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Verschuur A, Pritchard-Jones K, Merks H, Bisogno G, Marec-Berrard P, van den Heuvel-Eibrink MM. In Memoriam: Christophe Bergeron. Pediatr Blood Cancer 2024; 71:e30957. [PMID: 38520043 DOI: 10.1002/pbc.30957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Arnauld Verschuur
- Pediatric Oncology and Hematology Department, La Timone, Hospital, AP-HM, Marseille, France
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Hans Merks
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Gianni Bisogno
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- Pediatric Hematology Oncology Division, University Hospital of Padua, Padua, Italy
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Awounou D, Mancini M, Lacour B, de Crouy-Chanel P, Aerts I, Minard-Colin V, Schleiermacher G, Verschuur A, Guissou S, Desandes E, Guldner L, Clavel J, Goujon S. Residential proximity to vines and risk of childhood embryonal tumours in France - GEOCAP case-control study, 2006-2013. Environ Res 2024; 240:117417. [PMID: 37865323 DOI: 10.1016/j.envres.2023.117417] [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] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/29/2023] [Accepted: 10/14/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Exposure to pesticides has been suggested as a potential risk factor for childhood embryonal tumour. The existing literature has mainly focused on parental occupational exposure and domestic use of pesticides, and is very limited for residential exposures to agricultural pesticides. The study aimed to test the hypothesis of an increased risk of embryonal tumour in children living close to viticultural plots, likely to be subject to frequent pesticide applications. METHODS The study is part of the French national registry-based GEOCAP program. We included 2761 cases of neuroblastoma, retinoblastoma, Wilms tumour and rhabdomyosarcoma diagnosed before the age of 15 years in the 2006-2013 period, and 40,196 controls representative of the same age population during this period. Indicators of proximity to vines, the presence of vines and viticulture density within 1000 m of the geocoded addresses of residence, were evaluated combining three sources of data on agricultural land use in a geographic information system. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regressions and carried out several sensitivity analyses to test the stability of the results. RESULTS Approximately 10% of the controls lived within 1000 m of vines, with regional variations ranging from <1% to 38%. We observed a 5% increase in the risk of neuroblastoma for a 10% increase in viticulture density (OR = 1.05, 95% CI: 0.98-1.13), with a regional heterogeneity. The indicators of proximity to vines were not associated with the other non-CNS embryonal tumours. CONCLUSION The study showed a slight increase in the risk of neuroblastoma in children living close to vines, suggesting that residential exposure to agricultural pesticides may be involved in the occurrence of these tumours.
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Affiliation(s)
- Danielle Awounou
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France.
| | - Matthieu Mancini
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Brigitte Lacour
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Perrine de Crouy-Chanel
- Santé publique France, the French Public Health Agency, Direction Appui, Traitements et Analyses des données (DATA), Saint-Maurice, France
| | - Isabelle Aerts
- SIREDO Centre (Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology), Institut Curie, Paris, France
| | - Véronique Minard-Colin
- Department of Paediatric and Adolescent Oncology, Institut Gustave Roussy - Inserm UMR1015, Université Paris Saclay, Villejuif, France
| | - Gudrun Schleiermacher
- SIREDO Centre (Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology), Institut Curie, Paris, France
| | - Arnauld Verschuur
- Department of Paediatric Haematology, Immunology and Oncology, Children Hospital of La Timone, AP-HM, 13385, Marseille, France
| | - Sandra Guissou
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Emmanuel Desandes
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Laurence Guldner
- Santé publique France, the French Public Health Agency, Direction Santé Environnement Travail (DSET), Saint-Maurice, France
| | - Jacqueline Clavel
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Stéphanie Goujon
- Inserm UMR1153, Epidemiology of Childhood and Adolescent Cancers (EPICEA) team, Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France; French National Registry of Childhood Cancers, RNHE, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, AP-HP, Villejuif, and RNTSE, CHRU de Nancy, Vandœuvre-lès-Nancy, France.
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Su X, Lu X, Bazai SK, Dainese L, Verschuur A, Dumont B, Mouawad R, Xu L, Cheng W, Yan F, Irtan S, Lindner V, Paillard C, Le Bouc Y, Coulomb A, Malouf GG. Delineating the interplay between oncogenic pathways and immunity in anaplastic Wilms tumors. Nat Commun 2023; 14:7884. [PMID: 38036539 PMCID: PMC10689851 DOI: 10.1038/s41467-023-43290-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Wilms tumors are highly curable in up to 90% of cases with a combination of surgery and radio-chemotherapy, but treatment-resistant types such as diffuse anaplastic Wilms tumors pose significant therapeutic challenges. Our multi-omics profiling unveils a distinct desert-like diffuse anaplastic Wilms tumor subtype marked by immune/stromal cell depletion, TP53 alterations, and cGAS-STING pathway downregulation, accounting for one-third of all diffuse anaplastic cases. This subtype, also characterized by reduced CD8 and CD3 infiltration and active oncogenic pathways involving histone deacetylase and DNA repair, correlates with poor clinical outcomes. These oncogenic pathways are found to be conserved in anaplastic Wilms tumor cell models. We identify histone deacetylase and/or WEE1 inhibitors as potential therapeutic vulnerabilities in these tumors, which might also restore tumor immunogenicity and potentially enhance the effects of immunotherapy. These insights offer a foundation for predicting outcomes and personalizing treatment strategies for aggressive pediatric Wilms tumors, tailored to individual immunological landscapes.
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Affiliation(s)
- Xiaoping Su
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xiaofan Lu
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Sehrish Khan Bazai
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France
| | - Linda Dainese
- Department of Pathology, Hôpital Armand Trousseau, Assistance-Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
- UF Tumorothèque HUEP, Hôpital Armand Trousseau, Assistance-Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
- Centre de Recherche Saint-Antoine (CRSA), INSERM, Sorbonne Université, UMR_S .938, Paris, France
| | - Arnauld Verschuur
- Department of Pediatric Oncology, Hôpital d'Enfants de La Timone, F-13005, Marseille, France
| | - Benoit Dumont
- Centre Léon Bérard, Institut d'Hématologie et d'Oncologie Pédiatrique (IHOPe), Lyon, France
| | - Roger Mouawad
- Department of Medical Oncology, Groupe Hospitalier Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Li Xu
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Wenxuan Cheng
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Fangrong Yan
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Sabine Irtan
- Department of Pediaric Surgery, AP-HP, Hôpital Armand Trousseau, Sorbonne Université, Paris, France
| | | | - Catherine Paillard
- Department of Pediatric Onco-hematology, CHRU Strasbourg, Strasbourg Université, Strasbourg, France
| | - Yves Le Bouc
- Centre de Recherche Saint-Antoine (CRSA), INSERM, Sorbonne Université, UMR_S .938, Paris, France
| | - Aurore Coulomb
- Department of Pathology, Hôpital Armand Trousseau, Assistance-Publique Hôpitaux de Paris, Sorbonne Université, Paris, France.
- UF Tumorothèque HUEP, Hôpital Armand Trousseau, Assistance-Publique Hôpitaux de Paris, Sorbonne Université, Paris, France.
- Centre de Recherche Saint-Antoine (CRSA), INSERM, Sorbonne Université, UMR_S .938, Paris, France.
| | - Gabriel G Malouf
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France.
- Department of Medical Oncology, Institut de Cancérologie de Strasbourg, Strasbourg University, Strasbourg, France.
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Roy P, van Peer SE, Dandis R, Duncan C, de Aguirre‐Neto JC, Verschuur A, de Camargo B, Karim‐Kos HE, Boschetti L, Spreafico F, Ramirez‐Villar GL, Graf N, van Tinteren H, Pritchard‐Jones K, van den Heuvel‐Eibrink MM. Impact of the COVID-19 pandemic on paediatric renal tumour presentation and management, a SIOP renal tumour study group study. Cancer Med 2023; 12:17098-17111. [PMID: 37496317 PMCID: PMC10501283 DOI: 10.1002/cam4.6358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/26/2023] [Accepted: 07/09/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic had global catastrophic effects on the management of non-communicable diseases including paediatric cancers. Restrictions during the start of 2020 complicated timely referrals of patients to specialized centres. We aimed to evaluate the pandemic's impact on the number of new diagnoses, disease characteristics and management delay for paediatric renal tumour patients included in the SIOP-RTSG-UMBRELLA study, as compared with data from a historical SIOP-RTSG trial (2005-2009). METHODS The number of intensive care admissions, population mobility rates and national lockdown periods/restrictions were used as proxies of the pandemic's severity and impact on societies. Clinical and tumour data were extracted from the SIOP-RTSG-UMBRELLA study and from historical SIOP-RTSG trials. RESULTS During the first lockdown in Europe, the number of newly diagnosed patients decreased following restrictions and population immobilisation. Additionally, there was a higher proportion of advanced disease (37% vs. 17% before and after COVID-9, p < 0.001) and larger median tumour volume (559 cm3 vs. 328 and 434 cm3 before and after, p < 0.0001). Also in Brazil, the proportion of advanced disease was higher during the national decrease in mobilisation and start of restrictions (50% and 24% vs. 11% and 18% before and after, p < 0.01). Tumour volume in Brazil was also higher during the first months of COVID-19 (599 cm3 vs. 459 and 514 cm3 ), although not significant (p = 0.17). We did not observe any delays in referral time nor in time to start treatment, even though COVID-19 restrictions may have caused children to reach care later. CONCLUSION The COVID-19 pandemic briefly changed the tumour characteristics of children presenting with renal tumours. The longer-term impact on clinical outcomes will be kept under review.
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Affiliation(s)
- Prakriti Roy
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
| | | | - Rana Dandis
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
| | | | | | - Arnauld Verschuur
- Department of Paediatric Oncology & HaematologyLa Timone Children's HospitalMarseilleFrance
| | - Beatriz de Camargo
- Grupo Brasileiro de Tumores Renais (Brazilian Renal Tumor Group)São PauloBrazil
| | - Henrike E. Karim‐Kos
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
- Department of ResearchNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Luna Boschetti
- Department of Medical Oncology and Hematology, Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori di MilanMilanItaly
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori di MilanMilanItaly
| | | | - Norbert Graf
- Department of Paediatric Oncology & HaematologySaarland UniversityHomburgGermany
| | | | - Kathy Pritchard‐Jones
- UCL Great Ormond Street Institute of Child Health, University College LondonLondonUK
| | - Marry M. van den Heuvel‐Eibrink
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
- Division of Child Health, Wilhelmina Children's HospitalUniversity Medical Center UtrechtThe Netherlands
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Donze C, Min V, Ninove L, de Lamballerie X, Revon Rivière G, Verschuur A, Saultier P, André N. BNT162b2 COVID-19 Vaccines in Children, Adolescents and Young Adults with Cancer-A 1-Year Follow-Up. Vaccines (Basel) 2023; 11:vaccines11050989. [PMID: 37243093 DOI: 10.3390/vaccines11050989] [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: 04/03/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Children and young adults with cancer are poorly represented in COVID-19 vaccination studies, and long-term protection conferred by vaccination is not known. (2) Objectives: 1. To determine the adverse effects associated with BNT162B2 vaccination in children and young adults with cancer. 2. To assess its efficacy in stimulating immunological response and in preventing severe COVID-19 disease. (3) Methods: Retrospective single-center study evaluating patients aged 8 to 22 years, with cancer, who underwent vaccination from January 2021 to June 2022. ELISA serologies and serum neutralization were collected monthly from the first injection. Serologies below 26 were considered negative, while those above 264 BAU/mL were considered positive and indicative of protection. Antibodies titers were considered positive above 20. Data on adverse events and infections were collected. (4) Results: 38 patients were included (M/F = 1.7, median age 16 years), of whom 63% had a localized tumor and 76% were undergoing treatment at the time of the first vaccination. Two or three vaccine injections were administered in 90% of patients. Adverse events were mainly systemic and not severe, except for seven grade 3 toxicities. Four cancer-related deaths were reported. Median serology was negative the month following the first vaccination and became protective during the third month. At 3 and 12 months, median serology was 1778 and 6437 BAU/mL, respectively. Serum neutralization was positive in 97% of the patients. COVID-19 infection occurred despite vaccination in 18%; all were mild forms. (5) Conclusions: In children and young adults with cancer, vaccination was well tolerated and conferred effective serum neutralization. COVID-19 infections were mild, and vaccine seroconversion persisted after 12 months in most patients. The value of additional vaccination should be further established.
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Affiliation(s)
- Caroline Donze
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, 13000 Marseille, France
| | - Victoria Min
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, 13000 Marseille, France
| | - Laetitia Ninove
- Unité des Virus Émergents, UVE Aix Marseille University, IRD 190, INSERM 1207, APHM, 13005 Marseille, France
| | - Xavier de Lamballerie
- Unité des Virus Émergents, UVE Aix Marseille University, IRD 190, INSERM 1207, APHM, 13005 Marseille, France
| | - Gabriel Revon Rivière
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, 13000 Marseille, France
| | - Arnauld Verschuur
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, 13000 Marseille, France
| | - Paul Saultier
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, 13000 Marseille, France
- INSERM, INRAe, C2VN, Aix Marseille University, 13005 Marseille, France
| | - Nicolas André
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, 13000 Marseille, France
- CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Aix Marseille University, 13009 Marseille, France
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Irtan S, Coulomb-Lhermine A, Lanz C, Tabone MD, Pasqualini C, Dumont B, Thebaud E, Guellec I, Verschuur A. Number of lymph nodes sampled in SFCE/SIOP 2001 patients with Wilms tumour: Is the goal of more than six achievable? Pediatr Blood Cancer 2023; 70:e30107. [PMID: 36453594 DOI: 10.1002/pbc.30107] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/30/2022] [Accepted: 10/31/2022] [Indexed: 12/04/2022]
Abstract
AIM The number of lymph nodes (LN) that should be sampled during nephrectomy for Wilms tumour (WT) remains controversial but of utmost importance for staging purposes. The aim of this French national retrospective study of patients enrolled in SIOPWT2001 trial was to analyse the number of LN sampled according to their site and to determine if the number of six asked by the International Society of Paediatric Oncology - Renal Tumour Study Group (SIOP-RTSG) UMBRELLA protocol is achievable. METHODS We reviewed the data collected on central pathology review forms from 2002 to 2014 for only unilateral WT. LN were divided whether they were clearly identified by surgeons at nephrectomy or only found by pathologists on the nephrectomy specimen. RESULTS A total of 539 patients (240 male/299 female) were included (458 localized/81 metastatic). Median age at surgery was 41.3 months [0-189]. The number of LN sampled was 0, 1-6, ≥7 and unknown in 69 (12.8%), 293 (54.3%), 160 (29.7%) and 17 (3.2%) cases, respectively. The number of patients with sampled LN were higher if LN were identified by both the pathologist and the surgeon (n = 231, 42.8%) (p = < .001). At least one invaded LN (LN+) was found in 66 patients (12.2%), more than half being found among patients having LN sampled by both pathologist and surgeon (p < .001). The mean number of identified LN was six if no LN+ was detected on final histological analysis, while it was 11 in case of LN+ (p < .001). CONCLUSIONS The aim of sampling more than six LN is achievable, but only with the active collaboration of both surgeons and pathologists.
