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Alix-Doucet AS, Vinatier C, Fin L, Léna H, Rangé H, Locher C, Naudet F. Reporting of interventional clinical trial results in an academic center: a survey of completed studies. BMC Med Res Methodol 2024; 24:93. [PMID: 38649798 PMCID: PMC11034140 DOI: 10.1186/s12874-024-02221-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The dissemination of clinical trial results is an important scientific and ethical endeavour. This survey of completed interventional studies in a French academic center describes their reporting status. METHODS We explored all interventional studies sponsored by Rennes University Hospital identified on the French Open Science Monitor which tracks trials registered on EUCTR or clinicaltrials.gov, and provides an automatic assessment of the reporting of results. For each study, we ascertained the actual reporting of results using systematic searches on the hospital internal database, bibliographic databases (Google Scholar, PubMed), and by contacting all principal investigators (PIs). We describe several features (including total budget and numbers of trial participants) of the studies that did not report any results. RESULTS The French Open Science Monitor identified 93 interventional studies, among which 10 (11%) reported results. In contrast, our survey identified 36 studies (39%) reporting primary analysis results and an additional 18 (19%) reporting results for secondary analyses (without results for their primary analysis). The overall budget for studies that did not report any results was estimated to be €5,051,253 for a total of 6,735 trial participants. The most frequent reasons for the absence of results reported by PIs were lack of time for 18 (42%), and logistic difficulties (e.g. delay in obtaining results or another blocking factor) for 12 (28%). An association was found between non-publication and negative results (adjusted Odds Ratio = 4.70, 95% Confidence Interval [1.67;14.11]). CONCLUSIONS Even allowing for the fact that automatic searches underestimate the number of studies with published results, the level of reporting was disappointingly low. This amounts to a waste of trial participants' implication and money. Corrective actions are needed. TRIAL REGISTRATION https://osf.io/q5hcs.
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Affiliation(s)
| | - Constant Vinatier
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Et Travail)-UMR_S 1085, CIC 1414 [(Centre d'investigation clinique de Rennes)], F- 35000, Rennes, France
| | - Loïc Fin
- Research and Innovation Department, CHU Rennes, Rennes, France
| | - Hervé Léna
- Centre Hospitalier Universitaire, Hôpital de Pontchaillou, INSERM U 1242, Université Rennes 1, Rennes, France
| | - Hélène Rangé
- CIC 1414 [(Centre d'Investigation Clinique de Rennes)], Univ Rennes, CHU Rennes, Inserm, Institut Numecan (Nutrition, Métabolismes Et Cancer) -UMR_S 1317, Rennes, France
| | - Clara Locher
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Et Travail)-UMR_S 1085, CIC 1414 [(Centre d'investigation clinique de Rennes)], F- 35000, Rennes, France
| | - Florian Naudet
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Et Travail)-UMR_S 1085, CIC 1414 [(Centre d'investigation clinique de Rennes)], F- 35000, Rennes, France.
- Institut Universitaire de France (IUF), Paris, France.
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Levallet G, Dubois F, Elie N, Creveuil C, Brosseau S, Danel C, Scherpereel A, Lantuejoul S, Mazières J, Greillier L, Audigier-Valette C, Bergot E, Moro-Sibilot D, Molinier O, Léna H, Monnet I, Morin F, Gounant V, Zalcman G. VEGFR2 and CD34 expression associated with longer survival in patients with pleural mesothelioma in the IFCT-GFPC-0701 MAPS phase 3 trial. Lung Cancer 2023; 182:107287. [PMID: 37393757 DOI: 10.1016/j.lungcan.2023.107287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/19/2023] [Accepted: 06/24/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES VEGF/VEGFR autocrine loop is a hallmark of pleural mesothelioma (PM). We thus assayed the prognostic and predictive values of VEGFR-2 [vascular endothelial growth factor receptor 2 or Flk-1] and CD34, a marker of endothelial cells, in samples from patients accrued in the Mesothelioma Avastin Cisplatin Pemetrexed Study ('MAPS', NCT00651456). MATERIALS AND METHODS VEGFR2 and CD34 expression were assayed using immunohistochemistry in 333 MAPS patients (74.3%), and their prognostic value was evaluated in terms of overall survival (OS) and progression-free survival (PFS) in univariate and multivariate analyses, before validation by bootstrap methodology. RESULTS Positive VEGFR2 or CD34 staining was observed in 234/333 (70.2%) and 322/323 (99.6%) of tested specimens, respectively. VEGFR2 and CD34 staining correlated weakly, yet significantly, with each other (r = 0.36, p < 0.001). High VEGFR2 expression or high CD34 levels were associated with longer OS in PM patients in multivariate analysis (VEGFR2: adjusted [adj.] hazard ratio [HR]: 0.91, 95% confidence interval [CI] [0.88; 0.95], p < 0.001; CD34: adj. HR: 0.86, 95 %CI [0.76; 0.96], p = 0.010), with only high VEGFR2 expression resulting in significantly longer PFS (VEGFR2: adj. HR: 0.96, 95 %CI [0.92; 0.996], p = 0.032). Stability of these results was confirmed using bootstrap procedure. Nevertheless, VEGFR2 expression failed to specifically predict longer survival in bevacizumab-chemotherapy combination trial arm, regardless of whether the VEGFR2 score was combined or not with serum VEGF concentrations. CONCLUSION VEGFR2 overexpression independently correlated with longer OS or PFS in PM patients, such biomarker deserving prospective evaluation as stratification variable in future clinical trials.
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Affiliation(s)
- Guénaëlle Levallet
- Université de Caen-Normandie, CNRS, Normandie Univ, ISTCT UMR6030, GIP Cyceron, F-14000 Caen, France; Department of Pathology, Caen University Hospital, Caen, France
| | - Fatéméh Dubois
- Université de Caen-Normandie, CNRS, Normandie Univ, ISTCT UMR6030, GIP Cyceron, F-14000 Caen, France; Department of Pathology, Caen University Hospital, Caen, France
| | - Nicolas Elie
- Université de Caen-Normandie, Normandie Univ, Federative Structure 4207 "Normandie Oncologie", Service Unit PLATON, Virtual'His platform, Caen, France
| | - Christian Creveuil
- Université de Caen-Normandie, Normandie Univ, Biomedical Research Unit, University Hospital, Caen, France
| | - Solenn Brosseau
- Université Paris Cité, Thoracic Oncology Department & CIC1425, Hôpital Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; U830 INSERM "Cancer, Heterogeneity, Instability, Plasticity, A.R.T group", Curie Institute, Paris, France
| | - Claire Danel
- Université Paris Cité Department of Pathology, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Arnaud Scherpereel
- Department of Pulmonary and Thoracic Oncology, Centre Hospitalier Universitaire Lille, University of Lille, U1019 INSERM, Center of Infection and Immunity of Lille, Lille, France
| | - Sylvie Lantuejoul
- Department of Biopathology, Reference National Center MESOPATH, Centre Léon Bérard, Lyon, France
| | - Julien Mazières
- Grenoble Alpes University, Department of Pulmonology, Hôpital Larrey, University Hospital of Toulouse, Toulouse, France
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | | | - Emmanuel Bergot
- Université de Caen-Normandie, CNRS, Normandie Univ, ISTCT UMR6030, GIP Cyceron, F-14000 Caen, France; Normandie Univ, UNICAEN, Pulmonology and Thoracic Oncology Department, Caen University Hospital, Caen, France
| | - Denis Moro-Sibilot
- Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble, Grenoble, France
| | - Olivier Molinier
- Department of Pulmonology, Centre Hospitalier Le Mans, Le Mans, France
| | - Hervé Léna
- Department of Pulmonology, Ponchaillou University Hospital, Rennes, France
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - Valérie Gounant
- Université Paris Cité, Thoracic Oncology Department & CIC1425, Hôpital Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; Pulmonology and thoracic oncology Department, Tenon University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | - Gérard Zalcman
- Université Paris Cité, Thoracic Oncology Department & CIC1425, Hôpital Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; U830 INSERM "Cancer, Heterogeneity, Instability, Plasticity, A.R.T group", Curie Institute, Paris, France.
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Ricordel C, Chaillot L, Vlachavas EI, Logotheti M, Desvallees T, Aubry M, Kontogianni G, Mastrokalou C, Jouan F, Jarry U, Guillaudeux T, Léna H, Chatziioannou A, Pedeux R. EP16.02-004 Clinical Significance and Genomic Characteristics of CD56+ Circulating Tumor Cells in Small Cell Lung Carcinoma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1035] [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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Maille E, Levallet J, Dubois F, Antoine M, Danel C, Creveuil C, Mazieres J, Margery J, Greillier L, Gounant V, Moro‐Sibilot D, Molinier O, Léna H, Monnet I, Bergot E, Langlais A, Morin F, Scherpereel A, Zalcman G, Levallet G. A Defect of Amphiregulin Release Predicted Longer Survival Independently of YAP Expression in Patients with Pleural Mesothelioma in the IFCT-0701 MAPS Phase 3 Trial. Int J Cancer 2022; 150:1889-1904. [PMID: 35262190 PMCID: PMC9545369 DOI: 10.1002/ijc.33997] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/12/2022] [Accepted: 02/22/2022] [Indexed: 11/07/2022]
Abstract
The Hippo pathway effector YAP is dysregulated in malignant pleural mesothelioma (MPM). YAP's target genes include the secreted growth factor amphiregulin (AREG), which is overexpressed in a wide range of epithelial cancers and plays an elusive role in MPM. We assayed the expression of YAP and AREG in MPM pathology samples and that of AREG additionally in plasma samples of patients from the randomized phase 3 IFCT‐0701 Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS) using immunohistochemistry and ELISA assays, respectively. MPM patients frequently presented high levels of tumor AREG (64.3%), a high cytosolic AREG expression being predictive of a better prognosis with longer median overall and progression‐free survival. Surprisingly, tumor AREG cytosolic expression was not correlated with secreted plasma AREG. By investigating the AREG metabolism and function in MPM cell lines H2452, H2052, MSTO‐211H and H28, in comparison with the T47D ER+ breast cancer cell line used as a positive control, we confirm that AREG is important for cell invasion, growth without anchorage, proliferation and apoptosis in mesothelioma cells. Yet, most of these MPM cell lines failed to correctly execute AREG posttranslational processing by metalloprotease ADAM17/tumor necrosis factor‐alpha‐converting enzyme (TACE) and extracell secretion. The favorable prognostic value of high cytosolic AREG expression in MPM patients could therefore be sustained by default AREG posttranslational processing and release. Thus, the determination of mesothelioma cell AREG content could be further investigated as a prognostic marker for MPM patients and used as a stratification factor in future clinical trials.
