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Zaibet S, Hautefeuille V, Auclin E, Lièvre A, Tougeron D, Sarabi M, Gilabert M, Wasselin J, Edeline J, Artru P, Bechade D, Morin C, Ducoulombier A, Taieb J, Pernot S. Gemcitabine + Nab-paclitaxel or Gemcitabine alone after FOLFIRINOX failure in patients with metastatic pancreatic adenocarcinoma: a real-world AGEO study. Br J Cancer 2022; 126:1394-1400. [PMID: 35094032 PMCID: PMC9091233 DOI: 10.1038/s41416-022-01713-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/20/2021] [Accepted: 01/20/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Gemcitabine (Gem) alone or with Nab-paclitaxel (Gem-Nab) is used as second-line treatment for metastatic pancreatic adenocarcinoma (mPA) after FOLFIRINOX (FFX) failure; however, no comparative data exist. This study evaluates the efficacy and safety of adding Nab-paclitaxel to Gem for mPA after FFX failure. METHODS In this retrospective real-world multicenter study, from 2011 to 2019, patients with mPA receiving Gem-Nab (Gem 1000 mg/m² + Nab 125 mg/m², 3 out of 4 weeks) or Gem alone were included after progression on FFX. RESULTS A total of 427 patients were included. Patients receiving Gem-Nab had more metastatic sites, peritoneal disease and less PS 2 (24% vs. 35%). After median follow-up of 22 months, Gem-Nab was associated with better disease control rate (DCR) (56% vs. 32%; P < 0.001), progression-free survival (PFS) (3.5 vs. 2.3 months; 95% CI: 0.43-0.65) and overall survival (OS) (7.1 vs. 4.7 months; 95% CI: 0.53-0.86). After multivariate analysis, Gem-Nab and PS 0/1 were associated with better OS and PFS. Grade 3/4 toxicity was more frequent with Gem-Nab (44% vs. 29%). CONCLUSION In this study, Gem-Nab was associated with better DCR, PFS and OS compared with Gem alone in patients with mPA after FFX failure, at the cost of higher toxicity.
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Affiliation(s)
- Sonia Zaibet
- Department of Hepato-Gastroenterology and Gastrointestinal Oncology, Hôpital Européen Georges Pompidou, Université de Paris, SIRIC CARPEM Comprehensive Cancer Center, Paris, France
| | - Vincent Hautefeuille
- Department of Hepato-Gastroenterology and Gastrointestinal Oncology, CHU Amiens Picardie, Amiens, France
| | - Edouard Auclin
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Université de Paris, SIRIC CARPEM Comprehensive Cancer Center, Paris, France
- INSERM, UMR 1138, team 22, Centre de Recherche des Cordeliers, Université de Paris, Paris, France
| | - Astrid Lièvre
- Department of Gastroenterology, CHU Rennes, INSERM U1242, Rennes, France
| | - David Tougeron
- Department of Hepato-Gastroenterology, CHU Poitiers, Poitiers, France
| | - Mathieu Sarabi
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Marine Gilabert
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Julie Wasselin
- Department of Hepato-Gastroenterology and Gastrointestinal Oncology, CHU Amiens Picardie, Amiens, France
| | - Julien Edeline
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Pascal Artru
- Department of Hepato-Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France
| | | | - Clémence Morin
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Julien Taieb
- Department of Hepato-Gastroenterology and Gastrointestinal Oncology, Hôpital Européen Georges Pompidou, Université de Paris, SIRIC CARPEM Comprehensive Cancer Center, Paris, France
| | - Simon Pernot
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France.
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2
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Zaibet S, Hautefeuille V, Auclin E, Lièvre A, Tougeron D, Sarabi M, Gilabert M, Wasselin J, Edeline J, Artru P, Bechade D, Morin C, Ducoulombier A, Taieb J, Pernot S. Correction to: Gemcitabine + Nab-paclitaxel or Gemcitabine alone after FOLFIRINOX failure in patients with metastatic pancreatic adenocarcinoma: a real-world AGEO study. Br J Cancer 2022; 126:969. [PMID: 35149856 DOI: 10.1038/s41416-022-01734-5] [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: 11/09/2022] Open
Affiliation(s)
- Sonia Zaibet
- Department of Hepato-Gastroenterology and Gastrointestinal Oncology, Hôpital Européen Georges Pompidou, Université de Paris, SIRIC CARPEM Comprehensive Cancer Center, Paris, France
| | - Vincent Hautefeuille
- Department of Hepato-Gastroenterology and Gastrointestinal Oncology, CHU Amiens Picardie, Amiens, France
| | - Edouard Auclin
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Université de Paris, SIRIC CARPEM Comprehensive Cancer Center, Paris, France.,INSERM, UMR 1138, team 22, Centre de Recherche des Cordeliers, Université de Paris, Paris, France
| | - Astrid Lièvre
- Department of Gastroenterology, CHU Rennes, INSERM U1242, Rennes, France
| | - David Tougeron
- Department of Hepato-Gastroenterology, CHU Poitiers, Poitiers, France
| | - Mathieu Sarabi
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Marine Gilabert
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Julie Wasselin
- Department of Hepato-Gastroenterology and Gastrointestinal Oncology, CHU Amiens Picardie, Amiens, France
| | - Julien Edeline
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Pascal Artru
- Department of Hepato-Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France
| | | | - Clémence Morin
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Julien Taieb
- Department of Hepato-Gastroenterology and Gastrointestinal Oncology, Hôpital Européen Georges Pompidou, Université de Paris, SIRIC CARPEM Comprehensive Cancer Center, Paris, France
| | - Simon Pernot
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France.
