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Varnier R, Toullec C, Philonenko S, Dupré A, Artru P, Hafliger E, Drouillard A, Torregrosa C, Pernot S, McLellan P, Lecomte T, Moulin V, Lécaille C, Touchefeu Y, Locher C, Taieb J, Coutzac C. Triplet chemotherapy with or without bevacizumab as first line treatment for metastatic colorectal cancer: An AGEO multicenter real-world study. Dig Liver Dis 2024:S1590-8658(24)00270-6. [PMID: 38403514 DOI: 10.1016/j.dld.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/03/2024] [Accepted: 02/11/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Prior trials validated triplet chemotherapy (Tri-CT) with bevacizumab as first line treatment for metastatic colorectal cancer (mCRC) but real-world data are scarce and practices remain heterogeneous. AIMS To evaluate Tri-CT +/- bevacizumab efficacy and safety, and to identify factors influencing treatment decisions. METHODS The COLOTRIP retrospective study enrolled mCRC patients treated from 2014 to 2019 in 14 French centers. RESULTS Of 299 patients (81% PS 0-1, 58% RAS-mutated and 19% BRAF-mutated), 51% received Tri-CT and 49% Tri-CT + bevacizumab. Metastatic disease was classified as resectable (6.5%), potentially resectable (40%), and unresectable (54%). Bevacizumab use was associated with primary tumor location, mutational status and number of metastases. Median overall survival was 33.5 months in the Tri-CT group and 23.9 months in the Tri-CT + bevacizumab group, with median progression-free survival being 14.5 and 11.4 months. After adjusting for initial characteristics, no difference in survival was noted. Around 30% of patients experienced grade ≥3 adverse events. CONCLUSIONS This study highlights several factors influencing Tri-CT use +/- bevacizumab decision and confirms the real-world good oncological outcomes and tolerability of these regimens in mCRC patients. Our results suggest that Tri-CT alone may by an appropriate option for specific subgroups of patients.
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Affiliation(s)
- R Varnier
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Research on Healthcare Performance (RESHAPE, Inserm U1290), Université Claude Bernard Lyon 1, Lyon, France
| | - C Toullec
- Department of Digestive Oncology, Institut du Cancer Avignon-Provence, Avignon, France
| | - S Philonenko
- Department of Gastroenterology and Digestive Oncology, Hôpital Pitié Salpêtrière, Paris, France
| | - A Dupré
- Department of Surgery, Centre Léon Bérard, Lyon, France
| | - P Artru
- Department of Gastroenterology and Digestive Oncology, Hôpital Privé Jean Mermoz, Lyon, France
| | - E Hafliger
- Department of Gastroenterology and Digestive Oncology, Hôpital Privé Jean Mermoz, Lyon, France
| | - A Drouillard
- Department of Hepato-Gastroenterology and Digestive Oncology, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - C Torregrosa
- Department of Medical Oncology, Institut Curie, Paris, France
| | - S Pernot
- Department of Digestive Oncology, Institut Bergonié, Bordeaux, France
| | - P McLellan
- Department of Hepato-Gastroenterology and Digestive Oncology, Hôpital Saint-Louis, Paris, France
| | - T Lecomte
- Department of Hepato-Gastroenterology and Digestive Oncology, Centre Hospitalier Universitaire de Tours, Tours, France
| | - V Moulin
- Department of Hepato-Gastroenterology and Digestive Oncology, Centre Hospitalier de La Rochelle, La Rochelle, France
| | - C Lécaille
- Department of Hepato-Gastroenterology and Digestive Oncology, Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France
| | - Y Touchefeu
- Department of Hepato-Gastroenterology and Digestive Oncology, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - C Locher
- Department of Hepato-Gastroenterology, Centre Hospitalier de Meaux, Meaux, France
| | - J Taieb
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, AP-HP, Paris-Cité University, SIRIC CARPEM Comprehensive Cancer Center, Paris, France
| | - C Coutzac
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Association des Gastro-Entérologues Oncologues (AGEO), France.
