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Antoine A, Pérol D, Gilberg M, Lasset C, Choquet R, Robain M, Yahia BBH, Drouet Y. Utilisation des données de vie réelle pour estimer l'effet traitement en cancérologie: émulation du protocole de l'essai randomisé E2100 à partir de la base nationale ESME. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.03.100] [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: 10/18/2022] Open
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Pérol D, Carton M, Delaloge S, Mailliez A, Frenel JS, Patsouris A, Levy C, Guiu S, Goncalves A, Mouret-Reynier MA, Desmoulins I, Ferrero JM, De La Motte Rouge T, Leheurteur M, Petit T, Guesmia T, Cabel L, Debled M, Bachelot T, Dalenc F, Uwer L, Jouannaud C, Robain M. Facteurs pronostiques de la survie sans progression chez les patientes atteintes d’un cancer du sein métastatique de type RH+/HER2- avant l’avènement des inhibiteurs CDK dans la cohorte nationale ESME. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.04.015] [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: 11/24/2022] Open
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Cottu P, Livartoswki A, Pérol D, Trédan O, Gilberg M, Ghorbal R, Dupin J, Maillard C. KADor – Étude rétrospective française visant à décrire la prise en charge thérapeutique des patientes présentant un cancer du sein précoce HER2+ ayant bénéficié d’un traitement néoadjuvant à base d’Herceptin®. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Vanacker H, Cassier P, Pérol M, Saintigny P, Eberst L, Carbonnaux M, Brahmi M, Verlingue L, Ray-Coquard I, Pérol D, Blay JY. Cell lineage context and type of genomic alteration predict for the therapeutic relevance of tyrosine kinase inhibitors in human cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ray-Coquard I, Pautier P, Pignata S, Pérol D, González-Martín A, Sevelda P, Fujiwara K, Vergote I, Colombo N, Mäenpää J, Selle F, Sehouli J, Lorusso D, Alia EMG, Lefeuvre-Plesse C, Canzler U, Lortholary A, Marmé F, Pujade-Lauraine E, Harter P. Phase III PAOLA-1/ENGOT-ov25 trial: Olaparib plus bevacizumab (bev) as maintenance therapy in patients (pts) with newly diagnosed, advanced ovarian cancer (OC) treated with platinum-based chemotherapy (PCh) plus bev. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Boussageon M, Ortiz-Cuaran S, Chabaud S, Pérol D, Avrillon V, Mastroianni B, Fayette J, Ghiringhelli F, Neidhardt E, Swalduz A, Paulus V, Kaderbhai C, Fumet J, Saintigny P, Perol M. P1.01-116 Early Immune-Related Adverse Events Under PD-1/PD-L1 Inhibitors Predict Better Progression-Free Survival in NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Barlesi F, Pérol D, Mazieres J, Perol M, Varoqueaux N, Monville F, Audigier-Valette C, Barre P, Domergue F, Falchero L, Foa C, Frikha A, Hominal S, Le Treut J, Zahi S, Roumieux M, Olive D, Vivier E. P1.04-30 Pioneer Study: Precision Immuno-Oncology for Advanced Non-Small Cell Lung Cancer Patients with PD1/L1 ICI Resistance. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Frappaz D, Barritault M, Montané L, Laigle-Donadey F, Chinot O, Le Rhun E, Bonneville-Levard A, Meyronnet D, Garin G, Pérol D. OS4.1 MEVITEM: A European, randomized, open-label, Phase I/II study of vismodegib in combination with temozolomide versus temozolomide alone in adult patients with recurrent or refractory medulloblastoma presenting an activation of the Sonic Hedgehog (SHH) pathway. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.031] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Vismodegib (V) suppresses sonic hedgehog (SHH) signaling. We postulated that vismodegib together with chemotherapy may be more efficient than chemotherapy alone in patients (pts) relapsing of a SHH-activated medulloblastoma (MB).
MATERIAL AND METHODS
Adult pts with recurrent SHH-MB not previously exposed to temozolomide (T) were randomly assigned (2:1 ratio) to Arm A (V daily 150mg/d, po) + T (D1-5: 150 mg/m2 for cycle 1 and 200 mg/m2 thereafter; n=up to 25pts) or Am B (T alone; n=up to 13pts). Identification of SHH activation was performed centrally by IHC (GAB1, β-catenin, filamin A, and YAP1). NGS analyses were performed to identify the mutations responsible for SHH activation. Primary objectives were to assess the incidence of severe toxicities (safety run-in based on a 3 + 3 design) and the 6-month non-progression rate (NPR-6m) according to WHO criteria and based on central read tumor assessment (Phase II). A Minimax Simon’s two-stage design was used to detect NPR-6m of 55% (p0: 30%, type I error rate of 5%, power of 80%). At first stage, ≥ 3/9 pts without progression at 6m were required for the accrual of 16 additional pts in Arm A. A 3rd independent and parallel arm with V as single agent (Arm C, n= up to15pts) was added for pts previously treated by T.
RESULTS
24 SHH-MB pts were enrolled (Arm A: 10, Arm B: 5 and Arm C: 9; median age: 37 y [21–55]). At the end of the safety run-in; no major safety concerns were reported. At the end of Stage I: no objective response were reported and 2 pts among 10 were free of progression at 6m among in Arm A. According to statistical rules, the study was definitively closed to enrolment. NGS analyses showed a PTCH1 inactivating mutation in 6 pts (n=4 in arm A; n= 2 in arm B); a SMO activating mutation in 4 pts (n= 3 in Arm A; n=1 in Arm B). For 1 pt in each arm, no tumor sample was available for analysis, for 1 pt in Arm A DNA quality was insufficient, and for 1 patient in each arm no mutations of SMO, PTCH1, SUFU or SHH were found. Out of the 4 pts in Arm A with an inactivating PTCH1 mutation, only 1 was progression free at 6m. PFS and OS data will be presented at the meeting.
CONCLUSION
The combination of vismodegib with monthly T failed to demonstrate superior activity as compared with T alone. Further studies are warranted to refine therapeutic indication for vismodegib
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Affiliation(s)
- D Frappaz
- Centre Léon Bérard et IHOP, Lyon, France
| | - M Barritault
- Hospices Civils de Lyon, Service de Cytologie et d’Anatomie Pathologique, Dpt Biopathologie Moléculaire et Dpt Neuropathologie, Lyon, France
- Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR 5286, Lyon, France
| | | | | | - O Chinot
- APHM La Timone, Marseille, France
| | - E Le Rhun
- CHRU Lille, Dpt Neuro-oncologie, Lille, France
- Oscar Lambret Cancer Center et University of Lille, Lille, France
| | | | - D Meyronnet
- Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Cytologie et d’Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Lyon, France., Lyon, France
| | - G Garin
- Centre Léon Bérard - Direction de la Recherche Clinique et de l’Innovation, Lyon, France
| | - D Pérol
- Centre Léon Bérard - Direction de la Recherche Clinique et de l’Innovation, Lyon, France
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Blay JY, Honoré C, Stoeckle E, Meeus P, Jafari M, Gouin F, Anract P, Ferron G, Rochwerger A, Ropars M, Carrere S, Marchal F, Sirveaux F, Di Marco A, Le Nail LR, Guiramand J, Vaz G, Machiavello JC, Marco O, Causeret S, Gimbergues P, Fiorenza F, Chaigneau L, Guillemin F, Guilloit JM, Dujardin F, Spano JP, Ruzic JC, Michot A, Soibinet P, Bompas E, Chevreau C, Duffaud F, Rios M, Perrin C, Firmin N, Bertucci F, Le Pechoux C, Le Loarer F, Collard O, Karanian-Philippe M, Brahmi M, Dufresne A, Dupré A, Ducimetière F, Giraud A, Pérol D, Toulmonde M, Ray-Coquard I, Italiano A, Le Cesne A, Penel N, Bonvalot S. Surgery in reference centers improves survival of sarcoma patients: a nationwide study. Ann Oncol 2019; 30:1407. [PMID: 31168580 PMCID: PMC6683855 DOI: 10.1093/annonc/mdz170] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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10
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Blay JY, Honoré C, Stoeckle E, Meeus P, Jafari M, Gouin F, Anract P, Ferron G, Rochwerger A, Ropars M, Carrere S, Marchal F, Sirveaux F, Di Marco A, Le Nail LR, Guiramand J, Vaz G, Machiavello JC, Marco O, Causeret S, Gimbergues P, Fiorenza F, Chaigneau L, Guillemin F, Guilloit JM, Dujardin F, Spano JP, Ruzic JC, Michot A, Soibinet P, Bompas E, Chevreau C, Duffaud F, Rios M, Perrin C, Firmin N, Bertucci F, Le Pechoux C, Le Loarer F, Collard O, Karanian-Philippe M, Brahmi M, Dufresne A, Dupré A, Ducimetière F, Giraud A, Pérol D, Toulmonde M, Ray-Coquard I, Italiano A, Le Cesne A, Penel N, Bonvalot S. Surgery in reference centers improves survival of sarcoma patients: a nationwide study. Ann Oncol 2019; 30:1143-1153. [PMID: 31081028 PMCID: PMC6637376 DOI: 10.1093/annonc/mdz124] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND NETSARC (netsarc.org) is a network of 26 sarcoma reference centers with specialized multidisciplinary tumor boards (MDTB) aiming to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB and expert pathological review are mandatory for sarcoma patients nationwide. In the present work, the impact of surgery in a reference center on the survival of sarcoma patients investigated using this national NETSARC registry. PATIENTS AND METHODS Patients' characteristics and follow-up are prospectively collected and data monitored. Descriptive, uni- and multivariate analysis of prognostic factors were conducted in the entire series (N = 35 784) and in the subgroup of incident patient population (N = 29 497). RESULTS Among the 35 784 patients, 155 different histological subtypes were reported. 4310 (11.6%) patients were metastatic at diagnosis. Previous cancer, previous radiotherapy, neurofibromatosis type 1 (NF1), and Li-Fraumeni syndrome were reported in 12.5%, 3.6%, 0.7%, and 0.1% of patients respectively. Among the 29 497 incident patients, 25 851 (87.6%) patients had surgical removal of the sarcoma, including 9949 (33.7%) operated in a NETSARC center. Location, grade, age, size, depth, histotypes, gender, NF1, and surgery outside a NETSARC center all correlated to overall survival (OS), local relapse free survival (LRFS), and event-free survival (EFS) in the incident patient population. NF1 history was one of the strongest adverse prognostic factors for LRFS, EFS, and OS. Presentation to an MDTB was associated with an improved LRFS and EFS, but was an adverse prognostic factor for OS if surgery was not carried out in a reference center. In multivariate analysis, surgery in a NETSARC center was positively correlated with LRFS, EFS, and OS [P < 0.001 for all, with a hazard ratio of 0.681 (95% CI 0.618-0.749) for OS]. CONCLUSION This nationwide registry of sarcoma patients shows that surgical treatment in a reference center reduces the risk of relapse and death.
