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Loirat D, de la barre MD, Thery JC, Hrab I, Jouannaud C, Mouysset JL, Salabert L, Soibinet P, Mailliez A, Valery R, Creisson A, Villanueva C, Dohollou N, Fumet JD, grellety T, Perez-staub N, Lachaier E, Iltis-roux A, delbado M, Najem A, Scodan RL, Curtit E, aldabbagh K, Pujol P, DE LA MOTTE ROUGE T. Abstract P4-01-20: Phase IV study evaluating talazoparib in patients with locally advanced or metastatic negative HER2 breast cancer and a somatic or germline BRCA1/2 mutation (ViTAL) – Analysis of cohort 1 according to hormonal receptor status. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-01-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: Talazoparib (TALA) is a highly potent, dual-mechanism PARP inhibitor that has demonstrated clinical benefit in EMBRACA Phase III trial for patients with germline BRCA1/2 mutated locally advanced or metastatic HER2- breast cancer.
Objective: The aim of the study is to ensure the effectiveness and safety of TALA in real-life setting among patients with locally advanced or metastatic HER2- breast cancer, with somatic or germline BRCA1/2 mutation.
Methods: ViTAL is an ambispective, multicentric, longitudinal, phase IV study. It includes two ambispective cohorts:
- Cohort 1: patients treated through the French Early Access Program and inclusion of patients with somatic BRCA1/2 mutation was allowed.
- Cohort 2: patients treated according to the European Marketing Approval granted in 09/21/2021.
Here we present the results of the primary and some secondary endpoints for cohort 1.
Results: From November 2018 to May 2021, 86 patients were included in Cohort 1, with updated results after a median follow-up of 17.3 months (11.2 - 24.4).
Patients’ characteristics are 53.5% of ER+ BC/46.5% of TNBC (refer to the table).
The median Time to Treatment Discontinuation (mTTD) was 9.0 months [range 6.0; 11.5] with 37.7% of patients still on treatment at 12 months. Subgroup analysis shows similar mTTD according HR status, germline vs somatic mutation and prior platinum exposure (refer to the table).
The Clinical Benefit Rate assessed by the investigators is 82.4% (Complete Response for 25.7%, Partial response R for 32.4% and stable disease for 24.3%).
The median of duration of CNS metastases control was 6.6 months, and 80.0% of patients had control of CNS metastases during TALA.
Out of the 85 treated patients, 69 patients (80,2%) experienced a TALA permanent discontinuation for progressive disease (84.1%), toxicity (10.1%), cancer-related death (1.4%), or other reasons (1.4%).
After discontinuation of TALA, 65.1% of patients received a subsequent treatment with a TTD of 2.3 months [1.7; 2.7]. The most common subsequent treatments were non-platinum chemotherapy (64.3%), platinum chemotherapy (19.6%) and others (19.1%).
At least one adverse events (AEs) was recorded in 74.4% of patients. Hematologic AEs (any grade) occurred in 48.8% (anemia 27.9%, thrombocytopenia 12.8%, neutropenia 10.5%).
Most common non-hematologic AEs were alopecia (8.1%) and asthenia (7.0%). Related Serious Hematologic AEs occurred in 10 patients (11.6%) including 7 (8.1%) Anemia.
Related Serious Non-hematologic AEs (vomiting, pyelonephritis and ascitis) were seen in 3 patients (3.6%). AEs associated with temporary drug interruption, dose modification and permanent drug discontinuation occurred in 36 (41.9%), 24 (27.9%), and 7 (10.1%) patients respectively.
The mOS is expected to be reached at the time of the congress, with 51.9% of patients still alive at 24 months.
Conclusions: ViTAL is the largest study that reports real-word data with TALA. Outcomes and safety in Cohort 1 are consistent with the results of EMBRACA study and give additional data on subgroups of interest (ie patients previously treated with carboplatin, presence of CNS).
(Litton et al. NEJM 2018)
mTTD on subgroups of interest
Patients’ characteristics
Citation Format: Delphine Loirat, Marie Duboys de la barre, Jean-Christophe Thery, Ioana Hrab, Christelle Jouannaud, Jean-Loup Mouysset, Laura Salabert, Pauline Soibinet, Audrey Mailliez, Romain Valery, Anne Creisson, Cristian Villanueva, Nadine Dohollou, Jean-david Fumet, Thomas grellety, Nathalie Perez-staub, Emma Lachaier, Aurore Iltis-roux, Miguel delbado, Abeer Najem, Romuald Le Scodan, Elsa Curtit, kais aldabbagh, Pascal Pujol, thibault DE LA MOTTE ROUGE. Phase IV study evaluating talazoparib in patients with locally advanced or metastatic negative HER2 breast cancer and a somatic or germline BRCA1/2 mutation (ViTAL) – Analysis of cohort 1 according to hormonal receptor status [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-01-20.