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Taïeb J, Bouche O, André T, Le Malicot K, Laurent-Puig P, Bez J, Toullec C, Borg C, Randrian V, Evesque L, Corbinais S, Perrier H, Buecher B, Di Fiore F, Gallois C, Emile JF, Lepage C, Elhajbi F, Tougeron D. Avelumab vs Standard Second-Line Chemotherapy in Patients With Metastatic Colorectal Cancer and Microsatellite Instability: A Randomized Clinical Trial. JAMA Oncol 2023; 9:1356-1363. [PMID: 37535388 PMCID: PMC10401392 DOI: 10.1001/jamaoncol.2023.2761] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/24/2023] [Indexed: 08/04/2023]
Abstract
Importance Only 1 randomized clinical trial has shown the superiority of immune checkpoint inhibitors in patients with deficient mismatch repair and/or microsatellite instability (dMMR/MSI) metastatic colorectal cancer (mCRC) in the first-line setting. Objectives To determine whether avelumab (an anti-programmed cell death ligand 1 antibody) improves progression-free survival (PFS) compared with standard second-line chemotherapy in patients with dMMR/MSI mCRC. Design, Setting, and Participants The SAMCO-PRODIGE 54 trial is a national open-label phase 2 randomized clinical trial that was conducted from April 24, 2018, to April 29, 2021, at 49 French sites. Patients with dMMR/MSI mCRC who experienced progression while receiving standard first-line therapy were included in the analysis. Interventions Patients were randomized to receive standard second-line therapy or avelumab every 2 weeks until progression, unacceptable toxic effects, or patient refusal. Main Outcome and Measures The primary end point was PFS according to RECIST (Response Evaluation Criteria in Solid Tumours), version 1.1, evaluated by investigators in patients with mCRC and confirmed dMMR and MSI status who received at least 1 dose of treatment (modified intention-to-treat [mITT] population). Results A total of 122 patients were enrolled in the mITT population. Median age was 66 (IQR, 56-76) years, 65 patients (53.3%) were women, 100 (82.0%) had a right-sided tumor, and 52 (42.6%) had BRAF V600E-mutated tumors. There was no difference in patients and tumor characteristics between treatment groups. No new safety concerns in either group were detected, with fewer treatment-related adverse events of at least grade 3 in the avelumab group than in the chemotherapy group (20 [31.7%] vs 34 [53.1%]; P = .02). After a median follow-up of 33.3 (95% CI, 28.3-34.8) months, avelumab was superior to chemotherapy with or without targeted agents with respect to PFS (15 [24.6%] vs 5 [8.2%] among patients without progression; P = .03). Rates of PFS rates at 12 months were 31.2% (95% CI, 20.1%-42.9%) and 19.4% (95% CI, 10.6%-30.2%) in the avelumab and control groups, respectively, and 27.4% (95% CI, 16.8%-39.0%) and 9.1% (95% CI, 3.2%-18.8%) at 18 months. Objective response rates were similar in both groups (18 [29.5%] vs 16 [26.2%]; P = .45). Among patients with disease control, 18 (75.7%) in the avelumab group compared with 9 (19.1%) in the control group had ongoing disease control at 18 months. Conclusions The SAMCO-PRODIGE 54 phase 2 randomized clinical trial showed, in patients with dMMR/MSI mCRC, better PFS and disease control duration with avelumab over standard second-line treatment, with a favorable safety profile. Trial Registration ClinicalTrials.gov Identifier: NCT03186326.
