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Le Pechoux C, Pourel N, Barlesi F, Lerouge D, Antoni D, Lamezec B, Nestle U, Boisselier P, Dansin E, Paumier A, Peignaux K, Thillays F, Zalcman G, Madelaine J, Pichon E, Larrouy A, Lavole A, Argo-Leignel D, Derollez M, Faivre-Finn C, Hatton MQ, Riesterer O, Bouvier-Morel E, Dunant A, Edwards JG, Thomas PA, Mercier O, Bardet A. Postoperative radiotherapy versus no postoperative radiotherapy in patients with completely resected non-small-cell lung cancer and proven mediastinal N2 involvement (Lung ART): an open-label, randomised, phase 3 trial. Lancet Oncol 2022; 23:104-114. [PMID: 34919827 DOI: 10.1016/s1470-2045(21)00606-9] [Citation(s) in RCA: 94] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND In patients with non-small-cell lung cancer (NSCLC), the use of postoperative radiotherapy (PORT) has been controversial since 1998, because of one meta-analysis showing a deleterious effect on survival in patients with pN0 and pN1, but with an unclear effect in patients with pN2 NSCLC. Because many changes have occurred in the management of patients with NSCLC, the role of three-dimensional (3D) conformal PORT warrants further investigation in patients with stage IIIAN2 NSCLC. The aim of this study was to establish whether PORT should be part of their standard treatment. METHODS Lung ART is an open-label, randomised, phase 3, superiority trial comparing mediastinal PORT to no PORT in patients with NSCLC with complete resection, nodal exploration, and cytologically or histologically proven N2 involvement. Previous neoadjuvant or adjuvant chemotherapy was allowed. Patients aged 18 years or older, with an WHO performance status of 0-2, were recruited from 64 hospitals and cancer centres in five countries (France, UK, Germany, Switzerland, and Belgium). Patients were randomly assigned (1:1) to either the PORT or no PORT (control) groups via a web randomisation system, and minimisation factors were the institution, administration of chemotherapy, number of mediastinal lymph node stations involved, histology, and use of pre-treatment PET scan. Patients received PORT at a dose of 54 Gy in 27 or 30 daily fractions, on five consecutive days a week. Three dimensional conformal radiotherapy was mandatory, and intensity-modulated radiotherapy was permitted in centres with expertise. The primary endpoint was disease-free survival, analysed by intention to treat at 3 years; patients from the PORT group who did not receive radiotherapy and patients from the control group with no follow-up were excluded from the safety analyses. This trial is now closed. This trial is registered with ClinicalTrials.gov number, NCT00410683. FINDINGS Between Aug 7, 2007, and July 17, 2018, 501 patients, predominantly staged with 18F-fluorodeoxyglucose (18F-FDG) PET (456 [91%]; 232 (92%) in the PORT group and 224 (90%) in the control group), were enrolled and randomly assigned to receive PORT (252 patients) or no PORT (249 patients). At the cutoff date of May 31, 2019, median follow-up was 4·8 years (IQR 2·9-7·0). 3-year disease-free survival was 47% (95% CI 40-54) with PORT versus 44% (37-51) without PORT, and the median disease-free survival was 30·5 months (95% CI 24-49) in the PORT group and 22·8 months (17-37) in the control group (hazard ratio 0·86; 95% CI 0·68-1·08; p=0·18). The most common grade 3-4 adverse events were pneumonitis (13 [5%] of 241 patients in the PORT group vs one [<1%] of 246 in the control group), lymphopenia (nine [4%] vs 0), and fatigue (six [3%] vs one [<1%]). Late-grade 3-4 cardiopulmonary toxicity was reported in 26 patients (11%) in the PORT group versus 12 (5%) in the control group. Two patients died from pneumonitis, partly related to radiotherapy and infection, and one patient died due to chemotherapy toxicity (sepsis) that was deemed to be treatment-related, all of whom were in the PORT group. INTERPRETATION Lung ART evaluated 3D conformal PORT after complete resection in patients who predominantly had been staged using (18F-FDG PET-CT and received neoadjuvant or adjuvant chemotherapy. 3-year disease-free survival was higher than expected in both groups, but PORT was not associated with an increased disease-free survival compared with no PORT. Conformal PORT cannot be recommended as the standard of care in patients with stage IIIAN2 NSCLC. FUNDING French National Cancer Institute, Programme Hospitalier de Recherche Clinique from the French Health Ministry, Gustave Roussy, Cancer Research UK, Swiss State Secretary for Education, Research, and Innovation, Swiss Cancer Research Foundation, Swiss Cancer League.
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Affiliation(s)
- Cecile Le Pechoux
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France.
| | - Nicolas Pourel
- Radiation Oncology, Institut Sainte Catherine, Avignon, France
| | - Fabrice Barlesi
- Department of Medical Oncology, Gustave Roussy, Villejuif, France; Aix-Marseille University, Centre National de la Recherche Scientifique, Institut National des Sciences et de la Recherche Médicale, Centre de Recherche en Cancérologie de Marseille, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | | | - Delphine Antoni
- Department of Radiation Oncology, Centre Paul Strauss, Strasbourg, France
| | - Bruno Lamezec
- Radiation Oncology, Centre Armoricain de Radiothérapie, d'Imagerie médicale et d'Oncologie, St Brieuc, France
| | - Ursula Nestle
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany; Department of Radiation Oncology, Kliniken Maria Hilf, Moenchengladbach, Germany
| | - Pierre Boisselier
- Department of Radiation Oncology, Centre Val d'Aurelle, Montpellier, France
| | - Eric Dansin
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - Amaury Paumier
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest Centre Paul Papin, Angers, France
| | - Karine Peignaux
- Department of Radiation Oncology, Centre Georges-Francois Leclerc, Dijon, France
| | - François Thillays
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest Centre René Gauducheau, Nantes, France
| | - Gerard Zalcman
- Department of Pneumology, Centre Hospitalier Universitaire de Caen, Caen, France; Department of Thoracic Oncology, Université de Paris, Centre d'Investigation Clinique-1425-Bichat-Claude Bernard Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - Jeannick Madelaine
- Department of Pneumology, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Eric Pichon
- Department of Pneumology, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Anne Larrouy
- Radiation Oncology, Centre Specialisé Cancerologie Paris Nord, Sarcelles, France
| | - Armelle Lavole
- Department of Thoracic Oncology, Tenon University Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | | | - Marc Derollez
- Pneumology, Polyclinique du Val de Sambre, Maubeuge, France
| | - Corinne Faivre-Finn
- University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - Matthew Q Hatton
- Department of Clinical Oncology, Weston Park Hospital, Sheffield, UK
| | - Oliver Riesterer
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich and Centre for Radiation Oncology, Cantonal Hospitals Aarau and Baden, Aarau, Switzerland
| | - Emilie Bouvier-Morel
- International Center for Thoracic Cancers, and Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France
| | - Ariane Dunant
- International Center for Thoracic Cancers, and Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France
| | - John G Edwards
- Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield, UK
| | - Pascal Alexandre Thomas
- Department of Thoracic Surgery, Hôpital Nord, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Institut d'Oncologie Thoracique, Marie-Lannelongue Hospital, Paris-Saclay University, Le Plessis Robinson, France
| | - Aurelie Bardet
- International Center for Thoracic Cancers, and Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat Unité Mixte de Recherche 1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
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Vacchelli E, Galluzzi L, Rousseau V, Rigoni A, Tesniere A, Delahaye N, Schlemmer FDR, Menger L, Sukkurwala AQ, Adjemian S, Martins I, Michaud M, Dunant A, Kepp O, Brambilla E, Soria JC, Zitvogel L, Kroemer G. Loss-of-function alleles of P2RX7 and TLR4 fail to affect the response to chemotherapy in non-small cell lung cancer. Oncoimmunology 2021; 1:271-278. [PMID: 22737602 PMCID: PMC3382853 DOI: 10.4161/onci.18684] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The success of anticancer chemotherapy relies at least in part on the induction of an immune response against tumor cells. Thus, tumors growing on mice that lack the pattern recognition receptor TLR4 or the purinergic receptor P2RX7 fail to respond to chemotherapy with anthracyclins or oxaliplatin in conditions in which the same neoplasms growing on immunocompetent mice would do so. Similarly, the therapeutic efficacy (measured as progression-free survival) of adjuvant chemotherapy with anthracyclins is reduced in breast cancer patients bearing loss-of-function alleles of TLR4 or P2RX7. TLR4 loss-of-function alleles also have a negative impact on the therapeutic outcome of oxaliplatin in colorectal cancer patients. Here, we report that loss-of-function TLR4 and P2RX7 alleles do not affect overall survival in non-small cell lung cancer (NSCLC) patients, irrespective of the administration and type of chemotherapy. The intrinsic characteristics of NSCLC (which near-to-always is chemoresistant and associated with poor prognosis) and/or the type of therapy that is employed to treat this malignancy (which near-to-always is based on cisplatin) may explain why two genes that affect the immune response to dying cells fail to influence the clinical progression of NSCLC patients.
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Affiliation(s)
- Erika Vacchelli
- INSERM; U848; Villejuif, France ; Institut Gustave Roussy; Villejuif, France ; Université Paris Sud-XI; Faculté de Médecine; Le Kremlin Bicêtre, France
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3
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Michels J, Genestie C, Dunant A, Caron O, Lanoy E, Colomba E, Pommeret F, Rey A, Gouy S, Duvillard P, Teuff GL, Larue C, Savoye AM, Lhommé C, Leary A, Morice P, Pautier P. Impact of young age on platinum response in women with epithelial ovarian cancer: Results of a large single-institution registry. Gynecol Oncol 2020; 160:77-82. [PMID: 33059915 DOI: 10.1016/j.ygyno.2020.09.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/28/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE In young women, EOC is a rare disease with an uncertain genetic and biological substrate. METHODS We report a long follow-up of EOC patients treated at Gustave Roussy between 1990 and 2009. We matched young patients aged ≤30 years to randomly selected older patients aged ≥40 years according to known prognostic factors (i.e. FIGO stage, histology and surgical residual disease) and the date of diagnosis with a threshold at the year 2000 to balance the treatment procedures. RESULTS EOC was diagnosed in 68 patients aged ≤30 years matched with 111 patients aged ≥40 years. Low-grade (LG) (i.e. serous and endometrioid) (52%, n = 35) and mucinous (i.e. 23%, n = 16 infiltrative and 12% n = 8 expansile) tumors are prevalent. High-grade (HG) tumors are rare (7%, n = 5). Early stage diseases (53%, n = 36 FIGO I/II) are predominant. Response to platinum based chemotherapy is observed to be inferior in young patients as compared to matched older patients (ORR, 29 vs 84% p = 0.0002). For HG tumors the PFS is of 0% at 5 and 10 years in younger as compared to 30% in older patients. No difference in PFS (median 4.9 vs 9.8 ms, p = 0.58) and OS (not reached vs 15.3 ms, p = 0.47) is found overall among younger and older patients respectively. The median follow-up was 72 months (range, 11-288 months). No genetic abnormalities were found. CONCLUSIONS Young EOC patients are most often diagnosed at an early FIGO stage with LG serous or mucinous histology. Tumors are significantly more resistant to platinum-based chemotherapy in younger patients.
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Affiliation(s)
- Judith Michels
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France.
| | | | - Ariane Dunant
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France
| | | | - Emilie Lanoy
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France; Paris-Saclay University, Paris-Sud Univ., UVSQ, CESP, INSERM, Villejuif, France
| | - Emeline Colomba
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Fanny Pommeret
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Annie Rey
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France
| | | | | | - Gwenael Le Teuff
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France; Paris-Saclay University, Paris-Sud Univ., UVSQ, CESP, INSERM, Villejuif, France
| | - Christine Larue
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France
| | | | - Catherine Lhommé
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Alexandra Leary
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | | | - Patricia Pautier
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
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Genestie C, Blanc-Durand F, Auguste A, Pautier P, Dunant A, Scoazec JY, Gouy S, Morice P, Bentivegna E, Maulard A, LeFormal A, Devouassoux-Shisheboran M, Leary A. Clinical utility of SMARCA4 testing by immunohistochemistry in rare ovarian tumours. Br J Cancer 2019; 122:564-568. [PMID: 31844183 PMCID: PMC7028983 DOI: 10.1038/s41416-019-0687-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/30/2019] [Accepted: 11/27/2019] [Indexed: 01/03/2023] Open
Abstract
Background Ovarian small cell carcinoma, hypercalcaemic type (SCCOHT) is a rare and lethal disease affecting young women. As histological diagnosis is challenging and urgent, there is a clear need for a robust diagnostic test. While mutations in the chromatin-remodelling gene, SMARCA4, appear to be typical, it may not be feasible routinely to be clinically relevant. Methods Previous studies have described the value of SMARCA4 IHC to differentiate SCCOHT from ovarian neoplasms (ON), with similar histologic appearances. We aimed to evaluate its clinical utility among a cohort of 44 SCCOHT and 94 rare ON frequently misdiagnosed as SCCOHT. Results Forty-three percent (16/36) of SCCOHT had been classified locally as non-SCCOHT confirming the diagnosis challenge. Sensitivity and specificity of SMARCA4 IHC were excellent at 88% and 94%, respectively. In a community setting with a much lower prevalence of the disease, estimated PPV is 40% while NPV remained high at 99%. Finally, among the 16 SCCOHT misclassified locally, SMARCA4 IHC testing would have resulted in corrected diagnosis in 88% of cases. Conclusions SMARCA4 IHC is a highly sensitive, and specific test for the diagnosis of SCCOHT and is of huge clinical utility in providing a timely and accurate diagnosis of this challenging disease.