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Affiliation(s)
- Elodie Maille
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
| | - Jérôme Levallet
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
| | - Fatéméh Dubois
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
- Department of PathologyCHU de CaenCaenFrance
| | | | - Claire Danel
- Department of PathologyHôpital Bichat‐Claude Bernard, AP‐HP, Université Paris‐DiderotParisFrance
| | - Christian Creveuil
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
- Biomedical Research UnitCHU de CaenCaenFrance
| | - Julien Mazieres
- Department of PulmonologyHôpital Larrey, CHU de ToulouseToulouseFrance
| | - Jacques Margery
- Department of Medical OncologyInstitut Gustave RoussyVillejuifFrance
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic InnovationsAssistance Publique Hôpitaux de Marseille, Université Aix‐Marseille UM015MarseilleFrance
| | - Valérie Gounant
- Department of PulmonologyHôpital Tenon, AP‐HPParisFrance
- Department of Thoracic Oncology & CIC 1425University Hospital Bichat‐Claude Bernard, AP‐HP, Université de ParisParisFrance
| | - Denis Moro‐Sibilot
- Pôle Thorax et Vaisseaux, University Hospital of Grenoble‐AlpesLa TroncheFrance
| | - Olivier Molinier
- Department of PulmonologyCentre Hospitalier Le MansLe MansFrance
| | - Hervé Léna
- Department of PulmonologyUniversity Hospital PontchaillouRennesFrance
| | - Isabelle Monnet
- Department of PulmonologyCentre Hospitalier Intercommunal de CréteilCréteilFrance
| | - Emmanuel Bergot
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
- Department of Pulmonology and Thoracic OncologyUniversity Hospital of CaenCaenFrance
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique (IFCT)ParisFrance
| | - Arnaud Scherpereel
- Department of Pulmonary and Thoracic OncologyCentre Hospitalier Universitaire Lille, University of Lille, U1019 INSERM, Center of Infection and Immunity of LilleLilleFrance
| | - Gérard Zalcman
- Department of Thoracic Oncology & CIC 1425University Hospital Bichat‐Claude Bernard, AP‐HP, Université de ParisParisFrance
- U830 INSERM, “Cancer, Hétérogénéité, Instabilité et Plasticité” Centre de Recherche, Institut CurieParisFrance
| | - Guénaëlle Levallet
- Normandie Univ, UNICAEN, CNRS, ISTCT‐UMR6030CaenGIP CYCERONFrance
- Department of PathologyCHU de CaenCaenFrance
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5
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Agar C, Geier M, Léveiller G, Lamy R, Bizec JL, Tiercin M, Bernier C, Robinet G, Léna H, Ricordel C, Corre R. Brief Report on the Efficacy of Nivolumab in Patients With Previously Treated Advanced Large-Cell Neuroendocrine Cancer of the Lung. JTO Clin Res Rep 2021; 2:100129. [PMID: 34590004 PMCID: PMC8474479 DOI: 10.1016/j.jtocrr.2020.100129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/19/2020] [Accepted: 12/04/2020] [Indexed: 11/08/2022] Open
Abstract
Introduction The optimal management of large cell neuroendocrine cancer of the lung (LCNEC) is unclear, and data regarding anti–programmed cell death protein 1 (PD-1) antibodies are scarce. This study reports the clinical efficacy of a PD-1 inhibitor in patients with advanced LCNEC. Methods All patients with stage III to IV LCNEC treated with at least one previous cycle of chemotherapy between January 1, 2015 and December 31, 2018 were reviewed retrospectively. Patients were divided into two groups depending on their exposure to nivolumab as second-line treatment or beyond. The primary objective was to assess nivolumab’s efficacy. Results A total of 51 patients with advanced LCNEC from eight centers were analyzed, including 17 who received nivolumab. The PD-1 inhibitor was used as second-line treatment in 77% of cases, with a median number of eight doses (range: 1–62). After nivolumab treatment, the median overall survival was 12.1 months (95% confidence interval [CI]: 7.10–14.20). The objective response rate was 29.4% (95% CI: 10.3–56.0), and median progression-free survival was 3.9 months (95% CI: 1.68–7.17). The programmed death-ligand 1 status was unknown. There was no difference in the efficacy of first-line chemotherapy; the objective response rate was 23.5% (n = four of 17) in the nivolumab group versus 32.4% (n = 11 of 34) in the conventional treatment group, and progression-free survival was 3.5 months (95% CI: 1.7–4.4) versus 2.1 months (95% CI: 1.4–4.2), respectively. Conclusions In a real-world setting, nivolumab seems to be an effective second-line treatment in patients with advanced LCNEC. Large prospective studies in this setting are still required.
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Affiliation(s)
- Camille Agar
- Centre Hospitalier Universitaire de Rennes, Service de Pneumologie, Université de Rennes 1, Rennes, France
| | - Margaux Geier
- Centre Hospitalier Régional Universitaire Morvan, Service d'Oncologie, Université de Bretagne Occidentale, Brest, France
| | - Guillaume Léveiller
- Centre Hospitalier Yves le Foll, Service de Pneumologie, Saint-Brieuc, France
| | - Régine Lamy
- Centre Hospitalier Bretagne Sud, Service d'Oncologie, Lorient, France
| | - Jean-Louis Bizec
- Centre Hospitalier Bretagne-Atlantique, Service de Pneumologie, Vannes, France
| | - Marie Tiercin
- Centre Hospitalier Saint Malo, Service de Pneumologie, Saint Malo, France
| | - Cyril Bernier
- Centre Hospitalier Rene Pleven, Service de Pneumologie, Dinan, France
| | - Gilles Robinet
- Centre Hospitalier Régional Universitaire Morvan, Service d'Oncologie, Université de Bretagne Occidentale, Brest, France
| | - Hervé Léna
- Centre Hospitalier Universitaire de Rennes, Service de Pneumologie, Université de Rennes 1, Rennes, France.,Institut National de la Santé et de la Recherche Médicale U1242, Chemistry Oncogenesis Stress and Signalling, Centres de Lutte Contre le Cancer Eugène Marquis, Rennes, France
| | - Charles Ricordel
- Centre Hospitalier Universitaire de Rennes, Service de Pneumologie, Université de Rennes 1, Rennes, France.,Institut National de la Santé et de la Recherche Médicale U1242, Chemistry Oncogenesis Stress and Signalling, Centres de Lutte Contre le Cancer Eugène Marquis, Rennes, France
| | - Romain Corre
- Centre Hospitalier Intercommunal de Cornouaille, Service de Pneumologie, Quimper, France
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Duvergé L, Bondiau PY, Claude L, Supiot S, Vaugier L, Thillays F, Doyen J, Ricordel C, Léna H, Bellec J, Chajon E, de Crevoisier R, Castelli J. Discontinuous stereotactic body radiotherapy schedule increases overall survival in early-stage non-small cell lung cancer. Lung Cancer 2021; 157:100-108. [PMID: 34016489 DOI: 10.1016/j.lungcan.2021.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The duration of stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) may affect patient outcomes. We aimed to determine the impact of a continuous versus discontinuous SBRT schedule on local control (LC) and overall survival (OS) in NSCLC patients. MATERIALS AND METHODS Consecutive NSCLC stage I patients (475) treated with SBRT in four centers were retrospectively analyzed. The delivered dose ranged from 48 to 75 Gy in 3-10 fractions. Based on the ratio between the treatment duration (TD) and number of fractions (n), patients were divided into two groups: continuous schedule (CS) (TD ≤ 1.6n; 239 patients) and discontinuous schedule (DS) (TD > 1.6n; 236 patients). LC and OS were compared using Cox regression analyses after propensity score matching (216 pairs). RESULTS The median follow-up period was 41 months. Multivariate analysis showed that the DS (hazard ratio (HR): 0.42; 95 % confidence interval (CI): 0.22-0.78) and number of fractions (HR: 1.24; 95 % CI: 1.07-1.43) were significantly associated with LC. The DS (HR: 0.67; 95 % CI: 0.51-0.89), age (HR: 1.02; 95 % CI: 1-1.03), WHO performance status (HR: 2.27; 95 % CI: 1.39-3.7), and T stage (HR: 1.4; 95 % CI: 1.03-1.87) were significantly associated with OS. The 3-year LC and OS were 92 % and 64 % and 81 % and 53 % for DS and CS treatments, respectively (p < 0.01). Cox analysis confirmed that the discontinuous SBRT schedule significantly increased LC and OS. CONCLUSION DS is associated with significantly improved LC and OS in early-stage NSCLC patients treated with SBRT.
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Affiliation(s)
- L Duvergé
- Radiation Oncology Department, Centre Eugène Marquis, Avenue Flandres Dunkerque, 35000 Rennes, France.
| | - P-Y Bondiau
- Radiation Oncology Department, Centre Antoine Lacassagne, 06000 Nice, France
| | - L Claude
- Radiation Oncology Department, Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - S Supiot
- Radiation Oncology Department, Institut de Cancérologie de l'Ouest- René Gauducheau, Bd J Monod, 44800 Nantes, St-Herblain, France
| | - L Vaugier
- Radiation Oncology Department, Institut de Cancérologie de l'Ouest- René Gauducheau, Bd J Monod, 44800 Nantes, St-Herblain, France
| | - F Thillays
- Radiation Oncology Department, Institut de Cancérologie de l'Ouest- René Gauducheau, Bd J Monod, 44800 Nantes, St-Herblain, France
| | - J Doyen
- Radiation Oncology Department, Centre Antoine Lacassagne, 06000 Nice, France
| | - C Ricordel
- Pneumology Department, Centre Hospitalier Universitaire de Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France
| | - H Léna
- Pneumology Department, Centre Hospitalier Universitaire de Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France
| | - J Bellec
- Radiation Oncology Department, Centre Eugène Marquis, Avenue Flandres Dunkerque, 35000 Rennes, France
| | - E Chajon
- Radiation Oncology Department, Centre Eugène Marquis, Avenue Flandres Dunkerque, 35000 Rennes, France
| | - R de Crevoisier
- Radiation Oncology Department, Centre Eugène Marquis, Avenue Flandres Dunkerque, 35000 Rennes, France
| | - J Castelli
- Radiation Oncology Department, Centre Eugène Marquis, Avenue Flandres Dunkerque, 35000 Rennes, France
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7
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Mezquita L, Jové M, Nadal E, Kfoury M, Morán T, Ricordel C, Dhooge M, Tlemsani C, Léna H, Teulé A, Álvarez JV, Raimbourg J, Hiret S, Lacroix L, Menéndez M, Saldaña J, Brunet J, Lianes P, Coupier I, Auclin E, Recondo G, Friboulet L, Adam J, Green E, Planchard D, Frébourg T, Capellà G, Rouleau E, Lázaro C, Caron O, Besse B. High Prevalence of Somatic Oncogenic Driver Alterations in Patients With NSCLC and Li-Fraumeni Syndrome. J Thorac Oncol 2020; 15:1232-1239. [PMID: 32179180 DOI: 10.1016/j.jtho.2020.03.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Actionable somatic molecular alterations are found in 15% to 20% of NSCLC in Europe. NSCLC is a tumor observed in patients with germline TP53 variants causing Li-Fraumeni syndrome (LFS), but its somatic molecular profile is unknown. METHODS Retrospective study of clinical and molecular profiles of patients with NSCLC and germline TP53 variants. RESULTS Among 22 patients with NSCLC and LFS (n = 23 lung tumors), 64% were women, median age was 51 years, 84% were nonsmokers, 73% had adenocarcinoma histological subtype, and 84% were diagnosed with advanced-stage disease. These patients harbored 16 distinct germline TP53 variants; the most common was p.R158H (5/22; three in the same family). Personal and family histories of cancer were reported in 71% and 90% of patients, respectively. In most cases (87%, 13/15), lung cancer was diagnosed with a late onset. Of the 21 tumors analyzed, somatic oncogenic driver mutations were found in 19 of 21 (90%), EGFR mutations in 18 (exon 19 deletion in 12 cases, L858R in three cases, and G719A, exon 20 insertion, and missing mutation subtype, each with one case), and ROS1 fusion in one case. A PI3KCA mutation was concurrently detected at diagnosis in three EGFR exon 19-deleted tumors (3/12). The median overall survival was 37.3 months in 14 patients treated with EGFR inhibitors; seven developed resistance, five (71%) acquired EGFR-T790M mutation, and one had SCLC transformation. CONCLUSIONS Driver oncogenic alterations were observed in 90% of the LFS tumors, mainly EGFR mutations; one ROS1 fusion was also observed. The germline TP53 variants and lung cancer carcinogenesis driven by oncogenic processes need further evaluation.
