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Milliet F, Bozec A, Schiappa R, Viotti J, Modesto A, Dassonville O, Poissonnet G, Guelfucci B, Bizeau A, Vergez S, Dupret-Bories A, Garrel R, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Sophie Ramay A, Roger P, Galissier T, Coste V, Ben Lakdar A, Guerlain J, Temam S, Mirghani H, Gorphe P, Chamorey E, Culié D. Metachronous second primary neoplasia in oropharyngeal cancer patients: Impact of tumor HPV status. A GETTEC multicentric study. Oral Oncol 2021; 122:105503. [PMID: 34500315 DOI: 10.1016/j.oraloncology.2021.105503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/02/2021] [Accepted: 08/18/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk to develop a metachronous second primary neoplasia (MSPN). HPV and non-HPV-related OPSCC are 2 distinct entities with biological, clinical and prognostic differences. The aims of our study were to analyze the impact of tumor HPV status and other relevant clinical factors, such as tobacco and/or alcohol (T/A) consumption, on the risk and distribution of MSPN in OPSCC patients and to assess the impact of MSPN on patient survival. MATERIAL AND METHODS All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. P16 immunohistochemical expression was used as a surrogate maker of tumor HPV status. The impact of tumor p16 status on the risk of MSPN was assessed in uni- and multivariate analyses. Overall survival (OS) was determined by Kaplan-Meier analysis. RESULTS Among the 1291 patients included in this study, 138 (10.7%) displayed a MSPN which was preferentially located in the head and neck area (H&N), lung and esophagus. Multivariate analyses showed that p16- tumor status (p = 0.003), T/A consumption (p = 0.005) and soft palate tumor site (p = 0.009) were significantly associated with a higher risk of MSPN. We found no impact of p16 tumor status on the median time between index OPSCC diagnosis and MSPN development, but a higher proportion of MSPN arising outside the H&N, lung and esophagus was found in p16 + than in p16- patients. MSPN development had an unfavorable impact (p = 0.04) on OS only in the p16 + patient group. CONCLUSION P16 tumor status and T/A consumption were the main predictive factors of MSPN in OPSCC patients. This study provides crucial results with a view to tailoring global management and follow-up of OPSCC patients.
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Affiliation(s)
- Florent Milliet
- Department of Otorhinolaryngology, University Hospital of Nice, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Julien Viotti
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha Ben Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Haitham Mirghani
- Otolaryngology and Head and Neck Surgery Department, European Hospital Georges Pompidou, APHP, Paris, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Emmanuel Chamorey
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France.
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Bologna S, Vander Borght T, Briere J, Ribrag V, Damaj GL, Thieblemont C, Feugier P, Peyrade F, Lebras L, Coso D, Sibon D, Bonnet C, Morschhauser F, Ghesquieres H, Becker S, Olivier P, Fabiani B, Tilly H, Haioun C, Bastie JN. EARLY POSITRON EMISSION TOMOGRAPHY RESPONSE‐ADAPTED TREATMENT IN LOCALIZED DIFFUSE LARGE B‐CELL LYMPHOMA (AAIPI=0) : RESULTS OF THE PHASE 3 LYSA LNH 09‐1B TRIAL. Hematol Oncol 2021. [DOI: 10.1002/hon.5_2879] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S Bologna
- Hématologie Privée Nancéienne 54 Essey lès Nancy France
| | | | - J Briere
- CHU Henri Mondor 94 Créteil France
| | - V Ribrag
- Institut Gustave Roussy 94 Villejuif France
| | | | | | - P Feugier
- CHRU Nancy 54 Vandoeuvre lès Nancy France
| | - F Peyrade
- Centre Antoine Lacassagne 06 Nice France
| | - L Lebras
- Centre Léon Berard 69 Lyon, France
| | - D Coso
- Institut Paoli Calmette 13 Marseille France
| | - D Sibon
- Hôpital Necker-Enfants Malades 75 Paris France
| | | | | | | | - S Becker
- Centre Henri Becquerel 76 Rouen France
| | - P Olivier
- CHRU Nancy 54 Vandoeuvre lès Nancy France
| | - B Fabiani
- Hopital Saint Antoine 75 Paris France
| | - H Tilly
- Centre Henry Becquerel 76 Rouen France
| | - C Haioun
- Hopital Henri Mondor 94 Créteil France
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Oberic L, Peyrade F, Puyade M, Bonnet C, Dartigues-Cuillères P, Fabiani B, Ruminy P, Maisonneuve H, Abraham J, Thieblemont C, Feugier P, Salles G, Bijou F, Pica GM, Damaj G, Haioun C, Casasnovas RO, Farhat H, Le Calloch R, Waultier-Rascalou A, Malak S, Paget J, Gat E, Tilly H, Jardin F. Subcutaneous Rituximab-MiniCHOP Compared With Subcutaneous Rituximab-MiniCHOP Plus Lenalidomide in Diffuse Large B-Cell Lymphoma for Patients Age 80 Years or Older. J Clin Oncol 2021; 39:1203-1213. [PMID: 33444079 DOI: 10.1200/jco.20.02666] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The prognosis of elderly patients with diffuse large B-cell lymphoma (DLBCL) is worse than that of young patients. An attenuated dose of chemotherapy-cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab (R-miniCHOP)-is a good compromise between efficacy and safety in very elderly patients. In combination with R-CHOP (R2-CHOP), lenalidomide has an acceptable level of toxicity and may mitigate the negative prognosis of the non-germinal center B-cell-like phenotype. The Lymphoma Study association conducted a multicentric, phase III, open-label, randomized trial to compare R-miniCHOP and R2-miniCHOP. PATIENTS AND METHODS Patients of age 80 years or older with untreated DLBCL were randomly assigned into the R-miniCHOP21 group or the R2-miniCHOP21 group for six cycles and stratified according to CD10 expression and age. The first cycle of rituximab was delivered by IV on D1 after a prephase and then delivered subcutaneously on D1 of cycles 2-6. Lenalidomide was delivered at a dose of 10 mg once daily on D1-D14 of each cycle. The primary end point was overall survival (OS). RESULTS A total of 249 patients with new DLBCL were randomly assigned (127 R-miniCHOP and 122 R2-miniCHOP). The median age was 83 years (range, 80-96), and 55% of the patients were classified as non-GCB. The delivered dose for each R-miniCHOP compound was similar in both arms. Over a median follow-up of 25.1 months, the intention-to-treat analysis revealed that R2-miniCHOP did not improve OS (2-year OS 66% in R-miniCHOP and 65.7% in R2-miniCHOP arm, P = .98) in the overall population or in the non-GCB population. Grade 3-4 adverse events occurred in 53% of patients with R-miniCHOP and in 81% of patients with R2-miniCHOP. CONCLUSION The addition of lenalidomide to R-miniCHOP does not improve OS. Rituximab delivered subcutaneously was safe in this population.