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Affiliation(s)
- J-Y Blay
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth.
| | - C Honoré
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - E Stoeckle
- Department of Medical Oncology and Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - P Meeus
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - M Jafari
- Department of Medical Oncology and Department of Surgical Oncology, Centre Oscar Lambret, Lille; Department of Surgical Oncology, CHU, Lille
| | - F Gouin
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth; Department of Medical Oncology and Department of Surgical Oncology, Institut de Cancerologie Nantes, Nantes; Department of Orthopedics, CHU Nantes, Nantes
| | - P Anract
- Department of Orthopedics, Hôpital Cochin-Saint-Vincent de Paul, Paris
| | - G Ferron
- Department of Medical Oncology and Department of Surgical Oncology, Institut Universitaire de Cancerologie de Toulouse, Claudius Regaud, Toulouse
| | - A Rochwerger
- Department of Medical Oncology and Department of Orthopedics, La Timone University Hospital, Marseille
| | - M Ropars
- Medical Oncology Department, Eugene Marquis Comprehensive Cancer Center, Rennes; Department of Orthopedics, CHU, Rennes
| | - S Carrere
- Medical Oncology Department, Institut de Cancérologie de Montpellier, Montpellier
| | - F Marchal
- Department of Medical Oncology and Department of Surgical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - F Sirveaux
- Department of Medical Oncology and Department of Surgical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - A Di Marco
- Department of Surgical Oncology and Department of Medical Oncology, Centre Paul Strauss & CHU Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - L R Le Nail
- Department of Orthopedics, CHU de Tours, Tours
| | - J Guiramand
- Department of Medical Oncology and Department of Surgical Oncology, Institut Paoli Calmettes, Marseille
| | - G Vaz
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - J-C Machiavello
- Department of Medical Oncology and Department of Surgical Oncology, Centre Antoine-Lacassagne, Nice
| | - O Marco
- Oncology Unit, Saint Louis Hospital, Paris
| | - S Causeret
- Department of Surgery, Centre Georges François Leclerc, Dijon
| | - P Gimbergues
- Department of Surgery, Centre Jean Perrin/ERTICa EA, Clermont-Ferrand
| | - F Fiorenza
- Department of Medical Oncology and Department of Surgical Oncology, CHU Limoges, Limoges
| | - L Chaigneau
- Medical Oncology Department, CHU Besancon, Besançon
| | - F Guillemin
- Department of Medical Oncology and Department of Surgical Oncology, Institut J Godinot Reims
| | - J-M Guilloit
- Department of Surgical Oncology, Centre Francois Baclesse, Caen
| | - F Dujardin
- Department of Surgery, Centre Henri Becquerel, Rouen
| | - J-P Spano
- Medical Oncology Department, APHP La Pitié Salpetriere/Tenon/Bicetre, Paris
| | - J-C Ruzic
- Medical Oncology Department, CHU La Réunion, Saint-Pierre, La Réunion
| | - A Michot
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - P Soibinet
- Department of Medical Oncology and Department of Surgical Oncology, Institut J Godinot Reims
| | - E Bompas
- Department of Medical Oncology and Department of Surgical Oncology, Institut de Cancerologie Nantes, Nantes; Department of Orthopedics, CHU Nantes, Nantes
| | - C Chevreau
- Department of Medical Oncology and Department of Surgical Oncology, Institut Universitaire de Cancerologie de Toulouse, Claudius Regaud, Toulouse
| | - F Duffaud
- Department of Medical Oncology and Department of Orthopedics, La Timone University Hospital, Marseille
| | - M Rios
- Medical Oncology Department, Eugene Marquis Comprehensive Cancer Center, Rennes; Department of Orthopedics, CHU, Rennes
| | - C Perrin
- Medical Oncology Department, Eugene Marquis Comprehensive Cancer Center, Rennes; Department of Orthopedics, CHU, Rennes
| | - N Firmin
- Medical Oncology Department, Institut de Cancérologie de Montpellier, Montpellier
| | - F Bertucci
- Department of Medical Oncology and Department of Surgical Oncology, Institut Paoli Calmettes, Marseille
| | - C Le Pechoux
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - F Le Loarer
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - O Collard
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - M Karanian-Philippe
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - M Brahmi
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - A Dufresne
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - A Dupré
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - F Ducimetière
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - A Giraud
- Department of Orthopedics, Hôpital Cochin-Saint-Vincent de Paul, Paris
| | - D Pérol
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - M Toulmonde
- Department of Medical Oncology and Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - I Ray-Coquard
- Department of Medical Oncology and Department of Surgical Oncology, Centre Léon Bérard, Lyon; Université Claude Bernard, Lyon; Institut de Cancerologie L. Neuwirth
| | - A Italiano
- Department of Medical Oncology and Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - A Le Cesne
- Department of Medical Oncology and Department of Surgical Oncology, Gustave Roussy Cancer Campus-Surgery, Villejuif
| | - N Penel
- Department of Medical Oncology and Department of Surgical Oncology, Centre Oscar Lambret, Lille; Department of Surgical Oncology, CHU, Lille
| | - S Bonvalot
- Surgery Department, Institut Curie, Paris, France
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Trédan O, Wang Q, Pissaloux D, Cassier P, de la Fouchardière A, Fayette J, Desseigne F, Ray-Coquard I, de la Fouchardière C, Frappaz D, Heudel PE, Bonneville-Levard A, Fléchon A, Sarabi M, Guibert P, Bachelot T, Pérol M, You B, Bonnin N, Collard O, Leyronnas C, Attignon V, Baudet C, Sohier E, Villemin JP, Viari A, Boyault S, Lantuejoul S, Paindavoine S, Treillleux I, Rodriguez C, Agrapart V, Corset V, Garin G, Chabaud S, Pérol D, Blay JY. Molecular screening program to select molecular-based recommended therapies for metastatic cancer patients: analysis from the ProfiLER trial. Ann Oncol 2019; 30:757-765. [PMID: 30865223 DOI: 10.1093/annonc/mdz080] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Antitumor activity of molecular-targeted agents is guided by the presence of documented genomic alteration in specific histological subtypes. We aim to explore the feasibility, efficacy and therapeutic impact of molecular profiling in routine setting. PATIENTS AND METHODS This multicentric prospective study enrolled adult or pediatric patients with solid or hematological advanced cancer previously treated in advanced/metastatic setting and noneligible to curative treatment. Each molecular profile was established on tumor, relapse or biopsies, and reviewed by a molecular tumor board (MTB) to identify molecular-based recommended therapies (MBRT). The main outcome was to assess the incidence rate of genomic mutations in routine setting, across specific histological types. Secondary objectives included a description of patients with actionable alterations and for whom MBRT was initiated, and overall response rate. RESULTS Four centers included 2579 patients from February 2013 to February 2017, and the MTB reviewed the molecular profiles achieved for 1980 (76.8%) patients. The most frequently altered genes were CDKN2A (N = 181, 7%), KRAS (N = 177, 7%), PIK3CA (N = 185, 7%), and CCND1 (N = 104, 4%). An MBRT was recommended for 699/2579 patients (27%), and only 163/2579 patients (6%) received at least one MBRT. Out of the 182 lines of MBRT initiated, 23 (13%) partial responses were observed. However, only 0.9% of the whole cohort experienced an objective response. CONCLUSION An MBRT was provided for 27% of patients in our study, but only 6% of patients actually received matched therapy with an overall response rate of 0.9%. Molecular screening should not be used at present to guide decision-making in routine clinical practice outside of clinical trials.This trial is registered with ClinicalTrials.gov, number NCT01774409.
