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Lucchi E, Berger F, Milder M, Commer JM, Morin S, Capodano G, Thomaso M, Fogliarini A, Bremaud N, Henry A, Mastroianni B, Chvetzoff G, Bouleuc C. Palliative Care Interventions and End-of-Life Care for Patients with Metastatic Breast Cancer: A Multicentre Analysis. Oncologist 2024; 29:e708-e715. [PMID: 38387031 PMCID: PMC11067792 DOI: 10.1093/oncolo/oyae023] [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: 09/19/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The aim of this study was to describe the implementation of integrated palliative care (PC) and the intensity of care in the last 3 months before death for patients with metastatic breast cancer. MATERIALS AND METHODS We conducted a multicentric study of all adult patients with metastatic breast cancer who died over a 4-month period. Complete data were collected and checked from clinical records, including PC interventions and criteria regarding EOL care aggressiveness. RESULTS A total of 340 decedent patients from 12 comprehensive cancer centres in France were included in the study. Sixty-five percent met the PC team with a median time of 39 days between the first intervention and death. In the last month before death, 11.5% received chemotherapy, the frequency of admission to intensive care unit was 2.4%, and 83% experienced acute hospitalization. The place of death was home for 16.7%, hospitalization for 63.3%, PC unit for 20%. Univariate and multivariate analyses showed factors independently associated with a higher frequency of chemotherapy in the last month before death: having a dependent person at home, meeting for the first time with a PC team < 30 days before death, and time between the first metastasis and death below the median. CONCLUSION PC team integration was frequent and late for patients with metastatic breast cancer. However, PC intervention > 30 days is associated with less chemotherapy in the last month before death. Further studies are needed to better understand how to implement a more effective mode of PC integration for patients with metastatic breast cancer.
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Affiliation(s)
- Elisabeth Lucchi
- Supportive and Palliative Care Department, Institut Curie, Paris, France
| | | | - Maude Milder
- Biostatistics Department, Institut Curie, Paris, France
| | - Jean-Marie Commer
- Supportive and Palliative Care Department, Institut de Cancerologie de Loire, Anger, France
| | - Sophie Morin
- Supportive and Palliative Care Department, Institut Bergonie, Paris, France
| | - Geraldine Capodano
- Supportive and Palliative Care Department, Institut Paoli-Calmette, Marseille, France
| | - Muriel Thomaso
- Supportive and Palliative Care Department, Institut de Cancerologie de Montpellier, Montpellier, France
| | - Anne Fogliarini
- Supportive and Palliative Care Department, Centre Lacassagne, Nice, France
| | - Nathalie Bremaud
- Supportive and Palliative Care Department, Centre Georges François Leclerc, Dijon, France
| | - Aline Henry
- Supportive and Palliative Care Department, Centre Alexis Vautrin, Nancy, France
| | | | - Gisele Chvetzoff
- Supportive and Palliative Care Department, Centre Léon Berard, Lyon, France
| | - Carole Bouleuc
- Supportive and Palliative Care Department, Institut Curie, Paris, France
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Pierga JY, Billa O, Dabakuyo S, Lemonnier J, Berger F, Trédan O, Jacot W, Gonçalves A, Debled M, Levy C, Jouannaud C, Mouret-Reynier MA, Ferrero JM, Dalenc F, Toumi FZ, Bonnetain F, Bidard FC, Renault S. Abstract P4-07-24: Circulating tumor cells enumeration and Health Related Quality of Life of patients treated with first-line chemotherapy for HER2 negative metastatic breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-07-24] [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: 03/06/2023]
Abstract
Abstract
Background: In patients with metastatic breast cancer (mBC), Circulating Tumor Cells (CTC) counts have a strong prognostic impact on progression free survival (PFS) and overall survival (OS). Changes 4 weeks after the start of a new line of therapy, inform on treatment efficacy. Despite improvements in systemic treatment, metastatic BC remains mainly uncurable with alteration of health-related quality of life (HRQOL) during the course of the disease. The aim of this work was to assess impact of clinical factors and biological factors as CTC on HRQOL. Methods: The French cohort COMET is a prospective study including first line HER2 negative patients receiving weekly paclitaxel and bevacizumab according to EMA approved combination. The aim of this cohort was to evaluate clinical, biological and radiological parameters associated with patients’ outcome (CTC, CEC, serum markers, ctDNA, pharmacogenomic polymorphisms, metabolomic parameters, visceral fat assessed by initial CTscan, serum estradiol level, and quality of life). HRQOL was assessed at baseline, at every cycle until progression and then every 3 months up to death using the EORTC QLQ-C30 questionnaire and its breast cancer specific module, the EORTC QLQ-BR23. Five dimensions of HRQOL were analyzed for the primary analyses: Global health status (GHS), physical functioning (PF), Emotional functioning (EF), fatigue (FA) and pain (PA). Time until definitive deterioration (TUDD) in HRQOL was defined as the interval between inclusion and the first decrease in HRQOL score ≥ 5 compared to baseline HRQOL score with no further improvement or in case of death. CTC counts were determined using the standard CellSearch system [Menarini Silicon Biosystems]. Results: Out of 510 patients included in COMET study, 432 patients with available HRQOL data were analyzed in this study. At baseline, patients reported a mean score for GHS of 57.6 (SD=22.7), for PF of 75.8 (23.2), for EF of 62.2 (25.8), for FA of 42.2 (29.60) and for PA of 38.1 (31.5). The Median TUDDs for the 5 targeted dimensions was 10.1 months [7.5-16.9] for GHS, 6.1 months [4.1-8.9] for PF, 21.6 [18.7-31.2] for EF, 10.8 [6.2-16.6] for FA and 13.6[10.1-22.5] months for PA. CTC counts were available in 261 patients at base line and in 229 patients after 4 weeks of treatment, before second cycle of chemotherapy. CTC high count was independent of main clinical and biological characteristics except lobular subtype. We confirmed the poor outcome of patients with high CTC count at base line and after one cycle of treatment with the threshold of > 4CTC/7.5 ml of blood. Out of the 5 dimensions of HRQOL, TUDD of EF was significantly correlated with a high CTC level at base line (p=0.0262) and even more with still an elevated count of CTC after one cycle of chemotherapy(p=0.0137). There was no association of CTC with the other dimensions of HRQOL. Conclusion: This is the first study ever reporting an analysis of QoL and CTC. We observed an association of high CTC count with one component of HRQOL scale. This suggests that CTC could be complementary to clinical factors that could influence HRQOL in HER2 negative metastatic BC treated with first line chemotherapy.
Citation Format: Jean-Yves Pierga, Oumar Billa, Sandrine Dabakuyo, Jérôme Lemonnier, Frédérique Berger, Olivier Trédan, William Jacot, Anthony Gonçalves, Marc Debled, Christelle Levy, Christelle Jouannaud, Marie-Ange Mouret-Reynier, Jean-Marc Ferrero, Florence Dalenc, Fatima-Zohra Toumi, Franck Bonnetain, Francois-Clement Bidard, Shufang Renault. Circulating tumor cells enumeration and Health Related Quality of Life of patients treated with first-line chemotherapy for HER2 negative metastatic breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-24.
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Affiliation(s)
| | - Oumar Billa
- 2Centre George Francois Leclerc, Dijon, France
| | | | | | | | - Olivier Trédan
- 6Medical Oncology Department, Centre Léon Bérard, Lyon, France
| | - William Jacot
- 7Institut du Cancer de Montpellier, Université de Montpellier, INSERM U1194, Montpellier, Languedoc-Roussillon, France
| | | | | | | | | | | | | | | | | | - Franck Bonnetain
- 16Centre de Recherche Lipides-Nutrition-Cancer, Besançon, France
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Billa O, Dabakuyo S, Chevrier M, Bonnetain F, Desmoulins I, Jacot W, Trédan O, Debled M, Levy C, Gonçalves A, Ferrero JM, Dalenc F, Jouannaud C, Mouret-Reynier MA, Mousseau M, Grenier J, Jacquin JP, Toumi FZ, Berger F, Lemonnier J, Pierga JY. Abstract P4-07-54: Health related quality of life of patients treated with bevacizumab and paclitaxel as first-line treatment for HER2 negative metastatic breast cancer: impact of clinical factors. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-07-54] [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: 03/06/2023]
Abstract
Abstract
Background: Advances in screening and treatment have led to increase in breast cancer (BC) survival in recent years but prognoses for metastatic BC remain poor with poorer outcomes as health-related quality of life (HRQOL). Treatment as bevacizumab and paclitaxel for metastatic BC, although that can increase time to progression of disease, often carry toxicity and is not curative but rather palliative in intent with the goal to improve or maintain HRQOL. The aim of this work was to assess impact of clinical factors such as disease progression, toxicity on HRQOL. Methods: COMET study is a multicenter prospective single-arm cohort study in France whose main objective was to identify biological factor that could predict the clinical benefit of bevacizumab-paclitaxel combination therapy as first treatment in HER2 negative metastatic BC. HRQOL was assessed at baseline, at every cycle (every for 4 weeks) until progression and then every 3 months up to death using the EORTC QLQ-C30 questionnaire and its BC specific module, the EORTC QLQ-BR23. In this ancillary study, we targeted 5 dimensions HRQOL for the primary analyses: Global health status (GHS), physical functioning (PF), Emotional functioning (EF), fatigue (FA) and pain (PA). The primary endpoint was time until definitive deterioration (TUDD) in HRQOL scales that defined as time between inclusion and the first decrease HRQOL score ≥ 5 points compared to baseline score, with no further improvement of at least 5 points. Multivariable Cox model with time dependent covariate was performed to assess clinical factors associated with TUDD for each of the 5 target dimensions HRQOL. We performed 3 models for each dimension: model 1 including all covariate with p< 0.10 in univariable; model 2 including model 1 and adjusted on cancer subtype and model 3 included model 1 stratified by cancer subtype. P value < 0.01 were considered statistically significant. Results: Out of 510 patients included in COMET study, 432 patients with available HRQOL data were analyzed in this study. Median age at inclusion was 58 years (range: 29-83), and 24.4% of patients had triple negative tumor subtype. About 79 % of cancers were invasive ductal carcinoma and 43 % patients had least 3 metastasis sites at baseline. At baseline, patients reported a mean score for GHS of 57.6 (SD=22.7), for PF of 75.8 (23.2), for EF of 62.2 (25.8), for FA of 42.2 (29.60) and for PA of 38.1 (31.5). The Median TUDDs for the 5 targeted dimensions was 10.1 months [7.5-16.9] for GHS, 6.1 months [4.1-8.9] for PF, 21.6 [18.7-31.2] for EF, 10.8 [6.2-16.6] for FA and 13.6[10.1-22.5] months for PA. In multivariable analyses, Disease Progression was associated with TUDD of GHS (HR [99%CI] =2.4 [1.2-4.9] and TUDD of PF (2.1 [1.1-3.7]). After adjusted on cancer subtype, association persisted with TUDD of GHS (p=0.009). Performance Status was associated with TUDD of PF (1.6 [1.2-2.3]), and TUDD of Pain (1.6 [1.1-2.3]). Performance Status association with TUDD of PF continued after adjustment on cancer subtype (p=0.0003). Prior endocrine therapy was associated with TUDD of pain in patients with tumor with positive hormone receptor (HR+) (2.4 [1.2-4.7]). There was no factor associated with TUDD of EF and TUDD of FA. Conclusion: Results of this study have shown that among the 5 targeted dimensions HRQOL, Physical Functioning was deteriorated in the shortest time. Disease progression, base line performance status and prior endocrine therapy for HR+ subtype, are clinical factors that could influence HRQOL in HER2 negative metastatic BC treated with first line chemotherapy.
Citation Format: Oumar Billa, Sandrine Dabakuyo, Marion Chevrier, Franck Bonnetain, Isabelle Desmoulins, William Jacot, Olivier Trédan, Marc Debled, Christelle Levy, Anthony Gonçalves, Jean-Marc Ferrero, Florence Dalenc, Christelle Jouannaud, Marie-Ange Mouret-Reynier, Mireille Mousseau, Julien Grenier, Jean-Philippe Jacquin, Fatima-Zohra Toumi, Frédérique Berger, Jérôme Lemonnier, Jean-Yves Pierga. Health related quality of life of patients treated with bevacizumab and paclitaxel as first-line treatment for HER2 negative metastatic breast cancer: impact of clinical factors [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-54.
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Affiliation(s)
- Oumar Billa
- 1Centre George Francois Leclerc, Dijon, France
| | | | | | | | | | - William Jacot
- 6Institut du Cancer de Montpellier, Université de Montpellier, INSERM U1194, Montpellier, Languedoc-Roussillon, France
| | - Olivier Trédan
- 7Medical Oncology Department, Centre Léon Bérard, Lyon, France
| | | | | | | | | | | | | | | | | | - Julien Grenier
- 16Institut Sainte Catherine, Avignon, Provence-Alpes-Cote d’Azur, France
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Guiu S, Guiu B, Chevrier M, Billa O, Levy C, Trédan O, Desmoulins I, Debled M, Ferrero JM, Jouannaud C, Gonçalves A, Rios M, Mouret-Reynier MA, Berger F, TOUMI FZ, Lemonnier J, Pierga JY, Dabakuyo S, Gourgou S. Abstract P1-03-04: Visceral fat area as a predictive factor in metastatic HER2 negative breast cancer patients treated by first line chemotherapy with weekly paclitaxel and bevacizumab. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p1-03-04] [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: 03/06/2023]
Abstract
Abstract
Background Obesity has previously been correlated with poorer survival in both early and metastatic breast cancer. Adipose tissues release proangiogenic factors such as Insulin-like Growth Factor and Vascular Endothelial Growth Factor that may ultimately promote tumor growth. CTscan can be used to measure the visceral fat area (VFA) and the subcutaneous fat area (SFA) on the same section. High VFA has been shown to independently predict poorer outcome in patients given first-line bevacizumab-based treatment for metastatic colorectal cancer and metastatic renal cell carcinoma. The prospective multicenter COMET trial included metastatic HER2 negative breast cancer patients receiving bevacizumab and paclitaxel as fist-line chemotherapy. This study was designed to identify and validate reliable factors to predict benefit of bevacizumab and allow for a more personalized use of this antiangiogenic agent. Our aim was to evaluate the prognostic value of BMI (Body Mass Index), VFA and SFA in the COMET cohort and their impact on the quality of life. Patients and Methods Out of the 510 patients included in the COMET trial from 9/2012 to 3/2016, 480 received bevacizumab and paclitaxel as first-line treatment and 360 had available CTscan data. VFA and SFA were measured retrospectively on the CTscans performed before chemotherapy initiation, at the level of the umbilicus with the patient in the supine position. ImageJ software was used to measure pixels with densities in the -190 HU to -30 HU range in order to delineate the subcutaneous and visceral compartments and to compute the cross-sectional area of each in cm2. These measurements were performed by a radiologist blinded to patients’ characteristics and outcomes. For VFA and SFA, we used a threshold at the median value. VFA and SFA levels were tested for their association with progression-free survival (PFS) and overall survival (OS). The impact on quality of life was based on the Global Health Status, the Physical functioning, the Emotional functioning, Fatigue and Pain scores. Results The mean age at inclusion was 57 years (range: 28-83). At initial diagnosis, the main histological type was invasive ductal carcinoma (n = 247, 80.7%). Most patients had received prior neoadjuvant/adjuvant chemotherapy (n = 245, 68.1%) and a large majority (95.4%) had less than 3 metastatic sites. One hundred and forty patients (46.7%) had histological grade II and 41% had grade III tumors. The majority of the patients had positive hormone receptor tumor (n = 238, 79.3 %) and 62 (20.7%) had triple-negative tumor subtype. The median BMI was 24.7 (range : 17-46). After a median follow-up of 60.6 months (95%CI, 60-61.3), median PFS was 9.5 months (95CI, 8.6-10.3). There was no significant correlation between BMI (p = 0.69), VFA (p = 0.24) or SFA (p = 0.58) and PFS in the univariate analysis. The median OS was 29.6 months (95CI, 25.9-32.4). BMI, VFA and SFA were not correlated with OS. Out of the 360 patients, 328 had available data regarding the quality of life. There was no impact of the VFA or the SFA on the different quality of life scores. Conclusions In our prospective cohort of 360 patients with metastatic breast cancer receiving bevacizumab and paclitaxel as first-line treatment, high VFA or high SFA were not associated with a poorer survival. VFA and SFA had no impact on quality of life.
