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Vujanić GM, Graf N, D'Hooghe E, Pritchard-Jones K, Bergeron C, Tinteren HV, Furtwängler R. Omission of adjuvant chemotherapy in patients with completely necrotic Wilms tumor stage I and radiotherapy in stage III: The 30-year SIOP-RTSG experience. Pediatr Blood Cancer 2024; 71:e30852. [PMID: 38185745 DOI: 10.1002/pbc.30852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/27/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Completely necrotic Wilms tumor (CN-WT) following preoperative chemotherapy has been regarded as low-risk WT since the International Society of Paediatric Oncology (SIOP) 93-01 study, and patients have been treated with reduced postoperative therapy. The aim of the study was to evaluate whether the omission of adjuvant chemotherapy in patients with localized CN-WT stage I and radiotherapy in stage III was safe. PATIENTS AND METHODS The retrospective observational study of outcomes of patients diagnosed with localized CN-WT on central pathology review and treated according to the SIOP 93-01 and SIOP-WT-2001 protocols (1993-2022). RESULTS There were 125 patients with localized CN-WT: 90 with stage I, 10 with stage II, and 25 with stage III. Sixty-two of 125 (49.6%) patients had a discrepant diagnosis and/or staging between the institutional pathologist and central pathology review. In the group of 90 patients with stage I, postoperative chemotherapy was not given to 41 (46%) patients, whereas 49 patients received postoperative chemotherapy-in the latter group, two patients relapsed, and one of them died. One stage I and one stage II patient developed chemotherapy-induced toxicity and died. Nineteen of 25 patients with stage III received no flank radiotherapy. No stage III patient relapsed or died. The overall 5-year event-free survival (EFS) estimate for the entire cohort (stages I-III) was 96.8% [95% confidence interval, CI: 93.6%-99.6%] and the overall survival (OS) was 97.6% [95% CI: 95.0-100%]. The EFS and OS were 97% and 98%, respectively, for stage I, and 100% for stage III. CONCLUSION Omission of postoperative chemotherapy for patients with CN-WT stage I, and radiotherapy for stage III is safe. Rapid central pathology review is required to assign appropriate treatment and avoid treatment-related side effects.
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Affiliation(s)
- Gordan M Vujanić
- Department of Pathology, Sidra Medicine, Doha, Qatar
- Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Norbert Graf
- Department of Hematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Ellen D'Hooghe
- Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Christophe Bergeron
- Institut d'Hematologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Harm van Tinteren
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Rhoikos Furtwängler
- Department of Hematology and Oncology, Saarland University Hospital, Homburg, Germany
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Inselspital University Hospital, Bern, Switzerland
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2
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Savary C, Luciana L, Huchedé P, Tourbez A, Coquet C, Broustal M, Lopez Gonzalez A, Deligne C, Diot T, Naret O, Costa M, Meynard N, Barbet V, Müller K, Tonon L, Gadot N, Degletagne C, Attignon V, Léon S, Vanbelle C, Bomane A, Rochet I, Mournetas V, Oliveira L, Rinaudo P, Bergeron C, Dutour A, Cordier-Bussat M, Roch A, Brandenberg N, El Zein S, Watson S, Orbach D, Delattre O, Dijoud F, Corradini N, Picard C, Maucort-Boulch D, Le Grand M, Pasquier E, Blay JY, Castets M, Broutier L. Fusion-negative rhabdomyosarcoma 3D organoids to predict effective drug combinations: A proof-of-concept on cell death inducers. Cell Rep Med 2023; 4:101339. [PMID: 38118405 PMCID: PMC10772578 DOI: 10.1016/j.xcrm.2023.101339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/29/2023] [Accepted: 11/22/2023] [Indexed: 12/22/2023]
Abstract
Rhabdomyosarcoma (RMS) is the main form of pediatric soft-tissue sarcoma. Its cure rate has not notably improved in the last 20 years following relapse, and the lack of reliable preclinical models has hampered the design of new therapies. This is particularly true for highly heterogeneous fusion-negative RMS (FNRMS). Although methods have been proposed to establish FNRMS organoids, their efficiency remains limited to date, both in terms of derivation rate and ability to accurately mimic the original tumor. Here, we present the development of a next-generation 3D organoid model derived from relapsed adult and pediatric FNRMS. This model preserves the molecular features of the patients' tumors and is expandable for several months in 3D, reinforcing its interest to drug combination screening with longitudinal efficacy monitoring. As a proof-of-concept, we demonstrate its preclinical relevance by reevaluating the therapeutic opportunities of targeting apoptosis in FNRMS from a streamlined approach based on transcriptomic data exploitation.
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Affiliation(s)
- Clara Savary
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Léa Luciana
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Paul Huchedé
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Arthur Tourbez
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Claire Coquet
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Maëlle Broustal
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Alejandro Lopez Gonzalez
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Clémence Deligne
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Thomas Diot
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Olivier Naret
- DOPPL, EPFL Innovation Park, Building L, Ch. de la Dent d'Oche 1, 1024 Ecublens, Switzerland
| | - Mariana Costa
- DOPPL, EPFL Innovation Park, Building L, Ch. de la Dent d'Oche 1, 1024 Ecublens, Switzerland
| | - Nina Meynard
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Virginie Barbet
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Kevin Müller
- Université Aix-Marseille, CNRS 7258, INSERM 1068, Institute Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille (CRCM), 13009 Marseille, France
| | - Laurie Tonon
- Synergie Lyon Cancer, Gilles Thomas' Bioinformatics Platform, Centre Léon Bérard, 69008 Lyon, France
| | - Nicolas Gadot
- Anatomopathology Research Platform, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Cyril Degletagne
- Cancer Genomics Platform, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Valéry Attignon
- Cancer Genomics Platform, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Sophie Léon
- EX-VIVO Platform, Centre de recherche en cancérologie de Lyon (CRCL), Centre Léon Bérard, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Christophe Vanbelle
- Plateforme d'Imagerie cellulaire, Centre de recherche en cancérologie de Lyon (CRCL), Centre Léon Bérard, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Alexandra Bomane
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Isabelle Rochet
- Multisite Institute of Pathology, Groupement Hospitalier Est du CHU de Lyon, Hôpital Femme-Mère-Enfant, 69677 Bron, France; Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 69008 Lyon, France
| | | | | | | | - Christophe Bergeron
- Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 69008 Lyon, France
| | - Aurélie Dutour
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Martine Cordier-Bussat
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Aline Roch
- DOPPL, EPFL Innovation Park, Building L, Ch. de la Dent d'Oche 1, 1024 Ecublens, Switzerland
| | - Nathalie Brandenberg
- DOPPL, EPFL Innovation Park, Building L, Ch. de la Dent d'Oche 1, 1024 Ecublens, Switzerland
| | - Sophie El Zein
- Department of Biopathology, Institut Curie, Paris, France
| | - Sarah Watson
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL Research University, Paris, France; INSERM U830, Diversity and Plasticity of Childhood Tumors Lab, Institut Curie, PSL Research University, Paris, France; Medical Oncology Department, Institut Curie, PSL Research University, Paris, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL Research University, Paris, France
| | - Olivier Delattre
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL Research University, Paris, France; INSERM U830, Diversity and Plasticity of Childhood Tumors Lab, Institut Curie, PSL Research University, Paris, France
| | - Frédérique Dijoud
- Multisite Institute of Pathology, Groupement Hospitalier Est du CHU de Lyon, Hôpital Femme-Mère-Enfant, 69677 Bron, France
| | - Nadège Corradini
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France; Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 69008 Lyon, France; Department of Translational Research in Pediatric Oncology PROSPECT, Centre Léon Bérard, 69008 Lyon, France
| | - Cécile Picard
- Multisite Institute of Pathology, Groupement Hospitalier Est du CHU de Lyon, Hôpital Femme-Mère-Enfant, 69677 Bron, France
| | - Delphine Maucort-Boulch
- Université Lyon 1, 69100 Villeurbanne, France; Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, 69003 Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, 69100 Villeurbanne, France
| | - Marion Le Grand
- Université Aix-Marseille, CNRS 7258, INSERM 1068, Institute Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille (CRCM), 13009 Marseille, France
| | - Eddy Pasquier
- Université Aix-Marseille, CNRS 7258, INSERM 1068, Institute Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille (CRCM), 13009 Marseille, France
| | - Jean-Yves Blay
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France; Department of Translational Research in Pediatric Oncology PROSPECT, Centre Léon Bérard, 69008 Lyon, France
| | - Marie Castets
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France; Department of Translational Research in Pediatric Oncology PROSPECT, Centre Léon Bérard, 69008 Lyon, France.
| | - Laura Broutier
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France; Department of Translational Research in Pediatric Oncology PROSPECT, Centre Léon Bérard, 69008 Lyon, France.
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Bitterman R, Soualhine H, Poirier C, Ferraro P, Kabbani D, Hirji A, Tyrrell G, Bergeron C, Levy R, Wright A, Leung V, Singer L, Chaparro C, Keshavjee S, Richard-Greenblatt M, Husain S, Luong M. Mycobacterium Abscessus Complex Infections Among Lung Transplant Recipients: A National Retrospective Cohort Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1646] [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: 04/05/2023] Open
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4
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Bergeron C, Lee H, Hescock G. Recurrent rhabdomyolysis without hemolysis in a pediatric patient with glucose-6-phosphate dehydrogenase deficiency. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00214-8] [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: 01/28/2023]
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5
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de Aguirre-Neto JC, de Camargo B, van Tinteren H, Bergeron C, Brok J, Ramírez-Villar G, Verschuur A, Furtwängler R, Howell L, Saunders D, Olsen O, Coulomb A, Vokuhl C, Godzinski J, Smets AM, Vujanic GM, van den Heuvel-Eibrink MM, Graf N, Pritchard-Jones K. International Comparisons of Clinical Demographics and Outcomes in the International Society of Pediatric Oncology Wilms Tumor 2001 Trial and Study. JCO Glob Oncol 2022; 8:e2100425. [PMID: 35537105 PMCID: PMC9126524 DOI: 10.1200/go.21.00425] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 01/10/2023] Open
Abstract
International comparisons of patient demographics, tumor characteristics, and survival can shed light on areas for health care system improvement. The International Society of Pediatric Oncology Wilms Tumor 2001 trial/study registered patients through national clinical study groups in Western Europe and Brazil. This retrospective post hoc analysis of the International Society of Pediatric Oncology Wilms Tumor 2001 database aims to make visible and suggest reasons for any variations in outcomes. International variation in Wilms tumor survival parallels disease burden at diagnosis.![]()
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Affiliation(s)
| | | | - Harm van Tinteren
- Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Christophe Bergeron
- Centre Léon Bérard, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Jesper Brok
- Department of Paediatric Oncology and Haematology, Rigshospitalet, Copenhagen, Denmark
| | | | - Arnauld Verschuur
- Service d'hématologie-oncologie Pédiatrique, Hôpital de la Timone, Marseille, France
| | - Rhoikos Furtwängler
- Department of Pediatric Hematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Lisa Howell
- Paediatric Oncology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Daniel Saunders
- Paediatric Radiotherapy, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Oystein Olsen
- Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Aurore Coulomb
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Armand Trousseau, Paris, France
| | | | - Jan Godzinski
- Department of Paed. Surgery, Marciniak Hospital, Wroclaw, Poland
| | - Anne M Smets
- Radiology, Amsterdam University Medical Centre-AMC, Amsterdam, the Netherlands
| | | | | | - Norbert Graf
- Department of Pediatric Hematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, Developmental Biology and Cancer Research and Teaching Department, University College London, London, United Kingdom
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6
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Delafoy M, Verschuur A, Scheleirmacher G, Tabone MD, Sudour-Bonnange H, Thébaud E, Freycon C, Notz-Carrère A, Boulanger C, Pellier I, Irtan S, Muracciole X, Coulomb-L'Hermine A, Dijoud F, Morelle M, Bergeron C, Pasqualini C. High-dose chemotherapy followed by autologous stem cell rescue in Wilms tumors: French report on toxicity and efficacy. Pediatr Blood Cancer 2022; 69:e29431. [PMID: 34811873 DOI: 10.1002/pbc.29431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Heterogeneous data have been reported on high-dose chemotherapy (HDCT) with autologous stem cell rescue (ASCR) in Wilms tumors (WTs). We aimed to define its safety and efficacy in the French cohort, and to compare this management to current international recommendations. METHODS Data prospectively collected from children, adolescents, and young adults with WT treated with HDCT/ASCR between 2000 and 2016 in French centers were retrospectively analyzed. Toxicity was reported according to CTCAE v4.03. RESULTS Fifty-four patients received HDCT/ASCR (first line, n = 13; recurrence, n = 41). Their median age at the time of ASCR was 5.3 years (range 2.2-21.6). Main nonhematological acute grades 3-4 toxicities were digestive and renal. No significant difference of toxicity rate was observed among HDCT regimens and schedules. Two patients died shortly after ASCR (renal and multiorgan failure), and one heavily pretreated patient died of late respiratory failure. The selection criteria applied to define those patients eligible for HDCT/ASCR retrospectively matched to those currently used in the International Society of Pediatric Oncology (SIOP) UMBRELLA protocol for 38 patients, with encouraging survival rates compared to published data. The objective response rate to HDCT was 21%, with a disease control rate after HDCT of 85%. After a median follow-up of 7 years, the 5-year event-free survival (EFS) and overall survival (OS) were 54% (95% CI: 32%-76%) and 62% (95% CI: 31%-82%) for frontline patients, and 57% (95% CI: 39%-71%) and 69% (95% CI: 52%-81%) at recurrence. CONCLUSION HDCT was feasible and showed encouraging results in well-defined settings. Data from the current prospective protocol will help to better evaluate HDCT impact on survival.
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Affiliation(s)
- Manon Delafoy
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Arnauld Verschuur
- Pediatric Hematology-Oncology Department, La Timone Hospital, AP-HM, Marseille, France
| | | | | | | | - Estelle Thébaud
- Pediatric Onco-Hematology Department, University Hospital Center of Nantes, Nantes, France
| | - Claire Freycon
- Pediatric Hematology-Oncology Department, University Hospital Center of Grenoble, Grenoble, France
| | - Anne Notz-Carrère
- Pediatric Onco-Hematology Department, University Hospital Center of Bordeaux, Bordeaux, France
| | - Cécile Boulanger
- Pediatric Hematology-Oncology Department, University Hospital Center of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Pediatric Hematology-Oncology Department, University Hospital Center of Angers, Angers, France
| | - Sabine Irtan
- Department of Pediatric Surgery, Sorbonne Université, Armand Trousseau Hospital, APHP, Paris, France
| | - Xavier Muracciole
- Department of Radiotherapy, La Timone Hospital, AP-HM, Marseille, France
| | | | | | - Magali Morelle
- Department of Statistic, Centre Léon Bérard, Lyon, France
| | - Christophe Bergeron
- Pediatric Onco-Hematology Department, Centre Leon Bérard/IHOPE, Lyon, France
| | - Claudia Pasqualini
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
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Graf N, Bergeron C, Brok J, de Camargo B, Chowdhury T, Furtwängler R, Gessler M, Godzinski J, Pritchard-Jones K, Ramirez-Villar GL, Rübe C, Sandstedt B, Schenk JP, Spreafico F, Sudour-Bonnange H, van Tinteren H, Verschuur A, Vujanic G, van den Heuvel-Eibrink MM. Fifty years of clinical and research studies for childhood renal tumors within the International Society of Pediatric Oncology (SIOP). Ann Oncol 2021; 32:1327-1331. [PMID: 34416363 DOI: 10.1016/j.annonc.2021.08.1749] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/08/2021] [Indexed: 01/01/2023] Open
Affiliation(s)
- N Graf
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg, Germany.