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Affiliation(s)
- Catherine Genestie
- Pathology Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Groupe des Investigateurs Nationaux des Cancers de l'Ovaire (GINECO)-GINECO Group for Early Phase Studies (GINEGEPS), Paris, France
| | - Félix Blanc-Durand
- Gynecological Cancer Unit, Department of Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Aurélie Auguste
- INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Patricia Pautier
- Gynecological Cancer Unit, Department of Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Ariane Dunant
- Biostatistics and Epidemiology Unit, Gustave Roussy, Villejuif, France
| | - Jean-Yves Scoazec
- Pathology Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Sébastien Gouy
- Gynecological Cancer Unit, Department of Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Philippe Morice
- Gynecological Cancer Unit, Department of Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Enrica Bentivegna
- Gynecological Cancer Unit, Department of Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Amandine Maulard
- Gynecological Cancer Unit, Department of Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Audrey LeFormal
- INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Alexandra Leary
- Groupe des Investigateurs Nationaux des Cancers de l'Ovaire (GINECO)-GINECO Group for Early Phase Studies (GINEGEPS), Paris, France. .,Gynecological Cancer Unit, Department of Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France. .,INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
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Mockenhaupt M, Wang C, Hung S, Sekula P, Schmidt AH, Pan R, Chen C, Dunant A, Gouvello SL, Schumacher M, Valeyrie‐Allanore L, Bellon T, Kardaun SH, Jan Y, Chung W, Roujeau J. HLA-B*57:01 confers genetic susceptibility to carbamazepine-induced SJS/TEN in Europeans. Allergy 2019; 74:2227-2230. [PMID: 30972788 DOI: 10.1111/all.13821] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Maja Mockenhaupt
- Dokumentationszentrum schwerer Hautreaktionen, Department of Dermatology, Faculty of Medicine and Medical Center University of Freiburg Freiburg Germany
| | - Chuang‐Wei Wang
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou, Taipei and Keelung Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan
- Cancer Vaccine and Immune Cell Therapy Core Laboratory Chang Gung Memorial Hospital Linkou Taiwan
| | - Shuen‐Iu Hung
- Cancer Vaccine and Immune Cell Therapy Core Laboratory Chang Gung Memorial Hospital Linkou Taiwan
- Department and Institute of Pharmacology, School of Medicine, Infection and Immunity Research Center National Yang‐Ming University Taipei Taiwan
| | - Peggy Sekula
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center University of Freiburg Freiburg Germany
| | | | - Ren‐You Pan
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou, Taipei and Keelung Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan
| | - Chun‐Bing Chen
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou, Taipei and Keelung Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
- Graduate Institute of Clinical Medical Sciences Chang Gung University Taoyuan Taiwan
- Immune‐Oncology Center of Excellence Chang Gung Memorial Hospital Linkou Taiwan
| | - Ariane Dunant
- Biostatistics and Epidemiology Unit Gustave Roussy Villejuif France
| | - Sabine Le Gouvello
- ImmunoBiology Department and Inserm U955 University Medical Center Henri Mondor Créteil France
| | - Martin Schumacher
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center University of Freiburg Freiburg Germany
| | | | - Teresa Bellon
- Research Unit, Hospital La Paz Health Research Institute (IdiPAZ) Madrid Spain
| | - Sylvia H. Kardaun
- Department of Dermatology, Reference Center for Cutaneous Adverse Reactions University Medical Center Groningen, University of Groningen Groningen The Netherlands
| | - Yun‐Shen Jan
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou, Taipei and Keelung Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan
| | - Wen‐Hung Chung
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou, Taipei and Keelung Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan
- Cancer Vaccine and Immune Cell Therapy Core Laboratory Chang Gung Memorial Hospital Linkou Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
- Immune‐Oncology Center of Excellence Chang Gung Memorial Hospital Linkou Taiwan
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Affiliation(s)
| | - Ariane Dunant
- Biostatistics and Epidemiology Unit, Gustave Roussy, Villejuif, France
| | - Maja Mockenhaupt
- Department of Dermatology Universitätsklinikum/Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany
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7
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Balleyguier C, Dunant A, Ceugnart L, Kandel M, Chauvet MP, Chérel P, Mazouni C, Henrot P, Rauch P, Chopier J, Zilberman S, Doutriaux-Dumoulin I, Jaffre I, Jalaguier A, Houvenaeghel G, Guérin N, Callonnec F, Chapellier C, Raoust I, Mathieu MC, Rimareix F, Bonastre J, Garbay JR. Preoperative Breast Magnetic Resonance Imaging in Women With Local Ductal Carcinoma in Situ to Optimize Surgical Outcomes: Results From the Randomized Phase III Trial IRCIS. J Clin Oncol 2019; 37:885-892. [DOI: 10.1200/jco.18.00595] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We evaluated the addition of breast magnetic resonance imaging (MRI) to standard radiologic evaluation on the re-intervention rate in women with ductal carcinoma in situ (DCIS) undergoing breast-conserving surgery. PATIENTS AND METHODS Women with biopsy-proven DCIS corresponding to a unifocal microcalcification cluster or a mass less than 30 mm were randomly assigned to undergo MRI or standard evaluation. The primary end point was the re-intervention rate for positive or close margins (< 2 mm) in the 6 months after randomization ( ClinicalTrials.gov identifier: NCT01112254). RESULTS A total of 360 patients from 10 hospitals in France were included in the study. Of the 352 analyzable patients, 178 were randomly assigned to the MRI arm, and 174 were assigned to the control arm. In the intent-to-treat analysis, 82 of 345 patients with the assessable end point were reoperated for positive or close margins within 6 months, resulting in a re-intervention rate of 20% (35 of 173) in the MRI arm and 27% (47 of 172) in the control arm. The absolute difference of 7% (95% CI, −2% to 16%) corresponded to a relative reduction of 26% (stratified odds ratio, 0.68; 95% CI, 0.41 to 1.1; P = .13). When considering only the per-protocol population with an assessable end point, the difference was 9% (stratified odds ratio, 0.59; 95% CI, 0.35 to 1.0; P = .05). Total mastectomy rates were 18% (31 of 176) in the MRI arm and 17% (30 of 173) in the control arm (stratified P = .93). For 100 lesions seen on MRI, nonmass-like enhancement was more predominant (82%) than mass enhancement (20%). Nevertheless, no specific morphologic and kinetic parameters for DCIS were identified. CONCLUSION The study did not show sufficient surgical improvement with the use of preoperative MRI to be clinically relevant in DCIS staging. However, this could be reconsidered with the improvement of new MRI sequences and new modalities in magnetic resonance techniques.
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Affiliation(s)
| | | | | | - Marguerite Kandel
- Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | | | | | | | - Philippe Henrot
- Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - Philippe Rauch
- Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | | | | | | | | | | | - Gilles Houvenaeghel
- Institut Paoli Calmettes, Marseille, France
- Cancer Research Center of Marseille, Marseille, France
- Aix-Marseille Université, Marseille, France
| | | | | | | | | | | | | | - Julia Bonastre
- Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
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Seban RD, Robert C, Dercle L, Yeh R, Dunant A, Reuze S, Schernberg A, Sun R, Mignot F, Terroir M, Schlumberger M, Haie-Meder C, Chargari C, Deutsch E. Increased bone marrow SUVmax on 18F-FDG PET is associated with higher pelvic treatment failure in patients with cervical cancer treated by chemoradiotherapy and brachytherapy. Oncoimmunology 2019; 8:e1574197. [PMID: 31069132 PMCID: PMC6492982 DOI: 10.1080/2162402x.2019.1574197] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 09/20/2018] [Revised: 01/07/2019] [Accepted: 01/10/2019] [Indexed: 01/19/2023] Open
Abstract
The aim of this study was to evaluate if bone marrow (BM) SUVmax measured on pre-treatment 18F-FDG PET/CT predicts the clinical outcome of locally advanced cervical cancer (LACC). We recruited retrospectively patients with LACC who underwent staging 18F-FDG PET/CT and had baseline blood tests, then treated by chemoradiation therapy (CRT), followed by image-guided adaptive brachytherapy (IGABT). BM SUVmax was calculated and correlated to inflammatory blood markers. Tumor size and pelvic lymph node involvement were evaluated on baseline MRI. Prognostic value of SUV uptake and blood markers regarding overall survival (OS), pelvic and extra-pelvic recurrence-free survival (PRFS and EPRFS respectively) was assessed using Cox models with adjusted p-values. 116 patients with FIGO stage Ib-IVa cervical cancer, treated between 2005 and 2014, were analyzed. The median follow-up was 75.5 months. BM SUVmax was significantly correlated to tumor SUVmax. In multivariate analysis, PRFS was significantly poorer in patients with high BM SUVmax (>2.8) and neutrophilia (p < .05). Tumor size (>5 vs ≤5 cm) could predict PRFS, EPRFS and OS (p < .05). In our cohort, FIGO stage (I-II vs III-IV), pelvic lymph node involvement and tumor SUVmax (>12 vs ≤12) were not prognostic for OS or pelvic and extra-pelvic relapses. Patients with LACC and high BM SUVmax on 18F-FDG PET have worse PFRS following CRT plus IGABT. These results can be potentially explained by the pro-inflammatory role of the tumor microenvironment and G-CSF expressed by tumor cells. These data support the role of PET as a potential indicator of disease aggressiveness beyond tumor staging.
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Affiliation(s)
- Romain-David Seban
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Charlotte Robert
- INSERM, Villejuif, France.,Faculté de médecine, Université Paris-Sud, Université Paris-Saclay, France.,Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Department of Medical Physics, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Laurent Dercle
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,INSERM, Villejuif, France.,Department of Radiology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Randy Yeh
- Department of Radiology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Ariane Dunant
- Biostatistics and Epidemiology Unit, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Sylvain Reuze
- INSERM, Villejuif, France.,Faculté de médecine, Université Paris-Sud, Université Paris-Saclay, France.,Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Department of Medical Physics, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Antoine Schernberg
- Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Roger Sun
- INSERM, Villejuif, France.,Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Fabien Mignot
- Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Marie Terroir
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Martin Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Faculté de médecine, Université Paris-Sud, Université Paris-Saclay, France
| | - Christine Haie-Meder
- Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Cyrus Chargari
- INSERM, Villejuif, France.,Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,French Military Health Services Academy, Paris, France.,Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France
| | - Eric Deutsch
- INSERM, Villejuif, France.,Faculté de médecine, Université Paris-Sud, Université Paris-Saclay, France.,Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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9
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Seymour L, Le Teuff G, Brambilla E, Shepherd FA, Soria JC, Kratzke R, Graziano S, Douillard JY, Rosell R, Reiman A, Lacas B, Lueza B, Aviel-Ronen S, McLeer A, Le Chevalier T, Pirker R, Filipits M, Dunant A, Pignon JP, Tsao MS. LACE-Bio: Validation of Predictive and/or Prognostic Immunohistochemistry/Histochemistry-based Biomarkers in Resected Non–small-cell Lung Cancer. Clin Lung Cancer 2019; 20:66-73.e6. [DOI: 10.1016/j.cllc.2018.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/28/2018] [Accepted: 10/02/2018] [Indexed: 01/02/2023]
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10
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Loi M, Dunant A, Ghith S, Cascales-Garcia AM, Mazouni C, Pistilli B, Mathieu MC, Deutsch E, Arriagada R, Rivera S. Clinical Response to Induction Chemotherapy Predicts Outcome after Combined-Modality Therapy in Inflammatory Breast Cancer. Cancer Invest 2019; 37:29-38. [PMID: 30656969 DOI: 10.1080/07357907.2018.1564325] [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] [Indexed: 10/27/2022]
Abstract
PURPOSE To assess predictors of outcome in a cohort of Inflammatory Breast Cancer (IBC) patients receiving induction chemotherapy followed by local treatment. METHODS We retrospectively reviewed 95 non-metastatic IBC patient files. RESULTS Complete clinical response (cCR) was obtained in 15 (16%) patients. Median follow up was 13.4 years (IC95%: 10.4-14.6). Loco-regional control (LC), disease-free survival (DFS), and overall survival (OS) at 5 years were 85%, 41%, and 55%, respectively; cCR was associated with better DFS and OS in multivariate analyses adjusted for age (p = 0.02). CONCLUSIONS Clinical response to upfront chemotherapy predicts the outcome of patients affected by IBC.
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Affiliation(s)
- Mauro Loi
- a Department of Radiation Oncology , Institut Gustave Roussy , Villejuif , France.,b Department of Radiation Oncology , Erasmus MC , Rotterdam , The Netherlands
| | - Ariane Dunant
- c Biostatistics and Epidemiology Unit , Institut Gustave Roussy , Villejuif , France
| | - Sahar Ghith
- a Department of Radiation Oncology , Institut Gustave Roussy , Villejuif , France
| | | | - Chafika Mazouni
- d Department of Surgery, Surgical Oncology Unit , Institut Gustave Roussy , Villejuif , France
| | - Barbara Pistilli
- e Departments of Cancer Medicine and Breast Oncology , Institut Gustave Roussy , Villejuif , France
| | | | - Eric Deutsch
- a Department of Radiation Oncology , Institut Gustave Roussy , Villejuif , France
| | - Rodrigo Arriagada
- a Department of Radiation Oncology , Institut Gustave Roussy , Villejuif , France.,g Oncology Pathology Department , Karolinska Institutet , Stockholm , Sweden
| | - Sofia Rivera
- a Department of Radiation Oncology , Institut Gustave Roussy , Villejuif , France
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11
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Balleyguier C, Cousin M, Dunant A, Attard M, Delaloge S, Arfi-Rouche J. Patient-assisted compression helps for image quality reduction dose and improves patient experience in mammography. Eur J Cancer 2018; 103:137-142. [DOI: 10.1016/j.ejca.2018.08.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/07/2018] [Indexed: 11/28/2022]
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12
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Lecler A, Dunant A, Delaloge S, Wehrer D, Moussa T, Caron O, Balleyguier C. Breast tissue density change after oophorectomy in BRCA mutation carrier patients using visual and volumetric analysis. Br J Radiol 2018; 91:20170163. [PMID: 29182397 DOI: 10.1259/bjr.20170163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE BRCA1/2 mutations account for 30-50% of hereditary breast cancers and bilateral oophorectomy is associated with a reduced risk of breast cancer in these patients. Breast density is a well-established breast cancer risk factor and is also associated with increased risk in BRCA carriers. The aim of the study was to evaluate the impact of oophorectomy on mammographic breast density and to assess which method of breast density assessment is more sensitive to change over time. METHODS Retrospective study of 50 BRCA1/2 patients who underwent bilateral oophorectomy and had at least a baseline and post-surgery mammogram. Mammographic breast density was determined by Volpara and consensus visual assessment by two radiologists. The primary endpoint was change in density between baseline and the first mammogram post-surgery. RESULTS At baseline, there was a non-significant trend for decreased density with increasing age. Volumetric breast density (VBD) significantly decreased after oophorectomy from a median VBD of 12.5% at baseline to 10.2% post-surgery which was driven by a reduction in fibroglandular volume. There was a higher absolute decrease in VBD in patients aged between 40-50 (p < 0.01). Using Volpara Density Grades (analogous to BI-RADS 4th edition density categories), 84% of females displayed a decrease in density category over the study period compared to only 76% using the radiologists' visual classification (p < 0.001) Conclusion: Oophorectomy is associated with a decrease in breast density and younger patients exhibit a larger absolute decrease. Volpara is more sensitive to identify change over time compared to visual assessment. Advances in knowledge: Oophorectomy is associated with a significant decrease in VBD in patients with BRCA mutations and Volpara Density Grades were more sensitive to identify decreases in density compared to visually assessed BI-RADS categories. Decreases in breast density following oophorectomy surgery in BRCA patients may be one of the mechanisms contributing to the observed decreased breast cancer risk after surgery. However, further studies are needed to investigate the relationship between breast density, oophorectomy and breast cancer risk in BRCA patients.
