Oncologic Surgery, Centre Georges François Leclerc, Dijon, France
| | - Aurélie Bertaut
- Methodology and Biostatistics Unit, Centre Georges François Leclerc, Dijon, France
| | - François Ghiringhelli
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France; Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; University of Burgundy-Franche Comté, France
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Tankere P, Zanetta S, Kaderbhai CG, Bellio H, Lagrange A, Garcier M, Ghiringhelli F. Small Cell Neuroendocrine Carcinoma of the Paranasal Sinuses with Unexpected Location and Clinical Presentation and Occupational Exposure: A Case Report. Am J Case Rep 2022; 23:e934980. [PMID: 35232952 PMCID: PMC8900442 DOI: 10.12659/ajcr.934980] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patient: Male, 56-year-old
Final Diagnosis: Small cell carcinoma head and neck
Symptoms: Initial clinical digestive presentation • occupational exposure to sawdust
Medication: —
Clinical Procedure: —
Specialty: Oncology • Otolaryngology • Pulmonology
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Affiliation(s)
- Pierre Tankere
- Department of Pulmonary Medicine, University Hospital, Dijon, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Cancer Center GF Leclerc, Dijon, France
| | | | - Hélène Bellio
- Department of Medical Oncology, Cancer Center GF Leclerc, Dijon, France
| | - Aurélie Lagrange
- Department of Medical Oncology, Cancer Center GF Leclerc, Dijon, France
| | - Martin Garcier
- Department of Otorhinolaryngology, University Hospital, Dijon, France
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Siefker-Radtke AO, Necchi A, Park SH, García-Donas J, Huddart RA, Burgess EF, Fleming MT, Rezazadeh Kalebasty A, Mellado B, Varlamov S, Joshi M, Duran I, Tagawa ST, Zakharia Y, Akapame S, Santiago-Walker AE, Monga M, O'Hagan A, Loriot Y, Loriot Y, Park SH, Tagawa S, Flechon A, Alexeev B, Varlamov S, Huddart R, Burgess E, Rezazadeh A, Siefker-Radtke A, Vano Y, Gasparro D, Hamzaj A, Kopyltsov E, Gracia Donas J, Mellado B, Parikh O, Schatteman P, Culine S, Houédé N, Zanetta S, Facchini G, Scagliotti G, Schinzari G, Lee JL, Shkolnik M, Fleming M, Joshi M, O'Donnell P, Stöger H, Decaestecker K, Dirix L, Machiels JP, Borchiellini D, Delva R, Rolland F, Hadaschik B, Retz M, Rosenbaum E, Basso U, Mosca A, Lee HJ, Shin DB, Cebotaru C, Duran I, Moreno V, Perez Gracia JL, Pinto A, Su WP, Wang SS, Hainsworth J, Schnadig I, Srinivas S, Vogelzang N, Loidl W, Meran J, Gross Goupil M, Joly F, Imkamp F, Klotz T, Krege S, May M, Schultze-Seemann W, Strauss A, Zimmermann U, Keizman D, Peer A, Sella A, Berardi R, De Giorgi U, Sternberg CN, Rha SY, Bulat I, Izmailov A, Matveev V, Vladimirov V, Carles J, Font A, Saez M, Syndikus I, Tarver K, Appleman L, Burke J, Dawson N, Jain S, Zakharia Y. Efficacy and safety of erdafitinib in patients with locally advanced or metastatic urothelial carcinoma: long-term follow-up of a phase 2 study. Lancet Oncol 2022; 23:248-258. [PMID: 35030333 DOI: 10.1016/s1470-2045(21)00660-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Erdafitinib, a pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor, was shown to be clinically active and tolerable in patients with advanced urothelial carcinoma and prespecified FGFR alterations in the primary analysis of the BLC2001 study at median 11 months of follow-up. We aimed to assess the long-term efficacy and safety of the selected regimen of erdafitinib determined in the initial part of the study. METHODS The open-label, non-comparator, phase 2, BLC2001 study was done at 126 medical centres in 14 countries across Asia, Europe, and North America. Eligible patients were aged 18 years or older with locally advanced and unresectable or metastatic urothelial carcinoma, at least one prespecified FGFR alteration, an Eastern Cooperative Oncology Group performance status of 0-2, and progressive disease after receiving at least one systemic chemotherapy or within 12 months of neoadjuvant or adjuvant chemotherapy or were ineligible for cisplatin. The selected regimen determined in the initial part of the study was continuous once daily 8 mg/day oral erdafitinib in 28-day cycles, with provision for pharmacodynamically guided uptitration to 9 mg/day (8 mg/day UpT). The primary endpoint was investigator-assessed confirmed objective response rate according to Response Evaluation Criteria In Solid Tumors version 1.1. Efficacy and safety were analysed in all treated patients who received at least one dose of erdafitinib. This is the final analysis of this study. This study is registered with ClinicalTrials.gov, NCT02365597. FINDINGS Between May 25, 2015, and Aug 9, 2018, 2328 patients were screened, of whom 212 were enrolled and 101 were treated with the selected erdafitinib 8 mg/day UpT regimen. The data cutoff date for this analysis was Aug 9, 2019. Median efficacy follow-up was 24·0 months (IQR 22·7-26·6). The investigator-assessed objective response rate for patients treated with the selected erdafitinib regimen was 40 (40%; 95% CI 30-49) of 101 patients. The safety profile remained similar to that in the primary analysis, with no new safety signals reported with longer follow-up. Grade 3-4 treatment-emergent adverse events of any causality occurred in 72 (71%) of 101 patients. The most common grade 3-4 treatment-emergent adverse events of any cause were stomatitis (in 14 [14%] of 101 patients) and hyponatraemia (in 11 [11%]). There were no treatment-related deaths. INTERPRETATION With longer follow-up, treatment with the selected regimen of erdafitinib showed consistent activity and a manageable safety profile in patients with locally advanced or metastatic urothelial carcinoma and prespecified FGFR alterations. FUNDING Janssen Research & Development.
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Affiliation(s)
- Arlene O Siefker-Radtke
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Andrea Necchi
- Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Se Hoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jesús García-Donas
- Medical Oncology Department, Fundacion Hospital de Madrid and IMMA Medicine Faculty, San Pablo CEU University, Madrid, Spain
| | - Robert A Huddart
- Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Earle F Burgess
- Medical Oncology Department, Levine Cancer Institute, Charlotte, NC, USA
| | - Mark T Fleming
- Medical Oncology Department, Virginia Oncology Associates, US Oncology Research, Norfolk, VA, USA
| | | | - Begoña Mellado
- Medical Oncology Department, Hospital Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Sergei Varlamov
- Department of Urologic Oncology, Altai Regional Cancer Center, Barnaul, Russia
| | - Monika Joshi
- Department of Medicine, Penn State Cancer Institute, Hershey, PA, USA
| | - Ignacio Duran
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Scott T Tagawa
- Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY, USA
| | - Yousef Zakharia
- Department of Internal Medicine, University of Iowa, Holden Comprehensive Cancer Center, Iowa City, IA, USA
| | | | | | - Manish Monga
- Janssen Research & Development, Spring House, PA, USA
| | - Anne O'Hagan
- Janssen Research & Development, Spring House, PA, USA
| | - Yohann Loriot
- Department of Cancer Medicine, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Bellio H, Bertaut A, Hervieu A, Zanetta S, Hennequin A, Vincent J, Palmier R, Bengrine-Lefevre L, Ghiringhelli F, Fumet JD. Phase I Dose-Escalation Trial of an Innovative Chemotherapy Regimen Combining a Fractionated Dose of Irinotecan Plus Bevacizumab, Oxaliplatin, 5-Fluorouracil, and Folinic Acid (bFOLFIRINOX-3) in Chemorefractory Metastatic Colorectal Cancer. Cancers (Basel) 2021; 13:cancers13215472. [PMID: 34771635 PMCID: PMC8582415 DOI: 10.3390/cancers13215472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/20/2022] Open
Abstract
Simple Summary Treatment of non-resectable metastatic colorectal cancer (mCRC) involves chemotherapy based on 5-fluorouracil, oxaliplatin and irinotecan and monoclonal antibodies targeting VEGF or EGFR. After an initial progression, it is usual to change the chemotherapy regimen and targeted therapy, with rather moderate results. Several studies have focused on the interest of using again already used molecules and rechallenge with oxaliplatin and irinotecan bi fractionation (FOLFIRI3) have previously shown efficacy in chemorefractory patients, but desynchronized triplet chemotherapy was never tested. The aim of this study was to evaluate the safety and efficacy of a new regimen so-called: FOLFIRINOX-3 bevacizumab in chemorefractory metastatic colorectal cancer. Abstract The care of metastatic colorectal cancers is based on combination chemotherapies including 5-fluorouracil, oxaliplatin, irinotecan, and monoclonal antibodies targeting the epidermal growth factor receptor or vascular endothelial growth factor. The regimen is determined based on the patient’s molecular biology and general condition. Irinotecan bifractionation showed efficacy in chemorefractory patients in a previous study, FOLFIRI-3, but a desynchronized triplet has never been tested. The aim of bFOLFIRINOX-3 is to determine the safety, tolerance, and efficacy of a new regimen (FOLFIRINOX-3 bevacizumab) in chemorefractory patients. The aim of this study was to evaluate the safety and efficacy of FOLFIRINOX-3 bevacizumab in chemorefractory metastatic colorectal cancer (mCRC). A standard phase I, “3 + 3” design study was performed. The standard protocol comprised simplified FOLFOX 4 (folinic acid 400 mg/m2), 5-fluorouracil (a 400 mg/m2 bolus followed by 2400 mg/m2 for 46 h), oxaliplatin (85 mg/m2) and irinotecan (administered before and after 5-fluorouracil infusion), plus bevacizumab (5 mg/kg). In a “3 + 3” design, three different doses of irinotecan were tested: 60, 70 and 90 mg/m2. The primary endpoint was the maximum tolerable dose (MTD) of irinotecan. The secondary endpoints included the objective response (at 8 and 16 weeks) according to the RECIST 1.1 criteria and progression free survival. Thirteen patients were enrolled, and twelve patients were finally evaluated for dose-limiting toxicity (DLT). The dose level defined was 70 mg/m2 irinotecan. A total of three DLTs were observed (grade 3 diarrhea): two DLTs at the 90 mg/m2 dose level and one at the 70 mg/m2 dose level. The most frequently described adverse events were asthenia (93%), diarrhea (77%), nausea (62%) and peripheral sensory neuropathy (46%). The most frequent biological event was thrombopenia (54%). Regarding efficacy, among the 11 evaluable patients, no progression was observed at 8 weeks, and the partial response rate was 18.2%. At 16 weeks, a partial response rate of 27.3% was observed, and five patients had a stable disease. The new regimen of bFOLFIRINOX-3 with irinotecan at 70 mg/m2 was well tolerated. In chemorefractory patients, this protocol shows a high response rate.
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Affiliation(s)
- Hélène Bellio
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
- Correspondence: (H.B.); (J.-D.F.)
| | - Aurélie Bertaut
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
| | - Alice Hervieu
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
| | - Sylvie Zanetta
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
| | - Audrey Hennequin
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
| | - Julie Vincent
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
| | - Rémi Palmier
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
| | - Leila Bengrine-Lefevre
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
| | - François Ghiringhelli
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
- UMR INSERM 1231, 7 Boulevard Jeanne d’Arc, 21000 Dijon, France
| | - Jean-David Fumet
- Platform of Transfer in Biological Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France; (A.B.); (A.H.); (S.Z.); (A.H.); (J.V.); (R.P.); (L.B.-L.); (F.G.)
- Department of Medical Oncology, Georges François Leclerc Cancer Center—UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France
- Maison de L’université Esplanade Erasme, University of Burgundy-Franche Comté, 21000 Dijon, France
- Correspondence: (H.B.); (J.-D.F.)