| | - C Bergeron
- Department of Paediatric Haemato-Oncology, Centre Léon Bérard, Lyon, France
| | - J Brok
- Department of Pediatric Oncology and Hematology, Rigshospitalet, Copenhagen, Denmark
| | - B de Camargo
- Research Center, Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - T Chowdhury
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - R Furtwängler
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg, Germany
| | - M Gessler
- Theodor-Boveri-Institute/Biocenter and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - J Godzinski
- Department of Pediatric Surgery, Marciniak Hospital, Fieldorfa 2, Poland; Department of Paediatric Traumatology and Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - K Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, University College London, London, UK
| | - G L Ramirez-Villar
- Department of Paediatric Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - C Rübe
- Department of Radiation Oncology, Saarland University, Homburg, Germany
| | - B Sandstedt
- Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - J-P Schenk
- Pediatric Radiology Section, Department for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - F Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - H Sudour-Bonnange
- Centre Oscar Lambret, Department of Children and AJA Oncology, Lille, France
| | - H van Tinteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - A Verschuur
- Department of Pediatric Oncology, Hôpital d'Enfants de la Timone, Marseille, France
| | - G Vujanic
- Department of Pathology, Sidra Medicine and Weill Cornell Medicine - Qatar, Doha, Qatar
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8
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Hol JA, Jongmans MCJ, Sudour‐Bonnange H, Ramírez‐Villar GL, Chowdhury T, Rechnitzer C, Pal N, Schleiermacher G, Karow A, Kuiper RP, de Camargo B, Avcin S, Redzic D, Wachtel A, Segers H, Vujanic GM, van Tinteren H, Bergeron C, Pritchard‐Jones K, Graf N, van den Heuvel‐Eibrink MM. Clinical characteristics and outcomes of children with WAGR syndrome and Wilms tumor and/or nephroblastomatosis: The 30-year SIOP-RTSG experience. Cancer 2021; 127:628-638. [PMID: 33146894 PMCID: PMC7894534 DOI: 10.1002/cncr.33304] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND WAGR syndrome (Wilms tumor, aniridia, genitourinary anomalies, and range of developmental delays) is a rare contiguous gene deletion syndrome with a 45% to 60% risk of developing Wilms tumor (WT). Currently, surveillance and treatment recommendations are based on limited evidence. METHODS Clinical characteristics, treatments, and outcomes were analyzed for patients with WAGR and WT/nephroblastomatosis who were identified through International Society of Pediatric Oncology Renal Tumor Study Group (SIOP-RTSG) registries and the SIOP-RTSG network (1989-2019). Events were defined as relapse, metachronous tumors, or death. RESULTS Forty-three patients were identified. The median age at WT/nephroblastomatosis diagnosis was 22 months (range, 6-44 months). The overall stage was available for 40 patients, including 15 (37.5%) with bilateral disease and none with metastatic disease. Histology was available for 42 patients; 6 nephroblastomatosis without further WT and 36 WT, including 19 stromal WT (52.8%), 12 mixed WT (33.3%), 1 regressive WT (2.8%) and 2 other/indeterminable WT (5.6%). Blastemal type WT occurred in 2 patients (5.6%) after prolonged treatment for nephroblastomatosis; anaplasia was not reported. Nephrogenic rests were present in 78.9%. Among patients with WT, the 5-year event-free survival rate was 84.3% (95% confidence interval, 72.4%-98.1%), and the overall survival rate was 91.2% (95% confidence interval, 82.1%-100%). Events (n = 6) did not include relapse, but contralateral tumor development (n = 3) occurred up to 7 years after the initial diagnosis, and 3 deaths were related to hepatotoxicity (n = 2) and obstructive ileus (n = 1). CONCLUSIONS Patients with WAGR have a high rate of bilateral disease and no metastatic or anaplastic tumors. Although they can be treated according to existing WT protocols, intensive monitoring of toxicity and surveillance of the remaining kidney(s) are advised. LAY SUMMARY WAGR syndrome (Wilms tumor, aniridia, genitourinary anomalies, and range of developmental delays) is a rare genetic condition with an increased risk of developing Wilms tumor. In this study, 43 patients with WAGR and Wilms tumor (or Wilms tumor precursor lesions/nephroblastomatosis) were identified through the international registry of the International Society of Pediatric Oncology Renal Tumor Study Group (SIOP-RTSG) and the SIOP-RTSG network. In many patients (37.5%), both kidneys were affected. Disease spread to other organs (metastases) did not occur. Overall, this study demonstrates that patients with WAGR syndrome and Wilms tumor can be treated according to existing protocols. However, intensive monitoring of treatment complications and surveillance of the remaining kidney(s) are advised.
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Affiliation(s)
- Janna A. Hol
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
| | - Marjolijn C. J. Jongmans
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
- Department of GeneticsUniversity Medical Center Utrecht/Wilhelmina Children's HospitalUtrechtthe Netherlands
| | | | | | - Tanzina Chowdhury
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUnited Kingdom
| | | | - Niklas Pal
- Department of Pediatric OncologyKarolinska University HospitalSolnaSweden
| | | | - Axel Karow
- Department of Pediatrics and Adolescent MedicineFriedrich‐Alexander University Erlangen‐NürnbergErlangenGermany
| | - Roland P. Kuiper
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
| | - Beatriz de Camargo
- Pediatric Hematology‐Oncology ProgramInstituto Nacional de CancerRio de JaneiroBrazil
| | - Simona Avcin
- Department of Pediatric OncologyUniversity Children's HospitalLjubljanaSlovenia
| | - Danka Redzic
- Department of Hemato‐OncologyMother and Child Health Care Institute of SerbiaBelgradeSerbia
| | - Antonio Wachtel
- Pediatric OncologyInstituto Nacional de Enfermedades NeoplásicasLimaPeru
| | - Heidi Segers
- Department of Pediatric Hemato‐OncologyUniversity Hospital LeuvenLeuvenBelgium
| | | | - Harm van Tinteren
- Department of BiometricsNetherlands Cancer InstituteAmsterdamthe Netherlands
| | - Christophe Bergeron
- Institut d'Hematologie et d'Oncologie PédiatriqueCentre Léon BérardLyonFrance
| | - Kathy Pritchard‐Jones
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUnited Kingdom
| | - Norbert Graf
- Department of Pediatric Oncology and HematologySaarland UniversityHomburgGermany
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9
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Bergeron C, Jenney M, De Corti F, Gallego S, Merks H, Glosli H, Ferrari A, Ranchère-Vince D, De Salvo GL, Zanetti I, Chisholm J, Minard-Colin V, Rogers T, Bisogno G. Embryonal rhabdomyosarcoma completely resected at diagnosis: The European paediatric Soft tissue sarcoma Study Group RMS2005 experience. Eur J Cancer 2021; 146:21-29. [PMID: 33567392 DOI: 10.1016/j.ejca.2020.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/12/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Rhabdomyosarcoma (RMS) is the most common form of soft tissue sarcoma in children. We report the results of the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS 2005 study, which prospectively evaluated the reduction of chemotherapy in patients with embryonal RMS (ERMS) after initial surgery. METHODS Between October 2005 and December 2016, all patients with localised ERMS with an initial microscopically complete resection (IRS group I) with lymph node-negative (N0) were prospectively enrolled in the low-risk (n = 70, subgroup A; age < 10 years and tumour size ≤ 5 cm) or standard-risk group (n = 108, subgroup B; age ≥ 10 years or tumour size > 5 cm. Subgroup A received 8 courses of vincristine and dactinomycin (VA) for 22 weeks; subgroup B received 4 courses of VA with ifosfamide (IVA) and 5 courses of VA for 25 weeks. RESULTS The 5-year event-free survival (EFS) and overall survival (OS) were 90.8% (95% confidence interval [CI]: 85.0-94.4) and 95.7% (95% CI: 90.5-98.1), respectively (n = 178). The EFS and OS were 95.5% (95% CI: 86.8-98.5) and 100% (subgroupA), and 87.8% (95% CI: 79.3-93.0) and 93.0% (95% CI: 84.8-96.8)(subgroup B), respectively. Bearman stage 2 veno-occlusive disease (VOD) occurred in 4 very young patients. CONCLUSION VA treatment for 8 courses was effective and well tolerated by the subgroup of patients with low-risk ERMS (group A). Four courses of IVA and 5 courses of VA instead of 9 courses of IVA also has very good results. Careful monitoring for liver toxicity is important in very young patients. European union drug regulating authorities clinical trials EUDRACT No. 2005-000217-35.
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Affiliation(s)
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Cardiff, United Kingdom
| | - Federica De Corti
- Pediatric Surgery, Department of Women's and Children's Health, University-Hospital of Padova, Padova, Italy
| | - Soledad Gallego
- Paediatric Oncology, Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | - Hans Merks
- Department of Paediatric Oncology, Emma Children's Hospital/Academic Medical Centre, Amsterdam, the Netherlands
| | - Heidi Glosli
- Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, Istituto Oncologico Veneto - IRCCS, Padova, Italy
| | - Ilaria Zanetti
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Julia Chisholm
- Children and Young Peoples Unit, Royal Marsden Hospital, Surrey, United Kingdom
| | - Véronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy, Campus, Université Paris Saclay, Villejuif, France
| | - Timothy Rogers
- Department of Paediatric Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Gianni Bisogno
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
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10
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Bergeron C, Laberge P, Boutin A, Thériault M, Valcourt F, Lemyre M, Maheux-Lacroix S. Ablation/Resection Vs Levonorgestrel Intrauterine System (LNG-IUS) for Heavy Menstrual Bleeding : A Systematic Review and Meta-Analysis. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Benezech S, Saintigny P, Attignon V, Pissaloux D, Paindavoine S, Faure-Conter C, Corradini N, Marec-Berard P, Bergeron C, Cassier P, Eberst L, Dufresne A, Wang Q, Agrapart V, De La Fouchardière A, Perol D, Garin G, Corset V, Ben Abdesselem L, Chabaud S, Tredan O, Blay JY, Frappaz D. Tumor Molecular Profiling: Pediatric Results of the ProfiLER Study. JCO Precis Oncol 2020; 4:785-795. [PMID: 35050753 DOI: 10.1200/po.20.00023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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 The Program to Establish the Genetic and Immunologic Profile of Patient's Tumor for All Types of Advanced Cancer study (ClinicalTrials.gov identifier: NCT01774409) analyzed the genome of refractory cancers to identify a potential molecular-based recommended therapy (MBRT). The objectives of the pediatric substudy were to describe the incidence of genomic mutations, the MBRT, and the treatments undertaken with a molecular-targeted agent in a pediatric cohort. METHODS The tumor genome was analyzed within a 69-gene next-generation sequencing panel and an array comparative genomic hybridization assay. The results were evaluated by a multidisciplinary molecular board, and the targeted therapies were provided in the setting of a clinical trial or through compassionate use programs, when indicated. RESULTS Between November 2013 and June 2017, 50 patients younger than 19 years who were treated for a high-risk or relapsing tumor were included. Sarcomas (n = 24; 47%), CNS tumors (n = 14; 29%), and neuroblastomas (n = 5; 10%) were the most frequent tumor subtypes. Seven patients (14%) were excluded because no DNA could be recovered. Among the 43 remaining patients, 10 exhibited at least one targetable genomic alteration. Ultimately, four patients (8%) were treated with the recommended targeted therapy. CONCLUSION The results of this study confirm treatment with a targeted therapy for pediatric patients with cancer is still limited at present, as also is reported for adults.
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Affiliation(s)
- Sarah Benezech
- Institut d'Hématologie et Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Pierre Saintigny
- Department of Translational Research and Innovation, Centre Léon Bérard, Lyon, France.,Department of Medical Oncology, Centre Léon Bérard, France
| | - Valery Attignon
- Department of Translational Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Daniel Pissaloux
- Department of Translational Research and Innovation, Centre Léon Bérard, Lyon, France
| | | | - Cécile Faure-Conter
- Institut d'Hématologie et Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Nadège Corradini
- Institut d'Hématologie et Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Perrine Marec-Berard
- Institut d'Hématologie et Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Christophe Bergeron
- Institut d'Hématologie et Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | | | | | | | - Qing Wang
- Department of Translational Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Vincent Agrapart
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | | | - David Perol
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Gwenaëlle Garin
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Véronique Corset
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Leila Ben Abdesselem
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Sylvie Chabaud
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Olivier Tredan
- Department of Medical Oncology, Centre Léon Bérard, France.,University Claude Bernard Lyon 1, CNRS 5286, INSERM U1052, Cancer Research Center of Lyon, France
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard, France.,University Claude Bernard Lyon 1, CNRS 5286, INSERM U1052, Cancer Research Center of Lyon, France
| | - Didier Frappaz
- Institut d'Hématologie et Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
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12
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Bottero J, Reques L, Rolland C, Lallemand A, Lahmidi N, Hamers F, Bergeron C, Haguenoer K, Launoy G, Luhmann N. Apport de l’Auto-Prélèvement Vaginal (APV) détectant les Papillomavirus (HPV) pour promouvoir le dépistage du Cancer du Col de l’Utérus (CCU) de femmes en situation de précarité en France. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Dzhuma K, Ducou Le Pointe H, Coulomb A, Tabone MD, Bergeron C, Audry G, Irtan S. Wilms tumors and their precursors: Radiological diagnosis versus histology. Pediatr Blood Cancer 2020; 67:e28414. [PMID: 32568441 DOI: 10.1002/pbc.28414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/29/2020] [Indexed: 01/27/2023]
Abstract
The radiological distinction of Wilms tumor (WT) nodules from nephrogenic rests (NR) in patients with multifocal unilateral WT or bilateral disease is challenging. The study aims to compare the radiology assessment of kidney nodules with their final histology in 48 patients. The final histology of 118 nodules corresponded to the initial radiological diagnosis while 40 (25%) nodules were misdiagnosed, 20 being initially diagnosed WT on imaging were proved to be NR at histology. The size of nodules at diagnosis might help to distinguish WT from NR before surgery. Homogeneity did not seem to be a key feature.
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Affiliation(s)
- Kristina Dzhuma
- Department of Visceral Pediatric Surgery, APHP Hôpital Armand Trousseau, Paris, France
| | | | - Aurore Coulomb
- Department of Anatomy and Cytology Pathologic, APHP Hôpital Armand Trousseau, Paris, France.,Centre de Recherche St Antoine Inserm UMRS 938, UPMC Univ Paris 06, Sorbonne Université, Paris, France
| | | | - Christophe Bergeron
- Pediatric Hemato-Oncology Unit, Institut d'hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Georges Audry
- Department of Visceral Pediatric Surgery, APHP Hôpital Armand Trousseau, Paris, France.,Centre de Recherche St Antoine Inserm UMRS 938, UPMC Univ Paris 06, Sorbonne Université, Paris, France
| | - Sabine Irtan
- Department of Visceral Pediatric Surgery, APHP Hôpital Armand Trousseau, Paris, France.,Centre de Recherche St Antoine Inserm UMRS 938, UPMC Univ Paris 06, Sorbonne Université, Paris, France
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14
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Vial J, Huchedé P, Fagault S, Basset F, Rossi M, Geoffray J, Soldati H, Bisaccia J, Elsensohn MH, Creveaux M, Neves D, Blay JY, Fauvelle F, Bouquet F, Streichenberger N, Corradini N, Bergeron C, Maucort-Boulch D, Castets P, Carré M, Weber K, Castets M. Low expression of ANT1 confers oncogenic properties to rhabdomyosarcoma tumor cells by modulating metabolism and death pathways. Cell Death Discov 2020; 6:64. [PMID: 32728477 PMCID: PMC7382490 DOI: 10.1038/s41420-020-00302-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/17/2020] [Accepted: 07/06/2020] [Indexed: 01/23/2023] Open
Abstract
Rhabdomyosarcoma (RMS) is the most frequent form of pediatric soft-tissue sarcoma. It is divided into two main subtypes: ERMS (embryonal) and ARMS (alveolar). Current treatments are based on chemotherapy, surgery, and radiotherapy. The 5-year survival rate has plateaued at 70% since 2000, despite several clinical trials. RMS cells are thought to derive from the muscle lineage. During development, myogenesis includes the expansion of muscle precursors, the elimination of those in excess by cell death and the differentiation of the remaining ones into myofibers. The notion that these processes may be hijacked by tumor cells to sustain their oncogenic transformation has emerged, with RMS being considered as the dark side of myogenesis. Thus, dissecting myogenic developmental programs could improve our understanding of RMS molecular etiology. We focused herein on ANT1, which is involved in myogenesis and is responsible for genetic disorders associated with muscle degeneration. ANT1 is a mitochondrial protein, which has a dual functionality, as it is involved both in metabolism via the regulation of ATP/ADP release from mitochondria and in regulated cell death as part of the mitochondrial permeability transition pore. Bioinformatics analyses of transcriptomic datasets revealed that ANT1 is expressed at low levels in RMS. Using the CRISPR-Cas9 technology, we showed that reduced ANT1 expression confers selective advantages to RMS cells in terms of proliferation and resistance to stress-induced death. These effects arise notably from an abnormal metabolic switch induced by ANT1 downregulation. Restoration of ANT1 expression using a Tet-On system is sufficient to prime tumor cells to death and to increase their sensitivity to chemotherapy. Based on our results, modulation of ANT1 expression and/or activity appears as an appealing therapeutic approach in RMS management.