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Affiliation(s)
- Augustin Lecler
- 1 Department of Radiology, Fondation Ophtalmologique Rothschild , Fondation Ophtalmologique Rothschild , Paris , France.,2 Department of Radiology, Gustave Roussy , Gustave Roussy , Villejuif , France
| | - Ariane Dunant
- 3 Department of Biostatistic and Epidemiology, Gustave Roussy , Gustave Roussy , Villejuif , France
| | - Suzette Delaloge
- 4 Department of Medical Oncology, Gustave Roussy , Gustave Roussy , Villejuif , France
| | - Delphine Wehrer
- 5 Department of Genetics, Gustave Roussy , Gustave Roussy , Villejuif , France
| | - Tania Moussa
- 2 Department of Radiology, Gustave Roussy , Gustave Roussy , Villejuif , France
| | - Olivier Caron
- 5 Department of Genetics, Gustave Roussy , Gustave Roussy , Villejuif , France
| | - Corinne Balleyguier
- 2 Department of Radiology, Gustave Roussy , Gustave Roussy , Villejuif , France.,6 Department of Radiology, University Paris-Sud , University Paris-Sud , Orsay , France
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13
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Balleyguier C, Lakhdar AB, Dunant A, Mathieu MC, Delaloge S, Sinkus R. Value of whole breast magnetic resonance elastography added to MRI for lesion characterization. NMR Biomed 2018; 31:e3795. [PMID: 29073719 DOI: 10.1002/nbm.3795] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 07/23/2017] [Accepted: 07/24/2017] [Indexed: 06/07/2023]
Abstract
The purpose of this work was to assess the diagnostic value of magnetic resonance elastography (MRE) in addition to MRI to differentiate malignant from benign breast tumors, and the feasibility of performing MRE on the whole breast. MRE quantified biomechanical properties within the entire breast (50 slices) using an 11 min acquisition protocol at an isotropic image acquisition resolution of 2 × 2 × 2 mm3 . Fifty patients were included. Finally, 43 patients (median age 52) with a suspect breast lesion detected by mammography and/or ultrasound were examined by MRI and MRE at 1.5 T. The viscoelastic parameters, i.e. elasticity (Gd ), viscosity (Gl ), the magnitude of the complex shear modulus Gd2+Gl2, and the phase angle y=2πatanGlGd, were measured via MRE and correlated with MRI Breast Imaging-Reporting and Data System (BI-RADS) score, histological type, and histological grade. Stroma component and angiogenesis were also correlated with viscoelastic properties. In the 43 lesions, Gd decreased and y increased with the MRI BI-RADS score (pGd = 0.02, py = 0.002), whereas (Gl ) and y were increased in malignant lesions (pGl = 0.045, py = 0.0004). The area under the curve increased from 0.84 for MRI BI-RADS alone to 0.92 with the MRI BI-RADS and y (AUC increase +0.08; 95% CI (-0.003; 0.16)). Lesion characterization using the y parameter increased the diagnostic accuracy. The phase angle y was found to have a significant role (p = 0.01) in predicting malignancy independently of the MRI BI-RADS. Interestingly, histological analysis showed no correlation between viscoelastic parameters and percentage and type of stroma, CD34 quantification of vessels, or histological grade. The combination of MRE and MRI improves the diagnostic accuracy for breast lesions in the studied cohort. In particular, the phase angle y was found to have a significant role in predicting malignancy in addition to BI-RADS.
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Affiliation(s)
- Corinne Balleyguier
- Radiology Department, Gustave Roussy, Villejuif, France
- Paris-Sud University, IR4M UMR 8081, Orsay, France
| | - Aicha Ben Lakhdar
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif, France
| | - Ariane Dunant
- Department of Statistics, Gustave Roussy, Villejuif, France
| | | | - Suzette Delaloge
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Ralph Sinkus
- Paris Diderot University, Sorbonne Paris Cité, France
- INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
- BHF Centre of Excellence, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, UK
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14
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Mesnage SJL, Auguste A, Genestie C, Dunant A, Pain E, Drusch F, Gouy S, Morice P, Bentivegna E, Lhomme C, Pautier P, Michels J, Le Formal A, Cheaib B, Adam J, Leary AF. Neoadjuvant chemotherapy (NACT) increases immune infiltration and programmed death-ligand 1 (PD-L1) expression in epithelial ovarian cancer (EOC). Ann Oncol 2017; 28:651-657. [PMID: 27864219 DOI: 10.1093/annonc/mdw625] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Lymphocytic infiltration at diagnosis is prognostic in EOC, however, the impact of NACT on tumour infiltrating lymphocytes (TILs) or PD-L1 expression remains poorly described. Patients and methods Patients with EOC and sequential samples (pre-NACT, post-NACT or relapse) were retrospectively identified. TILs were evaluated on whole sections; stromal TILs (sTILs) scored as percentage of stromal area with high sTILs defined as ≥50%; intra-epithelial TILs (ieTILs) scored semi-quantitatively (0-3) with high ieTILs ≥2. A smaller number were available for PD-L1 evaluation, cut-off for positivity was ≥5% staining. Results sTILs were detected in all tumours at diagnosis (range 2-90%, median 20%), with 22% (25/113) showing high sTILs. Among evaluable paired pre/post-NACT samples (N = 83), an overall increase in median sTILs from 20% to 30% was seen following NACT (P = 0.0005); individually the impact of NACT varied with sTILs increasing in 51% (42/83), decreasing in 25%, and stable in 24%. Post-NACT sTILs were predictive of platinum-free interval (PFI), patients with PFI ≥6 months had significantly higher post-NACT sTILs (sTILs 28% versus 18% for PFI <6 months, P = 0.026); pre-NACT sTILS were not predictive. At diagnosis, 23% showed high ieTILs, and following NACT 33% showed increasing ieTILs. Proportion of tumours with PD-L1-positive immune cells was 30% (15/50) pre-NACT and 53% (27/51) post-NACT (P = 0.026). Among paired tumours, 63% of PD-L1-negative tumours became positive after NACT, furthermore cisplatin induced PD-L1 expression in PD-L1-negative EOC cell lines. On multivariate analysis, high sTILs both pre- and post-NACT were independent prognostic factors for progression-free survival (PFS) (HR 0.49, P = 0.02 and HR 0.60, P = 0.05, respectively). No prognostic impact of ieTILs or PD-L1 expression was detected. Conclusions In EOC, sTILs levels are prognostic at diagnosis and remain prognostic after NACT. TILs and PD-L1 expression increase following NACT. Evaluation of immune parameters in the post-NACT tumour may help select patients for immunotherapy trials.
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Affiliation(s)
- S J L Mesnage
- INSERM U981 Gynaecological Tumours, Gustave Roussy Cancer Center, Villejuif
| | - A Auguste
- INSERM U981 Gynaecological Tumours, Gustave Roussy Cancer Center, Villejuif.,Faculty of Sciences, University Paris-Sud, Orsay
| | - C Genestie
- INSERM U981 Gynaecological Tumours, Gustave Roussy Cancer Center, Villejuif.,Departments of Biopathology, Gustave Roussy, Villejuif, France
| | - A Dunant
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France
| | - E Pain
- INSERM U981 Gynaecological Tumours, Gustave Roussy Cancer Center, Villejuif
| | - F Drusch
- Translational Research and Histocytopathology Laboratory, Gustave Roussy, 114 rue E Vaillant, 94805, Villejuif, France
| | - S Gouy
- Gustave Roussy, Université Paris-Saclay, Department of Gynecologic Surgery, F-94805, Villejuif, France
| | - P Morice
- Gustave Roussy, Université Paris-Saclay, Department of Gynecologic Surgery, F-94805, Villejuif, France
| | - E Bentivegna
- Gustave Roussy, Université Paris-Saclay, Department of Gynecologic Surgery, F-94805, Villejuif, France
| | - C Lhomme
- Oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - P Pautier
- Oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - J Michels
- Oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - A Le Formal
- INSERM U981 Gynaecological Tumours, Gustave Roussy Cancer Center, Villejuif.,Faculty of Sciences, University Paris-Sud, Orsay
| | - B Cheaib
- Oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - J Adam
- INSERM U981 Gynaecological Tumours, Gustave Roussy Cancer Center, Villejuif.,Departments of Biopathology, Gustave Roussy, Villejuif, France
| | - A F Leary
- INSERM U981 Gynaecological Tumours, Gustave Roussy Cancer Center, Villejuif.,Faculty of Sciences, University Paris-Sud, Orsay.,Oncology, Gustave Roussy Cancer Center, Villejuif, France
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15
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Riet F, Fayard F, Arriagada R, Santos M, Bourgier C, Ferchiou M, Heymann S, Delaloge S, Mazouni C, Dunant A, Rivera S. Preoperative radiotherapy in breast cancer patients: 32 years of follow-up. Eur J Cancer 2017; 76:45-51. [DOI: 10.1016/j.ejca.2017.01.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 01/15/2017] [Accepted: 01/24/2017] [Indexed: 11/16/2022]
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16
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Mesnage SJL, Auguste A, Genestie C, Dunant A, Pain E, Drusch F, Gouy S, Morice P, Bentivegna E, Lhomme C, Pautier P, Michels J, Le Formal A, Cheaib B, Adam J, Leary A. Pattern of tumor-infiltrating lymphocytes (TILs) and PD-L1 expression in primary and metastatic epithelial ovarian cancer (EOC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.7_suppl.64] [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: 11/20/2022] Open
Abstract
64 Background: Tumour immune response plays a critical role in progression and prognosis of EOC, however patterns of TILs and PD-L1 expression in primary and metastatic disease remain poorly described. Methods: Patients treated with neoadjuvant chemotherapy (NACT) for advanced EOC, between 2002-2014, and available sequential tumours (pre-NACT, post-NACT, or relapse) were retrospectively identified. Stromal TILs (sTILs) were evaluated according to the International TILs Working Group 2014 (Salgado 2015) on whole sections, and scored as a percentage of stromal area. Immune cell PD-L1 expression was evaluated by immunohistochemistry (E1L3N clone, Cell Signaling) in a smaller number of tumours. Cutoffs for analysis were: high sTILs ≥50%, PD-L1 positivity ≥5% membranous staining. Results: Among a total of 236 tumour samples from 150 patients (110 pre-NACT, 111 post-NACT, and 15 relapse tumours) median sTILs levels was significantly higher in metastatic tumours ( n=151) compared with primary tumours ( n=85) (median 30, IQR 10-50 vs. 15, IQR 5-30, p=0.0004). Among diagnostic samples, median sTILs level was 20 (IQR 10-45, n=85) in metastatic tumours compared with 10 (IQR 5-20, n =25) in primary tumours ( p=0064). Similarly in post-NACT samples, median sTILs level was 40 (IQR 15-60, n=51) in metastatic tumours compared with 20 (IQR 6.25-30, n=60) in primary tumours ( p=0026). Among relapse samples median sTILs level was 30 (IQR 10-50, n=15). Among all available samples ( n=97) PD-L1 positivity was detected in 33% (9/30) of primary and 50% (34/68) of metastatic tumours (Fisher’s exact test OR 2.3, 95%CI 0.94-5.4, p =0.08). Conclusions: In patients with EOC there is increased lymphocytic infiltration in both synchronous metastatic disease at diagnosis, and metachronous metastatic disease at relapse, compared with the primary tumour. This suggests increased immunogenicity as disease progresses. Furthermore, there is a trend towards upregulation of the PD-L1 immune checkpoint with disease progression.
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Affiliation(s)
| | - Aurelie Auguste
- INSERM U981, Gustave Roussy Cancer Center, Villejuif, France
| | | | | | - Erwann Pain
- Gustave Roussy Cancer Center, Villejuif, France
| | | | - Sebastien Gouy
- Department of Surgery, Gustave Roussy Cancer Centre, Villejuif, France
| | - Philippe Morice
- Department of Surgery, Gustave Roussy Cancer Centre, Villejuif, France
| | - Enrica Bentivegna
- Department of Surgery, Gustave Roussy Cancer Center, Villejuif, France
| | - Catherine Lhomme
- Department of Medical Oncology, Gustave Roussy Cancer Center, Villejuif, France
| | | | - Judith Michels
- Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | | | | | - Julien Adam
- Department of Biopathology, Gustave Roussy Cancer Center, Villejuif, France
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17
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Balleyguier C, Dunant A, Kandel M, Ceugnart L, Cherel P, Henrot P, Chopier J, Mazouni C, Mathieu M, Rimareix F, Bonastre J, Garbay J. Breast magnetic resonance imaging (MRI) for local ductal carcinoma in-situ (DCIS) staging: Multicentric randomized controlled trial to assess the efficacy and cost-effectiveness of preoperative MRI to optimize breast surgery. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30200-9] [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: 11/28/2022]
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18