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Affiliation(s)
- Laura Mezquita
- Thoracic Oncology Group, Cancer Medicine Department, Gustave Roussy, Villejuif, France; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Medical Oncology Department, Hospital Clínic, Barcelona, Spain
| | - Maria Jové
- Medical Oncology Department, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ernest Nadal
- Medical Oncology Department, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Maria Kfoury
- Thoracic Oncology Group, Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology-Badalona (ICO-Badalona), Institut Germans Trias i Pujol (IGTP), Badalona Applied Research Group in Oncology (B-ARGO), Universitat Autònoma de Barcelona (UAB), Medicine Department, Badalona, Spain
| | - Charles Ricordel
- Department of Respiratory Medicine, Pontchaillou Hospital, Rennes, France; University of Rennes, Rennes, France; Chemistry, Oncogenesis, and Stress Signaling, INSERM, Centre Eugène Marquis, Rennes, France
| | - Marion Dhooge
- Gastroenterology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Camille Tlemsani
- Medical Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France
| | - Hervé Léna
- Department of Respiratory Medicine, Pontchaillou Hospital, Rennes, France; University of Rennes, Rennes, France; Chemistry, Oncogenesis, and Stress Signaling, INSERM, Centre Eugène Marquis, Rennes, France
| | - Alex Teulé
- Medical Oncology Department, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jose-Valero Álvarez
- Medical Oncology Department, Complejo Hospitalario de Zamora, Hospital Provincial, Zamora, Spain
| | - Judith Raimbourg
- Medical Oncology Department, Institute de Cancerologie de l'Ouest, Nantes, France
| | - Sandrine Hiret
- Medical Oncology Department, Institute de Cancerologie de l'Ouest, Nantes, France
| | - Ludovic Lacroix
- Medical Biology and Pathology Department, Translational Research Laboratory and BioBank, Gustave Roussy, Villejuif, France
| | - Mireia Menéndez
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL-CIBERONC), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juana Saldaña
- Medical Oncology Department, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Brunet
- Medical Oncology Department, Catalan Institute of Oncology-Badalona (ICO-Badalona), Institut Germans Trias i Pujol (IGTP), Badalona Applied Research Group in Oncology (B-ARGO), Universitat Autònoma de Barcelona (UAB), Medicine Department, Badalona, Spain
| | - Pilar Lianes
- Medical Oncology Department, Hospital de Mataró, Mataró, Spain
| | - Isabelle Coupier
- Clinical Genetic Unit, Montpeiller Cancer Institut, CHU Montpellier, Montpeiller, France
| | - Edouard Auclin
- Gastrointestinal and Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France
| | - Gonzalo Recondo
- INSERM, Gustave Roussy Cancer Campus, Université Paris Saclay, Saint-Aubin, France
| | - Luc Friboulet
- INSERM, Gustave Roussy Cancer Campus, Université Paris Saclay, Saint-Aubin, France
| | - Julien Adam
- Pathology Department, Gustave Roussy, Villejuif, France
| | | | - David Planchard
- Thoracic Oncology Group, Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Thierry Frébourg
- Normandie Univ, UNIROUEN, INSERM, and Rouen University Hospital, Department of Genetics, Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Gabriel Capellà
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL-CIBERONC), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Etienne Rouleau
- Medical Biology and Pathology Department, Translational Research Laboratory and BioBank, Gustave Roussy, Villejuif, France
| | - Conxi Lázaro
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL-CIBERONC), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olivier Caron
- Clinical Genetic Unit, Cancer Medicine Department, Gustave Roussy, Villejuif, France.
| | - Benjamin Besse
- Thoracic Oncology Group, Cancer Medicine Department, Gustave Roussy, Villejuif, France; INSERM, Gustave Roussy Cancer Campus, Université Paris Saclay, Saint-Aubin, France
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Amrane K, Geier M, Corre R, Léna H, Léveiller G, Gadby F, Lamy R, Bizec JL, Goarant E, Robinet G, Gouva S, Quere G, Abgral R, Schick U, Bernier C, Chouaid C, Descourt R. First-line pembrolizumab for non-small cell lung cancer patients with PD-L1 ≥50% in a multicenter real-life cohort: The PEMBREIZH study. Cancer Med 2020; 9:2309-2316. [PMID: 32022459 PMCID: PMC7131849 DOI: 10.1002/cam4.2806] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
Background The KEYNOTE‐024 trial demonstrated that pembrolizumab, a PD‐1 inhibitor, significantly improves progression‐free survival (PFS) and overall survival (OS) in selected patients with previously untreated advanced non–small cell lung cancer (NSCLC) with a PD‐L1 tumor proportion score (TPS) ≥50% and without EGFR/ALK aberrations. The main aim of this study was to report the efficacy and safety profile of pembrolizumab in real‐life conditions. Method This was a French retrospective multicenter longitudinal study of 108 consecutive patients with advanced NSCLC, a PD‐L1 TPS ≥50% and without EGFR/ALK aberrations who were treated by pembrolizumab, in first line. Patient data were obtained from medical files. Results The main characteristics of the cohort were: median age [range] 66.7 [37‐87] years, 64.8% male, 23.1% with a performance status (PS) of 2, and 88.9% current or former smokers. Eighty‐seven percent had stage IV NSCLC at diagnosis, 9.2% untreated brain metastases at inclusion,. With a median follow‐up of 8.2 months, the median PFS was 10.1 months (95% CI, 8.8‐11.4). The objective response rate was 57.3% (complete response 2.7%, partial response 54.6%). Disease control rate was 71.1%. At 6 months, the OS rate estimated was 86.2%. Treatment‐related adverse events (AE) of grade 3 occurred in 8% of patients. There were no grade 4 or 5 AEs. Conclusion In a real‐life cohort of advanced NSCLC patients (including PS 2 and untreated brain metastases), with PD‐L1 TPS ≥50%, pembrolizumab demonstrates similar PFS to the pivotal clinical trial.
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Affiliation(s)
| | | | - Romain Corre
- Pulmonology Department, CHU Hôpital Ponchaillou, Rennes, France
| | - Hervé Léna
- Pulmonology Department, CHU Hôpital Ponchaillou, Rennes, France
| | | | - Florence Gadby
- Pulmonology Department, CH des Pays Morlaix, Morlaix, France
| | - Régine Lamy
- Oncology Department, CH Bretagne Sud, Lorient, France
| | | | - Eric Goarant
- Pulmonology Department, CH Saint-Malo, Saint Malo, France
| | | | | | | | - Ronan Abgral
- Nuclear Medicine Department, CHRU Brest, Brest, France
| | | | - Cyril Bernier
- Pulmonology Department, CH René Pleven, Dinan, France
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Vergnenegre A, Monnet I, Bizieux A, Bernardi M, Chiapa AM, Léna H, Chouaïd C, Robinet G. Open-label Phase II trial to evaluate safety and efficacy of second-line metronomic oral vinorelbine-atezolizumab combination for stage-IV non-small-cell lung cancer - VinMetAtezo trial, (GFPC ‡ 04-2017). Future Oncol 2020; 16:5-10. [PMID: 31894704 DOI: 10.2217/fon-2019-0730] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Metronomic chemotherapy is defined as frequent low-dose administration without prolonged drug-free breaks. Combining immune-checkpoint inhibitors and metronomic chemotherapy is a new approach to improve responses and delay onset of resistance to immune-checkpoint inhibitors. This multicenter, Phase II, open-label, single-arm study was designed to assess the safety and efficacy of metronomic oral vinorelbine in combination with immune-checkpoint inhibitors in advanced non-small-cell lung cancers progressing after first-line platinum-based chemotherapy. The recommended metronomic oral vinorelbine dose will be determined during a safety run-in period including 12 patients; the main study will include 59 additional patients. The primary outcome is progression-free survival at 4 months. Secondary outcomes are safety of the combination, median overall survival, objective response rate, disease-control rate at 4 months and quality of life (NCT03801304).
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Affiliation(s)
| | - Isabelle Monnet
- Department of Pneumology, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Acya Bizieux
- Department of Pneumology, Centre Hospitalier Départemental Vendée, La Roche-sur-Yon, France
| | - Marie Bernardi
- Department of Pneumology, Centre Hospitalier Aix-en-Provence, Aix-en-Provence, France
| | - Anne Marie Chiapa
- Department of Pneumology, Centre Hospitalier Quimper, Quimper, France
| | - Hervé Léna
- Department of Pneumology, Centre Hospitalier Quimper, Quimper, France
| | - Christos Chouaïd
- Department of Pneumology, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Gilles Robinet
- Department of Pneumology, Centre Hospitalier Universitaire Brest, Brest France
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10
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Couraud S, Barlesi F, Fontaine-Deraluelle C, Debieuvre D, Merlio JP, Moreau L, Beau-Faller M, Veillon R, Mosser J, Al Freijat F, Bringuier PP, Léna H, Ouafik L, Westeel V, Morel A, Audigier-Valette C, Missy P, Langlais A, Morin F, Souquet PJ, Planchard D. Clinical outcomes of non-small-cell lung cancer patients with BRAF mutations: results from the French Cooperative Thoracic Intergroup biomarkers France study. Eur J Cancer 2019; 116:86-97. [PMID: 31181537 DOI: 10.1016/j.ejca.2019.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/17/2019] [Accepted: 04/10/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Patients with stage IV non-small-cell lung cancer (NSCLC) and BRAF V600 mutations may benefit from targeted therapies. Chemotherapy outcomes are little known in this population. METHODS The French Cooperative Thoracic Intergroup (IFCT) Biomarkers France study was a national prospective cohort study aiming to describe the molecular characteristics and clinical outcome of all consecutive NSCLC patients (N = 17,664) screened for molecular alterations. We used this data set to set up a case-control analysis. Cases had stage IV BRAF-mutated (BRAF-MT) NSCLC, whereas controls had NSCLC that was wild-type for EGFR, KRAS, HER2, BRAF, PIK3CA and ALK. Each case was matched for sex, age at diagnosis and smoking status to two controls randomly selected. RESULTS Overall, 83 cases with BRAF mutant disease (66.3% V600E) were matched to 166 controls. Five cases received tyrosine kinase inhibition in the first-line and 16 in the second-line. All others were treated with standard chemotherapy. There was no significant difference in first-line and second-line progression-free survival (PFS) between the groups, as well as in the disease control rate, BRAF mutation was not found to be prognostic of overall survival. We found no significant difference in outcome between the treatment types used in first-line or second-line in patients with BRAF-MT disease compared with controls nor between BRAF V600E or non-V600E compared with controls. CONCLUSIONS BRAF mutation is not a strong prognostic factor in NSCLC. Although taxan-based therapy shows poorest PFS in first-line, no chemotherapy regimen was associated with prognosis.
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Affiliation(s)
- Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France; EMR3738 Ciblage Thérapeutique en Oncologie, Programme CIRCAN (CIRculating CANcer), Faculté de Médecine et de Maïeutique Lyon Sud - Charles Mérieux, Université Lyon 1, Université de Lyon, Oullins, France
| | - Fabrice Barlesi
- Aix Marseille University, Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR1068, CNRS UMR7258, Marseille France; Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology & Therapeutic Innovations Dpt, Marseille, France
| | - Clara Fontaine-Deraluelle
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Didier Debieuvre
- Chest Department, Hôpital Emile Muller - GHRMSA, Mulhouse, France
| | - Jean-Philippe Merlio
- CHU and University Bordeaux, Hôpital Haut-Lévêque, Department of Pathology and Tumor Biology, Pessac, France
| | - Lionel Moreau
- Service de Pneumologie, Hôpital Louis Pasteur, Hôpitaux Civils de Colmar, Colmar, France
| | - Michèle Beau-Faller
- Laboratoire de Biochimie et de Biologie Moléculaire, Hôpitaux Universitaires de Strasbourg, Plate-forme de Génomique des Cancers d'Alsace, Laboratoire d'Onco-biologie, Institut Régional du Cancer d'Alsace, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; INSERM IRFAC UMR-S1113, Université de Strasbourg, Strasbourg, France
| | - Rémi Veillon
- Service des Maladies Respiratoires, CHU Bordeaux, Hôpital du Haut Lévêque, Pessac, France
| | - Jean Mosser
- Centre Hospitalier Universitaire de Rennes, Département de Génomique et Génétique Moléculaire, Rennes, France
| | - Faraj Al Freijat
- Centre Hospitalier de Belfort-Montbéliard, Service de Pneumologie, Belfort, France
| | - Pierre-Paul Bringuier
- Department of Biology and Pathology, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Hervé Léna
- Hôpital Pontchaillou, Service de Pneumologie, Centre Hospitalier Universitaire, Rennes, France
| | - L'Houcine Ouafik
- Aix Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, Marseille, France; Faculté de Médecine Secteur Nord, Service de Transfert d'Oncologie Biologique, Marseille, France
| | - Virginie Westeel
- Service de Pneumologie, Centre Hospitalier Régional Universitaire de Besançon, Hôpital Jean Minjoz, Besançon, France
| | - Alain Morel
- CRCINA, INSERM, Université d'Angers et Institut de Cancérologie de l'Ouest, Nantes Angers, France
| | | | - Pascale Missy
- French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | | | - Franck Morin
- French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | - Pierre-Jean Souquet
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - David Planchard
- Department of Medical Oncology, Thoracic Unit, Gustave Roussy, Villejuif, France.
