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Blay JY, Penel N, Valentin T, Anract P, Duffaud F, Dufresne A, Verret B, Cordoba A, Italiano A, Brahmi M, Henon C, Amouyel T, Ray-Coquard I, Ferron G, Boudou-Rouquette P, Tlemsani C, Salas S, Rochwerger R, Faron M, Bompas E, Ducassou A, Gangloff D, Gouin F, Firmin N, Piperno-Neumann S, Rios M, Ropars M, Kurtz JE, Le Nail LR, Bertucci F, Carrere S, Llacer C, Watson S, Bonvalot S, Leroux A, Perrin C, Gantzer J, Pracht M, Narciso B, Monneur A, Lebbe C, Hervieu A, Saada-Bouzid E, Dubray-Longeras P, Fiorenza F, Chaigneau L, Nevieres ZM, Soibinet P, Bouché O, Guillemet C, Spano JP, Ruzic JC, Isambert N, Vaz G, Meeus P, Karanian M, Ngo C, Coindre JM, De Pinieux G, Le Loarer F, Ducimetiere F, Chemin C, Morelle M, Toulmonde M, Le Cesne A. Improved nationwide survival of sarcoma patients with a network of reference centers. Ann Oncol 2024; 35:351-363. [PMID: 38246351 DOI: 10.1016/j.annonc.2024.01.001] [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: 11/01/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND We investigated the impact of the implementation of a network of reference centers for sarcomas (NETSARC) on the care and survival of sarcoma patients in France since 2010. PATIENTS AND METHODS NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor boards (MDTBs), funded by the French National Cancer Institute (INCa) since 2010. Its aims are to improve the quality of diagnosis and care of sarcoma patients. Patients' characteristics, treatments, and outcomes are collected in a nationwide database. The objective of this analysis was to compare the survival of patients in three periods: 2010-2012 (non-exhaustive), 2013-2015, and 2016-2020. RESULTS A total of 43 975 patients with sarcomas, gastrointestinal stromal tumors (GISTs), or connective tissue tumors of intermediate malignancy were included in the NETSARC+ database since 2010 (n = 9266 before 2013, n = 12 274 between 2013 and 2015, n = 22 435 in 2016-2020). Median age was 56 years, 50.5% were women, and 13.2% had metastasis at diagnosis. Overall survival was significantly superior in the period 2016-2020 versus 2013-2015 versus 2010-2012 for the entire population, for patients >18 years of age, and for both metastatic and non-metastatic patients in univariate and multivariate analyses (P < 0.0001). Over the three periods, we observed a significantly improved compliance to clinical practice guidelines (CPGs) nationwide: the proportion of patients biopsied before surgery increased from 62.9% to 72.6%; the percentage of patients presented to NETSARC MDTBs before first surgery increased from 31.7% to 44.4% (P < 0.0001). The proportion of patients with R0 resection on first surgery increased (from 36.1% to 46.6%), while R2 resection rate decreased (from 10.9% to 7.9%), with a better compliance and improvement in NETSARC centers. CONCLUSIONS The implementation of the national reference network for sarcoma was associated with an improvement of overall survival and compliance to guidelines nationwide in sarcoma patients. Referral to expert networks for sarcoma patients should be encouraged, though a better compliance to CPGs can still be achieved.
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Affiliation(s)
- J Y Blay
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon.
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - T Valentin
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - P Anract
- Department of Orthopedics, Hôpital Cochin Saint Vincent de Paul, Paris
| | - F Duffaud
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - A Dufresne
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - B Verret
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - A Cordoba
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - M Brahmi
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Henon
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - T Amouyel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - I Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - G Ferron
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | | | - C Tlemsani
- Department of Orthopedics, Hôpital Cochin Saint Vincent de Paul, Paris
| | - S Salas
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - R Rochwerger
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - M Faron
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - E Bompas
- Department of Medical Oncology, Cochin Hospital, Paris; Department of Medical Oncology, Centre René Gauducheau, Nantes St. Herblain
| | - A Ducassou
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - D Gangloff
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - F Gouin
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Service Orthopedie, CHU Nantes, Nantes
| | - N Firmin
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - S Piperno-Neumann
- INSERM U1194, IRCM, Univ Montpellier, Montpellier; Department of Medical Oncology, Institut Curie, Paris; Department of Surgical Oncology, Institut Curie, Paris
| | - M Rios
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - M Ropars
- Department of Orthopedics, CHU Rennes, Rennes
| | | | | | - F Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - S Carrere
- Service Orthopedie, CHU Nantes, Nantes
| | - C Llacer
- Service Orthopedie, CHU Nantes, Nantes
| | - S Watson
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - S Bonvalot
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - A Leroux
- INSERM U1194, IRCM, Univ Montpellier, Montpellier
| | - C Perrin
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - J Gantzer
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - M Pracht
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - B Narciso
- Department of Orthopedic Surgery, Tours
| | - A Monneur
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - C Lebbe
- Department of Dermatology, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris; Department of CIC, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris
| | - A Hervieu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon
| | - E Saada-Bouzid
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice
| | - P Dubray-Longeras
- Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand
| | - F Fiorenza
- Department of Orthopedic Surgery, CHU Limoges, Limoges
| | - L Chaigneau
- Department of Medicine, CHU Besancon, Besancon
| | | | - P Soibinet
- Department of Medicine, Centre Francois Baclesse, Caen
| | - O Bouché
- Department of Gastroenterology, CHU Reims, Reims
| | - C Guillemet
- Department of Medical Oncology, Centre J Godinot Reims, Reims
| | - J P Spano
- Department of Oncology, Hôpital Pitié-Salpétriere, Paris
| | - J C Ruzic
- Departement d'oncologie, CHU, La Reunion
| | - N Isambert
- Service d'oncologie, CHU Poitiers, Poitiers, France
| | - G Vaz
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - P Meeus
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Karanian
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Ngo
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - J M Coindre
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | | | - F Le Loarer
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - F Ducimetiere
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Chemin
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Morelle
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - A Le Cesne
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
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Blay JY, Tlemsani C, Toulmonde M, Italiano A, Rios M, Bompas E, Valentin T, Duffaud F, Le Nail LR, Watson S, Firmin N, Dubray-Longeras P, Ropars M, Perrin C, Hervieu A, Lebbe C, Saada-Bouzid E, Soibinet P, Fiorenza F, Bertucci F, Boudou P, Vaz G, Bonvalot S, Honoré C, Marec-Berard P, Minard V, Cleirec M, Biau D, Meeus P, Babinet A, Dumaine V, Carriere S, Fau M, Decanter G, Gouin F, Ngo C, Le Loarer F, Karanian M, Meurgey A, Dufresne A, Brahmi M, Chemin-Airiau C, Ducimetiere F, Penel N, Le Cesne A. Sclerosing Epithelioid Fibrosarcoma (SEF) versus Low Grade Fibromyxoid Sarcoma (LGFMS): Presentation and outcome in the nationwide NETSARC+ series of 330 patients over 13 years. Eur J Cancer 2024; 196:113454. [PMID: 38008029 DOI: 10.1016/j.ejca.2023.113454] [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: 09/27/2023] [Accepted: 11/08/2023] [Indexed: 11/28/2023]
Abstract
Sclerosing Epithelioid Fibrosarcoma (SEF) and Low Grade Fibromyxoid Sarcoma (LGFMS) are ultrarare sarcomas sharing common translocations whose natural history are not well known. We report on the nationwide exhaustive series of 330 patients with SEF or LGFMS in NETSARC+ since 2010. PATIENTS AND METHODS NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor boards (MDTB). Since 2010, (i) pathological review has been mandatory for sarcoma,and (ii) tumour/patients' characteristics have been collected in the NETSARC+ nationwide database. The characteristics of patients with SEF and LGFMS and their outcome are compared. RESULTS 35/73 (48%) and 125/257(49%) of patients with SEF and LGFMS were female. More visceral, bone and trunk primary sites were observed in SEF (p < 0.001). 30% of SEF vs 4% of LGFMS patients had metastasis at diagnosis (p < 0.0001). Median size of the primary tumor was 51 mm (range 10-90) for LGFMS vs 80 (20-320) for SEF (p < 0.001). Median age for LGFMS patients was 12 years younger than that of SEF patients (43 [range 4-98] vs 55 [range 10-91], p < 0.001). Neoadjuvant treatment was more often given to SEF (16% vs 9%, p = 0.05). More patients with LGFMS were operated first in reference centers (51% vs 26%, p < 0.001). The R0 rate on the operative specimen was 41% in LGFMS vs 16% in SEF (p < 0.001). Median event-free survival (EFS) of patients with SEF and LGFMS were 32 vs 136 months (p < 0.0001). The median overall survival (OS) was not reached. Fifty-months OS was 93% vs 81% for LGFMS vs SEF (p = 0.05). Median OS was 77 months after first relapse, similar for SEF and LGFMS. In multivariate analysis, age, tumor size, metastasis at diagnosis were independent prognostic factors for OS in LGFMS. CONCLUSIONS Although sharing close molecular alterations, SEF and LGFMS have a different natural history, clinical presentation and outcome, with a higher risk of metastatic relapse in SEF. Survival after relapse is longer than with other sarcomas, and similar for SEF and LGFMS.
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Affiliation(s)
- J Y Blay
- Centre Léon Bérard & Université Claude Bernard, Lyon, France.
| | | | - M Toulmonde
- Departement of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - A Italiano
- Departement of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - M Rios
- Institut Cancerologie Lorraine, Centre Alexis Vautrin, Nancy, France
| | - E Bompas
- Department of Medical Oncology, Institut de Cancerologie Ouest Nantes, France
| | - T Valentin
- Institut Claudius Regaud & Institut Universitaire de Cancerologie, Oncopole, Toulouse, France
| | - F Duffaud
- La Timone University Hospital, Marseille, France
| | | | - S Watson
- Dept of Medical Oncology, Institut Curie & INSERM U830, Institut Curie Research Center, Paris, France
| | - N Firmin
- Institut de Cancérologie de Montpellier, Montpellier, France
| | | | - M Ropars
- Eugene Marquis Comprehensive Cancer Center, France
| | | | - A Hervieu
- Centre George Francois Leclerc, Dijon, France
| | - C Lebbe
- Centre Georges François Leclerc, Dijon, France
| | - E Saada-Bouzid
- Dermato-Oncology Unit, Saint Louis Hospital, Paris, France
| | | | | | - F Bertucci
- Institut Paoli-Calmettes, Marseille, France
| | | | - G Vaz
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | | | - C Honoré
- Gustave Roussy Cancer Campus, Villejuif, France
| | - P Marec-Berard
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - V Minard
- Gustave Roussy Cancer Campus, Villejuif, France
| | | | - D Biau
- Hopital Cochin, Paris, France
| | - P Meeus
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | | | | | - S Carriere
- Institut de Cancérologie de Montpellier, Montpellier, France
| | - M Fau
- Departement of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - G Decanter
- Univ. Lille, CHU Lille, ULR 2694 - Metrics: Evaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France; Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - F Gouin
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - C Ngo
- Departement of Medical Oncology, Institut Bergonié, Bordeaux, France
| | | | - M Karanian
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - A Meurgey
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - A Dufresne
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - M Brahmi
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - C Chemin-Airiau
- Centre Léon Bérard & Université Claude Bernard, Lyon, France
| | - F Ducimetiere
- Centre Léon Bérard & Université Claude Bernard, Lyon, France.
