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Evin C, Quéro L, Le Malicot K, Blanchet-Deverly S, François E, Buchalet C, Lemanski C, Baba Hamed N, Rivin del Campo E, Bauwens L, Pommier P, Lièvre A, Tougeron D, Macé V, Sergent G, Diaz O, Zucman D, Mornex F, Locher C, De la Rochefordière A, Vendrely V, Huguet F. MO-0226 Clinical outcomes of HIV-positive patients with anal cancer in the ANABASE multicentric cohort. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02328-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Charton E, Falcoz A, François E, Touraine C, Bachet JB, Louvet C, Hamidou Z, Bascoul-Mollevi C, Anota A. %TTD and %TUDD: New SAS macro programs to calculate the survival data of the time to deterioration for patient-reported outcomes data in oncology. Comput Methods Programs Biomed 2022; 214:106537. [PMID: 34879326 DOI: 10.1016/j.cmpb.2021.106537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/29/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Longitudinal analysis of patient-reported outcome (PRO) data remains challenging, as no standardization of statistical methods has been proposed, making comparison of PRO results between clinical trials difficult. In this context, the time to deterioration approach has recently been proposed and is regularly used as a modality of longitudinal PRO analysis in oncology. METHODS Two new SAS macro programs were developed, %TTD and %TUDD, which implement longitudinal analysis of PRO data according to the time to deterioration approach. These programs implement the recommended deterioration definitions. We described the programs with their different functionalities. RESULTS The %TTD macro calculates the time to first or transient deterioration, and the %TUDD macro calculates the time until definitive deterioration. These macros allow to obtain the survival variables from the time to deterioration approach. We illustrate our programs by presenting different applications on the randomized phase II AFUGEM GERCOR clinical trial. CONCLUSION The implementation of the deterioration definitions in SAS software allows the dissemination of this approach, in order to move toward the goal of standardization of longitudinal PRO analysis in oncology clinical trials.
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Affiliation(s)
- E Charton
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France; Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France; UMR1098, University Bourgogne Franche-Comté, INSERM, EFS BFC, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, France.
| | - A Falcoz
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France; UMR1098, University Bourgogne Franche-Comté, INSERM, EFS BFC, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, France
| | | | - C Touraine
- Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France
| | - J-B Bachet
- Department of Hepato-Gastroenterology, Groupe hospitalier Pitié Salpêtrière, Sorbonne University, UPMC University, Paris, France
| | - C Louvet
- Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - Z Hamidou
- French National Platform Quality of Life and Cancer, France; EA3279 Self-perceived Health Assessment Research Unit, Aix-Marseille University, Marseille, France
| | - C Bascoul-Mollevi
- Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; French National Platform Quality of Life and Cancer, France; Institute of Cancer Research of Montpellier (IRCM), ICM, INSERM, Montpellier, France
| | - A Anota
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France; UMR1098, University Bourgogne Franche-Comté, INSERM, EFS BFC, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, France; French National Platform Quality of Life and Cancer, France; Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
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Evin C, Quéro L, Le Malicot K, Blanchet-Deverly S, François E, Buchalet C, Lemanski C, Baba Hamed N, Rivin Del Campo E, Bauwens L, Pommier P, Lièvre A, Tougeron D, Mace V, Sergent G, Diaz O, Zucman D, Mornex F, Locher C, de La Rochefordiere A, Vendrely V, Huguet F. Efficacité et toxicité de la (chimio)radiothérapie chez les patients séropositifs pour le VIH atteints d’un carcinome épidermoïde du canal anal, analyse en sous-groupe de la cohorte multicentrique Anabase. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Briens A, Neuzillet C, Huguet F, Rivin Del Campo E, Guimas V, Fallet E, Garcia Molina S, François E, Montagne L, Schick U, Lesueur P, Siphroudis L, Edeline J, Castelli J, de Crevoisier R, Lièvre A, Gnep K. PO-1263 Exclusive radiotherapy in early stage anal cancer - outcomes, patterns and predictors of relapse. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mineur L, François E, Plassot C, Phelip JM, Miglianico L, Dourthe LM, Bonichon N, Moreau L, Guimbaud R, Smith D, Achille E, Hervé R, Bons JM, Remy S, Faroux R, Villing AL, Mahamat A, Rabbia I, Soulié P, Baumgaertner I, Mathé N, Vazquez L, Boustany R. PREMIUM: A French prospective multicenter observational study of factors impacting on efficacy and compliance to cetuximab treatment in first-line KRAS wild-type metastatic colorectal cancer. PLoS One 2020; 15:e0243997. [PMID: 33347495 PMCID: PMC7752147 DOI: 10.1371/journal.pone.0243997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/01/2020] [Indexed: 11/18/2022] Open
Abstract
Background Cetuximab improves progression-free survival (PFS) and overall survival (OS) in patients with KRAS wild type (wt) metastatic colorectal cancer (mCRC). Few data are available on factors impacting both efficacy and compliance to cetuximab treatment, which is, in combination with chemotherapy, a standard-of-care first-line treatment regimen for patients with KRAS wt mCRC. Patients and methods PREMIUM is a prospective, French multicenter, observational study that recruited patients with KRAS wt mCRC scheduled to receive cetuximab, with or without first-line chemotherapy, as part of routine clinical practice, between October 28, 2009 and April 5, 2012 (ClinicalTrials.gov Identifier: NCT01756625). The main endpoints were the factors impacting on efficacy and compliance to cetuximab treatment. Predefined efficacy endpoints were PFS and safety. Results A total of 493 patients were recruited by 94 physicians. Median follow-up was 12.9 months. Median progression-free survival was 11 months [9.6–12]. In univariate analyses, ECOG performance status (PS), smoking status, primary tumor location, number of metastatic organs, metastasis resectability, surgery, folliculitis, xerosis and paronychia maximum grade, and acne preventive treatment were statistically significant. In multivariate analysis (Hazard Ratios of multivariate stepwise Cox models), ECOG PS, surgery, xerosis and folliculitis were positive prognostics factors for longer PFS. Among all patients, 69 (14%) were non-compliant. In multivariate analysis, no variables were statistically significant. The safety profile of cetuximab was consistent with previous studies. Conclusions ECOG PS <2, surgical treatment performed, and maximum grade xerosis or folliculitis developed were predictive factors of cetuximab efficacy on KRAS wt mCRC patients. Unfortunately, we failed in identifying predictive factors for compliance in these patients.