Citation Format: Séverine Guiu, Boris Guiu, Marion Chevrier, Oumar Billa, Christelle Levy, Olivier Trédan, Isabelle Desmoulins, Marc Debled, Jean-Marc Ferrero, Christelle Jouannaud, Anthony Gonçalves, Maria Rios, Marie-Ange Mouret-Reynier, Frédérique Berger, Fatima-Zohra TOUMI, Jérôme Lemonnier, Jean-Yves Pierga, Sandrine Dabakuyo, Sophie Gourgou. Visceral fat area as a predictive factor in metastatic HER2 negative breast cancer patients treated by first line chemotherapy with weekly paclitaxel and bevacizumab [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-03-04.
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Affiliation(s)
- Séverine Guiu
- 1Institut du Cancer de Montpellier (ICM) Val d’Aurelle, Montpellier University, INSERM U1194, Montpellier, France
| | | | | | - Oumar Billa
- 4Centre George Francois Leclerc, Dijon, France
| | | | - Olivier Trédan
- 6Medical Oncology Department, Centre Léon Bérard, Lyon, France
| | | | | | | | | | | | - Maria Rios
- 12INSTITUT DE CANCEROLGIE DE LORRAINE - ALEXIS VAUTRIN
| | | | | | | | | | | | | | - Sophie Gourgou
- 19Institut régional du Cancer, Montpellier, Montpellier, France
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Bidard FC, Kiavue N, Alix-Panabières C, Dureau S, Bachelot T, Bourgeois H, Gonçalves A, Brain E, Ladoire S, Dalenc F, Gligorov J, Teixeira L, Emile G, Ferrero JM, Loirat D, Cabel L, Diéras V, Berger F, Jacot W, Pierga JY. Abstract GS3-09: GS3-09 Circulating Tumor Cells-driven choice of first line therapy for ER+ HER2- metastatic breast cancer: overall survival analysis of the randomized STIC CTC trial. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-gs3-09] [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: 03/06/2023]
Abstract
Abstract
Background: High circulating tumor cell (CTC) count (CTChigh) is a strong adverse prognostic factor in patients with metastatic breast cancer (mBC). In the STIC CTC trial (NCT01710605), run before the introduction of CDK4/6 inhibitors for ER+/HER2- mBC, we showed that CTC count (CTC arm) was non inferior to clinician’s choice (standard arm) on progression-free survival (PFS) to guide first line treatment selection between chemotherapy (CT) and endocrine therapy (ET) (Bidard et al., JAMA Oncol 2021). Of note, patients who had treatment escalated from ET (a priori clinician choice) to CT in the CTC arm, had a significantly longer PFS. We report here overall survival (OS) results of this multicenter CTC clinical utility trial.
Methods: In the CTC arm, N=377 patients had their treatment determined by baseline CTC count: CT if CTChigh (≥5 CTCs/7.5 mL, CellSearch®), ET if CTClow. In the standard arm (N=378 patients), the choice was left to the investigator: CT if clinical high risk (Clinhigh), ET if clinical low risk (Clinlow). Therefore, patients with discordant Clinlow/CTChigh or Clinhigh/CTClow profiles had their first line treatment escalated from ET (standard arm) to CT (CTC arm) or de-escalated from CT (standard arm) to ET (CTC arm), respectively. Patients with concordant Clinlow/CTClow and Clinhigh/CTChigh profiles received ET and CT in both arms, respectively.
Results: Among 755 randomized patients, N=189 (25.0%) had a Clinlow/CTChigh profile, N=103 (13.6%) Clinhigh/CTClow, N=363 (48.2%) Clinlow/CTClow and N=100 (13.2%) Clinhigh/CTChigh. OS was analyzed after a median follow-up of 57 months and 382 events (50.6%). In the Clinlow/CTChigh subgroup, CT in the CTC arm led a longer OS (mOS: 51.8 months [43.3-NR]) than ET in the standard arm (35.4 months [30.4-45.4]; HR=0.53 [0.36-0.78], p=0.001). In patients Clinhigh/CTClow, no significant difference was observed whether they received CT (standard arm) or ET (CTC arm) (45.9 months [36.3-59.8] vs 49.4 months [35.4-65.4]; HR=0.88 [0.51-1.51], p=0.63). Pooling the two discordant groups (Clinlow/CTChigh or Clinhigh/CTClow), the CTC-driven strategy was superior to the clinician-driven treatment decision (HR=0.63 [0.46-0.86], p=0.02). Pooling all concordant and discordant groups together, a median OS of 45.5 (95%CI=[40.9-51.1]) and 51.3 months [46.8-55.1] was observed in the standard and CTC arms, respectively (HR=0.84 [0.69-1.03], p=0.10).
Conclusions: Prognostic information brought by CTC or standard factors is discordant in 40% of patients with ER+ HER2- mBC. In case of a discordant estimate, the STIC CTC trial shows the superiority on OS of the CTC-driven treatment decision strategy. These results also suggest a possible clinical utility of CTC to adjust systemic treatment for mBC in second and later lines, after progression on CDK4/6 inhibitors.
Funding:The study was funded by Institut Curie; the French National Cancer Institute (INCa), as part of the Programme de Soutien aux Techniques Innovantes Coûteuses 2011 (STIC 2011); and Menarini Silicon Biosystems (Castel Maggiore, Italy).
Citation Format: Francois-Clement Bidard, Nicolas Kiavue, Catherine Alix-Panabières, Sylvain Dureau, Thomas Bachelot, Hugues Bourgeois, Anthony Gonçalves, Etienne Brain, Sylvain Ladoire, Florence Dalenc, Joseph Gligorov, Luis Teixeira, George Emile, Jean-Marc Ferrero, Delphine Loirat, Luc Cabel, Véronique Diéras, Frédérique Berger, William Jacot, Jean-Yves Pierga. GS3-09 Circulating Tumor Cells-driven choice of first line therapy for ER+ HER2- metastatic breast cancer: overall survival analysis of the randomized STIC CTC trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr GS3-09.
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Affiliation(s)
| | | | | | | | | | | | | | - Etienne Brain
- 8European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | | | - Joseph Gligorov
- 11Institut Universitaire de Cancérologie AP-HP Sorbonne Université, Paris, Ile-de-France, France
| | | | | | | | - Delphine Loirat
- 15Institut Curie, Medical Oncology Department and D3i, Paris, France
| | | | | | | | - William Jacot
- 19Institut du Cancer de Montpellier, Université de Montpellier, INSERM U1194, Montpellier, Languedoc-Roussillon, France
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Bailleux C, Bachelot T, Bidard FC, Hardy-Bessard AC, Bièche I, Pradines A, Clatot F, ROUGE TDELAMOTTE, Canon JL, Pistilli B, Chang K, Quinn KJ, Gustafson HL, Dalenc F, Foa C, Ammarguellat H, Bernard-Marty C, Lucas B, Barthier S, Lorchel F, Gisserot O, Arnould L, Mauduit M, Lemonnier J, Berger F, Delaloge S, Andre F. Abstract PD17-02: ctDNA Molecular Response based on breast cancer driver mutations predicts progression in aromatase inhibitor-sensitive first line treatment of oestrogen receptor-positive (ER+) HER2-negative (HER2-) advanced breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-pd17-02] [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: 03/06/2023]
Abstract
Abstract
Background: The combination of a CDK4/6 inhibitor and an aromatase inhibitor (AI) is the gold standard for AI-sensitive first line treatment of ER+ HER2- advanced breast cancer. Nevertheless, some patients progress rapidly and may benefit from alternative strategies. Early ctDNA dynamics have been shown to predict disease course in several clinical situations. Here, we use samples from the PADA-1 trial to assess this strategy for patients receiving AI and palbociclib as first line treatment. PADA-1 was designed to assess the clinical utility of sequential analysis of ctDNA for emerging ESR1 mutations to trigger an early switch from AI plus palbociclib to fulvestrant plus palbociclib treatment. The study included 1,017 patients and was positive on its primary end-point. The objective of this translational study was to analyze the predictive value of 4-week molecular response (MR) for patient progression. Material & Method: First, a CLIA-validated targeted next-generation sequencing-based test (Guardant360 Response) was used to characterize changes in ctDNA level via detection of somatic single-nucleotide variants (SNVs), insertion/deletion mutations (indels), and gene fusions in 74 genes frequently mutated in cancer. A second analysis was restricted to cancer-associated mutations in 11 genes commonly mutated in breast cancer (PIK3CA, GATA3, TP53, AKT1, ERBB2, BRCA1, BRCA2, ATM, ESR1, PALB2 and RB1). The threshold for molecular response was defined as ≥ 50% decrease in ctDNA (MR score < 0.5). Subjects with ctDNA levels below the test’s limit of quantitation (ctDNA-low) were considered molecular responders. Results: 372 subjects with matched baseline and 4-weeks samples were available for analysis. Of these, 134 subjects (36%) were ctDNA-low, and 238 subjects (64%) quantifiable. Among the quantifiable subjects, 183 (77%) were molecular responders (MR+, MR < 0.5), and 55 (23%) were not (MR–, MR ≥ 0.5). PFS was moderately improved for both MR+ and ctDNA-low relative to MR– (HR=0.61 (95%CI 0.44-0.85), p< 0.01) over the full 29 months of follow up. Differential PFS event rate was observed only in the first 8 months following ctDNA assessment; during this time MR+ and ctDNA-low were associated with more significantly decreased risk of progression (HR 0.24, 95% CI 0.13 – 0.43, p=0.0001). Limiting ctDNA assessment to genes commonly mutated in breast cancer enhanced the predictive power of MR (HR=0.08, 95% CI 0.04 0.17, p< 0.001, for MR+ and ctDNA-low vs. MR– across 8 months post-assessment); however, fewer samples were quantifiable by this method (169 [45%] quantifiable; 203 [55%] ctDNA-low). Combining MR status with additional molecular features (e.g.tumor mutational burden and maximum mutation allele fraction) did not improve prediction of non-response. Conclusion: Changes in ctDNA fraction during the first weeks of treatment are predictive of long term clinical benefit on an individual patient basis, particularly during the first year of therapy. Adjusting the MR threshold and/or limiting to genes known to be relevant in the specific tumor can tailor the assessment of ctDNA change to specific clinical scenarios where greater sensitivity or specificity may be required. The identification of patients at high risk for early clinical failure at the onset of treatment may allow for therapy escalation and/or change to improve outcome in this population. Funding: Pfizer and Guardant Health
Citation Format: Caroline Bailleux, Thomas Bachelot, Francois-Clement Bidard, Anne-Claire Hardy-Bessard, Ivan Bièche, Anne Pradines, Florian Clatot, thibault DE LA MOTTE ROUGE, Jean-Luc Canon, Barbara Pistilli, Kyle Chang, Katie J. Quinn, Heather L. Gustafson, Florence Dalenc, Cyril Foa, Hanifa Ammarguellat, Chantal Bernard-Marty, Brigitte Lucas, Sophie Barthier, Fabrice Lorchel, Olivier Gisserot, Laurent Arnould, Marjorie Mauduit, Jérôme Lemonnier, Frédérique Berger, Suzette Delaloge, Fabrice Andre. ctDNA Molecular Response based on breast cancer driver mutations predicts progression in aromatase inhibitor-sensitive first line treatment of oestrogen receptor-positive (ER+) HER2-negative (HER2-) advanced breast cancer. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD17-02.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jean-Luc Canon
- 9Grand Hopital de Charleroi - GHdC site Notre Dame, Belgium
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Hoffmann L, Danne F, Weiss K, Photiadis J, Schleiger A, Sallmon H, Berger F, Ovroutski S, Kramer P. Longitudinal Somatic Growth in Patients with Complex Univentricular Heart Disease Undergoing Fontan Operation: Relation to Suboptimal Outcomes. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761843] [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: 03/22/2023]
Affiliation(s)
- L. Hoffmann
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - F. Danne
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - K. Weiss
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - J. Photiadis
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - A. Schleiger
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - H. Sallmon
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - F. Berger
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - S. Ovroutski
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - P. Kramer
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
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Buhagiar‑Labarchède G, Onclercq‑Delic R, Vacher S, Berger F, Bièche I, Stoppa‑Lyonnet D, Amor‑Guéret M. Author Correction: Cytidine deaminase activity increases in the blood of breast cancer patients. Sci Rep 2022; 12:21002. [PMID: 36470892 PMCID: PMC9722649 DOI: 10.1038/s41598-022-23982-4] [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: 12/12/2022] Open
Affiliation(s)
- Géraldine Buhagiar‑Labarchède
- grid.418596.70000 0004 0639 6384Institut Curie, PSL Research University, UMR 3348, 91405 Orsay, France ,grid.5842.b0000 0001 2171 2558CNRS UMR 3348, Centre Universitaire, Bat 110, 91405 Orsay, France ,grid.5842.b0000 0001 2171 2558Université Paris-Saclay, Centre Universitaire, Bat 110, UMR 3348, 91405 Orsay, France
| | - Rosine Onclercq‑Delic
- grid.418596.70000 0004 0639 6384Institut Curie, PSL Research University, UMR 3348, 91405 Orsay, France ,grid.5842.b0000 0001 2171 2558CNRS UMR 3348, Centre Universitaire, Bat 110, 91405 Orsay, France ,grid.5842.b0000 0001 2171 2558Université Paris-Saclay, Centre Universitaire, Bat 110, UMR 3348, 91405 Orsay, France
| | - Sophie Vacher
- grid.418596.70000 0004 0639 6384Department of Genetics, Institut Curie, Paris, France
| | - Frédérique Berger
- grid.418596.70000 0004 0639 6384Department of Biostatistics, Institut Curie, Paris, France
| | - Ivan Bièche
- grid.418596.70000 0004 0639 6384Department of Genetics, Institut Curie, Paris, France ,grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France
| | - Dominique Stoppa‑Lyonnet
- grid.418596.70000 0004 0639 6384Department of Genetics, Institut Curie, Paris, France ,grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.418596.70000 0004 0639 6384INSERM U830, Institut Curie, Paris, France
| | - Mounira Amor‑Guéret
- grid.418596.70000 0004 0639 6384Institut Curie, PSL Research University, UMR 3348, 91405 Orsay, France ,grid.5842.b0000 0001 2171 2558CNRS UMR 3348, Centre Universitaire, Bat 110, 91405 Orsay, France ,grid.5842.b0000 0001 2171 2558Université Paris-Saclay, Centre Universitaire, Bat 110, UMR 3348, 91405 Orsay, France
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9