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Carr DF, Chung WH, Jenkiins RE, Chaponda M, Nwikue G, Cornejo Castro EM, Antoine DJ, Pirmohamed M, Wuillemin N, Dina D, Eriksson KK, Yerly D, Pavlos R, Mckinnin E, Ostrov D, Peters B, Buus S, Koelle D, Chopra A, Rive C, Redwood A, Restrepo S, Bracey A, Yuan J, Gaudieri S, Carrington M, Haas D, Mallal S, Phillips E, De Boer D, Menheere P, Nieuwhof C, Bons J, Jonsson F, De Chaisemartin L, Granger V, Gillis C, Gouel A, Neukirch C, Dib F, Nicaise PR, Longrois D, Tubach F, Martin S, Bruhns P, Chen KL, Liao SL, Sheen YS, Cho YT, Yang CW, Liau JY, Chu CY, Aguiar R, Lopes A, Fernandes N, Viegas L, Pereira-Barbosa MA, Bünter A, Gupta N, Petkovic TP, Wirth N, Pichler WJ, Hausmann O, Yazicioglu M, Ozdemir PG, Ciplak G, Kaya O, Cooke PJ, Mota I, Gaspar Â, Benito-Garcia F, Chambel M, Morais-Almeida M, Marques L, Alcoceba E, Lara S, Carneiro-Leão L, Botelho C, Dias-Castro E, Cernadas JR, Nicholls K, Lay W, Smith O, Collins C, Unglik G, Spriggs K, Auyeung P, McComish J, Douglass JA, Peter JG, Potter P, Carolino F, De Castro ED, Moreira AS, Abreu C, Gomes E, Cardoso BK, Tomaz E, Correia S, Inácio F, Arnold A, Bear N, Rueter K, Gong G, O’Sullivan M, Muthusamy S, Noble V, Lucas M, Buterleviciute N, Rudzeviciene O, Abreu C, May S, Pongdee T, Park M, Griguola L, Vinikovas A, Kašinskaite S, Kvedariene V, Aktas A, Rahman S, Elbi H, Ozyurt BC, Cavkaytar O, Karaatmaca B, Cetinkaya PG, Esenboga S, Sahiner UM, Sekerel BE, Soyer O, Zubrinich C, Tong B, Patel M, Giles M, O’Hehir R, Puy R, Amaral L, Demir S, Gelincik A, Olgac M, Caskun R, Unal D, Colakoglu B, Buyukozturk S, Matute OV, Bernad A, Gastaminza G, Madamba R, Lacasa C, Goikoetxea MJ, D’Amelio C, Rifón J, Martínez N, Ferrer M, Ribeiro C, Faria E, Frutuoso C, Barros A, Lebre R, Pego A, Bom AT, Ensina LF, Aranda C, Nunes IC, Martins AM, Solé D, Bavbek S, Kendirlinan R, Çerçi P, Tutluer S, Soyyigit S, Sözener ZÇ, Aydin Ö, Gümüsburun R, Almeida M, Sai K, Imatoh T, Nakamura R, Fukazawa C, Hinomura Y, Saito Y, Sousa-Pinto B, Correia C, Gomes L, Gil-Mata S, Araújo L, Delgado L, Sai K, Okamoto-Uchida Y, Kajinami K, Matsunaga K, Aihara M, Wang CW, Su SC, Hung SI, Ho HC, Yang CH, Paulmann M, Dunant A, Mockenhaupt M, Sekula P, Schumacher M, Kardaun S, Naldi L, Bellón T, Creamer D, Haddad C, Sassolas B, Lebrun-Vignes B, Valeyrie-Allanore L, Roujeau JC, Paulmann M, Kremmler C, Mockenhaupt M, Dodiuk-Gad RP, Olteanu C, Feinstein A, Hashimoto R, Alhusayen R, Whyte-Croasdaile S, Finkelstein Y, Burnett M, Sade S, Cartotto R, Jeschke M, Shear NH, Takamura N, Yamane Y, Matsukura S, Nakamura K, Watanabe Y, Yamaguchi Y, Kambara T, Ikezawa Z, Aihara M, Hashimoto R, Chew H, Burnett M, Jeschke M, Knezevic B, Ionmhain UN, Barraclough A, Anstey M, Usui T, Meng X, Farrell J, Whitaker P, Watson J, French N, Park K, Naisbitt D, Neves AC, Cadinha S, Moreira A, Da Silva JPM, Drvar DL, Gulin SJ, Hadzavdic SL, Ceovic R, De Francisco AM, De Vicente Jiménez T, Luque AG, David NR, Galván JMM, Darlenski R, Gulin D, Sikic J, Habek JC, Galic E, Specht P, Staab D, Mayer B, Roehmel J, Solovan C, Chiriac A, Djurinec P, Kostovic K, Bradamante M, Almeida JP, Caiado J, Pedro E, Da Silva PC, Barbosa MP, Bogas G, Blanca-López N, Pérez-Alzate D, Doña I, Agúndez JA, García-Martín E, Cornejo-García JA, Mayorga C, Torres MJ, Canto MG, Blanca M, Aksakal S, Sin AZ, Koç ZP, Günsen FD, Ardeniz Ö, Gökmen ENM, Gülbahar O, Kokuludag A, Pérez-Sánchez N, Salas M, Salas M, Gomez F, Barrionuevo E, Andreu I, Miranda MÁ, Didžiokaite G, Gaidej O, Kašinskaite S, Garcimartin MI, Somoza ML, Bojas G, Cornejo-Garcia JA, Perez FJR, Miranda MA, Jerschow E, Pelletier T, Ren Z, Hudes G, Sanak M, Morales E, Schuster V, Spivack SD, Rosenstreich D, Erzen R, Silar M, Bajrovic N, Rijavec M, Zidarn M, Korosec P, Castro E, Al-Ahmad M, Rodriguez T, Azevedo JP, Tavares B, Regateiro F, Todo-Bom A, Miranda PA, De La Cruz Hoyos B, Abuzeid W, Akbar N, Gibber M, Fried M, Han W, Keskin T, Tamayev R, Spivack SD, Rosenstreich D, Jerschow E, Boni E, Russello M, Mauro M, Neto MF, Brosseron L, Malheiro D, Barreira P, Sprigg D, Trevenen M, Seet J, Trubiano J, Smith W, Jeelall Y, Vale S, Loh R, Mclean-Tooke A, Müller S, Amstutz U, Jörg L, Yawalkar N, Krähenbühl S, Leblanc A, Ribeiro L, Vega A, Rivas RG, Alonso A, Beitia JM, Mateo B, Cárdenas R, Garcia-Dominguez JJ, Pavlos R, Strautins K, James I, Mallal S, Redwood A, Aguiar R, Lopes A, Neves A, Do Céu Machado M, Dalgiç CT, Gökmen ENM, Bulut G, Ardeniz FÖ, Gülbahar O, Sin AZ, Hsu SH, Yang CW, Ye YM, Hur GY, Park HS, Kim SH, Ali S, Hollingsworth PN, Mclean-Tooke APC, Chadly Z, Fredj NB, Aouam K, Romdhane HB, Boughattas NA, Chaabane A, Salazar ML, Pola B, Fiandor A, Ramírez E, Ortega JD, Quirce S, Cabañas R, Baynova K, Labella M, Prados M, Ramonaite A, Bajoriuniene I, Sitkauskiene B, Sakalauskas R, Kwon JW, Park S, Silva D, Leão LC, Castro E, Garcimartin M, De La Torre MV, Pérez FJR, Haroun E, Diez GC, Ónodi-Nagy K, Kinyó Á, Kemény L, Bata-Csörgo Z, Pita JS, Fernandes RA, Moura A, Sousa N, Loureiro C, Pfützner W, Marrouche N, Grattan C, Chen YE, Chen CB, Hsiao YP, Garcimartin MI, Ruano FJ. 7th drug hypersensitivity meeting: part one. Clin Transl Allergy 2016. [PMCID: PMC5009634 DOI: 10.1186/s13601-016-0121-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Oral Abstracts O1 Functionally distinct HMGB1 isoforms correlate with physiological processes in drug-induced SJS/TEN Daniel F. Carr, Wen-Hung Chung, Rosalind E. Jenkiins, Mas Chaponda, Gospel Nwikue, Elena M. Cornejo Castro, Daniel J. Antoine, Munir Pirmohamed O2 Hypersensitivity reactions to beta-lactams, does the t cell recognition pattern influence the clinical picture? Natascha Wuillemin, Dolores Dina, Klara K. Eriksson, Daniel Yerly O3 Specific binding characteristics of HLA alleles associated with nevirapine hypersensitivity Rebecca Pavlos, Elizabeth Mckinnin, David Ostrov, Bjoern Peters, Soren Buus, David Koelle, Abha Chopra, Craig Rive, Alec Redwood, Susana Restrepo, Austin Bracey, Jing Yuan, Silvana Gaudieri, Mary Carrington, David Haas, Simon Mallal, Elizabeth Phillips O4 Do we need to measure total ige for the interpretation of analytical results of ImmunoCAP dnd 3gAllergy specific IgE? Douwe De Boer, Paul Menheere, Chris Nieuwhof, Judith Bons O5 Neutrophil activation in systemic anaphylaxis: results from the multicentric NASA study Friederike Jonsson, Luc De Chaisemartin, Vanessa Granger, Caitlin Gillis, Aurelie Gouel, Catherine Neukirch, Fadia Dib, Pascale Roland Nicaise, Dan Longrois, Florence Tubach, Sylvie Martin, Pierre Bruhns, NASA Study Group O6 Purpuric drug eruptions due to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for non-small-cell lung cancer (NSCLC): a clinic-pathological study of 32 cases Kai-Lung Chen, Shu-Ling Liao, Yi-Shuan Sheen, Yung-Tsu Cho, Che-Wen Yang, Jau-Yu Liau, Chia-Yu Chu Poster presentations: Poster Walk 1—Anaphylaxis (P01–P09) P1 Anaphylactic reactions during anaesthesia and the perioperative period Rita Aguiar, Anabela Lopes, Natália Fernandes, Leonor Viegas, M. A. Pereira-Barbosa P2 Anaphylaxis to chlorhexidine: is there a cross-reactivity to alexidine? Antonia Bünter, Nisha Gupta, Tatjana Pecaric Petkovic, Nicole Wirth, Werner J. Pichler, Oliver Hausmann P3 Cefotaxime-induced severe anaphylaxis in a neonate Mehtap Yazicioglu, Pinar G. Ozdemir, Gokce Ciplak, Ozkan Kaya P4 Clinical features and diagnosis of anaphylaxis resulting from exposure to chlorhexidine Peter John Cooke P5 Drug-induced anaphylaxis: five-year single-center survey Inês Mota, Ângela Gaspar, Filipe Benito-Garcia, Marta Chambel, Mário Morais-Almeida P6 Intraoperative severe anaphylactic reaction due to patent blue v dye Luis Marques, Eva Alcoceba, Silvia Lara P7 Kounis syndrome in the setting of anaphylaxis to diclofenac Leonor Carneiro-Leão, Carmen Botelho, Eunice Dias-Castro, Josefina Cernadas P8 Perioperative anaphylaxis audit: Royal Melbourne Hospital Katherine Nicholls, William Lay, Olivia Smith, Christine Collins, Gary Unglik, Kymble Spriggs, Priscilla Auyeung, Jeremy McComish, Jo A. Douglass P9 Recurrent peri-operative anaphylaxis: a perfect storm Jonny G. Peter, Paul Potter Poster Walk 2: DH regions and patient groups (P10–P19) P10 A rare presentation of amoxicillin allergy in a young child Fabrícia Carolino, Eunice Dias De Castro, Josefina R. Cernadas P11 Adverse drug reactions in children: antibiotics or virus? Ana Sofia Moreira, Carmo Abreu, Eva Gomes P12 Allergic reactions in invasive medical procedures Bárbara Kong Cardoso, Elza Tomaz, Sara Correia, Filipe Inácio P13 Antibiotic allergy in children: room for improvement Annabelle Arnold, Natasha Bear, Kristina Rueter, Grace Gong, Michael O’Sullivan, Saravanan Muthusamy, Valerie Noble, Michaela Lucas P14 Drug hypersensitivity reactions in children and results of diagnostic evaluation Neringa Buterleviciute, Odilija Rudzeviciene P15 Nonimmediate cutaneous drug reactions in children: are skin tests required? Ana Sofia Moreira, Carmo Abreu, Eva Gomes P16 Pediatric patients with a history of penicillin allergy and a positive penicillin skin test may not be at an increased risk for multiple drug allergies Sara May, Thanai Pongdee, Miguel Park P17 Proved hypersensitivity to drugs according data of Vilnius University Hospital Santariskiu Klinikos Linas Griguola, Arturas Vinikovas, Simona Kašinskaite, Violeta Kvedariene P18 Self-reported prevalence of drug hypersensitivity reactions among students in Celal Bayar University, Turkey Ayse Aktas, Suheyla Rahman, Huseyin Elbi, Beyhan Cengiz Ozyurt P19 Severe drug hypersensitivity reactions in pediatric age Ozlem Cavkaytar, Betul Karaatmaca, Pinar Gur Cetinkaya, Saliha Esenboga, Umit M. Sahiner, Bulent E. Sekerel, Ozge Soyer Poster Walk 3: Desensitisation (P20–P28) P20 A protocol for desensitisation to valaciclovir Celia Zubrinich, Bianca Tong, Mittal Patel, Michelle Giles, Robyn O’Hehir, Robert Puy P21 A rare case of desensitization to modafinil Josefina Cernadas, Luís Amaral, Fabrícia Carolino P22 A sixteen-day desensitization protocol in delayed type hypersensitivity reactions to oral drugs Semra Demir, Asli Gelincik, Muge Olgac, Raif Caskun, Derya Unal, Bahauddin Colakoglu, Suna Buyukozturk P23 Desensitization to intravenous etoposide using a 12 and a 13-step protocol. Two cases report Olga Vega Matute, Amalia Bernad, Gabriel Gastaminza, Roselle Madamba, Carlos Lacasa, M. J. Goikoetxea, Carmen D’Amelio, Jose Rifón, Nicolas Martínez, Marta Ferrer P24 Drug desensitisation in oncology: the experience of an immunoallergology department for 5 years Carmelita Ribeiro, Emília Faria, Cristina Frutuoso, Anabela Barros, Rosário Lebre, Alice Pego, Ana Todo Bom P25 Filgrastim anaphylaxis: a successful desensitization protocol Luis Amaral, Josefina Cernadas P26 Galsulfase hypersensitivity and desensitization of a mucopolysaccharidosis VI patient Luis Felipe Ensina, Carolina Aranda, Ines Camelo Nunes, Ana Maria Martins, Dirceu Solé P27 Rapid drug desensitization with biologicals: one-center experience with four biologicals Sevim Bavbek, Resat Kendirlinan, Pamir Çerçi, Seda Tutluer, Sadan Soyyigit, Zeynep Çelebi Sözener, Ömür Aydin, Reyhan Gümüsburun P28 Successful desensitization to a high dose of methotrexate in a delayed type hypersensitivity reaction Josefina Cernadas, Leonor Carneiro-Leão, Fabrícia Carolino, Marta Almeida Poster Walk 4: SJS (P29–P38) P29 Assessment of impact of infection on drug-induced severe cutaneous adverse reactions and rhabdomyolysis using the Japanese adverse drug event report database Kimie Sai, Takuya Imatoh, Ryosuke Nakamura, Chisato Fukazawa, Yasushi Hinomura, Yoshiro Saito P30 Characterization of erythema multiforme and severe cutaneous adverse reactions hospitalizations Bernardo Sousa-Pinto, Cláudia Correia, Lídia Gomes, Sara Gil-Mata, Luís Araújo, Luís Delgado P31 Effects of infection on incidence/severity of SJS/TEN and myopathy in Japanese cases analyzed by voluntary case reports Ryosuke Nakamura, Kimie Sai, Takuya Imatoh, Yoshimi Okamoto-Uchida, Koji Kajinami, Kayoko Matsunaga, Michiko Aihara, Yoshiro Saito P32 Efficacy of tumor necrosis factor—a antagonists in Stevens–Johnson syndrome and toxic epidermal necrolysis: a randomized controlled trial and immunosuppressive effects evaluation Chuang-Wei Wang, Shih-Chi Su, Shuen-Iu Hung, Hsin-Chun Ho, Chih-Hsun Yang, Wen-Hung Chung P33 Evolution of drug causality in Stevens–Johnson syndrome and toxic epidermal necrolysis in Europe: analysis of 10 years RegiSCAR-Study Maren Paulmann, Ariane Dunant, Maja Mockenhaupt, Peggy Sekula, Martin Schumacher, Sylvia Kardaun, Luigi Naldi, Teresa Bellón, Daniel Creamer, Cynthia Haddad, Bruno Sassolas, Bénédicte Lebrun-Vignes, Laurence Valeyrie-Allanore, Jean-Claude Roujeau P34 Long-term sequelae in patients with Stevens–Johnson syndrome and toxic epidermal necrolysis: a 5-year analysis Maren Paulmann, Carmen Kremmler, Peggy Sekula, Laurence Valeyrie-Allanore, Luigi Naldi, Sylvia Kardaun, Maja Mockenhaupt P35 Major emotional complications and decreased health related quality of life among survivors of Stevens–Johnson syndrome and toxic epidermal necrolysis Roni P. Dodiuk-Gad, Cristina Olteanu, Anthony Feinstein, Rena Hashimoto, Raed Alhusayen, Sonia Whyte-Croasdaile, Yaron Finkelstein, Marjorie Burnett, Shachar Sade, Robert Cartotto, Marc Jeschke, Neil H. Shear P36 Retrospective analysis of Stevens–Johnson syndrome and toxic epidermal necrolysis in Japanese patients: treatment and outcome Naoko Takamura, Yumiko Yamane, Setsuko Matsukura, Kazuko Nakamura, Yuko Watanabe, Yukie Yamaguchi, Takeshi Kambara, Zenro Ikezawa, Michiko Aihara P37 Severe physical complications among survivors of Stevens–Johnson syndrome and toxic epidermal necrolysis Roni P. Dodiuk-Gad, Cristina Olteanu, Rena Hashimoto, Hall Chew, Raed Alhusayen, Sonia Whyte-Croasdaile, Yaron Finkelstein, Marjorie Burnett, Shachar Sade, Robert Cartotto, Marc Jeschke, Neil H. Shear P38 Stevens–Johnson syndrome/toxic epidermal necrolysis combined with haemophagocytic lymphohistiocytosis: a case report Brittany Knezevic, Una Nic Ionmhain, Allison Barraclough, Michaela Lucas, Matthew Anstey Poster Walk 5: Other organs/unexpected immune reactions (P39–P47) P39 A case report of patient with anti-tuberculosis drug-related severe