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Affiliation(s)
- L. Mineur
- Institut Sainte-Catherine, Avignon, France
| | | | - C. Plassot
- Institut Universitaire de Recherche Clinique, Montpellier, France
| | - J. M. Phelip
- Hopital universitaire CHU Nord Saint Etienne, Saint Etienne, France
| | | | | | | | - L. Moreau
- Clinique les Domes, Clermont-Ferrand, France
| | | | - D. Smith
- Hopital Saint-André, Bordeaux, France
| | - E. Achille
- Clinique de l’Orangerie, Strasbourg, France
| | - R. Hervé
- CH Privé Clairval, Marseille, France
| | - J. M. Bons
- Polyclinique Saint-Francois, Desertine, France
| | - S. Remy
- Centre d’Oncologie de la côte Basque, Bayonne, France
| | | | | | | | - I. Rabbia
- Cabinet médical, Orange, Paris, France
| | | | | | - N. Mathé
- Centre Clinique de Soyaux, Soyaux, France
| | - L. Vazquez
- Institut Sainte-Catherine, Avignon, France
- * E-mail:
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Kinj R, Doyen J, Hannoun-Lévi JM, Naghavi AO, Chand ME, Baudin G, Ferrero JM, François E, Evesque L, Borchiellini D, Benezery K, Bondiau PY. Stereotactic Pelvic Reirradiation for Locoregional Cancer Relapse. Clin Oncol (R Coll Radiol) 2020; 33:e15-e21. [PMID: 32641243 DOI: 10.1016/j.clon.2020.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/12/2020] [Accepted: 06/09/2020] [Indexed: 10/23/2022]
Abstract
AIMS Up to 40% of patients who have received radiation for a pelvic malignancy will develop locoregional recurrence in the previously irradiated volume. Stereotactic body radiotherapy (SBRT) has been used in the oligometastatic setting, and provides an ablative approach ideal for reirradiation. The purpose of this study was to evaluate the outcomes after SBRT reirradiation of extraosseous recurrences in the pelvis. MATERIALS AND METHODS This single institution retrospective study evaluated patients treated with SBRT reirradiation in the pelvis from January 2011 to February 2018. Patients with more than five oligometastatic lesions, >7 cm in size, and recurrence within the prostate were excluded. RESULTS In total, 30 patients were treated with SBRT with a median follow-up of 29.4 months. The primary tumour sites were most commonly rectum (30.8%) and prostate (30.8%). The median time interval between irradiation for the primary and SBRT reirradiation was 48 months (3-245). The typical reirradiation treatment was 35 Gy in five fractions, the median gross tumour volume size was 10.2 (0.3-110.5) ml and the most common target was the iliac nodes (40%). There were three (10%) acute grade 3 toxicities and no late grade 3 or more toxicities. At 12/24 months, local relapse-free survival, metastasis-free survival, progression-free survival and overall survival were 67.7%/50.7%, 67%/41.7%, 34.8%/14.9% and 83.2%/62.5%, respectively. On univariate analysis, improved local control was associated with low gross tumour volume (<10 ml) (P = 0.003) and prostate primary (P = 0.02), but was no longer significant on multivariate analysis. The proximity of organ at risk to the target did not significantly correlate with worse toxicity (P = 0.14) or tumour coverage (gross tumour volume: P = 0.8, planning target volume: P = 0.4). CONCLUSION SBRT pelvic reirradiation in oligometastatic patients is a safe and effective treatment modality. Careful consideration should be taken with larger tumour size, as it may be associated with worse oncological and toxicity outcome.
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Affiliation(s)
- R Kinj
- Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - J Doyen
- Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France; University of Côte d'Azur, Nice, France
| | - J M Hannoun-Lévi
- Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France; University of Côte d'Azur, Nice, France
| | - A O Naghavi
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - M E Chand
- Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France
| | - G Baudin
- Department of Radiology, Centre Antoine Lacassagne, Nice, France
| | - J M Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - E François
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - L Evesque
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - D Borchiellini
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - K Benezery
- Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France
| | - P Y Bondiau
- Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France
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Metges J, François E, Shah M, Adenis A, Enzinger P, Kojima T, Muro K, Bennouna J, Hsu C, Moriwaki T, Kim S, Lee S, Kato K, Shen L, Qin S, Ferreira P, Wang R, Bhagia P, Kang S, Doi T. The phase 3 KEYNOTE-181 study: pembrolizumab versus chemotherapy as second-line therapy for advanced esophageal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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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Aparicio T, Bouché O, Taieb J, Maillard E, Kirscher S, Etienne PL, Faroux R, Khemissa Akouz F, El Hajbi F, Locher C, Rinaldi Y, Lecomte T, Lavau-Denes S, Baconnier M, Oden-Gangloff A, Genet D, Paillaud E, Retornaz F, François E, Bedenne L. Bevacizumab+chemotherapy versus chemotherapy alone in elderly patients with untreated metastatic colorectal cancer: a randomized phase II trial-PRODIGE 20 study results. Ann Oncol 2019; 29:133-138. [PMID: 29045659 PMCID: PMC5834151 DOI: 10.1093/annonc/mdx529] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Metastatic colorectal cancer frequently occurs in elderly patients. Bevacizumab in combination with front line chemotherapy (CT) is a standard treatment but some concern raised about tolerance of bevacizumab for these patients. The purpose of PRODIGE 20 was to evaluate tolerance and efficacy of bevacizumab according to specific end points in this population. Patients and methods Patients aged 75 years and over were randomly assigned to bevacizumab + CT (BEV) versus CT. LV5FU2, FOLFOX and FOLFIRI regimen were prescribed according to investigator’s choice. The composite co-primary end point, assessed 4 months after randomization, was based on efficacy (tumor control and absence of decrease of the Spitzer QoL index) and safety (absence of severe cardiovascular toxicities and unexpected hospitalization). For each arm, the treatment will be consider as inefficient if 20% or less of the patients met the efficacy criteria and not safe if 40% or less met the safety criteria. Results About 102 patients were randomized (51 BEV and 51 CT), median age was 80 years (range 75–91). Primary end point was met for efficacy in 50% and 58% and for safety in 61% and 71% of patients in BEV and CT, respectively. Median progression-free survival was 9.7 months in BEV and 7.8 months in CT. Median overall survival was 21.7 months in BEV and 19.8 months in CT. The 36-month overall survival rate was 27% in BEV and 10.1% in CT. Severe toxicities grade 3/4 were mainly non-hematologic toxicities (80.4% in BEV, 63.3% in CT). Conclusion Bevacizumab combined with CT was safe and efficient. Both arms met the primary safety and efficacy criteria.
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Affiliation(s)
- T Aparicio
- Gastroenterology Department, CHU Saint Louis, APHP, Paris, France.,Université Paris 7, Sorbonne Paris Cité, Paris, France
| | - O Bouché
- Digestive Oncology Department, CHU Robert Debré, Reims, France
| | - J Taieb
- Digestive Oncology Department, CHU Georges Pompidou, APHP, Paris, France
| | - E Maillard
- Statistics Department, Fédération Francophone de Cancérologie Digestive, Dijon, France
| | - S Kirscher
- Oncology Department, Institut Sainte Catherine, Avignon, France
| | - P-L Etienne
- Oncology Department, CARIO, HPCA, Plérin, France
| | - R Faroux
- Gastroenterology Department, CHG Vendée, La Roche sur Yon, France
| | | | - F El Hajbi
- Oncology Department, Centre Oscar Lambret, Lille, France
| | - C Locher
- Gastroenterology Department, CH Meaux, Meaux, France
| | - Y Rinaldi
- Gastroenterology Departement, Hôpital Européen, Marseille, France
| | - T Lecomte
- Gastroenterology Department, CHU Trousseau, Tours, France
| | | | - M Baconnier
- Gastroenterology Department, CH Annecy Genevois, Pringy, France
| | - A Oden-Gangloff
- Gastroenterology Department, CHU Charles Nicolle, Rouen, France
| | - D Genet
- Oncology Department, Clinique Chenieux, Limoges, France
| | - E Paillaud
- Geriatric Department, CHU Henri Mondor, APHP, Créteil, France
| | - F Retornaz
- Geriatric Department, Hôpital Européen, Marseille, France
| | - E François
- Gastroenterology Department, Centre Antoine Lacassagne, Nice, France
| | - L Bedenne
- Gastroenterology Department, CHU Le Bocage, INSERM U 866, Dijon, France
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Besnard I, François E, Bachmann P, Abakar Mahamat A, Mazard T, Khemissa F, Mineur L, Seitz JF, Senesse P, Schneider S, Hébuterne X. Impact d’une prise en charge diététique précoce et active sur les toxicités de grade 3 ou plus chez des patients en première ligne de chimiothérapie pour cancer colorectal métastatique. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.006] [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: 10/27/2022]
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Aparicio T, Bouché O, Taieb J, Maillard E, Kirscher S, Etienne PL, Faroux R, Khemissa Akouz F, El Hajbi F, Locher C, Rinaldi Y, Lecomte T, Lavau-Denes S, Baconnier M, Oden-Gangloff A, Genet D, Paillaud E, Retornaz F, François E, Bedenne L. Bevacizumab+chemotherapy versus chemotherapy alone in elderly patients with untreated metastatic colorectal cancer: a randomized phase II trial-PRODIGE 20 study results. Ann Oncol 2018; 29:2270. [PMID: 29718089 DOI: 10.1093/annonc/mdx808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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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Bertin É, Bénézery K, Lam Cham Kee D, François E, Gautier M, Gérard JP, Falk A, Hannoun-Lévi JM. Efficacité et tolérance de la curiethérapie de haut débit de dose de complément pour le carcinome épidermoïde du canal anal. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.078] [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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Hébuterne X, Besnard I, François E, Bachmann P, Mahamat AA, Assenat E, Akouz FK, Mineur L, Seitz JF, Senesse P, Schneider S. Impact of an early active dietary counselling on grade ≥3 toxicity in patients receiving first-line chemotherapy for metastatic colorectal cancer. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1116] [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]
