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Lange M, Clarisse B, Leconte A, Dembélé KP, Lequesne J, Nicola C, Dubois M, Derues L, Gidron Y, Castel H, Joly F. Cognitive assessment in patients treated by immunotherapy: the prospective Cog-Immuno trial. BMC Cancer 2022; 22:1308. [PMID: 36513991 PMCID: PMC9749352 DOI: 10.1186/s12885-022-10384-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The discovery of the importance of the immune system and its role in oncogenesis led to the development of immunotherapy, a treatment that represents a major advance in oncology management. Due to the recent nature of immunotherapy, little is known about its side effects and their impact on quality of life. To date, there is no published study that accurately assesses the impact of immunotherapy on cognition, mood and/or fatigue in patients treated for cancer, despite potential neurological toxicities. The purpose of this study is to prospectively assess the incidence of cognitive impairment and cognitive complaints among cancer patients naïve for immunotherapy without concomitant anti-cancer treatment. METHODS The Cog-Immuno trial is a multicentre longitudinal study addressing patients with cancer candidate to receive immunotherapy alone (n = 100). Immunotherapy treatment will include either anti-PD1/PDL1 or anti-CTLA4 monotherapy or combination therapy. Cognitive and quality of life assessment, electrocardiogram (ECG) and biological tests will be performed at baseline, thereafter 3, and 6 months after immunotherapy initiation. The primary endpoint is the proportion of patients treated by immunotherapy who will experience a decline in cognitive performances or in Montreal Cognitive Assessment (MoCA) score within 3 months after inclusion. Secondary endpoints concern: anxiety, depression, fatigue, clinical characteristics, biological data and neurophysiological measures (heart rate variability and hemispheric lateralization). A pre-clinical study will be conducted in cancer bearing mice receiving checkpoint inhibitors (ICI) with the evaluation of cognitive functions and emotional reactivity, collection of blood samples and investigation of neurobiological mechanisms from brain slices. DISCUSSION Assessing and understanding the incidence and the severity of cognitive impairment and its impact on quality of life in cancer patients treated by immunotherapy is a major issue. The results of this study will provide information on the impact of these treatments on cognitive functions in order to help the physicians in the choice of the treatment. TRIAL REGISTRATION NCT03599830, registered July 26, 2018. PROTOCOL VERSION Version 5.1 dated from 2020/10/02.
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Affiliation(s)
- Marie Lange
- grid.418189.d0000 0001 2175 1768Clinical Research Department, Centre François Baclesse, 14000 Caen, France ,grid.7429.80000000121866389Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France ,Cancer & Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France
| | - Bénédicte Clarisse
- grid.418189.d0000 0001 2175 1768Clinical Research Department, Centre François Baclesse, 14000 Caen, France
| | - Alexandra Leconte
- grid.418189.d0000 0001 2175 1768Clinical Research Department, Centre François Baclesse, 14000 Caen, France
| | - Kléouforo-Paul Dembélé
- Cancer & Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France ,grid.7429.80000000121866389Normandie University, UNIROUEN, INSERM, U1245, Cancer and Brain Genomics, 76000 Rouen, France ,grid.503198.6Institute for Research and Innovation in Biomedicine (IRIB), 76000 Rouen, France
| | - Justine Lequesne
- grid.418189.d0000 0001 2175 1768Clinical Research Department, Centre François Baclesse, 14000 Caen, France ,grid.7429.80000000121866389Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France ,Cancer & Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France
| | - Celeste Nicola
- Cancer & Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France ,grid.7429.80000000121866389Normandie University, UNIROUEN, INSERM, U1245, Cancer and Brain Genomics, 76000 Rouen, France ,grid.503198.6Institute for Research and Innovation in Biomedicine (IRIB), 76000 Rouen, France
| | - Martine Dubois
- Cancer & Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France ,grid.7429.80000000121866389Normandie University, UNIROUEN, INSERM, U1245, Cancer and Brain Genomics, 76000 Rouen, France ,grid.503198.6Institute for Research and Innovation in Biomedicine (IRIB), 76000 Rouen, France
| | - Laurence Derues
- Cancer & Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France ,grid.7429.80000000121866389Normandie University, UNIROUEN, INSERM, U1245, Cancer and Brain Genomics, 76000 Rouen, France ,grid.503198.6Institute for Research and Innovation in Biomedicine (IRIB), 76000 Rouen, France
| | - Yori Gidron
- grid.18098.380000 0004 1937 0562Dept. of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Hélène Castel
- Cancer & Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France ,grid.7429.80000000121866389Normandie University, UNIROUEN, INSERM, U1245, Cancer and Brain Genomics, 76000 Rouen, France ,grid.503198.6Institute for Research and Innovation in Biomedicine (IRIB), 76000 Rouen, France
| | - Florence Joly
- grid.418189.d0000 0001 2175 1768Clinical Research Department, Centre François Baclesse, 14000 Caen, France ,grid.7429.80000000121866389Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France ,Cancer & Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France ,grid.418189.d0000 0001 2175 1768Medical oncology department, Centre François Baclesse, 14000 Caen, France
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Dubois M, Ardin C, André F, Scherpereel A, Mortier L. [The revolution of immuno-oncology therapy: review of immune checkpoint inhibitors efficacy]. Med Sci (Paris) 2020; 35:937-945. [PMID: 31903897 DOI: 10.1051/medsci/2019225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Immunotherapy represents a major paradigm shift, as the treatment no longer directly targets tumor cells, but the patient him/herself, in order to restore an effective anti-tumor immunity. This article illustrates the growing place of immune checkpoint inhibitors in the available therapeutic options, by focusing on two cancers with poor outcome: metastatic melanoma and metastatic non-small cell lung cancer (NSCLC), against which Immune checkpoints inhibitors now occupy a central place. Many questions remain unresolved, such as the search for markers predicting a good response to treatment, which would allow the selection of responder patients. Numerous trials are in progress, evaluating the relevance of these new molecules at earlier stages of the disease (adjuvant and neoadjuvant strategies) and their place in combined strategies (associated with chemotherapy, targeted therapies, and other types of immunotherapy).
