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Loirat D, de la barre MD, Thery JC, Hrab I, Jouannaud C, Mouysset JL, Salabert L, Soibinet P, Mailliez A, Valery R, Creisson A, Villanueva C, Dohollou N, Fumet JD, grellety T, Perez-staub N, Lachaier E, Iltis-roux A, delbado M, Najem A, Scodan RL, Curtit E, aldabbagh K, Pujol P, DE LA MOTTE ROUGE T. Abstract P4-01-20: Phase IV study evaluating talazoparib in patients with locally advanced or metastatic negative HER2 breast cancer and a somatic or germline BRCA1/2 mutation (ViTAL) – Analysis of cohort 1 according to hormonal receptor status. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-01-20] [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: 03/06/2023]
Abstract
Abstract
Background: Talazoparib (TALA) is a highly potent, dual-mechanism PARP inhibitor that has demonstrated clinical benefit in EMBRACA Phase III trial for patients with germline BRCA1/2 mutated locally advanced or metastatic HER2- breast cancer.
Objective: The aim of the study is to ensure the effectiveness and safety of TALA in real-life setting among patients with locally advanced or metastatic HER2- breast cancer, with somatic or germline BRCA1/2 mutation.
Methods: ViTAL is an ambispective, multicentric, longitudinal, phase IV study. It includes two ambispective cohorts:
- Cohort 1: patients treated through the French Early Access Program and inclusion of patients with somatic BRCA1/2 mutation was allowed.
- Cohort 2: patients treated according to the European Marketing Approval granted in 09/21/2021.
Here we present the results of the primary and some secondary endpoints for cohort 1.
Results: From November 2018 to May 2021, 86 patients were included in Cohort 1, with updated results after a median follow-up of 17.3 months (11.2 - 24.4).
Patients’ characteristics are 53.5% of ER+ BC/46.5% of TNBC (refer to the table).
The median Time to Treatment Discontinuation (mTTD) was 9.0 months [range 6.0; 11.5] with 37.7% of patients still on treatment at 12 months. Subgroup analysis shows similar mTTD according HR status, germline vs somatic mutation and prior platinum exposure (refer to the table).
The Clinical Benefit Rate assessed by the investigators is 82.4% (Complete Response for 25.7%, Partial response R for 32.4% and stable disease for 24.3%).
The median of duration of CNS metastases control was 6.6 months, and 80.0% of patients had control of CNS metastases during TALA.
Out of the 85 treated patients, 69 patients (80,2%) experienced a TALA permanent discontinuation for progressive disease (84.1%), toxicity (10.1%), cancer-related death (1.4%), or other reasons (1.4%).
After discontinuation of TALA, 65.1% of patients received a subsequent treatment with a TTD of 2.3 months [1.7; 2.7]. The most common subsequent treatments were non-platinum chemotherapy (64.3%), platinum chemotherapy (19.6%) and others (19.1%).
At least one adverse events (AEs) was recorded in 74.4% of patients. Hematologic AEs (any grade) occurred in 48.8% (anemia 27.9%, thrombocytopenia 12.8%, neutropenia 10.5%).
Most common non-hematologic AEs were alopecia (8.1%) and asthenia (7.0%). Related Serious Hematologic AEs occurred in 10 patients (11.6%) including 7 (8.1%) Anemia.
Related Serious Non-hematologic AEs (vomiting, pyelonephritis and ascitis) were seen in 3 patients (3.6%). AEs associated with temporary drug interruption, dose modification and permanent drug discontinuation occurred in 36 (41.9%), 24 (27.9%), and 7 (10.1%) patients respectively.
The mOS is expected to be reached at the time of the congress, with 51.9% of patients still alive at 24 months.
Conclusions: ViTAL is the largest study that reports real-word data with TALA. Outcomes and safety in Cohort 1 are consistent with the results of EMBRACA study and give additional data on subgroups of interest (ie patients previously treated with carboplatin, presence of CNS).
