1
|
Blanc-Durand F, Yaniz-Galende E, Llop-Guevara A, Genestie C, Serra V, Herencia-Ropero A, Klein C, Berton D, Lortholary A, Dohollou N, Desauw C, Fabbro M, Malaurie E, Bonichon-Lamaichhane N, Dubot C, Kurtz JE, de Rauglaudre G, Raban N, Chevalier-Place A, Ferron G, Kaminsky MC, Kramer C, Rouleau E, Leary A. Corrigendum to "A RAD51 functional assay as a candidate test for homologous recombination deficiency in ovarian cancer". Gynecol Oncol 2023:S0090-8258(23)00299-8. [PMID: 37271667 DOI: 10.1016/j.ygyno.2023.05.058] [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: 06/06/2023]
Affiliation(s)
- Félix Blanc-Durand
- Medical Oncology, Gynecology Unit, Gustave Roussy Institute, Villejuif, France
| | | | - Alba Llop-Guevara
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - Violeta Serra
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - Christophe Klein
- Center of Cellular Imaging and Cytometry, INSERM UMRS 1138, Cordeliers Research Center, Paris, France
| | - Dominique Berton
- Medical Oncology, GINECO & Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Alain Lortholary
- Medical Oncology, GINECO-Hôpital Privé du Confluent, Nantes, France
| | - Nadine Dohollou
- Medical Oncology, Polyclinique Bordeaux Nord Aquitain, Bordeaux, France
| | | | - Michel Fabbro
- Medical Oncology, ICM Val d'Aurelle, Montpellier, France
| | - Emmanuelle Malaurie
- Medical Oncology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | - Coraline Dubot
- Medical Oncology, GINECO and Institut Curie - Hôpital René Huguenin, Saint-Cloud, France
| | | | | | - Nadia Raban
- Medical Oncology, GINECO and CHU La Milétrie, Poitiers, France
| | | | - Gwenael Ferron
- Medical Oncology, GINECO and Institut Claudius Regaud, Toulouse, France
| | - Marie-Christine Kaminsky
- Medical Oncology, GINECO and Institut de Cancérologie de Lorraine, Vandoeuvre-Les-, Nancy, France
| | - Claire Kramer
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Etienne Rouleau
- Cancer Genetics Laboratory, Gustave Roussy Institute, Villejuif, France
| | - Alexandra Leary
- Medical Oncology, Gynecology Unit, Gustave Roussy Institute, Villejuif, France; INSERM UMR981, Gustave Roussy Institute, Villejuif, France.
| |
Collapse
|
2
|
Blanc-Durand F, Yaniz-Galende E, Llop-Guevara A, Genestie C, Serra V, Herencia-Ropero A, Klein C, Berton D, Lortholary A, Dohollou N, Desauw C, Fabbro M, Malaurie E, Bonichon-Lamaichhane N, Dubot C, Kurtz JE, de Rauglaudre G, Raban N, Chevalier-Place A, Ferron G, Kaminsky MC, Kramer C, Rouleau E, Leary A. A RAD51 functional assay as a candidate test for homologous recombination deficiency in ovarian cancer. Gynecol Oncol 2023; 171:106-113. [PMID: 36868112 DOI: 10.1016/j.ygyno.2023.01.026] [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: 10/03/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 03/05/2023]
Abstract
RATIONALE Homologous recombination deficiency (HRD), defined as BRCA1/2 mutation (BRCAmut) or high genomic instability, is used to identify ovarian cancer (OC) patients most likely to benefit from PARP inhibitors. While these tests are useful, they are imperfect. Another approach is to measure the capacity of tumor cells to form RAD51 foci in the presence of DNA damage using an immunofluorescence assay (IF). We aimed to describe for the first time this assay in OC and correlate it to platinum response and BRCAmut. METHODS Tumor samples were prospectively collected from the randomized CHIVA trial of neoadjuvant platinum +/- nintedanib. IF for RAD51, GMN and gH2AX was performed on FFPE blocks. Tumors were considered RAD51-low if ≤10% of GMN-positive tumor cells had ≥5 RAD51 foci. BRCAmut were identified by NGS. RESULTS 155 samples were available. RAD51 assay was contributive for 92% of samples and NGS available for 77%. gH2AX foci confirmed the presence of significant basal DNA damage. 54% of samples were considered HRD by RAD51 and presented higher overall response rates to neoadjuvant platinum (P = 0.04) and longer progression-free survival (P = 0.02). In addition, 67% of BRCAmut were HRD by RAD51. Among BRCAmut, RAD51-high tumors seem to harbor poorer response to chemotherapy (P = 0.02). CONCLUSIONS We evaluated a functional assay of HR competency. OC demonstrate high levels of DNA damage, yet 54% fail to form RAD51 foci. These RAD51-low OC tend to be more sensitive to neoadjuvant platinum. The RAD51 assay also identified a subset of RAD51-high BRCAmut tumors with unexpected poor platinum response.
