1
|
Goetz MP, Toi M, Huober J, Sohn J, Trédan O, Park IH, Campone M, Chen SC, Manso LM, Paluch-Shimon S, Freedman OC, O'Shaughnessy J, Pivot X, Tolaney SM, Hurvitz S, Llombart-Cussac A, André V, Saha A, van Hal G, Shahir A, Iwata H, Johnston SRD. Abemaciclib plus a nonsteroidal aromatase inhibitor as initial therapy for HR+, HER2- advanced breast cancer: Final overall survival results of MONARCH 3. Ann Oncol 2024:S0923-7534(24)00139-X. [PMID: 38729566 DOI: 10.1016/j.annonc.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND In MONARCH 2, the addition of abemaciclib to fulvestrant significantly improved both progression-free survival (PFS) and overall survival (OS) in patients with HR+, HER2- advanced breast cancer (ABC) with disease progression on prior endocrine therapy (ET). In MONARCH 3, the addition of abemaciclib to a nonsteroidal aromatase inhibitor (NSAI) as initial therapy for HR+, HER2- ABC significantly improved PFS. Here, we present the prespecified final OS results for MONARCH 3. PATIENTS AND METHODS MONARCH 3 is a randomized, double-blind, phase 3 study of abemaciclib plus NSAI (anastrozole or letrozole) versus placebo plus NSAI in postmenopausal women with HR+, HER2- ABC without prior systemic therapy in the advanced setting. The primary objective was investigator-assessed PFS; OS was a gated secondary endpoint, and chemotherapy-free survival (CFS) was an exploratory endpoint. RESULTS A total of 493 women were randomized 2:1 to receive abemaciclib plus NSAI (n = 328) or placebo plus NSAI (n = 165). After a median follow-up of 8.1 years, there were 198 OS events (60.4%) in the abemaciclib arm and 116 (70.3%) in the placebo arm (hazard ratio, 0.804; 95% confidence interval [CI], 0.637-1.015; P = 0.0664, non-significant). Median OS was 66.8 versus 53.7 months for abemaciclib versus placebo. In the subgroup with visceral disease (sVD), there were 113 OS events (65.3%) in the abemaciclib arm and 65 (72.2%) in the placebo arm (hazard ratio, 0.758; 95% CI, 0.558-1.030; P = 0.0757, non-significant). Median OS was 63.7 months versus 48.8 months for abemaciclib versus placebo. The previously demonstrated PFS benefit was sustained, and CFS numerically improved with the addition of abemaciclib. No new safety signals were observed. CONCLUSION Abemaciclib combined with an NSAI resulted in clinically meaningful improvement in median OS (ITT: 13.1 months; sVD: 14.9 months) in patients with HR+ HER2- ABC; however, statistical significance was not reached.
Collapse
Affiliation(s)
- M P Goetz
- Department of Oncology, Mayo Clinic, Rochester, MN, USA.