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Affiliation(s)
- Delphine Loirat
- 1Institut Curie, Medical Oncology Department and D3i, Paris, France, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aurore Iltis-roux
- 18Clinique Sainte-Anne, Strasbourg, France, Strasbourg, Alsace, France
| | - Miguel delbado
- 19Groupe hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Abeer Najem
- 20Centre Hospitalier de Boulogne-sur-Mer, Boulogne-sur-Mer, France
| | | | | | | | - Pascal Pujol
- 24CHU and University of Montpellier, Montpellier, France
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Loirat D, de la barre MD, Villanueva C, Mailliez A, Isambert N, Moreau L, Jacquet E, Spaëth D, Creisson A, Jouannaud C, Legouffe E, delbado M, Deiana L, Soibinet P, Hrab I, grellety T, Dohollou N, Longo R, Thery JC, Fumet JD, Zineb S, Pujol P, DE LA MOTTE ROUGE T. Abstract P4-01-04: Phase IV multicenter study evaluating RWE and the safety of talazoparib in patients with locally advanced or metastatic negative HER2 breast cancer and a BRCA1/2 mutation (ViTAL) - Cohort 2: patients treated according to the EMA. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-01-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: Talazoparib (TALA) is a highly potent, dual-mechanism PARP inhibitor that has demonstrated clinical benefit in EMBRACA Phase III trial for patients with germline BRCA1/2 (BRCA1/2)-mutated locally advanced or metastatic HER2- breast cancer. Objective: The aim of the study is to ensure the effectiveness and safety of TALA in the real-world setting among patients with locally advanced or metastatic HER2- breast cancer, with somatic or germline BRCA1/2 mutation. Methods: ViTAL is an ambispective, multicentric, longitudinal, phase IV study. It includes two ambispective cohorts: - Cohort 1: patients treated through the French Early Access Program and inclusion of patients with somatic BRCA1/2 mutation was allowed. - Cohort 2: patients treated according to the European Marketing Approval granted in 09/21/2021. The primary endpoint of the study is the Time to Treatment Discontinuation (TTD) which is defined as time between the date of first dose of TALA and the date of last dose or death. Results: From November 2018 to May 2021, 85 patients were included in Cohort 2, Patients’ characteristics are: - a median age of 49.0 years; - 65.8% ER+ BC/34.2% TNBC; - 42.1% mBRCA1/55.3 % mBRCA2/2,6% mBRCA1 and mBRCA2. - 85.7% ECOG PS 0 or 1; - 23.4% de novo mBC. - Visceral, bones and CNS metastases were found in 59.0%, 61.5% and 10.3% of patients respectively. - No breast or ovarian cancer family history at 1st degree was found in 39 patients (50.0%). - 38.5% were chemo-naïve; - 21.8% received prior platinum in (neo)adjuvant or metastatic setting, with a median of prior cytotoxic regimen of 1 - For patients with ER+/HER2- ABC the median number of prior endocrine therapy was 1 and 62.0% of these patients received a CDK4/6 inhibitor prior to TALA. - 8 patients (10.3%) had CNS metastases. Out of the 78 treated patients, 57 patients (73.0%) experienced a TALA permanent discontinuation for Progressive disease (80.7%), toxicity (12.3%), cancer-related death (1.8%), or other reasons (1.8%). The median TTD for TALA is 9.6 months [6.7;10.8] with 34.5% of patients still on treatment at 12 months. After discontinuation of TALA, 59.0% of patients received a subsequent treatment with a TTD of 3.9 months [2.1; 45]. The most common subsequent treatments were non-platinum chemotherapy (67.4%), platinum therapy (6.5%) and other (26.1%). The Clinical Benefit Rate assessed by the investigators is 87.6% (Complete Response for 14.1%, Partial Response for 56.3% and Stable Disease for 17.2%). The median duration of CNS metastases control was 10.2 months, and 25.0% of patients had a control of