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Meersseman C, Grolleau E, Freymond N, Wallet F, Gilbert T, Locatelli-Sanchez M, Gérinière L, Perrot E, Souquet PJ, Fontaine-Delaruelle C, David JS, Couraud S. High flow nasal oxygen in frail COVID-19 patients hospitalized in intermediate care units and non-eligible to invasive mechanical ventilation. Respir Med Res 2023; 84:101026. [PMID: 37717386 PMCID: PMC10195878 DOI: 10.1016/j.resmer.2023.101026] [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: 10/10/2022] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND In COVID-19 patients, older age (sixty or older), comorbidities, and frailty are associated with a higher risk for mortality and invasive mechanical ventilation (IMV) failure. It therefore seems appropriate to suggest limitations of care to older and vulnerable patients with severe COVID-19 pneumonia and a poor expected outcome, who would not benefit from invasive treatment. HFNO (high flow nasal oxygen) is a non-invasive respiratory support device already used in de novo acute respiratory failure. The main objective of this study was to evaluate the survival of patients treated with HFNO outside the ICU (intensive care unit) for a severe COVID-19 pneumonia, otherwise presenting limitations of care making them non-eligible for IMV. Secondary objectives were the description of our cohort and the identification of prognostic factors for HFNO failure. METHODS We conducted a retrospective cohort study. We included all patients with limitations of care making them non-eligible for IMV and treated with HFNO for a severe COVID-19 pneumonia, hospitalized in a COVID-19 unit of the pulmonology department of Lyon Sud University Hospital, France, from March 2020 to March 2021. Primary outcome was the description of the vital status at day-30 after HFNO initiation, using the WHO (World Health Organization) 7-points ordinal scale. RESULTS Fifty-six patients were included. Median age was 83 years [76.3-87.0], mean duration for HFNO was 7.5 days, 53% had a CFS score (Clinical Frailty Scale) >4. At day-30, 73% of patients were deceased, one patient (2%) was undergoing HFNO, 9% of patients were discharged from hospital. HFNO failure occurred in 66% of patients. Clinical signs of respiratory failure before HFNO initiation (respiratory rate >30/min, retractions, and abdominal paradoxical breathing pattern) were associated with mortality (p = 0.001). CONCLUSIONS We suggest that HFNO is an option in non-ICU skilled units for older and frail patients with a severe COVID-19 pneumonia, otherwise non-suitable for intensive care and mechanical ventilation. Observation of clinical signs of respiratory failure before HFNO initiation was associated with mortality.
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Affiliation(s)
- Corentin Meersseman
- Lyon-Est Medical School, Claude Bernard Lyon 1 University, Villeurbanne, France; Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France.
| | - Emmanuel Grolleau
- Lyon-Est Medical School, Claude Bernard Lyon 1 University, Villeurbanne, France; Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Nathalie Freymond
- Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Florent Wallet
- Anesthesia and Critical Care Medicine Department, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Thomas Gilbert
- Department of Geriatric Medicine, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Myriam Locatelli-Sanchez
- Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Laurence Gérinière
- Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Emilie Perrot
- Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Pierre-Jean Souquet
- Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Clara Fontaine-Delaruelle
- Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Jean-Stéphane David
- Anesthesia and Critical Care Medicine Department, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France
| | - Sébastien Couraud
- Department of Respiratory Diseases, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre Bénite, France; Lyon Center for Innovation in Cancerology, Lyon-Sud Medical School, Claude Bernard Lyon 1 University, Oullins, France
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Léonce C, Guerriau C, Chalabreysse L, Duruisseaux M, Couraud S, Brevet M, Bringuier PP, Poncet DA. Comparison and Validation of Rapid Molecular Testing Methods for Theranostic Epidermal Growth Factor Receptor Alterations in Lung Cancer: Idylla versus Digital Droplet PCR. Int J Mol Sci 2023; 24:15684. [PMID: 37958668 PMCID: PMC10648419 DOI: 10.3390/ijms242115684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Targeting EGFR alterations, particularly the L858R (Exon 21) mutation and Exon 19 deletion (del19), has significantly improved the survival of lung cancer patients. From now on, the issue is to shorten the time to treatment. Here, we challenge two well-known rapid strategies for EGFR testing: the cartridge-based platform Idylla™ (Biocartis) and a digital droplet PCR (ddPCR) approach (ID_Solution). To thoroughly investigate each testing performance, we selected a highly comprehensive cohort of 39 unique del19 (in comparison, the cbioportal contains 40 unique del19), and 9 samples bearing unique polymorphisms in exon 19. Additional L858R (N = 24), L861Q (N = 1), del19 (N = 63), and WT samples (N = 34) were used to determine clear technical and biological cutoffs. A total of 122 DNA samples extracted from formaldehyde-fixed samples was used as input. No false positive results were reported for either of the technologies, as long as careful droplet selection (ddPCR) was ensured for two polymorphisms. ddPCR demonstrated higher sensitivity in detecting unique del19 (92.3%, 36/39) compared to Idylla (67.7%, 21/31). However, considering the prevalence of del19 and L858R in the lung cancer population, the adjusted theranostic values were similar (96.51% and 95.26%, respectively). ddPCR performs better for small specimens and low tumoral content, but in other situations, Idylla is an alternative (especially if a molecular platform is absent).
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Affiliation(s)
- Camille Léonce
- Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France; (C.L.); (C.G.); (L.C.); (M.B.); (P.-P.B.)
- University of Lyon, Université Claude Bernard Lyon 1, 69100 Lyon, France; (M.D.); (S.C.)
- Cancer Research Center of Lyon, UMR INSERM 1052 CNRS 5286, 69008 Lyon, France
| | - Clémence Guerriau
- Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France; (C.L.); (C.G.); (L.C.); (M.B.); (P.-P.B.)
- CNRS UMR 5261, INSERM U 1315, LabEx DEVweCAN, Institut NeuroMyoGène (INMG), Pathophysiology and Genetics of the Neuron and Muscle (PGNM) Laboratory, Team Chromatin Dynamics, Nuclear Domains, Virus, 69008 Lyon, France
| | - Lara Chalabreysse
- Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France; (C.L.); (C.G.); (L.C.); (M.B.); (P.-P.B.)
- University of Lyon, Université Claude Bernard Lyon 1, 69100 Lyon, France; (M.D.); (S.C.)
| | - Michaël Duruisseaux
- University of Lyon, Université Claude Bernard Lyon 1, 69100 Lyon, France; (M.D.); (S.C.)
- Cancer Research Center of Lyon, UMR INSERM 1052 CNRS 5286, 69008 Lyon, France
- Respiratory Department and Early Phase, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, 69100 Lyon, France
| | - Sébastien Couraud
- University of Lyon, Université Claude Bernard Lyon 1, 69100 Lyon, France; (M.D.); (S.C.)
- Department of Pulmonology and Thoracic Oncology, Lyon Sud Hospital, 69495 Pierre Bénite, France
| | - Marie Brevet
- Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France; (C.L.); (C.G.); (L.C.); (M.B.); (P.-P.B.)
- University of Lyon, Université Claude Bernard Lyon 1, 69100 Lyon, France; (M.D.); (S.C.)
| | - Pierre-Paul Bringuier
- Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France; (C.L.); (C.G.); (L.C.); (M.B.); (P.-P.B.)
- University of Lyon, Université Claude Bernard Lyon 1, 69100 Lyon, France; (M.D.); (S.C.)
| | - Delphine Aude Poncet
- Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France; (C.L.); (C.G.); (L.C.); (M.B.); (P.-P.B.)
- University of Lyon, Université Claude Bernard Lyon 1, 69100 Lyon, France; (M.D.); (S.C.)
- CNRS UMR 5261, INSERM U 1315, LabEx DEVweCAN, Institut NeuroMyoGène (INMG), Pathophysiology and Genetics of the Neuron and Muscle (PGNM) Laboratory, Team Chromatin Dynamics, Nuclear Domains, Virus, 69008 Lyon, France
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Grolleau E, Candiracci J, Lescuyer G, Barthelemy D, Benzerdjeb N, Haon C, Geiguer F, Raffin M, Hardat N, Balandier J, Rabeuf R, Chalabreysse L, Wozny AS, Rommelaere G, Rodriguez-Lafrasse C, Subtil F, Couraud S, Herzog M, Payen-Gay L. Circulating H3K27 Methylated Nucleosome Plasma Concentration: Synergistic Information with Circulating Tumor DNA Molecular Profiling. Biomolecules 2023; 13:1255. [PMID: 37627320 PMCID: PMC10452235 DOI: 10.3390/biom13081255] [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: 07/05/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
The molecular profiling of circulating tumor DNA (ctDNA) is a helpful tool not only in cancer treatment, but also in the early detection of relapse. However, the clinical interpretation of a ctDNA negative result remains challenging. The characterization of circulating nucleosomes (carrying cell-free DNA) and associated epigenetic modifications (playing a key role in the tumorigenesis of different cancers) may provide useful information for patient management, by supporting the contributive value of ctDNA molecular profiling. Significantly elevated concentrations of H3K27Me3 nucleosomes were found in plasmas at the diagnosis, and during the follow-up, of NSCLC patients, compared to healthy donors (p-value < 0.0001). By combining the H3K27Me3 level and the ctDNA molecular profile, we found that 25.5% of the patients had H3K27Me3 levels above the cut off, and no somatic alteration was detected at diagnosis. This strongly supports the presence of non-mutated ctDNA in the corresponding plasma. During the patient follow-up, a high H3K27Me3-nucleosome level was found in 15.1% of the sample, despite no somatic mutations being detected, allowing the identification of disease progression from 43.1% to 58.2% over molecular profiling alone. Measuring H3K27Me3-nucleosome levels in combination with ctDNA molecular profiling may improve confidence in the negative molecular result for cfDNA in lung cancer at diagnosis, and may also be a promising biomarker for molecular residual disease (MRD) monitoring, during and/or after treatment.
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Affiliation(s)
- Emmanuel Grolleau
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Pulmonology Department, Lyon Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Julie Candiracci
- Belgian Volition SRL, Parc Scientifique Créalys, 5032 Isnes, Belgium
| | - Gaelle Lescuyer
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Institute of Pharmaceutical and Biological Sciences (ISPB), Claude Bernard University Lyon I, 69373 Lyon, France
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
| | - David Barthelemy
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Institute of Pharmaceutical and Biological Sciences (ISPB), Claude Bernard University Lyon I, 69373 Lyon, France
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
| | - Nazim Benzerdjeb
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Pathology Department, Claude Bernard University Lyon I, Hospices Civils de Lyon, 69677 Bron, France
| | - Christine Haon
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
| | - Florence Geiguer
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Institute of Pharmaceutical and Biological Sciences (ISPB), Claude Bernard University Lyon I, 69373 Lyon, France
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
| | - Margaux Raffin
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Institute of Pharmaceutical and Biological Sciences (ISPB), Claude Bernard University Lyon I, 69373 Lyon, France
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
| | - Nathalie Hardat
- Belgian Volition SRL, Parc Scientifique Créalys, 5032 Isnes, Belgium
| | - Julie Balandier
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Institute of Pharmaceutical and Biological Sciences (ISPB), Claude Bernard University Lyon I, 69373 Lyon, France
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
| | - Rémi Rabeuf
- Belgian Volition SRL, Parc Scientifique Créalys, 5032 Isnes, Belgium
| | - Lara Chalabreysse
- Pathology Department, Claude Bernard University Lyon I, Hospices Civils de Lyon, 69677 Bron, France
| | - Anne-Sophie Wozny
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
- Cellular and Molecular Radiobiology Laboratory UMR CNRS5822/IP2I, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
| | | | - Claire Rodriguez-Lafrasse
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
- Cellular and Molecular Radiobiology Laboratory UMR CNRS5822/IP2I, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
| | - Fabien Subtil
- Statistic Department, Hospices Civils de Lyon, 69008 Lyon, France
- LBBE, Claude Bernard University Lyon I, UMR 5558, CNRS, 69100 Villeurbanne, France
| | - Sébastien Couraud
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Pulmonology Department, Lyon Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Marielle Herzog
- Belgian Volition SRL, Parc Scientifique Créalys, 5032 Isnes, Belgium
| | - Lea Payen-Gay
- Center for Innovation in Cancerology of Lyon (CICLY) EA 3738, Faculty of Medicine and Maieutic Lyon Sud, Claude Bernard University Lyon I, 69921 Oullins, France
- Institute of Pharmaceutical and Biological Sciences (ISPB), Claude Bernard University Lyon I, 69373 Lyon, France
- Department of Biochemistry and Molecular Biology, Lyon-Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre-Bénite, France
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Grolleau E, Candiracci J, Gauthier A, Lescuyer G, Barthelemy D, Haon C, Geiguer F, Raffin M, Hardat N, Balandier J, Rabeuf R, Wozny AS, Rommelaere G, Rodriguez-Lafrasse C, Subtil F, Couraud S, Herzog M, Payen-Gay L. Abstract 2163: Circulating H3K27 nucleosomes to monitor lung cancer patients during treatment, a universal biomarker quantifying the molecular residual disease (MRD) in plasma samples. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-2163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Introduction: Treatment options of lung cancer (LC) comprise radiotherapy, and/or combined treatment approaches, including chemotherapy, immunotherapy and targeted therapies based on the tumoral molecular profile. Following curative-intent first-line therapies, clinical surveillance involves serial CT imaging. However, such surveillance can detect only macroscopic disease recurrence and is frequently inconclusive. NGS has been utilized to help identify and monitor treatment plans. Nucleosomes, complexes of DNA and histones proteins, are released during cell death into blood circulation. Trimethylation of lysine 27 on histone H3 (H3K27Me3), catalyzed by enhancer of zeste homolog 2 (EZH2), is a crucial epigenetic process in tumorigenesis. We investigated if H3K27Me3-nucleosome concentration could be a biomarker for molecular residual disease (MRD).
Patients and Methods: Plasmas were retrospectively collected from patients with advanced LC during treatment (CIRCAN’s cohort, n= 200) and from healthy donors (n=100). We carried out standard targeted NGS on paired plasmas. Samples were divided in two sub-groups based on genetical results: ctDNA negative (n=120) or positive (n=80) for presence of somatic alterations. Concentration of circulating H3K27Me3-nucleosome was measured using chemiluminescent Nu.Q® immunoassay (Belgian Volition SRL, Belgium).
Results: Significantly elevated concentrations of H3K27Me3-nucleosomes were found in LC plasmas during the follow-up of patients compared to healthy donors (median 14.9 ng/ml vs 6.15 ng/ml, respectively, p<0.001). In addition, H3K27Me3 levels is lower in the ctDNA-negative group compared to ctDNA-positive group (median 12.1 vs 24.8 ng/ml, respectively, p<0.001). At a clinical cut-off of 14 ng/ml, 62% of samples were positive for either H3K27Me3 or ctDNA, or for both, suggesting an active disease progression compared to only 40% detection using the NGS assay alone. 38% of the patients have low levels of H3K27Me3 and were ctDNA-negative strongly suggesting a therapeutic response under treatment.
Conclusions: High levels of Nu.Q® H3K27Me3 could allow physicians to detect MRD in LC patients following treatment with curative intent. This could be achieved by monitoring testing of patients at defined intervals of treatment and recovery, alongside imaging, to incorporate analyses of evolving molecular landscapes during treatment. In this setting, the H3K27Me3-nucleosome quantification, to complete the molecular exploration of cfDNA is highly encouraging, especially in advanced NSCLC, where re-tissue biopsies are impractical, expensive, and may cause undue harm. H3K27Me3-nucleosome quantification may also be useful in patient identification for specific treatments such as EZH2 inhibitor, but this requires investigation.
