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Peuvrel L, Cassecuel J, Bernier C, Joubert A, Saint-Jean M, Quereux G, Le Moigne M, Brocard A, Khammari A, Dréno B. Toxican : un outil à d’aide à la cotation des toxicités cutanées des traitements anticancéreux au quotidien. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Frenard C, Peuvrel L, Saint-Jean M, Brocard A, NGuyen JM, Khammari A, Quereux G, Dreno B. Étude de la survenue de métastases cérébrales sous traitement par ipilimumab de mélanomes métastatiques. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.490] [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: 10/22/2022]
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Knol A, Vallée A, Varey E, Nguyen JM, Herbreteau G, Théoleyre S, Saint-Jean M, Quéreux G, Peuvrel L, Brocard A, Khammari A, Denis M, Dréno B. Détection de mutations de BRAF dans le plasma de patients atteints de mélanome métastatique. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.083] [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: 10/22/2022]
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Martin C, Bouwes Bavinck JN, Decullier E, Brocard A, Von Elsäcker M, Lebbé C, Francès C, Morelon E, Glotz D, Legendre C, Joly P, Ducroux E, Kanitakis J, Euvrard S, Dantal J. Étude de 62 greffés rénaux ayant eu au moins un carcinome épidermoïde après greffe en cas de retransplantation. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.008] [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: 10/22/2022]
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Le Naour S, Saint-Jean M, Peuvrel L, Quéreux G, Brocard A, Dréno B. Premier cas d’érythème polymorphe sous anti-PD-1 (nivolumab). Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.571] [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: 10/22/2022]
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Peuvrel L, Quéreux G, Saint-Jean M, Brocard A, Nguyen JM, Khammari A, Knol AC, Varey E, Dréno B. Profile of vemurafenib-induced severe skin toxicities. J Eur Acad Dermatol Venereol 2015; 30:250-7. [PMID: 26524690 DOI: 10.1111/jdv.13443] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 09/04/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Vemurafenib, a BRAF inhibitor, is commonly associated with skin toxicity. The impact of severe forms is unknown. OBJECTIVE To determine the rate of permanent vemurafenib discontinuation due to grade 3-4 skin toxicity, features of these toxicities, their recurrence rate after a switch to dabrafenib and their impact on overall survival. METHODS Retrospective cohort study of 131 patients treated with vemurafenib for melanoma between November 2010 and December 2014. Data on skin toxicities, the need for vemurafenib adjustment and the impact of switching to dabrafenib were collected. Regarding survival analysis, a conditional landmark analysis was performed to correct lead-time bias. RESULTS Among the 131 vemurafenib-treated patients, 26% developed grade 3-4 skin toxicity. Forty-four percent of them permanently discontinued their treatment, mainly due to rash and classic skin adverse reactions (Steven-Johnson syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms). Conversely, photosensitivity and carcinomas rarely required treatment adjustment. Grade 3-4 rashes were associated with clinical or biological abnormalities in 94% of patients. Among the 10 patients who subsequently switched to dabrafenib, skin toxicity recurred only in one patient. Overall survival was significantly prolonged in case of severe skin toxicity emerging within the first 4 (P = 0.014) and 8 weeks (P = 0.038) on vemurafenib, with only a trend at 12 weeks (P = 0.052). Median overall survival was also prolonged in case of severe rash. CONCLUSION In this study, vemurafenib was continued in 56% of patients with grade 3-4 skin toxicity, which was associated with prolonged overall survival when emerging within the first 4 and 8 weeks of treatment. While developing severe skin adverse reactions permanently contraindicates vemurafenib use, other rashes should lead to retreatment attempts with dose reduction. In case of recurrence, dabrafenib seems to be an interesting option. For other skin toxicities, including photosensitivity and cutaneous carcinoma, treatment adjustment is usually not needed.