| | - N Penel
- Univ. Lille, CHU Lille, ULR 2694 - Metrics: Evaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France; Department of Medical Oncology, Centre Oscar Lambret, Lille, France
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Blay JY, Cropet C, Mansard S, Loriot Y, De La Fouchardière C, Haroche J, Topart D, Tougeron D, You B, Italiano A, Le Brun-Ly V, Ferrero JM, Penel N, Fabbro M, Troussard X, Malka D, Ray-Coquard I, Leboulleux S, Fléchon A, Maubec E, Charles J, Dalle S, Taieb S, Garcia GCTE, Mandache AM, Colignon N, Gavrel M, Nowak F, Hoog Labouret N, Mahier Aït Oukhatar C, Gomez-Roca C. Long term activity of vemurafenib in cancers with BRAF mutations: the ACSE basket study for advanced cancers other than BRAF V600-mutated melanoma. ESMO Open 2023; 8:102038. [PMID: 37922690 PMCID: PMC10774964 DOI: 10.1016/j.esmoop.2023.102038] [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: 08/09/2023] [Revised: 09/14/2023] [Accepted: 09/21/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND BRAF inhibitors are approved in BRAFV600-mutated metastatic melanoma, non-small-cell lung cancer (NSCLC), Erdheim-Chester disease (ECD), and thyroid cancer. We report here the efficacy, safety, and long-term results of single-agent vemurafenib given in the AcSé vemurafenib basket study to patients with various BRAF-mutated advanced tumours other than BRAFV600-mutated melanoma and NSCLC. PATIENTS AND METHODS Patients with advanced tumours other than BRAFV600E melanoma and progressing after standard treatment were eligible for inclusion in nine cohorts (including a miscellaneous cohort) and received oral vemurafenib 960 mg two times daily. The primary endpoint was the objective response rate (ORR) estimated with a Bayesian design. The secondary outcomes were disease control rate, duration of response, progression-free survival (PFS), overall survival (OS), and vemurafenib safety. RESULTS A total of 98 advanced patients with various solid or haematological cancers, 88 with BRAFV600 mutations and 10 with BRAFnonV600 mutations, were included. The median follow-up duration was 47.7 months. The Bayesian estimate of ORR was 89.7% in hairy cell leukaemias (HCLs), 33.3% in the glioblastomas cohort, 18.2% in cholangiocarcinomas, 80.0% in ECD, 50.0% in ovarian cancers, 50.0% in xanthoastrocytomas, 66.7% in gangliogliomas, and 60.0% in sarcomas. The median PFS of the whole series was 8.8 months. The 12-, 24-, and 36-month PFS rates were 42.2%, 23.8%, and 17.9%, respectively. Overall, 54 patients died with a median OS of 25.9 months, with a projected 4-year OS of 40%. Adverse events were similar to those previously reported with vemurafenib. CONCLUSION Responses and prolonged PFS were observed in many tumours with BRAF mutations, including HCL, ECD, ovarian carcinoma, gliomas, ganglioglioma, and sarcomas. Although not all cancer types responded, vemurafenib is an agnostic oncogene therapy of cancers.
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Affiliation(s)
- J Y Blay
- Department of Medicine, CentreLeon bErard, Lyon.
| | | | - S Mansard
- Dermatology Department, Hôpital Estaing, University Hospital of Clermont Ferrand, Clermont-Ferrand
| | - Y Loriot
- Department of Medicine, Gustave Roussy, Villejuif
| | | | - J Haroche
- Department of Internal Medicine, Institut E3M, French Reference Centre for Histiocytosis, Pitié-Salpȇtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris
| | - D Topart
- Onco-urology Department, Hôpital Saint ELOI, Montpellier
| | - D Tougeron
- Gastroenterology and Hepatology Department, Poitiers University Hospital and Faculty of Medicine of Poitiers, Poitiers
| | - B You
- Centre d'Investigation des Thérapeutiques en Oncologie et Hématologie de Lyon (CITOHL), Hospices Civils de Lyon (IC-HCL), EA 3738 CICLY, Lyon
| | - A Italiano
- Department of Medicine, Institut Bergonié, Bordeaux; Faculty of Medicine, University of Bordeaux, Bordeaux
| | - V Le Brun-Ly
- Department of Medicine, CHU Limoges, Medical Oncology, Limoges
| | - J M Ferrero
- Department of Medicine, Centre A. Lacassagne, Nice
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille; Université de Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille
| | - M Fabbro
- Department of Medicine, Institut de Cancerologie de Montpellier, Montpellier
| | | | - D Malka
- Department of Medical Oncology, Institut Mutualiste Montsouris, Paris
| | | | - S Leboulleux
- Department of Medicine, Gustave Roussy, Villejuif
| | | | - E Maubec
- Assistance Publique-Hôpitaux de Paris, Department of Dermatology, Hôpital Avicenne, Bobigny; University Sorbonne Paris Nord - Campus de Bobigny, Bobigny and UMR 1124, Campus Saint-Germain-des-Prés, Paris
| | - J Charles
- Dermatology, Allergology & Photobiology Department, CHU Grenoble Alpes, Grenoble; Institute for Advanced Biosciences, INSERM U1209, CNRS UMR5309, Université Grenoble Alpes, La Tronche
| | - S Dalle
- Department of Dermatology, Hospices Civils de Lyon, CRCL, Université Claude Bernard Lyon1, Lyon
| | - S Taieb
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | | | | | - N Colignon
- Department of Radiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris
| | - M Gavrel
- Department of Medicine, Gustave Roussy, Villejuif
| | - F Nowak
- Institut National Du Cancer, Boulogne-Billancourt
| | | | | | - C Gomez-Roca
- Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse (IUCT-Oncopole), Clinical Research Unit, Toulouse, France
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Aldea M, Vasseur D, Italiano A, Nikolaev SI. WGS/WES-RNAseq compared to targeted NGS in oncology: is there something to unlock? Ann Oncol 2023; 34:1090-1093. [PMID: 37816462 DOI: 10.1016/j.annonc.2023.09.3118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Affiliation(s)
- M Aldea
- Department of Medical Oncology, Gustave Roussy, Villejuif; Paris-Saclay University, Kremlin-Bicetre; Precision Medicine, Gustave Roussy, Villejuif
| | - D Vasseur
- Precision Medicine, Gustave Roussy, Villejuif; Department of Molecular Pathology, Gustave Roussy, Villejuif
| | - A Italiano
- Precision Medicine, Gustave Roussy, Villejuif; Drug Development Department, Gustave Roussy, Villejuif
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5
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Blay JY, Piperno-Neumann S, Watson S, Dufresne A, Valentin T, Duffaud F, Toulmonde M, Italiano A, Bertucci F, Tlemsani C, Firmin N, Bompas E, Perrin C, Ropars M, Saada-Bouzid E, Dubray-Longeras P, Hervieu A, Lebbe C, Gantzer J, Chaigneau L, Fiorenza F, Rios M, Isambert N, Soibinet P, Boudou-Roquette P, Verret B, Ferron G, Ryckewaert T, Lebellec L, Brahmi M, Gouin F, Meeus P, Vaz G, Le Loarer F, Karanian M, De Pinieux G, Ducimetiere F, Chemin C, Morelle M, Le Cesne A, Penel N. Epithelioid hemangio-endothelioma (EHE) in NETSARC: The nationwide series of 267 patients over 12 years. Eur J Cancer 2023; 192:113262. [PMID: 37625241 DOI: 10.1016/j.ejca.2023.113262] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/06/2023] [Revised: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023]
Abstract
EPITHELIOID HEMANGIOENDOTHELIOMA A NATIONWIDE STUDY: Epithelioid hemangioendothelioma (EHE) is an ultrarare sarcoma whose natural history and treatment is not well defined. We report on the presentation and outcome of 267 patients with EHE in the NETSARC+ network since 2010 in France. PATIENTS AND METHODS NETSARC (netsarc.org) is a network of 26 reference sarcoma centres with specialised multidisciplinary tumour boards (MDTB), funded by the French National Cancer Institute (NCI), Institut National du Cancer (INCA). Since 2010, presentation to an MDTB and second pathological review are mandatory for sarcoma patients. Patients' characteristics are collected in a nationwide database regularly monitored with stable incidence since 2013. The characteristics of patients with EHE at diagnosis are presented as well as progression-free survival (PFS), overall survival (OS), and outcome under treatment. RESULTS Two hundred and sixty-seven patients with EHE were included in the NETSARC+ database since 2010. Median age in the series was 51 (range 10-90) years, 58% were women. Median tumour size was 37 mm (4-220). Forty-eight percent, 42%, and 10% were visceral, soft parts, or bone primaries. The most frequent sites were liver (28%), lung (13%). 40% were reported to have systemic (i.e. multifocal or metastatic disease) at diagnosis. With a median follow-up of 20 months, OS and PFS rates at 24 months were 82% and 67%, with 10-year projected OS and PFS of 62% and 21% respectively. Male and M+ patients at diagnosis had a significantly worse OS, but not PFS. Local treatment was associated with a favourable survival in localised but not in patients with advanced stage at diagnosis. For 23 patients receiving medical treatment, PFS and OS were 50.2% and 33.2% at 60 months were respectively. CONCLUSIONS EHE is a frequently metastatic sarcoma at diagnosis with a unique natural history. This study shows in a nationwide series over 12 years that most patients progressed but are still alive at 10 years, both in localised and metastatic stages.
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Affiliation(s)
- J Y Blay
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France.
| | - S Piperno-Neumann
- Department of Medical Oncology, Institut Curie and INSERM U830, Institut Curie Research Center, Paris, France
| | - S Watson
- Department of Medical Oncology, Institut Curie and INSERM U830, Institut Curie Research Center, Paris, France
| | - A Dufresne
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - T Valentin
- Department of Medical oncology, Institut Claudius Regaud and Institut Universitaire de Cancerologie, Oncopole, Toulouse, France
| | - F Duffaud
- Department of Medical oncology, La Timone University Hospital, Marseille, France
| | - M Toulmonde
- Departement of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - A Italiano
- Departement of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - F Bertucci
- Department of Medical oncology, Institut Paoli-Calmettes, Marseille, France
| | - C Tlemsani
- Department of Medical oncology, Hôpital Cochin-Saint-Vincent de Paul, Paris, France
| | - N Firmin
- Department of Medical oncology, Institut de Cancérologie de Montpellier, Montpellier, France
| | - E Bompas
- Department of Medical Oncology, Institut de Cancerologie Ouest, Nantes, France
| | - C Perrin
- Department of Medical oncology, Eugene Marquis Comprehensive Cancer Center and CHU, Rennes, France
| | - M Ropars
- Department of Medical oncology, Eugene Marquis Comprehensive Cancer Center and CHU, Rennes, France
| | - E Saada-Bouzid
- Department of Medical oncology, Centre Antoine-Lacassagne, Nice, France
| | - P Dubray-Longeras
- Department of Medical oncology, Centre Georges François Leclerc, Dijon, France
| | - A Hervieu
- Department of Medical oncology, Centre Jean Perrin/ERTICa EA 4677, Clermont-Ferrand, France
| | - C Lebbe
- Department of Medical oncology, Oncology Unit, Saint Louis Hospital, Paris, France
| | - J Gantzer
- Department of Medicine, ICANS, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - L Chaigneau
- Department of Medical oncology, CHU Besancon, Besançon, France
| | - F Fiorenza
- Department of Medical oncology, CHU Limoges, Limoges, France
| | - M Rios
- Department of Medical oncology, Institut Cancerologie Lorraine, Centre Alexis Vautrin, Nancy, France
| | - N Isambert
- Department of Medical oncology, CHU, Poitiers, France
| | - P Soibinet
- Department of Medical oncology, Institut J Godinot Reims, Reims, France
| | - P Boudou-Roquette
- Department of Medical oncology, Hôpital Cochin-Saint-Vincent de Paul, Paris, France
| | - B Verret
- Department of Medical oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - G Ferron
- Department of Medical oncology, Institut Claudius Regaud and Institut Universitaire de Cancerologie, Oncopole, Toulouse, France
| | - T Ryckewaert
- Department of Medical oncology, Centre Oscar Lambret, and Université de Lille ULR 2694, Lille, France
| | - L Lebellec
- Department of Medical oncology, Centre Oscar Lambret, and Université de Lille ULR 2694, Lille, France
| | - M Brahmi
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - F Gouin
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - P Meeus
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - G Vaz
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - F Le Loarer
- Departement of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - M Karanian
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - G De Pinieux
- Department of Medical oncology, CHU Tours, Tours, France
| | - F Ducimetiere
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - C Chemin
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - M Morelle
- Department of Medical oncology, Centre Léon Bérard and Université Claude Bernard, Lyon, France
| | - A Le Cesne
- Department of Medical oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - N Penel
- Department of Medical oncology, Centre Oscar Lambret, and Université de Lille ULR 2694, Lille, France
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Charton E, Baldini C, Fayet Y, Schultz E, Auroy L, Vallier E, Italiano A, Robert M, Coquan E, Isambert N, Moreau P, Touzeau C, Le Tourneau C, Ghrieb Z, Kiladjian JJ, Delord JP, Gomez Roca C, Vey N, Barlesi F, Lesimple T, Penel N, Soria JC, Massard C, Besle S. Inequality factors in access to early-phase clinical trials in oncology in France: results of the EGALICAN-2 study. ESMO Open 2023; 8:101610. [PMID: 37536254 PMCID: PMC10415590 DOI: 10.1016/j.esmoop.2023.101610] [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: 12/09/2022] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Investigation of the disparities in the access to experimental treatment in early-phase clinical trials is lacking. The objective of the EGALICAN-2 study was to identify the factors underpinning such inequalities. METHODS A national prospective survey was conducted in 11 early-phase clinical trial centers (CLIP2) certified by the French National Cancer Institute. Sociodemographic, socioeconomic and medical data were collected. Univariate logistic regression models were carried out to estimate odds ratios and 90% confidence intervals associated with the effect of each study variable. A multivariate logistic regression model was built to explore the independent factors associated with the administration of the experimental treatment (C1D1). A post hoc analysis was carried out excluding female cancer patients. RESULTS Between 2015 and 2016, 1355 patients referred from 11 CLIP2 centers in France were included in the study. Eight hundred and forty-eight patients received C1D1 (73%) and 320 patients (27%) were screening failure. Median age was 58 years (range 17-97 years) and 667 patients (54%) were female. Most patients had a metastatic disease (n = 751, 87%). In the multivariate logistic regression analysis, the significant independent factors associated with C1D1 were male sex, initial care received in a hospital with an early-phase unit and living in wealthy metropolitan areas (P values <0.05). In the post hoc analysis, the sex factor was no longer significant [odds ratio = 1.21 (95% confidence interval 0.86-1.70), P value = 0.271]. CONCLUSIONS This study investigated the factors producing social inequalities in the context of early-phase clinical trials in oncology. Our research highlights factors of sex, care pathway and geographic location. Gynecological cancer was found to impact C1D1 significantly, unlike breast cancer. The results of this study should contribute to improve patient access to early-phase clinical trials.