Collapse
Affiliation(s)
- Félix Blanc-Durand
- Medical Oncology, Gynecology Unit, Gustave Roussy Institute, Villejuif, France
| | | | - Alba Llop-Guevara
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - Violeta Serra
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - Christophe Klein
- Center of Cellular Imaging and Cytometry, INSERM UMRS 1138, Cordeliers Research Center, Paris, France
| | - Dominique Berton
- Medical Oncology, GINECO & Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Alain Lortholary
- Medical Oncology, GINECO-Hôpital Privé du Confluent, Nantes, France
| | - Nadine Dohollou
- Medical Oncology, Polyclinique Bordeaux Nord Aquitain, Bordeaux, France
| | | | - Michel Fabbro
- Medical Oncology, ICM Val d'Aurelle, Montpellier, France
| | - Emmanuelle Malaurie
- Medical Oncology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | - Coraline Dubot
- Medical Oncology, GINECO and Institut Curie - Hôpital René Huguenin, Saint-Cloud, France
| | | | | | - Nadia Raban
- Medical Oncology, GINECO and CHU La Milétrie, Poitiers, France
| | | | - Gwenael Ferron
- Medical Oncology, GINECO and Institut Claudius Regaud, Toulouse, France
| | | | - Claire Kramer
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Etienne Rouleau
- Cancer Genetics Laboratory, Gustave Roussy Institute, Villejuif, France
| | - Alexandra Leary
- Medical Oncology, Gynecology Unit, Gustave Roussy Institute, Villejuif, France; INSERM UMR981, Gustave Roussy Institute, Villejuif, France.
| |
Collapse
|
3
|
Heudel P, Frenel JS, Dalban C, Bazan F, Joly F, Arnaud A, Abdeddaim C, Chevalier-Place A, Augereau P, Pautier P, Chakiba C, You B, Lancry-Lecomte L, Garin G, Marcel V, Diaz JJ, Treilleux I, Pérol D, Fabbro M, Ray-Coquard I. Safety and Efficacy of the mTOR Inhibitor, Vistusertib, Combined With Anastrozole in Patients With Hormone Receptor-Positive Recurrent or Metastatic Endometrial Cancer: The VICTORIA Multicenter, Open-label, Phase 1/2 Randomized Clinical Trial. JAMA Oncol 2022; 8:1001-1009. [PMID: 35551299 PMCID: PMC9100474 DOI: 10.1001/jamaoncol.2022.1047] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance Endometrial cancer is often hormone-dependent and treated with aromatase inhibitors. The PI3K-AKT-mTOR pathway deregulation observed in endometrial cancer drives hormonal resistance, thus supporting the rationale of combining mTOR inhibitor with endocrine therapy. Objective To evaluate the safety and efficacy of vistusertib in combination with anastrozole in the treatment of women with hormone receptor-positive recurrent or metastatic endometrial cancer. Design, Settings, and Participants The VICTORIA study was a multicenter, open-label, randomized clinical trial that accrued 75 patients with hormone receptor-positive recurrent or metastatic endometrial cancer from 12 cancer centers in France in April 2016 to October 2019. After a safety run-in period, a Simon 2-stage design was used. Data analyses were performed from December 11, 2020, to March 11, 2021. Interventions Patients were randomized in a 2:1 ratio to oral vistusertib (125 mg twice daily 2 days per week) and oral anastrozole (1 mg daily) in the combination vistusertib with anastrozole arm (V+A arm) or oral anastrozole alone (A arm). Main Outcomes and Measures The primary end point was serious adverse events for the safety run-in period and progression-free rate at 8 weeks (8wk-PFR)-assessed with a blinded independent central review in phase 2. The secondary end points were objective response rate, duration of response, progression-free survival (PFS), overall survival, and incidence of adverse events. Results Of the 75 patients who were randomized, 73 (median [range] age, 69.5 [37-88] y; all female) were treated: V+A arm, 49 patients; A arm, 24 patients. In the V+A arm, the 8wk-PFR was 67.3% (unilateral 95% CI, 54.7%) and in the A arm, 39.1% (unilateral 95% CI, 22.2%). No significant serious adverse events were reported during the safety run-in period (n = 6 in V+A arm). The overall response rate was 24.5% (95% CI, 13.3%-38.9%) in the V+A arm vs 17.4% (95% CI, 5.0%-38.8%) in the A arm. With a median follow-up of 27.7 months, median PFS was 5.2 (95% CI, 3.4-8.9) in the V+A arm and 1.9 (95% CI, 1.6-8.9) months in the A arm. Fatigue, lymphopenia, hyperglycemia, and diarrhea were the most common (grade ≥2) adverse events associated with vistusertib. Conclusions and Relevance This multicenter, open-label, phase 1/2 randomized clinical trial demonstrated that adding vistusertib to anastrozole improved 8wk-PFR, overall response rate, and PFS for patients with endometrial cancer and had manageable adverse events. Identification of molecular subgroups would allow for more precise selection of patients who may be most likely to experience favorable outcomes. Trial Registration ClinicalTrials.gov Identifier: NCT02730923.