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Galot R, Le Tourneau C, Saada-Bouzid E, Daste A, Even C, Debruyne P, Henry S, Zanetta S, Rutten A, Licitra L, Canon JL, Kaminsky MC, Specenier P, Rottey S, Guigay J, Kong A, Tinhofer I, Borcoman E, Dirix L, Raveloarivahy T, Fortpied C, Vanlancker M, Morfouace M, Govaerts AS, Machiels JP. A phase II study of monalizumab in patients with recurrent/metastatic squamous cell carcinoma of the head and neck: The I1 cohort of the EORTC-HNCG-1559 UPSTREAM trial. Eur J Cancer 2021; 158:17-26. [PMID: 34638090 DOI: 10.1016/j.ejca.2021.09.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/05/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Monalizumab is a monoclonal antibody targeting the inhibitory natural killer group 2A (NKG2A) receptor localised on natural killer (NK) and T cells. Its ligand, the human leukocyte antigen E (HLA-E), is overexpressed in squamous cell carcinoma of the head and neck (SCCHN). By targeting the HLA-E-NKG2A pathway, monalizumab may enhance NK and T cell activity. EXPERIMENTAL DESIGN The UPSTREAM trial is a biomarker-driven umbrella trial studying targeted therapies and immunotherapies in patients with recurrent/metastatic (R/M) SCCHN progressing after platinum therapy. The immunotherapy 1 (I1) cohort was a phase II, single-arm substudy evaluating monalizumab (10 mg/kg intravenously on day 1 of a 14-day cycle). The primary end-point was the objective response (OR) rate (Response Evaluation Criteria in Solid Tumours 1.1) over the first 16 weeks. A two-stage Simon design was used (H1 15%, H0 3%, α 8%, power 90%) with pre-planned interruption of accrual if no OR was observed after the first 25 patients. RESULTS Twenty-six eligible patients were enrolled. Seventeen (65%) patients had received ≥2 previous lines of systemic treatment, and 15 (58%) patients were PD(-L)1 inhibitor pretreated. No OR was observed. Stable disease was observed in 6 patients (23%) with a median duration of 3.8 months (95% confidence interval [CI]: 2.7-NE). The median progression-free survival and overall survival were 1.7 months (95% CI: 1.5-1.8) and 6.7 months (95% CI: 3.0-9.6), respectively. The most frequent treatment-related adverse event was grade I/II fatigue (19%). CONCLUSIONS Monalizumab monotherapy has limited activity in R/M SCCHN. The I1 cohort did not meet its primary objective. Monalizumab combined with durvalumab is under investigation within UPSTREAM.
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Affiliation(s)
- Rachel Galot
- Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium.
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris, Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud, France; Versailles-Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France.
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice Cedex 2, France.
| | - Amaury Daste
- Département d'Oncologie Médicale, Hôpital Saint André, CHU de Bordeaux, 1 Rue Jean Burguet, 33075, Bordeaux Cedex, France.
| | - Caroline Even
- Head and Neck Department, Gustave Roussy, Villejuif, France.
| | - Philip Debruyne
- Kortrijk Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium; School of Life Sciences, Anglia Ruskin University, Cambridge, UK.
| | - Stéphanie Henry
- Université Catholique de Louvain, CHU UCL Namur, Département d'oncologie Médicale, Site Ste Elisabeth, Place Louise Godin 15, B5000, Namur, Belgium.
| | - Sylvie Zanetta
- Département d'oncologie Médicale, Centre GF Leclerc, 1 Rue Du Pr Marion, 21000 DIJON, France.
| | | | - Lisa Licitra
- Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS "Istituto Nazionale Dei Tumori, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Italy.
| | - Jean-Luc Canon
- Grand Hôpital de Charleroi, Pôle Cancer et Maladies Du Sang, Site Notre Dame, Grand Rue 3, 6000 Charleroi, Belgium.
| | - Marie-Christine Kaminsky
- Institut de Cancérologie de Lorraine - Alexis Vautrin, 6 Avenue de Bourgogne - CS 30519, 54519 Vandoeuvre-les-Nancy Cedex, France.
| | - Pol Specenier
- Universitair Ziekenhuis Antwerpen, Wilrijkstraat 10, 2610 Edegem, Belgium.
| | - Sylvie Rottey
- Drug Research Unit Ghent and Department Medical Oncology, Universitair Ziekenhuis Gent, C. Heymanslaan 10, 9000 Gent, Belgium.
| | - Joël Guigay
- Department of Medical Oncology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice Cedex 2, France.
| | - Anthony Kong
- Comprehensive Cancer Centre, King's College London, Guy's Campus, Room 2.36b New Hunt's House, London SE1 1UL, UK.
| | - Inge Tinhofer
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Radiooncology and Radiotherapy, Charitéplatz 1, 10117, Berlin, Germany.
| | - Edith Borcoman
- Department of Drug Development and Innovation, Institut Curie, Paris, Saint-Cloud, France.
| | - Lieve Dirix
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
| | - Tiana Raveloarivahy
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
| | - Catherine Fortpied
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
| | - Maureen Vanlancker
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
| | - Marie Morfouace
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
| | - Anne-Sophie Govaerts
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
| | - Jean-Pascal Machiels
- Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium.
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Cancel M, Fromont G, Blonz C, Chevreau C, Rioux-Leclercq N, Laguerre B, Oudard S, Gross-Goupil M, Gravis G, Goldwasser F, Rolland F, Delva R, Moise L, Emambux S, Vassal C, Zanetta S, Penel N, Fléchon A, Barthélémy P, Saldana C, Lefort F, Escudier B, Linassier C, Albiges L. Everolimus or sunitinib as first-line treatment of metastatic papillary renal cell carcinoma: A retrospective study of the GETUG group (Groupe d'Etude des Tumeurs Uro-Génitales). Eur J Cancer 2021; 158:1-11. [PMID: 34619467 DOI: 10.1016/j.ejca.2021.08.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/24/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Two phase II trials (NCT00688753 and NCT00541008) reported efficacy data of sunitinib and everolimus in first-line treatment of metastatic papillary renal cell carcinoma (mpRCC). Although most patients receive sunitinib or a mammalian target of rapamycin (mTOR) inhibitor in first- and second-line treatment, the optimal strategy remained unknown. MATERIAL AND METHODS In 23 centres of the Groupe d'Etude des Tumeurs Urogénitales group, after centralised pathological review, we analysed retrospectively progression-free survival (PFS) of patients with mpRCC treated in first-line treatment (PFS-1) with sunitinib or everolimus (primary end-point), PFS in second-line treatment (PFS-2), overall survival (OS), objective response rate, disease control rate (DCR), overall sequence and prognostic factors for OS (secondary end-points). RESULTS One hundred thirty-eight patients (119 men and 19 women), median age 62.5 years, with mpRCC type 1 (n = 24) or non-type 1 (n = 114), received first-line sunitinib (n = 107) or everolimus (n = 31). With a median follow-up of 92 months, we found no significant difference between the treatment groups in terms of PFS-1 (5.5 versus 6.2 months) and DCR (69% versus 83%). Ninety-eight patients received a second-line treatment, 69% with mTOR inhibitors after sunitinib and 100% with tyrosine kinase inhibitors after everolimus, with similar DCR (64% versus 58%), median PFS-2 (3.4 versus 4.8 months) and OS (16.0 versus 20.3 months). No factor was prognostic for PFS-1, whereas leukocytosis, anaemia and the time from diagnosis to first systemic therapy < 1 year were prognostic for OS. We found no prognostic difference between both pRCC subtypes. The International Metastatic Renal Cell Database Consortium risk factors were prognostic for OS. CONCLUSION Sunitinib and everolimus had similar efficacy in first-line treatment of patients with mpRCC.
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Affiliation(s)
- Mathilde Cancel
- Department of Medical Oncology, CHU Bretonneau Tours, France
| | | | - Cyriac Blonz
- Department of Medical Oncology, Institut de Cancérologie de L'Ouest, Saint-Herblain, France
| | - Christine Chevreau
- Department of Medical Oncology, IUCT Oncopole - CLCC Institut Claudius Regaud, Toulouse, France
| | | | | | - Stéphane Oudard
- Department of Medical Oncology, CHU Hôpital Européen Georges Pompidou, Paris, France
| | | | - Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | | | - Frédéric Rolland
- Department of Medical Oncology, Institut de Cancérologie de L'Ouest, Saint-Herblain, France
| | - Rémy Delva
- Department of Medical Oncology, Institut de Cancérologie de L'Ouest, Angers, France
| | - Laura Moise
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Sheik Emambux
- Department of Medical Oncology, CHU La Milétrie, Poitiers, France
| | - Cécile Vassal
- Department of Medical Oncology, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Nicolas Penel
- Lille University and Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - Aude Fléchon
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Philippe Barthélémy
- Department of Medical Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | | | - Félix Lefort
- Department of Medical Oncology, CHU Saint-André, Bordeaux, France
| | - Bernard Escudier
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | | | - Laurence Albiges
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
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12
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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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13
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Fumet JD, Hervieu A, Hennequin A, Zanetta S, Bertaut A, Ghiringhelli F. Phase I dose-escalation study of desynchronized irinotecan plus bevacizumab, oxaliplatin, 5-fluorouracil, and folinic acid (bFOLFIRINOX-3) administration in chemorefractory metastatic colorectal cancer patients. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e15573] [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
e15573 Background: Treatment of non-resectable metastatic colorectal cancer (mCRC) involves chemotherapy based on 5-fluorouracil, oxaliplatin and irinotecan and monoclonal antibodies targeting VEGF or EGFR. Rechallenge with oxaliplatin and irinotecan bi fractionation (FOLFIRI3) have previously shown efficacy in chemorefractory patients but desynchronized triplet chemotherapy was never tested. The aim of this study was to evaluate the safety and efficacy of a new regimen so-called: FOLFIRINOX-3 bevacizumab in chemorefractory mCRC. Methods: A phase I study to test bFOLFIRINOX 3 regimen was designed using Standard “3 + 3” design for dose escalation. Patients enrolled, >18years and ECOG 0 or 1, have a pathologically confirmed mCRC and experienced treatment failure after standard chemotherapy that include 5-fluorouracil, oxaliplatin and irinotecan. Absence of residual neuropathy and previous grade 3 irinotecan related toxicity was manditory. Regimen tested consisted of bevacizumab (5mg/kg) plus simplified FOLFOX4 (folinic acid (400mg/m2), 5-fluorouracil (400mg/m2 bolus followed by 2400mg/m2 for 46h), oxaliplatin (85mg/m2) and irinotecan (administered before and after infusional 5-fluorouracil). Three irinotecan levels were planned at 60, 70 and 90 mg/m² (day 1 and day 3). Dose limiting toxicities (DLT) were identified during the first 2 cycles. Primary endpoint was assessment of maximum tolerable dose trough evaluation of acute toxicities (CTCAE v4.03). Secondary endpoints included objective response (RECIST 1.1), progression free survival, overall survival and late toxicity. Results: Thirteen patients received experimental treatment on this study. The RP2D was irinotecan 70mg/m² day 1 and day 3. Two patients experienced DLTs (G3 diarhea ) at dose level 90mg/m² and one DLT occured (G3 diarrhea) at 70mg/m² level. The most common drug-related adverse events (all grades) were fatigue (92.3%), diarrhea (76.9%), nausea (61.5%), peripheral neuropathy (61.5%), thrombopenia (46.1%) and anemia (15.3%). Among 11 response-evaluable patients, we noticed 4 partial responses, 7 stable disease and no progression as best response. Conclusions: The combination of bFOLFIRINOX-3 at the RP2D of 70mg/m² day 1 and day 3. was well tolerated and feseably. The regimen resulted in high response rate in chemorefractory metastatic colorectal cancer. Phase II is ongoing. Clinical trial information: NCT03795311.