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Eberst G, Anota A, Scherpereel A, Mazieres J, Margery J, Greillier L, Audigier-Valette C, Moro-Sibilot D, Molinier O, Léna H, Rivière F, Monnet I, Gounant V, Janicot H, Gervais R, Locher C, Charton E, Morin F, Zalcman G, Westeel V. Health-Related Quality of Life Impact from Adding Bevacizumab to Cisplatin-Pemetrexed in Malignant Pleural Mesothelioma in the MAPS IFCT-GFPC-0701 Phase III Trial. Clin Cancer Res 2019; 25:5759-5765. [DOI: 10.1158/1078-0432.ccr-18-2860] [Citation(s) in RCA: 10] [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] [Received: 11/06/2018] [Revised: 03/18/2019] [Accepted: 06/04/2019] [Indexed: 11/16/2022]
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12
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Lescure C, Lescoat A, Salé A, Bazin Y, Duvergé L, Desrues B, Léna H. Systemic Capillary Leak Syndrome (Clarkson’s Disease) as a Complication of Anti–Programmed Death 1 Immunotherapy. J Thorac Oncol 2019; 14:e131-e132. [DOI: 10.1016/j.jtho.2019.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/02/2019] [Accepted: 02/02/2019] [Indexed: 10/26/2022]
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13
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Loubière S, Drezet A, Beau-Faller M, Moro-Sibilot D, Friard S, Wislez M, Blons H, Daniel C, Westeel V, Madroszyk A, Léna H, Merle P, Mazières J, Zalcman G, Lacave R, Antoine M, Morin F, Missy P, Barlesi F, Auquier P, Cadranel J. Cost-effectiveness of KRAS, EGFR and ALK testing for decision making in advanced nonsmall cell lung carcinoma: the French IFCT-PREDICT.amm study. Eur Respir J 2018; 51:13993003.01467-2017. [DOI: 10.1183/13993003.01467-2017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 01/31/2018] [Indexed: 11/05/2022]
Abstract
ALK rearrangement and EGFR/KRAS mutations constitute the primary biomarkers tested to provide targeted or nontargeted therapies in advanced nonsmall cell lung cancer (NSCLC) patients. Our objective was to assess the cost-effectiveness of biomarker testing for NSCLC.Between 2013 and 2014, 843 treatment-naive patients were prospectively recruited at 19 French hospitals into a longitudinal observational cohort study. Two testing strategies were compared, i.e. with “at least one biomarker status known” and “at least KRAS status known”, in addition to “no biomarker testing” as the reference strategy. The Kaplan–Meier approach was employed to assess restricted mean survival time. Direct medical costs incurred by hospitals were estimated with regard to treatment, inpatient care and biomarker testing.Compared with “no biomarker testing”, the “at least one biomarker status known” strategy yielded an incremental cost-effectiveness ratio of EUR13 230 per life-year saved, which decreased to EUR7444 per life-year saved with the “at least KRAS status known” testing strategy. In sensitivity analyses, biomarker testing strategies were less costly and more effective in 41% of iterations.In summary, molecular testing prior to treatment initiation proves to be cost-effective in advanced NSCLC management and may assist decision makers in defining conditions for further implementation of these innovations in general practice.
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Wislez M, Beau-Faller M, Debieuvre D, Ouafik L, Westeel V, Rouquette I, Mazières J, Bringier P, Monnet I, Escande F, Léna H, Merlio J, Jeanicot H, Lemoine A, Foucher P, Poudenx M, Missy P, Langlais A, Souquet P, Barlesi F. Détermination de la valeur pronostique et prédictive de K-RAS à partir de la cohorte de CBNPC Biomarqueurs France. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.230] [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]
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Ferolla P, Brizzi MP, Meyer T, Mansoor W, Mazieres J, Do Cao C, Léna H, Berruti A, Damiano V, Buikhuisen W, Grønbæk H, Lombard-Bohas C, Grohé C, Minotti V, Tiseo M, De Castro J, Reed N, Gislimberti G, Singh N, Stankovic M, Öberg K, Baudin E. Efficacy and safety of long-acting pasireotide or everolimus alone or in combination in patients with advanced carcinoids of the lung and thymus (LUNA): an open-label, multicentre, randomised, phase 2 trial. Lancet Oncol 2017; 18:1652-1664. [PMID: 29074099 DOI: 10.1016/s1470-2045(17)30681-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/07/2017] [Accepted: 08/10/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND There are no data from prospective studies focused exclusively on patients with advanced lung and thymic carcinoids. We aimed to assess the efficacy and safety of long-acting pasireotide and everolimus, administered alone or in combination, in patients with advanced carcinoids of the lung or thymus. METHODS LUNA was a prospective, multicentre, randomised, open-label, phase 2 trial of adult patients (aged >18 years) with advanced (unresectable or metastatic), well differentiated carcinoid tumours of the lung or thymus, with radiological progression within 12 months before randomisation, and a WHO performance status of 0-2. At each centre, the investigator or their designee registered each patient using an interactive voice recognition system into one of the three treatment groups. The randomisation allocation sequence was generated by an external company; patients were randomly assigned (1:1:1) to receive treatment with long-acting pasireotide (60 mg intramuscularly every 28 days), everolimus (10 mg orally once daily), or both in combination, for the core 12-month treatment period. Patients were stratified by carcinoid type (typical vs atypical) and line of study treatment (first line vs others). The primary endpoint was the proportion of patients progression-free at month 9, defined as the proportion of patients with overall lesion assessment at month 9 showing a complete response, partial response, or stable disease according to local Response Evaluation Criteria in Solid Tumors, version 1.1, assessed in the intention-to-treat population. Safety was assessed in all patients who received at least one dose of study drug and had at least one post-baseline safety assessment. The trial is registered with ClinicalTrials.gov, number NCT01563354. The extension phase of the study is ongoing. FINDINGS Between Aug 16, 2013, and Sept 30, 2014, 124 patients were enrolled from 36 centres in nine countries: 41 were allocated to the long-acting pasireotide group, 42 to the everolimus group, and 41 to the combination group. At month 9, the proportion of patients with an overall lesion assessment of complete response, partial response, or stable disease was 16 of 41 patients (39·0%, 95% CI 24·2-55·5) in the long-acting pasireotide group, 14 of 42 patients (33·3%, 19·6-49·5) in the everolimus group, and 24 of 41 patients (58·5%, 42·1-73·7) in the combination group. The most common grade 1-2 adverse events with a suspected association with long-acting pasireotide monotherapy were diarrhoea (15 [37%] of 41), hyperglycaemia (17 [41%]), and weight loss (8 [20%]); those with a suspected association with everolimus monotherapy were stomatitis (26 [62%] of 42) and diarrhoea (16 [38%]); and those suspected to be associated with combination treatment were hyperglycaemia (27 [66%] of 41]), diarrhoea (19 [46%]), and asthenia (8 [20%]). The most common grade 3-4 adverse events with a suspected association with long-acting pasireotide monotherapy were γ-glutamyltransferase increased (four [10%] of 41 patients), diarrhoea (three [7%]), and hyperglycaemia (three [7%]); those for everolimus were hyperglycaemia (seven [17%] of 42 patients), stomatitis (four [10%]), and diarrhoea (three [7%]); those for combination treatment were hyperglycaemia (nine [22%] of 41 patients) and diarrhoea (four [10%]). 11 patients died during the core 12-month treatment phase or up to 56 days after the last study treatment exposure date: two (5%) of 41 in the long-acting pasireotide group, six (14%) of 42 in the everolimus group, and three (7%) of 41 in the combination group. No deaths were suspected to be related to long-acting pasireotide treatment. One death in the everolimus group (acute kidney injury associated with diarrhoea), and two deaths in the combination group (diarrhoea and urinary sepsis in one patient, and acute renal failure and respiratory failure in one patient) were suspected to be related to everolimus treatment. In the latter patient, acute renal failure was not suspected to be related to everolimus treatment, but respiratory failure was suspected to be related. INTERPRETATION The study met the primary endpoint in all three treatment groups. Safety profiles were consistent with the known safety profiles of these agents. Further studies are needed to confirm the antitumour efficacy of the combination of a somatostatin analogue with everolimus in lung and thymic carcinoids. FUNDING Novartis Pharma AG.
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Affiliation(s)
- Piero Ferolla
- Department of Medical Oncology, Multidisciplinary NET Group, Umbria Regional Cancer Network and University of Perugia, Perugia, Italy.
| | | | - Tim Meyer
- Department of Medical Oncology, Royal Free Hospital and University College London, London, UK
| | - Wasat Mansoor
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Julien Mazieres
- Pneumologie, CHU Toulouse, Université Paul Sabatier, Toulouse, France
| | | | - Hervé Léna
- Pneumologie, Centre Hospitalier Universitaire, Rennes, France
| | | | - Vincenzo Damiano
- Molecular Cancer Therapy, University of Naples Federico II, Naples, Italy
| | - Wieneke Buikhuisen
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Henning Grønbæk
- Department of Hepatology & Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Christian Grohé
- Evangelische Lungenklinik Berlin, Thoracic Oncology, Berlin, Germany
| | - Vincenzo Minotti
- Department of Medical Oncology, SM Misericordia Hospital, Perugia, Italy
| | - Marcello Tiseo
- Medical Oncology, University Hospital of Parma, Parma, Italy
| | | | - Nicholas Reed
- Clinical Oncology, Gartnavel General Hospital, Glasgow, UK
| | | | - Neha Singh
- Cognizant Technology Solutions, Mumbai, India
| | | | - Kjell Öberg
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Eric Baudin
- Endocrine Oncology and Nuclear Medicine, Institut Gustave Roussy, Villejuif, France
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Dugay F, Llamas-Gutierrez F, Gournay M, Medane S, Mazet F, Chiforeanu DC, Becker E, Lamy R, Léna H, Rioux-Leclercq N, Belaud-Rotureau MA, Cabillic F. Clinicopathological characteristics of ROS1- and RET-rearranged NSCLC in caucasian patients: Data from a cohort of 713 non-squamous NSCLC lacking KRAS/EGFR/HER2/BRAF/PIK3CA/ALK alterations. Oncotarget 2017; 8:53336-53351. [PMID: 28881815 PMCID: PMC5581114 DOI: 10.18632/oncotarget.18408] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/13/2017] [Indexed: 01/16/2023] Open
Abstract
Targeted therapies have substantially changed the management of non-small cell lung cancer (NSCLC) patients with driver oncogenes. Given the high frequency, EGFR and ALK aberrations were the first to be detected and paved the way for tyrosine kinase inhibitor (TKI) treatments. Other kinases such as ROS1 and more recently RET have emerged as promising targets, and ROS1 and RET TKIs are already available for precision medicine. We screened a large cohort of 713 Caucasian non-squamous NSCLC patients lacking EGFR/KRAS/BRAF/HER2/PI3KCA/ALK aberrations for ROS1 and RET rearrangements using fluorescence in situ hybridization to determine the frequency and clinicopathological characteristics of ROS1- and RET-positive patients. Frequencies of ROS1 and RET rearrangements were 2.1% and 2.52%, respectively. Contrary to common belief, both ROS1 and RET rearrangements were detected in patients with a history of smoking, and the RET-positive patients were not younger than the negative patients. Moreover, RET but not ROS1 rearrangement was associated with the female gender. Nearly half of the ROS1-rearranged patients were successfully treated with ROS1 TKIs. In contrast, only 5/18 RET-positive patients received off-label RET TKIs. Two patients had stable disease, and three experienced disease progression. In addition to the 18 RET-positive cases, 10 showed isolated 5' signals. The clinical relevance is unknown but if the frequency is confirmed by other groups, the question whether these patients are eligible to TKIs will arise. More potent RET TKIs are under development and may improve the response rate in RET-positive patients. Therefore, we recommend the routine implementation of RET testing in non-squamous NSCLC patients, including those with a history of smoking.
