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Roy L, Chomel JC, Guilhot J, Guerci-Bresler A, Escoffre-Barbe M, Giraudier S, Charbonnier A, Dubruille V, Huguet F, Johnson-Ansah H, Lenain P, Ame S, Etienne G, Nicolini FE, Rea D, Cony-Makhoul P, Courby S, Ianotto JC, Legros L, Machet A, Coiteux V, Hermet E, Cayssials E, Bouchet S, Mahon FX, Rousselot P, Guilhot F. Dasatinib plus Peg-Interferon alpha 2b combination in newly diagnosed chronic phase chronic myeloid leukaemia: Results of a multicenter phase 2 study (DASA-PegIFN study). Br J Haematol 2023; 200:175-186. [PMID: 36214090 DOI: 10.1111/bjh.18486] [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: 05/13/2022] [Revised: 09/04/2022] [Accepted: 09/16/2022] [Indexed: 01/14/2023]
Abstract
Superior rates of deep molecular response (DMR) have been reported with the combination of tyrosine kinase inhibitors and pegylated-interferon-alpha (Peg-IFN) in patients with newly diagnosed chronic phase-chronic myeloid leukaemia (CP-CML). In this setting, this study investigated the efficacy and safety of dasatinib combined to Peg-IFN-α2b (Dasa-PegIFN, NCT01872442). A total of 79 patients (age ≤65 years) started dasatinib; 61 were eligible for Peg-IFNα-2b add-on therapy at month 3 for a maximum 21-months duration. Dasatinib was continued thereafter. The primary endpoint was the cumulative rate of molecular response 4.5 log (MR4.5 ) by 12 months. The results are reported for the 5-year duration of the study. Grade 3 neutropenia was frequent with the combination but did not induce severe infection (one of grade 3). Other adverse events were generally low grade (4% of grade 3-4) and expected. Seventy-nine per cent and 61% of patients continued the Peg-IFN until months 12 and 24, respectively. Overall, at these time points, MR4.5 rates were 25% and 38%, respectively. Thereafter, 32% and 46% of patients achieved a sustained (≥2 years) MR4.5 or MR4 , respectively. This work established the feasibility and high rates of achievement of early and sustained DMR (a prerequisite for treatment-free-remission) with dasatinib and Peg-IFNα-2b combination as initial therapy.
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Affiliation(s)
- Lydia Roy
- Hôpital Universitaire Henri Mondor, APHP, Faculté de Santé, UPEC, Service d'Hématologie Clinique, Créteil, France
| | | | | | | | | | - Stéphane Giraudier
- Hôpital Saint-Louis, APHP et INSERM Université de Paris, Service de biologie cellulaire, Paris, France
| | - Aude Charbonnier
- Institut Paoli-Calmettes, Service d'Hématologie Clinique, Marseille, France
| | | | - Françoise Huguet
- Service d'Hématologie Clinique, CHU Toulouse, I.U.C.T.O, Toulouse, France
| | | | - Pascal Lenain
- Centre Henri Becquerel, Service d'Hématologie Clinique, Rouen, France
| | - Shanti Ame
- CHU Strasbourg, Service d'Hématologie Clinique, Strasbourg, France
| | - Gabriel Etienne
- Institut Bergonié, Service d'Hématologie Clinique, Bordeaux, France
| | - Franck E Nicolini
- Centre Léon Bérard, Service d'Hématologie Clinique & INSERM U1052 CRC, Lyon, France
| | - Delphine Rea
- Hôpital St Louis, APHP, Service d'Hématologie Clinique, Paris, France
| | | | - Stéphane Courby
- CHU Grenoble Service d'Hématologie Clinique, Grenoble, France
| | | | - Laurence Legros
- Hôpital Paul Brousse, AP-HP, Service d'Hématologie Clinique, INSERM UMRS-MD1197, Villejuif, France
| | - Antoine Machet
- Hôpital Bretonneau, CHRU Tours Service d'Hématologie Clinique, Tours, France
| | - Valérie Coiteux
- Hôpital Claude Huriez, CHRU Lille Service d'Hématologie Clinique, Lille, France
| | - Eric Hermet
- CHU d'Estaing, Clermont-Ferrand, Service d'Hématologie Clinique, Clermont-Ferrand, France
| | - Emilie Cayssials
- INSERM CIC 1402, CHU Poitiers, Poitiers, France.,CHU de Poitiers, Service d'Hématologie Clinique, Poitiers, France