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Affiliation(s)
- J. Vial
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - P. Huchedé
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - S. Fagault
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - F. Basset
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - M. Rossi
- Aix-Marseille Université, Inserm UMR_S 911, Centre de Recherche en Oncologie biologique et Oncopharmacologie, Faculté de pharmacie, Marseille, France
| | - J. Geoffray
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - H. Soldati
- Department of Cell Physiology and Metabolism, University of Geneva, CMU, CH-1211 Geneva, Switzerland
| | - J. Bisaccia
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - M. H. Elsensohn
- Service de Biostatistique—Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
| | - M. Creveaux
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | | | - J. Y. Blay
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - F. Fauvelle
- Université Grenoble Alpes, INSERM, US17, MRI facility IRMaGe, 38000 Grenoble, France
| | - F. Bouquet
- Roche Institute, Boulogne-Billancourt, France
| | - N. Streichenberger
- Hospices Civils de Lyon, Lyon, France
- INMG CNRS UMR 5310, INSERM U1217, Université Claude Bernard Lyon, Lyon, France
| | - N. Corradini
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - C. Bergeron
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - D. Maucort-Boulch
- Service de Biostatistique—Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
| | - P. Castets
- Department of Cell Physiology and Metabolism, University of Geneva, CMU, CH-1211 Geneva, Switzerland
| | - M. Carré
- Aix-Marseille Université, Inserm UMR_S 911, Centre de Recherche en Oncologie biologique et Oncopharmacologie, Faculté de pharmacie, Marseille, France
| | - K. Weber
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
| | - M. Castets
- Cell death and Childhood Cancers Laboratory—Equipe labellisée LabEx DEV2CAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Université de Lyon, Centre Léon Bérard, 69008 Lyon, France
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15
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Bonhoure A, Colomba J, Boudreau V, Bergeron C, Potter K, Carricart M, Tremblay F, Lavoie A, Rabasa-Lhoret R. ePS2.10 Peak glucose during an oral glucose tolerance test associated with clinical status in adult patients with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30300-3] [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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16
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Boudreau V, Bonhoure A, Bergeron C, Colomba J, Mignault D, Desjardins K, Tremblay F, Rabasa-Lhoret R. P244 Simplification of Cystic Fibrosis-Related Diabetes screening by the use of a home-based oral glucose tolerance test: a pilot study to evaluate feasibility, validity and patient perception (AtHome). J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Liné A, Sudour-Bonnange H, Languillat-Fouquet V, Brisse H, Irtan S, Verschuur A, Sarnacki S, Thébaud E, Coulomb-L'Hermine A, Notz-Carrère A, Michon J, Tabone MD, Boulanger C, Pellier I, Freycon C, Audry G, Dijoud F, Morelle M, Bergeron C, Pasqualini C. Liver metastasis at diagnosis in children with nephroblastoma enrolled in SIOP2001 protocol: A French multicentric study. Pediatr Blood Cancer 2020; 67:e28201. [PMID: 32207555 DOI: 10.1002/pbc.28201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/14/2020] [Accepted: 01/14/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Liver metastases are rare in children with Wilms tumor (WT), and their impact on the outcome is unclear. PATIENTS AND METHODS The French cohort of patients with WT presenting liver metastases at diagnosis and enrolled in the International Society of Pediatric Oncology (SIOP) 2001 study was reviewed. RESULTS From 2002 to 2012, 906 French patients were enrolled in the SIOP2001 trial. Among them, 131 (14%) presented with stage IV WT and 18 (1.9%) had liver metastases at diagnosis. Isolated liver metastases were displayed in four of them. After preoperative chemotherapy, persistent liver disease was reported in 14/18 patients, and 13 of them underwent metastasectomy after nephrectomy. In resected liver lesions, the same histology of the primary tumor was reported for three patients, blastemal cells without anaplasia were identified in one patient with DA-WT, and post-chemotherapy necrosis/fibrosis was identified for the other 10 patients. For the four patients who had liver and lung surgery, both sites had nonviable cells with post-chemotherapy necrosis/fibrosis. Six patients had hepatic radiotherapy. Sixteen patients achieved primary complete remission and were alive at the last follow-up (median follow-up: 6.4 years). The only two deceased patients presented diffuse anaplasia histology. The five-year EFS and OS were 83% (60%-94%) and 88% (66%-97%), respectively. CONCLUSION Liver involvement does not appear to be an adverse prognostic factor in metastatic WT. The role of hepatic surgery and radiotherapy remains unclear, and should be carefully considered in case of persistent liver metastases, according to histology and radiological response to other metastatic sites.
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Affiliation(s)
- Antoine Liné
- Department of Pediatric Surgery, University Hospital Center of Reims, Reims, France
| | | | | | - Hervé Brisse
- Department of Radiology, Curie Institute, Paris, France
| | - Sabine Irtan
- Department of Pediatric Surgery, Armand Trousseau Hospital, APHP, Paris, France
| | - Arnauld Verschuur
- Pediatric Hematology-Oncology Department, La Timone Hospital, AP-HM, Marseille, France
| | - Sabine Sarnacki
- Department of Pediatric Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Estelle Thébaud
- Pediatric Onco-Hematology Department, University Hospital Center of Nantes, Nantes, France
| | | | - Anne Notz-Carrère
- Pediatric Onco-Hematology Department, University Hospital Center of Bordeaux, Bordeaux, France
| | - Jean Michon
- Pediatric Onco-Hematology Department, Curie Institute, Paris, France
| | | | - Cécile Boulanger
- Pediatric Hematology-Oncology Department, University Hospital Center of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Pediatric Hematology-Oncology Department, University Hospital Center of Angers, Angers, France
| | - Claire Freycon
- Pediatric Hematology-Oncology Department, University Hospital Center of Grenoble, Grenoble, France
| | - Georges Audry
- Department of Pediatric Surgery, Armand Trousseau Hospital, APHP, Paris, France
| | | | - Magali Morelle
- Department of Statistic, Centre Léon Bérard, Lyon, France
| | - Christophe Bergeron
- Pediatric Onco-Hematology Department, Centre Leon Bérard/ IHOPE, Lyon, France
| | - Claudia Pasqualini
- Children and Adolescents Oncology Department, Gustave Roussy, Villejuif, France
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Ferrari A, Merks JH, Chisholm JC, Orbach D, Brennan B, Gallego S, van Noesel MM, McHugh K, van Rijn RR, Gaze MN, Martelli H, Bergeron C, Corradini N, Minard-Colin V, Bisogno G, Geoerger B, Caron HN, De Salvo GL, Casanova M. Outcomes of metastatic non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) treated within the BERNIE study: a randomised, phase II study evaluating the addition of bevacizumab to chemotherapy. Eur J Cancer 2020; 130:72-80. [DOI: 10.1016/j.ejca.2020.01.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/09/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
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Rios P, Bauer H, Schleiermacher G, Pasqualini C, Boulanger C, Thebaud E, Gandemer V, Pellier I, Verschuur A, Sudour-Bonnange H, Coulomb-l'Hermine A, Spiegel A, Notz-Carrere A, Bergeron C, Orsi L, Lacour B, Clavel J. Environmental exposures related to parental habits in the perinatal period and the risk of Wilms' tumor in children. Cancer Epidemiol 2020; 66:101706. [PMID: 32247207 DOI: 10.1016/j.canep.2020.101706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Wilms' tumor is the most frequently diagnosed renal tumor in children. Little is known about its etiology. The aim of this study was to investigate the potential role of specific exposures related to parental habits such as parental smoking, maternal alcohol consumption and the use of household pesticides during pregnancy. METHODS The ESTELLE study was a nationwide case-control study that included 117 Wilms' tumor cases and 1100 control children from the general French population, frequency-matched by age and gender. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals. RESULTS After controlling for matching variables and potential confounders, the maternal use of any type of pesticide during pregnancy was associated with the risk of Wilms' tumor in children (OR 1.6 [95 % CI 1.1-2.3]). Insecticides were the most commonly reported type of pesticide and there was a positive association with their use (OR 1.7 [95 % CI 1.1-2.6]. The association was stronger when they were used more often than once a month (OR 1.9 [95 % CI 1.2-3.0]. Neither maternal smoking during pregnancy nor paternal smoking during preconception/pregnancy was associated with a risk of Wilms' tumor (ORs 1.1[95 % CI 0.7-1.8] and 1.1 [95 % CI 0.7-1.7], respectively). No association was observed with maternal alcohol intake during pregnancy (OR 1.2 [95 % CI 0.8-2.0]). CONCLUSION Our findings suggest an association between the maternal use of household pesticides during pregnancy and the risk of Wilms' tumor.
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Affiliation(s)
- Paula Rios
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.
| | - Hélène Bauer
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | | | - Claudia Pasqualini
- Gustave Roussy, Université Paris-Saclay, Child and Adolescent Oncology Department, Villejuif, France
| | | | | | | | | | | | | | | | | | | | | | - Laurent Orsi
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Brigitte Lacour
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France; National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif and CHU de Nancy, France
| | - Jacqueline Clavel
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France; National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif and CHU de Nancy, France
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20
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Bauer H, Rios P, Schleiermacher G, Valteau-Couanet D, Bertozzi AI, Thebaud E, Gandemer V, Pellier I, Verschuur A, Spiegel A, Notz-Carrere A, Bergeron C, Orsi L, Lacour B, Clavel J. Maternal and perinatal characteristics, congenital malformations and the risk of wilms tumor: the ESTELLE study. Cancer Causes Control 2020; 31:491-501. [PMID: 32144681 DOI: 10.1007/s10552-020-01288-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/24/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Wilms tumor (WT), or nephroblastoma, is an embryonic tumor that constitutes the most common renal tumor in children. Little is known about the etiology of WT. The aim of this study was to investigate whether maternal or perinatal characteristics were associated with the risk of WT. METHODS The ESTELLE study is a national-based case-control study that included 117 cases of WT and 1,100 controls younger than 11 years old. The cases were children diagnosed in France in 2010-2011 and the controls were frequency matched with cases by age and gender. The mothers of case and control children responded to a telephone questionnaire addressing sociodemographic and perinatal characteristics, childhood environment, and lifestyle. Unconditional logistic regression models adjusted on potential cofounders were used to estimate the odds ratios (OR) and their confidence intervals (95% CI). RESULTS High birth weight and the presence of congenital malformation were associated with WT (OR 1.9 [95% CI 1.0-3.7] and OR 2.5 [95% CI 1.1-5.8], respectively). No association with breastfeeding or folic acid supplementation was observed. CONCLUSIONS Although potential recall bias cannot be excluded, our findings reinforce the hypothesis that high birth weight and the presence of congenital malformation may be associated with an increased risk of WT. Further investigations are needed to further elucidate the possible role of maternal characteristics in the etiology of WT.
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Affiliation(s)
- Hélène Bauer
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Paula Rios
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.
| | | | - Dominique Valteau-Couanet
- Children and Adolescent Cancerology Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | | | | | | | | | | | | | - Laurent Orsi
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Brigitte Lacour
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
| | - Jacqueline Clavel
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
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21
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Pasqualini C, Furtwängler R, van Tinteren H, Teixeira RAP, Acha T, Howell L, Vujanic G, Godzinski J, Melchior P, Smets AM, Coulomb-L'Hermine A, Brisse H, Pritchard-Jones K, Bergeron C, de Camargo B, van den Heuvel-Eibrink MM, Graf N, Verschuur AC. Outcome of patients with stage IV high-risk Wilms tumour treated according to the SIOP2001 protocol: A report of the SIOP Renal Tumour Study Group. Eur J Cancer 2020; 128:38-46. [PMID: 32109849 DOI: 10.1016/j.ejca.2020.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 09/23/2019] [Revised: 11/27/2019] [Accepted: 01/08/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION High-risk (HR) metastatic (stage IV) Wilms tumours (WTs) have a particular poor outcome. METHODS Here, we report the results of HR (diffuse anaplastic [DA] or blastemal type [BT]) stage IV WT treated patients according to the HR arm in the SIOP2001 prospective study. RESULTS From January 2002 to August 2014, 3559 patients with WT were included in the SIOP2001 trial. Among the 525 patients (15%) with metastatic WT, 74 (14%) had stage IV HR-WT. The median age at diagnosis was 5.5 years (range: 1.4-18.3). Thirty-four patients (47%) had BT-WT and 40 (53%) had DA-WT. Five-year event-free survival rates were 44 ± 17% and 28 ± 15% for BT-WT and DA-WT, respectively (p = 0.09). Five-year overall survival rates were 53 ± 17% and 29 ± 16% for BT-WT and DA-WT, respectively (p = 0.03). Metastatic complete response after preoperative treatment was significantly associated with outcome in univariate and multivariate analyses (hazards ratio = 0.3; p = 0.01). Postoperative radiotherapy of metastatic sites might also be beneficial. Forty-three of 74 patients experienced a relapse or progression predominantly in the lungs (80%). The median time to relapse/progression after diagnosis was 7.3 months (range: 1.6-33.3) and 4.9 months (range: 0.7-28.4) for BT-WT and DA-WT, respectively (p = 0.67). This is the first prospective evidence of inferior survival of stage IV BT-WT as compared with historical intermediate-risk WT. Survival of patients with stage IV DA-WT has not improved compared to the previous SIOP93-01 study. CONCLUSION These results call for new treatment approaches for patients with HR stage IV WT.
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Affiliation(s)
- Claudia Pasqualini
- Children and Adolescents Oncology Department, Gustave Roussy, Villejuif, France.
| | - Rhoikos Furtwängler
- Department of Pediatric Haematology/Oncology, Saarland University Hospital, Homburg, Germany.
| | - Harm van Tinteren
- Biometrics Department, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Roberto A P Teixeira
- Instituto Do Tratamento Do Câncer Infantil, Department of Pediatrics, São Paulo University, São Paulo, Brazil.
| | - Tomas Acha
- Hospital Materno-Infantil "Carlos Haya", Department of Pediatrics, Malaga, Spain.
| | - Lisa Howell
- Department of Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom.
| | | | - Jan Godzinski
- Department of Pediatric Surgery, Marciniak Hospital Wroclaw, Wroclaw, Poland; Department of Pediatric Traumatology and Emergency Medicine, Medical University, Wroclaw, Poland.
| | - Patrick Melchior
- Department of Radiation Oncology, Saarland University Hospital, Homburg, Germany.
| | - Anne M Smets
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands.
| | | | - Hervé Brisse
- Department of Radiology, Curie Institut, Paris, France.
| | - Kathy Pritchard-Jones
- Great Ormond Street Institute of Child Health, University College London, London, UK.
| | | | - Beatriz de Camargo
- Instituto Nacional Do Cancer, Pediatric Onco-Haematology, Rio de Janeiro, Brazil.
| | - Marry M van den Heuvel-Eibrink
- Oncology, Princess Maxima Centre for Pediatric Oncology, Utrecht, the Netherlands; Dutch Childhood Oncology Group, The Hague, the Netherlands.
| | - Norbert Graf
- Department of Pediatric Haematology/Oncology, Saarland University Hospital, Homburg, Germany.
| | - Arnauld C Verschuur
- Pediatric Onco-Haematology Department, Hopital de La Timone, AP-HM, Marseille, France.
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22
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Fajardo RD, van den Heuvel-Eibrink MM, van Tinteren H, Spreafico F, Acha T, Bergeron C, de Camargo B, Oldenburger F, Rübe C, Oue T, Vokuhl C, de Krijger RR, Vujanic G, Sebire N, Coulomb-L'Hermine A, Collini P, Gandola L, Pritchard-Jones K, Graf N, Janssens GO, van Grotel M. Is radiotherapy required in first-line treatment of stage I diffuse anaplastic Wilms tumor? A report of SIOP-RTSG, AIEOP, JWiTS, and UKCCSG. Pediatr Blood Cancer 2020; 67:e28039. [PMID: 31625685 DOI: 10.1002/pbc.28039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 09/05/2019] [Accepted: 09/23/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND As a significant proportion of relapses occurred in the tumor bed or abdomen on patients with the fifth National Wilms Tumor Study stage I anaplastic Wilms tumor (WT), flank radiotherapy was added for stage I anaplastic WT in the subsequent study of the Children's Oncology Group (AREN0321). Preliminary results revealed reduction of relapse rate and improved survival. In cases treated with preoperative chemotherapy, such as in International Society of Pediatric Oncology (SIOP), the value of radiotherapy has never been studied. The aim of this observational study is to describe the pattern of recurrence and survival of patients with stage I diffuse anaplastic WT (DAWT) after induction chemotherapy. METHODS Retrospective data analysis of the pattern of relapse and survival of all patients with stage I DAWT were included in recent SIOP, L'Associazone Italiana Ematologica Oncologia Pediatrica (AIEOP), Japan Wilms Tumor Study Group (JWiTS), United Kingdom Children's Cancer Study Group (UKCCSG) renal tumor registries. Postoperative treatment consisted of actinomycin D, vincristine, and doxorubicin for 28 weeks without local irradiation. RESULTS One hundred nine cases with stage I DAWT were identified, of which 95 cases received preoperative chemotherapy. Of these, seven patients underwent preoperative true-cut biopsy. Sixteen of the 95 patients relapsed (17%), six locally, four at distant site, and six combined, and all treated according to SIOP 2001 relapse protocol, which resulted in a 5-year overall survival of 93%. CONCLUSION Despite 13% locoregional relapse rate, an excellent rescue rate was achieved after salvage treatment, in patients with stage I DAWT whose first-line treatment comprised three-drug chemotherapy (including doxorubicin), without flank irradiation. Therefore, we continue not to advocate the use of radiotherapy in first-line treatment after preoperative chemotherapy in stage I DAWT in the next SIOP protocol.