| | - M Toi
- Kyoto University, Kyoto, Japan
| | - J Huober
- Breast Center Cantonal Hospital St. Gallen, Switzerland and University of Ulm, Ulm, Germany
| | - J Sohn
- Yonsei Cancer Center, Seoul, Korea
| | - O Trédan
- Centre Léon Bérard, Lyon, France
| | - I H Park
- National Cancer Center, Goyang-si, Korea
| | - M Campone
- Institut de Cancérologie de l'Ouest, Angers, France
| | - S-C Chen
- Chang Gung University Medical College, Taipei, Taiwan
| | - L M Manso
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Paluch-Shimon
- Hadassah University Hospital & Faculty of Medicine Hebrew University, Jerusalem, Israel
| | | | - J O'Shaughnessy
- Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX, USA
| | - X Pivot
- Centre Paul Strauss, INSERM 110, Strasbourg, France
| | - S M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - S Hurvitz
- Department of Medicine, UW Medicine, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | | | - V André
- Eli Lilly, Indianapolis, IN, USA
| | - A Saha
- Eli Lilly, Indianapolis, IN, USA
| | | | - A Shahir
- Eli Lilly, Indianapolis, IN, USA
| | - H Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - S R D Johnston
- Breast Unit, The Royal Marsden NHS Foundation Trust, London, UK
| |
Collapse
|
2
|
Cottu P, Livartoswki A, Pérol D, Trédan O, Gilberg M, Ghorbal R, Dupin J, Maillard C. KADor – Étude rétrospective française visant à décrire la prise en charge thérapeutique des patientes présentant un cancer du sein précoce HER2+ ayant bénéficié d’un traitement néoadjuvant à base d’Herceptin®. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
3
|
Trédan O, Wang Q, Pissaloux D, Cassier P, de la Fouchardière A, Fayette J, Desseigne F, Ray-Coquard I, de la Fouchardière C, Frappaz D, Heudel PE, Bonneville-Levard A, Fléchon A, Sarabi M, Guibert P, Bachelot T, Pérol M, You B, Bonnin N, Collard O, Leyronnas C, Attignon V, Baudet C, Sohier E, Villemin JP, Viari A, Boyault S, Lantuejoul S, Paindavoine S, Treillleux I, Rodriguez C, Agrapart V, Corset V, Garin G, Chabaud S, Pérol D, Blay JY. Molecular screening program to select molecular-based recommended therapies for metastatic cancer patients: analysis from the ProfiLER trial. Ann Oncol 2019; 30:757-765. [PMID: 30865223 DOI: 10.1093/annonc/mdz080] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Antitumor activity of molecular-targeted agents is guided by the presence of documented genomic alteration in specific histological subtypes. We aim to explore the feasibility, efficacy and therapeutic impact of molecular profiling in routine setting. PATIENTS AND METHODS This multicentric prospective study enrolled adult or pediatric patients with solid or hematological advanced cancer previously treated in advanced/metastatic setting and noneligible to curative treatment. Each molecular profile was established on tumor, relapse or biopsies, and reviewed by a molecular tumor board (MTB) to identify molecular-based recommended therapies (MBRT). The main outcome was to assess the incidence rate of genomic mutations in routine setting, across specific histological types. Secondary objectives included a description of patients with actionable alterations and for whom MBRT was initiated, and overall response rate. RESULTS Four centers included 2579 patients from February 2013 to February 2017, and the MTB reviewed the molecular profiles achieved for 1980 (76.8%) patients. The most frequently altered genes were CDKN2A (N = 181, 7%), KRAS (N = 177, 7%), PIK3CA (N = 185, 7%), and CCND1 (N = 104, 4%). An MBRT was recommended for 699/2579 patients (27%), and only 163/2579 patients (6%) received at least one MBRT. Out of the 182 lines of MBRT initiated, 23 (13%) partial responses were observed. However, only 0.9% of the whole cohort experienced an objective response. CONCLUSION An MBRT was provided for 27% of patients in our study, but only 6% of patients actually received matched therapy with an overall response rate of 0.9%. Molecular screening should not be used at present to guide decision-making in routine clinical practice outside of clinical trials.This trial is registered with ClinicalTrials.gov, number NCT01774409.
Collapse
Affiliation(s)
- O Trédan
- Departments of Medical Oncology, University Claude Bernard
| | - Q Wang
- Translational Research and Innovation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - B You
- Department of Medical Oncology, Lyon Sud Hospital Center, CITOHL, Institute of Cancerology, Hospices Civils de Lyon (IC-HCL), Lyon; Faculty of Medicine-Lyon Sud, EMR UCBL/HCL 3738, University of Lyon 1, Oullins
| | - N Bonnin
- Department of Medical Oncology, Lyon Sud Hospital Center, CITOHL, Institute of Cancerology, Hospices Civils de Lyon (IC-HCL), Lyon
| | - O Collard
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - C Leyronnas
- Department of Medical Oncology, Mutualist Hospital Group, Grenoble
| | | | - C Baudet
- Synergie Lyon Cancer, Bio-Informatics Platform
| | - E Sohier
- Synergie Lyon Cancer, Bio-Informatics Platform
| | | | - A Viari
- Synergie Lyon Cancer, Bio-Informatics Platform
| | - S Boyault
- Translational Research and Innovation
| | | | | | | | - C Rodriguez
- BioPathology, Léon Bérard Cancer center, Lyon
| | - V Agrapart
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - V Corset
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - G Garin
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - S Chabaud
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - D Pérol
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - J-Y Blay
- Departments of Medical Oncology, University Claude Bernard.