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Bidard FC, Hardy-Bessard AC, Dalenc F, Bachelot T, Pierga JY, de la Motte Rouge T, Sabatier R, Dubot C, Frenel JS, Ferrero JM, Ladoire S, Levy C, Mouret-Reynier MA, Lortholary A, Grenier J, Chakiba C, Stefani L, Plaza JE, Clatot F, Teixeira L, D'Hondt V, Vegas H, Derbel O, Garnier-Tixidre C, Canon JL, Pistilli B, André F, Arnould L, Pradines A, Bièche I, Callens C, Lemonnier J, Berger F, Delaloge S, PISTILLI B, DALENC F, BACHELOT T, DE LA MOTTE ROUGE T, SABATIER R, DUBOT C, FRENEL JS, FERRERO JM, LADOIRE S, LEVY C, MOURET-REYNIER MA, HARDY-BESSARD AC, LORTHOLARY A, GRENIER J, CHAKIBA C, STEFANI L, SOULIE P, JACQUIN JP, PLAZA JE, CLATOT F, TEIXEIRA L, D'HONDT V, VEGAS H, DERBEL O, GARNIER TIXIDRE C, DELBALDO C, MOREAU L, CHENEAU C, PAITEL JF, BERNARD-MARTY C, SPAETH D, GENET D, MOULLET I, BONICHON-LAMICHHANE N, DEIANA L, GREILSAMER C, VENAT-BOUVET L, DELECROIX V, MELIS A, ORFEUVRE H, NGUYEN S, LEGOUFFE E, ZANNETTI A, LE SCODAN R, DOHOLLOU N, DALIVOUST P, ARSENE O, MARQUES N, PETIT T, MOLLON D, DAUBA J, BONNIN N, MORVAN F, GARDNER M, MARTI A, LEVACHE CB, LACHAIER E, ACHILLE M, VALMAR C, BOUAITA R, MEDIONI J, FOA C, BERNARD-MARTY C, DEL PIANO F, GOZY M, ESCANDE A, LEDUC N, LUCAS B, MILLE D, AMMARGUELLAT H, NAJEM A, TROUBOUL F, BARTHELEMY P, DESCLOS H, MAYEUR D, LORCHEL F, GUINET F, LAURENTY AP, BOUDRANT A, GISSEROT O, ALLEAUME C, DE GRAMONT A. Switch to fulvestrant and palbociclib versus no switch in advanced breast cancer with rising ESR1 mutation during aromatase inhibitor and palbociclib therapy (PADA-1): a randomised, open-label, multicentre, phase 3 trial. Lancet Oncol 2022; 23:1367-1377. [PMID: 36183733 DOI: 10.1016/s1470-2045(22)00555-1] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND In advanced oestrogen receptor-positive, HER2-negative breast cancer, acquired resistance to aromatase inhibitors frequently stems from ESR1-mutated subclones, which might be sensitive to fulvestrant. The PADA-1 trial aimed to show the efficacy of an early change in therapy on the basis of a rising ESR1 mutation in blood (bESR1mut), while assessing the global safety of combination fulvestrant and palbociclib. METHODS We did a randomised, open-label, phase 3 trial in 83 hospitals in France. Women aged at least 18 years with oestrogen receptor-positive, HER2-negative advanced breast cancer and an Eastern Cooperative Oncology Group performance status of 0-2 were recruited and monitored for rising bESR1mut during first-line aromatase inhibitor (2·5 mg letrozole, 1 mg anastrozole, or 25 mg exemestane, orally once per day, taken continuously) and palbociclib (125 mg orally once per day on days 1-21 of a 28-day cycle) therapy. Patients with newly present or increased bESR1mut in circulating tumour DNA and no synchronous disease progression were randomly assigned (1:1) to continue with the same therapy or to switch to fulvestrant (500 mg intramuscularly on day 1 of each 28-day cycle and on day 15 of cycle 1) and palbociclib (dosing unchanged). The randomisation sequence was generated within an interactive web response system using a minimisation method (with an 80% random factor); patients were stratified according to visceral involvement (present or absent) and the time from inclusion to bESR1mut detection (<12 months or ≥12 months). The co-primary endpoints were investigator-assessed progression-free survival from random assignment, analysed in the intention-to-treat population (ie, all randomly assigned patients), and grade 3 or worse haematological adverse events in all patients. The trial is registered with Clinicaltrials.gov (NCT03079011), and is now complete. FINDINGS From March 22, 2017, to Jan 31, 2019, 1017 patients were included, of whom 279 (27%) developed a rising bESR1mut and 172 (17%) were randomly assigned to treatment: 88 to switching to fulvestrant and palbociclib and 84 patients to continuing aromatase inhibitor and palbociclib. At database lock on July 31, 2021, randomly assigned patients had a median follow-up of 35·3 months (IQR 29·2-41·4) from inclusion and 26·0 months (13·8-34·3) from random assignment. Median progression-free survival from random assignment was 11·9 months (95% CI 9·1-13·6) in the fulvestrant and palbociclib group versus 5·7 months (3·9-7·5) in the aromatase inhibitor and palbociclib group (stratified HR 0·61, 0·43-0·86; p=0·0040). The most frequent grade 3 or worse haematological adverse events were neutropenia (715 [70·3%] of 1017 patients), lymphopenia (66 [6·5%]), and thrombocytopenia (20 [2·0%]). The most common grade 3 or worse adverse events in step 2 were neutropenia (35 [41·7%] of 84 patients in the aromatase inhibitor and palbociclib group vs 39 [44·3%] of 88 patients in the fulvestrant and palbociclib group) and lymphopenia (three [3·6%] vs four [4·5%]). 31 (3·1%) patients had grade 3 or worse serious adverse events related to treatment in the overall population. Three (1·7%) of 172 patients randomly assigned had one serious adverse event in step 2: one (1·2%) grade 4 neutropenia and one (1·2%) grade 3 fatigue among 84 patients in the aromatase inhibitor and palbociclib group, and one (1·1%) grade 4 neutropenia among 88 patients in the fulvestrant and palbociclib group. One death by pulmonary embolism in step 1 was declared as being treatment related. INTERPRETATION PADA-1 is the first prospective randomised trial showing that the early therapeutic targeting of bESR1mut results in significant clinical benefit. Additionally, the original design explored in PADA-1 might help with tackling acquired resistance with new drugs in future trials. FUNDING Pfizer.
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Affiliation(s)
- François-Clément Bidard
- Department of Medical Oncology, Institut Curie, Université Versailles Saint-Quentin, Université Paris-Saclay, Saint-Cloud, France; Circulating Tumour Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, Paris, France.
| | | | - Florence Dalenc
- Department of Medical Oncology, Institut Claudius-Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Thomas Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Jean-Yves Pierga
- Circulating Tumour Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, Paris, France; Department of Medical Oncology, Institut Curie and Université de Paris, Paris, France
| | | | - Renaud Sabatier
- Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille Université, Marseille, France
| | - Coraline Dubot
- Department of Medical Oncology, Institut Curie, Université Versailles Saint-Quentin, Université Paris-Saclay, Saint-Cloud, France
| | | | - Jean Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Christelle Levy
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | | | - Alain Lortholary
- Department of Medical Oncology, Hopital Privé du Confluent, Nantes, France
| | - Julien Grenier
- Department of Medical Oncology, Institut Sainte Catherine, Avignon, France
| | - Camille Chakiba
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Laetitia Stefani
- Department of Medical Oncology, Centre Hospitalier Annecy Genvoi, Pringy-Metz-Tessy, France
| | - Jérôme Edouard Plaza
- Department of Medical Oncology, UNEOS Site Hôpital Robert Schuman, Vantoux, France
| | - Florian Clatot
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | - Luis Teixeira
- Department of Medical Oncology, Hôpital Saint Louis, Paris, France
| | - Véronique D'Hondt
- Department of Medical Oncology, Institut du Cancer de Montpellier Val d'Aurelle, Montpellier, France
| | - Hélène Vegas
- Department of Medical Oncology, Centre Hospitalier de Tours, Hôpital Bretonneau, Tours, France
| | - Olfa Derbel
- Department of Medical Oncology, Hôpital Privé Jean Mermoz, Lyon, France
| | - Claire Garnier-Tixidre
- Department of Medical Oncology, Institut Daniel Hollard, G H Mutualiste de Grenoble, Grenoble, France
| | - Jean-Luc Canon
- Department of Medical Oncology, Grand Hôpital de Charleroi, Charleroi, Belgique
| | | | - Fabrice André
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Laurent Arnould
- Department of Pathology, Centre Georges François Leclerc, Dijon, France
| | - Anne Pradines
- INSERM U1037 CNRS ERL5294 UPS, Cancer Research Center of Toulouse, Toulouse, France; Prospective Biology Unit, Medical Laboratory, Claudius Regaud Institute, Toulouse University Cancer Institute, Toulouse, France
| | - Ivan Bièche
- Pharmacogenomic Unit, Genetics Laboratory, Department of Diagnostic and Theranostic Medicine, Institut Curie, PSL University, Saint-Cloud, Paris, France
| | - Céline Callens
- Pharmacogenomic Unit, Genetics Laboratory, Department of Diagnostic and Theranostic Medicine, Institut Curie, PSL University, Saint-Cloud, Paris, France
| | | | - Frédérique Berger
- Biometry Unit, Institut Curie, PSL University, Saint-Cloud, Paris, France
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Clift P, Berger F, Sondergaard L, Antonova P, Disney P, Nicolarsen J, Thambo JB, Tomkiewicz Pajak L, Wang JK, Schophuus Jensen A, Burgess G, Efficace M, Friberg M, Lassen C, d'Udekem Y. The efficacy and safety of macitentan in Fontan-palliated patients: results of the 52-week randomised, placebo-controlled RUBATO trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1560] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The clinical utility and long-term effects of endothelin receptor antagonists (ERAs) in Fontan-palliated patients remain unclear and there are currently no approved therapies. A decline in peak VO2 between consecutive cardiopulmonary exercise tests (CPETs) is highly prognostic for death or transplant in adult Fontan patients, hence its use as a primary endpoint in clinical trials of ERAs in patients with Fontan circulation.
Purpose
The RUBATO trial aimed to assess the efficacy and safety of macitentan, an endothelin receptor antagonist, in Fontan-palliated patients over 52 weeks.
Methods
In the multicentre, double-blind, randomised, placebo-controlled, phase 3 RUBATO trial, Fontan-palliated patients were randomised 1:1 to macitentan 10 mg once-daily or placebo for 52 weeks. Eligible patients were aged ≥12 years, in New York Heart Association functional class II or III, had no limitations for CPET (including no pacemakers), had undergone lateral tunnel or extracardiac conduit Fontan (total cavopulmonary connection) >1 year before screening and showed no signs of Fontan failure or clinical deterioration within 3 months before screening. Primary efficacy endpoint was change in peak VO2 from baseline to week 16. Secondary endpoints were change in peak VO2 from baseline over 52 weeks and change in mean count per minute of daily physical activity from baseline to week 16 as measured by an accelerometer. Adverse events were also assessed.
Results
137 patients were randomised to macitentan (n=68) or placebo (n=69). 92.7% of patients completed 52 weeks of double-blind treatment: 7 and 3 patients prematurely discontinued study treatment in macitentan and placebo arms, respectively. Patient baseline characteristics are shown in Table 1. At week 16, the mean (SD) change from baseline in peak VO2 was –0.16 (2.86) with macitentan vs –0.67 (2.66) mL/kg/min with placebo (median unbiased estimate of the difference between macitentan and placebo: 0.62 mL/kg/min [99% repeated confidence interval –0.62; 1.85], p=0.1930). No treatment effect was observed in the two secondary endpoints (Table 2): mean (SD) count per minute of daily physical activity decreased from baseline to week 16 by 3.02 (92.44) with macitentan and by 14.34 (117.56) with placebo (p=0.4512). The most common AEs were headache (10.3% vs 8.7% on placebo), nasopharyngitis (5.9% vs 4.3%), and pyrexia (5.9% vs 4.3%). AEs leading to treatment discontinuation were reported in 3 (4.4%) and 1 (1.4%) of macitentan and placebo patients.
Conclusion
The 52-week RUBATO trial provides an important addition to data on the clinical utility of ERAs in Fontan-palliated patients. The primary efficacy endpoint was not met and no treatment effect was observed for the two secondary endpoints. Macitentan was well tolerated; safety findings were consistent with the known safety profile of macitentan 10 mg.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Actelion Pharmaceuticals Ltd., a Janssen pharmaceutical company of Johnson & Johnson.
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Affiliation(s)
- P Clift
- Queen Elizabeth Hospital Birmingham, Adult Congenital Heart Disease Unit , Birmingham , United Kingdom
| | - F Berger
- German Heart Center Berlin, Department of Congenital Heart Disease/Pediatric Cardiology , Berlin , Germany
| | - L Sondergaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - P Antonova
- Charles University in Prague, Motol University Hospital, Department of Cardiovascular Surgery, 2nd Faculty of Medicine , Motol , Czechia
| | - P Disney
- Royal Adelaide Hospital, Department of Cardiology , Adelaide , Australia
| | - J Nicolarsen
- Providence Sacred Heart Medical Center and Children's Hospital, Providence Adult and Teen Congenital Heart Program (PATCH) , Spokane , United States of America
| | - J B Thambo
- Bordeaux University Hospital (CHU), Department of Pediatric and Adult Congenital Cardiology , Pessac , France
| | - L Tomkiewicz Pajak
- Jagiellonian University Medical College, John Paul II Hospital, Department of Cardiac and Vascular Diseases, Institute of Cardiology , Krakow , Poland
| | - J K Wang
- National Taiwan University Hospital, Department of Pediatrics , Taipei , Taiwan
| | - A Schophuus Jensen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - G Burgess
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | | | - M Friberg
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | - C Lassen
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | - Y d'Udekem
- Children's National Hospital, Washington , D.C. , United States of America
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Tucci G, Roldán É, Gambassi A, Belousov R, Berger F, Alonso RG, Hudspeth AJ. Modeling Active Non-Markovian Oscillations. Phys Rev Lett 2022; 129:030603. [PMID: 35905355 DOI: 10.1103/physrevlett.129.030603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
Modeling noisy oscillations of active systems is one of the current challenges in physics and biology. Because the physical mechanisms of such processes are often difficult to identify, we propose a linear stochastic model driven by a non-Markovian bistable noise that is capable of generating self-sustained periodic oscillation. We derive analytical predictions for most relevant dynamical and thermodynamic properties of the model. This minimal model turns out to describe accurately bistablelike oscillatory motion of hair bundles in bullfrog sacculus, extracted from experimental data. Based on and in agreement with these data, we estimate the power required to sustain such active oscillations to be of the order of 100 k_{B}T per oscillation cycle.