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Affiliation(s)
- Julien Taïeb
- Institut du Cancer Paris Cancer Research for Personalized Medicine, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
- Centre de Recherche des Cordeliers, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique, Sorbonne Université, Université Sorbonne Paris Cité, Université de Paris, Paris, France
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, AP-HP Centre, Université Paris Cité, Paris, France
| | - Olivier Bouche
- Department of Digestive Oncology, Centre Hospitalier Universitaire (CHU) Reims, Reims, France
| | - Thierry André
- Sorbonne Université and Hôpital Saint Antoine, INSERM 938 and Site de Recherche Intégrée sur le Cancer CURAMUS, Paris, France
| | - Karine Le Malicot
- Fédération Francophone de Cancérologie Digestive, EPICAD INSERM Lipides Nutrition Cancer–Unité Mixte de Recherche 1231, University of Burgundy and Franche Comté, Dijon, France
| | - Pierre Laurent-Puig
- Institut du Cancer Paris Cancer Research for Personalized Medicine, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
- Centre de Recherche des Cordeliers, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique, Sorbonne Université, Université Sorbonne Paris Cité, Université de Paris, Paris, France
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, AP-HP Centre, Université Paris Cité, Paris, France
| | - Jérémie Bez
- Fédération Francophone de Cancérologie Digestive, EPICAD INSERM Lipides Nutrition Cancer–Unité Mixte de Recherche 1231, University of Burgundy and Franche Comté, Dijon, France
| | - Clémence Toullec
- Department of Medical Oncology, Institut du Cancer, Avignon-Provence, France
| | - Christophe Borg
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Violaine Randrian
- Department of Gastroenterology and Hepatology, Poitiers University Hospital, Poitiers, France
| | - Ludovic Evesque
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | | | - Hervé Perrier
- Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, Marseille, France
| | - Bruno Buecher
- Department of Oncology, Institut Curie, Paris, France
| | - Frederic Di Fiore
- Hepatogastroenterology Department, CHU Rouen, University of Rouen Normandy, INSERM 1245, Institut de Recherche en Oncologie Group, Normandie University, Rouen, France
| | - Claire Gallois
- Institut du Cancer Paris Cancer Research for Personalized Medicine, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
- Centre de Recherche des Cordeliers, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique, Sorbonne Université, Université Sorbonne Paris Cité, Université de Paris, Paris, France
| | - Jean Francois Emile
- EA4340, Pathology Department and INSERM, Ambroise Paré Hospital, Boulogne, France
| | - Côme Lepage
- Sorbonne Université and Hôpital Saint Antoine, INSERM 938 and Site de Recherche Intégrée sur le Cancer CURAMUS, Paris, France
- Department of Digestive Oncology, University Hospital Dijon, University of Burgundy and Franche Comté, Dijon, France
| | - Farid Elhajbi
- Medical Oncology Department, Oscar Lambret Center, Lille, France
| | - David Tougeron
- Department of Gastroenterology and Hepatology, Poitiers University Hospital, Poitiers, France
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Mineur L, Vazquez L, Belkacemi M, Toullec C, Bentaleb N, Boustany R, Plat F. Capecitabine/Mitomycin versus 5-Fluorouracil/Mitomycin in Combination with Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy for Anal Cancer. Curr Oncol 2023; 30:8563-8574. [PMID: 37754536 PMCID: PMC10528380 DOI: 10.3390/curroncol30090621] [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: 07/31/2023] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
Since EXTRA, a non-randomized phase II trial with 31 patients, explored the use of capecitabine, mitomycin and radiation therapy (RT) in the treatment of localized squamous cell carcinoma of the anal canal (SCCAC), this treatment has been considered as an acceptable alternative to infusional 5-FU. However, the differences in efficacy between capecitabine and 5-FU in chemoradiation therapy (CRT) with simultaneous integrated boost (SIB) radiation therapy (SIB-IMRT) for local SCCAC are not well documented. Patients included in this prospective monocentric cohort study were treated with SIB-RapidArc (a unique RT method treatment for all patients: identical technique, volume and constraints for at-risk organs), mitomycin C and 5-FU each day of RT for 7 weeks (group 1) or capecitabine each day of RT (group 2). Patients treated between July 2009 and August 2017 (group 1) and between November 2012 and April 2018 (group 2) for local SCCAC T2-4 classified as N, M0 or T, N1-3, M0 were included. Primary endpoints were progression-free survival (PFS) and acute toxicities. Results: One hundred forty-seven patients were included, 91 in group 1 and 56 in group 2. The two groups were statistically comparable in terms of sex, Eastern Cooperative Oncology Group Performance Status (ECOG PS) and TNM. With a median duration of follow-up of 53.5 months, the PFS rate at 3 years was 80% for group 1 and 75% for group 2 (p = 0.32). The 3-year colostomy-free survival rate was 92% for group 1 and 85% for group 2 (p = 0.11). The rate of patients with at least one grade 3 or higher acute toxicity was 35.5% in group 1 and 21.4% in group 2 (p = 0.10), with a trend of fewer acute toxicities with capecitabine. Conclusion: Capecitabine/mitomycin in combination with SIB RapidArc radiation therapy for anal cancer seems as effective as 5-FU-based chemotherapy and is well tolerated with minimal toxicity.