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Affiliation(s)
- L Peuvrel
- Department of Dermatology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
| | - G Quéreux
- Department of Dermatology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
| | - M Saint-Jean
- Department of Dermatology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
| | - A Brocard
- Department of Dermatology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
| | - J M Nguyen
- Department of Epidemiology and Biostatistics, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
| | - A Khammari
- Department of Dermatology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
| | - A C Knol
- Department of Dermatology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
| | - E Varey
- Department of Dermatology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
| | - B Dréno
- Department of Dermatology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
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Frenard C, Peuvrel L, Jean MS, Brocard A, Knol AC, Nguyen JM, Khammari A, Quereux G, Dreno B. Development of brain metastases in patients with metastatic melanoma while receiving ipilimumab. J Neurooncol 2015; 126:355-60. [PMID: 26511495 DOI: 10.1007/s11060-015-1977-9] [Citation(s) in RCA: 12] [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] [Received: 07/03/2015] [Accepted: 10/25/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED Ipilimumab is a monoclonal antibody blocking the inhibitory molecule CTLA4 expressed by activated T lympocytes, used for the treatment of metastatic melanoma. Recent studies have shown its potential efficacy on brain metastases. OBJECTIVES To assess the development of brain metastases under ipilimumab and identify clinical, histological or evolving criteria related to the appearance of these metastases. A retrospective study was conducted in 52 patients treated with 4 cycles of ipilimumab 3 mg/kg every 3 weeks for unresectable stage III or stage IV melanoma between January 2011 and July 2013 in a Department of Dermato-Oncology. As no data has been find in the literature, the results were compared to our other cohort of patients treated with vemurafenib during the same period. Ten patients (21.7 %) developed brain metastases under ipilimumab in a median time of 6.58 months after treatment initiation. The multivariate analysis showed a lower rate of brain metastases in patients with acral lentiginous melanoma and melanoma of unknown primary site. The median survival after diagnosis of brain metastases was of 2.5 months. There was no significant difference with vemurafenib-treated patients in terms of incidence rate of brain metastasis, time of development and survival after diagnosis of cerebral metastases. This was the first study focused on the development of brain metastases under treatment with ipilimumab 3 mg/kg. Although ipilimumab is used for the treatment of brain metastases, it paradoxically did not seem to reduce the risk of developing brain metastases.
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Affiliation(s)
- C Frenard
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France
| | - L Peuvrel
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France
| | - M Saint Jean
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France
| | - A Brocard
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France
| | - A C Knol
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France
| | - J M Nguyen
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France
| | - A Khammari
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France
| | - G Quereux
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France
| | - B Dreno
- Department of dermatology, Skin Cancer Unit, Nantes University Hospital, INSERM 892, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France.
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Haim H, Dutartre H, Saint-Jean M, Brocard A, Peuvrel L, Quéreux G, Dréno B. [Diagnostic pitfalls of solar urticaria]. Ann Dermatol Venereol 2015; 142:299-300. [PMID: 25813186 DOI: 10.1016/j.annder.2014.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 11/09/2014] [Accepted: 12/29/2014] [Indexed: 11/30/2022]
Affiliation(s)
- H Haim
- Service de dermatologie, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - H Dutartre
- Service de dermatologie, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - M Saint-Jean
- Service de dermatologie, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - A Brocard
- Service de dermatologie, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - L Peuvrel
- Service de dermatologie, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - G Quéreux
- Service de dermatologie, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - B Dréno
- Service de dermatologie, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
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Guillet A, Brocard A, Bach Ngohou K, Graveline N, Leloup AG, Ali D, Nguyen JM, Loirat MJ, Chevalier C, Khammari A, Dreno B. Verneuil's disease, innate immunity and vitamin D: a pilot study. J Eur Acad Dermatol Venereol 2014; 29:1347-53. [PMID: 25512084 DOI: 10.1111/jdv.12857] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 10/17/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Verneuil's disease is a chronic inflammatory skin disease of the follicles in apocrine glands rich area of the skin (axillary, inguinal, anogenital) and is associated with a deficient skin innate immunity. It is characterized by the occurrence of nodules, abscesses, fistulas, scars. Recently, vitamin D has been shown to stimulate skin innate immunity. OBJECTIVE The primary objective of the study was to assess whether Verneuil's disease was associated with vitamin D deficiency. The secondary objective was to determine whether vitamin D supplementation could improve inflammatory lesions. METHODS First, 25(OH) vitamin D3 serum levels in patients with Verneuil's disease followed at Nantes University Hospital were compared to those of healthy donors from the French Blood Bank. Then, a pilot study was conducted in 14 patients supplemented with vitamin D according to their vitamin D level at baseline at months 3 and 6. The endpoints at 6 months were decreased by at least 20% in the number of nodules and in the frequency of flare-ups. RESULTS Twenty-two patients (100%) had vitamin D deficiency (level <30 ng/mL) of whom 36% were severely deficient (level <10 ng/mL), having correlation with the disease severity (P = 0.03268) vs. 20 controls with vitamin D deficiency (91%) of whom 14% were severely deficient. In 14 patients, the supplementation significantly decreased the number of nodules at 6 months (P = 0.01133), and the endpoints were achieved in 79% of these patients. A correlation between the therapeutic success and the importance of the increase in vitamin D level after supplementation was observed (P = 0.01099). CONCLUSION Our study shows that Verneuil's disease is associated with a major vitamin D deficiency, correlated with the disease severity. It suggests that vitamin D could significantly improve the inflammatory nodules, probably by stimulating the skin innate immunity. A larger randomized study is needed to confirm these findings.