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Affiliation(s)
- Frédéric Dugay
- Department of Cytogenetics and Cell Biology, CHU de Rennes, Rennes, France.,IRSET UMR INSERM 1085, Faculté de Médecine, Université de Rennes 1, Rennes, France
| | | | - Marjory Gournay
- Department of Cytogenetics and Cell Biology, CHU de Rennes, Rennes, France
| | - Sarah Medane
- Department of Cytogenetics and Cell Biology, CHU de Rennes, Rennes, France
| | - François Mazet
- Department of Cytogenetics and Cell Biology, CHU de Rennes, Rennes, France
| | | | - Emmanuelle Becker
- IRSET UMR INSERM 1085, Faculté de Médecine, Université de Rennes 1, Rennes, France
| | - Régine Lamy
- Department of Pneumology, CHU de Lorient, Lorient, France
| | - Hervé Léna
- Department of Pneumology, CHU de Rennes, Rennes, France
| | - Nathalie Rioux-Leclercq
- IRSET UMR INSERM 1085, Faculté de Médecine, Université de Rennes 1, Rennes, France.,Department of Pathology, CHU de Rennes, Rennes, France
| | - Marc-Antoine Belaud-Rotureau
- Department of Cytogenetics and Cell Biology, CHU de Rennes, Rennes, France.,IRSET UMR INSERM 1085, Faculté de Médecine, Université de Rennes 1, Rennes, France
| | - Florian Cabillic
- Department of Cytogenetics and Cell Biology, CHU de Rennes, Rennes, France.,INSERM, INRA, Université de Rennes 1, Université Bretagne Loire, Nutrition Metabolisms and Cancer, Rennes, France
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Guibert N, Barlesi F, Descourt R, Léna H, Besse B, Beau-Faller M, Mosser J, Pichon E, Merlio JP, Ouafik L, Guichard F, Mastroianni B, Moreau L, Wdowik A, Sabourin JC, Lemoine A, Missy P, Langlais A, Moro-Sibilot D, Mazières J. Characteristics and Outcomes of Patients with Lung Cancer Harboring Multiple Molecular Alterations: Results from the IFCT Study Biomarkers France. J Thorac Oncol 2017; 12:963-973. [DOI: 10.1016/j.jtho.2017.02.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/14/2017] [Accepted: 02/02/2017] [Indexed: 01/24/2023]
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Basse C, Thureau S, Bota S, Dansin E, Thomas PA, Pichon E, Léna H, Massabeau C, Clément-Duchêne C, Massard G, Westeel V, Thillays F, Quantin X, Oulkhouir Y, Danhier S, Lerouge D, Thiberville L, Besse B, Girard N. OA18.01 Postoperative Radiotherapy in Thymic Epithelial Tumors: Insights from the RYTHMIC Prospective Cohort. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.331] [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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Guibert N, Barlesi F, Descourt R, Léna H, Besse B, Beau-Faller M, Mosser J, Pichon E, Merlio JP, Ouafik L, Guichard F, Mastroianni B, Moreau L, Wdowik A, Sabourin JC, Lemoine A, Missy P, Langlais A, Moro-Sibilot D, Mazieres J. OA10.06 Characteristics and Outcomes of Patients with Lung Cancer Harboring Multiple Molecular Alterations (Biomarker IFCT Study). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.286] [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]
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Garassino M, Vansteenkiste J, Kim JH, Léna H, Mazières J, Powderly J, Dennis P, Huang Y, Wadsworth C, Rizvi N. PL04a.03: Durvalumab in ≥3rd-Line Locally Advanced or Metastatic, EGFR/ALK Wild-Type NSCLC: Results from the Phase 2 ATLANTIC Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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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Du Vignaux CM, Bluthgen M, Mhanna L, Dansin E, Greillier L, Pichon E, Léna H, Clément-Duchêne C, Massard G, Westeel V, Robert M, Quantin X, Zalcman G, Thiberville L, Molina T, Mazieres J, Besse B, Girard N. P2.04-003 Chemotherapy in Advanced Thymic Epithelial Tumors: Insights from the RYTHMIC Prospective Cohort. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1383] [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]
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Bluthgen M, Dansin E, Ou D, Léna H, Mazieres J, Pichon E, Thillays F, Massard G, Quantin X, Oulkhouir Y, Nguyen T, Thiberville L, Clément-Duchêne C, Lindsay C, Missy P, Molina T, Girard N, Besse B, Thomas PA. OA18.07 Quality of Resection and Outcome in Stage III TETs: The French RYTHMIC Network Experience. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.336] [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]
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Cadranel J, Quoix E, Duruisseaux M, Friard S, Wislez M, Daniel C, Fabre E, Madroszyk A, Westeel V, Merle P, Léna H, Dansin E, Mazieres J, Scherpereel A, Hiret S, Kaderbhai C, Souquet PJ, Missy P, Langlais A, Morin F, Zalcman G, Moro-Sibilot D, Barlesi F. Impact pronostique du choix de la première ligne thérapeutique et de la connaissance des résultats des biomarqueurs chez les malades atteints de cancers bronchiques non à petites cellules (CBNPC) étendus en France : résultats de l’étude IFCT PREDICT.amm. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Guibert N, Barlesi F, Descourt R, Léna H, Besse B, Beau-Faller M, Mosser J, Pichon E, Merlio JP, Ouafik L, Guichard F, Mastroianni B, Moreau L, Wdowik A, Sabourin JC, Lemoine A, Missy P, Langlais A, Moro-Sibilot D, Mazières J. Caractéristiques et réponses aux traitements des patients porteurs de cancers du poumon non à petites cellules (CBNPC) avec altérations moléculaires multiples : analyse de l’étude Biomarqueurs France (IFCT). Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.018] [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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Affiliation(s)
- Romain Corre
- Romain Corre, Hervé Léna, Centre Hospitalier Universitaire Pontchaillou de Rennes; and Institut National de la Santé et de la Recherche Médicale, Centre de Lutte Contre le Cancer Eugene Marquis, Rennes, France; Alain Vergnenègre, Centre Hospitalier Universitaire du Cluzeau de Limoges, Limoges, France; and Christos Chouaïd, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Hervé Léna
- Romain Corre, Hervé Léna, Centre Hospitalier Universitaire Pontchaillou de Rennes; and Institut National de la Santé et de la Recherche Médicale, Centre de Lutte Contre le Cancer Eugene Marquis, Rennes, France; Alain Vergnenègre, Centre Hospitalier Universitaire du Cluzeau de Limoges, Limoges, France; and Christos Chouaïd, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Alain Vergnenègre
- Romain Corre, Hervé Léna, Centre Hospitalier Universitaire Pontchaillou de Rennes; and Institut National de la Santé et de la Recherche Médicale, Centre de Lutte Contre le Cancer Eugene Marquis, Rennes, France; Alain Vergnenègre, Centre Hospitalier Universitaire du Cluzeau de Limoges, Limoges, France; and Christos Chouaïd, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Christos Chouaïd
- Romain Corre, Hervé Léna, Centre Hospitalier Universitaire Pontchaillou de Rennes; and Institut National de la Santé et de la Recherche Médicale, Centre de Lutte Contre le Cancer Eugene Marquis, Rennes, France; Alain Vergnenègre, Centre Hospitalier Universitaire du Cluzeau de Limoges, Limoges, France; and Christos Chouaïd, Centre Hospitalier Intercommunal de Creteil, Creteil, France
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Corre R, Greillier L, Le Caër H, Audigier-Valette C, Baize N, Bérard H, Falchero L, Monnet I, Dansin E, Vergnenègre A, Marcq M, Decroisette C, Auliac JB, Bota S, Lamy R, Massuti B, Dujon C, Pérol M, Daurès JP, Descourt R, Léna H, Plassot C, Chouaïd C. Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study. J Clin Oncol 2016; 34:1476-83. [DOI: 10.1200/jco.2015.63.5839] [Citation(s) in RCA: 278] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Comprehensive geriatric assessment (CGA) is recommended to assess the vulnerability of elderly patients, but its integration in cancer treatment decision making has never been prospectively evaluated. Here, in elderly patients with advanced non–small-cell lung cancer (NSCLC), we compared a standard strategy of chemotherapy allocation on the basis of performance status (PS) and age with an experimental strategy on the basis of CGA. Patients and Methods In a multicenter, open-label, phase III trial, elderly patients ≥ 70 years old with a PS of 0 to 2 and stage IV NSCLC were randomly assigned between chemotherapy allocation on the basis of PS and age (standard arm: carboplatin-based doublet if PS ≤ 1 and age ≤ 75 years; docetaxel if PS = 2 or age > 75 years) and treatment allocation on the basis of CGA (CGA arm: carboplatin-based doublet for fit patients, docetaxel for vulnerable patients, and best supportive care for frail patients). The primary end point was treatment failure free survival (TFFS). Secondary end points were overall survival (OS), progression-free survival, tolerability, and quality of life. Results Four hundred ninety-four patients were randomly assigned (standard arm, n = 251; CGA arm, n = 243). Median age was 77 years. In the standard and CGA arms, 35.1% and 45.7% of patients received a carboplatin-based doublet, 64.9% and 31.3% received docetaxel, and 0% and 23.0% received best supportive care, respectively. In the standard and CGA arms, median TFFS times were 3.2 and 3.1 months, respectively (hazard ratio, 0.91; 95% CI, 0.76 to 1.1), and median OS times were 6.4 and 6.1 months, respectively (hazard ratio, 0.92; 95% CI, 0.79 to 1.1). Patients in the CGA arm, compared with standard arm patients, experienced significantly less all grade toxicity (85.6% v 93.4%, respectively P = .015) and fewer treatment failures as a result of toxicity (4.8% v 11.8%, respectively; P = .007). Conclusion In elderly patients with advanced NSCLC, treatment allocation on the basis of CGA failed to improve the TFFS or OS but slightly reduced treatment toxicity.
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Affiliation(s)
- Romain Corre
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Laurent Greillier
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Hervé Le Caër
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Clarisse Audigier-Valette
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Nathalie Baize
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Henri Bérard
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Lionel Falchero
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Isabelle Monnet
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Eric Dansin
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Alain Vergnenègre
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Marie Marcq
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Chantal Decroisette
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Jean-Bernard Auliac
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Suzanna Bota
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Régine Lamy
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Bartomeu Massuti
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Cécile Dujon
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Maurice Pérol
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Jean-Pierre Daurès
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Renaud Descourt
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Hervé Léna
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Carine Plassot
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
| | - Christos Chouaïd
- Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos
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Fourrier A, Ricordel C, Lespagnol A, Llamas Gutierrez F, Lederlin M, Mosser J, Léna H, Desrues B. Analyse des différentes méthodes diagnostiques dans le cancer bronchique non à petites cellules métastatiques et de leur rendement dans l’étude histologique et en biologie moléculaire. Recherche de facteurs prédictifs d’échec. Étude rétrospective, monocentrique, portant sur les patients de 2012 et 2013. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.177] [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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Cadranel J, Quoix E, Duruisseaux M, Friard S, Fabre E, Daniel C, Westeel V, Madroszyk A, Léna H, Merle P, Mazières J, Dansin E, Scherpereel A, Hiret S, Coudert B, Souquet P, Wislez M, Morin F, Zalcman G, Barlesi F, Missy P. Valeur pronostique du statut moléculaire de KRAS, EGFR et ALK dans la cohorte prospective IFCT-PREDICT.amm de carcinomes bronchiques non à petites cellules (CBNPC) étendus, non préalablement traités. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.049] [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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Ricordel C, Lespagnol A, Kerjouan M, Fievet A, De Tayrac M, Aliouat A, Hamdi H, Mosser J, Léna H. Mutation du gène DDR2 dans les carcinomes épidermoïdes bronchiques primitifs : analyse d’une cohorte rétrospective monocentrique. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.678] [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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Guibert N, Ilie M, Léna H, Didier A, Hofman P, Mazieres J. [KRAS and bronchial adenocarcinoma. Between disappointments and hopes]. Rev Mal Respir 2015; 33:156-64. [PMID: 26520779 DOI: 10.1016/j.rmr.2015.05.012] [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: 01/28/2015] [Accepted: 05/05/2015] [Indexed: 12/20/2022]
Abstract
A better understanding of oncogenesis and the development of targeted therapies have led to improved outcomes in the treatment of lung cancer. KRAS mutation has the potential to drive the oncogenesis of almost one third of lung adenocarcinomas but it leads to a highly complex proliferation signal involving multiple signaling pathways, explaining the disappointing results of various inhibition strategies of K-ras or its effectors. Nevertheless, recent data suggest different roles of distinct KRAS mutation subtypes and KRAS interactions with new genes in the field of synthetic lethality mechanisms open the way to new therapeutic possibilities. This review aims to provide an overview of: 1) epidemiological data and particularly the prognostic impact of KRAS mutations in non-small cell lung cancer, 2) the results of different drugs either being tested in humans or sources of hope.