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Affiliation(s)
- Laurent Mineur
- Oncodigestive and Clinical Research Department, Sainte Catherine Institut du Cancer Avignon-Provence, 84918 Avignon, France
| | - Léa Vazquez
- Oncodigestive and Clinical Research Department, Sainte Catherine Institut du Cancer Avignon-Provence, 84918 Avignon, France
| | - Mohamed Belkacemi
- Statistics Department, PRECIS, Nouvelles Technologies, Languedoc Mutualité, 34000 Montpellier, France
| | - Clémence Toullec
- Oncodigestive and Clinical Research Department, Sainte Catherine Institut du Cancer Avignon-Provence, 84918 Avignon, France
| | - Newfel Bentaleb
- Oncodigestive and Clinical Research Department, Sainte Catherine Institut du Cancer Avignon-Provence, 84918 Avignon, France
| | - Rania Boustany
- Oncodigestive and Clinical Research Department, Sainte Catherine Institut du Cancer Avignon-Provence, 84918 Avignon, France
| | - Frederi Plat
- Oncodigestive and Clinical Research Department, Sainte Catherine Institut du Cancer Avignon-Provence, 84918 Avignon, France
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4
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Tran BTT, Gelin A, Durand S, Texier M, Daste A, Toullec C, Benihoud K, Breuskin I, Gorphe P, Garic F, Brenner C, Le Tourneau C, Fayette J, Niki T, David M, Busson P, Even C. Plasma galectins and metabolites in advanced head and neck carcinomas: evidence of distinct immune characteristics linked to hypopharyngeal tumors. Oncoimmunology 2022; 12:2150472. [PMID: 36545254 PMCID: PMC9762837 DOI: 10.1080/2162402x.2022.2150472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Extra-cellular galectins 1, 3 and 9 (gal-1, -3 and -9) are known to act as soluble immunosuppressive agents in various malignancies. Previous publications have suggested that their expression is dependent on the metabolic status of producing cells and reciprocally that they can influence metabolic pathways in their target cells. Very little is known about the status of gal-1, -3 and -9 in patients bearing head and neck squamous cell carcinomas (HNSCC) and about their relationships with the systemic metabolic condition. This study was conducted in plasma samples from a prospective cohort of 83 HNSCC patients with advanced disease. These samples were used to explore the distribution of gal-1, -3 and -9 and simultaneously to profile a series of 87 metabolites assessed by mass spectrometry. We identified galectin and metabolic patterns within five disease categories defined according to the primary site and human papillomavirus (HPV) status (HPV-positive and -negative oropharyngeal carcinomas, carcinomas of the oral cavity, hypopharynx and larynx carcinomas). Remarkably, samples related to hypopharyngeal carcinomas displayed the highest average concentration of gal-9 (p = .017) and a trend toward higher concentrations of kynurenine, a potential factor of tumor growth and immune suppression. In contrast, there was a tendency toward higher concentrations of fatty acids in samples related to oral cavity. These observations emphasize the diversity of HPV-negative HNSCCs. Depending on their primary site, they evolve into distinct types of immune and metabolic landscapes that seem to be congruent with specific oncogenic mechanisms.