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Falcone A, André T, Edeline J, François E, Taieb J, Phelip J, Portales F, Price T, Becquart M, Moreno Vera S, Mounedji N, Van Cutsem E, Seitz J. Safety and efficacy of trifluridine/tipiracil in previously treated metastatic colorectal cancer (mCRC): Preliminary results from the phase IIIb, international, open-label, early-access PRECONNECT study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Azria D, Doyen J, Jarlier M, Martel-Lafay I, Hennequin C, Etienne P, Vendrely V, François E, de La Roche G, Bouché O, Mirabel X, Denis B, Mineur L, Berdah J, Mahé M, Bécouarn Y, Dupuis O, Lledo G, Seitz J, Bedenne L, Gourgou-Bourgade S, Juzyna B, Conroy T, Gérard J. Late toxicities and clinical outcome at 5 years of the ACCORD 12/0405-PRODIGE 02 trial comparing two neoadjuvant chemoradiotherapy regimens for intermediate-risk rectal cancer. Ann Oncol 2018; 28:2436-2442. [PMID: 28961836 DOI: 10.1093/annonc/mdx351] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Outcome of intermediate risk rectal cancer may be improved by the addition of oxaliplatin during 5-fluoruracil concomitant neoadjuvant chemoradiotherapy. The purpose of this study is to analyze the main clinical results of the ACCORD12 trial (NCT00227747) in rectal cancer after 5 years of follow-up. Patients and methods Inclusion criteria were as follows: rectal adenocarcinoma accessible to digital examination staged T3-T4 Nx M0 (or T2 Nx distal anterior rectum). Two neoadjuvant chemoradiotherapy regimens were randomized: CAP45 (RT 45 Gy + capecitabine) and CAPOX50 (RT 50 Gy + capecitabine and oxaliplatin). Main end point was sterilization of the operative specimen. Acute and late toxicities were prospectively analyzed with dedicated questionnaires. Results Between November 2005 and July 2008, 598 patients were included in the trial. After a median follow-up of 60.2 months, there was no difference between treatment arms in multivariate analysis either for disease-free survival or overall survival (OS) [P = 0.9, hazard ratio (HR)=1.02; 95% confidence interval (CI), 0.76-1.36 and P = 0.3, HR = 0.87; 95% CI, 0.66-1.15, respectively]. There was also no difference of local control in univariate analysis (P = 0.7, HR = 0.92; 95% CI, 0.51-1.66). Late toxicities were acceptable with 1.6% G3 anal incontinence, and <1% G3 diarrhea, G3 rectal bleeding, G3 stenosis, G3-4 pain, G3 urinary incontinence, G3 urinary retention and G3 skeletal toxicity. There was a slight increase of erectile dysfunction over time with a 63% rate of erectile dysfunction at 5 years. There was no significant statistical difference for these toxicities between treatment arms. Conclusions The CAPOX50 regimen did not improve local control, disease-free survival and overall survival in the ACCORD12 trial. Late toxicities did not differ between treatment arms.
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Affiliation(s)
- D Azria
- Department of Radiation oncology, Montpellier Cancer Institute, Montpellier
| | - J Doyen
- Department of Radiation oncology, Antoine-Lacassagne Center, Nice;; University of Côte d'Azur, Nice;.
| | - M Jarlier
- Biometrics Unit, Montpellier Cancer Institute, Montpellier
| | - I Martel-Lafay
- Department of Radiation Oncology, Léon-Bérard Center, Lyon
| | - C Hennequin
- Department of Radiation Oncology, Saint-Louis Hospital, Paris
| | - P Etienne
- Department of Radiation Oncology, Armorican Center of Radiotherapy and Radiology, Plérin
| | - V Vendrely
- Department of Radiation Oncology, Teaching Hospital CHU of Bordeaux, Bordeaux
| | - E François
- University of Côte d'Azur, Nice;; Department of Medical Oncology, Antoine-Lacassagne Center, Nice
| | - G de La Roche
- Department of Medical Oncology, Oncology Institute of Loire, Saint Priest en Jarez
| | - O Bouché
- Department of Medical Oncology, Teaching Hospital CHU of Reims, Reims
| | - X Mirabel
- Department of Radiation Oncology, Oscar-Lambret Center, Lille
| | - B Denis
- Department of Medical Oncology, Teaching Hospital CHU Louis Pasteur, Colmar
| | - L Mineur
- Department of Radiation Oncology, Sainte-Catherine Institute, Avignon
| | - J Berdah
- Sainte-Marguerite Private Hospital, Toulon-Hyères
| | - M Mahé
- Department of Radiation Oncology, West Oncology Institute, Saint-Herblain
| | - Y Bécouarn
- Department of Medical Oncology, Institut Bergonié, Bordeaux
| | - O Dupuis
- Department of Medical Oncology, Jean Bernard Center, Le Mans
| | - G Lledo
- Department of Medical Oncology, Jean Mermoz Private Hospital, Lyon
| | - J Seitz
- Department of Medical Oncology, Teaching Hospital CHU La Timone, Marseille
| | - L Bedenne
- Department of Medical Oncology, Teaching Hospital CHU of Dijon, Dijon
| | | | | | - T Conroy
- Department of Medical Oncology, Oncology Institute of Lorraine, Vandoeuvre-les-Nancy, France
| | - J Gérard
- Department of Radiation oncology, Antoine-Lacassagne Center, Nice;; University of Côte d'Azur, Nice
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Schiappa R, Chateau Y, Gal J, Daideri G, Lemoine P, Besrest E, Paugam F, François E, Viotti J, Chamorey E. Fouille de données : comment valoriser les ressources de données médicales dans les centres hospitaliers ? Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Vendrely V, Lemanski C, François E, Barbier E, Baba Hamed N, Bonichon-Lamichhane N, De La Rochefordière A, Bouché O, Tougeron D, Diaz O, Pommier P, Ronchin P, Saliou M, Cretin J, Lepage C, Quéro L. OC-0284: First results of the French cohort ANABASE : treatment and outcome in non-metastatic anal cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30594-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rouyer M, Smith D, Cunha AS, François E, Monnereau A, Yon E, Bignon E, Balestra A, Noize P, Droz-Perroteau C, Moore N, Fourrier-Réglat A. Efficacité en vie réelle du cétuximab en première ligne de traitement d’un cancer colorectal métastatique (CCRm) selon le statut génomique tumoral RAS et BRAF : actualisation des résultats de la cohorte EREBUS. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.04.009] [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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François E, Kim S, Deplanque G, Smith D, Gourgou S, Rollot-Trad F, Gally S, Berthier A, Mineur L. P-346 Non-interventional study in elderly patients with metastatic colorectal cancer treated with first line bevacizumab combined to chemotherapy in real life: The CASSIOPEE Study - Interim analysis on patients' characteristics. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gerard JP, Frin AC, Doyen J, Zhou FX, Gal J, Romestaing P, Barbet N, Coquard R, Chapet O, François E, Marcié S, Benezery K. Organ preservation in rectal adenocarcinoma (T1) T2-T3 Nx M0. Historical overview of the Lyon Sud - nice experience using contact x-ray brachytherapy and external beam radiotherapy for 120 patients. Acta Oncol 2015; 54:545-51. [PMID: 25389568 DOI: 10.3109/0284186x.2014.975840] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Bindels L, Neyrinck A, Salazar N, Taminiau B, Druart C, Muccioli G, François E, Blecker C, Richel A, Daube G, Mahillon J, de los Reyes-Gavilan C, Cani P, Delzenne N. P180: Intérêt de la modulation du microbiote intestinal par les oligosaccharides non digestibles dans le contrôle de la leucémie et de la cachexie cancéreuse. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70822-2] [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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Boulahssass R, gonfrier S, Auben F, Mari V, Rambaud C, Turpin J, Brocker P, François E, Guerin O. Poor nutritional status is an independent factor of worse outcomes in the second group of Balducci score. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bénézery K, Frin A, Gal J, Zhou F, François E, Benchimol D, Marcié S, Gérard J. Conservation du rectum dans le traitement des adénocarcinomes rectaux de stade T 1-2-3 Nx M0 : rôle de la radiothérapie de contact, expérience niçoise sur 60 patients. Cancer Radiother 2014. [DOI: 10.1016/j.canrad.2014.07.026] [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: 10/24/2022]
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Quaranta D, Delotte J, Bongain A, François E, Bereder JM, Bernard JL. [Vaginal metastasis revealing an adenocarcinoma of the transverse colon]. ACTA ACUST UNITED AC 2014; 42:622-5. [PMID: 25153435 DOI: 10.1016/j.gyobfe.2014.07.019] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/11/2014] [Indexed: 12/23/2022]
Abstract
Secondary localization to vagina had a severe prognosis, suggesting a disseminated metatastic disease. We report the case of prevalent vaginal metastasis of adenocarcinoma of the transverse colon. A 65 years old patient has consulted for vaginal mass. After delayed diagnosis, she presented with disseminated metastatic disease with peritoneal carcinomatosis. After neoadjuvant chemotherapy, the following treatment consisted of complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and vaginal adjuvant radiotherapy. No recurrence occurred after one year. Vaginal metastasis of colon cancer are rare. The dark prognosis might justify a systematic gynecological examination of women presenting colorectal neoplasy.