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Affiliation(s)
- E Charton
- Human and Social Sciences Department, Centre Léon Bérard, Lyon.
| | - C Baldini
- Drug Development Department (DITEP), Gustave Roussy, Paris-Saclay University, Villejuif
| | - Y Fayet
- Human and Social Sciences Department, Centre Léon Bérard, Lyon; Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon
| | - E Schultz
- CEPED (UMR 196), University of Paris, IRD, Paris; SESSTIM, CANBIOS Team, Aix-Marseille University, INSERM, IRD, Marseille
| | - L Auroy
- University of Grenoble Alpes, CNRS, Sciences Po Grenoble, Grenoble
| | - E Vallier
- Human and Social Sciences Department, Centre Léon Bérard, Lyon; Drug Development Department (DITEP), Gustave Roussy, Paris-Saclay University, Villejuif
| | | | - M Robert
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint-Herblain
| | - E Coquan
- Medical Oncology Department, Centre François Baclesse, Caen
| | - N Isambert
- Medical Oncology Department, University Hospital of Poitiers, Poitiers
| | - P Moreau
- Medical Oncology Department, Centre Georges-François Leclerc, Dijon
| | - C Touzeau
- Department of Hematology, University Hospital of Nantes, Nantes
| | - C Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris
| | - Z Ghrieb
- Service de Pharmacologie et Investigations Cliniques, Hôpital Saint-Louis, AP-HP, Paris
| | - J-J Kiladjian
- Service de Pharmacologie et Investigations Cliniques, Hôpital Saint-Louis, AP-HP, Paris
| | - J-P Delord
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse
| | - C Gomez Roca
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse
| | - N Vey
- Department of Hematology, Institut Paoli-Calmettes, Marseille
| | - F Barlesi
- CRCM, INSERM, CNRS, APHM, Aix-Marseille University, Marseille; Gustave Roussy, Villejuif
| | - T Lesimple
- Department of Oncology, Eugene Marquis Center, Rennes
| | - N Penel
- Centre Oscar Lambret, Lille University, Lille
| | - J-C Soria
- Drug Development Department (DITEP), Gustave Roussy, Paris-Saclay University, Villejuif
| | - C Massard
- Drug Development Department (DITEP), Gustave Roussy, Paris-Saclay University, Villejuif
| | - S Besle
- Human and Social Sciences Department, Centre Léon Bérard, Lyon; Drug Development Department (DITEP), Gustave Roussy, Paris-Saclay University, Villejuif; Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, Institut Convergence PLAsCAN, Lyon, France
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Le Cesne A, Chevreau C, Perrin C, Italiano A, Hervieu A, Blay JY, Piperno-Neumann S, Saada-Bouzid E, Bertucci F, Firmin N, Kalbacher E, Narciso B, Schiffler C, Yara S, Jimenez M, Bouvier C, Vidal V, Chabaud S, Duffaud F. Regorafenib in patients with relapsed advanced or metastatic chordoma: results of a non-comparative, randomised, double-blind, placebo-controlled, multicentre phase II study. ESMO Open 2023; 8:101569. [PMID: 37285716 DOI: 10.1016/j.esmoop.2023.101569] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND REGOBONE multicohort study explored the efficacy and safety of regorafenib for patients with advanced bone sarcomas; this report details the cohort of patients with relapsed advanced or metastatic chordoma. METHODS Patients with relapsed chordoma progressing despite 0-2 prior lines of systemic therapy, were randomised (2 : 1) to receive regorafenib (160 mg/day, 21/28 days) or placebo. Patients on placebo could cross over to receive regorafenib after centrally-confirmed progression. The primary endpoint was the progression-free rate at 6 months (PFR-6) (by RECIST 1.1). With one-sided α of 0.05, and 80% power, at least 10/24 progression-free patients at 6 months (PFR-6) were needed for success. RESULTS From March 2016 to February 2020, 27 patients were enrolled. A total of 23 patients were assessable for efficacy: 7 on placebo, 16 on regorafenib, 16 were men, median age was 66 (32-85) years. At 6 months, in the regorafenib arm, 1 patient was not assessable, 6/14 were non-progressive (PFR-6: 42.9%; one-sided 95% CI = 20.6) 3/14 discontinued regorafenib due to toxicity; and in the placebo arm, 2/5 patients were non-progressive (PFR-6: 40.0%; one-sided 95% CI = 7.6), 2 were non-assessable. Median progression-free survival was 8.2 months (95% CI 4.5-12.9 months) on regorafenib and 10.1 months (95% CI 0.8 months-non evaluable [NE]) on placebo. Median overall survival rates were 28.3 months (95% CI 14.8 months-NE) on regorafenib but not reached in placebo arm. Four placebo patients crossed over to receive regorafenib after centrally-confirmed progression. The most common grade ≥3 regorafenib-related adverse events were hand-foot skin reaction (22%), hypertension (22%), pain (22%), and diarrhoea (17%), with no toxic death. CONCLUSION This study failed to show any signal of benefit for regorafenib in patients with advanced/metastatic recurrent chordoma.
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Affiliation(s)
- A Le Cesne
- Medical Oncology Department, Gustave Roussy, Villejuif
| | - C Chevreau
- Medical Oncology Department, Institut Universitaire de Cancérologie de Toulouse, Oncopole, Toulouse
| | - C Perrin
- Medical Oncology Unit, Centre Eugène Marquis, Rennes
| | - A Italiano
- Medical Oncology Department, Institut Bergonié, Bordeaux
| | - A Hervieu
- Medical Oncology Department, Centre Georges Francois Leclerc, Dijon
| | - J Y Blay
- Medical Oncology Department, Centre Léon Bérard, Lyons. https://twitter.com/jeanyvesblay
| | | | - E Saada-Bouzid
- Medical Oncology Department, Centre Antoine Lacassagne, Nice
| | - F Bertucci
- Medical Oncology Department, Institut Paoli Calmettes, Marseille
| | - N Firmin
- Medical Oncologie Department, Centre Valdorelle, Montpellier
| | - E Kalbacher
- Medical Oncology Department, CHU J Minjoz, Besançon
| | - B Narciso
- Medical Oncology Department, CHU Bretonneau, Tours
| | - C Schiffler
- Department of Statistics, Centre Léon Bérard, Lyons
| | | | | | - C Bouvier
- Aix Marseille Univ, APHM Hopital La Timone, Pathology Department, Marseille
| | - V Vidal
- Aix Marseille Univ, APHM Hopital La Timone, Radiology Department, Marseille
| | - S Chabaud
- Department of Statistics, Centre Léon Bérard, Lyons
| | - F Duffaud
- Aix Marseille University (AMU), APHM Hopital La Timone, Medical Oncology Unit, APHM, Marseille, France.
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8
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Spalato-Ceruso M, Laroche-Clary A, Perret R, Valverde Y, Chaire V, Derieppe MA, Velasco V, Bourdon A, Italiano A. Genome-wide CRISPR/Cas9 library screening identified ATM signaling network genes as critical drivers for resistance to ATR inhibition in soft-tissue sarcomas: synthetic lethality and therapeutic implications. Exp Hematol Oncol 2023; 12:51. [PMID: 37259134 DOI: 10.1186/s40164-023-00416-z] [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: 12/27/2022] [Accepted: 05/16/2023] [Indexed: 06/02/2023] Open
Abstract
Soft-tissue sarcoma (STS) are a heterogeneous group of rare tumors with different biological behavior that are fatal in more than 40% of cases, due to their metastatic evolution and inadequate treatment options. ATR inhibition already showed an activity, even if modest, in broad pre-clinical models of STS. By using genome-wide CRISPR/Cas9 library screening, we identified ATM signaling network genes as critical drivers for resistance to the specific ATR inhibitor AZD6738. The role of such genes in resistance to AZD6738 was confirmed by using CRISPR/Cas9 knockout models. More strikingly, the ATM inhibitor AZD0156 works synergistically with AZD6738 in vitro and abolishes STS growth in vivo in our models of most frequent histotypes (such as dedifferentiated liposarcoma, leiomyosarcoma, and undifferentiated pleomorphic sarcoma among others). Moreover, the combination of AZD6738 and AZD0156 induced significantly higher levels of DNA damage than either drug used as single agent alone. In summary, our results demonstrate that targeting ATM is an effective approach to overcome resistance to ATR inhibition in different STS subtypes, including the most frequent histologies.
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Affiliation(s)
- M Spalato-Ceruso
- Sarcoma Unit, Institut Bergonié, 229 cours de l'Argonne, Bordeaux, 33000, France
- INSERM, U1312, Bordeaux, France
| | - A Laroche-Clary
- Sarcoma Unit, Institut Bergonié, 229 cours de l'Argonne, Bordeaux, 33000, France
- INSERM, U1312, Bordeaux, France
| | - R Perret
- Department of Pathology, Institut Bergonié, Bordeaux, France
| | - Y Valverde
- Sarcoma Unit, Institut Bergonié, 229 cours de l'Argonne, Bordeaux, 33000, France
- INSERM, U1312, Bordeaux, France
| | - V Chaire
- Sarcoma Unit, Institut Bergonié, 229 cours de l'Argonne, Bordeaux, 33000, France
- INSERM, U1312, Bordeaux, France
| | | | - V Velasco
- Department of Pathology, Institut Bergonié, Bordeaux, France
| | - A Bourdon
- Bioinformatics, Data and Digital Health Departement, Insitut Bergonié, Bordeaux, France
| | - A Italiano
- Sarcoma Unit, Institut Bergonié, 229 cours de l'Argonne, Bordeaux, 33000, France.
