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Guisier F, Descourt R, Babey H, Huchot E, Falchero L, Veillon R, Cortot AB, Tissot C, Chouaid C, Decroisette C. Brief Report: First-line Pembrolizumab in Metastatic Non-Small Cell Lung Cancer Habouring MET Exon 14 Skipping Mutation and PD-L1 ≥50% (GFPC 01-20 Study). Clin Lung Cancer 2022; 23:e545-e549. [PMID: 36210290 DOI: 10.1016/j.cllc.2022.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Florian Guisier
- Department of Pneumology and Inserm CIC-CRB 1404, Normandie Univ, UNIROUEN, LITIS Lab QuantIF team EA4108, CHU Rouen, Rouen, France.
| | - Renaud Descourt
- Institut de cancérologie, Hopital Morvan, CHRU Brest, Brest, France
| | - Helene Babey
- Institut de cancérologie, Hopital Morvan, CHRU Brest, Brest, France
| | - Eric Huchot
- CHU sud Reunion, Service de Pneumologie, Saint-Pierre, France
| | - Lionel Falchero
- L'Hôpital Nord-Ouest, Service de Pneumologie et Cancérologie Thoracique, Villefranche Sur Saône, France
| | - Remi Veillon
- CHU Bordeaux, service des maladies respiratoire, Bordeaux, France
| | - Alexis B Cortot
- CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, Univ. Lille, Plasticity and Resistance to Therapies, Lille, France
| | - Claire Tissot
- Department of Medical Oncology, Institut de Cancérologie Lucien-Neuwirth, Saint-Etienne, France
| | - Christos Chouaid
- Department of Pneumology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
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Mazieres J, Drilon A, Lusque A, Mhanna L, Cortot AB, Mezquita L, Thai AA, Mascaux C, Couraud S, Veillon R, Van den Heuvel M, Neal J, Peled N, Früh M, Ng TL, Gounant V, Popat S, Diebold J, Sabari J, Zhu VW, Rothschild SI, Bironzo P, Martinez-Marti A, Curioni-Fontecedro A, Rosell R, Lattuca-Truc M, Wiesweg M, Besse B, Solomon B, Barlesi F, Schouten RD, Wakelee H, Camidge DR, Zalcman G, Novello S, Ou SI, Milia J, Gautschi O. Immune checkpoint inhibitors for patients with advanced lung cancer and oncogenic driver alterations: results from the IMMUNOTARGET registry. Ann Oncol 2020; 30:1321-1328. [PMID: 31125062 PMCID: PMC7389252 DOI: 10.1093/annonc/mdz167] [Citation(s) in RCA: 759] [Impact Index Per Article: 189.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Anti-PD1/PD-L1 directed immune checkpoint inhibitors (ICI) are widely used to treat patients with advanced non-small-cell lung cancer (NSCLC). The activity of ICI across NSCLC harboring oncogenic alterations is poorly characterized. The aim of our study was to address the efficacy of ICI in the context of oncogenic addiction. Patients and methods We conducted a retrospective study for patients receiving ICI monotherapy for advanced NSCLC with at least one oncogenic driver alteration. Anonymized data were evaluated for clinicopathologic characteristics and outcomes for ICI therapy: best response (RECIST 1.1), progression-free survival (PFS), and overall survival (OS) from ICI initiation. The primary end point was PFS under ICI. Secondary end points were best response (RECIST 1.1) and OS from ICI initiation. Results We studied 551 patients treated in 24 centers from 10 countries. The molecular alterations involved KRAS (n = 271), EGFR (n = 125), BRAF (n = 43), MET (n = 36), HER2 (n = 29), ALK (n = 23), RET (n = 16), ROS1 (n = 7), and multiple drivers (n = 1). Median age was 60 years, gender ratio was 1 : 1, never/former/current smokers were 28%/51%/21%, respectively, and the majority of tumors were adenocarcinoma. The objective response rate by driver alteration was: KRAS = 26%, BRAF = 24%, ROS1 = 17%, MET = 16%, EGFR = 12%, HER2 = 7%, RET = 6%, and ALK = 0%. In the entire cohort, median PFS was 2.8 months, OS 13.3 months, and the best response rate 19%. In a subgroup analysis, median PFS (in months) was 2.1 for EGFR, 3.2 for KRAS, 2.5 for ALK, 3.1 for BRAF, 2.5 for HER2, 2.1 for RET, and 3.4 for MET. In certain subgroups, PFS was positively associated with PD-L1 expression (KRAS, EGFR) and with smoking status (BRAF, HER2). Conclusions : ICI induced regression in some tumors with actionable driver alterations, but clinical activity was lower compared with the KRAS group and the lack of response in the ALK group was notable. Patients with actionable tumor alterations should receive targeted therapies and chemotherapy before considering immunotherapy as a single agent.