Citation Format: Emmanuel Grolleau, Julie Candiracci, Arnaud Gauthier, Gaelle Lescuyer, David Barthelemy, Christine Haon, Florence Geiguer, Margaux Raffin, Nathalie Hardat, Julie Balandier, Rémi Rabeuf, Anne-Sophie Wozny, Guillaume Rommelaere, Claire Rodriguez-Lafrasse, Fabien Subtil, Sébastien Couraud, Marielle Herzog, Lea Payen-Gay. Circulating H3K27 nucleosomes to monitor lung cancer patients during treatment, a universal biomarker quantifying the molecular residual disease (MRD) in plasma samples [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2163.
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Affiliation(s)
| | | | | | | | | | - Christine Haon
- 1Centre Hospitalier Lyon Sud - HCL, Pierre Benite, France
| | | | - Margaux Raffin
- 1Centre Hospitalier Lyon Sud - HCL, Pierre Benite, France
| | | | | | | | | | | | | | - Fabien Subtil
- 1Centre Hospitalier Lyon Sud - HCL, Pierre Benite, France
| | | | | | - Lea Payen-Gay
- 1Centre Hospitalier Lyon Sud - HCL, Pierre Benite, France
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Grolleau E, de Bermont J, Devun F, Pérol D, Lacoste V, Delastre L, Fleurisson F, Devouassoux G, Mornex JF, Cotton F, Darrason M, Tammemagi M, Couraud S. Eligibility to lung cancer screening among staffs of a university hospital: A large cross-sectional survey. Respir Med Res 2022; 83:100970. [PMID: 36724677 DOI: 10.1016/j.resmer.2022.100970] [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: 06/21/2022] [Revised: 09/26/2022] [Accepted: 10/24/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Implementation of Lung cancer screening (LCS) programs is challenging. The ILYAD study objectives is to evaluate communication methods to improve participation rate among the Lyon University Hospital employees. In this first part of the study, we aimed to determinate the number of eligible individuals among our population of employees. METHOD In November 2020, we conducted a questionnaire based cross sectional survey among the Lyon University Hospital employees (N = 26,954). We evaluated the PLCO m2012 risk prediction model and the eligibility criteria recommended by French guidelines. We assessed the proportion of eligible individuals among the responders and calculated the total eligible individuals in our hospital. RESULTS Overall, 4,526 questionnaires were available for analysis. 16.0% were current smokers, and 28.2% were former smokers. Among the 50-75yo ever-smoker employees, 27% were eligible according to the French guidelines, 2.7% of all eversmokers according to a PLCO m2012 score ≥ 1.51%, and thus, 3.8% of the surveyed population were eligible to the combined criteria. The factors associated with higher eligibility among 50-75yo ever-smokers were educational level, feeling symptoms related to tobacco smoking, personal history of COPD and family history of lung cancer. Using the French guidelines criteria only, we estimated the total number of eligible individuals in the hospital at 838. CONCLUSION In this study, we determined a theoretical number of eligible employees to LCS in our institution and the factors associated to eligibility. Secondly, we will propose LCS to all eligible employees of Lyon University Hospital with incremented information actions.
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Affiliation(s)
- Emmanuel Grolleau
- Service de pneumologie aigue et cancérologie thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310, Pierre Bénite, France; Centre d'Innovation en Cancérologie de Lyon EA 3738, Faculté de médecine Lyon-Sud, Université Lyon 1, 69600, Oullins, France
| | - Julie de Bermont
- Service de pneumologie aigue et cancérologie thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310, Pierre Bénite, France.
| | - Flavien Devun
- Unité de Recherche Commune en Oncologie Thoracique, Hospices Civils de Lyon, Lyon, France
| | - David Pérol
- Bureau d'études cliniques, Centre Léon Bérard, Lyon, France
| | - Véronique Lacoste
- Applied Linguistics Research Center, Lyon 2 university, Lyon, France
| | - Loïc Delastre
- Medical Management Department, Hospices Civils de Lyon, Lyon, France
| | - Fanny Fleurisson
- Medical Management Department, Hospices Civils de Lyon, Lyon, France
| | - Gilles Devouassoux
- Service de Pneumologie, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Jean-François Mornex
- Service de Pneumologie, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - François Cotton
- Service d'Imagerie Médicale, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Marie Darrason
- Service de pneumologie aigue et cancérologie thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310, Pierre Bénite, France; Institut de Recherche en Philosophie, Lyon 3 University, Lyon, France
| | | | - Sébastien Couraud
- Service de pneumologie aigue et cancérologie thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310, Pierre Bénite, France; Centre d'Innovation en Cancérologie de Lyon EA 3738, Faculté de médecine Lyon-Sud, Université Lyon 1, 69600, Oullins, France; Unité de Recherche Commune en Oncologie Thoracique, Hospices Civils de Lyon, Lyon, France
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Debieuvre D, Molinier O, Falchero L, Locher C, Templement-Grangerat D, Meyer N, Morel H, Duval Y, Asselain B, Letierce A, Trédaniel J, Auliac JB, Bylicki O, Moreau L, Fore M, Corre R, Couraud S, Cortot A. Lung cancer trends and tumor characteristic changes over 20 years (2000–2020): Results of three French consecutive nationwide prospective cohorts’ studies. Lancet Reg Health Eur 2022; 22:100492. [PMID: 36108315 PMCID: PMC9445429 DOI: 10.1016/j.lanepe.2022.100492] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Long-term changes in lung cancer (LC) patients are difficult to evaluate. We report results from the French KBP-2020 real-life cohort. Methods KBP-2020 was a prospective cohort that included all patients diagnosed with LC in 2020, in nonacademic public hospital in France. Patient and tumour characteristics were described and compared with similarly designed cohorts in 2000 and 2010. Findings In 2020, 82 centers included 8,999 patients diagnosed with LC. The proportion of women increased: 34·6% (3114/8999) compared to, 24·3% (1711/7051) and 16·0% (904/5667) in 2010 and 2000 (p<0·0001). The proportion of non-smokers was higher in 2020 (12·6%, 1129/8983) than in previous cohorts (10·9% (762/7008) in 2010; 7·2% (402/5586) in 2000, p<0·0001). In 2020, at diagnosis, 57·6% (4405/7648) of patients had a metastatic/disseminated stage non-small-cell lung cancer (NSCLC) (58·3% (3522/6046) in 2010; 42·6% (1879/4411) in 2000, p<0·0001). Compared with 2000 and 2010 data, early survival improved slightly. In 2020, 3-month mortality of NSCLC varied from 3·0% [2·2 – 3·8] for localized to 9·6% [8·1 – 11·0] for locally advanced to 29·2% [27·8 – 30·6] for metastatic and was 24·8% [22·3 – 27·3] for SCLC. Interpretation To our knowledge KBP cohorts have been the largest, prospective, real-world cohort studies involving LC patients conducted in worldwide. The trend found in our study shows an increase in LC in women and still a large proportion of patients diagnosed at metastatic or disseminated stage. Funding The study was promoted by the French College of General Hospital Pulmonologists with financial support of industrials laboratories.
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Affiliation(s)
- Didier Debieuvre
- Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Emile Muller, Mulhouse, France
- Corresponding author at: Service de Pneumologie, GHRMSA, Hôpital Emile Muller, 20 rue du Dr Laënnec, BP 1370, 68070 Mulhouse CEDEX, France.
| | - Olivier Molinier
- Respiratory Medicine Department, Centre Hospitalier Le Mans, Le Mans, France
| | - Lionel Falchero
- Respiratory Medicine Department, L'Hôpital Nord-Ouest, Villefranche-Sur-Saône, France
| | - Chrystèle Locher
- Respiratory Medicine Department, Grand Hôpital de l'Est Francilien (GHEF), Meaux, France
| | | | - Nicolas Meyer
- Biostatistician, Public Health Department, CHU de Strasbourg, GMRC, Strasbourg, France
| | - Hugues Morel
- Respiratory Medicine Department, Centre Hospitalier Régional D'Orléans Hôpital de La Source, Orléans, France
| | - Yannick Duval
- Respiratory Medicine Department, Hôpital de Cannes Simone Veil, Cannes, France
| | - Bernard Asselain
- Methodologist, Groupe Statistique, ARCAGY - GINECO, Paris, France
| | | | - Jean Trédaniel
- Department of Thoracic Oncology, Groupe hospitalier Paris-Saint Joseph, Paris, France
| | - Jean-Bernard Auliac
- Respiratory Medicine Department, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Olivier Bylicki
- Respiratory Medicine Department, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France
| | - Lionel Moreau
- Respiratory Medicine Department, Centre Hospitalier de Colmar, Colmar, France
| | - Mathieu Fore
- Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Emile Muller, Mulhouse, France
| | - Romain Corre
- Respiratory Medicine Department, Centre Hospitalier de Cornouaille, Quimper, France
| | - Sébastien Couraud
- Respiratory Medicine Department, Centre Hospitalier de Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Alexis Cortot
- Department of Thoracic Oncology, CHU de Lille, CNRS, Inserm, Institut Pasteur de Lille, UMR9020-U1277-CANTHER, Lille, France
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Molinier O, Falchero L, Monnet I, Decroisette C, Neidhart AC, Redureau E, Chiappa AM, Bigot F, Bedossa A, Amrane K, Jeandeau S, Dujon C, Bugnet AS, Bonnefoy P, Alizon C, Meyer N, Couraud S, Cortot A, Letierce A, Debieuvre D. 509P COVID-19 disease among lung cancer (LC) patients: Data from a real-life prospective multicentric study. Ann Oncol 2022. [PMCID: PMC9472519 DOI: 10.1016/j.annonc.2022.07.637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Rousset X, Maillet D, Grolleau E, Barthelemy D, Calattini S, Brevet M, Balandier J, Raffin M, Geiguer F, Garcia J, Decaussin-Petrucci M, Peron J, Benzerdjeb N, Couraud S, Viallet J, Payen L. Embryonated Chicken Tumor Xenografts Derived from Circulating Tumor Cells as a Relevant Model to Study Metastatic Dissemination: A Proof of Concept. Cancers (Basel) 2022; 14:cancers14174085. [PMID: 36077622 PMCID: PMC9454737 DOI: 10.3390/cancers14174085] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 06/10/2022] [Revised: 07/21/2022] [Accepted: 08/19/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Circulating Tumor Cells (CTCs) are heterogeneous and rare in the bloodstream, but responsible for cancer metastasis. Their in vitro or in vivo expansion remains a major challenge. The chicken Chorioallantoic Membrane (CAM) assay has proven to be a reliable alternative to the murine model, notably for tumor xenografts. We have developed a promising model of CTC-derived xenografts in the chicken CAM and demonstrated the feasibility of Next Generation Sequencing (NGS) analysis in this assay, with a genomic concordance between the in ovo tumor and the original patient’s tumor. We also evidenced metastatic dissemination from the xenograft in the chicken embryo’s distant organs. Further characterization of the in ovo tumors and metastases may provide new insights into the mechanisms of tumor dissemination. The development of a xenograft from a given patient’s CTCs, in a time frame compatible with managing the patient’s treatment, could also be a step forward towards personalized medicine. Abstract Patient-Derived Xenografts (PDXs) in the Chorioallantoic Membrane (CAM) are a representative model for studying human tumors. Circulating Tumor Cells (CTCs) are involved in cancer dissemination and treatment resistance mechanisms. To facilitate research and deep analysis of these few cells, significant efforts were made to expand them. We evaluated here whether the isolation of fresh CTCs from patients with metastatic cancers could provide a reliable tumor model after a CAM xenograft. We enrolled 35 patients, with breast, prostate, or lung metastatic cancers. We performed microfluidic-based CTC enrichment. After 48–72 h of culture, the CTCs were engrafted onto the CAM of embryonated chicken eggs at day 9 of embryonic development (EDD9). The tumors were resected 9 days after engraftment and histopathological, immunochemical, and genomic analyses were performed. We obtained in ovo tumors for 61% of the patients. Dedifferentiated small tumors with spindle-shaped cells were observed. The epithelial-to-mesenchymal transition of CTCs could explain this phenotype. Beyond the feasibility of NGS in this model, we have highlighted a genomic concordance between the in ovo tumor and the original patient’s tumor for constitutional polymorphism and somatic alteration in one patient. Alu DNA sequences were detected in the chicken embryo’s distant organs, supporting the idea of dedifferentiated cells with aggressive behavior. To our knowledge, we performed the first chicken CAM CTC-derived xenografts with NGS analysis and evidence of CTC dissemination in the chicken embryo.
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Affiliation(s)
| | - Denis Maillet
- University Claude Bernard Lyon, 69100 Villeurbanne, France
- Department of Medical Oncology, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
- Centre de Recherche en Cancérologie de Lyon, INSERM 1052 CNRS UMR 5286, 69008 Lyon, France
| | - Emmanuel Grolleau
- University Claude Bernard Lyon, 69100 Villeurbanne, France
- Acute Respiratory Disease and Thoracic Oncology Department, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
- EMR-3738 Therapeutic Targeting in Oncology, Lyon Sud Medical Faculty, 69000 Lyon, France
| | - David Barthelemy
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre Bénite, France
| | - Sara Calattini
- Clinical Research Plateform, Institut de Cancérologie des Hospices Civils de Lyon, 69002 Lyon, France
| | - Marie Brevet
- Department of Pathology, Lyon Est Hospital, Hospices Civils de Lyon, 69677 Bron, France
| | - Julie Balandier
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre Bénite, France
| | - Margaux Raffin
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre Bénite, France
| | - Florence Geiguer
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre Bénite, France
| | - Jessica Garcia
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre Bénite, France
| | - Myriam Decaussin-Petrucci
- University Claude Bernard Lyon, 69100 Villeurbanne, France
- EMR-3738 Therapeutic Targeting in Oncology, Lyon Sud Medical Faculty, 69000 Lyon, France
- Department of Pathology, Lyon Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Julien Peron
- University Claude Bernard Lyon, 69100 Villeurbanne, France
- Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, CNRS UMR 5558, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Nazim Benzerdjeb
- University Claude Bernard Lyon, 69100 Villeurbanne, France
- EMR-3738 Therapeutic Targeting in Oncology, Lyon Sud Medical Faculty, 69000 Lyon, France
- Department of Pathology, Lyon Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Sébastien Couraud
- University Claude Bernard Lyon, 69100 Villeurbanne, France
- Acute Respiratory Disease and Thoracic Oncology Department, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
- EMR-3738 Therapeutic Targeting in Oncology, Lyon Sud Medical Faculty, 69000 Lyon, France
| | | | - Léa Payen
- University Claude Bernard Lyon, 69100 Villeurbanne, France
- EMR-3738 Therapeutic Targeting in Oncology, Lyon Sud Medical Faculty, 69000 Lyon, France
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon, Cancer Institute, 69495 Pierre Bénite, France
- Correspondence:
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Storme S, Debieuvre D, Souquet PJ, Toffart AC, Couraud S. [Management of immunotherapy in patients with non-small cell lung cancer presenting durable oncological response]. Rev Mal Respir 2022; 39:578-586. [PMID: 35909007 DOI: 10.1016/j.rmr.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/20/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Concerns about the proper schedule for discontinuing immunotherapy have been raised by many clinicians, as well as the minimal check-up required to assess residual disease before stopping immunotherapy. In fact, there currently exist no recommendations concerning immunotherapy prescription and optimal assessment in the event of persistent oncological response in cases of metastatic non-small cell lung cancer (NSCLC). METHODS We conducted an online survey among board-certified French Thoracic Oncologists belonging to two professional associations. The survey included multiple-choice questions that either stood alone or were included in case reports. RESULTS The survey was sent to 490 physicians, of whom 88 responded. For minimal residual disease assessment after 2 years of immunotherapy, PET-scan is prescribed by 92% of respondents and cerebral MRI by 59%. In the event of complete response after 2 years of treatment, 83% of physicians stop prescribing pembrolizumab and 70% discontinue nivolumab. In the event of partial response, 88% of respondents continue immunotherapy. In this case, only 33% use a complementary locoregional treatment such as radiotherapy. CONCLUSION Our survey highlights a pronounced tendency to stop immunotherapy in the event of complete oncological response. In the event of partial morphologic response, on the other hand, there is a tendency to continue immunotherapy. However, the use of locoregional treatments remains more heterogeneous.