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Affiliation(s)
- O Trédan
- Departments of Medical Oncology, University Claude Bernard
| | - Q Wang
- Translational Research and Innovation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - B You
- Department of Medical Oncology, Lyon Sud Hospital Center, CITOHL, Institute of Cancerology, Hospices Civils de Lyon (IC-HCL), Lyon; Faculty of Medicine-Lyon Sud, EMR UCBL/HCL 3738, University of Lyon 1, Oullins
| | - N Bonnin
- Department of Medical Oncology, Lyon Sud Hospital Center, CITOHL, Institute of Cancerology, Hospices Civils de Lyon (IC-HCL), Lyon
| | - O Collard
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - C Leyronnas
- Department of Medical Oncology, Mutualist Hospital Group, Grenoble
| | | | - C Baudet
- Synergie Lyon Cancer, Bio-Informatics Platform
| | - E Sohier
- Synergie Lyon Cancer, Bio-Informatics Platform
| | | | - A Viari
- Synergie Lyon Cancer, Bio-Informatics Platform
| | - S Boyault
- Translational Research and Innovation
| | | | | | | | - C Rodriguez
- BioPathology, Léon Bérard Cancer center, Lyon
| | - V Agrapart
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - V Corset
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - G Garin
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - S Chabaud
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - D Pérol
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - J-Y Blay
- Departments of Medical Oncology, University Claude Bernard.
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Courtinard C, Robain M, Bousquet PJ, Pérol D, Cossais S, Vanni A, Le Vu B, Le Bihan-Benjamin C, Lefeuvre D. Construction de paramètres d’extrapolation des résultats statistiques de la cohorte ESME Sein métastatique – Reconstruction d’une cohorte de patients traités pour un cancer du sein métastatique dans un CLCC à partir de la cohorte Cancer de l’INCa. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Courtinard C, Asselain B, Brain E, Piot I, Payen O, Campion L, Jaffré A, Girerd-Chambaz N, Pérol D, Mathoulin-Pelissier S, Diéras V, Perrocheau G, Robain M. Construction et évaluation d’un substitut de l’indice fonctionnel ECOG (PS), mesure de l’état de santé général du patient au diagnostic du cancer du sein métastatique. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.301] [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: 11/16/2022] Open
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Ezzalfani M, Delaloge S, Porcher R, Savignoni A, Courtinard C, Chenuc G, Robain M, Pérol D. Addressing the issue of bias in observational studies : Instrumental variable & Quasi-trial in ESME Research program. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.355] [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: 10/17/2022] Open
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Saghatchian M, Carton M, Piot I, Pérol D, Pistilli B, Brain E, Ghouadni A, Ricci F, Vanlemmens L, Loeb A, Levy C, Goncalves A, Dalenc F, Lefeuvre-Plesse C, Campone M, Jaffre A, Gourgou S, Cailliot C, Robain M, Dieras V. Abstract P5-20-03: Impact of prior adjuvant trastuzumab (aT) on clinical characteristics, patterns of recurrence and outcome in 2863 patients with Her2 positive (HER2+) metastatic breast cancer (MBC)- Results from the French ESME UNICANCER program. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-20-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The management of HER2+ BC has changed dramatically with the introduction and widespread use of HER2-targeted therapies, especially in the adjuvant setting. However, there is relatively limited real-world information on the impact of adjuvant Trastuzumab (aT) on patterns of recurrence and outcome of HER2+ MBC.
Methods: In 2014, the 18 French Cancer Centers launched the Epidemiological Strategy and Medical Economics (ESME) program to provide real-world data on MBC patients (pts). All pts who started a 1st-line treatment for MBC between 01-Jan-2008 and 31-Dec-2014 were included. We examined clinical characteristics and outcomes (overall survival [OS] and time to next treatment [TNT]) in patients with HER2+ MBC pretreated with trastuzumab in the adjuvant setting (aT) compared with trastuzumab-naïve patients (nT) and patients with de novo HER2+ MBC (dn). Multivariate analyses adjusted for baseline demographic, prognostic factors and year of diagnosis (prior or after 2005, when aT was approved and widely administered in France for early HER2+ breast cancer).
Results: Among the 15170 pts of the ESME database, 2863 (19%) were HER2+: 1093 pts (38%) had de novo and 1765 pts (62%) recurrent MBC; 63% were Hormone Receptor (HR) +; 54%, 25% and 21% had respectively 1, 2, or > 2 metastatic sites (68% visceral and 12% brain). Median time to 1st metastasis was 43.4 months (m) (95% CI: 24.6-84.4): 54 m in HR+ and 30 m in HR-. Among pts with recurrent MBC, 55% (995) had received aT. As 1st-line therapy for MBC, 90 % of pts received HER2-targeted agents (73% T-based). With a median follow-up of 46 m, median OS is 45 m (95% CI: 42.5-48). OS is significantly higher in de novo compared to recurrent MBC: 54 m (95% CI: 50.2-60.4) vs. 38.4 m (95% CI: 36.7-41.9), (p < 0.0001). Among pts with recurrent cancers, median OS is inferior in pts who had received aT, as compared to those who had not: 33.4 m (95% CI: 29.6-36.7) vs. 49.5 m (95% CI: 44.3-56.8), (p < 0.0001). Statistically significant differences persist after adjustment for age at MBC, disease-free interval, metastatic sites and RH status in the multivariate model (HR=1.45, 95% CI: 1.26-1.67) but not after adjustment for year of diagnosis (prior or after 2005) (HR=0.90, 95% CI: 0.70-1.15).
Conclusions: These large-scale real-world data in patients with HER2+ MBC provide evidence that the survival outcome remain similar in patients with failure of adjuvant trastuzumab compared with trastuzumab-naïve patients after adjustment for year of diagnosis. De novo HER2+ MBC pts have the best outcomes. Data on clinical characteristics of metastasis and time to next treatment for the three subgroups will be presented at the meeting.
Citation Format: Saghatchian M, Carton M, Piot I, Pérol D, Pistilli B, Brain E, Ghouadni A, Ricci F, Vanlemmens L, Loeb A, Levy C, Goncalves A, Dalenc F, Lefeuvre-Plesse C, Campone M, Jaffre A, Gourgou S, Cailliot C, Robain M, Dieras V. Impact of prior adjuvant trastuzumab (aT) on clinical characteristics, patterns of recurrence and outcome in 2863 patients with Her2 positive (HER2+) metastatic breast cancer (MBC)- Results from the French ESME UNICANCER program [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-20-03.