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14
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Guigay J, Aupérin A, Fayette J, Saada-Bouzid E, Lafond C, Taberna M, Geoffrois L, Martin L, Capitain O, Cupissol D, Castanie H, Vansteene D, Schafhausen P, Johnson A, Even C, Sire C, Duplomb S, Evrard C, Delord JP, Laguerre B, Zanetta S, Chevassus-Clément C, Fraslin A, Louat F, Sinigaglia L, Keilholz U, Bourhis J, Mesia R. Cetuximab, docetaxel, and cisplatin versus platinum, fluorouracil, and cetuximab as first-line treatment in patients with recurrent or metastatic head and neck squamous-cell carcinoma (GORTEC 2014-01 TPExtreme): a multicentre, open-label, randomised, phase 2 trial. Lancet Oncol 2021; 22:463-475. [PMID: 33684370 DOI: 10.1016/s1470-2045(20)30755-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/03/2020] [Accepted: 12/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Results from a phase 2 trial of the TPEx chemotherapy regimen (docetaxel-platinum-cetuximab) showed promising results, with a median overall survival of 14·0 months in first-line recurrent or metastatic head and neck squamous-cell carcinoma (HNSCC). We therefore aimed to compare the efficacy and safety of the TPEx regimen with the standard of care EXTREME regimen (platinum-fluorouracil-cetuximab) in this setting. METHODS This was a multicentre, open-label, randomised, phase 2 trial, done in 68 centres (cancer centres, university and general hospitals, and private clinics) in France, Spain, and Germany. Eligible patients were aged 18-70 years with histologically confirmed recurrent or metastatic HNSCC unsuitable for curative treatment; had at least one measurable lesion according to Response Evaluation Criteria in Solid Tumors version 1.1; and had an Eastern Cooperative Oncology Group (ECOG) performance status of 1 or less. Participants were randomly assigned (1:1) using the TenAlea website by investigators or delegated clinical research associates to the TPEx regimen or the EXTREME regimen, with minimisation by ECOG performance status, type of disease evolution, previous cetuximab treatment, and country. The TPEx regimen consisted of docetaxel 75 mg/m2 and cisplatin 75 mg/m2, both intravenously on day 1, and cetuximab on days 1, 8, and 15 (intravenously 400 mg/m2 on day 1 of cycle 1 and 250 mg/m2 weekly subsequently). Four cycles were repeated every 21 days with systematic granulocyte colony-stimulating factor (G-CSF) support at each cycle. In case of disease control after four cycles, intravenous cetuximab 500 mg/m2 was continued every 2 weeks as maintenance therapy until progression or unacceptable toxicity. The EXTREME regimen consisted of fluorouracil 4000 mg/m2 on day 1-4, cisplatin 100 mg/m2 on day 1, and cetuximab on days 1, 8, and 15 (400 mg/m2 on day 1 of cycle 1 and 250 mg/m2 weekly subsequently) all delivered intravenously. Six cycles were delivered every 21 days followed by weekly 250 mg/m2 cetuximab as maintenance therapy in case of disease control. G-CSF support was not mandatory per the protocol in the EXTREME regimen. The primary endpoint was overall survival in the intention-to-treat population; safety was analysed in all patients who received at least one dose of chemotherapy or cetuximab. Enrolment is closed and this is the final analysis. This study is registered at ClinicalTrials.gov, NCT02268695. FINDINGS Between Oct 10, 2014, and Nov 29, 2017, 541 patients were enrolled and randomly assigned to the two treatment regimens (271 to TPEx, 270 to EXTREME). Two patients in the TPEx group had major deviations in consent forms and were not included in the final analysis. Median follow-up was 34·4 months (IQR 26·6-44·8) in the TPEx group and 30·2 months (25·5-45·3) in the EXTREME group. At data cutoff, 209 patients had died in the TPEx group and 218 had died in the EXTREME group. Overall survival did not differ significantly between the groups (median 14·5 months [95% CI 12·5-15·7] in the TPEx group and 13·4 months [12·2-15·4] in the EXTREME group; hazard ratio 0·89 [95% CI 0·74-1·08]; p=0·23). 214 (81%) of 263 patients in the TPEx group versus 246 (93%) of 265 patients in the EXTREME group had grade 3 or worse adverse events during chemotherapy (p<0·0001). In the TPEx group, 118 (45%) of 263 patients had at least one serious adverse event versus 143 (54%) of 265 patients in the EXTREME group. 16 patients in the TPEx group and 21 in the EXTREME group died in association with adverse events, including seven patients in each group who had fatal infections (including febrile neutropenia). Eight deaths in the TPEx group and 11 deaths in the EXTREME group were assessed as treatment related, most frequently sepsis or septic shock (four in each treatment group). INTERPRETATION Although the trial did not meet its primary endpoint, with no significant improvement in overall survival with TPEx versus EXTREME, the TPEx regimen had a favourable safety profile. The TPEx regimen could provide an alternative to standard of care with the EXTREME regimen in the first-line treatment of patients with recurrent or metastatic HNSCC, especially for those who might not be good candidates for up-front pembrolizumab treatment. FUNDING Merck Santé and Chugai Pharma.
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Affiliation(s)
- Joël Guigay
- Department of Medical Oncology and Research, Centre Antoine Lacassagne, FHU Oncoage, University Côte d'Azur, Nice, France.
| | - Anne Aupérin
- Biostatistic and Epidemiology Unit, Gustave Roussy, Oncostat 1018 INSERM, labeled Ligue Contre le Cancer, University Paris-Saclay, Villejuif, France
| | - Jérôme Fayette
- Department of Medical Oncology, University of Lyon, Centre Léon Bérard, Lyon, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, FHU Oncoage, University Côte d'Azur, Nice, France
| | - Cédrik Lafond
- Department of Medical Oncology, ILC Centre Jean Bernard/Clinique Victor Hugo, Le Mans, France
| | - Miren Taberna
- Department of Medical Oncology, Institut Català de Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lionnel Geoffrois
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Nancy, France
| | - Laurent Martin
- Department of Medical Oncology, Clinique des Ormeaux, Le Havre, France
| | - Olivier Capitain
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest Paul Papin, Angers, France
| | - Didier Cupissol
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier, France
| | - Hélène Castanie
- Department of Medical Oncology, Hôpital Privé le Confluent, Sainte Catherine de Sienne, Nantes, France
| | - Damien Vansteene
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest René Gauducheau, Nantes, France
| | - Philippe Schafhausen
- Department of Medical Oncology, Universitätsklinikum Hamburg Eppendorf Hubertus Wald Tumorzentrum, Hamburg, Germany
| | - Alison Johnson
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Caroline Even
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - Christian Sire
- Department of Medical Oncology, Centre Hospitalier de Bretagne Sud, Lorient, France
| | - Sophie Duplomb
- Department of Medical Oncology, HCL, Hôpital de la Croix Rousse, Lyon, France
| | - Camille Evrard
- Department of Medical Oncology, CHU, Université de Poitiers, Poitiers, France
| | - Jean-Pierre Delord
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | - Brigitte Laguerre
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Cécile Chevassus-Clément
- Biostatistic and Epidemiology Unit, Gustave Roussy, Oncostat 1018 INSERM, labeled Ligue Contre le Cancer, University Paris-Saclay, Villejuif, France
| | - Aldéric Fraslin
- Biostatistic and Epidemiology Unit, Gustave Roussy, Oncostat 1018 INSERM, labeled Ligue Contre le Cancer, University Paris-Saclay, Villejuif, France
| | | | | | - Ulrich Keilholz
- Charité Comprehensive Cancer Center, Charité, Berlin, Germany
| | | | - Ricard Mesia
- Department of Medical Oncology, Institut Català de Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
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Ladoire S, Goussot V, Redersdorff E, Cueff A, Ballot E, Truntzer C, Ayati S, Bengrine-Lefevre L, Bremaud N, Coudert B, Desmoulins I, Favier L, Fraisse C, Fumet JD, Hanu R, Hennequin A, Hervieu A, Ilie S, Kaderbhai C, Lagrange A, Martin N, Mazilu I, Mayeur D, Palmier R, Simonet-Lamm AL, Vincent J, Zanetta S, Arnould L, Coutant C, Bertaut A, Ghiringhelli F. Seroprevalence of SARS-CoV-2 among the staff and patients of a French cancer centre after first lockdown: The canSEROcov study. Eur J Cancer 2021; 148:359-370. [PMID: 33780664 PMCID: PMC7914029 DOI: 10.1016/j.ejca.2021.02.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/12/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023]
Abstract
Background In view of the potential gravity of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection for patients with cancer, epidemiological data are vital to assess virus circulation among patients and staff of cancer centres. We performed a prospective study to investigate seroprevalence of SARS-CoV-2 antibodies among staff and patients with cancer at a large cancer centre, at the end of the period of first national lockdown in France and to determine factors associated with the risk of SARS-CoV-2 infection. Methods After the first lockdown, all medical and non-medical staff, as well as all patients attending the medical oncology department were invited to undergo serological testing for SARS-CoV-2 between 11 May and 30 June 2020. All participants were also invited to complete a questionnaire collecting data about their living and working conditions, and for patients, medical management during lockdown. Findings A total of 1,674 subjects (663 staff members, 1011 patients) were included. Seroprevalence was low in both staff (1.8%) and patients (1.7%), despite more features of high risk for severe forms among patients. None of the risk factors tested in our analysis (working or living conditions, comorbidities, management characteristics during lockdown) was found to be statistically associated with seroprevalence in either staff or patients. There was no significant difference in the proportion of symptomatic and asymptomatic subjects between staff and patients. Only fever, loss of smell, and loss of taste were significantly more frequent among seropositive patients, in both staff and patients. Interpretation We report very low seroprevalence of antibodies against SARS-CoV-2 in the staff (caregiving and non-caregiving) and patients of a large cancer care centre in which strict hygiene, personal protection, and social distancing measures were implemented.
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Affiliation(s)
- Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France; Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; University of Burgundy-Franche Comté, France.
| | - Vincent Goussot
- Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
| | - Emilie Redersdorff
- Clinical Research Center (CRC), Centre Georges François Leclerc, Dijon, France
| | - Adele Cueff
- Methodology and Biostatistics Unit, Centre Georges François Leclerc, Dijon, France
| | - Elise Ballot
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; Bioinformatic Core Facility Georges, François Leclerc Cancer Center, Dijon, France
| | - Caroline Truntzer
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; Bioinformatic Core Facility Georges, François Leclerc Cancer Center, Dijon, France
| | - Siavoshe Ayati
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | - Nathalie Bremaud
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Bruno Coudert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Isabelle Desmoulins
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Laure Favier
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Cléa Fraisse
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Jean-David Fumet
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Roxana Hanu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Audrey Hennequin
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Alice Hervieu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Silvia Ilie
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Courèche Kaderbhai
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Aurélie Lagrange
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Nils Martin
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Irina Mazilu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Didier Mayeur
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Rémi Palmier
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | - Julie Vincent
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Laurent Arnould
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
| | - Charles Coutant
- University of Burgundy-Franche Comté, France; Department of Oncologic Surgery, Centre Georges François Leclerc, Dijon, France
| | - Aurélie Bertaut
- Methodology and Biostatistics Unit, Centre Georges François Leclerc, Dijon, France
| | - François Ghiringhelli
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France; Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; University of Burgundy-Franche Comté, France
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Zanetta S, Germino C, Rodrigues I, Waragaia A. Urbanization and increased cases of scorpionism in Brazilian cities. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.163] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Scorpionism is a growing problem in Brazil; the hot climate in most of the country makes it suitable for the proliferation in urban and domestic regions alike. The temperatures, low levels of basic sanitation and disorganized urbanization result in an perfect environment for scorpionic accidents.
Objectives
Analyze the urbanization of scorpion accidents in the State of São Paulo - SSP as a public health problem.
Methods
Observational and descriptive study with data from the National System of Notifiable Diseases - SINAN of the Department of Health of Brazil, with direct risk calculation, from the analysis of the incidence of accidents with scorpions in urban areas of SSP, in the period from 1975 to 2019.
Results
In SSP, accidents with scorpions increased 642% between the years 1975 and 2019 in the most densely urbanized nuclei: the cities of São Paulo, Guarulhos, Campinas, São Bernardo do Campo and Santo André. These cases are associated with increased mortality in children and the elderly and corresponded to 56.63% of the total accidents with venomous animals in the SSP. This increase in the occurrence of scorpionic accidents is associated with the behavior of the animal, which finds conditions for its proliferation in the urban environment facilitated by the absence of predators and becomes a relevant public health problem.
Conclusions
Urban areas have become a propitious environment to scorpions' proliferation. Urban dynamics, garbage and other urban waste displacement, human habitation, combined with deficiencies in infrastructure and basic sanitation, created the conditions for the emergence of accidents with scorpions in urban areas as a relevant public health problem with significant mortality numbers, especially vulnerable groups of elderly people and children, in the large urban centers of SSP, Brazil.
Key messages
Discuss the synanthropy and proliferation of venomous animals in urban centers. New public health challenges with the change of accidents with venomous animals from rural to urban areas.
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Affiliation(s)
- S Zanetta
- Saude Publica, Centro Universitário Sao Camilo, Sao Paulo, Brazil
| | - C Germino
- Discentes, Centro Universitario Sao Camilo, Sao Paulo, Brazil
| | - I Rodrigues
- Discentes, Centro Universitario Sao Camilo, Sao Paulo, Brazil
| | - A Waragaia
- Discentes, Centro Universitario Sao Camilo, Sao Paulo, Brazil
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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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18
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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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Chanteloup G, Cordonnier M, Isambert N, Bertaut A, Hervieu A, Hennequin A, Luu M, Zanetta S, Coudert B, Bengrine L, Desmoulins I, Favier L, Lagrange A, Pages PB, Gutierrez I, Lherminier J, Avoscan L, Jankowski C, Rébé C, Chevriaux A, Padeano MM, Coutant C, Ladoire S, Causeret S, Arnould L, Charon-Barra C, Cottet V, Blanc J, Binquet C, Bardou M, Garrido C, Gobbo J. Monitoring HSP70 exosomes in cancer patients' follow up: a clinical prospective pilot study. J Extracell Vesicles 2020; 9:1766192. [PMID: 32595915 PMCID: PMC7301715 DOI: 10.1080/20013078.2020.1766192] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/26/2020] [Accepted: 04/21/2020] [Indexed: 12/19/2022] Open
Abstract
Exosomes are nanovesicles released by all cells that can be found in the blood. A key point for their use as potential biomarkers in cancer is to differentiate tumour-derived exosomes from other circulating nanovesicles. Heat shock protein-70 (HSP70) has been shown to be abundantly expressed by cancer cells and to be associated with bad prognosis. We previously showed that exosomes derived from cancer cells carried HSP70 in the membrane while those from non-cancerous cells did not. In this work, we opened a prospective clinical pilot study including breast and lung cancer patients to determine whether it was possible to detect and quantify HSP70 exosomes in the blood of patients with solid cancers. We found that circulating exosomal HSP70 levels, but not soluble HSP70, reflected HSP70 content within the tumour biopsies. Circulating HSP70 exosomes increased in metastatic patients compared to non-metastatic patients or healthy volunteers. Further, we demonstrated that HSP70-exosome levels correlated with the disease status and, when compared with circulating tumour cells, were more sensitive tumour dissemination predictors. Finally, our case studies indicated that HSP70-exosome levels inversely correlated with response to the therapy and that, therefore, monitoring changes in circulating exosomal HSP70 might be useful to predict tumour response and clinical outcome.