liver failure Toru Usui, Xiaoli Meng, John Farrell, Paul Whitaker, John Watson, Neil French, Kevin Park, Dean Naisbitt P40 Acute interstitial nephritis induced by ibuprofen Ana Castro Neves, Susana Cadinha, Ana Moreira, J. P. Moreira Da Silva P41 Cetuximab induced acneiform rash—two case reports Daniela Ledic Drvar, Sandra Jerkovic Gulin, Suzana Ljubojevic Hadzavdic, Romana Ceovic P42 Enteropathy associated with losartan Ana Montoro De Francisco, Talía De Vicente Jiménez, Amelia García Luque, Natalia Rosado David, José Mª Mateos Galván P43 Granuloma annulare after therapy with canakinumab Razvigor Darlenski P44 Hypersensitivity eosinophilic myocarditis or acute coronary syndrome? Case report Dario Gulin, Jozica Sikic, Jasna Cerkez Habek, Sandra Jerkovic Gulin, Edvard Galic P45 Piperacillin-induced immune haemolytic anaemia: a severe and frequent complication of antibiotic treatment in patients with cystic fibrosis Philip Specht, Doris Staab, Beate Mayer, Jobst Roehmel P46 Progesterone triggered pemphigus foliaceus: case report Sandra Jerkovic Gulin, Caius Solovan, Anca Chiriac P47 Ramipril: triggered generalized pustular psoriasis Paola Djurinec, Kresimir Kostovic, Mirna Bradamante, Sandra Jerkovic Gulin, Romana Ceovic Poster Walk 6: NSAIDs (P48–P56) P48 Aspirin desensitization in cardiovascular disease—Portuguese experience Jose Pedro Almeida, Joana Caiado, Elisa Pedro, Pedro Canas Da Silva, Manuel Pereira Barbosa P49 Asthma and/or rhinitis to NSAIDs with good tolerance to ASA Gador Bogas, Natalia Blanca-López, Diana Pérez-Alzate, Inmaculada Doña, José Augusto Agúndez, Elena García-Martín, José Antonio Cornejo-García, Cristobalina Mayorga, María José Torres, Gabriela Canto, Miguel Blanca P50 Clinical characteristics of 196 patients with non-steroidal anti-inflammatory drug (NSAIDs) hypersensitivity Sengül Aksakal, Aytül Zerrin Sin, Zeynep Peker Koç, Fatma Düsünür Günsen, Ömür Ardeniz, Emine Nihal Mete Gökmen, Okan Gülbahar, Ali Kokuludag P51 Development of immediate hypersensitivity to several NSAIDs maintaining good tolerance to ASA Natalia Pérez-Sánchez, Natalia Blanca-López, Diana Pérez-Alzate, Gador Bogas, Inmaculada Doña, María Salas, María José Torres, Miguel Blanca, Gabriela Canto P52 Diagnosis of hypersensitivity reactions to paracetamol in a large series of cases Inmaculada Doña, Maria Salas, Francisca Gomez, Natalia Blanca-Lopez, Diana Perez-Alzate, Gador Bogas, Esther Barrionuevo, Maria Jose Torres, Inmaculada Andreu, Miguel Ángel Miranda, Gabriela Canto, Miguel Blanca P53 Hypersensitivity to paracetamol according to the new classification of hypersensitivity to NSAIDs Gabija Didžiokaite, Olesia Gaidej, Simona Kašinskaite, Violeta Kvedariene P54 Ibuprofen and other aryl propionic derivates can induce immediate selective hypersensitivity responses Diana Perez-Alzate, Natalia Blanca-López, Maria Isabel Garcimartin, Inmaculada Doña, Maria Luisa Somoza, Cristobalina Mayorga, Maria Jose Torres, Gador Bojas, Jose Antonio Cornejo-Garcia, Maria Gabriela Canto, Miguel Blanca P55 Subjects developing immediate responses to several NSAIDs can be selective with good tolerance to ASA Natalia Blanca-Lopez, Diana Pérez-Alzate, Francisco Javier Ruano Perez, Inmaculada Doña, Maria Luisa Somoza, Inmaculada Andreu, Miguel Angel Miranda, Cristobalina Mayorga, Maria Jose Torres, Jose Antonio Cornejo-Garcia, Miguel Blanca, Maria Gabriela Canto P56 Utility of low-dose oral aspirin challenges for diagnosis of aspirin exacerbated respiratory disease Elina Jerschow, Teresa Pelletier, Zhen Ren, Golda Hudes, Marek Sanak, Esperanza Morales, Victor Schuster, Simon D. Spivack, David Rosenstreich Poster Walk 7: NSAID 2 (P57–P65) P57 Alternate regulation of cyclooxygenase-2 (COX-2) MRNA expression may predispose patients to aspirin-induced exacerbations Renato Erzen, Mira Silar, Nissera Bajrovic, Matija Rijavec, Mihaela Zidarn, Peter Korosec P58 Anaphylaxis to diclofenac: what about the underlying mechanism? Leonor Carneiro-Leão, Fabrícia Carolino, Luís Amaral, Carmen Botelho, Eunice Dias-Castro, Josefina Cernadas P59 COX-2 inhibitors: are they always a safe alternative in hypersensitivity to nonsteroidal anti-inflammatory drugs? Luis Amaral, Fabricia Carolino, Eunice Castro, Josefina Cernadas P60 Management of patients with history of NSAIDs reactions prior to coronary angioplasty Mona Al-Ahmad, Tito Rodriguez P61 Oral drug challenge with non-steroidal anti-inflammatory drug under spirometric control: clinical series of 110 patients João Pedro Azevedo, Emília Faria, Beatriz Tavares, Frederico Regateiro, Ana Todo-Bom P62 Prevalence and incidence of analgesic hypersensitivity reactions in Colombia Pablo Andrés Miranda, Bautista De La Cruz Hoyos P63 Recent endoscopic sinus surgery lessens reactions during aspirin challenge in patients with aspirin exacerbated respiratory disease Teresa Pelletier, Waleed Abuzeid, Nadeem Akbar, Marc Gibber, Marvin Fried, Weiguo Han, Taha Keskin, Robert Tamayev, Golda Hudes, Simon D. Spivack, David Rosenstreich, Elina Jerschow P64 Safe use of imidazole salycilate in a case of multiple NSAIDs induced urticaria-angioedema Elisa Boni, Marina Russello, Marina Mauro P65 Selective hypersensitivity reactions to ibuprofen—seven years experience Marta Ferreira Neto Poster Walk 8: Epidemiological methods (P66–P72) P66 Allopurinol hypersensitivity: a 7-year review Lise Brosseron, Daniela Malheiro, Susana Cadinha, Patrícia Barreira, J. P. Moreira Da Silva P67 Antibiotic allergy labelling is associated with increased hospital readmission rates in Australia Brittany Knezevic, Dustin Sprigg, Michelle Trevenen, Jason Seet, Jason Trubiano, William Smith, Yogesh Jeelall, Sandra Vale, Richard Loh, Andrew Mclean-Tooke, Michaela Lucas P68 Experts’ opinions on severe cutaneous adverse drug reactions-report of a survey from the 9th international congress on cutaneous adverse drug reactions 2015 Roni P. Dodiuk-Gad, Cristina Olteanu, Wen-Hung Chung, Neil H. Shear P69 HLA-A*31-positive AGEP with carbamazepine use and other severe cutaneous adverse drug reactions (SCARs) detected by electronic medical records screening Sabine Müller, Ursula Amstutz, Lukas Jörg, Nikhil Yawalkar, Stephan Krähenbühl P70 Patients with suspected drug allergy: a specific psychological profile? Eunice Dias-Castro, Ana Leblanc, Laura Ribeiro, Josefina R. Cernadas P71 Use of an electronic device and a computerized mathematic algorithm to detect the allergic drug reactions through the analysis of heart rate variability Arantza Vega, Raquel Gutierrez Rivas, Ana Alonso, Juan Maria Beitia, Belén Mateo, Remedios Cárdenas, Juan Jesus Garcia-Dominguez P72 Variation in ERAP influences risk for HLA-B*57:01 positive abacavir hypersensitivity Rebecca Pavlos, Kaija Strautins, Ian James, Simon Mallal, Alec Redwood, Elizabeth Phillips Poster Walk 9: DRESS/AGEP (P73–P81) P73 A clinical case of DRESS syndrome in a child after administration of amoxicillin-clavulanic acid Rita Aguiar, Anabela Lopes, Ana Neves, Maria Do Céu Machado, M. A. Pereira-Barbosa P74 Acute generalized exanthematous pustulosis (AGEP) induced by mesalazine, reliable and oftenly used drug to treat inflammatory bowel disease Ceyda Tunakan Dalgiç, Emine Nihal Mete Gökmen, Fatma Düsünür Günsen, Gökten Bulut, Fatma Ömür Ardeniz, Okan Gülbahar, Ali Kokuludag, Aytül Zerrin Sin P75 Changes of blood plasmacytoid dendritic cells, myeloid dendritic cells, and basophils during the acute stage of drug reaction with eosinophilia and systemic symptoms (DRESS) and other drug eruptions Shao-Hsuan Hsu, Yung-Tsu Cho, Che-Wen Yang, Kai-Lung Chen, Chia-Yu Chu P76 Characterization of isoniazid/rifampicin-specific t-cell responses in patients with DRESS syndrome Young-Min Ye, Gyu-Young Hur, Hae-Sim Park, Seung-Hyun Kim P77 DRESS syndrome secondary to sulfasalazine with delayed TEN: a case presentation Syed Ali, Michaela Lucas, Peter N. Hollingsworth, Andrew P. C. Mclean-Tooke P78 Drug rash with eosinophilia and systemic symptoms (DRESS) features according to the culprit drug Zohra Chadly, Nadia Ben Fredj, Karim Aouam, Haifa Ben Romdhane, Naceur A. Boughattas, Amel Chaabane P79 Drug reaction with eosinophilia and systemic symptoms induced by allopurinol: not always easy to diagnose Marina Lluncor Salazar, Beatriz Pola, Ana Fiandor, Teresa Bellón, Elena Ramírez, Javier Domínguez Ortega, Santiago Quirce, Rosario Cabañas P80 Drug reaction with eosinophilia and systemic symptoms syndrome induced by two drugs simultaneously: a case report Krasimira Baynova, Marina Labella, Manuel Prados P81 The drug reaction with eosinophilia and systemic symptoms (DRESS) induced by the second-line antituberculosis drugs and Epstein–Barr virus infection Agne Ramonaite, Ieva Bajoriuniene, Brigita Sitkauskiene, Raimundas Sakalauskas Poster Walk 10: Miscellaneous drug hypersensitivity (P82–P91) P82 A case of cycloserine-induced lichenoid drug eruption confirmed with a lymphocatye transformation test Jae-Woo Kwon, Shinyoung Park P83 Allergic reaction to topical eye drops: 5 years’ retrospective study in a drug allergy unit Diana Silva, Leonor Carneiro Leão, Fabricia Carolino, Eunice Castro, Josefina Cernadas P84 Allergy to heparins Diana Perez-Alzate, Natalia Blanca-López, Maria Luisa Somoza Alvarez, Maria Garcimartin, Maria Vazquez De La Torre, Francisco Javier Ruano Pérez, Elisa Haroun, Gabriela Canto Diez P85 Allopurinol-induced adverse drug reactions Katinka Ónodi-Nagy, Ágnes Kinyó, Lajos Kemény, Zsuzsanna Bata-Csörgo P86 Analysis of a population with immediate hypersensitivity to corticosteroids: an 11 year review Joana Sofia Pita, Emília Faria, Rosa Anita Fernandes, Ana Moura, Nuno Sousa, Carmelita Ribeiro, Carlos Loureiro, Ana Todo Bom P87 Anaphylaxis against mivacurium in a 12-months old boy at first-time exposure Wolfgang Pfützner P88 Antihistamine-exacerbated chronic spontaneous urticaria: a paradox? Nadine Marrouche, Clive Grattan P89 Anti-osteoporotic agents-induced cutaneous adverse drug reactions in Asians Yu-En Chen, Chun-Bing Chen, Wen-Hung Chung, Yu-Ping Hsiao, Chia-Yu Chu P90 Diagnosis of allergic reactions to eye drops Maria Vazquez De La Torre, Natalia Blanca-Lopez, Diana Perez-Alzate, Maria Isabel Garcimartin, Francisco Javier Ruano, Maria Luisa Somoza, Elisa Haroun, Gabriela Canto P91 Diagnostic approach in suspected hypersensitivity reactions to corticosteroids Fabrícia Carolino, Eunice Dias De Castro, Josefina R. Cernadas
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Marguet S, Mazouni C, Ramaekers BL, Dunant A, Kates R, Jacobs VR, Joore MA, Harbeck N, Bonastre J. European cost-effectiveness study of uPA/PAI-1 biomarkers to guide adjuvant chemotherapy decisions in breast cancer. Eur J Cancer 2016; 63:168-79. [DOI: 10.1016/j.ejca.2016.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/15/2016] [Accepted: 05/14/2016] [Indexed: 12/25/2022]
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Tardivel AM, Balleyguier C, Dunant A, Delaloge S, Mazouni C, Mathieu MC, Dromain C. Added Value of Contrast-Enhanced Spectral Mammography in Postscreening Assessment. Breast J 2016; 22:520-8. [DOI: 10.1111/tbj.12627] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Corinne Balleyguier
- Radiology Department; Gustave Roussy; Villejuif France
- UMR 8081, IR4M; Paris-Sud University; Orsay France
| | - Ariane Dunant
- Department of Statstics; Gustave Roussy; Villejuif France
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Brambilla E, Le Teuff G, Marguet S, Lantuejoul S, Dunant A, Graziano S, Pirker R, Douillard JY, Le Chevalier T, Filipits M, Rosell R, Kratzke R, Popper H, Soria JC, Shepherd FA, Seymour L, Tsao MS. Prognostic Effect of Tumor Lymphocytic Infiltration in Resectable Non-Small-Cell Lung Cancer. J Clin Oncol 2016; 34:1223-30. [PMID: 26834066 PMCID: PMC4872323 DOI: 10.1200/jco.2015.63.0970] [Citation(s) in RCA: 235] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Tumor lymphocytic infiltration (TLI) has differing prognostic value among various cancers. The objective of this study was to assess the effect of TLI in lung cancer. PATIENTS AND METHODS A discovery set (one trial, n = 824) and a validation set (three trials, n = 984) that evaluated the benefit of platinum-based adjuvant chemotherapy in non-small-cell lung cancer were used as part of the LACE-Bio (Lung Adjuvant Cisplatin Evaluation Biomarker) study. TLI was defined as intense versus nonintense. The main end point was overall survival (OS); secondary end points were disease-free survival (DFS) and specific DFS (SDFS). Hazard ratios (HRs) and 95% CIs associated with TLI were estimated through a multivariable Cox model in both sets. TLI-histology and TLI-treatment interactions were explored in the combined set. RESULTS Discovery and validation sets with complete data included 783 (409 deaths) and 763 (344 deaths) patients, respectively. Median follow-up was 4.8 and 6 years, respectively. TLI was intense in 11% of patients in the discovery set compared with 6% in the validation set (P < .001). The prognostic value of TLI in the discovery set (OS: HR, 0.56; 95% CI, 0.38 to 0.81; P = .002; DFS: HR, 0.59; 95% CI, 0.42 to 0.83; P = .002; SDFS: HR, 0.56; 95% CI, 0.38 to 0.82; P = .003) was confirmed in the validation set (OS: HR, 0.45; 95% CI, 0.23 to 0.85; P = .01; DFS: HR, 0.44; 95% CI, 0.24 to 0.78; P = .005; SDFS: HR, 0.42; 95% CI, 0.22 to 0.80; P = .008) with no heterogeneity across trials (P ≥ .38 for all end points). No significant predictive effect was observed for TLI (P ≥ .78 for all end points). CONCLUSION Intense lymphocytic infiltration, found in a minority of tumors, was validated as a favorable prognostic marker for survival in resected non-small-cell lung cancer.