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Affiliation(s)
- Lucie Oberic
- Department of Hematology, Institut Universitaire du Cancer, Toulouse-Oncopole, Toulouse, France
| | - Frederic Peyrade
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Mathieu Puyade
- Department of Oncology-Haematology and Cell Therapy, CHU, Poitiers, INSERM, Inserm CIC 1402, Poitiers, France
| | - Christophe Bonnet
- Clinical Hematology Unit, CHU Liège, Liège Université, Campus Universitaire de Sart Tilman, Liège, Belgique
| | - Peggy Dartigues-Cuillères
- Anapath Research Unit (EA) EA4340 and Pathology Laboratory, Versailles University and APHP, Ambroise Paré Hospital, Boulogne, France
| | - Bettina Fabiani
- Department of Pathology, Hopital Saint-Antoine, APHP, Paris, France
| | | | - Hervé Maisonneuve
- Department of Clinical Hematology, Centre Hospitalier Départemental Vendée, La Roche-sur-Yon, France
| | - Julie Abraham
- Department of Hematology, CHU Dupuytren, Limoges, France
| | - Catherine Thieblemont
- APHP, Hopital Saint-Louis, Hemato-oncologie; Université de Paris, Paris Diderot, Paris, France
| | - Pierre Feugier
- Department of Haematology, Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre Les Nancy, France
| | - Gilles Salles
- Department of Hematology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Benite, France
| | - Fontanet Bijou
- Department of Hematology, Hospital Bergonié, Bordeaux, France
| | - Gian-Matteo Pica
- Department of Hematology, Centre Hospitalier Métropole Savoie, Chambery, France
| | - Gandhi Damaj
- Department of Hematology, CHU Caen, Caen, France
| | - Corinne Haioun
- Department of Hematology, Henri Mondor University Hospital, UPEC, Creteil, France
| | | | - Hassan Farhat
- Department of Hematology, Centre Hospitalier de Versailles André Mignot, Versailles, France
| | - Ronan Le Calloch
- Centre hospitalier de Quimper Cornouaille/Université de Bretagne Occidentale, France
| | | | - Sandra Malak
- Department of Hematology, CLCC Rene Huguenin Institut Curie, Saint-Cloud, France
| | - Jerome Paget
- LYSARC, The Lymphoma Academic Research Organisation, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Elodie Gat
- LYSARC, The Lymphoma Academic Research Organisation, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Hervé Tilly
- Department of Hematology, Centre Henri Becquerel, UNIROUEN, University of Normandy, INSERM U1245, Rouen, France
| | - Fabrice Jardin
- Department of Hematology, Centre Henri Becquerel, UNIROUEN, University of Normandy, INSERM U1245, Rouen, France
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Culié D, Schiappa R, Modesto A, Viotti J, Chamorey E, Dassonville O, Poissonnet G, Bizeau A, Vergez S, Dupret-Bories A, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Ramay AS, Roger P, Galissier T, Coste V, Ben Lakdar A, Guerlain J, Mirghani H, Gorphe P, Guelfucci B, Garrel R, Temam S, Bozec A. Upfront surgery or definitive radiotherapy for p16+ oropharyngeal cancer. A GETTEC multicentric study. Eur J Surg Oncol 2021; 47:1389-1397. [PMID: 33390333 DOI: 10.1016/j.ejso.2020.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/25/2020] [Accepted: 12/15/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the impact of the initial therapeutic strategy on oncologic outcomes in patients with HPV-positive OPSCC. METHODS All p16-positive OPSCCs treated from 2009 to 2014 in 7 centers were retrospectively included and classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Univariate, multivariate propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS). RESULTS 382 patients were included (surgical group: 144; non-surgical group: 238). Five-year OS, DSS and RFS were 89.2, 96.8 and 83.9% in the surgical group and 84.2, 87.1 and 70.4% in the non-surgical group, respectively. These differences were statistically significant for DSS and RFS after multivariate analysis, but only for RFS after propensity score matching analysis. CONCLUSION In p16+ OPSCC patients, upfront surgery results in higher RFS than definitive radiotherapy ± chemotherapy but does not impact OS.
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Affiliation(s)
- Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France.
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Julien Viotti
- Department of Statistics, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Emmanuel Chamorey
- Department of Statistics, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha Ben Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Haitham Mirghani
- Department of Otorhinolaryngology and Head and Neck Surgery, European Hospital Georges Pompidou, Paris, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
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Culié D, Lisan Q, Leroy C, Modesto A, Schiappa R, Chamorey E, Dassonville O, Poissonnet G, Guelfucci B, Bizeau A, Vergez S, Dupret-Bories A, Garrel R, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Ramay AS, Roger P, Galissier T, Coste V, Lakdar AB, Temam S, Gorphe P, Guerlain J, Bozec A, Mirghani H. Oropharyngeal cancer: First relapse description and prognostic factor of salvage treatment according to p16 status, a GETTEC multicentric study. Eur J Cancer 2020; 143:168-177. [PMID: 33333482 DOI: 10.1016/j.ejca.2020.10.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/21/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Although Human Papilloma Virus (HPV)-driven oropharyngeal cancer (OPC) prognosis is significantly better than that of other head and neck cancers, up to 25% of cases will recur within 5 years. Data on the pattern of disease recurrence and efficiency of salvage treatment are still sparse. MATERIAL AND METHOD Observational study of all recurrent OPCs diagnosed, following a curative intent treatment, in seven French centers from 2009 to 2014. p16 Immunohistochemistry was used to determine HPV status. Clinical characteristics, distribution of recurrence site, and treatment modalities were compared by HPV tumor status. Overall survival was examined using Kaplan-Meier and multivariate Cox regression modeling. RESULTS 350 recurrent OPC patients (246 p16-negative and 104 p16-positive patients). The site of recurrence was more frequently locoregional for p16-negative patients (65.4% versus 52.9% in p16-positive patients) and metastatic for p16-positive patients (47.1% versus 34.6% in p16-patients, p = 0.03). Time from diagnosis to recurrence did not differ between p16-positive and p16-negative patients (12 and 9.6 months, respectively, p-value = 0.2), as the main site of distant metastasis (all p-values ≥0.10). Overall and relapse-free survival following the first recurrence did not differ according to p16 status (p-values from log-rank 0.30 and 0.40, respectively). In multivariate analysis, prognosis factors for overall survival in p16-negative patients were distant metastasis (HR 2.11, 95% CI 1.30-3.43) and concurrent local and regional recurrences (HR 2.20, 95% CI 1.24-3.88). CONCLUSION With the exception of the initial site of recurrence, the pattern of disease relapse and the efficiency of salvage treatment are not different between p16-positive and negative OPCs.