| |
Collapse
|
4
|
Delrieu L, Martin A, Fervers B, Morelle M, Febvey-Combes O, Pérol O, Freyssenet D, Bachmann P, Trédan O, Pilleul F, Touillaud M, Pialoux V. Cancer du sein métastatique et masse musculaire : rôle de l’activité physique dans la prévention de la sarcopénie et des toxicités. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2019.01.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
5
|
Trédan O, Ménétrier-Caux C, Ray-Coquard I, Garin G, Cropet C, Verronèse E, Bachelot T, Rebattu P, Heudel PE, Cassier P, Chabaud S, Croughs T, Dupont P, Cadore AC, Clapisson G, Delgado A, Bardin-Dit-Courageot C, Rigal C, N'Kodia A, Gilles-Afchain L, Morre M, Pérol D, Blay JY, Caux C. ELYPSE-7: a randomized placebo-controlled phase IIa trial with CYT107 exploring the restoration of CD4+ lymphocyte count in lymphopenic metastatic breast cancer patients. Ann Oncol 2018; 29:523. [PMID: 28368453 DOI: 10.1093/annonc/mdx058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
6
|
Bernichon E, Vallard A, Wang Q, Attignon V, Pissaloux D, Bachelot T, Heudel PE, Ray-Coquard I, Bonnet E, de la Fouchardière A, Faure C, Chopin N, Beurrier F, Racadot S, Sunyach MP, Rancoule C, Perol D, Corset V, Agrapart V, Tinquaut F, Blay JY, Magné N, Trédan O. Genomic alterations and radioresistance in breast cancer: an analysis of the ProfiLER protocol. Ann Oncol 2017; 28:2773-2779. [PMID: 28945826 DOI: 10.1093/annonc/mdx488] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Breast cancer (BC) patients with comparable prognostic features have heterogeneous outcomes, party related to a possible radiotherapy resistance leading to local-regional recurrences (LRR). The objective of the present study was to identify predictive molecular biomarkers of LRR of BC. PATIENTS AND METHODS Genetic profile of 146 BC patients' tumours included in the ProfiLER clinical trial (NC01774409) between 2013 and 2016 were analysed using next-generation-sequencing and comparative-genomic-hybridization tests. Patients and tumour characteristics were retrospectively collected and analysed for association with genomic rearrangements (mutations, amplification, deletions). Only gene alterations observed in >3% of the tumours were selected. RESULTS A total of 193 genomic rearrangements were identified, and 16 were observed in >3% of tumours. One was statistically correlated to the risk of local relapse. A median loco-regional progression-free survival (LRPFS) of 23.6 years was reported for PIK3CA mutation carriers (n = 31, 21.2%) versus 9.9 years for PIK3CA wild-type patients (HR 0.27, 95% CI 0.12-0.65, P = 0.002 in univariate analysis). PIK3CA mutation was identified as an independent protective factor on LRR using multivariate analysis (HR 0.29, 95% CI 0.09-0.99, P = 0.047). All other mutations, amplifications or deletions were not found associated with LRPFS. CONCLUSION PIK3CA mutation was associated with a lower risk of local relapse in this population of BCs. This is consistent with recent studies suggesting PIK3CA to be part of biological pathways impacting the radiosensitivity.
