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Thomas-Joulié A, Tran S, El Houari L, Seyve A, Bielle F, Birzu C, Lozano-Sanchez F, Mokhtari K, Giry M, Marie Y, Laigle-Donadey F, Dehais C, Houillier C, Psimaras D, Alentorn A, Laurenge A, Touat M, Sanson M, Hoang-Xuan K, Kas A, Rozenblum L, Habert MO, Nichelli L, Leclercq D, Galanaud D, Jacob J, Karachi C, Capelle L, Carpentier A, Mathon B, Belin L, Idbaih A. Prognosis of glioblastoma patients improves significantly over time interrogating historical controls. Eur J Cancer 2024; 202:114004. [PMID: 38493668 DOI: 10.1016/j.ejca.2024.114004] [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: 11/07/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Glioblastoma (GBM) is the most common devastating primary brain cancer in adults. In our clinical practice, median overall survival (mOS) of GBM patients seems increasing over time. METHODS To address this observation, we have retrospectively analyzed the prognosis of 722 newly diagnosed GBM patients, aged below 70, in good clinical conditions (i.e. Karnofsky Performance Status -KPS- above 70%) and treated in our department according to the standard of care (SOC) between 2005 and 2018. Patients were divided into two groups according to the year of diagnosis (group 1: from 2005 to 2012; group 2: from 2013 to 2018). RESULTS Characteristics of patients and tumors of both groups were very similar regarding confounding factors (age, KPS, MGMT promoter methylation status and treatments). Follow-up time was fixed at 24 months to ensure comparable survival times between both groups. Group 1 patients had a mOS of 19 months ([17.3-21.3]) while mOS of group 2 patients was not reached. The recent period of diagnosis was significantly associated with a longer mOS in univariate analysis (HR=0.64, 95% CI [0.51 - 0.81]), p < 0.001). Multivariate Cox analysis showed that the period of diagnosis remained significantly prognostic after adjustment on confounding factors (adjusted Hazard Ratio (aHR) 0.49, 95% CI [0.36-0.67], p < 0.001). CONCLUSION This increase of mOS over time in newly diagnosed GBM patients could be explained by better management of potentially associated non-neurological diseases, optimization of validated SOC, better management of treatments side effects, supportive care and participation in clinical trials.
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Affiliation(s)
- A Thomas-Joulié
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France; AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service d'Oncologie-Radiothérapie, F-75013 Paris, France
| | - S Tran
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - L El Houari
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Unité de Recherche Clinique, F-75013 Paris, France
| | - A Seyve
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - F Bielle
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - C Birzu
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - F Lozano-Sanchez
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - K Mokhtari
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - M Giry
- Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, F-75013 Paris, France
| | - Y Marie
- Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, F-75013 Paris, France
| | - F Laigle-Donadey
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - C Dehais
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - C Houillier
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - D Psimaras
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Alentorn
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Laurenge
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - M Touat
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - M Sanson
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - K Hoang-Xuan
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Kas
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - L Rozenblum
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - M-O Habert
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - L Nichelli
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - D Leclercq
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - D Galanaud
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - J Jacob
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service d'Oncologie-Radiothérapie, F-75013 Paris, France
| | - C Karachi
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - L Capelle
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - A Carpentier
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - B Mathon
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - L Belin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Département de Santé Publique, Unité de Recherche Clinique Pitié-Salpêtrière-Charles Foix, Paris, France
| | - A Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Département de Santé Publique, Unité de Recherche Clinique Pitié-Salpêtrière-Charles Foix, Paris, France.
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Guillaume-Jugnot P, Shor N, Bielle F, Zavanone C, Barete S, Maillart E. Atypical multiple sclerosis associated with indolent systemic mastocytosis treated by cladribine. Rev Neurol (Paris) 2023; 179:925-927. [PMID: 37500352 DOI: 10.1016/j.neurol.2023.03.020] [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] [Received: 09/17/2022] [Revised: 12/14/2022] [Accepted: 03/11/2023] [Indexed: 07/29/2023]
Affiliation(s)
- P Guillaume-Jugnot
- Department of Internal Medicine and Clinical Immunology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.
| | - N Shor
- Department of Neuroradiology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - F Bielle
- Department of Neuropathology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Sorbonne Université, Paris, France
| | - C Zavanone
- Department of Neurology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - S Barete
- Unit of Dermatology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; Reference center for mastocytosis (CEREMAST), Hôpital Pitié-Salpêtrière, Paris, France
| | - E Maillart
- Department of Neurology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
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White K, Connor K, Meylan M, Bougoüin A, Salvucci M, Bielle F, O'Farrell AC, Sweeney K, Weng L, Bergers G, Dicker P, Ashley DM, Lipp ES, Low JT, Zhao J, Wen P, Prins R, Verreault M, Idbaih A, Biswas A, Prehn JHM, Lambrechts D, Arijs I, Lodi F, Dilcan G, Lamfers M, Leenstra S, Fabro F, Ntafoulis I, Kros JM, Cryan J, Brett F, Quissac E, Beausang A, MacNally S, O'Halloran P, Clerkin J, Bacon O, Kremer A, Chi Yen RT, Varn FS, Verhaak RGW, Sautès-Fridman C, Fridman WH, Byrne AT. Identification, validation and biological characterisation of novel glioblastoma tumour microenvironment subtypes: implications for precision immunotherapy. Ann Oncol 2023; 34:300-314. [PMID: 36494005 DOI: 10.1016/j.annonc.2022.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [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: 05/05/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND New precision medicine therapies are urgently required for glioblastoma (GBM). However, to date, efforts to subtype patients based on molecular profiles have failed to direct treatment strategies. We hypothesised that interrogation of the GBM tumour microenvironment (TME) and identification of novel TME-specific subtypes could inform new precision immunotherapy treatment strategies. MATERIALS AND METHODS A refined and validated microenvironment cell population (MCP) counter method was applied to >800 GBM patient tumours (GBM-MCP-counter). Specifically, partition around medoids (PAM) clustering of GBM-MCP-counter scores in the GLIOTRAIN discovery cohort identified three novel patient clusters, uniquely characterised by TME composition, functional orientation markers and immune checkpoint proteins. Validation was carried out in three independent GBM-RNA-seq datasets. Neoantigen, mutational and gene ontology analysis identified mutations and uniquely altered pathways across subtypes. The longitudinal Glioma Longitudinal AnalySiS (GLASS) cohort and three immunotherapy clinical trial cohorts [treatment with neoadjuvant/adjuvant anti-programmed cell death protein 1 (PD-1) or PSVRIPO] were further interrogated to assess subtype alterations between primary and recurrent tumours and to assess the utility of TME classifiers as immunotherapy biomarkers. RESULTS TMEHigh tumours (30%) displayed elevated lymphocyte, myeloid cell immune checkpoint, programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 transcripts. TMEHigh/mesenchymal+ patients featured tertiary lymphoid structures. TMEMed (46%) tumours were enriched for endothelial cell gene expression profiles and displayed heterogeneous immune populations. TMELow (24%) tumours were manifest as an 'immune-desert' group. TME subtype transitions upon recurrence were identified in the longitudinal GLASS cohort. Assessment of GBM immunotherapy trial datasets revealed that TMEHigh patients receiving neoadjuvant anti-PD-1 had significantly increased overall survival (P = 0.04). Moreover, TMEHigh patients treated with adjuvant anti-PD-1 or oncolytic virus (PVSRIPO) showed a trend towards improved survival. CONCLUSIONS We have established a novel TME-based classification system for application in intracranial malignancies. TME subtypes represent canonical 'termini a quo' (starting points) to support an improved precision immunotherapy treatment approach.