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Affiliation(s)
- J Mazieres
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France.
| | - A Drilon
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - A Lusque
- Biostatistics Unit, Institut Claudius Regaud, IUCT-O, Toulouse
| | - L Mhanna
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - A B Cortot
- Thoracic Oncology Department, Lille University Hospital, Lille University, Lille
| | - L Mezquita
- Cancer Medicine Department, Gustave Roussy, Villejuif, Paris Sud University Orsay, Paris France
| | - A A Thai
- Medical Oncology Department, Peter MacCallum Cancer Institute, Melbourne, Australia
| | - C Mascaux
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - S Couraud
- Respiratory Diseases and Thoracic Oncology Department, Lyon Sud Hospital, Cancer Institute of Hospices Civils de Lyon, Lyon 1 University
| | - R Veillon
- CHU Bordeaux, Respiratory Diseases Department, Bordeaux, France
| | - M Van den Heuvel
- Faculty of Medical Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Neal
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, USA
| | - N Peled
- Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel
| | - M Früh
- Department of Oncology, Haematology, Cantonal Hospital St Gallen, St Gallen, University of Bern, Switzerland
| | - T L Ng
- Thoracic Oncology Department, University of Colorado Cancer Center, Aurora, USA
| | - V Gounant
- Department of Thoracic Oncology, CIC1425-CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - S Popat
- Royal Marsden Hospital, London, UK
| | - J Diebold
- Cantonal Hospital, Lucerne, Switzerland
| | - J Sabari
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - V W Zhu
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine School of Medicine, Orange, USA
| | - S I Rothschild
- Department Internal Medicine, University Hospital Basel, Medical Oncology, Basel, Switzerland
| | - P Bironzo
- Department of Oncology, University of Torino, Torino, Italy
| | - A Martinez-Marti
- Medical Oncology Department, Vall d'Hebron Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - R Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - M Lattuca-Truc
- Pulmonology Department, Grenoble University Hospital, Grenoble, France
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - B Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, Paris Sud University Orsay, Paris France
| | - B Solomon
- Medical Oncology Department, Peter MacCallum Cancer Institute, Melbourne, Australia
| | - F Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - R D Schouten
- Faculty of Medical Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H Wakelee
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, USA
| | - D R Camidge
- Thoracic Oncology Department, University of Colorado Cancer Center, Aurora, USA
| | - G Zalcman
- Department of Thoracic Oncology, CIC1425-CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - S Novello
- Department of Oncology, University of Torino, Torino, Italy
| | - S I Ou
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine School of Medicine, Orange, USA
| | - J Milia
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - O Gautschi
- University of Bern and Cantonal Hospital, Lucerne, Switzerland
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Coliat P, Ramolu L, Jégu J, Gaiddon C, Jung AC, Pencreach E. Constitutive or Induced HIF-2 Addiction is Involved in Resistance to Anti-EGFR Treatment and Radiation Therapy in HNSCC. Cancers (Basel) 2019; 11:cancers11101607. [PMID: 31640284 PMCID: PMC6827016 DOI: 10.3390/cancers11101607] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/29/2019] [Revised: 10/14/2019] [Accepted: 10/17/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND management of head and neck squamous cell carcinomas (HNSCC) include anti-Epidermal Growth Factor Receptor (EGFR) antibodies and radiotherapy, but resistance emerges in most patients. RAS mutations lead to primary resistance to EGFR blockade in metastatic colorectal cancer but are infrequent in HNSCC, suggesting that other mechanisms are implicated. Since hypoxia and Hypoxia Inducible Factor-1 (HIF-1) have been associated with treatment failure and tumor progression, we hypothesized that EGFR/mammalian Target Of Rapamycin (mTOR)/HIF-1 axis inhibition could radiosensitize HNSCC. METHODS We treated the radiosensitive Cal27 used as control, and radioresistant SQ20B and UD-SCC1 cells, in vivo and in vitro, with rapamycin and cetuximab before irradiation and evaluated tumor progression and clonogenic survival. RESULTS Rapamycin and cetuximab inhibited the mTOR/HIF-1α axis, and sensitized the SQ20B cell line to EGFR-inhibition. However, concomitant delivery of radiation to SQ20B xenografts increased tumor relapse frequency, despite effective HIF-1 inhibition. Treatment failure was associated with the induction of HIF-2α expression by cetuximab and radiotherapy. Strikingly, SQ20B and UD-SCC1 cells clonogenic survival dropped <30% after HIF-2α silencing, suggesting a HIF-2-dependent mechanism of oncogenic addiction. CONCLUSIONS altogether, our data suggest that resistance to EGFR inhibition combined with radiotherapy in HNSCC may depend on tumor HIF-2 expression and underline the urgent need to develop novel HIF-2 targeted treatments.
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Affiliation(s)
- Pierre Coliat
- Centre de Lutte Contre le Cancer Paul Strauss, 67200 Strasbourg, France.
- Service de Pharmacie, Centre de Lutte Contre le Cancer Paul Strauss, 67200 Strasbourg, France.
- Université de Strasbourg, Inserm, UMR_S1113, 67200 Strasbourg, France.
| | - Ludivine Ramolu
- Centre de Lutte Contre le Cancer Paul Strauss, 67200 Strasbourg, France.
- Université de Strasbourg, Inserm, UMR_S1113, 67200 Strasbourg, France.
| | - Jérémie Jégu
- Université de Strasbourg, Inserm, UMR_S1113, 67200 Strasbourg, France.
- Laboratoire d'Épidémiologie et de Santé Publique, Université de Strasbourg, 67200 Strasbourg, France.
- Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France.
| | - Christian Gaiddon
- Université de Strasbourg, Inserm, UMR_S1113, 67200 Strasbourg, France.
| | - Alain C Jung
- Centre de Lutte Contre le Cancer Paul Strauss, 67200 Strasbourg, France.
- Université de Strasbourg, Inserm, UMR_S1113, 67200 Strasbourg, France.
| | - Erwan Pencreach
- Université de Strasbourg, Inserm, UMR_S1113, 67200 Strasbourg, France.
- Laboratoire de Biochimie et Biologie Moléculaire, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France.
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