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Affiliation(s)
- S Storme
- Faculté de médecine Lyon-Est, Claude-Bernard, université Claude-Bernard, Lyon 1, France.
| | - D Debieuvre
- Service de pneumologie, hôpital Émile-Muller, Mulhouse, France
| | - P-J Souquet
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hospices civils de Lyon, hôpital Lyon Sud, Lyon, France
| | - A-C Toffart
- Service hospitalo-universitaire de pneumologie et physiologie, CHU de Grenoble-Alpes, Grenoble, France
| | - S Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hospices civils de Lyon, hôpital Lyon Sud, Lyon, France
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10
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Collomb B, Dubromel A, Caffin AG, Herledan C, Larbre V, Baudouin A, Cerutti A, Couturier L, Maire M, Karlin L, Maucort-Boulch D, Huot L, Dalle S, Bachy E, Ghesquieres H, Salles G, Couraud S, You B, Freyer G, Trillet-Lenoir V, Ranchon F, Rioufol C. Assessment of Patient Reported Outcomes (PROs) in Outpatients Taking Oral Anticancer Drugs Included in the Real-Life Oncoral Program. Cancers (Basel) 2022; 14:cancers14030660. [PMID: 35158928 PMCID: PMC8833408 DOI: 10.3390/cancers14030660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/25/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Patients receiving oral anticancer agents (OAAs) have a substantial symptom burden. Given the trend toward patient-centered care, the use of patient-reported outcomes (PROs) seems appropriate to secure medication management, and to improve clinical decision-making. The aim of this study was to assess symptoms potentially related to adverse events experienced by cancer outpatients treated by OAAs using PROs. In total, 407 questionnaires were completed by 63 patients, in which 2333 symptoms were reported. Almost three-quarters (74.6%) reported at least one high-level symptom. The symptoms most commonly experienced were fatigue, various psychological disorders and general pain. This initiative is the first step in the implementation of symptom assessment by PROs in patients treated by OAAs. The results highlight the need for close coordination between community and hospital health professionals, and the integration of patient self-reporting systems in oncologic clinical practice. Abstract Background In previous studies, patient-reported outcomes (PROs) have been shown to improve survival in cancer patients. The aim of the present study was to assess symptoms potentially related to adverse events experienced by cancer outpatients treated by oral anticancer agents (OAAs) using PROs. Methods Between September 2018 and May 2019, outpatients starting OAAs were included in a 12-week follow-up to assess 15 symptoms listed in the National Cancer Institute PRO Common Terminology Criteria for Adverse Events, using a 5-point scale of severity or frequency. Patients were requested to alert a referral nurse or pharmacist when they self-assessed high-level (level 3 or 4) symptoms. Results 407 questionnaires were completed by 63 patients in which 2333 symptoms were reported. Almost three-quarters (74.6%) reported at least one high-level symptom. The symptoms that were most commonly experienced were fatigue (>9 in 10 patients; 13.2% of symptoms declared), various psychological disorders (>9 in 10 patients; 28.6% of symptoms declared) and general pain (>8 in 10 patients; 9.4% of symptoms declared). Conclusion PROs are appropriate to detect potential adverse events in cancer outpatients treated by OAAs. This study is the first step for integrating the patient’s perspective in a digital e-health device in routine oncology care.
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Affiliation(s)
- Bastien Collomb
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Amélie Dubromel
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Anne Gaëlle Caffin
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Chloé Herledan
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
| | - Virginie Larbre
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
| | - Amandine Baudouin
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Ariane Cerutti
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Laurence Couturier
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Magali Maire
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Lionel Karlin
- Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Delphine Maucort-Boulch
- Department of Statistics and Bioinformatics, Hospices Civils de Lyon, 69002 Lyon, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, 69622 Lyon, France
| | - Laure Huot
- Cellule Innovation, Département de la Recherche Clinique et de L'innovation, Hospices Civils de Lyon, 69002 Lyon, France
| | - Stéphane Dalle
- Dermatology Department, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Emmanuel Bachy
- Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Hervé Ghesquieres
- Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Gilles Salles
- Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Sébastien Couraud
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
- Department of Pneumology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Benoit You
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
- Department of Oncology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Gilles Freyer
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
- Department of Oncology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Véronique Trillet-Lenoir
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
- Department of Oncology, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
| | - Florence Ranchon
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
| | - Catherine Rioufol
- Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 69495 Lyon, France
- CICLY Centre pour l'Innovation en Cancérologie de Lyon, Université Lyon 1-EA 3738, 69921 Lyon, France
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Catoire S, Nourredine M, Lefebvre S, Couraud S, Gronfier C, Rey R, Peter-Derex L, Geoffroy PA, Rolland B. Tobacco-induced sleep disturbances: A systematic review and meta-analysis. Sleep Med Rev 2021; 60:101544. [PMID: 34597890 DOI: 10.1016/j.smrv.2021.101544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/30/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/26/2022]
Abstract
Even though tobacco-induced sleep disturbances (TISDs) have been reported in previous studies, the present article is the first meta-analysis quantitatively assessing the impact of tobacco on sleep parameters. We conducted a systematic review and meta-analysis of the studies comparing objective (i.e. polysomnography and actigraphy) and/or subjective sleep parameters in chronic tobacco smokers without comorbidities versus healthy controls. Studies were retrieved using PubMed, PsycINFO, and Web of Science. Differences are expressed as standardized mean deviations (SMD) and their 95% confidence intervals (95%CI). Fourteen studies were finally included into the review, among which ten were suitable for meta-analysis. Compared to healthy controls, chronic tobacco users displayed increased N1 percentage (SMD = 0.65, 95%CI: 0.22 to 1.07), N2 percentage (SMD = 1.45, 95%CI: 0.26 to 2.63), wake time after sleep onset (SMD = 6.37, 95%CI: 2.48 to 10.26), and decreased slow-wave sleep (SMD = -2.00, 95%CI: -3.30 to -0.70). Objective TISDs preferentially occurred during the first part of the night. Regarding subjective parameters, only the Pittsburgh Sleep Quality Index (PSQI) total score could be analyzed, with no significant between-groups difference (SMD = 0.53, 95%CI: -0.18 to 1.23). Smoking status should be carefully assessed in sleep medicine, while TISDs should be regularly explored in chronic tobacco users.
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Affiliation(s)
- Sébastien Catoire
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Unité Michel Jouvet, 69Z19, Pôle Est, CH Le Vinatier, 69500, Bron, France; Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Hôpital Lyon-Sud, CHU Lyon, 69310 Pierre Bénite, France.
| | - Mikail Nourredine
- Service Hospitalo-Universitaire de pharmacotoxicologie, Service de recherche et épidémiologie clinique Hospices Civils de Lyon, 69424, Lyon, France; Faculté de Médecine Lyon-Sud, 69921, Oullins, France
| | - Stéphanie Lefebvre
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Hôpital Lyon-Sud, CHU Lyon, 69310 Pierre Bénite, France; EMR 3738 Ciblage thérapeutique en Oncologie, Faculté de médecine et de maïeutique Lyon Sud Charles - Mérieux, Université Lyon 1, France
| | - Claude Gronfier
- Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Romain Rey
- Unité Michel Jouvet, 69Z19, Pôle Est, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Laure Peter-Derex
- Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France; Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Pierre A Geoffroy
- Service de Psychiatrie et d'Addictologie, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Bichat, Paris, France; Université de Paris, NeuroDiderot, Inserm, Paris, France; GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France; Service d'Addictologie, Hôpital Édouard Herriot, CHU Lyon, 69003, Lyon, France
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Bieler J, Pozzorini C, Garcia J, Tuck AC, Macheret M, Willig A, Couraud S, Xing X, Menu P, Steinmetz LM, Payen L, Xu Z. High-Throughput Nucleotide Resolution Predictions of Assay Limitations Increase the Reliability and Concordance of Clinical Tests. JCO Clin Cancer Inform 2021; 5:1085-1095. [PMID: 34731027 DOI: 10.1200/cci.21.00057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The ability of next-generation sequencing (NGS) assays to interrogate thousands of genomic loci has revolutionized genetic testing. However, translation to the clinic is impeded by false-negative results that pose a risk to patients. In response, regulatory bodies are calling for reliability measures to be reported alongside NGS results. Existing methods to estimate reliability do not account for sample- and position-specific variability, which can be significant. Here, we report an approach that computes reliability metrics for every genomic position and sample interrogated by an NGS assay. METHODS Our approach predicts the limit of detection (LOD), the lowest reliably detectable variant fraction, by taking technical factors into account. We initially explored how LOD is affected by input material amount, library conversion rate, sequencing coverage, and sequencing error rate. This revealed that LOD depends heavily on genomic context and sample properties. Using these insights, we developed a computational approach to predict LOD on the basis of a biophysical model of the NGS workflow. We focused on targeted assays for cell-free DNA, but, in principle, this approach applies to any NGS assay. RESULTS We validated our approach by showing that it accurately predicts LOD and distinguishes reliable from unreliable results when screening 580 lung cancer samples for actionable mutations. Compared with a standard variant calling workflow, our approach avoided most false negatives and improved interassay concordance from 94% to 99%. CONCLUSION Our approach, which we name LAVA (LOD-aware variant analysis), reports the LOD for every position and sample interrogated by an NGS assay. This enables reliable results to be identified and improves the transparency and safety of genetic tests.
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Affiliation(s)
| | | | - Jessica Garcia
- Laboratoire de Biochimie et Biologie Moléculaire, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Institut de Cancérologie des Hospices Civils de Lyon, CIRculating CANcer Program (CIRCAN), Lyon, France
| | - Alex C Tuck
- SOPHiA GENETICS SA, Saint Sulpice, Switzerland
| | | | | | - Sébastien Couraud
- Institut de Cancérologie des Hospices Civils de Lyon, CIRculating CANcer Program (CIRCAN), Lyon, France.,Service de Pneumologie aigue spécialisée et cancérologie thoracique, Groupement hospitalier sud, Institut de Cancérologie des Hospices Civils de Lyon, Pierre Bénite, France
| | | | | | - Lars M Steinmetz
- Stanford Genome Technology Center, Stanford University, Palo Alto, CA.,Department of Genetics, School of Medicine, Stanford University, Stanford, CA
| | - Léa Payen
- Laboratoire de Biochimie et Biologie Moléculaire, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Institut de Cancérologie des Hospices Civils de Lyon, CIRculating CANcer Program (CIRCAN), Lyon, France
| | - Zhenyu Xu
- SOPHiA GENETICS SA, Saint Sulpice, Switzerland
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Affiliation(s)
- Marie Darrason
- Service de Pneumologie et oncologie thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
- Institut de Recherches Philosophiques de Lyon, Université Jean Moulin Lyon 3, France
| | - Emmanuel Grolleau
- Service de Pneumologie et oncologie thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
- Center for Innovation in Cancer of Lyon, Lyon 1 University, Oullins, France
| | - Julie De Bermont
- Service de Pneumologie et oncologie thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Sébastien Couraud
- Service de Pneumologie et oncologie thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
- Center for Innovation in Cancer of Lyon, Lyon 1 University, Oullins, France
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14
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Simon L, Déméautis T, Dupont D, Kramer R, Garnier H, Durieu I, Sénéchal A, Reix P, Couraud S, Devouassoux G, Lina B, Rabodonirina M, Wallon M, Dannaoui E, Persat F, Menotti J. Azole resistance in Aspergillus fumigatus isolates from respiratory specimens in Lyon University Hospitals, France: prevalence and mechanisms involved. Int J Antimicrob Agents 2021; 58:106447. [PMID: 34619334 DOI: 10.1016/j.ijantimicag.2021.106447] [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: 04/29/2021] [Revised: 08/05/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022]
Abstract
Resistance of Aspergillus fumigatus to triazoles has been reported increasingly in Europe. As few data are available from Southern France, the objectives of this study were to assess the burden of A. fumigatus isolates with azole resistance from clinical specimens in Lyon, and explore the resistance mechanisms involved. In this retrospective cross-sectional study, 221 consecutive A. fumigatus isolates from respiratory samples were identified from an 8-month period from 195 patients attending the Pulmonary Medicine Departments of Lyon University Hospitals. Morphological identification was confirmed by sequence analysis of the β-tubulin gene. All samples were tested for susceptibilities to itraconazole, voriconazole, posaconazole and isavuconazole using concentration gradient strips, and the results were confirmed using the EUCAST broth microdilution method. Resistance mechanisms were investigated by sequencing the cyp51A gene and its promoter, and by expression analysis of cyp51 and genes encoding several efflux transporters. Four isolates exhibited azole resistance. Three isolates presented with polymorphisms in an intronic region of cyp51A, and one isolate had F46Y, M172V and E427K polymorphisms. No mutations were identified in the cyp51A promoter, but significant induction of cyp51A and cyp51B gene expression was observed for all four and three isolates, respectively. Significant induction of atrF and cdr1B gene expression was observed for two and three isolates, respectively. No significant induction of MDR1/2/3/4, MFS56 and M85 gene expression was observed. To conclude, the observed prevalence of azole resistance was 2.1%. Significant induction of expression of the cyp51 genes and two genes encoding efflux transporters was evidenced, underlying the diversity of resistance mechanisms to be explored.