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Affiliation(s)
- Sabine Irtan
- Department of Visceral and Neonatal Paediatric Surgery, Sorbonne Université, Hôpital Armand Trousseau - APHP, Paris, France
| | - Aurore Coulomb-Lhermine
- Sorbonne Université, Service d'Anatomie et Cytologie Pathologiques, Hôpital Armand Trousseau - APHP, Paris, France
| | - Camille Lanz
- Department of Visceral and Neonatal Paediatric Surgery, Sorbonne Université, Hôpital Armand Trousseau - APHP, Paris, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hemato-Oncology, Sorbonne Université, Hôpital Armand Trousseau - APHP, Paris, France
| | - Claudia Pasqualini
- Department of Pediatric Hemato-Oncology, Institut Gustave Roussy, Villejuif, France
| | - Benoit Dumont
- Department of Pediatric Hemato-Oncology, Institut Léon Bérard, Lyon, France
| | - Estelle Thebaud
- Department of Pediatric Hemato-Oncology, Hôpitaux Universitaires de Nantes, Nantes, France
| | - Isabelle Guellec
- Neonatal Intensive Care Unit, APHP.6 Hôpital Armand Trousseau, Paris, France
| | - Arnauld Verschuur
- Pediatric Hemato-Oncology Unit, Groupe Hospitalier La Timone, APHM, Marseille, France
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Awounou D, Lacour B, Desandes E, Guissou S, Cassoux N, Doz F, Dufour C, Minard-Colin V, Schleiermacher G, Taque S, Verschuur A, Clavel J, Goujon S. Seasonality of main childhood embryonal tumours and rhabdomyosarcoma, France, 2000-2015. Cancer Med 2023; 12:8789-8803. [PMID: 36726302 PMCID: PMC10134357 DOI: 10.1002/cam4.5624] [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: 07/22/2022] [Revised: 12/13/2022] [Accepted: 01/03/2023] [Indexed: 02/03/2023] Open
Abstract
Few studies have investigated the seasonal patterns of embryonal tumours. Based on data from the French National Registry of Childhood Cancers, the present study aimed to investigate seasonal variations in embryonal tumour incidence rates by month of birth and by month of diagnosis. The study included 6635 primary embryonal tumour cases diagnosed before the age of 15 years over the period 2000-2015 in mainland France. Assuming monthly variations in incidence rates were homogeneous over 2000-2015, we used a Poisson regression model to test for overall heterogeneity in standardised incidence ratios (SIRs) by month of birth or diagnosis. The seasonal scan statistic method was used to detect monthly excesses or deficits of embryonal tumour cases over the whole study period. The annual reproducibility of the observed monthly variations was formally tested. An overall heterogeneity in incidence rates by month of birth was observed for rhabdomyosarcoma in boys only. Based on the month of diagnosis, a seasonality was evidenced for unilateral retinoblastoma, with a lower incidence rate in the summer (SIRJul-Aug = 0.68, 95% CI = 0.52-0.87), whilst the incidence rate of rhabdomyosarcoma tended to be lower in August (SIRAug = 0.68, 95% CI = 0.52-0.89). No seasonality was detected for the other embryonal tumour groups by month of birth or month of diagnosis. This study is one of the largest to have investigated the seasonality of childhood embryonal tumours. The study showed a seasonal variation in the incidence rates by month of diagnosis for unilateral retinoblastoma and rhabdomyosarcoma. Our findings are likely to reflect a delay in consultation during the summer months. However, the role of seasonally varying environmental exposures cannot be ruled out.
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Affiliation(s)
- Danielle Awounou
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France
| | - Brigitte Lacour
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Solid Tumours (RNTSE), CHU Nancy, Nancy, France
| | - Emmanuel Desandes
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Solid Tumours (RNTSE), CHU Nancy, Nancy, France
| | - Sandra Guissou
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Solid Tumours (RNTSE), CHU Nancy, Nancy, France
| | - Nathalie Cassoux
- Université Paris Cité, Paris, France.,Department of Surgical Oncology, Institut Curie, Paris, France
| | - François Doz
- Université Paris Cité, Paris, France.,SIREDO Centre (Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology), Institut Curie, Paris, France
| | - Christelle Dufour
- Department of Paediatric and Adolescent Oncology, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Véronique Minard-Colin
- Department of Paediatric and Adolescent Oncology, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France.,Inserm, UMR 1015, Université Paris Saclay, Villejuif, France
| | - Gudrun Schleiermacher
- SIREDO Centre (Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology), Institut Curie, Paris, France
| | - Sophie Taque
- Department of Paediatrics, CHU Rennes, Rennes, France
| | - Arnauld Verschuur
- Department of Paediatric Haematology, Immunology and Oncology, Children Hospital of La Timone, APHM, Marseille, France
| | - Jacqueline Clavel
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Haematological Malignancies (RNHE), Villejuif, France
| | - Stéphanie Goujon
- Inserm, UMR 1153 Centre of Research in Epidemiology and StatisticS (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France.,Université Paris Cité, Paris, France.,French National Registry of Childhood Haematological Malignancies (RNHE), Villejuif, France
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Otth M, Brack E, Kearns PR, Kozhaeva O, Ocokoljic M, Schoot RA, Vassal G, Balduzzi A, Beck Popovic M, Beishuizen A, Bergamaschi L, Biondi A, Bourdeaut F, Braicu E, Brok J, Brugières L, Burke A, Calaminus G, Casanova M, Choucair ML, Cleirec M, Corbaciouglu S, Correa Llano MG, De Rojas T, Domínguez Pinilla N, Elmaraghi C, Ferrari A, Fossa A, Gaspar N, Herold N, Karapiperi K, Karu M, Kjærsgaar M, Knörr F, Koenig C, Kranjcec I, Krawczyk M, Lehmberg K, Lehrnbecher T, Lunesink M, Massano D, Matijasic N, Merks H, Metzler M, Michalski A, Minkov M, Morland B, Niktoreh N, Oltenau E, Orbach D, Owens C, Papachristidou S, Pasqualini C, Pavlovic M, Perez Albert P, Poyer F, Radulovic I, Reinhardt D, Rebelo J, Roser E, Russo I, Scheinemann K, Schindera C, Schrappe M, Sehested A, Sehouli J, Spreafico F, Strauss SJ, Stutterheim J, Svojgr K, Tzotzola V, Van Ewijk R, Verschuur A, Vora A, Woessmann W, Zajac-Spychala O, Zwaan M. Essential medicines for childhood cancer in Europe: a pan-European, systematic analysis by SIOPE. Lancet Oncol 2022; 23:1537-1546. [PMID: 36332647 DOI: 10.1016/s1470-2045(22)00623-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Shortages and unequal access to anticancer medicines for children and adolescents are a reality in Europe. The aim of the European Society for Paediatric Oncology (SIOPE) Essential Anticancer Medicines Project was to provide a list of anticancer medicines that are considered essential in the treatment of paediatric cancers to help ensure their continuous access to all children and adolescents with cancer across Europe. METHODS This pan-European project, done between Jan 20, 2020, and Feb 18, 2022, was designed to be a systematic collection and review of treatment protocols and strategies that are used to treat childhood cancer in Europe. We formed 16 working groups on the basis of paediatric cancer types, and which were based on the existing SIOPE Clinical Trial Groups. Workings groups consisted of representatives from the SIOPE Clinical Trial Groups, Young SIOPE members, and senior paediatric oncology experts. Each group collected existing treatment protocols that are used to treat the respective cancer types in Europe. Medicines from the standard group of each protocol were extracted. For medicines not on the WHO Essential Medicines List for children (EMLc) 2017, working groups did a literature search to determine whether the medicines should be defined as essential, promising, or neither essential nor promising. Each group provided an individual summary, and all medicines that were considered essential by at least one group were combined in a joint list. FINDINGS The working groups identified 73 treatment protocols used in Europe and defined 66 medicines as essential. For several newer medicines, such as kinase inhibitors or tisagenlecleucel, the supporting evidence was insufficient to consider them essential, so these medicines were defined as promising. 25 medicines were considered promising by at least one working group. 22 (33%) of the 66 essential and none of the promising medicines were included in the WHO EMLc 2017. The WHO EMLc 2021 included two new medicines (everolimus and vinorelbine) following applications we made as a result of this project. INTERPRETATION Medicines that were defined as essential within this project should be available for the treatment of childhood and adolescent cancer continuously and across Europe. This list can be used to support and guide stakeholders and policy makers in negotiations on a national and European level regarding shortages, accessibility, and affordability of these medicines. FUNDING None.
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Affiliation(s)
- Maria Otth
- Division of Oncology-Hematology, Department of Pediatrics, Kantonsspital Aarau, Aarau, Switzerland; Department of Oncology, Haematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children's Hospital Zurich, Zurich, Switzerland.
| | - Eva Brack
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Bern, Switzerland
| | - Pamela R Kearns
- Cancer Research UK Clinical Trials Unit, National Institute for Health Research Birmingham Biomedical Research Centre, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Olga Kozhaeva
- Policy Department, European Society for Paediatric Oncology, SIOP Europe, Brussels, Belgium
| | - Marko Ocokoljic
- Policy Department, European Society for Paediatric Oncology, SIOP Europe, Brussels, Belgium
| | - Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Gilles Vassal
- Department of Children and Adolescent Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
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Hont AB, Dumont B, Sutton KS, Anderson J, Kentsis A, Drost J, Hong AL, Verschuur A. The tumor microenvironment and immune targeting therapy in pediatric renal tumors. Pediatr Blood Cancer 2022; 70 Suppl 2:e30110. [PMID: 36451260 DOI: 10.1002/pbc.30110] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 12/04/2022]
Abstract
This review highlights the role of several immunomodulating elements contributing to the tumor microenvironment of various pediatric renal tumors including Wilms tumor. The roles of innate and adaptive immune cells in renal tumors are summarized as well as immunomodulatory cytokines and other proteins. The expression and the predictive role of checkpoint modulators like PD-L1 and immunomodulating proteins like glypican-3, B7-H3, COX-2 are highlighted with a translational view toward potential therapeutic innovations. We further discuss the current state of preclinical models in advancing this field of study. Finally, examples of clinical trials of immunomodulating strategies such as monoclonal antibodies and chimeric antigen receptor T (CAR-T) cells for relapsed/refractory/progressive pediatric renal tumors are described.
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Affiliation(s)
- Amy B Hont
- Department of Hematology/Oncology, Children's National Hospital, George Washington University, Washington, District of Columbia, USA
| | - Benoit Dumont
- Pediatric Hematology and Oncology Institute, Léon Bérard Cancer Center, Lyon, France
| | - Kathryn S Sutton
- Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - John Anderson
- Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alex Kentsis
- Tow Center for Developmental Oncology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center and Weill Medical College of Cornell University, New York, New York, USA
| | - Jarno Drost
- Princess Máxima Center and Oncode Institute, Utrecht, The Netherlands
| | - Andrew L Hong
- Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Arnauld Verschuur
- Department of Pediatric Hematology and Oncology, Hôpital d'Enfants de la Timone, APHM, Marseille, France
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10
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Minard-Colin V, Aupérin A, Burke A, Alexander S, Moreno M, Buffardi S, Uyttebroeck A, Bollard C, Zsiros J, Csoka M, Kazanowska B, Chiang A, Verschuur A, Miles R, Wotherspoon A, Barkauskas D, Wheatley K, Vassal G, Adamson P, Gross T, Patte C, Pillon M. INTER-B NHL-RITUX-2010 TRIAL FOR CHILDREN/ADOLESCENTS WITH HIGH-RISK MATURE B-NHL: SAFETY AND EFFICACY IN PATIENTS TREATED WITH RITUXIMAB AND LMB CHEMOTHERAPY. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00255-7] [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: 11/07/2022]
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Cahn F, Revon-Riviere G, Min V, Rome A, Filaine P, Pelletier A, Abed S, Gentet JC, Verschuur A, André N. Blood-Derived Liquid Biopsies Using Foundation One ® Liquid CDx for Children and Adolescents with High-Risk Malignancies: A Monocentric Experience. Cancers (Basel) 2022; 14:cancers14112774. [PMID: 35681754 PMCID: PMC9179410 DOI: 10.3390/cancers14112774] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/15/2022] [Accepted: 05/22/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Precision oncology requires tumor molecular profiling to identify actionable targets. Blood-derived liquid biopsy (LB) is a potential alternative that is not yet documented in real-world settings, especially in pediatric oncology. Analyzing, retrospectively, the use of LB in children with refractory relapsing diseases, we were able to show that this is a feasible alternative to tissue biopsy, resulting in successful analysis in a subset of patients. Abstract Precision oncology requires tumor molecular profiling to identify actionable targets. Tumor biopsies are considered as the gold standard, but their indications are limited by the burden of procedures in children. Blood-derived liquid biopsy (LB) is a potential alternative that is not yet documented in real-world settings, especially in pediatric oncology. We performed a retrospective analysis of children and teenagers with a relapsing or refractory disease, upon whom LB was performed using the Foundation One® liquid CDx from 1 January 2020 to 31 December 2021 in a single center. Forty-five patients (27 boys) were included, with a median age of 9 years of age (range: 1.5–17 years old). Underlying malignancies were neuroblastoma (12 patients), bone sarcoma (12), soft tissue sarcoma (9), brain tumors (7), and miscellaneous tumors (5). Forty-three patients had metastatic disease. Six patients had more than one biopsy because of a failure in first LB. Median time to obtain results was 13 days. Overall, analysis was successful for 33/45 patients. Eight patients did not present any molecular abnormalities. Molecular alterations were identified in 25 samples with a mean of 2.1 alterations per sample. The most common alterations concerned TP53 (7 pts), EWS-FLI1 (5), ALK (3), MYC (3), and CREBBP (2). TMB was low in all cases. Six patients received treatment based on the results from LB analysis and all were treated off-trial. Three additional patients were included in early phase clinical trials. Mean duration of treatment was 85 days, with one patient with stable disease after eight months. Molecular profiling using Foundation One® Liquid CDx was feasible in pediatric patients with high-risk solid tumors and lead to identification of targetable mutations in a subset of patients.
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Affiliation(s)
- Fanny Cahn
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
| | - Gabriel Revon-Riviere
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
- Centre d’essais Précoces en Cancérologie de Marseille (CEPCM), CLIPP2, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France;
| | - Victoria Min
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
| | - Angélique Rome
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
| | - Pauline Filaine
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
- Centre d’essais Précoces en Cancérologie de Marseille (CEPCM), CLIPP2, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France;
| | - Annick Pelletier
- Centre d’essais Précoces en Cancérologie de Marseille (CEPCM), CLIPP2, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France;
| | - Sylvie Abed
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
| | - Jean-Claude Gentet
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
| | - Arnauld Verschuur
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
| | - Nicolas André
- Department of Pediatric Oncology, La Timone University Hospital of Marseille, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France; (F.C.); (G.R.-R.); (V.M.); (A.R.); (P.F.); (S.A.); (J.-C.G.); (A.V.)