- INSERM, U1312, Bordeaux, France.
- University of Bordeaux, Bordeaux, France.
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Bayle A, Belcaid L, Aldea M, Vasseur D, Peyraud F, Nicotra C, Geraud A, Sakkal M, Seknazi L, Cerbone L, Blanc-Durand F, Hadoux J, Mosele F, Tagliamento M, Bernard-Tessier A, Verret B, Smolenschi C, Clodion R, Auger N, Romano PM, Gazzah A, Camus MN, Micol J, Caron O, Hollebecque A, Loriot Y, Besse B, Lacroix L, Rouleau E, Ponce S, Soria JC, Barlesi F, Andre F, Italiano A. Clinical utility of circulating tumor DNA sequencing with a large panel: a National Center for Precision Medicine (PRISM) study. Ann Oncol 2023; 34:389-396. [PMID: 36709039 DOI: 10.1016/j.annonc.2023.01.008] [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: 10/31/2022] [Revised: 12/10/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Circulating tumor DNA (ctDNA) sequencing is a promising approach for tailoring therapy in patients with cancer. We report hereby the results from a prospective study where we investigated the impact of comprehensive molecular profiling of ctDNA in patients with advanced solid tumors. PATIENTS AND METHODS Genomic analysis was performed using the FoundationOne Liquid CDx Assay [324 genes, tumor mutational burden (TMB), microsatellite instability status]. Each individual genomic report was reviewed and discussed weekly by a multidisciplinary tumor board (MTB). Actionable targets were classified by ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT) tier leading to molecular-based treatment suggestions wherever it was possible. RESULTS Between December 2020 and November 2021, 1772 patients with metastatic solid tumors underwent molecular profiling. Median time to assay results was 12 days. Results were contributive for 1658 patients (94%). At least one actionable target was detected in 1059 patients (64%) with a total of 1825 actionable alterations including alteration of the DNA damage repair response pathway (n = 336, 18%), high TMB (>16 mutations/Mb; n = 243, 13%), PIK3CA mutations (n = 150, 8%), ERBB family pathway alterations (n = 127, 7%), PTEN alterations (n = 95, 5%), FGFR alterations (n = 67, 4%) and MET activations (n = 13, 0.7%). The MTB recommended a matched therapy for 597 patients (56%) with a total of 819 therapeutic orientations: clinical trials (n = 639, 78%), off-label/compassionate use (n = 81, 10%), approved drug (n = 51, 6%), and early access program (n = 48, 6%). In total, 122 patients (21%) were treated. Among the assessable patients (n = 107), 4 (4%) had complete response, 35 (33%) had partial response, 27 (25%) had stable disease, and 41 (38%) a progressive disease as best response. The median progression-free survival and median overall survival were 4.7 months (95% confidence interval 2.7-6.7 months) and 8.3 months (95% confidence interval 4.7-11.9 months) respectively. CONCLUSIONS ctDNA sequencing with a large panel is an efficient approach to match patients with advanced cancer with targeted therapies.
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Affiliation(s)
- A Bayle
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif; Université Paris-Saclay, Faculté de médecine, Le Kremlin Bicêtre, Paris; Oncostat U1018, Inserm, Paris-Saclay University, labeled Ligue Contre le Cancer, Villejuif, France
| | - L Belcaid
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif; Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Aldea
- Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - D Vasseur
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif
| | - F Peyraud
- Department of Early Phase Trial Unit, Institut Bergonié Comprehensive Cancer Centre, Bordeaux
| | - C Nicotra
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - A Geraud
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - M Sakkal
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif; Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - L Seknazi
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - L Cerbone
- Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - F Blanc-Durand
- Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - J Hadoux
- Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - F Mosele
- Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - M Tagliamento
- Department of Cancer Medicine, Gustave Roussy, Villejuif
| | | | - B Verret
- Université Paris-Saclay, Faculté de médecine, Le Kremlin Bicêtre, Paris; Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - C Smolenschi
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - R Clodion
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - N Auger
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif
| | - P M Romano
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - A Gazzah
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - M N Camus
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - J Micol
- Department of Hematology, Gustave Roussy, Villejuif
| | - O Caron
- Department of Genetics, Gustave Roussy, Villejuif
| | - A Hollebecque
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - Y Loriot
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - B Besse
- Université Paris-Saclay, Faculté de médecine, Le Kremlin Bicêtre, Paris; Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - L Lacroix
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif
| | - E Rouleau
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif
| | - S Ponce
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - J C Soria
- Université Paris-Saclay, Faculté de médecine, Le Kremlin Bicêtre, Paris; Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - F Barlesi
- Université Paris-Saclay, Faculté de médecine, Le Kremlin Bicêtre, Paris; Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - F Andre
- Université Paris-Saclay, Faculté de médecine, Le Kremlin Bicêtre, Paris; Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - A Italiano
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif; Department of Early Phase Trial Unit, Institut Bergonié Comprehensive Cancer Centre, Bordeaux; Faculty of Medicine, University of Bordeaux, Bordeaux, France.
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Blay JY, Italiano A, Penel N, Le Loarer F, Karanian M, De Pinieux G, Coindre JM, Ducimetiere F, Chemin C, Morelle M, Gouin F, Toulmonde M, Le Cesne A. Impact d’un réseau de centre de référence pour le diagnostic et la prise en charge des patients atteints de sarcomes en France depuis 2010. Bulletin de l'Académie Nationale de Médecine 2023. [DOI: 10.1016/j.banm.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Ridolfi L, Masini G, Castiglione V, Gentile F, Favilli M, Mazzola M, Lepone A, Scalera ST, Italiano A, Negro F, Guarini G, Ricci F, Renda G, De Caterina R, Morrone D. 3 SAFETY OF NOVEL ORAL ANTICOAGULANTS COMPARED TO VITAMIN K ANTAGONISTS IN THE TREATMENT OF VENOUS THROMBOEMBOLISM: A SYSTEMATIC REVIEW AND META-ANALYSIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.572] [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: 12/23/2022]
Abstract
Abstract
Background
Individual randomized controlled trials (RCTs) enrolling patients with venous thromboembolism (VTE) have demonstrated that novel oral anticoagulants (NOACs) are comparable to vitamin K antagonists (VKAs) in reducing the risk of recurrent VTE but hold a safer bleeding profile. Nonetheless, pooled data from RCTs on the safety of NOACs versus VKAs in patients with VTE are still scarce.
Purpose
We aimed to compare the effect of NOACs versus VKA on the risk of fatal bleeding, major bleeding, clinically relevant non-major bleeding (CRNMB) and any bleeding in patients with VTE through a meta-analysis of RCTs.
Methods
We performed a systematic review of the literature, from January 1970 to December 2021, using PubMed database with four independent reviewers (L.R.; G.M.; V.C.; F.G.). Discrepancies were solved by consensus with a senior researcher (D.M.). Phase 3 randomized controlled trials comparing NOACs versus VKAs, either as an acute treatment or as an extended therapy, in patients with pulmonary embolism or deep vein thrombosis were selected. We performed a meta-analysis using a random-effects model with the Mantel–Haenszel method for each safety endpoint. Study outcomes were expressed as odd ratios (OR) with 95% confidence interval (CI) and illustrated in a Forest plot diagram. A two-sided p-value <0.05 was considered statistically significant. Heterogeneity was tested using the I2-statistic.
Results
Seven trials were included (n=29,879 patients), either investigating the direct thrombin inhibitor dabigatran (RE-COVER, RE-COVER II and RESONATE trials) or the factor Xa inhibitors rivaroxaban (EINSTEIN-DVT and EINSTEIN-PE studies), apixaban (AMPLIFY study) and edoxaban (Hokusai-VTE study). Compared to VKAs, treatment with NOACs was associated with lower risk of fatal bleeding (OR 0.35; 95% CI 0.16-0.81), major bleeding (OR 0.60; 95% CI 0.45-0.80), and any bleeding (OR 0.62; 95% CI 0.54-0.72) - fig. 1. There was no significant difference between the two groups concerning the risk of CRNMB.
Conclusions
In patients with VTE, treatment with NOACs was associated with fewer bleeding complications compared with VKAs.
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Affiliation(s)
- Lorenzo Ridolfi
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Gabriele Masini
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Vincenzo Castiglione
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Francesco Gentile
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Marco Favilli
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Matteo Mazzola
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Attilio Lepone
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Silvia Teresa Scalera
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Andrea Italiano
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Francesco Negro
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Giacinta Guarini
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Fabrizio Ricci
- Università Gabriele D’annunzio, Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche (Chieti)
| | - Giulia Renda
- Università Gabriele D’annunzio, Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche (Chieti)
| | - Raffaele De Caterina
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
| | - Doralisa Morrone
- Azienda Ospedaliero-Universitaria Pisana, Dipartimento Cardio-Toraco-Vascolare (Pisa)
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Vanhersecke L, Gillet L, Le Douget JE, Schmauch B, Maussion C, Italiano A, Soubeyran I, Le Loarer F. 10P Deep learning-based prediction of patient’s TLS status from HE images in pan-cancer cohort. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Imbimbo M, Hollebecque A, Italiano A, McKean M, Macarulla T, Castanon Alvarez E, Carneiro B, Mager R, Barnhart V, Murtomaki E, He Y, Cooper Z, Tu E, Linke A, Fan C, Zhou D, Boyer Chammard A, Paturel C, Fraenkel P, Powderly J. 188P IPH5201 as monotherapy or in combination with durvalumab (D) in advanced solid tumours. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Sargos P, Stoeckle E, Giraud A, Mahe M, Italiano A, Kind M, Toulmonde M, Mervoyer A, Ducassou A, Ferron G, Bellera C, Gillon P, Kantor G. High Dose (54 Gy) Pre-Operative Helical Tomotherapy for Retroperitoneal Liposarcoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1819] [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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Lepone A, Castiglione V, Gentile F, Scalera S, Negro F, Ridolfi L, Favilli M, Italiano A, Mazzola M, Masaracchia G, Mancini S, Guarini G, Masini G, De Caterina R, Morrone D. Comparison of the efficacy and safety between different oral P2Y12 receptor inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1231] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor for at least 1 month is the mainstay of therapy after an acute coronary syndrome (ACS). Despite several randomized controlled trials (RCTs) having compared different DAPT regimens after an ACS, the choice of the optimal P2Y12 receptor inhibitor is still debated.
Purpose
We aimed to compare the efficacy and safety profiles of the new P2Y12 receptor inhibitors (prasugrel and ticagrelor) versus clopidogrel in patients with ACS through a meta-analysis of RCTs.
Methods
We performed an extensive literature search, from January 1970 to December 2021 using PubMed database. Studies were eligible if they were RCTs directly comparing different oral P2Y12 receptor inhibitors in patients with ACS. Data on study methods, patient characteristics, and outcomes of interest (all-cause and cardiovascular death, recurrent myocardial infarction, stroke, major and non-major bleeding) were extracted from the original publications. We performed a meta-analysis using a random-effects model with the Mantel–Haenszel method. The effect measures of each study included were calculated and reported as odds ratio (OR) with 95% confidence interval (CI), visually presented in forest plots. A two-sided p-value <0.05 was considered statistically significant. Heterogeneity was tested using the I2-statistic.