| | - Stéphane Bouchet
- Hôpital Pellegrin, CHU Bordeaux, Laboratoire de pharmacologie, Bordeaux, France
| | | | - Philippe Rousselot
- Centre Hospitalier de Versailles, Université Paris Saclay UMR 1184, Service d'Hématologie Clinique, Le Chesnay, France
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- French CML group (Fi-LMC), Centre Léon Bérard, Lyon, France
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Vibert F, Martel C, Ionescu RA, Mathelin C, Ame S. A New Modality for Breast Cancer Diagnosis During the COVID-19 Pandemic: A Case Report. Eur J Breast Health 2022; 18:91-93. [DOI: 10.4274/ejbh.galenos.2021.2021-4-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/12/2021] [Indexed: 12/01/2022]
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3
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Vibert F, Martel C, Ionescu RA, Ame S, Mathelin C. A New Modality for Breast Cancer Diagnosis During the COVID-19 Pandemic. A Case Report. Eur J Breast Health 2021. [DOI: 10.4274/ejbh.galenos.2021-4-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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4
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Mathelin C, Ame S, Anyanwu S, Avisar E, Boubnider WM, Breitling K, Anie HA, Conceição JC, Dupont V, Elder E, Elfgen C, Elonge T, Iglesias E, Imoto S, Ioannidou-Mouzaka L, Kappos EA, Kaufmann M, Knauer M, Luzuy F, Margaritoni M, Mbodj M, Mundinger A, Orda R, Ostapenko V, Özbaş S, Özmen V, Pagani O, Pieńkowski T, Schneebaum S, Shmalts E, Selim A, Pavel Z, Lodi M, Maghales-Costa M. Breast Cancer Management During the COVID-19 Pandemic: The Senologic International Society Survey. Eur J Breast Health 2021; 17:188-196. [PMID: 33870120 DOI: 10.4274/ejbh.galenos.2021.2021-1-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/09/2021] [Indexed: 01/19/2023]
Abstract
Objective In early 2020, the spread of coronavirus disease-2019 (COVID-19) led the World Health Organization to declare this disease a pandemic. Initial epidemiological data showed that patients with cancer were at high risk of developing severe forms of COVID-19. National scientific societies published recommendations modifying the patients' breast cancer (BC) management to preserve, in theory, quality oncologic care, avoiding the increased risk of contamination. The Senology International Society (SIS) decided to take an inventory of the actions taken worldwide. This study investigates COVID-19-related changes concerning BC management and analyzes the will to maintain them after the pandemic, evaluating their oncological safety consequences. Materials and Methods SIS network members participated in an online survey using a questionnaire (Microsoft® Forms) from June 15th to July 31st, 2020. Results Forty-five responses from 24 countries showed that screening programs had been suspended (68%); magnetic resonance imagines were postponed (73%); telemedicine was preferred when possible (71%). Surgeries were postponed: reconstructive (77%), for benign diseases (84%), and in patients with significant comorbidities (66%). Chemotherapy and radiotherapy protocols had been adapted in 28% of patients in both. Exception for telemedicine (34%), these changes in practice should not be continued. Conclusion The SIS survey showed significant changes in BC's diagnosis and treatment during the first wave of the COVID-19 pandemic, but most of these changes should not be maintained. Indeed, women have fewer severe forms of COVID-19 and are less likely to die than men. The risk of dying from COVID-19 is more related to the presence of comorbidities and age than to BC. Stopping screening and delaying treatment leads to more advanced stages of BC. Only women aged over 65 with BC under treatment and comorbidities require adaptation of their cancer management.