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Affiliation(s)
- Elisabeth Brambilla
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada.
| | - Gwénaël Le Teuff
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Sophie Marguet
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Sylvie Lantuejoul
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Ariane Dunant
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Stephen Graziano
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Robert Pirker
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Jean-Yves Douillard
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Thierry Le Chevalier
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Martin Filipits
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Rafael Rosell
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Robert Kratzke
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Helmut Popper
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Jean-Charles Soria
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Frances A Shepherd
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Lesley Seymour
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
| | - Ming Sound Tsao
- Elisabeth Brambilla and Sylvie Lantuejoul, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale U823; and Centre Hospitalier Universitaire Albert Michallon, Grenoble; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Institut Gustave Roussy, Villejuif; Gwénaël Le Teuff, Sophie Marguet, Ariane Dunant, Thierry Le Chevalier, and Jean-Charles Soria, Université Paris-Sud, Orsay; Gwénaël Le Teuff, Université Paris-Saclay, Saint-Aubin; Jean-Yves Douillard, Centre René Gauducheau Institut de Cancerologie de l'Ouest, Saint-Herblain, France; Stephen Graziano, State University of New York Upstate Medical University, Syracuse, NY; Robert Pirker and Martin Filipits, Medical University of Vienna, Vienna; Helmut Popper, Medical University of Graz, Graz, Austria; Rafael Rosell, Catalan Institute of Oncology, Barcelona, Spain; Robert Kratzke, University of Minnesota, Minneapolis, MN; Frances A. Shepherd and Ming Sound Tsao, Princess Margaret Cancer Centre; Frances A. Shepherd and Ming Sound Tsao, University of Toronto, Toronto; and Lesley Seymour, Queen's University, Kingston, Ontario, Canada
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Le Péchoux C, Dunant A, Faivre-Finn C, Thomas PA, Pourel N, Lerouge D, Edwards J, Van Schil P, Rami-Porta R, Dansin E, Nestle U, Fadel E, Zalcman G. Postoperative Radiotherapy for Pathologic N2 Non-Small-Cell Lung Cancer Treated With Adjuvant Chemotherapy: Need for Randomized Evidence. J Clin Oncol 2015; 33:2930-1. [PMID: 26215941 DOI: 10.1200/jco.2015.62.1458] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2024] Open
Affiliation(s)
| | - Ariane Dunant
- Gustave-Roussy, Paris Sud University, Villejuif, France
| | | | | | | | | | - John Edwards
- Northern General Hospital, Sheffield, United Kingdom
| | | | | | | | - Ursula Nestle
- Freiburg University Medical Center, Freiburg im Breisgau, Germany
| | - Elie Fadel
- Centre Chirurgical Marie Lannelongue, Paris Sud University, Paris, France
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Michels J, Caron O, Rey A, Dunant A, Duvillard P, Gouy S, Leary A, Lhomme C, Morice P, Pautier P. Epithelial ovarian carcinoma in very young patients. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Riet F, Fayard F, Arriagada R, Santos M, Bourgier C, Ferchiou M, Heymann S, Delaloge S, Mazouni C, Dunant A, Rivera S. PD-0432: Preoperative radiotherapy in breast cancer patients: 32-year follow-up. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40428-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Burdett S, Pignon JP, Tierney J, Tribodet H, Stewart L, Le Pechoux C, Aupérin A, Le Chevalier T, Stephens RJ, Arriagada R, Higgins JPT, Johnson DH, Van Meerbeeck J, Parmar MKB, Souhami RL, Bergman B, Douillard J, Dunant A, Endo C, Girling D, Kato H, Keller SM, Kimura H, Knuuttila A, Kodama K, Komaki R, Kris MG, Lad T, Mineo T, Piantadosi S, Rosell R, Scagliotti G, Seymour LK, Shepherd FA, Sylvester R, Tada H, Tanaka F, Torri V, Waller D, Liang Y. Adjuvant chemotherapy for resected early-stage non-small cell lung cancer. Cochrane Database Syst Rev 2015; 2015:CD011430. [PMID: 25730344 PMCID: PMC10542092 DOI: 10.1002/14651858.cd011430] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND To evaluate the effects of administering chemotherapy following surgery, or following surgery plus radiotherapy (known as adjuvant chemotherapy) in patients with early stage non-small cell lung cancer (NSCLC),we performed two systematic reviews and meta-analyses of all randomised controlled trials using individual participant data. Results were first published in The Lancet in 2010. OBJECTIVES To compare, in terms of overall survival, time to locoregional recurrence, time to distant recurrence and recurrence-free survival:A. Surgery versus surgery plus adjuvant chemotherapyB. Surgery plus radiotherapy versus surgery plus radiotherapy plus adjuvant chemotherapyin patients with histologically diagnosed early stage NSCLC.(2)To investigate whether or not predefined patient subgroups benefit more or less from cisplatin-based chemotherapy in terms of survival. SEARCH METHODS We supplemented MEDLINE and CANCERLIT searches (1995 to December 2013) with information from trial registers, handsearching relevant meeting proceedings and by discussion with trialists and organisations. SELECTION CRITERIA We included trials of a) surgery versus surgery plus adjuvant chemotherapy; and b) surgery plus radiotherapy versus surgery plus radiotherapy plus adjuvant chemotherapy, provided that they randomised NSCLC patients using a method which precluded prior knowledge of treatment assignment. DATA COLLECTION AND ANALYSIS We carried out a quantitative meta-analysis using updated information from individual participants from all randomised trials. Data from all patients were sought from those responsible for the trial. We obtained updated individual participant data (IPD) on survival, and date of last follow-up, as well as details of treatment allocated, date of randomisation, age, sex, histological cell type, stage, and performance status. To avoid potential bias, we requested information for all randomised patients, including those excluded from the investigators' original analyses. We conducted all analyses on intention-to-treat on the endpoint of survival. For trials using cisplatin-based regimens, we carried out subgroup analyses by age, sex, histological cell type, tumour stage, and performance status. MAIN RESULTS We identified 35 trials evaluating surgery plus adjuvant chemotherapy versus surgery alone. IPD were available for 26 of these trials and our analyses are based on 8447 participants (3323 deaths) in 34 trial comparisons. There was clear evidence of a benefit of adding chemotherapy after surgery (hazard ratio (HR)= 0.86, 95% confidence interval (CI)= 0.81 to 0.92, p< 0.0001), with an absolute increase in survival of 4% at five years.We identified 15 trials evaluating surgery plus radiotherapy plus chemotherapy versus surgery plus radiotherapy alone. IPD were available for 12 of these trials and our analyses are based on 2660 participants (1909 deaths) in 13 trial comparisons. There was also evidence of a benefit of adding chemotherapy to surgery plus radiotherapy (HR= 0.88, 95% CI= 0.81 to 0.97, p= 0.009). This represents an absolute improvement in survival of 4% at five years.For both meta-analyses, we found similar benefits for recurrence outcomes and there was little variation in effect according to the type of chemotherapy, other trial characteristics or patient subgroup.We did not undertake analysis of the effects of adjuvant chemotherapy on quality of life and adverse events. Quality of life information was not routinely collected during the trials, but where toxicity was assessed and mentioned in the publications, it was thought to be manageable. We considered the risk of bias in the included trials to be low. AUTHORS' CONCLUSIONS Results from 47 trial comparisons and 11,107 patients demonstrate the clear benefit of adjuvant chemotherapy for these patients, irrespective of whether chemotherapy was given in addition to surgery or surgery plus radiotherapy. This is the most up-to-date and complete systematic review and individual participant data (IPD) meta-analysis that has been carried out.
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Affiliation(s)
- Sarah Burdett
- MRC Clinical Trials Unit at UCLMeta‐analysis GroupAviation House125 KingswayLondonUKWC2B 6NH
| | - Jean Pierre Pignon
- Gustave Roussy Cancer CampusPlateforme LNCC de Méta‐analyse en Oncologie et Service de Biostatistique et d’EpidémiologieVillejuifFrance
| | - Jayne Tierney
- MRC Clinical Trials Unit at UCLMeta‐analysis GroupAviation House125 KingswayLondonUKWC2B 6NH
| | - Helene Tribodet
- Gustave Roussy Cancer CampusPlateforme LNCC de Méta‐analyse en Oncologie et Service de Biostatistique et d’EpidémiologieVillejuifFrance
| | - Lesley Stewart
- University of YorkCentre for Reviews and DisseminationYorkUKYO10 5DD
| | - Cecile Le Pechoux
- Gustave Roussy Cancer CampusDépartement de RadiothérapieVillejuifFrance
| | - Anne Aupérin
- Gustave Roussy Cancer CampusPlateforme LNCC de Méta‐analyse en Oncologie et Service de Biostatistique et d’EpidémiologieVillejuifFrance
| | - Thierry Le Chevalier
- Gustave Roussy Cancer CampusDépartement de Médecine39, rue Camille DesmoulinsVillejuifFrance94805
| | | | | | - Julian PT Higgins
- University of BristolSchool of Social and Community MedicineCanynge Hall39 Whatley RoadBristolUKBS8 2PS
| | - David H Johnson
- University of Texas Southwestern Medical CenterDepartment of Medicine5323 Harry Hines BlvdRm. G5.210DallasTexasUSA75390‐9030
| | | | | | | | | | | | - Ariane Dunant
- Gustave Roussy Cancer CampusPlateforme LNCC de Méta‐analyse en Oncologie et Service de Biostatistique et d’EpidémiologieVillejuifFrance
| | - Chiaki Endo
- Institute of Development, Aging and Cancer, Tohoku UniversitySendaiJapan
| | - David Girling
- MRC Clinical Trials Unit at UCLCancer DivisionLondonUK
| | | | | | | | - Aija Knuuttila
- Helsinki University Central HospitalPulmonary DepartmentPO Box 340HaartmaninkatuHelsinkiFinlandFIN‐00290 HUS
| | - Ken Kodama
- Osaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
| | - Ritsuko Komaki
- University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Mark G Kris
- Memorial Sloan‐Kettering Cancer CenterNew YorkUSA
| | | | | | - Steven Piantadosi
- Cedars Sinai Medical Centre, Samuel Oschin Comprehensive Cancer InstituteLos AngelesCaliforniaUSA
| | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i PujolBarcelonaSpain
| | | | - Lesley K Seymour
- Queen’s University, NCIC Clinical Trials GroupKingstonOntarioCanada
| | | | - Richard Sylvester
- European Organisation for Research and Treatment of CancerData CenterAvenue E Mounier 83 ‐ Bte 11BrusselsBelgium1200
| | | | - Fumihiro Tanaka
- University of Occupational and Environmental HealthChest Surgery (Second Department of Surgery)Iseigaoka 1‐1Yahata‐nishi‐kuKitakyusyuFukuokaJapan8078555
| | - Valter Torri
- Mario Negri InstituteLaboratorio di Epidemiologia ClinicaVia Eritrea 62MilanoMilanoItaly20157
| | | | - Ying Liang
- Sun Yat‐Sen University Cancer CenterGuangzhouChina
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Rotolo F, Dunant A, Le Chevalier T, Pignon JP, Arriagada R. Adjuvant cisplatin-based chemotherapy in nonsmall-cell lung cancer: new insights into the effect on failure type via a multistate approach. Ann Oncol 2014; 25:2162-2166. [PMID: 25193990 DOI: 10.1093/annonc/mdu442] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Adjuvant cisplatin-based chemotherapy has become the standard therapy against resected nonsmall-cell lung cancer (NSCLC). Because of variable results on its late effect, we reanalyze the long-term data of the International Adjuvant Lung Cancer Trial (IALT) to describe in details the role of adjuvant chemotherapy. PATIENTS AND METHODS In the IALT, 1867 patients were randomized between adjuvant cisplatin-based chemotherapy and control, who were followed up for a median of 7.5 years. Of these, 1687 patients were enrolled from 132 centers accepting to report the times to cancer events. We used event history methodology to estimate the effects of adjuvant chemotherapy on the risks of local relapse, distant metastasis, and death. RESULTS Adjuvant chemotherapy was highly effective against local relapses [HR = 0.73; 95% confidence interval (CI) 0.60-0.90; P = 0.003] and nonbrain metastases (HR = 0.79; 95% CI 0.66-0.94; P = 0.008) but not against brain metastases (HR = 1.1; 95% CI 0.82-1.4; P = 0.61). The effect on noncancer mortality was nonsignificant during the first 5 years (HR = 1.1; 95% CI 0.81-1.5; P = 0.29), whereas the risk of noncancer mortality was subsequently higher with treatment (HR = 3.6; 95% CI 2.2-5.9; P < 0.001). This harmful effect, however, potentially concerned only about 2% of the patients at 8 years. CONCLUSION Adjuvant cisplatin-based chemotherapy reduced the risk of local relapse and of nonbrain metastasis, thereby improving survival. This treatment exerted no residual effect on mortality during the first 5 years, but a higher risk of noncancer mortality was found thereafter. Detailed long-term follow-up is strongly recommended for all patients in randomized trials evaluating adjuvant treatments in NSCLC.