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Affiliation(s)
- D Quaranta
- Service de gynécologie, obstétrique, reproduction et de médecine fœtale, hôpital Archet II, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine de Ginestière, BP 3079, 06202 Nice cedex 3, France.
| | - J Delotte
- Service de gynécologie, obstétrique, reproduction et de médecine fœtale, hôpital Archet II, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine de Ginestière, BP 3079, 06202 Nice cedex 3, France
| | - A Bongain
- Service de gynécologie, obstétrique, reproduction et de médecine fœtale, hôpital Archet II, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine de Ginestière, BP 3079, 06202 Nice cedex 3, France
| | - E François
- Service de cancérologie digestive, centre Antoine-Lacassagne, 33 avenue de Valombrose, 06189 Nice cedex 2, France; Service de chirurgie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - J-M Bereder
- Service de chirurgie générale et cancérologie digestive, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 3, France
| | - J-L Bernard
- Service de chirurgie générale et cancérologie digestive, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 3, France
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Smith D, Sa-cunha A, Rouyer M, François E, Mitry E, Monnereau A, Jové J, Bignon E, Balestra A, Noize P, Moore N, Fourrier-Reglat A. Real-Life Use of Cetuximab in 1st-Line Treatment of Unresectable Metastatic Colorectal Cancer (MCRC) and Outcomes After Surgical Resection of Metastases: Updated Data from the Erebus Cohort. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu164.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fourrier-Réglat A, Noize P, Rouyer M, Mitry E, François E, Monnerau A, Sa-Cunha A, Bignon E, Le Monies de Sagazan A, Jové J, Lassalle R, Moore N, Smith D. EREBUS : conditions d’utilisation et efficacité du cétuximab en traitement de 1re ligne d’un cancer colorectal métastatique en vie réelle. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2013.11.034] [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: 11/30/2022] Open
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Benezery K, Gérard J, Doyen J, François E. PO-1039: Contact brachytherapy X-Ray 50 kV as an adjuvant treatment after local excision for T1(2)N0 rectal adenocarcinoma. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31157-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Boyer S, Lechtman S, Tieulié N, Zanaldi H, François E, Queyrel V, Fuzibet JG. Fibrose rétropéritonéale et pelvienne extensive révélant une linite gastrique. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.263] [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: 10/26/2022]
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Falk A, Claren A, Benezery K, Leysalle A, Feuillade J, Chand M, François E, Hannoun-Lévi JM. Curiethérapie interstitielle de haut débit de dose en boost pour le cancer du canal anal : données dosimétriques et résultats cliniques. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.07.012] [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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Falk A, Claren A, Benezery K, Leysalle A, Feuillade J, Chand M, François E, Hannoun-Lévi J. High-Dose-Rate Interstitial Brachytherapy as Boost for Anal Canal Carcinoma: Dosimetric Results and Clinical Outcome. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ducreux M, Adenis A, Pignon JP, François E, Chauffert B, Ichanté JL, Boucher E, Ychou M, Pierga JY, Montoto-Grillot C, Conroy T. Efficacy and safety of bevacizumab-based combination regimens in patients with previously untreated metastatic colorectal cancer: final results from a randomised phase II study of bevacizumab plus 5-fluorouracil, leucovorin plus irinotecan versus bevacizumab plus capecitabine plus irinotecan (FNCLCC ACCORD 13/0503 study). Eur J Cancer 2013; 49:1236-45. [PMID: 23352604 DOI: 10.1016/j.ejca.2012.12.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 12/10/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND The combination of bevacizumab and bolus 5-fluorouracil, leucovorin and irinotecan is highly effective in patients with metastatic colorectal cancer (mCRC). This randomised, multicenter, non-comparative phase II trial assessed the efficacy and safety of bevacizumab plus oral capecitabine plus irinotecan (XELIRI) or infusional 5-fluorouracil, leucovorin plus irinotecan (FOLFIRI) as first-line therapy for patients with mCRC. PATIENTS AND METHODS Patients received bevacizumab 7.5mg/kg on day 1 plus XELIRI (irinotecan 200mg/m(2) on day 1 and oral capecitabine 1,000 mg/m(2) bid on days 1-14) every 3 weeks or bevacizumab 5mg/kg on day 1 plus FOLFIRI (5-fluorouracil 400mg/m(2) on day 1 plus 2,400 mg/m(2) as a 46-h infusion, leucovorin 400mg/m(2) on day 1, and irinotecan 180 mg/m(2) on day 1) every 2 weeks. Patients aged ≥ 65 years received a lower dose of capecitabine (800 mg/m(2) twice daily). The primary endpoint was 6-month progression-free survival (PFS) rate. RESULTS A total of 145 patients were enrolled (bevacizumab-XELIRI, n=72; bevacizumab-FOLFIRI, n=73). The 6-month PFS rate was 82% (95% confidence intervals (CI) 71-90%) in the bevacizumab-XELIRI arm and 85% (95% CI 75-92%) in the bevacizumab-FOLFIRI arm. In both the bevacizumab-XELIRI and bevacizumab-FOLFIRI arms, median PFS and overall survival (OS) were 9 and 23 months, respectively. The most frequent toxicities were grade 3/4 neutropenia (bevacizumab-XELIRI 18%; bevacizumab-FOLFIRI 26%) and grade 3 diarrhoea (12% and 5%, respectively). CONCLUSIONS This randomised non-comparative study demonstrates that bevacizumab-XELIRI and bevacizumab-FOLFIRI are effective regimens for the first-line treatment of patients with mCRC with manageable toxicity profiles.
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Affiliation(s)
- M Ducreux
- Department of Medicine, Institut Gustave Roussy, Villejuif, Université Paris-Sud, Le Kremlin Bicêtre, France.