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3
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Bechade D, Bellera CA, Cantarel C, Soubeyran I, Debled M, Chomy F, Roubaud G, Fonck M, Cazeau AL. Diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the evaluation of hypermetabolic lymphadenopathy mediastinum lower, posterior, and middle, detected by PET-CT with 18F-FDG (PET) (APOGEE Study). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
798 Background: In the context of a new cancer or relapse, the high sensitivity (Se) (95-100%) of PET-CT with 18F-FDG can lead to the demonstration of hypermetabolic mediastinal adenopathies. Its lower specificity (Sp) (89%) can require histological examination. We report the results of a prospective, single-center study evaluating the diagnostic performance of EUS-FNA in this indication. Methods: Prospective single-center study featuring patients in whom PET had revealed hypermetabolic mediastinal lymphadenopathy requiring diagnostic certainty. All EUS-FNA were performed with a 19-gauge needle (EchoTip, Cook Endoscopy). Main objective: To evaluate the diagnostic performance in terms of Se and Sp of EUS-FNA in the characterization of hypermetabolic mediastinal adenopathies in PET in the context of a new cancer or relapse. Secondary objectives: To evaluate the negative predictive value (NPV) of the EUS-FNA and to evaluate the percentage of surgical diagnostic procedures avoided. The standard technique was a thoraco-abdominopelvic CT scan at 6 months and at 12 months. Results: 52 patients were eligible and evaluable for the primary endpoint. The most common primary cancers were mammary (17.3%) and bronchial (13.5%). The lymph nodes were analyzed as malignant in 44.2% of cases, benign in 50% of cases and atypical or suspicious in 3.8% of cases. The malignant lymph nodes were metastatic for breast cancer in 21.7% of cases, bronchial cancer in 17.4% of cases, colorectal cancer in 17.4% of cases and prostate cancer in 13% of cases. The Se of the EUS-FNA was 92% (95% CI 0.74-0.99) and the Sp 100%. NPV was 87% (95% CI: 0.59-0.98). A diagnostic surgical procedure was necessary in 2% of the cases. PET and EUS-FNA often allowed the modification of the therapeutic strategy. Conclusions: When a confirmed diagnosis is required, the diagnostic accuracy of the minimally invasive procedure of EUS-FNA, is sufficiently robust to avoid a surgical diagnosis technique. The combination of PET and EUS-FNA may alter the therapeutic strategy that would have been considered after PET alone. Clinical trial information: NCT01892501.
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Affiliation(s)
| | - Carine A. Bellera
- INSERM CIC 14.01 Bordeaux, Clinical Epidemiology Unit, Bordeaux, France
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4
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Williet N, Saint A, Pointet AL, Tougeron D, Pernot S, Pozet A, Bechade D, Trouilloud I, Lourenco N, Hautefeuille V, Locher C, Desrame J, Artru P, Thirot Bidault A, Le Roy B, Pezet D, Phelip JM, Taieb J. Folfirinox versus gemcitabine/nab-paclitaxel as first-line therapy in patients with metastatic pancreatic cancer: a comparative propensity score study. Therap Adv Gastroenterol 2019; 12:1756284819878660. [PMID: 31598136 PMCID: PMC6764033 DOI: 10.1177/1756284819878660] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/16/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Folfirinox (FFX) and gemcitabine/nab-paclitaxel (GN) are both standard first-line treatments in patients with metastatic pancreatic cancer (mPC). However, data comparing these two chemotherapeutic regimens and their sequential use remain scarce. METHODS Data from two independent cohorts enrolling patients treated with FFX (n = 107) or GN (n = 109) were retrospectively pooled. Primary endpoint was overall survival (OS). Progression-free survival (PFS) was the secondary endpoint. A propensity score based on age, gender, performance status (PS), and presence of liver metastases was used to make groups comparable. RESULTS In the whole study population, OS was significantly higher in FFX (14 months; 95% CI: 10-21) than in GN groups (9 months; 95% CI: 8-12) before (p = 0.008) and after (p = 0.021) adjusting for age, number of metastatic sites, liver metastases, peritoneal carcinomatosis and CA19.9 level at baseline. PFS tends to be higher in FFX (6 months) than GN groups (5 months; p = 0.053). After matching (n = 49/group), patients were comparable for all baseline characteristics including PS. In the matched population, there was a trend toward greater OS in patients treated with FFX (HR = 0.67; p = 0.097). However, survival in each group was not solely a result of the first-line regimen. The proportion of patients who were fit for GN after FFX failure (FFX-GN sequence) was higher (46.9%) than the reverse sequence (20.4%; p = 0.01), which suggests a higher feasibility for the FFX-GN sequence. Corresponding median OS were 19 months versus 9.5 months, respectively (p = 0.094). CONCLUSION This study shows greater OS with FFX than with GN in patients with mPC. GN after FFX failure appears more feasible than the reverse sequence.
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Affiliation(s)
| | - Angélique Saint
- Department of Medical Oncology, Antoine
Lacassagne Center, Nice, France
| | - Anne-Laure Pointet
- Department of Gastroenterology and
Gastro-intestinal Oncology, Hôpital Européen Georges-Pompidou, APHP, Paris
Descartes University, Sorbonne Paris Cité, Paris, France
| | - David Tougeron
- Department of Gastroenterology, Poitiers
University Hospital, Poitiers, France
| | - Simon Pernot
- Department of GI Oncology, Hôpital Européen
Georges-Pompidou, APHP, Paris Descartes University, Sorbonne Paris Cité,
Paris, France
| | - Astrid Pozet
- Methodology and Quality of Life in Oncology Unit
(INSERM UMR 1098), University Hospital of Besançon, Besançon, France
| | | | | | - Nelson Lourenco
- Gastroenterology Unit, Saint-Louis Teaching
Hospital, Paris, France
| | - Vincent Hautefeuille
- Department of Gastroenterology, Amiens-Picardie
University Hospital, Amiens, France
| | | | - Jérome Desrame
- Department of Oncology, Hôpital Privé Jean
Mermoz, Lyon, France
| | - Pascal Artru
- Department of Oncology, Hôpital Privé Jean
Mermoz, Lyon, France
| | - Anne Thirot Bidault
- Department of Gastroenterology, Hôpital Kremlin
Bicêtre, Le Kremlin-Bicêtre, Paris, France
| | - Bertrand Le Roy
- Department of Digestive and Hepatobiliary
Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez,
France
| | - Denis Pezet
- Department of Digestive and Hepatobiliary
Surgery, University Hospital of Clermont-Ferrand, Clermont-Ferrand,
France
| | - Jean-Marc Phelip
- Department of Hepatogastroenterology,
University Hospital of Saint-Etienne, Saint-Etienne, France,EA 7425 HESPER, Health Services and Performance
Research, Claude Bernard Lyon 1 University, Lyon, France
| | - Julien Taieb
- Department of Gastroenterology and
Gastro-intestinal Oncology, Hôpital Européen Georges-Pompidou, APHP, Paris
Descartes University, Sorbonne Paris Cité, Paris, France
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5
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Tomé M, Pappalardo A, Soulet F, López JJ, Olaizola J, Leger Y, Dubreuil M, Mouchard A, Fessart D, Delom F, Pitard V, Bechade D, Fonck M, Rosado JA, Ghiringhelli F, Déchanet-Merville J, Soubeyran I, Siegfried G, Evrard S, Khatib AM. Inactivation of Proprotein Convertases in T Cells Inhibits PD-1 Expression and Creates a Favorable Immune Microenvironment in Colorectal Cancer. Cancer Res 2019; 79:5008-5021. [PMID: 31358531 DOI: 10.1158/0008-5472.can-19-0086] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/27/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022]
Abstract
Proprotein convertases (PC) activate precursor proteins that play crucial roles in various cancers. In this study, we investigated whether PC enzyme activity is required for expression of the checkpoint protein programmed cell death protein 1 (PD-1) on cytotoxic T lymphocytes (CTL) in colon cancer. Although altered expression of the PC secretory pathway was observed in human colon cancers, only furin showed highly diffuse expression throughout the tumors. Inhibition of PCs in T cells using the general protein-based inhibitor α1-PDX or the pharmacologic inhibitor Decanoyl-Arg-Val-Lys-Arg-chloromethylketone repressed PD-1 and exhausted CTLs via induction of T-cell proliferation and apoptosis inhibition, which improved CTL efficacy against microsatellite instable and microsatellite stable colon cancer cells. In vivo, inhibition of PCs enhanced CTL infiltration in colorectal tumors and increased tumor clearance in syngeneic mice compared with immunodeficient mice. Inhibition of PCs repressed PD-1 expression by blocking proteolytic maturation of the Notch precursor, inhibiting calcium/NFAT and NF-κB signaling, and enhancing ERK activation. These findings define a key role for PCs in regulating PD-1 expression and suggest targeting PCs as an adjunct approach to colorectal tumor immunotherapy. SIGNIFICANCE: Protein convertase enzymatic activity is required for PD-1 expression on T cells, and inhibition of protein convertase improves T-cell targeting of microsatellite instable and stable colorectal cancer. GRAPHICAL ABSTRACT: http://cancerres.aacrjournals.org/content/canres/79/19/5008/F1.large.jpg.