Collapse
Affiliation(s)
- Pierre Heudel
- Medical Oncology Department, Centre Léon Bérard, Lyon, France.,University Claude Bernard Lyon 1, Lyon, France.,Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France
| | - Jean-Sébastien Frenel
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Medical Oncology Department Institut Cancérologie de l'Ouest, St Herblain, France
| | - Cécile Dalban
- Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - Fernando Bazan
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Medical Oncology Department, Hôpital Jean Minjoz, Besançon, France
| | - Florence Joly
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Medical Oncology Department, Centre François Baclesse, Caen, France
| | - Antoine Arnaud
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Institut Sainte Catherine, Avignon, France
| | - Cyril Abdeddaim
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Centre Oscar Lambret, Lille, France
| | - Annick Chevalier-Place
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Centre Oscar Lambret, Lille, France
| | - Paule Augereau
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Institut Cancérologie Paul Papin, Angers, France
| | - Patricia Pautier
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Institut Gustave Roussy, Villejuif, France
| | - Camille Chakiba
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Institut Bergonié, Bordeaux, France
| | - Benoit You
- University Claude Bernard Lyon 1, Lyon, France.,Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Department of Medical Oncology, Centre Hospitalier Lyon Sud, Pierre Bénite, France.,EMR EA UCBL/HCL 3738 CICLY, Lyon, France
| | - Laurence Lancry-Lecomte
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Institut Daniel Hollard, Grenoble, France
| | - Gwenaelle Garin
- Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - Virginie Marcel
- University Claude Bernard Lyon 1, Lyon, France.,Inserm U1052, CNRS UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France.,Institut Convergence PLAsCAN, Lyon, France
| | - Jean Jacques Diaz
- University Claude Bernard Lyon 1, Lyon, France.,Inserm U1052, CNRS UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France.,Institut Convergence PLAsCAN, Lyon, France
| | - Isabelle Treilleux
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France.,Biopathology Department, Centre Léon Bérard, Lyon, France
| | - David Pérol
- Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - Michel Fabbro
- Medical Oncology Department, Institut de Cancérologie de Montpellier, Montpellier, France
| | - Isabelle Ray-Coquard
- Medical Oncology Department, Centre Léon Bérard, Lyon, France.,University Claude Bernard Lyon 1, Lyon, France.,Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du Sein, France
| |
Collapse
|
4
|
Ray-Coquard I, Harter P, Lorusso D, Dalban C, Vergote I, Fujiwara K, Gladieff L, Lück HJ, Floquet A, Chevalier-Place A, Schnelzer A, Pignata S, Selle F, Sehouli J, Brocard F, Mangili G, Pautier P, De Giorgi U, Provansal M, Heudel PE. Effect of Weekly Paclitaxel With or Without Bevacizumab on Progression-Free Rate Among Patients With Relapsed Ovarian Sex Cord-Stromal Tumors: The ALIENOR/ENGOT-ov7 Randomized Clinical Trial. JAMA Oncol 2020; 6:1923-1930. [PMID: 33030515 DOI: 10.1001/jamaoncol.2020.4574] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Importance To our knowledge, this is the first randomized trial in sex cord-stromal tumors, and it establishes weekly paclitaxel as standard-of-care therapy after platinum-based therapy in this setting. Objective To determine the efficacy of weekly