Collapse
MESH Headings
- Adult
- Biomarkers, Tumor/genetics
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/radiotherapy
- Carcinoma, Lobular/secondary
- Class I Phosphatidylinositol 3-Kinases/genetics
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Gene Rearrangement
- Genomics
- High-Throughput Nucleotide Sequencing
- Humans
- Lymphatic Metastasis
- Middle Aged
- Mutation
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/radiotherapy
- Prognosis
- Prospective Studies
- Radiation Tolerance/genetics
- Retrospective Studies
- Survival Rate
Collapse
Affiliation(s)
| | - A Vallard
- Department of Radiation Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - Q Wang
- Department of Translational Research
| | | | | | | | | | | | | | | | | | | | | | | | | | - C Rancoule
- Department of Radiation Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - D Perol
- Department of Clinical Research, Léon Bérard Cancer Centre, Lyon
| | - V Corset
- Department of Clinical Research, Léon Bérard Cancer Centre, Lyon
| | - V Agrapart
- Department of Clinical Research, Léon Bérard Cancer Centre, Lyon
| | - F Tinquaut
- Department of Hygée Center, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - J-Y Blay
- Department of Translational Research; Department of Medical Oncology
| | - N Magné
- Department of Radiation Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez; Department of Laboratoire de Radiobiologie Cellulaire et Moléculaire, CNRS UMR 5822, Institut de Physique Nucléaire de Lyon, IPNL, Lyon Medicine University, Lyon, France.
| | - O Trédan
- Department of Translational Research; Department of Medical Oncology
| |
Collapse
|
7
|
Le Saux O, Ray-Coquard I, Corset V, Sohier E, Baudet C, Pissaloux D, Wang Q, Chabaud S, Varnier R, Heudel P, Derbel O, You B, Trédan O, Cassier P, Bonnin N, Biron P, Freyer G, Trillet-Lenoir V, Bachelot T, Pérol D, Blay JY. Actionable molecular alterations in advanced gynecologic malignancies: updated results from the ProfiLER program in France. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
8
|
Vallard A, Bernichon E, Wang Q, Attignon V, Pissaloux D, Heudel P, Bachelot T, Ray-Coquard I, de la Fouchardière A, Faure C, Chopin N, Beurrier F, Racadot S, Sunyach M, Rancoule C, Perol D, Corset V, Agrapart V, Tinquaut F, Blay JY, Magné N, Trédan O. Altération génétiques et radioresistance du cancer du sein : une analyse de l’essai ProfiLER. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.08.081] [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]
|
9
|
Blay JY, Corset V, Mastier C, Treilleux I, Le Tourneau C, Italiano A, Delord J, Attignon V, Wang Q, Baudet C, Sohier E, Bernardin M, Ben Abdesselem L, D'argenio A, Haddad V, Saintigny P, Perrier L, Chabaud S, Perol D, Trédan O. PROFILER 02 - A multicentric, prospective cohort study aiming to evaluate the added value of a large molecular profiling panel (315 cancer-related gene panel [FoundationOne]) versus a limited molecular profiling panel (74 cancer-related gene panel [CONTROL]) in advanced solid tumours. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx508.004] [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: 11/12/2022] Open
|
10
|
Belin L, Kamal M, Mauborgne C, Plancher C, Mulot F, Delord JP, Gonçalves A, Gavoille C, Dubot C, Isambert N, Campone M, Trédan O, Ricci F, Alt M, Loirat D, Sablin MP, Paoletti X, Servois V, Le Tourneau C. Randomized phase II trial comparing molecularly targeted therapy based on tumor molecular profiling versus conventional therapy in patients with refractory cancer: cross-over analysis from the SHIVA trial. Ann Oncol 2017; 28:590-596. [DOI: 10.1093/annonc/mdw666] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
11
|
Trédan O, Follana P, Moullet I, Cropet C, Trager-Maury S, Dauba J, Lavau-Denes S, Diéras V, Béal-Ardisson D, Gouttebel M, Orfeuvre H, Stefani L, Jouannaud C, Bürki F, Petit T, Guardiola E, Becuwe C, Blot E, Pujade-Lauraine E, Bachelot T. A phase III trial of exemestane plus bevacizumab maintenance therapy in patients with metastatic breast cancer after first-line taxane and bevacizumab: a GINECO group study. Ann Oncol 2016; 27:1020-1029. [DOI: 10.1093/annonc/mdw077] [Citation(s) in RCA: 19] [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] [Received: 02/09/2016] [Accepted: 02/15/2016] [Indexed: 11/12/2022] Open
|
12
|