(Litton et al. NEJM 2018)
mTTD on subgroups of interest
Patients’ characteristics
Citation Format: Delphine Loirat, Marie Duboys de la barre, Jean-Christophe Thery, Ioana Hrab, Christelle Jouannaud, Jean-Loup Mouysset, Laura Salabert, Pauline Soibinet, Audrey Mailliez, Romain Valery, Anne Creisson, Cristian Villanueva, Nadine Dohollou, Jean-david Fumet, Thomas grellety, Nathalie Perez-staub, Emma Lachaier, Aurore Iltis-roux, Miguel delbado, Abeer Najem, Romuald Le Scodan, Elsa Curtit, kais aldabbagh, Pascal Pujol, thibault DE LA MOTTE ROUGE. Phase IV study evaluating talazoparib in patients with locally advanced or metastatic negative HER2 breast cancer and a somatic or germline BRCA1/2 mutation (ViTAL) – Analysis of cohort 1 according to hormonal receptor status [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-01-20.
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Affiliation(s)
- Delphine Loirat
- 1Institut Curie, Medical Oncology Department and D3i, Paris, France, Paris, France
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- 18Clinique Sainte-Anne, Strasbourg, France, Strasbourg, Alsace, France
| | - Miguel delbado
- 19Groupe hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Abeer Najem
- 20Centre Hospitalier de Boulogne-sur-Mer, Boulogne-sur-Mer, France
| | | | | | | | - Pascal Pujol
- 24CHU and University of Montpellier, Montpellier, France
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Sebbag E, Cloarec N, Barthelemy P, Sedmak N, Hamamouche N, Servy H, Desjeux G, Monnet I, Najem A, Porneuf M, Rajpar LS, Meunier J, San T, Chauvenet L, Darut Jouve A, Falkowski S, Rizzo C, Litrowski N, Canellas A, Paitel JF, Pracht M, Cadranel J, Weiss L, Chouaid C, Aparicio T, Nancey S, Arnold C, Sauleau E, Gottenberg JE. POS1412 FIRSTS RESULTS OF THE PRAISE STUDY (PATIENT-REPORTED AUTOIMMUNITY SECONDARY TO CANCER IMMUNOTHERAPY): MULTICENTRIC PROSPECTIVE COHORT STUDY ON AUTOIMMUNE DISEASES SECONDARY TO CANCER IMMUNOTHÉRAPY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundIn cancer immunotherapy, T-lymphocyte activation can lead to secondary autoimmune diseases named OASI for Opportunistic Autoimmunity Secondary to cancer Immunotherapy [1]. The epidemiology of OASI deserves to be further studied due to the unadapted reporting of clinical trials and the lack of prospective studies. Moreover, literature focuses on the most severe OASI and/or on specific OASI (myocarditis, colitis, arthritis).ObjectivesOur goal was to determine incidence, severity of all grade OASI using a multicentric prospective patient cohort starting treatment with cancer immunotherapy.MethodsWe present a multicentric, prospective, observational, longitudinal, real life, French e-cohort. 900 patients treated with ipilimumumab and/or nivolumab will be included. Data is collected from the patient and the oncologist at inclusion, then patients report directly any symptom that could be suggestive of OASI with the help of monthly digital questionaries. In case an OASI is suspected, further confirmation is made with the practician in charge and by a paired analysis with the Système National De Santé (SNDS), the French health insurance registry.ResultsOn the 19/01/2022, 439 patients were included, 310 males (70.6%) and 129 females (29.4%). Mean age is 66 years old with a median follow up of 192 days. 354 patients (80.6%) are treated with Nivolumab alone, 7 (1.6%) with Ipilimumab alone and 76 (17.8 %) with combined Nivolumab + Ipilimumab. 136 patients (31.6%) are treated for a non-small cell lung carcinoma, 107 patients (24.9%) for a clear cell renal carcinoma, 91 patients (21.2%) for a skin melanoma, 49 patients (11.4%) for a head or neck epidermoid carcinoma, 24 patients (5.6%) for another lung cancer sub-type, and 32 patients (5.3%) for another histological cancer type. The mean follow-up is 294 days (+/- 192). 