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Blanchet B, Xu-Vuilard A, Jouinot A, Puisset F, Combarel D, Huillard O, Le Louedec F, Thomas F, Teixeira M, Flippot R, Mourey L, Albiges L, Pudlarz T, Joly C, Tournigand C, Chauvin J, Puszkiel A, Chatelut E, Decleves X, Vidal M, Goldwasser F, Oudard S, Medioni J, Vano YA. Exposure-response relationship of cabozantinib in patients with metastatic renal cell carcinoma treated in routine care. Br J Cancer 2024; 130:961-969. [PMID: 38272963 PMCID: PMC10950854 DOI: 10.1038/s41416-024-02585-y] [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: 09/28/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Interindividual pharmacokinetic variability may influence the clinical benefit or toxicity of cabozantinib in metastatic renal cell carcinoma (mRCC). We aimed to investigate the exposure-toxicity and exposure-response relationship of cabozantinib in unselected mRCC patients treated in routine care. METHODS This ambispective multicenter study enrolled consecutive patients receiving cabozantinib in monotherapy. Steady-state trough concentration (Cmin,ss) within the first 3 months after treatment initiation was used for the PK/PD analysis with dose-limiting toxicity (DLT) and survival outcomes. Logistic regression and Cox proportional-hazards models were used to identify the risk factors of DLT and inefficacy in patients, respectively. RESULTS Seventy-eight mRCC patients were eligible for the statistical analysis. Fifty-two patients (67%) experienced DLT with a median onset of 2.1 months (95%CI 0.7-8.2). In multivariate analysis, Cmin,ss was identified as an independent risk factor of DLT (OR 1.46, 95%CI [1.04-2.04]; p = 0.029). PFS and OS were not statistically associated with the starting dose (p = 0.81 and p = 0.98, respectively). In the multivariate analysis of PFS, Cmin, ss > 336 ng/mL resulted in a hazard ratio of 0.28 (95%CI, 0.10-0.77, p = 0.014). By contrast, Cmin, ss > 336 ng/mL was not statistically associated with longer OS. CONCLUSION Early plasma drug monitoring may be useful to optimise cabozantinib treatment in mRCC patients treated in monotherapy, especially in frail patients starting at a lower than standard dose.
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Affiliation(s)
- Benoit Blanchet
- Université de Paris, CNRS, INSERM, CiTCoM, U1268, F-75006, Paris, France.
- Biologie du Médicament - Toxicologie, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France.
- Groupe de Pharmacologie Clinique Oncologique GPCO-Unicancer, Paris, France.
| | - Alexandre Xu-Vuilard
- Department of Medical Oncology, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Georges Pompidou, Paris, France
| | - Anne Jouinot
- Department of Medical Oncology, ARIANE, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
- Université Paris Cité, Institut Cochin, Inserm U1016, CNRS UMR8104, Paris, France
| | - Florent Puisset
- Groupe de Pharmacologie Clinique Oncologique GPCO-Unicancer, Paris, France
- Oncopole Claudius-Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, 31059, Toulouse, France
| | - David Combarel
- Groupe de Pharmacologie Clinique Oncologique GPCO-Unicancer, Paris, France
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif, France
- Faculté de pharmacie, Université Paris Saclay, Orsay, France
- Medical School, University of Paris XI, Saclay, France
| | - Olivier Huillard
- Department of Medical Oncology, ARIANE, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Félicien Le Louedec
- Groupe de Pharmacologie Clinique Oncologique GPCO-Unicancer, Paris, France
- Oncopole Claudius-Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, 31059, Toulouse, France
| | - Fabienne Thomas
- Groupe de Pharmacologie Clinique Oncologique GPCO-Unicancer, Paris, France
- Oncopole Claudius-Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, 31059, Toulouse, France
- CRCT, Cancer Research Center of Toulouse, Inserm U1037, Université Paul Sabatier, 31037, Toulouse, France
| | - Marcus Teixeira
- Department of Oncological Medicine, Gustave Roussy, Villejuif, France
- Medical School, University of Paris XI Saclay, Saclay, France
| | - Ronan Flippot
- Department of Oncological Medicine, Gustave Roussy, Villejuif, France
- Medical School, University of Paris XI Saclay, Saclay, France
- Laboratoire d'immunomonitoring en oncologie, CNRS3655 & INSERM US23, Université Paris Saclay, Paris, France
| | - Loic Mourey
- Oncopole Claudius-Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, 31059, Toulouse, France
| | - Laurence Albiges
- Department of Oncological Medicine, Gustave Roussy, Villejuif, France
- Medical School, University of Paris XI Saclay, Saclay, France
| | - Thomas Pudlarz
- Department of Medical Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Saint Antoine, Paris, France
| | - Charlotte Joly
- Department of Medical Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, Université de Paris Est, Créteil, France
| | - Christophe Tournigand
- Department of Medical Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, Université de Paris Est, Créteil, France
| | | | - Alicja Puszkiel
- Biologie du Médicament - Toxicologie, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
- Groupe de Pharmacologie Clinique Oncologique GPCO-Unicancer, Paris, France
- Université Paris Cité, Inserm, UMR-S1144, Paris, France
| | - Etienne Chatelut
- Groupe de Pharmacologie Clinique Oncologique GPCO-Unicancer, Paris, France
- Oncopole Claudius-Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, 31059, Toulouse, France
- CRCT, Cancer Research Center of Toulouse, Inserm U1037, Université Paul Sabatier, 31037, Toulouse, France
| | - Xavier Decleves
- Biologie du Médicament - Toxicologie, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
- Groupe de Pharmacologie Clinique Oncologique GPCO-Unicancer, Paris, France
- Université Paris Cité, Inserm, UMR-S1144, Paris, France
| | - Michel Vidal
- Université de Paris, CNRS, INSERM, CiTCoM, U1268, F-75006, Paris, France
- Biologie du Médicament - Toxicologie, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - François Goldwasser
- Department of Medical Oncology, ARIANE, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Stéphane Oudard
- Department of Medical Oncology, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Georges Pompidou, Paris, France
- Université de Paris Cité, INSERM U970, PARCC, Paris, France
| | - Jacques Medioni
- Department of Medical Oncology, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Georges Pompidou, Paris, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Institut du Cancer Paris CARPEM, Assistance Publique Hôpitaux de Paris, Hôpital Georges Pompidou, Paris, France
- Université de Paris Cité, UMR_S1138-INSERM, Paris, France
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2
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Lu X, Vano YA, Su X, Helleux A, Lindner V, Mouawad R, Spano JP, Rouprêt M, Compérat E, Verkarre V, Sun CM, Bennamoun M, Lang H, Barthelemy P, Cheng W, Xu L, Davidson I, Yan F, Fridman WH, Sautes-Fridman C, Oudard S, Malouf GG. Silencing of genes by promoter hypermethylation shapes tumor microenvironment and resistance to immunotherapy in clear-cell renal cell carcinomas. Cell Rep Med 2023; 4:101287. [PMID: 37967556 PMCID: PMC10694769 DOI: 10.1016/j.xcrm.2023.101287] [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: 05/08/2023] [Revised: 07/21/2023] [Accepted: 10/19/2023] [Indexed: 11/17/2023]
Abstract
The efficacy of immune checkpoint inhibitors varies in clear-cell renal cell carcinoma (ccRCC), with notable primary resistance among patients. Here, we integrate epigenetic (DNA methylation) and transcriptome data to identify a ccRCC subtype characterized by cancer-specific promoter hypermethylation and epigenetic silencing of Polycomb targets. We develop and validate an index of methylation-based epigenetic silencing (iMES) that predicts primary resistance to immune checkpoint inhibition (ICI) in the BIONIKK trial. High iMES is associated with VEGF pathway silencing, endothelial cell depletion, immune activation/suppression, EZH2 activation, BAP1/SETD2 deficiency, and resistance to ICI. Combination therapy with hypomethylating agents or tyrosine kinase inhibitors may benefit patients with high iMES. Intriguingly, tumors with low iMES exhibit increased endothelial cells and improved ICI response, suggesting the importance of angiogenesis in ICI treatment. We also develop a transcriptome-based analogous system for extended applicability of iMES. Our study underscores the interplay between epigenetic alterations and tumor microenvironment in determining immunotherapy response.
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Affiliation(s)
- Xiaofan Lu
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, 67400 Illkirch, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP, Université Paris Cité, Paris, France; Centre de Recherche Cordeliers, INSERM 1138, Université de Paris Cité, Sorbonne Université, Equipe labellisée Ligue contre le Cancer, 75006 Paris, France
| | - Xiaoping Su
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexandra Helleux
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, 67400 Illkirch, France
| | - Véronique Lindner
- Department of Pathology, Strasbourg University Hospital, Strasbourg, France
| | - Roger Mouawad
- Department of Medical Oncology, Sorbonne University, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Philippe Spano
- Department of Medical Oncology, Sorbonne University, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Morgan Rouprêt
- Sorbonne University, GRC 5 P, UKredictive Onco-Uro, AP-HP, Urology, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Eva Compérat
- Department of Pathology, Sorbonne University, AP-HP, Hôpital Tenon, Paris, France
| | - Virginie Verkarre
- Department of Pathology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP, Université Paris Cité, Paris, France
| | - Cheng-Ming Sun
- Centre de Recherche Cordeliers, INSERM 1138, Université de Paris Cité, Sorbonne Université, Equipe labellisée Ligue contre le Cancer, 75006 Paris, France
| | - Mostefa Bennamoun
- Department of Medical Oncology, Institut Mutualiste Montsouris, Paris, France
| | - Hervé Lang
- Department of Urology, Strasbourg University Hospital, Strasbourg, France
| | - Philippe Barthelemy
- Department of Medical Oncology, Strasbourg University, Institut de Cancérologie de Strasbourg, Strasbourg, France
| | - Wenxuan Cheng
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, P.R. China
| | - Li Xu
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, P.R. China
| | - Irwin Davidson
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, 67400 Illkirch, France
| | - Fangrong Yan
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, P.R. China
| | - Wolf Hervé Fridman
- Centre de Recherche Cordeliers, INSERM 1138, Université de Paris Cité, Sorbonne Université, Equipe labellisée Ligue contre le Cancer, 75006 Paris, France
| | - Catherine Sautes-Fridman
- Centre de Recherche Cordeliers, INSERM 1138, Université de Paris Cité, Sorbonne Université, Equipe labellisée Ligue contre le Cancer, 75006 Paris, France
| | - Stéphane Oudard
- Centre de Recherche Cordeliers, INSERM 1138, Université de Paris Cité, Sorbonne Université, Equipe labellisée Ligue contre le Cancer, 75006 Paris, France
| | - Gabriel G Malouf
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, 67400 Illkirch, France; Department of Medical Oncology, Strasbourg University, Institut de Cancérologie de Strasbourg, Strasbourg, France.
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3
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André T, Berton D, Curigliano G, Sabatier R, Tinker AV, Oaknin A, Ellard S, de Braud F, Arkenau HT, Trigo J, Gravina A, Kristeleit R, Moreno V, Abdeddaim C, Vano YA, Samouëlian V, Miller R, Boni V, Torres AA, Gilbert L, Brown J, Dewal N, Dabrowski C, Antony G, Zografos E, Veneris J, Banerjee S. Antitumor Activity and Safety of Dostarlimab Monotherapy in Patients With Mismatch Repair Deficient Solid Tumors: A Nonrandomized Controlled Trial. JAMA Netw Open 2023; 6:e2341165. [PMID: 37917058 PMCID: PMC10623195 DOI: 10.1001/jamanetworkopen.2023.41165] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/14/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Mismatch repair deficiency (dMMR) occurs in various cancers, and these tumors are attractive candidates for anti-programmed cell death 1 therapies, such as dostarlimab, a recently approved immune checkpoint inhibitor. Objective To assess the antitumor activity and safety of dostarlimab in patients with advanced or recurrent dMMR solid tumors. Design, Setting, And Participants The GARNET trial was a phase 1, open-label, single-group, multicenter study that began enrolling May 8, 2017. Participants had advanced or recurrent dMMR and microsatellite instability-high (MSI-H) or polymerase epsilon (POLE)-altered solid tumors. The data cut for this interim analysis was from November 1, 2021, with median follow-up of 27.7 months. Interventions Patients received 500 mg of dostarlimab intravenously every 3 weeks for 4 doses, then 1000 mg every 6 weeks until disease progression, discontinuation, or withdrawal. Main Outcomes and Measures The primary objective was to evaluate objective response rate and duration of response in patients with dMMR solid tumors by blinded independent central review using Response Evaluation Criteria in Solid Tumors, version 1.1. Results The efficacy population included 327 patients (median [range] age, 63 [24-85] years; 235 [71.9%] female; 7 [2.1%] Asian, 6 [1.8%] Black, and 206 [63.0%] White patients), with 141 patients (43.1%) with dMMR endometrial cancer, 105 patients (32.1%) with dMMR colorectal cancer, and 81 patients (24.8%) with other dMMR tumor types. All patients had at least 1 previous line of therapy. Objective response rate assessed per blinded independent central review for dMMR solid tumors was 44.0% (95% CI, 38.6% to 49.6%). Median duration of response was not reached (range, ≥1.18 to ≥47.21 months); 72.2% of responders (104 of 144) had a response lasting 12 or more months. Median progression-free survival was 6.9 months (95% CI, 4.2 to 13.6 months); probability of progression-free survival at 24 months was 40.6% (95% CI, 35.0% to 46.1%). Median overall survival was not reached (95% CI, 31.6 months to not reached). The most frequent immune-related adverse events were hypothyroidism (25 [6.9%]), alanine aminotransferase increase (21 [5.8%]), and arthralgia (17 [4.7%]). No new safety concerns were identified. Conclusions And Relevance In this nonrandomized controlled trial, dostarlimab was a well-tolerated treatment option with rapid, robust, and durable antitumor activity in patients with diverse dMMR solid tumors. These findings suggest that dostarlimab provides meaningful long-term benefit in a population with high unmet need. Trial Registration ClinicalTrials.gov Identifier: NCT02715284.