Trédan O, Ménétrier-Caux C, Ray-Coquard I, Garin G, Cropet C, Verronèse E, Bachelot T, Rebattu P, Heudel P, Cassier P, Chabaud S, Croughs T, Dupont P, Cadore A, Clapisson G, Delgado A, Bardin-dit-Courageot C, Rigal C, N'Kodia A, Gilles-Afchain L, Morre M, Pérol D, Blay J, Caux C. ELYPSE-7: a randomized placebo-controlled phase IIa trial with CYT107 exploring the restoration of CD4+ lymphocyte count in lymphopenic metastatic breast cancer patients. Ann Oncol 2015; 26:1353-62. [DOI: 10.1093/annonc/mdv173] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/24/2015] [Indexed: 12/29/2022] Open
|
13
|
Touillaud M, Foucaut AM, Morelle M, Kempf-Lépine AS, Baudinet C, Meyrand R, Berthouze S, Trédan O, Fervers B, Bachmann P. P271: Poids, composition corporelle et modifications biologiques après un programme d’activité physique adaptée pendant les traitements adjuvants du cancer du sein localisé : une étude clinique contrôlée randomisée. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70913-6] [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]
|
14
|
Perrier L, Kembou NS, Rascle P, Bui B, Morelle M, Ranchère VD, Terrier P, Neuville A, Decouvelaere AV, Le Cesne A, Gomez F, de la Fouchardière C, Meeus P, Trédan O, Pérol M, Fayette J, Neidhardt EM, Biron P, Boyle HJ, Marec BP, Farsi F, Ducimetière F, Blay JY, Ray CI, Coindre JM. Economic Impact of Centralized Histological Reviews in Patients with Sarcoma, Gist, and Desmoid Tumors. Value Health 2014; 17:A624. [PMID: 27202203 DOI: 10.1016/j.jval.2014.08.2219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L Perrier
- Cancer Centre Léon Bérard, Lyon, France
| | | | - P Rascle
- Cancer Centre Léon Bérard, Lyon, France
| | - B Bui
- Institut Bergonié, Bordeaux, France
| | - M Morelle
- Cancer Centre Léon Bérard, Lyon, France
| | | | - P Terrier
- Insitut Gustave Roussy, Villejuif, France
| | | | | | - A Le Cesne
- Insitut Gustave Roussy, Villejuif, France
| | - F Gomez
- Cancer Centre Léon Bérard, Lyon, France
| | | | - P Meeus
- Cancer Centre Léon Bérard, Lyon, France
| | - O Trédan
- Cancer Centre Léon Bérard, Lyon, France
| | - M Pérol
- Cancer Centre Léon Bérard, Lyon, France
| | - J Fayette
- Cancer Centre Léon Bérard, Lyon, France
| | | | - P Biron
- Cancer Centre Léon Bérard, Lyon, France
| | - H J Boyle
- Cancer Centre Léon Bérard, Lyon, France
| | | | - F Farsi
- Regional oncology network Réseau Espace Santé Cancer, Lyon, France
| | | | - J Y Blay
- Cancer Centre Léon Bérard, Lyon, France
| | | | | |
Collapse
|
15
|
Le Tourneau C, Paoletti X, Servant N, Bièche I, Gentien D, Rio Frio T, Vincent-Salomon A, Servois V, Romejon J, Mariani O, Bernard V, Huppe P, Pierron G, Mulot F, Callens C, Wong J, Mauborgne C, Rouleau E, Reyes C, Henry E, Leroy Q, Gestraud P, La Rosa P, Escalup L, Mitry E, Trédan O, Delord JP, Campone M, Goncalves A, Isambert N, Gavoille C, Kamal M. Randomised proof-of-concept phase II trial comparing targeted therapy based on tumour molecular profiling vs conventional therapy in patients with refractory cancer: results of the feasibility part of the SHIVA trial. Br J Cancer 2014; 111:17-24. [PMID: 24762958 PMCID: PMC4090722 DOI: 10.1038/bjc.2014.211] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 03/24/2014] [Accepted: 03/27/2014] [Indexed: 12/24/2022] Open
Abstract
Background: The SHIVA trial is a multicentric randomised proof-of-concept phase II trial comparing molecularly targeted therapy based on tumour molecular profiling vs conventional therapy in patients with any type of refractory cancer. Results of the feasibility study on the first 100 enrolled patients are presented. Methods: Adult patients with any type of metastatic cancer who failed standard therapy were eligible for the study. The molecular profile was performed on a mandatory biopsy, and included mutations and gene copy number alteration analyses using high-throughput technologies, as well as the determination of oestrogen, progesterone, and androgen receptors by immunohistochemistry (IHC). Results: Biopsy was safely performed in 95 of the first 100 included patients. Median time between the biopsy and the therapeutic decision taken during a weekly molecular biology board was 26 days. Mutations, gene copy number alterations, and IHC analyses were successful in 63 (66%), 65 (68%), and 87 (92%) patients, respectively. A druggable molecular abnormality was present in 38 patients (40%). Conclusions: The establishment of a comprehensive tumour molecular profile was safe, feasible, and compatible with clinical practice in refractory cancer patients.