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Affiliation(s)
- N Guibert
- Unité d'oncologie cervico-thoracique-clinique des voies respiratoires, service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU de Toulouse, chemin de Pouvourville, 31059 Toulouse cedex, France.
| | - M Ilie
- Laboratoire de pathologie clinique et expérimentale, hôpital Pasteur, 06000 Nice, France
| | - H Léna
- Service de pneumologie, hôpital Pontchaillou, CHU de Rennes, 35000 Rennes, France
| | - A Didier
- Unité d'oncologie cervico-thoracique-clinique des voies respiratoires, service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU de Toulouse, chemin de Pouvourville, 31059 Toulouse cedex, France
| | - P Hofman
- Laboratoire de pathologie clinique et expérimentale, hôpital Pasteur, 06000 Nice, France
| | - J Mazieres
- Unité d'oncologie cervico-thoracique-clinique des voies respiratoires, service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU de Toulouse, chemin de Pouvourville, 31059 Toulouse cedex, France
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Colliaux J, Castelli J, Chajon E, Bellec J, Henry O, Le Prisé E, Léna H, Corre R, De Crevoisier R. EP-1168 Tumor regression on CBCT predicts the risk of recurrence and death in locally advanced non-small cell lung cancer. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41160-0] [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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Mazières J, Zalcman G, Crinò L, Biondani P, Barlesi F, Filleron T, Dingemans AMC, Léna H, Monnet I, Rothschild SI, Cappuzzo F, Besse B, Thiberville L, Rouvière D, Dziadziuszko R, Smit EF, Wolf J, Spirig C, Pecuchet N, Leenders F, Heuckmann JM, Diebold J, Milia JD, Thomas RK, Gautschi O. Crizotinib therapy for advanced lung adenocarcinoma and a ROS1 rearrangement: results from the EUROS1 cohort. J Clin Oncol 2015; 33:992-9. [PMID: 25667280 DOI: 10.1200/jco.2014.58.3302] [Citation(s) in RCA: 265] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Approximately 1% of lung adenocarcinomas are driven by oncogenic ROS1 rearrangement. Crizotinib is a potent inhibitor of both ROS1 and ALK kinase domains. PATIENTS AND METHODS In the absence of a prospective clinical trial in Europe, we conducted a retrospective study in centers that tested for ROS1 rearrangement. Eligible patients had stage IV lung adenocarcinoma, had ROS1 rearrangement according to fluorescent in situ hybridization, and had received crizotinib therapy through an individual off-label use. Best response was assessed locally using RECIST (version 1.1). All other data were analyzed centrally. RESULTS We identified 32 eligible patients. One patient was excluded because next-generation sequencing was negative for ROS1 fusion. Median age was 50.5 years, 64.5% of patients were women, and 67.7% were never-smokers. Thirty patients were evaluable for progression-free survival (PFS), and 29 patients were evaluable for best response. We observed four patients with disease progression, two patients with stable disease, and objective response in 24 patients, including five complete responses (overall response rate, 80%; disease control rate, 86.7%). Median PFS was 9.1 months, and the PFS rate at 12 months was 44%. No unexpected adverse effects were observed. Twenty-six patients received pemetrexed (either alone or in combination with platinum and either before or after crizotinib) and had a response rate of 57.7% and a median PFS of 7.2 months. CONCLUSION Crizotinib was highly active at treating lung cancer in patients with a ROS1 rearrangement, suggesting that patients with lung adenocarcinomas should be tested for ROS1. Prospective clinical trials with crizotinib and other ROS1 inhibitors are ongoing or planned.
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Affiliation(s)
- Julien Mazières
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany.
| | - Gérard Zalcman
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Lucio Crinò
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Pamela Biondani
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Fabrice Barlesi
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Thomas Filleron
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Anne-Marie C Dingemans
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Hervé Léna
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Isabelle Monnet
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Sacha I Rothschild
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Federico Cappuzzo
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Benjamin Besse
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Luc Thiberville
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Damien Rouvière
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Rafal Dziadziuszko
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Egbert F Smit
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Jurgen Wolf
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Christian Spirig
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Nicolas Pecuchet
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Frauke Leenders
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Johannes M Heuckmann
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Joachim Diebold
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Julie D Milia
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Roman K Thomas
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
| | - Oliver Gautschi
- Julien Mazières, Damien Rouvière, and Julie D. Milia, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier; Thomas Filleron, Institut Universitaire du Cancer, Toulouse; Gérard Zalcman, Centre Hospitalier Universitaire, Université de Caen-Basse Normandie, Caen; Pamela Biondani and Benjamin Besse, Gustave Roussy, Villejuif; Fabrice Barlesi, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille; Hervé Léna, Centre Hospitalier Universitaire, Rennes; Isabelle Monnet, Centre Hospitalier Intercommunal de Créteil, Créteil; Luc Thiberville, Centre Hospitalier Universitaire, Rouen; Nicolas Pecuchet, Institut Curie, Paris, France; Lucio Crinò, Medica-Azienda Ospedaliera, Perugia; Federico Cappuzzo, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy; Anne-Marie C. Dingemans, Maastricht University Medical Center, Maastricht; Egbert F. Smit, VU University Medical Center, Amsterdam, the Netherlands; Sacha I. Rothschild, University Hospital Basel, Medical Oncology, Basel; Christian Spirig, Klinik St Anna; Joachim Diebold and Oliver Gautschi, Cantonal Hospital Luzern, Lucerne, Switzerland; Rafal Dziadziuszko, Gdansk Medical University, Gdansk, Poland; Jurgen Wolf and Roman K. Thomas, Center of Integrated Oncology Köln-Bonn, University Hospital Cologne, University of Cologne; Frauke Leenders and Roman K. Thomas, University of Cologne; Johannes M. Heuckmann, Blackfield AG, Cologne, Germany
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Besse B, Le Moulec S, Mazières J, Senellart H, Barlesi F, Chouaid C, Dansin E, Bérard H, Falchero L, Gervais R, Robinet G, Ruppert AM, Schott R, Léna H, Clément-Duchêne C, Quantin X, Souquet PJ, Trédaniel J, Moro-Sibilot D, Pérol M, Madroszyk AC, Soria JC. Bevacizumab in Patients with Nonsquamous Non–Small Cell Lung Cancer and Asymptomatic, Untreated Brain Metastases (BRAIN): A Nonrandomized, Phase II Study. Clin Cancer Res 2015; 21:1896-903. [DOI: 10.1158/1078-0432.ccr-14-2082] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/12/2015] [Indexed: 11/16/2022]
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Letheulle J, Kerjouan M, Bénézit F, De Latour B, Tattevin P, Piau C, Léna H, Desrues B, Le Tulzo Y, Jouneau S. [Parapneumonic pleural effusions: Epidemiology, diagnosis, classification and management]. Rev Mal Respir 2015; 32:344-57. [PMID: 25595878 DOI: 10.1016/j.rmr.2014.12.001] [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: 12/21/2013] [Accepted: 11/13/2014] [Indexed: 10/24/2022]
Abstract
Parapneumonic pleural effusions represent the main cause of pleural infections. Their incidence is constantly increasing. Although by definition they are considered to be a "parapneumonic" phenomenon, the microbial epidemiology of these effusions differs from pneumonia with a higher prevalence of anaerobic bacteria. The first thoracentesis is the most important diagnostic stage because it allows for a distinction between complicated and non-complicated parapneumonic effusions. Only complicated parapneumonic effusions need to be drained. Therapeutic evacuation modalities include repeated therapeutic thoracentesis, chest tube drainage or thoracic surgery. The choice of the first-line evacuation treatment is still controversial and there are few prospective controlled studies. The effectiveness of fibrinolytic agents is not established except when they are combined with DNase. Antibiotics are mandatory; they should be initiated as quickly as possible and should be active against anaerobic bacteria except for in the context of pneumococcal infections. There are few data on the use of chest physiotherapy, which remains widely used. Mortality is still high and is influenced by underlying comorbidities.
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Affiliation(s)
- J Letheulle
- Service de maladies infectieuses et réanimation médicale, hôpital Pontchaillou, université de Rennes 1, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
| | - M Kerjouan
- Service de pneumologie, hôpital Pontchaillou, université de Rennes 1, 35033 Rennes cedex 9, France
| | - F Bénézit
- Service de pneumologie, hôpital Pontchaillou, université de Rennes 1, 35033 Rennes cedex 9, France
| | - B De Latour
- Service de chirurgie thoracique, hôpital Pontchaillou, université de Rennes 1, 35033 Rennes cedex 9, France
| | - P Tattevin
- Service de maladies infectieuses et réanimation médicale, hôpital Pontchaillou, université de Rennes 1, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France
| | - C Piau
- Laboratoire de bactériologie, hôpital Pontchaillou, université de Rennes 1, 35033 Rennes cedex 9, France
| | - H Léna
- Service de pneumologie, hôpital Pontchaillou, université de Rennes 1, 35033 Rennes cedex 9, France
| | - B Desrues
- Service de pneumologie, hôpital Pontchaillou, université de Rennes 1, 35033 Rennes cedex 9, France
| | - Y Le Tulzo
- Service de maladies infectieuses et réanimation médicale, hôpital Pontchaillou, université de Rennes 1, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France
| | - S Jouneau
- Service de pneumologie, hôpital Pontchaillou, université de Rennes 1, 35033 Rennes cedex 9, France; IRSET UMR 1085, université de Rennes 1, 35043 Rennes cedex 9, France
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Nemunaitis J, Papai Z, Léna H, Losonczy G, Forget F, Chouaid C, Szczesna A, Gervais R, Ottensmeier CH, Beck J, Kazarnowicz A, Westeel V, Debieuvre D, Madroszyk A, Felip E, Limacher J, Quoix E. TG4010 immunotherapy plus chemotherapy as first-line treatment of advanced non small cell lung cancer (NSCLC): Phase IIb results of the TIME trial. J Immunother Cancer 2015. [PMCID: PMC4652458 DOI: 10.1186/2051-1426-3-s2-p441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Borget I, Pérol M, Pérol D, Lavolé A, Greillier L, Dô P, Westeel V, Crequit J, Léna H, Monnet I, Le Caer H, Fournel P, Falchero L, Poudenx M, Vaylet F, Chabaud S, Vergnenegre A, Zalcman G, Chouaïd C. Cost-utility analysis of maintenance therapy with gemcitabine or erlotinib vs observation with predefined second-line treatment after cisplatin-gemcitabine induction chemotherapy for advanced NSCLC: IFCT-GFPC 0502-Eco phase III study. BMC Cancer 2014; 14:953. [PMID: 25511923 PMCID: PMC4302067 DOI: 10.1186/1471-2407-14-953] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 11/27/2014] [Indexed: 01/15/2023] Open
Abstract
Background The IFCT-GFPC 0502 phase III study reported prolongation of progression-free survival with gemcitabine or erlotinib maintenance vs. observation after cisplatin–gemcitabine induction chemotherapy for advanced non-small-cell lung cancer (NSCLC). This analysis was undertaken to assess the incremental cost-effectiveness ratio (ICER) of these strategies for the global population and pre-specified subgroups. Methods A cost-utility analysis evaluated the ICER of gemcitabine or erlotinib maintenance therapy vs. observation, from randomization until the end of follow-up. Direct medical costs (including drugs, hospitalization, follow-up examinations, second-line treatments and palliative care) were prospectively collected per patient during the trial, until death, from the primary health-insurance provider’s perspective. Utility data were extracted from literature. Sensitivity analyses were conducted. Results The ICERs for gemcitabine or erlotinib maintenance therapy were respectively 76,625 and 184,733 euros per quality-adjusted life year (QALY). Gemcitabine continuation maintenance therapy had a favourable ICER in patients with PS = 0 (52,213 €/QALY), in responders to induction chemotherapy (64,296 €/QALY), regardless of histology (adenocarcinoma, 62,292 €/QALY, non adenocarcinoma, 83,291 €/QALY). Erlotinib maintenance showed a favourable ICER in patients with PS = 0 (94,908 €/QALY), in patients with adenocarcinoma (97,160 €/QALY) and in patient with objective response to induction (101,186 €/QALY), but it is not cost-effective in patients with PS =1, in patients with non-adenocarcinoma or with stable disease after induction chemotherapy. Conclusion Gemcitabine- or erlotinib-maintenance therapy had ICERs that varied as a function of histology, PS and response to first-line chemotherapy.