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Affiliation(s)
- Raquel Dávila Fajardo
- Department of Radiation Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Harm van Tinteren
- Department of Statistics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Thomas Acha
- Department of Pediatric Oncology, Hospital Materno-Infantil, Málaga, Spain
| | | | - Beatriz de Camargo
- Department of Pediatric Hematology and Oncology, Instituto Nacional Do Cancer (INCA), Rio de Janeiro, Brazil
| | - Foppe Oldenburger
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Christian Rübe
- Department of Radio-Oncology, University Hospital of Saarland, Homburg, Germany
| | - Takaharu Oue
- Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya City, Hyogo Prefecture, Osaka, Japan
| | - Christian Vokuhl
- Institute of Pediatric Pathology, University of Kiel, Kiel, Germany
| | - Ronald R de Krijger
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Neil Sebire
- Department of Histopathology, Great Ormond Street Hospital, London, UK
| | | | - Paola Collini
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lorenza Gandola
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Norbert Graf
- Department of Pediatric Oncology, University Hospital of Saarland, Homburg, Germany
| | - Geert O Janssens
- Department of Radiation Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Martine van Grotel
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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23
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Bisogno G, Ferrari A, Melcon SG, De Salvo GL, Bergeron C, Jenney M. A new standard of care for patients with high-risk rhabdomyosarcoma? - Authors' reply. Lancet Oncol 2020; 21:e3. [PMID: 31908304 DOI: 10.1016/s1470-2045(19)30812-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Gianni Bisogno
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova 35128, Italy.
| | - Andrea Ferrari
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Soledad Gallego Melcon
- Servicio de Oncología y Hematología Pediatrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gian Luca De Salvo
- Clinical Research Unit, Istituto Oncologico, Veneto IOV-IRCCS, Padova, Italy
| | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, UK
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24
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Bisogno G, De Salvo GL, Bergeron C, Gallego Melcón S, Merks JH, Kelsey A, Martelli H, Minard-Colin V, Orbach D, Glosli H, Chisholm J, Casanova M, Zanetti I, Devalck C, Ben-Arush M, Mudry P, Ferman S, Jenney M, Ferrari A. Vinorelbine and continuous low-dose cyclophosphamide as maintenance chemotherapy in patients with high-risk rhabdomyosarcoma (RMS 2005): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2019; 20:1566-1575. [PMID: 31562043 DOI: 10.1016/s1470-2045(19)30617-5] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [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: 05/25/2019] [Revised: 08/06/2019] [Accepted: 08/19/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND For more than three decades, standard treatment for rhabdomyosarcoma in Europe has included 6 months of chemotherapy. The European paediatric Soft tissue sarcoma Study Group (EpSSG) aimed to investigate whether prolonging treatment with maintenance chemotherapy would improve survival in patients with high-risk rhabdomyosarcoma. METHODS RMS 2005 was a multicentre, open-label, randomised, controlled, phase 3 trial done at 102 hospitals in 14 countries. We included patients aged 6 months to 21 years with rhabdomyosarcoma who were considered to be at high risk of relapse: those with non-metastatic incompletely resected embryonal rhabdomyosarcoma occurring at unfavourable sites with unfavourable age (≥10 years) or tumour size (>5 cm), or both; those with any non-metastatic rhabdomyosarcoma with nodal involvement; and those with non-metastatic alveolar rhabdomyosarcoma but without nodal involvement. Patients in remission after standard treatment (nine cycles of ifosfamide, vincristine, dactinomycin with or without doxorubicin, and surgery or radiotherapy, or both) were randomly assigned (1:1) to stop treatment or continue maintenance chemotherapy (six cycles of intravenous vinorelbine 25 mg/m2 on days 1, 8, and 15, and daily oral cyclophosphamide 25 mg/m2, on days 1-28). Randomisation was done by use of a web-based system and was stratified (block size of four) by enrolling country and risk subgroup. Neither investigators nor patients were masked to treatment allocation. The primary outcome was disease-free survival in the intention-to-treat population. Secondary outcomes were overall survival and toxicity. This trial is registered with EudraCT, number 2005-000217-35, and ClinicalTrials.gov, number NCT00339118, and follow-up is ongoing. FINDINGS Between April 20, 2006, and Dec 21, 2016, 371 patients were enrolled and randomly assigned to the two groups: 186 to stop treatment and 185 to receive maintenance chemotherapy. Median follow-up was 60·3 months (IQR 32·4-89·4). In the intention-to-treat population, 5-year disease-free survival was 77·6% (95% CI 70·6-83·2) with maintenance chemotherapy versus 69·8% (62·2-76·2) without maintenance chemotherapy (hazard ratio [HR] 0·68 [95% CI 0·45-1·02]; p=0·061), and 5-year overall survival was 86·5% (95% CI 80·2-90·9) with maintenance chemotherapy versus 73·7% (65·8-80·1) without (HR 0·52 [95% CI 0·32-0·86]; p=0·0097). Toxicity was manageable in patients who received maintenance chemotherapy: 136 (75%) of 181 patients had grade 3-4 leucopenia, 148 (82%) had grade 3-4 neutropenia, 19 (10%) had anaemia, two (1%) had thrombocytopenia, and 56 (31%) had an infection. One (1%) patient had a grade 4 non-haematological toxicity (neurotoxicity). Two treatment-related serious adverse events occurred: one case of inappropriate antidiuretic hormone secretion and one of a severe steppage gait with limb pain, both of which resolved. INTERPRETATION Adding maintenance chemotherapy seems to improve survival for patients with high-risk rhabdomyosarcoma. This approach will be the new standard of care for patients with high-risk rhabdomyosarcoma in future EpSSG trials. FUNDING Fondazione Città della Speranza, Association Léon Berard Enfant Cancéreux, Clinical Research Hospital Program (French Ministry of Health), and Cancer Research UK.
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Affiliation(s)
- Gianni Bisogno
- Haematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy.
| | - Gian Luca De Salvo
- Clinical Research Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Soledad Gallego Melcón
- Servicio de Oncología y Hematología Pediatrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Johannes H Merks
- Princess Máxima Center for Paediatric Oncology, Utrecht, Netherlands; Department of Paediatric Oncology, Emma Children's Hospital-Academic Medical Center Amsterdam, Netherlands
| | - Anna Kelsey
- Department of Paediatric Histopathology, Royal Manchester Children's Hospital, Manchester, UK
| | - Helene Martelli
- Department of Paediatric Surgery, Hôpital Bicêtre-Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, Paris, France
| | | | - Daniel Orbach
- SIREDO Oncology Center, Institut Curie, PSL University, Paris, France
| | - Heidi Glosli
- Department of Paediatric Research and Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Julia Chisholm
- Children and Young Peoples Unit, Royal Marsden Hospital, Sutton, Surrey, UK
| | - Michela Casanova
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Ilaria Zanetti
- Haematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Christine Devalck
- Paediatric Haematology and Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Myriam Ben-Arush
- Joan and Sanford Weill Pediatric Hematology Oncology and Bone Marrow Transplantation Division, Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel
| | - Peter Mudry
- University Children's Hospital Brno, Czech Republic
| | - Sima Ferman
- Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, UK
| | - Andrea Ferrari
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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25
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Shekarian T, Sivado E, Jallas AC, Depil S, Kielbassa J, Janoueix-Lerosey I, Hutter G, Goutagny N, Bergeron C, Viari A, Valsesia-Wittmann S, Caux C, Marabelle A. Repurposing rotavirus vaccines for intratumoral immunotherapy can overcome resistance to immune checkpoint blockade. Sci Transl Med 2019; 11:eaat5025. [PMID: 31645452 DOI: 10.1126/scitranslmed.aat5025] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/18/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022]
Abstract
Although immune checkpoint-targeted therapies are currently revolutionizing cancer care, only a minority of patients develop durable objective responses to anti-PD-1, PD-L1, and CTLA-4 therapy. Therefore, new therapeutic interventions are needed to increase the immunogenicity of tumors and overcome the resistance to these immunotherapies. Oncolytic properties of common viruses can be exploited for the priming of antitumor immunity, and such oncolytic viruses are currently in active clinical development in combination with immune checkpoint-targeted therapies. However, the routine implementation of these therapies is limited by their manufacturing constraints, the risk of exposure of clinical staff, and the ongoing regulations on genetically modified organisms. We sought to determine whether anti-infectious disease vaccines could be used as a commercially available source of immunostimulatory agents for cancer immunotherapy. We found that rotavirus vaccines have both immunostimulatory and oncolytic properties. In vitro, they can directly kill cancer cells with features of immunogenic cell death. In vivo, intratumoral rotavirus therapy has antitumor effects that are dependent on the immune system. In several immunocompetent murine tumor models, intratumoral rotavirus overcomes resistance to and synergizes with immune checkpoint-targeted therapy. Heat- and UV-inactivated rotavirus lost their oncolytic activity but kept their synergy with immune checkpoint-targeted antibodies through the up-regulation of the double-stranded RNA receptor retinoic acid-induced gene 1 (RIG-I). Rotavirus vaccines are clinical-grade products used in pediatric and adult populations. Therefore, in situ immunization strategies with intratumoral-attenuated rotavirus could be implemented quickly in the clinic.
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Affiliation(s)
- Tala Shekarian
- Centre de Recherche en Cancérologie de Lyon (CRCL), UMR INSERM U1052 CNRS 5286 Université de Lyon, 69008 Lyon, France
- Centre de Lutte contre le Cancer Léon Bérard, 69008 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne France
- University Hospital Basel, 4031 Basel, Switzerland
| | - Eva Sivado
- Centre de Lutte contre le Cancer Léon Bérard, 69008 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne France
- INSERM UA8, 69008 Lyon, France
| | - Anne-Catherine Jallas
- Centre de Lutte contre le Cancer Léon Bérard, 69008 Lyon, France
- INSERM UA8, 69008 Lyon, France
| | - Stéphane Depil
- Centre de Recherche en Cancérologie de Lyon (CRCL), UMR INSERM U1052 CNRS 5286 Université de Lyon, 69008 Lyon, France
- Centre de Lutte contre le Cancer Léon Bérard, 69008 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne France
| | - Janice Kielbassa
- Synergie Lyon Cancer, Plateforme de bioinformatique 'Gilles Thomas', Centre Léon Bérard, 69008 Lyon, France
| | - Isabelle Janoueix-Lerosey
- Institut Curie, PSL Research University, Inserm U830, 75005 Paris, France
- SIREDO: Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer, Institut Curie, 75005 Paris, France
| | | | - Nadège Goutagny
- Centre de Recherche en Cancérologie de Lyon (CRCL), UMR INSERM U1052 CNRS 5286 Université de Lyon, 69008 Lyon, France
- Centre de Lutte contre le Cancer Léon Bérard, 69008 Lyon, France
| | - Christophe Bergeron
- Centre de Lutte contre le Cancer Léon Bérard, 69008 Lyon, France
- Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 69008 Lyon, France
| | - Alain Viari
- Synergie Lyon Cancer, Plateforme de bioinformatique 'Gilles Thomas', Centre Léon Bérard, 69008 Lyon, France
- Equipe Erable, INRIA Grenoble-Rhône-Alpes, 38330 Montbonnot-Saint Martin, France
| | | | - Christophe Caux
- Centre de Recherche en Cancérologie de Lyon (CRCL), UMR INSERM U1052 CNRS 5286 Université de Lyon, 69008 Lyon, France
- Centre de Lutte contre le Cancer Léon Bérard, 69008 Lyon, France
| | - Aurélien Marabelle
- Centre de Lutte contre le Cancer Léon Bérard, 69008 Lyon, France.
- Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 69008 Lyon, France
- Gustave Roussy, Université Paris-Saclay, Drug Development Department (DITEP), 94805 Villejuif, France
- INSERM U1015, Gustave Roussy, 94805 Villejuif, France
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Hol JA, Lopez-Yurda MI, Van Tinteren H, Van Grotel M, Godzinski J, Vujanic G, Oldenburger F, De Camargo B, Ramírez-Villar GL, Bergeron C, Pritchard-Jones K, Graf N, Van den Heuvel-Eibrink MM. Prognostic significance of age in 5631 patients with Wilms tumour prospectively registered in International Society of Paediatric Oncology (SIOP) 93-01 and 2001. PLoS One 2019; 14:e0221373. [PMID: 31425556 PMCID: PMC6699693 DOI: 10.1371/journal.pone.0221373] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/05/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND To enhance risk stratification for Wilms tumour (WT) in a pre-operative chemotherapy setting, we explored the prognostic significance and optimal age cutoffs in patients treated according to International Society of Paediatric Oncology Renal Tumour Study Group (SIOP-RTSG) protocols. METHODS Patients(6 months-18 years) with unilateral WT were selected from prospective SIOP 93-01 and 2001 studies(1993-2016). Martingale residual analysis was used to explore optimal age cutoffs. Outcome according to age was analyzed by uni- and multivariable analysis, adjusted for sex, biopsy(yes/no), stage, histology and tumour volume at surgery. RESULTS 5631 patients were included; median age was 3.4 years(IQR: 2-5.1). Estimated 5-year event-free survival (EFS) and overall survival (OS) were 85%(95%CI 83.5-85.5) and 93%(95%CI 92.0-93.4). Martingale residual plots detected no optimal age cutoffs. Multivariable analysis showed lower EFS with increasing age(linear trend P<0.001). Using previously described age categories, EFS was lower for patients aged 2-4(HR 1.34, P = 0.02), 4-10(HR 1.83, P<0.0001) and 10-18 years(HR 1.74, P = 0.01) as compared to patients aged 6 months-2 years. OS was lower for patients 4-10 years(HR 1.67, P = 0.01) and 10-18 years(HR 1.87, P = 0.04), but not for 2-4 years(HR 1.29, P = 0.23). Higher stage, histological risk group and tumour volume were independent adverse prognostic factors. CONCLUSION Although optimal age cutoffs could not be identified, we demonstrated the prognostic significance of age as well as previously described cutoffs for EFS (2 and 4 years) and OS (4 years) in children with WT treated with pre-operative chemotherapy. These findings encourage the consideration of age in the design of future SIOP-RTSG protocols.
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Affiliation(s)
- J. A. Hol
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - M. I. Lopez-Yurda
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H. Van Tinteren
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M. Van Grotel
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - J. Godzinski
- Department of Paediatric Surgery, Marciniak Hospital, Wroclaw, Poland
- Department of Paediatric Traumatology and Emergency Medicine, Medical University, Wroclaw, Poland
| | - G. Vujanic
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - F. Oldenburger
- Department of Radiotherapy, Academic Medical Center, Amsterdam, The Netherlands
| | - B. De Camargo
- Paediatric Haematology-Oncology Program, Instituto Nacional de Cancer (INCA), Rio de Janeiro, Brazil
| | - G. L. Ramírez-Villar
- Department of Paediatric Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - C. Bergeron
- Department of Paediatric Oncology, Institut d'Hematologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - K. Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - N. Graf
- Department of Paediatric Oncology & Haematology, Saarland University, Homburg, Germany
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Guérin F, Rogers T, Minard-Colin V, Gaze MN, Terwisscha S, Van Noesel M, De Corti F, Guillén Burrieza G, De Salvo GL, Kelsey A, Orbach D, Ferrari A, Bergeron C, Bisogno G, Martelli H. Outcome of localized liver-bile duct rhabdomyosarcoma according to local therapy: A report from the European Paediatric Soft-Tissue Sarcoma Study Group (EpSSG)-RMS 2005 study. Pediatr Blood Cancer 2019; 66:e27725. [PMID: 30920113 DOI: 10.1002/pbc.27725] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate the impact of local therapies on the outcome of patients with liver-bile duct rhabdomyosarcoma (LBDRMS). METHODS Data of 30 patients included in the EpSSG-RMS 2005 study were analyzed. RESULTS The median age at diagnosis was 3 years (11 months-8 years). All patients had non-alveolar histology. Fifteen patients had a tumor > 5 cm and six had enlarged regional lymph nodes on imaging. Eight patients (27%) had primary surgery (1 R0). Six of them received external beam radiotherapy (EBRT). All are in first complete remission (CR1) except one (R1, EBRT+ , local relapse, death). Six patients (20%) received EBRT without surgery: one had local relapse and died. Sixteen patients (53%) underwent delayed surgery, with 12 achieving R0 margins, which were higher than those in the primary surgery group (P = 0.003). Three patients with R0 margins received EBRT; one had a metastatic relapse and died. Nine patients with R0 resection did not receive EBRT, three relapsed locally (two deaths). Four R1 patients received additional EBRT without relapses. Local relapse occurred in two among 19 patients with EBRT and three among 11 without EBRT (P = 0.326). At a median follow-up of 61 months (48-84 months), five patients died; all had a tumor size > 5 cm (P = 0.01). The five-year overall survival was 85% (95% CI, 65-94), and event-free survival was 76% (95% CI, 54-89). CONCLUSION This analysis did not show any significant difference in outcome between irradiated and nonirradiated patients. Local relapse in LBDRMS is related to initial tumor size and is often fatal.