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Affiliation(s)
- Thierry André
- Saint-Antoine Hospital, INSERM, Unité Mixte de Recherche Scientifique 938, and SIRIC CURAMUS, Sorbonne University, Paris, France
| | - Dominique Berton
- GINECO and Institut de Cancerologie de l’Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - Giuseppe Curigliano
- European Institute of Oncology, IRCCS, Milan, Italy
- Department of Medical Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | - Renaud Sabatier
- Department of Medical Oncology, Institut Paoli-Calmettes, CRCM, INSERM, CNRS, Aix-Marseille University, Marseille, France
| | - Anna V. Tinker
- BC Cancer–Vancouver, Vancouver, British Columbia, Canada
| | - Ana Oaknin
- Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Susan Ellard
- BC Cancer–Kelowna, Kelowna, British Columbia, Canada
| | - Filippo de Braud
- Ordinario di Oncologia Medica Direttore Scuola di Specialità in Oncologia Medica Università di Milano, Direttore Dipartimento Oncologia e Ematoncologia Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - José Trigo
- Medical Oncology Department, Hospital Virgen de la Victoria IBIMA, Malaga, Spain
| | - Adriano Gravina
- Clinical Trials Unit, Instituto Nazionale Tumori, IRCCS, Fondazione “G. Pascale,” Naples, Italy
| | | | - Victor Moreno
- START Madrid FJD, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Cyril Abdeddaim
- Centre de Lutte Contre le Cancer–Centre Oscar Lambret, Lille, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Hôpital Européen Georges-Pompidou, Institut du Cancer Paris CARPEM, AP-HP Centre–Université Paris Cité, Paris, France
| | - Vanessa Samouëlian
- Gynecologic Oncology Division, Centre Hospitalier de l’Université de Montréal (CHUM), Centre de Recherche du CHUM, and Université de Montréal, Montreal, Quebec, Canada
| | - Rowan Miller
- University College London, St Bartholomew’s Hospital London, London, United Kingdom
| | - Valentina Boni
- NEXT Oncology Hospital Universitario Quirónsalud Madrid, Madrid, Spain
| | - Antonio Antón Torres
- Department of Medical Oncology, Hospital Universitario Miguel Servet and IIS Aragon, Zaragoza, Spain
| | - Lucy Gilbert
- Division of Gynecologic Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jubilee Brown
- Division of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | | | | | | | | | | | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
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4
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Daban A, Gonnin C, Phan L, Saldmann A, Granier C, Lillo-Lelouet A, Le Beller C, Pouchot J, Weiss L, Tartour E, Fabre E, Medioni J, Oudard S, Vano YA, Dragon-Durey MA, Simonaggio A. Preexisting autoantibodies as predictor of immune related adverse events (irAEs) for advanced solid tumors treated with immune checkpoint inhibitors (ICIs). Oncoimmunology 2023; 12:2204754. [PMID: 37187974 PMCID: PMC10177742 DOI: 10.1080/2162402x.2023.2204754] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/15/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Immune checkpoint inhibitors (ICIs) are now standard of care in many cancers. They can generate immune-related adverse events (irAEs), but no biomarkers are available to identify patients who are more likely to develop irAEs. We assess the association between pre-existing autoantibodies and occurrence of irAEs. PATIENTS AND METHODS We prospectively collected data from consecutive patients receiving ICIs for advanced cancers, in a single center between May 2015 and July 2021. Autoantibodies testing was performed before ICIs initiation including AntiNeutrophil Cytoplasmic Antibodies, Antinuclear Antibodies, Rheumatoid Factor anti-Thyroid Peroxidase and anti-Thyroglobulin. We analyzed the associations of pre-existing autoantibodies with onset, severity, time to irAEs and with survival outcomes. RESULTS Of the 221 patients included, most had renal cell carcinoma (n = 99; 45%) or lung carcinoma (n = 90; 41%). Grade ≥2 irAEs were more frequent among patients with pre-existing autoantibodies: 64 (50%) vs. 20 (22%) patients (Odds-Ratio= 3.5 [95% CI=1.8-6.8]; p < 0.001) in the positive vs negative group, respectively. irAEs occurred earlier in the positive group with a median time interval between ICI initiation and irAE of 13 weeks (IQR = 8.8-21.6) vs. 28.5 weeks (IQR=10.6-55.1) in the negative group (p = 0.01). Twelve patients (9.4%) experienced multiple (≥2) irAEs in the positive group vs. 2 (2%) in the negative group (OR = 4.5 [95% CI: 0.98-36], p = 0.04). After a median follow-up of 25 months, median PFS and OS were significantly longer among patients experiencing irAE (p = 0.00034 and p = 0.016, respectively). CONCLUSION The presence of pre-existing autoantibodies is significantly associated with the occurrence of grade ≥2 irAEs, with earlier and multiple irAEs in patients treated with ICIs.
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Affiliation(s)
- A Daban
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
| | - C Gonnin
- Department of Immunology, Hôpital Européen Georges Pompidou, AP-HP.Centre – Université Paris Cité, Paris, France
| | - L Phan
- ARTIC - Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie; Hǒpital Européen Georges Pompidou, AP-HP. Centre – Université Paris Cité, Paris, France
| | - A Saldmann
- Department of Immunology, Hôpital Européen Georges Pompidou, AP-HP.Centre – Université Paris Cité, Paris, France
| | - C Granier
- Department of Immunology, Hôpital Européen Georges Pompidou, AP-HP.Centre – Université Paris Cité, Paris, France
- INSERM U970, PARCC, Université Paris-Cité, Paris, France
| | - A Lillo-Lelouet
- Department of Pharmacovigilance, Hôpital Européen Georges Pompidou, AP-HP.Centre – Université Paris Cité, Paris, France
| | - C Le Beller
- Department of Pharmacovigilance, Hôpital Européen Georges Pompidou, AP-HP.Centre – Université Paris Cité, Paris, France
| | - J Pouchot
- Department of Internal Medicine, Hôpital Européen Georges Pompidou, AP-HP.Centre – Université Paris Cité, Paris, France
| | - l Weiss
- Department of Clinical Immunology, Hôpital Hôtel-Dieu, AP-HP.Centre – Université Paris Cité, Paris, France
| | - E Tartour
- Department of Immunology, Hôpital Européen Georges Pompidou, AP-HP.Centre – Université Paris Cité, Paris, France
- INSERM U970, PARCC, Université Paris-Cité, Paris, France
| | - E Fabre
- INSERM U970, PARCC, Université Paris-Cité, Paris, France
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris, France
| | - J Medioni
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
| | - S Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
- INSERM U970, PARCC, Université Paris-Cité, Paris, France
| | - YA Vano
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - MA Dragon-Durey
- Department of Immunology, Hôpital Européen Georges Pompidou, AP-HP.Centre – Université Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - A. Simonaggio
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
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5
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Guillaume Z, Allory Y, Auclin E, Gervais C, Auvray M, Rochand A, Mejean A, Audenet F, Vano YA, Oudard S, Thibault C. [Collecting duct carcinoma and renal medullary carcinoma in the age of new therapies]. Bull Cancer 2023; 110:450-462. [PMID: 36906403 DOI: 10.1016/j.bulcan.2023.02.015] [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: 11/01/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/12/2023]
Abstract
Collecting duct carcinoma (also known as Bellini tumour) and renal medullary carcinoma are two extremely rare and aggressive renal cancers. They are both less responsive to conventional treatments used in clear cell renal carcinoma. There are very few studies evaluating their optimal management and currently, at the metastatic stage, polychemotherapy based on platinum salts remains the most widely used. The emergence of new treatments such as anti-angiogenic TKIs, immunotherapy or treatments targeting specific genetic abnormalities, opens up a new field of possibilities in the management of these cancers. The evaluation of the response to these treatments is therefore essential. In this article, we will review the status of their management and the various studies that have evaluated recent treatments in these two cancers.
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Affiliation(s)
- Zoé Guillaume
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | | | - Edouard Auclin
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Claire Gervais
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Marie Auvray
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Adrien Rochand
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Arnaud Mejean
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - François Audenet
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Yann-Alexandre Vano
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Stéphane Oudard
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Constance Thibault
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France.
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6
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Carril-Ajuria L, Naigeon M, Dalban C, Desnoyer A, Rioux-Leclercq N, Sautès-Fridman C, Meylan M, Vano YA, Beusenlick B, Chouaib S, de Oliveira C, Tantot F, Flippot R, Escudier B, Albiges L, Chaput N. Baseline circulating soluble factors as predictors of immune-related adverse events (irAEs) in patients (pts) with metastatic clear cell renal carcinoma (mRCC) treated with nivolumab: A translational NIVOREN GETUG-AFU 26 study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.724] [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: 03/15/2023] Open
Abstract
724 Background: The NIVOREN GETUG-AFU 26 study launched a translational research program to quantify baseline circulating soluble factors levels and correlate them with outcomes and irAEs in mRCC pts treated with nivolumab. We previously identified (training-set = 80 pts, validation-set= 233 pts) several soluble factors associated with overall survival (IL-6, IL-8, VEGF, BAFF, and CXCL13) (Carril-Ajuria et al. ASCO. 2022). Our aim was to evaluate the association between baseline levels of circulating soluble factors and the presence of all grade and severe irAEs. Methods: 720 patients treated with nivolumab within the NIVOREN study and with available safety data were included in the study. The association between baseline levels of seven different circulating soluble factors (VEGF, VCAM-1, IL-6, IL-7, IL-8, BAFF, CXCL13) and the development of all grade and severe irAEs was evaluated in those pts who had previously undergone soluble factors quantification within the translational program. The association between other systemic inflammatory markers (the lung immune prognostic index (LIPI), LDH and the derived neutrophil to lymphocyte ratio (dNLR)) and irAEs was also evaluated. Results: Out of 720 pts, 456 (63%) and 143 (20%) pts presented all grade and severe irAEs respectively. Soluble factors quantification at baseline was available for 353 pts. Baseline characteristics were similar to the overall trial population. Lower levels of circulating IL-6 (cut-off: 8.7 pg/ml) at baseline were significantly associated with a higher risk of all grade irAEs (p=0.025). Lower dNLR levels (<3, p=0.003) at baseline and a good LIPI score (p=0.014) were also associated with a higher risk of all grade AEs. No other significant associations were found between circulating soluble factors and all grade irAEs. No significant associations were found between circulating solubles factors/systemic inflammatory markers and the presence of severe irAEs Conclusions: Using the cut-off values previously identified, we observed that lower baseline levels of circulating IL-6 were associated with an increased risk of all grade irAEs. Good LIPI patients and those with a lower dNLR also presented a higher risk of all grade irAEs. Baseline circulating soluble factors and systemic inflammatory markers failed to demonstrate a significant association with the development of severe irAEs.
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Affiliation(s)
| | - Marie Naigeon
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
| | | | - Aude Desnoyer
- Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Catherine Sautès-Fridman
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - Maxime Meylan
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
| | - Benoit Beusenlick
- General Medical Oncology, University Hospitals Leuven, 3000 - Leuven/BE, Leuven, Belgium
| | | | - Caroline de Oliveira
- Laboratoire D'immuno-oncologie, Gustave Roussy, 94800 - Villejuif/FR, Villejuif, France
| | | | | | | | - Laurence Albiges
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, University of Paris Sud, Villejuif, France
| | - Nathalie Chaput
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
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7
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Xu-Vuillard A, Jouinot A, Pudlarz T, Blanchet B, Huillard O, Joly C, Tournigand C, Oudard S, Medioni J, Vano YA. Exposure toxicity and response relationship of cabozantinib (CABO) in patients with metastatic renal cell carcinoma (mRCC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.676] [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: 03/16/2023] Open
Abstract
676 Background: At the recommended dose of 60mg/day in mRCC, CABO is associated with frequent and/or severe toxicities in mRCC, which may be modified, along with clinical benefit, by interindividual variability in pharmacokinetics (PK). The objective of this multicentre ambispective study was to determine whether the PK of CABO could help to better predict efficacy and early dose-limiting toxicities (DLT) in mRCC. Methods: We collected plasma and determined the concentration of CABO in the first 3 months of initiation in all consecutive mRCC patients (pts) treated in 3 French oncology departments from Dec. 2016 to Mar. 2022. Correlation of plasma trough concentration (Cmin) with objective response rate (ORR), progression free survival (PFS), overall survival (OS), and DLT (any discontinuation or dose reduction in the first 3 months) was explored. An optimal therapeutic range was defined using ROC curves to predict efficacy and DLT. Cox proportional-hazards models were used to identify risk factors of DLT, progression and death. Results: 80 pts were included, 80% clear cell RCC, mean age 62.1 years (+/-13.3) and sex ratio (male/female) 3.2. CABO was administered as second-line, or third-or later-line in 36% and 55% of pts, respectively. Thirty-six (45 %) and 32 (40%) pts initiated CABO at 60mg and 40mg, respectively. After a median follow-up of 17.9 months (9.4-27.9), 24 (30%) were alive, 16 (20%) were still on CABO, and 46 (50%) had experienced DLT with a median to onset of 2 months (CI95%: 0.7-6.2). In the whole cohort, median Cmin was 614 ng/mL [IQR 439-827], with an interindividual variability in dose-normalized exposure of 47.5%. DLT was not associated with the starting dose (p=0.18) but was associated with higher baseline albumin (p=0.03) and higher Cmin (p=0.003). In multivariate analysis, only Cmin was associated with DLT (HR per 100-unit increase: 1.35 [1.03-1.77]; p=0.03). ORR was achieved in 25/79 (32%) evaluable pts, including 16/35 (46%) pts starting CABO at 60mg vs 9/44 (20%) in pts starting at 20/40mg (p=0.03). No difference was found in PFS and OS according to the starting dose (p=0.72 and p=0.49, respectively), nor with previously reported Cmin≥750ng/mL (vs <750, p=0.77 for PFS and p=0.59 for OS). According to the ROC curves, Cmin<350ng/mL tended to be associated with shorter PFS (p=0.0748) and OS (p=0.264), and that Cmin>800ng/mL was significantly associated with DLT (HR 1.56 [1.13-2.15]; p=0.009), although it was not associated with an increase in PFS (p=0.94) or OS (p=0.33). Conclusions: We show that Cmin of CABO is more robustly associated with DLT and PFS/OS than the starting dose, probably due to a high interindividual variability in exposure. Early plasma drug monitoring associated with a target Cmin of 350-800 ng/mL may be useful to optimize CABO in mRCC pts. Future studies should focus on validating this therapeutic range in external validation cohorts.