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Affiliation(s)
- K White
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K Connor
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - M Meylan
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université de Paris, Paris, France
| | - A Bougoüin
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université de Paris, Paris, France
| | - M Salvucci
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - F Bielle
- Paris Brain Institute (ICM), CNRS UMR 7225, Inserm U 1127, UPMC-P6 UMR S 1127, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - A C O'Farrell
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K Sweeney
- National Centre of Neurosurgery, Beaumont Hospital, Dublin, Ireland
| | - L Weng
- VIB-KU Leuven Center for Cancer Biology, Department of Oncology, Leuven, Belgium
| | - G Bergers
- VIB-KU Leuven Center for Cancer Biology, Department of Oncology, Leuven, Belgium
| | - P Dicker
- Epidemiology & Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D M Ashley
- Duke Cancer Institute, Duke University, Durham, USA
| | - E S Lipp
- Duke Cancer Institute, Duke University, Durham, USA
| | - J T Low
- Duke Cancer Institute, Duke University, Durham, USA
| | - J Zhao
- Department of Systems Biology at Columbia University, New York, USA
| | - P Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - R Prins
- Department of Medical and Molecular Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - M Verreault
- Paris Brain Institute (ICM), CNRS UMR 7225, Inserm U 1127, UPMC-P6 UMR S 1127, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - A Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Paris Brain Institute (ICM), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France
| | - A Biswas
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - J H M Prehn
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, Leuven, Belgium; VIB Center for Cancer Biology, Leuven, Belgium
| | - I Arijs
- Laboratory for Translational Genetics, Department of Human Genetics, Leuven, Belgium; VIB Center for Cancer Biology, Leuven, Belgium
| | - F Lodi
- Laboratory for Translational Genetics, Department of Human Genetics, Leuven, Belgium; VIB Center for Cancer Biology, Leuven, Belgium
| | - G Dilcan
- Laboratory for Translational Genetics, Department of Human Genetics, Leuven, Belgium; VIB Center for Cancer Biology, Leuven, Belgium
| | - M Lamfers
- Department of Neurosurgery, Brain Tumor Center, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - S Leenstra
- Department of Neurosurgery, Brain Tumor Center, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - F Fabro
- Department of Neurosurgery, Brain Tumor Center, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - I Ntafoulis
- Department of Neurosurgery, Brain Tumor Center, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - J M Kros
- Department of Pathology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - J Cryan
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - F Brett
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - E Quissac
- Paris Brain Institute (ICM), CNRS UMR 7225, Inserm U 1127, UPMC-P6 UMR S 1127, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - A Beausang
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - S MacNally
- National Centre of Neurosurgery, Beaumont Hospital, Dublin, Ireland
| | - P O'Halloran
- National Centre of Neurosurgery, Beaumont Hospital, Dublin, Ireland
| | - J Clerkin
- National Centre of Neurosurgery, Beaumont Hospital, Dublin, Ireland
| | - O Bacon
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - A Kremer
- Information Technology for Translational Medicine (ITTM), Luxembourg, Luxembourg
| | - R T Chi Yen
- Information Technology for Translational Medicine (ITTM), Luxembourg, Luxembourg
| | - F S Varn
- The Jackson Laboratory for Genomic Medicine, Farmington, USA
| | - R G W Verhaak
- The Jackson Laboratory for Genomic Medicine, Farmington, USA; Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University Medical Center, Amsterdam, the Netherlands
| | - C Sautès-Fridman
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université de Paris, Paris, France
| | - W H Fridman
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université de Paris, Paris, France
| | - A T Byrne
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland.
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Cobes N, Tran S, Bielle F, Touat M, Kas A, Rozenblum L. Étude de l’expression de LAT-1 et de la fixation de la 18F-FDOPA dans les tumeurs cérébrales. Illustration par une série de cas. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Métais A, Tauziède-Espariat A, Garcia J, Appay R, Uro-Coste E, Meyronet D, Maurage CA, Vandenbos F, Rigau V, Chiforeanu DC, Pallud J, Senova S, Saffroy R, Colin C, Edjlali M, Varlet P, Figarella-Branger D, Godfraind C, Gauchotte G, Mokhtari K, Bielle F, Escande F, Fina F. Clinico-pathological and epigenetic heterogeneity of diffuse gliomas with FGFR3::TACC3 fusion. Acta Neuropathol Commun 2023; 11:14. [PMID: 36647073 PMCID: PMC9843943 DOI: 10.1186/s40478-023-01506-z] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/03/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Gliomas with FGFR3::TACC3 fusion mainly occur in adults, display pathological features of glioblastomas (GB) and are usually classified as glioblastoma, IDH-wildtype. However, cases demonstrating pathological features of low-grade glioma (LGG) lead to difficulties in classification and clinical management. We report a series of 8 GB and 14 LGG with FGFR3:TACC3 fusion in order to better characterize them. METHODS Centralized pathological examination, search for TERT promoter mutation and DNA-methylation profiling were performed in all cases. Search for prognostic factors was done by the Kaplan-Meir method. RESULTS TERT promoter mutation was recorded in all GB and 6/14 LGG. Among the 7 cases with a methylation score > 0.9 in the classifier (v12.5), 2 were classified as glioblastoma, 4 as ganglioglioma (GG) and 1 as dysembryoplastic neuroepithelial tumor (DNET). t-SNE analysis showed that the 22 cases clustered into three groups: one included 12 cases close to glioblastoma, IDH-wildtype methylation class (MC), 5 cases each clustered with GG or DNET MC but none with PLNTY MC. Unsupervised clustering analysis revealed four groups, two of them being clearly distinct: 5 cases shared age (< 40), pathological features of LGG, lack of TERT promoter mutation, FGFR3(Exon 17)::TACC3(Exon 10) fusion type and LGG MC. In contrast, 4 cases shared age (> 40), pathological features of glioblastoma, and were TERT-mutated. Relevant factors associated with a better prognosis were age < 40 and lack of TERT promoter mutation. CONCLUSION Among gliomas with FGFR3::TACC3 fusion, age, TERT promoter mutation, pathological features, DNA-methylation profiling and fusion subtype are of interest to determine patients' risk.