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Affiliation(s)
- Mercedes Tomé
- Université Bordeaux, Bordeaux, France.
- INSERM UMR1029, Pessac, France
| | - Angela Pappalardo
- ImmunoConcept, CNRS UMR 5164, University of Bordeaux, Bordeaux, France
| | - Fabienne Soulet
- Université Bordeaux, Bordeaux, France
- INSERM UMR1029, Pessac, France
| | - José Javier López
- Department of Physiology, Veterinary Faculty, University of Extremadura, Caceres, Spain
| | - Jone Olaizola
- Université Bordeaux, Bordeaux, France
- INSERM UMR1029, Pessac, France
| | - Yannick Leger
- Université Bordeaux, Bordeaux, France
- INSERM UMR1029, Pessac, France
| | | | - Amandine Mouchard
- Université Bordeaux, Bordeaux, France
- Institut Bergonié, Bordeaux, France
| | - Delphine Fessart
- Institut Bergonié, Bordeaux, France
- INSERM U1218, ACTION, Bordeaux, France
| | - Frédéric Delom
- Institut Bergonié, Bordeaux, France
- INSERM U1218, ACTION, Bordeaux, France
| | - Vincent Pitard
- ImmunoConcept, CNRS UMR 5164, University of Bordeaux, Bordeaux, France
| | | | | | - Juan Antonio Rosado
- Department of Physiology, Veterinary Faculty, University of Extremadura, Caceres, Spain
| | | | | | | | | | - Serge Evrard
- Université Bordeaux, Bordeaux, France
- INSERM UMR1029, Pessac, France
- Institut Bergonié, Bordeaux, France
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6
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Lafon M, Blaye C, Kind M, Bechade D, Chassaigne F, Italiano A, Grellety T. Sarcoidosis-like reaction in metastatic triple negative breast cancer treated by anti-PD-L1. Breast J 2019; 25:971-973. [PMID: 31165561 DOI: 10.1111/tbj.13386] [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] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 03/28/2019] [Accepted: 04/15/2019] [Indexed: 11/26/2022]
Abstract
We report the first case of sarcoidosis-like reaction in a patient treated by anti-PD-L1 for a breast cancer. A 69-year-old woman presented with a histologically confirmed lung metastasis of a triple negative breast cancer. She was treated by nab-paclitaxel plus anti-PD-L1 in first line. After 2 months, a dramatic lung response was noticed but an involvement of mediastinal lymph nodes appeared. Endoscopic ultrasound-guided fine-needle aspiration of these lymph nodes revealed multiple epitheloid granulomas without caseating necrosis in favour of a sarcoidosis-like reaction. The patient remained free of symptom and in complete lung response on anti-PD-L1 treatment as a maintenance therapy.
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Affiliation(s)
- Mathilde Lafon
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Celine Blaye
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Michele Kind
- Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, Bordeaux, France
| | - Dominique Bechade
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, Bordeaux, France
| | - Florence Chassaigne
- Department of Pathology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, Bordeaux, France
| | - Antoine Italiano
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Thomas Grellety
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, Bordeaux, France.,University of Bordeaux, Bordeaux, France
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7
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Aparicio T, Ducreux M, Faroux R, Barbier E, Manfredi S, Lecomte T, Etienne PL, Bedenne L, Bennouna J, Phelip JM, François E, Michel P, Legoux JL, Gasmi M, Breysacher G, Rougier P, De Gramont A, Lepage C, Bouché O, Seitz JF, Adenis A, Alessio A, Aouakli A, Azzedine A, Bedjaoui A, Bidault A, Blanchi A, Botton A, Cadier-Lagnes A, Fatisse A, Gagnaire A, Gilbert A, Gueye A, Hollebecque A, Lemaire A, Mahamat A, Marre A, Patenotte A, Rotenberg A, Roussel A, Thirot-Bidault A, Votte A, Weber A, Zaanan A, Dupont-Gossart A, Villing A, Queuniet A, Coudert B, Denis B, Garcia B, Lafforgue B, Landi B, Leduc B, Linot B, Paillot B, Rhein B, Winkfield B, Barberis C, Becht C, Belletier C, Berger C, Bineau C, Borel C, Brezault C, Buffet C, Cornila C, Couffon C, De La Fouchardière C, Giraud C, Lecaille C, Lepere C, Lobry C, Locher C, Lombard-Bohas C, Paoletti C, Platini C, Rebischung C, Sarda C, Vilain C, Briac-Levaché C, Auby D, Baudet-Klepping D, Bechade D, Besson D, Cleau D, Festin D, Gargot D, Genet D, Goldfain D, Luet D, Malka D, Peré-Vergé D, Pillon D, Sevin-Robiche D, Smith D, Soubrane D, Tougeron D, Zylberait D, Carola E, Cuillerier E, Dorval Danquechin E, Echinard E, Janssen E, Maillard E, Mitry E, Norguet-Monnereau E, Suc E, Terrebonne E, Zrihen E, Pariente E, Almaric F, Audemar F, Bonnetain F, Desseigne F, Dewaele F, Di Fiore F, Ghiringhelli F, Husseini F, Khemissa F, Kikolski F, Morvan F, Petit-Laurent F, Riot F, Subtil F, Zerouala-Boussaha F, Caroli-Bosc F, Boilleau-Jolimoy G, Bordes G, Cavaglione G, Coulanjon G, Deplanque G, Gatineau-Saillant G, Goujon G, Medinger G, Roquin G, Brixi-Benmansour H, Castanie H, Lacroix H, Maechel H, Perrier H, Salloum H, Senellart H, Baumgaertner I, Cumin I, Graber I, Trouilloud I, Boutin J, Butel J, Charneau J, Cretin J, Dauba J, Deguiral J, Egreteau J, Ezenfis J, Forestier J, Goineau J, Lacourt J, Lafon J, Martin J, Meunier J, Moreau J, Provencal J, Taieb J, Thaury J, Tuaillon J, Vergniol J, Villand J, Vincent J, Volet J, Bachet J, Barbare J, Souquet J, Grangé J, Dor J, Paitel J, Jouve J, Raoul J, Cheula J, Gornet J, Sabate J, Vantelon J, Vaillant J, Aucouturier J, Barbieux J, Herr J, Lafargue J, Lagasse J, Latrive J, Plachot J, Ramain J, Robin J, Spano J, Douillard J, Beerblock K, Bouhier-Leporrier K, Slimane Fawzi K, Cany L, Chone L, Dahan L, Gasnault L, Rob L, Stefani L, Wander L, Baconnier M, Ben Abdelghani M, Benchalal M, Blasquez M, Carreiro M, Charbit M, Combe M, Duluc M, Fayolle M, Gignoux M, Giovannini M, Glikmanas M, Mabro M, Mignot M, Mornet M, Mousseau M, Mozer M, Pauwels M, Pelletier M, Porneuf M, Ramdani M, Schnee M, Tissot M, Zawadi M, Clavero-Fabri M, Gouttebel M, Kaminsky M, Galais M, Abdelli N, Barrière N, Bouaria N, Bouarioua N, Delas N, Gérardin N, Hess-Laurens N, Stremsdoerfer N, Berthelet O, Boulat O, Capitain O, Favre O, Amoyal P, Bergerault P, Burtin P, Cassan P, Chatrenet P, Chiappa P, Claudé P, Couzigou P, Feydy P, Follana P, Geoffroy P, Godeau P, Hammel P, Laplaige P, Lehair P, Martin P, Novello P, Pantioni P, Pienkowski P, Pouderoux P, Prost P, Ruszniewski P, Souillac P, Texereau P, Thévenet P, Haineaux P, Benoit R, Coriat R, Lamy R, Mackiewicz R, Beorchia S, Chaussade S, Hiret S, Jacquot S, Lavau Denes S, Montembault S, Nahon S, Nasca S, Nguyen S, Oddou-Lagraniere S, Pesque-Penaud S, Fratte S, Chatellier T, Mansourbakht T, Morin T, Walter T, Boige V, Bourgeois V, Derias V, Guérin-Meyer V, Hautefeuille V, Jestin Le Tallec V, Lorgis V, Quentin V, Sebbagh V, Veuillez V, Adhoute X, Coulaud X, Becouarn Y, Coscas Y, Courouble Y, Le Bricquir Y, Molin Y, Rinaldi Y, Lam Y, Ladhib Z. Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials. Eur J Cancer 2018; 98:1-9. [DOI: 10.1016/j.ejca.2018.03.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 02/07/2023]