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Gonçalves A, Gilabert M, François E, Dahan L, Perrier H, Lamy R, Re D, Largillier R, Gasmi M, Tchiknavorian X, Esterni B, Genre D, Moureau-Zabotto L, Giovannini M, Seitz JF, Delpero JR, Turrini O, Viens P, Raoul JL. BAYPAN study: a double-blind phase III randomized trial comparing gemcitabine plus sorafenib and gemcitabine plus placebo in patients with advanced pancreatic cancer. Ann Oncol 2012; 23:2799-2805. [PMID: 22771827 DOI: 10.1093/annonc/mds135] [Citation(s) in RCA: 157] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sorafenib is an oral anticancer agent targeting Ras-dependent signaling and angiogenic pathways. A phase I trial demonstrated that the combination of gemcitabine and sorafenib was well tolerated and had activity in advanced pancreatic cancer (APC) patients. The BAYPAN study was a multicentric, placebo-controlled, double-blind, randomized phase III trial comparing gemcitabine/sorafenib and gemcitabine/placebo in the treatment of APC. PATIENTS AND METHODS The patient eligibility criteria were locally advanced or metastatic pancreatic adenocarcinoma, no prior therapy for advanced disease and a performance status of zero to two. The primary end point was progression-free survival (PFS). The patients received gemcitabine 1000 mg/m(2) i.v., weekly seven times followed by 1 rest week, then weekly three times every 4 weeks plus sorafenib 200 mg or placebo, two tablets p.o., twice daily continuously. RESULTS Between December 2006 and September 2009, 104 patients were enrolled on the study (52 pts in each arm) and 102 patients were treated. The median and the 6-month PFS were 5.7 months and 48% for gemcitabine/placebo and 3.8 months and 33% for gemcitabine/sorafenib (P = 0.902, stratified log-rank test), respectively. The median overall survivals were 9.2 and 8 months, respectively (P = 0.231, log-rank test). The overall response rates were similar (19 and 23%, respectively). CONCLUSION The addition of sorafenib to gemcitabine does not improve PFS in APC patients.
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Affiliation(s)
- A Gonçalves
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Cancer Research Center of Marseille, U1068 INSERM, CNRS UMR7258; Aix-Marseille University, Marseille; Clinical Investigation Center 9502, Marseille.
| | - M Gilabert
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - E François
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice
| | - L Dahan
- Aix-Marseille University, Marseille; Clinical Investigation Center 9502, Marseille; Department of Digestive Oncology, Hôpital de le Timone, Assistance Publique-Hôpitaux de Marseille, Marseille
| | - H Perrier
- Digestive Oncology Unit, Hôpital Saint-Joseph, Marseille
| | - R Lamy
- Department of Oncology, Centre Hospitalier Bretagne Sud (Lorient), Lorient
| | - D Re
- Medicine Unit, Centre Hospitalier Antibes Juan-les-Pins, Antibes
| | - R Largillier
- Department of Oncology, Centre azuréen de cancérologie, Mougins
| | - M Gasmi
- Department of Gastro-enterology, Hôpital Nord APHM, Marseille
| | - X Tchiknavorian
- Department of Medical Oncology, Centre Hospitalier Toulon, Toulon, France
| | - B Esterni
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Clinical Investigation Center 9502, Marseille
| | - D Genre
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Clinical Investigation Center 9502, Marseille
| | | | - M Giovannini
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - J-F Seitz
- Aix-Marseille University, Marseille; Clinical Investigation Center 9502, Marseille; Department of Digestive Oncology, Hôpital de le Timone, Assistance Publique-Hôpitaux de Marseille, Marseille
| | - J-R Delpero
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Cancer Research Center of Marseille, U1068 INSERM, CNRS UMR7258; Aix-Marseille University, Marseille; Clinical Investigation Center 9502, Marseille
| | - O Turrini
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Cancer Research Center of Marseille, U1068 INSERM, CNRS UMR7258; Aix-Marseille University, Marseille
| | - P Viens
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Cancer Research Center of Marseille, U1068 INSERM, CNRS UMR7258; Aix-Marseille University, Marseille; Clinical Investigation Center 9502, Marseille
| | - J-L Raoul
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Cancer Research Center of Marseille, U1068 INSERM, CNRS UMR7258
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Malka D, Boige V, Jacques N, Vimond N, Adenis A, Boucher E, Pierga J, Conroy T, Chauffert B, François E, Guichard P, Galais M, Cvitkovic F, Ducreux M, Farace F. Clinical value of circulating endothelial cell levels in metastatic colorectal cancer patients treated with first-line chemotherapy and bevacizumab. Ann Oncol 2012; 23:919-27. [DOI: 10.1093/annonc/mdr365] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Gerard J, Gourgou-Bourgade S, Azria D, Martel-Laffay I, Hennequin C, Etienne P, Vendrely V, François E, Romestaing P, Conroy T. ACCORD12/0405-Prodige 2 Phase III Trial Neoadjuvant Treatment in Rectal Cancer: Results after 3 Years of Follow-up. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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Goncalves A, Viret F, François E, Dahan L, Perrier H, Lamy R, Re D, Largillier R, Gasmi M, Tchiknavorian X, Turrini O, Moureau-Zabotto L, Delpero J, Viens P. BAYPAN study: A double-blind, phase III randomized trial of gemcitabine plus sorafenib versus gemcitabine plus placebo in patients with advanced pancreatic cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4028] [Citation(s) in RCA: 7] [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: 11/20/2022] Open
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François E, Guérin O, Follana P, Evesque L, Mari V, Aparicio T. Use of bevacizumab in elderly patients with metastatic colorectal cancer: Review. J Geriatr Oncol 2011. [DOI: 10.1016/j.jgo.2010.09.005] [Citation(s) in RCA: 6] [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: 11/27/2022]
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Ychou M, François E, Thézenas S, Laurent-Puig P, Bouche O, Adenis A, Bennouna J, Assenat E, Portales F, Samalin E. Sorafenib (S) in combination with irinotecan (I) as a treatment in metastatic colorectal cancer (mCRC) patients (pts) with KRAS mutation (mt) as second line or later: Interim analysis results of multicenter phase II part trial (NEXIRI). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14022] [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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Prenen H, D'Haens G, Capdevila J, Carrato A, Sobrero A, Ducreux M, François E, Staines H, Amellal N, Van Cutsem E. A phase I dose escalation study of BIBF 1120 combined with FOLFOX in metastatic colorectal cancer (mCRC) patients (pts). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14054] [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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Ducreux M, Adenis A, Pignon J, François E, Chauffert B, Boucher E, Ychou M, Pierga J, Montot-Grillot C, Conroy T. 6084 Efficacy and safety of bevacizumab-based combination regimens in patients with metastatic colorectal cancer: final results from a randomised phase II study of bevacizumab + FOLFIRI vs. bevacizumab + XELIRI (FNCLCC ACCORD 13/0503 study). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71179-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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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Dastis NS, François E, Deviere J, Hittelet A, Ilah Mehdi A, Barea M, Dumonceau JM. Intragastric balloon for weight loss: results in 100 individuals followed for at least 2.5 years. Endoscopy 2009; 41:575-80. [PMID: 19588283 DOI: 10.1055/s-0029-1214826] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS To determine long-term outcome after treatment with an intragastric balloon for 6 months, with no structured weight maintenance program offered after balloon removal. PATIENTS AND METHODS 100 consecutive overweight/obese individuals (mean body mass index [BMI] 35.0 +/- 5.6 kg/m (2)) were prospectively followed after endoscopic implantation of a saline-filled intragastric balloon; 97 completed final follow-up at a mean of 4.8 +/- 1.6 years. Successful intragastric balloon therapy was defined as weight loss at 6 months of > or = 10 % of weight at baseline, that remained > or = 10 % until 2.5 years, without bariatric surgery. All analyses followed intention-to-treat principles. RESULTS At 6 months, mean weight loss was 12.6 +/- 8.3 kg, 63 individuals had > or = 10 % baseline weight loss; no severe morbidity was detected. During the first and second years following intragastric balloon removal, mean body mass increased by 4.2 +/- 6.8 and 2.3 +/- 6.0 kg, respectively ( P < 0.001 for both year-on-year comparisons). At 2.5 years, intragastric balloon therapy had been successful in 24 participants. At final follow-up (4.8 +/- 1.6 years), 28 had > or = 10 % baseline weight loss, 35 had undergone bariatric surgery (60 % had preoperative mass higher than baseline), and 3 were lost to follow-up; the 34 remaining had lost 1.5 +/- 5.8 kg compared with baseline. During follow-up, 13 had a second intragastric balloon implanted and 13 took sibutramine for short periods. CONCLUSION Intragastric balloon therapy was relatively innocuous and associated with successful weight loss and maintenance at 2.5 years in a quarter of participants. It represents a valid option for weight loss.