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Affiliation(s)
- Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France.
| | - Quentin Lisan
- Department of Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France; INSERM UMR970, Department of Epidemiology, Paris, France
| | - Charlotte Leroy
- Department of Otorhinolaryngology, Lariboisière Hospital, Paris, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Schiappa
- Department of Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France; INSERM UMR970, Department of Epidemiology, Paris, France
| | - Emmanuel Chamorey
- Department of Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France; INSERM UMR970, Department of Epidemiology, Paris, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha B Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Haitham Mirghani
- Department of Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France
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Sesques P, Ferrant E, Safar V, Wallet F, Tordo J, Dhomps A, Karlin L, Brisou G, Vercasson M, Hospital‐Gustem C, Schwiertz V, Ranchon F, Rioufol C, Choquet M, Sujobert P, Ghergus D, Bouafia F, Golfier C, Lequeu H, Lazareth A, Novelli S, Devic P, Traverse Glehen A, Viel S, Venet F, Mialou V, Hequet O, Chauchet A, Arkam Y, Nicolas‐Virelizier E, Peyrade F, Cavalieri D, Ader F, Ghesquières H, Salles G, Bachy E. Commercial anti-CD19 CAR T cell therapy for patients with relapsed/refractory aggressive B cell lymphoma in a European center. Am J Hematol 2020; 95:1324-1333. [PMID: 32744738 DOI: 10.1002/ajh.25951] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/08/2020] [Accepted: 07/28/2020] [Indexed: 11/07/2022]
Abstract
Two autologous anti-CD19 chimeric antigen receptors (CAR) T cells (axicabtagene ciloleucel [axi-cel] and tisagenlecleucel [tisa-cel]) are commercially approved in Europe for relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL). We performed a retrospective study to evaluate patterns of use, efficacy and safety for axi-cel and tisa-cel. Data from 70 patients who underwent apheresis for commercial CAR T cells between January 2018 and November 2019 in our institution were retrospectively collected. Sixty-one patients were infused. The median age at infusion was 59 years old (range 27-75 years). The median number of prior therapies was 3 (range, 2-6). The overall response rates (ORRs) at 1 month and 3 months were 63% and 45%, respectively, with 48% and 39% achieving a complete response (CR), respectively. After a median follow-up after infusion of 5.7 months, the median progression-free survival (PFS) was 3.0 months (95% CI, 2.8-8.8 months), and the median overall survival (OS) was 11.8 months (95% CI, 6.0-12.6 months). In multivariate analysis, factors associated with poor PFS were the number of previous lines of treatment before CAR T cells (≥4) (P = .010) and a C reactive protein (CRP) value >30 mg/L at the time of lymphodepletion (P < .001). Likewise, the only factor associated with a shorter OS was CRP >30 mg/L (P = .009). Cytokine release syndrome (CRS) of any grade occurred in 85% of patients, including 8% of patients with CRS of grade 3 or higher. Immune cell-associated neurotoxicity syndrome (ICANS) of any grade occurred in 28% of patients, including 10% of patients with ICANS of grade 3 or higher. Regarding efficacy and safety, no significant difference was found between axi-cel and tisa-cel. This analysis describes one of the largest real-life cohorts of patients treated with axi-cel and tisa-cel for R/R aggressive B cell lymphoma in Europe.
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Affiliation(s)
- Pierre Sesques
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
- Claude Bernard Lyon 1 University Lyon France
| | - Emmanuelle Ferrant
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Violaine Safar
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Florent Wallet
- Department of Critical Care Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Jérémie Tordo
- Department of Nuclear Medicine Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Anthony Dhomps
- Department of Nuclear Medicine Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Lionel Karlin
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Gabriel Brisou
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
- Claude Bernard Lyon 1 University Lyon France
| | - Marlène Vercasson
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Carole Hospital‐Gustem
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Vérane Schwiertz
- Department of Pharmacy Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Florence Ranchon
- Claude Bernard Lyon 1 University Lyon France
- Department of Pharmacy Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Catherine Rioufol
- Claude Bernard Lyon 1 University Lyon France
- Department of Pharmacy Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Marion Choquet
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Pierre Sujobert
- Claude Bernard Lyon 1 University Lyon France
- Department of Hematology Laboratory Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
- Lyon Cancer Research Center INSERM U1052 and CNRS UMR5286 Lyon France
| | - Dana Ghergus
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Fadhela Bouafia
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Camille Golfier
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
- Claude Bernard Lyon 1 University Lyon France
| | - Helène Lequeu
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Anne Lazareth
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Silvana Novelli
- Lyon Cancer Research Center INSERM U1052 and CNRS UMR5286 Lyon France
| | - Perrine Devic
- Department of Neurology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Alexandra Traverse Glehen
- Claude Bernard Lyon 1 University Lyon France
- Lyon Cancer Research Center INSERM U1052 and CNRS UMR5286 Lyon France
- Department of Pathology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
| | - Sébastien Viel
- Claude Bernard Lyon 1 University Lyon France
- Department of Biological Immunology Hospices Civils de Lyon, Lyon Sud Hospital Lyon France
- International Center for Research in Infectious Diseases INSERM U1111 and CNRS UMR5308 Lyon France
| | - Fabienne Venet
- Claude Bernard Lyon 1 University Lyon France
- Department of Clinical Immunology Hospices Civils de Lyon, Edouard Herriot Hospital Lyon France
| | - Valérie Mialou
- Department of Biology and Therapy Etablissement Français du Sang Auvergne‐Rhône‐Alpes Decines‐Charpieu France
| | - Olivier Hequet