- Centre d’essais Précoces en Cancérologie de Marseille (CEPCM), CLIPP2, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France;
- SMARTc Unit, CRCM Inserm 1068, CNRS UMR 7258, Aix-Marseille University, 13005 Marseille, France
- Correspondence:
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12
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de Aguirre-Neto JC, de Camargo B, van Tinteren H, Bergeron C, Brok J, Ramírez-Villar G, Verschuur A, Furtwängler R, Howell L, Saunders D, Olsen O, Coulomb A, Vokuhl C, Godzinski J, Smets AM, Vujanic GM, van den Heuvel-Eibrink MM, Graf N, Pritchard-Jones K. International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study. JCO Glob Oncol 2022; 8:e2100425. [PMID: 35537105 PMCID: PMC9126524 DOI: 10.1200/go.21.00425] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
International comparisons of patient demographics, tumor characteristics, and survival can shed light on areas for health care system improvement. The International Society of Pediatric Oncology Wilms Tumor 2001 trial/study registered patients through national clinical study groups in Western Europe and Brazil. This retrospective post hoc analysis of the International Society of Pediatric Oncology Wilms Tumor 2001 database aims to make visible and suggest reasons for any variations in outcomes. International variation in Wilms tumor survival parallels disease burden at diagnosis.![]()
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Affiliation(s)
| | | | - Harm van Tinteren
- Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Christophe Bergeron
- Centre Léon Bérard, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Jesper Brok
- Department of Paediatric Oncology and Haematology, Rigshospitalet, Copenhagen, Denmark
| | | | - Arnauld Verschuur
- Service d'hématologie-oncologie Pédiatrique, Hôpital de la Timone, Marseille, France
| | - Rhoikos Furtwängler
- Department of Pediatric Hematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Lisa Howell
- Paediatric Oncology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Daniel Saunders
- Paediatric Radiotherapy, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Oystein Olsen
- Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Aurore Coulomb
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Armand Trousseau, Paris, France
| | | | - Jan Godzinski
- Department of Paed. Surgery, Marciniak Hospital, Wroclaw, Poland
| | - Anne M Smets
- Radiology, Amsterdam University Medical Centre-AMC, Amsterdam, the Netherlands
| | | | | | - Norbert Graf
- Department of Pediatric Hematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, Developmental Biology and Cancer Research and Teaching Department, University College London, London, United Kingdom
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13
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Trippett T, Toledano H, Campbell Hewson Q, Verschuur A, Langevin AM, Aerts I, Howell L, Gallego S, Rossig C, Smith A, Patel D, Pereira LR, Cheeti S, Musib L, Hutchinson KE, Devlin C, Bernardi R, Geoerger B. Cobimetinib in Pediatric and Young Adult Patients with Relapsed or Refractory Solid Tumors (iMATRIX-cobi): A Multicenter, Phase I/II Study. Target Oncol 2022; 17:283-293. [PMID: 35715627 PMCID: PMC9217999 DOI: 10.1007/s11523-022-00888-9] [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] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
Background The MAPK pathway is an emerging target across a number of adult and pediatric tumors. Targeting the downstream effector of MAPK, MEK1, is a proposed strategy to control the growth of MAPK-dependent tumors. Objective iMATRIX-cobi assessed the safety, pharmacokinetics, and anti-tumor activity of cobimetinib, a highly selective MEK inhibitor, in children and young adults with relapsed/refractory solid tumors. Patients and Methods This multicenter Phase I/II study enrolled patients aged 6 months to < 30 years with solid tumors with known/expected MAPK pathway involvement. Patients received cobimetinib tablet or suspension formulation on Days 1–21 of a 28-day cycle. Dose escalation followed a rolling 6 design. The primary endpoint was safety; secondary endpoints were pharmacokinetics and anti-tumor activity. Results Of 56 enrolled patients (median age 9 years [range 3–29]), 18 received cobimetinib tablets and 38 cobimetinib suspension. Most common diagnoses were low-grade glioma (LGG; n = 32, including n = 12 in the expansion cohort) and plexiform neurofibroma within neurofibromatosis type 1 (n = 12). Six patients (11 %) experienced dose-limiting toxicities (including five ocular toxicity events), which established a pediatric recommended Phase II dose (RP2D) of 0.8 mg/kg tablet and 1.0 mg/kg suspension. Most frequently reported treatment-related adverse events were gastrointestinal and skin disorders. Steady state mean exposure (Cmax, AUC0–24) of cobimetinib at the RP2D (1.0 mg/kg suspension) was ~ 50 % lower than in adults receiving the approved 60 mg/day dose. Overall response rate was 5.4 % (3/56; all partial responses in patients with LGG). Conclusions The safety profile of cobimetinib in pediatrics was similar to that reported in adults. Clinical activity was observed in LGG patients with known/suspected MAPK pathway activation. Cobimetinib combination regimens may be required to improve response rates in this pediatric population. Clinical Trial Registration ClinicalTrials.gov NCT02639546, registered December 24, 2015. Supplementary Information The online version contains supplementary material available at 10.1007/s11523-022-00888-9.
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Affiliation(s)
- Tanya Trippett
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
| | - Helen Toledano
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Quentin Campbell Hewson
- Department of Paediatric and Adolescent Oncology, The Great North Children's Hospital, Newcastle Upon Tyne, UK
| | - Arnauld Verschuur
- Assistance Publique-Hopitaux de Marseille, Pediatric Oncology, Timone Children's Hospital, Marseille, France
| | | | - Isabelle Aerts
- Oncology Center SIREDO, Institut Curie, PSL Research University, Paris, France
| | - Lisa Howell
- Paediatric Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Soledad Gallego
- Paediatric Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Claudia Rossig
- Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany
| | - Amy Smith
- Haley Center for Children's Cancer and Blood Disorders, Orlando-Health Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Darshak Patel
- Product Development, Biometrics, Biostatistics, F. Hoffmann-La Roche Ltd, Mississauga, ON, Canada.,Parexel International Ltd, Ottawa, ON, Canada
| | | | - Sravanthi Cheeti
- Clinical Pharmacology, Genentech, Inc., South San Francisco, CA, USA
| | - Luna Musib
- Clinical Pharmacology, Genentech, Inc., South San Francisco, CA, USA.,Arrivent Biopharma, Newtown Square, PA, USA
| | | | - Clare Devlin
- Product Development Oncology, Roche Products Ltd, Welwyn, UK
| | - Ronald Bernardi
- Product Development Oncology, Genentech, Inc., South San Francisco, CA, USA
| | - Birgit Geoerger
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Center, Université Paris-Saclay, INSERM U1015, Villejuif, France
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14
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Denize T, Massa S, Valent A, Militti L, Bertolotti A, Barisella M, Rioux-Leclercq N, Malouf GG, Spreafico F, Verschuur A, van der Beek J, Tytgat L, van den Heuvel-Eibrink MM, Vujanic G, Collini P, Coulomb A. Renal cell carcinoma in children and adolescents: A retrospective study of a French-Italian series of 93 cases. Histopathology 2022; 80:928-945. [PMID: 35238063 DOI: 10.1111/his.14634] [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: 09/06/2021] [Revised: 02/06/2022] [Accepted: 02/23/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Renal cell carcinomas represent 2 to 5% of kidney malignancies in children and adolescents. Appropriate diagnostic and classification are crucial for the correct management of the patients and in order to avoid inappropriate preoperative chemotherapy, which is usually recommended if a Wilms tumor is suspected. METHODS a French-Italian series of 93 renal cell carcinomas collected from 1990 to 2019 in patients aged less than 18 years old was reclassified according to the 2016 WHO classification and the latest literature. TFE3 and TFEB FISH analyses and a panel of immunohistochemical stains were applied. RESULTS The median age at diagnosis was 11 years (range: 9 months - 17 years). MiT family (MiTF) translocation renal cell carcinomas accounted for 52% of the tumors, followed by papillary renal cell carcinomas (20%) and unclassified renal cell carcinomas (13%). Other subtypes, such as SDHB-deficient and Fumarate hydratase-deficient renal cell carcinomas, represented 1 to 3% of the cases. We also described a case of ALK-rearranged renal cell carcinoma with a metanephric adenoma-like morphology. CONCLUSION A precise histological diagnosis is mandatory as targeted therapy could be applied for some RCC subtypes, i.e., MiTF-translocation and ALK-translocation renal cell carcinomas. Moreover, some RCC subtypes may be associated with a predisposition syndrome that will impact patients' and family's management and genetic counseling. A precise RCC subtype is also mandatory for the clinical management of the patients and the inclusion in new prospective clinical trials.
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Affiliation(s)
- Thomas Denize
- Department of Pathology, Sorbonne Université, Assistance Publique Hôpitaux de Paris - Hôpital Armand Trousseau, Paris, France
| | - Simona Massa
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,present address: Unit of Pathology, Azienda Ospedaliera Specialistica dei Colli Monaldi-Cotugno-CTO, Naples, Italy
| | - Alexander Valent
- Service de Génétique des tumeurs, Département de Pathologie, Institut Gustave Roussy, Villejuif, France
| | - Lucia Militti
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessia Bertolotti
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marta Barisella
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Gabriel G Malouf
- Service d'Oncologie Médicale, Institut de Cancérologie de Strasbourg, Strasbourg, France
| | - Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Arnauld Verschuur
- Department of Pediatric Oncology, Hôpital d'enfants de la Timone, Marseille, France
| | - Justine van der Beek
- Princess Máxima Center for Pediatric Oncology, and Utrecht University, Utrecht, The Netherlands
| | - Lieve Tytgat
- Princess Máxima Center for Pediatric Oncology, and Utrecht University, Utrecht, The Netherlands
| | | | - Gordan Vujanic
- Department of Pathology, Sidra Medicine / Weill Cornell Medicine, Doha, Qatar.,Sorbonne Université, Assistance Publique Hôpitaux de Paris - Hôpital Armand Trousseau, Paris, France
| | - Paola Collini
- Soft Tissue and Bone Pathology and Pediatric Pathology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Aurore Coulomb
- Department of Pathology, Sorbonne Université, Assistance Publique Hôpitaux de Paris - Hôpital Armand Trousseau, Paris, France
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15
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Delafoy M, Verschuur A, Scheleirmacher G, Tabone MD, Sudour-Bonnange H, Thébaud E, Freycon C, Notz-Carrère A, Boulanger C, Pellier I, Irtan S, Muracciole X, Coulomb-L'Hermine A, Dijoud F, Morelle M, Bergeron C, Pasqualini C. High-dose chemotherapy followed by autologous stem cell rescue in Wilms tumors: French report on toxicity and efficacy. Pediatr Blood Cancer 2022; 69:e29431. [PMID: 34811873 DOI: 10.1002/pbc.29431] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Heterogeneous data have been reported on high-dose chemotherapy (HDCT) with autologous stem cell rescue (ASCR) in Wilms tumors (WTs). We aimed to define its safety and efficacy in the French cohort, and to compare this management to current international recommendations. METHODS Data prospectively collected from children, adolescents, and young adults with WT treated with HDCT/ASCR between 2000 and 2016 in French centers were retrospectively analyzed. Toxicity was reported according to CTCAE v4.03. RESULTS Fifty-four patients received HDCT/ASCR (first line, n = 13; recurrence, n = 41). Their median age at the time of ASCR was 5.3 years (range 2.2-21.6). Main nonhematological acute grades 3-4 toxicities were digestive and renal. No significant difference of toxicity rate was observed among HDCT regimens and schedules. Two patients died shortly after ASCR (renal and multiorgan failure), and one heavily pretreated patient died of late respiratory failure. The selection criteria applied to define those patients eligible for HDCT/ASCR retrospectively matched to those currently used in the International Society of Pediatric Oncology (SIOP) UMBRELLA protocol for 38 patients, with encouraging survival rates compared to published data. The objective response rate to HDCT was 21%, with a disease control rate after HDCT of 85%. After a median follow-up of 7 years, the 5-year event-free survival (EFS) and overall survival (OS) were 54% (95% CI: 32%-76%) and 62% (95% CI: 31%-82%) for frontline patients, and 57% (95% CI: 39%-71%) and 69% (95% CI: 52%-81%) at recurrence. CONCLUSION HDCT was feasible and showed encouraging results in well-defined settings. Data from the current prospective protocol will help to better evaluate HDCT impact on survival.
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Affiliation(s)
- Manon Delafoy
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Arnauld Verschuur
- Pediatric Hematology-Oncology Department, La Timone Hospital, AP-HM, Marseille, France
| | | | | | | | - Estelle Thébaud
- Pediatric Onco-Hematology Department, University Hospital Center of Nantes, Nantes, France
| | - Claire Freycon
- Pediatric Hematology-Oncology Department, University Hospital Center of Grenoble, Grenoble, France
| | - Anne Notz-Carrère
- Pediatric Onco-Hematology Department, University Hospital Center of Bordeaux, Bordeaux, France
| | - Cécile Boulanger
- Pediatric Hematology-Oncology Department, University Hospital Center of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Pediatric Hematology-Oncology Department, University Hospital Center of Angers, Angers, France
| | - Sabine Irtan
- Department of Pediatric Surgery, Sorbonne Université, Armand Trousseau Hospital, APHP, Paris, France
| | - Xavier Muracciole
- Department of Radiotherapy, La Timone Hospital, AP-HM, Marseille, France
| | | | | | - Magali Morelle
- Department of Statistic, Centre Léon Bérard, Lyon, France
| | - Christophe Bergeron
- Pediatric Onco-Hematology Department, Centre Leon Bérard/IHOPE, Lyon, France
| | - Claudia Pasqualini
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
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16
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Graf N, Bergeron C, Brok J, de Camargo B, Chowdhury T, Furtwängler R, Gessler M, Godzinski J, Pritchard-Jones K, Ramirez-Villar GL, Rübe C, Sandstedt B, Schenk JP, Spreafico F, Sudour-Bonnange H, van Tinteren H, Verschuur A, Vujanic G, van den Heuvel-Eibrink MM. Fifty years of clinical and research studies for childhood renal tumors within the International Society of Pediatric Oncology (SIOP). Ann Oncol 2021; 32:1327-1331. [PMID: 34416363 DOI: 10.1016/j.annonc.2021.08.1749] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/08/2021] [Indexed: 01/01/2023] Open
Affiliation(s)
- N Graf
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg, Germany.
| | - C Bergeron
- Department of Paediatric Haemato-Oncology, Centre Léon Bérard, Lyon, France
| | - J Brok
- Department of Pediatric Oncology and Hematology, Rigshospitalet, Copenhagen, Denmark
| | - B de Camargo
- Research Center, Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - T Chowdhury
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - R Furtwängler
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg, Germany
| | - M Gessler
- Theodor-Boveri-Institute/Biocenter and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - J Godzinski
- Department of Pediatric Surgery, Marciniak Hospital, Fieldorfa 2, Poland; Department of Paediatric Traumatology and Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - K Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, University College London, London, UK
| | - G L Ramirez-Villar
- Department of Paediatric Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - C Rübe
- Department of Radiation Oncology, Saarland University, Homburg, Germany
| | - B Sandstedt
- Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - J-P Schenk
- Pediatric Radiology Section, Department for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - F Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - H Sudour-Bonnange
- Centre Oscar Lambret, Department of Children and AJA Oncology, Lille, France
| | - H van Tinteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - A Verschuur
- Department of Pediatric Oncology, Hôpital d'Enfants de la Timone, Marseille, France
| | - G Vujanic
- Department of Pathology, Sidra Medicine and Weill Cornell Medicine - Qatar, Doha, Qatar
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17
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Roux C, Revon-Rivière G, Gentet JC, Verschuur A, Scavarda D, Saultier P, Appay R, Padovani L, André N. Metronomic Maintenance With Weekly Vinblastine After Induction With Bevacizumab-Irinotecan in Children With Low-grade Glioma Prevents Early Relapse. J Pediatr Hematol Oncol 2021; 43:e630-e634. [PMID: 33235152 DOI: 10.1097/mph.0000000000002002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Received: 06/30/2020] [Accepted: 10/09/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pediatric low-grade glioma (pLGG) represents the most common brain tumor in childhood. Previous studies have reported that a therapeutic strategy on the basis of the association of bevacizumab alone (B) or in combination with irinotecan (BI) could produce rapid tumor response and clinical improvement in children with pLGG. Nevertheless, a majority of patients relapses shortly (median, 5 mo) after stopping B or BI treatment. We proposed metronomic maintenance with weekly vinblastine added after a 6 months induction of B/BI to prevent early relapse. PATIENTS AND METHODS Monocentric retrospective analysis of a patient with pLGG treated with B or BI for 6 months followed by a 12-month maintenance with weekly vinblastine (6 mg/m²) from October 2012 to September 2019 in a single institution. RESULTS In total, 18 patients (7 males and 11 females) were identified. Because of progression during the B or BI induction 2/18 children were excluded. In total, 16 patients were analyzed with a median age of 10 years (range, 4 to 16 y). A total of 13 patients received BI and 3 patients received B alone. The mean duration of induction was 6.2 months (range, 2 to 12 mo). After induction 5/16 patients had a partial radiologic response, 11/16 patients had stable disease. All patients started maintenance (median duration, 12 mo; range, 3 to 12 mo). With a median follow-up of 3.9 years after the end of B or BI (range, 11 mo to 7.2 y), 15/16 patients were alive and 9/16 patients were progression-free. Seven of 16 children progressed with a median time to progression of 23 months (ranges, 5 to 39 mo). Three of 16 (18%) children progressed during vinblastine maintenance and 4/16 (25%) patients after the end of maintenance. After the total duration of treatment, clinical improvement was noted in 4 patients, 9 patients had stable symptoms, and only 3 patients progressed. One and 2-year event-free survival were, respectively, 81.2% and 56.2%. Two-year overall survival was 93.7%. CONCLUSIONS We report here, the potential benefit and the improvement of progression-free survival by adding metronomic maintenance with weekly vinblastine after initial induction with B or BI in children with low-grade glioma.