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Affiliation(s)
- M Saghatchian
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - M Carton
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - I Piot
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - D Pérol
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - B Pistilli
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - E Brain
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - A Ghouadni
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - F Ricci
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - L Vanlemmens
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - A Loeb
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - C Levy
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - A Goncalves
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - F Dalenc
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - C Lefeuvre-Plesse
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - M Campone
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - A Jaffre
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - S Gourgou
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - C Cailliot
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - M Robain
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
| | - V Dieras
- Institut Gustave Roussy, Villejuif, France; Institut Curie; Unicancer; Centre Oscar Lambret; Centre François Baclesse; Institut Paoli-Calmettes; Institut Claudius Regaud; Centre Eugène Marquis; Institut de Cancérologie de l'Ouest - René Gauducheau; Institut Bergonié; ICM-Montpellier Cancer Institute
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Trédan O, Ménétrier-Caux C, Ray-Coquard I, Garin G, Cropet C, Verronèse E, Bachelot T, Rebattu P, Heudel PE, Cassier P, Chabaud S, Croughs T, Dupont P, Cadore AC, Clapisson G, Delgado A, Bardin-Dit-Courageot C, Rigal C, N'Kodia A, Gilles-Afchain L, Morre M, Pérol D, Blay JY, Caux C. ELYPSE-7: a randomized placebo-controlled phase IIa trial with CYT107 exploring the restoration of CD4+ lymphocyte count in lymphopenic metastatic breast cancer patients. Ann Oncol 2018; 29:523. [PMID: 28368453 DOI: 10.1093/annonc/mdx058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gambotti L, Pérol D, Frering B, Kaemmerlen P, Coronel B, Sebban H, Bulso V, Bachelot V, Chauvin F, Bachmann P. Safety of Percutaneous Internal Jugular Catheterization in Cancer Patients: Prospective Observational Study. J Vasc Access 2018; 5:161-7. [PMID: 16596560 DOI: 10.1177/112972980400500405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose To determine predictors for failure and early complications of percutaneous internal jugular catheterization (IJC) in cancer patients. Methods Six hundred and thirty consecutive cancer patients who required central venous catheterization were included in a prospective observational study. The rates of failure (defined as the intervention of a second physician and/or failure at initial insertion site) and of early complications were prospectively ascertained. Logistic regression analysis estimated odds ratio (OR) and 95% confidence intervals (95% CI) for independent predictors for failure and early complications of percutaneous IJC. Results The failure rate was 6.7%, and the early complication rate was 6.7%. In multivariate analysis, left-side initial catheterization (p<0.01), prior catheterization at the same site (p=0.001) and physician inexperience (p<0.0001) were independently associated with failure. Placement requiring more than one needle pass (p<0.01 for two and p<0.0001 for three and more) and absence of fluoroscopy (p<0.0001) were independently associated with early complications. Conclusions Percutaneous IJC is a valid option in the central venous catheterization of cancer patients due to its reliability and safety. Skilled physicians must manage difficult placements. If placement requires more than one needle pass or is made without fluoroscopy, patients must be carefully followed for potential complications.
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Affiliation(s)
- L Gambotti
- Department of Public Health, Léon Bérard Center, Lyon, France
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Le Saux O, Ray-Coquard I, Corset V, Sohier E, Baudet C, Pissaloux D, Wang Q, Chabaud S, Varnier R, Heudel P, Derbel O, You B, Trédan O, Cassier P, Bonnin N, Biron P, Freyer G, Trillet-Lenoir V, Bachelot T, Pérol D, Blay JY. Actionable molecular alterations in advanced gynecologic malignancies: updated results from the ProfiLER program in France. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx511] [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: 11/15/2022] Open
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Bourmaud A, Anota A, Moncharmont C, Tinquaut F, Oriol M, Trillet-Lenoir V, Bajard A, Parnalland S, Rotonda C, Bonnetain F, Pérol D, Chauvin F. Cancer-related fatigue management: evaluation of a patient education program with a large-scale randomised controlled trial, the PEPs fatigue study. Br J Cancer 2017; 116:849-858. [PMID: 28196066 PMCID: PMC5379143 DOI: 10.1038/bjc.2017.31] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/23/2016] [Accepted: 01/21/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To assess the efficacy of a patient educational program built according to guidelines that aims at reducing cancer-related fatigue (CRF). METHODS Randomised controlled trial, multicentre, comparing a patient education program, vs the standard of care. Patients were adult cancer outpatients with any tumour site. The primary outcome was fatigue severity assessed with a visual analogical scale (VAS), between the day of randomisation and week 7. Secondary outcomes were fatigue assessed with other scales, health-related quality of life, anxiety and depression. The time to fatigue severity deterioration was assessed. Analyses were performed in a modified intent-to-treat way, that is, including all patients with at least one baseline and 1 week 7 score. RESULTS A total of 212 patients were included. Fatigue severity assessment was made on 79 patients in the experimental group and 65 in the control group. Between randomisation and week 7, the fatigue (VAS) improved by 0.96 (2.85) points in the experimental group vs 1.63 (2.63) points in the control group (P=0.15). No differences with the secondary outcomes were highlighted between two groups. No other factors were found to be associated with fatigue severity deterioration. CONCLUSIONS Despite rigorous methodology, this study failed to highlight the program efficacy in fatigue reduction for cancer patients. Other assessment tools should be developed to measure the effect of the program on CRF and behaviour. The implementation of the program should also be explored in order to identify its mechanisms and longer-term impact.
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Affiliation(s)
- A Bourmaud
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
- Inserm, Clinical Investigation Center 1408, Saint-Etienne 42055, France
| | - A Anota
- French National Platform Quality of Life and Cancer, Besançon, France
- Methodology and Quality of Life Unit in Cancer, INSERM UMR 1098, University Hospital of Besançon, Besançon, France
| | - C Moncharmont
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Radiotherapy Department, Lucien Neuwirth Cancer Institut, Saint Priest en Jarez, France
| | - F Tinquaut
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, Saint-Etienne 42055, France
| | - M Oriol
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Inserm, Clinical Investigation Center 1408, Saint-Etienne 42055, France
| | - V Trillet-Lenoir
- Medical Oncology Department, Lyon-Sud Lyon-Sud teaching hospital, Lyon, France
| | - A Bajard
- Direction of Clinical Research and of Innovation, Léon Bérard Cancer Center, Lyon, France
| | - S Parnalland
- French National Platform Quality of Life and Cancer, Besançon, France
| | - C Rotonda
- French National Platform Quality of Life and Cancer, Besançon, France
- INSERM, CIC-EC CIE6, Nancy, France CHU Nancy, Clinical Epidemiology and Evaluation Department, Nancy, France
| | - F Bonnetain
- French National Platform Quality of Life and Cancer, Besançon, France
- Methodology and Quality of Life Unit in Cancer, INSERM UMR 1098, University Hospital of Besançon, Besançon, France
| | - D Pérol
- Direction of Clinical Research and of Innovation, Léon Bérard Cancer Center, Lyon, France
| | - F Chauvin
- Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
- Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
- Inserm, Clinical Investigation Center 1408, Saint-Etienne 42055, France
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Affiliation(s)
- S Delaloge
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - D Pérol
- Department of Biostatistics, Centre Léon Bérard, Lyon, France
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Delaloge S, Pérol D, Courtinard C, Brain E, Asselain B, Bachelot T, Debled M, Dieras V, Campone M, Levy C, Jacot W, Lorgis V, Veyret C, Dalenc F, Ferrero JM, Uwer L, Kerbrat P, Goncalves A, Mouret-Reynier MA, Petit T, Jouannaud C, Vanlemmens L, Chenuc G, Guesmia T, Robain M, Cailliot C. Paclitaxel plus bevacizumab or paclitaxel as first-line treatment for HER2-negative metastatic breast cancer in a multicenter national observational study. Ann Oncol 2016; 27:1725-32. [PMID: 27436849 DOI: 10.1093/annonc/mdw260] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [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: 04/19/2016] [Accepted: 06/21/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Bevacizumab combined with paclitaxel as first-line chemotherapy for patients with HER2-negative metastatic breast cancer (MBC) has led to mixed results in randomized trials, with an improvement in progression-free survival (PFS) but no statistically significant overall survival (OS) benefit. Real-life data could help in assessing the value of this combination. PATIENTS AND METHODS This study aimed to describe the outcome following first-line paclitaxel with or without bevacizumab in the French Epidemiological Strategy and Medical Economics (ESME) database of MBC patients, established in 2014 by Unicancer. The primary and secondary end points were OS and PFS, respectively. RESULTS From 2008 to 2013, 14 014 MBC patient files were identified, including 10 605 patients with a HER2-negative status. Of these, 3426 received paclitaxel and bevacizumab (2127) or paclitaxel (1299) as first-line chemotherapy. OS adjusted for major prognostic factors was significantly longer in the paclitaxel and bevacizumab group compared with paclitaxel [hazard ratio (HR) 0.672, 95% confidence interval (CI) 0.601-0.752; median survival time 27.7 versus 19.8 months]. Results were consistent in all supportive analyses (using a propensity score for adjustment and as a matching factor for nested case-control analyses) and sensitivity analyses. Similar results were observed for the adjusted PFS, favoring the combination (HR 0.739, 95% CI 0.672-0.813; 8.1 versus 6.4 months). CONCLUSIONS In this large-scale, real-life setting, patients with HER2-negative MBC who received paclitaxel plus bevacizumab as first-line chemotherapy had a significantly better OS and PFS than those receiving paclitaxel. Despite robust methodology, real-life data are exposed to important potential biases, and therefore, results need to be treated with caution. Our data cannot therefore support extension of current use of bevacizumab in MBC.