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Affiliation(s)
- Alexandre Xu-Vuillard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France, Paris, France
| | - Anne Jouinot
- AP-HP, Hôpital Cochin Port-Royal, Department of Medical Oncology, ARIANE, Institut du Cancer Paris CARPEM, Paris, France
| | - Thomas Pudlarz
- Sorbonne University, Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, Paris, France
| | - Benoit Blanchet
- Department of Pharmacology, Hôpital Cochin, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
| | - Olivier Huillard
- Department of Medical Oncology, Hôpital Cochin, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
| | - Charlotte Joly
- Department of Medical Oncology, Hôpital Henri-Mondor, AP-HP - Université de Paris Est, Créteil France, Creteil, France
| | - Christophe Tournigand
- Department of Medical Oncology, Hôpital Henri-Mondor, AP-HP - Université de Paris Est, Créteil, France
| | - Stephane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
| | - Jacques Medioni
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France, Paris, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
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8
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Vano YA, Phan L, Simonaggio A, Bennamoun M, Pannier D, Chevreau C, Borchiellini D, Maillet D, Gross-Goupil M, Laguerre B, Tournigand C, Barthelemy P, Coquan E, Gravis G, Sun CM, Meylan M, Fridman WH, Sautès-Fridman C, Elaidi R, Oudard S. Overall survival (OS) and efficacy results of second-line treatment in patients (pts) with metastatic clear cell renal cell carcinoma (mRCC) treated in the randomized phase II BIONIKK trial. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.607] [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: 03/18/2023] Open
Abstract
607 Background: To date, no biomarker of efficacy of nivolumab+/-ipilimumab (N+/-I) or anti-VEGFR TKI has been prospectively validated in mRCC. The BIONIKK trial showed promising objective response rate (ORR) and progression-free survival (PFS) with these treatments in first line (L1) after selection by tumour molecular group. We report OS and efficacy results of the second-line (L2) treatment. Methods: BIONIKK is a French multicentre non-comparative phase II trial, randomising 199 mRCC pts to receive N (58), NI (101) or TKI (40) in L1 according to four molecular groups (ccrcc1-4). ORR and PFS were already reported. With an additional follow-up of ≥20 months, we report OS from randomization and from the start of L2, as well as ORR and PFS with a TKI in L2 by molecular group. Results: With a median follow-up of 42.1 months (40.5-45.2), 86 (43%) patients died: 27/58 (46.5%), 39/101 (39%) and 20/40 (50%) in the N, NI, and TKI arm, respectively. Median OS were 43.4 months (95%CI=31.4-NR) with N, 52.7 months (95%CI=46-NR) with NI and 38.1 months (95%CI=33.2-NR) with TKI (table). 175 (88%) patients discontinued first-line treatment, including 20 deaths, and 129 (74%) received a L2, 38/58 (65.5%), 64/101 (63%), and 27/40 (67.5%) after N, NI and TKI, respectively. The most frequent L2 received after N+/-I was a TKI in 96/102 (94%) pts, including cabozantinib in 49, sunitinib/pazopanib in 32, axitinib in 13, and lenvatinib in 2. N was the most frequent L2 after TKI, 20/27 (74%). ORR with TKI in L2 was 28.5% (10/35) after N, 39% (24/61) after NI and 80% (4/5) after TKI, with marked benefit in ccrcc2 pts (table). The mPFS with TKI in L2 was 8.2 (95%CI=6.9-19.3) after N, 11.4 (95%CI= 8.9-16.8) after NI, and 12.1 (95%CI =11.4-NR) months after TKI, with a higher benefit in ccrcc2 pts (vs. ccrcc1+4, p=0.04). Conversely, ORR and mPFS with N after TKI in ccrcc2-pts were 12.5% (2/16) and 5.4 (2.6-NR) months, respectively. Median OS L2 was reported in the table. The updated ORR and PFS in L1 will presented at the Meeting, as well as PFS2 and efficacy by TKI type in L2. Conclusions: We report for the first-time OS and L2 efficacy results by molecular group in a randomized trial. Molecular selection also has an impact on treatment efficacy in L2. These results, together with those reported in L1, can inform clinicians on the best treatment sequence in L1-2. Clinical trial information: NCT02960906 . [Table: see text]
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Affiliation(s)
- Yann-Alexandre Vano
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
| | - Letuan Phan
- ARTIC - Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie; Hôpital Européen Georges Pompidou, AP-HP. Centre – Université Paris Cité, Paris, France
| | - Audrey Simonaggio
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
| | - Mostefa Bennamoun
- Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - Diane Pannier
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | | | - Delphine Borchiellini
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Denis Maillet
- Department of Medical Oncology, IMMUCARE, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices de Lyon (IC-HCL); Faculté de médecine de Saint Etienne, Pierre-Bénite, France
| | - Marine Gross-Goupil
- Department of Medical Oncology, Centre Hospitalier Universitaire de Bordeaux - Hôpital Saint-André, Bordeaux, France
| | - Brigitte Laguerre
- Department of Medical Oncology, Centre Eugène - Marquis, Rennes, France
| | - Christophe Tournigand
- Department of Medical Oncology, Hôpital Henri-Mondor, AP-HP - Université de Paris Est, Créteil, France
| | - Philippe Barthelemy
- Department of Medical Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - Elodie Coquan
- Department of Medical Oncology, Centre de Lutte Contre le Cancer François Baclesse, Caen, France
| | - Gwenaelle Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Universite, CRCM, Marseille, France
| | - Cheng-Ming Sun
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - Maxime Meylan
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - Wolf-Hervé Fridman
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - Catherine Sautès-Fridman
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - Réza Elaidi
- ARTIC - Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie; Hôpital Européen Georges Pompidou, AP-HP. Centre – Université Paris Cité, Paris, France
| | - Stephane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre – Université Paris Cité, Paris, France
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9
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Alhalabi O, Thouvenin J, Négrier S, Vano YA, Campedel L, Hasanov E, Bakouny Z, Hahn AW, Bilen MA, Msaouel P, Choueiri TK, Viswanathan SR, Sircar K, Albiges L, Malouf GG, Tannir NM. Immune Checkpoint Therapy Combinations in Adult Advanced MiT Family Translocation Renal Cell Carcinomas. Oncologist 2023; 28:433-439. [PMID: 36640141 PMCID: PMC10166175 DOI: 10.1093/oncolo/oyac262] [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: 09/10/2022] [Accepted: 10/15/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND There remains a paucity of data regarding the efficacy of immune checkpoint therapy (ICT) combinations ± vascular endothelial growth factor (VEGF) targeted therapy (TT) in translocation renal cell carcinoma (tRCC). METHODS This is a retrospective study of patients with advanced tRCC treated with ICT combinations at 11 centers in the US, France, and Belgium. Only cases with confirmed fluorescence in situ hybridization (FISH) were included. Objective response rates (ORR) and progression-free survival (PFS) were assessed by RECIST, and overall survival (OS) was estimated by Kaplan-Meier methods. RESULTS There were 29 patients identified with median age of 38 (21-70) years, and F:M ratio 0.9:1. FISH revealed TFE3 and TFEB translocations in 22 and 7 patients, respectively. Dual ICT and ICT + VEGF TT were used in 18 and 11 patients, respectively. Seventeen (59%) patients received ICT combinations as first-line therapy. ORR was 1/18 (5.5%) for dual ICT and 4/11 (36%) for ICT + VEGF TT. At a median follow-up of 12.9 months, median PFS was 2.8 and 5.4 months in the dual ICT and ICT + VEGF TT groups, respectively. Median OS from metastatic disease was 17.8 and 30.7 months in the dual ICT and ICT + VEGF TT groups, respectively. CONCLUSION In this retrospective study of advanced tRCC, limited response and survival were seen after frontline dual ICT combination therapy, while ICT + VEGF TT therapy offered some efficacy. Due to the heterogeneity of tRCC, insights into the biological underpinnings are necessary to develop more effective therapies.
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Affiliation(s)
- Omar Alhalabi
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Jonathan Thouvenin
- Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France.,Institut de Cancérologie Strasbourg Europe (ICANS/HUS), Strasbourg, France
| | | | - Yann-Alexandre Vano
- Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP.Centre-Université de Paris, Paris, France
| | - Luca Campedel
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Elshad Hasanov
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Ziad Bakouny
- Dana-Farber Cancer Institute, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew W Hahn
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Pavlos Msaouel
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - Kanishka Sircar
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Gabriel G Malouf
- Institut de Cancérologie Strasbourg Europe (ICANS/HUS), Strasbourg, France
| | - Nizar M Tannir
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
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10
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Simonaggio A, Ambrosetti D, Verkarre V, Auvray M, Oudard S, Vano YA. MiTF/TFE Translocation Renal Cell Carcinomas: From Clinical Entities to Molecular Insights. Int J Mol Sci 2022; 23:ijms23147649. [PMID: 35886994 PMCID: PMC9324307 DOI: 10.3390/ijms23147649] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 12/30/2022] Open
Abstract
MiTF/TFE translocation renal cell carcinoma (tRCC) is a rare and aggressive subtype of RCC representing the most prevalent RCC in the pediatric population (up to 40%) and making up 4% of all RCCs in adults. It is characterized by translocations involving either TFE3 (TFE3-tRCC), TFEB (TFEB-tRCC) or MITF, all members of the MIT family (microphthalmia-associated transcriptional factor). TFE3-tRCC was first recognized in the World Health Organization (WHO) classification of kidney cancers in 2004. In contrast to TFEB-tRCC, TFE3-tRCC is associated with many partners that can be detected by RNA or exome sequencing. Both diagnoses of TFE3 and TFEB-tRCC are performed on morphological and immunohistochemical features, but, to date, TFE break-apart fluorescent in situ hybridization (FISH) remains the gold standard for diagnosis. The clinical behavior of tRCC is heterogeneous and more aggressive in adults. Management of metastatic tRCC is challenging, especially in the younger population, and data are scarce. Efficacy of the standard of care-targeted therapies and immune checkpoint inhibitors remains low. Recent integrative exome and RNA sequencing analyses have provided a better understanding of the biological heterogeneity, which can contribute to a better therapeutic approach. We describe the clinico-pathological entities, the response to systemic therapy and the molecular features and techniques used to diagnose tRCC.
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Affiliation(s)
- Audrey Simonaggio
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP. Centre—Université Paris-Cité, F-75015 Paris, France; (A.S.); (M.A.); (S.O.)
| | - Damien Ambrosetti
- Department of Pathology, CHU Nice, Université Côte d’Azur, F-06107 Nice, France;
- Institute for Research on Cancer and Aging of Nice (IRCAN), CNRS UMR 7284, INSERM U1081, University Côte d’Azur, F-06107 Nice, France
| | - Virginie Verkarre
- Department of Pathology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP. Centre—Université Paris-Cité, F-75015 Paris, France;
- INSERM UMR-970, PARCC, Université Paris-Cité, F-75015 Paris, France
| | - Marie Auvray
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP. Centre—Université Paris-Cité, F-75015 Paris, France; (A.S.); (M.A.); (S.O.)
| | - Stéphane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP. Centre—Université Paris-Cité, F-75015 Paris, France; (A.S.); (M.A.); (S.O.)
- INSERM UMR-970, PARCC, Université Paris-Cité, F-75015 Paris, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP. Centre—Université Paris-Cité, F-75015 Paris, France; (A.S.); (M.A.); (S.O.)
- INSERM UMR-970, PARCC, Université Paris-Cité, F-75015 Paris, France
- Centre de Recherche des Cordeliers, INSERM, Université Paris-Cité, Sorbonne Université, F-75006 Paris, France
- Correspondence: ; Tel.: +33-624281311
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11
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Vano YA, Elaidi R, Phan L, Fridman WH, Sautès-Fridman C, Oudard S. Optimal molecular selection to benefit from nivolumab–ipilimumab in clear-cell renal cell carcinoma. Lancet Oncol 2022; 23:e318. [DOI: 10.1016/s1470-2045(22)00331-x] [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: 05/16/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 02/04/2023]
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12
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Daban A, Gonnin C, Vano YA, Phan L, lillo-Lelouet A, le Beller C, Pouchot J, Fabre E, Weiss L, Tartour E, Oudard S, Dragon Durey MA, Simonaggio A. Preexisting autoantibodies as predictor of immune-related adverse events for advanced solid tumors treated with immune checkpoint inhibitors. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2523] [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
2523 Background: Immune checkpoint inhibitors (ICIs), used alone or as a combination are standard of care in many cancers. Generally well tolerated, they can generate immune-related adverse events (irAEs). No biomarkers are available to identify patients who are more likely to develop irAEs. The aim of this study was to assess the association between preexisting autoantibodies, occurrence of irAEs and survival outcomes. Methods: We performed a prospective study including 221 patients receiving ICIs for advanced solid tumors between May 2015 and July 2021. Autoantibodies testing (anti-neutrophil cytoplasmic, anti-nuclear, thyroid peroxidase and thyroglobulin) was performed before ICIs initiation. The associations among preexisting autoantibodies, the occurrence, the severity, the delay of irAEs and the survival outcomes, including progression-free survival (PFS) and overall survival (OS) were analyzed. Statistical analyses were performed with T-test, Cox regression models, univariate and multivariate analyses and Kaplan-Meier’s method. Results: Of the 221 patients, 151 (68%) were men, the median age was 66,5 (range 21-90) years and 103 (81%) had an ECOG-PS of 0 or 1. Seventy-three percent (n=162) received an anti-PD-(L)1 in monotherapy, 27% (n=59) an anti-PD-(L)1 in combination, for a renal cell carcinoma in 45% (n=99) and a lung carcinoma in 41% (n=90). In total, 129 (58%) patients had preexisting antibodies. IrAEs were significantly more frequent in patients with preexisting autoantibodies: 64 patients (50%) in the positive group vs. 20 patients (22%) in the negative group, OR = 3.5 (95%CI=1.8 - 6.8), p=0.00002. Median time interval between ICI initiation and irAE was shorter in the positive group vs. the negative group, 13 weeks (IQR=43weeks) vs. 28.5 weeks (IQR=12weeks) respectively (p=0.01). Twelve patients (9.4%) experienced multi toxicities in the positive group vs. two (2%) in the negative group, OR=4.5 (95%CI0.98-36), p=0.04. ICIs exposure was identical in preexisting and non-preexisting autoantibodies groups. After a median follow-up of 25 months (95%CI=19-31), median PFS and OS were significantly longer among patients experiencing irAE: 12.6 months (95%CI=11-22.7) vs 5 months (95%CI=4.2-7.0), p= 0.0003 and 30 months (95%CI= 22.7-NR) vs 21 months (95%CI=15-34.6), p= 0.016. In multivariate analyses irAEs remain statistically associated with survival outcomes. Preexisting autoantibodies were not associated with survival outcomes. Conclusions: The presence of preexisting autoantibodies is significantly associated with the occurrence of irAE in patients treated with ICIs. Earlier and multiple irAEs were observed in the presence of preexisting autoantibodies. Thus, these biomarkers could help to identify patients at risk of irAEs and would prompt us to closely monitor them.