- Department of Biology and Therapy Etablissement Français du Sang Auvergne‐Rhône‐Alpes Decines‐Charpieu France
| | - Adrien Chauchet
- Department of Hematology Besançon University Hospital Besançon France
| | - Yazid Arkam
- Department of Hematology Hopital Emile Muller Mulhouse France
| | | | | | - Doriane Cavalieri
- Department of Hematology Clermont Ferrand University Hospital Clermont Ferrand France
| | - Florence Ader
- Department of Infectious Disease Hospices Civils de Lyon, Croix Rousse Hospital Lyon France
| | - Hervé Ghesquières
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
- Claude Bernard Lyon 1 University Lyon France
- Lyon Cancer Research Center INSERM U1052 and CNRS UMR5286 Lyon France
| | - Gilles Salles
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
- Claude Bernard Lyon 1 University Lyon France
- Lyon Cancer Research Center INSERM U1052 and CNRS UMR5286 Lyon France
| | - Emmanuel Bachy
- Department of Hematology Hospices Civils de Lyon, Lyon Sud Hospital Pierre‐Bénite France
- Claude Bernard Lyon 1 University Lyon France
- Lyon Cancer Research Center INSERM U1052 and CNRS UMR5286 Lyon France
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Milliet F, Bozec A, Schiappa R, Viotti J, Modesto A, Dassonville O, Poissonnet G, Guelfucci B, Bizeau A, Vergez S, Dupret-Bories A, Garrel R, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Sophie Ramay A, Roger P, Galissier T, Coste V, Ben Lakdar A, Guerlain J, Temam S, Mirghani H, Gorphe P, Chamorey E, Culié D. Synchronous primary neoplasia in patients with oropharyngeal cancer: Impact of tumor HPV status. A GETTEC multicentric study. Oral Oncol 2020; 112:105041. [PMID: 33129057 DOI: 10.1016/j.oraloncology.2020.105041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/28/2020] [Accepted: 10/04/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk of synchronous primary neoplasia (SPN) which could impact their management. The aims of this study were to evaluate the risk and distribution of SPN in OPSCC patients according to their HPV (p16) status, the predictive factors of SPN and the impact of SPN on therapeutic strategy and oncologic outcomes. MATERIAL AND METHODS All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. Univariate analyses were conducted using Chi-2 and Fisher exact tests. For multivariate analyses, all variables associated with a p ≤ 0.10 in univariate analysis were included in logistic regression models. RESULTS Among the 1291 patients included in this study, 75 (5.8%) displayed a SPN which was preferentially located in the upper aerodigestive tract, lung and esophagus. Comorbidity level (p = 0.03), alcohol (p = 0.005) and tobacco (p = 0.01) consumptions, and p16 tumor status (p < 0.0001) were significant predictors of SPN. In multivariate analysis, p16+ status was significantly associated with a lower risk of SPN (OR = 0.251, IC95% [0.133;0.474]). Patients with a SPN were more frequently referred for non-curative treatment (p = 0.02). In patients treated with curative intent, there was no impact of SPN on the therapeutic strategy (surgical vs. non-surgical treatment). We observed no overall survival differences between patients with or without SPN. CONCLUSION P16 tumor status is the main predictive factor of SPN in OPSCC patients. This study provides crucial results which should help adapt the initial work-up and the global management of OPSCC patients.
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Affiliation(s)
- Florent Milliet
- Department of Otorhinolaryngology, University Hospital of Nice, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Julien Viotti
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha Ben Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Haitham Mirghani
- Department of Head and Neck Surgery, European Georges Pompidou Hospital, APHP, Paris, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Emmanuel Chamorey
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France.
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Toumi E, Peyrade F, Nahon S, Marin L, Baillif S, Martel A. [Orbital mantle cell lymphoma succesfully treated by Bcl-2 inhibitor: Report of a case]. J Fr Ophtalmol 2020; 44:239-243. [PMID: 32981740 DOI: 10.1016/j.jfo.2020.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/17/2020] [Accepted: 02/25/2020] [Indexed: 10/23/2022]
Abstract
Lymphoma is the most common orbital malignancy in adults. Among the types of lymphoma, mantle cell lymphoma is a particularly aggressive form, often discovered through systemic involvement, with a dismal prognosis due to frequent recurrences. It is secondary to a t (11 ; 14) (q13; q32) chromosomal translocation resulting in an anti-apoptotic signal via overexpression of Bcl-2. Treatment is based on R-CHOP poly-chemotherapy. We describe the case of a patient with an orbital recurrence of mantle cell lymphoma successfully treated with oral Bcl-2 inhibitor monotherapy. A 58-year-old man who was treated with R-CHOP 8 years ago for mantle cell lymphoma, in remission for 5 years, presented with progressive decreased visual acuity in the left eye, along with binocular diplopia. Clinical examination revealed a decrease in visual acuity in the left eye to 1/20 Parinaud 20 and a relative afferent pupillary defect on the left. External examination revealed a left cranial nerve VI palsy, 2mm of painless proptosis, and hypesthesia of the left V1 territory, leading to a diagnosis of left orbital apex syndrome. The disc and macular OCT were normal. The visual field showed enlargement of the left blind spot. An emergency CT scan and MRI revealed an apical extraconal tissue mass infiltrating the medial rectus muscle, extending to the superior orbital fissure, optic canal and left cavernous sinus, hyperintense on T2 weighted images and isointense on T1. The morphological appearance was strongly suggestive of an infiltrative lymphomatous process. An 18 FDG PET-scan identified the orbital lesion as well as enhancing lesions in the axilla and colon; given the clinical features and test results, the diagnosis of recurrent mantle cell lymphoma was made without biopsy. Treatment with Venetoclax (Bcl-2 inhibitor) was initiated. At one month of treatment, the orbital apex syndrome had entirely resolved, with visual acuity increased to 8/10 Parinaud 4 and a metabolic return to normal on PET scan. The PET scanner and clinical examination at 3 months were entirely normal. At the one-year follow-up visit, the patient was still on Venetoclax, the clinical examination was unchanged, and the PET-scan still showed a complete metabolic response.