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Affiliation(s)
- Bao-Tram Thi Tran
- CNRS UMR 9018-METSY, Gustave Roussy and Université Paris-Saclay, Villejuif, France
| | - Aurore Gelin
- CNRS UMR 9018-METSY, Gustave Roussy and Université Paris-Saclay, Villejuif, France
| | - Sylvère Durand
- Plateforme de Métabolomique/UMR 1138, Gustave Roussy and Université Paris-Saclay, Villejuif, France
| | - Matthieu Texier
- Service d’Epidémiologie et de Biostatistiques, Gustave Roussy and Université Paris-Saclay, Villejuif, France
| | - Amaury Daste
- Department of Medical Oncology, Hôpital Saint André, Bordeaux, France
| | - Clémence Toullec
- GI and Liver/Head and Neck unit, Institut du Cancer-Avignon Provence, Avignon, France
| | - Karim Benihoud
- CNRS UMR 9018-METSY, Gustave Roussy and Université Paris-Saclay, Villejuif, France
| | - Ingrid Breuskin
- Service de Cancérologie Cervico-Faciale, Gustave Roussy, Villejuif, France
| | - Philippe Gorphe
- Service de Cancérologie Cervico-Faciale, Gustave Roussy, Villejuif, France
| | | | - Catherine Brenner
- CNRS UMR 9018-METSY, Gustave Roussy and Université Paris-Saclay, Villejuif, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie and Paris-Saclay University, Paris, France
| | - Jérôme Fayette
- Claude Bernard Lyon 1 University, INSERM 1052, CNRS 5286 & Department of Medical Oncology, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France
| | - Toshiro Niki
- Department of Immunology, Kagawa University, Kita-gun, Japan
| | - Muriel David
- HiFiBiO Therapeutics, Pépinière Paris Santé Cochin, Paris, France
| | - Pierre Busson
- CNRS UMR 9018-METSY, Gustave Roussy and Université Paris-Saclay, Villejuif, France,CONTACT Pierre Busson CNRS UMR 9018-METSY, Gustave Roussy, 39, Rue Camile Desmoulins, F-94805Villejuif, France
| | - Caroline Even
- Service de Cancérologie Cervico-Faciale, Gustave Roussy, Villejuif, France
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Le Tourneau C, Salas S, Pointreau Y, Ceruse P, Babin E, Rondeau V, Guigay J, Rotarski M, Chehimi M, Toullec C, Marie G, Sire C, Darut Jouve A, Theron A, Calderon B, Houessinon A, Cotté FE, Lavignon M, Even C, Fayette J. 695P Effectiveness and quality-of-life (QoL) data from real-world study (ProNiHN) in patients (pts) with recurrent and/or metastatic squamous cell carcinoma of head and neck (R/M SCCHN) treated with nivolumab (nivo) in France. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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6
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Muratori L, Texier M, Mayache-Badis L, Bidault F, Iacob M, Daste A, Fayette J, Lefebvre G, Saada-Bouzid E, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminsky-Forrett MC, Johnson A, Ferrand F, Aupérin A, Guigay J, Raynard B, Even C. 916P Impact of sarcopenia (S) on efficacy and toxicity of nivolumab (N) in patients (pts) with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) in TOPNIVO (T) study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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7
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Varnier R, Toullec C, Fonnesu M, Philonenko S, Artru P, Hafliger E, Drouillard A, Torregrosa C, Pernot S, McLellan P, Lecomte T, Moulin V, Lecaille C, Touchefeu Y, Locher C, Turpin A, Taieb J, Coutzac C. 421P FOLFIRINOX with or without targeted therapy as first line for metastatic colorectal cancer: An AGEO multicenter real-world study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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8