CNS metastases. At least one adverse events (AEs) was recorded in 67.9% of patients. Hematologic adverse events (AEs) (any grade) occurred in 55.1% (anemia 37.2%, thrombocytopenia 16.7%, neutropenia 15.4%). Most common non-hematologic AEs were Nausea (15.4%) and asthenia (15.4%). Related Serious Hematologic AEs occurred in 6 patients (7.7%) including 3 (3.8%) thrombocytopenia and 3 (3.8%) anemia. Related Serious Non-hematologic AEs (metrorrhagia) were seen in 1 patient (1.3%). AEs associated with temporary drug interruption, dose modification and permanent drug discontinuation occurred in 26 (33.3%), 22 (28.2%), and 7 (12.3%) patients respectively. The mOS is not mature for this analysis. Conclusions: ViTAL is the largest study that reports real-word data with TALA. Outcomes and safety in Cohort 2 (patients treated with TALA according to the European Marketing Approval), are consistent with the results of EMBRACA study and with the Cohort 1. (Litton et al. NEJM 2018)
Citation Format: Delphine Loirat, Marie Duboys de la barre, Cristian Villanueva, Audrey Mailliez, Nicolas Isambert, Lionel Moreau, Emmanuelle Jacquet, Dominique Spaëth, Anne Creisson, Christelle Jouannaud, Eric Legouffe, Miguel delbado, Laura Deiana, Pauline Soibinet, Ioana Hrab, Thomas grellety, Nadine Dohollou, Raffaele Longo, Jean-Christophe Thery, Jean-david Fumet, Sellam Zineb, Pascal Pujol, thibault DE LA MOTTE ROUGE. Phase IV multicenter study evaluating RWE and the safety of talazoparib in patients with locally advanced or metastatic negative HER2 breast cancer and a BRCA1/2 mutation (ViTAL) - Cohort 2: patients treated according to the EMA [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-01-04.
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Affiliation(s)
- Delphine Loirat
- 1Institut Curie, Medical Oncology Department and D3i, Paris, France, Paris, France
| | | | | | | | | | | | | | | | | | | | | | - Miguel delbado
- 12Groupe hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | | | | | - Ioana Hrab
- 15Centre François Baclesse, Caen, France
| | | | | | | | | | | | | | - Pascal Pujol
- 22CHU and University of Montpellier, Montpellier, France
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Loirat D, de Labarre MD, Essner C, Hrab I, Thery JC, Jouannaud C, Villanueva C, Vuagnat P, Soibinet-Oudot P, Creisson A, Mailliez A, Mouysset JL, Salabert L, Dohollou N, Fumet JD, De La Motte Rouge T, Vauthier JM, Decrop M, Pujol P. Abstract P1-18-28: Phase IV study evaluating effectiveness and safety of talazoparib in patients with locally advanced or metastatic HER2 negative breast cancer and a BRCA1 or BRCA2 mutation (ViTAL). Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p1-18-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Talazoparib (TALA) is a highly potent PARP inhibitor that has demonstrated clinical benefit in the phase III EMBRACA trial for patients with germline BRCA1 or BRCA2-mutation and a locally advanced or metastatic HER2 negative (HER2-) breast cancer (BC). Methods: ViTAL is an ambispective, multi-center longitudinal, phase IV study that aims to ensure the effectiveness and safety of TALA in the real-world setting among patients with locally advanced or metastatic HER2- BC, with somatic or germline BRCA mutation (sBRCA or gBRCA). This study includes two cohorts: - Cohort 1: patients treated through the French Early Access Program from November 2018 to September 2019. Inclusion of patients with sBRCA mutation was allowed. - Cohort 2: patients treated according to the European Marketing Approval granted 21/09/2021. The primary endpoint is Time to Treatment Discontinuation (TTD) for TALA defined as Time between the date of first dose of TALA and the date of last dose or death. Results: We present the results of Cohort 1 in which includes 85 patients. Patients’ characteristics are as follows: median age 50 years; 46% triple negative BC and 54% ER+ BC; 47% BRCA1-mutated and 53% BRCA2-mutated; 94% gBRCA and 6% sBRCA; 95% ECOG PS 0 or 1; 31% premenopausal status; 40% de novo metastatic BC (mBC). Visceral, bones and central nervous system metastases were found in 61%, 54% and 11% of patients, respectively. No breast or ovarian cancer in first degree relative was found in 35 patients (41%). The median number of prior cytotoxic regimen was 2, 15% were chemo-naïve for mBC; 35% received prior platinum in the neoadjuvant, adjuvant or metastatic setting. For patients with ER+/HER2- mBC the median number of prior endocrine therapy was 2 and 74% of these patients received a CDK4/6 inhibitor prior to TALA. The median follow-up was 17.4 months [range 15.7-20.5]. Of 85 treated patients, 66 patients (78%) experienced permanent discontinuation of TALA due to progressive disease (88%), toxicity (8%), cancer-related death (3%), or other reasons (1.5%). The median TTD for TALA was 9.0 months [range 6.0-11.0] with 35% of patients still in under treatment at 12 months. At least one adverse event (AEs) was recorded in 71% of patients. Hematologic AEs (any grade) occurred in 44% of patients (anemia for 26%, thrombocytopenia for 9%, neutropenia for 8%). The most common non-hematologic AEs were alopecia (6%) and asthenia (5%). Related serious hematologic AEs occurred in 7 (8%) patients including 6 (7%) with anemia. Related serious non-hematologic AEs (vomiting, pyelonephritis) were seen in 2 patients (2%). AEs associated with temporary drug interruption, dose modification and permanent drug discontinuation occurred in 32 (38%), 16 (19%), and 5 (8%) patients respectively. After discontinuation of TALA, 83% of patients received a subsequent treatment with a TTD of 2.4 months [range 1.7-3.3]. The most common subsequent treatments were non-platinum chemotherapy (64%) and platinum therapy (24%). Conclusions: The TTD of 9 months is consistent with the outcomes and safety results of the EMBRACA study. ViTAL, the first real-word study with TALA confirms its interest in locally advanced or metastatic HER2- BC. Analysis of Cohort 2 will occur when data are mature. (Ref Litton JK, Rugo HR, Ellt J et al. Talazoparib in Patients with Advanced Breast Cancer and a Germline BRCA Mutation. N Engl J Med. 2018; 379:753-763.
Citation Format: Delphine Loirat, Marie Duboys de Labarre, Christine Essner, Ioana Hrab, Jean-Christophe Thery, Christelle Jouannaud, Cristian Villanueva, Perrine Vuagnat, Pauline Soibinet-Oudot, Anne Creisson, Audrey Mailliez, Jean-Loup Mouysset, Laura Salabert, Nadine Dohollou, Jean-David Fumet, Thibault De La Motte Rouge, Jean-Michel Vauthier, Maylis Decrop, Pascal Pujol. Phase IV study evaluating effectiveness and safety of talazoparib in patients with locally advanced or metastatic HER2 negative breast cancer and a BRCA1 or BRCA2 mutation (ViTAL) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-18-28.
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Milano G, Gal J, Creisson A, Chamorey E. Myocarditis and COVID-19 mRNA vaccines: a mechanistic hypothesis involving dsRNA. Future Virol 2021. [PMID: 34887937 PMCID: PMC8647997 DOI: 10.2217/fvl-2021-0280] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 09/30/2021] [Accepted: 11/24/2021] [Indexed: 12/18/2022]
Abstract
While tolerance to COVID-19 vaccination is considered satisfactory, a phenomenon of myocarditis, although rare, is becoming a safety concern in mRNA COVID-19 vaccination. The presence of low residual levels of double-strand RNA (dsRNA) has been reported in mRNA COVID-19 vaccine preparations. dsRNA is a known inducer of immune-inflammatory reactions. dsRNA present in vaccine nanoparticles may be suspected to be at the origin of the still unexplained cases of myocarditis.