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Affiliation(s)
- Loïc Simon
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France; Centre Hospitalier Universitaire de Nice, Service de Parasitologie-Mycologie, Université Côte d'Azur, Nice, France
| | - Tanguy Déméautis
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France; Université Claude Bernard Lyon 1, EA7426 équipe Inflammation et immunité de l'épithélium respiratoire, Oullins, France
| | - Damien Dupont
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France; Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Inserm U1028, CNRS UMR5292, équipe WAKING, Lyon, France
| | - Rolf Kramer
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France; European Public Health Microbiology Training Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Héloïse Garnier
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France
| | - Isabelle Durieu
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Médecine Interne et Vasculaire, Centre de Ressources et de Compétences de la Mucoviscidose Adultes, Pierre-Bénite, France
| | - Agathe Sénéchal
- Hospices Civils de Lyon, Hôpital Louis Pradel, Département de Pneumologie et de Transplantation Pulmonaire, Hospices Civils de Lyon, Bron, France
| | - Philippe Reix
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressources et de Compétences de la Mucoviscidose Enfants, Bron, France
| | - Sébastien Couraud
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Pneumologie Aiguë Spécialisée et Cancérologie Thoracique, Pierre-Bénite, France
| | - Gilles Devouassoux
- Université Claude Bernard Lyon 1, EA7426 équipe Inflammation et immunité de l'épithélium respiratoire, Oullins, France; Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service de Pneumologie, Lyon, France
| | - Bruno Lina
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Virologie, Hôpital de la Croix-Rousse, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Inserm U1111, Lyon, France
| | - Meja Rabodonirina
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Inserm U1111, Lyon, France
| | - Martine Wallon
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France; Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Inserm U1028, CNRS UMR5292, équipe WAKING, Lyon, France
| | - Eric Dannaoui
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Microbiologie, Unité de Parasitologie-Mycologie, Paris, France; Université Paris-Est Créteil, Équipe Dynamyc, EA 7380, Créteil, France
| | - Florence Persat
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France; Université Claude Bernard Lyon 1, EA7426 équipe Inflammation et immunité de l'épithélium respiratoire, Oullins, France
| | - Jean Menotti
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie médicale, Hôpital de la Croix-Rousse, Lyon, France; Université Claude Bernard Lyon 1, EA7426 équipe Inflammation et immunité de l'épithélium respiratoire, Oullins, France.
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Darrason M, Souquet PJ, Couraud S. Standardized vs peer-played patients for learning how to break bad news in lung cancer: A prospective crossover study. Respir Med Res 2021; 80:100856. [PMID: 34481303 DOI: 10.1016/j.resmer.2021.100856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
CONTEXT Residents in respiratory medicine are often confronted with breaking bad news to patients. In communication skill training, a recurring question is whether to use standardized or peer-played patients for simulation METHODS: In this prospective single-center crossover study in pulmonology residents, a range of scenarios were performed during training sessions using standardized or peer-played patients. The aim was to assess whether patient type did alter the quality of the role-play. The residents completed post-scenario questionnaires about the role-play of each scenario, but also pre- and post-session questionnaires about their perception of the effectiveness of both modalities, and pre- and post-testing questionnaires about the psychological impact of the training. RESULTS Collectively, 4 scenarios were performed 52 times and evaluated 208 times by 52 residents. The use of standardized patients appeared to improve the quality of the patient role (8.8 ± 1.0 vs. 8.3 ± 1.1; p = 0.001) and the general quality of role-play (8.8 ± 1.0 vs. 8.2 ± 0.9; p = 0.008), without affecting the quality of the physician role played by the resident. There were no significant differences between standardized and peer-played patients regarding learning interest or psychological impact. Regardless of the modality, the training sessions did appear to significantly affect the residents' evaluations of their ability to break bad news to patients (5.7 ± 1.1 vs. 7.4 ± 1.1; p < 10-4). CONCLUSION Our results did not point to a superiority of either of these modalities for learning how to break bad news. Both may be used, depending on the local resources.
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Affiliation(s)
- Marie Darrason
- Service de Pneumologie Aigue et Cancérologie Thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France; Institut de Recherches Philosophiques de Lyon, Université Lyon 3, Lyon, France.
| | - Pierre-Jean Souquet
- Service de Pneumologie Aigue et Cancérologie Thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue et Cancérologie Thoracique, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France; Plateforme Lyon Sud de Simulation en Santé (PL3S), Faculté de médecine et de maïeutique Lyon Sud, Université de Lyon, Lyon, France
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16
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Grolleau E, Fonteille V, Lebourgeois C, Darrason M, Michel P, Ragonnet D, Freyer G, Deculty A, Gippet C, Leclercq C, Neugnot C, Malek R, Perdriolat O, Rigaud M, Torrecillas S, Barral MC, Souquet PJ, Fassier JB, Tanguy L, Rolland B, Couraud S. Tobacco use and related behaviors among staff and students in a university hospital: A large cross-sectional survey. Tob Prev Cessat 2021; 7:49. [PMID: 34268457 PMCID: PMC8265395 DOI: 10.18332/tpc/137670] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/14/2021] [Accepted: 05/18/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Smoking prevalence in the overall population in France was 27% in 2017. There are few data about smoking prevalence in hospital workers. The aim of this study was to assess prevalence of current smoking in student and staff populations at Lyon University Hospital. Secondary objectives were to identify main variables associated with current smoking and willingness to quit. METHODS We designed a single center, cross-sectional survey, using printed questionnaires. During one day, all registered staff and students were surveyed. We used optical reading to extract information from questionnaires. We performed univariate and multivariate analysis adjusted on most relevant factors. RESULTS We analyzed 9712 questionnaires. The participating rates were high: 40.6% in the student cohort and 51.5% in the staff cohort. The proportion of current cigarette users was 26% in students and 25% in staff. In multivariate analysis, current smoking was significantly associated with: younger age, male sex, occupation type (e.g. logistical staff, and paramedical students), overnight work, and e-cigarette use. Among smokers, 53% reported a willingness to quit. In multivariate analysis, number of quit attempts, and feeling symptoms from tobacco were associated with willingness to quit. CONCLUSIONS Current smoking is less frequent in our cohorts of hospital staff and students than in the general French population. However, there are deep disparities in current smoking prevalence underlining a heterogeneous population. Among smokers, the majority reported a willingness to quit and some predictive factors may help to target this audience.
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Affiliation(s)
- Emmanuel Grolleau
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Véronique Fonteille
- Equipe de Liaison en Addictologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Caroline Lebourgeois
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France.,Direction de la Performance et du Contrôle de Gestion, Hospices Civils de Lyon, Lyon, France
| | - Marie Darrason
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Philippe Michel
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France.,Direction de l'Organisation, de la Qualité des Soins et des Relations avec les Usagers Hospices Civils de Lyon, Lyon, France
| | - Delphine Ragonnet
- Service d'Addictologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Gilles Freyer
- Institut de Cancérologie des Hospices Civils de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Amélie Deculty
- Centre de Coordination en Cancérologie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Carine Gippet
- Centre de Coordination en Cancérologie, Hospices Civils de Lyon, Lyon, France
| | - Céline Leclercq
- Centre de Coordination en Cancérologie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Carole Neugnot
- Centre de Coordination en Cancérologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Radoudja Malek
- Centre de Coordination en Cancérologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Odile Perdriolat
- Unité de Tabacologie, Service de Maternité, Hôpital Femme-Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Michele Rigaud
- Centre de Coordination en Cancérologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Séverine Torrecillas
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Centre de Coordination en Cancérologie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Maud-Catherine Barral
- Unité de Tabacologie, Service de Maternité, Hôpital Femme-Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Pierre-Jean Souquet
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Jean-Baptiste Fassier
- Service de Médecine et Santé au Travail, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Lénaïck Tanguy
- Institut de Cancérologie des Hospices Civils de Lyon, Hospices Civils de Lyon, Lyon, France.,Direction de la Coopération et des Stratégies, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- Equipe de Liaison en Addictologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.,Service d'Addictologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Service Universitaire d'Addictologie de Lyon, Centre Hospitalier du Vinatier, Bron, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Equipe IBISCUS, Centre d'Innovation en Cancérologie de Lyon (CICLY), Faculté de Médecine Lyon Sud, Oullins, France
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Garcia J, Kamps-Hughes N, Geiguer F, Couraud S, Sarver B, Payen L, Ionescu-Zanetti C. Sensitivity, specificity, and accuracy of a liquid biopsy approach utilizing molecular amplification pools. Sci Rep 2021. [PMID: 34031447 DOI: 10.1038/s41598‐021‐89592‐8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Circulating cell-free DNA (cfDNA) has the potential to be a specific biomarker for the therapeutic management of lung cancer patients. Here, a new sequencing error-reduction method based on molecular amplification pools (MAPs) was utilized to analyze cfDNA in lung cancer patients. We determined the accuracy of MAPs plasma sequencing with respect to droplet digital polymerase chain reaction assays (ddPCR), and tested whether actionable mutation discovery is improved by next-generation sequencing (NGS) in a clinical setting. This study reports data from 356 lung cancer patients receiving plasma testing as part of routine clinical management. Sequencing of cfDNA via MAPs had a sensitivity of 98.5% and specificity 98.9%. The ddPCR assay was used as the reference, since it is an established, accurate assay that can be performed contemporaneously on the same plasma sample. MAPs sequencing detected somatic variants in 261 of 356 samples (73%). Non-actionable clonal hematopoiesis-associated variants were identified via sequencing in 21% of samples. The accuracy of this cfDNA sequencing approach was similar to that of ddPCR assays in a clinical setting, down to an allele frequency of 0.1%. Due to broader coverage and high sensitivity for insertions and deletions, sequencing via MAPs afforded important detection of additional actionable mutations.
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Affiliation(s)
- Jessica Garcia
- Laboratoire de Biochimie Et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France.,CIRculating CANcer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute, 69495, Pierre Bénite, France
| | | | - Florence Geiguer
- Laboratoire de Biochimie Et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France.,CIRculating CANcer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute, 69495, Pierre Bénite, France
| | - Sébastien Couraud
- CIRculating CANcer (CIRCAN) Program, Acute Respiratory Disease and Thoracic Oncology Department, Lyon Sud Hospital, Cancer Institute of Hospices Civils de Lyon, Lyon, France
| | | | - Léa Payen
- Laboratoire de Biochimie Et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France.,CIRculating CANcer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute, 69495, Pierre Bénite, France
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18
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Garcia J, Kamps-Hughes N, Geiguer F, Couraud S, Sarver B, Payen L, Ionescu-Zanetti C. Sensitivity, specificity, and accuracy of a liquid biopsy approach utilizing molecular amplification pools. Sci Rep 2021; 11:10761. [PMID: 34031447 PMCID: PMC8144209 DOI: 10.1038/s41598-021-89592-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 12/03/2020] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
Circulating cell-free DNA (cfDNA) has the potential to be a specific biomarker for the therapeutic management of lung cancer patients. Here, a new sequencing error-reduction method based on molecular amplification pools (MAPs) was utilized to analyze cfDNA in lung cancer patients. We determined the accuracy of MAPs plasma sequencing with respect to droplet digital polymerase chain reaction assays (ddPCR), and tested whether actionable mutation discovery is improved by next-generation sequencing (NGS) in a clinical setting. This study reports data from 356 lung cancer patients receiving plasma testing as part of routine clinical management. Sequencing of cfDNA via MAPs had a sensitivity of 98.5% and specificity 98.9%. The ddPCR assay was used as the reference, since it is an established, accurate assay that can be performed contemporaneously on the same plasma sample. MAPs sequencing detected somatic variants in 261 of 356 samples (73%). Non-actionable clonal hematopoiesis-associated variants were identified via sequencing in 21% of samples. The accuracy of this cfDNA sequencing approach was similar to that of ddPCR assays in a clinical setting, down to an allele frequency of 0.1%. Due to broader coverage and high sensitivity for insertions and deletions, sequencing via MAPs afforded important detection of additional actionable mutations.
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Affiliation(s)
- Jessica Garcia
- Laboratoire de Biochimie Et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France
- CIRculating CANcer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute, 69495, Pierre Bénite, France
| | | | - Florence Geiguer
- Laboratoire de Biochimie Et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France
- CIRculating CANcer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute, 69495, Pierre Bénite, France
| | - Sébastien Couraud
- CIRculating CANcer (CIRCAN) Program, Acute Respiratory Disease and Thoracic Oncology Department, Lyon Sud Hospital, Cancer Institute of Hospices Civils de Lyon, Lyon, France
| | | | - Léa Payen
- Laboratoire de Biochimie Et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, France
- CIRculating CANcer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute, 69495, Pierre Bénite, France
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Garcia J, Gauthier A, Lescuyer G, Barthelemy D, Geiguer F, Balandier J, Edelstein DL, Jones FS, Holtrup F, Duruisseau M, Grolleau E, Rodriguez-Lafrasse C, Merle P, Couraud S, Payen L. Routine Molecular Screening of Patients with Advanced Non-SmallCell Lung Cancer in Circulating Cell-Free DNA at Diagnosis and During Progression Using OncoBEAM TM EGFR V2 and NGS Technologies. Mol Diagn Ther 2021; 25:239-250. [PMID: 33660188 PMCID: PMC7956937 DOI: 10.1007/s40291-021-00515-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 12/30/2022]
Abstract
Background and Objectives The use of ultra-sensitive diagnostic tests to detect clinically actionable somatic alterations within the gene encoding the epidermal growth factor receptor (EGFR) within circulating cell-free DNA is an important first step in determining the eligibility of patients with non-small cell lung cancer to receive tyrosine kinase inhibitors. Methods We present the clinical validation (accuracy, sensitivity, and specificity) of a highly sensitive OncoBEAMTMEGFR V2 test, which we compare to a custom next-generation sequencing assay, for the treatment of patients with non-small cell lung cancer with EGFR tyrosine kinase inhibitor therapies. The OncoBEAMTM digital-polymerase chain reaction method detects 36 different EGFR alterations in circulating cell-free DNA, whereas the next-generation sequencing assay covers major solid tumor oncodrivers. Of the 540 samples analyzed with the OncoBEAMTMEGFR V2 test, 42.4% of patients had undergone molecular testing at diagnosis (N = 229/540) and 57.7% of patients during disease progression (N = 311/540). Results The sensitivity and specificity were measured for this BEAMing assay. The number of mutant beads and mutant allelic fraction were measured for each EGFR alteration and the level of detection was established at 0.1% for a median of 2861 genome equivalent (GE) in each reaction using HD780 horizon control DNA, as well as by an internal quality reference standard. Approximately 10%, 27%, and 63% of the 540 samples contained < 1500 GE, a range of 1500–3000 GE, and > 3000 GE, which corresponded to a maximal assay sensitivity of 2.0%, 0.5–0.1%, and 0.1–0.05% mutant allelic fraction, respectively. In a routine hospital setting, 11.4% of non-small cell lung cancer tumors were positive at diagnosis for EGFR alterations, while 43.7% samples harbored EGFR mutations at progression, among which 40.3% expressed EGFR resistance mutations after first-line tyrosine kinase inhibitor treatment with first- and second-generation drugs. Conclusions The OncoBEAMTMEGFR V2 is a sensitive, robust, and accurate assay that delivers reproducible results. Next-generation sequencing and BEAMing technologies act complementarily in the routine molecular screening. We show that using a next-generation sequencing assay, despite its lower sensitivity, enables the identification of rare EGFR alterations or resistance mechanisms (mutation, deletion, insertion, and copy number variation) to orient first- and second-line treatments. Supplementary Information The online version contains supplementary material available at 10.1007/s40291-021-00515-9.