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Affiliation(s)
- Gaëtan Chanteloup
- Inserm, UMR 1231, label d’Excellence Ligue National contre le Cancer and Laboratoire d’Excellence LipSTIC, Dijon, France
- Faculty of Medicine and Pharmacy, University of Burgundy, Dijon, France
| | - Marine Cordonnier
- Inserm, UMR 1231, label d’Excellence Ligue National contre le Cancer and Laboratoire d’Excellence LipSTIC, Dijon, France
- Faculty of Medicine and Pharmacy, University of Burgundy, Dijon, France
| | - Nicolas Isambert
- Inserm U-1084, Pôle Régional de Cancérologie, CHU de Poitiers Poitiers Cedex – France, Université de Poitiers, Poitiers, France
| | - Aurélie Bertaut
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Alice Hervieu
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Audrey Hennequin
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Maxime Luu
- Centre d’investigation Clinique INSERM 1432, CHU Dijon-Bourgogne, Dijon, France
| | - Sylvie Zanetta
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Bruno Coudert
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Leila Bengrine
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | | | - Laure Favier
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Aurélie Lagrange
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | | | - Ivan Gutierrez
- Department of Thoracic Surgery, Dijon University Hospital, Dijon, France
| | - Jeanine Lherminier
- INRA, UMR1347 Agroécologie, ERL CNRS 6300, Plateforme DImaCell, Centre de Microscopie INRA/Université de Bourgogne, Dijon, France
| | - Laure Avoscan
- INRA, UMR1347 Agroécologie, ERL CNRS 6300, Plateforme DImaCell, Centre de Microscopie INRA/Université de Bourgogne, Dijon, France
| | | | - Cédric Rébé
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | | | | | - Charles Coutant
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Sylvain Ladoire
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Sylvain Causeret
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Laurent Arnould
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | | | - Vanessa Cottet
- Centre d’investigation Clinique INSERM 1432, CHU Dijon-Bourgogne, Dijon, France
| | - Julie Blanc
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Christine Binquet
- Centre d’investigation Clinique INSERM 1432, CHU Dijon-Bourgogne, Dijon, France
| | - Marc Bardou
- Centre d’investigation Clinique INSERM 1432, CHU Dijon-Bourgogne, Dijon, France
| | - Carmen Garrido
- Inserm, UMR 1231, label d’Excellence Ligue National contre le Cancer and Laboratoire d’Excellence LipSTIC, Dijon, France
- Faculty of Medicine and Pharmacy, University of Burgundy, Dijon, France
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
| | - Jessica Gobbo
- Inserm, UMR 1231, label d’Excellence Ligue National contre le Cancer and Laboratoire d’Excellence LipSTIC, Dijon, France
- Faculty of Medicine and Pharmacy, University of Burgundy, Dijon, France
- CHU Dijon-Bourgogne, Georges-François Leclerc Centre, CGFL, Dijon, France
- Centre d’investigation Clinique INSERM 1432, CHU Dijon-Bourgogne, Dijon, France
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20
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Galot R, Le Tourneau C, Saada-Bouzid E, Daste A, Even C, Debruyne P, Henry S, Zanetta S, Rutten A, Licitra L, Canon JL, Kaminsky-Forrett MC, Specenier P, Rottey S, Dirix L, Raveloarivahy T, Fortpied Lefevre C, Vanlancker M, Govaerts AS, Machiels JP. A phase II study of monalizumab in patients with recurrent/metastatic (RM) squamous cell carcinoma of the head and neck (SCCHN): Results of the I1 cohort of the EORTC-HNCG-1559 trial (UPSTREAM). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Fayette J, Even C, Digue L, Geoffrois L, Rolland F, Cupissol D, Guigay J, Le Tourneau C, Dillies AF, Zanetta S, Bozec Lemoal L, Borel C, Guyennon A, Couchon-Thaunat S, Costes V, Jallut I, Delaye J, Lardy-Cleaud A, Chabaud S. NISCAHN: A phase II, multicenter nonrandomized trial aiming at evaluating nivolumab (N) in two cohorts of patients (pts) with recurrent/metastatic (R/M) salivary gland carcinoma of the head and neck (SGCHN), on behalf of the Unicancer Head & Neck Group. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.6083] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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
6083 Background: SGCHN are rare tumors including adenoid cystic carcinoma (ACC) and non-ACC, with no standard systemic treatment for R/M pts. We evaluated N monotherapy in R/M SGCHN pts. Methods: R/M SGCHN pts (ACC or non-ACC) not eligible to local treatment and with centrally confirmed RECIST 1.1 disease progression over the last 6 months were enrolled and received N 3 mg/kg IV, every 2 weeks for a maximum of 12 months (mo). Possibility was given to re-start N in case of progression during the 2-year follow-up phase. Primary endpoint was 6-mo non-progression Rate (NPR6m) as per RECIST 1.1. Secondary endpoints included ORR, PFS, OS, and safety. Considering that N would be uninteresting if NPR6m ≤ 20% and promising if ≥ 40% and using a Fleming’s single-stage design (α: 5% unilateral, power: 90%), at least 14 successes/42 evaluable pts were required for each cohort to be positive. Results: 46 ACC and 52 Non-ACC pts (median age 61 yrs (range 29-81), 43.9% female, 55.1% PS1 and 2.0% PS2) were enrolled and received at least one dose of N. Median treatment duration was 5.5 mo (ACC) and 3.3 (Non-ACC). Median FU was 10.8 mo (ACC) and 8.3 mo (Non-ACC). 95 patients were evaluable for the primary endpoint. NPR6m was 15/45 pts (33.3%, 90%CI :21.8;46.6) and 7/50 pts (14.0%, 90%CI:6.8;24.7) for ACC and non-ACC pts respectively. 4 (8.7%) partial responses (PR) and 26 (56.5%) stable diseases (SD) were observed in ACC cohort while 2 (3.8%) PR and 22 (42.3%) SD were observed in non-ACC. Median PFS was 4.9 mo (95%CI = 3.4;5.6) in ACC pts and 1.8 mo (95%CI = 1.7;3.5) in non-ACC pts. The most common related adverse events (AE) ( > 10% by cohort) were asthenia, hyperthyroidism, diarrhea, rash, pruritus and hypothyroidism. 7/98 pts (7.1%) presented at least one related AE Grade 3-4 (mainly hepatic) and 9 pts (9.2%) prematurely discontinued Nivolumab due to toxicity. Conclusions: Limited efficacy was observed with N in R/M SGCHN pts. N in combination might be of interest and deserves exploration in ACC pts. Clinical trial information: NCT03132038.
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Affiliation(s)
| | | | | | | | - Frederic Rolland
- Institut de Cancérologie de l'Ouest, Department of Medical Oncology, St Herblain, France
| | | | - Joel Guigay
- Department of Medical Oncology, Antoine Lacassagne Comprehensive Cancer Centre, FHU OncoAge, Université Côte d'Azur, Nice, France
| | | | | | | | | | | | | | | | - Valerie Costes
- CHU Hôpital Gui de Chauliac, Montpellier, REFCOR, Paris, France
| | | | | | | | - Sylvie Chabaud
- Statistician - GINECO - Centre Léon-Bérard, Lyon, France
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22
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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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23
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Fumet JD, Isambert N, Hervieu A, Zanetta S, Guion JF, Hennequin A, Rederstorff E, Bertaut A, Ghiringhelli F. Evaluation of the safety and the tolerability of durvalumab plus tremelimumab combined with FOLFOX in metastatic colorectal cancer (MEDITREME). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy487.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Even C, Daste A, Saada-Bouzid E, Fayette J, Kaminsky-Forrett MC, Zanetta S, Prevost A, Lefebvre G, Borel C, Cupissol D, Huguet F, Delord JP, Baste Rotllan N, Delaye J, Jallut I, Vintonenko N, Bourhis J, Guigay J, Texier M, Auperin A. TOPNIVO: 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): First results on behalf of the UNICANCER Head&Neck Group and the GORTEC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.021] [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: 11/12/2022] Open
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25
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Castagno M, Monzani A, Zanetta S, Genoni G, Giglione E, Ricotti R, Bona G, Prodam F, Bellone S. Evaluation of growth hormone response to GHRH plus arginine test in children with idiopathic short stature: role of peak time. J Endocrinol Invest 2018; 41:977-983. [PMID: 29423542 DOI: 10.1007/s40618-017-0824-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/28/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To describe the course of growth hormone response to growth hormone releasing hormone (GHRH) plus arginine provocative test in children with idiopathic short stature (ISS) and to evaluate the role of peak time. METHODS A retrospective study was performed analyzing 344 GHRH plus arginine provocative tests performed in children and adolescents with short stature. Serum GH levels were measured at four-time points (T0', T30', T45' and T60') and GH peak was defined as the maximum value at any time point. Mean (T30'-T60') GH value and area under the curve (AUC) were calculated. RESULTS When analyzing the time of peak at the provocative test, the most frequent peak time was T45' (53.8%) in the ISS group, with no differences in gender, age, and pubertal stage. Analyzing GHD subjects, the most frequent time of peak was T30 (50%). Analyzing the whole population, the GH T0' levels were significantly lower in subjects with the GH peak at T45' than those with the GH peak at T30' (1.7 ± 2.0 vs. 3.2 ± 4.0, p < 0.001). In subjects with GH peak at T45', the value of GH peak, AUC and mean GH were significantly higher than in those with GH peak at T30' and T60'. A direct correlation was found between the value of GH peak and growth velocity SDS (r = 0.127, p = 0.04) and a negative one between GH peak and GH level at T0' (r = - 0.111, p = 0.04), even when adjusted for gender, age, pubertal stage and BMI Z score. CONCLUSIONS The time peak at 45 min seems to be associated with a better response to the test considering GH peak, mean and AUC. Patients with a GH peak at 30 min more probably could have a derangement in GH secretion showing worst growth pattern and/or a GH deficiency and should be carefully observed.
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Affiliation(s)
- M Castagno
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - A Monzani
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - S Zanetta
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - G Genoni
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - E Giglione
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - R Ricotti
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - G Bona
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - F Prodam
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Università del Piemonte Orientale, Novara, Italy.
| | - S Bellone
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Università del Piemonte Orientale, Novara, Italy
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26
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Isambert N, Hervieu A, Rébé C, Hennequin A, Borg C, Zanetta S, Chevriaux A, Richard C, Derangère V, Limagne E, Blanc J, Bertaut A, Ghiringhelli F. Fluorouracil and bevacizumab plus anakinra for patients with metastatic colorectal cancer refractory to standard therapies (IRAFU): a single-arm phase 2 study. Oncoimmunology 2018; 7:e1474319. [PMID: 30228942 PMCID: PMC6140586 DOI: 10.1080/2162402x.2018.1474319] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 04/27/2018] [Accepted: 04/30/2018] [Indexed: 11/02/2022] Open
Abstract
In preclinical models, IL-1β inhibition could enhance the efficacy of fluorouracil (5-FU). In this phase 2 study, we assessed the activity and safety of 5-FU plus bevacizumab and anakinra (an IL-1β and α inhibitor) in patients with metastatic colorectal (mCRC) refractory to chemotherapy and anti-angiogenic therapy. Eligible patients had unresectable mCRC; were refractory or intolerant to fluoropyrimidine, irinotecan, oxaliplatin, anti-VEGF therapy, and anti-EGFR therapy (for tumors with wild-type KRAS). Patients were treated with a simplified acid folinic plus 5-FU regimen and bevacizumab (5 mg/kg) both administered by intravenous infusion for 30 min every 2 weeks. Anakinra (100 mg) was injected subcutaneously once daily. The primary endpoint was the 2-month response rate determined upon CHOI criteria. Thirty two patients with metastatic colorectal cancer were enrolled. Five patients demonstrated response (Choi criteria) and 22 patients had stable disease as the best 2-month overall response. Median progression-free and overall survival were 5.4 (95% CI, 3.6-6.6) and 14.5 months (95% CI, 9-20.6) respectively. Twenty patients experienced grade 3 toxicity. No grade 4 or 5 toxicity related to therapy occurred. The most common grade 3 adverse events were neutropenia in 8 (25%) patients, digestive side effects in 7 (21.9%) patients and hypertension in 6 (18.75%) patients. No treatment-related deaths or serious adverse events were reported.5-FU plus bevacizumab and anakinra has promising activity and a manageable safety profile, suggesting that this combination might become a potential treatment option for patients with refractory mCRC.