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Affiliation(s)
- Florent Guérin
- Department of Paediatric Surgery, Bicêtre Hospital, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicetre, France
| | - Timothy Rogers
- Department of Paediatric Surgery, University Hospitals Bristol NHS Foundation trust, Bristol, United Kingdom
| | - Véronique Minard-Colin
- Département d'Oncologie de l'Enfant et de l'Adolescent, Institut Gustave Roussy, Villejuif, France
| | - Mark N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sheila Terwisscha
- Department of Paediatric Surgery, Prinses Máxima Centrum voor Kinderoncologie, Utrecht, the Netherlands
| | - Max Van Noesel
- Department of Paediatric Surgery, Prinses Máxima Centrum voor Kinderoncologie, Utrecht, the Netherlands
| | - Federica De Corti
- Pediatric Surgery Unit, Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy
| | | | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Anna Kelsey
- Department of Paediatric Histopathology, Royal Manchester Children Hospital, Manchester, United Kingdom
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Gianni Bisogno
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Hélène Martelli
- Department of Paediatric Surgery, Bicêtre Hospital, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicetre, France
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Irtan S, Van Tinteren H, Graf N, van den Heuvel-Eibrink MM, Heij H, Bergeron C, de Camargo B, Acha T, Spreafico F, Vujanic G, Powis M, Okoye B, Wilde J, Godzinski J, Pritchard-Jones K. Evaluation of needle biopsy as a potential risk factor for local recurrence of Wilms tumour in the SIOP WT 2001 trial. Eur J Cancer 2019; 116:13-20. [PMID: 31163337 DOI: 10.1016/j.ejca.2019.04.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 11/20/2018] [Revised: 03/25/2019] [Accepted: 04/10/2019] [Indexed: 10/26/2022]
Abstract
RATIONALE The impact of biopsying Wilms tumour (WT) at diagnosis on assigning the tumour stage and recommended treatment remains controversial. To address this important question, we analysed the potential association of all types of biopsy with local recurrence in patients treated in the SIOP WT 2001 trial, where needle biopsy was permitted without 'upstaging' the tumour to stage III. Only open biopsy required treatment as stage III. METHODS Among 2971 patients with unilateral WT (stages I-IV), 420 relapsed (139 local). Risk factors for recurrence were analysed by Cox proportional hazard methods. RESULTS Biopsy was performed in 969 of 2971 (33%) patients (64% cutting needle, 30% fine needle aspiration [FNA] and 6% open biopsy). Biopsied patients were older, with larger tumours and a greater proportion with high-risk histology. In multivariate analysis that included all factors associated with local recurrence in univariate analysis, only high-risk histology (hazard ratio [HR] = 2.32; 95% confidence interval [CI]: 1.58-3.42, p=<0.0001), age≥2 years (HR = 2.24; 95% CI: 1.22-4.09, p = 0.01) and preoperative tumour volume (HR = 1.07 per 100 ml; 95% CI: 1.02-1.12, p = 0.01) were significant. The HR for the association of local recurrence and event-free and overall survival with biopsy was not significant (HR = 1.4; 95% CI: 0.9-2.17, p = 0.13; HR = 1.1; 95% CI: 0.85-1.42, p = 0.46 and HR = 1.13; 95% CI: 0.79-1.62, p = 0.51, respectively). These results were not materially different whether FNA or open biopsy were included in the biopsy group or not. CONCLUSIONS This post hoc analysis provides some reassurance that needle biopsy is not an independent adverse factor for either local recurrence or survival after adjustment for all relevant risk factors. Needle biopsy should not be an automatic criterion to 'upstage' WT.
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Affiliation(s)
- Sabine Irtan
- Cancer Section, Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Paediatric Surgery Department, Trousseau Hospital - Assistance Publique des Hôpitaux de Paris, Paris, France.
| | - Harm Van Tinteren
- Biostatistics Department, Netherlands Cancer Institute - Antonie van Leeuwenhoekhuis Plesmanlaan, Amsterdam, Netherlands.
| | - Norbert Graf
- Saarland University, Department of Pediatric Oncology & Hematology, Homburg, Germany.
| | | | - Hugo Heij
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | | | - Beatriz de Camargo
- Pediatric Hematology and Oncology Program, Research Center, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
| | - Tomas Acha
- Department of Pediatric Oncology, Hospital Materno-Infantil, Malaga, Spain.
| | - Filippo Spreafico
- Department of Clinical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | | | - Mark Powis
- Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - Bruce Okoye
- St. Georges Healthcare NHS Trust, Tooting, London, UK.
| | - Jim Wilde
- Division of Pediatric Surgery, Geneva University Hospitals, University Center of Pediatric Surgery of Western Switzerland, Geneva, Switzerland.
| | - Jan Godzinski
- Department of Paediatric Surgery, Marciniak Hospital, and Dept. of Paediatric Traumatology and Emergency Medicine, Medical University, Wroclaw, Poland.
| | - Kathy Pritchard-Jones
- Cancer Section, Developmental Biology & Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
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Bonhoure A, Boudreau V, Bergeron C, Ouliass B, Colomba J, Mailhot M, Lavoie A, Tremblay F, Ferland G, Rabasa-Lhoret R. ePS4.07 Vitamin K in adults with cystic fibrosis is correlated to fat mass and insulin secretion. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30275-9] [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: 11/30/2022]
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Raney RB, Bergeron C, Parham D. English Translation of M. Bérard: Tumeur Embryonnaire Du Muscle Strié. [Embryonal Tumor of Striated Muscle]. Lyon Med 1894; 77: 52. Fetal Pediatr Pathol 2019; 38:182-184. [PMID: 30468401 DOI: 10.1080/15513815.2018.1538276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/04/2018] [Indexed: 10/27/2022]
Abstract
We have chosen to translate what we believe to be the first publication of a well-documented case of a young patient with embryonal rhabdomyosarcoma. The author, M. Léon Bérard, was a hospital fellow working in the department of M. Vincent at the Charité Hospital. The document was presented to La Société des Sciences médicales de Lyon (The Society of Medical Sciences of Lyon, France), in July,1894. The translation follows below.
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Affiliation(s)
- R Beverly Raney
- a Emeritus Professor, Division of Pediatrics, U. T. M. D. Anderson Cancer Center and Childrens' Cancer Hospital, Houston, TX, USA
| | - Christophe Bergeron
- b Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - David Parham
- c Professor of Pathology, 4650 Sunset Boulevard #43, Children's Hospital of Los Angeles, CA, USA
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31
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Rios P, Bailey HD, Poulalhon C, Valteau‐Couanet D, Schleiermacher G, Bergeron C, Petit A, Defachelles A, Marion G, Sirvent N, Ducassou S, Munzer C, Orsi L, Lacour B, Clavel J. Parental smoking, maternal alcohol consumption during pregnancy and the risk of neuroblastoma in children. A pooled analysis of the ESCALE and ESTELLE French studies. Int J Cancer 2019; 145:2907-2916. [DOI: 10.1002/ijc.32161] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/19/2018] [Accepted: 01/10/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Paula Rios
- CRESS, UMRS1153, INSERMUniversité Paris‐Descartes Paris France
| | - Helen D. Bailey
- CRESS, UMRS1153, INSERMUniversité Paris‐Descartes Paris France
- Telethon Kids InstituteUniversity of Western Australia West Perth Australia
| | - Claire Poulalhon
- CRESS, UMRS1153, INSERMUniversité Paris‐Descartes Paris France
- National Registry of childhood haematological malignanciesAPHP Hôpital Paul Brousse, Villejuif and National registry of childhood solid tumours, CHU de Nancy Vandœuvre‐lès‐Nancy France
| | | | | | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, IHOPe, Centre Léon Bérard Lyon France
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, Assistance Publique‐Hôpitaux de Paris (AP‐HP), GH HUEPArmand Trousseau Hospital Paris France
- Sorbonne Université, UMRS_938, CDR Saint‐Antoine Paris France
| | | | - Gambart Marion
- Département d'oncohématologie pédiatriqueHôpital des Enfants, CHU Toulouse France
| | - Nicolas Sirvent
- Service d'Hémato‐Oncologie PédiatriqueHôpital Arnaud De Villeneuve, CHU Montpellier France
| | - Stéphane Ducassou
- Service D'oncohématologie PédiatriqueHôpital Pellegrin Tripode, CHU Bordeaux France
| | - Caroline Munzer
- Unité de recherche clinique pédiatrique / Unité d'hémato‐immuno‐oncologieHôpital des Enfants, CHU Toulouse France
| | - Laurent Orsi
- CRESS, UMRS1153, INSERMUniversité Paris‐Descartes Paris France
| | - Brigitte Lacour
- CRESS, UMRS1153, INSERMUniversité Paris‐Descartes Paris France
- National Registry of childhood haematological malignanciesAPHP Hôpital Paul Brousse, Villejuif and National registry of childhood solid tumours, CHU de Nancy Vandœuvre‐lès‐Nancy France
| | - Jacqueline Clavel
- CRESS, UMRS1153, INSERMUniversité Paris‐Descartes Paris France
- National Registry of childhood haematological malignanciesAPHP Hôpital Paul Brousse, Villejuif and National registry of childhood solid tumours, CHU de Nancy Vandœuvre‐lès‐Nancy France
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Adelnia F, Cameron D, Bergeron C, Fishbein K, Spencer R, Reiter D, Ferrucci L. THE ROLE OF PERFUSION IN THE AGE-ASSOCIATED DECLINE OF MITOCHONDRIAL FUNCTION WITH AGING IN HEALTHY INDIVIDUALS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.349] [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: 11/12/2022] Open
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Adelnia F, Shardell M, Bergeron C, Fishbein K, Spencer R, Reiter D, Ferrucci L. SKELETAL MUSCLE PERFUSION IN POST-EXERCISE HYPEREMIA IN YOUNG AND OLD ADULTS AS ASSESSED BY DIFFUSION-WEIGHTED MRI. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.385] [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: 11/12/2022] Open
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Walterhouse DO, Barkauskas DA, Hall D, Ferrari A, De Salvo GL, Koscielniak E, Stevens MCG, Martelli H, Seitz G, Rodeberg DA, Shnorhavorian M, Dasgupta R, Breneman JC, Anderson JR, Bergeron C, Bisogno G, Meyer WH, Hawkins DS, Minard-Colin V. Demographic and Treatment Variables Influencing Outcome for Localized Paratesticular Rhabdomyosarcoma: Results From a Pooled Analysis of North American and European Cooperative Groups. J Clin Oncol 2018; 36:JCO2018789388. [PMID: 30351998 PMCID: PMC6286163 DOI: 10.1200/jco.2018.78.9388] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Treatment recommendations for localized paratesticular rhabdomyosarcoma (PT RMS) differ in North America and Europe. We conducted a pooled analysis to identify demographic features and treatment choices that affect outcome. PATIENTS AND METHODS We retrospectively analyzed the effect of nine demographic variables and four treatment choices on event-free survival (EFS) and overall survival (OS) from 12 studies conducted by five cooperative groups. RESULTS Eight hundred forty-two patients with localized PT RMS who enrolled from 1988 to 2013 were included. Patients age ≥ 10 years were more likely than younger patients to have tumors that were > 5 cm, enlarged nodes (N1), or pathologically involved nodes ( P ≤ .05 each). With a median follow-up of 7.5 years, Kaplan-Meier estimates for 5-year EFS and OS were 87.7% and 94.8%, respectively. Of demographic variables, cooperative group, era of enrollment, age category, tumor size, Intergroup Rhabdomyosarcoma Study group, and T stage affected EFS ( P ≤ .05 each). Surgical assessment of regional nodes, which was performed in 23.5% of patients-usually in those age ≥ 10 years or with suspicious or N1 nodes-was the only treatment variable associated with EFS by univariable and multivariable analyses ( P ≤ .05 each) in patients age ≥ 1 year. A variable selection procedure on a proportional hazards regression model selected era of enrollment, age, tumor size, and surgical assessment of regional nodes as significant ( P ≤ .05 each) in the EFS model, and era of enrollment, age, tumor size, and histology ( P ≤ .05 each) in the OS model. CONCLUSION Localized PT RMS has a favorable prognosis. Age ≥ 10 years at diagnosis and tumor size larger than 5 cm are unfavorable prognostic features. Surgical assessment of regional nodes is important in patients age ≥ 10 years and in those with N1 nodes as it affects EFS.
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Affiliation(s)
- David O Walterhouse
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Donald A Barkauskas
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - David Hall
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Andrea Ferrari
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Gian Luca De Salvo
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Ewa Koscielniak
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Michael C G Stevens
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Hélène Martelli
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Guido Seitz
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - David A Rodeberg
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Margarett Shnorhavorian
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Roshni Dasgupta
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - John C Breneman
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - James R Anderson
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Christophe Bergeron
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Gianni Bisogno
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - William H Meyer
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Douglas S Hawkins
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
| | - Veronique Minard-Colin
- David O. Walterhouse, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Donald A. Barkauskas, University of Southern California, Los Angeles; David Hall, Children's Oncology Group, Monrovia, CA; Andrea Ferrari, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan; Gian Luca De Salvo, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padua; Gianni Bisogno, University of Padua, Padova, Italy; Ewa Koscielniak, Olgahospital, Stuttgart; Guido Seitz, University Hospital, Marburg, Germany; Michael C.G. Stevens, Royal Hospital for Children, Bristol, United Kingdom; Hélène Martelli, Assistance Publique-Hôpitaux de Paris, Hopital Bicetre, Le Kremlin-Bicetre; Christophe Bergeron, Centre Léon Bérard, Lyon; Veronique Minard-Colin, Gustave Roussy, Villejuif, France; David A. Rodeberg, East Carolina University, Greenville, NC; Margarett Shnorhavorian and Douglas S. Hawkins, Seattle Children's Hospital, University of Washington; Douglas S. Hawkins, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Roshni Dasgupta and John C. Breneman, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James R. Anderson, Merck Research Laboratories, North Wales, PA; and William H. Meyer, University of Oklahoma School of Medicine, Oklahoma City, OK
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Bertrand A, Marcault-Derouard A, Devaux Y, Bertrand Y, Bergeron C, Veyet V, Cervos M, Filion S, Goy F, Schell M. [Palliative care for children in onco-hematology: Role of a specific home-care team]. Bull Cancer 2018; 105:771-779. [PMID: 30251628 DOI: 10.1016/j.bulcan.2018.05.007] [Citation(s) in RCA: 2] [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: 08/09/2017] [Revised: 05/14/2018] [Accepted: 05/18/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVE Our home-care unit (HCU) is specialized for pediatric cancer patients and has a strong palliative care activity. We believe that the introduction of home-care services can influence the place of palliative care and of death as well as the length of hospitalization. We aimed at describing characteristics and care course of patients treated in our HCU, and tried to identify some factors contributing to home care at the end of life. DESIGN/METHODS We conducted a retrospective, observational, monocentric study about patients in pediatric onco-hematology, treated at least one day in our home-care unit, who died between July 1st 2013 and December 31st 2015. Statistical analysis was descriptive and analytic. RESULTS A total of 74 patients known by our HCU died during study period. Eight were excluded. Forty-three out of 66 patients died at home. During the last 3 months of life, oncology patients have significantly less classical hospitalization, when compared to hematology patients. The implication of general physicians (GP) and nurses and information given to the family increase the possibility for home death. No significant association was found between ages at death, distance between home and hospital, other life conditions and place of death. CONCLUSIONS Our HCU has a strong palliative care activity and a high rate of children dying at home. Good collaborations between our pediatric onco-hematology team and our HCU as well as between our HCU and caregivers optimize palliative care.
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Affiliation(s)
- Amandine Bertrand
- Centre Léon-Bérard, IHOPe, hospitalisation à domicile pédiatrique, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France.
| | - Anna Marcault-Derouard
- Centre Léon-Bérard, ERRSPP Rhône-Alpes, ESPPéRA, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France
| | - Yves Devaux
- Centre Léon-Bérard, hospitalisation à domicile adulte, 28, rue Laennec, 69008 Lyon, France
| | - Yves Bertrand
- Hospices civils de Lyon, IHOPe, hématologie pédiatrique, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France
| | - Christophe Bergeron
- Centre Léon-Bérard, IHOPe, oncologie pédiatrique, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France
| | - Véronique Veyet
- Centre Léon-Bérard, IHOPe, hospitalisation à domicile pédiatrique, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France
| | - Marie Cervos
- Centre Léon-Bérard, IHOPe, hospitalisation à domicile pédiatrique, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France
| | - Shirley Filion
- Centre Léon-Bérard, ERRSPP Rhône-Alpes, ESPPéRA, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France
| | - Florence Goy
- Centre Léon-Bérard, IHOPe, hospitalisation à domicile pédiatrique, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France
| | - Matthias Schell
- Centre Léon-Bérard, IHOPe, hospitalisation à domicile pédiatrique, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France; Centre Léon-Bérard, ERRSPP Rhône-Alpes, ESPPéRA, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France
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Minard-Colin V, Walterhouse D, Bisogno G, Martelli H, Anderson J, Rodeberg DA, Ferrari A, Jenney M, Wolden S, De Salvo G, Arndt C, Merks JHM, Gallego S, Schwob D, Haie-Meder C, Bergeron C, Stevens MCG, Oberlin O, Hawkins D. Localized vaginal/uterine rhabdomyosarcoma-results of a pooled analysis from four international cooperative groups. Pediatr Blood Cancer 2018; 65:e27096. [PMID: 29781567 PMCID: PMC8117251 DOI: 10.1002/pbc.27096] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Vaginal/uterine rhabdomyosarcoma (VU RMS) is one of the most favorable RMS sites. To determine the optimal therapy, the experience of four cooperative groups (Children's Oncology Group [COG], International Society of Pediatric Oncology (SIOP) Malignant Mesenchymal Tumor Group [MMT], Italian Cooperative Soft Tissue Sarcoma Group [ICG], and European pediatric Soft tissue sarcoma Study Group [EpSSG]) was analyzed. PROCEDURE From 1981 to 2009, 237 patients were identified. Median age (years) at diagnosis differed by tumor location; it was 1.9 for vagina (n = 160), 2.7 for uterus corpus (n = 26), and 13.5 for uterus cervix (n = 51). Twenty-eight percent of patients received radiation therapy (RT) as part of primary therapy (23% COG, 27% MMT, 46% ICG, and 42% EpSSG), with significant differences in the use of brachytherapy between the cooperative groups (23% COG, 76% MMT, 64% ICG, and 88% EpSSG). RESULTS Ten-year event-free (EFS) and overall survival (OS) were 74% (95% CI, 67-79%) and 92% (95% CI, 88-96%), respectively. In univariate analysis, OS was inferior for patients with uterine RMS and for those with regional lymph node involvement. Although EFS was slightly lower in patients without initial RT (71% without RT vs. 81% with RT; P = 0.08), there was no difference in OS (94% without RT vs. 89% with RT; P = 0.18). Local control using brachytherapy was excellent (93%). Fifty-one (51.5%) of the 99 survivors with known primary therapy and treatment for relapse were cured with chemotherapy with or without conservative surgery. CONCLUSIONS About half of all patients with VU RMS can be cured without systematic RT or radical surgery. When RT is indicated, modalities that limit sequelae should be considered, such as brachytherapy.