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Affiliation(s)
- Alice Métais
- GHU Psychiatrie et Neurosciences, Site Sainte-Anne, service de Neuropathologie, Paris, France ,grid.5842.b0000 0001 2171 2558Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Equipe IMA-BRAIN (Imaging Biomarkers for Brain Development and Disorders), Université de Paris, Paris, France
| | - Arnault Tauziède-Espariat
- GHU Psychiatrie et Neurosciences, Site Sainte-Anne, service de Neuropathologie, Paris, France ,grid.5842.b0000 0001 2171 2558Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Equipe IMA-BRAIN (Imaging Biomarkers for Brain Development and Disorders), Université de Paris, Paris, France
| | - Jeremy Garcia
- grid.411266.60000 0001 0404 1115APHM, CHU Timone, Service d’Anatomie Pathologique et de Neuropathologie, Marseille, France
| | - Romain Appay
- grid.411266.60000 0001 0404 1115APHM, CHU Timone, Service d’Anatomie Pathologique et de Neuropathologie, Marseille, France ,grid.464051.20000 0004 0385 4984Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Emmanuelle Uro-Coste
- grid.411175.70000 0001 1457 2980Department of Pathology, Toulouse University Hospital, Toulouse, France
| | - David Meyronet
- grid.413852.90000 0001 2163 3825Groupe Hospitalier Est, Département de Neuropathologie, Hospices Civils de Lyon, Bron, France ,grid.7849.20000 0001 2150 7757Claude Bernard University Lyon 1, Lyon, France ,grid.462282.80000 0004 0384 0005Department of Cancer cell plasticity – INSERM U1052, Cancer Research Center of Lyon, Lyon, France
| | - Claude-Alain Maurage
- grid.410463.40000 0004 0471 8845Department of Pathology, Lille University Hospital, Lille, France
| | - Fanny Vandenbos
- grid.464719.90000 0004 0639 4696Department of Neuropathology, Hôpital Pasteur, Nice, France
| | - Valérie Rigau
- grid.121334.60000 0001 2097 0141Department of Pathology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Dan Christian Chiforeanu
- grid.414271.5Service d’Anatomie et Cytologie Pathologiques, Pontchaillou University Hospital, Rennes, France
| | - Johan Pallud
- grid.5842.b0000 0001 2171 2558Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Equipe IMA-BRAIN (Imaging Biomarkers for Brain Development and Disorders), Université de Paris, Paris, France ,Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Paris, France
| | - Suhan Senova
- grid.50550.350000 0001 2175 4109Departments of Neurosurgery and Psychiatry, Assistance Publique-Hôpitaux de Paris (APHP) Groupe Henri-Mondor Albert-Chenevier, Créteil, France
| | - Raphaël Saffroy
- grid.413133.70000 0001 0206 8146Department of Biochemistry and Oncogenetic, APHP, Paul-Brousse Hospital, Villejuif, France
| | - Carole Colin
- grid.464051.20000 0004 0385 4984Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Myriam Edjlali
- grid.460789.40000 0004 4910 6535Department of Radiology, APHP, Hôpitaux Raymond-Poincaré and Ambroise Paré, DMU Smart Imaging, U 1179 UVSQ/Paris-Saclay, GH Université Paris-Saclay, Paris, France ,grid.503243.3Laboratoire d’imagerie Biomédicale Multimodale (BioMaps), CEA, CNRS, Inserm, Service Hospitalier Frédéric Joliot, Université Paris-Saclay, Orsay, France
| | - Pascale Varlet
- GHU Psychiatrie et Neurosciences, Site Sainte-Anne, service de Neuropathologie, Paris, France ,grid.5842.b0000 0001 2171 2558Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Equipe IMA-BRAIN (Imaging Biomarkers for Brain Development and Disorders), Université de Paris, Paris, France
| | - Dominique Figarella-Branger
- grid.411266.60000 0001 0404 1115APHM, CHU Timone, Service d’Anatomie Pathologique et de Neuropathologie, Marseille, France ,grid.464051.20000 0004 0385 4984Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
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6
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Ouvrard C, Metais A, Brigot E, Berthaud C, Pucelle N, Lacombe J, Hasty L, Chrétien F, Bielle F, Mokhtari K, Cazals‐Hatem D, Lhermitte B, Uro‐Coste E, Varlet P, Tauziède‐Espariat A. ETV4
Immunohistostaining is a sensitive and specific diagnostic biomarker for
CIC
‐rearranged sarcoma of the central nervous system. Histopathology 2022; 81:852-855. [DOI: 10.1111/his.14796] [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: 07/21/2022] [Revised: 08/23/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022]
Affiliation(s)
- C Ouvrard
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
| | - A Metais
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
- Université de Paris Paris France
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, IMA‐BRAIN Paris France
| | - E Brigot
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
| | - C Berthaud
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
| | - N Pucelle
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
| | - J Lacombe
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
| | - L Hasty
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
| | - F Chrétien
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
- Université de Paris Paris France
| | - F Bielle
- Sorbonne Université, AP‐HP, Institut du Cerveau ‐ Paris Brain Institute ‐ ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière ‐ Charles Foix, Service de Neuropathologie F‐75013 Paris France
| | - K Mokhtari
- Sorbonne Université, AP‐HP, Institut du Cerveau ‐ Paris Brain Institute ‐ ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière ‐ Charles Foix, Service de Neuropathologie F‐75013 Paris France
| | - D Cazals‐Hatem
- Department of Pathology APHP University Hospital Beaujon Clichy France
| | - B Lhermitte
- Department of Pathology, Strasbourg Hospital Strasbourg France
| | - E Uro‐Coste
- Department of Pathology Toulouse University Hospital Toulouse France
- INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse France
- Université Paul Sabatier, Toulouse III Toulouse France
| | - P Varlet
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
- Université de Paris Paris France
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, IMA‐BRAIN Paris France
| | - A Tauziède‐Espariat
- Department of Neuropathology, GHU Paris‐Psychiatrie et Neurosciences, Sainte‐Anne Hospital Paris France
- Université de Paris Paris France
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, IMA‐BRAIN Paris France
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7
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Tran S, Thomas A, Touat M, Karachi C, Lozano F, Mokhtari K, Dehais C, Feuvret L, Carpentier C, Giry M, Doukani H, Lerond J, Marie Y, Sanson M, Idbaih A, Carpentier A, Hoang-Xuan K, Capelle L, Bielle F. OS07.1.A A threshold of mitotic activity and post-surgery residual volume are independant prognostic factors in astrocytoma IDH-mutant. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.046] [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: 11/13/2022] Open
Abstract
Abstract
Background
The distinction between grade 2 and 3 is instrumental to choose between observational follow-up and adjuvant treatment in resected astrocytoma IDH-mutant. However, criteria of grade 2 versus 3 have not been updated since the WHO 2007 classification. There is no consensus on the method of evaluation of the mitotic activity or a cut-off of mitoses separating grade 2 and grade 3 tumors. The objectives were to evaluate the maximal mitotic activity on a series of resected astrocytoma IDH-mutant and assess its prognostic impact on survival.