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Chevalier T, Daste A, Saada‐Bouzid E, Loundou A, Peyraud F, Lambert T, Le Tourneau C, Peyrade F, Dupuis C, Alfonsi M, Fayette J, Reure J, Huguet F, Fakhry N, Toullec C, Salas S. Cetuximab combined with paclitaxel or paclitaxel alone for patients with recurrent or metastatic head and neck squamous cell carcinoma progressing after EXTREME. Cancer Med 2021; 10:3952-3963. [PMID: 34080776 PMCID: PMC8209557 DOI: 10.1002/cam4.3953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Prognosis of recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) remains poor. The addition of cetuximab, to platinum and fluorouracil chemotherapy (EXTREME regimen) has been shown to improve patients' outcomes in first-line settings. METHODS We conducted a retrospective, multicenter study, including HNSCC that progressed after a first line of platinum-based chemotherapy and cetuximab, treated either by paclitaxel + cetuximab (PC) or paclitaxel alone (P), between January 2010 and April 2018. The end points were overall survival (OS), progression-free survival (PFS), and overall response rates (ORR). Patients were matched according to their propensity scores, estimated with a logistic regression model. The secondary objectives were to study the safety profile and to look for prognostic and predictive factors of effectiveness. RESULTS Of the 340 identified patients, 262 were included in the analysis, 165 received PC, and 97 received P. In unmatched population, ORR was 16.4% with PC and 6.2% for P. Median PFS was 2.9 months [95% Confidence Interval 2.7-3.0] for PC versus 2.5 months [2.2-2.7] for P, hazard ratio (HR) = 0.770 [0.596-0.996]. Median OS was 5.5 months [4.4-6.9] for PC versus 4.2 months [3.4-4.8] for P, HR = 0.774 [0.590-1.015]. In multivariate analysis, PC was associated with better PFS and OS. These results were consistent in matched-paired population. Previous cetuximab maintenance for more than 3 months was predictive of better OS with PC. CONCLUSION Although the continuation of cetuximab in combination with paclitaxel after EXTREME provides moderate benefit, it could be an interesting option for selected patients.
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Affiliation(s)
| | - Amaury Daste
- Department of Medical OncologyHôpital Saint‐AndréBordeaux University Hospital‐CHUBordeauxFrance
| | | | - Anderson Loundou
- EA3279Self‐Perceived Health Assessment Research UnitAix‐Marseille UniversityMarseilleFrance
| | - Florent Peyraud
- Department of Medical OncologyHôpital Saint‐AndréBordeaux University Hospital‐CHUBordeauxFrance
| | - Tiphaine Lambert
- Department of Drug Development and Innovation (D3i)Paris‐Saclay UniversityInstitut CurieParis & Saint‐CloudFrance
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i)Paris‐Saclay UniversityInstitut CurieParis & Saint‐CloudFrance
| | - Frédéric Peyrade
- Department of Medical OncologyCentre Antoine LacassagneNiceFrance
| | | | - Marc Alfonsi
- Department of Radiation OncologyClinique Sainte CatherineAvignonFrance
| | - Jérôme Fayette
- Department of Medical OncologyLéon Bérard CenterUniversity of LyonLyonFrance
| | - Juliette Reure
- Department of Medical OncologyLéon Bérard CenterUniversity of LyonLyonFrance
| | - Florence Huguet
- Department of Radiation OncologyTenon HospitalParis Sorbonne Université, Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Nicolas Fakhry
- Department of Otorhinolaryngology ‐ Head and Neck SurgeryAP‐HMAix‐Marseille UniversityFrance
| | - Clémence Toullec
- Department of Medical OncologyClinique Sainte CatherineAvignonFrance
| | - Sébastien Salas
- Department of Medical OncologyCHU la TimoneAP‐HMMarseilleFrance
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9
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Taïeb J, André T, El Hajbi F, Barbier E, Toullec C, Kim S, Bouche O, Di Fiore F, Chauvenet M, Perrier H, Evesque L, Laurent-Puig P, Emile JF, Bez J, Lepage C, Tougeron D. Avelumab versus standard second line treatment chemotherapy in metastatic colorectal cancer patients with microsatellite instability: The SAMCO-PRODIGE 54 randomised phase II trial. Dig Liver Dis 2021; 53:318-323. [PMID: 33359404 DOI: 10.1016/j.dld.2020.11.031] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/26/2020] [Indexed: 12/11/2022]