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Affiliation(s)
- Isabelle Borget
- Études et Recherche en Économie de la Santé, Service de Biostatistique et d'Epidémiologie, Institut Gustave Roussy, 114, rue Edouard-Vaillant, 94805 Villejuif, Cedex, France.
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Quoix E, Losonczy G, Forget F, Chouaid C, Papai Z, Gervais R, Ottensmeier C, Szczesna A, Kazarnowicz A, Beck J, Westeel V, Vanderheyde K, Lacoste G, Bastien B, Halluard C, Marchand S, Limacher J, Léna H. TIME, a Phase 2b/3 Study Evaluating TG4010 in Combination With First-Line Therapy in Advanced Non-Small Cell Lung Cancer (NSCLC): Phase 2b Results. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.08.211] [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: 11/26/2022]
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Makinson A, Hayot M, Eymard-Duvernay S, Quesnoy M, Raffi F, Thirard L, Bonnet F, Tattevin P, Abgrall S, Quantin X, Léna H, Bommart S, Reynes J, Le Moing V. High prevalence of undiagnosed COPD in a cohort of HIV-infected smokers. Eur Respir J 2014; 45:828-31. [DOI: 10.1183/09031936.00154914] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Letheulle J, Tattevin P, Saunders L, Kerjouan M, Léna H, Desrues B, Le Tulzo Y, Jouneau S. Iterative thoracentesis as first-line treatment of complicated parapneumonic effusion. PLoS One 2014; 9:e84788. [PMID: 24400113 PMCID: PMC3882258 DOI: 10.1371/journal.pone.0084788] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 11/26/2013] [Indexed: 11/19/2022] Open
Abstract
Rationale Optimal management of complicated parapneumonic effusions (CPPE) remains controversial. Objectives to assess safety and efficacy of iterative therapeutic thoracentesis (ITTC), the first-line treatment of CPPE in Rennes University Hospital. Methods Patients with CPPE were identified through our computerized database. We retrospectively studied all cases of CPPE initially managed with ITTC in our institution between 2001 and 2010. ITTC failure was defined by the need for additional treatment (i.e. surgery or percutaneous drainage), or death. Results Seventy-nine consecutive patients were included. The success rate was 81% (n = 64). Only 3 patients (4%) were referred to thoracic surgery. The one-year survival rate was 88%. On multivariate analysis, microorganisms observed in pleural fluid after Gram staining and first thoracentesis volume ≥450 mL were associated with ITTC failure with adjusted odds-ratios of 7.65 [95% CI, 1.44–40.67] and 6.97 [95% CI, 1.86–26.07], respectively. The main complications of ITTC were iatrogenic pneumothorax (n = 5, 6%) and vasovagal reactions (n = 3, 4%). None of the pneumothoraces required chest tube drainage, and no hemothorax or re-expansion pulmonary edema was observed. Conclusions Although not indicated in international recommendations, ITTC is safe and effective as first-line treatment of CPPE, with limited invasiveness.
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Affiliation(s)
- Julien Letheulle
- Respiratory medicine department, Pontchaillou Hospital, Rennes 1 University, Rennes, France
- Infectious diseases and intensive care unit, Pontchaillou Hospital, Rennes 1 University, Rennes, France
| | - Pierre Tattevin
- Infectious diseases and intensive care unit, Pontchaillou Hospital, Rennes 1 University, Rennes, France
- INSERM U835, Rennes 1 University, Rennes, France
| | - Lauren Saunders
- Department of medical information, Pontchaillou Hospital, Rennes 1 University, Rennes, France
| | - Mallorie Kerjouan
- Respiratory medicine department, Pontchaillou Hospital, Rennes 1 University, Rennes, France
| | - Hervé Léna
- Respiratory medicine department, Pontchaillou Hospital, Rennes 1 University, Rennes, France
| | - Benoit Desrues
- Respiratory medicine department, Pontchaillou Hospital, Rennes 1 University, Rennes, France
| | - Yves Le Tulzo
- Infectious diseases and intensive care unit, Pontchaillou Hospital, Rennes 1 University, Rennes, France
- CIC –INSERM 0203Rennes 1 University, Rennes, France
| | - Stéphane Jouneau
- Respiratory medicine department, Pontchaillou Hospital, Rennes 1 University, Rennes, France
- IRSET U1085, Rennes 1 University, Rennes, France
- * E-mail:
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Lesimple T, Edeline J, Carrothers TJ, Cvitkovic F, Darpo B, Delord JP, Léna H, Penel N, Edwards GJ, Law K, Wanders J, Kristensen A, Reyderman L. A phase I, open-label, single-arm study for QT assessment of eribulin mesylate in patients with advanced solid tumors. Invest New Drugs 2012; 31:900-9. [DOI: 10.1007/s10637-012-9893-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 10/18/2012] [Indexed: 10/27/2022]
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Pérol M, Chouaid C, Pérol D, Barlési F, Gervais R, Westeel V, Crequit J, Léna H, Vergnenègre A, Zalcman G, Monnet I, Le Caer H, Fournel P, Falchero L, Poudenx M, Vaylet F, Ségura-Ferlay C, Devouassoux-Shisheboran M, Taron M, Milleron B. Randomized, phase III study of gemcitabine or erlotinib maintenance therapy versus observation, with predefined second-line treatment, after cisplatin-gemcitabine induction chemotherapy in advanced non-small-cell lung cancer. J Clin Oncol 2012; 30:3516-24. [PMID: 22949150 DOI: 10.1200/jco.2011.39.9782] [Citation(s) in RCA: 160] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE This phase III study investigated whether continuation maintenance with gemcitabine or switch maintenance with erlotinib improves clinical outcome compared with observation in patients with advanced non-small-cell lung cancer (NSCLC) whose disease was controlled after cisplatin-gemcitabine induction chemotherapy. PATIENTS AND METHODS Four hundred sixty-four patients with stage IIIB/IV NSCLC without tumor progression after four cycles of cisplatin-gemcitabine were randomly assigned to observation or to gemcitabine (1,250 mg/m(2) days 1 and 8 of a 3-week cycle) or daily erlotinib (150 mg/day) study arms. On disease progression, patients in all three arms received pemetrexed (500 mg/m(2) once every 21 days) as predefined second-line therapy. The primary end point was progression-free survival (PFS). RESULTS PFS was significantly prolonged by gemcitabine (median, 3.8 v 1.9 months; hazard ratio [HR], 0.56; 95% CI, 0.44 to 0.72; log-rank P < .001) and erlotinib (median, 2.9 v 1.9 months; HR, 0.69; 95% CI, 0.54 to 0.88; log-rank P = .003) versus observation; this benefit was consistent across all clinical subgroups. Both maintenance strategies resulted in a nonsignificant improvement in overall survival (OS); patients who received second-line pemetrexed or with a performance status of 0 appeared to derive greater benefit. Exploratory analysis showed that magnitude of response to induction chemotherapy may affect the OS benefit as a result of gemcitabine maintenance. Maintenance gemcitabine and erlotinib were well tolerated with no unexpected adverse events. CONCLUSION Gemcitabine continuation maintenance or erlotinib switch maintenance significantly reduces disease progression in patients with advanced NSCLC treated with cisplatin-gemcitabine as first-line chemotherapy. Response to induction chemotherapy may affect OS only for continuation maintenance.
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Benchalal M, Cazoulat G, Bellec J, Leseur J, Chajon E, Haigron P, Léna H, de Crevoisier R, Simon A. Planification selon la position moyenne du cycle respiratoire : modèle de planification optimale pour une distribution de dose dans les tumeurs pulmonaires. Cancer Radiother 2012; 16:91-9. [DOI: 10.1016/j.canrad.2011.07.246] [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] [Received: 04/01/2011] [Revised: 07/17/2011] [Accepted: 07/26/2011] [Indexed: 10/14/2022]
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Rauch M, Léna H, Brinchault G, Leveiller G, Delaval P. 283 Rupture de prothèse endotrachéale : à propos de trois cas dans la trachéobronchomalacie. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72659-1] [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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Fournel P, Vergnenégre A, Robinet G, Léna H, Gervais R, Le Caer H, Souquet PJ, Chavaillon JM, Chouaid C, Martel-Lafay I. Induction (ICT) or consolidation chemotherapy (CT) with cisplatin (C) and paclitaxel (P) plus concurrent chemo-radiation (CT/TRT) with cisplatin and vinorelbine (V) for unresectable non-small cell lung cancer (NSCLC) patients (pts): Randomized phase II trial GFPC-GLOT-IFCT 02–01. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7048] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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
7048 Background: Concurrent CT/TRT is the standard treatment for unresectable stage III NSCLC, but the optimal sequencing of TRT and CT is not well defined.Consolidation CT with taxane seems to be a good approach (SWOG 95–04). Methods: Unresectable stage III NSCLC pts (weight loss < 10%, ECOG PS 0–1, no supraclavicular lymph node or superior vena cava syndrome) were eligible. in Arm A, pts received 2 cycles of C 80 mg/m2 and P 200 mg/m2 followed by a concurrent CT/TRT including TRT as 66 Gy in 33 fractions and C 80 mg/m2 d1,29 and 57 and V d1,8,29,36,57 and 64. In Arm B, the same CT/TRT began on d1 followed by 2 cycles of C and P. The primary objective was response rate at the end of treatment, assessed by RECIST criteria. 132 pts were needed. Results: From 05/2002 to 03/2005, 133 pts were included by 35 centers. 5 pts were ineligible. Both groups were well-matched for baseline characteristics. 30 pts were stage IIIAN2 and 98 stage IIIB. Toxicities (106 pts analyzable) grade 3–4 by CTC and RTOG criteria (Arm A/Arm B) were: neutropenia 36%/41%, infection 11%/15%, esophagitis 6%/13%, pneumonitis 0%/1%. 5 toxic deaths were observed (2 sepsis, 1 massive hemoptysis, 1 post-irradiation pneumonitis, 1 esophageal fistula). In Arm A, objective response rate was 36% after ICT. At the end of treatment, response rate (Arm A/Arm B) was in intent to treat: progression 19%/19%, stable-disease 6%/11%, objective response 55%/48%. 13 pts were not evaluable for response in Arm A and 14 in Arm B [ table ]. Conclusions: Toxicities and response rates are similar in both arms, but ICT followed by CT/TRT appears to provide a better therapeutic outcome. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- P. Fournel
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - A. Vergnenégre
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - G. Robinet
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - H. Léna
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - R. Gervais
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - H. Le Caer
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - P. J. Souquet
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - J. M. Chavaillon
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - C. Chouaid
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
| | - I. Martel-Lafay
- University Hospital, St. Etienne, France; University Hospital, Limoges, France; University Hospital, Brest, France; University Hospital, Rennes, France; Centre François Baclesse, Caen, France; General Hospital, Draguignan, France; University Hospital, Lyon, France; General Hospital, Antibes, France; Saint-Antoine Hospital, Paris, France; Centre Leon Berard, Lyon, France
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Brinchault G, Avignon M, Morel V, Hugot P, Léna H, Delaval P. Traitement des sténoses trachéales bénignes par prothèses ENDOXANE ST chez 15 patients. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71528-5] [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: 11/17/2022]
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Thomas P, Robinet G, Gouva S, Fournel P, Léna H, Le Caer H, Perol M, Berard H, Bombaron P, Vergnenegre A, Kleisbauer JP. Randomized multicentric phase II study of carboplatin/gemcitabine and cisplatin/vinorelbine in advanced non-small cell lung cancer. Lung Cancer 2006; 51:105-14. [PMID: 16310886 DOI: 10.1016/j.lungcan.2005.10.004] [Citation(s) in RCA: 17] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2005] [Revised: 09/19/2005] [Accepted: 10/03/2005] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of gemcitabine and carboplatin in the treatment of previously untreated patients with advanced non-small cell lung cancer (NSCLC). METHODS A randomized phase II study was conducted by the Groupe Français de Pneumo-Cancérologie (GFPC) in 15 centers. The patients were randomized in either arm A (GC): gemcitabine 1250 mg/m2 on days 1 and 8+carboplatin AUC 6 mg/(mLmin) on day 1; or in arm B (VP): vinorelbine 30 mg/m2 weekly+cisplatin 80 mg/m2 on day 1. Treatment cycles were repeated every 3 weeks. RESULTS A total of 100 patients were randomized with stage IV or stage III NSCLC with malignant pleural effusion: 51 patients in arm A and 49 patients in arm B. A total of 190 cycles were administered in the GC arm and 172 cycles in the VP arm, with a median of four cycles per patient in each arm. The dose intensity was 84.9% for gemcitabine, 99.8% for carboplatin, 97.7% for cisplatin and 67.7% for vinorelbine. The objective response rates were 19.6% (95% CI, 9.8-33.1) for GC and 29.2% (95% CI, 17.0-44.1) for VP in an ITT analysis. The response duration was 169 days in arm A and 226 days in arm B. The TTP was similar with 140 days (GC) and 148 days (VP), respectively. Overall survival rates were 334 days in the GC combination and 304 days in the VP combination. Overall, the treatment was safe and toxicities observed were different in each arm: neutropenia was the most common toxicity in the VP treatment, whereas thrombocytopenia was more frequent in the GC combination. Anemia was similar in both arms. Non-haematologic toxicity was mild. One toxic death in arm A and three toxic deaths in arm B were observed. CONCLUSION In terms of response rate, the gemcitabine-carboplatin combination was not efficient enough to allow further phase III study. Survival data are in the same range as the standard arm. This chemotherapy is feasible and may represent an alternative to a standard cisplatin-based regimen, allowing treatment in an outpatient setting.