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Affiliation(s)
- Gerard Milano
- Centre Antoine Lacassagne, Unité Propre de Recherche 7497, Université Côte d'Azur, 06100, Nice, France.,Centre Antoine Lacassagne, UNS EA 7497 Nice University, 33 Avenue de Valombrose, 06189, Nice, France
| | - Jocelyn Gal
- Centre Antoine Lacassagne, UNS EA 7497 Nice University, 33 Avenue de Valombrose, 06189, Nice, France.,Epidemiology & Biostatistics Department, Centre Antoine Lacassagne, University Côte d'Azur, 33 Avenue de Valombrose, 06189, Nice, France
| | - Anne Creisson
- Medical oncology Department, Centre Antoine Lacassagne, University Côte d'Azur, 33 Avenue de Valombrose, 06189, Nice, France
| | - Emmanuel Chamorey
- Centre Antoine Lacassagne, UNS EA 7497 Nice University, 33 Avenue de Valombrose, 06189, Nice, France.,Epidemiology & Biostatistics Department, Centre Antoine Lacassagne, University Côte d'Azur, 33 Avenue de Valombrose, 06189, Nice, France
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Jardel P, Vignot S, Cutuli B, Creisson A, Vass S, Barranger E, Thariat J. Should Adjuvant Radiation Therapy Be Systematically Proposed for Male Breast Cancer? A Systematic Review. Anticancer Res 2018; 38:23-31. [PMID: 29277752 DOI: 10.21873/anticanres.12187] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 09/29/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Guidelines for radiotherapy in male breast cancer (MBC) are lacking. Some extrapolate the results from female breast cancer trials, while others advocate systematic adjuvant irradiation. We evaluated clinical practices and outcomes with respect to radiation therapy in MBC treated with locoregional irradiation in the adjuvant setting using a systematic literature review. MATERIAL AND METHODS We included studies with data about adjuvant radiotherapy published between 1984 and 2017 and including at least 40 patients. RESULTS We found 29 retrospective series, 10,065 men were diagnosed with breast cancer; 3-100% (mean=54%) received adjuvant radiotherapy. Tumor size and nodal involvement were the strongest prognostic factors. Approximatively half of all cases had nodal metastases. Radiation therapy improved locoregional control in six series, overall survival in three and distant metastasis-free survival in one. CONCLUSION MBC is diagnosed at a highly advanced stage and may be linked with poorer outcomes. Adjuvant radiation therapy must, at least, be proposed to men with positive nodes. Despite the large number of cases gathered here, arguments for radiotherapy in other prognostic subgroups (especially in pN0) may exist but are not well supported.
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Affiliation(s)
- Pauline Jardel
- Department of Radiation Oncology, Chicoutimi Hospital, Saguenay, QC, Canada
| | - Stéphane Vignot
- Department of Medical Oncology, Louis Pasteur Hospital, Le Coudray, France
| | - Bruno Cutuli
- Department of Radiation Oncology, Courlancy Polyclinic, Reims, France
| | - Anne Creisson
- Department of Medical Oncology, Antoine Lacassagne Anticancer Center, Nice, France
| | - Sylvie Vass
- Department of Radiation Oncology, Chicoutimi Hospital, Saguenay, QC, Canada
| | - Emmanuel Barranger
- Department of Surgery, Antoine Lacassagne Anticancer Center, Nice, France
| | - Juliette Thariat
- Department of Radiation Oncology, François Baclesse Anticancer Center, Caen, France
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Ducray J, Vignot S, Lacout A, Pougnet I, Marcy PY, Chapellier C, Foray N, Creisson A, Thariat J. Complications pulmonaires de la radiothérapie après cancer du sein : penser à la BOOP. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.03.001] [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: 12/01/2022]
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Ducray J, Vignot S, Lacout A, Pougnet I, Marcy PY, Chapellier C, Foray N, Creisson A, Thariat J. Complications pulmonaires de la radiothérapie après cancer du sein : penser à la BOOP. Cancer Radiother 2017; 21:148-154. [DOI: 10.1016/j.canrad.2016.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/19/2016] [Accepted: 12/21/2016] [Indexed: 10/19/2022]
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Thariat J, Creisson A, Chamignon B, Dejode M, Gastineau M, Hébert C, Boissin F, Topfer C, Gilbert E, Grondin B, Guennoc H, Mari V, Buzzo S, Saja D, Duboue N, Boulahssass R, Tosi A, Verne S, Ducray J, Benard-Thiery I, Ferrero JM. [Integrating patient education in your oncology practice]. Bull Cancer 2016; 103:674-90. [PMID: 27286758 DOI: 10.1016/j.bulcan.2016.04.007] [Citation(s) in RCA: 4] [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: 12/14/2015] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient education is the process by which health professionals impart information to patients and their caregivers that will alter their health behaviors; improve their health status to better manage their lives with a chronic disease. Patient education implies a profound paradigm shift in the conception of care among health professionals, and should result in structural care changes. Patient education has been promoted by the French Health system for 30years, including in the 2009 HPST law and Cancer Plan 2014-2019. A patient education program was designed in our hospital for breast cancer patients. MATERIAL AND METHODS A multidisciplinary and transversal team of health professionals and resource patients was trained before grant application for funding of the program by the regional health care agency. Management of the project required that a functional unit be built for recording of all patient education related activities. A customized patient education program process was built under the leadership of a coordinator and several patient education project managers during bimonthly meetings, using an accurate timeline and a communication strategy to ensure full institutional support and team engagement. RESULTS The grant was prepared in four months and the program started within the next four months with the aim to include 120 patients during year 1. The program includes a diagnosis of patient abilities and well-being resources, followed by collective and individual workshops undertaken in 4months for each patient. DISCUSSION Patient education is positively evaluated by all participants and may contribute to better health care management in the long term but the financial and human resources allocated to such programs currently underestimate the needs. Sustainability of patient education programs requires that specific tools and more commitment be developed to support health care professionals and to promote patient coping and empowerment in the long term.