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Affiliation(s)
- E Toumi
- CHU Pasteur II, service d'ophtalmologie, 30, voie Romaine, 06000 Nice, France.
| | - F Peyrade
- Service d'oncologie, centre Antoine Lacassagne, 33 avenue de Valombrose, 06189 Nice Cedex 2, France
| | - S Nahon
- CHU Pasteur II, service d'ophtalmologie, 30, voie Romaine, 06000 Nice, France
| | - L Marin
- CHU Pasteur II, service d'ophtalmologie, 30, voie Romaine, 06000 Nice, France
| | - S Baillif
- CHU Pasteur II, service d'ophtalmologie, 30, voie Romaine, 06000 Nice, France
| | - A Martel
- CHU Pasteur II, service d'ophtalmologie, 30, voie Romaine, 06000 Nice, France
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Culié D, Viotti J, Modesto A, Schiappa R, Chamorey E, Dassonville O, Poissonnet G, Guelfucci B, Bizeau A, Vergez S, Dupret-Bories A, Garrel R, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Ramay AS, Roger P, Galissier T, Coste V, Ben Lakdar A, Guerlain J, Temam S, Mirghani H, Gorphe P, Bozec A. Upfront surgery or definitive radiotherapy for patients with p16-negative oropharyngeal squamous cell carcinoma. A GETTEC multicentric study. Eur J Surg Oncol 2020; 47:367-374. [PMID: 33004271 DOI: 10.1016/j.ejso.2020.07.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 07/13/2020] [Accepted: 07/23/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Therapeutic management of oropharyngeal squamous cell carcinomas (OPSCC) is still debated. Since the role of HPV was demonstrated, few studies have focused on HPV-negative OPSCC. The aim of our study was to assess the impact of therapeutic strategy (surgical vs. non-surgical) on oncologic outcomes in patients with HPV-negative OPSCC. MATERIAL AND METHOD All p16-negative OPSCCs treated from 2009 to 2014 in 7 tertiary-care centers were included in this retrospective study and were classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Patients not eligible for surgery (unresectable tumor, poor general-health status) were excluded. Univariate, multivariate and propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS). RESULTS Four hundred seventy-four (474) patients were included in the study (surgical group: 196; non-surgical group: 278). Five-year OS, DSS and RFS were 76.5, 81.3 and 61.3%, respectively, in the surgical group and 49.9, 61.8 and 43.4%, respectively, in the non-surgical group. The favorable impact of primary surgical treatment on oncologic outcomes was statistically significant after multivariate analysis. This effect was more marked for locally-advanced than for early-stage tumors. Propensity score matching analysis confirmed the prognostic impact of primary surgical treatment for RFS. CONCLUSION Therapeutic strategy is an independent prognostic factor in patients with p16-negative OPSCC and primary surgical treatment is associated with improved OS, DSS and RFS. These results suggest that surgical strategy is a reliable option for advanced stage OPSCC.
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Affiliation(s)
- Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France.
| | - Julien Viotti
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Emmanuel Chamorey
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha Ben Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Haitham Mirghani
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
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Saada E, Koudou Y, Daste A, Fayette J, Lefebvre G, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminsky-Forrett MC, Johnson A, Vauleon E, Ebran N, Schmidt M, Texier M, Peyrade F, Milano G, Guigay J, Even C, Etienne-Grimaldi MC. 946P Germinal immunogenetics and response to nivolumab in recurrent/metastatic head and neck squamous cell carcinoma (RM HNSCC) patients (pts): TopNIVO ancillary study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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11
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Refae S, Gal J, Ebran N, Otto J, Borchiellini D, Peyrade F, Chamorey E, Brest P, Milano G, Saada-Bouzid E. Correction to: Germinal Immunogenetics predict treatment outcome for PD-1/PD-L1 checkpoint inhibitors. Invest New Drugs 2020; 39:287-292. [PMID: 32500464 DOI: 10.1007/s10637-020-00954-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Sadal Refae
- Centre Antoine Lacassagne, Oncopharmacology Unit, University Côte d'Azur, F-06189, Nice, France
| | - Jocelyn Gal
- Centre Antoine Lacassagne, Epidemiology and Biostatistics Department, University Côte d'Azur, F-06189, Nice, France
| | - Nathalie Ebran
- Centre Antoine Lacassagne, Oncopharmacology Unit, University Côte d'Azur, F-06189, Nice, France
| | - Josiane Otto
- Centre Antoine Lacassagne, Medical Oncology Department, University Côte d'Azur, F-06189, Nice, France
| | - Delphine Borchiellini
- Centre Antoine Lacassagne, Medical Oncology Department, University Côte d'Azur, F-06189, Nice, France
| | - Frederic Peyrade
- Centre Antoine Lacassagne, Medical Oncology Department, University Côte d'Azur, F-06189, Nice, France
| | - Emmanuel Chamorey
- Centre Antoine Lacassagne, Epidemiology and Biostatistics Department, University Côte d'Azur, F-06189, Nice, France
| | - Patrick Brest
- Centre Antoine Lacassagne, CNRS, Inserm, Ircan, FHU-Oncoage, University Côte d'Azur, F-06189, Nice, France
| | - Gérard Milano
- Centre Antoine Lacassagne, Oncopharmacology Unit, University Côte d'Azur, F-06189, Nice, France.
| | - Esma Saada-Bouzid
- Centre Antoine Lacassagne, Medical Oncology Department, University Côte d'Azur, F-06189, Nice, France.
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Refae S, Gal J, Brest P, Giacchero D, Borchiellini D, Ebran N, Peyrade F, Guigay J, Milano G, Saada-Bouzid E. Hyperprogression under Immune Checkpoint Inhibitor: a potential role for germinal immunogenetics. Sci Rep 2020; 10:3565. [PMID: 32107407 PMCID: PMC7046673 DOI: 10.1038/s41598-020-60437-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 08/09/2019] [Accepted: 02/11/2020] [Indexed: 12/25/2022] Open
Abstract
Hyperprogressive disease (HPD), an unexpected acceleration of tumor growth kinetics, is described in cancer patients treated with anti-PD-1/anti-PD-L1 agents. Here, our aim was to take into consideration the host and explore whether single nucleotide polymorphisms (SNPs) in key genes involved in immune response might predispose to HPD. DNA was extracted from blood-samples from 98 patients treated under CPI monotherapy. Four candidate genes (PD-1, PD-L1, IDO1 and VEGFR2) and 15 potential SNPs were selected. The TGKR (ratio of the slope of tumor growth before treatment and the slope of tumor growth on treatment) was calculated. Hyperprogression was defined as a TGKR≥2. TGKR calculation was feasible for 80 patients (82%). HPD was observed for 11 patients (14%) and was associated with shorter overall survival (P = 0.003). In univariate analysis, HPD was significantly associated with age ≥70 y (P = 0.025), immune-related toxicity (P = 0.016), VEGFR2 rs1870377 A/T or A/A (P = 0.005), PD-L1 rs2282055 G/T or G/G (P = 0.024) and PD-L1 rs2227981 G/A or A/A (P = 0.024). Multivariate analysis confirmed the correlation between HPD and age ≥70 y (P = 0.006), VEGFR2 rs1870377 A/T or A/A (P = 0.007) and PD-L1 rs2282055 G/T or G/G (P = 0.018). Immunogenetics could become integral predictive factors for CPI-based immunotherapy.