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8
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Pointet AL, Tougeron D, Pernot S, Pozet A, Bechade D, Trouilloud I, Lourenco N, Hautefeuille V, Locher C, Williet N, Desrame J, Thirot Bidault A, Pezet D, Taieb J. Three fluoropyrimidine-based regimens in second-line therapy following nab-paclitaxel plus gemcitabine in metastatic pancreatic cancer: Efficacy and tolerance in clinical practice. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
370 Background: Combination of nab-paclitaxel plus gemcitabine (N+G) has recently become a valid first-line treatment (1L) in metastatic pancreatic adenocarcinoma (MPA) in patients (pts) with performance status (PS) of 0,1 or 2, but there is currently no standard second-line treatment (2L) after this new 1L option. We evaluated survival outcomes and tolerability of three usual fluoropyrimidine-based regimens: FOLFOX, FOLFIRI or FOLFIRI.3 (FOLFIRI1/3), and FOLFIRINOX after N+G failure in MPA pts. Methods: We prospectively identified 138 pts from 11 French centers who received 1L N+G for unresectable pancreatic adenocarcinoma. After disease progression or unacceptable toxicity, we excluded pts with locally advanced cancer, or who underwent secondary resection/chemoradiotherapy. Three subgroups of 2L chemotherapy were identified: FOLFOX, FOLFIRI1/3 and FOLFIRINOX regimens. Response was evaluated by RECIST criteria, progression-free survivals (PFS1, PFS2), and overall survival (OS1, OS2) were calculated using Kaplan-Meier method and compared with the Log-rank test. Results: 61 pts with MPA received a 2L. Persistent neuropathy was present in 27% of pts. Median age was 71.7 years [41-83]. PS was 0, 1 or 2. Median 1L duration, number of metastatic sites, PS, CA19.9, albumin, and bilirubin levels, and persistent neuropathy grade were statistically comparable between the 3 subgroups. Median OS for all 2L pts was 6.0 months [4-8]. Third line regimen was used in 32.8% of 2L pts without statistical significance between the subgroups. Main grade 3/4 adverse events reported were thrombocytopenia (18%), anemia (7.7%), neutropenia (21.4%) and nausea (5.4%). No toxic deaths occurred. Conclusions: This study suggests a clinical benefit and a manageable toxicity profile of 2L fluoropyrimidine-based regimens after N+G failure in patients with MPA, in particularly combined with irinotecan.[Table: see text]
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Affiliation(s)
| | | | - Simon Pernot
- Hôpital Européen Georges Pompidou, Paris, France
| | | | | | | | | | | | | | | | | | | | | | - Julien Taieb
- Sorbonne Paris Cité, Paris Descartes University, Georges Pompidou European Hospital, Paris, France
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9
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Desjardin M, Evrard S, Brouste V, Desolneux G, Fonck M, Bechade D, Bonhomme B, Becouarn Y. Parenchymal sparing surgery for colorectal liver metastases: The need for a common definition. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e15013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15013 Background: Colorectal cancer metastases (CRLM) are major public health issue. Recently, surgeons have advocated the use of parenchymal sparing surgery (PSS) however, a common definition of the concept is lacking.To clarify and try to validate the concept of PSS to treat CRLM through the available retrospectives studies, including ours. Methods: Retrospective analysis of a cohort of patients treated by combined resections and intra-operative ablation (IOA) based on PSS, prospectively recorded in a database from 2003 to 2015 in a regional referral cancer center. All the patients benefited from the same strategy, constituting a homogenous series.PSS consists of using resection or IOA in order to spare the healthy parenchyma. One-stage is favored over two-stage surgery and use of portal vein embolization was restricted to the minimum.Post-operative complications were the primary endpoint with a special focus on post-operative liver failure. Liver toxicities and overall survival were also scrutinized. Results: Three hundred and eighty-seven patients underwent a PSS out of which 348 patients received a median of 9 pre-operative cycles of oxaliplatin or irinotecan with targeted therapies for half of them. Resection was major in 128 patients, combined with IOA in 137 patients and IOA alone in 50 cases. Thirty-eight patients had a PVO by strict necessity. The 5yr-overall survival was 50.3%. Seventy-eight patients had a complication > grade 3 out of which 10 patients died. Nine patients had a liver failure (LF) grade B and C and four died. There was no difference in post-operative complications comparing minor and major resections, validating our PSS definition. Chemotherapy and liver toxicity were not related to more post-operative complications. Only one patient died from a primitive LF. Conclusions: With PSS, healthy liver is no more a target. Routine use of chemotherapy does not impair the results and severe LFs are rare. PSS is the optimal strategy to treat CRLM. Definition of PSS cannot be based just on the retrived volume but on the ratio Tumor burden/Healthy liver. A major hepatectomy can be a PSS and a minor may not be one. That is why PSS defintion must be clarify especially for further prospective validations.