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Affiliation(s)
- Clémence Roux
- Departments of Pediatric Hematology, Immunology and Oncology
| | | | | | - Arnauld Verschuur
- Departments of Pediatric Hematology, Immunology and Oncology
- Metronomics Global Health Initiative
| | | | - Paul Saultier
- Departments of Pediatric Hematology, Immunology and Oncology
- C2VN, INSERM, INRAe, Aix Marseille University
| | | | - Laetitia Padovani
- Radiotherapy Department, La Timone Children's University Hospital, AP-HM
| | - Nicolas André
- Departments of Pediatric Hematology, Immunology and Oncology
- Metronomics Global Health Initiative
- SMARTc unit Centre de Recherche en Cancérologie de Marseille Inserm U1068, Aix Marseille University, Marseille, France
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18
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Gaspari L, Paris F, Cassel-Knipping N, Villeret J, Verschuur A, Soyer-Gobillard MO, Carcopino-Tusoli X, Hamamah S, Kalfa N, Sultan C. Diethylstilbestrol exposure during pregnancy with primary clear cell carcinoma of the cervix in an 8-year-old granddaughter: a multigenerational effect of endocrine disruptors? Hum Reprod 2021; 36:82-86. [PMID: 33147330 DOI: 10.1093/humrep/deaa267] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/10/2020] [Indexed: 11/13/2022] Open
Abstract
To date, vaginal/cervical clear cell adenocarcinoma (CCAC) has not been reported in the granddaughters of women treated with diethylstilbestrol (DES) during pregnancy. We present an 8-year-old girl with a history of severe vaginal bleeding who was diagnosed with cervical CCAC. She underwent fertility-sparing surgery and radiotherapy. No sign of recurrence was detected throughout a 10-year follow-up. Her grandmother had received DES therapy during pregnancy with the patient's mother. Although no direct causal link is demonstrated, this case raises for the first time, the hypothesis of multigenerational effects of DES in girls and strongly suggests the need to follow the granddaughters of DES-treated women.
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Affiliation(s)
- Laura Gaspari
- Unité d'Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie, Hôpital Arnaud-de-Villeneuve, CHU Montpellier et Université Montpellier, Montpellier, France.,Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier et Université Montpellier, Montpellier, France.,INSERM U 1203, Montpellier, France
| | - Françoise Paris
- Unité d'Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie, Hôpital Arnaud-de-Villeneuve, CHU Montpellier et Université Montpellier, Montpellier, France.,Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier et Université Montpellier, Montpellier, France.,INSERM U 1203, Montpellier, France
| | | | - Julia Villeret
- Hôpital Henri Duffaut, Service de Pathologie, Avignon, France
| | - Arnauld Verschuur
- Hôpital d'Enfants de la Timone, Centre de Cancérologie Pédiatrique, Marseille, France
| | | | | | - Samir Hamamah
- INSERM U 1203, Montpellier, France.,Département de Biologie de La Reproduction et DPI (ART/PGD), Hôpital A. de Villeneuve, CHU Montpellier et Université, Montpellier, France
| | - Nicolas Kalfa
- Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier et Université Montpellier, Montpellier, France.,Département de Chirurgie Pédiatrique, Hôpital Lapeyronie, CHU Montpellier et Université Montpellier 1, Montpellier, France
| | - Charles Sultan
- Unité d'Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie, Hôpital Arnaud-de-Villeneuve, CHU Montpellier et Université Montpellier, Montpellier, France.,Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier et Université Montpellier, Montpellier, France
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19
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Saultier P, Vallet C, Sotteau F, Hamidou Z, Gentet JC, Barlogis V, Curtillet C, Verschuur A, Revon-Riviere G, Galambrun C, Chambost H, Auquier P, Michel G, André N. A Randomized Trial of Physical Activity in Children and Adolescents with Cancer. Cancers (Basel) 2021; 13:cancers13010121. [PMID: 33401713 PMCID: PMC7795208 DOI: 10.3390/cancers13010121] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 11/26/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Malignant diseases and anticancer treatments alter physical activity and performance in children and adolescents. Physical inactivity may cause both early and long-term complications, increasing the disease-associated burden. However, data on the safety and efficacy of physical activity programs in children with cancer are still scarce. In this randomized controlled open-label clinical trial that included 80 children and adolescents with cancer, the six-minute walk test distance (evaluating exercise capacity) was improved in the intervention group (physical activity program) vs. the control group (86 ± 12 m vs. 32 ± 6 m), a significant difference. Several other physical parameters (flexibility, balance, upper and lower limb strength, trunk and abdominal muscle endurance), global self-esteem and parent-reported quality of life were also better in the intervention group. In children and adolescents undergoing treatment for cancer, a physical activity program is safe, improves exercise capacity, and may have persistent physical and psychological benefits. Abstract Background: to evaluate the safety and efficacy of a physical activity program (PAP) in children and adolescents with cancer. Methods: children and adolescents with cancer were randomly assigned in a 1:1 ratio to the six-month PAP (intervention group) or to the control group. The first evaluation was performed at the end of the PAP (T0 + 6 mo). At T0 + 6 mo, both groups received the six-month PAP with a second evaluation at T0 + 12 mo. The primary outcome was the evolution of exercise capacity measured using the six-minute walk test (6 MWT) at T0 + 6 mo. Secondary outcomes included PAP safety and changes in other physical functions, self-esteem, and quality-of-life parameters. Results: The trial involved 80 children and adolescents (age range 5.0–18.4 years), of whom 41 were assigned to the interventional group and 39 to the control group. Underlying malignancies were leukemia (39%) and a broad range of solid tumors (61%). No adverse events occurred. At T0 + 6 mo, the evolution of the 6 MWT distance (±SEM) was improved in the intervention group vs. the control group (86 ± 12 m vs. 32 ± 6 m, p < 0.001). Several other physical parameters were significantly improved in the intervention group. Global self-esteem and parent-reported quality-of-life were significantly increased in the intervention group. Analysis at T0 + 12 mo showed persistence of the benefits in the intervention group on exercise capacity evolution (115 ± 18 m vs. 49 ± 11 m, p = 0.004) and on most physical and QoL parameters. Conclusion: In children and adolescents with cancer, a physical activity program is safe, improves exercise capacity, and may have physical and psychological benefits.
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Affiliation(s)
- Paul Saultier
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
- C2VN, Aix Marseille Univ, INSERM, INRAe, 13385 Marseille, France
- Correspondence: ; Tel.: +33-491386778; Fax: +33-491384989
| | - Clothilde Vallet
- Association ‘Sourire à la Vie’, 13016 Marseille, France; (C.V.); (F.S.)
| | - Frédéric Sotteau
- Association ‘Sourire à la Vie’, 13016 Marseille, France; (C.V.); (F.S.)
| | - Zeinab Hamidou
- CERESS, Aix Marseille Univ, 13385 Marseille, France; (Z.H.); (P.A.)
- Department of Public Health, La Timone Hospital, APHM, 13385 Marseille, France
| | - Jean-Claude Gentet
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
| | - Vincent Barlogis
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
| | - Catherine Curtillet
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
| | - Arnauld Verschuur
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
| | - Gabriel Revon-Riviere
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
| | - Claire Galambrun
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
| | - Hervé Chambost
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
- C2VN, Aix Marseille Univ, INSERM, INRAe, 13385 Marseille, France
| | - Pascal Auquier
- CERESS, Aix Marseille Univ, 13385 Marseille, France; (Z.H.); (P.A.)
- Department of Public Health, La Timone Hospital, APHM, 13385 Marseille, France
| | - Gérard Michel
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
- CERESS, Aix Marseille Univ, 13385 Marseille, France; (Z.H.); (P.A.)
| | - Nicolas André
- Department of Pediatric Hematology, Immunology and Oncology, La Timone Children’s Hospital, APHM, 13385 Marseille, France; (J.-C.G.); (V.B.); (C.C.); (A.V.); (G.R.-R.); (C.G.); (H.C.); (G.M.); (N.A.)
- CRCM, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, 13009 Marseille, France
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20
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Brok J, Mavinkurve-Groothuis AMC, Drost J, Perotti D, Geller JI, Walz AL, Geoerger B, Pasqualini C, Verschuur A, Polanco A, Jones KP, van den Heuvel-Eibrink M, Graf N, Spreafico F. Unmet needs for relapsed or refractory Wilms tumour: Mapping the molecular features, exploring organoids and designing early phase trials - A collaborative SIOP-RTSG, COG and ITCC session at the first SIOPE meeting. Eur J Cancer 2020; 144:113-122. [PMID: 33341445 DOI: 10.1016/j.ejca.2020.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/22/2020] [Accepted: 11/10/2020] [Indexed: 01/18/2023]
Abstract
Wilms tumour (WT) accounts for about 6% of all childhood cancers and overall survival of WT is about 90% in international protocols. However, for WT subgroups with much poorer prognoses, i.e. typically high-risk (unfavorable) histology and/or relapse, there is an unmet need to better understand the biology of WT and to translate biological findings into clinics through early phase clinical trials that evaluate innovative therapies. The main challenges are the small numbers of children suitable for early phase trials, the genetic heterogeneity of WT and the low number of somatic mutations that are currently considered 'druggable'. Accordingly, a joint meeting between clinical and biology experts from the international cooperative groups of the Renal Tumour Study Group of the International Society of Paediatric Oncology, the Renal Tumour Committee of the Children's Oncology Group and the European Innovative Therapies for Children with Cancer consortium and parents representatives was organised during the first SIOPE meeting in Prague, 2019. We reviewed WT molecular features, ongoing/planned early phase trials and explored available knowledge on organoid technology. The key messages were: (1) relapsed WT should undergo whenever possible thorough molecular characterization and be enrolled in protocols or trials with systematic data collecting and reporting; (2) WT displays few known 'actionable' targets and currently no novel agent has appeared promising; (3) we need to improve the enrolment rate of WT candidates in early phase trials especially for the relatively small subgroup of relapses with an adverse prognostic signature; (4) despite some agnostic early phase trials existing, development of WT-focused trials are warranted; (5) growing organoids with parallel testing of drug panels seems feasible and may direct individual treatment and encourage clinical researchers to incorporate the most promising agents into early phase trials.
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Affiliation(s)
- Jesper Brok
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, UK; Department of Paediatric Haematology and Oncology, Rigshospitalet, Copenhagen University Hospital, Denmark Division of Pediatric Oncology, Denmark.
| | | | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Daniela Perotti
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - James I Geller
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Amy L Walz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL, USA
| | - Birgit Geoerger
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, INSERM U1015, Université Paris-Saclay, Villejuif, France
| | - Claudia Pasqualini
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, INSERM U1015, Université Paris-Saclay, Villejuif, France
| | - Arnauld Verschuur
- Dept. of Pediatric Hematology and Oncology, Hôpital D'Enfants de La Timone, APHM, Marseille, France
| | - Angela Polanco
- National Cancer Research Institute Children's Group Consumer Representative, London, UK
| | - Kathy P Jones
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, UK
| | | | - Norbert Graf
- Dept. Haematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
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21
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Liné A, Sudour-Bonnange H, Languillat-Fouquet V, Brisse H, Irtan S, Verschuur A, Sarnacki S, Thébaud E, Coulomb-L'Hermine A, Notz-Carrère A, Michon J, Tabone MD, Boulanger C, Pellier I, Freycon C, Audry G, Dijoud F, Morelle M, Bergeron C, Pasqualini C. Liver metastasis at diagnosis in children with nephroblastoma enrolled in SIOP2001 protocol: A French multicentric study. Pediatr Blood Cancer 2020; 67:e28201. [PMID: 32207555 DOI: 10.1002/pbc.28201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/14/2020] [Accepted: 01/14/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Liver metastases are rare in children with Wilms tumor (WT), and their impact on the outcome is unclear. PATIENTS AND METHODS The French cohort of patients with WT presenting liver metastases at diagnosis and enrolled in the International Society of Pediatric Oncology (SIOP) 2001 study was reviewed. RESULTS From 2002 to 2012, 906 French patients were enrolled in the SIOP2001 trial. Among them, 131 (14%) presented with stage IV WT and 18 (1.9%) had liver metastases at diagnosis. Isolated liver metastases were displayed in four of them. After preoperative chemotherapy, persistent liver disease was reported in 14/18 patients, and 13 of them underwent metastasectomy after nephrectomy. In resected liver lesions, the same histology of the primary tumor was reported for three patients, blastemal cells without anaplasia were identified in one patient with DA-WT, and post-chemotherapy necrosis/fibrosis was identified for the other 10 patients. For the four patients who had liver and lung surgery, both sites had nonviable cells with post-chemotherapy necrosis/fibrosis. Six patients had hepatic radiotherapy. Sixteen patients achieved primary complete remission and were alive at the last follow-up (median follow-up: 6.4 years). The only two deceased patients presented diffuse anaplasia histology. The five-year EFS and OS were 83% (60%-94%) and 88% (66%-97%), respectively. CONCLUSION Liver involvement does not appear to be an adverse prognostic factor in metastatic WT. The role of hepatic surgery and radiotherapy remains unclear, and should be carefully considered in case of persistent liver metastases, according to histology and radiological response to other metastatic sites.