Material and Methods
Maximal mitotic activity on consecutive high power fields corresponding to 3 mm2 was examined in 118 lower-grade astrocytoma IDH-mutant. The prognostic value for time-to-treatment (TTT) and overall survival (OS) of mitotic activity and other putative prognostic factors (including age, performance status, pre-surgical tumor volume, plurilobar involvement, post-surgical residual tumor volume, midline involvement) was assessed in tumors with (i) ATRX loss, and (ii) without CDKN2A homozygous deletion, lesional enhancement, histological necrosis nor microvascular proliferation.
Results
Among the 75 (64%) of tumors which had gone through observational follow-up after resection, the maximal mitotic activity, the post-surgical residual volume and the plurilobar involvement were independent prognostic factors of TTT (p < 0.0001). A threshold of mitotic activity for grade 2 was fitted on TTT and OS prognosis. Using this threshold, patients with “grade 2 tumors” had a median TTT of 55 months versus 19 months for “grade 3” (p = 0.0057) and a median OS of 102 months versus 73 months respectively (p = 0.001). Residual volume < 1 cm3 was associated with longer OS (113 months versus 88 months, p = 0.0021).
Conclusion
Mitotic activity and post-surgical residual volume can be combined to evaluate prognosis in resected astrocytoma IDH-mutant and could select the best candidates for observational follow-up.
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Affiliation(s)
- S Tran
- Pitie-Salpetriere Hospital, Department of Neuropathology , Paris , France
| | - A Thomas
- Institut de Cancérologie Strasbourg Europe, Department of Radiation Oncology , Strasbourg , France
| | - M Touat
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - C Karachi
- Pitie-Salpetriere Hospital, Department of Neurosurgery , Paris , France
| | - F Lozano
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - K Mokhtari
- Pitie-Salpetriere Hospital, Department of Neuropathology , Paris , France
| | - C Dehais
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - L Feuvret
- Pitie-Salpetriere Hospital, Department of Radiotherapy , Paris , France
| | - C Carpentier
- Sorbonne Universite, Paris Brain Institute - ICM , Paris , France
| | - M Giry
- Sorbonne Universite, Paris Brain Institute - ICM , Paris , France
| | - H Doukani
- Sorbonne Universite INSERM, Plateforme post-genomique de la Pitie-Salpetriere , Paris , France
| | - J Lerond
- Sorbonne Universite, Paris Brain Institute - ICM , Paris , France
| | - Y Marie
- Sorbonne Universite, Paris Brain Institute - ICM , Paris , France
| | - M Sanson
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - A Idbaih
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - A Carpentier
- Pitie-Salpetriere Hospital, Department of Neurosurgery , Paris , France
| | - K Hoang-Xuan
- Pitie-Salpetriere Hospital, Department of Neurology Mazarin , Paris , France
| | - L Capelle
- Pitie-Salpetriere Hospital, Department of Neurosurgery , Paris , France
| | - F Bielle
- Pitie-Salpetriere Hospital, Department of Neuropathology , Paris , France
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8
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Picca A, Berzero G, Di Stefano A, Trabelsi N, Bielle F, Sanson M. PL02.4.A Chromosome 1p19q codeletion frequency, but not survival, varies according to the IDH mutation subtypes: analysis of 1050 IDH-mutated diffuse gliomas. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.001] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
recurring hotspot mutations in isocitrate dehydrogenase (IDH) 1 enzymes, and to a lesser extent IDH2, are the main oncogenic alteration in most of lower-grade diffuse gliomas and a subset of grade 4 gliomas. Although most commonly represented by the IDH1R132H mutation, non-canonical IDH1/2-nonR132H mutations are present in about 10% of cases. As the neomorphic enzymatic activity can vary depending on the type of the hotspot mutation, a different biological behaviour may be inferred. Nevertheless, the prognostic significance of the different IDH1/2 mutations remains a matter of debate.
MATERIAL AND METHODS
we queried the OncoNeuroTek tumor bank (Pitié-Salpêtrière Hospital, Paris) to identify all registered cases of IDH-mutated diffuse gliomas. Most relevant clinical and molecular data were collected.
RESULTS
We identified 1050 IDH mutated diffuse gliomas (481 grade 2 [46%], 459 grade 3 [44%], and 110 grade 4 [10%]), of which 1007 (96%) were IDH1 mutated (934 IDH1R132H [89%] and 73 IDH-nonR132H [7%]) and 43 (4%) were IDH2 mutated (24 IDH2R172K [2%] and 19 IDH2-nonR172K [2%]). The chromosomes 1p/19q codeletion was more frequent in IDH2-mutated tumors (25/42 [60%] versus 350/918 [38%] in IDH1-mutated cases, p=0.005). Nevertheless, only IDH2R172K mutation was associated with the codeletion (18/24 [75%], versus 7/18 [39%] in IDH2-nonR172K-mutated tumors, p=0.02). IDH1-nonR132H tumors showed the lowest rate of 1p/19q codeletion (9/69 [13%], versus 341/849 [40%] in IDH1R132H-mutated cases, p<0.001). At the time of observation, 536 patients were deceased (51%), with a median overall survival (OS) of 115 months (mo., 95% CI 108–125 mo.). Median follow up for censored patients was 77 mo. Codeleted patients had a significantly longer OS compared to non-codeleted ones (179 vs. 96 mo., p<0.001). No significant differences in survival were seen when stratifying according to IDH mutation type (115 mo. for IDH1R132H vs. 136 mo. for IDH1-nonR132H vs. 112 mo. for IDH2R172K vs. 150 mo. for IDH2-nonR172K, p=0.8). No differences were seen when restricting the analysis to codeleted or not-codeleted patients only, respectively. In a multivariate analysis including the main prognostic factors (age, sex, preoperative performance status, tumor grade, surgical resection, midline location, 1p/19q codeletion, and p16 homozygous deletion), no survival difference was associated with any of the IDH mutation subtype.