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Affiliation(s)
- Sadal Refae
- University Côte d'Azur, Centre Antoine Lacassagne, Oncopharmacology Unit, Nice, France
| | - Jocelyn Gal
- University Côte d'Azur, Centre Antoine Lacassagne, Epidemiology and Biostatistics Department, Nice, France
| | - Patrick Brest
- University Côte d'Azur, Centre Antoine Lacassagne, CNRS, Inserm, Ircan, FHU-Oncoage, Nice, F-06189, France
| | - Damien Giacchero
- University Côte d'Azur, Centre Antoine Lacassagne, Medical Oncology Department, Nice, France
| | - Delphine Borchiellini
- University Côte d'Azur, Centre Antoine Lacassagne, Medical Oncology Department, Nice, France
| | - Nathalie Ebran
- University Côte d'Azur, Centre Antoine Lacassagne, Oncopharmacology Unit, Nice, France
| | - Frederic Peyrade
- University Côte d'Azur, Centre Antoine Lacassagne, Medical Oncology Department, Nice, France
| | - Joël Guigay
- University Côte d'Azur, Centre Antoine Lacassagne, Medical Oncology Department, Nice, France
| | - Gérard Milano
- University Côte d'Azur, Centre Antoine Lacassagne, Oncopharmacology Unit, Nice, France.
| | - Esma Saada-Bouzid
- University Côte d'Azur, Centre Antoine Lacassagne, Medical Oncology Department, Nice, France
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Morschhauser F, Machiels JP, Salles G, Rottey S, Rule SAJ, Cunningham D, Peyrade F, Fruchart C, Arkenau HT, Genvresse I, Liu L, Köchert K, Shen K, Kneip C, Peña CE, Grevel J, Zhang J, Cisternas G, Reschke S, Granvil C, Awada A. On-Target Pharmacodynamic Activity of the PI3K Inhibitor Copanlisib in Paired Biopsies from Patients with Malignant Lymphoma and Advanced Solid Tumors. Mol Cancer Ther 2019; 19:468-478. [PMID: 31619463 DOI: 10.1158/1535-7163.mct-19-0466] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/12/2019] [Accepted: 10/07/2019] [Indexed: 11/16/2022]
Abstract
The PI3K inhibitor copanlisib has efficacy and manageable safety in patients with indolent lymphoma and solid tumors. Pharmacodynamic effects relative to copanlisib dose and plasma exposure were evaluated. Patients with lymphoma or solid tumors received copanlisib 0.4 or 0.8 mg/kg on days 1, 8, and 15 of a 28-day cycle. Primary variables were maximum changes in phosphorylated AKT (pAKT) levels in platelet-rich plasma (PRP) and plasma glucose. Other evaluations included PI3K signaling markers and T-lymphocytes in paired tumor biopsies, the relationship between estimated plasma exposure and pharmacodynamic markers, response, and safety. Sixty-three patients received copanlisib. PRP pAKT levels showed sustained reductions from baseline following copanlisib [median inhibition: 0.4 mg/kg, 73.8% (range -94.9 to 144.0); 0.8 mg/kg, 79.6% (range -96.0 to 408.0)]. Tumor pAKT was reduced versus baseline with copanlisib 0.8 mg/kg in paired biopsy samples (P < 0.05). Dose-related transient plasma glucose elevations were observed. Estimated copanlisib plasma exposure significantly correlated with changes in plasma pAKT and glucose metabolism markers. There were two complete responses and six partial responses; seven of eight responders received copanlisib 0.8 mg/kg. Adverse events (all grade) included hyperglycemia (52.4%), fatigue (46.0%), and hypertension (41.3%). Copanlisib demonstrated dose-dependent pharmacodynamic evidence of target engagement and PI3K pathway modulation/inhibition in tumor and immune cells. Results support the use of copanlisib 0.8 mg/kg (or flat-dose equivalent of 60 mg) in solid tumors and lymphoma, and provide a biomarker hypothesis for studies of copanlisib combined with immune checkpoint inhibitors (NCT03711058).
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Affiliation(s)
- Franck Morschhauser
- Service des Maladies du Sang, Université de Lille, CHU Lille, Lille, France.
| | - Jean-Pascal Machiels
- Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale, UCLouvain, Brussels, Belgium
| | - Gilles Salles
- Service d'Hématologie, Clinique Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
- Hospices Civils de Lyon, Lyon, France
| | - Sylvie Rottey
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Simon A J Rule
- Department of Haematology, Plymouth University Medical School, Plymouth Hospitals NHS Trust, Plymouth, United Kingdom
| | - David Cunningham
- Department of Clinical and Experimental Haematology, The Royal Marsden Hospital, Sutton, United Kingdom
| | - Frederic Peyrade
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Christophe Fruchart
- Institut d'Hématologie de Basse Normandie, Centre Hospitalier Universitaire, Caen, France
| | | | | | - Li Liu
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, New Jersey
| | - Karl Köchert
- Pharmaceuticals Division, Bayer AG, Berlin, Germany
| | - Kui Shen
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, New Jersey
| | | | - Carol E Peña
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, New Jersey
| | | | - Jun Zhang
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, New Jersey
| | | | | | - Camille Granvil
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, New Jersey
| | - Ahmad Awada
- Clinique Oncologie Médicale, Institut Jules Bordet, Brussels, Belgium
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Fayette J, Digue L, Ségura-Ferlay C, Treilleux I, Wang Q, Lefebvre G, Daste A, Even C, Couchon Thaunat S, Guyennon A, Peyrade F, Cupissol D, You B, Le Tourneau C, Jaouen L, Grinand E, Tabone-Eglinger S, Garin G, Perol D. Buparlisib (BKM120) in refractory head and neck squamous cell carcinoma harbouring or not a PI3KCA mutation: A phase II multicenter trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.012] [Citation(s) in RCA: 5] [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: 11/13/2022] Open
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15
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Guigay J, Auperin A, Mertens C, Even C, Geoffrois L, Cupissol D, Rolland F, Sire C, Fayette J, Peyrade F, Blot E, Debourdeau P, Bozec L, Capitain O, Pointreau Y, Brard C, Michel C, Schwob D, Ortholan C, Le Caer H. Personalized treatment according to geriatric assessment in first-line recurrent and/or metastatic (R/M) head and neck squamous cell cancer (HNSCC) patients aged 70 or over: ELAN (ELderly heAd and Neck cancer) FIT and UNFIT trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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REFAE S, GAL J, EBRAN N, OTTO J, BORCHIELLINI D, Peyrade F, CHAMOREY E, Brest P, Milano GA, SAADA-BOUZID E. Abstract 1370: Germinal immunogenetics predicts treatment outcome for PD1 PD-L1 checkpoint inhibitors. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Checkpoint inhibitors (CPIs) benefit only a proportion of patients and may be associated with severe adverse events (AEs) which cannot be predicted. We hypothesized that the host genetics could be used as predictive biomarkers for CPI response and AE prediction. Therefore, we conducted a study based on single nucleotide polymorphisms (SNPs) from genes affiliated with immune response and tumor-microenvironment interaction.