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Affiliation(s)
- G Tucci
- SISSA-International School for Advanced Studies and INFN, via Bonomea 265, 34136 Trieste, Italy
| | - É Roldán
- ICTP-The Abdus Salam International Centre for Theoretical Physics, Strada Costiera 11, 34151 Trieste, Italy
| | - A Gambassi
- SISSA-International School for Advanced Studies and INFN, via Bonomea 265, 34136 Trieste, Italy
| | - R Belousov
- ICTP-The Abdus Salam International Centre for Theoretical Physics, Strada Costiera 11, 34151 Trieste, Italy
- EMBL-European Molecular Biology Laboratory, Meyerhofstrasse 1, 69117 Heidelberg, Germany
| | - F Berger
- Cell Biology, Neurobiology and Biophysics, Department of Biology, Faculty of Science, Utrecht University, 3584 CH Utrecht, Netherlands
| | - R G Alonso
- Howard Hughes Medical Institute and Laboratory of Sensory Neuroscience, The Rockefeller University, 1230 York Avenue, New York, New York 10065, USA
| | - A J Hudspeth
- Howard Hughes Medical Institute and Laboratory of Sensory Neuroscience, The Rockefeller University, 1230 York Avenue, New York, New York 10065, USA
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Berger F, Marce M, Delaloge S, Hardy-Bessard AC, Bachelot T, Bièche I, Pradines A, De La Motte Rouge T, Canon JL, André F, Arnould L, Clatot F, Lemonnier J, Marques S, Bidard FC. Randomised, open-label, multicentric phase III trial to evaluate the safety and efficacy of palbociclib in combination with endocrine therapy, guided by ESR1 mutation monitoring in oestrogen receptor-positive, HER2-negative metastatic breast cancer patients: study design of PADA-1. BMJ Open 2022; 12:e055821. [PMID: 35241469 PMCID: PMC8896060 DOI: 10.1136/bmjopen-2021-055821] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The combination of a CDK4/6 inhibitor with an aromatase inhibitor (AI) has recently become the gold standard for AI-sensitive first line treatment of oestrogen receptor-positive (ER+) HER2-negative (HER2-) advanced breast cancer. However, most patients receiving this combination will ultimately progress and require further therapies.Several studies have demonstrated that the onset of a ESR1 gene mutation lead to AIs resistance in the advanced setting. ESR1 mutations can be detected in circulating tumour DNA (ctDNA) using a digital PCR assay. Our study aims to prove the clinical efficacy of periodic monitoring for emerging or rise of ESR1 mutations in ctDNA to trigger an early change from AI plus palbociclib to fulvestrant plus palbociclib treatment while assessing global safety. METHODS PADA-1 is a randomised, open-label, multicentric, phase III trial conducted in patients receiving AI and palbociclib as first line therapy for metastatic ER +HER2- breast cancer. 1000 patients will be included and treated with palbociclib in combination with an AI. Patients will be screened for circulating blood ESR1 mutation detection at regular intervals. Patients for whom a rising circulating ESR1 mutation is detected without tumour progression (up to N=200) will be randomised (1:1) between (1) Arm A: no modification of therapy; and (2) Arm B: palbociclib in combination with fulvestrant, a selective ER down-regulator. At tumour progression, an optional crossover will be offered to patients randomised in arm A. The coprimary endpoints are (1) Grade ≥3 haematological toxicities and their associations with baseline characteristics and (2) progression-free survival in randomised patients. ETHICS AND DISSEMINATION The study has been approved by the French medicines agency (ANSM) and by an ethics committee (ref 01/17_1 CPP Ouest-IV Nantes) in January 2017. The trial results will be published in academic conference presentations and international peer-reviewed journals. TRIAL REGISTRATION NUMBERS EudraCT: 2016-004360-18; NCT03079011.
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Affiliation(s)
- Frédérique Berger
- Biometry Unit, Institut Curie, PSL Research University, Paris and Saint-Cloud, France
| | - Margaux Marce
- Biometry Unit, Data Center, Institut Régional du Cancer de Montpellier, Montpellier, France
| | | | | | - Thomas Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Ivan Bièche
- Pharmacogenomic Unit, Genetics laboratory, Department of Diagnostic and Theranostic Medicine, Institut Curie and PSL University, Paris, France
| | - Anne Pradines
- INSERM U1037 CNRS ERL5294 UPS, Cancer Research Center of Toulouse, Toulouse, France
- Prospective Biology Unit, Medical Laboratory, Claudius Regaud Institute, Toulouse University Cancer Institute (IUCT-O), Toulouse, France
| | | | - Jean-Luc Canon
- Department of Medical Oncology, Grand Hôpital de Charleroi, Charleroi, Belgique
| | - Fabrice André
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Laurent Arnould
- Department of Pathology, Centre Georges François Leclerc, Dijon, France
| | - Florian Clatot
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | | | | | - François-Clement Bidard
- Department of Medical Oncology, Institut Curie, UVSQ/Paris Saclay University, Saint Cloud, France
- Circulating Tumor Biomarkers laboratory, Inserm CIC-BT 1428, Institut Curie, Paris, France
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13
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Sallmon H, Kramer P, Avian A, Gamillscheg A, Cvirn G, Schweintzger S, Kurath-Koller S, Cantinotti M, Berger F, Köstenberger M. Right Ventricular Wall Tension in the Assessment of Pediatric Pulmonary Arterial Hypertension. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1743035] [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: 10/18/2022]
Affiliation(s)
- H. Sallmon
- Deutsches Herzzentrum Berlin (DHZB), Berlin, Deutschland
| | - P. Kramer
- Deutsches Herzzentrum Berlin (DHZB), Berlin, Deutschland
| | - A. Avian
- Medical University of Graz, Graz, Austria
| | | | - G. Cvirn
- Medical University of Graz, Graz, Austria
| | | | | | - M. Cantinotti
- Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy
| | - F. Berger
- Deutsches Herzzentrum Berlin (DHZB), Berlin, Deutschland
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14
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Seidel F, Kuehnisch J, Klingel K, Dartsch J, Laser KT, Berger F, Thomas P, Milting H, Schubert S, Klaassen S. Pathogenic Variants in Cardiomyopathy and Not Immune Disorder Genes Cause Pediatric Myocarditis with Dilated Cardiomyopathy Phenotype. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742972] [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: 10/18/2022]
Affiliation(s)
- F. Seidel
- Augustenburger Platz 1, Berlin, Deutschland
| | - J. Kuehnisch
- Experimental and Clinical Research Center Berlin, Berlin, Deutschland
| | | | - J. Dartsch
- Dzhk (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Experimental and Clinical Research Center Berlin, Berlin, Deutschland
| | | | - F. Berger
- Augustenburger Platz 1, Berlin, Deutschland
| | - P. Thomas
- Kompetenznetz Angeborene Herzfehler, Berlin, Deutschland
| | - H. Milting
- Herz- und Diabeteszentrum NRW, Georgstraße, Bad Oeynhausen, Germany, Bad Oeynhausen, Deutschland
| | | | - S. Klaassen
- Max-Delbrück-Centrum für Molekulare Medizin, Berlin, Deutschland
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Sun X, Hao Y, Emeis J, Steitz M, Breitenstein-Attach A, Berger F, Schmitt B, Kiekenap JF. Four-Dimensional Computed Tomography–Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742979] [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: 10/18/2022]
Affiliation(s)
- X. Sun
- Charité – Universitätsmedizin Berlin, Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - Y. Hao
- Charité – Universitätsmedizin Berlin, Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - J. Emeis
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - M. Steitz
- German Heart Institute Berlin, Berlin, Deutschland
| | | | - F. Berger
- Charité – Universitätsmedizin Berlin, Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - B. Schmitt
- Charité – Universitätsmedizin Berlin, Deutsches Herzzentrum Berlin, Berlin, Deutschland
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16
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Kieslich M, Parwani A, Weber-Bärenbrinker S, Opgen-Rhein B, Schwarz A, Berger F, Will J. Successful Epicardial Mapping and Ablation of Ventricular Tachycardia after Failed Medical Therapy and Conventional Endocardial Ablation Therapy in a 10-Year-Old Girl with Severe Biventricular Arrhythmogenic Cardiomyopathy. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742969] [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: 10/18/2022]
Affiliation(s)
- M. Kieslich
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - A. Parwani
- Cardiology Charité University, Berlin, Deutschland
| | | | - B. Opgen-Rhein
- Pediatric Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Deutschland
| | - A. Schwarz
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - F. Berger
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - J. Will
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
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17
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Schwarz A, Timme N, Kieslich M, Opgen-Rhein B, Weber-Bärenbrinker S, Berger F, Will J. Nonsustained Ventricular Tachycardia in Adolescents after mRNA-SARS-CoV-2 Vaccine: Report of Two Cases. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742970] [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: 10/18/2022]
Affiliation(s)
- A. Schwarz
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
| | - N. Timme
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
| | - M. Kieslich
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
| | | | | | - F. Berger
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
| | - J. Will
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
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18
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Schleiger A, Kramer P, Jentsch N, Pileckaite M, Schafstedde M, Danne F, Müller HP, Müller T, Tacke F, Jara M, Stockmann M, Berger F, Ovroutski S. Evaluation of Enzymatic Liver Function Using Liver Maximum Capacity Test (LiMAx) in Adult Fontan Patients. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742948] [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: 10/18/2022]
Affiliation(s)
- A. Schleiger
- Deutsches Herzzentrum Berlin Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Deutschland
| | - P. Kramer
- Deutsches Herzzentrum Berlin Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Deutschland
| | - N. Jentsch
- Deutsches Herzzentrum Berlin Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Deutschland
| | - M. Pileckaite
- Deutsches Herzzentrum Berlin Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Deutschland
| | - M. Schafstedde
- Deutsches Herzzentrum Berlin Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Deutschland
| | - F. Danne
- Deutsches Herzzentrum Berlin Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Deutschland
| | - H.-P. Müller
- Charité Centre for Internal Medicine and Dermatology, Berlin, Deutschland
| | - T. Müller
- Charité Campus Virchow Clinic, Berlin, Deutschland
| | - F. Tacke
- Charité Campus Virchow Clinic, Berlin, Deutschland
| | - M. Jara
- Department of General, Visceral and Vascular Surgery, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - M. Stockmann
- Department of General, Visceral and Vascular Surgery, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - F. Berger
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - S. Ovroutski
- German Heart Institute Berlin, Berlin, Deutschland
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19
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Schleiger A, Kramer P, Berger F, Nordmeyer J. Transcatheter Correction of Superior Sinus Venosus Atrial Septal Defect: A Case Series. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742980] [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: 10/18/2022]
Affiliation(s)
| | - P. Kramer
- Deutsches Herzzentrum Berlin Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Deutschland
| | - F. Berger
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - J. Nordmeyer
- German Heart Institute Berlin, Berlin, Deutschland
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20
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Timme N, Opgen-Rhein B, Weber-Bärenbrinker S, Weiss K, Berger F, Will J. Aborted Sudden Cardiac Death and Ventricular Fibrillation in Patients with Wolff–Parkinson–White Syndrome. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1743029] [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: 10/18/2022]
Affiliation(s)
- N. Timme
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - B. Opgen-Rhein
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | | | - K. Weiss
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - F. Berger
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - J. Will
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
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21
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Kramer P, Schleiger A, Schafstedde M, Danne F, Nordmeyer J, Berger F, Ovroutski S. Development of an Uncomplex Multimodal Score that Accurately Classifies Late Fontan Failure. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742997] [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: 10/18/2022]
Affiliation(s)
- P. Kramer
- Klinik für Angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany, Deutschland
| | - A. Schleiger
- Klinik für Angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany, Deutschland
| | - M. Schafstedde
- Klinik für Angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany, Deutschland
| | - F. Danne
- Klinik für Angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany, Deutschland
| | - J. Nordmeyer
- Klinik für Angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany, Deutschland
| | - F. Berger
- Klinik für Angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany, Deutschland
| | - S. Ovroutski
- Klinik für Angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany, Deutschland
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22
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Boethig D, Avsar M, Bauer U, Beerbaum P, Berger F, Cesnjevar R, Dähnert I, Dittrich S, Ewert P, Haverich A, Hörer J, Kostelka M, Photiadis J, Sandica E, Sarikouch S, Schubert S, Urban A, Westhoff-Bleck M, Bobylev D, Horke A. Lifetime Endocarditis Risk with Congenital Heart Disease and Pulmonary Valve Prosthesis (PVP): Results from the German Registry for Congenital Heart Defects (CHD). Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742863] [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: 10/19/2022]
Affiliation(s)
| | - M. Avsar
- Cardiac, thoracic, transplantation and vascular surgery, Hannover Medical School, Hanover, Deutschland
| | - U. Bauer
- Nationales Register Angeborene Herzfehler, Berlin, Deutschland
| | - P. Beerbaum
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - F. Berger
- Augustenburger Platz 1, Berlin, Deutschland
| | | | - I. Dähnert
- Kinderkardiologie, Herzzentrum Leipzig, Leipzig, Deutschland
| | | | - P. Ewert
- German Heart Centre Munich / Deutsches Herzzentrum München, München, Deutschland
| | - A. Haverich
- Carl-Neuberg-Straße 1, Hannover, Deutschland
| | | | | | | | - E. Sandica
- Herz-, Diabetes-Zentrum, Bad Oeynhausen, Deutschland
| | | | | | - A. Urban
- Nationales Register Angeborene Herzfehler, Berlin, Deutschland
| | | | - D. Bobylev
- Carl-Neuberg-Straße 1, Hannover, Deutschland
| | - A. Horke
- Carl-Neuberg-Str. 1, Hannover, Deutschland
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23
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Loap P, Loirat D, Berger F, Rodrigues M, Bazire L, Pierga J, Ricci F, Cao K, Vincent-Salomon A, Laki F, Ezzili C, Raizonville L, Mosseri V, Neffati S, Ezzalfani M, Fourquet A, Kirova Y. One-Year Toxicity Report of the RADIOPARP Phase I Trial Evaluating Olaparib With Radiotherapy for Triple Negative Breast Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.052] [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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Guggiari E, De Gani SM, Berger F, Jaks R. Corona-specific health literacy: a longitudinal study in the German-speaking part of Switzerland. Eur J Public Health 2021. [PMCID: PMC8574744 DOI: 10.1093/eurpub/ckab165.138] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The COVID-19 pandemic is accompanied by an infodemic, i.e. a flood of conflicting infor-mation through numerous channels and mis-/disinformation. To cope with these challenges and to make sound health-decisions, people need skills that enable them to access, under-stand, appraise, and use health-related information, i.e. adequate health literacy (HL). Thus, the present study investigates how people in the German-speaking part of Switzerland handle with Corona-specific information, what their difficulties are and what potential improvement measures could be.
Methods
Three representative samples of 1'000 individuals each were interviewed online in early sum-mer, autumn and winter 2020 using a modified version of the HLS-EU-Q16 questionnaire. Da-ta were analyzed using descriptive methods and an index for Corona-specific HL was built.
Results
In early summer, 55% of the German-speaking Swiss population reported adequate Corona-specific HL, with a tendency to increase with the duration of the pandemic (autumn: 62%; winter: 63%). Nonetheless, a great proportion reported difficulties, especially with assessing the trustworthiness of information from the media. With the progress of the pandemic, partici-pants felt less informed and the proportion of (very) poorly informed increased from 8% in early summer to 16% in winter 2020.
Conclusions
Participants often found it difficult to assess the trustworthiness of information on COVID-19 and to derive consequences for their own behavior. Hence, it is important that all relevant stakeholders such as health organizations, authorities and media support the population with tools to facilitate the use of health information and to empower them to take responsibility for their own health as well as for their community.