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Affiliation(s)
- S Delaloge
- Department of Cancer Medicine, Institut Gustave Roussy, Villejuif
| | - D Pérol
- Department of Biostatistics, Centre Léon Bérard, Lyon
| | - C Courtinard
- Department of Research and Development, R&D Unicancer, Paris
| | - E Brain
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud
| | - B Asselain
- Department of Research and Development, R&D Unicancer, Paris
| | - T Bachelot
- Department of Biostatistics, Centre Léon Bérard, Lyon
| | - M Debled
- Department of Medical Oncology, Institut Bergonié, Bordeaux
| | - V Dieras
- Department of Medical Oncology, Institut Curie, Paris and Saint-Cloud
| | - M Campone
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes and Angers
| | - C Levy
- Department of Medical Oncology, Centre François Baclesse, Caen
| | - W Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier
| | - V Lorgis
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon
| | - C Veyret
- Department of Medical Oncology, Centre Henri Becquerel, Rouen
| | - F Dalenc
- Department of Medical Oncology, Institut Claudius Regaud, IUCT-Oncopole, Toulouse
| | - J M Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice
| | - L Uwer
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy
| | - P Kerbrat
- Department of Medical Oncology, Centre Eugène Marquis, Rennes
| | - A Goncalves
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | | | - T Petit
- Department of Medical Oncology, Centre Paul Strauss, Strasbourg
| | - C Jouannaud
- Department of Medical Oncology, Institut de Cancérologie Jean-Godinot, Reims
| | - L Vanlemmens
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | | | - T Guesmia
- Department of Research and Development, R&D Unicancer, Paris
| | - M Robain
- Department of Research and Development, R&D Unicancer, Paris
| | - C Cailliot
- Department of Research and Development, R&D Unicancer, Paris
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Bibault JE, Morelle M, Perrier L, Pommier P, Boisselier P, Coche-Dequéant B, Gallocher O, Alfonsi M, Bardet É, Rives M, Calugaru V, Chajon E, Noël G, Mecellem H, Pérol D, Dussart S, Giraud P. Toxicity and efficacy of cetuximab associated with several modalities of IMRT for locally advanced head and neck cancer. Cancer Radiother 2016; 20:357-61. [DOI: 10.1016/j.canrad.2016.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/06/2016] [Accepted: 05/13/2016] [Indexed: 11/16/2022]
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Verronèse E, Delgado A, Valladeau-Guilemond J, Garin G, Guillemaut S, Tredan O, Ray-Coquard I, Bachelot T, N'Kodia A, Bardin-Dit-Courageot C, Rigal C, Pérol D, Caux C, Ménétrier-Caux C. Immune cell dysfunctions in breast cancer patients detected through whole blood multi-parametric flow cytometry assay. Oncoimmunology 2015; 5:e1100791. [PMID: 27141361 PMCID: PMC4839376 DOI: 10.1080/2162402x.2015.1100791] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/18/2015] [Accepted: 09/22/2015] [Indexed: 01/08/2023] Open
Abstract
Monitoring functional competence of immune cell populations in clinical routine represents a major challenge. We developed a whole-blood assay to monitor functional competence of peripheral innate immune cells including NK cells, dendritic and monocyte cell subsets through their ability to produce specific cytokines after short-term stimulation, detected through intra-cytoplasmic staining and multi-parametric flow-cytometry. A PMA/ionomycin T cell activation assay complemented this analysis. Comparing cohorts of healthy women and breast cancer (BC) patients at different stages, we identified significant functional alteration of circulating immune cells during BC progression prior to initiation of treatment. Of upmost importance, as early as the localized primary tumor (PT) stage, we observed functional alterations in several innate immune populations and T cells i.e. (i) reduced TNFα production by BDCA-1+ DC and non-classical monocytes in response to Type-I IFN, (ii) a strong drop in IFNγ production by NK cells in response to either Type-I IFN or TLR7/8 ligand, and (iii) a coordinated impairment of cytokine (IL-2, IFNγ, IL-21) production by T cell subpopulations. Overall, these alterations are further accentuated according to the stage of the disease in first-line metastatic patients. Finally, whereas we did not detect functional modification of DC subsets in response to TLR7/8 ligand, we highlighted increased IL-12p40 production by monocytes specifically at first relapse (FR). Our results reinforce the importance of monitoring both innate and adaptive immunity to better evaluate dysfunctions in cancer patients and suggest that our whole-blood assay will be useful to monitor response to treatment, particularly for immunotherapeutic strategies.
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Affiliation(s)
- E Verronèse
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - A Delgado
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - J Valladeau-Guilemond
- Team 11, INSERM U1052/CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, ISPB, Lyon, France
| | - G Garin
- DRCI department, Léon Bérard Cancer Center , Lyon, France
| | - S Guillemaut
- DRCI department, Léon Bérard Cancer Center , Lyon, France
| | - O Tredan
- Department of Medical Oncology, Léon Bérard Cancer Center , Lyon, France
| | - I Ray-Coquard
- Department of Medical Oncology, Léon Bérard Cancer Center , Lyon, France
| | - T Bachelot
- Team 11, INSERM U1052/CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, ISPB, Lyon, France; Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | - A N'Kodia
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - C Bardin-Dit-Courageot
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - C Rigal
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - D Pérol
- DRCI department, Léon Bérard Cancer Center , Lyon, France
| | - C Caux
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center, Lyon, France; Team 11, INSERM U1052/CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, ISPB, Lyon, France
| | - C Ménétrier-Caux
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center, Lyon, France; Team 11, INSERM U1052/CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, ISPB, Lyon, France
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Trédan O, Ménétrier-Caux C, Ray-Coquard I, Garin G, Cropet C, Verronèse E, Bachelot T, Rebattu P, Heudel P, Cassier P, Chabaud S, Croughs T, Dupont P, Cadore A, Clapisson G, Delgado A, Bardin-dit-Courageot C, Rigal C, N'Kodia A, Gilles-Afchain L, Morre M, Pérol D, Blay J, Caux C. ELYPSE-7: a randomized placebo-controlled phase IIa trial with CYT107 exploring the restoration of CD4+ lymphocyte count in lymphopenic metastatic breast cancer patients. Ann Oncol 2015; 26:1353-62. [DOI: 10.1093/annonc/mdv173] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/24/2015] [Indexed: 12/29/2022] Open
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Perrier L, Morelle M, Pommier P, Boisselier P, Lartigau E, Gallocher O, Alfonsi M, Bardet E, Rives M, Calugaru V, Chajon E, Noel G, Mecellem H, Pérol D, Dussart S, Giraud P. A Cost-Analysis of Complex Radiotherapy in Patients with Head and Neck Cancer Results from the Art-Orl Study. Value Health 2014; 17:A624. [PMID: 27202205 DOI: 10.1016/j.jval.2014.08.2220] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L Perrier
- Cancer Centre Léon Bérard, Lyon, France
| | - M Morelle
- Cancer Centre Léon Bérard, Lyon, France
| | - P Pommier
- Leon Berard Cancer Centre, Lyon, France
| | - P Boisselier
- Institut Régional de Cancérologie de Montpellier, Montpellier, France
| | | | | | - M Alfonsi
- Institut Sainte Catherine, Avignon, France
| | - E Bardet
- Centre René Gauducheau, Saint Herblain, France
| | - M Rives
- Institut Claudius Regaud, Toulouse, France
| | | | - E Chajon
- Centre Eugène Marquis, Rennes, France
| | - G Noel
- Centre Paul Strauss, Strasbourg, France
| | - H Mecellem
- Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - D Pérol
- Cancer Centre Léon Bérard, Lyon, France
| | - S Dussart
- Cancer Centre Léon Bérard, Lyon, France
| | - P Giraud
- Hôpital Européen Georges Pompidou, Paris, France
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Touillaud M, Foucaut AM, Berthouze SE, Reynes E, Kempf-Lépine AS, Carretier J, Pérol D, Guillemaut S, Chabaud S, Bourne-Branchu V, Perrier L, Trédan O, Fervers B, Bachmann P. Design of a randomised controlled trial of adapted physical activity during adjuvant treatment for localised breast cancer: the PASAPAS feasibility study. BMJ Open 2013; 3:e003855. [PMID: 24165030 PMCID: PMC3816240 DOI: 10.1136/bmjopen-2013-003855] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION After a diagnosis of localised breast cancer, overweight, obesity and weight gain are negatively associated with prognosis. In contrast, maintaining an optimal weight through a balanced diet combined with regular physical activity appears to be effective protective behaviour against comorbidity or mortality after a breast cancer diagnosis. The primary aim of the Programme pour une Alimentation Saine et une Activité Physique Adaptée pour les patientes atteintes d'un cancer du Sein (PASAPAS) randomised controlled trial is to evaluate the feasibility of implementing an intervention of adapted physical activity (APA) for 6 months concomitant with the prescription of a first line of adjuvant chemotherapy. Secondary aims include assessing the acceptability of the intervention, compliance to the programme, process implementation, patients' satisfaction, evolution of biological parameters and the medicoeconomic impact of the intervention. METHODS AND ANALYSIS The study population consists of 60 women eligible for adjuvant chemotherapy after a diagnosis of localised invasive breast cancer. They will be recruited during a 2-year inclusion period and randomly allocated between an APA intervention arm and a control arm following a 2:1 ratio. All participants should benefit from personalised dietetic counselling and patients allocated to the intervention arm will be offered an APA programme of two to three weekly sessions of Nordic walking and aerobic fitness. During the 6-month intervention and 6-month follow-up, four assessments will be performed including blood draw, anthropometrics and body composition measurements, and questionnaires about physical activity level, diet, lifestyle factors, psychological criteria, satisfaction with the intervention and medical data. ETHICS AND DISSEMINATION The study was approved by the French Ethics Committee (Comité de Protection des Personnes Sud-Est IV) and the national agencies for biomedical studies and for privacy. All participants will give written informed consent. The study findings will be disseminated through the scientific public and serve as a foundation for future randomised controlled trials of efficacy.