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10
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Cousin S, Toulmonde M, Kind M, Cazeau AL, Bechade D, Coindre JM, Italiano A. Pulmonary sarcoidosis induced by the anti-PD1 monoclonal antibody pembrolizumab. Ann Oncol 2016; 27:1178-1179. [DOI: 10.1093/annonc/mdw125] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Alberti N, Buy X, Desjardin M, Al Ammari S, Cazzato RL, Bechade D, Desolneux G, Michot A, Palussiere J. Diaphragmatic Hernia After Lung Percutaneous Radiofrequency Ablation: Incidence and Risk Factors—Reply. Cardiovasc Intervent Radiol 2015; 39:318-9. [PMID: 26493823 DOI: 10.1007/s00270-015-1231-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 11/30/2022]
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12
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Desjardin M, Bonhomme B, Soubeyran I, Vara J, Fonck M, Becouarn Y, Desolneux G, Brouste V, Evrard S, Bechade D. An investigation of the role of irinotecan and oxaliplatin in liver toxicity during first-line neoadjuvant chemotherapy. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
689 Background: Neoadjuvant chemotherapy (CT) have been associated with an increased risk of surgery for colorectal liver metastases (CRLM). Irinotecan (IRI) is claimed to induce CT-associated steatohepatitis (CASH) and oxaliplatin (OX) to induce sinusoidal obstruction (SOS). Imputability is sometimes difficult to establish and the impact on postoperative complications is unclear. The objective of this study is to investigate the impact of IRI and OX on induced liver toxicity, and to study the effects of toxicity on surgical outcomes. Methods: Patients (Pts) who received only one line of CT before resection of CRLM were retrospectively included. CASH and SOS were described according to Kleiner and Rubbia-Brandt classifications respectively. Associations were sought between CASH or SOS and various patient and treatment factors, and between patient and treatment factors and the occurrence of post-operative complications grade 3 or over. Results: Among 379 pts operated on for CRLM from 2003 to 2013, 223 were eligible for inclusion; 57 were excluded as there was no healthy hepatic parenchyma to be analyzed. Median age was 64 y [34-88], BMI ≥25 kg/m² for 52%, 8% had diabetes, and 28% had a dyslipidemia. CRLM were synchronous in 76.5%. 65 (39.2%) received Folfox, 95 (57.2%) Folfiri and 6 (3.6%) Folfirinox. Bevacizumab, cetuximab and panitumumab were given in 71 (42.8%), 30 (17.5%), 4 (2.4%) respectively. Extra-hepatic resections were performed in 78 pts (47%). 90-day mortality was 1.8% and 31 pts encountered complications more severe than 3A. Histological hepatoxicity was established for 82 pts (49%) including 33 (19.9%) with grade 2 or 3 SOS and 22 (13%) with CASH. No significant associations were identified between SOS and OX, nor CASH and IRI. BMI ≥ 25 kg/m² was correlated with an increased risk of CASH. Only septic extra-hepatic surgeries were correlated with the prediction of postoperative complications. Conclusions: In this selected series, preoperative CT was not associated to liver toxicity. The presence of histological lesions did not worsen post-operative outcomes. BMI and extra-hepatic surgery were the only co-factors correlated with CASH and post-operative complications respectively.
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Alberti N, Bechade D, Dupuis F, Crombe A, Neuville A, Debled M, Palussiere J, Buy X, Perez JT, Desjardin M, Frulio N, Kind M. Hepar lobatum carcinomatosum associated with liver metastases from breast cancer: Report of five cases. Diagn Interv Imaging 2015; 96:73-8. [DOI: 10.1016/j.diii.2014.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tougeron D, Desseigne F, Etienne P, Dourthe L, Mineur L, Paule B, Hollebecque A, Tresch E, Spaeth D, Michel P, Dauba J, Laplaige P, Borg C, Bechade D, Clisant S, Phelip J, De Fouchardiere C, André T, Adenis A. Rebecca: a Large Cohort Study of Regorafenib (Reg) in the Real-Life Setting in Patients (Pts) Previously Treated for Metastatic Colorectal Cancer (Mcrc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.104] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Desolneux G, Maziere C, Fonck M, Bechade D, Becouarn Y, Vara J, Brouste V, Lalet C, Evrard S. Colorectal peritoneal carcinomatosis treated by completed surgery plus systemic chemotherapy: Futility of HIPEC? J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e14513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Marianne Fonck
- Comprehensive Cancer Center, Institut Bergonié, Bordeaux, France
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Alberti N, Ferretti G, Buy X, Desjardin M, Al Ammari S, Cazzato RL, Monnin-Bares V, Bechade D, Desolneux G, Michot A, Palussiere J. Diaphragmatic hernia after lung percutaneous radiofrequency ablation: incidence and risk factors. Cardiovasc Intervent Radiol 2014; 37:1516-22. [PMID: 24519640 DOI: 10.1007/s00270-014-0854-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/12/2014] [Indexed: 01/20/2023]
Abstract
PURPOSE To evaluate diaphragmatic hernias (DH) after percutaneous radiofrequency ablation (PRFA) for basal lung nodules and to detect risk factors. MATERIALS AND METHODS Between January 2009 and December 2012, the presence of DH was retrospectively recorded in all of the patients who underwent PRFA with multitine expandable electrodes for ablation of nodules in the lower lobe. All nodules were classified into three groups according to the location of the tines after deployment relative to the diaphragm: In group 1, the tines were at a distance of >1 cm from the diaphragm; in group 2, at least one tine was in contact with the diaphragm without perforation; and in group 3, at least one tine was perforating the diaphragm. RESULTS We recorded 4 cases of DH (3 on the left side, 1 on the right side) in 156 patients (2.3% of procedures). The delay of onset was 7.8 months. DH occurred in groups 2 (n = 1) and 3 (n = 3). Only the 3 cases that occurred on the left side were symptomatic (2 intussusceptions and 1 gastroesophageal reflux) and were surgically repaired. The electrode was positioned in the center of the diaphragm in all cases. CONCLUSION The central position of the electrode and the contact of at least one tine with the diaphragm after deployment seem to be a risk factor to develop DH.