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Affiliation(s)
| | - David Walterhouse
- Division of Hematology, Oncology, and Stem Cell
Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago,
Illinois
| | - Gianni Bisogno
- Pediatric Hematology and Oncology Division, Padova
University, Padova, Italy
| | - Helene Martelli
- Department of Pediatric Surgery, CHU Bicetre, Le
Kremlin-Bicêtre, France
| | - James Anderson
- Department of Oncology Clinical Research, Merck Research
Laboratories, North Wales, Pennsylvania
| | - David A. Rodeberg
- Department of Surgery, East Carolina University,
Greenville, North Carolina
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto
Nazionale Tumori, Milano, Italy
| | - Meriel Jenney
- Department of Pediatric Oncology, University of Wales,
Cardiff, United Kingdom
| | - Suzanne Wolden
- Department of Radiotherapy, Memorial Sloan Kettering Cancer
Center, New York City, New York
| | - Gianluca De Salvo
- Clinical Trials and Biostatistics Unit, IRCCS Istituto
Oncologico Veneto, Padova, Italy
| | - Carola Arndt
- Department of Pediatric and Adolescent Medicine, Mayo
Clinic and Foundation, Rochester, Minnesota
| | - Johannes H. M. Merks
- Department of Pediatric Oncology, Emma Children's
Hospital, Academic Medical Centre, Amsterdam, The Netherlands
| | - Soledad Gallego
- Department of Pediatric Oncology, Hospital Universitari
Vall d'Hebron, Barcelona, Spain
| | | | | | - Christophe Bergeron
- Department of Pediatric and Adolescent Oncology, Centre
Leon Berard, Lyon, France
| | - Michael C. G. Stevens
- Department of Paediatric Oncology, Bristol Royal Hospital
for Children, University of Bristol, Bristol, United Kingdom
| | - Odile Oberlin
- Department of Pediatric and Adolescent Oncology, Gustave
Roussy, Villejuif, France
| | - Douglas Hawkins
- Division of Hematology/Oncology, Seattle Children's
Hospital, University of Washington, Seattle, Washington,Fred Hutchinson Cancer Research Center, University of
Washington, Seattle, Washington
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Brok J, Lopez-Yurda M, Tinteren HV, Treger TD, Furtwängler R, Graf N, Bergeron C, van den Heuvel-Eibrink MM, Pritchard-Jones K, Olsen ØE, de Camargo B, Verschuur A, Spreafico F. Relapse of Wilms' tumour and detection methods: a retrospective analysis of the 2001 Renal Tumour Study Group-International Society of Paediatric Oncology Wilms' tumour protocol database. Lancet Oncol 2018; 19:1072-1081. [PMID: 29960848 DOI: 10.1016/s1470-2045(18)30293-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [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: 12/21/2017] [Revised: 04/04/2018] [Accepted: 04/11/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Wilms' tumour is the most common renal cancer in childhood and about 15% of patients will relapse. There is scarce evidence about optimal surveillance schedules and methods for detection of tumour relapse after therapy. METHODS The Renal Tumour Study Group-International Society of Paediatric Oncology (RTSG-SIOP) Wilms' tumour 2001 trial and study is an international, multicentre, prospective registration, biological study with an embedded randomised clinical trial for children with renal tumours aged between 6 months and 18 years. The study covers 243 different centres in 27 countries grouped into five consortia. The current protocol of SIOP surveillance for Wilms' tumour recommends that abdominal ultrasound and chest x-ray should be done every 3 months for the first 2 years after treatment and be repeated every 4-6 months in the third and fourth year and annually in the fifth year. In this retrospective cohort study of the protocol database, we analysed data from participating institutions on timing, anatomical site, and mode of detection of all first relapses of Wilms' tumour. The primary outcomes were how relapse of Wilms' tumour was detected (ie, at or between scheduled surveillance and with or without clinical symptoms, scan modality, and physical examination) and to estimate the number of scans needed to capture one subclinical relapse. The RTSG-SIOP study is registered with Eudra-CT, number 2007-004591-39. FINDINGS Between June 26, 2001, and May 8, 2015, of 4271 eligible patients in the 2001 RTSG-SIOP Wilms' tumour database, 538 (13%) relapsed. Median follow-up from surgery was 62 months (IQR 32-93). The method used to detect relapse was registered for 410 (76%) of 538 relapses. Planned surveillance imaging captured 289 (70%) of these 410 relapses. The primary imaging modality used to detect relapse was reported for 251 patients, among which relapse was identified by abdominal ultrasound (80 [32%] patients), chest x-ray (78 [31%]), CT scan of the chest (64 [25%]) or abdomen (20 [8%]), and abdominal MRI (nine [4%]). 279 (68%) of 410 relapses were not detectable by physical examination and 261 (64%) patients did not have clinical symptoms at relapse. The estimated number of scans needed to detect one subclinical relapse during the first 2 years after nephrectomy was 112 (95% CI 106-119) and, for 2-5 years after nephrectomy, 500 (416-588). INTERPRETATION Planned surveillance imaging captured more than two-thirds of predominantly asymptomatic relapses of Wilms' tumours, with most detected by abdominal ultrasound, chest x-ray, or chest CT scan. Beyond 2 years post-nephrectomy, a substantial number of surveillance scans are needed to capture one relapse, which places a burden on families and health-care systems. FUNDING Great Ormond Street Hospital Children's Charity, the European Expert Paediatric Oncology Reference Network for Diagnostics and Treatment, The Danish Childhood Cancer Foundation, Cancer Research UK, the UK National Cancer Research Network and Children's Cancer and Leukaemia Group, Société Française des Cancers de l'Enfant and Association Leon Berard Enfant Cancéreux and Enfant et Santé, Gesellschaft für Pädiatrische Onkologie und Hämatologie and Deutsche Krebshilfe, Grupo Cooperativo Brasileiro para o Tratamento do Tumor de Wilms and Sociedade Brasileira de Oncologia Pediátrica, the Spanish Society of Pediatric Haematology and Oncology and the Spanish Association Against Cancer, and SIOP-Netherlands.
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Affiliation(s)
- Jesper Brok
- University College London Great Ormond Street Institute of Child Health, London, UK; Department of Paediatric Oncology and Haematology, Rigshospitalet, Copenhagen, Denmark.
| | - Marta Lopez-Yurda
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Harm V Tinteren
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Taryn D Treger
- University College London Great Ormond Street Institute of Child Health, London, UK; Department of Paediatrics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rhoikos Furtwängler
- Department of Paediatric Haematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Norbert Graf
- Department of Paediatric Haematology and Oncology, Saarland University Hospital, Homburg, Germany
| | - Christophe Bergeron
- Centre Léon Bérard, Institut d'Haematology and d'Oncology Paediatric, Lyon, France
| | | | | | - Øystein E Olsen
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Arnauld Verschuur
- Department of Pediatric Hematology and Oncology, Hôpital de la Timone Enfant, Marseille, France
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Bisogno G, Jenney M, Bergeron C, Gallego Melcón S, Ferrari A, Oberlin O, Carli M, Stevens M, Kelsey A, De Paoli A, Gaze MN, Martelli H, Devalck C, Merks JH, Ben-Arush M, Glosli H, Chisholm J, Orbach D, Minard-Colin V, De Salvo GL. Addition of dose-intensified doxorubicin to standard chemotherapy for rhabdomyosarcoma (EpSSG RMS 2005): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet Oncol 2018; 19:1061-1071. [PMID: 29941280 DOI: 10.1016/s1470-2045(18)30337-1] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [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: 03/03/2018] [Revised: 04/10/2018] [Accepted: 04/23/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Rhabdomyosarcoma is an aggressive tumour that can develop in almost any part of the body. Doxorubicin is an effective drug against rhabdomyosarcoma, but its role in combination with an established multidrug regimen remains controversial. Therefore, we aimed to evaluate the possible benefit of early dose intensification with doxorubicin in patients with non-metastatic rhabdomyosarcoma. METHODS We did a multicentre, open-label, randomised controlled, phase 3 trial involving 108 hospitals from 14 countries. We included patients older than 6 months but younger than 21 years with a pathologically proven diagnosis of rhabdomyosarcoma. We assigned each patient to a specific subgroup according to the EpSSG stratification system. Those with embryonal rhabdomyosarcoma incompletely resected and localised at unfavourable sites with or without nodal involvement, or those with alveolar rhabdomyosarcoma without nodal involvement were considered at high risk of relapse. These high-risk patients were randomly assigned (1:1) to receive either nine cycles of IVA (ifosfamide 3 g/m2 given as a 3-h intravenous infusion on days 1 and 2, vincristine 1·5 mg/m2 weekly during the first 7 weeks then only on day 1 of each cycle [given as a single intravenous injection], and dactinomycin 1·5 mg/m2 on day 1 given as a single intravenous injection) or four cycles of IVA with doxorubicin 30 mg/m2 given as a 4-h intravenous infusion on days 1 and 2 followed by five cycles of IVA. The interval between cycles was 3 weeks. Randomisation was done using a web-based system and was stratified (block sizes of four) by enrolling country and risk subgroup. Neither investigators nor patients were masked to treatment allocation. The primary endpoint was 3-year event-free survival assessed by the investigator at each centre in the intention-to-treat population. Patients who received at least one dose of study treatment were considered in the safety analysis. In agreement with the independent data monitoring committee, the study was closed to patient entry on Dec 16, 2013, after futility analysis. This trial is registered with EudraCT, number 2005-000217-35, and is currently in follow-up. FINDINGS Between Oct 1, 2005, and Dec 16, 2013, 484 patients were randomly assigned to receive each chemotherapy regimen (242 in the IVA group and 242 in the IVA plus doxorubicin group). Median follow-up was 63·9 months (IQR 44·6-78·9). The 3-year event-free survival was 67·5% (95% CI 61·2-73·1) in the IVA plus doxorubicin group and 63·3% (56·8-69·0) in the IVA group (hazard ratio 0·87, 95% CI 0·65-1·16; p=0·33). Grade 3-4 leucopenia (232 [93%] of 249 patients in the IVA plus doxorubicin group vs 194 [85%] of 227 in the IVA group; p=0·0061), anaemia (195 [78%] vs 111 [49%]; p<0·0001), thrombocytopenia (168 [67%] vs 59 [26%]; p<0.0001), and gastrointestinal adverse events (78 [31%] vs 19 [8%]; p<0·0001) were significantly more common in the IVA plus doxorubicin group than in the IVA group. Grade 3-5 infections (198 [79%] vs 128 [56%]; p<0·0001) were also significantly more common in the IVA plus doxorubicin group than in the IVA group, in which one patient had grade 5 infection. Two treatment-related deaths were reported (one patient developed septic shock and one affected by Goldenhar syndrome developed intractable seizures) in the IVA plus doxorubicin group, both occurring after the first cycle of treatment, and none were reported in the IVA group. INTERPRETATIONS The addition of dose-intensified doxorubicin to standard IVA chemotherapy did not show a significant improvement in the outcome of patients with high-risk non-metastatic rhabdomyosarcoma. Therefore, the IVA chemotherapy regimen should remain the standard of care for patients with localised rhabdomyosarcoma in Europe. FUNDING Fondazione Città della Speranza, Italy, and the Association Léon Berard Enfant Cancéreux, France.
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Affiliation(s)
- Gianni Bisogno
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy.
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Cardiff, UK
| | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Soledad Gallego Melcón
- Servicio de Oncología y Hematología Pediatrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Odile Oberlin
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy, Villejuif, France
| | - Modesto Carli
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Michael Stevens
- Department of Paediatric Oncology, Bristol Royal Hospital for Children, Bristol, UK
| | - Anna Kelsey
- Department of Paediatric Histopathology, Royal Manchester Children's Hospital, Manchester, UK
| | - Angela De Paoli
- Clinical Trials and Biostatistics Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Mark N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Helene Martelli
- Department of Paediatric Surgery, Hôpital Bicêtre-Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, Paris, France
| | - Christine Devalck
- Pediatric Hematology and Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Johannes H Merks
- Department of Pediatric Oncology Emma Children's Hospital-Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Myriam Ben-Arush
- The Joan and Sanford Weill Pediatric Hematology Oncology and Bone Marrow Transplantation Division, The Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel
| | - Heidi Glosli
- Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Julia Chisholm
- Children and Young Peoples Unit, The Royal Marsden Hospital, Surrey, UK
| | - Daniel Orbach
- SIREDO Oncology Center, Institut Curie, PSL University, Paris, France
| | | | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
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Dávila Fajardo R, Oldenburger E, Rübe C, López-Yurda M, Pritchard-Jones K, Bergeron C, Graf N, van Grotel M, van Tinteren H, Saunders D, van den Heuvel-Eibrink MM, Janssens GO, Oldenburger F. Evaluation of boost irradiation in patients with intermediate-risk stage III Wilms tumour with positive lymph nodes only: Results from the SIOP-WT-2001 Registry. Pediatr Blood Cancer 2018; 65:e27085. [PMID: 29693799 DOI: 10.1002/pbc.27085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/22/2018] [Accepted: 03/13/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the value of radiotherapy boost omission in patients with intermediate-risk, stage III Wilms tumours (WT) with positive lymph nodes (LN). METHODS AND MATERIALS All patients with intermediate-risk, stage III (LN positive) WT consecutively registered in the SIOP-WT-2001 study were included in this analysis. Endpoints were 5-year event-free survival (EFS), loco-regional control (LRC) and overall survival (OS). RESULTS Between June 2001 and May 2015, 2,569 patients with stage I to III WT after preoperative chemotherapy were registered in the SIOP-WT-2001 study. Five hundred and twenty-three (20%) had stage III disease, of which 113 patients had stage III due to positive LN only. Of those, 101 (89%) received radiotherapy, 36 of which (36%) received, apart from flank irradiation, a boost dose to the LN positive area. Four patients (4%) did not receive any adjuvant radiotherapy. In eight patients information on radiotherapy was not available. With a median follow-up of 71 months, no difference in 5-year EFS (84% vs. 83%, P = 0.77) and LRC (96% vs. 97%, P = 0.91) was observed between patients receiving a radiotherapy boost and those without boost, respectively. Five-year OS, including salvage therapy, was excellent (boost vs. no boost: 97% vs. 95%, P = 0.58). CONCLUSIONS Outcome data demonstrate that omission of the radiotherapy boost to the loco-regional positive lymph nodes in patients with intermediate-risk, stage III WT who receive preoperative chemotherapy and postoperative flank irradiation (14.4 Gy) can be considered a safe approach for future SIOP protocols.