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Affiliation(s)
| | | | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | | | | | | | | | | | | | - Eric Tartour
- Immunology Department, European Georges Pompidou Hospital, Paris, France
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Carril-Ajuria L, Naigeon M, Dalban C, Desnoyer A, Rioux-Leclercq N, Sautes-Fridman C, Meylan M, Vano YA, Beusenlick B, Chouaib S, de Oliveira C, Tantot F, Flippot R, Escudier B, Albiges L, Chaput N. Baseline circulating soluble factors as predictors of response to nivolumab in metastatic clear cell renal cell carcinoma (mRCC): A validation study within the NIVOREN GETUG-AFU 26 translational study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.4552] [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
4552 Background: The NIVOREN GETUG-AFU 26 study launched a translational research program to quantify baseline circulating soluble factors levels and correlate them with outcomes to nivolumab in mRCC pts. We previously identified on a training set (n = 80, 40 responders/40 progressors) several soluble factors significantly associated with worse overall survival (OS), progression-free survival (PFS) and response (IL-8 and VEGF), or with worse OS only (IL-6, IL-7) (Carril-Ajuria et al. ASCO GU. 2022). Our aim was to confirm these findings using an independent validation set. Methods: The remaining pts (n = 233) included in the translational-program of the NIVOREN study were included in this validation set. Based on previous results (training set), a panel of 7 different soluble factors (VEGF, VCAM-1, IL-6, IL-7, IL-8, BAFF, CXCL13) were quantified for each plasma sample using the MSD electrochemiluminescence assay. The association between baseline soluble-factors levels and response, PFS and OS was evaluated using previously identified cut-off values. Results: Two hundred thirty-three pts were included in the validation set. Baseline characteristics were similar to the overall trial population. The IMDC risk score breakdown was 17.7% good, 57.3% intermediate and 25.0% poor. With a median follow-up of 21.8 months (mo), the OS rate was 69.6% at 12 mo and median PFS was 3.0 mo. IL-8 (cut-off: 17.9 pg/ml) and IL-6 (cut-off: 8.7 pg/ml), involved in inflammation, confirmed an association with worse OS (IL8: HR = 2.57, p < 0.0001, IL-6: HR = 3.28,p < 0.0001) and worse PFS (IL-8: HR = 1.61,p = 0.0008, IL-6: HR = 1.68, p = 0.0021). VEGF (cut-off: 48.3 pg/ml) confirmed the association with worse OS (HR = 1.56, p = 0.0176), but not with PFS (p = 0.2068). IL-7, involved in T and B cells development, did not show a significant association with OS or PFS when using 8.6 pg/ml (training set) as cut-off (p = 0.0675 and p = 0.7818, respectively). IL-7 was the only cytokine to show an association with response (p = 0.044). Interestingly, circulating CXCL13 (cut-off: 106.4 pg/ml) and BAFF (cut-off: 1122.6 pg/ml), involved in B cell differentiation/survival, were significantly associated with worse OS (HR = 2.09, p = 0.0001 and HR = 2.34, p = 0.0001, respectively); BAFF showed a trend for worse PFS (HR = 1.29, p = 0.0920). Conclusions: Using the cut-off values previously identified in the training set, we confirmed a significant association between baseline blood concentration of IL-6/IL-8 and worse OS/PFS, and of VEGF with worse OS. Non-responders presented lower baseline circulating IL-7 concentrations. CXCL13 and BAFF were significantly associated with worse OS. Multivariate analyses are ongoing.
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Affiliation(s)
| | - Marie Naigeon
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
| | | | - Aude Desnoyer
- Assistance Publique Hôpitaux de Paris, PARIS, France
| | | | | | - Maxime Meylan
- Inflammation, Complement And Cancer, Centre de Recherche des Cordeliers, Paris, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | - Benoit Beusenlick
- General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | | | | | | | - Nathalie Chaput
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
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14
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Vano YA, Phan L, Gravis G, Korakis I, Schlürmann F, Maillet D, Bennamoun M, Houede N, Topart D, Borchiellini D, Barthelemy P, Ratta R, Ryckewaert T, Hasbini A, Hans S, Emambux S, Cournier S, Braychenko E, Elaidi RT, Oudard S. Cabozantinib-nivolumab sequence in metastatic renal cell carcinoma: the CABIR study. Int J Cancer 2022; 151:1335-1344. [PMID: 35603906 PMCID: PMC9541795 DOI: 10.1002/ijc.34126] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 01/14/2022] [Revised: 03/09/2022] [Accepted: 03/29/2022] [Indexed: 11/25/2022]
Abstract
Nivolumab and cabozantinib are approved agents in mRCC patients after sunitinib/pazopanib (TKI) failure. However, the optimal sequence, cabozantinib then nivolumab (CN) or nivolumab then cabozantinib (NC), is still unknown. The CABIR study aimed to identify the optimal sequence between CN and NC after frontline VEGFR‐TKI. In this multicenter retrospective study, we collected data from mRCC pts receiving CN or NC, after frontline VEGFR‐TKI. A propensity score (PrS) was calculated to manage bias selection, and sequence comparisons were carried out with a cox model on a matched sample 1:1. The primary endpoint was progression‐free survival (PFS) from the start of second line to progression in third line (PFS2‐3). Key secondary endpoints included overall survival from second line (OS2). Out of 139 included mRCC patients, 38 (27%) and 101 (73%) received CN and NC, respectively. Overlap in PrS allowed 1:1 matching for each CN pts, with characteristics well balanced. For both PFS2‐3 and OS2, NC sequence was superior to CN (PFS2‐3: HR = 0.58 [0.34‐0.98], P = .043; OS2: 0.66 [0.42‐1.05], P = .080). Superior PFS2‐3 was in patients treated between 6 and 18 months with prior VEGFR‐TKI (P = .019) and was driven by a higher PFSL3 with cabozantinib when given after nivolumab (P < .001). The CABIR study shows a prolonged PFS of the NC sequence compared to CN in mRCC after first line VEGFR‐TKI failure. The data suggest that cabozantinib may be more effective than nivolumab in the third‐line setting, possibly related to an ability of cabozantinib to overcome resistance to PD‐1 blockade.
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Affiliation(s)
- Yann-Alexandre Vano
- Medical Oncology, Hôpital Européen Georges Pompidou, AP-HP Centre - Université Paris Cité, Paris, France.,INSERM U970, PARCC, Paris, France.,Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France
| | - Letuan Phan
- ARTIC -Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie; Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France
| | - Gwenaelle Gravis
- Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille University, CRCM, Marseille, France
| | - Iphigénie Korakis
- Medical Oncology, Institut Universitaire du Cancer -Toulouse- Oncopole, Toulouse, France
| | | | - Denis Maillet
- Medical Oncology, IMMUCARE, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices de Lyon (IC-HCL), Pierre-Bénite, France
| | | | - Nadine Houede
- Medical Oncology, Institut de cancérologie du Gard, Nimes, Montpellier University, France
| | - Delphine Topart
- Medical Oncology, Hopital Saint-Eloi (CHU de Montpellier), Montpellier, France
| | | | - Philippe Barthelemy
- Medical Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | | | | | - Ali Hasbini
- Medical Oncology, Clinique Pasteur Lanroze, Brest, France
| | - Sophie Hans
- Department of Medical Oncology, Hôpital Henri-Mondor, AP-HP - Université de Paris Est, Créteil, France
| | - Sheik Emambux
- Medical Oncology, Centre Hospitalier Universitaire Poitiers, Poitiers, France
| | - Sandra Cournier
- ARTIC -Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie; Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France
| | - Elena Braychenko
- ARTIC -Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie; Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France
| | - Réza-Thierry Elaidi
- ARTIC -Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie; Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France
| | - Stéphane Oudard
- Medical Oncology, Hôpital Européen Georges Pompidou, AP-HP Centre - Université Paris Cité, Paris, France.,INSERM U970, PARCC, Paris, France
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15
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Simonaggio A, Auvray-Kuentz M, Rochand A, Thibault C, Gervais C, Oudard S, Vano YA. Future treatment options in metastatic clear cell renal cell carcinoma. Bull Cancer 2022; 109:2S47-2S58. [DOI: 10.1016/s0007-4551(22)00238-7] [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: 10/17/2022]
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16
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Motzer RJ, Choueiri TK, McDermott DF, Powles T, Vano YA, Gupta S, Yao J, Han C, Ammar R, Papillon-Cavanagh S, Saggi SS, McHenry MB, Ross-Macdonald P, Wind-Rotolo M. Biomarker analysis from CheckMate 214: nivolumab plus ipilimumab versus sunitinib in renal cell carcinoma. J Immunother Cancer 2022; 10:jitc-2021-004316. [PMID: 35304405 PMCID: PMC8935174 DOI: 10.1136/jitc-2021-004316] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [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] [Accepted: 02/01/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The phase 3 CheckMate 214 trial demonstrated higher response rates and improved overall survival with nivolumab plus ipilimumab versus sunitinib in first-line therapy for advanced clear-cell renal cell carcinoma (RCC). An unmet need exists to identify patients with RCC who are most likely to benefit from treatment with nivolumab plus ipilimumab. METHODS In exploratory analyses, pretreatment levels of programmed death ligand 1 were assessed by immunohistochemistry. Genomic and transcriptomic biomarkers (including tumor mutational burden and gene expression signatures) were also investigated. RESULTS Biomarkers previously associated with benefit from immune checkpoint inhibitor-containing regimens in RCC were not predictive for survival in patients with RCC treated with nivolumab plus ipilimumab. Analysis of gene expression identified an association between an inflammatory response and progression-free survival with nivolumab plus ipilimumab. CONCLUSIONS The exploratory analyses reveal relationships between molecular biomarkers and provide supportive data on how the inflammation status of the tumor microenvironment may be important for identifying predictive biomarkers of response and survival with combination immunotherapy in patients with RCC. Further validation may help to provide biomarker-driven precision treatment for patients with RCC.
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Affiliation(s)
- Robert J Motzer
- Kidney Cancer Section, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | | | - Yann-Alexandre Vano
- Medical Oncology, Hôpital Européen Georges Pompidou, APHP-Centre, Université de Paris, Paris, France.,Inflammation, Complement and Cancer, Centre de Recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Paris, France
| | - Saurabh Gupta
- Translational Medicine, Bristol Myers Squibb Co, Princeton, New Jersey, USA
| | - Jin Yao
- Translational Medicine, Bristol Myers Squibb Co, Princeton, New Jersey, USA
| | - Celine Han
- Translational Medicine, Bristol Myers Squibb Co, Princeton, New Jersey, USA
| | - Ron Ammar
- Translational Medicine, Bristol Myers Squibb Co, Princeton, New Jersey, USA
| | | | - Shruti S Saggi
- Translational Medicine, Bristol Myers Squibb Co, Princeton, New Jersey, USA
| | - M Brent McHenry
- Translational Medicine, Bristol Myers Squibb Co, Princeton, New Jersey, USA
| | | | - Megan Wind-Rotolo
- Translational Medicine, Bristol Myers Squibb Co, Princeton, New Jersey, USA
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17
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Meylan M, Petitprez F, Becht E, Bougoüin A, Pupier G, Calvez A, Giglioli I, Verkarre V, Lacroix G, Verneau J, Sun CM, Laurent-Puig P, Vano YA, Elaïdi R, Méjean A, Sanchez-Salas R, Barret E, Cathelineau X, Oudard S, Reynaud CA, de Reyniès A, Sautès-Fridman C, Fridman WH. Tertiary lymphoid structures generate and propagate anti-tumor antibody-producing plasma cells in renal cell cancer. Immunity 2022; 55:527-541.e5. [PMID: 35231421 DOI: 10.1016/j.immuni.2022.02.001] [Citation(s) in RCA: 194] [Impact Index Per Article: 97.0] [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: 05/17/2021] [Revised: 12/09/2021] [Accepted: 02/02/2022] [Indexed: 12/30/2022]
Abstract
The presence of intratumoral tertiary lymphoid structures (TLS) is associated with positive clinical outcomes and responses to immunotherapy in cancer. Here, we used spatial transcriptomics to examine the nature of B cell responses within TLS in renal cell carcinoma (RCC). B cells were enriched in TLS, and therein, we could identify all B cell maturation stages toward plasma cell (PC) formation. B cell repertoire analysis revealed clonal diversification, selection, expansion in TLS, and the presence of fully mature clonotypes at distance. In TLS+ tumors, IgG- and IgA-producing PCs disseminated into the tumor beds along fibroblastic tracks. TLS+ tumors exhibited high frequencies of IgG-producing PCs and IgG-stained and apoptotic malignant cells, suggestive of anti-tumor effector activity. Therapeutic responses and progression-free survival correlated with IgG-stained tumor cells in RCC patients treated with immune checkpoint inhibitors. Thus, intratumoral TLS sustains B cell maturation and antibody production that is associated with response to immunotherapy, potentially via direct anti-tumor effects.
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Affiliation(s)
- Maxime Meylan
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Florent Petitprez
- Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France; MRC Centre for Reproductive Health, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Etienne Becht
- Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France
| | - Antoine Bougoüin
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Guilhem Pupier
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Anne Calvez
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Ilenia Giglioli
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Virginie Verkarre
- Département de pathologie, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris - Paris Centre, 75015 Paris, France; Université de Paris, 75006 Paris, France; PARCC, INSERM, Equipe Labellisée Ligue contre le Cancer, 75015 Paris, France
| | - Guillaume Lacroix
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Johanna Verneau
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Chen-Ming Sun
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, EPIGENETEC, 75006 Paris, France
| | - Yann-Alexandre Vano
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France; Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France; MRC Centre for Reproductive Health, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK; Département d'oncologie médicale, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris - Paris Centre, F-75015 Paris, France; Université de Paris, 75006 Paris, France; PARCC, INSERM, Equipe Labellisée Ligue contre le Cancer, 75015 Paris, France
| | - Reza Elaïdi
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, 75015 Paris, France
| | - Arnaud Méjean
- Département d'urologie, Hôpital européen Georges Pompidou, Université de Paris, 75015 Paris, France
| | - Rafaël Sanchez-Salas
- Département d'urologie, Institut Mutualiste Montsouris, Université de Paris, 75014 Paris, France
| | - Eric Barret
- Département d'urologie, Institut Mutualiste Montsouris, Université de Paris, 75014 Paris, France
| | - Xavier Cathelineau
- Département d'urologie, Institut Mutualiste Montsouris, Université de Paris, 75014 Paris, France
| | - Stephane Oudard
- Département d'oncologie médicale, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris - Paris Centre, F-75015 Paris, France; Université de Paris, 75006 Paris, France
| | - Claude-Agnès Reynaud
- Institut Necker Enfants Malades (INEM), INSERM U1151/CNRS UMRS8253, Université de Paris, 75015 Paris, France
| | - Aurélien de Reyniès
- Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France; MRC Centre for Reproductive Health, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK; Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, EPIGENETEC, 75006 Paris, France; Université de Paris, 75006 Paris, France
| | - Catherine Sautès-Fridman
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Wolf Herman Fridman
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France.