Key messages
People need adequate HL to handle the amount and complexity of COVID-19-related information. Relevant stakeholders need to take over responsibility to empower the population and to enhance their HL.
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Affiliation(s)
- E Guggiari
- Health Literacy Division, Careum Foundation, Zurich, Switzerland
- Research Department, Careum School of Health, Zurich, Switzerland
| | - SM De Gani
- Health Literacy Division, Careum Foundation, Zurich, Switzerland
| | - F Berger
- Health Literacy Division, Careum Foundation, Zurich, Switzerland
- Research Department, Careum School of Health, Zurich, Switzerland
| | - R Jaks
- Health Literacy Division, Careum Foundation, Zurich, Switzerland
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Eisfeld M, Weiss K, Yigitbasi M, Pieske B, Berger F, Gehle P. Aortic Z-scores in paediatric patients with marfan syndrome and other hereditary thoracic aortic diseases. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1862] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Marfan syndrome (MFS) and other hereditary thoracic aortic diseases (HTAD) are characterized by dilatation of the aorta caused by mutations in the FBN1-gene and other aortic genes. To prevent aortic dissection or rupture, patients are prophylactically treated by aortic surgery. Different z-scores of the aortic root are used for diagnosis and monitoring in paediatric patients.
Purpose
What are the differences between the various aortic Z-scores in their use for monitoring, assessing the severity of the aortic disease, and establishing the indication for surgery in this age group?
Methods
We retrospectively analyzed the diameters of aortic roots measured by echocardiography in 180 children and young adults (1 month to 25 years) with MFS and other HTADs presenting at our specialized outpatient clinic between January 2010 and August 2019. Thirteen patients underwent surgery during this period and 121 were monitored for a duration of one up to nine years. Five aortic z-scores were compared: Pettersen, Gautier, Cantinotti, Lopez, Boston. For evaluation of the severity of dilatation and indication for surgery, we used the last value before operation or the last follow-up value. For monitoring, we used the difference between the first and the last value. For comparison of the z-scores, values of the sinuses of Valsalva were analyzed. We investigated theoretic backgrounds and reference groups of each z-score.
Results
The z-score values differ significantly (p<0,001) for each score. The medians reach from 2.06 to 3.45, in operated patients 4.90 to 8.52, non-operated patients 1.86 to 3.31 (p<0,001). 93 aortic diameters to 136 were classified as dilatated (z-score ≥2). There were significant differences of almost all z-scores in the comparison with one another. During follow-up, the increase of the median z-score ranged from 0.11 to 0.24, in operated patients from 0.73 to 1.93, in non-operated patients from 0.02 to 0.21, respectively. The median monitoring time was 4.14 years and 2.93 years, for patients monitored for more than one year and all patients, respectively. In the operated subgroup, a weak correlation showed that the longer the monitoring time and the closer the surgery arrived, the faster the z-scores rose. Lopez, Boston and Cantinotti have higher values and label a value quicker than dilatated, but also reveal the severity of dilatation and the potential necessity of surgery.
Conclusions
Our data show that the various z-scores differ significantly. No z-score was superior regarding above-mentioned aspects, their differences in monitoring were small. However, it seems important to consistently use one same z-score. Expectedly, z-score values of each score were higher in the operated subgroup than in patients without surgery. However, there is no z-score value that determines a clear-cut indication for surgery.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Eisfeld
- Charite - Campus Virchow-Klinikum (CVK), Department of Medicine and Cardiology, Berlin, Germany
| | - K Weiss
- Charite - Campus Virchow-Klinikum (CVK), Department of Pediatric Cardiology, Berlin, Germany
| | - M Yigitbasi
- Deutsches Herzzentrum Berlin, Berlin, Germany
| | - B Pieske
- Charite - Campus Virchow-Klinikum (CVK), Department of Medicine and Cardiology, Berlin, Germany
| | - F Berger
- Charite - Campus Virchow-Klinikum (CVK), Department of Pediatric Cardiology, Berlin, Germany
| | - P Gehle
- Charite - Campus Virchow-Klinikum (CVK), Department of Medicine and Cardiology, Berlin, Germany
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Kiekenap J, Sun X, Hultsch J, Dietrich T, Oetvoes J, Schmidt T, Reiter K, Kargin H, Emeis J, Berger F, Schmitt B. First results of a regenerative transcatheter heart valve implant from autologous tissue in a long-term animal model. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2229] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The perfect heart valve replacement remains to be found regarding longevity, freedom of anticoagulation and availability in each size.
Purpose
Examination of a new technique for a regenerative, immunocompatible, transcatheter pulmonary valve implant from autologous pericardium was performed in an adult sheep model.
Methods
For each valve implant a pericardial patch was harvested by left antero-lateral mini-thoracotomy, placed on one of two slightly different shaped moulds either made of acrylic glass (AG) or printed in a 3D Printer (3D) and transferred into a container filled with a biological crosslinking agent at a non-toxic concentration to stabilize the given shape. After a median of 3 days (d) they were unpacked, sewn into a self-expandable nitinol stent with a diameter of 26 or 30mm and implanted via the jugular vein into pulmonary valve position of the same animal using a custom-made delivery system (1). Three groups (Gr) were planned: Gr 1) 4 animals with at least 6 d of crosslinking and AG mould; Gr 2) 5 animals with at least 3 d of crosslinking and AG mould; Gr 3) 6 animals with at least 3 d crosslinking and 3D mould. Follow ups (FU) were performed every 3 months (mo) evaluating valve function by intracardiac echocardiography (ICE) and cardiac MRI for up to 20.5 mo. All experiments were approved and conducted according to German federal law.
Results
In 11 of 13 animals minimally-invasive implantation was successful. One animal died because of ventricular fibrillation, in the other the implant dislocated into the right ventricle, so it had to be sacrificed. Direct post-implantation valve insufficiency was evaluated in 9 animals using ICE or angiography. In Gr 1 insufficiency was non-existent (n=2), in Gr 2 moderate or severe (n=2) and in Gr 3 non-existent or mild (n=5). Long term function as shown in figure 1 decreased rapidly in Gr 1 and 2 with median MRI regurgitation fractions (RF) in Gr 1 of 31% at 3 mo (n=3), 41% at 6 mo (n=3), 48% at 9 mo (n=2), 47% at 12 mo (n=3) and in Gr 2 of 43% at 3 and 54% at 6 mo (n=1) after implantation. Median RF in Gr 3 was small with 9% at 3 mo (n=4), 8% at 6 mo (n=3), 8% at 9 mo (n=3), 12% at 13 mo (n=3), 8% at 17 mo (n=2) and 20.5 mo (n=2). We never witnessed valve stenosis in any group at any point in time.
Conclusion
Gr 3 showed promising results regarding long time function of the implant which encourages further research with higher validity. The reason for failing of Gr 1 and 2 remains a topic of discussion. Regardless, valuable experience was gained in crafting and conducting the implantation of this new regenerative heart valve implant.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): EXIST research transfer program of the federal ministry of education and research
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Affiliation(s)
- J Kiekenap
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Berlin, Germany
| | - X Sun
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Berlin, Germany
| | - J Hultsch
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Berlin, Germany
| | - T Dietrich
- Charité - Universitätsmedizin Berlin, Department of Pediatrics, Division Cardiology, Berlin, Germany
| | - J Oetvoes
- Charité - Universitätsmedizin Berlin, Department of Pediatrics, Division Cardiology, Berlin, Germany
| | - T Schmidt
- Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Reiter
- Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - H Kargin
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Berlin, Germany
| | - J Emeis
- Charité - Universitätsmedizin Berlin, Department of Pediatrics, Division Cardiology, Berlin, Germany
| | - F Berger
- German Heart Center Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Berlin, Germany
| | - B Schmitt
- Charité - Universitätsmedizin Berlin, Department of Pediatrics, Division Cardiology, Berlin, Germany
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Bortolini Silveira A, Bidard FC, Tanguy ML, Girard E, Trédan O, Dubot C, Jacot W, Goncalves A, Debled M, Levy C, Ferrero JM, Jouannaud C, Rios M, Mouret-Reynier MA, Dalenc F, Hego C, Rampanou A, Albaud B, Baulande S, Berger F, Lemonnier J, Renault S, Desmoulins I, Proudhon C, Pierga JY. Multimodal liquid biopsy for early monitoring and outcome prediction of chemotherapy in metastatic breast cancer. NPJ Breast Cancer 2021; 7:115. [PMID: 34504096 PMCID: PMC8429692 DOI: 10.1038/s41523-021-00319-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022] Open
Abstract
Circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) are two cancer-derived blood biomarkers that inform on patient prognosis and treatment efficacy in breast cancer. We prospectively evaluated the clinical validity of quantifying both CTCs (CellSearch) and ctDNA (targeted next-generation sequencing). Their combined value as prognostic and early monitoring markers was assessed in 198 HER2-negative metastatic breast cancer patients. All patients were included in the prospective multicenter UCBG study COMET (NCT01745757) and treated by first-line chemotherapy with weekly paclitaxel and bevacizumab. Blood samples were obtained at baseline and before the second cycle of chemotherapy. At baseline, CTCs and ctDNA were respectively detected in 72 and 74% of patients and were moderately correlated (Kendall’s τ = 0.3). Only 26 (13%) patients had neither detectable ctDNA nor CTCs. Variants were most frequently observed in TP53 and PIK3CA genes. KMT2C/MLL3 variants detected in ctDNA were significantly associated with a lower CTC count, while the opposite trend was seen with GATA3 alterations. Both CTC and ctDNA levels at baseline and after four weeks of treatment were correlated with survival. For progression-free and overall survival, the best multivariate prognostic model included tumor subtype (triple negative vs other), grade (grade 3 vs other), ctDNA variant allele frequency (VAF) at baseline (per 10% increase), and CTC count at four weeks (≥5CTC/7.5 mL). Overall, this study demonstrates that CTCs and ctDNA have nonoverlapping detection profiles and complementary prognostic values in metastatic breast cancer patients. A comprehensive liquid-biopsy approach may involve simultaneous detection of ctDNA and CTCs.
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Affiliation(s)
| | - François-Clément Bidard
- Circulating Tumor Biomarkers laboratory, INSERM CIC BT-1428, Institut Curie, Paris, France.,Department of Medical Oncology, Institut Curie, Paris and Saint Cloud, Paris, France.,UVSQ, Université Paris-Saclay, Paris, France
| | | | - Elodie Girard
- INSERM U900, Institut Curie, Mines ParisTech, PSL Research University, Paris, France
| | - Olivier Trédan
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Coraline Dubot
- Department of Medical Oncology, Institut Curie, Paris and Saint Cloud, Paris, France
| | - William Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier University, IRCM INSERM, Montpellier, France
| | - Anthony Goncalves
- Department of Medical Oncology, Aix-Marseille Univ, INSERM U1068, CNRS UMR7258, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - Marc Debled
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Christelle Levy
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | | | - Maria Rios
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, France
| | | | - Florence Dalenc
- Department of Medical Oncology, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - Caroline Hego
- Circulating Tumor Biomarkers laboratory, INSERM CIC BT-1428, Institut Curie, Paris, France
| | - Aurore Rampanou
- Circulating Tumor Biomarkers laboratory, INSERM CIC BT-1428, Institut Curie, Paris, France
| | - Benoit Albaud
- ICGex Next-Generation Sequencing Platform, Institut Curie, Paris, France
| | - Sylvain Baulande
- ICGex Next-Generation Sequencing Platform, Institut Curie, Paris, France
| | | | | | - Shufang Renault
- Circulating Tumor Biomarkers laboratory, INSERM CIC BT-1428, Institut Curie, Paris, France
| | - Isabelle Desmoulins
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Charlotte Proudhon
- Circulating Tumor Biomarkers laboratory, INSERM CIC BT-1428, Institut Curie, Paris, France.,INSERM U934 CNRS UMR3215, Paris, France
| | - Jean-Yves Pierga
- Circulating Tumor Biomarkers laboratory, INSERM CIC BT-1428, Institut Curie, Paris, France. .,Department of Medical Oncology, Institut Curie, Paris and Saint Cloud, Paris, France. .,Université de Paris, Paris, France.
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28
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Verrelle P, Meseure D, Berger F, Forest A, Leclère R, Nicolas A, Fortas E, Sastre-Garau X, Lae M, Boudjemaa S, Mbagui R, Calugaru V, Labiod D, De Koning L, Almouzni G, Quivy JP. CENP-A Subnuclear Localization Pattern as Marker Predicting Curability by Chemoradiation Therapy for Locally Advanced Head and Neck Cancer Patients. Cancers (Basel) 2021; 13:cancers13163928. [PMID: 34439087 PMCID: PMC8391827 DOI: 10.3390/cancers13163928] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary For clinicians, rapid diagnosis of early neoplastic lesions and prediction of treatment response are two key aspects to guide their choice of treatment. Current histological markers are based on proliferation, differentiation states or specific cell function, but do not take full advantage of tumor characteristics. We show that the subnuclear distribution of CENP-A, the centromeric histone variant, provides, for both aspects, information distinct from and independent of commonly used markers. Our study reveals that in locally advanced head and neck squamous cell cancer patients, the subnuclear distribution of CENP-A at the time of diagnosis is an independent predictive marker of local disease control and curability by concurrent chemoradiation therapy. We provide evidence for the clinical applicability of this CENP-A labeling as a cost-effective marker regardless of genetic alterations in the tumor, perfectly compatible with the clinical time constraints in the course of therapy. Abstract Effective biomarkers predictive of the response to treatments are key for precision medicine. This study identifies the staining pattern of the centromeric histone 3 variant, CENP-A, as a predictive biomarker of locoregional disease curability by chemoradiation therapy. We compared by imaging the subnuclear distribution of CENP-A in normal and tumoral tissues, and in a retrospective study in biopsies of 62 locally advanced head and neck squamous cell carcinoma (HNSCC) patients treated by chemoradiation therapy. We looked for predictive factors of locoregional disease control and patient’s survival, including CENP-A patterns, Ki67, HPV status and anisokaryosis. In different normal tissues, we reproducibly found a CENP-A subnuclear pattern characterized by CENP-A clusters both localized at the nuclear periphery and regularly spaced. In corresponding tumors, both features are lost. In locally advanced HNSCC, a specific CENP-A pattern identified in pretreatment biopsies predicts definitive locoregional disease control after chemoradiation treatment in 96% (24/25) of patients (OR = 17.6 CI 95% [2.6; 362.8], p = 0.002), independently of anisokaryosis, Ki67 labeling or HPV status. The characteristics of the subnuclear pattern of CENP-A in cell nuclei revealed by immunohistochemistry could provide an easy to use a reliable marker of disease curability by chemoradiation therapy in locally advanced HNSCC patients.
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Affiliation(s)
- Pierre Verrelle
- Institut Curie, PSL Research University, CNRS, Sorbonne Université, Nuclear Dynamics Unit, Equipe Labellisée Ligue Contre le Cancer, 26 rue d’Ulm, 75005 Paris, France;
- University of Clermont Auvergne, UFR Médecine, 63001 Clermont-Ferrand, France
- CNRS UMR 9187, INSERM U1196, Institut Curie, PSL Research University and Paris-Saclay University, 91405 Orsay, France
- Radiation Oncology Department, Institut Curie, 75005 Paris, France; (R.M.); (V.C.)