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Affiliation(s)
- Antoine Liné
- Department of Pediatric Surgery, University Hospital Center of Reims, Reims, France
| | | | | | - Hervé Brisse
- Department of Radiology, Curie Institute, Paris, France
| | - Sabine Irtan
- Department of Pediatric Surgery, Armand Trousseau Hospital, APHP, Paris, France
| | - Arnauld Verschuur
- Pediatric Hematology-Oncology Department, La Timone Hospital, AP-HM, Marseille, France
| | - Sabine Sarnacki
- Department of Pediatric Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Estelle Thébaud
- Pediatric Onco-Hematology Department, University Hospital Center of Nantes, Nantes, France
| | | | - Anne Notz-Carrère
- Pediatric Onco-Hematology Department, University Hospital Center of Bordeaux, Bordeaux, France
| | - Jean Michon
- Pediatric Onco-Hematology Department, Curie Institute, Paris, France
| | | | - Cécile Boulanger
- Pediatric Hematology-Oncology Department, University Hospital Center of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Pediatric Hematology-Oncology Department, University Hospital Center of Angers, Angers, France
| | - Claire Freycon
- Pediatric Hematology-Oncology Department, University Hospital Center of Grenoble, Grenoble, France
| | - Georges Audry
- Department of Pediatric Surgery, Armand Trousseau Hospital, APHP, Paris, France
| | | | - Magali Morelle
- Department of Statistic, Centre Léon Bérard, Lyon, France
| | - Christophe Bergeron
- Pediatric Onco-Hematology Department, Centre Leon Bérard/ IHOPE, Lyon, France
| | - Claudia Pasqualini
- Children and Adolescents Oncology Department, Gustave Roussy, Villejuif, France
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22
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Goldsmith KC, Verschuur A, Morgenstern DA, van Eijkelenburg N, Federico SM, Fraser C, Forlenza CJ, Ziegler DS, Gerber NU, Khaw SL, Cooper TM, Flotho C, Prine BA, Salem AH, Unnebrink K, Tong B, Palenski TL, Place AE. The first report of pediatric patients with solid tumors treated with venetoclax. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.10524] [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
10524 Background: Dependence on the prosurvival protein B-cell lymphoma 2 (BCL-2) occurs in certain pediatric solid tumors, resulting in tumorigenesis and resistance to therapies. Venetoclax (VEN), an orally administered BCL-2-selective inhibitor, has preclinical anticancer activity in human-derived neuroblastoma models. Reported here are preliminary results from pediatric patients (pts) with recurrent or refractory (R/R) solid tumors treated with VEN monotherapy or VEN with cyclophosphamide and topotecan (Cy-Topo). Methods: This phase 1 open-label, 2-part study (NCT03236857) enrolled pts < 25 yr old with R/R malignancies; we report only on pts with solid tumors. Following a dose ramp-up, pts received 800 mg VEN (age/weight-adjusted adult equivalent) once daily for the first 8 wk; Cy-Topo was added optionally after wk 8. Dose-limiting toxicities (DLTs) were assessed during the first 21 days of VEN therapy or cycle 1 of VEN-Cy-Topo. Objectives included safety, toxicity, and preliminary efficacy. Results: As of Dec 17, 2019, 11 solid tumor pts were enrolled: neuroblastoma (n = 6), rhabdomyosarcoma (n = 2), Wilms’ tumor, Carney-Stratakis syndrome, and low-grade fibromyxoid sarcoma (n = 1 each). Median age was 11 yr (range 3–22); median time on study was 6.9 mo (range 1.2–17.8). All pts experienced ≥1 treatment-emergent adverse event (TEAE); vomiting (72%; all grades) was most common. Grade ≥3 TEAEs were reported in 82% of pts; febrile neutropenia (64%), decreased blood cell count, and neutropenia (36% each) were the most common. Seven pts received 800-mg monotherapy for 8 wk; 3 of these pts did not receive Cy-Topo after monotherapy. Of the 7 pts who received VEN-Cy-Topo, 3 pts received 400 mg VEN with Cy-Topo. DLTs of grade 4 neutropenia/thrombocytopenia with delayed count recovery occurred in 2 pts on 800 mg VEN-Cy-Topo, necessitating a dose de-escalation (to 400 mg VEN). Grade 4 neutropenia occurred in 2 pts on 400 mg VEN with Cy-Topo, leading to the addition of myeloid growth factor to the therapy regimen. The best response after 8 wk of VEN monotherapy was stable disease (SD). Six pts were evaluable for tumor response with VEN-Cy-Topo; 1 neuroblastoma pt had a complete response after 5 cycles of 400 mg VEN, 4 pts had SD (3 on 800 mg and 1 on 400 mg VEN) and 1 (800 mg VEN) had progressive disease as best response. Conclusions: Continuous dosing of VEN with Cy-Topo was not tolerated due to cytopenias in 4/7 pts with solid tumors. Discontinuous dosing of VEN with Cy-Topo is being explored. Clinical trial information: NCT03236857.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Bo Tong
- AbbVie Inc., North Chicago, IL
| | | | - Andrew E. Place
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA
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23
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Casanova M, Bautista F, Campbell Hewson Q, Makin G, Marshall LV, Verschuur A, Canete A, Corradini N, Ploeger B, Mueller U, Zebger-Gong H, Chung JW, Geoerger B. Phase I study of regorafenib in combination with vincristine and irinotecan in pediatric patients with recurrent or refractory solid tumors. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.10507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10507 Background: In pediatric patients with solid tumors, regorafenib demonstrated acceptable tolerability and preliminary anti-tumor activity. This phase 1 study evaluated regorafenib in combination with vincristine/irinotecan in pediatric patients with rhabdomyosarcoma (RMS) and other solid tumors. Methods: Patients with relapsed/refractory tumors received intravenous vincristine (1.5 mg/m2, Days 1 and 8) and irinotecan (50 mg/m2/day, Days 1–5) plus once-daily oral regorafenib (patients 6– < 24 months: 60 mg/m2 escalating to 65 mg/m2; patients 2– < 18 years: 72 mg/m2 escalating to 82 mg/m2) on either Days 1–14 (concomitant dosing) or Days 8–21 (sequential dosing) during each 21-day cycle. As per protocol, at least 50% of patients were required to have RMS. Results: At the time of the cut-off, of 21 treated patients (RMS, n = 12; Ewing sarcoma, n = 5; neuroblastoma, n = 3; Wilms tumor, n = 1), two had concomitant (72 mg/m2) and 19 had sequential (72 mg/m2, n = 6; 82 mg/m2, n = 13) dosing. Median age was 10 years (1.5–17.0). Patients received a median of 3 cycles (1–17); dose reductions of irinotecan occurred in 62% of patients. Grade 3 dose-limiting toxicities were reported in both patients receiving concomitant dosing (peripheral neuropathy and liver injury; pain, vomiting, febrile aplasia) and one patient each in the sequential groups (rash and elevated AST; thrombocytopenia). Concomitant dosing was discontinued. The maximum tolerated dose and recommended phase 2 dose (RP2D) of regorafenib in the sequential combination was 82 mg/m2. The most common grade ≥3 treatment-emergent adverse events were neutropenia (71%), thrombocytopenia (33%), leukopenia (29%), anemia (24%), and ALT increased (24%). The response rate was 38%, including 1 complete (RMS) and 7 partial responders (5 RMS, 2 Ewing sarcoma); 3 of whom had prior irinotecan. Six (4 with alveolar subtype) of 12 patients with RMS had a response. Nine patients (43%) had stable disease (maximum duration 17 cycles). After the cut-off, partial response was reported for two additional patients (1 RMS, 1 Ewing sarcoma). Conclusions: Regorafenib can be combined at its single agent RP2D of 82 mg/m2 with standard-dose vincristine/irinotecan (with appropriate dose modifications) in pediatric patients with refractory/relapsed solid tumors in a sequential dosing schedule. Clinical activity was observed in patients with sarcoma. Clinical trial information: NCT02085148.
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Affiliation(s)
- Michela Casanova
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francisco Bautista
- Department of Paediatric Oncology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - Guy Makin
- Division of Cancer Sciences, School of Medical Sciences, University of Manchester and Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | - Lynley V. Marshall
- Paediatric and Adolescent Drug Development Team, The Royal Marsden Hospital and The Institute of Cancer Research, London, United Kingdom
| | - Arnauld Verschuur
- Department of Pediatric Oncology, La Timone Children's Hospital, Marseille, France
| | - Adela Canete
- Unidad de Oncología Pediátrica, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - Nadège Corradini
- Hematology and Oncology Pediatric Institute, Leon Berard Center, Lyon, France
| | - Bart Ploeger
- Clinical Pharmacometrics, Bayer AG, Berlin, Germany
| | - Udo Mueller
- Department of Statistics, ClinStat GmbH, Cologne, Germany
| | | | - John Woojune Chung
- Clinical Development Oncology, Bayer HealthCare Pharmaceuticals, Whippany, NJ
| | - Birgit Geoerger
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Center, Université Paris-Saclay, Villejuif, France
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24
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Rios P, Bauer H, Schleiermacher G, Pasqualini C, Boulanger C, Thebaud E, Gandemer V, Pellier I, Verschuur A, Sudour-Bonnange H, Coulomb-l'Hermine A, Spiegel A, Notz-Carrere A, Bergeron C, Orsi L, Lacour B, Clavel J. Environmental exposures related to parental habits in the perinatal period and the risk of Wilms' tumor in children. Cancer Epidemiol 2020; 66:101706. [PMID: 32247207 DOI: 10.1016/j.canep.2020.101706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Wilms' tumor is the most frequently diagnosed renal tumor in children. Little is known about its etiology. The aim of this study was to investigate the potential role of specific exposures related to parental habits such as parental smoking, maternal alcohol consumption and the use of household pesticides during pregnancy. METHODS The ESTELLE study was a nationwide case-control study that included 117 Wilms' tumor cases and 1100 control children from the general French population, frequency-matched by age and gender. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals. RESULTS After controlling for matching variables and potential confounders, the maternal use of any type of pesticide during pregnancy was associated with the risk of Wilms' tumor in children (OR 1.6 [95 % CI 1.1-2.3]). Insecticides were the most commonly reported type of pesticide and there was a positive association with their use (OR 1.7 [95 % CI 1.1-2.6]. The association was stronger when they were used more often than once a month (OR 1.9 [95 % CI 1.2-3.0]. Neither maternal smoking during pregnancy nor paternal smoking during preconception/pregnancy was associated with a risk of Wilms' tumor (ORs 1.1[95 % CI 0.7-1.8] and 1.1 [95 % CI 0.7-1.7], respectively). No association was observed with maternal alcohol intake during pregnancy (OR 1.2 [95 % CI 0.8-2.0]). CONCLUSION Our findings suggest an association between the maternal use of household pesticides during pregnancy and the risk of Wilms' tumor.
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Affiliation(s)
- Paula Rios
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.
| | - Hélène Bauer
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | | | - Claudia Pasqualini
- Gustave Roussy, Université Paris-Saclay, Child and Adolescent Oncology Department, Villejuif, France
| | | | | | | | | | | | | | | | | | | | | | - Laurent Orsi
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Brigitte Lacour
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France; National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif and CHU de Nancy, France
| | - Jacqueline Clavel
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France; National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif and CHU de Nancy, France
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25
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Bauer H, Rios P, Schleiermacher G, Valteau-Couanet D, Bertozzi AI, Thebaud E, Gandemer V, Pellier I, Verschuur A, Spiegel A, Notz-Carrere A, Bergeron C, Orsi L, Lacour B, Clavel J. Maternal and perinatal characteristics, congenital malformations and the risk of wilms tumor: the ESTELLE study. Cancer Causes Control 2020; 31:491-501. [PMID: 32144681 DOI: 10.1007/s10552-020-01288-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/15/2019] [Accepted: 02/24/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Wilms tumor (WT), or nephroblastoma, is an embryonic tumor that constitutes the most common renal tumor in children. Little is known about the etiology of WT. The aim of this study was to investigate whether maternal or perinatal characteristics were associated with the risk of WT. METHODS The ESTELLE study is a national-based case-control study that included 117 cases of WT and 1,100 controls younger than 11 years old. The cases were children diagnosed in France in 2010-2011 and the controls were frequency matched with cases by age and gender. The mothers of case and control children responded to a telephone questionnaire addressing sociodemographic and perinatal characteristics, childhood environment, and lifestyle. Unconditional logistic regression models adjusted on potential cofounders were used to estimate the odds ratios (OR) and their confidence intervals (95% CI). RESULTS High birth weight and the presence of congenital malformation were associated with WT (OR 1.9 [95% CI 1.0-3.7] and OR 2.5 [95% CI 1.1-5.8], respectively). No association with breastfeeding or folic acid supplementation was observed. CONCLUSIONS Although potential recall bias cannot be excluded, our findings reinforce the hypothesis that high birth weight and the presence of congenital malformation may be associated with an increased risk of WT. Further investigations are needed to further elucidate the possible role of maternal characteristics in the etiology of WT.
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Affiliation(s)
- Hélène Bauer
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Paula Rios
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.
| | | | - Dominique Valteau-Couanet
- Children and Adolescent Cancerology Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | | | | | | | | | | | | | - Laurent Orsi
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Brigitte Lacour
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
| | - Jacqueline Clavel
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
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26
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Picard C, Faure-Conter C, Leblond P, Brugières L, Thomas-Teinturier C, Hameury F, Defachelles AS, Verschuur A, Brisse HJ, Sarnacki S, Dijoud F, Reguerre Y, Chastagner P, Carton M, Orbach D. Exploring heterogeneity of adrenal cortical tumors in children: The French pediatric rare tumor group (Fracture) experience. Pediatr Blood Cancer 2020; 67:e28086. [PMID: 31738008 DOI: 10.1002/pbc.28086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/25/2019] [Accepted: 10/29/2019] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Pediatric adrenal cortical tumors are characterized by a wide spectrum of behavior. Questions remain regarding intermediate disease stages with isolated tumor rupture or relapse. OBJECTIVES To describe clinical characteristics, treatment strategy, and outcome of patients depending on disease stage, tumor rupture, or in case of a refractory tumor, to discuss optimal management. MATERIAL AND METHODS Pediatric patients with histological material reviewed and treated between 2000 and 2018 in 23 French oncology centers were included. RESULTS Among 95 cases, 59% of patients had stage I tumors (n = 55), 16% had stage II tumors (n = 16), 19% had stage III tumors (n = 17), and 5% had stage IV tumors (n = 5) (missing data: 2). Overall, 27% of patients (n = 25) had an unfavorable histology. Initial tumor resection was performed for 90% of patients (n = 86). Systemic therapies included mitotane in 20 cases and chemotherapy in 13 cases. Among 17 stage III patients, 12 had microscopic residual tumor due to an initial biopsy (n = 5), intraoperative rupture (n = 8), or surgical resection with microscopic residue or tumor spillage surgery (n = 1) (two patients with two modalities). After a median follow-up of 96 months (25-119), four early progressions and two relapses occurred. A total of seven patients died, including five of disease. Stage III diseases due to microscopic residual disease correlated with a worse prognosis: 5-year progression-free survival 44% (95% CI, 22-87%) versus 82% (95% CI, 73-91%) for the whole cohort (P < .0001). Among the 14 patients with refractory disease, only 3 were alive and free of disease after multimodal second-line therapy. CONCLUSIONS Stage III diseases due to a microscopic residual tumor have a dismal prognosis, arguing for the systematic use of adjuvant therapy. Patients with a relapsed disease should be included in experimental studies.
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Affiliation(s)
- Cécile Picard
- Institut de Pathologie Multisite, Groupement hospitalier Est, Hospices Civils de Lyon, UCBL Lyon 1 University, Lyon, France
| | - Cécile Faure-Conter
- Département de Cancérologie pédiatrique, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Pierre Leblond
- Département de Cancérologie pédiatrique, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Laurence Brugières
- Département de Cancérologie de l'Enfant et l'Adolescent, Gustave Roussy Cancer Campus, Villejuif, France
| | - Cécile Thomas-Teinturier
- Department of Pediatric Endocrinology, AP-HP, Hôpitaux universitaires Paris-Sud, site Bicêtre, Le Kremlin-Bicêtre, France
| | - Frédéric Hameury
- Département de chirurgie viscérale pédiatrique, Groupement hospitalier Est, Hospices Civils de Lyon, Le Kremlin-Bicêtre, France
| | - Anne-Sophie Defachelles
- Département d'hématologie et de Cancérologie pédiatrique, Centre Oscar Lambret, Lille, France
| | - Arnauld Verschuur
- Service d'hématologie-oncologie pédiatrique, Hôpital de La Timone, AP-HM, Marseille, France
| | - Hervé J Brisse
- Département d'imagerie médicale, Institut Curie, PSL University, Paris, France
| | - Sabine Sarnacki
- Département de chirurgie viscérale pédiatrique, Hôpital Necker, AP-HP, Paris, France
| | - Frédérique Dijoud
- Institut de Pathologie Multisite, Groupement hospitalier Est, Hospices Civils de Lyon, UCBL Lyon 1 University, Lyon, France
| | - Yves Reguerre
- Département d'hématologie et de Cancérologie pédiatrique, Centre Hospitalier Universitaire, Saint Denis de La Réunion, France
| | - Pascal Chastagner
- Département d'Hématologie et de Cancérologie pédiatrique, Centre Hospitalier Universitaire, Nancy, France
| | - Matthieu Carton
- Institut Curie, PSL Research University, DRCI, Biométrie, Saint-Cloud, France
| | - Daniel Orbach
- SIREDO Oncology Center, Institut Curie, PSL University, Paris, France
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27
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Bailly C, Verschuur A, Bosdure E, Dabadie A, Petit P, Maues de Paula A, Coulomb-L'hermine A, Longy M, André N. Pulmonary giant chondromatous hamartoma with multifocal evolution in an infant. Pediatr Blood Cancer 2020; 67:e27973. [PMID: 31545011 DOI: 10.1002/pbc.27973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/03/2019] [Accepted: 07/23/2019] [Indexed: 11/09/2022]
Abstract
Hamartoma is the most common benign pulmonary tumor in adults, but is rarely described in the pediatric population. Giant chondromatous and progressive forms are even rarer. We report the novel case of a 13-month-old infant hospitalized for giant pulmonary chondromatous hamartoma discovered during a septic episode, rapidly progressive, with severe multifocal lesions, without clear response to several cytotoxic therapies. No predisposition syndrome was identified.