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Affiliation(s)
- Raquel Dávila Fajardo
- Department of Radiation Oncology, University Medical Center Utrecht and Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Eva Oldenburger
- Radiation Oncology Department, Leuven Cancer Center, Leuven, Belgium
| | - Christian Rübe
- Department of Radio-Oncology, University Hospital of Saarland, Homburg, Germany
| | - Marta López-Yurda
- Department of Statistics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | - Norbert Graf
- Department of Paediatric Oncology, University Hospital of Saarland, Homburg, Germany
| | - Martine van Grotel
- Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
| | - Harm van Tinteren
- Department of Statistics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Daniel Saunders
- Department of Radiation Oncology. The Christie NHS Foundation Trust, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Geert O Janssens
- Department of Radiation Oncology, University Medical Center Utrecht and Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Foppe Oldenburger
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
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Shekarian T, Depil S, Jallas AC, Bergeron C, Caux C, Marabelle A, Valsesia-Wittmann S. Abstract 4934: Immunostimulatory and oncolytic properties of rotavirus can overcome resistance to immune checkpoint blockade therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-4934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Immune checkpoint targeted therapies against PD-1, PD-L1 and CTLA-4 are currently revolutionizing cancer care. However, only a minority of patients generate objective tumor responses with these treatments. Therefore, new therapeutic interventions are needed to increase the immunogenicity of tumors in order to overcome the resistance to immune checkpoint blockade therapy. Pattern recognition receptors (PRR) such as toll-like receptor agonists have been shown to overcome resistance to immune checkpoint targeted therapy in pre-clinical models. Besides their intrinsic ability to stimulate PRR, the oncolytic properties of common viruses can be exploited also for the priming of anti-tumor immune responses. Several oncolytic viruses are currently in clinical development for cancer immunotherapy. However the routine implementation of these therapies is limited by the ongoing regulations on GMOs. With the aim to analyze if anti-infectious vaccines can be used as a source or PRR agonists and/or oncolytic viruses, we infected different tumors cell lines with commercially available anti-infectious vaccines. We first confirmed that commercially available vaccines do have PRR agonist properties. More interestingly, we discovered that rotavirus vaccines also have oncolytic properties. These attenuated viruses can directly kill cancer cells with features of immunogenic cell death such as upregulation of calreticulin on dying cancer cells but doesn't have cytotoxicity on healthy primary fibroblasts. Moreover, they have pro-inflammatory properties and can activate the NF-KB pathway in a toll-like receptor and IRF3 independent manner. These in vitro biological properties translate into in vivo anti-tumor activity. Intra-tumoral (IT) rotavirus therapy has anti-tumor effects which are mainly immune mediated as demonstrated by their weaken activity in NSG mice. Interestingly, in immunocompetent syngeneic murine tumor models of neuroblastoma and lymphoma, IT rotavirus therapy can overcome resistance to immune checkpoint targeted therapy and in particular synergies with anti-CTLA4. This therapeutic effect relied on specific modifications of tumor immune infiltrates and immune activation pathways. IT rotavirus vaccines was associated to an increase of myeloid infiltrating cells expressing up-regulated level of CD86 in the tumor microenvironment, and upregulation of activation markers such as OX40/CD137 on T cells. Rotavirus vaccines are clinical grade products, including for children. Therefore, in situ immunization strategies with IT attenuated rotavirus can be implemented quickly in the clinic including in pediatric cancers. IT priming of the anti-tumor immunity with oncolytic and immunostimulatory rotavirus vaccines could be a feasible strategy to overcome resistance to anti-PD-1/anti-CTLA-4 therapy in patients with cancer.* co-last authors.
Citation Format: Tala Shekarian, Stéphane Depil, Anne-Catherine Jallas, Christophe Bergeron, Christophe Caux, Aurélien Marabelle, Sandrine Valsesia-Wittmann. Immunostimulatory and oncolytic properties of rotavirus can overcome resistance to immune checkpoint blockade therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4934.
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Moreno L, Casanova M, Chisholm JC, Berlanga P, Chastagner PB, Baruchel S, Amoroso L, Gallego Melcón S, Gerber NU, Bisogno G, Fagioli F, Geoerger B, Glade Bender JL, Aerts I, Bergeron C, Hingorani P, Elias I, Simcock M, Ferrara S, Le Bruchec Y, Slepetis R, Chen N, Vassal G. Phase I results of a phase I/II study of weekly nab-paclitaxel in paediatric patients with recurrent/refractory solid tumours: A collaboration with innovative therapies for children with cancer. Eur J Cancer 2018; 100:27-34. [PMID: 29936064 DOI: 10.1016/j.ejca.2018.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 11/21/2017] [Revised: 03/29/2018] [Accepted: 05/01/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND nab-Paclitaxel has demonstrated efficacy in adults with solid tumours and preclinical activity in paediatric solid tumour models. Results from phase I of a phase I/II study in paediatric patients with recurrent/refractory solid tumours treated with nab-paclitaxel are reported. PATIENTS AND METHODS Patients with recurrent/refractory extracranial solid tumours received nab-paclitaxel on days 1, 8 and 15 every 4 weeks at 120, 150, 180, 210, 240, or 270 mg/m2 (rolling-6 dose-escalation) to establish the maximum tolerated dose (MTD) and recommended phase II dose (RP2D). RESULTS Sixty-four patients were treated. Dose-limiting toxicities were grade 3 dizziness at 120 mg/m2 and grade 4 neutropenia >7 days at 270 mg/m2. The most frequent grade 3/4 adverse events were haematologic, including neutropenia (36%), leukopenia (36%) and lymphopenia (25%). Although the MTD was not reached, 270 mg/m2 was declared non-tolerable due to grade 3/4 toxicities during cycles 1-2 (neutropenia, n = 5/7; skin toxicity, n = 2/7; peripheral neuropathy, n = 1/7). Of 58 efficacy-evaluable patients, complete response occurred in one patient (2%; Ewing sarcoma) and partial responses in four patients (7%; rhabdomyosarcoma, Ewing sarcoma, renal tumour with pulmonary metastases [high-grade, malignant] and sarcoma not otherwise specified); all responses occurred at ≥210 mg/m2. Thirteen patients (22%) had stable disease (5 lasting ≥16 weeks) per RECIST. CONCLUSIONS nab-Paclitaxel 240 mg/m2 qw3/4 (nearly double the adult recommended monotherapy dose for this schedule in metastatic breast cancer) was selected as the RP2D based on the tolerability profile, pharmacokinetics and antitumour activity. Phase II is currently enrolling patients with recurrent/refractory neuroblastoma, rhabdomyosarcoma and Ewing sarcoma. CLINICALTRIALS.GOV: NCT01962103. EUDRACT 2013-000144-26.
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Affiliation(s)
- Lucas Moreno
- Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
| | | | | | - Pablo Berlanga
- Unidad de Oncologia Pediatrica, Hospital Universitario I Politècnic La Fe, Valencia, Spain
| | | | | | | | | | | | - Gianni Bisogno
- Department of Pediatrics, Hematology/Oncology Division, Padova, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology Division, Regina Margherita, Torino, Italy
| | - Birgit Geoerger
- Gustave Roussy, Department of Pediatric and Adolescent Oncology, Villejuif, France
| | | | - Isabelle Aerts
- Institut Curie, PSL Research University, Oncology Center SIREDO (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Paris, France
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Bisogno G, De Salvo GL, Bergeron C, Jenney M, Merks JH, Minard-Colin V, Orbach D, Glosli H, Chisholm J, Casanova M, Gallego Melcon S, Ferrari A. Maintenance low-dose chemotherapy in patients with high-risk (HR) rhabdomyosarcoma (RMS): A report from the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.18_suppl.lba2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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
LBA2 Background: Most patients with localized RMS achieve complete remission during standard (std) treatment but approximately 20-30% of them relapse and chance of salvage is poor. We tested whether adding maintenance metronomic chemotherapy after std chemotherapy would improve survival for patients with non metastatic RMS defined as HR according to EpSSG stratification. Methods: Patients (pts) age >6 months <21 years, with N0 alveolar (A)RMS or incompletely resected (Group II or III) embryonal (E)RMS arising in an unfavorable primary site and/or N1 in complete remission after std treatment including 9 cycles of ifosfamide, vincristine and actinomycin D +/- doxorubicin, surgery and/or radiotherapy were eligible for randomization to stop treatment (Std-arm) or receive maintenance chemotherapy (M-arm) with 6 28-day cycles of iv vinorelbine 25 mg/m2 on day 1,8,15 of each cycle and continuous daily oral cyclophosphamide 25 mg/m2 . The study was initially designed with 80% power (5% 2-sided alpha level) to detect an increase in 3 yr Event Free Survival (EFS) from 55% to 67%, a Hazard Ratio of 0.67, but was successively amended to allow a detection of a relative reduction in the relapse rate of 50% in the M-arm, with 80% power, testing at the 5% significance level (2-sided). Results: 670 pts were entered between 4/2006-12/2016, with 371 confirmed eligible and 186 assigned to the std-arm and 185 to M-arm. Clinical features were well balanced in the two arms and included ERMS 67%, ARMS 33%, age 10+ years 21%; IRS Group III 86%; N1 16%. Most common primary tumor sites were parameningeal (32%) and “other” sites (23%). With median follow up of 5 years in surviving pts, 3 yr EFS and overall survival (OS) in M-arm vs Std-arm were respectively: EFS 78.4% (95% IC -71.5-83.8) vs 72.3% (95% IC -65.0-78.3) (p 0.061) and OS 87.3% (95% IC 81.2-91.6) vs 77.4 (95% IC 70.1-83.1) (p = 0.011). Toxicity in the M-arm was manageable: grade 3/4 febrile neutropenia in 25% of pts, grade 4 neurotoxicity in 1.1%. Conclusions: The addition of maintenance after std treatment significantly improves OS in HR RMS patients and support its inclusion in future EpSSG trials. Clinical trial information: 2005-000217-35.
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Affiliation(s)
- Gianni Bisogno
- Department of Women and Children Health, University Hospital of Padova, Padova, Italy
| | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Christophe Bergeron
- Institut d'Hematologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Meriel Jenney
- Department of paediatric oncology, Children’s Hospital for Wales, Cardiff, GB
| | - Johannes H.M. Merks
- Emma Children’s Hospital-Academic Medical Center (EKZ-AMC), Amsterdam, Netherlands
| | | | | | - Heidi Glosli
- Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Julia Chisholm
- Children and Young People’s Unit, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | | | - Andrea Ferrari
- Istituto Nazionale per lo Studio e la Cura dei Tumori - IRCCS, Milan, Italy
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43
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Gallego S, Zanetti I, Orbach D, Ranchère D, Shipley J, Zin A, Bergeron C, de Salvo GL, Chisholm J, Ferrari A, Jenney M, Mandeville HC, Rogers T, Merks JHM, Mudry P, Glosli H, Milano GM, Ferman S, Bisogno G. Fusion status in patients with lymph node-positive (N1) alveolar rhabdomyosarcoma is a powerful predictor of prognosis: Experience of the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG). Cancer 2018; 124:3201-3209. [PMID: 29797665 DOI: 10.1002/cncr.31553] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [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: 03/27/2018] [Revised: 04/19/2018] [Accepted: 04/23/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Alveolar rhabdomyosarcoma (aRMS) with lymph node involvement (N1 classification) accounts for up to 10% of all cases of RMS. The prognosis is poor, and is comparable to that of distant metastatic disease. In the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG) RMS2005 protocol, patients with a histologic diagnosis of aRMS/N1 received intensified chemotherapy with systematic locoregional treatment. METHODS Patients with aRMS/N1 were enrolled prospectively after primary surgery/biopsy and fusion status was assessed in tumor samples. All patients received 9 cycles of induction chemotherapy and 6 months of maintenance therapy. Local treatment included radiotherapy to the primary site and lymph nodes with or without secondary surgical resection. RESULTS A total of 103 patients were enrolled. The clinical characteristics of the patients were predominantly unfavorable: 90% had macroscopic residual disease after initial surgery/biopsy, 63% had locally invasive tumors, 77% had a tumor measuring >5 cm, and 81% had disease at unfavorable sites. Fusion genes involving forkhead box protein O1 (FOXO1) were detected in 56 of 84 patients. Events occurred in 52 patients: 43 developed disease recurrence, 7 had disease that was refractory to treatment, and 2 patients developed second neoplasms. On univariate analysis, unfavorable disease site, tumor invasiveness, Intergroup Rhabdomyosarcoma Study group III, and fusion-positive status correlated with worse prognosis. The 5-year event-free survival rate of patients with fusion-positive tumors was 43% compared with 74% in patients with fusion-negative tumors (P = .01). On multivariate analysis, fusion positivity and tumor invasiveness proved to be unfavorable prognostic markers. CONCLUSIONS Fusion status and tumor invasiveness appear to have a strong impact on prognosis in patients with aRMS/N1. Fusion status will be used to stratify these patients in the next EpSSG RMS study, and treatment will be intensified in patients with fusion-positive tumors. Cancer 2018. © 2018 American Cancer Society.
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Affiliation(s)
- Soledad Gallego
- Pediatric Oncology and Hematology, Children's Hospital Vall d'Hebron, Barcelona, Spain
| | | | - Daniel Orbach
- Pediatric Oncology, SIREDO Oncology Center, Institute Curie, Paris Sciences and Letters University, Paris, France
| | | | - Janet Shipley
- Institute of Cancer Research, London, United Kingdom
| | - Angelica Zin
- Pediatric Research Institute Citta della Speranza, Padova, Italy
| | | | - Gian Luca de Salvo
- Clinical Trials and Biostatistics Unit, Veneto Oncologic Institute IOV-IRCCS, Padova, Italy
| | - Julia Chisholm
- The Royal Marsden National Health Service Foundation Trust, Sutton, United Kingdom
| | | | - Meriel Jenney
- Pediatric Oncology, Children Hospital for Wales Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - Henry C Mandeville
- The Royal Marsden National Health Service Foundation Trust, Sutton, United Kingdom
| | - Timothy Rogers
- University Hospitals Bristol National Health Service Foundation Trust, Bristol, United Kingdom
| | - Johannes H M Merks
- Pediatric Oncology, Emma Children's Hospital-Academic Medical Center, Amsterdam, The Netherlands
| | - Peter Mudry
- Pediatric Oncology, University Children's Hospital Brno, Brno, Czech Republic
| | - Heidi Glosli
- Pediatric Oncology, Oslo University Hospital, Oslo, Norway
| | | | - Sima Ferman
- Pediatric Oncology, National Cancer Institute, Rio de Janeiro, RJ, Brazil
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44
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Hoegy D, Goutelle S, Garnier N, Rénard C, Faure-Conter C, Bergeron C, Bertrand Y, Bleyzac N. Continuous intravenous vancomycin in children with normal renal function hospitalized in hematology-oncology: prospective validation of a dosing regimen optimizing steady-state concentration. Fundam Clin Pharmacol 2018; 32:323-329. [PMID: 29315849 DOI: 10.1111/fcp.12344] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 12/16/2017] [Accepted: 12/22/2017] [Indexed: 01/26/2023]
Abstract
Continuous intravenous (IV) infusion has been shown to be the best option to administer vancomycin because of its time-dependent bactericidal activity. Available IV vancomycin dosing guidelines in pediatrics with normal renal function leads to less than 50% of patients achieving a vancomycin serum concentration (Css) in the target range (15-20 mg/L). The primary objective of this study was to prospectively validate an age-based dosing regimen in pediatric oncology-hematology. The secondary objective was to investigate the influence on Css attainment of different variables. A continuous IV dosing nomogram was built by retrospective study (2000-2010) on Bayesian dosing adjustments performed in 161 patients. This study assessed the prospective validation of this age-based nomogram and the influence on Css attainment of variables as the gender, underlying disease (oncology or hematology), and hematopoietic stem cell transplantation (HSCT) before receiving vancomycin therapy. A total of 94 patients aged from 4.3 months to 17.9 years old with normal renal function were eligible for the prospective validation. Fifty-five of those patients (58.5%) achieved the target range of vancomycin Css. There was no significant difference between age groups (P = 0.816) and no influence of gender (P = 0.500). There was a nonsignificant trend to a better target attainment in oncology patients (69.2% vs. hematology 54.4%, P = 0.142) and patients who did not undergo HSCT (63.3% vs. 33.3%, P = 0.031). This study proposed an age-based nomogram prospectively validated which near 60% of patients of each age class achieving the target range of Css.
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Affiliation(s)
- Delphine Hoegy
- Institut d'Hématologie et d'Oncologie Pédiatrique, 1 Place Pr J. Renaut 69008, Lyon, France.,Hospices Civiles de Lyon, Lyon, France.,EA4129, Laboratoire Parcours santé systémique, 7-9 rue G. Paradin 69008, Lyon, France
| | - Sylvain Goutelle
- Hospices Civiles de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, 43 bd du 11 novembre 1918 69622, Villeurbanne Cedex, France.,Université Lyon I, Villeurbanne, France.,Pharmacie, Groupe Hospitalier Nord, Lyon, France
| | - Nathalie Garnier
- Institut d'Hématologie et d'Oncologie Pédiatrique, 1 Place Pr J. Renaut 69008, Lyon, France.,Hospices Civiles de Lyon, Lyon, France
| | - Cécile Rénard
- Institut d'Hématologie et d'Oncologie Pédiatrique, 1 Place Pr J. Renaut 69008, Lyon, France.,Hospices Civiles de Lyon, Lyon, France
| | - Cécile Faure-Conter
- Institut d'Hématologie et d'Oncologie Pédiatrique, 1 Place Pr J. Renaut 69008, Lyon, France.,Centre Léon Bérard, Lyon, France
| | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, 1 Place Pr J. Renaut 69008, Lyon, France.,Centre Léon Bérard, Lyon, France
| | - Yves Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique, 1 Place Pr J. Renaut 69008, Lyon, France.,Hospices Civiles de Lyon, Lyon, France.,Université Lyon I, Villeurbanne, France
| | - Nathalie Bleyzac
- Institut d'Hématologie et d'Oncologie Pédiatrique, 1 Place Pr J. Renaut 69008, Lyon, France.,Hospices Civiles de Lyon, Lyon, France.,EMR 3738 Optimisation Thérapeutique en Oncologie et Onco-hématologie, Lyon, France
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45
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Gooskens SL, Graf N, Furtwängler R, Spreafico F, Bergeron C, Ramírez-Villar GL, Godzinski J, Rübe C, Janssens GO, Vujanic GM, Leuschner I, Coulomb-L'Hermine A, Smets AM, de Camargo B, Stoneham S, van Tinteren H, Pritchard-Jones K, van den Heuvel-Eibrink MM. Position paper: Rationale for the treatment of children with CCSK in the UMBRELLA SIOP-RTSG 2016 protocol. Nat Rev Urol 2018; 15:309-319. [PMID: 29485128 DOI: 10.1038/nrurol.2018.14] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The International Society of Paediatric Oncology-Renal Tumour Study Group (SIOP-RTSG) has developed a new protocol for the diagnosis, treatment, and follow-up monitoring of childhood renal tumours - the UMBRELLA SIOP-RTSG 2016 protocol (the UMBRELLA protocol). This protocol has been designed to continue international collaboration in the treatment of childhood renal tumours and will be implemented in over 50 different countries. Clear cell sarcoma of the kidney, which is a rare paediatric renal tumour that most commonly occurs in children between 2 and 4 years of age, is specifically addressed in the UMBRELLA protocol.