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Affiliation(s)
- Jessica Garcia
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Hospices Civils de Lyon Cancer Institute, CIRculating CANcer (CIRCAN) Program, Pierre-Bénite, France
| | - Arnaud Gauthier
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Gaëlle Lescuyer
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Hospices Civils de Lyon Cancer Institute, CIRculating CANcer (CIRCAN) Program, Pierre-Bénite, France
| | - David Barthelemy
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Hospices Civils de Lyon Cancer Institute, CIRculating CANcer (CIRCAN) Program, Pierre-Bénite, France
| | - Florence Geiguer
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Hospices Civils de Lyon Cancer Institute, CIRculating CANcer (CIRCAN) Program, Pierre-Bénite, France
| | - Julie Balandier
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Hospices Civils de Lyon Cancer Institute, CIRculating CANcer (CIRCAN) Program, Pierre-Bénite, France
| | - Daniel L Edelstein
- Life Sciences Medical Affairs and Research and Development Sysmex Inostics, GmBH, Hamburg, Germany
| | - Frederick S Jones
- Life Sciences Medical Affairs and Research and Development Sysmex Inostics, GmBH, Hamburg, Germany
| | - Frank Holtrup
- Life Sciences Medical Affairs and Research and Development Sysmex Inostics, GmBH, Hamburg, Germany
| | - Mickael Duruisseau
- Service de Pneumologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Emmanuel Grolleau
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Groupement Hospitalier Sud, Institut de Cancérologie des Hospices Civils de Lyon, Pierre-Bénite, France
| | - Claire Rodriguez-Lafrasse
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Patrick Merle
- Service de Pneumologie, Centre Hospitalier Gabriel Montpied, Clermont-Ferrand, France
| | - Sébastien Couraud
- Hospices Civils de Lyon Cancer Institute, CIRculating CANcer (CIRCAN) Program, Pierre-Bénite, France.,Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Groupement Hospitalier Sud, Institut de Cancérologie des Hospices Civils de Lyon, Pierre-Bénite, France.,EMR 3738 Ciblage Thérapeutique en Oncologie, Faculté de Médecine Lyon-Sud, Université de Lyon, Oullins, France
| | - Léa Payen
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France. .,Hospices Civils de Lyon Cancer Institute, CIRculating CANcer (CIRCAN) Program, Pierre-Bénite, France. .,Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165, Chemin du Grand Revoyet, 69495, Pierre-Bénite, France.
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20
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Couraud S, Ferretti G, Milleron B, Cortot A, Girard N, Gounant V, Laurent F, Leleu O, Quoix E, Revel MP, Wislez M, Westeel V, Zalcman G, Scherpereel A, Khalil A. [Recommendations of French specialists on screening for lung cancer]. Rev Mal Respir 2021; 38:310-325. [PMID: 33637394 DOI: 10.1016/j.rmr.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 01/25/2021] [Indexed: 12/17/2022]
Affiliation(s)
- S Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hospices civils de Lyon, hôpital Lyon Sud, Pierre-Bénite, France; Intergroupe francophone de cancérologie thoracique, Paris, France.
| | - G Ferretti
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de radiologie diagnostique et interventionnel, CHU de Grenoble-Alpes, Grenoble, France
| | - B Milleron
- Intergroupe francophone de cancérologie thoracique, Paris, France
| | - A Cortot
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et oncologie thoracique, CHU de Lille, Lille, France
| | - N Girard
- Intergroupe francophone de cancérologie thoracique, Paris, France; Unité d'oncologie thoracique, institut Curie, Paris, France
| | - V Gounant
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
| | - F Laurent
- Service de radiologie, CHU de Bordeaux, Pessac, France
| | - O Leleu
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie, centre hospitalier Abbeville, Abbeville, France
| | - E Quoix
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie, CHRU Strasbourg, Strasbourg, France
| | - M-P Revel
- Service de radiologie, hôpital Cochin, Paris, France
| | - M Wislez
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, hôpital Cochin, Paris, France
| | - V Westeel
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et cancérologie thoracique, CHU de Besançon, Besançon, France
| | - G Zalcman
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
| | - A Scherpereel
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et oncologie thoracique, CHU de Lille, Lille, France
| | - A Khalil
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de radiologie, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
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21
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Rouprêt M, Morère JF, Touboul C, Lhomel C, Couraud S, de la Motte Rouge T. Knowledge of bladder cancer in the French population: results of the EDIFICE 6 survey. Eur J Cancer Care (Engl) 2020; 30:e13392. [PMID: 33336542 DOI: 10.1111/ecc.13392] [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: 06/02/2020] [Revised: 10/26/2020] [Accepted: 12/01/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess awareness of bladder cancer (BCa) in France. METHODS The French nationwide observational survey EDIFICE 6 was conducted online (26 June-28 July 2017) in 12,046 individuals (age, 18-69 years). The present analysis focuses on laypersons' knowledge of the severity and frequency of BCa, signs and symptoms, associated risk factors and screening tests. Quantitative data were expressed as means and standard deviation, and categorical data as percentages. RESULTS Analyses were conducted on 11,313 questionnaires. Among the top five acknowledged risk factors for BCa, tobacco was ranked as having the second lowest impact (5.9/10 [2.5]). Only 28% of the study population were aware that active tobacco smoking is a major risk factor for BCa (rating ≥8/10); 61% of the study population was unaware of the existence of any signs or symptoms of BCa, and 69% was not able to cite any of the most widely used diagnostic tests. CONCLUSIONS We found that the French population has a poor knowledge of BCa risk factors, early signs and diagnostic tests. Effective prevention of BCa requires dissemination of clear information and prevention messages to the lay population, focusing particularly on tobacco consumption and early signs of the disease.
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Affiliation(s)
- Morgan Rouprêt
- Sorbonne Université, GRC n°5, PREDICTIVE ONCO-URO, Assistance Publique - Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
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22
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Couraud S, Grolleau E. [How to implement lung cancer screening ?]. Rev Prat 2020; 70:864-867. [PMID: 33739688] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
How to implement lung cancer screening ? In this review, we will focus on practical approaches to lung cancer screening in France and worldwide. In France, these modalities are determined by recommendations, currently in edition. However, main outcomes recommended for screening are reported here.
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Affiliation(s)
- Sébastien Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, Hospices civils de Lyon, Pierre-Bénite, France
| | - Emmanuel Grolleau
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, Hospices civils de Lyon, Pierre-Bénite, France
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23
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Mazieres J, Tomasini P, Lusque A, Boucekine M, Gautschi O, Cortot A, Couraud S, Thai A, Ng T, Greillier L, Veillon R, Neal J, Popat S, Gounant V, Mhanna L, Drilon A, Baron JM, Barlesi F. 1279P Impact of KRAS mutations and subtypes on efficacy of immune-checkpoint inhibitors (ICI) in non-small cell lung cancer (NSCLC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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24
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Darrason M, Chatelain E, Ranchon F, Gervaise C, Duruisseaux M, Couraud S. Do systemic treatments delivered after Nivolumab result in better outcomes? A bicentric case-control study. Respir Med Res 2020; 77:100-105. [PMID: 32512522 DOI: 10.1016/j.resmer.2020.02.001] [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: 08/19/2019] [Revised: 01/08/2020] [Accepted: 02/04/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) are now widely used at different stages of non-small cell lung cancers (NSCLC). Some clinical studies suggest that chemotherapy and immunotherapy have synergic activities, raising the question of the best therapeutic sequence. We studied the effect of chemotherapy in advanced NSCLC when administered after immunotherapy by nivolumab. METHODS We performed a bicentric, retrospective, case-control study in two French hospitals. Patients with NSCLC treated with chemotherapy after nivolumab between January 2015 and January 2016 were included. Each case was matched on age and number of previous lines to one lung cancer patient who had not received nivolumab. Each CT-scanner has been reviewed and the objective response to chemotherapy was assessed for each patient according to the RECIST 1.1 criteria. RESULTS Thirty-one patients with advanced NSCL who had at least received one cycle of chemotherapy after progression under nivolumab in the inclusion period were matched to 31 controls. The median age for cases was 59 yo and the predominant tumoral histology was adenocarcinoma (77%). The progression free survival (PFS) was 2.95 months in the studied group vs 2.69 months (P=0.18) in the control group. At best response, disease control (DC=partial response and stable disease) was better in the case group than in the control group (58% vs 39%, P=0.127). Cases were about five times more likely to get objective response to best evaluation than controls (OR=5.043 [95% CI: 0.975-26.086]; P=0.054). The overall survival (OS) was 7.3 months in the case group and 3.3 months in the control group (P=0.074). Patients who have been treated with targeted therapy instead of chemotherapy and patients with squamous lung cancer had worst PFS and OS. CONCLUSION In advanced NSCLC, the chemotherapy progression free survival does not seem higher when administered after nivolumab. However, when administered post-nivolumab, traditional chemotherapy has 5 times more chances to achieve objective response and seems to improve overall survival of cases. Pooled analysis with other similar studies might be interesting for a next step.
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Affiliation(s)
- M Darrason
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut de cancérologie des hospices civils de Lyon, hôpital Lyon Sud, Pierre-Bénite, France
| | - E Chatelain
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut de cancérologie des hospices civils de Lyon, hôpital Lyon Sud, Pierre-Bénite, France
| | - F Ranchon
- Service de pharmacie, institut de cancérologie des hospices civils de Lyon, hôpital Lyon Sud, Pierre-Bénite, France
| | - C Gervaise
- Service de pharmacie, institut de cancérologie des hospices civils de Lyon, hôpital Lyon Sud, Pierre-Bénite, France
| | - M Duruisseaux
- Service de pneumologie, groupe hospitalier Est, hospices civils de Lyon, Bron, France
| | - S Couraud
- EMR 3738 ciblage thérapeutique en oncologie, faculté de médecine Lyon Sud Charles-Mérieux, université de Lyon, Oullins, France.
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25
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Mazieres J, Drilon A, Lusque A, Mhanna L, Cortot AB, Mezquita L, Thai AA, Mascaux C, Couraud S, Veillon R, Van den Heuvel M, Neal J, Peled N, Früh M, Ng TL, Gounant V, Popat S, Diebold J, Sabari J, Zhu VW, Rothschild SI, Bironzo P, Martinez-Marti A, Curioni-Fontecedro A, Rosell R, Lattuca-Truc M, Wiesweg M, Besse B, Solomon B, Barlesi F, Schouten RD, Wakelee H, Camidge DR, Zalcman G, Novello S, Ou SI, Milia J, Gautschi O. Immune checkpoint inhibitors for patients with advanced lung cancer and oncogenic driver alterations: results from the IMMUNOTARGET registry. Ann Oncol 2020; 30:1321-1328. [PMID: 31125062 PMCID: PMC7389252 DOI: 10.1093/annonc/mdz167] [Citation(s) in RCA: 770] [Impact Index Per Article: 192.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Anti-PD1/PD-L1 directed immune checkpoint inhibitors (ICI) are widely used to treat patients with advanced non-small-cell lung cancer (NSCLC). The activity of ICI across NSCLC harboring oncogenic alterations is poorly characterized. The aim of our study was to address the efficacy of ICI in the context of oncogenic addiction. Patients and methods We conducted a retrospective study for patients receiving ICI monotherapy for advanced NSCLC with at least one oncogenic driver alteration. Anonymized data were evaluated for clinicopathologic characteristics and outcomes for ICI therapy: best response (RECIST 1.1), progression-free survival (PFS), and overall survival (OS) from ICI initiation. The primary end point was PFS under ICI. Secondary end points were best response (RECIST 1.1) and OS from ICI initiation. Results We studied 551 patients treated in 24 centers from 10 countries. The molecular alterations involved KRAS (n = 271), EGFR (n = 125), BRAF (n = 43), MET (n = 36), HER2 (n = 29), ALK (n = 23), RET (n = 16), ROS1 (n = 7), and multiple drivers (n = 1). Median age was 60 years, gender ratio was 1 : 1, never/former/current smokers were 28%/51%/21%, respectively, and the majority of tumors were adenocarcinoma. The objective response rate by driver alteration was: KRAS = 26%, BRAF = 24%, ROS1 = 17%, MET = 16%, EGFR = 12%, HER2 = 7%, RET = 6%, and ALK = 0%. In the entire cohort, median PFS was 2.8 months, OS 13.3 months, and the best response rate 19%. In a subgroup analysis, median PFS (in months) was 2.1 for EGFR, 3.2 for KRAS, 2.5 for ALK, 3.1 for BRAF, 2.5 for HER2, 2.1 for RET, and 3.4 for MET. In certain subgroups, PFS was positively associated with PD-L1 expression (KRAS, EGFR) and with smoking status (BRAF, HER2). Conclusions : ICI induced regression in some tumors with actionable driver alterations, but clinical activity was lower compared with the KRAS group and the lack of response in the ALK group was notable. Patients with actionable tumor alterations should receive targeted therapies and chemotherapy before considering immunotherapy as a single agent.
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Affiliation(s)
- J Mazieres
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France.
| | - A Drilon
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - A Lusque
- Biostatistics Unit, Institut Claudius Regaud, IUCT-O, Toulouse
| | - L Mhanna
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - A B Cortot
- Thoracic Oncology Department, Lille University Hospital, Lille University, Lille
| | - L Mezquita
- Cancer Medicine Department, Gustave Roussy, Villejuif, Paris Sud University Orsay, Paris France
| | - A A Thai
- Medical Oncology Department, Peter MacCallum Cancer Institute, Melbourne, Australia
| | - C Mascaux
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - S Couraud
- Respiratory Diseases and Thoracic Oncology Department, Lyon Sud Hospital, Cancer Institute of Hospices Civils de Lyon, Lyon 1 University
| | - R Veillon
- CHU Bordeaux, Respiratory Diseases Department, Bordeaux, France
| | - M Van den Heuvel
- Faculty of Medical Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Neal
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, USA
| | - N Peled
- Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel
| | - M Früh
- Department of Oncology, Haematology, Cantonal Hospital St Gallen, St Gallen, University of Bern, Switzerland
| | - T L Ng
- Thoracic Oncology Department, University of Colorado Cancer Center, Aurora, USA
| | - V Gounant
- Department of Thoracic Oncology, CIC1425-CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - S Popat
- Royal Marsden Hospital, London, UK
| | - J Diebold
- Cantonal Hospital, Lucerne, Switzerland
| | - J Sabari
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - V W Zhu
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine School of Medicine, Orange, USA
| | - S I Rothschild
- Department Internal Medicine, University Hospital Basel, Medical Oncology, Basel, Switzerland
| | - P Bironzo
- Department of Oncology, University of Torino, Torino, Italy
| | - A Martinez-Marti
- Medical Oncology Department, Vall d'Hebron Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - R Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - M Lattuca-Truc
- Pulmonology Department, Grenoble University Hospital, Grenoble, France
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - B Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, Paris Sud University Orsay, Paris France
| | - B Solomon
- Medical Oncology Department, Peter MacCallum Cancer Institute, Melbourne, Australia
| | - F Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - R D Schouten
- Faculty of Medical Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H Wakelee
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, USA
| | - D R Camidge
- Thoracic Oncology Department, University of Colorado Cancer Center, Aurora, USA
| | - G Zalcman
- Department of Thoracic Oncology, CIC1425-CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - S Novello
- Department of Oncology, University of Torino, Torino, Italy
| | - S I Ou
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine School of Medicine, Orange, USA
| | - J Milia
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - O Gautschi
- University of Bern and Cantonal Hospital, Lucerne, Switzerland
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Lachkar S, Couraud S, Salaün M, Roger M, Bota S, Guisier F, Thiberville L. Self-expanding metallic Y-stent compared to silicone Y-stent for malignant lesions of the main carina: A single center retrospective study. Respir Med Res 2020; 78:100767. [PMID: 32498021 DOI: 10.1016/j.resmer.2020.100767] [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: 02/17/2020] [Revised: 05/04/2020] [Accepted: 05/08/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Bifurcation stents are often required in patients with malignant airway obstruction or fistulization involving the main carina. The silicone Y stent is the most used but remains challenging to place. The self-expanding metallic Y (SEM) stent appears easy to use. The objective is to report the feasibility, efficacy, and tolerance of SEM Y stent compared to silicone Y stent in patients with malignant tumors involving the main carina. PATIENTS AND METHODS This retrospective single center study was performed between May 2004 and May 2017. All patients with malignant carina involvement treated with a bronchial Y stent were included. RESULTS Forty silicone Y stents and 38 SEM Y stents were placed. Seven stenting placements failed in the silicone Y group but none in the SEM Y stent group (P=0.008). The median duration of the procedure was 80min (25-210) in the silicone Y group and.50min (25-110min) in the SEM Y group (P=0.001). There was no significant difference in terms of early or late complications between the 2 groups. Nine silicone Y stents (26.5%) and 7 SEM Y stents (18.4%) were removed (P=0.4). The median survival time following stent insertion was 171 days (Interquartile range (IQR): 53-379) in the silicone Y group and 104 days (IQR: 53-230) in the SEM Y group. CONCLUSION If silicone Y stent remains the best solution for benign obstruction, SEM Y stent seems to be an easy alternative with no difference in terms of complication or ablation for malignant lesions involving the main carina.