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Affiliation(s)
- Charlotte Bailly
- Department of Pediatric Hematology-Oncology, Timone Children's Hospital, Marseille, France.,Department of Pediatrics and Pediatric Pneumology, Timone Children's Hospital, Marseille, France
| | - Arnauld Verschuur
- Department of Pediatric Hematology-Oncology, Timone Children's Hospital, Marseille, France.,Metronomics Global Health Initiative, Marseille, France
| | - Emmanuelle Bosdure
- Department of Pediatrics and Pediatric Pneumology, Timone Children's Hospital, Marseille, France
| | - Alexia Dabadie
- Department of Pediatric Radiology, Timone Children's Hospital, Marseille, France
| | - Philippe Petit
- Department of Pediatric Radiology, Timone Children's Hospital, Marseille, France
| | | | | | - Michel Longy
- Department of Genetics, Institut Bergonié, Bordeaux, France
| | - Nicolas André
- Department of Pediatric Hematology-Oncology, Timone Children's Hospital, Marseille, France.,Metronomics Global Health Initiative, Marseille, France.,SMARTc Unit, Pharmacokinetics Laboratory, CRCM UMR U1068 CNRS UMR 7258 Aix Marseille Université, Marseille, France
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28
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Le Teuff G, Castaneda-Heredia A, Dufour C, Jaspan T, Calmon R, Devos A, McHugh K, Leblond P, Frappaz D, Aerts I, Zwaan CM, Ducassou S, Chastagner P, Verschuur A, Corradini N, Casanova M, Rubie H, Riccardi R, Le Deley MC, Vassal G, Geoerger B. Phase II study of temozolomide and topotecan (TOTEM) in children with relapsed or refractory extracranial and central nervous system tumors including medulloblastoma with post hoc Bayesian analysis: A European ITCC study. Pediatr Blood Cancer 2020; 67:e28032. [PMID: 31595663 DOI: 10.1002/pbc.28032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/19/2019] [Accepted: 09/23/2019] [Indexed: 11/06/2022]
Abstract
AIM To assess objective response after two cycles of temozolomide and topotecan (TOTEM) in children with refractory or relapsed miscellaneous extracranial solid and central nervous system (CNS) tumors, including medulloblastoma and primitive neuroectodermal tumors (PNET). PROCEDURE Multicenter, nonrandomized, phase 2 basket trial including children with solid tumors, completed by a one-stage design confirmatory cohort for medulloblastoma, and an exploratory cohort for PNET. Main eligibility criteria were refractory/relapsed measurable disease and no more than two prior treatment lines. Temozolomide was administered orally at 150 mg/m2 /day followed by topotecan at 0.75 mg/m2 /day intravenously for five consecutive days every 28 days. Tumor response was assessed every two cycles according to WHO criteria and reviewed independently. RESULTS Thirty-two patients were enrolled and treated in the miscellaneous solid tumor and 33 in the CNS strata; 20 patients with medulloblastoma and six with PNET were included in the expansion cohorts. The median age at inclusion was 10.0 years (range, 0.9-20.9). In the basket cohorts, confirmed complete and partial responses were observed in one glioma, four medulloblastoma, and one PNET, leading to the extension. The overall objective response rate (ORR) in medulloblastoma was 28% (95% CI, 12.7-47.2) with 1/29 complete and 7/29 partial responses, those for PNET 10% (95% CI, 0.3-44.5). Post hoc Bayesian analysis estimates that the true ORR in medulloblastoma is probably between 20% and 30% and below 20% in PNET. The most common treatment-related toxicities of the combination therapy were hematologic. CONCLUSIONS Temozolomide-topotecan results in significant ORR in children with recurrent and refractory medulloblastoma with a favorable toxicity profile.
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Affiliation(s)
- Gwénaël Le Teuff
- Université Paris-Saclay, Univ Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Gustave Roussy Cancer Center, Université Paris-Saclay, Biostatistics and Epidemiology Unit, Villejuif, France
| | - Alicia Castaneda-Heredia
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Villejuif, France
| | - Christelle Dufour
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Villejuif, France
| | - Timothy Jaspan
- University Hospital Nottingham, Nottingham, United Kingdom
| | | | - Annick Devos
- Erasmus MC/Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands
| | - Kieran McHugh
- Great Ormond Street Hospital for Children, London, United Kingdom
| | - Pierre Leblond
- Centre Oscar-Lambret, Department of Pediatric Oncology, Lille, France
| | - Didier Frappaz
- Institut d'Hématologie et d'Oncologie pédiatrique, Lyon, France
| | - Isabelle Aerts
- Institut Curie, SIREDO Oncology Center, PSL Research University, Paris, France
| | - Christian M Zwaan
- Erasmus MC/Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands
| | | | | | | | - Nadège Corradini
- Centre Hospitalier Universitaire, Department of Pediatric and Adolescent Oncology, Nantes, France
| | | | | | | | - Marie-Cecile Le Deley
- Université Paris-Saclay, Univ Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Gustave Roussy Cancer Center, Université Paris-Saclay, Biostatistics and Epidemiology Unit, Villejuif, France
| | - Gilles Vassal
- Gustave Roussy Cancer Center, Clinical Research Direction, Université Paris-Saclay, Univ Paris-Sud, Villejuif, France
| | - Birgit Geoerger
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Villejuif, France.,Université Paris-Saclay, Univ Paris-Sud, CNRS UMR8203, Villejuif, France
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29
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Heng-Maillard MA, Verschuur A, Aschero A, Dabadie A, Jouve E, Chastagner P, Leblond P, Aerts I, De Luca B, André N. SFCE METRO-01 four-drug metronomic regimen phase II trial for pediatric extracranial tumor. Pediatr Blood Cancer 2019; 66:e27693. [PMID: 30920117 DOI: 10.1002/pbc.27693] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/27/2019] [Accepted: 02/12/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate the antitumor activity of a four-drug metronomic chemotherapy (MC) regimen in relapsed/progressing pediatric extracranial solid tumors (EST). The primary objective was clinical benefit (complete response /partial response/stable disease [SD]) after two cycles of therapy (four months). METHODS Patients aged ≥4 to 25 years with progressing EST and adequate organ function were eligible. Treatment consisted of an eight-week cycle of oral celecoxib b.i.d., weekly vinblastine, and oral cyclophosphamide for three weeks alternating with oral methotrexate for three weeks, with a two-week rest. The Kepner-Chang two-stage model was used with 10 patients in the first stage. If primary objective was reached in two or more patients, eight additional patients were included according to four groups: neuroblastoma (NBL), soft-tissue sarcoma (STS), bone sarcoma (BS), and miscellaneous (Misc.). RESULTS Forty-four patients were evaluable. The NBL cohort could be expanded to 18 patients: 4 of 18 patients stabilized with MC treatment for 6 (n = 1) and 12 (n = 3) months. In STS, two of seven patients (metastatic hemangioendothelioma and angiosarcoma) had SD for > 2 cycles. One of nine Misc. (metastatic myoepithelial carcinoma) had SD for one year. All patients with BS had progressive disease. One-year progression-free survival of the whole cohort was 6.8% and one-year overall survival was 55.3%. Grade 3 toxicity occurred in 18 patients and grade 4 in 15 patients. The most frequent toxicity was hematologic, predominantly neutropenia. CONCLUSIONS This MC has no activity in BS and limited though interesting activity in NBL with some patients being stable for > 1 year. It is not possible to conclude activity in STS and Misc.
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Affiliation(s)
| | - Arnauld Verschuur
- Department of Pediatric Oncology, La Timone Children's Hospital, Marseille, France.,Metronomics Global Health Initiative, Marseille, France
| | - Audrey Aschero
- Department of pediatric imaging, La Timone Children's Hospital, Marseille, France
| | - Alexia Dabadie
- Department of pediatric imaging, La Timone Children's Hospital, Marseille, France
| | | | - Pascal Chastagner
- Department of Pediatric Oncology, Children's Hospital, Nancy, France
| | - Pierre Leblond
- Pediatric Oncology Unit, Oscar Lambret Centre, Lille, France
| | | | - Bénédicte De Luca
- Department of Clinical Pharmacy, AP-HM, La Timone Children's Hospital, Marseille, France
| | - Nicolas André
- Department of Pediatric Oncology, La Timone Children's Hospital, Marseille, France.,Metronomics Global Health Initiative, Marseille, France.,SMARTc Unit, Pharmacokinetics Laboratory, CRCM UMR U1068 CNRS UMR 7258 Aix Marseille Université, Marseille, France
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Verschuur A, Heng-Maillard MA, Dory-Lautrec P, Truillet R, Jouve E, Chastagner P, Leblond P, Aerts I, Honoré S, Entz-Werle N, Sirvent N, Gentet JC, Corradini N, André N. Metronomic Four-Drug Regimen Has Anti-tumor Activity in Pediatric Low-Grade Glioma; The Results of a Phase II Clinical Trial. Front Pharmacol 2018; 9:00950. [PMID: 30319400 PMCID: PMC6171442 DOI: 10.3389/fphar.2018.00950] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 05/31/2018] [Accepted: 08/02/2018] [Indexed: 12/14/2022] Open
Abstract
Background: Metronomic chemotherapy (MC) is defined as the frequent administration of chemotherapy at doses below the maximal tolerated dose and with no prolonged drug-free break. MC has shown its efficacy in adult tumor types such as breast and ovarian cancer and has to some extent been studied in pediatrics. Objective: To assess the anti-tumor activity and toxicity of a four-drug metronomic regimen in relapsing/refractory pediatric brain tumors (BT) with progression-free survival (PFS) after two cycles as primary endpoint. Methods: Patients ≥4 to 25 years of age were included with progressing BT. Treatment consisted of an 8-week cycle of celecoxib, vinblastine, and cyclophosphamide alternating with methotrexate. Kepner and Chang two-steps model was used with 10 patients in the first stage. If stabilization was observed in ≥2 patients, 8 additional patients were recruited. Assessment was according WHO criteria with central radiology review. Results: Twenty-nine patients (27 evaluable) were included in two groups: ependymoma (group 1, N = 8), and miscellaneous BT (group 2): 3 medulloblastoma (MB), 5 high grade glioma (HGG), 11 low grade glioma (LGG), 2 other BT. After first stage, recruitment for ependymoma was closed [one patient had stable disease (SD) for 4 months]. Cohort 2 was opened for second stage since 1 HGG and 3 LGG patients had SD after two cycles. Recruitment was limited to LGG for the second stage and 2 partial responses (PR), 6 SD and 2 progressive disease (PD) were observed after two cycles. Of these patients with LGG, median age was 10 years, nine patients received vinblastine previously. Median number of cycles was 6.8 (range: 1–12). Treatment was interrupted in five patients for grade 3/4 toxicity. Conclusion: This regimen is active in patients with LGG, even if patients had previously received vinblastine. Toxicity is acceptable. Trial Registration: This study was registered under clinicaltrials.gov – NCT01285817; EUDRACT nr: 2010-021792-81.
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Affiliation(s)
- Arnauld Verschuur
- Department of Pediatric Oncology, La Timone Children's Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Marie-Amélie Heng-Maillard
- Department of Pediatric Oncology, La Timone Children's Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Philippe Dory-Lautrec
- Department of Neuroradiology, La Timone Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Romain Truillet
- CIC-CPCET, La Timone Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Elisabeth Jouve
- CIC-CPCET, La Timone Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pascal Chastagner
- Department of Pediatric Oncology, Children's Hospital, Nancy, France
| | - Pierre Leblond
- Pediatric Oncology Unit, Oscar Lambret Centre, Lille, France
| | | | - Stéphane Honoré
- Department of Clinical Pharmacy, La Timone Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | - Nicolas Sirvent
- Department of Pediatric and Adolescent Hematology-Oncology, Children's Hospital Arnaud de Villeneuve, Montpellier, France
| | - Jean-Claude Gentet
- Department of Pediatric Oncology, La Timone Children's Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Nadège Corradini
- Department of Pediatric and Adolescent Hematology-Oncology, Hôpital Mère-Enfant, Nantes, France
| | - Nicolas André
- Department of Pediatric Oncology, La Timone Children's Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France.,Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut Paoli Calmettes, Centre de Recherche en Cancérologie de Marseille, Aix-Marseille Université, Marseille, France.,Metronomics Global Health Initiative, Marseille, France
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31
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Papalia H, Audic F, Rivière GR, Verschuur A, André N. Quick and sustained clinical response to MEK inhibitor I in a NF1 patient with neurofibromas. Ecancermedicalscience 2018; 12:862. [PMID: 30174724 PMCID: PMC6113984 DOI: 10.3332/ecancer.2018.862] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 04/16/2018] [Indexed: 12/04/2022] Open
Abstract
Neurofibromatosis 1 (NF1) is an autosomal dominant tumour predisposition disorder with a birth incidence of about 1 in 2,700 and prevalence of 1 in 4,560. The NF1 gene codes for an ubiquitous protein: neurofibromin. Neurofibromin interacts with the proto-oncogene RAS to suppress tumour formation. Individuals with germline inactivation of the NF1 gene have a propensity to develop both benign and malignant tumours. We report the case of a 12-year-old child with NF1, diagnosed at the age of 15 months, for whom the clinical course has been marked by the appearance of multiple cutaneous and paraspinal neurofibromas responsible for impaired walking, motor deficiency and pain. A treatment with an MEK inhibitor, trametinib, was initiated and led to a quick and sustained clinical response.
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Affiliation(s)
- Honoré Papalia
- Department of Paediatric Haematology and Oncology, AP-HM, La Timone Children's Hospital, Marseille 13005, France
| | - Frédérique Audic
- Department of Paediatric Neurology, AP-HM, La Timone Children's Hospital, Marseille 13005, France
| | - Gabriel Revon Rivière
- Department of Paediatric Haematology and Oncology, AP-HM, La Timone Children's Hospital, Marseille 13005, France.,Centre d'Essais Précoce en Cancérologie de Marseille, AP-HM, La Timone Children's Hospital, Marseille 13005, France
| | - Arnauld Verschuur
- Department of Paediatric Haematology and Oncology, AP-HM, La Timone Children's Hospital, Marseille 13005, France.,Centre d'Essais Précoce en Cancérologie de Marseille, AP-HM, La Timone Children's Hospital, Marseille 13005, France
| | - Nicolas André
- Department of Paediatric Haematology and Oncology, AP-HM, La Timone Children's Hospital, Marseille 13005, France.,Centre d'Essais Précoce en Cancérologie de Marseille, AP-HM, La Timone Children's Hospital, Marseille 13005, France.,Centre d'Essais Précoce en Cancérologie de Marseille, AP-HM, La Timone Children's Hospital, Marseille 13005, France
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32
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Brok J, Lopez-Yurda M, Tinteren HV, Treger TD, Furtwängler R, Graf N, Bergeron C, van den Heuvel-Eibrink MM, Pritchard-Jones K, Olsen ØE, de Camargo B, Verschuur A, Spreafico F. Relapse of Wilms' tumour and detection methods: a retrospective analysis of the 2001 Renal Tumour Study Group-International Society of Paediatric Oncology Wilms' tumour protocol database. Lancet Oncol 2018; 19:1072-1081. [PMID: 29960848 DOI: 10.1016/s1470-2045(18)30293-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/04/2018] [Accepted: 04/11/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Wilms' tumour is the most common renal cancer in childhood and about 15% of patients will relapse. There is scarce evidence about optimal surveillance schedules and methods for detection of tumour relapse after therapy. METHODS The Renal Tumour Study Group-International Society of Paediatric Oncology (RTSG-SIOP) Wilms' tumour 2001 trial and study is an international, multicentre, prospective registration, biological study with an embedded randomised clinical trial for children with renal tumours aged between 6 months and 18 years. The study covers 243 different centres in 27 countries grouped into five consortia. The current protocol of SIOP surveillance for Wilms' tumour recommends that abdominal ultrasound and chest x-ray should be done every 3 months for the first 2 years after treatment and be repeated every 4-6 months in the third and fourth year and annually in the fifth year. In this retrospective cohort study of the protocol database, we analysed data from participating institutions on timing, anatomical site, and mode of detection of all first relapses of Wilms' tumour. The primary outcomes were how relapse of Wilms' tumour was detected (ie, at or between scheduled surveillance and with or without clinical symptoms, scan modality, and physical examination) and to estimate the number of scans needed to capture one subclinical relapse. The RTSG-SIOP study is registered with Eudra-CT, number 2007-004591-39. FINDINGS Between June 26, 2001, and May 8, 2015, of 4271 eligible patients in the 2001 RTSG-SIOP Wilms' tumour database, 538 (13%) relapsed. Median follow-up from surgery was 62 months (IQR 32-93). The method used to detect relapse was registered for 410 (76%) of 538 relapses. Planned surveillance imaging captured 289 (70%) of these 410 relapses. The primary imaging modality used to detect relapse was reported for 251 patients, among which relapse was identified by abdominal ultrasound (80 [32%] patients), chest x-ray (78 [31%]), CT scan of the chest (64 [25%]) or abdomen (20 [8%]), and abdominal MRI (nine [4%]). 279 (68%) of 410 relapses were not detectable by physical examination and 261 (64%) patients did not have clinical symptoms at relapse. The estimated number of scans needed to detect one subclinical relapse during the first 2 years after nephrectomy was 112 (95% CI 106-119) and, for 2-5 years after nephrectomy, 500 (416-588). INTERPRETATION Planned surveillance imaging captured more than two-thirds of predominantly asymptomatic relapses of Wilms' tumours, with most detected by abdominal ultrasound, chest x-ray, or chest CT scan. Beyond 2 years post-nephrectomy, a substantial number of surveillance scans are needed to capture one relapse, which places a burden on families and health-care systems. FUNDING Great Ormond Street Hospital Children's Charity, the European Expert Paediatric Oncology Reference Network for Diagnostics and Treatment, The Danish Childhood Cancer Foundation, Cancer Research UK, the UK National Cancer Research Network and Children's Cancer and Leukaemia Group, Société Française des Cancers de l'Enfant and Association Leon Berard Enfant Cancéreux and Enfant et Santé, Gesellschaft für Pädiatrische Onkologie und Hämatologie and Deutsche Krebshilfe, Grupo Cooperativo Brasileiro para o Tratamento do Tumor de Wilms and Sociedade Brasileira de Oncologia Pediátrica, the Spanish Society of Pediatric Haematology and Oncology and the Spanish Association Against Cancer, and SIOP-Netherlands.