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Affiliation(s)
- Juliette Thariat
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France.
| | - Anne Creisson
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Blandine Chamignon
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Magali Dejode
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Marie Gastineau
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Christophe Hébert
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Fabienne Boissin
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Christelle Topfer
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Elise Gilbert
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Benoit Grondin
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Helène Guennoc
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Veronique Mari
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Solange Buzzo
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Dominique Saja
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Nathalie Duboue
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Rabia Boulahssass
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Alexia Tosi
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Suzanne Verne
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Julie Ducray
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Isabelle Benard-Thiery
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - Jean Marc Ferrero
- Centre Lacassagne, équipe éducation thérapeutique patient, 33, avenue Valombrose, 06189 Nice cedex 2, France
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Boulahssass R, Gonfrier S, Isabelle B, Evesque L, Gary A, Hannoun Levi JM, Borchiellini D, Brocker P, Cavaglione G, Barranger E, Benizri E, Frin AC, Creisson A, Kreitmann T, Bernard JL, Poissonnet G, Amiel J, Guigay J, Francois E, Guerin O. Influence of the comprehensive geriatric assessment (CGA) in elderly metastatic cancer patients. Analysis from a prospective cohort of 1048 patients. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.10045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Eric Francois
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
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10
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Largillier R, Valenza B, Ferrero JM, Novo C, Creisson A, Lesbats G, Mari V, Hebert C, Chamorey E. Haematological Evaluation of Weekly Therapy with Topotecan for the Treatment of Recurrent Ovarian Cancer Resistant to Platinum-Based Therapy. Oncology 2007; 73:177-84. [DOI: 10.1159/000127384] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2007] [Accepted: 09/12/2007] [Indexed: 11/19/2022]
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Lagrange M, Ferrero JM, Lagrange JL, Machiavello JC, Monticelli J, Bayle C, Creisson A, Namer M, Thyss A, Bourcier C, Gioanni J, Schneider M. Non-specifically labelled cells that simulate bone marrow metastases in patients with non-metastatic breast cancer. J Clin Pathol 1997; 50:206-11. [PMID: 9155670 PMCID: PMC499814 DOI: 10.1136/jcp.50.3.206] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIMS To determine whether the presence of disseminated bone marrow tumour cells at diagnosis is a prognostic factor for breast cancer patients at high risk of recurrence or bone metastasis, and to assess their presence as a criterion for evaluation of the potential benefits of adjuvant chemotherapy. METHODS Multiple bone marrow aspirates from 72 breast cancer patients free from metastasis were obtained during surgery at the time of diagnosis and were tested immunologically by alkaline phosphatase antialkaline phosphatase technique with a panel of three antiepithelial monoclonal antibodies (MoAb) KL1, EMA, and HMFG2. RESULTS In nine of 72 patients, with each MoAb tested, numerous strongly positive cells always isolated were observed. However, it was demonstrated that these cells were non-specifically labelled and could be found in normal controls. CONCLUSIONS There was no evidence of marrow tumour cells in 72 operable breast cancer patients. It is suggested that published results may be greatly overestimated and that non-specific labelling may be undetected. More specific MoAb should be found and a correlation with molecular biology should be performed if this criterion is to be considered as a prognostic factor.