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Affiliation(s)
- Nicolas Isambert
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Alice Hervieu
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Cedric Rébé
- Platform of Transfer in Biological Oncology, Dijon, France
| | - Audrey Hennequin
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Christophe Borg
- University Hospital of Besançon and CIC-BT506, Besancon, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | | | | | | | - Emeric Limagne
- Platform of Transfer in Biological Oncology, Dijon, France
| | - Julie Blanc
- Unit of Methodology and Biostatistics, Centre Georges-François Leclerc, Dijon, France
| | - Aurélie Bertaut
- Unit of Methodology and Biostatistics, Centre Georges-François Leclerc, Dijon, France
| | - François Ghiringhelli
- Platform of Transfer in Biological Oncology, Dijon, France.,Institut National de la Santé et de la Recherche Médicale, CADIR Team INSERM. CRI-1231, Dijon, France.,University of Burgundy and Franche Comté, Dijon, France
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27
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Fumet JD, Isambert N, Hervieu A, Zanetta S, Guion JF, Hennequin A, Rederstorff E, Bertaut A, Ghiringhelli F. Phase Ib/II trial evaluating the safety, tolerability and immunological activity of durvalumab (MEDI4736) (anti-PD-L1) plus tremelimumab (anti-CTLA-4) combined with FOLFOX in patients with metastatic colorectal cancer. ESMO Open 2018; 3:e000375. [PMID: 29942666 PMCID: PMC6012564 DOI: 10.1136/esmoopen-2018-000375] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND 5-Fluorouracil plus irinotecan or oxaliplatin alone or in association with target therapy are standard first-line therapy for metastatic colorectal cancer (mCRC). Checkpoint inhibitors targeting PD-1/PD-L1 demonstrated efficacy on mCRC with microsatellite instability but remain ineffective alone in microsatellite stable tumour. 5-Fluorouracil and oxaliplatin were known to present immunogenic properties. Durvalumab (D) is a human monoclonal antibody (mAb) that inhibits binding of programmed cell death ligand 1 (PD-L1) to its receptor. Tremelimumab (T) is a mAb directed against the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). This study is designed to evaluate whether the addition of PD-L1 and CTLA-4 inhibition to oxaliplatin, fluorouracil and leucovorin (FOLFOX) increases treatment efficacy. METHODS This phase II study (ClinicalTrials.gov NCT03202758) will assess the efficacy and safety of FOLFOX/D/T association in patients with mCRC (n=48). Good performance status patients (Eastern Cooperative Oncology Group <2) with untreated, RAS mutational status mCRC will be eligible. Prior adjuvant therapy is allowed provided recurrence is >6 months postcompletion. There is a safety lead in nine patients receiving FOLFOX/D/T. Assuming no safety concerns the study will go on to include 39 additional patients. Patients will receive folinic acid (400 mg/m²)/5-fluorouracil (400 mg/m² as bolus followed by 2400 mg/m2 as a 46-hour infusion)/oxaliplatin (85 mg/m2) every 14 days with D (750 mg) D1 every 14 days and T (75 mg) D1 every 28 days. After six cycles of FOLFOX only D/T will continue until disease progression, death, intolerable toxicity, or patient/investigator decision to stop. Primary endpoint is safety and efficacy according to progression-free survival (PFS); secondary endpoints include overall response rate and quality of life. Hypothesis is that a PFS of 50% at 6 months is insufficient and a PFS of 70.7% is expected (with α=10%, β=10%). Blood, plasma and tumour tissue will be collected and assessed for potential prognostic and predictive biomarkers.
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Affiliation(s)
- Jean-David Fumet
- Department of Medical Oncology, Center Georges Francois Leclerc, Dijon, France
- Research Platform in Biological Oncology, Georges Francois Leclerc Center, Dijon, France
- University of Burgundy-Franche Comté, Dijon, France
| | - Nicolas Isambert
- Department of Medical Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Alice Hervieu
- Department of Medical Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Jean-Florian Guion
- Department of Medical Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Audrey Hennequin
- Department of Medical Oncology, Center Georges Francois Leclerc, Dijon, France
| | - Emilie Rederstorff
- Department of Epidemiology and Biostatistics, Georges François Leclerc Center, Dijon, France
| | - Aurélie Bertaut
- Department of Epidemiology and Biostatistics, Georges François Leclerc Center, Dijon, France
| | - Francois Ghiringhelli
- Department of Medical Oncology, Center Georges Francois Leclerc, Dijon, France
- Research Platform in Biological Oncology, Georges Francois Leclerc Center, Dijon, France
- University of Burgundy-Franche Comté, Dijon, France
- INSERM UMR1231, Dijon, France
- GIMI Genetic and Immunology Medical Institute, Dijon, France
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28
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Isambert N, Elez E, Zanetta S, Matos I, Nazabadioko S, Xue W, Carrière P, Tabernero J. A phase I, open-label dose-escalation trial of weekly (qw) BI 836880, a vascular endothelial growth factor (VEGF)/angiopoietin-2 (Ang-2)-blocking Nanobody, in patients (pts) with advanced/metastatic solid tumors. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e24013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Elena Elez
- Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | | | - Wenqiong Xue
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT
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29
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Schlumberger M, Newbold K, Hasan B, Marreaud S, Assele S, Licitra LF, Schoffski P, Leboulleux S, Locati L, Godbert Y, Rohmer V, Jarzab B, Domenico S, Bechter OE, Zanetta S, Capdevila J, Kapiteijn E, Bastholt L. A randomized doubled blind phase II study exploring the safety and efficacy of nintedanib (BIBF1120) as second line therapy for patients (pts) with differentiated thyroid carcinoma (DTC) progressing after first line therapy: EORTC 1209. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.6021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Martin Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and University Paris-Sud, Villejuif, France
| | | | - Baktiar Hasan
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Sandrine Marreaud
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | - Lisa F. Licitra
- Head and Neck Cancer Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori - University of Milan, Milan, Italy
| | - Patrick Schoffski
- Department of General Medical Oncology Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Laura Locati
- Head and Neck Cancer Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Yann Godbert
- TUTHYREF Network, Institut Bergonié, Bordeaux, France
| | | | - Barbara Jarzab
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | | | - Oliver Edgar Bechter
- Department of General Medical Oncology Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Jaume Capdevila
- Medical Oncology Department, Vall d’Hebron University Hospital; Vall d’Hebron Institute of Oncology (VHIO)., Barcelona, Spain
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Lavaud P, Gravis G, Foulon S, Joly F, Oudard S, Priou F, Latorzeff I, Mourey L, Soulié M, Delva R, Krakowski I, Laguerre B, Théodore C, Ferrero JM, Beuzeboc P, Habibian M, Rolland F, Deplanque G, Pouessel D, Zanetta S, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Tubiana-Mathieu N, Machiels JP, Kouri CE, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Culine S, Boher JM, Tergemina-Clain G, Legoupil C, Fizazi K. Anticancer Activity and Tolerance of Treatments Received Beyond Progression in Men Treated Upfront with Androgen Deprivation Therapy With or Without Docetaxel for Metastatic Castration-naïve Prostate Cancer in the GETUG-AFU 15 Phase 3 Trial. Eur Urol 2018; 73:696-703. [DOI: 10.1016/j.eururo.2017.09.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/19/2017] [Indexed: 12/19/2022]
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Borchiellini D, Mahammedi H, Viotti J, Gravis G, Roubaud G, Beuzeboc P, Largillier R, Linassier C, Khalil A, Kaphan R, Joly F, Eymard JC, Falkowski S, Bompas E, Zanetta S, Schiappa R, Maurin M, Etienne-Grimaldi MC, Milano GA, Ferrero JM. Association of single nucleotide polymorphisms (SNPs) in CYP17A1 and SLCO2B1 genes and clinical outcome in metastatic castration-resistant prostate cancer patients treated with abiraterone acetate: results of the ABIGENE prospective study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.358] [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
358 Background: Abiraterone acetate (AA), a CYP17A1 inhibitor, has been approved in the treatment of metastatic castration-resistant prostate cancer (mCRPC). Germline polymorphisms in genes involved in androgen biosynthesis or transport may influence response and survival in this setting. Methods: ABIGENE is a multicentric prospective non-randomized pharmacogenetic study (NCT01858441). The primary objective was to investigate the association between 13 SNPs in genes related to AA pharmacology (CYP17A1, SLCO2B1 and SLCO2B3) and radiographic progression-free survival (rPFS), according to PCWG2 criteria, in pts with mCRPC treated with first-line AA + prednisone. The main secondary objectives were to evaluate the impact of these SNPs on radiographic and PSA response, overall survival (OS) and toxicity. SNPs were detected in blood samples before starting AA and analyzed by pyrosequencing or PCR-RFLP methods. Kaplan-Meyer’s curves with log-rank tests and cox regression models were used to identify relationships between SNPs and survival. Chi2 tests and student t-tests were used to identify association with response rate and toxicity. Results: 147 pts in 17 french centers were included between 2013 and 2017. Here are presented the results for the first 109 pts. The median follow-up was 28.7 months. Overall response rate (ORR) was 17%, and 74% pts had stable disease as the best response. Median rPFS was 10.9 months (95% CI 9.2-15.3). One SNP (rs10883782) in CYP17A1 was associated with rPFS on AA therapy (Table). Two other SNPs in CYP17A1 (rs4919683) and SLCO2B1 (rs1077858) were significantly associated with radiographic response. Data on PSA response, OS and toxicity will be presented at the meeting. Conclusions: This is the first prospective dedicated study to show an association between SNPs related to androgen metabolism and clinical outcome in mCRPC treated with AA. Clinical trial information: NCT01858441. [Table: see text]
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Dupont B, Mariotte D, Dugué AE, Clarisse B, Grellard JM, Babin E, Chauffert B, Dakpé S, Moldovan C, Bouhier-Leporrier K, Reimund JM, Di Fiore F, Zanetta S, Mailliez A, Do P, Peytier A, Galais MP, Florescu C, Schott R, Le Mauff B, Gervais R. Utility of serum anti-cetuximab immunoglobulin E levels to identify patients at a high risk of severe hypersensitivity reaction to cetuximab. Br J Clin Pharmacol 2016; 83:623-631. [PMID: 27662818 DOI: 10.1111/bcp.13140] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 08/28/2016] [Accepted: 09/18/2016] [Indexed: 12/14/2022] Open
Abstract
AIM Cetuximab is an anti-epidermal growth factor receptor antibody used for the treatment of metastatic colorectal cancer and head and neck cancer. Hypersensitivity reactions (HSRs) are associated with cetuximab use. The aim of the study was to evaluate the utility of anti-cetuximab immunoglobulin E (IgE) detection in order to identify patients at risk of HSR to cetuximab. METHODS We included patients ready to receive a first cetuximab infusion in a prospective cohort carried out at nine French centres. Pretreatment anti-cetuximab IgE levels were measured. We compared the proportion of severe HSRs in the low anti-cetuximab IgE levels (≤29 IgE arbitrary units) subgroup with that in a historical cohort of 213 patients extracted from a previous study. RESULTS Of the 301 assessable patients (mean age: 60.9 ± 9.3 years, head-and-neck cancer: 77%), 66 patients (22%) had high anti-cetuximab IgE levels, and 247 patients received cetuximab (including 38 with high anti-cetuximab levels). Severe HSRs occurred in eight patients (five grade 3 and three grade 4). The proportion of severe HSRs was lower in the low anti-cetuximab IgE levels subgroup vs. the historical cohort (3/209 [1.4%] vs. 11/213 [5.2%], odds ratio, 0.27, 95% confidence interval, 0.07-0.97), and higher in high vs. low anti-cetuximab IgE levels subgroup (5/38 [13.2%] vs. 3/209 [1.4%]; odds ratio, 10.4, 95% confidence interval, 2.4-45.6). Patients with severe HSRs had higher anti-cetuximab IgE levels than patients without reaction (median, 45 vs. 2 IgE arbitrary units, P = 0.006). CONCLUSIONS Detection of pretreatment anti-cetuximab IgE is feasible and helpful to identify patients at risk of severe cetuximab-induced HSRs.