83 patients (18.9%) died since the beginning of the follow up.47 patients (10.7%) developed 63 OASI. The mean delay between the beginning of cancer immunotherapy and the OASI is 134.7 days (+/- 103.4).Approximately, one third of the OASI were musculoskeletal diseases. The OASI included polymyalgia rheumatica (3 patients), psoriatic arthritis (1 patient), polyarthritis (1 patient) systemic lupus (1 patient), arthralgias and myalgias (8 patients), colitis (11 patients), dysthyroïditis (6 patients), hepatitis (4 patients), nephritis (3 patients), pneumonitis (2 patients), hypophysitis (2 patients), adrenal insufficiency (4 patients), myocarditis (1 patient), hemophagocytic lympho-histiocytosis (1 patient), and other types of OASI (15 patients).26 patients (55% of patients with OASI, 5,9% of all patients) had to stop cancer immunotherapy due to an OASI, one because of a rheumatic disease (systemic lupus). 52 patients were treated with corticosteroids, 1 patient with methotrexate (psoriatic arthritis), 3 patients with infliximab (colitis) and 1 patient with abatacept (myocarditis). 1 patient died after an OASI (colitis).ConclusionThe first results of this prospective study, using an original patient-centered methodology, confirm the expected incidence of autoimmune events secondary to cancer immunotherapy and the role of rheumatologists in their therapeutic management.References[1]Kostine M, Chiche L, Lazaro E, et al. Opportunistic autoimmunity secondary to cancer immunotherapy (OASI): An emerging challenge. Rev Med Interne. 2017;38(8):513-525. doi:10.1016/j.revmed.2017.01.004AcknowledgementsBMS funded the study (unrestricted grant) but had no role in study design, data collection, analysis or decision to publish.Disclosure of InterestsEden Sebbag: None declared, Nicolas Cloarec: None declared, Philippe Barthelemy: None declared, Nathanaël Sedmak: None declared, Naima Hamamouche Consultant of: Work for Sanoia Digital CRO, Hervé Servy Consultant of: Work for Sanoia Digital CRO, Guillaume Desjeux Consultant of: Work for Sanoia Digital CRO, Isabelle Monnet: None declared, Abeer Najem: None declared, Marc Porneuf: None declared, Laetitia-Shanna Rajpar: None declared, Jérôme Meunier: None declared, Tévy San: None declared, Laure Chauvenet: None declared, Ariane DARUT JOUVE: None declared, Sabrina FALKOWSKI: None declared, Claudia Rizzo: None declared, Noémie Litrowski: None declared, Anthony Canellas: None declared, Jean-François Paitel: None declared, Marc Pracht: None declared, Jacques Cadranel: None declared, Laurence Weiss: None declared, Christos Chouaid: None declared, Thomas Aparicio: None declared, Stephane Nancey: None declared, Cécile Arnold: None declared, Erik Sauleau: None declared, Jaqcues-Eric Gottenberg: None declared
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Najem A, Sabiha M, Laourayed M, Belfhaili A, Benhiba F, Boudalia M, Warad I, Bellaouchou A, Guenbour A, Zarrouk A. New Green Anti-corrosion Inhibitor of Citrus Peels for Mild Steel in 1 M HCl: Experimental and Theoretical Approaches. Chemistry Africa 2022. [DOI: 10.1007/s42250-022-00366-9] [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] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Rivière P, Bauer J, Hégo F, Raad N, Najem A, Tomaszewski A, Dandoy S, Marie G. Staphylococcus aureus mediastinitis due to subclavian vein perforation and catheter-related-infection. IDCases 2021; 23:e01044. [PMID: 33473350 PMCID: PMC7803646 DOI: 10.1016/j.idcr.2020.e01044] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/24/2022] Open
Abstract
In rare cases the implantation or use of a port-a-cath can be complicated by venous perforation or catheter-related infection. We describe a patient with these two complications resulting in Staphylococcus aureus mediastinitis. Removal of the device and prolonged antibiotic therapy cured the infection.