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Affiliation(s)
- A Guillet
- Service de Dermato-Cancérologie, CHU Hôtel-Dieu, Nantes, France
| | - A Brocard
- Service de Dermato-Cancérologie, CHU Hôtel-Dieu, Nantes, France
| | - K Bach Ngohou
- Laboratoire de radio-immunologie, CHU Hôtel Dieu, Nantes, France
| | - N Graveline
- Laboratoire de radio-immunologie, CHU Hôtel Dieu, Nantes, France
| | - A-G Leloup
- Laboratoire de radio-immunologie, CHU Hôtel Dieu, Nantes, France
| | - D Ali
- Laboratoire de radio-immunologie, CHU Hôtel Dieu, Nantes, France
| | - J-M Nguyen
- Service de santé publique PIMESP, Hôpital Saint Jacques, Nantes, France
| | - M-J Loirat
- Etablissement Français du Sang, CHU Hôtel Dieu, Nantes, France
| | - C Chevalier
- Etablissement Français du Sang, CHU Hôtel Dieu, Nantes, France
| | - A Khammari
- Service de Dermato-Cancérologie, CHU Hôtel-Dieu, Nantes, France
| | - B Dreno
- Service de Dermato-Cancérologie, CHU Hôtel-Dieu, Nantes, France
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Munch M, Quereux G, Peuvrel L, Brocard A, Saint Jean M, Dreno B, Khammari A. Apparition rare d’un DRESS syndrome sous vémurafénib. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Guillet A, Brocard A, Bach K, Chevalier C, Nguyen JM, Graveline N, Leloupp AG, Loirat MJ, Khammari A, Dreno B. Déficit en vitamine D et supplémentation dans la maladie de Verneuil : étude pilote. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jirka A, Saint-Jean M, Le Moigne M, Quéreux G, Peuvrel L, Brocard A, Khammari A, Darmaun D, Dréno B. P273: Dysgueusie et dénutrition au cours des traitements par le vismodegib : effet d’une prise en charge nutritionnelle. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70915-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Frenard C, Peuvrel L, Brocard A, Saint Jean M, Dreno B, Quereux G. Réponse spectaculaire d’un carcinome de Merkel sous imatinib. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.203] [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: 10/24/2022]
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Quereux G, Brocard A, Peuvrel L, Saint-Jean M, Wylomanski S, Bouquin R, Vaucel E, Dréno B. Mélanomes vaginaux et vulvaires métastatiques : intérêt de l’ipilimumab ? Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.081] [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: 10/24/2022]
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Haim H, Dutartre H, Saint-Jean M, Brocard A, Peuvrel L, Querreux G, Dréno B. Quand les habits aident au diagnostic d’une photodermatose rare. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Haim H, Hurault M, Renaud JJ, Saint-Jean M, Brocard A, Peuvrel L, Quéreux G, Dréno B. Acneiform rash: an unusual presentation of epithelioid haemangioma. J Eur Acad Dermatol Venereol 2014; 30:470-2. [PMID: 25376982 DOI: 10.1111/jdv.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Haim
- Department of Oncodermatology, CHU Hôtel Dieu, Nantes, France
| | - M Hurault
- Department of Oncodermatology, CHU Hôtel Dieu, Nantes, France
| | - J J Renaud
- Department of Oncodermatology, CHU Hôtel Dieu, Nantes, France
| | - M Saint-Jean
- Department of Oncodermatology, CHU Hôtel Dieu, Nantes, France
| | - A Brocard
- Department of Oncodermatology, CHU Hôtel Dieu, Nantes, France
| | - L Peuvrel
- Department of Oncodermatology, CHU Hôtel Dieu, Nantes, France
| | - G Quéreux
- Department of Oncodermatology, CHU Hôtel Dieu, Nantes, France
| | - B Dréno
- Department of Oncodermatology, CHU Hôtel Dieu, Nantes, France