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Affiliation(s)
- Carole Mathelin
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France.,Immediate the Senology International Society (SIS) Past President, France
| | - Shanti Ame
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France
| | - Stanley Anyanwu
- The Senology International Society Vice-President for Africa, Nigeria
| | - Eli Avisar
- Miller School of Medicine, University of Miami, USA
| | | | | | | | | | | | - Elisabeth Elder
- Westmead Breast Cancer Institute, University of Sydney, Australia
| | | | | | - Edelmiro Iglesias
- The Senology International Society (SIS) Vice-President for Europe, Spain
| | | | | | - Elisabeth A Kappos
- Breast Center and Department of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Switzerland
| | | | - Michael Knauer
- Breast Center Eastern Switzerland, St. Gallen, Switzerland
| | - Franck Luzuy
- Department of Breast Surgery, Hirslanden Clinic, Geneva, Switzerland
| | | | - Mamadou Mbodj
- Department of Nuclear Medicine, General Hospital Idrissa POUYE, Dakar, Senegal
| | | | - Ruben Orda
- The Senology International Society (SIS) International School of Senology, Israel
| | | | | | - Vahit Özmen
- The Senology International Society (SIS) Standing Committee, Turkey
| | - Olivia Pagani
- Department of Oncology, Breast Unit and Institute of Oncology of Southern Switzerland
| | | | | | - Ekaterina Shmalts
- Department of Oncology, Multi-field Clinical Medical Centre "Medical City", Tyumen, Russia
| | - Ashraf Selim
- Department of Radiology, Cairo University, Egypt
| | - Zotov Pavel
- Department of Oncology, Tyumen State Medical University, Russia
| | - Massimo Lodi
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France
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5
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Levecke B, Vlaminck J, Andriamaro L, Ame S, Belizario V, Degarege A, Engels D, Erko B, Garba AD, Kaatano GM, Mekonnen Z, Montresor A, Olliaro P, Pieri OS, Sacko M, Sam-Wobo SO, Tchuem Tchuenté LA, Webster JP, Vercruysse J. Evaluation of the therapeutic efficacy of praziquantel against schistosomes in seven countries with ongoing large-scale deworming programs. Int J Parasitol Drugs Drug Resist 2020; 14:183-187. [PMID: 33125936 PMCID: PMC7595844 DOI: 10.1016/j.ijpddr.2020.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/27/2022]
Abstract
The World Health Organization (WHO) recommends periodic assessment of the therapeutic efficacy of praziquantel (PZQ) to detect reduced efficacy that may arise from drug resistance in schistosomes. In this multi-country study (2014), we assessed the therapeutic efficacy of a single oral dose of PZQ (40 mg/kg) against Schistosoma mansoni (Brazil, Cameroon, Ethiopia, Mali, Madagascar and Tanzania), S. haematobium (Cameroon, Ethiopia, Mali, Tanzania and Zanzibar) and S. japonicum (the Philippines) infections in school-aged children, across a total of 12 different trials. Each trial was performed according to the standardized methodology for evaluating PZQ efficacy as described by the WHO. Overall, therapeutic efficacy, measured as the reduction in arithmetic mean of schistosome egg counts following drug administration (egg reduction rate; ERR), was high for all three schistosome species (S. mansoni: 93.4% (95%CI: 88.8–96.8); S. haematobium: 97.7% (95%CI: 96.5–98.7) and S. japonicum: 90.0% (95%CI: 68.4–99.3). At the trial level, therapeutic efficacy was satisfactory (point estimate ERR ≥90%) for all three Schistosoma species with the exception of S. mansoni in Cameroon where the ERR was 88.5% (95%CI: 79.0–95.1). Furthermore, we observed that in some trials individual drug response could vary significantly (wide 95%CI) and that few non-responsive individuals could significantly impact ERR point estimates. In conclusion, these results do not suggest any established reduced efficacy of the standard PZQ treatment to any of the three schistosome species within these countries. Nevertheless, the substantial degree of variation in individual responses to treatment in some countries underpins the need for future monitoring. The reported ERR values serve as reference values to compare with outcomes of future PZQ efficacy studies to ensure early detection of reduced efficacies that could occur as drug pressure continues increase. Finally, this study highlights that 95%CI should be considered in WHO guidelines to classify the therapeutic efficacy of PZQ. PZQ efficacy against schistosomes was assessed in school-aged-children in seven countries. There was no overall sign of reduced PZQ efficacy against any schistosome species. Notable variation in individual responses to treatment does require future monitoring. It is recommended to include reporting of the 95%CI in future WHO guidelines.