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Affiliation(s)
- Negrin S Dastis
- Gastroenterology and Hepatology Service, Geneva University Hospitals, 1205 Geneva, Switzerland
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Etienne-Grimaldi M, Bennouna J, Formento J, Douillard J, Francoual M, François E, Faroux R, El Hannani C, Jacob J, Milano G. Prospective pharmacogenetic analysis in advanced colorectal cancer (CRC) patients receiving first-line cetuximab-UFT-irinotecan therapy: Importance of gene polymorphisms related to antibody-dependent cellular cytotoxicity (ADCC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4069] [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
4069 Background: Our purpose was to test the predictive value of germinal gene polymorphisms potentially linked to cetuximab, fluoropyrimidine and irinotecan pharmacodynamics on toxicity, clinical response, time to progression (TTP) and overall survival (OS). Methods: 52 patients with advanced CRC were enrolled in an ancillary pharmacogenetic study of the phase II CETUFTIRI trial (33 men, 19 women, mean age 63, range 36–84, PS 0–1). Treatment consisted in cetuximab (day 1-day 8-day 15, 250 mg/m2/week following a 400 mg/m2 loading dose) associated with irinotecan (day 1, 250 mg/m2) and UFT-folinic acid (day 1 to day 14, 250 mg/m2/day UFT, 90 mg/day folinic acid). Median number of administered cycles was 7 (range 1–8). The following gene polymorphisms were analyzed on blood genomic DNA: EGFR (CA repeats in intron 1, - 216G>T, -191C>A), EGF (61A>G), FCGR2A (131Arg>His), FCGR3A (158Phe>Val), UGT1A1 (TA repeats), TYMS (28 bp repeats including the G>C mutation on the 3R allele, 6 bp deletion in 3’ UTR), MTHFR (677C>T, 1298A>C). Results: Grade 3–4 toxicity was recorded in 59.6 % of patients. The toxicity score (sum of maximum grade for each toxicity pattern) was significantly linked to the FCGR2A genotype (median score 9, 9.5 and 13 in Arg/Arg, Arg/His and His/His patients, respectively, p = 0.035) and to the EGFR -191 genotype (median score 11 in CC patients versus 8.5 in CA patients, p = 0.040). Response rate was 49% (3 CR and 21 PR over 49 assessable patients) and was significantly higher in patients bearing the FCGR3A Val allele (62.1 % in Val/Val or Val/Phe versus 26.3 % in Phe/Phe, p = 0.020) or the TYMS 3RG allele (65.0 % versus 28.6 % in patients with no 3RG allele, p = 0.029). Gene polymorphisms did not influence TTP. A multivariate Cox analysis including gene polymorphisms and PS showed that overall survival was improved in patients bearing the FCGR3A Val allele (relative risk of death was 2.25 in Phe/Phe patients relative to Val-containing genotypes, 95% CI 1.03–4.91, p = 0.041). Conclusions: Present data suggest the importance of ADCC in cetuximab pharmacodynamics, as outlined by the role of FCGR gene polymorphisms on toxicity, responsiveness and survival. No significant financial relationships to disclose.
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Affiliation(s)
- M. Etienne-Grimaldi
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - J. Bennouna
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - J. Formento
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - J. Douillard
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - M. Francoual
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - E. François
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - R. Faroux
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - C. El Hannani
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - J. Jacob
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
| | - G. Milano
- Centre Antoine Lacassagne, Nice, France; Centre René Gauducheau, Saint-Herblain, France; CHD Les Oudairies, La Roche sur Yon, France; CH de Chateaubriant, Chateaubriant, France; Centre François Baclesse, Caen, France
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Marcy P, Chamorey E, Macchiavello J, Largillier R, Peyrade F, Ferrero J, Hanoun-Levi J, Poudenx M, François E, Frenay M. Distal or proximal venous port device insertion: Results of a prospective randomized trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20605] [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
e20605 Background: Open, nonblinded, prospective, randomized, controlled trial comparing two techniques of venous port device insertion: percutaneous distal (phlebography-guided arm port- study technique- 2) vs proximal surgical (cephalic vein cutdown- control technique- 1) placement -To determine whether technique 1 is superior to technique 2. Methods: 230 eligible patients beginning a course of i.v. chemotherapy via a port device catheter with an expected duration of treatment of 3 months or longer were randomized (written informed consent). Eligibility criteria included adult patients with solid tissue malignancy (neuro oncology, gynecology, lung, abdominal, head§neck) beginning a course of I.V.chemotherapy, normal hemostatic parameters, no organ failure, a life expectancy >3months, WHO status<3. Exclusion criteria included current anticoagulant therapy, previous ipsilateral venous catheter/pacewires/surgical axillary node dissection/radiodermatitis, local tumor growth/sepsis, symptomatic brain metastasis, psychosis. The silicone rubber 7F catheter was connected to a 11mm port reservoir, and implanted under local anesthesia using either technique 1 or 2 after randomization. Outcome measurements included technical feasibility/procedure duration, port complications, quality of life (EORTC) questionnaires. Results: Median study duration was 12.2 vs 11.9 months (p: 0.9), median chemotherapy cycles were 6.0 in both groups. Patients groups differed significantly in venous access side (left access in group 2) and sex ratio (p=0.028). In group 2, technical success rate was higher (99 vs 91%, p<0.02), procedure was shorter: 18.0min (10.0–90.0) vs 21min (15.0- 45.0)(p<0.008), but global complication rate was higher (p<0.05). Device complication related explantation rate was 11.9 vs 2.8% (p=0.022). Conclusions: Both techniques are safe and effective. Despite a higher technical success rate and a shorter procedure duration, arm port insertion has a lower complication-free duration. Distal (arm port) technique should be recommended in young female cancer patients (neckline cosmesis/discretion), head and neck cancer patients, obese patients (upright position) and in patients presenting with respiratory insufficiency or at high risk for pneumothorax. No significant financial relationships to disclose.