Collapse
Affiliation(s)
- C Le Tourneau
- 1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France [3] Institut Curie, Saint-Cloud, France
| | - X Paoletti
- 1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France
| | - N Servant
- 1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France
| | | | | | | | | | | | - J Romejon
- 1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France
| | | | | | - P Huppe
- 1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France
| | | | - F Mulot
- Institut Curie, Paris, France
| | | | - J Wong
- Institut Curie, Paris, France
| | | | | | - C Reyes
- Institut Curie, Paris, France
| | - E Henry
- Institut Curie, Paris, France
| | - Q Leroy
- Institut Curie, Paris, France
| | - P Gestraud
- 1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France
| | - P La Rosa
- 1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France
| | | | - E Mitry
- Institut Curie, Saint-Cloud, France
| | - O Trédan
- Centre Léon Bérard, Lyon, France
| | - J-P Delord
- Institut Claudius Régaud, Toulouse, France
| | - M Campone
- Centre René Gauducheau, Nantes, France
| | | | - N Isambert
- Centre Georges-François Leclerc, Dijon, France
| | | | - M Kamal
- Institut Curie, Paris, France
| |
Collapse
|
16
|
Touillaud M, Foucaut AM, Berthouze SE, Reynes E, Kempf-Lépine AS, Carretier J, Pérol D, Guillemaut S, Chabaud S, Bourne-Branchu V, Perrier L, Trédan O, Fervers B, Bachmann P. Design of a randomised controlled trial of adapted physical activity during adjuvant treatment for localised breast cancer: the PASAPAS feasibility study. BMJ Open 2013; 3:e003855. [PMID: 24165030 PMCID: PMC3816240 DOI: 10.1136/bmjopen-2013-003855] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION After a diagnosis of localised breast cancer, overweight, obesity and weight gain are negatively associated with prognosis. In contrast, maintaining an optimal weight through a balanced diet combined with regular physical activity appears to be effective protective behaviour against comorbidity or mortality after a breast cancer diagnosis. The primary aim of the Programme pour une Alimentation Saine et une Activité Physique Adaptée pour les patientes atteintes d'un cancer du Sein (PASAPAS) randomised controlled trial is to evaluate the feasibility of implementing an intervention of adapted physical activity (APA) for 6 months concomitant with the prescription of a first line of adjuvant chemotherapy. Secondary aims include assessing the acceptability of the intervention, compliance to the programme, process implementation, patients' satisfaction, evolution of biological parameters and the medicoeconomic impact of the intervention. METHODS AND ANALYSIS The study population consists of 60 women eligible for adjuvant chemotherapy after a diagnosis of localised invasive breast cancer. They will be recruited during a 2-year inclusion period and randomly allocated between an APA intervention arm and a control arm following a 2:1 ratio. All participants should benefit from personalised dietetic counselling and patients allocated to the intervention arm will be offered an APA programme of two to three weekly sessions of Nordic walking and aerobic fitness. During the 6-month intervention and 6-month follow-up, four assessments will be performed including blood draw, anthropometrics and body composition measurements, and questionnaires about physical activity level, diet, lifestyle factors, psychological criteria, satisfaction with the intervention and medical data. ETHICS AND DISSEMINATION The study was approved by the French Ethics Committee (Comité de Protection des Personnes Sud-Est IV) and the national agencies for biomedical studies and for privacy. All participants will give written informed consent. The study findings will be disseminated through the scientific public and serve as a foundation for future randomised controlled trials of efficacy.