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Affiliation(s)
- F Rotolo
- Department of Biostatistics and Epidemiology.
| | - A Dunant
- Department of Biostatistics and Epidemiology
| | | | - J-P Pignon
- Department of Biostatistics and Epidemiology
| | - R Arriagada
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
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Rotolo F, Dunant A, Le Chevalier T, Pignon J, Arriagada R. New Insights Into the Effect of Adjuvant Cisplatin-Based Chemotherapy on the Type of Failure in Non-Small-Cell Lung Cancer. a Competing-Risk and Multistate Approach. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu347.12] [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: 11/12/2022] Open
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Cascales Garcia M, Acevedo-Henao C, Mangoni M, Castaing M, Dunant A, Livi L, Mathieu M, Marsiglia H, Bourgier C, Rivera S. Borderline and Malignant Phylloides Tumors of the Breast: A Retrospective Analysis of 37 Cases. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ma X, Rousseau V, Sun H, Lantuejoul S, Filipits M, Pirker R, Popper H, Mendiboure J, Vataire AL, Le Chevalier T, Soria JC, Brambilla E, Dunant A, Hainaut P. Significance of TP53 mutations as predictive markers of adjuvant cisplatin-based chemotherapy in completely resected non-small-cell lung cancer. Mol Oncol 2014; 8:555-64. [PMID: 24495481 PMCID: PMC5528648 DOI: 10.1016/j.molonc.2013.12.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 11/29/2013] [Accepted: 12/23/2013] [Indexed: 01/16/2023] Open
Abstract
Adjuvant cisplatin-based chemotherapy only marginally improves survival in patients with completely resected non-small-cell lung cancer (NSCLC). We have evaluated the predictive value of mutations in TP53, encoding the tumour suppressor p53, in the International Adjuvant Lung Cancer Trial (IALT), a randomized trial of adjuvant cisplatin-based chemotherapy against observation. TP53 (exons 4-8) was sequenced in 524 archived specimens of IALT patients with a median follow-up of 7.5 years. Predictive analyses were based on Cox models adjusted for clinical and pathological variables. P-values ≤ 0.01 were considered as significant. Mutations were detected in 221 patients (42%) and had no predictive value for the effect of chemotherapy (interaction between TP53 and treatment: p = 0.17 for Overall Survival (OS); p = 0.06 for Disease-Free Interval, (DFS)). However, among patients with mutations, outcome appeared worse in treatment compared to observation arms (HR for OS = 1.36 (95% CI [0.97-1.31), p = 0.08; DFS = 1.40 (95% CI [1.01-1.95]), p = 0.04). When grouping mutations into classes according to predicted effects on protein structure, the tendency towards worse outcomes was restricted to "structure" mutations affecting residues of the hydrophobic core that are not located at the p53 protein-DNA interface (HR for death in this class vs wild-type T53 = 1.66; 95% CI [1.10-2.52], p = 0.02). Overall, TP53 mutations are not significant predictors of outcome in this trial of cisplatin-based chemotherapy, although a specific class of structural mutations may be associated with a tendency towards worse outcomes upon treatment.
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Affiliation(s)
- Xiaoli Ma
- International Agency for Research on Cancer, Lyon, France
| | - Vanessa Rousseau
- Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France
| | - Haiji Sun
- International Agency for Research on Cancer, Lyon, France
| | - Sylvie Lantuejoul
- Department of Anatomy and Cytology, Centre Hospitalo-Universitaire, Albert Michallon, Grenoble, France
| | - Martin Filipits
- Department of Medicine I, Medical University Vienna, Vienna, Austria
| | - Robert Pirker
- Department of Medicine I, Medical University Vienna, Vienna, Austria
| | - Helmut Popper
- Institute of Pathology, Medical University of Graz, Austria
| | - Jean Mendiboure
- Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France
| | - Anne-Lise Vataire
- Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France
| | - Thierry Le Chevalier
- Department of Medicine/Service des Innovations Thérapeutiques Précoces, Institut Gustave Roussy, Villejuif, France
| | - Jean Charles Soria
- Department of Medicine/Service des Innovations Thérapeutiques Précoces, Institut Gustave Roussy, Villejuif, France; Institut National de la Santé et de la Recherche Médicale U981, Villejuif, France; Clinical and Translational Research Division, Institut Gustave Roussy, Villejuif, France
| | - Elisabeth Brambilla
- Department of Anatomy and Cytology, Centre Hospitalo-Universitaire, Albert Michallon, Grenoble, France
| | - Ariane Dunant
- Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France
| | - Pierre Hainaut
- University of Strathclyde School of Global Public Health at iPRI, International Prevention Research Institute, Lyon, France; Institut Albert Bonniot, Institut National de la Santé et de la Recherche Médicale U 823, Grenoble, France.
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Bonvalot S, Ternès N, Fiore M, Bitsakou G, Colombo C, Honoré C, Marrari A, Le Cesne A, Perrone F, Dunant A, Gronchi A. Spontaneous Regression of Primary Abdominal Wall Desmoid Tumors: More Common than Previously Thought. Ann Surg Oncol 2013; 20:4096-102. [DOI: 10.1245/s10434-013-3197-x] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Indexed: 12/27/2022]
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Mazouni C, Naveau A, Kane A, Dunant A, Garbay JR, Leymarie N, Sarfati B, Delaloge S, Rimareix F. The role of oncoplastic breast surgery in the management of breast cancer treated with primary chemotherapy. Breast 2013; 22:1189-93. [PMID: 24054903 DOI: 10.1016/j.breast.2013.07.055] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [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: 03/28/2013] [Revised: 07/04/2013] [Accepted: 07/20/2013] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the benefit of Oncoplastic Breast Conserving Surgery (BCS) compared to standard BCS after primary CT, in terms of oncologic safety and cosmetic outcomes. BACKGROUND The development of new drugs has led to greater use of primary chemotherapy (CT) for bulky breast cancer (BC) and has allowed wider indications for conservative surgery. PATIENTS AND METHODS We identified 259 patients consecutively treated with BCS for primary BC from January 2002 to November 2010. All patients had undergone Oncoplastic Breast Surgery (OBS) or standard BCS after primary CT. Mastectomy rates, and oncological and cosmetic outcomes were compared. RESULTS A total of 45 OBS and 214 standard BCS were analyzed. The median tumor size was 40 mm in the two groups (p = 0.66). The median operative specimen volumes were larger in the OBS group than in the standard group (respectively, 180 cm3 and 98 cm3, p < 0.0001). Re-excision (9% vs. 2%) and mastectomy (24% vs. 18%) rates were similar (p = 0.22 and p = 0.30) in the standard BCS group and in the OBS group respectively. At a median follow-up of 46 months, local relapse (p = 0.23) and distant relapse (p = 0.35) rates were similar. CONCLUSION OBS allows excision of larger volumes of residual tumor after primary CT. OBS outcomes results were similar to those of standard BCS. Oncoplastic Breast Conserving Surgery (BCS) after primary chemotherapy allows wider breast resection than standard BCS. Survival and relapse probabilities are similar in both groups.
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Affiliation(s)
- Chafika Mazouni
- Department of Breast and Plastic Surgery, Institut Gustave Roussy, Villejuif, France.
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Friboulet L, Olaussen KA, Pignon JP, Shepherd FA, Tsao MS, Graziano S, Kratzke R, Douillard JY, Seymour L, Pirker R, Filipits M, André F, Solary E, Ponsonnailles F, Robin A, Stoclin A, Dorvault N, Commo F, Adam J, Vanhecke E, Saulnier P, Thomale J, Le Chevalier T, Dunant A, Rousseau V, Le Teuff G, Brambilla E, Soria JC. ERCC1 isoform expression and DNA repair in non-small-cell lung cancer. N Engl J Med 2013; 368:1101-10. [PMID: 23514287 PMCID: PMC4054818 DOI: 10.1056/nejmoa1214271] [Citation(s) in RCA: 292] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The excision repair cross-complementation group 1 (ERCC1) protein is a potential prognostic biomarker of the efficacy of cisplatin-based chemotherapy in non-small-cell lung cancer (NSCLC). Although several ongoing trials are evaluating the level of expression of ERCC1, no consensus has been reached regarding a method for evaluation. METHODS We used the 8F1 antibody to measure the level of expression of ERCC1 protein by means of immunohistochemical analysis in a validation set of samples obtained from 494 patients in two independent phase 3 trials (the National Cancer Institute of Canada Clinical Trials Group JBR.10 and the Cancer and Leukemia Group B 9633 trial from the Lung Adjuvant Cisplatin Evaluation Biology project). We compared the results of repeated staining of the entire original set of samples obtained from 589 patients in the International Adjuvant Lung Cancer Trial Biology study, which had led to the initial correlation between the absence of ERCC1 expression and platinum response, with our previous results in the same tumors. We mapped the epitope recognized by 16 commercially available ERCC1 antibodies and investigated the capacity of the different ERCC1 isoforms to repair platinum-induced DNA damage. RESULTS We were unable to validate the predictive effect of immunostaining for ERCC1 protein. The discordance in the results of staining for ERCC1 suggested a change in the performance of the 8F1 antibody since 2006. We found that none of the 16 antibodies could distinguish among the four ERCC1 protein isoforms, whereas only one isoform produced a protein that had full capacities for nucleotide excision repair and cisplatin resistance. CONCLUSIONS Immunohistochemical analysis with the use of currently available ERCC1 antibodies did not specifically detect the unique functional ERCC1 isoform. As a result, its usefulness in guiding therapeutic decision making is limited. (Funded by Eli Lilly and others.).
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Affiliation(s)
- Luc Friboulet
- INSERM Unité 981, and Département Hospitalo-Universitaire Thorax Innovation, Institut Gustave-Roussy, Villejuif, France
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Lipowicz S, Sekula P, Ingen-Housz-Oro S, Liss Y, Sassolas B, Dunant A, Roujeau JC, Mockenhaupt M. Prognosis of generalized bullous fixed drug eruption: comparison with Stevens-Johnson syndrome and toxic epidermal necrolysis. Br J Dermatol 2013; 168:726-32. [DOI: 10.1111/bjd.12133] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee HY, Dunant A, Sekula P, Mockenhaupt M, Wolkenstein P, Valeyrie-Allanore L, Naldi L, Halevy S, Roujeau JC. The role of prior corticosteroid use on the clinical course of Stevens-Johnson syndrome and toxic epidermal necrolysis: a case-control analysis of patients selected from the multinational EuroSCAR and RegiSCAR studies. Br J Dermatol 2013; 167:555-62. [PMID: 22639874 DOI: 10.1111/j.1365-2133.2012.11074.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immunologically mediated, severe cutaneous adverse reactions involving cytotoxic T cells, natural killer cells and various mediators. In large studies, up to 15% of SJS/TEN occurred in patients with chronic corticosteroid use. It is unclear if this prior exposure to corticosteroids modified the disease course. OBJECTIVES To evaluate whether systemic corticosteroid usage prior to the onset of SJS/TEN modified the clinical course and outcome. If a disease-modifying effect is present, information from such an analysis may have implications on the therapeutic use of corticosteroids in SJS/TEN. METHODS This is a case-control study based on data collected in the EuroSCAR and RegiSCAR studies. Ninety-two cases of SJS/TEN with exposure to corticosteroids prior to the onset of disease, and 321 randomly selected SJS/TEN patients without prior exposure were included. Primary outcomes included progression of disease, disease severity and mortality. A secondary analysis of latency between the beginning of drug use and the onset of disease, based on exposure to a single high-risk drug, was also performed. RESULTS On multivariate analysis, cases with prior exposure to corticosteroids had a longer progression of disease by 2·2 days [95% confidence interval (CI) 1·1-3·2]. The disease severity and mortality outcome were unaffected. In addition, there is evidence that corticosteroids delayed the onset of SJS/TEN in patients with exposure to high-risk drugs by 7·1 days (CI -0·2 to 14·5). CONCLUSIONS The prior use of corticosteroids prolonged the period of disease progression without influencing the disease severity or mortality. In addition, when SJS/TEN is preceded by use of a single high-risk drug, the latency between the drug intake and the onset of SJS/TEN may also be increased. These findings suggest that corticosteroids have a mild impact on the course of SJS/TEN, and further studies are required to clarify any potential therapeutic effects.
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Affiliation(s)
- H Y Lee
- Dermatology Unit, Singapore General Hospital, Singapore, Singapore.
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Hainaut P, Ma X, Lacas B, Tsao M, Douillard J, Rousseau V, Dunant A, Seymour L, Filipits M, Graziano S. Lace-Bio Pooled Analysis of the Prognostic and Predictive Value of TP53 Mutations in Completely Resected Non Small Cell Lung Cancer (NSCLC). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33753-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bourgier C, Acevedo-Henao C, Dunant A, Rossier C, Levy A, El Nemr M, Dumas I, Delaloge S, Mathieu MC, Garbay JR, Taghian A, Marsiglia H. Higher toxicity with 42 Gy in 10 fractions as a total dose for 3D-conformal accelerated partial breast irradiation: results from a dose escalation phase II trial. Radiat Oncol 2012; 7:141. [PMID: 22913640 PMCID: PMC3502482 DOI: 10.1186/1748-717x-7-141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 07/13/2012] [Indexed: 11/25/2022] Open
Abstract
Objective Recent recommendations regarding indications of accelerated partial breast irradiation (APBI) have been put forward for selected breast cancer (BC) patients. However, some treatment planning parameters, such as total dose, are not yet well defined. The Institut Gustave Roussy has initiated a dose escalation trial at the 40 Gy/10 fractions/5 days and at a further step of total dose (TD) of 42 Gy/10 fractions/ 5 days. Here, we report early results of the latest step compared with the 40 Gy dose level. Methods and materials From October 2007 to March 2010, a total of 48 pT1N0 BC patients were enrolled within this clinical trial: 17 patients at a TD of 42 Gy/10f/5d and 31 at a TD of 40 Gy/10f/5d. Median follow-up was 19 months (min-max, 12–26). All the patients were treated by APBI using a technique with 2 minitangents and an “enface” electrons delivering 20% of the total dose. Toxicities were systematically assessed at 1; 2; 6 months and then every 6 months. Results Patients’ recruitment of 42 Gy step was ended owing to persistent grade 3 toxicity 6 months after APBI completion (n = 1). Early toxicities were statistically higher after a total dose of 42 Gy regarding grade ≥2 dry (p = 0.01) and moist (p = 0.05) skin desquamation. Breast pain was also statistically higher in the 42 Gy step compared to 40 Gy step (p = 0.02). Other late toxicities (grade ≥2 fibrosis and telangectasia) were not statistically different between 42 Gy and 40 Gy. Conclusions Early toxicities were more severe and higher rates of late toxicities were observed after 42 Gy/10 fractions/5 days when compared to 40 Gy/10 fractions/5 days. This data suggest that 40 Gy/10 fractions/ 5 days could potentially be the maximum tolerance for PBI although longer follow-up is warranted to better assess late toxicities.
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Affiliation(s)
- Celine Bourgier
- Department of Radiation Oncology, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94 805, Villejuif, France.