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Affiliation(s)
- M Touillaud
- Department of Cancer and Environment, Léon Bérard Cancer Centre, Lyon, France
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Bourmaud A, Pérol D, Annota A, Trillet-Lenoir V, Bajard A, Parnalland S, Bonnetain F, Chauvin F. Éducation thérapeutique du patient – résultats d’un essai d’intervention randomisé multicentrique, Saint-Étienne, France. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.312] [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: 11/16/2022] Open
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Patrikidou A, Chabaud S, Ray-Coquard I, Bui BN, Adenis A, Rios M, Bertucci F, Duffaud F, Chevreau C, Cupissol D, Domont J, Pérol D, Blay JY, Le Cesne A. Influence of imatinib interruption and rechallenge on the residual disease in patients with advanced GIST: results of the BFR14 prospective French Sarcoma Group randomised, phase III trial. Ann Oncol 2012; 24:1087-93. [PMID: 23175622 DOI: 10.1093/annonc/mds587] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We previously demonstrated that interruption of imatinib mesylate (IM) in responding patients (pts) with advanced gastrointestinal stromal tumours (GISTs) results in rapid reprogression. The impact of interruption on residual tumour, quality of response and secondary resistance has not been fully investigated. PATIENTS AND METHODS Within the BRF14 study, 71 non-progressing patients were randomly assigned in the interruption arms after 1, 3 or 5 years. IM was resumed in the case of progressive disease (PD). Tumour status at randomisation, relapse and after IM rechallenge, progression-free survival (PFS) and time to secondary resistance were analysed. RESULTS At data cut-off, 51 of 71 patients had restarted IM following documented PD. Eighteen patients (35%) progressed on known lesions only, while 33 patients (65%) had new lesions, with concomitant progression of known lesions in 17 patients. Only 8 (42%) of complete remission (CR) patients and 12 (52%) of partial response (PR) patients at randomisation achieved a new CR and PR. Patients progressing rapidly after interruption had a poorer prognosis. Tumour status at randomisation influenced time to progression after rechallenge. CONCLUSION In advanced GIST patients interrupting IM, quality of response upon reintroduction did not reach the tumour status observed at randomisation. Rapid progression after imatinib interruption is associated with poor PFS after reintroduction.
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Affiliation(s)
- A Patrikidou
- Department of Medicine, Institut Gustave Roussy, Villejuif, France
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Abstract
BACKGROUND Imatinib is the standard of care for patients with advanced gastrointestinal stromal tumors (GIST). DESIGN This article reviews recent data on the impact of imatinib treatment interruption and subsequent rechallenge in patients with advanced GIST. RESULTS The randomized BFR14 trial showed that (i) interruption of imatinib after 1, 3, or 5 years of treatment in patients with nonprogressive GIST was associated with a high risk of progression even in patients with a complete response; (ii) rechallenge with imatinib restored tumor control in most patients, but the tumor response seldom reached that before treatment interruption; (iii) patients receiving continuous imatinib had a high rate of prolonged tumor control, which increased with longer imatinib treatment. The findings in the metastatic setting have important implications regarding the duration of adjuvant imatinib in GIST. CONCLUSIONS Discontinuation of imatinib in responding patients with advanced GIST is associated with a high risk of progression and is therefore not recommended. Although rechallenge is a strategy for treating patients who relapse after stopping imatinib, suboptimal tumor response indicates that continuous kinase suppression is necessary to achieve the best clinical outcome. Three-year adjuvant imatinib is recommended for patients with resected 'high-risk' GIST; however, a longer duration may provide additional benefits.
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Affiliation(s)
- J-Y Blay
- Department of Medical Oncology, Centre Léon-Bérard, Lyon, France.
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Sebban C, Lefranc A, Perrier L, Moreau P, Espinouse D, Schmidt A, Kammoun L, Ghesquieres H, Ferlay C, Bay JO, Lissandre S, Pérol D, Michallet M, Quittet P. A randomised phase II study of the efficacy, safety and cost-effectiveness of pegfilgrastim and filgrastim after autologous stem cell transplant for lymphoma and myeloma (PALM study). Eur J Cancer 2012; 48:713-20. [PMID: 22248711 DOI: 10.1016/j.ejca.2011.12.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 12/18/2011] [Indexed: 11/27/2022]
Abstract
AIM To evaluate in a multicentre randomised study the effect on duration of febrile neutropenia (FN), the safety and cost-effectiveness of a single subcutaneous pegfilgrastim injection compared with daily injections of filgrastim after peripheral blood stem cell transplantation in patients receiving high dose chemotherapy for myeloma and lymphoma. METHODS Patients were randomly assigned to a single dose of pegfilgrastim at day 5 (D5) or daily filgrastim from D5 to the recovery of absolute neutrophil count (ANC) to 0.5 G/L. Duration of FN, of neutrophil and platelet recovery, transfusion and antibiotic requirements were the main end-points of the study. Costs were calculated from D0 until transplant unit discharge. The incremental cost-effectiveness ratio was expressed as the cost per day of FN prevented. Probabilistic sensitivity analysis was performed by non-parametric bootstrap methods. RESULTS Between October 2008 and September 2009, 10 centres enrolled 151 patients: 80 patients with lymphoma and 71 patients with myeloma. The mean duration of FN was 3.07 days (standard deviation (SD) 1.96) in the pegfilgrastin arm and 3.29 (SD 2.54) in the filgrastim one. Mean total costs were 23,256 and 25,448 euros for pegfilgrastim and filgrastim patients, respectively. There was a 62% probability that pegfilgrastim strictly dominates filgrastim. CONCLUDING STATEMENT Pegfilgrastim after PBSC transplantation in myeloma and lymphoma is safe, effective when compared with filgrastim and could represent a cost-effective alternative in this setting.
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Affiliation(s)
- C Sebban
- Hematology Department, Cancer Centre Léon Bérard, Lyon, France.