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Affiliation(s)
- B Levecke
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Belgium.
| | - J Vlaminck
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - L Andriamaro
- Reseau International Schistosomiase Environnement Amenagement et Lutte (RISEAL), Madagascar
| | - S Ame
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, United Republic of Tanzania
| | - V Belizario
- Department of Parasitology, College of Public Health, University of the Philippines, Manilla, Philippines
| | - A Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - D Engels
- Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - B Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - A D Garba
- Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - G M Kaatano
- National Institute for Medical Research (NIMR), Mwanza Centre, Mwanza City, United Republic of Tanzania
| | - Z Mekonnen
- Jimma University Institute of Health, Jimma University, Jimma, Ethiopia
| | - A Montresor
- Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - P Olliaro
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - O S Pieri
- Environmental and Health Education Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - M Sacko
- Service de Parasitologie, Institut National de Recherche en Santé Publique, Bamako, Mali
| | - S O Sam-Wobo
- Department of Pure and Applied Zoology, Federal University of Agriculture Abeokuta, Nigeria
| | - L A Tchuem Tchuenté
- Centre for Schistosomiasis and Parasitology, Faculty of Sciences, University of Yaoundé I, Cameroon
| | - J P Webster
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, UK
| | - J Vercruysse
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Belgium
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6
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Rea D, Ame S, Berger M, Cayuela JM, Charbonnier A, Coiteux V, Cony-Makhoul P, Dubruille V, Dulucq S, Etienne G, Legros L, Nicolini F, Roche-Lestienne C, Escoffre-Barbe M, Gardembas M, Guerci-Bresler A, Johnson-Ansah H, Rigal-Huguet F, Rousselot P, Mahon FX. Discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia: Recommendations for clinical practice from the French Chronic Myeloid Leukemia Study Group. Cancer 2018; 124:2956-2963. [DOI: 10.1002/cncr.31411] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/14/2018] [Accepted: 03/14/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Delphine Rea
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Shanti Ame
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Marc Berger
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Jean-Michel Cayuela
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Aude Charbonnier
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Valérie Coiteux
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Pascale Cony-Makhoul
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Viviane Dubruille
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Stéphanie Dulucq
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Gabriel Etienne
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Laurence Legros
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Franck Nicolini
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | | | | | - Martine Gardembas
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | - Agnès Guerci-Bresler
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
| | | | | | - Philippe Rousselot
- French Chronic Myeloid Leukemia Study Group, Bergonié Institute; Bordeaux France
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Díez-Campelo M, Lorenzo JI, Itzykson R, Rojas SM, Berthon C, Luño E, Beyne-Rauzy O, Perez-Oteyza J, Vey N, Bargay J, Park S, Cedena T, Bordessoule D, Muñoz JA, Gyan E, Such E, Visanica S, López-Cadenas F, de Botton S, Hernández-Rivas JM, Ame S, Stamatoullas A, Delaunay J, Salanoubat C, Isnard F, Guieze R, Pérez Guallar J, Badiella L, Sanz G, Cañizo C, Fenaux P. Azacitidine improves outcome in higher-risk MDS patients with chromosome 7 abnormalities: a retrospective comparison of GESMD and GFM registries. Br J Haematol 2018; 181:350-359. [DOI: 10.1111/bjh.15190] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 01/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- María Díez-Campelo
- Haematology, Hospital Universitario de Salamanca; Salamanca Spain
- Institute of Biomedical Research of Salamanca (IBSAL); Salamanca Spain
| | - Jose I. Lorenzo