- Correspondence: (P.V.); (G.A.); (J.-P.Q.)
| | - Didier Meseure
- Platform of Experimental Pathology PATHEX, Institut Curie, 75005 Paris, France; (D.M.); (R.L.); (A.N.); (E.F.)
- Department of Diagnostic and Theranostic Medicine, Institut Curie, 75005 Paris, France
| | - Frédérique Berger
- Institut Curie, PSL Research University, Biometry Unit, 75005 Paris, France;
| | - Audrey Forest
- Institut Curie, PSL Research University, CNRS, Sorbonne Université, Nuclear Dynamics Unit, Equipe Labellisée Ligue Contre le Cancer, 26 rue d’Ulm, 75005 Paris, France;
| | - Renaud Leclère
- Platform of Experimental Pathology PATHEX, Institut Curie, 75005 Paris, France; (D.M.); (R.L.); (A.N.); (E.F.)
- Department of Diagnostic and Theranostic Medicine, Institut Curie, 75005 Paris, France
| | - André Nicolas
- Platform of Experimental Pathology PATHEX, Institut Curie, 75005 Paris, France; (D.M.); (R.L.); (A.N.); (E.F.)
- Department of Diagnostic and Theranostic Medicine, Institut Curie, 75005 Paris, France
| | - Emilie Fortas
- Platform of Experimental Pathology PATHEX, Institut Curie, 75005 Paris, France; (D.M.); (R.L.); (A.N.); (E.F.)
- Department of Diagnostic and Theranostic Medicine, Institut Curie, 75005 Paris, France
| | - Xavier Sastre-Garau
- Department of Pathology, Intercommunal Hospital Center of Creteil, 94000 Créteil, France;
| | - Marick Lae
- Department of Pathology, Centre Henri Becquerel, INSERM U1245, UNIROUEN, University of Normandie, 76031 Rouen, France;
| | - Sabah Boudjemaa
- Department of Pathology, Hôpital Armand Trousseau, 75012 Paris, France;
| | - Rodrigue Mbagui
- Radiation Oncology Department, Institut Curie, 75005 Paris, France; (R.M.); (V.C.)
| | - Valentin Calugaru
- Radiation Oncology Department, Institut Curie, 75005 Paris, France; (R.M.); (V.C.)
| | - Dalila Labiod
- Translational Research Department, Experimental Radiotherapy Platform, Institut Curie, PSL Research University, University Paris Saclay, 91400 Orsay, France;
| | - Leanne De Koning
- Department of Translational Research, Institut Curie, PSL Research University, 75005 Paris, France;
| | - Geneviève Almouzni
- Institut Curie, PSL Research University, CNRS, Sorbonne Université, Nuclear Dynamics Unit, Equipe Labellisée Ligue Contre le Cancer, 26 rue d’Ulm, 75005 Paris, France;
- Correspondence: (P.V.); (G.A.); (J.-P.Q.)
| | - Jean-Pierre Quivy
- Institut Curie, PSL Research University, CNRS, Sorbonne Université, Nuclear Dynamics Unit, Equipe Labellisée Ligue Contre le Cancer, 26 rue d’Ulm, 75005 Paris, France;
- Correspondence: (P.V.); (G.A.); (J.-P.Q.)
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29
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Loap P, Loirat D, Berger F, Rodrigues M, Bazire L, Pierga J, Ricci F, Cao K, Vincent-Salomon A, Laki F, Ezzili C, Jochem A, Raizonville L, Mosseri V, Ezzalfani M, Fourquet A, Kirova Y. OC-0630 Olaparib combined with radiotherapy for TNBC: 1-year toxicity report of the RADIOPARP phase 1 trial. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06986-3] [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: 10/20/2022]
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30
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Pradines A, Callens C, Doussine A, Bièche I, Lemonnier J, Mauduit M, Bachelot T, Dalenc F, Lortholary A, Pistilli B, Rouge TDLM, Sabatier R, Ferrero JM, Ladoire S, Berger F, Bidard FC. Abstract CT189: Characterization of ESR1 mutations at metastatic relapse and outcome under first line aromatase inhibitor and palbociclib in the PADA-1 trial. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-ct189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Palbociclib (Pal) combined with an aromatase inhibitor (AI) is a standard of care as first line therapy in ER+ HER2- metastatic breast cancer (MBC). Cell-free DNA (cfDNA) ESR1 mutation (ESR1mut) status prior to treatment initiation may be associated with shorter progression-free survival (PFS) under first line Pal+AI; however, the impact of the exact type of ESR1mut, of their quantitative levels and clonality are unknown. In a subsidiary analysis of the first line PADA-1 phase 3 trial, cfDNA samples previously detected as positive by ddPCR were submitted to NGS; mutations types, level and clonality were correlated with patient outcomes under first line Pal+AI. Methods: PADA-1 (NCT03079011) is a phase III trial testing the clinical utility of real time ESR1mut detection in the blood of patients treated with AI-Pal. Main inclusion criteria are patients with ER+ HER2- MBC, who never received adjuvant AI or completed adjuvant AI for >12 months, with neither prior therapy for MBC nor visceral crisis. ESR1mut are tracked in cfDNA from up to 4ml of plasma by a single ddPCR assay targeting E380, L536, Y537 and D538 hotspots (i.e. >90% of known ESR1 activating mutations) with 0.1% sensitivity (Jeannot et al, Oncogene 2020). We sequenced the ddPCR positive cfDNA samples using a short amplicon-based NGS panel spanning 30 genes, including the full sequence of ESR1. We assessed for the correlation between PFS and ESR1mut type (NGS), absolute level (copy/ml, ddPCR) or variant allelic frequency (VAF, NGS & ddPCR), and clonality (NGS, pending the detection of other driver mutations). Results: Among the 1,017 included patients, N=33 (3.2%) had an ESR1mut detected by ddPCR at inclusion (median VAF= 2.5%, range (0.09-46.6%). 26/33 left-over cfDNA samples were available for NGS. ESR1mut VAFs retrieved by NGS and ddPCR showed an excellent intraclass correlation coefficient (ICC= 0.98; 95% CI [0.89;0.99]). In N=3 samples with low VAF by ddPCR (<1%), NGS was not able to detect ESR1mut. ESR1 codons 380, 536, 537 and 538 were mutated in N=5, 6, 10 and 7 patients, respectively (5 patients (19.2%) having polyclonal mutations). Among evaluable patients, ESR1mut were found clonal and subclonal in 11 (47.8%) and 12 (52.2%) patients, respectively. After a median follow-up of 24.8 months (range 0-41.9 months) (485 PFS events among the 1,017 included patients), ESR1mut detection at inclusion was found to be a prognostic factor for PFS (median PFS = 11.6 months 95% CI [8.3; NR] vs 28.5 months 95% CI [23.3;30.2]; HR= 2.2 95% CI = [1.4;3.4]). ESR1mut type, clonality and baseline levels had no significant additional impact on PFS. Conclusion: Presence of ESR1mut detected in cfDNA at metastatic relapse are associated with a shorter PFS under first line AI and palbociclib. ddPCR and NGS yielded similar quantitative results, while supplementary information obtained by NGS (mutation type and clonality) did not add further prognostic information. Funding: Pfizer, French National Cancer Institute (Grant PRT-K 2020-041)
Citation Format: Anne Pradines, Céline Callens, Aurélia Doussine, Ivan Bièche, Jérôme Lemonnier, Marjorie Mauduit, Thomas Bachelot, Florence Dalenc, Alain Lortholary, Barbara Pistilli, Thibault De La Motte Rouge, Renaud Sabatier, Jean-Marc Ferrero, Sylvain Ladoire, Frédérique Berger, François-Clément Bidard. Characterization of ESR1 mutations at metastatic relapse and outcome under first line aromatase inhibitor and palbociclib in the PADA-1 trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT189.
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31
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Callens C, Driouch K, Boulai A, Tariq Z, Comte A, Berger F, Belin L, Bièche I, Servois V, Legoix P, Bernard V, Baulande S, Chemlali W, Bidard FC, Fourchotte V, Salomon AV, Brain E, Lidereau R, Bachelot T, Saghatchian M, Campone M, Giacchetti S, Zafrani BS, Cottu P. Molecular features of untreated breast cancer and initial metastatic event inform clinical decision-making and predict outcome: long-term results of ESOPE, a single-arm prospective multicenter study. Genome Med 2021; 13:44. [PMID: 33722295 PMCID: PMC7962302 DOI: 10.1186/s13073-021-00862-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background Prognosis evaluation of advanced breast cancer and therapeutic strategy are mostly based on clinical features of advanced disease and molecular profiling of the primary tumor. Very few studies have evaluated the impact of metastatic subtyping during the initial metastatic event in a prospective study. The genomic landscape of metastatic breast cancer has mostly been described in very advanced, pretreated disease, limiting the findings transferability to clinical use. Methods We developed a multicenter, single-arm, prospective clinical trial in order to address these issues. Between November 2010 and September 2013, 123 eligible patients were included. Patients at the first, untreated metastatic event were eligible. All matched primary tumors and metastatic samples were centrally reviewed for pathological typing. Targeted and whole-exome sequencing was applied to matched pairs of frozen tissue. A multivariate overall survival analysis was performed (median follow-up 64 months). Results Per central review in 84 patients (out of 130), we show that luminal A breast tumors are more prone to subtype switching. By combining targeted sequencing of a 91 gene panel (n = 67) and whole-exome sequencing (n = 30), a slight excess of mutations is observed in the metastases. Luminal A breast cancer has the most heterogeneous mutational profile and the highest number of mutational signatures, when comparing primary tumor and the matched metastatic tissue. Tumors with a subtype change have more mutations that are private. The metastasis-specific mutation load is significantly higher in late than in de novo metastases. The most frequently mutated genes were TP53 and PIK3CA. The most frequent metastasis-specific druggable genes were PIK3CA, PTEN, KDR, ALK, CDKN2A, NOTCH4, POLE, SETD2, SF3B1, and TSC2. Long-term outcome is driven by a combination of tumor load and metastasis biology. Conclusions Profiling of the first, untreated, metastatic event of breast cancer reveals a profound heterogeneity mostly in luminal A tumors and in late metastases. Based on this profiling, we can derive information relevant to prognosis and therapeutic intervention, which support current guidelines recommending a biopsy at the first metastatic relapse. Trial registration The trial was registered at ClinicalTrials.gov (NCT01956552). Supplementary Information The online version contains supplementary material available at 10.1186/s13073-021-00862-6.
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Affiliation(s)
- Céline Callens
- Genetics Department, Institut Curie, PSL Research University, Paris, France
| | - Keltouma Driouch
- Genetics Department, Institut Curie, PSL Research University, Paris, France
| | - Anaïs Boulai
- Genetics Department, Institut Curie, PSL Research University, Paris, France
| | - Zakia Tariq
- Genetics Department, Institut Curie, PSL Research University, Paris, France
| | - Aurélie Comte
- Department of Medical Oncology, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France
| | | | - Lisa Belin
- Department of Biostatistics, Institut Curie, Saint-Cloud, France
| | - Ivan Bièche
- Genetics Department, Institut Curie, PSL Research University, Paris, France
| | - Vincent Servois
- Imaging Department, Institut Curie, PSL Research University, Paris, France
| | - Patricia Legoix
- Institut Curie Genomics of Excellence (ICGex) Platform, Institut Curie Research Center, PSL Research University, Paris, France
| | - Virginie Bernard
- Institut Curie Genomics of Excellence (ICGex) Platform, Institut Curie Research Center, PSL Research University, Paris, France
| | - Sylvain Baulande
- Institut Curie Genomics of Excellence (ICGex) Platform, Institut Curie Research Center, PSL Research University, Paris, France
| | - Walid Chemlali
- Genetics Department, Institut Curie, PSL Research University, Paris, France
| | - François-Clément Bidard
- Department of Medical Oncology, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France
| | | | - Anne Vincent- Salomon
- Pathology and Tumor Biology Department, Institut Curie, PSL Research University, Paris, France
| | - Etienne Brain
- Medical Oncology, Institut Curie, Saint-Cloud, France
| | - Rosette Lidereau
- Genetics Department, Institut Curie, PSL Research University, Paris, France
| | | | | | - Mario Campone
- Institut de Cancérologie de l'Ouest Nantes, Nantes, France
| | | | - Brigitte Sigal Zafrani
- Pathology and Tumor Biology Department, Institut Curie, PSL Research University, Paris, France
| | - Paul Cottu
- Department of Medical Oncology, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France.
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32
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Nordmeyer S, Lee CB, Goubergrits L, Knosalla C, Berger F, Falk V, Ghorbani N, Hireche-Chikaoui H, Zhu M, Kelle S, Kuehne T, Kelm M. Circulatory efficiency in patients with severe aortic valve stenosis before and after aortic valve replacement. J Cardiovasc Magn Reson 2021; 23:15. [PMID: 33641670 PMCID: PMC7919094 DOI: 10.1186/s12968-020-00686-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/29/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Circulatory efficiency reflects the ratio between total left ventricular work and the work required for maintaining cardiovascular circulation. The effect of severe aortic valve stenosis (AS) and aortic valve replacement (AVR) on left ventricular/circulatory mechanical power and efficiency is not yet fully understood. We aimed to quantify left ventricular (LV) efficiency in patients with severe AS before and after surgical AVR. METHODS Circulatory efficiency was computed from cardiovascular magnetic resonance (CMR) imaging derived volumetric data, echocardiographic and clinical data in patients with severe AS (n = 41) before and 4 months after AVR and in age and sex-matched healthy subjects (n = 10). RESULTS In patients with AS circulatory efficiency was significantly decreased compared to healthy subjects (9 ± 3% vs 12 ± 2%; p = 0.004). There were significant negative correlations between circulatory efficiency and LV myocardial mass (r = - 0.591, p < 0.001), myocardial fibrosis volume (r = - 0.427, p = 0.015), end systolic volume (r = - 0.609, p < 0.001) and NT-proBNP (r = - 0.444, p = 0.009) and significant positive correlation between circulatory efficiency and LV ejection fraction (r = 0.704, p < 0.001). After AVR, circulatory efficiency increased significantly in the total cohort (9 ± 3 vs 13 ± 5%; p < 0.001). However, in 10/41 (24%) patients, circulatory efficiency remained below 10% after AVR and, thus, did not restore to normal values. These patients also showed less reduction in myocardial fibrosis volume compared to patients with restored circulatory efficiency after AVR. CONCLUSION In our cohort, circulatory efficiency is reduced in patients with severe AS. In 76% of cases, AVR leads to normalization of circulatory efficiency. However, in 24% of patients, circulatory efficiency remained below normal values even after successful AVR. In these patients also less regression of myocardial fibrosis volume was seen. Trial Registration clinicaltrials.gov NCT03172338, June 1, 2017, retrospectively registered.
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Affiliation(s)
- S Nordmeyer
- Department of Congenital Heart Disease, German Heart Centre Berlin, Berlin, Germany.