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Affiliation(s)
- Nicolas Alberti
- Department of Interventional Radiology, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France,
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Becouarn Y, Maziere C, Brouste V, Desolneux G, Fonck M, Bechade D, Evrard S. Colorectal peritoneal carcinomatosis treated by completed surgery and systemic chemotherapy without HIPEC. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e14017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14017 Background: Cytoreductive peritoneal surgery (CPS) associated with hyperthermic peritoneal chemotherapy (HIPEC) has become the standard treatment for peritoneal carcinomatosis (PC) of colorectal origins. Nevertheless, if CPS efficacy is demonstrated, evidence supporting HIPEC role is lacking. Methods: Overall survival (OS), progression-free survival (PFS) and outcomes were analysed retrospectively for thirty consecutively included patients treated for colorectal PC with CPS and systemic chemotherapy only. Outcomes and morbidity of the treatment were compared to outcomes and morbidity in the literature following CPS + HIPEC treatments. Results: PCI indices ranged from 1-21 with a mean of 9. Median hospitalization duration was 15 days (range 5-51), and median intensive care unit stay was 1 day (range 0-7). There was no post-operative mortality. Seventeen complications were Grade 1 or 2 (Dindo & Clavien), and remaining 13 were Grade 3. Median follow up was 40.7 [95%CI: 15.1 – 66.3] months. Median OS was 30.7 months [95%CI: 12.65-48.66}]. OS estimates were 83% [95CI%: 63.9- 92.5] and 45% [95%CI: 23.7-64.4] at 1 year and 3 years respectively. Median PFS was 11.1 months [95%CI: 7.98-14.25]. PFS at one year was 43.2% [95%CI: 24.7-60.4]. Patients without any other metastases (n=17) had a median OS of 73.3 months [95%CI: 25.7-120.9], compared with median OS of 18.7 months [95%CI, 16.9-20.6] for patients with at least one liver or lung metastases (p=0.011). Conclusions: The results obtained for patients with colorectal PC treated by CPS and systemic chemotherapy compare favourably with series including HIPEC in the treatment. No mortality, shorter operation duration and hospitalization, less blood loss and transfusions, and no hematologic toxicity were observed.
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Affiliation(s)
| | | | | | | | - Marianne Fonck
- Comprehensive Cancer Center, Institut Bergonié, Bordeaux, France
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Robert J, Becouarn Y, Cany L, Pulido M, Dauba J, Beyssac R, Bechade D, Lalet C, Mathoulin-Pelissier S, Brunet R, Fonck M. Results of a phase II study assessing efficacy and tolerance of fluorouracil (FU), leucovorin, irinotecan, and bevacizumab (FOLFIRI + B) in first-line metastatic colorectal cancer (MCRC): The Omega Trial (NTC 00467142). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e14023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14023 Background: This phase II study evaluates efficacy and tolerance of FOLFIRI+B in first-line MCRC treatment and assesses several genetic polymorphisms as potential markers of treatment activity or toxicity. Methods: Adult patients (pts) with histologically-proven, non-resectable MCRC, ECOG≤2, were included in this two-stage Simon’s design requiring 61 evaluable pts. 14-day cycles consisted of B (5mg/kg), irinotecan (180mg/m²), bolus FU (400mg/m²) and leucovorin (400mg/m²) followed by a 46-hour infusion of FU (2400mg/m²). UGT1A1, thymidylate synthase and VEGFA promoter SNPs were assessed. Primary endpoint was response rate according to RECIST criteria. Results: Sixty-two pts (25 male) from 7 centers were enrolled between Jan07 – Aug09. Median age: 68 years (1st-3rd quartile : 60.4-75.4]); ECOG 0-1 (95.2%); primary tumor location was colon (85.4%) or rectum (14.6%). Principal MCRC locations were: liver (54 pts), lung (28 pts) or peritoneum (17 pts). All pts were evaluable for toxicity. 1058 cycles were administered, median of 13 (range 3-62). Grade 3/4 toxicities were: neutropenia 19.4%; no febrile neutropenia; diarrhea 11.3%; nausea-vomiting 1.6%. No hypertension, thrombotic events, proteinuria or gastrointestinal perforation were observed. 59/62 pts were evaluable for efficacy with 28 pts in PR (47.5%; 95%CI 34.3-60.9), 20 with SD (33.9%) and 11 in PD (18.6%). Median response duration: 9.5 months (range 2.7-20); median time to progression: 10.3 months (range 8.8-11.7); median overall survival (OS) 25.7 months (range 20.2-29.7). 11/59 unresectable pts could finally be resected. To date, three VEGFA polymorphisms have been identified and associations with OS tested. The common genotype of rs25648 is associated with better OS (HR: 0.277; 95%CI: 0.12-0.64). Conclusions: FOLFIRI+B has a good safety profile, is active, with a long median OS leading to resect 18.6% of initially unresectable pts. Genetic polymorphism rs25648 has currently been identified as a marker of better OS, and further analyses for potential UGT1A1 and thymidylate synthase markers are underway.