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18
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Thiery-Vuillemin A, Gravis G, Schlürmann F, Bompas E, Rolland F, Gross-Goupil M, Vano YA, Guillot A, Barthélémy P, Joly C, Laramas M, Dourthe LM, Maurina T, Gauthier H, Taillandy K, Meurisse A, Vernerey D, Albiges L. Randomized phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen in anti-angiogenic naïve patients with metastatic renal cell carcinoma (mRCC): Final analysis of SURF study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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
344 Background: SUN is approved in mRCC setting at the dose of 50mg daily for 4 weeks followed by 2 weeks rest (4/2 schedule). The 4/2 schedule often requires dose modifications for toxicity. Current recommendation is to reduce the dose to 37.5mg per day. Alternative schedules (2 weeks of treatment followed by one-week rest (2/1 schedule) have shown promising results. SURF trial evaluated prospectively schedule 2/1 when toxicity occurs. Methods: SURF [NCT02689167] is a prospective, non-comparative randomized study. Patients (pts) with mRCC (clear cell) were included at SUN initiation. When a dose adjustment of SUN was required, patients were randomized between 4/2 schedule at 37.5mg daily and experimental 2/1 schedule at 50mg daily. Primary objective was to assess duration of SUN treatment among the 73 first evaluable pts. Overall 226 pts were enrolled with 133 randomized. All other analyses are shown for the 133 randomized patients. Results: Pts were 75.2% males, with a median age 63.7 years for 94% with a Karnofsky ≥ 80%. Of them, 54.9% had partial/total nephrectomy. IMDC risk score was favourable (45.1%), intermediate (46.6%) or poor (8.3%). Pts characteristics were well balanced between 2 arms. Metastatic sites were lungs (60.5%), bones (16.3%), lymph nodes (15.5%). At 6 months, 48 patients (65.8%) of the 2/1 schedule were still on treatment (above predefined threshold for positivity). Other data are listed on the table. No new safety signal was identified. Permanent SUN discontinuation due to toxicity was 22.2% in control arm vs 12.3% in experimental arm. Conclusions: SURF is the largest prospective randomised trial evaluating two different SUN schedules modifications in mRCC in case of toxicity. This positive trial confirms the role of adapting SUN to a 2/1 schedule rather than reducing SUN dose to the classical 4/2 schedule. Clinical trial information: NCT02689167. [Table: see text]
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Affiliation(s)
| | | | | | | | - Frederic Rolland
- Institut de Cancérologie de l'Ouest, Department of Medical Oncology, Saint-Herblain, France
| | - Marine Gross-Goupil
- Centre Hospitalier Universitaire de Bordeaux-Hôpital Saint-André, Bordeaux, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | | | - Charlotte Joly
- Oncology Department, Hôpital Henri Mondor, APHP, Créteil, France
| | | | | | | | | | | | - Aurelia Meurisse
- Methodology and Quality of Life Unit, Department of Oncology University Hospital, Besancon, France
| | - Dewi Vernerey
- Methodology and Quality of Life Unit in Oncology, Department of Oncology, University Hospital of Besancon, Besançon, France
| | - Laurence Albiges
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
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19
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Alhalabi O, Thouvenin J, Negrier S, Vano YA, Campedel L, Hasanov E, Bakouny Z, Hahn AW, Bilen MA, Choueiri TK, Viswanathan SR, Sircar K, Albiges L, Malouf G, Tannir NM. Immuno-oncology (IO) combinations +/- VEGF targeted therapy (VEGF TT) in patients (pts) with advanced mit family translocation renal cell carcinomas (tRCC): Results from an international multicenter study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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
343 Background: IO combinations are standard of care for first-line therapy of clear-cell RCC; however, non-clear cell histologies including tRCC were not included in the registrational trials. We previously reported a modest efficacy (objective response rate [ORR] <20%) with IO monotherapy (PD-1 blockade) in tRCC (Boilève et al, JITC. 2018). The efficacy of IO combinations +/- VEGF TT has not been reported. Methods: This is a retrospective, international, multicenter study of pts with tRCC treated with IO-IO or IO+VEGF TT at 11 centers in the US, France, and Belgium. Only pts with confirmed TFE3 or TFEB translocation by fluorescent-in-situ hybridization (FISH) were included. ORR and progression-free survival (PFS) were assessed by RECIST. Overall survival (OS) was assessed by Kaplan-Meier methods. OS was measured from initiation of therapy till death or last follow up. We also assessed the association between OS and baseline prognostic variables. Results: 29 patients with metastatic tRCC were included in this analysis. Median age at starting therapy was 38 (IQR 27, 53) years. Female:Male ratio was 0.9:1. FISH revealed a translocation involving TFE3 and TFEB in 22 and 7 patients, respectively. Most frequent metastatic sites at diagnosis were lungs (76%), liver (52%), retroperitoneal adenopathy (48%), and bone (38%). IMDC risk at diagnosis was favorable (31%), intermediate (45%) and poor (24%). Combinations of IO+VEGF TT and anti-PD1 (L1) + anti-CTLA-4 (IO+IO) were used in 11 and 18 pts, respectively. 17 (59%) pts received IO combinations as 1L, 7 (24%) pts as 2L and 5 (17%) pts as ≥3L. ORR in the IO+IO group was 1/18 (5.5%), while in IO+VEGF TT group was 4/11 (36%). For 20 (69%) pts, progressive disease was the best overall response. At a median follow-up of 12.9 months (mo), median PFS was 3.2 mo and median OS was 13.5 mo for all 29 pts (Table). Median PFS in the IO+IO group was 2.8 mo, and 5.4 mo in IO+VEGF TT group (HR=0.81, 95% CI: 0.35-1.84). Conclusions: In this small retrospective study of tRCC, IO+IO therapy produced modest activity based on low ORR and short PFS while IO+VEGF TT produced numerically higher ORR and longer PFS. Insights into the biological basis of tRCC are necessary to develop more effective therapies for this rare and aggressive RCC variant.[Table: see text]
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Affiliation(s)
- Omar Alhalabi
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Sylvie Negrier
- Departement of Medical Oncology, Centre Léon Bérard, University Lyon I, Lyon, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | - Luca Campedel
- Department of Medical Oncology, Groupe Hospitalier Pitie-Salpetriere, University Pierre and Marie Curie (Paris VI), Institut Universitaire de Cancerologie, Paris, France
| | - Elshad Hasanov
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ziad Bakouny
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Mehmet Asim Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
| | - Toni K. Choueiri
- Dana-Farber Cancer Institute, The Lank Center for Genitourinary Oncology, Boston, MA
| | | | - Kanishka Sircar
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Laurence Albiges
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Gabriel Malouf
- Department of Medical Oncology, Institut de Cancérologie de Strasbourg (ICANS), Strasbourg, France
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Carril L, Naigeon M, Dalban C, Desnoyer A, Rioux-Leclercq N, Sautes-Fridman C, Meylan M, Vano YA, Beusenlick B, Chouaib S, de Oliveira C, Tantot F, Escudier B, Albiges L, Chaput N. The impact of baseline peripheral cytokines on survival in metastatic clear cell renal cell carcinoma (RCC) treated with nivolumab: NIVOREN GETUG-AFU 26 Translational study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.379] [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
379 Background: The NIVOREN GETUG-AFU 26 study reported safety and efficacy of nivolumab in patients with RCC in a “real world setting”. A translational research program was launched to quantify baseline cytokine levels and correlate them with outcomes to nivolumab. Methods: Extreme responder patients (pts) treated with nivolumab as part of the phase II NIVOREN GETUG-AFU 26 were included in this TRAINING cohort. A panel of 14 different plasma cytokines and proteins (VEGF, VCAM-1, IL-6, IL-7, IL-8, IL-10, APRIL, BAFF, 4-1BB, BCA, SDF-1, MDC, IFN-gamma and TNF-alpha) were quantified for each plasma sample using the Elisa-based Meso Scale Discovery electrochemiluminescence assay. The association between baseline cytokine levels and objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) was evaluated. Results: Overall, 80 pts, 40 responders and 40 progressors, were included for cytokine analysis. Baseline characteristics were similar to the overall trial population. The IMDC risk score breakdown was 11.3% good, 56.3% intermediate and 32.5% poor. With a median follow-up of 21.2 months, mOS data was immature at data cut-off. Overall survival rate was 67.3% at 12 months and median PFS was 3.8 months. Increased levels of IL-6 (75th percentile=P75), IL-7 (P75), IL-8 (P50) and VEGF (P50) were significantly negatively associated with survival (IL-6: HR=2.44, p=0.0112; IL-7: HR=2.38, p=0.0123; IL-8: HR=2.80, p=0.0045, and VEGF: HR=2.43, p=0.0133). 4-1BB (P50) was associated with improved OS (HR=0.39, p=0.0375). Higher levels of IL-8 (P50) and VEGF (P50) were associated with worse PFS (IL-8: HR=2.50, p=0.0133, and VEGF: HR=1.96, p=0.0132) and worse ORR (IL-8: p=0.013, and VEGF: p=0.044). Except for IL-8 and VEGF, no other associations with response were observed. Conclusions: Higher baseline plasma levels of IL-6, IL-7, IL-8 and VEGF were significantly associated with worse survival outcomes in mRCC pts treated with nivolumab within TRAINING cohort of the NIVOREN trial. In contrast, 4-1BB was significantly associated with improved OS. IL-8 and VEGF were also associated with worse PFS and ORR. VALIDATION cohort within the entire NIVOREN study is ongoing.
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Affiliation(s)
| | - Marie Naigeon
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
| | | | - Aude Desnoyer
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
| | | | | | - Maxime Meylan
- Inflammation, Complement And Cancer, Centre de Recherche des Cordeliers, Paris, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | - Benoit Beusenlick
- General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | | | - Laurence Albiges
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Nathalie Chaput
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
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Vano YA, Ladoire S, Elaidi R, Dermeche S, Eymard JC, Falkowski S, Gross-Goupil M, Malouf G, Narciso B, Sajous C, Tartas S, Voog E, Ravaud A. First-Line Treatment of Metastatic Clear Cell Renal Cell Carcinoma: What Are the Most Appropriate Combination Therapies? Cancers (Basel) 2021; 13:5548. [PMID: 34771710 PMCID: PMC8583335 DOI: 10.3390/cancers13215548] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 02/08/2023] Open
Abstract
The development of antiangiogenic treatments, followed by immune checkpoint inhibitors (ICI), has significantly changed the management of metastatic clear cell renal cell cancer. Several phase III trials show the superiority of combination therapy, dual immunotherapy (ICI-ICI) or ICI plus tyrosine kinase inhibitors (TKI) of the vascular endothelium growth factor (VEGF) over sunitinib monotherapy. The question is therefore what is the best combination for a given patient? A strategy based on the International Metastatic Database Consortium (IMDC) classification is currently recommended with pembrolizumab + axitinib, cabozantinib + nivolumab, and lenvatinib + pembrolizumab (for all patients) or nivolumab + ipilimumab (for patients with intermediate or poor risk), which are the first-line treatment standards of care. However, several issues remain unresolved and require further investigation, such as the PD-L1 status, the relevance of possible options based on the patient's profile, and consideration of second-line and subsequent treatments.
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Affiliation(s)
| | | | - Réza Elaidi
- Association for the Research of Innovative Therapeutics in Cancerology (ARTIC), 75015 Paris, France;
| | | | | | | | | | - Gabriel Malouf
- Institute of Cancerology of Strasbourg (ICANS), 67200 Strasbourg, France;
| | | | - Christophe Sajous
- Lyon Civil Hospices Institute of Cancerology, Pierre Bénite, 69002 Lyon, France; (C.S.); (S.T.)
| | - Sophie Tartas
- Lyon Civil Hospices Institute of Cancerology, Pierre Bénite, 69002 Lyon, France; (C.S.); (S.T.)
| | - Eric Voog
- Victor Hugo Clinic, Inter-Regional Institute of Cancerology, 72000 Le Mans, France;
| | - Alain Ravaud
- Bordeaux University Hospital, 33000 Bordeaux, France;
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Procureur A, Simonaggio A, Bibault JE, Oudard S, Vano YA. Enhance the Immune Checkpoint Inhibitors Efficacy with Radiotherapy Induced Immunogenic Cell Death: A Comprehensive Review and Latest Developments. Cancers (Basel) 2021; 13:678. [PMID: 33567530 PMCID: PMC7915834 DOI: 10.3390/cancers13040678] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
The immunogenic cell death (ICD) is defined as a regulated cell death able to induce an adaptive immunity. It depends on different parameters including sufficient antigenicity, adjuvanticity and favorable microenvironment conditions. Radiation therapy (RT), a pillar of modern cancer treatment, is being used in many tumor types in curative, (neo) adjuvant, as well as metastatic settings. The anti-tumor effects of RT have been traditionally attributed to the mitotic cell death resulting from the DNA damages triggered by the release of reactive oxygen species. Recent evidence suggests that RT may also exert its anti-tumor effect by recruiting tumor-specific immunity. RT is able to induce the release of tumor antigens, to act as an immune adjuvant and thus to synergize with the anti-tumor immunity. The advent of new efficient immunotherapeutic agents, such as immune checkpoint inhibitors (ICI), in multiple tumor types sheds new light on the opportunity of combining RT and ICI. Here, we will describe the biological and radiobiological rationale of the RT-induced ICD. We will then focus on the interest to combine RT and ICI, from bench to bedside, and summarize the clinical data existing with this combination. Finally, RT technical adaptations to optimize the ICD induction will be discussed.
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Affiliation(s)
- Adrien Procureur
- Hôpital Européen Georges Pompidou, Service d’Oncologie Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP) Paris-Centre, F-75015 Paris, France; (A.P.); (A.S.); (S.O.)
| | - Audrey Simonaggio
- Hôpital Européen Georges Pompidou, Service d’Oncologie Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP) Paris-Centre, F-75015 Paris, France; (A.P.); (A.S.); (S.O.)
| | - Jean-Emmanuel Bibault
- Hôpital Européen Georges Pompidou, Service d’Oncologie Radiothérapie, Assistance Publique-Hôpitaux de Paris (AP-HP) Paris-Centre, F-75015 Paris, France;
| | - Stéphane Oudard
- Hôpital Européen Georges Pompidou, Service d’Oncologie Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP) Paris-Centre, F-75015 Paris, France; (A.P.); (A.S.); (S.O.)
| | - Yann-Alexandre Vano
- Hôpital Européen Georges Pompidou, Service d’Oncologie Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP) Paris-Centre, F-75015 Paris, France; (A.P.); (A.S.); (S.O.)