paclitaxel with or without bevacizumab as treatment for relapsed sex cord-stromal tumors and evaluate whether the addition of bevacizumab to weekly paclitaxel improves 6-month progression-free rate. Design, Setting, and Participants This open-label, academic, international, randomized phase 2 trial (ALIENOR) was conducted at 28 referral centers in France, Germany, Italy, Japan, and Belgium in collaboration with the Rare Tumor committee of the Gynecologic Cancer InterGroup and used an adaptive bayesian design. It included 60 women with sex cord-stromal tumors that had relapsed after at least 1 platinum-based chemotherapy. Enrollment occurred from 2013 to 2016, and the final analysis database lock was on March 27, 2020 (median follow-up, 38.9 months). Interventions Participants were randomized to receive either paclitaxel (80 mg/m2, days 1, 8, and 15 every 4 weeks) alone or paclitaxel with bevacizumab (10 mg/kg, every 2 weeks) for 6 cycles followed by maintenance bevacizumab (15 mg/kg, every 3 weeks) for up to 1 year or until progression or unacceptable toxicity. Crossover to bevacizumab was permitted after progression during or following paclitaxel alone. Main Outcomes and Measures Six-month progression-free rate. Results Sixty patients (predominantly with granulosa cell tumors) were randomized, 32 to receive single-agent paclitaxel (median [interquartile range] age at inclusion, 60 [53-64] years) and 28 to receive paclitaxel-bevacizumab (median [interquartile range] age at inclusion, 55 [47-61] years; 1 did not receive treatment). The estimated 6-month progression-free rate was 71% (95% credible interval, 55%-84%) with paclitaxel alone and 72% (95% credible interval, 55%-87%) with paclitaxel-bevacizumab. The bayesian estimate for the probability that the 6-month progression-free rate distribution was higher with the combination than with paclitaxel alone was 57%, less than the predefined superiority threshold. The objective response rate increased from 25% (95% CI, 12%-43%) to 44% (95% CI, 26%-65%) with the addition of bevacizumab. One patient discontinued combination therapy within 6 months because of toxicity. Conclusions and Relevance Weekly paclitaxel is a new option for relapsed sex cord-stromal tumors. In this international randomized clinical trial of patients with relapsed sex cord-stromal tumors unsuitable for surgery, adding bevacizumab to weekly paclitaxel does not improve clinical benefit. Trial Registration ClinicalTrials.gov Identifier: NCT01770301.
Collapse
Affiliation(s)
| | - Philipp Harter
- AGO Study Group and Ev Kliniken Essen-Mitte, Essen, Germany
| | | | - Cécile Dalban
- GINECO and Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Ignace Vergote
- BGOG and University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Keiichi Fujiwara
- GOTIC and Saitama Medical University International Medical Center, Hidaka, Japan
| | - Laurence Gladieff
- GINECO and Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | | | | | | | - Andreas Schnelzer
- AGO Study Group and Frauenklinik Technical University Munich, Munich, Germany.,Current, RoMed Klinikum Rosenheim, Rosenheim, Germany
| | - Sandro Pignata
- MITO and Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Frédéric Selle
- GINECO and Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Jalid Sehouli
- AGO Study Group and Medical University of Berlin, Charité-CVK, Berlin, Germany
| | | | | | | | - Ugo De Giorgi
- MITO and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRST IRCCS, Meldola, Italy
| | | | | |
Collapse
|
5
|
Robelin P, Tod M, Colomban O, Lachuer J, Ray-Coquard I, Rauglaudre GD, Joly F, Chevalier-Place A, Combe P, Lortholary A, Hamizi S, Raban N, Ferron G, Meunier J, Berton-Rigaud D, Alexandre J, Kaminsky MC, Dubot C, Leary A, Malaurie E, You B. Comparative analysis of predictive values of the kinetics of 11 circulating miRNAs and of CA125 in ovarian cancer during first line treatment (a GINECO study). Gynecol Oncol 2020; 159:256-263. [DOI: 10.1016/j.ygyno.2020.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/11/2020] [Indexed: 01/26/2023]
|
6
|