Results
A total of 117 studies were available for the analysis; after full reading 11 studies were eligible to be analyzed. The 11 studies reported data on 50,722 patients: 25,424 [50.1%] taking a new oral P2Y12 receptor inhibitor and 25,298 [49.9%] taking clopidogrel. Patients receiving ticagrelor or prasugrel showed a lower risk of all-cause mortality (OR 0.88, 95% confidence interval [CI] 0.80–0.97, I2=8%), cardiovascular mortality (OR 0.88, 95% CI 0.81–0.95, I2=0%), and recurrent myocardial infarction (OR 0.86, 95% CI 0.76–0.97, I2=43%) compared to those receiving clopidogrel. The two groups did not differ significantly concerning the risk of stroke (OR 0.98, 95% CI 0.82–1.17, I2=0%), major bleeding (OR 1.05, 95% CI 0.97–1.15, I2=0%), or non-major bleeding (OR 1.36, 95% CI 0.85–2.20, I2=67%). By restricting the analysis to the studies comparing ticagrelor versus clopidogrel, the ticagrelor group showed a lower risk of all-cause mortality (OR 0.79, 95% CI 0.70–0.90, I2=0%), but a higher risk of non-major bleeding (OR 1.67, 95% CI 1.05–2.66, I2=30%). There was no significant difference between ticagrelor and clopidogrel in terms of cardiovascular death (OR 0.87, 95% CI 0.73–1.05, I2=0%), stroke (OR 1.06, 95% CI 0.85–1.13, I2=0%), or major bleeding (OR 1.02, 95% CI 0.93–1.12, I2=0%).
Conclusions
In patients with an ACS, a DAPT strategy with aspirin plus either prasugrel or ticagrelor is associated with a reduced risk of all-cause and cardiovascular mortality as well as of recurrent myocardial infarction compared to aspirin plus clopidogrel, without an increased risk of bleeding.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Lepone
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - V Castiglione
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - F Gentile
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - S Scalera
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - F Negro
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - L Ridolfi
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - M Favilli
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - A Italiano
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - M Mazzola
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - G Masaracchia
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - S Mancini
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - G Guarini
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - G Masini
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - R De Caterina
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
| | - D Morrone
- Azienda Ospedaliero Universitaria Pisana , Pisa , Italy
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Tagliamento M, Aldea M, Verge V, Bayle A, Blanc-Durand F, Marinello A, Hadoux J, Loriot Y, Vasseur D, Nicotra C, Smolenschi C, Martin-Romano P, Hollebecque A, Ponce S, Lacroix L, Rouleau E, Marzac C, Italiano A, Besse B, Micol J. Detection of myeloid malignancies through cfDNA profiling in patients with advanced stage cancer. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00830-9] [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: 11/17/2022]
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Vozy A, Roussel-Simonin C, Houessinon A, Bayle A, Blanc-Durand F, Ferrand F, Fouilloux A, Iacob M, Khalife N, Ponce S, Loriot Y, Baldini C, Italiano A, Even C. 129P Molecular screening and early phase trial inclusion for head and neck squamous cell carcinoma patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.130] [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: 11/17/2022] Open
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Bayle A, Peyraud F, Belcaid L, Brunet M, Aldea M, Clodion R, Dubos P, Vasseur D, Nicotra C, Geraud A, Sakkal M, Cerbone L, Blanc-Durand F, Mosele F, Romano PM, Camus MN, Soubeyran I, Khalifa E, Alame M, Blouin L, Dinart D, Bellera C, Hollebecque A, Ponce S, Loriot Y, Besse B, Lacroix L, Rouleau E, Barlesi F, Andre F, Italiano A. Liquid versus tissue biopsy for detecting actionable alterations according to ESCAT in patients with advanced cancer: A study from the French National Center for Precision Medicine (PRISM). Ann Oncol 2022; 33:1328-1331. [PMID: 36122799 DOI: 10.1016/j.annonc.2022.08.089] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/01/2022] Open
Affiliation(s)
- A Bayle
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif;; Université Paris Saclay, Université Paris-Sud, Faculté de médicine, Le Kremlin Bicêtre, Paris;; Oncostat U1018, Inserm, Paris-Saclay University, labeled Ligue Contre le Cancer, Villejuif
| | - F Peyraud
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif;; Department of Early Phase Trial Unit, Institut Bergonié Comprehensive Cancer Centre, Bordeaux,; University of Bordeaux, Bordeaux, France
| | - L Belcaid
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif;; Department of Oncology, Rigshospitalet, The University of Copenhagen, Denmark
| | - M Brunet
- Department of Early Phase Trial Unit, Institut Bergonié Comprehensive Cancer Centre, Bordeaux
| | - M Aldea
- Université Paris Saclay, Université Paris-Sud, Faculté de médicine, Le Kremlin Bicêtre, Paris;; Department of Cancer Medicine, Gustave Roussy
| | - R Clodion
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - P Dubos
- Department of Early Phase Trial Unit, Institut Bergonié Comprehensive Cancer Centre, Bordeaux
| | - D Vasseur
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif
| | - C Nicotra
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - A Geraud
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - M Sakkal
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - L Cerbone
- Department of Cancer Medicine, Gustave Roussy
| | | | - F Mosele
- Department of Cancer Medicine, Gustave Roussy
| | - P Martin Romano
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - M Ngo Camus
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - I Soubeyran
- Department of Medical Biology and Pathology, Institut Bergonié Comprehensive Cancer Centre
| | - E Khalifa
- Department of Medical Biology and Pathology, Institut Bergonié Comprehensive Cancer Centre
| | - M Alame
- Department of Medical Biology and Pathology, Institut Bergonié Comprehensive Cancer Centre
| | - L Blouin
- Department of Medical Biology and Pathology, Institut Bergonié Comprehensive Cancer Centre
| | - D Dinart
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team; Inserm CIC1401, Clinical and Epidemiological Research Unit,Institut Bergonié, Comprehensive Cancer Center, Bordeaux
| | - C Bellera
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team; Inserm CIC1401, Clinical and Epidemiological Research Unit,Institut Bergonié, Comprehensive Cancer Center, Bordeaux
| | - A Hollebecque
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - S Ponce
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - Y Loriot
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif
| | - B Besse
- Université Paris Saclay, Université Paris-Sud, Faculté de médicine, Le Kremlin Bicêtre, Paris;; Department of Cancer Medicine, Gustave Roussy
| | - Ludovic Lacroix
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif
| | - E Rouleau
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif
| | - F Barlesi
- Department of Cancer Medicine, Gustave Roussy;; Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - F Andre
- Université Paris Saclay, Université Paris-Sud, Faculté de médicine, Le Kremlin Bicêtre, Paris;; Department of Cancer Medicine, Gustave Roussy
| | - A Italiano
- Drug Development Department (DITEP) Gustave Roussy - Cancer Campus, Villejuif;; Department of Early Phase Trial Unit, Institut Bergonié Comprehensive Cancer Centre, Bordeaux,; University of Bordeaux, Bordeaux, France;.
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Soubeyran I, Dubois R, Jacquemin M, Courtet K, Y. Laizet, Lucchesi C, Allard B, Rousset A, Jaeger A, Moreira J, Khalifa E, Bonhomme B, Italiano A. 1084P Predicting KRAS G12C subtype from non-small cell lung cancer H&E slides using deep learning. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1210] [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] Open
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Penel N, Bonvalot S, Bimbai AM, Italiano A, Orbach D, Verret B, Toulmonde M, Dufresne A, Bay JO, Chaigneau L, Kurtz J, Bompas E, Salas S, Bertucci F, Guillemet C, Ryckewaert T, Thery J, Le Deley MC, Blay JY, Le Cesne A. 1512P Pain in patients with desmoid fibromatosis (DF). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1615] [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] Open
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O'Malley D, Bariani G, Cassier P, Marabelle A, Hansen A, De Jesus-Acosta A, Miller W, Safra T, Italiano A, Mileshkin L, Yao L, Gozman A, Jin F, Maio M. 546P Pembrolizumab for microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) advanced endometrial cancer: Long-term follow-up results from KEYNOTE-158. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.674] [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] Open
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Chabot C, Cousin S, Khalifa E, Spalato Ceruso M, Soubeyran I, Y. laizet, Crombe A, Italiano A. 1719P Predictive value of DNA repair gene alterations for the response to platinum-based chemotherapy and immunotherapy in advanced solid tumors patients: Results from a single center molecular screening program. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1797] [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: 11/01/2022] Open
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Martin Romano P, Roubaud G, Lavaud P, Cabart M, Pages A, Vasseur D, Colomba E, Cousin S, Toulmonde M, Grellety T, Castel Ajgal Z, Chabanon R, Parpaleix A, Buzzatti G, Fizazi K, Gomez-Roca C, Italiano A, Loriot Y, Postel-Vinay S. 1742P Phase II study of rucaparib and atezolizumab (ARIANES): Results in patients (pts) with platinum-sensitive metastatic urothelial cancer (mUC) and metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1820] [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: 11/01/2022] Open
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Cousin S, Bellera C, J-P. Guegan, Valentin T, Bahleda R, Metges JP, Cassier P, Cantarel C, Spalato Ceruso M, Kind M, Soubeyran I, Palussiere J, Bessede A, Italiano A. 1494P Regomune - a phase II study of regorafenib + avelumab in solid tumors: Results of the soft tissue sarcoma (STS) cohort. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1597] [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: 11/01/2022] Open
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Albert S, Italiano A, Toulmonde M, Cousin S, Bahleda R, Brahmi M, Watson S, Auzanneau C, Douiri N, Poignie L, Lortal B, Le Loarer F, Bellera C. 1525TiP TORNADO: A randomized multicenter open-label phase II study evaluating retifanlimab in combination with neoadjuvant chemotherapy in patients with selected retroperitoneal sarcomas. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1914] [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] Open
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Guillaume Z, Bayle A, Pobel C, Lacroix L, Vasseur D, Albiges L, Colomba E, Flippot R, Naoun N, Patrikidou A, Goldschmidt V, Vuagnat P, Massard C, Ponce S, Fizazi K, Loriot Y, Baldini C, Italiano A, Bernard-Tessier A. 1405P Circulating tumor DNA in advanced prostate cancer: Focus on high blood tumor mutational burden (h-bTMB). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1891] [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: 11/17/2022] Open
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Italiano A, Fu Y, Karanian M, Perret R, Camara A, Le Loarer F, Jean-Denis M, Hostein I, Michot A, Ducimetiere F, Giraud A, Courreges JB, Courtet K, Laizet Y, du Terrail J, Schmauch B, Maussion C, Blay JY, Coindre J. 1484O Deep learning predicts patients’ outcome and mutations from H&E slides in gastrointestinal stromal tumor (GIST). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1587] [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: 11/01/2022] Open
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Postel-Vinay S, Italiano A, Martin Romano P, Cassier P, Siu L, Lossos I, Hilton J, Mckean M, Strauss J, Falchook G, de Jonge M, Opdam F, Rasco D, Vermaat J, Crossman T, Zajac M, Hainline A, Kremer B, Barbash O, Gounder M. 456MO METEOR-1: A phase I study of the safety and efficacy of the protein arginine methyltransferase 5 (PRMT5) inhibitor GSK3326595 in advanced solid tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.585] [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] Open
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Italiano A, Coutzac Bergouignan C, Pasquier D, Rochigneux P, Sablin M, Gomez-Roca C, Ghiringhelli F, Metges JP, Toulmonde M, Cousin S, Pernot S, Auzanneau C, Lortal B, Kind M, Sargos P, Batard S, Petit A, Gillon P, Albert S, Pulido M. 781TiP AGADIR: A basket multicenter open-label phase II study evaluating the first in class TLR7/8 agonist BDB001 in combination with atezolizumab and stereotactic body radiation therapy in patients with advanced solid tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.907] [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: 11/01/2022] Open
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Rodriguez J, Bayle A, Pages A, Danlos FX, Vasseur D, Rouleau E, Lacroix L, Goldschmidt V, Seknazi L, Hollebecque A, Michot JM, Champiat S, Marabelle A, Postel-Vinay S, Ouali K, Marzac C, Ponce S, Italiano A, Baptiste Micol J, Baldini C. 508P High prevalence of clonal hematopoiesis of indeterminate potential (CHIP) associated mutations in elderly patients with solid tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.636] [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] Open
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Italiano A, Drilon A, Shen L, Hong D, van Tilburg C, Tan D, Lin J, Kummar S, Doz F, Geoerger B, Brose M, Briggs A, Lassen U, Vassal G, Keating K, Norenberg R, Dima L, Brega N, Laetsch T, Garcia-Foncillas J. 464P Intra-patient (Pt) comparison from larotrectinib (Laro) clinical trials in tropomyosin receptor kinase (TRK) fusion cancer: An expanded dataset. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.593] [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] Open
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Italiano A, Gazzah A, Tabernero J, Kang YK, Calvo E, Provencio Pulla M, Bang YJ, Barlesi F, Bedard P, Park J, Kim JS, Chadjaa M, Yoruk S, Delord JP. 490P Safety and efficacy of tusamitamab ravtansine in patients with colorectal or gastric cancer expressing carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.618] [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: 11/01/2022] Open
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33
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O'Malley DM, Bariani GM, Cassier PA, Marabelle A, Hansen AR, De Jesus Acosta A, Miller WH, Safra T, Italiano A, Mileshkin L, Amonkar M, Yao L, Jin F, Norwood K, Maio M. Health-related quality of life with pembrolizumab monotherapy in patients with previously treated advanced microsatellite instability high/mismatch repair deficient endometrial cancer in the KEYNOTE-158 study. Gynecol Oncol 2022; 166:245-253. [PMID: 35835611 DOI: 10.1016/j.ygyno.2022.06.005] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Pembrolizumab demonstrated a clinically meaningful objective response rate in patients with previously treated, advanced MSI-H/dMMR endometrial cancer in the multicohort phase 2 KEYNOTE-158 study (ClinicalTrials.gov, NCT02628067). We present health-related quality of life (HRQoL) results for these patients. METHODS This analysis included patients from cohorts D (endometrial cancer with any MSI status) and K (any MSI-H/dMMR solid tumor except colorectal) who had previously treated, advanced MSI-H/dMMR endometrial cancer. Patients received pembrolizumab 200 mg Q3W for 35 cycles. EORTC QLQ-C30 and EQ-5D-3L questionnaires were administered at baseline, at regular intervals during treatment, and 30 days after treatment discontinuation. Pre-specified exploratory analyses included changes from baseline to week 9 in QLQ-C30 global health status (GHS)/QoL and EQ-5D-3L visual analog scale (VAS) score for all patients and by best overall response. RESULTS 84 of 90 enrolled patients completed ≥1 HRQoL questionnaire and were included in the analysis. QLQ-C30 and EQ-5D-3L compliance rates were 90% and 94%, respectively, at baseline, and 92% and 93% at week 9. Mean (95% CI) QLQ-C30 GHS/QoL scores improved from baseline to week 9 by 6.08 (0.71-11.46) points in the overall population, with greater improvement in patients who achieved complete or partial response (11.67 [5.33-18.00]-point increase). Mean (95% CI) EQ-5D-3L VAS scores improved by 6.00 (2.25-9.75) points in the overall population and 9.11 (5.24-12.98) points in patients with CR/PR. CONCLUSIONS Pembrolizumab maintained or improved HRQoL in patients with previously treated, advanced MSI-H/dMMR endometrial cancer, further supporting efficacy and safety results from KEYNOTE-158 and pembrolizumab use in this setting.