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - C B Lee
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - L Goubergrits
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C Knosalla
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Cardiothoracic and Vascular Surgery, German Heart Centre Berlin, Berlin, Germany
| | - F Berger
- Department of Congenital Heart Disease, German Heart Centre Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - V Falk
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Cardiothoracic and Vascular Surgery, German Heart Centre Berlin, Berlin, Germany
| | - N Ghorbani
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - H Hireche-Chikaoui
- Department of Internal Medicine and Cardiology, German Heart Centre Berlin, Berlin, Germany
| | - M Zhu
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Kelle
- Department of Internal Medicine and Cardiology, German Heart Centre Berlin, Berlin, Germany
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - T Kuehne
- Department of Congenital Heart Disease, German Heart Centre Berlin, Berlin, Germany
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - M Kelm
- Department of Congenital Heart Disease, German Heart Centre Berlin, Berlin, Germany
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
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Cabel L, Berger F, Cottu P, Loirat D, Rampanou A, Brain E, Cyrille S, Bourgeois H, Kiavue N, Deluche E, Ladoire S, Campone M, Pierga JY, Bidard FC. Clinical utility of circulating tumour cell-based monitoring of late-line chemotherapy for metastatic breast cancer: the randomised CirCe01 trial. Br J Cancer 2021; 124:1207-1213. [PMID: 33473163 PMCID: PMC8007590 DOI: 10.1038/s41416-020-01227-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 11/30/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND CirCe01 trial aimed to assess the clinical utility of circulating tumour cell (CTC)-based monitoring in metastatic breast cancer (MBC) patients beyond the third line of chemotherapy (LC). METHODS CirCe01 was a prospective, multicentre, randomised trial (NCT01349842) that included patients with MBC after two systemic LC. Patients with ≥5 CTC/7.5 mL (CellSearch®) were randomised between the CTC-driven and the standard arm. In the CTC arm, changes in CTC count were assessed at the first cycle of each LC; patients in whom CTC levels predicted early tumour progression had to switch to a subsequent LC. RESULTS Greater than or equal to 5 CTC/7.5 mL were observed in N = 101/204 patients. In the CTC arm (N = 51), 43 (83%) and 18 (44%) patients completed CTC monitoring in the third and fourth lines, respectively, and 18 (42%) and 11 (61%) of these patients, respectively, had no CTC response. Thirteen (72%) and 5 (46%) of these patients underwent early switch to the next LC. Overall survival was not different between the two arms (hazard ratio = 0.95, 95% confidence interval = [0.6;1.4], p = 0.8). In subgroup analyses, patients with no CTC response who switched chemotherapy experienced longer survival than patients who did not. CONCLUSIONS Due to the limited accrual and compliance, this trial failed to demonstrate the clinical utility of CTC monitoring. CLINICAL TRIAL REGISTRATION NCT, NCT01349842, https://clinicaltrials.gov/ct2/show/NCT01349842 , registered 9 May 2011.
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Affiliation(s)
- Luc Cabel
- Department of Medical Oncology, Institut Curie, Paris, France.,Department of Medical Oncology, Institut Curie, Saint Cloud, France.,Circulating Tumor Biomarkers Laboratory, SIRIC2 Institut Curie, Paris, France.,UVSQ, Université Paris-Saclay, Saint Cloud, France
| | - Frédérique Berger
- Department of Biostatistics, Institut Curie, PSL Research University, Saint Cloud, France
| | - Paul Cottu
- Department of Medical Oncology, Institut Curie, Paris, France.,Department of Medical Oncology, Institut Curie, Saint Cloud, France
| | - Delphine Loirat
- Department of Medical Oncology, Institut Curie, Paris, France.,Department of Medical Oncology, Institut Curie, Saint Cloud, France
| | - Aurore Rampanou
- Circulating Tumor Biomarkers Laboratory, SIRIC2 Institut Curie, Paris, France
| | - Etienne Brain
- Department of Medical Oncology, Institut Curie, Paris, France.,Department of Medical Oncology, Institut Curie, Saint Cloud, France
| | - Stacy Cyrille
- Department of Biostatistics, Institut Curie, PSL Research University, Saint Cloud, France
| | - Hugues Bourgeois
- Department of Medical Oncology, Centre Jean Bernard, Le Mans, France
| | - Nicolas Kiavue
- Department of Medical Oncology, Institut Curie, Paris, France.,Department of Medical Oncology, Institut Curie, Saint Cloud, France
| | - Elise Deluche
- Department of Medical Oncology, CHU de Limoges, Limoges, France
| | - Sylvain Ladoire
- Department of Medical Oncology, CLCC Georges François Leclerc, Dijon, France
| | - Mario Campone
- Department of Medical Oncology, Institut de cancérologie de l'Ouest, Saint-Herblain, France
| | - Jean-Yves Pierga
- Department of Medical Oncology, Institut Curie, Paris, France.,Department of Medical Oncology, Institut Curie, Saint Cloud, France.,Circulating Tumor Biomarkers Laboratory, SIRIC2 Institut Curie, Paris, France.,Université de Paris, Paris, France
| | - Francois-Clement Bidard
- Department of Medical Oncology, Institut Curie, Paris, France. .,Department of Medical Oncology, Institut Curie, Saint Cloud, France. .,Circulating Tumor Biomarkers Laboratory, SIRIC2 Institut Curie, Paris, France. .,UVSQ, Université Paris-Saclay, Saint Cloud, France.
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Menon A, Sandica E, Akintürk H, Derita F, Meyns B, D'udekem Y, Photiadis J, Cesnjevar R, Ovroutski S, Hübler M, Zimpfer D, Hörer J, Hagl C, Rambach A, Berger F, Miera O. A Novel Method to Bridge Failing Fontan Patients to Heart Transplantation: The Re-Give Study. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725795] [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: 10/21/2022]
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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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Bidard FC, Jacot W, Kiavue N, Dureau S, Kadi A, Brain E, Bachelot T, Bourgeois H, Gonçalves A, Ladoire S, Naman H, Dalenc F, Gligorov J, Espié M, Emile G, Ferrero JM, Loirat D, Frank S, Cabel L, Diéras V, Cayrefourcq L, Simondi C, Berger F, Alix-Panabières C, Pierga JY. Efficacy of Circulating Tumor Cell Count-Driven vs Clinician-Driven First-line Therapy Choice in Hormone Receptor-Positive, ERBB2-Negative Metastatic Breast Cancer: The STIC CTC Randomized Clinical Trial. JAMA Oncol 2021; 7:34-41. [PMID: 33151266 DOI: 10.1001/jamaoncol.2020.5660] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [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]
Abstract
Importance The choice between chemotherapy and endocrine therapy as first-line treatment for hormone receptor-positive, ERBB2 (also known as HER2)-negative metastatic breast cancer is usually based on the presence of clinical features associated with a poor prognosis. In this setting, a high circulating tumor cell (CTC) count (≥5 CTCs/7.5 mL) is a strong adverse prognostic factor for overall survival and progression-free survival (PFS). Objective To compare the efficacy of a clinician-driven treatment choice vs a CTC-driven choice for first-line treatment. Interventions In the CTC arm, patients received chemotherapy or endocrine therapy according to the CTC count (chemotherapy if ≥5 CTCs/7.5 mL; endocrine therapy if <5 CTCs/7.5 mL), whereas in the control arm, the choice was left to the investigator. Design, Setting, and Participants In the STIC CTC randomized, open-label, noninferiority phase 3 trial, participants were randomized to a clinician-driven choice of first-line treatment or a CTC count-driven first-line treatment choice. Eligible participants were premenopausal and postmenopausal women 18 years or older diagnosed with hormone receptor-positive, ERBB2-negative metastatic breast cancer. Data were collected at 17 French cancer centers from February 1, 2012, to July 28, 2016, and analyzed June 2019 to October 2019. Main Outcome and Measures The primary end point was the investigator-assessed PFS in the per-protocol population, with a noninferiority margin of 1.25 for the 90% CI of the hazard ratio. Results Among the 755 women in the per-protocol population, the median (range) age was 63 (30-88) years [64 (30-88) years for the 377 patients allocated to the CTC arm and 63 (31-87) years for the 378 patients allocated to the standard arm]; 138 (37%) and 103 (27%) received chemotherapy, respectively. Median PFS was 15.5 months (95% CI, 12.7-17.3) in the CTC arm and 13.9 months (95% CI, 12.2-16.3) in the standard arm. The primary end point was met, with a hazard ratio of 0.94 (90% CI, 0.81-1.09). Conclusions and Relevance This randomized clinical trial found that the CTC count may be a reliable biomarker method for guiding the choice between chemotherapy and endocrine therapy as the first-line treatment in hormone receptor-positive, ERBB2-negative metastatic breast cancer. Trial Registration ClinicalTrials.gov Identifier: NCT01710605.
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Affiliation(s)
- François-Clément Bidard
- Department of Medical Oncology, Institut Curie, UVSQ and Paris-Saclay University, Saint-Cloud, France.,INSERM Center of Clinical Investigations in Biotherapies of Cancer (CIC-BT) 1428, Paris, France
| | - William Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier (ICM), Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Montpellier University, Montpellier, France
| | - Nicolas Kiavue
- Department of Medical Oncology, Institut Curie, UVSQ and Paris-Saclay University, Saint-Cloud, France
| | - Sylvain Dureau
- Biometry Unit, Institut Curie, PSL Research University, Paris, France
| | - Amir Kadi
- Biometry Unit, Institut Curie, PSL Research University, Paris, France
| | - Etienne Brain
- Department of Medical Oncology, Institut Curie, UVSQ and Paris-Saclay University, Saint-Cloud, France
| | - Thomas Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Hugues Bourgeois
- Department of Medical Oncology, Victor Hugo Clinic, Le Mans, France
| | - Anthony Gonçalves
- Department of Medical Oncology, Institut Paoli-Calmettes, CRCM, Aix-Marseille University, Marseille, France
| | - Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Hervé Naman
- Department of Medical Oncology, Centre Azuréen de Cancérologie, Mougins, France
| | - Florence Dalenc
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | - Joseph Gligorov
- Department of Medical Oncology, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Marc Espié
- Department of Medical Oncology, Hôpital Saint-Louis, Paris, France
| | - George Emile
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Delphine Loirat
- Department of Medical Oncology, Institut Curie, Université de Paris, Paris, France
| | - Sophie Frank
- Department of Medical Oncology, Institut Curie, Université de Paris, Paris, France
| | - Luc Cabel
- Department of Medical Oncology, Institut Curie, UVSQ and Paris-Saclay University, Saint-Cloud, France
| | - Véronique Diéras
- Formerly with Department of Medical Oncology, Institut Curie, Paris, France.,Now with Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Laure Cayrefourcq
- Laboratory of Rare Human Circulating Cells, University Medical Center of Montpellier, EA 2415, Montpellier University, Montpellier, France
| | - Cécile Simondi
- Clinical Research Department, Institut Curie, PSL Research University, Paris, France
| | - Frédérique Berger
- Biometry Unit, Institut Curie, PSL Research University, Paris, France
| | - Catherine Alix-Panabières
- Laboratory of Rare Human Circulating Cells, University Medical Center of Montpellier, EA 2415, Montpellier University, Montpellier, France
| | - Jean-Yves Pierga
- Department of Medical Oncology, Institut Curie, Université de Paris, Paris, France
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Bergmann M, Germann CP, Nordmeyer J, Peters B, Berger F, Schubert S. Short- and Long-term Outcome After Interventional VSD Closure: A Single-Center Experience in Pediatric and Adult Patients. Pediatr Cardiol 2021; 42:78-88. [PMID: 33009919 PMCID: PMC7864847 DOI: 10.1007/s00246-020-02456-2] [Citation(s) in RCA: 18] [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: 05/13/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
Interventional closure of congenital ventricular septal defects (VSD) is recording a continuous rise in acceptance. Complete atrioventricular block (cAVB) and residual shunting are major concerns during follow-up, but long-term data for both are still limited. We retrospectively evaluated the outcome of patients with interventional VSD closure and focused on long-term results (> 1 year follow-up). Transcatheter VSD closures were performed between 1993 and 2015, in 149 patients requiring 155 procedures (104 perimembranous, 29 muscular, 19 residual post-surgical VSDs, and 3 with multiple defects). The following devices were used: 65 × Amplatzer™ Membranous VSD Occluder, 33 × Duct Occluder II, 27 × Muscular VSD Occluder, 3 × Duct Occluder I, 24 × PFM-Nit-Occlud®, and 3 × Rashkind-Occluder. The median age at time of implantation was 6.2 (0.01-66.1) years, median height 117 (49-188) cm, and median weight 20.9 (3.2-117) kg. Median follow-up time was 6.2 (1.1-21.3) years and closure rate was 86.2% at last follow-up. Complications resulting in device explantation include one case of cAVB with a Membranous VSD occluder 7 days after implantation and four cases due to residual shunt/malposition. Six (4%) deaths occurred during follow-up with only one procedural related death from a hybrid VSD closure. Overall, our reported results of interventional VSD closure show favorable outcomes with only one (0.7%) episode of cAVB. Interventional closure offers a good alternative to surgical closure and shows improved performance by using softer devices. However, prospective long-term data in the current era with different devices are still mandatory to assess the effectiveness and safety of this procedure.
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Affiliation(s)
- M. Bergmann
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - C. P. Germann
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - J. Nordmeyer
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - B. Peters
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - F. Berger
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Schubert
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany ,grid.418457.b0000 0001 0723 8327Clinic for Pediatric Cardiology and Congenital Heart Defects, Herz- Und Diabeteszentrum NRW, Ruhr University of Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany
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Lange A, Weixler V, Kramer P, Romanchenko O, Murin P, Mykychak Y, Cho MY, Berger F, Dähnert I, Photiadis J. 30 Years of Surgical Repair of Complex D-Transposition of the Great Arteries: How to Avoid Outflow Tract Obstructions? Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725697] [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: 10/21/2022]
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Kirova Y, Loirat D, Berger F, Ricci F, Sablin M, Vincent-Salomon A, Laki F, Mosseri V, Ezzalfani M, Fourquet A. RADIOPARP: A Phase I of Olaparib with Radiation Therapy (RT) in Patients with Inflammatory, Loco-regionally Advanced or Metastatic TNBC (Triple Negative Breast Cancer) or Patient with Operated TNBC with Residual Disease. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sri D, Thakkar R, Patel HRH, Lazarus J, Berger F, McArthur R, Lavigueur-Blouin H, Afshar M, Fraser-Taylor C, Le Roux P, Liban J, Anderson CJ. Robotic-assisted partial nephrectomy (RAPN) and standardization of outcome reporting: a prospective, observational study on reaching the "Trifecta and Pentafecta". J Robot Surg 2020; 15:571-577. [PMID: 32885379 PMCID: PMC8295154 DOI: 10.1007/s11701-020-01141-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/17/2020] [Indexed: 12/29/2022]
Abstract
Partial nephrectomy (PN) for small renal masses is common, but outcomes are not reported in a standard manner. Traditionally, parameters such as 90-day mortality, blood loss, transfusion rates, length of stay, nephrometry scoring and complications are published but their collective impact on warm ischemia time (WIT) and post-surgery GFR is rarely determined. Thus, our aim was to assess if “Trifecta” and “Pentafecta” outcomes could be used as useful surgical outcome markers. A prospective database of 252 Robotic-Assisted PN (RAPN) cases (2008–2019) was analysed. “Pentafecta” was defined as achievement of “Trifecta” (negative surgical margin, no postoperative complications and WIT of < 25 min) plus over 90% estimated GFR preservation and no CKD stage upgrading at 1 year. Binary logistic regression analysis was conducted to predict factors which may prevent achieving a Trifecta/Pentafecta. Median tumour size was 3 cm and mean WIT was 15 min. Positive surgical margins (PSM) occurred in 2 cases. Overall, the intra-operative complication rate was 7%. One recurrence conferred 5-year cancer-free survival of 97%. Trifecta outcome was achieved in 169 (67%) and Pentafecta in 141 (56%) of cases. At logistic regression analysis, intraoperative blood loss was the only factor to affect Trifecta achievement (p = 0.018). Advanced patient age negatively impacted Pentafecta achievement (p = 0.010). The Trifecta and Pentafecta outcomes are easily applicable to PN data, and offer an internationally comparable PN outcome, quality measure. We recommend applying this standardization to national data collection to improve the quality of reporting and ease of interpretation of surgeon/centres’ outcomes.