Collapse
Affiliation(s)
- M Touillaud
- Department of Cancer and Environment, Léon Bérard Cancer Centre, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Trédan O, Geay JF, Touzet S, Delva R, Weber B, Cretin J, Provencal J, Martin J, Stefani L, Pujade-Lauraine E, Freyer G. Carboplatin/cyclophosphamide or carboplatin/paclitaxel in elderly patients with advanced ovarian cancer? Analysis of two consecutive trials from the Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens. Ann Oncol 2007; 18:256-62. [PMID: 17082510 DOI: 10.1093/annonc/mdl400] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To determine the feasibility of two chemotherapy regimens in elderly patients with advanced ovarian carcinoma (AOC). PATIENTS AND METHODS Eighty-three patients >or=70 years were previously enrolled in a trial evaluating carboplatin and cyclophosphamide (CC). On the basis of identical eligibility criteria, 75 further patients were enrolled in a trial evaluating carboplatin and paclitaxel (Taxol) (CP). The primary end point of these studies was the feasibility of six courses of chemotherapy. Comprehensive geriatric assessment (CGA) parameters were assessed in terms of prognostic factors. RESULTS More patients in the CC group presented with performance status of two or more, depression symptoms, use of co-medications, hypoalbuminemia, abnormal Mini-Mental Status score, or sub-optimal surgery. Both regimens appeared feasible: 75.6% in the CC group and 68.1% in the CP group completed six courses. CC and CP groups had similar overall survival (OS). Independent prognostic factors of poorer OS were the following: increasing age (P = 0.013), depression symptoms at baseline (P < 0.001), International Federation of Gynecology and Obstetrics stage IV (P = 0.001), and use of paclitaxel (P = 0.025). CONCLUSION As this is a non-randomised retrospective review of two consecutive studies, no firm conclusion can be drawn. It seems, however, that in elderly patients with AOC the use of paclitaxel results in more toxicity. CGA parameters and particularly emotional disorders might help to determine a priori the risk/benefit ratio of chemotherapy in this patient population.
Collapse
Affiliation(s)
- O Trédan
- Medical Oncology Department, Hospices Civils de Lyon et Université de Lyon, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Freyer G, Trédan O, Meille C, Barbolosi D, Tranchand B, Girard P, Iliadis A. Optimal duration of G-CSF prophylaxis after docetaxel (D) + epirubicin (E) in metastatic breast cancer (MBC): Prediction using a mathematical model. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G. Freyer
- Oncologie Médicale, Pierre-Benite, France; Université de la Liberté, Marseille, France; Université Lyon I, Lyon, France
| | - O. Trédan
- Oncologie Médicale, Pierre-Benite, France; Université de la Liberté, Marseille, France; Université Lyon I, Lyon, France
| | - C. Meille
- Oncologie Médicale, Pierre-Benite, France; Université de la Liberté, Marseille, France; Université Lyon I, Lyon, France
| | - D. Barbolosi
- Oncologie Médicale, Pierre-Benite, France; Université de la Liberté, Marseille, France; Université Lyon I, Lyon, France
| | - B. Tranchand
- Oncologie Médicale, Pierre-Benite, France; Université de la Liberté, Marseille, France; Université Lyon I, Lyon, France
| | - P. Girard
- Oncologie Médicale, Pierre-Benite, France; Université de la Liberté, Marseille, France; Université Lyon I, Lyon, France
| | - A. Iliadis
- Oncologie Médicale, Pierre-Benite, France; Université de la Liberté, Marseille, France; Université Lyon I, Lyon, France
| |
Collapse
|
19
|
Trédan O, Ray-Coquard I, Terret C, Lurkin A, Bachelot T, Philip T, Droz JP. Retrospective analysis of conformity with Clinical Practice Guidelines (CPGs) for elderly patients (pts) with early breast cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|