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Affiliation(s)
- P. Marcy
- Antoine Lacassagne, Nice, France
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Ducreux M, Adenis A, Mendiboure J, François E, Boucher E, Chauffert B, Ychou M, Pierga J, Montoto-Grillot C, Conroy T. Efficacy and safety of bevacizumab (BEV)-based combination regimens in patients with metastatic colorectal cancer (mCRC): Randomized phase II study of BEV + FOLFIRI versus BEV + XELIRI (FNCLCC ACCORD 13/0503 study). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4086] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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
4086 Background: The combination of BEV and chemotherapy is highly effective in patients with mCRC and improves response rate, progression-free survival and overall survival compared with chemotherapy alone. This randomized non-comparative phase II trial evaluated the efficacy and safety of BEV in combination with either XELIRI or FOLFIRI as first-line therapy for mCRC. Methods: Patients were eligible for inclusion in this study if they had histologically proven measurable mCRC, were aged 18–75 years, and had an ECOG performance status (PS) of 0–2. Patients were treated with 8 cycles of XELIRI (irinotecan 200 mg/m2 on Day 1 and capecitabine 1000 mg/m2 bid on Days 1–14) + BEV 7.5 mg/kg on Day 1, every 3 weeks or 12 cycles of FOLFIRI (irinotecan 200 mg/m2 on Day 1 + 5-fluorouracil (5-FU) 400 mg/m2 + folinic acid 400 mg/m2 on day 1 followed by 5-FU 2400 mg/m2 via 46-h infusion) + BEV 5 mg/kg on day 1, every 2 weeks. BEV was continued to disease progression. Patients aged ≥65 years received a lower daily dose of capecitabine (800 mg/m2 bid). The primary endpoint was crude progression-free survival (PFS) at 6 months. Results: In total, 145 patients were entered in the study between March 2006 and January 2008; 72 patients received BEV + XELIRI and 73 patients received BEV + FOLFIRI (male 64%/48%; median age 61/61 years; 35/36% aged >65 years). Preliminary results from the first 6 months of follow-up are reported here. A total of 491/783 cycles was administered, 63%/67% receiving at least the initially planned number of cycles (8 cycles for BEV + XELIRI and 12 for BEV + FOLFIRI). Main results are given in the table . Conclusions: This randomized non-comparative study has shown that BEV + XELIRI and BEV + FOLFIRI are similarly effective treatments for patients with mCRC, with manageable toxicity profiles. Results with updated follow-up will be presented at the Meeting. [Table: see text] [Table: see text]
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Affiliation(s)
- M. Ducreux
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - A. Adenis
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - J. Mendiboure
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - E. François
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - E. Boucher
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - B. Chauffert
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - M. Ychou
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - J. Pierga
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - C. Montoto-Grillot
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
| | - T. Conroy
- Institut Gustave Roussy, Villejuif, France; Centre Oscar Lambret, Lille, France; Centre Antoine Lacassagne, Nice, France; Centre Eugène Marquis, Rennes, France; Centre Georges-François Leclerc, Dijon, France; Centre Val d’Aurelle, Montpellier, France; Institut Curie, Paris, France; FNCLCC, Paris, France; Centre Alexis Vautrin, Nancy, France
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Barriere J, Fischel J, Formento P, Renée N, Francoual M, Formento J, Chefrour M, Etienne-Grimaldi M, François E, Milano G. Cetuximab-mediated antibody-dependent cellular cytotoxicity (ADCC) against tumor cell lines characterized for EGFR expression and K-ras mutation. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e14583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14583 Background: Mutated K-ras protein is a strong predictive factor of cetuximab resistance, bypassing the classical direct inhibitory effect on epidermal growth factor receptor (EGFR) signaling. However, cetuximab is also able to mediate ADCC, which may be part of the clinical response. The aim of this ex-vivo study was to quantify cetuximab-mediated ADCC on various human cancer cell lines characterized for EGFR-expression and K-ras mutation. Methods: Two K-ras mutated cell lines over-expressing EGFR and resistant to anti-EGFR tyrosine kinase inhibitor were tested (Capan-1 and Capan-2, pancreatic), along with 2 K-ras wild-type cell lines over- expressing EGFR (CAL166, head and neck; A431, epidermoid carcinoma) and an EGFR-negative cell line (OCM1, uveal melanoma). The tested monoclonal antibodies (mAbs) were: cetuximab (Merck, anti-EGFR IgG1 mAb), panitumumab (Amgen, anti-EGFR IgG2 mAb), and as a negative control, rituximab (Roche, IgG1 anti-CD20 mAb). ADCC (51Cr release assay) was performed using freshly- isolated peripheral blood mononuclear cells from a healthy donor. Results were expressed as % of potentially maximum 51Cr release. Results: Cetuximab mediates ADCC against EGFR-over-expressing cell lines CAL166 (38.4 ± 3.1 %), A431 (13.5 ± 1.7 %), Capan-1 (31.2 ± 0.8 %) and Capan-2 (27.8 ± 8.6 %) irrespective of the K-ras mutational status, but not against EGFR-negative OCM-1 (6.2 ± 1 %). Conversely, unlike IgG1 cetuximab, the anti-EGFR IgG2 panitumumab and the irrelevant antibody rituximab were both unable to induce significant ADCC (< 10 % on all tested cell lines). Conclusions: Cetuximab-mediated ADCC is independent of the K-ras mutational status of the tumor cell lines. Present data suggest that cetuximab may remain of clinical interest in K-ras-mutated patients. Immunostimulation, as well as new generation anti-EGFR mAbs with improved ability to induce ADCC, may be promising in the management of K-ras-mutated patients. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | - N. Renée
- Centre Antoine Lacassagne, Nice, France
| | | | | | | | | | | | - G. Milano
- Centre Antoine Lacassagne, Nice, France
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Conroy T, Viret F, François E, Seitz JF, Boige V, Ducreux M, Ychou M, Metges JP, Giovannini M, Yataghene Y, Peiffert D. Phase I trial of oxaliplatin with fluorouracil, folinic acid and concurrent radiotherapy for oesophageal cancer. Br J Cancer 2008; 99:1395-401. [PMID: 18841161 PMCID: PMC2579679 DOI: 10.1038/sj.bjc.6604708] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This dose escalation study was designed to determine the maximum tolerated dose (MTD) and recommended doses (RDs) of 5-fluorouracil (5FU), folinic acid and oxaliplatin (FOLFOX) with concomitant radiotherapy in inoperable/metastatic oesophageal squamous cell carcinoma or adenocarcinoma. Patients received three courses of LV5FU2 regimen (folinic acid 200 mg m−2, bolus 5FU 300–400 mg/m2, continuous infusion 5FU 400–600 mg m−2 on days 1 and 2) and escalating doses of oxaliplatin 50 to 100 mg m−2 on day 1 (FOLFOX). This regimen was repeated every 2 weeks, concomitant to a 50-gray radiotherapy per 5 weeks. Three more cycles were delivered after completion of radiation therapy. Three to six patients were allocated to each of the five dose levels until MTD was reached. Thirty-three patients were enroled and 21 had metastatic disease. Maximum tolerated dose was oxaliplatin 100 mg m−2, and continuous infusion 5FU was 600 mg m−2 day− (level 5). The most common toxicities were neutropenia, dysphagia and oesophagitis. The RDs were those of FOLFOX-4 regimen (oxaliplatin 85 mg m−2 and full doses of LV5FU2). The overall response was 48.5%, including 12% complete response. Response rate on primary tumour was 62.9%. This FOLFOX-4 regimen was reasonably well tolerated and effective in inoperable/metastatic oesophageal carcinoma and warrants additional investigation.
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Affiliation(s)
- T Conroy
- 1Department of Medical Oncology and Radiotherapy, EA 4003, Nancy-University and Centre Alexis Vautrin, 6 avenue de Bourgogne, 54511 Vandoeuvre-lès-Nancy, France
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Gérard JP, Benezery K, Ortholan C, Follana P, François E, Hannoun-Levi JM, Marcie S. Les cancers du rectum T2 N0 M0, vers la conservation du rectum: une nouvelle voie de recherche clinique. ONCOLOGIE 2008. [DOI: 10.1007/s10269-008-0968-2] [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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Bécouarn Y, Guillo S, Artru P, Assenat E, Bosset JF, Conroy T, François E, Taïeb J, Touboul E. [Systematic review: value of perioperative chemotherapy in the management of resectable rectal adenocarcinoma (brief report)]. Bull Cancer 2008; 95:717-734. [PMID: 18763385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED At the request of the National Thesaurus of Gastrointestinal Cancer (TNCD), the SOR program undertaken by the French federation of cancer centers and now led by the French National Cancer Institute, completed a systematic review to evaluate the value of perioperative chemotherapy in the management of resectable rectal adenocarcinoma in collaboration with clinician experts. METHODS Results of a systematic literature search using Medline and Embase (from January 1996 to October 2007) were completed by a survey of Evidence- Based Medicine websites. All phase III randomized trials and systematic reviews comparing surgery (alone or associated with adjuvant therapy) to the same treatment plus chemotherapy, or comparing different perioperative chemotherapy modalities in patients with resectable rectal adenocarcinoma, were included in the study. The quality and clinical relevance of the trials were evaluated using validated checklists, allowing to associate each result with its level of evidence. Data synthesis was performed taking into account both efficacy and toxicity outcomes for each intervention. Finally, research recommendations were formulated. RESULTS Of 29 studies meeting the selection criteria, 19 were included after critical methodological and clinical appraisal. As compared with preoperative radiotherapy, preoperative chemoradiotherapy with 5-fluorouracil and folinic acid does not improve overall or relapse-free survivals but decreases local recurrence rates. Postoperative chemotherapy with 5-fluorouracil and folinic acid does not improve overall or relapse-free survivals, whether the patients received preoperative radiotherapy or preoperative chemoradiotherapy, whereas it seems to decrease local recurrence rates after preoperative radiotherapy but not after preoperative chemoradiotherapy. As compared with postoperative chemoradiotherapy, preoperative chemoradiotherapy with continuous infusion of 5-fluorouracil does not improve overall or relapse-free survivals, but decreases local recurrence rates as well as acute and long-term toxicities. In the absence of preoperative radiotherapy, fluoropyrimidine-based postoperative chemotherapy improves both overall and relapse-free survivals and decreases local recurrence rates. CONCLUSIONS Preoperative chemoradiotherapy reduces the risk of local recurrence as compared with preoperative radiotherapy or postoperative chemoradiotherapy.