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Affiliation(s)
| | | | | | | | - Jérôme Dauba
- Centre Hospitalier Layné, Mont de Marsan, France
| | | | | | | | | | | | - Marianne Fonck
- Comprehensive Cancer Center, Institut Bergonié, Bordeaux, France
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Bordier L, Lecoules S, Carmoi T, Zyani M, Ficko C, Desrame J, Bechade D, Algayres JP. [Bone and articular lesions in a patient with chronic hepatopathy]. Rev Med Interne 2007; 29:577-8. [PMID: 17977625 DOI: 10.1016/j.revmed.2007.08.002] [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] [Received: 08/01/2007] [Accepted: 08/07/2007] [Indexed: 12/01/2022]
Affiliation(s)
- L Bordier
- Service d'endocrinologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
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Lecoules S, Blade JS, Bordier L, Desramé J, Coutant G, Bechade D, Algayres JP. [A spinal disease which causes toothache...]. Rev Med Interne 2005; 26 Suppl 2:S307-9. [PMID: 16129185 DOI: 10.1016/s0248-8663(05)81295-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Lecoules
- Clinique médicale, hôpital d'Instruction de Armées du Val-de-Grâce, Paris, France
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Desrame J, Lechevalier D, Bechade D, Teritehau C, Lecoules S, Raynaud JJ, Bladé JS, Damiano J, du Bourguet F, Coutant G, Algayres JP. Un antécédent difficile à digérer. Rev Med Interne 2004; 25 Suppl 2:S286-8. [PMID: 15460482 DOI: 10.1016/s0248-8663(04)80035-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J Desrame
- Clinique médicale, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
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Abstract
INTRODUCTION The authors report four cases of non Hodgkin's lymphomas (NHL) among patients infected by the hepatitis C virus (HCV). They discuss the epidemiological, physiopathological and clinical features of this association. CURRENT KNOWLEDGE AND KEY POINTS The role of the HCV in the development of B-cell NHL is probable but the reported frequency of the association with HCV infection is variable especially in different countries. Most of the reported cases are low-grade NHL with frequent extranodal involvement. FUTURE PROSPECTS AND PROJECTS New studies will improve the understanding of the physiopathological mechanisms that might explain the occurrence of NHL in the course of HCV infection. The recent evidence that the antiviral treatment is effective in splenic lymphoma with villous lymphocytes leads to reconsider the relationship between HCV and NHL and to think about new therapeutic possibilities.
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Affiliation(s)
- K Ennibi
- Service de médecine interne A, hôpital militaire d'instruction Mohammed V, Rabat, Maroc
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Delacour H, Desrame J, Bouhsain S, Bechade D, Lecoules S, Clerc Y. [A case of bisalbuminemia]. Ann Biol Clin (Paris) 2002; 60:719-22. [PMID: 12446240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- H Delacour
- Laboratoire de biochimie, toxicologie cliniques, Hôpital d'instruction des armées du Val de Grâce, 74 boulevard Port Royal 75005 Paris, France
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Karsenti D, Bechade D, Fallik D, Bili H, Desrame J, Coutant G, Algayres JP, Daly JP. [Small intestine bacterial overgrowth: six case reports and literature review]. Rev Med Interne 2001; 22:20-9. [PMID: 11218295 DOI: 10.1016/s0248-8663(00)00282-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Small intestinal bacterial overgrowth syndrome (SIBOS) has various clinical and biological presentations. Six observations are described in this review which is aimed at reporting recent data on SIBOS and proposing diagnosis and therapeutic attitudes. CURRENT KNOWLEDGE AND KEY POINTS Chronic diarrhea, malabsorption syndrome and exsudative enteropathy are the main criteria of diagnosis. Breath hydrogen testing is commonly performed to confirm diagnosis, with a 78% sensitivity and a 89% specificity. The aim of therapy is reparation of malabsorption consequences, reduction of intestinal bacterial overgrowth, and surgical correction of intestinal stasis. In the absence of consensus, norfloxacin or amoxicillin-clavulinic acid (administered for a mean of 7 to 15 days) seem the more appropriate antibiotics. When possible, surgery represents the primary treatment of SIBOS recurrences. FUTURE PROSPECTS AND PROJECTS Diagnosis of small intestinal bacterial overgrowth syndrome must be evoked on the basis of either surgical or medical context, i.e., the existence of chronic diarrhea, malabsorption syndrome (complete or not), and exsudative enteropathy. This review reports essential factors for diagnosis and treatment.
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Affiliation(s)
- D Karsenti
- Service de clinique médicale hôpital du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris, France.
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Coutant G, Bechade D, Mayaudon H, Moulin O, Algayres JP. [Association of sarcoidosis and multiple autoimmune syndrome]. Ann Med Interne (Paris) 2000; 151:519-20. [PMID: 11104935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Helie C, Bechade D, Texier F, Moulin O, Nizou J, Algayres J. Une fièvre bien peu exotique. Rev Med Interne 2000. [DOI: 10.1016/s0248-8663(00)89269-3] [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: 10/17/2022]
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Casassus-Builhe D, Chauveau E, Bechade D, Terrier F, Oddes B. [Systemic amyloidosis: localization in the gallbladder]. Presse Med 2000; 29:306. [PMID: 10719446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
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Bechade D, Algayres JP, Baranger B, Bili H, Edery J, Coutant G, Daly JP. [Symptomatic gastric diverticulum]. Gastroenterol Clin Biol 1999; 23:1258-60. [PMID: 10651537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Dourthe LM, Coutant G, Bechade D, Bili H, Algayres JP, Daly JP. [Postpartum thyroiditis: a silent entity]. Presse Med 1999; 28:339. [PMID: 10083878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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Raymond JM, Marquis P, Bechade D, Smith D, Mathiex Fortunet H, Poynard T, Galmiche JP, Amouretti M. [Assessment of quality of life of patients with gastroesophageal reflux. Elaboration and validation of a specific questionnaire]. Gastroenterol Clin Biol 1999; 23:32-9. [PMID: 10219602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
UNLABELLED Quality of life is frequently impaired in patients with gastro-esophageal reflux. The aim of this study was the validation of a new specific quality of life questionnaire in patients with gastro-esophageal reflux. METHODS A questionnaire was generated as follows: a) item generation with patients, b) item reduction, c) psychometric validation and comparison to a reference questionnaire (SF36) in patients with symptomatic gastro-esophageal reflux, d) assessment of reproducibility, and e) responsiveness over time. RESULTS The primary questionnaire was made of 104 items. Two hundred twenty three patients were enrolled, 38 items were selected in 7 dimensions. One item was deleted following a new analysis conducted in 349 patients. Cronbach coefficient ranged from 0.84 to 0.91 for the specific questionnaire and from 0.78 to 0.90 for the SF36 questionnaire. Dimensions of specific questionnaire and SF36 were correlated. Quality of life was more impaired in patients with more frequent symptoms. Severity of endoscopic lesions was partly correlated with impaired quality-of-life. Reproducibility and responsiveness over time were correct. The final valid questionnaire was made of 37 items in 7 dimensions. CONCLUSION This work is the first validation of a specific questionnaire in French which has the ability to measure quality of life in patients with gastro-esophageal reflux. The use of this questionnaire during therapeutic trials might allow to be more accurate in assessment of treatment efficacy.
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Bechade D, Blanc JF, Lescene R, Drouillard J, Oddes B. [Treatment of refractory hydrothorax with intrahepatic portosystemic shunt in the course of primary biliary cirrhosis]. Gastroenterol Clin Biol 1998; 22:743-5. [PMID: 9823569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Abstract
INTRODUCTION Empty sella syndrome is sometimes associated with anterior pituitary insufficiency, the latter being mostly partial or dissociated. EXEGESIS We report a case of a profound panhypopituitarism revealing an empty sella syndrome. This case shows that empty sella syndrome, although a generally benign and asymptomatic condition, can be associated with hypopituitarism. CONCLUSION In case of empty sella syndrome, especially if an endocrine dysfunction is clinically suspected, minimal hormonal analysis must be requested.