- Haematology Department; Hospital Universitario y Politécnico La Fe; Valencia Spain
| | - Raphael Itzykson
- Service d'Hematologie; St Louis, assistance publique hôpitaux de Paris and Paris Diderot University; Paris France
| | - Silvia M. Rojas
- Haematology, Hospital Universitario de Salamanca; Salamanca Spain
| | - Céline Berthon
- Maladies du Sang; Hopital Huriez; CHRU de Lille; Lille France
| | - Elisa Luño
- Haematology; Hospital Universitario Central de Asturias; Oviedo Spain
| | | | | | - Norbert Vey
- Haematology department; Institut Paoli Calmettes; Marseille France
| | - Joan Bargay
- Hospital Sont Llatzer; Palma de Mallorca Spain
| | - Sophie Park
- Haematology; Clinique Universitaire d′Hématologie; CHU de Grenoble; Grenoble France
| | | | - Dominique Bordessoule
- Unité de Recherche Clinique; Service d'Hématologie Clinique et Thérapie Cellulaire; Limoges France
| | | | - Emmanuel Gyan
- Service d'hématologie et thérapie cellulaire; CHRU de Tours; Team 3 UMR CNRS 7292; Université François Rabelais; Tours France
| | - Esperanza Such
- Haematology Department; Hospital Universitario y Politécnico La Fe; Valencia Spain
| | - Sorin Visanica
- Hématologie - Hôpital Bon Secours; Metz-Thionville; Thionville France
| | | | | | - Jesús M. Hernández-Rivas
- Haematology, Hospital Universitario de Salamanca; Salamanca Spain
- Institute of Biomedical Research of Salamanca (IBSAL); Salamanca Spain
| | - Shanti Ame
- Haematology Department; Hôpital Civil; Strasbourg France
| | | | | | | | - Françoise Isnard
- Department of Haematology; Assistance Publique-Hopitaux de Paris (AP-HP) Saint-Antoine; Universite Pierre et Marie Curie; Paris France
| | | | - Joan Pérez Guallar
- Department of application statistics; Universidad Autónoma de Barcelona; Barcelona Spain
| | - Llorenc Badiella
- Department of application statistics; Universidad Autónoma de Barcelona; Barcelona Spain
| | - Guillermo Sanz
- Haematology Department; Hospital Universitario y Politécnico La Fe; Valencia Spain
| | - Consuelo Cañizo
- Haematology, Hospital Universitario de Salamanca; Salamanca Spain
- Institute of Biomedical Research of Salamanca (IBSAL); Salamanca Spain
| | - Pierre Fenaux
- Service d'Hematologie; St Louis, assistance publique hôpitaux de Paris and Paris Diderot University; Paris France
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8
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Chomel JC, Bonnet ML, Sorel N, Sloma I, Bennaceur-Griscelli A, Rea D, Legros L, Marfaing-Koka A, Bourhis JH, Ame S, Guerci-Bresler A, Rousselot P, Turhan AG. Leukemic stem cell persistence in chronic myeloid leukemia patients in deep molecular response induced by tyrosine kinase inhibitors and the impact of therapy discontinuation. Oncotarget 2018; 7:35293-301. [PMID: 27167108 PMCID: PMC5085229 DOI: 10.18632/oncotarget.9182] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/10/2016] [Indexed: 11/25/2022] Open
Abstract
During the last decade, the use of tyrosine kinase inhibitor (TKI) therapy has modified the natural history of chronic myeloid leukemia (CML) allowing an increase of the overall and disease-free survival, especially in patients in whom molecular residual disease becomes undetectable. However, it has been demonstrated that BCR-ABL1- expressing leukemic stem cells (LSCs) persist in patients in deep molecular response. It has also been shown that the discontinuation of Imatinib leads to a molecular relapse in the majority of cases. To determine a possible relationship between these two phenomena, we have evaluated by clonogenic and long-term culture initiating cell (LTC-IC) assays, the presence of BCR-ABL1-expressing LSCs in marrow samples from 21 patients in deep molecular response for three years after TKI therapy (mean duration seven years). LSCs were detected in 4/21 patients. Discontinuation of TKI therapy in 13/21 patients led to a rapid molecular relapse in five patients (4 without detectable LSCs and one with detectable LSCs). No relapse occurred in the eight patients still on TKI therapy, whether LSCs were detectable or not. Thus, this study demonstrates for the first time the in vivo efficiency of TKIs, both in the progenitor and the LSC compartments. It also confirms the persistence of leukemic stem cells in patients in deep molecular response, certainly at the origin of relapses. Finally, it emphasizes the difficulty of detecting residual LSCs due to their rarity and their low BCR-ABL1 mRNA expression.