Methods Germinal DNA was obtained from advanced cancer patients treated with anti PD-1/PD-L1 CPIs in the Centre Antoine Lacassagne (Nice, France) from July 2012 to January 2018. DNA was genotyped on the MassARRAY system (Agena Bioscience®) using a custom panel of 166 SNPs covering 86 preselected immunogenetic-related genes (Minor allele frequency MAF>0.05 in Caucasians). All tested SNPs were in Hardy-Weinberg equilibrium. Univariate analysis was performed to select the significant SNPs (p<0.05) by either Fisher or Ki2 tests. Treatment outcome prediction was based on an elastic-net penalized logistic regression with 5-fold cross validation. The predictive ability model was performed using a concordance (c)-index (c-index > 0.5 being considered as good prediction). Computational analysis using a GTEX portal was used to determine potential eQTL (expression Quantitative Trait Loci) in tissues.
Results 94 patients were identified, with median age 68 (32-85), 67% male, with a majority (51%) having advanced non-small cell lung cancer. Median follow-up was 16.3 months (95% CI: 12.5-18.3). Overall response rate (ORR) was observed in 49/94 (54%) of patients, with adverse events (grade 3-4) observed in 15/94 (16%) of patients. ORR was significantly predicted by tumor microenvironment related gene polymorphisms (CCL2, NOS3, IL1RN, IL12B, CXCR3, IL6R). In contrast, grade 3-4 AEs were linked to target-related gene SNPs (UNG, IFNW1, CTLA-4, PD-L1, IFNL4). The predictive (c)-index was 0.81 (95% CI: 0.72-0.9) for response and 0.89 (95% CI: 0.76-1.00) for toxicity. In silico functionality exploring (GTEX portal) pointed IL6R (rs4845618) and CTLA4 (rs3087243) as impacting gene expression.
Conclusion Our data strongly support the role of distinct SNPs in immunogenetic related genes to predict efficacy and safety of anti PD1/PD-L1 therapies. These data support the notion that patient-specific, germinal biomarkers may supplement tumor-specific biomarkers in predicting response to CPI therapy, and that additional germinal biomarkers may predict grade 3-4 AEs.
Citation Format: Sadal REFAE, Jocelyn GAL, Nathalie EBRAN, Josiane OTTO, Delphine BORCHIELLINI, Frederic Peyrade, Emmanuel CHAMOREY, Patrick Brest, Gerard Alain Milano, Esma SAADA-BOUZID. Germinal immunogenetics predicts treatment outcome for PD1 PD-L1 checkpoint inhibitors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1370.
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Affiliation(s)
| | | | | | | | | | | | | | - Patrick Brest
- 2Université Cote d’Azur, CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), FHU-OncoAge, Nice, France
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Wang M, Ramchandren R, Chen R, Karlin L, Chong G, Jurczak W, Wu K, Bishton M, Collins G, Eliadis P, Peyrade F, Freise K, Sukbuntherng J, Lee Y, Dobkowska E, Fedorov V, Neuenburg J, Tam C. RESULTS FROM THE SAFETY RUN-IN PERIOD OF THE SYMPATICO STUDY EVALUATING IBRUTINIB IN COMBINATION WITH VENETOCLAX IN PATIENTS WITH RELAPSED/REFRACTORY MANTLE CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.146_2630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- M. Wang
- Department of Lymphoma/Myeloma; University of Texas MD Anderson Cancer Center; Houston United States
| | - R. Ramchandren
- Department of Oncology; Karmanos Cancer Institute; Detroit United States
| | - R. Chen
- Department of Hematology & Hematopoietic Cell Transplantation; City of Hope; Duarte United States
| | - L. Karlin
- Department of Hematology; Centre Hospitalier Lyon Sud; Pierre-Bénite France
| | - G. Chong
- Department of Medical Oncology and Clinical Haematology; Olivia Newton-John Cancer Centre, and University of Melbourne; Melbourne Australia
| | - W. Jurczak
- Department of Hematology; Jagiellonian University; Kraków Poland
| | - K. Wu
- Department of Hematology; Ziekenhuis Netwerk Antwerpen; Antwerp Belgium
| | - M. Bishton
- Department of Clinical Haematology; Nottingham University Hospitals NHS Trust; Nottingham United Kingdom
| | - G. Collins
- Department of Hematology; Oxford University Hospitals, NHS Foundation Trust; Oxford United Kingdom
| | - P. Eliadis
- Department of Oncology; ICON Cancer Care; South Brisbane Australia
| | - F. Peyrade
- Department of Oncology; Centre Antoine Lacassagne; Nice France
| | - K. Freise
- Department of Clinical Pharmacology and Pharmacometrics; AbbVie Inc; North Chicago United States
| | - J. Sukbuntherng
- Department of Drug Metabolism & Pharmacokinetics; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - Y. Lee
- Department of Biostatistics; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - E. Dobkowska
- Department of Clinical Science; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - V. Fedorov
- Department of Clinical Science; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - J. Neuenburg
- Department of Clinical Science; Pharmacyclics LLC, an AbbVie Company; Sunnyvale United States
| | - C. Tam
- Department of Haematology; Peter MacCallum Cancer Centre & St. Vincent's Hospital and the University of Melbourne; Melbourne Australia
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Mertens C, Le Caer H, Ortholan C, Blot E, Even C, Rousselot H, Peyrade F, Sire C, Cupissol D, Pointreau Y, Debourdeau P, Rolland F, Fayette J, Capitain O, Sun XS, Debbah M, Boulahssass R, Schwob D, Auperin A, Guigay J. ELAN-ONCOVAL (Elderly Head and Neck Cancer-Oncology Evaluation) study: Evaluation of the G8 screening tool and the ELAN geriatric evaluation (EGE) for elderly patients (pts) with head and neck squamous cell carcinomas (HNSCC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.11541] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11541 Background: About 47% and 10% of HNSCC occur in pts aged ≥65 or ≥80 respectively. This population being heterogeneous, balancing efficacy with toxicity is challenging. As the G8 screening tool includes 3 nutritional items, we need to evaluate its usefulness in HNSCC pts and to establish an adapted tool for HNSCC pts. Methods: ONCOVAL is the first step of the ELAN program for pts ≥70 with HNSCC not amenable to surgery. Pts were assessed for geriatric frailties before inclusion in appropriate trials (ELAN-RT, FIT, UNFIT) depending on curative or palliative setting and fit or unfit status. The aim was to evaluate the G8 tool and EGE usable by oncologists to classify pts as fit or unfit. The EGE was elaborated by the French GERICO group for HNSCC pts, evaluating functional status, comorbidity, cognition/mood, social status. To estimate sensitivity and specificity of G8 and EGE, we used comprehensive geriatric assessment (CGA) performed by geriatricians as gold standard. Results: From 06/2013 to 08/2018, 633 pts were included in 44 centers. Data are available for 613 pts. Median age 79 years (70-97) with 45% ≥ 80. 