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Affiliation(s)
- P Schmoor
- Service de clinique médicale, hôpital d'instruction des armées du Val de-Grâce, Paris, France
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Desrame J, Bili H, Dourthe LM, Bronstein JA, Jean R, Bechade D, Coutant G, Algayres JP, Daly JP. Lymphome non hodgkinien primitif de la voie biliaire principale. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80159-8] [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: 11/30/2022]
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Coutant G, Algayres JP, Bili H, Bechade D, Cruel T, Daly JP. Syndrome hémophagocytaire révélateur d'un lymphome B. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80158-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ngo MD, Algayres JP, Baranger B, Bili H, Bechade D, Coutant G, Daly JP. [Biliary ileus preceded by hematemesis: role of the tomodensitometry assessment]. Gastroenterol Clin Biol 1998; 22:558-9. [PMID: 9762299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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36
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Algayres JP, Carsuzaa F, Coutant G, Bechade D, Bili H, Rapp C, Daly JP. Nocardiose cutanée du sujet immunocompétent. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Coutant G, Algayres JP, Ceccaldi B, Bili H, Bechade D, Daly JP. Syndrome d’arrêt des antiandrogènes au cours du cancer de la prostate métastatique. Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80012-4] [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: 10/18/2022]
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Zerbib F, Vialette G, Cayla R, Rudelli A, Sauvet P, Bechade D, Seurat PL, Lamouliatte H. [Follicular gastritis in adults. Relations with Helicobacter pylori, histological and endoscopic aspects]. Gastroenterol Clin Biol 1993; 17:529-534. [PMID: 8253308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Follicular gastritis (FG) is characterized by lymphoid follicle hyperplasia in the gastric mucosa. The aim of this prospective study was to determine the prevalence of FG in adults, their relation to Helicobacter pylori infection, and their histological and endoscopic features. Of 445 patients (379 men, 66 women), 36.4 years old (range: 18-86), FG was detected in 63 patients (14.2%). This was highly significantly associated with H. pylori infection: 49/138 infected patients (35.5%) versus 14/307 non infected patients (4.6%) (P < 0.001). None of the histological features of the antral mucosa were correlated with FG. The prevalence of FG in patients less than 20 years old (in 45.4%) and between 20 and 40 years (in 41.3%) was higher than in patients aged from 40 to 60 years (in 33%) and older than 60 years (in 23%) (no significant difference). No one endoscopic feature of the gastric mucosa was predictive of the presence of FG. We conclude that FG is highly correlated with H. pylori infection and represents a local immune response to bacterial antigens. Their occurrence is probably multifactorial and related to age, duration of infection, bacterial strains, host immune status.
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Affiliation(s)
- F Zerbib
- Service de Gastroentérologie, HIA Robert-Picqué, Bordeaux-Armées
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Aruin LI, Sarkisov DS, Lisenco OA, O’Connor H, Cunnane K, Queiroz DMM, Mendes EN, Rocha GA, Moura SB, Resende LMH, Cunha-Melo JR, Carvalho AST, Coelho LGV, Passos MCG, Castro LP, Oliveira CA, Lima GF, Barbosa AJA, Passos MCF, Castro P, Testino G, Perasso A, Boixeda D, de Argila CM, Vila T, Redondo C, Cantón R, Avila C, Alvarez-Baleriola I, de Rafael L, Witteman EM, Becx MCJM, De Koning RW, Silva JCP, Nogueira AMMF, Paulino E, Miranda CR, Rudelli A, Vialette G, Sevestre H, Capron D, Ducroix JP, Smail A, Baillet J, Zerbib F, Seurat PL, Sauvet P, Bechade D, Rapp N, Peacock JS, Marchildon P, Zamaniyan F, Bond-Green J, Liu P, Ciota L, Lee A, Coltro N, Chen M, Alhomsi M, Adeyemi E, Goodwin CS, Rizzi C, Maieron R, Desinan L, Avellini C, Da Broi GL, Beltrami CA, Proto G, Grimaldi F, Proietti A, Scott CA, Takasashi S, Igarshi H, Ishiyama N, Nakamura K, Masubuchi N, Ozaki M, Saito S, Aoyagi T, Itoh T, Hirata I, Matysiak-Budnik T, Poniewierka E, Gasciniak G, Jelen M, Knapik Z, Gosciniak G, Neri WM, Susi D, Bovani I, Laterza F, Cuccurullo F, Amorosi A, Bechi P, Dei R, Mazzanti R, Lynch DAF, Sobala GM, Gledhill A, Jackson P, Crabtree JE, Foster PN, Axon ATR, Dixon MF, Maaroos HI, Sipponen P, Kekki M, Di Bello MG, Raspanti S, Vardar T, Sancho FJ, Olivia E, Saiz S, Mones JP, Hood C, Lesna M, Alcolado R, Knitht T, Greaves S, Wilson A, Corlett M, Webb P, Wyatt J, Newell D, Hengels K, Forman D, Elder JB, Farinati F, Cardin R, Valiante F, Libera GD, Plebani M, Rugge M, Baffa R, Guido M, Mario FD, Naccarato R, Gilvarry J, Leen E, Sant S, Sweeney E, Morain CO, Schönlebe J, Riedel H, Prinz M, Hahn L, Porst H, Lohmann H, Orsini E, Guerre J, Tulliez M, Chaussade S, Gaudric M, Canton R, Sampedro J, García-Plaza A, Cognein P, Parodi MC, Tucci A, Gasperoni S, Stanghellini V, Tosetti C, Paparo GF, Varoli O, Siringo S, Santucci R, Monetti N, Barbara G, Corinaldesi R, Di Mario F, Dotto P, Vianello F, M. F, Grasso GA, Bianco TD, Laino G, Germanà B, Battaglia G, Axelson CK, Andersen LP, Szecsi PB, Olsen KN, Lundborg CJ, Andre C, Descos L, Martin A, Cavagna S, Brassens-Rabbé MP, Wu S, Wadström T, Mégraud F, Perdichizzi G, Muratori L, Pallio S, Bottair M, T. Fera M, Quattrocchi E, Caruso V, Karttunen T, Kerola T, Kartttunen R, Niemelä S, Kosunen TU, Bonchviam F, Pretolani S, Baraldine M, Cilla D, Baldinelli S, Gasparrini G. Pathology. Ir J Med Sci 1992. [DOI: 10.1007/bf02942888] [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: 10/21/2022]
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