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Affiliation(s)
- D M O'Malley
- The Ohio State University Wexner Medical Center and The James Comprehensive Cancer Center, Columbus, OH, USA. David.O'
| | - G M Bariani
- Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
| | | | - A Marabelle
- Gustave Roussy, Institut National de la Santé et de la Recherche Médicale U1015 & CIC1428, Université Paris Saclay, Villejuif, France.
| | - A R Hansen
- Princess Margaret Cancer Centre, Toronto, ON, Canada.
| | - A De Jesus Acosta
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
| | - W H Miller
- Segal Cancer Centre, Jewish General Hospital, Rossy Cancer Network, McGill University, Montreal, QC, Canada.
| | - T Safra
- Tel Aviv Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - A Italiano
- Early Phase Trials Unit, Institut Bergonié and Faculty of Medicine, University of Bordeaux, Bordeaux, France.
| | - L Mileshkin
- Peter MacCallum Cancer Centre and the Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
| | | | - L Yao
- Merck & Co., Inc., Rahway, NJ, USA.
| | - F Jin
- Merck & Co., Inc., Rahway, NJ, USA.
| | | | - M Maio
- University of Siena and Center for Immuno-Oncology, Department of Oncology, University Hospital, Siena, Italy.
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Peyraud F, Guegan JP, Bodet D, Nafia I, Fontan L, Auzanneau C, Cousin S, Roubaud G, Cabart M, Chomy F, Le Loarer F, Chaput N, Danlos FX, Planchard D, Even C, Khettab M, Tselikas L, Besse B, Barlesi F, Soria JC, Marabelle A, Bessede A, Italiano A. Circulating L-Arginine predicts the survival of cancer patients treated with immune checkpoint inhibitors. Ann Oncol 2022; 33:1041-1051. [PMID: 35850444 DOI: 10.1016/j.annonc.2022.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 04/17/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The discovery of immune checkpoint inhibitors (ICIs) has revolutionized the systemic approach to cancer treatment. However, most patients receiving ICIs do not derive benefits. Therefore, it is crucial to identify reliable predictive biomarkers of response to ICIs. One important pathway in regulating immune cell reactivity is L-arginine (ARG) metabolism, essential to T-cell activation. We therefore aimed to evaluate the association between baseline plasma ARG levels and the clinical benefit of ICIs. PATIENTS AND METHODS The correlation between ARG levels and clinical ICI activity was assessed by analyzing plasma samples obtained before treatment onset in two independent cohorts of patients with advanced cancer included in two institutional molecular profiling programs (BIP, NCT02534649, n = 77; PREMIS, NCT03984318, n = 296) and from patients in a phase 1 first-in-human study of budigalimab monotherapy (NCT03000257). Additionally, the correlation between ARG levels and ICI efficacy in preclinical settings was evaluated using a syngeneic mouse model of colorectal cancer responsive to ICIs. Using matched PBMC plasma samples, we analyzed the correlation between ARG levels and PBMC features through multiplexed flow cytometry analysis. RESULTS In both discovery and validation cohorts, low ARG levels at baseline (<42 μM) were significantly and independently associated with a worse clinical benefit rate, progression-free survival, and overall survival. Moreover, at the preclinical level, the tumor rejection rate was significantly higher in mice with high baseline ARG levels than in those with low ARG levels (85.7% versus 23.8%; P = 0.004). Finally, PBMC immunophenotyping showed that low ARG levels were significantly associated with increased PD-L1 expression in several immune cell subsets from the myeloid lineage. CONCLUSION We demonstrate that baseline ARG levels predict ICI response. Plasma ARG quantification may therefore represent an attractive biomarker to tailor novel therapeutic regimens targeting the ARG pathway in combination with ICIs.
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Affiliation(s)
- F Peyraud
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France; Department of Medicine, Institut Bergonié, Bordeaux, France; Explicyte Immuno-Oncology, Bordeaux, France; University of Bordeaux, Bordeaux, France
| | - J-P Guegan
- Explicyte Immuno-Oncology, Bordeaux, France
| | - D Bodet
- Explicyte Immuno-Oncology, Bordeaux, France
| | - I Nafia
- Explicyte Immuno-Oncology, Bordeaux, France
| | - L Fontan
- Explicyte Immuno-Oncology, Bordeaux, France
| | - C Auzanneau
- Department of Biopathology, Institut Bergonié, Bordeaux, France
| | - S Cousin
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - G Roubaud
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - M Cabart
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - F Chomy
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - F Le Loarer
- Department of Biopathology, Institut Bergonié, Bordeaux, France
| | - N Chaput
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay, UFR pharmacy, Chatenay-Malabry F-92290, France
| | - F-X Danlos
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - D Planchard
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - C Even
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - M Khettab
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - L Tselikas
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France
| | - B Besse
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - F Barlesi
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - J-C Soria
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - A Marabelle
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France; Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - A Bessede
- Explicyte Immuno-Oncology, Bordeaux, France
| | - A Italiano
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France; Department of Medicine, Institut Bergonié, Bordeaux, France; University of Bordeaux, Bordeaux, France.
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Baldini C, Charton E, Schultz E, Auroy L, Italiano A, Robert M, Coquan E, Isambert N, Moreau P, Le Gouill S, Le Tourneau C, Ghrieb Z, Kiladjian J, Delord J, Roca CG, Vey N, Barlesi F, Lesimple T, Penel N, Soria J, Massard C, Besle S. Access to early-phase clinical trials in older patients with cancer in France: the EGALICAN-2 study. ESMO Open 2022; 7:100468. [PMID: 35533427 PMCID: PMC9271476 DOI: 10.1016/j.esmoop.2022.100468] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/15/2022] [Accepted: 03/04/2022] [Indexed: 11/26/2022] Open
Abstract
Background Patients and methods Results Conclusions Older patients are underrepresented in early-phase clinical trials (17.7%) compared with the number of new cases (50%). The rate of signed informed consent was similar across age groups (92.7% in younger patients versus 90.6% in older patients). The rate of screening failure was consistent across all age groups (28.5% in younger patients versus 24.3% in older patients). In older patients the initial care received in the center having a phase I unit was associated with study drug administration.
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36
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Bessede A, Marabelle A, Guégan JP, Danlos FX, Cousin S, Peyraud F, Chaput N, Spalato M, Roubaud G, Cabart M, Khettab M, Chaibi A, Rey C, Nafia I, Mahon FX, Soria JC, Italiano A. Impact of acetaminophen on the efficacy of immunotherapy in cancer patients. Ann Oncol 2022; 33:909-915. [PMID: 35654248 DOI: 10.1016/j.annonc.2022.05.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/09/2022] [Accepted: 05/24/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Acetaminophen (APAP) use has been associated with blunted vaccine immune responses. This study aimed to assess APAP impact on immunotherapy efficacy in patients with cancer. PATIENTS AND METHODS Exposure to APAP was assessed by plasma analysis and was correlated with clinical outcome in three independent cohorts of patients with advanced cancer who were treated with immune checkpoint blockers (ICB). APAP immunomodulatory effects were evaluated on a pre-clinical tumor model and on human peripheral blood mononuclear cells (PBMCs) from healthy donors. RESULTS Detectable plasma APAP levels at treatment onset was associated with a significantly worse clinical outcome in ICB-treated cancer patients, independently of other prognostic factors. APAP significantly reduced ICB efficacy in the pre-clinical MC38 model, as well as the production of PD1 blockade-related interferon-γ secretion by human PBMCs. Moreover, reduction of ICB efficacy in vivo was associated with significantly increased tumor infiltration by regulatory T cells (Tregs). Administration of APAP over 24 h induced a significant expansion of peripheral Tregs in healthy individuals. In addition, interleukin-10, a crucial mediator of Treg-induced immune suppression, was significantly upregulated upon treatment with ICB in cancer patients taking APAP. CONCLUSION This study provides strong pre-clinical and clinical evidence of the role of APAP as a potential suppressor of antitumor immunity. Hence, APAP should be used with caution in patients treated with ICB.
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Affiliation(s)
- A Bessede
- Explicyte, 229 cours de l'Argonne, Bordeaux, France
| | - A Marabelle
- Département d'Innovation Précoce et d'Essais Thérapeutiques (DITEP), INSERM U1015 & CIC1428, Université Paris Saclay, Gustave Roussy, Villejuif, France
| | - J P Guégan
- Explicyte, 229 cours de l'Argonne, Bordeaux, France
| | - F X Danlos
- Département d'Innovation Précoce et d'Essais Thérapeutiques (DITEP), INSERM U1015 & CIC1428, Université Paris Saclay, Gustave Roussy, Villejuif, France
| | - S Cousin
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - F Peyraud
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - N Chaput
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy Cancer Campus, CNRS-UMS 3655 and INSERM-US23, Villejuif, France; Faculty of Pharmacy, University Paris-Saclay, Chatenay-Malabry, France; Laboratory of Genetic Instability and Oncogenesis, UMR CNRS 8200, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - M Spalato
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - G Roubaud
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - M Cabart
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - M Khettab
- Faculty of Medicine, University of Bordeaux, Bordeaux, France
| | - A Chaibi
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - C Rey
- Department of Medicine, Institut Bergonié, Bordeaux, France
| | - I Nafia
- Explicyte, 229 cours de l'Argonne, Bordeaux, France
| | - F X Mahon
- Department of Medicine, Institut Bergonié, Bordeaux, France; Faculty of Medicine, University of Bordeaux, Bordeaux, France
| | - J C Soria
- Department of Medicine, Gustave Roussy, Villejuif, France
| | - A Italiano
- Département d'Innovation Précoce et d'Essais Thérapeutiques (DITEP), INSERM U1015 & CIC1428, Université Paris Saclay, Gustave Roussy, Villejuif, France; Department of Medicine, Institut Bergonié, Bordeaux, France; Faculty of Medicine, University of Bordeaux, Bordeaux, France.