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, F-75006 Paris, France
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Pobel C, Auclin E, Procureur A, Clément-Zhao A, Simonaggio A, Delanoy N, Vano YA, Thibault C, Oudard S. Cabazitaxel schedules in metastatic castration-resistant prostate cancer: a review. Future Oncol 2021; 17:91-102. [PMID: 33463373 DOI: 10.2217/fon-2020-0672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Cabazitaxel (25 mg/m2 every 3 weeks) is the standard second-line chemotherapy for patients with metastatic castration-resistant prostate cancer previously treated with docetaxel. It is associated with a risk of neutropenic complications, which may be a barrier to its use in daily clinical practice, particularly in frail elderly patients. Here the authors reviewed key studies conducted with cabazitaxel (TROPIC, PROSELICA, AFFINITY, CARD and the European compassionate use program) and pilot studies with adapted schedules. Based on this review, the use of prophylactic granulocyte colony-stimulating factor from cycle 1 appears crucial to maximize the benefit-risk ratio of cabazitaxel in metastatic castration-resistant prostate cancer. Preliminary data with alternative schedules look promising, especially for frail patients. Results of the ongoing Phase III CABASTY trial (ClinicalTrials.gov: NCT02961257) are awaited.
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Affiliation(s)
- Cedric Pobel
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
| | - Edouard Auclin
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
| | - Adrien Procureur
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
| | - Alice Clément-Zhao
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
| | - Audrey Simonaggio
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
| | - Nicolas Delanoy
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
| | - Constance Thibault
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
| | - Stéphane Oudard
- Department of Medical Oncology, European Hospital Georges Pompidou & University of Paris, 20 rue Leblanc, Paris, 75015, France
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Simonaggio A, Epaillard N, Pobel C, Moreira M, Oudard S, Vano YA. Tumor Microenvironment Features as Predictive Biomarkers of Response to Immune Checkpoint Inhibitors (ICI) in Metastatic Clear Cell Renal Cell Carcinoma (mccRCC). Cancers (Basel) 2021; 13:E231. [PMID: 33435262 PMCID: PMC7827724 DOI: 10.3390/cancers13020231] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 11/07/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 12/11/2022] Open
Abstract
Renal cell carcinoma (RCC) is the seventh most frequently diagnosed malignancy with an increasing incidence in developed countries. Despite a greater understanding of the cancer biology, which has led to an increase of therapeutic options, metastatic clear cell renal cell carcinoma (mccRCC) still have a poor prognosis with a median five-years survival rate lower than 10%. The standard of care for mccRCC has changed dramatically over the past decades with the emergence of new treatments: anti-VEGFR tyrosine kinase inhibitors, mTOR Inhibitors and immune checkpoint inhibitors (ICI) such as anti-Programmed cell-Death 1 (PD-1) and anti-anti-Programmed Death Ligand-1 (PD-L1) used as monotherapy or as a combination with anti CTLA-4 or anti angiogenic therapies. In the face of these rising therapeutic options, the question of the therapeutic sequences is crucial. Predictive biomarkers are urgently required to provide a personalized treatment for each patient. Disappointingly, the usual ICI biomarkers, PD-L1 expression and Tumor Mutational Burden, approved in melanoma or non-small cell lung cancer (NSCLC) have failed to distinguish good and poor mccRCC responders to ICI. The tumor microenvironment is known to be involved in ICI response. Innovative technologies can be used to explore the immune contexture of tumors and to find predictive and prognostic biomarkers. Recent comprehensive molecular characterization of RCC has led to the development of robust genomic signatures, which could be used as predictive biomarkers. This review will provide an overview of the components of the RCC tumor microenvironment and discuss their role in disease progression and resistance to ICI. We will then highlight the current and future ICI predictive biomarkers assessed in mccRCC with a major focus on immunohistochemistry markers and genomic signatures.
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Affiliation(s)
- Audrey Simonaggio
- Medical Oncology, Hôpital Européen Georges Pompidou, APHP Centre–Université de Paris, 75015 Paris, France; (A.S.); (N.E.); (C.P.); (S.O.)
| | - Nicolas Epaillard
- Medical Oncology, Hôpital Européen Georges Pompidou, APHP Centre–Université de Paris, 75015 Paris, France; (A.S.); (N.E.); (C.P.); (S.O.)
| | - Cédric Pobel
- Medical Oncology, Hôpital Européen Georges Pompidou, APHP Centre–Université de Paris, 75015 Paris, France; (A.S.); (N.E.); (C.P.); (S.O.)
| | - Marco Moreira
- INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Team “Cancer, Immune Control and Escape”, University Paris Descartes Paris 5, Sorbonne Paris Cite, 75006 Paris, France;
| | - Stéphane Oudard
- Medical Oncology, Hôpital Européen Georges Pompidou, APHP Centre–Université de Paris, 75015 Paris, France; (A.S.); (N.E.); (C.P.); (S.O.)
- INSERM UMR-S1147, Université de Paris, Sorbonne Université, 75006 Paris, France
| | - Yann-Alexandre Vano
- Medical Oncology, Hôpital Européen Georges Pompidou, APHP Centre–Université de Paris, 75015 Paris, France; (A.S.); (N.E.); (C.P.); (S.O.)
- INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Team “Cancer, Immune Control and Escape”, University Paris Descartes Paris 5, Sorbonne Paris Cite, 75006 Paris, France;
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Pourmir I, Noel J, Simonaggio A, Oudard S, Vano YA. Update on the most promising biomarkers of response to immune checkpoint inhibitors in clear cell renal cell carcinoma. World J Urol 2021; 39:1377-1385. [PMID: 33386948 DOI: 10.1007/s00345-020-03528-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/13/2020] [Indexed: 12/21/2022] Open
Abstract
In the last few years, the standard of care for metastatic clear cell renal cell carcinoma (mccRCC) has changed dramatically with the emergence of the immune checkpoint inhibitors (ICI): anti-PD(L)-1 used as a monotherapy or as in combination either with an anti CTLA-4 or with an anti-angiogenic molecule (VEGFR tyrosine kinase inhibitor (TKI)). These combinations are now recommended in first line setting for mccRCC, according to the last European recommendations. In the face of these new therapeutic options, the question of selecting the best treatment arises as well as the optimal sequence. Predictive biomarkers are required to guide the therapeutic choice and provide a personalized treatment for each patient. This narrative review will provide an overview of the main predictive biomarkers assessed in mccRCC treatment, with a particular focus on mRNA panel signatures.
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Affiliation(s)
- Ivan Pourmir
- Medical Oncology Department, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France
| | - Johanna Noel
- Medical Oncology Department, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France
| | - Audrey Simonaggio
- Medical Oncology Department, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France
| | - Stéphane Oudard
- Medical Oncology Department, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France.,UMR-S1147, INSERM, 75006, Paris, France
| | - Yann-Alexandre Vano
- Medical Oncology Department, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France. .,Centre de Recherche Des Cordeliers, Sorbonne Université, Inserm, Université de Paris, 75006, Paris, France.
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Epaillard N, Simonaggio A, Elaidi R, Azzouz F, Braychenko E, Thibault C, Sun CM, Moreira M, Oudard S, Vano YA. BIONIKK: A phase 2 biomarker driven trial with nivolumab and ipilimumab or VEGFR tyrosine kinase inhibitor (TKI) in naïve metastatic kidney cancer. Bull Cancer 2020; 107:eS22-eS27. [PMID: 32620212 DOI: 10.1016/s0007-4551(20)30283-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The nivolumab-ipilimumab combination provides an overall response rate of 42% in first-line metastatic treatment of clear cell renal carcinoma (mccRCC). To date, there is no robust predictive biomarker of response to immune checkpoint inhibitor (ICI). In addition, severe autoimmune disorders occur more frequently with ICI combination than with ICI alone. The objective of this study is to compare the efficacy of ICI alone or in combination in patients according to tumor molecular characteristics. METHODS Using a 35-gene expression mRNA signature, patients were divided into 4 molecular groups (1 to 4). Patients in groups 1 and 4 were randomized to receive nivolumab alone (arms 1A and 4A) or nivolumab plus ipilimumab for 4 injections followed by nivolumab alone (arms 1B and 4B). Patients in groups 2 and 3 were randomized to receive nivolumab plus ipilimumab followed by nivolumab alone (arms 2B and 3B) or a tyrosine kinase inhibitor (sunitinib or pazopanib at the investigator's choice (arms 2C and 3C)). The main objective is the overall response rate by treatment and molecular group. DISCUSSION BIONIKK is the first trial in mccRCC to study the personalization of treatment with ICI or TKI according to tumor molecular characteristics in mccRCC. This trial is the most appropriate to prospectively identify biomarkers of response to nivolumab used alone or in combination or TKI monotherapy in patients with mccRCC. NCT02960906.
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Affiliation(s)
- Nicolas Epaillard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, APHP. Centre - Université de Paris, Paris, France
| | - Audrey Simonaggio
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, APHP. Centre - Université de Paris, Paris, France
| | - Reza Elaidi
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris, France
| | - Fouzia Azzouz
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris, France
| | - Elena Braychenko
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris, France
| | - Constance Thibault
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, APHP. Centre - Université de Paris, Paris, France
| | - Cheng-Ming Sun
- Centre de Recherche des Cordeliers, Université Paris 5, Sorbonne Université, Inserm U1138, F-75006 Paris, France
| | - Marco Moreira
- Centre de Recherche des Cordeliers, Université Paris 5, Sorbonne Université, Inserm U1138, F-75006 Paris, France
| | - Stéphane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, APHP. Centre - Université de Paris, Paris, France; INSERM U970. Paris Cardiovascular research Center (PARCC). Université Paris Descartes. Paris. France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, APHP. Centre - Université de Paris, Paris, France; Centre de Recherche des Cordeliers, Université Paris 5, Sorbonne Université, Inserm U1138, F-75006 Paris, France.
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Thibault C, Elaidi R, Vano YA, Rouabah M, Braychenko E, Helali I, Audenet F, Oudard S. Open-label phase II to evaluate the efficacy of NEoadjuvant dose-dense MVAC In cOmbination with durvalumab and tremelimumab in muscle-invasive urothelial carcinoma: NEMIO. Bull Cancer 2020; 107:eS8-eS15. [PMID: 32620213 DOI: 10.1016/s0007-4551(20)30281-2] [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] [Indexed: 01/17/2023]
Abstract
BACKGROUND Neoadjuvant cisplatin-based chemotherapy (NAC) is the standard of care in localized muscle-invasive bladder cancer (MIBC). However, 60-70% of patients have residual tumor after NAC. Based on the overall response rate observed in the metastatic setting, ddMVAC is the most commonly used NAC regimen in Europe. The emergence of immune checkpoint inhibitor (ICI) in the metastatic setting raises the question if the combination of chemo plus ICI could increase the pCR rate. METHODS/DESIGN NEMIO is a French open-label randomized phase I/II trial assessing in the neoadjuvant setting the combination of ddMVAC plus durvalumab alone or with tremelimumab: 4 cycles of ddMVAC/2 weeks + 2 cycles of Durvalumab +/- Tremelimumab/4 weeks. Cystectomy is performed 4-8 weeks after the last dose of ddMVAC. Six pts will be included in each arm in a safety run-in cohort to evaluate the toxicity rate. Each arm will be expanded to a maximum of 60 pts. The primary endpoint of the safety run-in phase will be the rate of grade 3/4 treatment-related adverse events G3/4 TRAE. The primary endpoint of the phase II will be the pathological response rate and G 3/4 TRAE. Exploratory endpoints will include biomarkers of response and resistance to the combo. A total of 120 patients will be included in 15 French centers and we expect the recruitment to be completed in 2021. DISCUSSION NEMIO trial will assess for the first time the tolerance and the efficacy of ddMVAC regimen associated with checkpoints inhibitors as neoadjuvant treatment in localized MIBC. NCT number: NCT03549715. Registered on June 8, 2018.
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Affiliation(s)
| | - Reza Elaidi
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris
| | | | - Mouna Rouabah
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris
| | - Elena Braychenko
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris
| | - Imen Helali
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris
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Simonaggio A, Epaillard N, Elaidi R, Sun CM, Moreira M, Oudard S, Vano YA. [Impact of molecular signatures on the choice of systemic treatment for metastatic kidney cancer]. Bull Cancer 2020; 107:S24-S34. [PMID: 32620204 DOI: 10.1016/s0007-4551(20)30275-7] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The standard of care for metastatic clear cell renal cell carcinoma (mccRCC) has changed dramatically over the past decades thanks to the increasing number of treatments: anti-VEGFR tyrosine kinase inhibitors (TKI), mTOR inhibitors and immune checkpoint inhibitors (ICI): anti PD(L)-1 used as monotherapy or in combination with anti CTLA-4 or anti angiogenic therapies. In the face of rising therapeutic options, the question of the therapeutic sequences arises: which treatment for which patient? Actually, there is a lack of predictive biomarkers. A greater understanding of the cancer biology and its interaction with the microenvironment has allowed the development of genomic signatures which could perhaps be used as predictive biomarker. This review will give an insight on some robust genomic signatures assessed in mccRCC and will have a closer look at BIONIKK phase II trial, which is the first trial to adapt treatments according to the molecular characteristics of the tumor in the context of mccRCC.
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Affiliation(s)
- Audrey Simonaggio
- Service d'oncologie médicale, Hôpital européen Georges-Pompidou, APHP Centre - Université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - Nicolas Epaillard
- Service d'oncologie médicale, Hôpital européen Georges-Pompidou, APHP Centre - Université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - Reza Elaidi
- Association pour la recherche de thérapeutiques innovantes en cancérologie, 20, rue Leblanc, 75015 Paris, France
| | - Cheng-Ming Sun
- INSERM UMRS1138, Centre de recherche des Cordeliers, Université de Paris, 15, rue de l'École-de-Médecine, 75006 Paris, France
| | - Marco Moreira
- INSERM UMRS1138, Centre de recherche des Cordeliers, Université de Paris, 15, rue de l'École-de-Médecine, 75006 Paris, France
| | - Stéphane Oudard
- Service d'oncologie médicale, Hôpital européen Georges-Pompidou, APHP Centre - Université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - Yann-Alexandre Vano
- Service d'oncologie médicale, Hôpital européen Georges-Pompidou, APHP Centre - Université de Paris, 20, rue Leblanc, 75015 Paris, France; INSERM UMRS1138, Centre de recherche des Cordeliers, Université de Paris, 15, rue de l'École-de-Médecine, 75006 Paris, France.