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Perol M, Chouaid C, Milleron BJ, Gervais R, Barlesi F, Westeel V, Crequit J, Lena H, Vergnenegre A, Pérol D. Maintenance with either gemcitabine or erlotinib versus observation with predefined second-line treatment after cisplatin-gemcitabine induction chemotherapy in advanced NSCLC: IFCT-GFPC 0502 phase III study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7507] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [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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Ray-Coquard IL, Bin Bui N, Adenis A, Rios M, Bertucci F, Chabaud S, Pérol D, Blay J, Le Cesne A. Risk of relapse with imatinib (IM) discontinuation at 5 years in advanced GIST patients: Results of the prospective BFR14 randomized phase III study comparing interruption versus continuation of IM at 5 years of treatment: A French Sarcoma Group Study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10032] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [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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Negrier S, Pérol D, Soria J, Chabaud S, Metzger S, Escudier B. Attempt to improve the safety of development studies with a new design for phase I combination trials of targeted therapies: The PARASOL trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps165] [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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Ray-Coquard I, Provençal J, Hardy-Bessard A, Bachelot T, Coeffic D, Jacquin J, Guastalla J, Agostini C, Bajard A, Pérol D. 5193 Can adjuvant homeopathy improve the control of post-chemotherapy emesis in breast cancer patients? Results of a randomized placebo-controlled trial. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71085-7] [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: 10/20/2022] Open
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Ray-Coquard IL, Provençal J, Hardy-Bessard AC, Bachelot T, Coeffic D, Jacquin JP, Guastalla JP, Agostini C, Pivot X, Bajard A, Pérol D. Can adjuvant homeopathy improve the control of post-chemotherapy emesis in breast cancer patients? Results of a randomized placebo-controlled trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20566 Background: Homeopathy used as an adjunct in the treatment of chemotherapy (CT)-induced emesis has rarely been evaluated. Methods: Patients with non-metastatic breast cancer treated with 6 courses of FAC 50, FEC 100 or TAC chemotherapy were randomized to Cocculus/nux vomica/tabacum/petroleum extract (Cocculine, C) or Placebo (P) in a multicentric comparative double-blind phase III study. Anti-emetic treatment was standardized (corticoids + ondansetron). Patients were evaluated after each course. The primary endpoint was nausea measured after the 1st CT course using the FLIE (Functional Living Index for Emesis) with 5-day recall. The planned sample size was 396 evaluable patients based on a minimum expected difference in mean of 0.5 ± 1.6 on a scale from 1 (a lot) to 7 (not at all) with 5% two-sided α error and 85% power. An intent-to-treat analysis was planned. Secondary evaluation criteria were: vomiting measured by the FLIE score, patient self-evaluation (EVA) and investigator recording (NCI-CTC) of nausea and vomiting intensities, and compliance. Results: From September 05 to January 08, 431 patients were randomized (217 to P and 214 to C). Patient characteristics were well balanced between groups. Median age was 53 years, 35% of the patients experienced nausea or vomiting. In total, 403 patients (93.5%) were assessable for the primary endpoint, with few nausea episodes (FLIE nausea scores after the 1st CT course were 6.02 and 6.07 for P and C, respectively) and very good compliance (81% patients complied with the protocol). Adverse events related to nausea occurred in 51% vs. 47% of the patients treated with P and C, respectively (p = 0.48). FLIE and NCI-CTC vomiting scores were similar between the 2 arms (6.91 vs. 6.88, p = 0.47, and 20% vs. 21%, p = 0.73, for P and C, respectively). Grade II-III nausea occurred in 17.6% and 15.7% of patients receiving P and C (p = 0.62). Conclusions: No benefit of homeopathy over standard treatment was noted in this study. But surprisingly we observed lower rates of nausea and vomiting measured by patients and by investigators, than in other studies using identical chemotherapy regimens. The observation and management of emesis could modify the perception and rate of such adverse events. No significant financial relationships to disclose.
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Affiliation(s)
- I. L. Ray-Coquard
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - J. Provençal
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - A. C. Hardy-Bessard
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - T. Bachelot
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - D. Coeffic
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - J. P. Jacquin
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - J. P. Guastalla
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - C. Agostini
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - X. Pivot
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - A. Bajard
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
| | - D. Pérol
- Centre Léon Berard, Lyon, France; Centre Hospitalier de la Région d'Annecy, Annecy, France; Clinique Armoricaine de Radiologie, Saint-Brieuc, France; Institut Daniel Hollard, Grenoble, France; Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France; Centre Hospitalier Général, Chambéry, France; Centre Hospitalier Universitaire, Besançon, France
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Tredan O, Chvetzoff G, Bajard A, Pérol D, Rebattu P, Ray-Coquard IL, Bachelot T. Prognostic factors for survival in adult patients (pts) with metastatic cancer (MC) after the first-line chemotherapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9573] [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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Pérol D, Dômont J, Ray-Coquard IL, Bui BN, Rios M, Duffaud F, Bertucci F, Moneron C, Chabaud S, Le Cesne A, Blay JY. Does interruption of imatinib (IM) in responding GIST patients after one year of treatment influence the secondary resistance to IM after its reintroduction? Updated results of the prospective French Sarcoma Group randomized phase III trial on long term survival. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.10556] [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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Bachelot T, Luporsi E, Bajard A, Provencal J, Coefic D, Platini C, Dramais D, Oprea C, Ferri-Dessens R, Pérol D. Randomized trial of first-line docetaxel + capecitabine (XT) versus docetaxel + epirubicin (ET) for metastatic breast cancer (MBC): Efficacy results of ERASME-4/CAPEDOC-EPIDOC. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Chvetzoff G, Pérol D, Rebattu P, Devaux Y, Saltel P. Prospective cohort study of quality of care (QC) and quality of life (QL) of palliative cancer patients in three different situations: In-patient hospitalization (IN), palliative care unit (PA) and home care (HO). Final analysis. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20670] [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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Chabaud S, Tredan O, Treilleux I, Bourdes V, Gargi T, Pérol D, Bachelot T. Pathologic node involvement as a prognostic factor in HER2-amplified primary breast cancer (BC) patients (pts) treated without trastuzumab. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.11537] [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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Négrier S, Gross-Goupil M, Pérol D, Gautier J, Balcaceres J, Massard C, Celier C, Ravaud A, Oudard S, Escudier BJ. Analysis of characteristics in patients (pts) with metastatic renal cell cancer (MRCC) who achieved a prolonged benefit from sunitinib or sorafenib. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Adenis A, Cassier PA, Bui BN, Rios M, Duffaud F, Bertucci F, Chabaud S, Pérol D, Blay JY, Le Cesne A. Does interruption of imatinib (IM) in responding patients after three years of treatment influence outcome of patients with advanced GIST included in the BFR14 trial? J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.10522] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Faure C, Escalon J, Brémond A, Mignotte H, Pérol D, Delay E. Chirurgie oncoplastique pour le traitement des tumeurs mammaires centrales. ANN CHIR PLAST ESTH 2008; 53:112-23. [DOI: 10.1016/j.anplas.2007.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Accepted: 11/07/2007] [Indexed: 10/22/2022]
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Claude L, Etienne-Mastroiani B, Arpin D, Vincent M, Falchero L, Ginestet C, Martel-Lafay I, Blay JY, Carrie C, Pérol D. Fibroses radiques pulmonaires: étude prospective desfacteurs prédictifs cliniques, dosimétriques etbiologiques après irradiation conformationnelle descarcinomes bronchiques non àpetites cellules. Cancer Radiother 2007. [DOI: 10.1016/j.canrad.2007.09.116] [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: 10/22/2022]
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Terret C, Pérol D, Albrand G, Fingal C, Roux P, Courpron P, Droz J. Nutritional status in elderly cancer patients: Why is it so important? J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.8532] [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
8532 Background: To assess the prevalence of malnutrition in elderly patients (pts) with cancer and to determine the effect of malnutrition on Overall Survival (OS). Methods: Cancer pts aged 65 and older underwent a multidimensional geriatric assessment at our institution. Data were collected for calorie and protein intakes, Mini Nutritional assessment (MNA Nestlé), functional status (ADL score), and comorbidity (CIRS-G). Survival time was defined as the time from geriatric assessment to date of death or last follow-up. A Cox regression model was used to estimate the hazards ratio (HR) and 95 percent confidence intervals (95%CI) of risk factors for death. Results: 133 consecutive pts (68% male, 50% hospitalized) were evaluated from 05/1999 to 08/2002. Median age was 78 years (range: 66–92). Main tumour sites were prostate (36%), breast (15%), bladder (12%) and Head and Neck (10%). Forty eight pts (36%) had metastatic disease. Only 55 pts (43%) were fully independent in ADLs (score = 6), and 15 pts were completely independent in IADLs (score = 14). Fifty one pts (43%) had mild to severe disability/morbidity status (CIRS-G severity index ≥2). Regarding nutritional status, only 34% were estimated well nourished with MNA >23.5, 54% had calorie intake ≤1500 kcal/day and 38% had body weight loss > 5% in the last 3 months. Survival analysis was performed with a 16-month median follow up. Median survival time was 7 months (95%CI 6–9 months). In the univariate analysis, male gender, metastatic stage, MNA, ADL score and CIRS-G severity index were significantly correlated with OS. In the multivariate analysis, male gender (HR=2.3, 95% CI: 1.3–4.1), metastasis (HR=1.6, 95% CI: 1.0–2.6), MNA<23.5 (HR=3.3, 95% CI: 1.8–6.0), CIRS-G severity index ≥2 (HR=2.8, 95%CI: 1.7–4.7) and ADL score <6 (HR=1.9, 95%CI: 1.1–3.3), were found to be independent prognostic factors for shorter OS. Conclusions: These data show that malnutrition has a major impact on survival independently of cancer severity. Thus, nutritional status must be systematically assessed before treatment decision-making. Benefits of nutritional interventions need to be studied in future trials. No significant financial relationships to disclose.