You B, Robelin P, Tod M, Louvet C, Lotz JP, Abadie-Lacourtoisie S, Fabbro M, Desauw C, Bonichon-Lamichhane N, Kurtz JE, Follana P, Leheurteur M, Piano FD, Ferron G, De Rauglaudre G, Ray-Coquard I, Combe P, Chevalier-Place A, Joly F, Leary A, Pujade-Lauraine E, Freyer G, Colomban O. CA-125 ELIMination Rate Constant K (KELIM) Is a Marker of Chemosensitivity in Patients with Ovarian Cancer: Results from the Phase II CHIVA Trial. Clin Cancer Res 2020; 26:4625-4632. [PMID: 32209570 DOI: 10.1158/1078-0432.ccr-20-0054] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/26/2020] [Accepted: 03/20/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE In patients with ovarian cancer receiving neoadjuvant chemotherapy, the first-line treatment success will depend on both the tumor-primary chemosensitivity and the completeness of interval debulking surgery (IDS). The modeled CA-125 ELIMination rate constant K (KELIM), calculated with the CA-125 longitudinal kinetics during the first 100 chemotherapy days, is a validated early marker of tumor chemosensitivity. The objective was to investigate the role of the chemosensitivity relative to the success of first-line medical-surgical treatment. EXPERIMENTAL DESIGN The CA-125 concentrations were prospectively measured in the randomized phase II trial CHIVA (NCT01583322, carboplatin-paclitaxel regimen ± nintedanib, and IDS, n = 188 patients). The KELIM predictive value regarding the tumor response rate, likelihood of complete IDS, risk of subsequent platinum-resistant relapse (PtRR), progression-free survival (PFS), and overall survival (OS) was assessed using univariate and multivariate tests. RESULTS The data from 134 patients were analyzed. KELIM was an independent and major predictor of subsequent PtRR risk, and of survivals. The final logistic regression model, including KELIM [OR = 0.13; 95% confidence interval (CI), 0.03-0.49] and complete IDS (no vs. yes, OR = 0.30; 95% CI, 0.11-0.76) highlights the preponderant role of chemosensitivity on the success of the first-line treatment. In patients with highly chemosensitive diseases, the patient prognosis was driven more by the chemotherapy-induced antitumor effects than by the surgery. CONCLUSIONS The tumor-primary chemosensitivity, assessed by the modeled CA-125 KELIM calculated during neoadjuvant chemotherapy (http://www.biomarker-kinetics.org/CA-125-neo), may be a major parameter to consider for decision-making regarding IDS attempt, and selecting patients for treatments meant to reverse the primary chemoresistance.See related commentary by May and Oza, p. 4432.
Collapse
Affiliation(s)
- Benoit You
- Univ Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon-Sud, Lyon, France. .,Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Centre Hospitalier Lyon-Sud, GINECO, GINEGEPS, Lyon, France
| | - Patrick Robelin
- Univ Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon-Sud, Lyon, France.,Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Centre Hospitalier Lyon-Sud, GINECO, GINEGEPS, Lyon, France
| | - Michel Tod
- Univ Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon-Sud, Lyon, France.,Hospices Civils de Lyon, Pharmacie, Hôpital de la Croix Rousse, Lyon, France
| | - Christophe Louvet
- L'Institut Mutualiste Montsouris, Service d'oncologie, GINECO, Paris, France
| | | | - Sophie Abadie-Lacourtoisie
- Institut de Cancérologie de l'Ouest - ICO - Site Paul Papin, Oncologie médicale gynécologique, Angers, GINECO, Paris, France
| | - Michel Fabbro
- ICM Val d'Aurelle Parc Euromedecine, Oncologie médicale, Montpellier, GINECO, Paris, France
| | - Christophe Desauw
- Centre Hospitalier Régional Universitaire de Lille, Oncologie médicale, Lille Cedex, GINECO, Paris, France
| | | | - Jean-Emmanuel Kurtz
- Hôpitaux Universitaires de Strasbourg, Service d'Oncologie et d'Hématologie, Strasbourg, France
| | - Philippe Follana
- CLCC Antoine Lacassagne, Département d'Hématologie - Oncologie médicale, NICE CEDEX 2, GINECO, Paris, France
| | | | - Francesco Del Piano
- Hôpitaux de LEMAN, Chirurgie Gynécologique, THONON LES BAINS, GINECO, Paris, France
| | - Gwénael Ferron
- Institut Claudius Regaud, Département de Chirurgie Oncologique, TOULOUSE, France
| | - Gaëtan De Rauglaudre
- Institut Sainte-Catherine, Oncologie radiothérapie, Avignon, GINECO, Paris, France
| | - Isabelle Ray-Coquard