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Affiliation(s)
- Saskia L Gooskens
- Department of Paediatric Oncology, Princess Máxima Center for Paediatric Oncology, Utrecht, Netherlands.,Department of Paediatric Haematology and Oncology, Erasmus MC - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Norbert Graf
- Department of Paediatric Haematology and Oncology, Saarland University, Homburg, Germany
| | - Rhoikos Furtwängler
- Department of Paediatric Haematology and Oncology, Saarland University, Homburg, Germany
| | - Filippo Spreafico
- Department of Haematology and Paediatric Onco-Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Gema L Ramírez-Villar
- Department of Paediatric Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Jan Godzinski
- Department of Emergency Medicine, Medical University of Wroclaw and Department of Paediatric Surgery, Marciniak Hospital, Wroclaw, Poland
| | - Christian Rübe
- Department of Radiotherapy and Radiation Oncology, Saarland University, Homburg, Germany
| | - Geert O Janssens
- Department of Paediatric Oncology, Princess Máxima Center for Paediatric Oncology, Utrecht, Netherlands.,Department of Radiation Oncology, Utrecht University Medical Center, Utrecht, Netherlands
| | - Gordan M Vujanic
- Department of Pathology, Sidra Medicine, Sidra Hospital, Qatar Foundation, Doha, Qatar
| | - Ivo Leuschner
- Kiel Paediatric Tumour Registry, Department of Paediatric Pathology, University Schleswig-Holstein, Kiel, Germany
| | - Aurore Coulomb-L'Hermine
- Department of Pathology, Hopitaux Universitaires Est Parisien, Trousseau La Roche-Guyon, Paris, France
| | - Anne M Smets
- Department of Radiology, Academic Medical Center (AMC), Amsterdam, Netherlands
| | - Beatriz de Camargo
- Instituto Nacional do Cancer, Paediatric Haematology and Oncology Program, Rio de Janeiro, Brazil
| | - Sara Stoneham
- Department of Paediatric and Adolescent Oncology, University College Hospital, Bloomsbury, London, UK
| | - Harm van Tinteren
- Department of Statistics, Netherlands Cancer Institute (NKI-AvL), Amsterdam, Netherlands
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, University College, London, UK
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46
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Hol JA, van den Heuvel-Eibrink MM, Graf N, Pritchard-Jones K, Brok J, van Tinteren H, Howell L, Verschuur A, Bergeron C, Kager L, Catania S, Spreafico F, Mavinkurve-Groothuis AMC. Irinotecan for relapsed Wilms tumor in pediatric patients: SIOP experience and review of the literature-A report from the SIOP Renal Tumor Study Group. Pediatr Blood Cancer 2018; 65. [PMID: 29077255 DOI: 10.1002/pbc.26849] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 11/11/2022]
Abstract
While irinotecan has been studied in various pediatric solid tumors, its potential role in Wilms tumor (WT) is less clear. We evaluated response and outcome of irinotecan-containing regimens in relapsed WT and compared our results to the available literature. Among 14 evaluable patients, one complete response (CR) and two partial responses (PRs) were observed in patients with initial intermediate-risk (CR and PR) and blastemal-type histologies (PR). Two patients were alive at last follow-up showing no evidence of disease. Our results and the reviewed literature suggest some effectiveness of irinotecan in the setting of relapsed WT.
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Affiliation(s)
- Janna A Hol
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Norbert Graf
- Department of Pediatric Oncology & Hematology, Saarland University, Homburg, Germany
| | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Jesper Brok
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.,Department of Pediatric Hematology and Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Harm van Tinteren
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lisa Howell
- Department of Pediatric Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Arnauld Verschuur
- Pediatric Oncology, La Timone Children's Hospital, Marseille, France
| | - Christophe Bergeron
- Department of Pediatric Oncology, Institut d'Hematologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Leo Kager
- St. Anna's Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - Serena Catania
- Pediatric Oncology Unit, Department of Hematology and Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Department of Hematology and Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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47
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Vaarwerk B, van der Lee JH, Breunis WB, Orbach D, Chisholm JC, Cozic N, Jenney M, van Rijn RR, McHugh K, Gallego S, Glosli H, Devalck C, Gaze MN, Kelsey A, Bergeron C, Stevens MCG, Oberlin O, Minard-Colin V, Merks JHM. Prognostic relevance of early radiologic response to induction chemotherapy in pediatric rhabdomyosarcoma: A report from the International Society of Pediatric Oncology Malignant Mesenchymal Tumor 95 study. Cancer 2017; 124:1016-1024. [DOI: 10.1002/cncr.31157] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 10/18/2017] [Accepted: 10/24/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Bas Vaarwerk
- Department of Pediatric Oncology; Emma Children's Hospital/Academic Medical Center; Amsterdam the Netherlands
| | - Johanna H. van der Lee
- Pediatric Clinical Research Office; Emma Children's Hospital/Academic Medical Center; Amsterdam the Netherlands
| | - Willemijn B. Breunis
- Department of Pediatric Oncology; Emma Children's Hospital/Academic Medical Center; Amsterdam the Netherlands
| | - Daniel Orbach
- Department of Pediatric, Adolescent, and Young Adult Oncology; Curie Institute; Paris France
| | - Julia C. Chisholm
- Children and Young People's Department; Royal Marsden Hospital; Sutton United Kingdom
| | - Nathalie Cozic
- Department of Biostatistics and Epidemiology; Gustave-Roussy; Villejuif France
| | - Meriel Jenney
- Department of Pediatric Oncology; Children's Hospital for Wales; Cardiff United Kingdom
| | - Rick R. van Rijn
- Pediatric Radiology; Emma Children's Hospital/Academic Medical Center; Amsterdam the Netherlands
| | - Kieran McHugh
- Department of Radiology; Great Ormond Street Hospital for Children; London United Kingdom
| | - Soledad Gallego
- Pediatric Oncology; Vall d'Hebron University Hospital; Barcelona Spain
| | - Heidi Glosli
- Department of Pediatric and Adolescent Medicine; Oslo University Hospital; Oslo Norway
| | - Christine Devalck
- Pediatric Hematology Oncology Department; Children's University Hospital; Brussels Belgium
| | - Mark N. Gaze
- Department of Oncology; University College London Hospitals NHS Foundation Trust; London United Kingdom
| | - Anna Kelsey
- Pathology Department; Royal Manchester Children's Hospital; Manchester United Kingdom
| | | | - Michael C. G. Stevens
- Department of Pediatric Oncology; Bristol Royal Hospital for Children; Bristol United Kingdom
| | - Odile Oberlin
- Department of Pediatric and Adolescent Oncology; Gustave-Roussy; Villejuif France
| | | | - Johannes H. M. Merks
- Department of Pediatric Oncology; Emma Children's Hospital/Academic Medical Center; Amsterdam the Netherlands
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48
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van den Heuvel-Eibrink MM, Hol JA, Pritchard-Jones K, van Tinteren H, Furtwängler R, Verschuur AC, Vujanic GM, Leuschner I, Brok J, Rübe C, Smets AM, Janssens GO, Godzinski J, Ramírez-Villar GL, de Camargo B, Segers H, Collini P, Gessler M, Bergeron C, Spreafico F, Graf N. Position paper: Rationale for the treatment of Wilms tumour in the UMBRELLA SIOP-RTSG 2016 protocol. Nat Rev Urol 2017; 14:743-752. [PMID: 29089605 DOI: 10.1038/nrurol.2017.163] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [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: 12/31/2022]
Abstract
The Renal Tumour Study Group of the International Society of Paediatric Oncology (SIOP-RTSG) has developed a new protocol for the diagnosis and treatment of childhood renal tumours, the UMBRELLA SIOP-RTSG 2016 (the UMBRELLA protocol), to continue international collaboration in the treatment of childhood renal tumours. This protocol will support integrated biomarker and imaging research, focussing on assessing the independent prognostic value of genomic changes within the tumour and the volume of the blastemal component that survives preoperative chemotherapy. Treatment guidelines for Wilms tumours in the UMBRELLA protocol include recommendations for localized, metastatic, and bilateral disease, for all age groups, and for relapsed disease. These recommendations have been established by a multidisciplinary panel of leading experts on renal tumours within the SIOP-RTSG. The UMBRELLA protocol should promote international collaboration and research and serve as the SIOP-RTSG best available treatment standard.
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Affiliation(s)
- Marry M van den Heuvel-Eibrink
- Department of Paediatric Oncology, Princess Máxima Center for Paediatric Oncology, Lundlaan 6, 3584EA Utrecht, The Netherlands
| | - Janna A Hol
- Department of Paediatric Oncology, Princess Máxima Center for Paediatric Oncology, Lundlaan 6, 3584EA Utrecht, The Netherlands
| | - Kathy Pritchard-Jones
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, London, WC1N 1EH, United Kingdom
| | - Harm van Tinteren
- Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Rhoikos Furtwängler
- Department of Paediatric Oncology & Haematology, Saarland University, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Arnauld C Verschuur
- Department of Paediatric Oncology & Haematology, La Timone Children's Hospital, 264 Rue Saint-Pierre, 13385, Marseille, France
| | - Gordan M Vujanic
- Department of Cellular Pathology, University Hospital of Wales, Cardiff University School of Medicine, Heath Park, Eastern Ave, Cardiff, CF14 4XW, United Kingdom
| | - Ivo Leuschner
- Kiel Paediatric Tumour Registry, Department of Paediatric Pathology, University Hospital of Kiel, Christian-Albrechts-Platz 4, 24118, Kiel, Germany
| | - Jesper Brok
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, London, WC1N 1EH, United Kingdom
| | - Christian Rübe
- Department of Radiotherapy, University Hospital of the Saarland, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Anne M Smets
- Department of Radiology, Academic Medical Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Geert O Janssens
- Department of Paediatric Oncology, Princess Máxima Center for Paediatric Oncology, Lundlaan 6, 3584EA Utrecht, The Netherlands
- Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Jan Godzinski
- Department of Paediatric Surgery, Marciniak Hospital, Fieldorfa 2, 54-049, Wroclaw, Poland
- Department of Paediatric Traumatology and Emergency Medicine, Medical University, Wybrzeze Ludwika Pasteura 1, 50-367, Wroclaw, Poland
| | - Gema L Ramírez-Villar
- Department of Paediatric Oncology, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, S/N, 41013 Seville, Spain
| | - Beatriz de Camargo
- Paediatric Haematology-Oncology Program, Instituto Nacional de Cancer (INCA), Praça Cruz Vermelha, 23, Rio de Janeiro, 20230-130, Brazil
| | - Heidi Segers
- Department of Paediatric Oncology, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Paola Collini
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Manfred Gessler
- Biocenter of the University of Wuerzburg, Developmental Biochemistry, and Comprehensive Cancer Center Mainfranken, Josef-Schneider-Straße 6, 97080, Wuerzburg, Germany
| | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 28 Prom. Léa et Napoléon Bullukian, 69008, Lyon, France
| | - Filippo Spreafico
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Norbert Graf
- Department of Paediatric Oncology & Haematology, Saarland University, Kirrberger Str. 100, 66421, Homburg, Germany
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49
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Geoerger B, Bergeron C, Gore L, Sender L, Dunkel IJ, Herzog C, Brochez L, Cruz O, Nysom K, Berghorn E, Simsek B, Shen J, Pappo A. Phase II study of ipilimumab in adolescents with unresectable stage III or IV malignant melanoma. Eur J Cancer 2017; 86:358-363. [PMID: 29100190 DOI: 10.1016/j.ejca.2017.09.032] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 09/24/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Ipilimumab is approved for the treatment of advanced melanoma in adults; however, little information on the efficacy and safety of ipilimumab in younger patients is available. METHODS Patients aged 12 to <18 years with previously treated or untreated, unresectable stage III or IV malignant melanoma received ipilimumab 3 or 10 mg/kg every 3 weeks. Primary end-points were 1-year overall survival and safety. RESULTS Over a period of 3.5 years, 12 patients received ipilimumab at either 3 mg/kg (n = 4) or 10 mg/kg (n = 8). The median number of ipilimumab doses was four for 3 mg/kg and three for 10 mg/kg. At 1 year, three of four patients on 3 mg/kg and five of eight patients on 10 mg/kg were alive. Two patients on 10 mg/kg had partial response, and one on 3 mg/kg had stable disease. One patient had durable partial response at 3 years without further treatment, at time of this report. There was one grade 3/4 immune-mediated adverse reaction with 3 mg/kg and five with 10 mg/kg. There were no treatment-related deaths. The study was stopped due to slow accrual. CONCLUSIONS At >1 year follow-up, ipilimumab demonstrated activity in melanoma patients aged 12 to <18 years, with a similar safety profile as that seen in adults. Our trial highlights the difficulties of enrolling younger patients with rare diseases in clinical trials for treatments that are approved in adults, suggesting adolescents with cancer types occurring predominantly in adults should be considered for inclusion in adult trials of promising new drugs. CLINICAL TRIAL REGISTRATION NCT01696045.
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Affiliation(s)
- Birgit Geoerger
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric and Adolescent Oncology, Villejuif, France.
| | - Christophe Bergeron
- Institut D'Hematologie et D'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Lia Gore
- University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA
| | - Leonard Sender
- University of California, Irvine School of Medicine, Orange, CA, USA
| | - Ira J Dunkel
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - Cynthia Herzog
- University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Ofelia Cruz
- Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Karsten Nysom
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Jun Shen
- Bristol-Myers Squibb, Princeton, NJ, USA
| | - Alberto Pappo
- St. Jude Children's Research Hospital, Memphis, TN, USA
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50
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Delloye-Bourgeois C, Bertin L, Thoinet K, Jarrosson L, Kindbeiter K, Buffet T, Tauszig-Delamasure S, Bozon M, Marabelle A, Combaret V, Bergeron C, Derrington E, Castellani V. Microenvironment-Driven Shift of Cohesion/Detachment Balance within Tumors Induces a Switch toward Metastasis in Neuroblastoma. Cancer Cell 2017; 32:427-443.e8. [PMID: 29017055 DOI: 10.1016/j.ccell.2017.09.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/22/2017] [Accepted: 09/12/2017] [Indexed: 12/13/2022]
Abstract
Neuroblastoma (NB) is a childhood cancer arising from sympatho-adrenal neural crest cells. Disseminated forms have high frequency of multiple tumoral foci whose etiology remains unknown; NB embryonic origin limits investigations in patients and current models. We developed an avian embryonic model driving human NB tumorigenesis in tissues homologous to patients. We found that aggressive NBs display a metastatic mode, secondary dissemination via peripheral nerves and aorta. Through tumor transcriptional profiling, we found that NB dissemination is induced by the shutdown of a pro-cohesion autocrine signal, SEMA3C, which constrains the tumoral mass. Lowering SEMA3C levels shifts the balance toward detachment, triggering NB cells to collectively evade the tumor. Together with patient cohort analysis, this identifies a microenvironment-driven pro-metastatic switch for NB.
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Affiliation(s)
- Céline Delloye-Bourgeois
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France
| | - Lorette Bertin
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France
| | - Karine Thoinet
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France
| | - Loraine Jarrosson
- OncoFactory SAS, L'Atrium, 43 boulevard du 11 Novembre 1918, 69100 Villeurbanne, France
| | - Karine Kindbeiter
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France
| | - Thomas Buffet
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France
| | - Servane Tauszig-Delamasure
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France
| | - Muriel Bozon
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France
| | - Aurélien Marabelle
- Drug Development Department (DITEP), Gustave Roussy Cancer Campus (GRCC), INSERM U1015, 114 rue Edouard Vaillant, 94805 Villejuif, France
| | - Valérie Combaret
- Laboratory of Translational Research, Léon Bérard Centre, 28 rue Laennec, 69008 Lyon, France
| | - Christophe Bergeron
- Departments of Oncology and Clinical Research, Centre Léon Berard and Institut d'Hématologie et d'Oncologie Pédiatrique, 1 Place Professeur Joseph Renaut, 69008 Lyon, France
| | - Edmund Derrington
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France
| | - Valérie Castellani
- University of Lyon, University of Lyon 1 Claude Bernard Lyon1, NeuroMyoGene Institute, CNRS UMR5310, INSERM U1217, 16 rue Raphael Dubois, F-69000 Lyon, France.
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