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Saintes C, Saint-Jean M, Brocard A, Peuvrel L, Renaut JJ, Khammari A, Quéreux G, Dréno B. Development of squamous cell carcinoma into basal cell carcinoma under treatment with Vismodegib. J Eur Acad Dermatol Venereol 2014; 29:1006-9. [PMID: 24980899 DOI: 10.1111/jdv.12526] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 03/17/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common cancer in humans. Vismodegib, a Hedgehog pathway inhibitor, has proved its effectiveness in treating non-resectable advanced BCC. AIM However, its action on squamous cell carcinoma (SCC) is unknown. We present three SCC cases developed into BCC in vismodegib-treated patients. MATERIAL AND METHODS We have described three cases of patients developing SCC during treatment by vismodegib for BCC. RESULTS Patient 1 was treated with vismodegib for five facial BCC. Due to the progression of one of the lesions at month 3 (M3), a biopsy was performed and showed SCC. Patient 2 was treated with vismodegib for a large facial BCC. A biopsy was performed at M2 on a BCC area not responding to treatment and showed SCC. Patient 3 was treated with vismodegib for a BCC on the nose. Due to vismodegib ineffectiveness, a biopsy was performed and showed SCC. DISCUSSION Two similar cases have been described in the literature. This could be due to the appearance of the squamous contingent of a metatypical BCC or to the squamous differentiation of stem cells through inhibition of the hedgehog pathway. CONCLUSION In practice, any dissociated response of a BCC to vismodegib should be biopsied.
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Affiliation(s)
- C Saintes
- Skin Cancer Unit, CHU Hôtel Dieu, Nantes, France
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Saint-Jean M, Brocard A, Quereux G, Nguyen JM, Peuvrel L, Knol AC, Khammari A, Denis M, Dréno B. Efficacité du vemurafenib chez deux patients atteints de mélanome métastatique BRAF discordant. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Quereux G, Saint-Jean M, Brocard A, Peuvrel L, Renaut JJ, Dréno B. Efficacité spectaculaire du brentuximab vedotin dans deux cas de lymphome cutané T épidermotrope en impasse thérapeutique. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Le Moigne M, Saint-Jean M, Jirka A, Quéreux G, Peuvrel L, Brocard A, Khammari A, Darmaun D, Dréno B. Dysgueusie et perte de poids sous vismodegib : intérêt d’une prise en charge nutritionnelle spécifique. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.069] [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: 10/26/2022]
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Leloup P, Nguyen JM, Quéreux G, Saint-Jean M, Peuvrel L, Brocard A, Dréno B. Predictive value of T-cell clone and CD13 antigen in parapsoriasis. J Eur Acad Dermatol Venereol 2013; 28:518-20. [PMID: 23859066 DOI: 10.1111/jdv.12212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 06/12/2013] [Indexed: 11/29/2022]
Affiliation(s)
- P Leloup
- Department of Skin Oncology, University Hospital, Nantes, France
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Peuvrel L, Chiffoleau A, Quéreux G, Brocard A, Saint-Jean M, Batz A, Jolliet P, Dréno B. Melanoma and rituximab: an incidental association? Dermatology 2013; 226:274-8. [PMID: 23941917 DOI: 10.1159/000350681] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 03/11/2013] [Indexed: 11/19/2022] Open
Abstract
Rituximab is an anti-CD20 monoclonal antibody increasingly used in haematology and rheumatology, but also in internal medicine and dermatology. It has a good tolerance profile without known increased risk of cancer. We report a case of nodular melanoma with a 4.8 mm Breslow thickness that appeared after 2 years of rituximab in a 45-year-old patient with non-Hodgkin lymphoma. Fifteen additional rituximab-associated melanoma cases in 13 patients have been identified in the literature and in the EudraVigilance database. These patients were treated for various indications and had melanomas, often aggressive, initially diagnosed at a metastatic stage in 31% of cases. Our work raises the question of rituximab accountability in melanoma onset in these immunosuppressed patients. A dermatological monitoring seems necessary in patients treated with rituximab, especially in case of risk factors for melanoma. In case of individual melanoma history, the benefit/risk ratio of initiating rituximab therapy should be carefully assessed.