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Affiliation(s)
- S Lachkar
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, Rouen University Hospital, 1, rue de Germont, 76000, Rouen, France.
| | - S Couraud
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, Rouen University Hospital, 1, rue de Germont, 76000, Rouen, France
| | - M Salaün
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, Rouen University Hospital, 1, rue de Germont, 76000, Rouen, France; Normandie University, UNIROUEN, QuantIF- LITIS EA 4108, Department of Pulmonology, Rouen University Hospital, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, 76000 Rouen, France
| | - M Roger
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, Rouen University Hospital, 1, rue de Germont, 76000, Rouen, France
| | - S Bota
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, Rouen University Hospital, 1, rue de Germont, 76000, Rouen, France
| | - F Guisier
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, Rouen University Hospital, 1, rue de Germont, 76000, Rouen, France; Normandie University, UNIROUEN, QuantIF- LITIS EA 4108, Department of Pulmonology, Rouen University Hospital, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, 76000 Rouen, France
| | - L Thiberville
- Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, Rouen University Hospital, 1, rue de Germont, 76000, Rouen, France; Normandie University, UNIROUEN, QuantIF- LITIS EA 4108, Department of Pulmonology, Rouen University Hospital, Thoracic Oncology and Respiratory Intensive Care & CIC- CRB 1404, 76000 Rouen, France
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27
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Girard N, Greillier L, Zalcman G, Cadranel J, Moro-Sibilot D, Mazières J, Audigier-Valette C, Bennouna J, Besse B, Cortot A, Couraud S, Duruisseaux M, Giroux-Leprieur E, Toffart AC, Westeel V, Wislez M. Proposals for managing patients with thoracic malignancies during COVID-19 pandemic. Respir Med Res 2020; 78:100769. [PMID: 32563968 PMCID: PMC7246014 DOI: 10.1016/j.resmer.2020.100769] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 12/25/2022]
Abstract
The objective of this document is to formalize a degraded mode management for patients with thoracic cancers in the context of the COVID-19 pandemic. The proposals are based on those of the French High Council for Public Health, on published data outside the context of COVID-19, and on a concerted analysis of the risk-benefit ratio for our patients by a panel of experts specialized on thoracic oncology under the aegis of the French-Language Society of Pulmonology (SPLF)/French-language oncology group. These proposals are evolving (10 April 2020) according to the situations encountered, which will enrich it, and are to be adapted to our institutional organisations and to the evolution of resources during the COVID-19 epidemic. Patients with symptoms and/or COVID-19+ are not discussed in this document and are managed within the framework of specific channels.
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Affiliation(s)
- N Girard
- Department of Medical Oncology, Institut Curie, 75005 Paris, France.
| | - L Greillier
- Aix-Marseille Université, AP-HM, INSERM, CNRS, CRCM, Hôpital Nord, Multidisciplinary Oncology and Therapeutic Innovations Department, 13915 Marseille, France
| | - G Zalcman
- Department of Thoracic Oncology, CIC 1425, AP-HP, Hôpital Bichat-Claude-Bernard, 75018 Paris, France
| | - J Cadranel
- Department of Thoracic Oncology, AP-HP, Hôpital Tenon, 75020 Paris, France
| | - D Moro-Sibilot
- Department of Pneumology, University Hospital of Grenoble, 38043 Grenoble, France
| | - J Mazières
- Department of Pneumology, University Hospital of Toulouse, 31059 Toulouse, France
| | | | - J Bennouna
- Department of Medical Oncology, University Hospital of Nantes, 44000 Nantes, France
| | - B Besse
- Department of Medical Oncology, Institut Gustave-Roussy, 94800 Villejuif, France
| | - A Cortot
- Department of Pneumology, University Hospital of Lille, 59000 Lille, France
| | - S Couraud
- Department of Pneumology and Thoracic Oncology, University Hospital of Lyon, 69002 Lyon, France
| | - M Duruisseaux
- Department of Pneumology and Thoracic Oncology, University Hospital of Lyon, 69002 Lyon, France
| | - E Giroux-Leprieur
- Department of Thoracic Oncology, AP-HP, Hôpital Ambroise-Paré, 92100 Boulogne-Billancourt, France
| | - A-C Toffart
- Department of Pneumology, University Hospital of Grenoble, 38043 Grenoble, France
| | - V Westeel
- Department of Pneumology and Thoracic Oncology, University Hospital of Besançon, INSERM UMR 1098, Université de Franche-Comté, 25000 Besançon, France
| | - M Wislez
- Department of Thoracic Oncology, AP-HP, Hôpital Cochin, Inserm UMR_S 1138, Université de Paris, 75014 Paris, France
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Fontaine-Delaruelle C, Mazières J, Cadranel J, Mastroianni B, Dubos-Arvis C, Dumont P, Monnet I, Pichon E, Locatelli-Sanchez M, Dixmier A, Coudert B, Fraboulet S, Foucher P, Dansin E, Baize N, Vincent M, Missy P, Morin F, Moro-Sibilot D, Couraud S. Somatic profile in lung cancers is associated to reproductive factors in never-smokers women: Results from the IFCT-1002 BioCAST study. Respir Med Res 2020; 77:58-66. [PMID: 32416585 DOI: 10.1016/j.resmer.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/30/2019] [Accepted: 01/24/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Lung cancer in women is on the rise, with a higher proportion occurring in lifelong never-smokers. Lung cancer in never-smokers (LCINS) exhibits a high frequency of driver oncogene alterations. In this study, we aimed to investigate whether exposure to reproductive factors in women with LCINS may modulate the molecular pattern. METHODS All newly diagnosed LCINSs were included in a prospective, observational study (IFCT-1002 BioCAST). Each patient responded to a questionnaire including reproductive factors. Biomarker test results were also collected. RESULTS Two hundred and sixty women were included in this analysis, and 166 alterations were characterized. EGFR mutation frequency proved greater among patients with late menarche (74% in age>14 vs. 40% and 41% for 12-14 and ≤12 years, respectively; P=0.020) and tended to decrease with increasingly late age at menopause. In multivariate analysis, EGFR mutation frequency increased by 23% per increment of 1 year of age at menarche (P=0.048), and by 9% for each year at age at first birth (P=0.035). ALK alteration frequency was greater in women with high parity (50% in≥5 vs. 12% and 7% for 1-4 and nulliparity, respectively; P=0.021). CONCLUSION In a cohort of women LCINSs, female hormonal factors appear to impact molecular pattern.
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Affiliation(s)
- C Fontaine-Delaruelle
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hôpital Lyon Sud, institut de cancérologie des hospices civils de Lyon, Pierre-Bénite, France
| | - J Mazières
- Service de pneumologie, université Paul-Sabatier, hôpital Larrey, centre hospitalier universitaire, Toulouse, France
| | - J Cadranel
- Service de pneumologie, hôpital Tenon, AP-HP, Paris, France
| | - B Mastroianni
- Service de pneumologie, institut de cancérologie des hospices civils de Lyon, hôpital Louis-Pradel, Bron, France
| | - C Dubos-Arvis
- UCP d'oncologie thoracique, centre de lutte contre le cancer François-Baclesse, Caen, France
| | - P Dumont
- Service de pneumologie, centre hospitalier de Chauny, Chauny, France
| | - I Monnet
- OncoThoParisEst, service de pneumologie, CHI de Créteil, UPEC, Créteil, France
| | - E Pichon
- Service de pneumologie, hôpital Bretonneau, CHRU de Tours, Tours, France
| | - M Locatelli-Sanchez
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hôpital Lyon Sud, institut de cancérologie des hospices civils de Lyon, Pierre-Bénite, France
| | - A Dixmier
- Service de pneumologie et oncologie thoracique, centre hospitalier régional d'Orléans, Orléans, France
| | - B Coudert
- Oncologie médicale, centre G.F.-Leclerc, Dijon, France
| | - S Fraboulet
- Service de pneumologie, hôpital Foch, Suresnes, France
| | - P Foucher
- Fédération d'oncologie thoracique, hôpital du Bocage, CHU Dijon-Bourgogne, Dijon, France
| | - E Dansin
- Département de cancérologie générale, centre Oscar-Lambret, Lille, France
| | - N Baize
- Unité transversale de thérapeutiques innovantes en oncologie médicale (UTTIOM), CHU d'Angers, Angers, France
| | - M Vincent
- Service de pneumologie et cancérologie thoracique, centre hospitalier Saint-Joseph et Saint-Luc, Lyon, et Minapath Développement Insavalor, Villeurbanne, France
| | - P Missy
- Intergroupe francophone de cancérologie thoracique (IFCT), Paris, France
| | - F Morin
- Intergroupe francophone de cancérologie thoracique (IFCT), Paris, France
| | - D Moro-Sibilot
- Intergroupe francophone de cancérologie thoracique (IFCT), Paris, France; Clinique de pneumologie et oncologie thoracique, CHU Grenoble-Alpes, La Tronche, France
| | - S Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hôpital Lyon Sud, institut de cancérologie des hospices civils de Lyon, Pierre-Bénite, France; EMR 3738 ciblage thérapeutique en oncologie, faculté de médecine Lyon Sud, université Lyon 1, Oullins, France.
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Kauczor HU, Baird AM, Blum TG, Bonomo L, Bostantzoglou C, Burghuber O, Čepická B, Comanescu A, Couraud S, Devaraj A, Jespersen V, Morozov S, Nardi Agmon I, Peled N, Powell P, Prosch H, Ravara S, Rawlinson J, Revel MP, Silva M, Snoeckx A, van Ginneken B, van Meerbeeck JP, Vardavas C, von Stackelberg O, Gaga M. ESR/ERS statement paper on lung cancer screening. Eur Respir J 2020; 55:13993003.00506-2019. [PMID: 32051182 DOI: 10.1183/13993003.00506-2019] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/16/2019] [Indexed: 12/18/2022]
Abstract
In Europe, lung cancer ranks third among the most common cancers, remaining the biggest killer. Since the publication of the first European Society of Radiology and European Respiratory Society joint white paper on lung cancer screening (LCS) in 2015, many new findings have been published and discussions have increased considerably. Thus, this updated expert opinion represents a narrative, non-systematic review of the evidence from LCS trials and description of the current practice of LCS as well as aspects that have not received adequate attention until now. Reaching out to the potential participants (persons at high risk), optimal communication and shared decision-making will be key starting points. Furthermore, standards for infrastructure, pathways and quality assurance are pivotal, including promoting tobacco cessation, benefits and harms, overdiagnosis, quality, minimum radiation exposure, definition of management of positive screen results and incidental findings linked to respective actions as well as cost-effectiveness. This requires a multidisciplinary team with experts from pulmonology and radiology as well as thoracic oncologists, thoracic surgeons, pathologists, family doctors, patient representatives and others. The ESR and ERS agree that Europe's health systems need to adapt to allow citizens to benefit from organised pathways, rather than unsupervised initiatives, to allow early diagnosis of lung cancer and reduce the mortality rate. Now is the time to set up and conduct demonstration programmes focusing, among other points, on methodology, standardisation, tobacco cessation, education on healthy lifestyle, cost-effectiveness and a central registry.
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Affiliation(s)
- Hans-Ulrich Kauczor
- Dept of Diagnostic and Interventional Radiology, University Hospital Heidelberg, German Center of Lung Research, Heidelberg, Germany
| | - Anne-Marie Baird
- Central Pathology Laboratory, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | | | - Lorenzo Bonomo
- Dept of Radiology, Policlinico Universitario Agostino Gemelli, Rome, Italy
| | | | | | | | | | - Sébastien Couraud
- Service de Pneumologie et Oncologie Thoracique, Hospices Civils de Lyon, CH Lyon Sud, Pierre Bénite, France.,Faculté de Médecine et de Maïeutique Lyon Sud - Charles Mérieux, Université Claude Bernard Lyon I, Oullins, France
| | | | | | - Sergey Morozov
- Dept of Health Care of Moscow, Research and Practical Clinical Center of Diagnostics and Telemedicine Technologies, Moscow, Russian Federation
| | | | - Nir Peled
- Thoracic Cancer Unit, Rabin Medical Center, Petach Tiqwa, Israel
| | | | - Helmut Prosch
- Dept of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Sofia Ravara
- Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal.,Tobacco Cessation Unit, CHCB University Hospital, Covilha, Portugal
| | | | | | - Mario Silva
- Section of Radiology, Dept of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | | | - Bram van Ginneken
- Image Sciences Institute, University Medical Centre, Utrecht, The Netherlands.,Dept of Radiology, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | - Constantine Vardavas
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.,Center for Global Tobacco Control, Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA
| | - Oyunbileg von Stackelberg
- Dept of Diagnostic and Interventional Radiology, University Hospital Heidelberg, German Center of Lung Research, Heidelberg, Germany
| | - Mina Gaga
- 7th Respiratory Medicine Dept, Athens Chest Hospital Sotiria, Athens, Greece
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30
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Kauczor HU, Baird AM, Blum TG, Bonomo L, Bostantzoglou C, Burghuber O, Čepická B, Comanescu A, Couraud S, Devaraj A, Jespersen V, Morozov S, Agmon IN, Peled N, Powell P, Prosch H, Ravara S, Rawlinson J, Revel MP, Silva M, Snoeckx A, van Ginneken B, van Meerbeeck JP, Vardavas C, von Stackelberg O, Gaga M. ESR/ERS statement paper on lung cancer screening. Eur Radiol 2020; 30:3277-3294. [PMID: 32052170 DOI: 10.1007/s00330-020-06727-7] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/16/2019] [Indexed: 12/17/2022]
Abstract
In Europe, lung cancer ranks third among the most common cancers, remaining the biggest killer. Since the publication of the first European Society of Radiology and European Respiratory Society joint white paper on lung cancer screening (LCS) in 2015, many new findings have been published and discussions have increased considerably. Thus, this updated expert opinion represents a narrative, non-systematic review of the evidence from LCS trials and description of the current practice of LCS as well as aspects that have not received adequate attention until now. Reaching out to the potential participants (persons at high risk), optimal communication and shared decision-making will be key starting points. Furthermore, standards for infrastructure, pathways and quality assurance are pivotal, including promoting tobacco cessation, benefits and harms, overdiagnosis, quality, minimum radiation exposure, definition of management of positive screen results and incidental findings linked to respective actions as well as cost-effectiveness. This requires a multidisciplinary team with experts from pulmonology and radiology as well as thoracic oncologists, thoracic surgeons, pathologists, family doctors, patient representatives and others. The ESR and ERS agree that Europe's health systems need to adapt to allow citizens to benefit from organised pathways, rather than unsupervised initiatives, to allow early diagnosis of lung cancer and reduce the mortality rate. Now is the time to set up and conduct demonstration programmes focusing, among other points, on methodology, standardisation, tobacco cessation, education on healthy lifestyle, cost-effectiveness and a central registry.Key Points• Pulmonologists and radiologists both have key roles in the set up of multidisciplinary LCS teams with experts from many other fields.• Pulmonologists identify people eligible for LCS, reach out to family doctors, share the decision-making process and promote tobacco cessation.• Radiologists ensure appropriate image quality, minimum dose and a standardised reading/reporting algorithm, together with a clear definition of a "positive screen".• Strict algorithms define the exact management of screen-detected nodules and incidental findings.• For LCS to be (cost-)effective, it has to target a population defined by risk prediction models.