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Affiliation(s)
- P Thomas
- Service d'Oncologie Respiratoire, Hôpital Sainte-Marguerite, 270 Bd Sainte-Marguerite, 13009 Marseille, and Service de Pneumologie, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Etienne, France.
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Fournel P, Robinet G, Thomas P, Souquet PJ, Léna H, Vergnenégre A, Delhoume JY, Le Treut J, Silvani JA, Dansin E, Bozonnat MC, Daurés JP, Mornex F, Pérol M. Randomized phase III trial of sequential chemoradiotherapy compared with concurrent chemoradiotherapy in locally advanced non-small-cell lung cancer: Groupe Lyon-Saint-Etienne d'Oncologie Thoracique-Groupe Français de Pneumo-Cancérologie NPC 95-01 Study. J Clin Oncol 2005; 23:5910-7. [PMID: 16087956 DOI: 10.1200/jco.2005.03.070] [Citation(s) in RCA: 388] [Impact Index Per Article: 20.4] [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: 01/01/2023] Open
Abstract
PURPOSE We conducted a phase III study to compare the survival impact of concurrent versus sequential treatment with radiotherapy (RT) and chemotherapy (CT) in unresectable stage III non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Patients were randomly assigned to one of the two treatment arms. In the sequential arm, patients received induction CT with cisplatin (120 mg/m2) on days 1, 29, and 57, and vinorelbine (30 mg/m2/wk) from day 1 to day 78, followed by thoracic RT at a dose of 66 Gy in 33 fractions (2 Gy per fraction and 5 fractions per week). In the concurrent arm, the same RT was started on day 1 with two concurrent cycles of cisplatin 20 mg/m2/d and etoposide 50 mg/m2/d (days 1 to 5 and days 29 to 33); patients then received consolidation therapy with cisplatin 80 mg/m2 on days 78 and 106 and vinorelbine 30 mg/m2/wk from days 78 to 127. RESULTS Two hundred five patients were randomly assigned. Pretreatment characteristics were well balanced between the two arms. There were six toxic deaths in the sequential arm and 10 in the concurrent arm. Median survival was 14.5 months in the sequential arm and 16.3 months in the concurrent arm (log-rank test P = .24). Two-, 3-, and 4-year survival rates were better in the concurrent arm (39%, 25%, and 21%, respectively) than in the sequential arm (26%, 19%, and 14%, respectively). Esophageal toxicity was significantly more frequent in the concurrent arm than in the sequential arm (32% v 3%). CONCLUSION Although not statistically significant, clinically important differences in the median, 2-, 3-, and 4-year survival rates were observed, with a trend in favor of concurrent chemoradiation therapy, suggesting that is the optimal strategy for patients with locally advanced NSCLC.
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Vergnenègre A, Daniel C, Léna H, Fournel P, Kleisbauer JP, Le Caer H, Letreut J, Paillotin D, Pérol M, Bouchaert E, Preux PM, Robinet G. Docetaxel and concurrent radiotherapy after two cycles of induction chemotherapy with cisplatin and vinorelbine in patients with locally advanced non-small-cell lung cancer. A phase II trial conducted by the Groupe Francais de Pneumo-Cancerologie (GFPC). Lung Cancer 2005; 47:395-404. [PMID: 15713523 DOI: 10.1016/j.lungcan.2004.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2004] [Revised: 08/12/2004] [Accepted: 08/18/2004] [Indexed: 10/26/2022]
Abstract
CONTEXT The most satisfactory treatment for patients with locally advanced non-small-cell lung cancer (NSCLC) is combination chemotherapy-radiotherapy (CT-RT). The optimal treatment modalities remain to be determined. OBJECTIVE We conducted a multicenter phase II trial of the docetaxel-radiotherapy combination after induction chemotherapy with cisplatin-vinorelbine. The main endpoint was the objective response rate. PATIENTS AND METHODS Patient with inoperable stage locally advanced NSCLC received induction chemotherapy consisting of two cycles of cisplatin 100 mg/m2 on D1 and vinorelbine 25 mg/m2 on D1, D8, D15 and D22. Patients with responses or stable disease then received concurrent RT-CT consisting of 25 mg/m2/week docetaxel and single-fraction radiotherapy (66 grays (Gy) in 33 fractions) over 6.5 weeks. RESULTS Fifty-six patients were enrolled from 1 July 2000 to 31 December 2001. Sixteen patients left the trial after induction chemotherapy, eight for progression, five for toxicity, and two for intercurrent events. One patient underwent surgery after induction chemotherapy. In total, 40 of the 56 patients received RT-CT. Twelve (30%) of these 40 patients experienced grade III or IV pulmonary or esophageal toxicity. In the intention-to-treat analysis, the objective response rate was 46.4% (95% CI 33.0-60.2). The median time to progression was 6.2 months [1.1-26.0]. The median survival time was 13 months [0.3-44.9 months]. Nine patients progressed during RT-CT, six with brain metastases. CONCLUSION Weekly docetaxel with concurrent radiotherapy, following chemotherapy is acceptable. The tumor response rate is moderate. Further trials are required to determine the risk-benefit relationship of this treatment schedule, and the possible benefit of adding other cytotoxic drugs.
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Affiliation(s)
- A Vergnenègre
- CHU de Limoges, Service de l'Information Médicale et de l'Evaluation, Service de Pathologie respiratoire et d'Allergologie, Hôpital du Cluzeau, CHU Dupuytren, 87042 Limoges Cedex, France.
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Pérol M, Léna H, Thomas P, Robinet G, Fournel P, Coste E, Belleguic C, Le Caer H, Blanchon F, Vergnenègre A, Vernejoux JM, Schuller-Lebeau MP, Pham E. Phase II randomized multicenter study evaluating a treatment regimen alternating docetaxel and cisplatin-vinorelbine with a cisplatin-vinorelbine control group in patients with stage IV non-small-cell lung cancer: GFPC 97.01 study. Ann Oncol 2002; 13:742-7. [PMID: 12075743 DOI: 10.1093/annonc/mdf128] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The potential absence of cross-resistance between cisplatin and docetaxel in non-small-cell lung cancer (NSCLC) suggests that alternating regimens of cisplatin-based chemotherapy and docetaxel might increase the activity of chemotherapy in stage IV NSCLC. PATIENTS AND METHODS Randomized, multicenter, non-comparative phase II study in patients with stage IV NSCLC (Eastern Cooperative Oncology Group performance status of 0-2). Patients randomized to alternating treatment group (A) received docetaxel 100 mg/m2 on days (D) 1 and 43 alternating with cisplatin 100 mg/m2 on D22 and vinorelbine 30 mg/m2 on D22, D29 and D36. Those randomized to the control group (B) received cisplatin 80 mg/m2 on D1, D22 and D43 and vinorelbine 30 mg/m2 once a week from D1 to D57. Treatment was continued for a further 6 weeks in the event of objective response or stabilization. RESULTS Seventy patients were enrolled (group A: 38, group B: 32). More premature treatment discontinuations due to toxicity were observed in group A (median number of cycles: 3) than in group B (median number of cycles: 5). The intention-to-treat objective response rate was 10.8% [95% confidence interval (CI) 0.8% to 20.8%] in group A compared with 25% (95% CI 10% to 40%) in group B, the median time to treatment failure being 10.2 weeks and 17.3 weeks, respectively. The median survival and 1-year survival were 29.1 weeks and 39% in group A compared with 41.6 weeks and 42% in group B. Febrile neutropenia occurred in 5.9 and 4.9% of the cycles in group A and group B, respectively. Non-hematological toxicity was moderate in the two groups. CONCLUSIONS The addition of docetaxel alternating with cisplatin-vinorelbine did not enhance the activity of this combination. The development of sequential regimens might be a more promising way of exploiting the absence of cross-resistance between these two drugs.
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Affiliation(s)
- M Pérol
- Groupe Français de Pneumo-Cancérologie, Hĵpital de la Croix-Rousse, Lyon, France.
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Thomas P, Robinet G, Ferri-Dessens RM, Léna H, Gouva S, Vernejoux JM, Kleisbauer JP. Phase I trial of gemcitabine and carboplatin in metastatic non-small-cell lung cancer: a Groupe Français de Pneumo-Cancérologie Study. Lung Cancer 2002; 36:191-8. [PMID: 11955654 DOI: 10.1016/s0169-5002(01)00480-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 10/27/2022]
Abstract
BACKGROUND The purpose of this study was to determine the maximum-tolerated dose (MTD) and the dose-limiting toxicity (DLT) of the 21 days carboplatin plus gemcitabine regimen in previously untreated patients with stage IV non small-cell lung cancer (NSCLC). METHODS At least three patients were entered at each dose level. The starting dose was carboplatin AUC 4 mg/ml per min (Area Under the Curve; Calvert formula) on day 1 and gemcitabine 750 mg/m(2) on days 1 and 8. Carboplatin was increased to AUC 5 (level 3, 4) then to AUC 6 (level 5-7). Gemcitabine was increased to 875 (level 2, 3), 1000 (level 4, 5), 1250 (level 6) and finally 1500 mg/m(2) (level 7). Twenty-nine patients were entered into this phase I study. RESULTS At dose level 6, a DLT (grade 4 thrombocytopenia) was observed in one out of six patients. At dose level 7, no DLT was observed during the first course, so the MTD was not reached. During the second course, two out of four patients presented grade 4 thrombocytopenia. None of the five patients receiving two courses at level 6 presented a DLT, so this level was retained for further phase II studies. Of the 25 patients assessable for response, five achieved partial responses with a response rate of 20% (95% CI, 7 to 41%). The median survival time was 7 months and the 1-year survival rate was 24% (95% CI, 9 to 45%). CONCLUSION The combination of carboplatin given on day 1 and gemcitabine given on days 1 and 8 every 3 weeks seems to be an acceptable regimen. The DLT consists exclusively of severe thrombocytopenia. Despite the MTD was not reached with carboplatin AUC 6 mg/ml per min and gemcitabine 1500 mg/m(2), the recommended dose for further phase II studies is carboplatin AUC 6 mg/ml per min and gemcitabine 1250 mg/m(2).
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Affiliation(s)
- Pascal Thomas
- Service d'Oncologie Respiratoire, Hôpital Sainte-Marguerite, 270 Bd Sainte-Marguerite, 13 009 Marseille, France.
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