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Moreira M, Pobel C, Epaillard N, Simonaggio A, Oudard S, Vano YA. Resistance to cancer immunotherapy in metastatic renal cell carcinoma. Cancer Drug Resist 2020; 3:454-471. [PMID: 35582435 PMCID: PMC8992500 DOI: 10.20517/cdr.2020.16] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/06/2020] [Accepted: 05/29/2020] [Indexed: 12/17/2022]
Abstract
The prognosis of metastatic clear cell renal cell carcinoma (mccRCC) has changed dramatically over the years with the emergence of immune checkpoint inhibitors (ICI) used alone, or in combination with another ICI, or with vascular endothelial growth factor receptor tyrosine kinase inhibitor. Although major response rates have been observed with ICI, many patients do not respond, reflecting primary resistance, and durable responses remain exceptional, reflecting secondary resistance. Factors contributing to primary and acquired resistance are manifold, including patient-intrinsic factors, tumor cell-intrinsic factors and factors associated with the tumoral microenvironment (TME). While some mechanisms of resistance are common to several tumor types, others are specific to mccRCC. Predictive biomarkers and alternative strategies are needed to overcome this resistance. This review provides an overview of the major ICI resistance mechanisms, highlights the potential of the TME to induce resistance to ICI, and discusses the predictive biomarkers available to guide therapeutic choice.
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Affiliation(s)
- Marco Moreira
- Centre de Recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Paris F-75006, France.,Both authors contributed equally
| | - Cedric Pobel
- Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France.,University François Rabelais, Tours 37200, France.,Both authors contributed equally
| | - Nicolas Epaillard
- Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France
| | - Audrey Simonaggio
- Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France
| | - Stéphane Oudard
- Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France.,INSERM UMR-S1147, Paris 75006, France
| | - Yann-Alexandre Vano
- Centre de Recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Paris F-75006, France.,Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France
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Simonaggio A, Elaidi R, Fournier L, Fabre E, Ferrari V, Borchiellini D, Thouvenin J, Barthelemy P, Thibault C, Tartour E, Oudard S, Vano YA. Variation in neutrophil to lymphocyte ratio (NLR) as predictor of outcomes in metastatic renal cell carcinoma (mRCC) and non-small cell lung cancer (mNSCLC) patients treated with nivolumab. Cancer Immunol Immunother 2020; 69:2513-2522. [PMID: 32561968 DOI: 10.1007/s00262-020-02637-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 01/20/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND An elevated pre-treatment neutrophil to lymphocytes ratio (NLR) is associated with poor prognosis in various malignancies. Optimal cut-off is highly variable across studies and could not be determined individually for a patient to inform his prognosis. We hypothesize that NLR variations could be more useful than baseline NLR to predict progression-free survival (PFS) and overall survival (OS) in patients (pts) receiving anti-PD1 treatment. PATIENTS AND METHODS All pts with metastatic renal cell carcinoma (mRCC) and metastatic non-small cell lung cancer (mNSCLC) who received anti-PD1 nivolumab monotherapy in second-line setting or later were included in this French multicentric retrospective study. NLR values were prospectively collected prior to each nivolumab administration. Clinical characteristics were recorded. Associations between baseline NLR, NLR variations and survival outcomes were determined using Kaplan-Meier's method and multivariable Cox regression models. RESULTS 161 pts (86 mRCC and 75 mNSCLC) were included with a median follow-up of 18 months. On the whole cohort, any NLR increase at week 6 was significantly associated with worse outcomes compared to NLR decrease, with a median PFS of 11 months vs 3.7 months (p < 0.0001), and a median OS of 28.5 months vs. 18 months (p = 0.013), respectively. In multivariate analysis, NLR increase was significantly associated with worse PFS (HR 2.2; p = 6.10-5) and OS (HR 2.1; p = 0.005). Consistent results were observed in each cohort when analyzed separately. CONCLUSION Any NLR increase at week 6 was associated with worse PFS and OS outcomes. NLR variation is an inexpensive and dynamic marker easily obtained to monitor anti-PD1 efficacy.
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Affiliation(s)
- A Simonaggio
- Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France
| | - R Elaidi
- Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France
| | - L Fournier
- Department of Radiology, Hôpital Européen Georges Pompidou, Paris, France
| | - E Fabre
- Medical Thoracic Oncology Department, Hopital Européen Georges Pompidou, Paris, France
- U970, Université Paris Descartes Sorbonne Paris-Cité, 75006, Paris, France
| | - V Ferrari
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - D Borchiellini
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - J Thouvenin
- Department of Medical Oncology, University Hospital of Strasbourg, Strasbourg, France
| | - P Barthelemy
- Department of Medical Oncology, University Hospital of Strasbourg, Strasbourg, France
| | - C Thibault
- Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France
| | - E Tartour
- Department of Immunology, Hôpital Européen Georges Pompidou, 75015, Paris, France
- U970, Université Paris Descartes Sorbonne Paris-Cité, 75006, Paris, France
| | - S Oudard
- Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France
| | - Y A Vano
- Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France.
- INSERM, UMR-S 1138, Centre de Recherche des Cordeliers, Team "Cancer, Immune Control and Escape", University Paris Descartes Sorbonne, 75006, Paris, France.
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Moreno V, Loriot Y, Valderrama BP, Beato C, Vano YA, Fleming MT, Duran I, Siena S, Tolbert JA, OHagan A, Akapame S, Lau YY, Geoffrois L, Tagawa ST, Mellado B, Siefker-Radtke AO. Does escalation results from phase Ib/II Norse study of erdafitinib (ERDA) + PD-1 inhibitor JNJ-63723283 (Cetrelimab [CET]) in patients (pts) with metastatic or locally advanced urothelial carcinoma (mUC) and selected fibroblast growth factor receptor (FGFR) gene alterations. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.511] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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
511 Background: ERDA, an oral pan-FGFR inhibitor, is approved by the US FDA for pts with metastatic urothelial carcinoma (mUC) with susceptible FGFR3/2 gene alterations and progressed after ≥1 line of prior platinum-containing chemotherapy (PCC).1 CET, an IgG4, binds to anti-programmed cell death proteins (PD-1) and has shown activity in solid tumors.2 ERDA+CET may demonstrate complementary mechanisms as neoantigen release by ERDA may prime the tumor microenvironment for response. NORSE is a phase 1b/2 study to evaluate ERDA+CET in pts with mUC. Methods: Adult mUC pts with specific FGFR alterations who have progressed after ≥1 prior systemic therapy and no prior FGFR or PD-1/PD(L)-1 inhibitors enrolled in 3 dose levels (DL) of ERDA (DL1: 6 mg, DL2A: 8 mg, DL2: 8 mg with uptitration [UPT] to 9 mg) + CET (IV, 240 mg). Cohorts enrolled until dose limiting toxicity (DLT) or RP2D was identified. Primary endpoints: DLT and adverse events (AEs). Results: Of 15 pts (DL1: 4, DL2A: 3, DL2: 8), 11 continued on treatment at the time of the data cut. 14/15 pts experienced AEs; 3 experienced serious unrelated AEs (urinary tract infection, urosepsis, and large intestinal obstruction) all in DL1, 2 led to death; 10 experienced Grade >3 AEs and 2 experienced AEs of special interest, considered related to ERDA (Table). No DLTs were observed in any cohorts, 8 mg with UPT + CET was established as the RP2D. At data cut-off, investigator-assessed best overall response rate (CR+PR+uCR+uPR) in pts treated with the RP2D was 71% and disease control rate was 100% for RECIST 1.1 evaluable pts (n=7). Conclusions: 8 mg ERDA with UPT+240 mg CET was well tolerated and established as the RP2D. The combination of ERDA+CET is being further explored in the ongoing randomized phase 2 study in first-line cisplatin-ineligible mUC pts (NCT03473743). Clinical trial information: 2017-001980-19. [Table: see text]
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Affiliation(s)
- Victor Moreno
- START Madrid-FJD, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Yohann Loriot
- Institute Gustave Roussy, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | | | - Carmen Beato
- Medical Oncology Service, Hospital Virgen de la Macarena, Sevilla, Spain
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | - Mark T. Fleming
- Virginia Oncology Associates, US Oncology Research, Norfolk, VA
| | - Ignacio Duran
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Salvatore Siena
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano and Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Anne OHagan
- Janssen Research & Development, LLC, Spring House, PA
| | | | | | - Lionnel Geoffrois
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-Lés-Nancy, France
| | | | - Begona Mellado
- Hospital Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
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Logeart J, Simonaggio A, Elaidi RT, Hans S, Thibault C, Oudard S, Vano YA. Optimal sequence strategy with nivolumab and targeted therapy in patients with metastatic renal cell carcinoma (mRCC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.700] [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
700 Background: Nivolumab is an approved standard tretatment for pts with mRCC after one VEGFR-TKI failure. Some reports suggest that Nibolumab provides similar response rate across treatment line. Nevetheless, no comparative data has been reported on the sequence of 2nd line Nivolumab followed by TKI vs TKI followed by Nivolumab in 3rd or later line. Objective: To determine the optimal sequence of Nivolumab monotherapy and anti-VEGFR-TKI in mRCC beginning from the 2nd line. Methods: We included in a French expert center all patients with mRCC who received real-life experienced of anti-PD1 nivolumab monotherapy in 2nd line setting or later were included in a French expert center. Clinical characteristics were prospectively recorded including IDMC prognostic factors. Patients who did not receive TKI on the 1st line were excluded. Survival outcomes and subgroups analysis were performed using log rank test and univariate cox regression analysis. Results: 91 patients with mRCC received Nivolumab between January 2006 and May 2018, 58 pts received nivolumab in 2nde line (63%) and 33 in 3rd line and more. Median follow-up was 18.9 [0.1;143] months starting from the beginning of the 2nd line. All received first line anti-VEGFR TKI, 83%/11% sunitinib/pazopanib. At the beginning of 2nd line, IMDC prognostic groups were Fav 19%/Int 56%/ Poor 24%, with similar repartition (p=0,8) between pts treated with Nivolumab vs others. PFS at 6 months for 2nd line was in favor of patients treated by targeted treatments with respectively 63% (IC95% [46%;80%]) and 34% (IC95% [23%;49%]), p=0,06. OS at 24 months for 2nd line was significatively higher for patients treated by targeted treatments with 72% (IC95% [56;87%]) and 46% (IC95% [31%;61%]), p=0,007. Conclusions: We report for the first time the optimal timing to sequence Nivolumab – targeted therapy in patients with mRCC. We found better PFS and OS when Nivolumab is given after the 2nde line of treatment. Subgroups analysis including IMDC prognostic groups and duration of fist line TKI will be presented at the meeting.
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Affiliation(s)
| | | | - Reza Thierry Elaidi
- Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France
| | | | | | | | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
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Vano YA, Rioux-Leclercq N, Dalban C, Sautes-Fridman C, Bougoüin A, Chaput N, Chouaib S, Beuselinck B, Chevreau C, Gross-Goupil M, Negrier S, Laguerre B, Borchiellini D, Colina-Moreno I, Fridman WH, Chabaud S, Tantot F, Barros Monteiro J, Escudier B, Albiges L. NIVOREN GETUG-AFU 26 translational study: Association of PD-1, AXL, and PBRM-1 with outcomes in patients (pts) with metastatic clear cell renal cell carcinoma (mccRCC) treated with nivolumab (N). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
618 Background: The NIVOREN GETUG-AFU 26 study reported safety and efficacy of N in mccRCC pts in a “real world setting”. A translationnal research program was launched to characterize immune cell populations in the tumor by immunohistochemistry (IHC) and correlate them with outcome on N. Methods: All pts treated with N in the GETUG AFU 26 NIVOREN trial who consented for translational program and with available archived paraffin- embedded (FFPE) tumor tissue samples were eligible. Tumor were centrally reviewed. Using IHC we quantified main immune populations (B-cells, CD8 T-cells, macrophages), and immune checkpoints receptors (TIM-3, LAG-3, PD-1) at the invasive margin (IM) and at the core of the tumor (CT). We also identified AXL and PBRM1/BAP1 expression. Results: Overall 324 pts were included. Pts had similar baseline characteristics (IMDC Good, Intermediate, Poor in 18%, 60% and 22%, respectively) and comparable outcomes than overall trial population (PFS/OS = 4.5 / 25.4 months). PD-1 (IM) expression was associated with better PFS whereas AXL expression by tumor cells (TC) was associated with worse PFS (table). LAG-3 expression tend to be associated with worse OS. PBRM-1 loss (15%) was associated with better OS and PFS and with a higher density of CD8 T-cells (p = 0.001) and CD163-macrophages (p = 0.01) (CT) and a higher expression of LAG-3 (CT) (p = 0.01) and PD-1 (CT) (p = 0.02). BAP-1 loss was not associated with PFS (p = 0.6) nor OS (p = 0.9) in this cohort. Conclusions: We report the largest translational analysis supporting that PD-1 and AXL expression are associated with PFS in pts with mccRCC receiving N. We further confirm that PBRM-1 loss is a strong prognostic factor in this setting.[Table: see text]
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Affiliation(s)
- Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | | | | | | | | | - Nathalie Chaput
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France
| | | | - Benoit Beuselinck
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Marine Gross-Goupil
- Oncology Department, Centre Hospitalier Universitaire, Bordeaux, Aquitaine, France
| | - Sylvie Negrier
- Departement of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | | | | | | | - Sylvie Chabaud
- Departement of Clinical Research,Centre Léon-Bérard, Lyon, France
| | | | | | - Bernard Escudier
- Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Laurence Albiges
- Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Auvray M, Auclin E, Barthelemy P, Bono P, Kellokumpu-Lehtinen P, Gross-Goupil M, De Velasco G, Powles T, Mouillet G, Vano YA, Gravis G, Mourey L, Priou F, Rolland F, Escudier B, Albiges L. Erratum to 'Second-line targeted therapies after nivolumab-ipilimumab failure in metastatic renal cell carcinoma' [Eur J Cancer 108 (February 2019) 33-40]. Eur J Cancer 2019; 119:200-201. [PMID: 31301937 DOI: 10.1016/j.ejca.2019.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Marie Auvray
- Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Edouard Auclin
- Gastrointestinal Oncology Department, European Georges Pompidou Hospital, Université René Descartes, Paris, France; Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France; Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000, Besançon, France
| | | | - Petri Bono
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Marine Gross-Goupil
- Oncology Department, Centre Hospitalier Universitaire, Bordeaux, Aquitaine, France
| | - Guillermo De Velasco
- Department of Medical Oncology, University Hospital 12 de Octubre, I + 12, Madrid, Spain
| | - Thomas Powles
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | | | - Yann-Alexandre Vano
- Oncology Department, European Georges Pompidou Hospital, Université René Descartes, Paris, France
| | | | - Loïc Mourey
- Department of Oncology, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - Franck Priou
- Department of Oncology, Centre Hospitalier Départemental Les Oudairies, La Roche-sur-Yon, France
| | - Frédéric Rolland
- Medical Oncology, Institut René Gauducheau, Saint Herblain, France
| | - Bernard Escudier
- Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Laurence Albiges
- Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
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Auvray M, Auclin E, Barthelemy P, Bono P, Kellokumpu-Lehtinen P, Gross-Goupil M, De Velasco G, Powles T, Mouillet G, Vano YA, Gravis G, Mourey L, Priou F, Rolland F, Escudier B, Albiges L. Second-line targeted therapies after nivolumab-ipilimumab failure in metastatic renal cell carcinoma. Eur J Cancer 2019; 108:33-40. [DOI: 10.1016/j.ejca.2018.11.031] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/07/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
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Vano YA, Simonaggio A, Thibault C, Oudard S. Immunothérapie des cancers du rein. Bull Cancer 2019; 105 Suppl 1:S24-S34. [PMID: 30595195 DOI: 10.1016/s0007-4551(18)30387-4] [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] [Indexed: 11/27/2022]
Abstract
IMMUNOTHERAPY FOR RENAL CELL CARCINOMA Clear cell kidney cancer is a tumour type whose development and progression is driven by the HIF/VEGF angiogenesis pathway. Anti-angiogenic (AA) agents, particularly anti-VEGFR tyrosine kinase (TKI) inhibitors, have profoundly modified the prognosis of patients in the metastatic setting (mRCC) since their registration in 2006. At the same time, mTOR inhibitors have also brought significant benefit to patients. More recently, treatments restoring adaptive anti-tumor immunity, anti-program death 1 (anti-PD-1) checkpoint inhibitors (ICP), have in turn revolutionized the management of patients with mRCC. The multi-tumor efficacy of these ICPs proves the crucial role of anti-tumor immunity in tumor development and progression in a number of tumors including clear cell kidney tumours (ccRCC). The tumor immune microenvironment (TME) of ccRCC is known to be highly immunosuppressive. Thus ccRCCs are characterized by a strong infiltration of CD8+ T lymphocytes, frequently expressing immunological checkpoint molecules on their surface, giving them a poor prognostic feature. These characteristics partly explain the effectiveness of ICP in ccRCC and constitute a strong rationale for their further development, either at an earlier stage or in combination, particularly with AA or TKI. In this review are compiled the main clinical results of immunological checkpoint molecules alone or in combination in 1stline or after TKI failure.