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Affiliation(s)
- D Sri
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK.
| | - R Thakkar
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | - H R H Patel
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | - J Lazarus
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | - F Berger
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | - R McArthur
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | | | - M Afshar
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | - C Fraser-Taylor
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | - P Le Roux
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | - J Liban
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
| | - C J Anderson
- St George's Hospital NHS Trust, Tooting, London, SW17 0QT, UK
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Frenel JS, Dalenc F, Pistilli B, de La Motte Rouge T, Levy C, Mouret-Reynier MA, Hardy-Bessard AC, Bonichon-Lamichhane N, Greilsamer C, Delecroix V, Nguyen S, Berger F, Everhard S, Lemonnier J, Loirat D, Callens C, Pradines A, Bachelot T, Delaloge S, Bidard F. 304P ESR1 mutations and outcomes in BRCA1/2 or PALB2 germline mutation carriers receiving first line aromatase inhibitor + palbociclib (AI+P) for metastatic breast cancer (MBC) in the PADA-1 trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Grandclaudon M, Perrot-Dockès M, Trichot C, Karpf L, Abouzid O, Chauvin C, Sirven P, Abou-Jaoudé W, Berger F, Hupé P, Thieffry D, Sansonnet L, Chiquet J, Lévy-Leduc C, Soumelis V. A Quantitative Multivariate Model of Human Dendritic Cell-T Helper Cell Communication. Cell 2020; 179:432-447.e21. [PMID: 31585082 DOI: 10.1016/j.cell.2019.09.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/20/2019] [Accepted: 09/09/2019] [Indexed: 12/24/2022]
Abstract
Cell-cell communication involves a large number of molecular signals that function as words of a complex language whose grammar remains mostly unknown. Here, we describe an integrative approach involving (1) protein-level measurement of multiple communication signals coupled to output responses in receiving cells and (2) mathematical modeling to uncover input-output relationships and interactions between signals. Using human dendritic cell (DC)-T helper (Th) cell communication as a model, we measured 36 DC-derived signals and 17 Th cytokines broadly covering Th diversity in 428 observations. We developed a data-driven, computationally validated model capturing 56 already described and 290 potentially novel mechanisms of Th cell specification. By predicting context-dependent behaviors, we demonstrate a new function for IL-12p70 as an inducer of Th17 in an IL-1 signaling context. This work provides a unique resource to decipher the complex combinatorial rules governing DC-Th cell communication and guide their manipulation for vaccine design and immunotherapies.
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Affiliation(s)
- Maximilien Grandclaudon
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; INSERM U932, Immunity and Cancer, 75005 Paris, France
| | - Marie Perrot-Dockès
- UMR MIA-Paris, AgroParisTech, INRA-Université Paris-Saclay, 75005 Paris, France
| | - Coline Trichot
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; INSERM U932, Immunity and Cancer, 75005 Paris, France
| | - Léa Karpf
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; INSERM U932, Immunity and Cancer, 75005 Paris, France
| | - Omar Abouzid
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; INSERM U932, Immunity and Cancer, 75005 Paris, France
| | - Camille Chauvin
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; INSERM U932, Immunity and Cancer, 75005 Paris, France
| | - Philémon Sirven
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; INSERM U932, Immunity and Cancer, 75005 Paris, France
| | - Wassim Abou-Jaoudé
- Computational Systems Biology Team, Institut de Biologie de l'École Normale Supérieure, Centre National de la Recherche Scientifique UMR8197, INSERM U1024, École Normale Supérieure, PSL Université, 75005 Paris, France
| | - Frédérique Berger
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; Institut Curie, PSL Research University, Unit of Biostatistics, 75005 Paris, France; Institut Curie, PSL Research University, INSERM U900, 75005 Paris, France
| | - Philippe Hupé
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; Institut Curie, PSL Research University, INSERM U900, 75005 Paris, France; Mines Paris Tech, 77305 Cedex Fontainebleau, France
| | - Denis Thieffry
- Computational Systems Biology Team, Institut de Biologie de l'École Normale Supérieure, Centre National de la Recherche Scientifique UMR8197, INSERM U1024, École Normale Supérieure, PSL Université, 75005 Paris, France
| | - Laure Sansonnet
- UMR MIA-Paris, AgroParisTech, INRA-Université Paris-Saclay, 75005 Paris, France
| | - Julien Chiquet
- UMR MIA-Paris, AgroParisTech, INRA-Université Paris-Saclay, 75005 Paris, France
| | - Céline Lévy-Leduc
- UMR MIA-Paris, AgroParisTech, INRA-Université Paris-Saclay, 75005 Paris, France
| | - Vassili Soumelis
- Institut Curie, Centre de Recherche, PSL Research University, 75005 Paris, France; INSERM U932, Immunity and Cancer, 75005 Paris, France.
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Degener F, Opgen-Rhein B, Hegel K, Pickardt T, Berger F, Messroghli D, Schubert S. Inflammatory Responses in Pediatric Patients with Suspected Myocarditis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Lunze F, Singh T, Harrild D, Gauvreau K, Molloy M, Narciso R, Goncalves A, Berger F, Blume E, Colan S. Three-Dimensional Speckle Tracking Echocardiography for Assessment of Left Ventricular Function and Myocardial Mechanics after Pediatric Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.296] [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: 11/26/2022] Open
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Leblanc O, Vacher S, Lecerf C, Jeannot E, Klijanienko J, Berger F, Hoffmann C, Calugaru V, Badois N, Chilles A, Lesnik M, Krhili S, Bieche I, Le Tourneau C, Kamal M. Biomarkers of cetuximab resistance in patients with head and neck squamous cell carcinoma. Cancer Biol Med 2020; 17:208-217. [PMID: 32296588 PMCID: PMC7142836 DOI: 10.20892/j.issn.2095-3941.2019.0153] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/28/2019] [Indexed: 01/08/2023] Open
Abstract
Objective: In patients with head and neck squamous cell carcinoma (HNSCC), cetuximab [a monoclonal antibody targeting epidermal growth factor receptor (EGFR)] has been shown to improve overall survival when combined with radiotherapy in the locally advanced setting or with chemotherapy in first-line recurrent and/or metastatic (R/M) setting, respectively. While biomarkers of resistance to cetuximab have been identified in metastatic colorectal cancer, no biomarkers of efficacy have been identified in HNSCC. Here, we aimed to identify biomarkers of cetuximab sensitivity/resistance in HNSCC. Methods: HNSCC patients treated with cetuximab at the Curie Institute, for whom complete clinicopathological data and formalin-fixed paraffin-embedded (FFPE) tumor tissue collected before cetuximab treatment were available, were included. Immunohistochemistry analyses of PTEN and EGFR were performed to assess protein expression levels. PIK3CA and H/N/KRAS mutations were analyzed using high-resolution melting (HRM) and Sanger sequencing. We evaluated the predictive value of these alterations in terms of progression-free survival (PFS). Results: Hot spot activating PIK3CA and KRAS/HRAS mutations were associated with poor PFS among HNSCC patients treated with cetuximab in the first-line R/M setting, but not among HNSCC patients treated with cetuximab in combination with radiotherapy. Loss of PTEN protein expression had a negative predictive value among HNSCC patients treated with cetuximab and radiotherapy. High EGFR expression did not predict cetuximab sensitivity in our patient population. Conclusions: Hot spot activating PIK3CA and RAS mutations predicted cetuximab resistance among HNSCC patients in the first-line R/M setting, whereas loss of PTEN protein expression predicted resistance to cetuximab when combined to radiotherapy.
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Affiliation(s)
- Olivia Leblanc
- Department of Genetics, Curie Institute, PSL Research University, Paris 75005, France
| | - Sophie Vacher
- Department of Genetics, Curie Institute, PSL Research University, Paris 75005, France
| | - Charlotte Lecerf
- Department of Drug Development and Innovation (D3i), Curie Institute, PSL Research University, Paris 75005, France
| | - Emmanuelle Jeannot
- Department of Genetics, Curie Institute, PSL Research University, Paris 75005, France
- Department of Pathology, Curie Institute, PSL Research University, Paris 75005, France
| | - Jerzy Klijanienko
- Department of Pathology, Curie Institute, PSL Research University, Paris 75005, France
| | - Frédérique Berger
- Department of Biostatistics, Curie Institute, PSL Research University, Paris 75005, France
| | - Caroline Hoffmann
- Department of Surgery, Curie Institute, PSL Research University, Paris 75005, France
- INSERM U932 Research Unit, Paris 75005, France
| | - Valentin Calugaru
- Department of Radiotherapy, Curie Institute, PSL Research University, Paris 75005, France
| | - Nathalie Badois
- Department of Surgery, Curie Institute, PSL Research University, Paris 75005, France
| | - Anne Chilles
- Department of Radiotherapy, Curie Institute, PSL Research University, Paris 75005, France
| | - Maria Lesnik
- Department of Surgery, Curie Institute, PSL Research University, Paris 75005, France
| | - Samar Krhili
- Department of Surgery, Curie Institute, PSL Research University, Paris 75005, France
| | - Ivan Bieche
- Department of Genetics, Curie Institute, PSL Research University, Paris 75005, France
- EA7331, Faculty of Pharmaceutical and Biological Sciences, Paris Descartes University, Paris 75005, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Curie Institute, PSL Research University, Paris 75005, France
- INSERM U900 Research Unit, Curie Institute, Paris 75005, France
| | - Maud Kamal
- Department of Drug Development and Innovation (D3i), Curie Institute, PSL Research University, Paris 75005, France
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Bidard FC, Callens C, Dalenc F, Pistilli B, de la Motte Rouge T, Clatot F, D'Hondt V, Teixeira L, Everhard S, Vegas H, Lemonnier J, Bieche I, Pradines A, Paitel JF, Spaeth D, Canon JL, Moullet I, Pierga JY, Berger F, Bachelot T, Delaloge S. Abstract P5-11-22: Clinical and biological efficacy of first line AI and palbociclib in ER+ HER2- MBC with detectable circulating ESR1 mutation prior to treatment initiation. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-11-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In ER+ HER2- metastatic breast cancer (MBC), activating ESR1 mutations (ESR1mut) confer resistance to aromatase inhibitors (AI) when used as single agent. The impact of ESR1mut, when detected at baseline (prior to the initiation of therapy), on the efficacy of first line combined AI- CDK4/6 inhibitor therapy remains however unknown.
Methods: The PADA-1 phase 3 trial (NCT03079011) aims at evaluating the utility of monitoring the onset of ESR1mut in cell-free DNA (cfDNA) from patients (pts) receiving AI-palbociclib, as a biomarker to trigger a switch from AI to fulvestrant. Main inclusion criteria were pts with no prior therapy for MBC and with no overt resistance to AI (i.e. no adjuvant AI or adjuvant AI completed >12 months prior to the metastatic relapse). The present exploratory analysis evaluated the biological and clinical outcome of patients who tested positive for ESR1mut at baseline (before any treatment).
Results: From 04/2017 to 01/2019, N=1017 ER+ HER2- MBC pts were included and had their cfDNA tested for ESR1mut at inclusion and during therapy (at 1 month and then every 2 months). N=33/1017 pts had a detectable circulating ESR1mut at inclusion (3.2%, 95%CI [2.2;4.5]), with a median allelic frequency (AF) of 2.5% (range: 0.1- 46%). First, we evaluated the kinetics of ESR1mut in the 33 ESR1mut-positive pts at inclusion. N=1 pt died after 1 month on treatment. In N=25/32 pts (78%), ESR1mut became undetectable (AF<0.1%) within the first 5 months on treatment, with a median time to ESR1mut ‘clearance’ in cfDNA of 34 days 95%CI[29;91d]. Among these 25 pts, with a median follow-up of 10 months (range 0-25.1m): 14 pts (56%) had ESR1mut detected again in cfDNA during AI-palbociclib therapy; 2 pts (8%) experienced a disease progression with no ESR1mut detected; the remaining 9 patients (36%) are still both ESR1mut -free and disease progression-free at time of analysis. Secondly, we evaluated the prognostic impact of cfDNA ESR1mut status at inclusion on progression-free survival (PFS) under AI palbociclib treatment, with an overall median follow-up time of 12.4 months (range: 0-25.3m). The 33 ESR1mut-positive pts experienced a shorter PFS (median PFS: 17.5mo, 95%CI=[10.5-NR]) than the 984 ESR1mut-negative pts (median PFS not reached), with an estimated HR= 2.8, 95%CI=[1.6;5].
Conclusions: ESR1mut are rarely detected in the cfDNA of ER+ HER2- MBC patients with no overt resistance to AI. The quick ‘clearance’ of ESR1mut observed in most patients following treatment initiation and the observed 17.5 months-long median PFS both suggest that the AI palbociclib combination retain clinical activity in ESR1mut-positive MBC. However, in most patients, these mutations were eventually detected again later during therapy and ESR1mut- positivity was associated with a significantly shorter PFS, suggesting that ESR1mut positivity at baseline could accelerate the onset of resistance to AI-palbociclib.
Funding: Pfizer
Citation Format: François-Clément Bidard, Céline Callens, Florence Dalenc, Barbara Pistilli, Thibault de la Motte Rouge, Florian Clatot, Véronique D'Hondt, Luis Teixeira, Sibille Everhard, Hélène Vegas, Jérôme Lemonnier, Ivan Bieche, Anne Pradines, Jean-François Paitel, Dominique Spaeth, Jean-Luc Canon, Isabelle Moullet, Jean-Yves Pierga, Frédérique Berger, Thomas Bachelot, Suzette Delaloge. Clinical and biological efficacy of first line AI and palbociclib in ER+ HER2- MBC with detectable circulating ESR1 mutation prior to treatment initiation [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-11-22.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Anne Pradines
- 11Institut Universitaire du Cancer de Toulouse, Toulouse, France
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Schubert S, Nordmeyer J, Peters B, Kramer P, Photiadis J, Berger F. Covered Stenting in Adult and Pediatric Patient with Native or Residual Coarctation of the Aorta. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705573] [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: 10/24/2022]
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Schubert S, Góreczny S, Nordmeyer J, Kramer P, Kühne T, Jenny EZ, Morgan G, Kim SH, Paweł D, Berger F. Results from an International Multicenter Prospective Registry of Cardiac Catheterizations Guided with Fusion of Computed Tomography and Magnetic Resonance Imaging. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705536] [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: 10/24/2022]
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Blickle M, Helm P, Ferentzi H, Berger F, Bauer U, Schmitt K, Pfitzer C. Education and School Performance of Children with Congenital Heart Disease. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705567] [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: 10/24/2022]
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Telishevska M, Berger F, Deisenhofer I, Hessling G. Case Report: Radiofrequency Ablation of an Epicardial Left Lateral Accessory Pathway. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705552] [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: 10/24/2022]
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