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Affiliation(s)
- Pierre Rivière
- Intensive Care Unit, Boulogne-sur-mer Hospital, Boulogne-sur-mer, France
| | - Jules Bauer
- Infectious Diseases Department, Lille University Hospital, Lille, France
| | | | - Naji Raad
- Radiology Department, Lille University Hospital, Lille, France
| | - Abeer Najem
- Medical Oncology Department, Boulogne-sur-mer Hospital, Boulogne-sur-mer, France
| | | | - Simon Dandoy
- Centre Joliot-Curie, Saint-Martin Boulogne, France
| | - Guillaume Marie
- Medical Oncology Department, Boulogne-sur-mer Hospital, Boulogne-sur-mer, France
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Najem A, Deregnaucourt D, Ramdane S, Dridba M, Djouba F, Vercambre-Darras S. Intertrigo-Like Dermatitis With Pegylated Liposomal Doxorubicin: Diagnosis and Management. J Clin Oncol 2014; 32:e104-6. [DOI: 10.1200/jco.2013.48.7470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Abeer Najem
- Dr Duchenne Hospital, Boulogne-sur-Mer, France
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Templier C, Deregnaucourt D, Najem A, Djouba F, Mortier L, Vercambre S. Inflammation de kératoses actiniques sous cétuximab. Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.10.219] [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: 10/15/2022]
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Scalbert C, Deregnaucourt D, Najem A, Djouba F, Vercambre-Darras S. Ulcérations génitales au cours d’un traitement par inhibiteurs de mTOR. Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.10.197] [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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Villa AE, Tetko IV, Hyland B, Najem A. Spatiotemporal activity patterns of rat cortical neurons predict responses in a conditioned task. Proc Natl Acad Sci U S A 1999; 96:1106-11. [PMID: 9927701 PMCID: PMC15358 DOI: 10.1073/pnas.96.3.1106] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Precise and repeated spike-train timings within and across neurons define spatiotemporal patterns of activity. Although the existence of these patterns in the brain is well established in several species, there has been no direct evidence of their influence on behavioral output. To address this question, up to 15 neurons were recorded simultaneously in the auditory cortex of freely moving rats while animals waited for acoustic cues in a Go/NoGo task. A total of 235 significant patterns were detected during this interval from an analysis of 13 hr of recording involving over 1 million spikes. Of particular interest were 129 (55%) patterns that were significantly associated with the type of response the animal made later, independent of whether the response was that prompted by the cue because the response occurred later and the cue was chosen randomly. Of these behavior-predicting patterns, half (59/129) were associated with an enhanced tendency to go in response to the stimulus, and for 11 patterns of this subset, trials including the pattern were followed by significantly faster reaction time than those lacking the pattern. The remaining behavior-predicting patterns were associated with an enhanced NoGo tendency. Overall mean discharge rates did not vary across trials. Hence, these data demonstrate that particular spatiotemporal patterns predict future behavioral responses. Such presignal activity could form templates for extracting specific sensory information, motor programs prespecifying preference for a particular act, and/or some intermediate, associative brain process.
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Affiliation(s)
- A E Villa
- Laboratoire de Neuro-Heuristique, Institut de Physiologie, Université de Lausanne, 7 Rue du Bugnon, CH-1005, Switzerland.
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Abstract
Simultaneous single unit spike trains were recorded in the auditory cortex of freely moving rats performing a complex cognitive task. The experimental paradigm is based on a two-choice task (Go/Nogo) with a two-component (pitch and location) auditory stimulus lasting 500 ms. We report evidence that firstly functional interactions, measured by cross-correlation analysis, between single units in the auditory cortex are dynamically modified in the period preceding the onset of the auditory stimulation, referred to as the 'waiting period'. We secondly observed that spatio-temporal firing patterns both within, and across cell spike trains also tended to appear in the waiting period, several seconds before the actual stimulus delivery. These patterns indicate a very precise repetition of spike discharges separated by long intervals (up to several hundreds of milliseconds). No consistent changes in mean rate were observed. These results suggest that network activity in the auditory cortex is selectively modified in rate independent ways before the actual sensory stimulation. These modifications may reflect participation of recurrent neuronal networks in processes anticipating the expected sensory input.
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Affiliation(s)
- A E Villa
- Laboratoire de Neuro-heuristique, Institut de Physiologie, University of Lausanne, Switzerland.
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Goldstein EJ, Alpert ML, Najem A, Eng RH, Ginsburg BP, Kahn RM, Cherubin CE. Norfloxacin in the treatment of complicated and uncomplicated urinary tract infections. A comparative multicenter trial. Am J Med 1987; 82:65-9. [PMID: 3300313 DOI: 10.1016/0002-9343(87)90621-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In a multicenter, prospective treatment study, 59 patients with complicated or uncomplicated urinary tract infections (UTIs) were treated with norfloxacin (400 mg orally twice daily) and compared with 45 patients treated with trimethoprim/sulfamethoxazole. Norfloxacin was relatively safe and highly effective in treating both uncomplicated UTIs (86 percent cure rate) and complicated UTIs (75 percent cure rate). Failure of trimethoprim/sulfamethoxazole therapy was associated with initial bacterial resistance, e.g., from Pseudomonas aeruginosa and Serratia marcescens; such multiresistant bacteria were successfully treated with norfloxacin. Thus, norfloxacin appears to extend the range of oral agents available to treat UTIs.
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