CONCLUSION
although significantly different rates of 1p/19q codeletion were seen according to the four main IDH mutation subgroups, these groups does not associate with different survival profiles in our cohort.
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Affiliation(s)
- A Picca
- Hôpital Universitaire Pitié-Salpêtrière, Paris, France
| | - G Berzero
- Hôpital Universitaire Pitié-Salpêtrière, Paris, France
| | | | - N Trabelsi
- Institut du cerveau et de la moelle épinière (ICM), Paris, France
| | - F Bielle
- Hôpital Universitaire Pitié-Salpêtrière, Paris, France
| | - M Sanson
- Hôpital Universitaire Pitié-Salpêtrière, Paris, France
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9
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Lampros A, Caumes E, Psimaras D, Galanaud D, Clarençon F, Peyre M, Deltour S, Bielle F, Lhote R, Haroche J, Amoura Z, Cohen Aubart F. [Infection associated cerebral vasculitis]. Rev Med Interne 2020; 42:258-268. [PMID: 32868117 DOI: 10.1016/j.revmed.2020.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/26/2020] [Accepted: 05/07/2020] [Indexed: 12/11/2022]
Abstract
Infections are a frequent cause of cerebral vasculitis, important to diagnose because a specific treatment may be required. Infection-associated vasculitis can be caused by angiotropic pathogens (varicella zoster virus, syphilis, aspergillus). They can be associated with subarachnoidal meningitis (tuberculosis, pyogenic meningitis, cysticercosis). They can appear contiguously to sinuses or orbital infection (aspergillosis, mucormycosis). Finally, they also may be due to an immune mechanism in the context of chronic infections (hepatitis B virus, hepatitis C virus, human immunodeficiency virus). Cerebral vasculitis are severe conditions and their prognosis is directly linked to early recognition and diagnosis. Infectious causes must therefore be systematically considered ahead of cerebral vasculitis, and the appropriate investigations must be determined according to the patient's clinical context. We propose here an update on the infectious causes of cerebral vasculitis, their diagnosis modalities, and therapeutic options.
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Affiliation(s)
- A Lampros
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France
| | - E Caumes
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service des maladies infectieuses et tropicales, 75013 Paris, France
| | - D Psimaras
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neurologie 2, 75013 Paris, France
| | - D Galanaud
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neuroradiologie, 75013 Paris, France
| | - F Clarençon
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neuroradiologie, 75013 Paris, France
| | - M Peyre
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neurochirurgie, 75013 Paris, France
| | - S Deltour
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service des Urgences cérébro-vasculaires, 75013 Paris, France
| | - F Bielle
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neuropathologie, 75013 Paris, France
| | - R Lhote
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France
| | - J Haroche
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France
| | - Z Amoura
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France
| | - F Cohen Aubart
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France.
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10
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de Rojas T, Kasper B, Van der Graaf W, Pfister S, Bielle F, Ribalta T, Shenjere P, Preusser M, Fröhling S, Morfouace M, McCabe M. EORTC SPECTA-AYA: A molecular profiling platform for adolescents and young adults with cancer in Europe. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.123] [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: 11/13/2022] Open
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11
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Vienne A, Dulou R, Bielle F, Baruteau M, Maison FL, Nikolova Yordanova Y. Awake surgery for isolated parenchymal degenerating neurocysticercosis - Case report and focused review of misdiagnosis of neurocysticercosis. Neurochirurgie 2019; 65:402-416. [PMID: 31518578 DOI: 10.1016/j.neuchi.2019.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/05/2019] [Accepted: 07/28/2019] [Indexed: 11/30/2022]
Abstract
Differential diagnosis of isolated single neurocysticercosis can be difficult, and management is controversial. We report here an original surgical strategy, and review previous studies reporting misdiagnosis, using the PRISMA guidelines. A 24-year-old man was admitted to our hospital for recent memory impairment, hypoesthesia of the right hand, and recurrent focal seizures without loss of consciousness. Brain MRI revealed a single ring-enhancing parenchymal lesion in the left superior postcentral gyrus, with large perilesional edema. Since exhaustive systemic exploration was negative, surgical resection of the lesion was decided on in a multidisciplinary team meeting. To preserve eloquent brain areas, surgery was performed in awake condition. It allowed complete resolution of clinical manifestations. The diagnosis of neurocysticercosis was confirmed on pathology. This case illustrates the utility of awake surgery in degenerating neurocysticercosis in functional areas, and emphasizes the importance of including it in differential diagnosis of cystic ring-enhancing brain lesions.
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Affiliation(s)
- A Vienne
- Defense Health Service, Cognition and Action Group, Cognac-G, CNRS UMR 8257, Paris Descartes University, 45, rue des Saints-Pères, 75006 Paris, France; Department of Neurosurgery, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - R Dulou
- Department of Neurosurgery, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France; Val de Grâce Military Medical Corps Academy, 74, boulevard du Port-Royal, 75005 Paris, France
| | - F Bielle
- Department of Neuropathology, Pitié-Salpêtrière Hospital, 41-83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Baruteau
- Department of Neurology, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - F-L Maison
- Department of Neurosurgery, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - Y Nikolova Yordanova
- Department of Neurosurgery, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France.
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12
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Baldini C, Younan N, Castanon Alvarez E, Bahleda R, Hollebecque A, Dhermain F, Ammari S, Alentorn A, Dumont S, Frenel J, Di Stefano A, Bielle F, Hoang-Xuan K, Delattre J, Soria J, Sanson M, Idbaih A, Massard C, Touat M. OS4.3 Feasibility and benefit of Molecular Profiling to Guide Enrollment of Patients with Recurrent Gliomas in Early Phase Trials. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.033] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Participation of glioma patients in early phase clinical trials has recently shown to be safe, although clinical benefits reported in this population were marginal. We aimed to evaluate whether an enrichment strategy based on molecular profiling associates with improved outcome in gliomas patients participating in early phase trials.
MATERIAL AND METHODS
Records of patients enrolled in early phase trials of cytotoxic therapies, small molecule inhibitors or monoclonal antibodies from 2008 to 2017 were analyzed for clinicopathological characteristics, toxicity, response, median progression-free survival (PFS) and overall survival (OS). The primary objective was to evaluate the feasibility and benefit of using molecular profiling to guide enrollment.