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Affiliation(s)
- Y Bécouarn
- oncologue médical, institut Bergonié, Bordeaux, France
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Borg C, Delord J, Husseini F, Trillet Lenoir V, Faroux R, François E, Ychou M, Bergougnoux L, Bennouna J, Douillard J. 3070 POSTER Bevacizumab in patients with previously treated metastatic colorectal cancer: preliminary results of a phase II study (bevacolor). EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70998-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Etienne-Grimaldi MC, Cardot JM, François E, Renée N, Douillard JY, Gamelin E, Milano G. Chronopharmacokinetics of oral tegafur and uracil in colorectal cancer patients. Clin Pharmacol Ther 2007; 83:413-5. [PMID: 17637782 DOI: 10.1038/sj.clpt.6100297] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Uracil-Ftorafur (UFT) combines the 5-fluorouracil (FU) prodrug tegafur with uracil (at a 1:4 molar ratio), which is a competitive inhibitor of dihydropyrimidine dehydrogenase (DPD), the limiting enzyme of FU catabolism. As a result, sustained FU concentrations are obtained in both plasma and tumor. UFT is an effective alternative to intravenous FU-Leucovorin (LV) in metastatic and adjuvant colorectal cancer treatment. A circadian rhythm for DPD activity has been shown in both human and animal studies, with consequences on FU plasma concentrations in patients receiving FU as a continuous infusion. The chronopharmacokinetics of FU has stimulated clinical trials of chronomodulated delivery schedules for floxuridine and FU infusions, suggesting that such schedules may improve the fluoropyrimidine therapeutic index. Molecular mechanisms responsible for the circadian dependence of FU pharmacodynamics include circadian rhythms in thymidylate synthase activity and DNA synthesis, as recently reported. Chronopharmacology of FU prodrugs is poorly documented. Recently, a feasibility study of chronomodulated administration of the FU oral prodrug capecitabine was reported. To our knowledge, the only study reporting on the time dependency of UFT pharmacokinetics is a phase I study by Muggia et al.
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Delord JP, Bennouna J, Artru P, Perrier H, Husseini F, Desseigne F, François E, Faroux R, Smith D, Piedbois P, Naman H, Douillard JY, Bugat R. Phase II study of UFT with leucovorin and irinotecan (TEGAFIRI): first-line therapy for metastatic colorectal cancer. Br J Cancer 2007; 97:297-301. [PMID: 17637682 PMCID: PMC2360336 DOI: 10.1038/sj.bjc.6603889] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
This phase II trial was performed to evaluate the efficacy and tolerability of oral tegafur-uracil (UFT) with leucovorin (LV) combined with intravenous (i.v.) irinotecan every 3 weeks (TEGAFIRI) as first-line treatment for patients with metastatic colorectal cancer (mCRC). Patients received oral UFT 250 mg m(-2) day(-1) and LV 90 mg day(-1) in three divided daily doses for 14 days followed by a 1-week rest and i.v. irinotecan 250 mg m(-2) as a 90-min infusion every 3 weeks. Tumour responses, assessed every two cycles using RECIST criteria, were reviewed by an independent review committee. In 52 evaluable patients, the best overall response rate was 33% (95% confidence intervals (CI) 20-47%; 1 complete and 16 partial responses). The median time to progression was 5.4 months (95% CI 3.02-7.52 months) and median overall survival was 14.9 months (11.73-17.97 months). A total of 307 cycles were administered, with a median number of five cycles per patient (range: 1-10). The most common grade 3/4 toxicities were neutropenia (25% of patients), diarrhoea (22%), vomiting (11%) and anaemia (11%). The TEGAFIRI regimen is a feasible, well-tolerated and convenient treatment option for patients with non-resectable mCRC.
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Affiliation(s)
- J-P Delord
- Institut Claudius Regaud, 20-24 rue du Pont saint Pierre, Toulouse 31052, France.
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Bennouna J, Faroux R, François E, Ligeza C, El Hannani C, Perrier H, Jacob J, Desseigne F, Perrocheau G, Douillard JY. CETUFTIRI, a new combination of UFT with leucovorin (LV), irinotecan, and cetuximab as first-line treatment for patients (pts) with unresectable metastatic colorectal cancer (mCRC): Preliminary results from a multicenter phase II trial. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4087] [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
4087 Background: A phase II study (ASCO 2004) established that the combination of UFT (tegafur-uracil) with LV and irinotecan (TEGAFIRI) could be safely administered to pts with unresectable mCRC, with an objective response rate (ORR) of 34% and a median time to progression (TTP) of 5.7 months. We initiated CETUFTIRI, a phase II study, to evaluate the efficacy and tolerability of cetuximab added to TEGAFIRI in chemonaïve pts with unresectable mCRC. Methods: Patients in this single-stage study were aged =18 years, with histologically or cytologically confirmed, bidimensionally measurable mCRC, ECOG performance status 0 or 1, and adequate bone marrow, renal, and hepatic function. EGFR expression was not an inclusion criterion. Treatment consisted of UFT 250 mg/m2/day d1–14, LV 90 mg/day d1–14, and irinotecan 250 mg/m2 d1 every 3 weeks, plus cetuximab 400 mg/m2 week 1 then 250 mg/m2 weekly thereafter. The primary endpoint was ORR and the planned sample size was 61 pts. The study is now closed to accrual. Results: To date, 48 patients are evaluable for safety and 31 are evaluable for efficacy. Patient characteristics (n=48): median age 65 years (range 45–84 years); ECOG PS 0/1: 73/27%; male 65%; tumor sites: colon 69%; rectum 17%; junction 14%; liver metastasis 83%; lung metastasis 46%; other 27%. Adverse events per patient (n=48) after a total of 230 cycles were: grade G3 mucositis 10%; G3/4 neutropenia 10%; G3 nausea/vomiting 8%; G3 asthenia 6%; febrile neutropenia 6%; G3 hypokalemia 6%; G3/4 anemia 4%; G3 diarrhea 2%; acne-like rash G1/2 50% (G3 4%); infusion- related reaction to cetuximab 6%. Two of 31 evaluable pts had a complete response and 11 had a partial response, for an ORR of 42%; 5 pts had stable disease (16%) and 11 pts had progressive disease (35.5%). An independent radiologist review is planned for all 61 pts included up to December 2006. Conclusions: The CETUFTIRI combination seems to have an acceptable toxicity profile with an attractive objective response rate in the first-line treatment of pts with mCRC. No significant financial relationships to disclose.
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Affiliation(s)
- J. Bennouna
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - R. Faroux
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - E. François
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - C. Ligeza
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - C. El Hannani
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - H. Perrier
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - J. Jacob
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - F. Desseigne
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - G. Perrocheau
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
| | - J. Y. Douillard
- Centre Rene Gauducheau, St. Herblain, France; Centre Hospitalier La Roche Sur Yon, La Roche Sur Yon, France; Centre Antoine Lacassagne, Nice, France; Centre Etienne Dolet, Saint-Nazaire, France; Centre Hospitalier Chateaubriand, Chateaubriand, France; Hôpital Saint- Joseph, Marseille, France; Centre Francois Baclesse, caen, France; Centre Leon Berard, Lyon, France
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