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Affiliation(s)
- Jesper Brok
- University College London Great Ormond Street Institute of Child Health, London, UK; Department of Paediatric Oncology and Haematology, Rigshospitalet, Copenhagen, Denmark.
| | - Marta Lopez-Yurda
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Harm V Tinteren
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Taryn D Treger
- University College London Great Ormond Street Institute of Child Health, London, UK; Department of Paediatrics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rhoikos Furtwängler
- Department of Paediatric Haematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Norbert Graf
- Department of Paediatric Haematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Christophe Bergeron
- Centre Léon Bérard, Institut d'Haematology and d'Oncology Paediatric, Lyon, France
| | | | | | - Øystein E Olsen
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Arnauld Verschuur
- Department of Pediatric Hematology and Oncology, Hôpital de la Timone Enfant, Marseille, France
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Lui G, Bouazza N, Denoyelle F, Moine M, Brugières L, Chastagner P, Corradini N, Entz-Werle N, Vérité C, Landmanparker J, Sudour-Bonnange H, Pasquet M, Verschuur A, Faure-Conter C, Doz F, Tréluyer JM. Association between genetic polymorphisms and platinum-induced ototoxicity in children. Oncotarget 2018; 9:30883-30893. [PMID: 30112115 PMCID: PMC6089394 DOI: 10.18632/oncotarget.25767] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/25/2018] [Indexed: 12/20/2022] Open
Abstract
Platinum is extensively used in the treatment of several childhood cancers. However, ototoxicity is one of the most notable adverse effects, especially in children. Several studies suggest that genetics may predict its occurrence. Here, polymorphisms associated with platinum-induced ototoxicity were selected from the literature and were investigated in a pediatric population treated with platinum-based agents. In this retrospective study, patients treated with cisplatin and/or carboplatin were screened. The patients with pre- and post-treatment audiogram (Brock criteria) available were included. We selected polymorphisms that have previously been associated with cisplatin ototoxicity with a minor allele frequency ≥30%. Deletion of GSTM1 and GSTT1, rs1799735 (GSTM3), rs1695 (GSTP1), rs4880 (SOD2), rs2228001 (XPC), rs1799793 (XPD) and rs4788863 (SLC16A5) were investigated. Data of one hundred and six children matching the eligible criteria were analyzed. Thirty-three patients (31%) developed ototoxicity (with a Brock grade ≥2). The probability of hearing loss increased significantly in patients carrying the null genotype for GSTT1 (P = 0.03), A/A genotype at rs1695 (P = 0.01), and C/C genotype at rs1799793 (P = 0.008). We also showed an association of the cumulative doses of carboplatin with cisplatin ototoxicity (P <0.05). To conclude, deletion of GSTT1, rs1695 and rs1799793 may constitute potential predictors of platinum-induced ototoxicity.
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Affiliation(s)
- Gabrielle Lui
- University of Paris Descartes, EA 7323, Sorbonne Paris-Cité, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France
| | - Naïm Bouazza
- University of Paris Descartes, EA 7323, Sorbonne Paris-Cité, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France.,Clinical Research Unit of Paris Descartes Necker Cochin, AP-HP, Paris, France
| | - Françoise Denoyelle
- Department of Pediatric Otolaryngology, Necker Children's Hospital, Paris, France
| | - Marion Moine
- University of Paris Descartes, EA 7323, Sorbonne Paris-Cité, France
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, France
| | - Pascal Chastagner
- Department of Pediatric Onco-Hematology, Children's Hospital, Vandoeuvre Les Nancy, France
| | - Nadège Corradini
- Pediatric Oncology Department, Mother-Children Hospital, Nantes, France
| | | | - Cécile Vérité
- Pediatric Hematology Department, Bordeaux University Hospital, Bordeaux, France
| | - Judith Landmanparker
- Sorbonne University, Department of Pediatric Hematology Oncology, APHP, Trousseau Hospital, Paris, France
| | - Hélène Sudour-Bonnange
- Pediatric Oncology Unit, Children, Adolescents and Young Adults Unit, Oscar Lambret Center, Lille, France
| | - Marlène Pasquet
- Children's Hospital, University Hospital of Toulouse, Toulouse, France
| | - Arnauld Verschuur
- Pediatric Oncology Department, La Timone Children's Hospital, Marseilles, France
| | | | - François Doz
- Oncology Center SIREDO, Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer, Curie Institute, Paris, France.,Paris Descartes University, Paris, France
| | - Jean-Marc Tréluyer
- University of Paris Descartes, EA 7323, Sorbonne Paris-Cité, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France.,Clinical Research Unit of Paris Descartes Necker Cochin, AP-HP, Paris, France.,Department of Clinical Pharmacology, Cochin Hospital AP-HP, Paris, France
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Hol JA, van den Heuvel-Eibrink MM, Graf N, Pritchard-Jones K, Brok J, van Tinteren H, Howell L, Verschuur A, Bergeron C, Kager L, Catania S, Spreafico F, Mavinkurve-Groothuis AMC. Irinotecan for relapsed Wilms tumor in pediatric patients: SIOP experience and review of the literature-A report from the SIOP Renal Tumor Study Group. Pediatr Blood Cancer 2018; 65. [PMID: 29077255 DOI: 10.1002/pbc.26849] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 11/11/2022]
Abstract
While irinotecan has been studied in various pediatric solid tumors, its potential role in Wilms tumor (WT) is less clear. We evaluated response and outcome of irinotecan-containing regimens in relapsed WT and compared our results to the available literature. Among 14 evaluable patients, one complete response (CR) and two partial responses (PRs) were observed in patients with initial intermediate-risk (CR and PR) and blastemal-type histologies (PR). Two patients were alive at last follow-up showing no evidence of disease. Our results and the reviewed literature suggest some effectiveness of irinotecan in the setting of relapsed WT.
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Affiliation(s)
- Janna A Hol
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Norbert Graf
- Department of Pediatric Oncology & Hematology, Saarland University, Homburg, Germany
| | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Jesper Brok
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.,Department of Pediatric Hematology and Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Harm van Tinteren
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lisa Howell
- Department of Pediatric Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Arnauld Verschuur
- Pediatric Oncology, La Timone Children's Hospital, Marseille, France
| | - Christophe Bergeron
- Department of Pediatric Oncology, Institut d'Hematologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Leo Kager
- St. Anna's Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - Serena Catania
- Pediatric Oncology Unit, Department of Hematology and Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Department of Hematology and Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Laugier O, Padovani L, Verschuur A, Gaudy-Marqueste C, André N. Necrotic ulcerated and bleeding striae distensae following bevacizumab in a palliative setting for gliobastomatosis cerebri. Ecancermedicalscience 2017; 11:756. [PMID: 28900469 PMCID: PMC5574658 DOI: 10.3332/ecancer.2017.756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Indexed: 01/08/2023] Open
Abstract
Glioblastoma cerebri is a rare paediatric malignancy with dismal prognosis [Chappé C, Riffaud L, and Tréguier C et al (2013) Primary gliomatosis cerebri involving gray matter in pediatrics: a distinct entity? A multicenter study of 14 casesChilds Nerv Syst29 565–571 https://doi.org/10.1007/s00381-012-2016-1 PMID: 23306961] and no established standard of care. Here, we report a case of ulcerated and bleeding striae distensae in a teenage girl following palliative treatment with bevacizumab and steroids.
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Affiliation(s)
- Olivia Laugier
- Department of Pediatric Hematology and Oncology, AP-HM, Boulevard Jean Moulin, 13005, Marseille France
| | - Laetitia Padovani
- Department of Radiotherapy, AP-HM, Aix-Marseille Université, Boulevard Jean Moulin, 13005, Marseille, France.,Inserm UMR_S 911, Centre de Recherche en Oncologie biologique et Oncopharmacologie, Aix-Marseille Université, Boulevard Jean Moulin, 13005, Marseille, France
| | - Arnauld Verschuur
- Department of Pediatric Hematology and Oncology, AP-HM, Boulevard Jean Moulin, 13005, Marseille France
| | | | - Nicolas André
- Department of Pediatric Hematology and Oncology, AP-HM, Boulevard Jean Moulin, 13005, Marseille France.,Inserm UMR_S 911, Centre de Recherche en Oncologie biologique et Oncopharmacologie, Aix-Marseille Université, Boulevard Jean Moulin, 13005, Marseille, France.,OncoSafetyNetwork, AP-HM, Boulevard Jean Moulin, 13005, Marseille, France
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36
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Scalabre A, Bergeron C, Brioude F, Dainese L, Cropet C, Coulomb L'hermine A, Pasqualini C, Auber F, Verschuur A, Schleiermacher G, Le Bouc Y, Audry G, Irtan S. Is Nephron Sparing Surgery Justified in Wilms Tumor With Beckwith-Wiedemann Syndrome or Isolated Hemihypertrophy? Pediatr Blood Cancer 2016; 63:1571-7. [PMID: 27228957 DOI: 10.1002/pbc.26073] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/28/2016] [Accepted: 04/29/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Patients with Beckwith-Wiedemann syndrome (BWS) or isolated hemihypertrophy (HH) treated for a Wilms tumor (WT) carry an increased risk of developing metachronous lesion. There are no guidelines on precise indications for nephron sparing surgery (NSS) in unilateral WT (UWT). The objective of this retrospective study was to delineate the indications of NSS in patients with BWS/HH treated for WT and to evaluate their outcome. PROCEDURE All cases of BWS/HH treated for a WT according to SIOP protocols from 1980 to 2013 were reviewed. Patients were divided into two groups (G): isolated UWT (G1) and bilateral lesions (G2) with two subgroups: bilateral tumors suspected of malignancy (G2a), and unilateral tumor suspected of malignancy with contralateral nephroblastomatosis (G2b). RESULTS Forty-six patients were included (34 G1, three G2a, and nine G2b). Nine NSS and 25 total nephrectomies (TN) were performed in G1, two bilateral NSS and one NSS with contralateral TN in G2a, and eight NSS and one TN in G2b. The 3-year event-free survival was 92.3% (95% CI [77.9-97.5%]). One death occurred after a local relapse following a TN for a stage III stromal WT (G1) and another after a combined local and distant relapse following a NSS for a stage I diffuse anaplastic WT (G2b). There were two metachronous WT (4%), 3 years after a TN (G1) and 12 years after a NSS (G2b). CONCLUSIONS NSS is recommended in bilateral WT and may be an option in selected UWT patients with BWS/HH because it was not associated with an increased risk of local relapse.
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Affiliation(s)
- Aurélien Scalabre
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau, Pediatric Surgery, 75012 Paris, France
| | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, Department of Pediatrics, 690008 Lyon, France
| | - Frederic Brioude
- Universités, UPMC Univ Paris 06, Centre de Recherche St Antoine Inserm UMRS.938, APHP Hôpital Armand Trousseau Pediatric and Genetic Endocinology, 75012 Paris, France
| | - Linda Dainese
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau Pathology Department, Centre de Recherche St Antoine, Inserm UMRS.938, 75012 Paris, France
| | - Claire Cropet
- Université de Lyon - Centre Léon Bérard, Department of Statistics, 69008 Lyon, France
| | - Aurore Coulomb L'hermine
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau Pathology Department, Centre de Recherche St Antoine, Inserm UMRS.938, 75012 Paris, France
| | - Claudia Pasqualini
- Gustave Roussy Cancer Campus, Pediatric Oncology, 94800 Villejuif, France
| | - Frederic Auber
- Université de Bourgogne Franche-Comté, Laboratoire de Nanomédecine, Imagerie et Thérapeutique EA 4662, CHRU Besançon, Service de Chirurgie Pédiatrique, 25030 Besançon, France
| | - Arnauld Verschuur
- Department of Pediatric Hematology and Oncology, Hôpital de la Timone Enfant, 13005 Marseille, France
| | - Gudrun Schleiermacher
- Institut Curie, Paediatric oncology, 3 INSERM U830, Laboratoire de Génétique et Biologie des Cancers, 75005 Paris, France
| | - Yves Le Bouc
- Universités, UPMC Univ Paris 06, Centre de Recherche St Antoine Inserm UMRS.938, APHP Hôpital Armand Trousseau Pediatric and Genetic Endocinology, 75012 Paris, France
| | - Georges Audry
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau, Pediatric Surgery, 75012 Paris, France
| | - Sabine Irtan
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau Pediatric Surgery, Centre de Recherche St Antoine, Inserm UMRS.938, 75012 Paris, France
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Vassal G, Faivre L, Geoerger B, Plantaz D, Auvrignon A, Coze C, Aladjidi N, Verschuur A, Icher C, Odile M, Sirvent N, Schleiermacher G, Auger N, Lonchamp E, Mahier - Ait Oukhatar C, Le Deley MC, Jimenez M, Hoog Labouret N. Crizotinib in children and adolescents with advanced ROS1, MET, or ALK-rearranged cancer: Results of the AcSé phase II trial. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.11509] [Citation(s) in RCA: 8] [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)
| | | | | | | | - Anne Auvrignon
- Pediatric Hematology, AP-HP, GH HUEP, Trousseau Hospital, Paris, France
| | - Carole Coze
- Hôpital d'Enfants de La Timone, Department of Pediatric Oncology, Marseille, France
| | | | - Arnauld Verschuur
- Hôpital d'Enfants de La Timone, Department of Pediatric Oncology, Marseille, France
| | | | | | | | | | - Nathalie Auger
- Gustave Roussy, Université Paris-Saclay, Department of Biopathology, Villejuif, France
| | | | | | - Marie-Cecile Le Deley
- Department of Biostatistics and Epidemiology, Gustave Roussy, Cancer Campus, Grand Paris, Villejuif, France
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Lesieur E, Menager N, Delagausie P, Verschuur A, Bretelle F, Coze C, Scavarda D, Guidicelli B, Gorincour G. Fetal paravertebral congenital fibrosarcoma: MR imaging findings. Diagn Interv Imaging 2015; 97:483-5. [PMID: 26711551 DOI: 10.1016/j.diii.2015.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Affiliation(s)
- E Lesieur
- Hôpital La Conception, Department of Gynecology and Obstetrics, 147, boulevard Baille, 13385 Marseille cedex 5, France; Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - N Menager
- Department of Gynecology and Obstetrics, 305, rue Raoul-Follereau, 84902 Avignon, France
| | - P Delagausie
- Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France; Children's Hospital La Timone, Department of Pediatric Surgery, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - A Verschuur
- Children's Hospital La Timone, Department of Pediatric Oncology, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - F Bretelle
- Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France; Hôpital Nord, Department of Gynecology and Obstetrics, chemin des Bourrely, 13015 Marseille, France
| | - C Coze
- Children's Hospital La Timone, Department of Pediatric Oncology, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - D Scavarda
- Chidren's Hospital La Timone, Department of Neurosurgery, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - B Guidicelli
- Hôpital La Conception, Department of Gynecology and Obstetrics, 147, boulevard Baille, 13385 Marseille cedex 5, France; Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - G Gorincour
- Children's Hospital La Timone, Multidisciplinary Center for Prenatal Diagnosis, 264, rue Saint-Pierre, 13385 Marseille cedex, France; Children's Hospital La Timone, Department of Pediatric Imaging, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Vallet C, André N, Gentet JC, Verschuur A, Michel G, Sotteau F, Martha C, Grélot L. Pilot evaluation of physical and psychological effects of a physical trek programme including a dog sledding expedition in children and teenagers with cancer. Ecancermedicalscience 2015; 9:558. [PMID: 26284122 PMCID: PMC4531124 DOI: 10.3332/ecancer.2015.558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Indexed: 11/06/2022] Open
Abstract
AIM OF THE STUDY To evaluate the feasibility and to measure the effects of a six-week-long adapted physical activity programme (APAP), including 5 days of intense dog sledding, on the physical and psychological health of children and adolescents treated for cancer. METHODS Eleven children and teenagers (4 girls, 7 boys; mean age 14.3 ± 2.9 years) participated in this monocentric pilot programme of adapted physical activities from February 2013 to March 2013. Seven were still on treatment. The programme lasted 6 weeks. A series of physical tests and psychological questionnaires were carried out before and after the programme. RESULTS All children and teenagers completed the full programme. An improvement in all physical and psychological parameters was observed. Statistically significant differences were observed for global self-esteem (6.2 ± 2.1 to 7.7 ± 1.8; p = 0.02), perceived sport competence (5.3 ± 3.2 to 7.4 ± 2; p = 0.02) and perceived physical strength (5.6 ± 2.5 to 7.1 ± 1.8; p = 0.001). Regarding physical tests, the physical training led to statistically significant improvement for sit-ups (13.8 ± 2.6 to 21.75 ± 5.4; p = 0.01), muscle tone (76 ± 23.7 to 100 ± 22.9; p = 0.01), and resting heart rate (96.1 ± 3.2 to 91.6 ± 4.5; p = 0.03). CONCLUSION This programme is feasible in children and adolescents even during their oncologic treatment. During the 6-week programme, children and adolescents improved their physical and psychological health, and the putative benefits of the APAP are discussed. A larger randomised trial started in 2014.