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37
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Italiano A, Bessede A, Pulido M, Bompas E, Piperno-Neumann S, Chevreau C, Penel N, Bertucci F, Toulmonde M, Bellera C, Guegan JP, Rey C, Sautès-Fridman C, Bougoüin A, Cantarel C, Kind M, Spalato M, Dadone-Montaudie B, Le Loarer F, Blay JY, Fridman WH. Pembrolizumab in soft-tissue sarcomas with tertiary lymphoid structures: a phase 2 PEMBROSARC trial cohort. Nat Med 2022; 28:1199-1206. [PMID: 35618839 DOI: 10.1038/s41591-022-01821-3] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/08/2022] [Indexed: 11/09/2022]
Abstract
Immune checkpoint inhibitors (ICIs) show limited clinical activity in patients with advanced soft-tissue sarcomas (STSs). Retrospective analysis suggests that intratumoral tertiary lymphoid structures (TLSs) are associated with improved outcome in these patients. PEMBROSARC is a multicohort phase 2 study of pembrolizumab combined with low-dose cyclophosphamide in patients with advanced STS (NCT02406781). The primary endpoint was the 6-month non-progression rate (NPR). Secondary endpoints included objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and safety. The 6-month NPR and ORRs for cohorts in this trial enrolling all comers were previously reported; here, we report the results of a cohort enrolling patients selected based on the presence of TLSs (n = 30). The 6-month NPR was 40% (95% confidence interval (CI), 22.7-59.4), so the primary endpoint was met. The ORR was 30% (95% CI, 14.7-49.4). In comparison, the 6-month NPR and ORR were 4.9% (95% CI, 0.6-16.5) and 2.4% (95% CI, 0.1-12.9), respectively, in the all-comer cohorts. The most frequent toxicities were grade 1 or 2 fatigue, nausea, dysthyroidism, diarrhea and anemia. Exploratory analyses revealed that the abundance of intratumoral plasma cells (PCs) was significantly associated with improved outcome. These results suggest that TLS presence in advanced STS is a potential predictive biomarker to improve patients' selection for pembrolizumab treatment.
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Affiliation(s)
- A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France. .,DITEP, Gustave Roussy, Villejuif, France. .,University of Bordeaux, Bordeaux, France.
| | | | - M Pulido
- Unité de Recherche et d'Epidémiologie Cliniques, Institut Bergonié, Bordeaux, France.,INSERM CIC, Bordeaux, France
| | - E Bompas
- Department of Medical Oncology, Institut de Cancérologie de L'Ouest, Nantes, France
| | | | - C Chevreau
- Department of Medical Oncology, Oncopole Toulouse, Toulouse, France
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - F Bertucci
- Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | - M Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - C Bellera
- Unité de Recherche et d'Epidémiologie Cliniques, Institut Bergonié, Bordeaux, France.,INSERM CIC, Bordeaux, France
| | | | - C Rey
- Explicyte, Bordeaux, France
| | - C Sautès-Fridman
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, Paris, France.,Equipe Labellisée Ligue contre le Cancer, Paris, France
| | - A Bougoüin
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, Paris, France.,Equipe Labellisée Ligue contre le Cancer, Paris, France
| | - C Cantarel
- Unité de Recherche et d'Epidémiologie Cliniques, Institut Bergonié, Bordeaux, France.,INSERM CIC, Bordeaux, France
| | - M Kind
- Department of Imaging, Institut Bergonié, Bordeaux, France
| | - M Spalato
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - B Dadone-Montaudie
- Department of Pathology, University Hospital Centre of Nice, Nice, France
| | - F Le Loarer
- University of Bordeaux, Bordeaux, France.,Department of Pathology, Institut Bergonié, Bordeaux, France
| | - J Y Blay
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - W H Fridman
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris Cité, Paris, France.,Equipe Labellisée Ligue contre le Cancer, Paris, France
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Tagliamento M, Vasseur D, A. Bayle, Aldea M, Gazzah A, Nicotra C, Hollebecque A, Planchard D, Frelaut M, Botticella A, Levy A, Lacroix L, Marzac C, Micol J, Ponce S, Rouleau E, Italiano A, Besse B. 169P Characteristics of clonal hematopoiesis (CH) in patients with non-small cell lung cancer (NSCLC): A retrospective analysis of plasma cell-free DNA (cfDNA) comprehensive genomic profiling. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.201] [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: 11/01/2022] Open
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Leroy K, Audigier Valette C, Galoin S, Civet A, Italiano A. 37P Retrospective analysis of real-world data to evaluate actionability of a large molecular profiling panel in solid tumors (REALM study). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.046] [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] Open
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40
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Moreau-Bachelard C, Campion L, Toulmonde M, Le Cesne A, Brahmi M, Italiano A, Mir O, Piperno-Neumann S, Laurence V, Firmin N, Penel N, Duffaud F, Chevreau C, Bertucci F, Narciso B, Dubray-Longeras P, Delcambre C, Saada-Bouzid E, Boudou-Rouquette P, Soulie P, Perrin C, Blay JY, Bompas E. Patterns of care and outcomes of 417 patients with METAstatic SYNovial sarcoma (METASYN): real-life data from the French Sarcoma Group (FSG). ESMO Open 2022; 7:100402. [PMID: 35202953 PMCID: PMC9058906 DOI: 10.1016/j.esmoop.2022.100402] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 01/13/2023] Open
Abstract
Background Synovial sarcoma (SS) occurs in both adult and pediatric patients. The primary aim of this study is to describe the outcomes, prognostic factors, and treatment of patients with metastatic SS within a nationwide cohort. Patients and methods All pediatric and adult patients with metastatic SS are registered in the French Sarcoma Group database. Data were collected from the national database https://conticabase.sarcomabcb.org/ up to March 2020. Descriptive and comparative analyses were conducted using SAS 9.4 and Stata Special Edition 16.1 software. Results Between January 1981 and December 2019, 417 patients with metastatic SS from 17 French sarcoma centers were included, including 64 (15.3%) under the age of 26 years. Median age was 42.5 years (range 9-87 years). The metastases were synchronous (cohort 1) or metachronous (cohort 2) in 18.9% (N = 79) and 81.1% (N = 338) patients, respectively. Median overall survival (OS) from the date of metastasis was 22.3 months (95% confidence interval 19.7-24.1 months). First-line chemotherapy without ifosfamide and/or doxorubicin was unfavorable for progression-free survival and OS (P < 0.001). Concerning cohort 1, young age, surgery of the primary tumor, and single metastatic site were independent favorable prognostic factors for OS. In cohort 2, surgery within an expert French Sarcoma Group center, absence of chemotherapy in the perioperative setting, the lungs as a single metastatic site, time to first metastasis >12 months, local therapy, and ifosfamide in the first metastatic line were independent favorable prognostic factors. Conclusions The outcome of patients with metastatic SS is influenced by local treatment, management in reference centers, and cytotoxic treatments given in the perioperative and metastatic setting. METASYN is the largest retrospective study on metastatic adult and pediatric SS. This study confirms that surgery remains the mainstay for improving OS in reference centers. METASYN emphasizes the importance of focal treatment of metastases for OS. This study offers real-life results in a metastatic setting and is a useful support for developing new strategies.
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Affiliation(s)
| | - L Campion
- ICO Centre René Gauducheau, Oncology, Nantes, France; CNRS, Inserm, CRCINA, Nantes, France
| | - M Toulmonde
- Institut Bergonié, Medical Oncology, Bordeaux, France
| | - A Le Cesne
- Department of Ambulatory Cancer Care & Sarcoma Group, Gustave Roussy, Villejuif, France
| | - M Brahmi
- Centre Leon Berard, Medical Oncology, Lyon, France
| | - A Italiano
- Institut Bergonié, Medical Oncology, Bordeaux, France
| | - O Mir
- Department of Ambulatory Cancer Care & Sarcoma Group, Gustave Roussy, Villejuif, France
| | | | - V Laurence
- Institut Curie, Medical Oncology, Paris, France
| | - N Firmin
- Department of Medical Oncology, ICM, INSERM U1194, IRCM, Université Montpellier, Montpellier, France
| | - N Penel
- Centre Oscar Lambret, Medical Oncology, Lille, France
| | - F Duffaud
- Hôpital De La Timone, Medical Oncology, Marseille, Aix Marseille Université, Marseille, France
| | - C Chevreau
- IUCT Oncopole, Oncology, Medical Toulouse, Toulouse, France
| | - F Bertucci
- Institut Paoli-Calmettes (IPC), Medical Oncology, Marseille, France
| | - B Narciso
- CHRU Bretonneau, Medical Oncology, Tours, France
| | | | - C Delcambre
- Centre François Baclesse, Medical Oncology, Caen, France
| | - E Saada-Bouzid
- Centre Antoine Lacassagne, Medical Oncology, Nice, France
| | | | - P Soulie
- ICO Centre Paul Pain, Medical Oncology, Angers, France
| | - C Perrin
- Centre Eugène Marquis, Medical Oncology, Rennes, France
| | - J Y Blay
- Centre Leon Berard, Medical Oncology, Lyon, France
| | - E Bompas
- ICO Centre René Gauducheau, Oncology, Nantes, France.
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Branchoux S, Sofeu CL, Gaudin AF, Kurt M, Moshyk A, Italiano A, Bellera C, Rondeau V. Time to next treatment or death as a candidate surrogate endpoint for overall survival in advanced melanoma patients treated with immune checkpoint inhibitors: an insight from the phase III CheckMate 067 trial. ESMO Open 2021; 7:100340. [PMID: 34929616 PMCID: PMC8693416 DOI: 10.1016/j.esmoop.2021.100340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/19/2021] [Revised: 10/22/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background Time to next treatment or death (TNT-D) may be a patient-relevant endpoint in patients treated with immune checkpoint inhibitors. This study investigated TNT-D as a surrogate endpoint (SE) for overall survival (OS) in previously untreated advanced melanoma patients. Methods Patient-level data from the 60-month results of the CheckMate 067 randomised, controlled trial were used. Analyses were carried out for nivolumab monotherapy or nivolumab with ipilimumab versus ipilimumab monotherapy. The SE 1-step validation method based on a joint frailty-copula model was used where the country of enrolment was applied to define clusters. Kendall’s τ and the coefficient of determination (R2trial) were estimated for respective measurements of association at the individual and cluster levels. The surrogate threshold effect, the maximum threshold hazard ratio for TNT-D that would translate into OS benefit, was estimated. A leave-one-out cross-validation analysis was carried out to evaluate model robustness. Results Fifteen clusters of data were generated from 945 patients. For both nivolumab-containing arms, the association between TNT-D and OS was deemed acceptable at the individual level (Kendall’s τ > 0.60) and strong at the cluster level, with R2trial fairly close to 1, with narrow confidence intervals. The estimated surrogate threshold effects were 0.61 for nivolumab versus ipilimumab and 0.49 for nivolimub + ipilimumab versus ipilimumab. Cross-validation results showed minimum variation of the correlation measures and satisfactory predictive accuracy for the model. Conclusion Results suggest that TNT-D may be a valuable SE in previously untreated advanced melanoma patients treated with immune checkpoint inhibitors. Surrogacy analyses considering multiple randomised controlled trials are warranted for confirming these findings. This is the first study to assess the surrogacy properties of TNT-D for OS in immune checkpoint inhibitor-treated patients. TNT-D is a clinically relevant, pragmatic and often measurable endpoint that reflects the result of a therapeutic decision. TNT-D appears to be a promising SE for OS in advanced melanoma patients treated with immune checkpoint inhibitors.