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Affiliation(s)
- L Peuvrel
- Department of Dermato-Cancerology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France
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Quereux G, Brocard A, Peuvrel L, Saint-Jean M, Knol AC, Renaut JJ, Khammari A, Dréno B. Traitement du mycosis fongoïde par photothérapie dynamique : étude prospective. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Quereux G, Saint-Jean M, Peuvrel L, Brocard A, Renaut JJ, Dréno B. Dix ans de traitement du lymphome cutané T épidermotrope par bexarotène. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kogge A, Saint-Jean M, Peuvrel L, Knol AC, Brocard A, Dréno B, Quereux G. Efficacité du vorinostat dans les lymphomes cutanés T réfractaires ou récidivant après traitement systémique. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.048] [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: 10/27/2022]
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Saint-Jean M, Quéreux G, Peuvrel L, Brocard A, Knol AC, Saiag S, Khammari A, Bedane C, Basset-Seguin N, Dréno B. Intérêt du traitement par TILs (Tumor-Infiltrating Lymphocytes) dans le mélanome métastatique. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Peuvrel L, Quéreux G, Saint-Jean M, Brocard A, Dréno B. Bilan à un an d’une consultation dédiée aux effets indésirables cutanés des traitements anticancéreux. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.535] [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: 10/27/2022]
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Peuvrel L, Quéreux G, Brocard A, Saint-Jean M, Dréno B. Onychopathy Induced by Temsirolimus, a Mammalian Target of Rapamycin Inhibitor. Dermatology 2012; 224:204-8. [DOI: 10.1159/000338893] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 04/17/2012] [Indexed: 11/19/2022] Open
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Quereux G, Bouquin R, Causse S, Peuvrel L, Brocard A, Wylomanski S, Dréno B. Réponse spectaculaire d’une maladie de Crohn vulvaire à l’infliximab. Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.10.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Quéreux G, Brocard A, Peuvrel L, Knol AC, Renaut JJ, Dréno B. Granulomatose lymphomatoïde de révélation cutanée. Ann Dermatol Venereol 2011; 138:591-6. [DOI: 10.1016/j.annder.2011.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 01/27/2011] [Accepted: 02/21/2011] [Indexed: 11/30/2022]
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Peuvrel L, Nguyen JM, Khammari A, Quereux G, Brocard A, Dreno B. Is primary melanoma ulceration a factor of good response to adoptive immunotherapy? J Eur Acad Dermatol Venereol 2011; 25:1311-7. [PMID: 21348897 DOI: 10.1111/j.1468-3083.2011.03978.x] [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: 11/28/2022]
Abstract
BACKGROUND Primary melanoma ulceration is a factor of poor prognosis at the local and regional stage. The physiopathological mechanisms which explain its prognostic impact are still little known. However, two recent studies suggest that it could be a predictive factor of good response to a non-specific immunotherapy (interferon-alpha) and to an active immunotherapy (vaccine). OBJECTIVE The aim of this study was to determine whether ulceration could be a factor of good prognosis in the context of an adoptive immunotherapy with tumour infiltrating lymphocytes (TIL) in stage III regional lymph node metastatic melanoma (sixth American Joint Committee on Cancer staging system) and whether it was associated with an improvement in the effectiveness of this treatment compared with the control group. METHODS We have included all the patients treated in open prospective randomized TIL vs. control protocols in our unit from 1997 to 2009. Clinical data were derived retrospectively from patient files. Statistical analysis was performed using log-rank tests, Cox models and tests for interaction. RESULTS A total of 144 patients were included. In the group of 80 patients treated with TIL, primary melanoma ulceration remained a pejorative factor for relapse-free and overall survival in univariate and multivariate analysis. The presence of ulceration did not change the effectiveness of TIL treatment in comparison with the control group with regards to relapse-free and overall survival. CONCLUSION Our study demonstrates that primary melanoma ulceration does not have any impact on the response to TIL adoptive immunotherapy and thus does not confirm its positive prognostic value suggested by two other immunotherapy approaches.