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Affiliation(s)
- Manon Dubois
- Service de dermatologie, CHU Lille, Lille, France
| | - Camille Ardin
- Service de pneumologie et oncologie thoracique, CHU Lille, Lille, France
| | - Fanny André
- Service de dermatologie, CHU Lille, Lille, France
| | - Arnaud Scherpereel
- Service de pneumologie et oncologie thoracique, CHU Lille, Lille, France - Université de Lille, Lille, France - Unité Inserm 1189 OncoThAI, Lille, France
| | - Laurent Mortier
- Service de dermatologie, CHU Lille, Lille, France - Université de Lille, Lille, France - Unité Inserm 1189 OncoThAI, Lille, France
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Campedel L, Assoun S, Bécourt S, Nguyen O, Ledoux F, Doucet L, Espié M, Teixeira L. Toxicités sévères des immunothérapies du cancer. MEDECINE INTENSIVE REANIMATION 2018. [DOI: 10.3166/rea-2018-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
L’immunothérapie représente une avancée récente et importante en cancérologie. Les inhibiteurs de checkpoints immunitaires, ciblant les protéines PD-1, PD-L1 et CTLA-4, sont les thérapies les plus prometteuses et sont utilisés dans la prise en charge de plusieurs cancers. Les toxicités associées à ces traitements sont généralement moins fréquentes et moins graves que celles associées aux chimiothérapies et à la plupart des thérapies ciblées. Cependant, il existe un certain nombre de toxicités spécifiques de ce type de traitement, qui peuvent parfois être sévères et dont les plus fréquentes sont les toxicités pulmonaire, digestive, endocrinienne et cutanée. Dans cette mise au point, nous reviendrons sur la fréquence, le mécanisme et les principes de traitement des différentes toxicités sévères associées à l’immunothérapie.
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Rancoule C, Guy JB, Vallard A, Ben Mrad M, Rehailia A, Magné N. [50th anniversary of cisplatin]. Bull Cancer 2016; 104:167-176. [PMID: 27989629 DOI: 10.1016/j.bulcan.2016.11.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/06/2016] [Accepted: 11/12/2016] [Indexed: 01/08/2023]
Abstract
We have just celebrated the 50th anniversary of cisplatin cytotoxic potential discovery. It is time to take stock… and it seems mainly positive. This drug, that revolutionized the treatment of many cancer types, continues to be the most widely prescribed chemotherapy. Despite significant toxicities, resistance mechanisms associated with treatment failures, and unresolved questions about its mechanism of action, the use of this cytotoxic agent remains unwavering. The interest concerning this "old" invincible drug has not yet abated. Indeed many research axes are in the news. New platinum salts agents are tested, new cisplatin formulations are developed to target tumor cells more efficiently, and new combinations are established to increase the cytotoxic potency of cisplatin or overcome the resistance mechanisms.
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Affiliation(s)
- Chloé Rancoule
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez, France; CNRS UMR 5822, laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, 165, chemin du Grand-Revoyet, BP 12, 69921 Oullins cedex, France
| | - Jean-Baptiste Guy
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez, France; CNRS UMR 5822, laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, 165, chemin du Grand-Revoyet, BP 12, 69921 Oullins cedex, France
| | - Alexis Vallard
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez, France
| | - Majed Ben Mrad
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez, France
| | - Amel Rehailia
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez, France
| | - Nicolas Magné
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez, France; CNRS UMR 5822, laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, 165, chemin du Grand-Revoyet, BP 12, 69921 Oullins cedex, France.
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