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Affiliation(s)
- Benoît Dupont
- Department of Hepato-Gastroenterology and Nutrition, CHU de Caen, Caen, France
| | - Delphine Mariotte
- Laboratory of Immunology and Immunopathology, CHU de Caen, Caen, France
| | - Audrey E Dugué
- Clinical Research Department, Centre François Baclesse, Caen, France
| | | | | | - Emmanuel Babin
- Department of Otolaryngology-Head and Neck Surgery, CHU de Caen, Caen, France
| | | | - Stéphanie Dakpé
- Department of Maxillofacial Surgery and Stomatology, CHU d'Amiens, Amiens, France
| | | | | | - Jean-Marie Reimund
- Department of Hepato-Gastroenterology and Nutrition, CHU de Caen, Caen, France.,Department of Hepato-Gastroenterology and Nutritional Support, CHU de Strasbourg, Strasbourg, France
| | - Frederic Di Fiore
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France.,Digestive Oncology Unit, Gastroenterology Department, CHU de Rouen, Rouen, France
| | - Sylvie Zanetta
- Medical Oncology Department, Centre Georges-François Leclerc, Dijon, France
| | - Audrey Mailliez
- Head and Neck Department, Centre Oscar Lambret, Lille, France
| | - Pascal Do
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - Annie Peytier
- Gastroenterology Department, Centre Hospitalier de Bayeux, Bayeux, France
| | | | - Carmen Florescu
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - Roland Schott
- Medical Oncology Department, Centre Paul Strauss, Strasbourg, France
| | - Brigitte Le Mauff
- Laboratory of Immunology and Immunopathology, CHU de Caen, Caen, France
| | - Radj Gervais
- Medical Oncology Department, Centre François Baclesse, Caen, France
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Guigay J, Bidault F, Fayette J, Even C, Cupissol D, Rolland F, Peyrade F, Laguerre B, Le Tourneau C, Zanetta S, Bozec Le Moal L, Borel C, Digue L, Delaye J, Diffetocq S, Costes V, Auperin A, Faivre L. Pazopanib in patients with progressive recurrent or metastatic (R/M) salivary gland carcinoma (SGC): Further evaluation of efficacy including tumor growth rates (GR) analysis. H&N Unicancer Group PACSA trial with the REFCOR. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guigay J, Fayette J, Even C, Cupissol D, Rolland F, Peyrade F, Laguerre B, Le Tourneau C, Zanetta S, Bozec Le Moal L, Borel C, Do P, Digue L, Delaye J, Auperin A, Bidault F, Costes V, Faivre L. PACSA: Phase II study of pazopanib in patients with progressive recurrent or metastatic (R/M) salivary gland carcinoma (SGC). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.6086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Didier Cupissol
- Institut Régional du Cancer Montpellier, Montpellier, France
| | | | | | | | | | | | | | | | - Pascal Do
- Centre Francois Baclesse, Caen, France
| | | | | | | | | | - Valerie Costes
- CHU Hôpital Gui de Chauliac, Montpellier; REFCOR, Paris, France
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Linassier C, Albiges L, Chevreau C, Laguerre B, Oudard S, Gross-Goupil M, Gravis G, Goldwasser F, Rolland F, Delva R, Moise L, Tourani JM, Vassal C, Zanetta S, Penel N, Flechon A, Theodore C, Barthelemy P, Saldana C, Escudier B. Everolimus and sunitinib as first- and second-line treatments of patients with metastatic papillary renal cell carcinoma (pRCC): A retrospective study of the GETUG (Groupe Français d’Etude des Tumeurs Uro-Génitales). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.2_suppl.505] [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
505 Background: pRCC accounts for 15% of all renal cancers. Two French prospective phase II trials demonstrated efficacy of both Sun and Eve in first-line treatment of metastatic disease (RAPTOR (NCT00688753) and SUPAP (NCT00541008)). Most patients (pts) usually receive the alternate drug at progression. We report the first series of drug sequencing in pRCCs. Methods: We updated clinical data of metastatic pts with pathologically documented pRCC, who were treated in firs line or more with Sun or Eve, from 2/06 to 6/15, in 24 GETUG centers. Results: 196 pts (166 men, 30 women), median aged of 61 years, with histological subtypes (HST) I (28 pts), II (122 pts) or unclassified (46 pts), were treated for metastatic pRCC in 1st-line: group 1 Su 50 mg daily 4/6 weeks (n=158 pts) ; group 2 Eve 10 mg daily (n=38 pts). 76 pts were included in the RAPTOR or SUPAP studies. The median follow-up was 59.5 months. We found no difference between the 2 groups in terms of patients’ characteristics, clinical benefit in first-line (CR+PR+SD) (71% vs 72%; p=0.95) or progression-free survival (PFS) (PFS-1: 5.7 vs 4.6 months; p=0.152). Reasons for treatment discontinuation were tumor progression (74% vs 70%) or toxicity (26 vs 30%) (p=0.58). 134 pts received the alternative drug in second-line (group 1: Eve; group 2: Sun) with similar clinical benefit (64% vs 58%; p=0.69) and median PFS (PFS-2: 3.5 vs 3.0 months p=0.98). Overall survival (OS) did not differ between the two groups (16.4 vs 17.6 months; p=0.58). Age, Karnofsky performance status < 80 (KPS-80), HST, platelet (Plts) and absolute neutrophil counts (ANC), hemoglobin and calcium levels, time from diagnosis to metastases (TTM) were studied as prognostic variables. In multivariable analysis, only Plts and KPS-80 had prognostic impact on EFS-1, whereas ANC, KPS-80 and TTM were prognostic for OS. We found a trend in favor of HST I vs non I, with no statistical difference in terms of PFS or OS. Conclusions: In this large retrospective series of metastatic pRCC pts, Sun and Eve had good compliance and similar efficacy in terms of first-, second-line PFS and overall survival.
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Affiliation(s)
| | | | | | | | | | | | - Gwenaelle Gravis
- Medical Oncology, Institut Paoli Calmette, Hôpital de Jour, Marseille, France
| | - Francois Goldwasser
- Medical Oncology, Paris Descartes University, Cochin - Port Royal Hospital, AP-HP, Paris, France
| | | | - Remy Delva
- Institut de Cancérologie de l'Ouest, Angers, France
| | | | | | - Cecile Vassal
- Institut de cancérologie Lucien Neuwirth, Saint Priez en Jarez, France
| | | | - Nicolas Penel
- Centre Oscar Lambret – General Oncology Department, Lille, France
| | | | | | | | - Carolina Saldana
- Oncology Department, Hôpital Henri Mondor, APHP, Créteil, France
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Guigay J, Fayette J, Dillies A, Sire C, Kerger J, Tennevet I, Machiels J, Zanetta S, Pointreau Y, Bozec Le Moal L, Henry S, Schilf A, Bourhis J. Cetuximab, docetaxel, and cisplatin as first-line treatment in patients with recurrent or metastatic head and neck squamous cell carcinoma: a multicenter, phase II GORTEC study. Ann Oncol 2015; 26:1941-1947. [DOI: 10.1093/annonc/mdv268] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/02/2015] [Indexed: 02/06/2023] Open
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Ravaud A, Oudard S, De Fromont M, Chevreau C, Gravis G, Zanetta S, Theodore C, Jimenez M, Sevin E, Laguerre B, Rolland F, Ouali M, Culine S, Escudier B. First-line treatment with sunitinib for type 1 and type 2 locally advanced or metastatic papillary renal cell carcinoma: a phase II study (SUPAP) by the French Genitourinary Group (GETUG)†. Ann Oncol 2015; 26:1123-1128. [PMID: 25802238 DOI: 10.1093/annonc/mdv149] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [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: 12/09/2014] [Accepted: 03/12/2015] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Papillary renal cell carcinoma (PRCC), type 1 and type 2, represents 10%-15% of renal cell carcinomas (RCC). There is no standard first-line treatment of metastatic PRCC (mPRCC). Anti-angiogenics have shown activity in retrospective studies but no prospective studies in pure papillary histology have been reported, but one with foretinib. PATIENTS AND METHODS A prospective phase II study evaluated sunitinib in first-line treatment of mPRCC. The primary end point was overall response rate (ORR). Secondary end points were progression-free survival (PFS) and overall survival (OS). RESULTS Fifteen and 46 patients, respectively, with type 1 and type 2 mPRCC were enrolled. Using the MSKCC scoring system: 12 (20%), 33 (55%) and 9 (15%) patients were, respectively, in the favourable, intermediate or poor risk group and 7 undetermined. Median follow-up is 51.4 months. In type 1, 2 patients 13% [95% confidence interval (CI) 0.1-30.5] had a partial response (PR), 10 had stable disease (SD) with 5 (33%) ≥12 weeks. In type 2, 5 patients 11% (95% CI 1.9-20.3) had a PR, 25 had SD with 10(22%) ≥12 weeks. Median PFS was 6.6 months (95% CI 2.8-14.8) in type 1 and 5.5 months (95% CI 3.8-7.1) in type 2. Median OS was 17.8 (95% CI 5.7-26.1) and 12.4 (95% CI 8.2-14.3) months, respectively, in type 1 and 2. Safety was as expected with sunitinib for metastatic RCC. CONCLUSION Sunitinib showed activity in treatment of type 1 and 2 mPRCC but lower than in clear-cell mRCC. Both PFS and OS are longer in type I PRCC. Sunitinib represents an acceptable option in first-line treatment of mPRCC.
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Affiliation(s)
- A Ravaud
- Department of Medical Oncology, Bordeaux University Hospital, Bordeaux.
| | - S Oudard
- Department of Medical Oncology, Paris Rene Descartes University, Paris
| | | | - C Chevreau
- Department of Medical Oncology, Institut Claudius Régaud/Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse
| | - G Gravis
- Department of Medical Oncology, Institut Paoli Calmettes, Marseille
| | - S Zanetta
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon
| | - C Theodore
- Department of Medical Oncology, Hôpital Foch, Suresnes
| | - M Jimenez
- Research and Development Department, Unicancer, Paris
| | - E Sevin
- Department of Medical Oncology, Centre François Baclesse, Caen
| | - B Laguerre
- Department of Medical Oncology, Centre Eugène Marquis, Rennes
| | - F Rolland
- Department of Medical Oncology, Institut de Cancérologie de L'Ouest, Nantes
| | - M Ouali
- Department of Biostatistics, Institut Claudius Régaud/Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse
| | - S Culine
- Medical Oncology, Hôpital Saint-Louis, Paris
| | - B Escudier
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
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Chougnet CN, Borget I, Leboulleux S, de la Fouchardiere C, Bonichon F, Criniere L, Niccoli P, Bardet S, Schneegans O, Zanetta S, Schvartz C, Drui D, Chauffert B, Rohmer V, Schlumberger M. Vandetanib for the treatment of advanced medullary thyroid cancer outside a clinical trial: results from a French cohort. Thyroid 2015; 25:386-91. [PMID: 25627619 DOI: 10.1089/thy.2014.0361] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND A randomized phase III trial demonstrated that vandetanib treatment is effective in patients with metastatic medullary thyroid cancer (MTC), leading to regulatory approval, but its use may be associated with toxicities that require specific monitoring and management. The objective of the present study performed in France was to describe the toxicity profile and efficacy of vandetanib treatment when given outside any trial. METHODS Sixty-eight patients were treated with vandetanib in the frame of a temporary use authorization (ATU) in France from August 2010 to February 2012, when the drug was available on request for patients with locally advanced or metastatic MTC. Patients were registered by the French health authorities, and characteristics, treatment parameters, toxicity profile, and efficacy were retrospectively reviewed. Eight patients were excluded from the analysis because vandetanib treatment was not administered (n=3), had been given in a trial before ATU (n=3), or was given for a non-MTC cancer (n=2). RESULTS Data from the 60 MTC patients were analyzed. Mean age was 58 years (range 11-83 years), 39 patients were male, and six had hereditary MTC. Fifty-six (93%) had metastatic disease in the mediastinum (82%), bones (65%), liver (53%), or lung (53%), and four had only locally advanced disease. At the time of study evaluation, with a median follow-up of 20 months and a median duration of treatment of 9.7 months (range 0.3-36 months), 15 patients were continuing vandetanib treatment (range 18-36 months). Median progression-free survival was 16.1 months. Twenty-five patients discontinued treatment for disease progression (range 0.3-29 months). Best tumor response was a complete response in one patient, a partial response in 12 (20%), stable disease in 33 (55%), and progression in seven patients (12%). All patients had at least one adverse event (AE) during treatment. The main AEs were skin toxicity, diarrhea, and asthenia. Sixteen patients (27%) discontinued treatment for toxicity, and one patient died from vandetanib-induced cardiac toxicity. CONCLUSIONS Vandetanib is an effective option for patients with advanced MTC. AEs should be monitored carefully and should be minimized by educating both patients and care providers and by applying symptomatic treatment and dose reduction.