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Affiliation(s)
- Clothilde Vallet
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille 13005, France
| | - Nicolas André
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Department of Paediatric Haematology and Oncology, Hôpital de la Timone Enfant, Marseille 13005, France
- Aix Marseille Université, Inserm, CRO2 UMR_S 911, Marseille 13005, France
| | - Jean-Claude Gentet
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Department of Paediatric Haematology and Oncology, Hôpital de la Timone Enfant, Marseille 13005, France
| | - Arnauld Verschuur
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Department of Paediatric Haematology and Oncology, Hôpital de la Timone Enfant, Marseille 13005, France
| | - Gérard Michel
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille 13005, France
- Aix Marseille Université, Inserm, CRO2 UMR_S 911, Marseille 13005, France
| | | | - Cécile Martha
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille 13005, France
- Department of Paediatric Haematology and Oncology, Hôpital de la Timone Enfant, Marseille 13005, France
- Aix Marseille Université, Inserm, CRO2 UMR_S 911, Marseille 13005, France
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France
- Faculty of Sport Sciences, Aix-Marseille University, Marseille 13009, France
| | - Laurent Grélot
- Faculty of Sport Sciences, Aix-Marseille University, Marseille 13009, France
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Malouf GG, Dainese L, Su X, Verschuur A, Bergeron C, Mouawad R, Blaise A, Le Bouc Y, Khayat D, Coulomb A. The genomic landscape of anaplastic Wilms tumors with diffuse versus focal anaplasia. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.10062] [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)
- Gabriel G Malouf
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Medical Oncology, UPMC Univ Paris 06, Institut Universitaire de Cancérologie GRC5, Paris, France
| | - Linda Dainese
- -HP, Hôpital Armand Trousseau, Department of Pathology, UPMC Univ Paris 06, Paris, France
| | - Xiaoping Su
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Arnauld Verschuur
- Hôpital d'Enfants de La Timone, Department of Pediatric Oncology, Marseille, France
| | | | | | - Annick Blaise
- , UMR_S 938, CDR Saint-Antoine, Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Yves Le Bouc
- UMR_S 938, CDR Saint-Antoine, Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - David Khayat
- Salpetriere Hospital, University Paris VI, Paris, France
| | - Aurore Coulomb
- Department of Pathology, Hopitaux Universitaires Est Parisien, Paris, France
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Verschuur A, Trent JC, Bajciova V, Thall AD, Lin X, Khosravan R, Ingrosso A, Janeway KA. A phase I/II study of sunitinib in young patients with advanced gastrointestinal stromal tumor. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.tps10601] [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)
| | - Jonathan C. Trent
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | | | | | - Xun Lin
- Pfizer Oncology, La Jolla, CA
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Renard C, Cropet C, Thiesse P, Schleiermacher G, Patte C, Sudour H, Pellier I, Thebaud E, Notz Carrere A, Verschuur A, Bergeron C. SFCE P-10 - Valeur pronostique du scanner thoracique au diagnostic de néphroblastome localisé. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71626-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lanvers-Kaminsky C, Abbou S, Daudigeos-Dubus E, Molenaar J, Verschuur A, Caron H, Vassal G, Geoerger B. 253 Anti-tumor Activity of the PLK Inhibitor Volasertib (BI 6727) and the Aurora Kinase Inhibitor BI 811283 in Pediatric Malignancies. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72051-8] [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: 10/27/2022]
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Verschuur A, Van Tinteren H, Graf N, Bergeron C, Sandstedt B, de Kraker J. Treatment of pulmonary metastases in children with stage IV nephroblastoma with risk-based use of pulmonary radiotherapy. J Clin Oncol 2012; 30:3533-9. [PMID: 22927531 DOI: 10.1200/jco.2011.35.8747] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The purpose of this study was to determine the outcome of children with nephroblastoma and pulmonary metastases (PM) treated according to International Society of Pediatric Oncology (SIOP) 93-01 recommendations using pulmonary radiotherapy (RT) in selected patients. PATIENTS AND METHODS Patients (6 months to 18 years) were treated with preoperative chemotherapy consisting of 6 weeks of vincristine, dactinomycin, and epirubicin or doxorubicin. If pulmonary complete remission (CR) was not obtained, metastasectomy was considered. Patients in CR received three-drug postoperative chemotherapy, whereas patients not in CR were switched to a high-risk (HR) regimen with an assessment at week 11. If CR was not obtained, pulmonary RT was mandatory. RESULTS Two hundred thirty-four of 1,770 patients had PM. Patients with PM were older (P < .001) and had larger tumor volumes compared with nonmetastatic patients (P < .001). Eighty-four percent of patients were in CR postoperatively, with 17% requiring metastasectomy. Thirty-five patients (16%) had multiple inoperable PM and required the HR protocol. Only 14% of patients received pulmonary RT during first-line treatment. For patients with PM, 5-year event-free survival rate was 73% (95% CI, 68% to 79%), and 5-year overall survival (OS) rate was 82% (95% CI, 77% to 88%). Five-year OS was similar for patients with local stage I and II disease (92% and 90%, respectively) but lower for patients with local stage III disease (68%; P < .001). Patients in CR after chemotherapy only and patients in CR after chemotherapy and metastasectomy had a better outcome than patients with multiple unresectable PM (5-year OS, 88%, 92%, and 48%, respectively; P < .001). CONCLUSION Following the SIOP protocol, pulmonary RT can be omitted for a majority of patients with PM and results in a relatively good outcome.
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Affiliation(s)
- Arnauld Verschuur
- Department of Pediatric Oncology, Hôpital d'Enfants de La Timone, 264, rue Saint Pierre, 13385 Marseille Cedex 5, France.
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Abstract
Background Metronomic chemotherapy (MC) is defined as the frequent administration of chemotherapy at doses below the maximal tolerated dose and with no prolonged drug-free break. MC is gaining interest as an alternative strategy to fight resistant cancer. Objective to assess the safety of 4 drug MC regimen in pediatric patients with refractory or relapsing various tumors types. Setting From November 2008 to December 2010, in three academic pediatric oncology centers, 16 children (median age 12 years old; range 5.5-20) were included in this pilot study. This treatment was proposed to children with refractory disease for whom no further effective treatments were available. Most frequent diagnosis were medulloblastoma/cerebral PNET (5) osteosarcoma (5), and one case each of nephroblastoma, high grade glioma, Hodgkin lymphoma, rhabdomyosarcoma, neuroblastoma and kidney rhabdoid tumour. The MC regimen consisted in cycles of 56 days (8 weeks) with weekly vinblastine 3 mg/m2 (week 1-7), daily cyclophosphamide 30 mg/m2 (days 1-21), and twice weekly methotrexate 10 mg/m2; (days 21-42), and daily celecoxib 100 mg to 400 mg twice daily (days1-56) followed by a 2-weeks chemotherapy break. Adverse events were determined through laboratory analysis and investigator observations. Results One objective response was observed in a patient with Hodgkin lymphoma, and 4 patients experienced disease stabilization and continued their treatment for 3 cycles (24 weeks) or more. At last follow-up, 7 patients (43%) are alive including 1 still undergoing treatment. During the overall 36 cycles of treatments received by patients, 4 grade IV toxicities and 24 grade III toxicities were observed in 11 cycles in only 10 different patients. Conclusion The metronomic regimen we report here was well tolerated and associated with disease stabilization. This regimen is currently being evaluated in a national multicenter phase II study.
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Affiliation(s)
- Nicolas André
- Service d'Hématologie et Oncologie Pédiatrique, Hôpital pour Enfants de La Timone, Marseille, France.
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Di Giannatale A, Mc Hugh K, Dias N, Devos A, Geoerger B, Jaspan T, Calmon R, Courbon F, Malekzadeh K, Aerts I, Verschuur A, Casanova M, Fouyssac F, Rubie H, Corradini N, Perel Y, Zwaan M, Riccardi R, Le Deley MC, Caron H. Phase II study of temozolomide in combination with topotecan (TOTEM) in relapsed or refractory neuroblastoma and other pediatric solid malignancies: A European ITCC study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.9517] [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
9517 Background: Temozolomide and topotecan have shown activity in several pediatric cancers, including neuroblastoma. Resistance to alkylating agents due to MGMT expression, MMR deficiency or microsatellite instability may be overcome through the combination with topoisomerase I inhibitors. The combination of temozolomide and topotecan (TOTEM) was well tolerated and showed preliminary activity in children with neuroblastoma and glioma (Rubie et al, 2010). Methods: This multicenter, non-randomized, multi-cohort Phase II study included children with neuroblastoma according to a 2-stage Simon design, and patients with central nervous system (CNS) and extra-cranial solid tumors in a descriptive design. Temozolomide was administered orally at 150 mg/m2 followed by topotecan at 0.75 mg/m2 intravenously for 5 consecutive days every 28 days. The main endpoint was objective response (OR), i.e., Complete or Partial Response (CR+PR), evaluated after 2 cycles according to WHO criteria, or INRC criteria for neuroblastoma patients with mIBG-positive lesions, by an independent radiological review. Independent review of mIBG imaging is pending. Results: 103 patients, median age 9.4 years (range 1-21), were treated between June 2009 and May 2011 in 18 centers: 38 neuroblastoma, 33 CNS tumors and 32 other solid tumors. Overall 420 cycles were administered (median 3 per patient; range 1-12). Grade 3 or 4 neutropenia was frequent (55% courses), though only 6% of patients developed febrile neutropenia. In the neuroblastoma cohort, 1 CR and 7 PR were observed, leading to an estimated OR rate of 21% (95%CI, 10-37%). Additionally 22 patients had disease stabilization (SD), leading to an overall tumor control (CR+PR+SD) of 79% (63-90%), and a 12-month progression-free survival rate of 47% (31-64%). Overall, 17/102 evaluable patients achieved an OR (17%, 10-25%), with 1 CR and 3 PR in 9 medulloblastoma (44%, 14-79%), 2 PR in 4 PNET, 1 PR in 12 malignant glioma, and 2 PR in 9 RMS. Conclusions: Temozolomide-topotecan combination results in significant tumor control in children with neuroblastoma and medulloblastoma/PNET with favorable toxicity profile.
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Affiliation(s)
| | | | | | - Annick Devos
- Sophia Children’s Hospital/Erasmus MC Rotterdam, Rotterdam, Netherlands
| | | | - Tim Jaspan
- University Hospital Nottingham, Nottingham, United Kingdom
| | - Raphael Calmon
- Hôpital Saint-Louis, Université Paris VII, Paris, France
| | | | | | - Isabelle Aerts
- Institut Curie, Pediatric Oncology Department, Paris, France
| | | | | | | | | | | | | | - Michel Zwaan
- Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
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Beaugrand A, Lanvers-Kaminsky C, Aviles Marin PM, Cuevas Marchante C, Opolon P, Le Dret L, Verschuur A, Vassal G, Geoerger B. Cell cycle and apoptotic effects of PM00104 in pediatric cell lines and xenographs. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9546] [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: 11/20/2022] Open
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André N, Verschuur A, Rossler J, Sterba J. Anti-angiogenic therapies for children with cancer. Curr Cancer Drug Targets 2011; 10:879-89. [PMID: 20718702 DOI: 10.2174/156800910793357899] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 08/09/2010] [Indexed: 11/22/2022]
Abstract
Tumor angiogenesis, i.e. the development of neovascularisation in and around solid tumors, plays a key role in the local and distant growth of cancer and anti-angiogenic treatments are now established strategies to treat cancer patients. Specific inhibitors of angiogenesis such as bevacizumab or receptor tyrosine kinase inhibitors targeting VEGFR or PDGFR are now in clinical trials and are being increasingly validated for the treatment of poor prognostic cancers. Other anti-angiogenic strategies such as cilengitide or metronomic chemotherapy (low-dose anti-angiogenic chemotherapy) have been developed to treat certain types of adult cancer. In children, the clinical potential of anti-angiogenic approach is still in an early stage of investigation. This review will focus on the role of angiogenesis in pediatric solid tumors and will describe the pre-clinical and clinical experience with several anti-angiogenic compounds as a potential treatment for children with cancer.
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Affiliation(s)
- Nicolas André
- Service d'Oncologie Pédiatrique, Hôpital pour Enfants de "La Timone", Marseille, France.
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Abstract
Angiogenesis is crucial for the growth of cancer. As such, it has become an established target to fight cancer. Metronomic chemotherapy-the chronic administration of chemotherapy at relatively low, minimally toxic doses on a frequent schedule of administration, at close regular intervals, with no prolonged drug-free breaks-is a potential approach to control advanced cancer disease. It is thought to work primarily through antiangiogenic mechanisms and has the property to kill resistant cancer cells and/or to inhibit tumor growth while significantly reducing undesirable toxic side effects. Here, we will discuss potential mechanisms of action of metronomic chemotherapy and briefly review the data regarding the clinical experience with this kind of anticancer treatment. Based on recent insights in the various mechanisms of action, we will try to predict the potential new developments of metronomic chemotherapy in oncology.
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Affiliation(s)
- Nicolas André
- Service d'Oncologie Pediatrique, Hopital pour Enfants de La Timone, AP-HM, Marseille, France.
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50
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Zwaan CM, Kearns P, Caron H, Verschuur A, Riccardi R, Boos J, Doz F, Geoerger B, Morland B, Vassal G. The role of the ‘innovative therapies for children with cancer’ (ITCC) European consortium. Cancer Treat Rev 2010; 36:328-34. [DOI: 10.1016/j.ctrv.2010.02.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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