RESULTS
Ninety-one patients were enrolled, of whom 47/91 (51.6%) were molecularly oriented. Molecular targets included IDH1/2 (n=15) and BRAF (11) mutations, FGFR1-3 fusions (n= 10) and mutations (n = 4), mismatch repair deficiency (8), and MDM2 amplification (1). Grade 3/4 adverse events were reported in 9/91 (9.9%) patients. In patients with IDH1/2-wild-type high-grade glioma (n=45), the overall response rate (24.0% [95% CI 11.5–43.4] vs 0.0% [95% CI 0.0–16.1], P=0.027) was significantly higher in molecularly-oriented vs non-molecularly-oriented patients. Updated outcome results, and clinical and molecular factors associated with response, PFS and OS in multivariate analyses will be presented at the conference.
CONCLUSION
Using molecular profiling to guide enrollment in early phase trials is feasible and offers potential benefit to gliomas patients. Further studies are warranted to identify the population most likely to benefit from this approach.
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Affiliation(s)
| | - N Younan
- Hopital Pitié Salpétrière, Paris, France
| | | | | | | | | | - S Ammari
- Gustave Roussy, Villejuif, France
| | - A Alentorn
- Hopital La Pitié Salpêtrière, Paris, France
| | - S Dumont
- Gustave Roussy, Villejuif, France
| | - J Frenel
- Centre René Gauducheau, Saint-Herblain, France
| | | | - F Bielle
- Hopital La Pitié Salpêtrière, Paris, France
| | | | - J Delattre
- Hopital La Pitié Salpêtrière, Paris, France
| | - J Soria
- Gustave Roussy, Villejuif, France
| | - M Sanson
- Gustave Roussy, Villejuif, France
| | - A Idbaih
- Hopital La Pitié Salpêtrière, Paris, France
| | | | - M Touat
- Hopital La Pitié Salpêtrière, Paris, France
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13
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Duran-Peña A, Garcilazo-Reyes Y, Frappaz D, Feuvret L, Bielle F, Capelle L, Savatovsky J, Laigle-Donadey F. P14.16 Complete sustaining radiological response of a multi-recurrent disseminated adult medulloblastoma after antiangiogenic metronomic combined pediatric regimen MEMMAT: a case report. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Even if medulloblastoma is considered as a curable disease, recurrent medulloblastoma has a poor prognosis, independently of therapy used. Medulloblastoma is very rare in adults, unlike children, and therapeutic strategies at recurrence are lacking. Nevertheless, adult teams sometimes use as “compassionate” chemotherapy some regimens published in children, such as the MEMMAT metronomic combination. However, this treatment, targeting both endothelial and proliferating tumor cells, has to date not been studied in the adult population.
MATERIAL AND METHODS
We present the case of a 40-year-old man, suffering from a right cerebellar SHH mutated medulloblastoma initially diagnosed and treated in 2014 by craniospinal radiotherapy associated with 4 cycles of carboplatine-VP16 following complete resection. Since April 2016, date of first relapse, numerous successive recurrences occurred, initially focal, treated by several surgeries (April and November 2016, January 2017), chemotherapy (rechallenge by carboplatine-VP16) then stereotactic radiotherapy. He then developed in October 2017 a new relapse in the posterior fossa, also associated with a meningeal dissemination on lumbar MRI. IK was 90%. He was then treated by TOTEM regimen (Temozolomide-Topotecan) followed by “Packer” regimen (Cisplatin-Belustine-Vincristin), without tumor control. However, because patient was non symptomatic with a KPS of 80%, we decided, according to the AJA French group, to propose what we presumed to be a “compassionate” chemotherapy, by metronomic pediatric regimen “MEMMAT”. For “supportive care” reasons, we decided not to realize the “Intrathecal part” of this regimen and administered to the patient intravenous bevacizumab (10 mg/kg d1-d14-d21), thalidomide (100 mg/d), celecoxib (300 mg bid), fenofibrate (160 mg/d) and etoposide (100 mg/d d1-21), alternating with cyclophosphamide (100 mg/d d22-42).
RESULTS
Clinical tolerance was very good, except grade 1 heel pain and fatigue; hematological toxicity was mild (transient grade 3 neutropenia, grade 4 lymphopenia); renal impairment, already present at the beginning, was increasing, and justified dose adjustment after 5 cycles and nephrologic explorations, ongoing. Radiological evaluation showed a complete radiological response with complete disappearance of enhancing lesions on first MRIs realized after 3 months (2 cycles); this response was confirmed after 6 months (4 cycles) and 9 months (6 cycles) on both cerebral and spinal MRI. Patient is now receiving the 7th cycle.
CONCLUSION
We report here the first case of a complete and sustaining response of an adult multi-recurrent metastatic medulloblastoma treated by a pediatric antiangiogenic metronomic regimen “MEMMAT”. This promising result incites to develop a dedicated prospective trial in adults in view to confirm the interest of this strategy.
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Affiliation(s)
- A Duran-Peña
- AP-HP, Service de Neurologie 2-Mazarin, Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, PARIS, France
| | - Y Garcilazo-Reyes
- AP-HP, Service de Neurologie 2-Mazarin, Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, PARIS, France
| | - D Frappaz
- Service de Cancerologie Centre Léon Bérard, LYON, France
| | - L Feuvret
- AP-HP, Service de Radiothérapie, CHU Pitié-salpêtrière Charles Foix, PARIS, France
| | - F Bielle
- AP-HP, Service de Neuropathologie CHU La Pitie Salpetriere-Charles Foix, PARIS, France
| | - L Capelle
- AP-HP, Service de Neurochirurgie CHU La Pitie Salpetriere-Charles Foix, PARIS, France
| | - J Savatovsky
- Fondation Ophtalmologique Rotschild, PARIS, France
| | - F Laigle-Donadey
- AP-HP, Service de Neurologie 2-Mazarin, Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, PARIS, France
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Nichelli L, Branzoli F, Valabregue R, Capelle L, Ottolenghi C, Bielle F, Lerond J, Giry M, Villa C, Galanaud D, Lehéricy S, Marjańska M, Sanson M, Di Stefano A. PL1.2 Multiparametric assessment of factors influencing 2 HG accumulation in diffuse brain gliomas. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.001] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
2-hydroxyglutarate (2HG) can be detected non-invasively in IDH-mutant gliomas by in vivo magnetic resonance spectroscopy (MRS). We investigated factors affecting 2 HG accumulation and explored the prognostic value of 2 HG detection in IDH mutant gliomas and 2 HG variations during anti-cancer therapies.