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Affiliation(s)
- Cecile N Chougnet
- 1 Department of Nuclear Medicine, Hôpital Saint Louis , Paris, France
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Campone M, Isambert N, Sabatier R, Castanie H, Zanetta S, Sudey I, Cantero F, Pauly J, Leroux E, Malasse S, Goncalves A. 586 Phase I study of pan-histone deacetylase inhibitor abexinostat in combination with cisplatin in patients with advanced solid tumors. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70712-9] [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: 11/27/2022]
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Gravis G, Boher JM, Fizazi K, Joly F, Priou F, Marino P, Latorzeff I, Delva R, Krakowski I, Laguerre B, Walz J, Rolland F, Théodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Habibian M, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Labourey JL, Machiels JP, El Kouri C, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Soulie M, Oudard S. Prognostic Factors for Survival in Noncastrate Metastatic Prostate Cancer: Validation of the Glass Model and Development of a Novel Simplified Prognostic Model. Eur Urol 2014; 68:196-204. [PMID: 25277272 DOI: 10.1016/j.eururo.2014.09.022] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 09/15/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Glass model developed in 2003 uses prognostic factors for noncastrate metastatic prostate cancer (NCMPC) to define subgroups with good, intermediate, and poor prognosis. OBJECTIVE To validate NCMPC risk groups in a more recently diagnosed population and to develop a more sensitive prognostic model. DESIGN, SETTING, AND PARTICIPANTS NCMPC patients were randomized to receive continuous androgen deprivation therapy (ADT) with or without docetaxel in the GETUG-15 phase 3 trial. Potential prognostic factors were recorded: age, performance status, Gleason score, hemoglobin (Hb), prostate-specific antigen, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), metastatic localization, body mass index, and pain. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS These factors were used to develop a new prognostic model using a recursive partitioning method. Before analysis, the data were split into learning and validation sets. The outcome was overall survival (OS). RESULTS AND LIMITATIONS For the 385 patients included, those with good (49%), intermediate (29%), and poor (22%) prognosis had median OS of 69.0, 46.5 and 36.6 mo (p=0.001), and 5-yr survival estimates of 60.7%, 39.4%, and 32.1%, respectively (p=0.001). The most discriminatory variables in univariate analysis were ALP, pain intensity, Hb, LDH, and bone metastases. ALP was the strongest prognostic factor in discriminating patients with good or poor prognosis. In the learning set, median OS in patients with normal and abnormal ALP was 69.1 and 33.6 mo, and 5-yr survival estimates were 62.1% and 23.2%, respectively. The hazard ratio for ALP was 3.11 and 3.13 in the learning and validation sets, respectively. The discriminatory ability of ALP (concordance [C] index 0.64, 95% confidence interval [CI] 0.58-0.71) was superior to that of the Glass risk model (C-index 0.59, 95% CI 0.52-0.66). The study limitations include the limited number of patients and low values for the C-index. CONCLUSION A new and simple prognostic model was developed for patients with NCMPC, underlying the role of normal or abnormal ALP. PATIENT SUMMARY We analyzed clinical and biological factors that could affect overall survival in noncastrate metastatic prostate cancer. We showed that normal or abnormal alkaline phosphatase at baseline might be useful in predicting survival.
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Affiliation(s)
- Gwenaelle Gravis
- Medical Oncology Department, Institut Paoli-Calmettes, Marseille, France.
| | - Jean-Marie Boher
- Biostatistics Department, Institut Paoli-Calmettes, and Aix-Marseille Université, UMR_S 912 (SESSTIM), Marseille, France
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | - Florence Joly
- Medical Oncology Department, Centre François Baclesse-CHU Côte de Nacre, Caen, France
| | - Franck Priou
- Medical Oncology Department, Centre Hospitalier Les Oudairies, La Roche-sur-Yon, France
| | - Patricia Marino
- Institut Paoli-Calmettes, and Aix-Marseille Université, UMR_S912 (SESSTIM), Marseille, France
| | - Igor Latorzeff
- Radiotherapy Department, Clinique Pasteur, Toulouse, France
| | - Remy Delva
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - Ivan Krakowski
- Medical Oncology Department, Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France
| | | | - Jochen Walz
- Surgical Urology Department, Institut Paoli-Calmettes, Marseille, France
| | - Fréderic Rolland
- Medical Oncology Department, Centre René Gauducheau, Saint-Herblain, France
| | | | - Gael Deplanque
- Medical Oncology Department, Groupe Hospitalier Saint Joseph, Paris, France
| | - Jean-Marc Ferrero
- Medical Oncology Department, Centre Antoine Lacassagne, Nice, France
| | - Damien Pouessel
- Medical Oncology Department, Centre Val d'Aurelle-Paul Lamarque, Montpellier, France
| | - Loïc Mourey
- Medical Oncology Department, Institut Claudius Régaud, Toulouse, France
| | | | - Sylvie Zanetta
- Medical Oncology Department, Centre Georges François Leclerc, Dijon, France
| | | | | | - Jerome Dauba
- Medical Oncology Department, Hôpital Layné, Mont de Marsan, France
| | - Marjorie Baciuchka
- Medical Oncology Department, Centre Hospitalier La Timone, Marseille, France
| | - Christian Platini
- Medical Oncology Department, Centre Régional Hospitalier, Metz-Thionville, France
| | | | - Jean-Luc Labourey
- Medical Oncology Department, Centre Hospitalier Dupuytren, Limoges, France
| | - Jean Pascal Machiels
- Medical Oncology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Claude El Kouri
- Medical Oncology Department, Centre Catherine de Sienne, Nantes, France
| | - Alain Ravaud
- Medical Oncology Department, Hôpital Saint-André, Bordeaux, France
| | - Etienne Suc
- Medical Oncology Department, Clinique Saint-Jean Languedoc, Toulouse, France
| | | | - Ali Hasbini
- Medical Oncology Department, Clinique Armoricaine de Radiologie, Saint-Brieux, France
| | | | - Michel Soulie
- Urology Department, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Stéphane Oudard
- Medical Oncology Department, Georges Pompidou Hospital and Rene Descartes University, Paris, France
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Cousin S, Isambert N, Cassier PA, Gomez-Roca CA, Kotecki N, Zanetta S, Bouchet J, Tassy L, Simonet-Lamm AL, De Maio E, Terret C, Penel N. Cancer patients (pts) being replaced in dose-seeking phase I trials (DSP1T): Occurrence, outcome, and risk factors. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.3035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Dupont B, Mariotte D, Dugue AE, Clarisse B, Grellard JM, Babin E, Chauffert B, Dakpe S, Moldovan C, Reimund JM, Di Fiore F, Zanetta S, Degardin M, Do P, Peytier A, Galais MP, Florescu C, Schott R, Le Mauff B, Gervais R. Interest of pretreatment quantification of anti-cetuximab IgE to prevent severe hypersensitivity reaction to cetuximab. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.6028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Pascal Do
- Centre Francois Baclesse, Caen, France
| | | | | | | | | | - Brigitte Le Mauff
- University Hospital (CHU) Laboratoire d'Immunologie et Immunopathologie, Caen, France
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Gravis G, Marino P, Joly F, Oudard S, Priou F, Esterni B, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Théodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Habibian M, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Labourey JL, Machiels JP, El Kouri C, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Soulie M, Fizazi K. Patients' self-assessment versus investigators' evaluation in a phase III trial in non-castrate metastatic prostate cancer (GETUG-AFU 15). Eur J Cancer 2014; 50:953-62. [PMID: 24424105 DOI: 10.1016/j.ejca.2013.11.034] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 11/27/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Toxicity, which is a key parameter in the evaluation of cancer treatments, can be underestimated by clinicians. We investigated differences between patients and physicians in reporting adverse events of androgen deprivation therapy (ADT) with or without docetaxel in a multicentre phase III trial in non-castrate metastatic prostate cancer. METHODS The 385 patients included were invited to complete a 26-symptom questionnaire 3 and 6 months after the start of treatment, among which eighteen symptoms were also assessed by physicians, reported in medical records and graded using the Common Toxicity Criteria of the National Cancer Institute. Positive and negative agreements as well as Kappa concordance coefficients were computed. FINDINGS Data were available for 220 and 165 patients at 3 and 6 months respectively. Physicians systematically under-reported patients' symptoms. Positive agreement rates (at respectively 3 and 6 months) for the five most commonly reported symptoms were: 61.0% and 64.3% hot flushes, 50.0% and 43.6% fatigue, 29.4% and 31.1% sexual dysfunction, 24.4% and 14.4% weigh gain/loss, 16.7% and 19.3% for joint/muscle pain. For symptoms most frequently reported as disturbing or very disturbing by patients, the clinicians' failure to report them ranged from 50.8% (hot flushes) to 89.5% (joint/muscle pain) at 3 months, and from 48.2% (hot flushes) to 88.4% (joint/muscle pain) at 6 months. INTERPRETATION Physicians often failed to report treatment-related symptoms, even the most common and disturbing ones. Patients' self-evaluation of toxicity should be used in clinical trials to improve the process of drug assessment in oncology. FUNDING French Health Ministry and Institut National du Cancer (PHRC), Sanofi-Aventis, Astra-Zeneca, and Amgen.
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Affiliation(s)
| | - Patricia Marino
- Institut Paoli-Calmettes, Marseilles, France; Inserm, UMR 912 'Economic & Social Sciences, Health Systems & Societies (SESSTIM)', Aix-Marseille Université, IRD, Marseilles, France
| | - Florence Joly
- Medical Oncology, Centre François Baclesse - CHU Côte de Nacre, Caen, France
| | - Stéphane Oudard
- Medical Oncology Department, Georges Pompidou Hospital and Rene Descartes University, Paris, France
| | - Franck Priou
- Medical Oncology, Centre Hospitalier Les Oudairies, La Roche-sur-Yon, France
| | | | - Igor Latorzeff
- Radiotherapy Department, Clinique Pasteur, Toulouse, France
| | - Remy Delva
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - Ivan Krakowski
- Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-les-nancy, France
| | | | - Fréderic Rolland
- Medical Oncology, Centre René Gauducheau, Saint-Herblain, France
| | | | - Gael Deplanque
- Medical Oncology, Groupe Hospitalier Saint Joseph, Paris, France
| | | | - Damien Pouessel
- Medical Oncology, Centre Val d'Aurelle-Paul Lamarque, Montpellier, France
| | - Loïc Mourey
- Medical Oncology, Institut Claudius Régaud, Toulouse, France
| | | | - Sylvie Zanetta
- Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | | | - Jerome Dauba
- Medical Oncology, Hôpital Layné, Mont de Marsan, France
| | | | - Christian Platini
- Medical Oncology, Centre Régional Hospitalier, Metz-Thionville, France
| | | | | | - Jean Pascal Machiels
- Medical Oncology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium
| | - Claude El Kouri
- Medical Oncology, Centre Catherine de Sienne, Nantes, France
| | - Alain Ravaud
- Medical Oncology, Hôpital Saint-André, Bordeaux, France
| | - Etienne Suc
- Medical Oncology, Clinique Saint-Jean Languedoc, Toulouse, France
| | | | - Ali Hasbini
- Medical Oncology, Clinique armoricaine de radiologie, Saint-Brieux, France
| | | | - Michel Soulie
- Urology Department, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
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Soltys B, Dalban C, Mirjolet C, Wiazzane N, Serre AA, Zanetta S, Thiebaut S, Maingon P. Comparaison des réirradiations conformationnelles avec modulation d’intensité des carcinomes de la tête et du cou selon le schéma de Vokes et le schéma monofractionné. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Soltys B, Wiazzane N, Mirjolet C, Dalban C, Serre AA, Zanetta S, Thiebaut S, Créhange G, Maingon P. [Reirradiations of head and neck cancers: state of the concept and ways of development]. Cancer Radiother 2013; 17:508-12. [PMID: 23999251 DOI: 10.1016/j.canrad.2013.07.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 07/12/2013] [Indexed: 11/28/2022]
Abstract
The treatment of local recurrence or second primary developed in irradiated area in the field of head and neck carcinoma, should be planned and organized through multidisciplinary discussions. The outcome of such a clinical situations benefits from second line and advanced technology treatments. Only a few patients are amenable to salvage surgery, hence radiation therapy, combined or not with chemotherapy, takes a major role in these indications. This overview of the literature describes recent development in this field, aiming to improve local control while the sparing of organ at risk remains an important goal. Radiation therapy is currently implementing major new technologies set to improve external beam irradiation with new concepts on dose, fractionation, intensity modulated radiation therapy and stereotactic approach - as well as in brachytherapy. Apart from dedicated studies, the great heterogeneity of the treated patients should be underlined and taken into consideration. However, current data confirm the feasibility of reirradiation with acceptable local control and toxicity.