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Bourgier C, Pessoa EL, Dunant A, Heymann S, Spielmann M, Uzan C, Mathieu MC, Arriagada R, Marsiglia H. Exclusive Alternating Chemotherapy and Radiotherapy in Nonmetastatic Inflammatory Breast Cancer: 20 Years of Follow-Up. Int J Radiat Oncol Biol Phys 2012; 82:690-5. [DOI: 10.1016/j.ijrobp.2010.11.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 11/08/2010] [Accepted: 11/11/2010] [Indexed: 10/18/2022]
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Sassolas B, Haddad C, Dunant A, Valeyrie-Allanore L, Roujeau JC. Évolution en Europe des causes de SJS/NET liées aux médicaments à haut risque. Analyse sur 10ans. Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.09.107] [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] [Indexed: 10/15/2022]
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Santos M, Heymann S, Fayard F, Dunant A, Merlusca V, Zainescu R, Arriagada R, Marsiglia H, Bourgier C. Preoperative Radiotherapy in Locally Advanced Breast Cancer Patients: Tumor Response and Patients Outcome after 26 Years of Median Follow-up. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Santos M, Heymann S, Fayard F, Dunant A, Arriagada R, Marsiglia H, Bourgier C. Preoperative radiotherapy in patients with locally advanced breast cancer: Tumor response and patient outcome after 26 years of median follow-up. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.113] [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: 11/20/2022] Open
Abstract
113 Background: Preoperative radiotherapy (PreopRT) in locally advanced breast cancer patients (LABC) has been rarely reported. The purpose of this study was to determine if pathological response to PreopRT could have prognostic value on locoregional control and survival. Methods: From 1970 to 1984, 203 LABC patients were treated by PreopRT, delivering 45Gy in 25 fractions to the breast, supraclavicular fossa, axilla and ipsilateral internal mammary chain. After a median interval of 38 days (range: 5-121 days), radical mastectomy and axillary dissection was performed independently of radiation response. Chemotherapy or endocrine therapy was prescribed according to physician discretion in 28% and 11% of patients, respectively. Premenopausal patients underwent ovarian ablation. Median follow-up was 26 years. Locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) were estimated using the Kaplan-Meier method, the comparison of survival between groups was performed using the log-rank test, multivariate analysis was performed using the Cox model. Results: Thirty-three patients (16.2%) had a pathologic complete response (pCR) in the breast. The 10- and 20-year Kaplan-Meier LC were 90% (95% confidence interval CI: 85-94%) and 84% (95% CI: 77-89%), respectively. The 10 and 20-years DFS were 49% (CI: 42-55%) and 35% (CI: 29-42%), and the 10 and 20-years OS, 56% (CI: 49-63%) and 41% (CI: 35-48%), in that order. Patients with pCR tended to have better DFS (p=0.06) and OS (p=0.07) when compared to patients with partial response or stable/progressive disease. Having a pCR did not significantly influenced LRC (p=0.44). Multivariate analysis showed that a lower number of positive nodes on axillary dissection and younger age were associated with better DFS (p<0.0001 and p=0.02) and OS (p<0.0001 and p=0.007). Conclusions: LCR achieved by PreopRT followed by radical mastectomy in LABC was excellent in this study, despite few patients having adjuvant systemic therapy. Complete pathologic response defined a subgroup of women with a trend toward better DFS and OS. Older patients and those with a higher number of involved axillary nodes had a worse prognosis.
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Affiliation(s)
- M. Santos
- Institut Gustave Roussy, Paris, France; Institut Gustave Roussy, Villejuif, France; Karolinska Hospital Solna Radiumhemmet, Stockholm, Sweden
| | - S. Heymann
- Institut Gustave Roussy, Paris, France; Institut Gustave Roussy, Villejuif, France; Karolinska Hospital Solna Radiumhemmet, Stockholm, Sweden
| | - F. Fayard
- Institut Gustave Roussy, Paris, France; Institut Gustave Roussy, Villejuif, France; Karolinska Hospital Solna Radiumhemmet, Stockholm, Sweden
| | - A. Dunant
- Institut Gustave Roussy, Paris, France; Institut Gustave Roussy, Villejuif, France; Karolinska Hospital Solna Radiumhemmet, Stockholm, Sweden
| | - R. Arriagada
- Institut Gustave Roussy, Paris, France; Institut Gustave Roussy, Villejuif, France; Karolinska Hospital Solna Radiumhemmet, Stockholm, Sweden
| | - H. Marsiglia
- Institut Gustave Roussy, Paris, France; Institut Gustave Roussy, Villejuif, France; Karolinska Hospital Solna Radiumhemmet, Stockholm, Sweden
| | - C. Bourgier
- Institut Gustave Roussy, Paris, France; Institut Gustave Roussy, Villejuif, France; Karolinska Hospital Solna Radiumhemmet, Stockholm, Sweden
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Touboul C, Uzan C, Ichanté JL, Caron O, Dunant A, Dauchy S, Gouy S, de Paillerets BB, Morice P, Delaloge S. Factors associated with altered long-term well-being after prophylactic salpingo-oophorectomy among women at increased hereditary risk for breast and ovarian cancer. Oncologist 2011; 16:1250-7. [PMID: 21765195 DOI: 10.1634/theoncologist.2010-0336] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [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: 01/11/2023] Open
Abstract
BACKGROUND Prophylactic bilateral salpingo-oophorectomy (PBSO) might alter several components of well-being, such as sexual functioning and endocrine symptoms, in women at high risk for hereditary breast and/or ovarian cancer, compared with the general population. We searched for factors associated with altered long-term well-being in this population (lower quality of life [QOL], altered sexual functioning, greater anxiety, more endocrine symptoms). METHODS All high-risk women who had undergone PBSO during the past 15 years in a single cancer center were contacted by mail. Upon acceptance, they were sent five questionnaires: (a) general social questions, (b) the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, (c) Sexual Activity Questionnaire, (d) Functional Assessment of Cancer Therapy - Endocrine Symptom, and (5) State-Trait Anxiety Inventory. Logistic analyses were used to identify factors associated with altered results. Because of multiple testing, only p-values ≤ .01 were considered significant. RESULTS One hundred twelve of 175 women (64%) returned the completed questionnaires at a mean duration (standard deviation) of 6.0 (5.1) years after PBSO. QOL was positively influenced by two baseline factors: a high educational level and occupying an executive position. However, younger age at PBSO was associated with lower social functioning and greater anxiety. At the time of the study, practicing a sport and the avoidance of weight gain (≥10%) were highly related to QOL, sexual pleasure, endocrine symptoms, and anxiety in the univariate analysis and predictive of better QOL and lower anxiety in the multivariate analysis. CONCLUSIONS Younger women and women with a low educational level and no occupation appear to be at higher risk for altered long-term well-being. After surgery, practicing a sport and stable weight may help maintain overall well-being.
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Affiliation(s)
- Cyril Touboul
- Department of Medicine, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif, France
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Besse B, Massard C, Haddad V, Andre F, Dunant A, Pirker R, Olaussen K, Brambilla E, Fouret P, Soria J. ERCC1 influence on the incidence of brain metastases in patients with non-squamous NSCLC treated with adjuvant cisplatin-based chemotherapy. Ann Oncol 2011; 22:575-581. [DOI: 10.1093/annonc/mdq407] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bepler G, Olaussen KA, Vataire AL, Soria JC, Zheng Z, Dunant A, Pignon JP, Schell MJ, Fouret P, Pirker R, Filipits M, Brambilla E. ERCC1 and RRM1 in the international adjuvant lung trial by automated quantitative in situ analysis. Am J Pathol 2010; 178:69-78. [PMID: 21224045 DOI: 10.1016/j.ajpath.2010.11.029] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 08/02/2010] [Accepted: 09/10/2010] [Indexed: 12/12/2022]
Abstract
The excision repair cross completing group 1 gene product (ERCC1) and the regulatory subunit of ribonucleotide reductase (RRM1) have been reported as being prognostic of outcome and predictive of therapeutic efficacy in patients with non-small cell lung cancer. Routinely processed surgical specimens from 784 patients from the International Adjuvant Lung Trial were arrayed as tissue microarrays. In situ protein levels were scored with an automated, quantitative analysis system, dichotomized into high and low marker categories, and analyzed for associations with patients' characteristics, survival, and benefit from adjuvant chemotherapy. Scores for both markers were significantly associated with contributing center (P < 0.001) and skewed, with the bulk of scores being low. High scores were more frequent in women for ERCC1 and RRM1 and in older patients and those with adenocarcinoma for RRM1. Low ERCC1 scores indicated significant benefit from adjuvant chemotherapy [hazard ratio (HR) = 0.73 for chemotherapy versus control, P = 0.02]. Although all other survival associations were not statistically significant, low RRM1 scores trended to indicate benefit from adjuvant chemotherapy (HR = 0.84, P = 0.25), and ERCC1 scores were marginally prognostic of survival (HR = 0.77 for high versus low scores, P = 0.10). We conclude that contributing center and specimen quality substantially affect the levels of both markers. Future trials should incorporate the collection and processing of tumor specimens prospectively on standardized protocols to better reveal the impact of biomarkers on clinically relevant outcomes.
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Affiliation(s)
- Gerold Bepler
- Karmanos Cancer Institute, Detroit, Michigan 48201, USA.
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Le Péchoux C, Laplanche A, Faivre-Finn C, Ciuleanu T, Wanders R, Lerouge D, Keus R, Hatton M, Videtic GM, Senan S, Wolfson A, Jones R, Arriagada R, Quoix E, Dunant A. Clinical neurological outcome and quality of life among patients with limited small-cell cancer treated with two different doses of prophylactic cranial irradiation in the intergroup phase III trial (PCI99-01, EORTC 22003-08004, RTOG 0212 and IFCT 99-01). Ann Oncol 2010; 22:1154-1163. [PMID: 21139020 DOI: 10.1093/annonc/mdq576] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We recently published the results of the PCI99 randomised trial comparing the effect of a prophylactic cranial irradiation (PCI) at 25 or 36 Gy on the incidence of brain metastases (BM) in 720 patients with limited small-cell lung cancer (SCLC). As concerns about neurotoxicity were a major issue surrounding PCI, we report here midterm and long-term repeated evaluation of neurocognitive functions and quality of life (QoL). PATIENTS AND METHODS At predetermined intervals, the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and brain module were used for self-reported patient data, whereas the EORTC-Radiation Therapy Oncology Group Late Effects Normal Tissue-Subjective, Objective, Management, Analytic scale was used for clinicians' assessment. For each scale, the unfavourable status was analysed with a logistic model including age, grade at baseline, time and PCI dose. RESULTS Over the 3 years studied, there was no significant difference between the two groups in any of the 17 selected items assessing QoL and neurological and cognitive functions. We observed in both groups a mild deterioration across time of communication deficit, weakness of legs, intellectual deficit and memory (all P < 0.005). CONCLUSION Patients should be informed of these potential adverse effects, as well as the benefit of PCI on survival and BM. PCI with a total dose of 25 Gy remains the standard of care in limited-stage SCLC.
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Affiliation(s)
| | - A Laplanche
- Biostatistics and Epidemiology Unit, Institut Gustave-Roussy, Villejuif, France
| | - C Faivre-Finn
- Department of Clinical Oncology, The Christie, Manchester, UK
| | - T Ciuleanu
- Medical Oncology Department, Institutul Oncologic I. Chiricuta, Cluj-Napoca, Romania
| | - R Wanders
- Radiation Oncology Department, MAASTRO Clinic, Maastricht, The Netherlands
| | - D Lerouge
- Radiation Oncology Department, Centre François Baclesse, Caen, France
| | - R Keus
- Radiation Oncology Department, Arnhem's Radiotherapeutisch Instituut, Arnhem, The Netherlands
| | - M Hatton
- Department of Clinical Oncology, Weston Park Hospital, Sheffield, UK
| | - G M Videtic
- Radiation Oncology Department, Cleveland Clinic Foundation, Cleveland, USA
| | - S Senan
- Radiation Oncology Department, VU University Medical Centre, Amsterdam, The Netherlands
| | - A Wolfson
- Radiation Oncology Department, University of Miami School of Medicine, Miami, USA
| | - R Jones
- Department of Clinical Oncology, Beatson Oncology Centre, Glasgow, UK
| | - R Arriagada
- Radiation Oncology Department, Karolinska Institutet, Stockholm, Sweden
| | - E Quoix
- Department of Pneumology, Hôpital Lyautey, Strasbourg, France
| | - A Dunant
- Biostatistics and Epidemiology Unit, Institut Gustave-Roussy, Villejuif, France
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Voortman J, Goto A, Mendiboure J, Sohn JJ, Schetter AJ, Saito M, Dunant A, Pham TC, Petrini I, Lee A, Khan MA, Hainaut P, Pignon JP, Brambilla E, Popper HH, Filipits M, Harris CC, Giaccone G. MicroRNA expression and clinical outcomes in patients treated with adjuvant chemotherapy after complete resection of non-small cell lung carcinoma. Cancer Res 2010; 70:8288-98. [PMID: 20978195 DOI: 10.1158/0008-5472.can-10-1348] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This study determined whether expression levels of a panel of biologically relevant microRNAs can be used as prognostic or predictive biomarkers in patients who participated in the International Adjuvant Lung Cancer Trial (IALT), the largest randomized study conducted to date of adjuvant chemotherapy in patients with radically resected non-small cell lung carcinoma (NSCLC). Expression of miR-21, miR-29b, miR-34a/b/c, miR-155, and let-7a was determined by quantitative real-time PCR in formalin-fixed paraffin-embedded tumor specimens from 639 IALT patients. The prognostic and predictive values of microRNA expression for survival were studied using a Cox model, which included every factor used in the stratified randomization, clinicopathologic prognostic factors, and other factors statistically related to microRNA expression. Investigation of the expression pattern of microRNAs in situ was performed. We also analyzed the association of TP53 mutation status and miR-34a/b/c expression, epidermal growth factor receptor and KRAS mutation status, and miR-21 and Let-7a expression. Finally, the association of p16 and miR-29b expression was assessed. Overall, no significant association was found between any of the tested microRNAs and survival, with the exception of miR-21 for which a deleterious prognostic effect of lowered expression was suggested. Otherwise, no single or combinatorial microRNA expression profile predicted response to adjuvant cisplatin-based chemotherapy. Together, our results indicate that the microRNA expression patterns examined were neither predictive nor prognostic in a large patient cohort with radically resected NSCLC, randomized to receive adjuvant cisplatin-based chemotherapy versus follow-up only.
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Affiliation(s)
- Johannes Voortman
- Medical Oncology Branch and Laboratory of Human Carcinogenesis, National Cancer Institute, NIH, Bethesda, Maryland 20892-1906, USA
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Bourgier C, Khodari W, Vataire AL, Pessoa EL, Dunant A, Delaloge S, Uzan C, Balleyguier C, Mathieu MC, Marsiglia H, Arriagada R. Breast radiotherapy as part of loco-regional treatments in stage IV breast cancer patients with oligometastatic disease. Radiother Oncol 2010; 96:199-203. [DOI: 10.1016/j.radonc.2010.02.028] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 02/12/2010] [Accepted: 02/23/2010] [Indexed: 11/30/2022]
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Bonvalot S, Dunant A, le Pechoux C, Terrier P, Rimareix F, Boulet B, Medjoub L, Cioffi A, Domont J, Le Cesne A. Quality of surgical margins and local recurrence in primary extremity soft tissue sarcoma (STS). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lima Pessoa E, Dunant A, Heymann S, Delaloge S, Spielmann M, Uzan C, Mathieu M, Arriagada R, Marsiglia H, Bourgier C. Twenty-year results of alternating radiotherapy and chemotherapy in nonmetastatic inflammatory breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.638] [Citation(s) in RCA: 2] [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] [Indexed: 11/20/2022] Open
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50
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Touboul C, Uzan C, Ichante J, Caron O, Dunant A, Dauchy S, Gouy S, Morice P, Spielmann M, Delaloge S. Factors influencing long-term altered quality of life, sexual functioning, and menopausal symptoms after prophylactic bilateral salpingo-oophorectomy (PBSO) among high-risk women (wm). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1564] [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: 11/20/2022] Open
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