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Affiliation(s)
- Jean Claude Chomel
- Laboratoire de Cancérologie Biologique, CHU de Poitiers, Poitiers, France.,INSERM U935, Poitiers, France
| | | | - Nathalie Sorel
- Laboratoire de Cancérologie Biologique, CHU de Poitiers, Poitiers, France.,INSERM U935, Poitiers, France
| | - Ivan Sloma
- Service d'Hématologie Biologique, Hôpital Paul Brousse, Villejuif, France.,INSERM U935, Villejuif, France.,Université Paris Sud, Le Kremlin-Bicêtre, France
| | - Annelise Bennaceur-Griscelli
- Service d'Hématologie Biologique, Hôpital Paul Brousse, Villejuif, France.,INSERM U935, Villejuif, France.,Université Paris Sud, Le Kremlin-Bicêtre, France
| | - Delphine Rea
- Service d'Hématologie Adulte, Hôpital Saint Louis, Paris, France.,INSERM UMRS-1160, IUH-Université Paris Diderot-Paris 7, Paris, France
| | - Laurence Legros
- Service d'Hématologie Clinique, Hôpital l'Archet, Nice, France
| | - Anne Marfaing-Koka
- Service d'Hématologie Biologique, Hôpital Antoine Béclère, Clamart, France
| | - Jean-Henri Bourhis
- Service d'Hématologie Biologique, Hôpital Antoine Béclère, Clamart, France.,Service d'Hématologie-Greffe de Moelle, Institut Gustave Roussy, Villejuif, France
| | - Shanti Ame
- Département d'Hématologie et Oncologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - Philippe Rousselot
- Service d'Hématologie et Oncologie, Centre Hospitalier de Versailles, Versailles, France.,EA4340, Université Versailles-Saint Quentin en Yvelines, Université Paris-Saclay, France
| | - Ali G Turhan
- INSERM U935, Poitiers, France.,Service d'Hématologie Biologique, Hôpital Paul Brousse, Villejuif, France.,INSERM U935, Villejuif, France.,Université Paris Sud, Le Kremlin-Bicêtre, France.,Service d'Hématologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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9
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Glady L, Guerin E, Ame S, Maloisel F, Lessinger J. A single-nucleotide polymorphism of ABCB1 (MDR1) is correlated with poor response to Imatinib chronic myeloid leukemia. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx508.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Campelo MD, Lorenzo J, Itzykson R, Rojas S, Berthon C, Luño E, Beyne-Rauzy O, Pérez-Oteyza J, Vey N, Bargay J, Park S, Cedena T, Bordessoule D, Muñoz J, Gyan E, Such E, Visanica S, Benlloch L, de Botton S, Hernández-Rivas J, Ame S, Stamatoullas A, Delaunay J, Salanoubat C, Isnard F, Guieze R, Sanz G, Cañizo M, Fenaux P. 213 AZACITIDINE (AZA) IN HIGHER RISK MDS PATIENTS WITH CHROMOSOME 7 ABNORMALITIES (ABN 7): RESULTS OF A RETROSPECTIVE STUDY FROM THE GFM AND GESMD REGISTRIES. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30214-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Bird C, Ame S, Albonico M, Bickle Q. Do shoes reduce hookworm infection in school-aged children on Pemba Island, Zanzibar? A pragmatic trial. Trans R Soc Trop Med Hyg 2014; 108:297-304. [DOI: 10.1093/trstmh/tru037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Barthelemy P, Dourthe LM, Serra S, Asmane-De la Porte I, Prim N, Ame S, Litique V, Giron C, Goldbarg V, Fornecker L, Duclos B, Kurtz JE. Adherence and patients’ attitude toward oral anticancer drugs: A prospective series of 226 patients focusing onto targeted therapies. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e17543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17543 Background: Patients’ adherence has been identified as a challenge in oncology and hematology practice. Hormone therapy data in breast cancer suggest insufficient adherence and poor persistence. Limited data is available for targeted therapies such as tyrosine kinase (TK) and mTOR inhibitors whereas poor adherence to TK treatment was linked to treatment failure in GIST and CML. Methods: We report the result of a prospective survey in 226 patients (pts), with solid tumors and hematologic malignancies receiving oral anticancer therapy including chemotherapy or hormone therapy (CT), and targeted therapies (TT). Treatment duration and setting (adjuvant vs metastatic), cancer type, age, co-medication were analyzed. Patients were given a 15-item questionnaire and asked to anonymously answer questions regarding their attitude towards oral anticancer drugs. To analyze adherence, patients were asked whether they voluntarily or not missed any drug dosing during the last month. Results: 226 patients (median age 65.5 y.o) participated, 115 with TT and 111 with CT, with a median time of drug intake of 10.5 months. Both TT and CT patients stated to be well informed about treatment modalities in (92%), mostly by their oncologist or hematologist (87%). Written information was more frequently given in TT pts (67.0 vs 27.0%, p<0.0001). TT pts declared to be more often fully adherent to therapy (84.3 vs 66.7%, p=0.01) despite experiencing more side-effects (p<0.0001) and taking more concomitant oral medication (p=0.029). The mean treatment duration was 28.0 vs 20.3 months in TT vs CT pts (NS), but in both groups non-adherence was observed at any time since initial prescription. Conclusions: Despite advances in patients’ information leading to better treatment adherence in TT pts, efforts are still warranted such as the onset of dedicated staff for early and prolonged monitoring of outpatient anticancer oral therapy.
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Affiliation(s)
| | | | | | | | - Nathalie Prim
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Shanti Ame
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - Cathy Giron
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - Luc Fornecker
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Brigitte Duclos
- Centre Hospitalier Régional Universitaire Strasbourg, Strasbourg, France
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Kelaidi C, Beyne-Rauzy O, Braun T, Sapena R, Cougoul P, Adès L, Pillard F, Lamberto C, Charniot JC, Guerci A, Choufi B, Stamatoullas A, Slama B, De Renzis B, Ame S, Damaj G, Boyer F, Chaury MP, Legros L, Cheze S, Testu A, Gyan E, Béné MC, Rose C, Dreyfus F, Fenaux P. Erratum to: High response rate and improved exercise capacity and quality of life with a new regimen of darbepoetin alfa with or without filgrastim in lower-risk myelodysplastic syndromes: a phase II study by the GFM. Ann Hematol 2013. [DOI: 10.1007/s00277-013-1713-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kelaidi C, Beyne-Rauzy O, Braun T, Sapena R, Cougoul P, Adès L, Pillard F, Lamberto C, Lambert C, Charniot JC, Guerci A, Choufi B, Stamatoullas A, Slama B, De Renzis B, Ame S, Damaj G, Boyer F, Chaury MP, Legros L, Cheze S, Testu A, Gyan E, Béné MC, Rose C, Dreyfus F, Fenaux P. High response rate and improved exercise capacity and quality of life with a new regimen of darbepoetin alfa with or without filgrastim in lower-risk myelodysplastic syndromes: a phase II study by the GFM. Ann Hematol 2013; 92:621-31. [PMID: 23358617 DOI: 10.1007/s00277-013-1686-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/17/2013] [Indexed: 11/24/2022]
Abstract