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Affiliation(s)
- B Soltys
- Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21079 Dijon, France
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Fumoleau P, Dalenc F, Mailliez A, Veyret C, Bonneterre J, Guillemet C, Zanetta S, Moldovan C, Guiu S, Skrzypski J, Gauthier M, Coudert BP, Isambert N. Phase I dose escalation study of oral lapatinib in combination with docetaxel in patients with HER2-positive locally advanced or metastatic breast cancer (LAMBC): Initial safety and tolerability results. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e11529] [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
e11529 Background: Previous studies evidenced that the combination docetaxel (D) (75 mg/m²) + lapatinib (L) (1,250 mg/d) is well tolerated in heavily pretreated HER2-positive metastatic breast cancer patients (pts) in association with systematic G-CSF. This phase I study was conducted to assess safety, optimal tolerated regimen (OTR) and clinical activity of D + L in naïve treatment pts with HER-2 positive LAMBC without primary use of growth factor. Methods: Women with HER2+ LAMBC, naïve of treatment for advanced or metastatic disease, ECOG PS 0-2, were eligible for this study. Pts received once daily oral dosing of L with intravenous D on day 1 of every 3 week cycle. Initial dose was D (75 mg/m²) + L (1,250 mg/d) escalating up to D 100 mg/m² and L 1,500 mg/d until the Maximal Tolerated Dose (MTD) was reached. An expansion cohort of 6 pts was treated at the OTR level. Primary use of G-CSF was not permitted. Results: From Aug 2008 to Nov 2011, 17 pts were enrolled: median age 54.4 years [34.6-77], 59% were PS 0. All patients have metastatic disease with lung (29,4%), bone (41,2%), liver (76.5%) and lymph nodes (35.3%) metastasis. 7 pts received previously chemotherapy in adjuvant setting, 5 pts hormonotherapy and 7 pts radiotherapy. All but two pts were evaluable for dose limiting toxicities (DLT). 1 DLT/6 pts (FN) was observed at dose level (DL) 1 (D 75 mg/m² + L 1,250 mg/d) and 2 DLT/3 pts (gr 3 diarrhoea; gr4 neutropenia >7 d) at DL2 (D 75 mg/m² + L 1,500 mg/d). Only one DLT (FN) was observed in expansion cohort at OTR (D 75 mg/m² + L 1,250 mg/d; 6 pts). Over all C1, other significant toxicities (% pts) included gr4 neutropenia 53%, gr3 transaminase increase 6%, gr2 skin rash 36%, gr2 nausea/vomiting 18%, gr2 diarrhoea 12%, gr2 stomatitis 12%, gr2 hand-foot syndrome 6%; no decrease of cardiac function occurred. Conclusions: OTR for D and L was 75 mg/m² once every 3 weeks and 1,250 mg once daily respectively. This study demonstrates that this combination could be administered without systematic use of G-CSF in non pretreated pts with LAMBC. Additional safety data and preliminary evidence of activity are anticipated to be available at the time of presentation. Clinical trial information: NCT01044485.
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Affiliation(s)
| | | | | | - Corinne Veyret
- Department of Medical Oncology, Henri Becquerel Center, Rouen, France
| | | | | | | | | | - Séverine Guiu
- Georges-François Leclerc Cancer Center, Dijon, France
| | | | - Mélanie Gauthier
- Biostatistic Unit, Georges-François Leclerc Cancer Center, Dijon, France
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Isambert N, Fumoleau P, Paul C, Ferrand C, Zanetta S, Bauer J, Ragot K, Lizard G, Jeannin JF, Bardou M. Phase I study of OM-174, a lipid A analogue, with assessment of immunological response, in patients with refractory solid tumors. BMC Cancer 2013; 13:172. [PMID: 23547558 PMCID: PMC3626800 DOI: 10.1186/1471-2407-13-172] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 03/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lipids A, the lipophilic partial structure of lipopolysaccharides, induce regression of several tumor types in animal models. Rather than exerting direct cytotoxic effect, these compounds trigger the immune system which in turn stimulates secretion of cytokines, and activates the inducible nitric oxide synthase, as well as immune cell infiltration of tumors. OM-174 is an analogue of lipid A with dual action on Toll-like receptors 2 and 4. In an experimental model of peritoneal carcinomatosis induced in BDIX rats by intraperitoneal injection of syngeneic PROb colon cancer cells, it induced a complete regression of tumors. The present phase I trial was conducted to determine the maximum tolerated dose, the recommended phase II dose and biological response associated with OM-174 administered as intravenous infusion. METHODS Patients received OM-174 twice weekly for a total of 5, 10 or 15 injections of either 600, 800 or 1000 μg/m(2). Blood samples for pharmacokinetic analysis and cytokine dosages were collected. NK cells activity and Toll-like receptors 4 polymorphism analysis were also performed. RESULTS Seventeen patients were included. The highest dose administered was 1000 μg/m(2) repeated in 15 injections. The most common toxicities were a chills, fever, nausea/vomiting, diarrhea, fatigue and headache. No patient experienced haematological side effects. As no dose limiting toxicity was observed, despite a grade 3 respiratory complication, the maximal tolerated dose and recommended dose were not established. Three patients exhibited disease stabilization with a mean duration of 4 months. Pharmacokinetic profile of OM-174 was characterized by a low distribution volume and clearance. Analysis of TLR 4 polymorphysm showed that most (16/17) patients carried the wild type alleles. A progressive increase in NK cell number and activity was observed only in patients receiving 1000 μg/m(2) of OM-174. A peak of IL-8 and IL-10 concentrations were observed after each OM-174 injection. Peaks of TNF-alpha and IL-6 concentrations were detected after the first infusion and decreased progressively suggesting tolerance. CONCLUSION OM-174 therapy was well tolerated at biologically active concentrations. Whereas the recommended dose was not determined, further studies are planned in combination with chemotherapy as animal models suggest a strong synergistic antitumor effect. TRIAL REGISTRATION NCT01800812 (ClinicalTrials.gov Identifier).
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Affiliation(s)
- Nicolas Isambert
- INSERM CIC-P803, CHU de Dijon, Batiment du Pr Marion, 14 rue Gaffarel, BP77908, 21079, Dijon Cedex, France.
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Gravis G, Fizazi K, Joly F, Oudard S, Priou F, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Theodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Esterni B, Habibian M, Soulie M. Identification of prognostic groups in patients with hormone-sensitive metastatic prostate cancer at the present time: An analysis of the GETUG 15 phase III trial. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.6_suppl.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
26 Background: Patients with upfront metastases at the time of prostate cancer (PC) diagnosis are less frequent than in the past in Western countries, but still represent 5-10% of all patients and almost one half of PC patients will eventually die of the disease. Prognostic factors (lymph node metastases/appendicular vs axial bone disease, performance status > 1, Gleason score > 8 and PSA > 65 ng/ml) have been proposed (Glass et al., 2003), leading to the definition of three subgroups with good, intermediate and poor prognosis. However, the current natural history of metastatic prostate cancer has not been well described. Methods: Patients with hormone sensitive metastatic PC were randomized to receive continuous androgen deprivation therapy (ADT) plus docetaxel (75 mg/m²/21d up to 9 cycles) and prednisone or ADT alone. Glass risk groups were used as stratification factors. Results: From October 2004 to December 2008, 385 pts were included. They were distributed into good (50%), intermediate (29%), and poor (21%) prognosis groups. The median follow up was 50 months [95% CI: 49 - 54]. The primary endpoint analysis showed no difference in overall survival (OS) (HR: 1.01 [95%CI: 0.75-1.36]) between the 2 arms but a significant PFS improvement was observed in the docetaxel group (HR: 0.75 [0.59-0.94] p=0.0147) (Gravis, ESMO 2012). The median OS in the ADT alone arm was 54 months [42-NR]. It was 69 [95% CI: 60.9-NR], 47 [95% CI: 37.7-NR, HR = 1.6] and 37 [95% CI: 28.5-58.9, HR = 2.12] months respectively in the good, intermediate, and poor prognosis groups (p=0.001) in the whole cohort. No interaction between prognosis groups and treatment was found. A detailed analysis using the Cox model will be presented. Conclusions: At the present time, median life expectancy of patients with metastatic PC seems to exceed 4 years. Subgroups with favorable or unfavorable outcome can be identified. Clinical trial information: NCT00055731.
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Affiliation(s)
- Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | | | | | | | - Frank Priou
- Centre Hospitalier La Roche sur Yon, La Roche sur Yon, France
| | | | - Remy Delva
- Institut de Cancérologie de l'Ouest Paul Papin, Angers, France
| | | | | | | | | | | | | | | | | | | | | | - Benjamin Esterni
- Department of Biostatistics, Institut Paoli-Calmettes, Marseille, France
| | | | - Michel Soulie
- Centre Hospitalier Universitaire Rangueil, Toulouse, France
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Boscardini L, Zanetta S, Ballardini G, Angellotti P, Gramatica P, Scotti A, Barbero E, Bona G, Pellai A, Guala A. Epistaxis in children under the age of two: possible marker of abuse/neglect? A retrospective study in North-Eastern Piedmont hospitals. Minerva Pediatr 2013; 65:71-75. [PMID: 23422575] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM Epistaxis is an extremely common event at all ages; however, under two years of age epistaxis is a very rare event and recent studies carried out in Great Britain concern this event as related to possible non-accidental trauma. To date, no other studies carried out in Italy are available on this topic. METHODS A file review of all cases of epistaxis occurred in children under the age of 2 who were admitted into the ED in our area over a period of two years was carried out. RESULTS We have collected data concerning 10 cases of epistaxis occurred in children under 2 years of age with an incidence of 10.4 cases per 10000 accessions to the ED of children under the age of 2. Four of the cases had attendances for head injury or facial trauma. CONCLUSION The results obtained are higher than the results of the British studies adopting the same methodology, but comparable to their surveillance data on the general population. Through the analysis of the collected data, two correlated assumptions have been made: a possible relationship between epistaxis and neglect, and a relation between epistaxis and domestic accidents.
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Affiliation(s)
- L Boscardini
- Unit of Pediatrics, Castelli Hospital, Verbania, Italy
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Gravis G, Fizazi K, Joly F, Oudard S, Priou F, Esterni B, Latorzeff I, Delva R, Krakowski I, Laguerre B, Rolland F, Théodore C, Deplanque G, Ferrero JM, Pouessel D, Mourey L, Beuzeboc P, Zanetta S, Habibian M, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Labourey JL, Machiels JP, El Kouri C, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Soulie M. Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial. Lancet Oncol 2013; 14:149-58. [PMID: 23306100 DOI: 10.1016/s1470-2045(12)70560-0] [Citation(s) in RCA: 483] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Early chemotherapy might improve the overall outcomes of patients with metastatic non-castrate (ie, hormone-sensitive) prostate cancer. We investigated the effects of the addition of docetaxel to androgen-deprivation therapy (ADT) for patients with metastatic non-castrate prostate cancer. METHODS In this randomised, open-label, phase 3 study, we enrolled patients in 29 centres in France and one in Belgium. Eligible patients were older than 18 years and had histologically confirmed adenocarcinoma of the prostate and radiologically proven metastatic disease; a Karnofsky score of at least 70%; a life expectancy of at least 3 months; and adequate hepatic, haematological, and renal function. They were randomly assigned to receive to ADT (orchiectomy or luteinising hormone-releasing hormone agonists, alone or combined with non-steroidal antiandrogens) alone or in combination with docetaxel (75 mg/m(2) intravenously on the first day of each 21-day cycle; up to nine cycles). Patients were randomised in a 1:1 ratio, with dynamic minimisation to minimise imbalances in previous systemic treatment with ADT, chemotherapy for local disease or isolated rising concentration of serum prostate-specific antigen, and Glass risk groups. Patients, physicians, and data analysts were not masked to treatment allocation. The primary endpoint was overall survival. Efficacy analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00104715. FINDINGS Between Oct 18, 2004, and Dec 31, 2008, 192 patients were randomly allocated to receive ADT plus docetaxel and 193 to receive ADT alone. Median follow-up was 50 months (IQR 39-63). Median overall survival was 58·9 months (95% CI 50·8-69·1) in the group given ADT plus docetaxel and 54·2 months (42·2-not reached) in that given ADT alone (hazard ratio 1·01, 95% CI 0·75-1·36). 72 serious adverse events were reported in the group given ADT plus docetaxel, of which the most frequent were neutropenia (40 [21%]), febrile neutropenia (six [3%]), abnormal liver function tests (three [2%]), and neutropenia with infection (two [1%]). Four treatment-related deaths occurred in the ADT plus docetaxel group (two of which were neutropenia-related), after which the data monitoring committee recommended treatment with granulocyte colony-stimulating factor. After this recommendation, no further treatment-related deaths occurred. No serious adverse events were reported in the ADT alone group. INTERPRETATION Docetaxel should not be used as part of first-line treatment for patients with non-castrate metastatic prostate cancer. FUNDING French Health Ministry and Institut National du Cancer (PHRC), Sanofi-Aventis, AstraZeneca, and Amgen.
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Affiliation(s)
- Gwenaelle Gravis
- Medical Oncology and Biostatistics, Institut Paoli-Calmettes, Marseille, France.
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