Abstract
Immune checkpoint inhibitors have failed in treating metastatic colorectal cancer (mCRC) patients except those with dMMR/MSI tumors. However, until very recently we had only non-comparative promising data in this population with anti-programmed cell death 1/ programmed cell death ligand 1 (PD1/PD-L1) antibodies alone or combined with anti- cytotoxic T-lymphocyte-associated protein 4 (CTLA4) antibodies. This comparative phase II trial (NCT03186326), conducted in more than 100 centers in France, will include dMMR/MSI mCRC patients with progression after a first-line treatment with chemotherapy ± targeted therapies, to evaluate efficacy and safety of the anti-PDL1 Avelumab versus a standard second-line treatment. Main inclusion criteria were patients aged 18 to 75 years, ECOG performance status ≤2, dMMR/MSI mCRC and failure of a standard first-line regimen. Patient will be randomised to receive Avelumab 10 mg/kg versus standard second-line doublet chemotherapy plus a targeted agent according to tumor RAS status. Patients will be followed for 4 years. A gain of 5 months in median PFS is expected in favour of the Avelumab arm (12 vs 7 months; HR=0.58). Secondary endpoints include objective response rate, overall survival, quality of life and toxicity. In addition, circulating tumour DNA and microbiota will be explored to test their potential prognostic and predictive values. The study was opened in March 2018.
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Affiliation(s)
- Julien Taïeb
- Assistance Publique - Hôpitaux de Paris, European Georges Pompidou hospital, Department of oncology, Paris France; Centre de Recherche des Cordeliers, INSERM, CNRS, Sorbonne Université, USPC, Université de Paris, Equipe labellisée Ligue Nationale contre le cancer, Paris, France.
| | - Thierry André
- Sorbonne Université and Hôpital Saint Antoine, Paris, France
| | - Farid El Hajbi
- Service de cancérologie Digestive et Urologique, centre Oscar Lambret, Lille, France
| | - Emilie Barbier
- Fédération Francophone de Cancérologie Digestive, EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon, France
| | | | - Stefano Kim
- Service d'oncologie CHU Jean Minjoz, Besancon, France
| | - Olivier Bouche
- Unité de Médecine Ambulatoire-Cancérologie, CHU Robert Debre, Reims, France
| | | | - Marion Chauvenet
- Service d'hépato-gastro-entérologie, CHU Lyon Sud, Hospices civils de Lyon, France
| | - Hervé Perrier
- Service d'Oncologie, Hôpital Saint Joseph, Marseille, France
| | - Ludovic Evesque
- Service d'Oncologie, Centre Antoine Lacassagne, Nice, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, INSERM, CNRS, Sorbonne Université, USPC, Université de Paris, Equipe labellisée Ligue Nationale contre le cancer, Paris, France; Assistance Publique - Hôpitaux de Paris, Department of Biology, European George Pompidou hospital
| | - Jean-François Emile
- EA4340, Pathology department and INSERM, Ambroise Pare Hospital, Boulogne, France
| | - Jérémie Bez
- Fédération Francophone de Cancérologie Digestive, EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon, France
| | - Côme Lepage
- Fédération Francophone de Cancérologie Digestive, EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon, France; Department of digestive oncology University hospital Dijon, University of Burgundy and Franche Comté, Dijon, France
| | - David Tougeron
- Gastroenterology Department and Medical Oncology Department, Poitiers University Hospital, Poitiers, France