- Centre Léon Bérard, 28 Prom. Léa et Napoléon Bullukian, & Université Claude Bernard Lyon, Lyon, GINECO, Paris, France
| | - Pierre Combe
- Hôpital Européen Georges Pompidou, Oncologie Médicale, GINECO, Paris, France
| | | | - Florence Joly
- Centre François Baclesse, Oncologie Médicale, GINECO, Paris, France
| | | | | | - Gilles Freyer
- Univ Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon-Sud, Lyon, France.,Medical Oncology, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Centre Hospitalier Lyon-Sud, GINECO, GINEGEPS, Lyon, France
| | - Olivier Colomban
- Univ Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon-Sud, Lyon, France
| |
Collapse
|
7
|
Joly F, Petit T, Pautier P, Guardiola E, Mayer F, Chevalier-Place A, Delva R, Sevin E, Henry-Amar M, Bourgeois H. Weekly association of gemcitabine and topotecan in early recurrent ovarian cancer patients: A French multicenter phase II study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.16016] [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
16016 Background: A weekly association of gemcitabine and topotecan was tested with the aim of evaluating its efficacy and tolerance in patients recurring after first line platinum and taxane-based chemotherapy. Methods: From December 2004 to April 2006, 77 patients whose disease has progressed within 12 months (time-free interval, TFI) after first line chemotherapy were enrolled in a multicenter phase II study. Primary endpoint was overall response rate (ORR). Gemcitabine (1000 mg/m2) and topotecan (2.5 mg/m2) were given day 1, 8 and 15 (q 28 d) for 6 to 9 cycles. Tumor response was assessed according to RECIST or Rustin criteria. Clinical response was assessed using symptoms improvement in responders and patients with stable disease. Follow-up was updated December 2006. Results: Initial characteristics were: median age 63 years (38 to 80), WHO PS 0–1 93%, serous histology 85%, TFI < 6 months 45%, measurable disease 71%. Four cycles (1 to 8) were administered in average. The only major toxicity was neutropenia (Grade 3 and 4 in 17% and 6% of patients) with one febrile neutropenia; one toxic death (pneumopathy) was observed. 34% of cycles were incomplete (d8 and/or d15 not administered) because of grade 1–2 thrombopenia or grade 1–4 neutropenia. Lenograstim and erythropoietin were administered in 14% and 34% of patients, respectively. Sixty-six (86%) patients were evaluable for response (2 cycles administered). The ORR was 14% (CR=3%, PR=11%); there were 53% of stable disease. ORR was 7% and 20% in patients with TFI < 6 months and = 6 months, respectively. Symptoms were improved in 18 (64%) of 28 patients and pain in 11 (39%) of 28 patients. Median event-free survival time was 3.7 months. Median overall survival time was 12.3 months (7.5 and 15.6 months in patients with TFI < 6 months and = 6 months, respectively; p=0.0244). Conclusions: In resistant/refractory ovarian cancer, weekly gemcitabine and topotecan is associated with low objective response rate but with a high proportion of stable disease and symptoms control leading to acceptable quality of life. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- F. Joly
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - T. Petit
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - P. Pautier
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - E. Guardiola
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - F. Mayer
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - A. Chevalier-Place
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - R. Delva
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - E. Sevin
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - M. Henry-Amar
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| | - H. Bourgeois
- Centre Francois Baclesse, Caen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; CHU Jean Minjoz, Besançon, France; Centre Georges-Francois Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Paul Papin, Angers, France; Centre Hospitalier, Amboise, France
| |
Collapse
|
8
|