MATERIAL AND METHODS
We prospectively scanned by MEGA-PRESS 70 glioma patients (24 before surgery and 46 IDH mutant operated glioma) and measured 2HG. CRLB cut-off was 50%. We followed up 9 IDH mutant patients during radiotherapy and chemotherapy.We analyzed radiological parameters (tumor and cystic/necrotic volumes, fractions of VOI filled with tumor, spectroscopic profile, “infiltrative” versus “expansive” morphology, contrast-enhancement) and genetic profile (IDH1, IDH2, 1p19q codeletion). 2HG concentrations in plasma, urine, and surgical obtained samples were measured by gas chromatography-mass spectrometry (GC-MS).
RESULTS
MEGA-PRESS sequence detected 2HG with a sensitivity of 95% in untreated patients, and of 69% in pre-treated patient. Positive predictive value was 100% in both groups. 2HG was lower in pre-treated IDH mutant gliomas (1.1 versus 2.3 mM, P=0.02) and decreased rapidly during radiotherapy and chemotherapy before any radiological change. 2HG detection was positively correlated with tumor volume (P=0.02), choline measurements (r=0.58 P<0.0001), cellular density (measured by restricted diffusivity, Pearson r -0.40 P=0.01), “expansive” presentation, mutated reads/total reads ratio by NGS and was inversely correlated with Myo-inositol (Pearson R -0.29 P=0.03) and cystic/necrotic areas (P=0.04). 2HG by MRS positively correlated with urine 2HG (r=0.80 P=0.003). 2 HG was higher in IDH2 mutant (4.7 versus 2.4 Mm, P=0.02) and lower in non R132H IDH1 mutant (1.12 mM P=0.004). Among IDH mutant glioma patients, 2 HG detection was associated with longer survival (HR 0.09; 95%CI 0.018–0.52).
CONCLUSION
Tumor volume, cellular density, previous radio- and chemotherapy and genetic features determine 2 HG detection in IDH mutant gliomas. 2 HG detection is associated with better outcome and can be reliably monitored during anti-cancer treatments.
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Affiliation(s)
- L Nichelli
- Institut du Cerveau et de la Moelle Epinière- ICM, Centre de NeuroImagerie de Recherche CENIR, Paris, France
- Department of Diagnostic Imaging, University of Modena and Reggio Emilia, Modena, Italy
| | - F Branzoli
- Institut du Cerveau et de la Moelle Epinière- ICM, Centre de NeuroImagerie de Recherche CENIR, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - R Valabregue
- Institut du Cerveau et de la Moelle Epinière- ICM, Centre de NeuroImagerie de Recherche CENIR, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - L Capelle
- University Hospitals Pitié Salpêtrière - Charles Foix Department of Neurosurgery, Paris, France
| | - C Ottolenghi
- Hôpital Necker and Université Paris Descartes Service de Biochimie Métabolique, Paris, France
| | - F Bielle
- Service de Neuropathologie, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France
- Institut du Cerveau et de la Moelle Epinière- ICM, Paris, France
| | - J Lerond
- Institut du Cerveau et de la Moelle Epinière- ICM, Paris, France
| | - M Giry
- Institut du Cerveau et de la Moelle Epinière- ICM, Paris, France
| | - C Villa
- Foch Hospital, Service d’Anatomie et Cytologie pathologiques, Suresnes, Paris, France
| | - D Galanaud
- University Hospitals Pitié Salpêtrière - Charles Foix Department of Neurordiology, Paris, France
- Institut du Cerveau et de la Moelle Epinière- ICM, Centre de NeuroImagerie de Recherche CENIR, Paris, France
| | - S Lehéricy
- Institut du Cerveau et de la Moelle Epinière- ICM, Centre de NeuroImagerie de Recherche CENIR, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, ICNRS UMR 7225, Paris, France
| | - M Marjańska
- Center for Magnetic Resonance Research Department of Radiology, Minneapolis, MN, United States
| | - M Sanson
- University Hospitals Pitié Salpêtrière - Charles Foix Department of Neurology, Paris, France
- Institut du Cerveau et de la Moelle Epinière- ICM, Paris, France
| | - A Di Stefano
- Foch Hospital, Service de Neurologie, Suresnes, Paris, France
- University Hospitals Pitié Salpêtrière - Charles Foix Department of Neurology, Paris, France
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Terziev R, Petrirena G, Marie Y, Mueller WC, Bielle F, Delattre JY. Posterior fossa recurrence of WHO grade II and III supratentorial gliomas. Rev Neurol (Paris) 2018; 174:705-710. [PMID: 30314742 DOI: 10.1016/j.neurol.2017.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 10/04/2017] [Accepted: 10/21/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE/BACKGROUND Posterior fossa (PF) recurrences of supratentorial (ST) World Health Organization (WHO) grade II and III gliomas are thought to be rare and to have grim prognoses. METHODS This study entailed searching through our database and reviewing the records of patients with grade II and III ST gliomas who developed PF recurrence with no overt secondary gliomatosis or leptomeningeal spread. RESULTS Of 2266 grade II and III gliomas, 14 fulfilled the inclusion criteria: 5 oligodendrogliomas (O; 1 OII, 4 OIII); 7 astrocytomas (A; 4 AII, 3 AIII); and 2 oligoastrocytomas (OA; both OAIII). The male/female gender ratio was 10/4, and median age at recurrence was 43 years. Two groups were identified. In one group (n=8; 1 AII, 3 AIII, 2 OAIII, 2 OIII), a rapidly growing contrast-enhancing PF mass (6/8) was associated with ST progression, and median survival time after detection was only 6.5 months despite radiotherapy and/or chemotherapy. In the second group (n=6; 3 AII, 1 OII, and 2 OIII), a non-contrast-enhancing (5/6), asymptomatic (5/6), slow-growing PF mass remained isolated, and treatment with radio- or chemotherapy produced objective responses in three patients and durable stabilization in the remaining three. After a median follow-up of 63months, only one patient died due to delayed recurrence of the ST lesion, while the remaining five patients are still alive. CONCLUSION Non-contiguous PF relapses of ST grade II and III gliomas are rare. A high-grade ST tumor that is concomitantly progressing appears to be a predictor of poor survival. Conversely, the tumor course may be indolent if the ST lesion is low-grade and non-progressive at the time of PF involvement. The possible mechanism(s) behind this tropism are also discussed.