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Affiliation(s)
- L Peuvrel
- Nantes University Hospital Centre, Skin Cancer Unit, Alexis Ricordeau CIC biothérapie, INSERM 0305, Nantes, France
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Quéreux G, Brocard A, Dréno B. [Dacarbazine: deticene]. Ann Dermatol Venereol 2008; 134:1001-3. [PMID: 18166926 DOI: 10.1016/s0151-9638(07)78266-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- G Quéreux
- Service de Dermatologie, Hôtel-Dieu, 1, place Alexis Ricordeau, 44093 Nantes Cedex 1
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Abstract
INTRODUCTION Thalidomide is the second line treatment of chronic lupus erythematosus. The efficacy of this treatment, the minimal effective doses and tolerance are poorly documented in the literature. PATIENTS AND METHODS We present the data of a single-center retrospective studied among 18 patients with chronic lupus erythematosus, treated with thalidomide from 1998 to 2003. Inclusion criteria were: the presence of clinical lesions evoking the disease, confirmed by histological examination and direct immunofluorescence and treatment with thalidomide for more than 2 months. RESULTS Mean age on diagnosis was of 35.8 years. Thalidomide had been initiated a mean of 10.6 years after diagnosis of chronic lupus erythematosus. In 13 out of 18 patients, thalidomide had been prescribed because of failure with prior treatments. Fifteen patients were improved by thalidomide (83.3 p. 100), with 11 (61 p. 100) complete and 4 (22 p. 100) partial remissions. Two (11 p. 100) patients were stabilized and treatment failed in one. The mean initial dose was of 100 mg/d (50-150), and maintenance dose was of around 50 mg/d (56 mg/d). The mean follow-up with thalidomide was of 19.4 months. Only one withdrawal due to side effects was reported. The most frequent side effects were: asthenia (33 p. 100), paresthesia (22 p. 100) and weight gain (16.6 p. 100). No side effects were reported in 10 out of 18 patients. DISCUSSION This study confirms the efficacy of low dose thalidomide in the treatment of chronic lupus erythematosus. In our experience, tolerance to this treatment is good, the most frequent side effect was asthenia, but usually mild. No significant peripheral neuropathy was noted. The fear of side effects, notably neurological, should not delay initiation of thalidomide in the case of failure with current treatments.
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Affiliation(s)
- A Brocard
- Clinique Dermatologique, CHU Hôtel-Dieu, Nantes
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Pontet F, Halimi C, Brocard A, Delacour T. Biclonal immunoglobulin M dysglobulinaemia: evolving aspects in a case of primary Sjögren's syndrome. Eur J Clin Chem Clin Biochem 1997; 35:287-90. [PMID: 9166971 DOI: 10.1515/cclm.1997.35.4.287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The observation of suggestive clinical symptoms in a patient suffering from a Gougerot-Sjögren syndrome led to a search for a cryoglobulin. Unusual physico-chemical features of this cryoglobulin were discovered, using standard electrophoresis, immunoelectrophoresis, immunofixation and electroimmunotransfer. The main unusual finding was that the cryoprecipitate was made up of a biclonal IgM kappa associated to polyclonal IgG. Therefore, we suggest that this new form of cryoglobulin be classified as a subtype IIb, thus distinguishing two subtypes in the usual classification.
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Affiliation(s)
- F Pontet
- Service de Biochimie, Hôpital Lariboisière, Paris, France
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Savier C, Galloueduc C, Dieudonné P, Bru M, Gattineau Y, Tardieu P, Monod O, Brocard A. [Reversed pulmonary arterial circulation (4 observations of segmental areas)]. J Fr Med Chir Thorac 1969; 23:309-20. [PMID: 5383369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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