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Affiliation(s)
- S Branchoux
- Health Economics and Outcomes Research, Bristol Myers Squibb, Rueil-Malmaison, France.
| | - C L Sofeu
- Biostatistic Team, Bordeaux Population Health Center, ISPED, Centre INSERM U1219, INSERM, Bordeaux, France
| | - A-F Gaudin
- Health Economics and Outcomes Research, Bristol Myers Squibb, Rueil-Malmaison, France
| | - M Kurt
- Health Economics and Outcomes Research, Bristol Myers Squibb, Princeton, USA
| | - A Moshyk
- Health Economics and Outcomes Research, Bristol Myers Squibb, Princeton, USA
| | - A Italiano
- Department of Early Phase Trial Unit, Institut Bergonié Comprehensive Cancer Centre, Bordeaux, France
| | - C Bellera
- Epicene Team (Cancer and Environment), Bordeaux Population Health Center, ISPED, Centre INSERM U1219, INSERM, Bordeaux, France
| | - V Rondeau
- Biostatistic Team, Bordeaux Population Health Center, ISPED, Centre INSERM U1219, INSERM, Bordeaux, France
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Verbeke S, Perret R, Chaire V, Richard E, Velasco V, Giles F, Cavalcante L, Italiano A. GSK3-beta as a candidate therapeutic target in soft tissue sarcomas. J Hematol Oncol 2021; 14:202. [PMID: 34857030 PMCID: PMC8641200 DOI: 10.1186/s13045-021-01215-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/09/2021] [Accepted: 11/09/2021] [Indexed: 01/13/2023] Open
Abstract
Soft tissue sarcoma (STS) is a predominantly fatal rare malignancy with inadequate treatment options. Glycogen synthase kinase 3β (GSK-3β) is an emerging target in human malignancies. Its therapeutic relevance in STS is unknown. We analyzed the prognostic impact of GSK-3β gene and protein expression in two independent cohorts of patients with STS. We then treated STS cell lines and mice xenografts with a novel GSK-3 inhibitor 9-ING-41 alone or in combination with chemotherapy. We demonstrated that 9-ING-41 treatment induced significant STS cells apoptosis and was synergistic in vivo when combined with chemotherapy. Mechanistically, 9-ING-41 induces significant apoptosis of STS cells via suppression of NF-κB-mediated X-linked inhibitor of apoptosis protein (XIAP) expression. These data support the inclusion of patients with STS in clinical studies of 9-ING-41 alone and in combination with chemotherapy.
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Affiliation(s)
- S Verbeke
- Sarcoma Unit, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
- INSERM, U1218, Bordeaux, France
| | - R Perret
- Department of Pathology, Institut Bergonié, Bordeaux, France
| | - V Chaire
- Sarcoma Unit, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
- INSERM, U1218, Bordeaux, France
| | | | - V Velasco
- Department of Pathology, Institut Bergonié, Bordeaux, France
| | - F Giles
- Actuate Therapeutics, Fort Worth, TX, USA
| | | | - A Italiano
- Sarcoma Unit, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France.
- INSERM, U1218, Bordeaux, France.
- Faculty of Medicine, University of Bordeaux, Bordeaux, France.
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Auditore L, Amato E, Pistone D, Pagano B, Italiano A. Evaluation of radiation exposure risk from 90Y in the light of internal bremsstrahlung emission. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00501-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Aldea M, Cerbone L, Bayle A, Parisi C, Sarkozy C, Vasseur D, Verlingue L, Blanc-Durand F, Mosele F, Sakkal M, Ponce S, Lavaud P, Loriot Y, Hollebecque A, Massard C, Soria JC, Lacroix L, Rouleau E, Italiano A. Detection of additional occult malignancy through profiling of ctDNA in late-stage cancer patients. Ann Oncol 2021; 32:1642-1645. [PMID: 34509616 DOI: 10.1016/j.annonc.2021.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- M Aldea
- Department of Medicine, Gustave Roussy, Villejuif, France; Drug Development
| | - L Cerbone
- Department of Medicine, Gustave Roussy, Villejuif, France
| | | | - C Parisi
- Department of Medicine, Gustave Roussy, Villejuif, France
| | | | - D Vasseur
- Biopathology, Gustave Roussy, Villejuif, France
| | | | - F Blanc-Durand
- Department of Medicine, Gustave Roussy, Villejuif, France
| | - F Mosele
- Department of Medicine, Gustave Roussy, Villejuif, France
| | - M Sakkal
- Department of Medicine, Gustave Roussy, Villejuif, France; Drug Development
| | | | - P Lavaud
- Department of Medicine, Gustave Roussy, Villejuif, France
| | - Y Loriot
- Department of Medicine, Gustave Roussy, Villejuif, France
| | | | | | - J-C Soria
- Drug Development; Faculty of Medicine, University of Paris Saclay, Paris, France
| | - L Lacroix
- Biopathology, Gustave Roussy, Villejuif, France
| | - E Rouleau
- Biopathology, Gustave Roussy, Villejuif, France
| | - A Italiano
- Drug Development; Faculty of Medicine, University of Bordeaux, Bordeaux, France.
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Mottet T, Soubeyran P, Godbert Y, Cabart M, Roubaud G, Chakiba C, Bourcier K, Haik L, Lebreton C, Floquet A, Charitansky H, Fournier M, Toulmonde M, Pernot S, Annonay M, Enfedaque S, Cassauba S, Italiano A, Mathoulin-Pelissier S, Tueux NQ. 1613P What are the barriers to routine clinical use of teleconsultation in oncology? A retrospective study on patient’s and their physician’s satisfaction with 603 video teleconsultations. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1606] [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: 10/20/2022] Open
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Chen TW, Chang RJ, Le Cesne A, Hsieh YC, Italiano A, Yang YW, Penel N, Lee WC, Bompas E, Valentin T, Anract P, Firmin N, Duffaud F, Chan K, Blay JY. 1544P Soft tissue sarcoma (STS) incidences and clinical characteristics are significantly different between different geographic and ethnic populations. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.874] [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: 11/24/2022] Open
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O'Malley D, Bariani G, Cassier P, Marabelle A, Hansen A, De Jesus Acosta A, Miller W, Safra T, Italiano A, Mileshkin L, Amonkar M, Xu L, Jin F, Norwood K, Maio M. 797P Health-related quality of life (HRQoL) with pembrolizumab (pembro) monotherapy in patients (pts) with previously treated advanced microsatellite instability high (MSI-H) endometrial cancer: Results from KEYNOTE-158. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1239] [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] Open
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Hansen A, Gomez-Roca C, Lolkema M, Verlingue L, Italiano A, Spicer J, Steeghs N, Bauman J, Fayette J, Niu J, Prenen H, Dejardin D, Boetsch C, Kraxner A, Evers S, Vardar T, Keshelava N, Teichgräber V, Bonomi M. 906P Simlukafusp α and cetuximab combination in patients with recurrent, unresectable or metastatic squamous cell carcinoma of the head and neck. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1316] [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] Open
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Loriot Y, Marabelle A, Guégan JP, Danlos FX, Besse B, Chaput N, Massard C, Planchard D, Robert C, Even C, Khettab M, Tselikas L, Friboulet L, André F, Nafia I, Le Loarer F, Soria JC, Bessede A, Italiano A. Plasma proteomics identifies leukemia inhibitory factor (LIF) as a novel predictive biomarker of immune-checkpoint blockade resistance. Ann Oncol 2021; 32:1381-1390. [PMID: 34416362 DOI: 10.1016/j.annonc.2021.08.1748] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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: 06/08/2021] [Revised: 07/23/2021] [Accepted: 08/06/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Immune checkpoint blockers (ICBs) are now widely used in oncology. Most patients, however, do not derive benefit from these agents. Therefore, there is a crucial need to identify novel and reliable biomarkers of resistance to such treatments in order to prescribe potentially toxic and costly treatments only to patients with expected therapeutic benefits. In the wake of genomics, the study of proteins is now emerging as the new frontier for understanding real-time human biology. PATIENTS AND METHODS We analyzed the proteome of plasma samples, collected before treatment onset, from two independent prospective cohorts of cancer patients treated with ICB (discovery cohort n = 95, validation cohort n = 292). We then investigated the correlation between protein plasma levels, clinical benefit rate, progression-free survival and overall survival by Cox proportional hazards models. RESULTS By using an unbiased proteomics approach, we show that, in both discovery and validation cohorts, elevated baseline serum level of leukemia inhibitory factor (LIF) is associated with a poor clinical outcome in cancer patients treated with ICB, independently of other prognostic factors. We also demonstrated that the circulating level of LIF is inversely correlated with the presence of tertiary lymphoid structures in the tumor microenvironment. CONCLUSION This novel clinical dataset brings strong evidence for the role of LIF as a potential suppressor of antitumor immunity and suggests that targeting LIF or its pathway may represent a promising approach to improve efficacy of cancer immunotherapy in combination with ICB.
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Affiliation(s)
- Y Loriot
- Cancer Medicine Department, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - A Marabelle
- Département d'Innovation Précoce et d'Essais Thérapeutiques (DITEP), INSERM U1015 & CIC1428, Université Paris Saclay, Gustave Roussy, Villejuif, France
| | | | - F X Danlos
- Département d'Innovation Précoce et d'Essais Thérapeutiques (DITEP), INSERM U1015 & CIC1428, Université Paris Saclay, Gustave Roussy, Villejuif, France
| | - B Besse
- Cancer Medicine Department, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre, France
| | - N Chaput
- Laboratory of Immunomonitoring in Oncology, Gustave Roussy Cancer Campus, CNRS-UMS 3655 and INSERM-US23, Villejuif, France; Faculty of Pharmacy, University Paris-Saclay, Chatenay-Malabry, France; Laboratory of Genetic Instability and Oncogenesis, UMR CNRS 8200, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - C Massard
- Département d'Innovation Précoce et d'Essais Thérapeutiques (DITEP), INSERM U1015 & CIC1428, Université Paris Saclay, Gustave Roussy, Villejuif, France
| | - D Planchard
- Cancer Medicine Department, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - C Robert
- Cancer Medicine Department, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - C Even
- Cancer Medicine Department, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - M Khettab
- Cancer Medicine Department, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - L Tselikas
- Interventional Radiology, Gustave Roussy, Villejuif, France
| | - L Friboulet
- Université Paris-Saclay, Institut Gustave Roussy, Inserm U981, Biomarqueurs prédictifs et nouvelles stratégies thérapeutiques en oncologie, Villejuif, France
| | - F André
- Cancer Medicine Department, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre, France
| | | | - F Le Loarer
- Department of Pathology, Institut Bergonié, Bordeaux, France; Faculty of Medicine, University of Bordeaux, Bordeaux, France
| | - J C Soria
- Cancer Medicine Department, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - A Italiano
- Département d'Innovation Précoce et d'Essais Thérapeutiques (DITEP), INSERM U1015 & CIC1428, Université Paris Saclay, Gustave Roussy, Villejuif, France; Faculty of Medicine, University of Bordeaux, Bordeaux, France; Department of Medicine, Institut Bergonié, Bordeaux, France.
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Wainberg Z, Matos I, Delord J, Cassier P, Gil-Martin M, Kim T, LoRusso P, Bahleda R, Italiano A, Mendus D, Hoang T, Xue C, Wen X, Carvalho O, Pham T, Patil N, Meng R, Bendell J, Cervantes A, Cho B. LBA-5 Phase Ib study of the anti-TIGIT antibody tiragolumab in combination with atezolizumab in patients with metastatic esophageal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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