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Affiliation(s)
- R Terziev
- Service de neurologie 2-Mazarin, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47, boulevard de l'Hôpital, 75013 Paris, France; Department of Neuro-Pathology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - G Petrirena
- Service de neurologie 2-Mazarin, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - Y Marie
- UMR S 1127, Inserm U 975, Institut du cerveau et de la moelle épinière, ICM, CNRS UMR 7225, Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
| | - W C Mueller
- Department of Neuro-Pathology, University Hospital of Leipzig, 04103 Leipzig, Germany
| | - F Bielle
- Service de neuropathologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - J-Y Delattre
- Service de neurologie 2-Mazarin, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47, boulevard de l'Hôpital, 75013 Paris, France; UMR S 1127, Inserm U 975, Institut du cerveau et de la moelle épinière, ICM, CNRS UMR 7225, Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
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Montero AS, Bielle F, Goldwirth L, Lalot A, Beccaria K, Pradat PF, Salachas F, Carpentier A. Ouverture transitoire de la barrière hémato-médullaire de lapin par ultrasons pulsés de faible intensité. Neurochirurgie 2018. [DOI: 10.1016/j.neuchi.2018.05.015] [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: 10/28/2022]
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17
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Joyon N, Tauziède-Espariat A, Alentorn A, Giry M, Castel D, Capelle L, Zanello M, Varlet P, Bielle F. K27M mutation in H3F3A in ganglioglioma grade I with spontaneous malignant transformation extends the histopathological spectrum of the histone H3 oncogenic pathway. Neuropathol Appl Neurobiol 2018; 43:271-276. [PMID: 27219822 DOI: 10.1111/nan.12329] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 04/29/2016] [Accepted: 05/18/2016] [Indexed: 12/24/2022]
Affiliation(s)
- N Joyon
- Neuropathologie, Laboratoire Escourolle, Hôpitaux Universitaires Pitié Salpêtrière Charles Foix, AP-HP, Paris, France
| | | | - A Alentorn
- Neurologie 2, Hôpitaux Universitaires Pitié Salpêtrière Charles Foix, AP-HP, Paris, France
| | - M Giry
- Institut du Cerveau et de la Moelle Epinière, Paris, France
| | - D Castel
- UMR 8203 CNRS "Vectorologie et Thérapeutiques Anticancéreuses", Université Paris-Sud, Villejuif, France
| | - L Capelle
- Neurochirurgie, Hôpitaux Universitaires Pitié Salpêtrière Charles Foix, AP-HP, Paris, France
| | - M Zanello
- Neurochirurgie, Hôpital Saint-Anne, Paris, France
| | - P Varlet
- Neuropathologie, Hôpital Saint-Anne, Paris, France
| | - F Bielle
- Neuropathologie, Laboratoire Escourolle, Hôpitaux Universitaires Pitié Salpêtrière Charles Foix, AP-HP, Paris, France.,Institut du Cerveau et de la Moelle Epinière, UPMC - Sorbonne Universités, Paris, France
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Peyre M, Gaillard S, de Marcellus C, Giry M, Bielle F, Villa C, Boch A, Loiseau H, Baussart B, Cazabat L, Raffin-Sanson M, Sanson M, Kalamarides M. Progestin-associated shift of meningioma mutational landscape. Ann Oncol 2018; 29:681-686. [DOI: 10.1093/annonc/mdx763] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [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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Mathon B, Navarro V, Carpentier A, Bielle F, Cornu P, Clemenceau S. Résultats et facteurs pronostiques de la chirurgie de l’épilepsie mésiotemporale associée à une sclérose hippocampique. Neurochirurgie 2017. [DOI: 10.1016/j.neuchi.2016.11.044] [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: 11/16/2022]
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Shotar E, Law-Ye B, Di Maria F, Baronnet-Chauvet F, Zeidan S, Psimaras D, Bielle F, Pecquet C, Navarro S, Rosso C, Cohen F, Chiras J, Sourour N, Clarençon F. P-020 Non-Ischemic Cerebral Enhancing (NICE) Lesions Secondary to Endovascular Aneurysm Therapy: Nickel Allergy or Foreign Body Reaction? Reports of Two Cases and Review of the Literature. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.62] [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: 11/04/2022]
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21
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Seilhean D, Bielle F, Plu I, Duyckaerts C. Frontotemporal lobar degeneration: Diversity of FTLD lesions. Rev Neurol (Paris) 2013; 169:786-92. [DOI: 10.1016/j.neurol.2013.07.015] [Citation(s) in RCA: 3] [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] [Received: 07/08/2013] [Revised: 07/15/2013] [Accepted: 07/16/2013] [Indexed: 12/13/2022]
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Garel S, Deck M, Lokmane L, Bielle F, Mailhes C, Keita M. ISDN2012_0193: Waiting period controls axonal pathfinding of pioneer corticofugal axons. Int J Dev Neurosci 2012. [DOI: 10.1016/j.ijdevneu.2012.10.018] [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: 11/16/2022] Open
Affiliation(s)
- S. Garel
- Ecole Normale SupérieureInstitut de Biologie de l'ENSIBENS, INSERM, U1024, Avenir Team, CNRS, UMR 8197ParisFrance
| | - M. Deck
- Ecole Normale SupérieureInstitut de Biologie de l'ENSIBENS, INSERM, U1024, Avenir Team, CNRS, UMR 8197ParisFrance
| | - L. Lokmane
- Ecole Normale SupérieureInstitut de Biologie de l'ENSIBENS, INSERM, U1024, Avenir Team, CNRS, UMR 8197ParisFrance
| | - F. Bielle
- Ecole Normale SupérieureInstitut de Biologie de l'ENSIBENS, INSERM, U1024, Avenir Team, CNRS, UMR 8197ParisFrance
| | - C. Mailhes
- Ecole Normale SupérieureInstitut de Biologie de l'ENSIBENS, INSERM, U1024, Avenir Team, CNRS, UMR 8197ParisFrance
| | - M. Keita
- Ecole Normale SupérieureInstitut de Biologie de l'ENSIBENS, INSERM, U1024, Avenir Team, CNRS, UMR 8197ParisFrance
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Bielle F, Fréneaux P, Jeanne-Pasquier C, Maran-Gonzalez A, Rousseau A, Lamant L, Paris R, Pierron G, Victor Nicolas A, Sastre-Garau X, Delattre O, Bourdeaut F, Peuchmaur M. L’immunomarquage PHOX2B : un nouvel outil pour le diagnostic des neuroblastomes indiffenciés au sein des tumeurs à petites cellules rondes de l’enfant. Ann Pathol 2012. [DOI: 10.1016/j.annpat.2012.09.171] [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: 11/15/2022]
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Pallud J, Capelle L, Le Vanquyen M, Bielle F, Cresto N, Baulac M, Duyckertz C, Roux F, Miles R, Huberfeld G. Genèse des activités épileptiques au sein du cortex péritumoral dans les gliomes diffus. Neurochirurgie 2011. [DOI: 10.1016/j.neuchi.2011.09.063] [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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