Le Péchoux C, Pautier P, Delannes M, Bui BN, Bonichon F, Bonvalot S, Chevalier-Place A, Coindre JM, Le Cesne A, Morice P, Ray-Coquard I, Stöeckle E, Taieb S. Recommandations pour la pratique clinique : mise à jour 2006 des Standards, Options et Recommandations pour l'irradiation des patients adultes atteints de sarcome des tissus mous (sarcome des membres, sarcomes rétropéritonéaux et sarcomes utérins). Cancer Radiother 2006; 10:185-207. [PMID: 16917992 DOI: 10.1016/j.canrad.2006.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The National French Federation of Comprehensive Cancer Centres (FNCLCC) initiated the update of clinical practice guideline for the management of patients with soft tissue sarcoma in collaboration with the French Sarcoma Group (GSF-GETO), specialists from French public universities, general hospitals and private clinics and with the French National Cancer Institute. This work is based on the methodology developed in the "Standards, Options and Recommendations" (SOR) project. OBJECTIVES To update SOR guidelines for the management of patients with soft tissue sarcoma previously validated in 1995. METHODS The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts who define the CPGsaccording to the definitions of the Standards, Options and Recommendations project. Once the guidelines have been developed, they are reviewed by independent reviewers. RESULTS This article presents the updated recommendations for radiotherapeutic management. The main recommendations are: 1) irradiation before or after surgical treatment is the standard for soft tissue sarcoma of the extremity and uterine sarcoma; 2) no systematic irradiation should be done in case of retroperitoneal sarcoma.
Collapse
|
9
|
Bourgain A, Acker O, Lambaudie E, Boukerrou M, Chevalier-Place A, Meignie P, Parent M, Baranzelli MC, Cabaret V, Wemeau JL, Querleu D. Carcinome à petites cellules de l'ovaire hypercalcémiant révélé par un épisode de pancréatite aiguë : à propos d'un cas. ACTA ACUST UNITED AC 2005; 33:35-8. [PMID: 15752664 DOI: 10.1016/j.gyobfe.2004.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2004] [Indexed: 11/20/2022]
Abstract
Small cell carcinoma of the ovary of the hypercalcemic type is a rare tumour, usually lethal and occurring almost exclusively in young patients. In the majority of described cases, signs of this lesion were revealed by the associated hypercalcemia or by virtue of the physical tumour bulk alone. We report the first case of ovarian small cell carcinoma of the hypercalcemic revealed by a severe acute pancreatitis in a 19-year-old patient.
Collapse
Affiliation(s)
- A Bourgain
- Département de cancérologie gynécologique, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59037 Lille cedex, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Collinet P, Lanvin D, Declerck D, Chevalier-Place A, Leblanc E, Querleu D. Neuroendocrine tumors of the uterine cervix. Clinicopathologic study of five patients. Eur J Obstet Gynecol Reprod Biol 2000; 91:51-7. [PMID: 10817879 DOI: 10.1016/s0301-2115(99)00253-5] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Four main clinicopathologic features of neuroendocrine tumors (NETs) of the cervix may be stressed: primary diagnosis at an advanced stage, early nodal metastasis even for low disease, early failure of appropriate local treatment (surgery and/or radiation therapy) and aggressive clinical treatment. Five patients with NET of the uterine cervix (small cell carcinoma type) are reported (one stage I, two stages II, one stage III and one stage IV). One patient was treated by surgery combined with radiation therapy, one by surgery combined with chemotherapy and one by surgery with radiation therapy and chemotherapy. Two patients received radiation therapy alone. Three early stage patients are alive with no evidence of disease 8, 26 and 41 months after diagnosis. The two patients with advanced stage died of disease, 3 and 12 months respectively, after diagnosis. Combination chemotherapy (cisplatin and etoposide) is warranted in disseminated NETs. Neoadjuvant or adjuvant chemotherapy should be combined with radiation therapy and surgery even in early stages.
Collapse
Affiliation(s)
- P Collinet
- Hôpital Jeanne de Flandre, Pôle de Chirurgie Gynécologique, Clinique de Gynécologie-Obstétrique et Néonatalogie, CHRU Lille, 2 Avenue Oscar Lambret, 59037, Lille, France
| | | | | | | | | | | |
Collapse
|