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Affiliation(s)
- Yann-Alexandre Vano
- Service d'oncologie médicale, Hôpital européen Georges-Pompidou, Paris, France; Inserm, UMRS 1138, Centre de recherche des cordeliers, cancer et immunité antitumorale, université Paris-Descartes, Sorbonne-Paris-Cité, F-75006, Paris, France.
| | - Audrey Simonaggio
- Service d'oncologie médicale, Hôpital européen Georges-Pompidou, Paris, France; Inserm, UMRS 1138, Centre de recherche des cordeliers, cancer et immunité antitumorale, université Paris-Descartes, Sorbonne-Paris-Cité, F-75006, Paris, France
| | - Constance Thibault
- Service d'oncologie médicale, Hôpital européen Georges-Pompidou, Paris, France; Inserm, UMRS 1138, Centre de recherche des cordeliers, cancer et immunité antitumorale, université Paris-Descartes, Sorbonne-Paris-Cité, F-75006, Paris, France
| | - Stéphane Oudard
- Service d'oncologie médicale, Hôpital européen Georges-Pompidou, Paris, France; Immunothérapies et antiangiogéniques en oncologie, équipe 10 PARCC, INSERM U970, Sorbonne-Paris-Cité, Paris, France
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Vano YA, Oudard S, By MA, Têtu P, Thibault C, Aboudagga H, Scotté F, Elaidi R. Optimal cut-off for neutrophil-to-lymphocyte ratio: Fact or Fantasy? A prospective cohort study in metastatic cancer patients. PLoS One 2018; 13:e0195042. [PMID: 29624591 PMCID: PMC5889159 DOI: 10.1371/journal.pone.0195042] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 03/08/2018] [Indexed: 01/04/2023] Open
Abstract
This study assessed the prognostic value of pre-treatment neutrophil-to-lymphocyte ratio (NLR) in patients with metastatic solid tumors. Clinical and biological data for patients with metastatic solid tumors treated in an oncology outpatient department and prospectively followed by a call center (PROCHE program) between January 2008 and December 2011 were analyzed. All patients with an NLR value within 28 days before the first cycle of first-line of chemotherapy were included (cohort 1). To assess influence of chemotherapy line on NLR prognostic value, data from patients treated with later chemotherapy lines were also analyzed (cohort 2). Adjusted multivariate Cox regressions with or without non-linear and time-dependent effects were performed. Optimal NLR cut-off was investigated by time-dependent sensitivity analysis using several indices. There were 317 and 134 patients in cohorts 1 and 2, respectively. Elevated NLR was associated with worse survival (hazard ratio [HR] for death, 1.35 [95% confidence interval 1.19-1.54]; p<0.0001). The optimal NLR cut-off in cohort 1 was dependent on index used and time of assessment: HR values were non-significant at a cut-off of 3.0 (1.34 [0.99-1.32], but significant when the cut-off was 4.0 (1.53 [1.11-2.10]). NLR was linearly related to mortality risk; in subgroup analysis, no significant interaction was found with co-variables or tumor localization overall (cohorts 1+2). Pre-treatment NLR is a useful prognostic tool in patients with metastatic solid tumors, irrespective of primary tumor site, chemotherapy line, age, gender and performance status. However, using an NLR cut-off value for clinical decision-making requires extreme caution.
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Affiliation(s)
- Yann-Alexandre Vano
- Department of Oncology, Hôpital Européen Georges Pompidou, Paris, France
- University of Paris 5 Descartes, Paris, France
- Cancer Immune control and Escape, UMRS1138, Cordeliers Research Center, Paris, France
- * E-mail:
| | - Stéphane Oudard
- Department of Oncology, Hôpital Européen Georges Pompidou, Paris, France
- University of Paris 5 Descartes, Paris, France
- Angiogenesis and Immunotherapy laboratory, PARCC, INSERM U970, team 10, Paris, France
| | - Marie-Agnès By
- Department of Oncology, Centre Hospitalier Universitaire Bretonneau, Tours, France
| | - Pauline Têtu
- Department of Oncology, Hôpital Européen Georges Pompidou, Paris, France
- University of Paris 5 Descartes, Paris, France
| | - Constance Thibault
- Department of Oncology, Hôpital Européen Georges Pompidou, Paris, France
- University of Paris 5 Descartes, Paris, France
| | - Hail Aboudagga
- University of Paris 5 Descartes, Paris, France
- Department of Pharmacy, Hôpital Européen Georges Pompidou, Paris, France
| | - Florian Scotté
- Department of Oncology, Hôpital Européen Georges Pompidou, Paris, France
- University of Paris 5 Descartes, Paris, France
| | - Reza Elaidi
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Department of Oncology, Hôpital Européen Georges Pompidou, Paris, France
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Abstract
Renal cell carcinoma (RCC) encompasses a wide spectrum of morphologically and molecularly distinct (>10) cancer subtypes originated from the kidney epithelium. Metastatic RCC (mRCC) is lethal and refractory to conventional chemotherapeutic agents. The incorporation of targeted therapies and immune checkpoint inhibitors into the current practice of mRCC has markedly improved the median overall survival of clear cell RCC (ccRCC) patients, the most common subtype, but not rare kidney cancer (RKC or non-ccRCC, nccRCC). Varied treatment response in mRCC patients is observed, which presents clinical challenges/opportunities at the modern mRCC therapeutic landscape consisting of 12 approved drugs representing 6 different effective mechanisms. Key contributing factors include inter- and intra-RCC heterogeneity. With the advances in pan-omics technologies, we now have a better understanding of the molecular pathobiology of individual RCC subtype. Here, we attempt to classify ccRCC based on contemporary molecular features with emphasis on their respective potential significance in clinical practice.
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Affiliation(s)
| | - Yann-Alexandre Vano
- Oncologie Médicale, Hôpital Européen Georges Pompidou and Centre de Recherche des Cordeliers, Paris, France
- INSERM, UMR_S 1138, Cordeliers Research Center, Team Cancer, Immune Control and Escape, Paris 5 Descartes University, Paris, France
| | - Wolf Herve Fridman
- INSERM, UMR_S 1138, Cordeliers Research Center, Team Cancer, Immune Control and Escape, Paris 5 Descartes University, Paris, France
| | - James J. Hsieh
- Molecular Oncology, Department of Medicine, Siteman Cancer Center, Washington University, St. Louis, MO, USA
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Joly F, Guillot A, Vano YA, Spaeth D, Topart D, Roffet P, El Amarti R, Hasbini A, Fléchon A. [French national survey on incoming phone calls in oncology departments]. Bull Cancer 2017; 104:565-573. [PMID: 28391984 DOI: 10.1016/j.bulcan.2017.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Oral therapies have shifted the follow-up of patients with cancer from hospital to home. As a consequence, the number of incoming calls has increased. To understand the source, reasons, management and burden of calls, we underwent a French national survey. The objective was to describe the way calls are managed in oncology departments. METHODS The study was a prospective survey in a representative sample of French oncology specialists using oral therapies. RESULTS Among 51 participating onco/radiotherapy departments, 86 % of specialists were oncologists or hematologists and 14 % radiation oncologists. Eighty percent were from public centers and 20 % from private ones. The median number of calls/week was 110. Sixty-six percent of calls were from patients and families and 23 % from general practitioners. Upon calls reception by the secretaries, half of them corresponded to a medical question. Sixty-five percent of centers did not have an established specific procedure and 70 % of responders did not specifically train their teams to address the management of calls. Sixty-five percent of the specialists spent more than 30min/day. Most of them considered it disturbing medical activities. Sixty-six percent of patients calls were related to adverse effects of treatments. Twenty-two percent of specialists declared at least one severe adverse effect linked to misinterpretation of a call. DISCUSSION With the increase of oral therapies, incoming phone calls represent an important burden of work. To improve calls management, adaptations of organizations are needed.
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Affiliation(s)
- Florence Joly
- Centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
| | - Aline Guillot
- Institut de cancérologie Lucien-Neuwirth, 108 bis, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | | | - Dominique Spaeth
- Centre d'oncologie de Gentilly, 2, rue Marie-Margingt, 54000 Nancy, France
| | - Delphine Topart
- Hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - Pascal Roffet
- Pfizer, 23-25, avenue du Dr-Lannelongue, 75014 Paris, France
| | - Rachid El Amarti
- CHI du Pays de Cognac, 65, avenue d'Angoulême, 16112 Cognac cedex, France
| | - Ali Hasbini
- Clinique Pasteur-Lanroze, 32, rue Auguste-Kervern, 29200 Brest, France
| | - Aude Fléchon
- Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
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Vano YA, Tartour E, Fournier LS, Beuselinck B, Mejean A, Oudard S. Prognostic factors in patients with advanced renal cell carcinoma treated with VEGF-targeted agents. Expert Rev Anticancer Ther 2014; 14:523-42. [DOI: 10.1586/14737140.2014.882773] [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: 12/25/2022]
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Beuselinck B, Vano YA, Oudard S, Wolter P, De Smet R, Depoorter L, Teghom C, Karadimou A, Zucman-Rossi J, Debruyne PR, Van Poppel H, Joniau S, Lerut E, Strijbos M, Dumez H, Paridaens R, Van Calster B, Schöffski P. Prognostic impact of baseline serum C-reactive protein in patients with metastatic renal cell carcinoma (RCC) treated with sunitinib. BJU Int 2014; 114:81-9. [DOI: 10.1111/bju.12494] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Benoit Beuselinck
- Department of General Medical Oncology and Laboratory for Experimental Oncology; University Hospitals Leuven; Leuven Cancer Institute; KU Leuven; Leuven Belgium
- Inserm U674 Génomique fonctionnelle des tumeurs solides; Université Paris-5 René Descartes; Paris France
| | - Yann-Alexandre Vano
- Department of Medical Oncology; Georges Pompidou European Hospital; Université Paris-5 René Descartes; Paris France
| | - Stéphane Oudard
- Department of Medical Oncology; Georges Pompidou European Hospital; Université Paris-5 René Descartes; Paris France
| | - Pascal Wolter
- Department of General Medical Oncology and Laboratory for Experimental Oncology; University Hospitals Leuven; Leuven Cancer Institute; KU Leuven; Leuven Belgium
| | - Robert De Smet
- Department of General Medical Oncology and Laboratory for Experimental Oncology; University Hospitals Leuven; Leuven Cancer Institute; KU Leuven; Leuven Belgium
| | - Lore Depoorter
- Department of General Medical Oncology and Laboratory for Experimental Oncology; University Hospitals Leuven; Leuven Cancer Institute; KU Leuven; Leuven Belgium
| | - Corine Teghom
- Department of Medical Oncology; Georges Pompidou European Hospital; Université Paris-5 René Descartes; Paris France
| | - Alexandra Karadimou
- Inserm U674 Génomique fonctionnelle des tumeurs solides; Université Paris-5 René Descartes; Paris France
| | - Jessica Zucman-Rossi
- Inserm U674 Génomique fonctionnelle des tumeurs solides; Université Paris-5 René Descartes; Paris France
| | | | | | | | | | - Michiel Strijbos
- Department of General Medical Oncology and Laboratory for Experimental Oncology; University Hospitals Leuven; Leuven Cancer Institute; KU Leuven; Leuven Belgium
| | - Herlinde Dumez
- Department of General Medical Oncology and Laboratory for Experimental Oncology; University Hospitals Leuven; Leuven Cancer Institute; KU Leuven; Leuven Belgium
| | - Robert Paridaens
- Department of General Medical Oncology and Laboratory for Experimental Oncology; University Hospitals Leuven; Leuven Cancer Institute; KU Leuven; Leuven Belgium
| | - Ben Van Calster
- Department of Biostatistics Section; Department of Development and Regeneration; KU Leuven; Leuven Belgium
| | - Patrick Schöffski
- Department of General Medical Oncology and Laboratory for Experimental Oncology; University Hospitals Leuven; Leuven Cancer Institute; KU Leuven; Leuven Belgium
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