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Affiliation(s)
- Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, German Center of Lung Research, INF 110, 69120, Heidelberg, Germany.
| | - Anne-Marie Baird
- Central Pathology Laboratory, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | | | - Lorenzo Bonomo
- Department of Radiology, Policlinico Universitario Agostino Gemelli, Rome, Italy
| | | | | | | | | | - Sébastien Couraud
- Service de Pneumologie et Oncologie Thoracique, Hospices Civils de Lyon, Sud, Pierre Bénite, Lyon, CH, France.,Faculté de Médecine et de Maïeutique Lyon Sud - Charles Mérieux, Université Claude Bernard Lyon I, Oullins, France
| | | | | | - Sergey Morozov
- Department of Health Care of Moscow, Research and Practical Clinical Center of Diagnostics and Telemedicine Technologies, Moscow, Russian Federation
| | | | - Nir Peled
- Thoracic Cancer Unit, Rabin Medical Center, Petach Tiqwa, Israel
| | | | - Helmut Prosch
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Sofia Ravara
- Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal.,Tobacco Cessation Unit, CHCB University Hospital, Covilha, Portugal
| | | | | | - Mario Silva
- Section of Radiology, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | | | - Bram van Ginneken
- Image Sciences Institute, University Medical Centre, Utrecht, The Netherlands.,Department of Radiology, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | - Constantine Vardavas
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.,Center for Global Tobacco Control, Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA
| | - Oyunbileg von Stackelberg
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, German Center of Lung Research, INF 110, 69120, Heidelberg, Germany
| | - Mina Gaga
- 7th Respiratory Medicine Department, Athens Chest Hospital Sotiria, Athens, Greece
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Lamblin G, Thiberville G, Druette L, Moret S, Couraud S, Martin X, Dubernard G, Chene G. Virtual reality simulation to enhance laparoscopic salpingectomy skills. J Gynecol Obstet Hum Reprod 2020; 49:101685. [PMID: 31931145 DOI: 10.1016/j.jogoh.2020.101685] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 11/29/2019] [Accepted: 01/07/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND To assess skill enhancement and maintenance by virtual-reality simulation of laparoscopic salpingectomy in gynecologic surgery fellows. Skill acquisition by virtual-reality surgical simulation is an active field of research and technological development. Salpingectomy is one of the first gynecologic surgery techniques taught to fellows that requires accompanied learning. METHODS A single-center prospective study was performed in the University of Lyon, France, including 26 junior fellows (≤ 3 semesters' internship) performing laparoscopic salpingectomy exercises on a LapSim® virtual reality simulator. Salpingectomy was performed and timed on 3 trials in session 1 and 3 trials in session 2, at a 3-month interval. Analysis was based on students' subjective assessments and a senior surgeon's objective assessment of skill. Progress between the 2 sessions was assessed on McNemar test and Wilcoxon test for matched series. RESULTS 26 junior specialist trainees performed all trials. Most performed anterograde salpingectomy, both in session 1 (69 %) and session 2 (86 %). Mean procedure time was significantly shorter in session 2: 6.10min versus 7.82min (p=0.0003). There was a significant decrease in blood loss between the first trial in session 1 and the last trial in session 2: 167ml versus 70.3ml (p=0.02). Subjective assessment showed a significant decrease in anxiety and significant increase in perceived efficacy, eye-hand coordination and ergonomics. Efficacy, performance quality and speed of execution as assessed by the senior surgeon all improved significantly from trial to trial, while hesitation significantly decreased. CONCLUSIONS The study showed that junior trainees improved their surgical skills on a short laparoscopic exercise using a virtual reality simulator. Virtual reality simulation is useful in the early learning curve, accelerating the acquisition of reflexes. Maintaining skill requires simulation sessions at shorter intervals.
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Affiliation(s)
- Gery Lamblin
- Department of Gynecology Surgery and Urogynecology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon-Bron, France; Claude Bernard Lyon 1 Medical Faculty, Lyon 1 University, 69008 Lyon, France; Surgery School, Claude Bernard Lyon 1 University, IDEFI Program, SAMSEI (ANR 11 IDFI 0034), Lyon, France.
| | - Gabriel Thiberville
- Department of Gynecology Surgery and Urogynecology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon-Bron, France
| | - Loic Druette
- Surgery School, Claude Bernard Lyon 1 University, IDEFI Program, SAMSEI (ANR 11 IDFI 0034), Lyon, France
| | - Stéphanie Moret
- Department of Gynecology Surgery and Urogynecology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon-Bron, France
| | | | - Xavier Martin
- Surgery School, Claude Bernard Lyon 1 University, IDEFI Program, SAMSEI (ANR 11 IDFI 0034), Lyon, France
| | - Gil Dubernard
- Department of Gynecology Surgery, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Gautier Chene
- Department of Gynecology Surgery and Urogynecology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon-Bron, France; Claude Bernard Lyon 1 Medical Faculty, Lyon 1 University, 69008 Lyon, France
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Yee S, Richert R, Viguie G, Couraud S, Dehurtevent M, Fages M, Corne P, Ducret M. Evaluation of the use of a guided bur during preclinical teaching of tooth preparation: A pilot study. Clin Exp Dent Res 2019; 5:588-593. [PMID: 31890295 PMCID: PMC6934350 DOI: 10.1002/cre2.184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 11/23/2022] Open
Abstract
Objectives An innovative calibrated bur, aiming to improve precision during reduction of the incisal edge, was recently proposed to guide practitioners during tooth preparation. However, limited information is available concerning its usefulness in dental preclinical education. The aim of this study was to evaluate whether using this innovative guided bur improves learning experience quality and the performance of students during tooth preparation. Material and methods After having provided written consent, 60 second-year students were divided into two groups. One group used a 1-mm rounded bur to perform depth grooves, whereas the second group used the innovative guided bur, consisting in a 2-mm-depth marker with a stopping surface. Once the grooves were obtained, they were then connected using the same wheel bur in both groups. The aim was to obtain a final 2-mm reduction of the incisal edge. Quality of the learning experience (stress level, motivation to restart, self-evaluation of the preparation, and difficulty) was quantified using a visual analog scale. Duration of the procedure was also measured in both groups. 3D measurements for each tooth were performed using an STL comparison software. Results There were no significant differences between groups in terms of stress and self-evaluation of the preparation. Students in the guided bur group reported significantly lower perception of exercise difficulty (p < .001) and significantly higher motivation to restart the procedure (p < .001). The guided bur group performed the procedure in 16.4% less time than the rounded bur group. The use of the guided bur led to a 23% over-reduction, whereas the use of the rounded bur led to a 10% under-reduction. Conclusions Overall, the present study shows that the guided bur provides significant improvement in the student's learning experience with increased motivation and decreased perception of difficulty. It shortens the duration of procedure performance, but it also induces a reduction in preparation accuracy.
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Affiliation(s)
- Soho Yee
- Faculté d'OdontologieUniversité de Lyon, Université Lyon 1LyonFrance
- Hospices Civils de LyonService de Consultations et Traitements DentairesLyonFrance
| | - Raphaël Richert
- Faculté d'OdontologieUniversité de Lyon, Université Lyon 1LyonFrance
- Hospices Civils de LyonService de Consultations et Traitements DentairesLyonFrance
| | - Gilbert Viguie
- Faculté d'OdontologieUniversité de Lyon, Université Lyon 1LyonFrance
- Hospices Civils de LyonService de Consultations et Traitements DentairesLyonFrance
| | - Sébastien Couraud
- Faculté de médecine et de maïeutique Lyon‐SudUniversité de Lyon, Université Lyon 1LyonFrance
- Service de Pneumologie Aiguë Spécialisée et Cancérologie ThoraciqueCentre Hospitalier Lyon SudPierre BéniteFrance
| | | | - Michel Fages
- Prosthetic DepartmentFaculté d'Odontologie de MontpellierMontpellierFrance
- Laboratoire de Bioingéniérie et Nanosciences (LBN)Montpellier UniversitéMontpellierFrance
| | - Pascale Corne
- Nancy School of DentistryUniversity of LorraineNancy CedexFrance
| | - Maxime Ducret
- Faculté d'OdontologieUniversité de Lyon, Université Lyon 1LyonFrance
- Hospices Civils de LyonService de Consultations et Traitements DentairesLyonFrance
- Laboratoire de Biologie Tissulaire et Ingénierie thérapeutiqueUMR5305 CNRS/Université Lyon 1, UMS3444 BioSciences Gerland‐Lyon SudLyonFrance
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Garcia J, Monjaret F, Geiguer F, Aurel JP, Puisieux A, Morel A, Bardel C, Vilchez G, Brigitte M, Couraud S, Vigneron A, Tourniaire G, Payen-Gay L. Whole transcriptomics analyses of mimicking circulating tumor cells (CTCs) by single-cell RNA sequencing (scRNAseq). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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de La Motte Rouge T, Eisinger F, Couraud S, Greillier L, Touboul C, Lhomel C, Rouprêt M, Viguier J, Morere JF. Who drops out of cervical cancer screening? Results from the EDIFICE 6 survey. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Couraud S, Greillier L, De La Motte Rouge T, Touboul C, Lhomel C, Viguier J, Eisinger F, Roupret M, Morère J. P1.10-07 Characteristics of Current and Former Smokers Who Acknowledge Their Risk of Lung Cancer: Results from the EDIFICE6 Survey. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Souquet PJ, Couraud S. Immune checkpoint inhibitors: a game changer for metastatic non-small-cell lung cancer. Lancet Oncol 2019; 20:1334-1335. [PMID: 31422027 DOI: 10.1016/s1470-2045(19)30508-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Pierre-Jean Souquet
- Service de Cancérologie Thoracique, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon, Lyon 69002, France; Intergroupe Francophone de Cancérologie Thoracique, Paris, France.
| | - Sébastien Couraud
- Service de Cancérologie Thoracique, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon, Lyon 69002, France; EMR 3738 Ciblage Thérapeutique en oncologie, Faculté de médecine Lyon Sud, Université Lyon, Lyon, France
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Garcia J, Barthelemy D, Geiguer F, Ballandier J, Li KW, Aurel JP, Le Breton F, Rodriguez-Lafrasse C, Manship B, Couraud S, Payen L. Semi-automatic PD-L1 Characterization and Enumeration of Circulating Tumor Cells from Non-small Cell Lung Cancer Patients by Immunofluorescence. J Vis Exp 2019. [PMID: 31475991 DOI: 10.3791/59873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Circulating tumor cells (CTCs) derived from the primary tumor are shed into the bloodstream or lymphatic system. These rare cells (1-10 cells per mL of blood) warrant a poor prognosis and are correlated with shorter overall survival in several cancers (e.g., breast, prostate and colorectal). Currently, the anti-EpCAM-coated magnetic bead-based CTC capturing system is the gold standard test approved by the U.S. Food and Drug Administration (FDA) for enumerating CTCs in the bloodstream. This test is based on the use of magnetic beads coated with anti-EpCAM markers, which specifically target epithelial cancer cells. Many studies have illustrated that EpCAM is not the optimal marker for CTC detection. Indeed, CTCs are a heterogeneous subpopulation of cancer cells and are able to undergo an epithelial-to-mesenchymal transition (EMT) associated with metastatic proliferation and invasion. These CTCs are able to reduce the expression of cell surface epithelial marker EpCAM, while increasing mesenchymal markers such as vimentin. To address this technical hurdle, other isolation methods based on physical properties of CTCs have been developed. Microfluidic technologies enable a label-free approach to CTC enrichment from whole blood samples. The spiral microfluidic technology uses the inertial and Dean drag forces with continuous flow in curved channels generated within a spiral microfluidic chip. The cells are separated based on the differences in size and plasticity between normal blood cells and tumoral cells. This protocol details the different steps to characterize the programmed death-ligand 1 (PD-L1) expression of CTCs, combining a spiral microfluidic device with customizable immunofluorescence (IF) marker set.
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Affiliation(s)
- Jessica Garcia
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon; Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute; University of Lyon, Claude Bernard University, Cancer Research Center of Lyon
| | - David Barthelemy
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon; Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute; University of Lyon, Claude Bernard University, Cancer Research Center of Lyon
| | - Florence Geiguer
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon; Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute
| | - Julie Ballandier
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon; Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute; University of Lyon, Claude Bernard University, Cancer Research Center of Lyon
| | | | | | | | | | - Brigitte Manship
- University of Lyon, Claude Bernard University, Cancer Research Center of Lyon
| | - Sébastien Couraud
- Acute Respiratory Disease and Thoracic Oncology Department, Lyon Sud Hospital, Hospices Civils de Lyon Cancer Institute; EMR-3738 Therapeutic Targeting in Oncology, Lyon Sud Medical Faculty, Lyon 1 University
| | - Léa Payen
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon; Circulating Cancer (CIRCAN) Program, Hospices Civils de Lyon Cancer Institute; University of Lyon, Claude Bernard University, Cancer Research Center of Lyon;
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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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Garcia J, Wozny AS, Geiguer F, Delherme A, Barthelemy D, Merle P, Tissot C, Jones FS, Johnson C, Xing X, Xu Z, Edelstein DL, Brevet M, Souquet PJ, Rodriguez-Lafrasse C, Payen L, Couraud S. Profiling of circulating tumor DNA in plasma of non-small cell lung cancer patients, monitoring of epidermal growth factor receptor p.T790M mutated allelic fraction using beads, emulsion, amplification, and magnetics companion assay and evaluation in future application in mimicking circulating tumor cells. Cancer Med 2019; 8:3685-3697. [PMID: 31112372 PMCID: PMC6866744 DOI: 10.1002/cam4.2244] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/12/2019] [Accepted: 04/26/2019] [Indexed: 12/12/2022] Open
Abstract
Cell-free plasma DNA (cfDNA) and mimicking circulating tumor cells (mCTCs) have demonstrated tremendous potential for molecular diagnosis of cancer and have been rapidly implemented in specific settings. However, widespread clinical adoption still faces some obstacles. The purpose was to compare the performance of a BEAMing (beads, emulsion, amplification, and magnetics) assay (OncoBEAM™-epidermal growth factor receptor [EGFR] [Sysmex Inostics]) and a next-generation sequencing assay (NGS; 56G Oncology panel kit, Swift Bioscience) to detect the p.T790M EGFR mutation in cfDNA of non-small cell lung cancer (NSCLC) patients. CfDNA samples (n = 183) were collected within our hospital from patients having a known EGFR sensitizing mutation, and presenting disease progression while under first-line therapy. EGFR mutations were detected using NGS in 42.1% of samples during progression in cfDNA. Testing using the OncoBEAM™-EGFR assay enabled detection of the p.T790M EGFR mutation in 40/183 NSCLC patients (21.8%) versus 20/183 (10.9%), using the NGS assay. Samples that were only positive with the OncoBEAM™-EGFR assay had lower mutant allelic fractions (Mean = 0.1304%; SD ± 0.1463%). In addition, we investigated the detection of p.T790M in mCTCs using H1975 cells. These cells spiked into whole blood were enriched using the ClearCellFX1 microfluidic device. Using the OncoBEAM™-EGFR assay, p.T790M was detected in as few as 1.33 tumoral cells/mL. Overall, these findings highlight the value of using the OncoBEAM™-EGFR to optimize detection of the p.T790M mutation, as well as the complementary clinical value that each of the mutation detection assay offers: NGS enabled the detection of mutations in other oncogenes that may be relevant to secondary resistance mechanisms, whereas the OncoBEAM™-EGFR assay achieved higher sensitivity for detection of clinically actionable mutations.