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Saada E, Koudou Y, Daste A, Fayette J, Lefebvre G, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminsky-Forrett MC, Johnson A, Vauleon E, Ebran N, Schmidt M, Texier M, Peyrade F, Milano G, Guigay J, Even C, Etienne-Grimaldi MC. 946P Germinal immunogenetics and response to nivolumab in recurrent/metastatic head and neck squamous cell carcinoma (RM HNSCC) patients (pts): TopNIVO ancillary study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Even C, Daste A, Fayette J, Lefebvre G, Saada-Bouzid E, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminski M, Johnson A, Vauleon E, Le Tourneau C, Sire C, Prevost A, Jallut I, Bourhis J, Guigay J, Aupérin A, Texier M. 917MO TOPNIVO - A safety study of nivolumab in patients with recurrent and/or metastatic platinum-refractory squamous cell carcinoma of head and neck (R/M SCCHN): Final analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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de Nonneville A, Toullec C, Blay JY, Ranchere D, Stoeckle PE, Italiano A, Bonvalot S, Terrier AP, Duffaud F, Bertucci F, Cupissol D, Isambert N, Piperno Neumann S, Coindre JM, Salas S. Patients with primary localized high-grade sarcomas of the digestive tract excluding GIST : a retrospective study from the French sarcoma group. Acta Gastroenterol Belg 2017; 80:481-486. [PMID: 29560643] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The natural history of localized high-grade sarcomas of the digestive tract (SDT) excluding GIST has been rarely considered owing to their low incidence and heterogeneity. We describe the histoclinical characteristics of SDT and correlate them with patients' outcomes. METHODS We retrospectively collected medical files from a European database covering connective tissue tumors listed in Europe for about twenty years. Only untreated localized primary high-grade SDT were included. A central histological review was performed for each case. Patients' characteristics were compared and correlated with clinical outcomes. RESULTS A total of 45 patients were identified. Leiomyosarcomas (LMS) and undifferentiated sarcomas (UDS) were predominant, the former having better overall survival (OS) and progressionfree survival (PFS) while the latter having a worse outcome than the other histological types. Complete remission was obtained in 34 patients (75%) and was associated with male sex, age over 40 years and monofocal tumor. Complete surgery and LMS histology were associated with a better prognosis without any significant difference in baseline characteristics or in treatment modalities. CONCLUSION Complete surgery and histological type seem to be prognostic indicators of SDT. These results suggest the importance of treating these patients in a reference center.
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Affiliation(s)
- A de Nonneville
- APHM, Hôpital de la Timone, Department of Medical Oncology, Marseille, France
- Aix Marseille Univ, Marseille, France
| | - C Toullec
- APHM, Hôpital de la Timone, Department of Medical Oncology, Marseille, France
| | - J Y Blay
- Centre Léon Bérard, Department of Medicine, Lyon, France
| | - D Ranchere
- Institut d'Hematologie et d'Oncologie Pediatrique, Lyon, France
| | - P E Stoeckle
- Department of Surgery, Institut Bergonie, Bordeaux, France
| | | | - S Bonvalot
- Institut Gustave Roussy, Villejuif, France
| | | | - F Duffaud
- APHM, Hôpital de la Timone, Department of Medical Oncology, Marseille, France
- Aix Marseille Univ, Marseille, France
| | - F Bertucci
- Aix Marseille Univ, Marseille, France
- Department of Medical Oncology, Institut Paoli-Calmettes, CRCM; Marseille, France
| | - D Cupissol
- Department of Medical Oncology, Centre Val d'Aurelle, Montpellier, France
| | - N Isambert
- Centre Georges-François Leclerc, Dijon, France
| | | | | | - S Salas
- APHM, Hôpital de la Timone, Department of Medical Oncology, Marseille, France
- Aix Marseille Univ, Marseille, France
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