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Ferrero JM, Namer M, Dufour JF, Largillier R, Creisson A, Teissier E, Machiavello JC, Lallement M, Monticelli J, Abbes M. [A comparative study of 4 sequential first-line chemotherapy protocols in locally advanced breast cancer]. Bull Cancer 1997; 84:10-6. [PMID: 9180853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Between 1977 and 1994, our center administered successively 4 different chemotherapy regimens to 242 evaluable patients with locally advanced breast cancer. Patients with inflammatory signs were excluded. Sixty-eight patients were treated by AVCF (A (adriamycine) + V (vincristine) + C (cytoxan) + F (5FU)), 47 by AECF (A + E (vindesine) + C + F), 81 by CAFP (C + A + F + P (prednisone)) and 46 by AN (A + N (vinorelbine)). The mean number of cycle was 3. One hundred and twenty-five patients (52.5%) responded to chemotherapy and we recorded 35 complete response (14.7%). The response rates at the different combinations were respectively: AVCF: 29.4%, AECF: 53.2%, CAFP: 64.9%, AN: 65.2%, and were independent of tumor size, grade and receptor status. The response rate at the AVCF regimen was significantly worse than the others (p = 0.0005). Breast conserving surgery was performed in 31 patients (14%) and 17 patients (8%) had a complete response. Among the 35 patients with complete response, 21 were treated by radiotherapy alone. Local recurrence occurred in 19 patients (7.9%) and 96 (40%) had advanced disease. The mean follow-up of AVCF regimen was 150 months, 115 months for AECF, 111 for CAFP and 42 months for AN. The disease-free survival and the overall survival were significantly better with AECF, CAFP and AN regimens (DFS p < 0.04, OS p < 0.02). Survival was better in those patients with an objective response (p = 0.002) or with non-affected axillary node at the time of surgery. Our study showed already that AVCF combination was significantly lower than AECF, CAFP, AN in terms of response rate, disease-free survival and overall survival. Waiting the results of randomized studies about the impact of neoadjuvant chemotherapy on survival, we look for chemotherapy regimen improving the rate of conservative surgery.
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Affiliation(s)
- J M Ferrero
- Service d'oncologie médicale, Centre Antoine-Lacassagne, Nice, France
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Abstract
PURPOSE Assessment of cisplatin (CDDP) tolerance in patients more than 80 years old in good general condition who may benefit from CDDP-based treatment. PATIENTS AND METHODS Data on 35 patients older than 80 years who received one to six chemotherapy cycles (median, three cycles; total number of cycles, 98) including CDDP (60 to 100 mg/m2) were analyzed retrospectively. Before treatment, all patients had normal renal function as defined by serum creatinine (SC) levels below 132 mumol/L. Renal function was evaluated by measurement of SC and creatinine clearance (CC) before and after each course of chemotherapy. CC was calculated according to the Cockroft and Gault formula, where CC = (140 - age) x weight kg/0.814 x SC mumol/L. Renal toxicity was evaluated by the difference between prechemotherapy SC and the maximum SC level observed (delta SC) and by the difference between prechemotherapy CC and the minimal CC observed after treatment with CDDP (delta CC). The evolution of SC and CC during repeated courses of CDDP was analyzed, as were any extrarenal toxicities. RESULTS Renal function remained stable in 19 patients (54%) with delta SC less than 18 mumol/L and 18 of 35 patients (51%) with delta CC less than 9 mL/min. A slight deterioration in renal function was observed in 13 patients (37%) with delta SC greater than 18 mumol/L and less than 60 mumol/L, and with a delta CC greater than 11 mL/min and less than 21 mL/min. In three patients (9%), delta SC was greater than 60 mumol/L (71, 73, 115 mumol/L) and delta CC was greater than 21 mL/min (25, 26, 36 mL/min). There were no cases of severe renal insufficiency, clinical ototoxicity, or neurotoxicity > or = grade 2. Treatment was terminated after one or two courses in three patients because of grade 2 or 3 hematologic toxicity and in two patients for grade 3 nausea or vomiting. CONCLUSION CDDP at moderate doses can reasonably be administered to patients older than 80 years who may benefit from antineoplastic chemotherapy.
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Affiliation(s)
- A Thyss
- Centre Antoine-Lacassagne, Nice, France
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Bondiau PY, Peyrade F, Creisson A, Pivot X, Lagrange JL, Thyss A. [Severe hypocalcemia after treatment with diphosphonates and aminoglycosides]. Presse Med 1994; 23:816. [PMID: 8078844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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15
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Creisson A, Martinot C, Fuzibet JG, Taillan B, Verdier JM, Dujardin P. [Salmonella enteritidis infection at the site of an articular prosthesis]. Presse Med 1991; 20:1290. [PMID: 1832770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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