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Affiliation(s)
- Jessica Garcia
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,Cancer Research Center of Lyon, INSERM U1052, CNRS UMR5286, Claude Bernard University, University of Lyon, Lyon, France.,CIRculating CANcer (CIRCAN) program, Hospices Civils de Lyon Cancer institute, Lyon, France.,Laboratoire Commun de Recherche Hospices Civils de Lyon - BioMérieux, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Anne-Sophie Wozny
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,CIRculating CANcer (CIRCAN) program, Hospices Civils de Lyon Cancer institute, Lyon, France
| | - Florence Geiguer
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,CIRculating CANcer (CIRCAN) program, Hospices Civils de Lyon Cancer institute, Lyon, France.,Laboratoire Commun de Recherche Hospices Civils de Lyon - BioMérieux, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Aurélia Delherme
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,CIRculating CANcer (CIRCAN) program, Hospices Civils de Lyon Cancer institute, Lyon, France.,Laboratoire Commun de Recherche Hospices Civils de Lyon - BioMérieux, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - David Barthelemy
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,Cancer Research Center of Lyon, INSERM U1052, CNRS UMR5286, Claude Bernard University, University of Lyon, Lyon, France.,CIRculating CANcer (CIRCAN) program, Hospices Civils de Lyon Cancer institute, Lyon, France.,Laboratoire Commun de Recherche Hospices Civils de Lyon - BioMérieux, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Patrick Merle
- Service de Pneumologie et oncologie thoracique, CHU G Montpied, Clermont-Ferrand, France
| | - Claire Tissot
- Service de Pneumologie et Cancérologie Thoracique, CHU Saint Etienne, Saint-Priest-en-Jarez, France
| | | | | | - Xiaobin Xing
- SOPHiA GENETICS SA, Headquarters, Saint Sulpice, Switzerland
| | - Zhenyu Xu
- SOPHiA GENETICS SA, Headquarters, Saint Sulpice, Switzerland
| | | | - Marie Brevet
- Cancer Research Center of Lyon, INSERM U1052, CNRS UMR5286, Claude Bernard University, University of Lyon, Lyon, France.,CIRculating CANcer (CIRCAN) program, Hospices Civils de Lyon Cancer institute, Lyon, France.,Institut de pathologie multisites des HCL-Site Est, Hospices Civils de Lyon, Lyon, France
| | - Pierre-Jean Souquet
- Service de Pneumologie aigue spécialisée et cancérologie thoracique, Groupement hospitalier sud, Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France
| | - Claire Rodriguez-Lafrasse
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,UMR CNRS 5822/IN2P3, IPNL, PRISME, Laboratoire de Radiobiologie Cellulaire et Moléculaire, Faculté de Médecine Lyon-Sud, Université Lyon 1, Lyon, France
| | - Léa Payen
- Laboratoire de Biochimie et Biologie Moléculaire, Groupe Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,Cancer Research Center of Lyon, INSERM U1052, CNRS UMR5286, Claude Bernard University, University of Lyon, Lyon, France.,CIRculating CANcer (CIRCAN) program, Hospices Civils de Lyon Cancer institute, Lyon, France.,Laboratoire Commun de Recherche Hospices Civils de Lyon - BioMérieux, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Couraud
- CIRculating CANcer (CIRCAN) program, Hospices Civils de Lyon Cancer institute, Lyon, France.,Service de Pneumologie aigue spécialisée et cancérologie thoracique, Groupement hospitalier sud, Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France.,EMR 3738 Ciblage Thérapeutique en Oncologie, Faculté de médecine Lyon Sud, Université Lyon 1, Université de Lyon, Lyon, France
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Corbaux P, Fontaine-Delaruelle C, Souquet PJ, Couraud S, Morel H, Tronc F, Eker E, Peron J, Raynard B. Is Nutritional Screening of Patients with Lung Cancer Optimal? An Expert Opinion Survey of French Physicians and Surgeons. Nutr Cancer 2019; 71:971-980. [DOI: 10.1080/01635581.2019.1595051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Pauline Corbaux
- Department of Medical Oncology, Centre Hospitalier Lyon-Sud, Institut de Cancérologie des Hospices Civils de Lyon-IC-HCL, University of Lyon 1, Pierre-Bénite, France
| | - Clara Fontaine-Delaruelle
- Department of Respiratory Medicine, Centre Hospitalier Lyon-Sud, University of Lyon 1, Pierre-Bénite, France
| | - Pierre-Jean Souquet
- Department of Respiratory Medicine, Centre Hospitalier Lyon-Sud, University of Lyon 1, Pierre-Bénite, France
| | - Sébastien Couraud
- Department of Respiratory Medicine, Centre Hospitalier Lyon-Sud, University of Lyon 1, Pierre-Bénite, France
| | - Hugues Morel
- Department of Respiratory Medicine, Centre Hospitalier Régional d’Orléans, Orléans, France
| | - François Tronc
- Department of Thoracic Surgery, Hôpital Louis Pradel, University of Lyon 1, Bron, France
| | - Elife Eker
- Department of Radiotherapy, Centre Hospitalier Lyon Sud, University of Lyon 1, Pierre-Bénite, France
| | - Julien Peron
- Department of Medical Oncology, Centre Hospitalier Lyon-Sud, Institut de Cancérologie des Hospices Civils de Lyon-IC-HCL, University of Lyon 1, Pierre-Bénite, France
- Centre National de la Recherche Scientifique, Unités Mixtes de Recherche 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Department of Biostatistics, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Bruno Raynard
- Transversal Unit of Dietetics and Nutrition, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
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Morère JF, Eisinger F, Couraud S, Greillier L, Touboul C, Lhomel C, Rouprêt M, Viguier J, De la Motte Rouge T. Abstract P1-02-05: Who drops out of breast cancer screening? Results from the EDIFICE 6 survey. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-02-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Breast cancer (BC) screening has been part of a nationally organized program in France since 2004. Women aged 50-74 years are invited for a mammography every two years. After stabilization of up-take figures over the period 2008-2014, the latest data from the French health authorities confirm a declining trend which began in 2015-2016. This fall has been observed in all age groups, with the exception of women aged 70-74 years. It therefore appeared important to gain clearer insight into the characteristics of women who have had at least one screening examination but have not returned after the recommended two-year interval for a repeat mammography.
Methodology The French nationwide observational survey EDIFICE 6 was conducted online from 26 June to 28 July 2017 on 12 046 individuals (age, 18-69 years). Representativeness was ensured by quota sampling on age, gender, profession, and stratification by geographical area and type of urban district. Multivariate stepwise logistic regression analysis was conducted to identify factors likely to explain the non-uptake of subsequent BC screening. The present analysis included 1954 women (50-69 years) with no history of cancer.
Results Of those who were in the target age range for BC screening, 26% (N=380) did not return for the repeat examination within the recommended 2 years. Compared to those who were compliant with the recommendations, the population of non-compliant women was characterized by higher proportions of unmarried women (23% vs 19%, P<0.05), socially vulnerable individuals (53% vs 38%, P<0.05), and smokers (33% vs 20%, P<0.05). No differences were observed between compliant and non-compliant women in terms of mean age (59.3 SD 5.8, years) or socioprofessional categories. In multivariate analysis, the items associated with non-compliance included: current smoking (OR=1.81 [CI=1.40 – 2.34]), individuals who would not encourage someone close to enroll in a clinical trial (OR=1.55 [1.17-2.04]), considering that protection provided by a prevention program is ineffective (OR=1.48 [1.11-1.97]), and social vulnerability (OR=1.38 [1.09-1.74]). The most frequently cited reasons for non-uptake of subsequent screening were "I don't feel concerned" (45%), “individual negligence/not a priority” (29%), fear of the examination/results (25%), "I have not received a screening invitation" (18%), and self-examination (15%).
Conclusion Indicators of non-uptake of repeat BC screening show various patterns: behavioral (currently smoking), social (vulnerability), and those related to information/education. In our analysis, this latter appeared concurrently with medical skepticism. The two main underlying reasons for not pursuing with breast cancer screening were "not feeling concerned" and "individual negligence". Our findings highlight the need for novel awareness campaigns that specifically target this population.
Citation Format: Morère J-F, Eisinger F, Couraud S, Greillier L, Touboul C, Lhomel C, Rouprêt M, Viguier J, De la Motte Rouge T. Who drops out of breast cancer screening? Results from the EDIFICE 6 survey [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-05.
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Affiliation(s)
- J-F Morère
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
| | - F Eisinger
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
| | - S Couraud
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
| | - L Greillier
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
| | - C Touboul
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
| | - C Lhomel
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
| | - M Rouprêt
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
| | - J Viguier
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
| | - T De la Motte Rouge
- Hôpital Paul Brousse, Villejuif, France; Institut Paoli-Calmettes, Marseille, France; Centre Hospitalier Lyon Sud, Pierre Bénite, France; Assistance Publique - Hopitaux de Marseille, Marseille, France; Kanta Health, Paris, France; Roche, Boulogne-Billancourt, France; Hôpital Pitié-Salpêtrière, Paris, France; Hôpital Bretonneau, Tours, France; Centre Eugène-Marquis, Rennes, France
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Couraud S, Beduneau G, Tamion F, Molano L, Artaud-Macari E, Cuvelier A. Typologie et réflexions éthique à propos des patients de 75 ans et plus hospitalisés en réanimation médicale ou en unité de soins intensifs respiratoires. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Corbaux P, Raynard B, Fontaine-Delaruelle C, Souquet PJ, Couraud S, Tronc F, Eker E, Peron J. Évaluation nutritionnelle des patients pris en charge pour un cancer bronchopulmonaire en France : enquête d’opinion d’experts par questionnaire auprès des médecins et chirurgiens. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Couraud S, Morère J, Viguier J, Roupret M, Brignoli-Guibaudet L, Lhomel C, de La Motte Rouge T, Eisinger F, Greillier L. Social and behavioral indicators of undergoing a screening test for lung cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Garcia J, Delherme A, Geigeur F, Merle P, Tissot C, Jones F, Edelstein D, Souquet PJ, Rodriguez-Lafrasse C, Couraud S, Payen L, Xu Z. Comparison of OncoBEAM and NGS methods to detect plasma EGFR T790M mutations at progression of NSCLC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Morere JF, Viguier J, Greillier L, Roupret M, Touboul C, Lhomel C, Couraud S, de La Motte Rouge T, Eisinger F. Indicators of non-uptake of breast cancer screening: Results from the EDIFICE 6 survey. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Viguier J, Morère J, Couraud S, Roupret M, Touboul C, Lhomel C, Greillier L, de La Motte Rouge T, Eisinger F. Profile of individuals who never undergo colorectal cancer screening. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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de La Motte Rouge T, Couraud S, Eisinger F, Roupret M, Brignoli-Guibaudet L, Lhomel C, Greillier L, Viguier J, Morère J. Indicators of non-participation in cervical cancer screening: Results from the EDIFICE 6 survey. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Veaudor M, Gérinière L, Souquet PJ, Druette L, Martin X, Vergnon JM, Couraud S. High-fidelity simulation self-training enables novice bronchoscopists to acquire basic bronchoscopy skills comparable to their moderately and highly experienced counterparts. BMC Med Educ 2018; 18:191. [PMID: 30086734 PMCID: PMC6081833 DOI: 10.1186/s12909-018-1304-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 07/30/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND We sought to determine whether a self-training program on a high-fidelity flexible bronchoscopy (FB) simulator would allow residents who were novices in bronchoscopy to acquire competencies similar to those of experienced bronchoscopists as concerns the visualization of the bronchial tree and the identification of its anatomical elements. METHODS We performed a prospective cohort study, categorizing bronchoscopists into three groups according to their experience level: novice (Group A, no FBs performed, n = 8), moderate (Group B, 30 ≤ FBs performed ≤200, n = 17) or high (Group C, > 200 FBs performed, n = 9). All were initially evaluated on their ability to perform on a high-fidelity FB simulator a complete visualization/identification of the bronchial tree in the least amount of time possible. The residents in Group A then completed a simulation-based self-training program and underwent a final evaluation thereafter. RESULTS The median total procedure time for Group A fell from 561 s (IQR = 134) in the initial evaluation to 216 s (IQR = 257) in the final evaluation (P = 0.002). The visualization and identification scores for Group A also improved significantly in the final evaluation. Resultantly, the overall performance score for Group A climbed from 5.9% (IQR = 5.1) before self-training to 25.5% (IQR = 26.3) after (P = 0.002), thus becoming comparable to the overall performance scores of Group B (25.3%, IQR = 13.8) and Group C (22.2%, IQR = 5.5). CONCLUSIONS Novice bronchoscopists who self-train on a high-fidelity simulator acquire basic competencies similar to those of moderately or even highly experienced bronchoscopists. High-fidelity simulation should be rapidly integrated within the learning curriculum and replace traditional, in-patient learning methods.
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Affiliation(s)
- Martin Veaudor
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 69310, Pierre Bénite, France
| | - Laurence Gérinière
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 69310, Pierre Bénite, France
| | - Pierre-Jean Souquet
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 69310, Pierre Bénite, France
| | - Loïc Druette
- Stratégie d'Apprentissage des Métiers de Santé en Environnement Immersif, Université Lyon 1, 69008, Lyon, France
| | - Xavier Martin
- Stratégie d'Apprentissage des Métiers de Santé en Environnement Immersif, Université Lyon 1, 69008, Lyon, France
| | - Jean-Michel Vergnon
- Service de Pneumologie et oncologie thoracique, CHU St Etienne, Hôpital Nord, 42270, Saint-Priest en Jarez, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Institut de Cancérologie des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 69310, Pierre Bénite, France.
- EMR 3738 Ciblage thérapeutique en oncologie, Faculté de médecine Lyon Sud Charles Mérieux, Université Lyon 1, 69600, Oullins, France.
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Gardes S, de Santis N, Claer I, Couraud S, Souquet P, Freymond N, Gerbier-colomban S. Dramatic decrease of implanted central venous catheter-related infections by applying a simple but multicomponent prophylactic multidisciplinary program in a lung cancer clinic. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.445] [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: 10/28/2022] Open
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