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Affiliation(s)
- C. Terret
- Geriatric Oncology Program; Centre Leon Berard, Lyon, France; Hôpital Antoine Charial—Hospices Civils de Lyon, Francheville, France
| | - D. Pérol
- Geriatric Oncology Program; Centre Leon Berard, Lyon, France; Hôpital Antoine Charial—Hospices Civils de Lyon, Francheville, France
| | - G. Albrand
- Geriatric Oncology Program; Centre Leon Berard, Lyon, France; Hôpital Antoine Charial—Hospices Civils de Lyon, Francheville, France
| | - C. Fingal
- Geriatric Oncology Program; Centre Leon Berard, Lyon, France; Hôpital Antoine Charial—Hospices Civils de Lyon, Francheville, France
| | - P. Roux
- Geriatric Oncology Program; Centre Leon Berard, Lyon, France; Hôpital Antoine Charial—Hospices Civils de Lyon, Francheville, France
| | - P. Courpron
- Geriatric Oncology Program; Centre Leon Berard, Lyon, France; Hôpital Antoine Charial—Hospices Civils de Lyon, Francheville, France
| | - J. Droz
- Geriatric Oncology Program; Centre Leon Berard, Lyon, France; Hôpital Antoine Charial—Hospices Civils de Lyon, Francheville, France
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Penel N, Le Cesne A, Bui B, Tubiana-Hulin M, Guillemet C, Cupissol D, Berthaud P, Mahier C, Pérol D, Blay J. Imatinib for the treatment of aggressive fibromatosis (desmoid tumors) failing local treatment. A phase II trial of the French Sarcoma Group. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.9516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9516 Background: Background: Aggressive fibromatosis/desmoid tumors (AF/DT) are rare tumors with loco regional spreading. Few options are available when local treatments have failed. Although cytotoxic agents, hormonal treatment have been reported to induced responses and tumor control in some patients, only few prospective phase II trials have been reported in the literature. Recently, antitumor activity of imatinib in AF/DT was reported. We report a phase II trial of imatinib in AF/DT after failure of local treatment options. Methods: Pts ≥ 18 years with advanced AF/DT from all sites in whom neither surgery nor radiotherapy was possible were eligible. The principal inclusion criterias were: disease not amenable to surgery and/or radiation with curative intent, systemic pre-treatments allowed and presence of a measurable lesion with evidence of progression. Imatinib was given at the dose of 400 mg/d and increased to 800 mg/d if progression. Primary endpoint was the rate of progression free at 3 months. A two stages Simon‘s optimal design was used with p0=10%, p1=30%, α=0.05 and 90% power. 18 pts were scheduled to be recruited in the first stage for a total of 35 evaluable pts. Results: Between 09/2004 and 10/2005, 40 pts were included in 15 centers. The median age was 40 years (range 20–72) with 26% males. Primary sites were extra abdominal, mesenteric, abdominal wall in 79, 15, and 6% respectively. 15% patients had not been operated previously and 17% undergone radiotherapy. Prior systemic treatments were: NSAID, hormonal therapy or chemotherapy in 34, 46 and 23%, respectively. Median treatment duration was 4 months (range 0–12). No G4 toxicity was reported. Toxicities (G1–3) were notified for 30 pts including asthenias (70%), nauseas (53%), diarrheas, oedema (40%). G3 toxicities were abdominal pain (10%), rash, nausea, vomiting and asthenia (7%). At 3 months, 22 pts (55%) were evaluable with 1 CR, 17 SD and 4PD. As of December 2005, 7 of the 40 pts had progressed. After progression, dose was stopped in 2 pts and increased to 800mg in 5 pts with 2 tumor control following dose-escalation. Conclusions: Imatinib induces prolonged disease stabilization in the majority of evaluable patients with AF/DT in whom no local treatment option was available. [Table: see text]
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Affiliation(s)
- N. Penel
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - A. Le Cesne
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - B. Bui
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - M. Tubiana-Hulin
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - C. Guillemet
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - D. Cupissol
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - P. Berthaud
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - C. Mahier
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - D. Pérol
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
| | - J. Blay
- Oscar Lambret Cancer Center, Lille, France; Institut Gustave Roussy, Villejuif, France; Institut Bergonié, Bordeaux, France; Centre René Huguenin, Saint Cloud, France; Centre Henri Becquerel, Rouen, France; Centre Val d’Aurelle, Montpellier, France; FNCLCC, Paris, France; Centre Leon Berard, Lyon, France; Hôpital Edouard Herriot, Lyon, France
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Sebban C, Fuhrmann C, Pérol D, Devaux Y, Ghesquière H, Galand-Desmé S, Lévêque N, Claude L, Biron P. Prise en charge à domicile des neutropénies fébriles courtes après chimiothérapie: résultats et leçons d’une étude pilote menée sur deux ans dans un centre de lutte contre le cancer. ONCOLOGIE 2006. [DOI: 10.1007/s10269-006-0437-8] [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: 11/29/2022]
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Martin E, Belleton F, Lallemand Y, Goy F, Pérol D, Bachmann P, Marec-Bérard P. Dénutrition en cancérologie pédiatrique : prévalence et dépistage. Arch Pediatr 2006; 13:352-7. [PMID: 16488583 DOI: 10.1016/j.arcped.2005.12.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2005] [Accepted: 12/17/2005] [Indexed: 11/23/2022]
Abstract
UNLABELLED Algorithms for nutritional pediatric support have been proposed in a French national nutritional framework program. However, they are not specific for oncology. With the pediatric nutritional risk score (PNRS) all children with cancer have a high risk of malnutrition, but a systematic nutritional support is not possible for all of them. AIM Estimation of malnutrition prevalence and identification of predictive factors of major weight loss during treatment defined by a weight loss more than 5% within 1 month, 7.5% within 3 months, 10% within 6 months. POPULATION AND METHODS This historical study included children registered with a solid tumor in 2002 in an oncology pediatric unit. Data collected at diagnosis were weight, height, PNRS, the Lansky functional score, tumor type. Furthermore weight, height, and major weight loss were collected at each cure of chemotherapy and during evolution. Malnutrition at diagnosis was defined using the weight for height ratio. Relations between major weight loss and risks factors were estimated using logistic regression. RESULTS Seventy children were included, 16 (22.9%) were malnourished at admission. During chemotherapy, 29 (41.4%) children experienced a major weight loss. Odds ratio of those who were malnourished at diagnosis was not significantly higher in comparison to well-nourished children. Children with a high risk of malnutrition are those affected by Ewing tumor, B lymphom, head and neck localisations, osteosarcomas, metastatic cancers, or cancers treated by high dose chemotherapy with stem cell rescue. For these 29 (41.4%) children the major weight loss odds ratio was 5.9 [IC95% 2.0-16.7]. CONCLUSION Taking into account others factors with items of PNRS allows to screen children with an higher risk of a major weight loss during treatment and to enhance nutritional care plan for them.
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Affiliation(s)
- E Martin
- Unité de biostatistiques, CRLCC Léon-Bérard, 28, rue Laennec, 69000 Lyon, France.
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Terret C, Pérol D, Albrand G, Droz JP. Quality of life (QOL): Use SF-36 or EORTC QLQ-C30 questionnaires in elderly cancer patients? J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8091] [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)
- C. Terret
- Ctr Léon Bérard, Lyon, France; Ctr Léon Bérard, Lyon, France; Hôpital Gériatrique Antoine Charial, Francheville, France
| | - D. Pérol
- Ctr Léon Bérard, Lyon, France; Ctr Léon Bérard, Lyon, France; Hôpital Gériatrique Antoine Charial, Francheville, France
| | - G. Albrand
- Ctr Léon Bérard, Lyon, France; Ctr Léon Bérard, Lyon, France; Hôpital Gériatrique Antoine Charial, Francheville, France
| | - J. P. Droz
- Ctr Léon Bérard, Lyon, France; Ctr Léon Bérard, Lyon, France; Hôpital Gériatrique Antoine Charial, Francheville, France
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Ray-Coquard I, Pérol D, Bui BNG, Duffaud F, Rios M, Viens P, Robert C, Berthaud P, Le Cesne A, Blay For The Group Sarcome Francais JY. Prognostic factors for progression free and overall survival in advanced GIST: Results from the BFR14 phase III trial of the French Sarcoma Group. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9035] [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)
- I. Ray-Coquard
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - D. Pérol
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - B. N. G. Bui
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - F. Duffaud
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - M. Rios
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - P. Viens
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - C. Robert
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - P. Berthaud
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - A. Le Cesne
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
| | - J. Y. Blay For The Group Sarcome Francais
- Ctr Léon Bérard, Lyon, France; Inst Bergonie, Bordeaux, France; Hosp de la Timone, Marseille, France; Ctr Alexis Vautrin, Nancy, France; Inst Paoli Calmettes, Marseille, France; Inst Gustave Roussy, Villejuif, France; Novartis Pharma, Rueil Malmaison, France; Inserm U590 Ctr Léon Bérard, Lyon, France
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