Darbepoetin (DAR), with or without granulocyte colony-stimulating factor (G-CSF), has proved effective in treating anemia in patients with lower-risk myelodysplastic syndrome (MDS), but its effects on quality of life (QoL) and exercise functioning are less well established. In this phase II study (no. NCT00443339), lower-risk MDS patients with anemia and endogenous erythropoietin (EPO) level <500 IU/L received DAR 500 μg once every 2 weeks for 12 weeks, with G-CSF added at week 12 in non-responders. Physical performance was assessed with the 6-min walking test and, for fit patients, maximal oxygen consumption (VO2max). QoL was evaluated using SF-36 and FACT-An tests. In 99 patients, erythroid response rate according to IWG 2006 criteria was 48 and 56 % at 12 and 24 weeks, respectively. Addition of G-CSF rescued 22 % of non-responders. In 48 % of the responders, interval between darbepoetin injections could be increased for maintenance treatment. Serum EPO level was the only independent predictive factor of response at 12 weeks, and its most discriminant cutoff value was 100 IU/L. QoL and VO2max showed improvement over time in responders, compared with non-responders. With a median follow-up of 52 months, median response duration was not reached, and 3-year cumulative incidence of acute myeloid leukemia and overall survival (OS) was 14.5 and 70 %, respectively. Baseline transfusion dependence, International Prognostic Score System (IPSS), and Revised IPSS accurately predicted OS from treatment onset. Tolerance of darbepoetin was good. In conclusion, this regimen of darbepoetin every 2 weeks yielded high response rates and prolonged response duration. Objective improvement in exercise testing and in patient-reported QoL confirms the clinical relevance of anemia correction with erythropoiesis-stimulating agents.
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Affiliation(s)
- C Kelaidi
- GFM Service d'Hématogie Clinique, Hôpital Avicenne, Assistance Publique des Hôpitaux de Paris, Université Paris 13, 125 rue de Stalingrad, Bobigny, France
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Itzykson R, Thépot S, Beyne-Rauzy O, Ame S, Isnard F, Dreyfus F, Salanoubat C, Taksin AL, Chelgoum Y, Berthon C, Malfuson JV, Legros L, Vey N, Turlure P, Gardin C, Boehrer S, Ades L, Fenaux P. Does addition of erythropoiesis stimulating agents improve the outcome of higher-risk myelodysplastic syndromes treated with azacitidine? Leuk Res 2011; 36:397-400. [PMID: 22177456 DOI: 10.1016/j.leukres.2011.11.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 11/10/2011] [Accepted: 11/24/2011] [Indexed: 11/25/2022]
Abstract
We studied a retrospective cohort of 282 higher-risk MDS treated with azacitidine, including 32 patients who concomitantly received an ESA for a median of 5.8 months after azacitidine onset. Forty-four percent of ESA and 29% of no-ESA patients reached HI-E (p=0.07); 48% and 20% achieved transfusion independence (p=0.01). Median OS was 19.6 months in the ESA and 11.9 months in the no-ESA groups (p=0.04). Addition of an ESA significantly improved OS (p=0.03) independently of azacitidine schedule and duration, and of our proposed azacitidine risk score (Blood 2011;117:403-11). Adding an ESA to azacitidine in higher-risk MDS should be studied prospectively.
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Affiliation(s)
- R Itzykson
- Service d'Hématogie Clinique Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, and Paris 13 University, France
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Park S, Sapena R, Kelaidi C, Vassilieff D, Bordessoule D, Stamatoullas A, Cheze S, Beyne-Rauzy O, Vey N, Rose C, Guerci A, Ame S, Tercian G, Slama B, Fenaux P, Dreyfus F. 99 Correlation between serum ferritin level at diagnosis and survival in lower risk, non-transfusion dependent, MDS patients. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70101-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Prebet T, Braun T, Beyne-Rauzy O, Dreyfus F, Stammatoulas A, Wattel E, Ame S, Raffoux E, Ades L, Fenaux P, Vey N. 191 Vorinostat and low dose cytarabine for high risk myelodysplastic syndromes with azacytidine failure: the GFM-VOR2007 study. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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