75% males. G8 score was ≤14, i.e. at risk of geriatric frailty, in 82% pts. Assessment by EGE was done by physicians (64%), nurses (11%), ELAN staff (21%) in 20 minutes of median time. After EGE, oncologists classified 71% pts as unfit. 49% of pts were assessed by CGA. The G8 score with cut-off ≤ 14 has sensitivity 91% and specificity 30%. Lowering cut-off to 12 increased specificity to 56% but decreased sensitivity to 75%. Sensitivity of EGE was 95% and specificity 60%. Multidisciplinary interventions were more frequently implemented in pts assessed by geriatricians than in others (71% vs 47%), even after adjusting for frailty. 58% of pts included in ONCOVAL were further included in ELAN therapeutic trials. Assessment by geriatricians did not modify the rate of inclusion in trials. Conclusions: The G8 screening tool is not appropriate for HNSCC pts. The EGE was feasible and had better sensitivity and specificity. Oncologists and geriatricians must continue such collaboration to propose tailored treatments. Clinical trial information: NCT03614936.
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Affiliation(s)
| | - Hervé Le Caer
- Centre Hospitalier de Saint Brieuc, Saint-Brieuc, France
| | | | | | | | - Hubert Rousselot
- Institut de Cancérologie de Lorraine-Alexis Vautrin, Vandoeuvre-Les-Nancy, France
| | | | - Christian Sire
- Groupe Hospitalier Bretagne Sud-Radiothérapie-Oncologie, Lorient, France
| | | | | | | | - Frederic Rolland
- Institut de Cancérologie de l'Ouest, Department of Medical Oncology, St Herblain, France
| | | | - Olivier Capitain
- Institut de Cancerologie de l'Ouest, Site Paul Papin, Angers, France
| | - Xu Shan Sun
- Centre Hospitalier de Belfort-Montbéliard, Montbéliard, France
| | | | - Rabia Boulahssass
- Centre Hospitalier Universitaire de Nice, Hôpital de Cimiez, Nice, France
| | | | | | - Joel Guigay
- Centre Antoine Lacassagne, FHU OncoAge, Université Côte d'Azur, Nice, France
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Montaudié H, Kogay M, Viotti J, Combemale P, Dutriaux C, Dupin N, Robert C, Mortier L, Duval-Modeste AB, Dalle S, de Quatrebarbes J, Stefan A, Brunet-Possenti F, Picard A, Poissonnet G, Peyrade F. Données d’efficacité et de tolérance en vie réelle du cétuximab dans le carcinome épidermoïde cutané avancé : étude nationale rétrospective et multicentrique. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Peyrade F, Kogay M, Viotti J, Combemale P, Dutriaux C, Dupin N, Robert C, Mortier L, Duval-Modeste AB, Dalle S, De Quatrebarbes J, Stefan A, Brunet-Possenti F, Picard A, Poissonnet G, Montaudié H. Cetuximab in patients with unresectable cutaneous squamous cell carcinoma is safe and effective: A real-life analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Awada A, Morschhauser F, Machiels JP, Salles G, Rottey S, Rule S, Cunningham D, Peyrade F, Fruchart C, Arkenau HT, Genvresse I, Koechert K, Cisternas G, Granvil C, Pena C, Liu L. PI3K inhibition and modulation of immune and tumor microenvironment markers by copanlisib in patients with non-Hodgkin's lymphoma or advanced solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Martin N, Ebran-Bendahhou N, Boyer J, Duranton-Tanneur V, Bozec A, Peyrade F, Guigay J, Sudaka-Bahadoran A, Milano G, Saada-Bouzid E. Next-generation sequencing reveals high intra-individual molecular concordance between primary head and neck tumors and matched local or distant recurrences. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy314.031] [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: 11/14/2022] Open
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23
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Chantepie SP, Garciaz S, Tchernonog E, Peyrade F, Larcher M, Diouf M, Fornecker L, Houot R, Gastinne T, Soussain C, Malak S, Lemal R, Delette C, Ibrahim A, Gac A, Reboursière E, Vilque J, Bekadja M, Casasnovas R, Gressin R, Guidez S, Coso D, Herbaux C, Yakoub‐Agha I, Bouabdallah K, Durot E, Damaj G. Bendamustine-based conditioning prior to autologous stem cell transplantation (ASCT): Results of a French multicenter study of 474 patients from LYmphoma Study Association (LYSA) centers. Am J Hematol 2018; 93:729-735. [PMID: 29473209 DOI: 10.1002/ajh.25077] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/28/2018] [Accepted: 02/21/2018] [Indexed: 11/06/2022]
Abstract
Carmustine shortage has led to an increase use of alternative conditioning regimens prior to autologous stem cell transplantation for the treatment of lymphoma, including Bendamustine-based (BeEAM). The aim of this study was to evaluate the safety of the BeEAM regimen in a large cohort of patients. A total of 474 patients with a median age of 56 years were analyzed. The majority of patients had diffuse large B-cell lymphoma (43.5%). Bendamustine was administered at a median dose of 197 mg/m2 /day (50-250) on days-7 and -6. The observed grade 1-4 toxicities included mucositis (83.5%), gastroenteritis (53%), skin toxicity (34%), colitis (29%), liver toxicity (19%), pneumonitis (5%), and cardiac rhythm disorders (4%). Nonrelapse mortality (NRM) was reported in 3.3% of patients. Acute renal failure (ARF) was reported in 132 cases (27.9%) (G ≥2; 12.3%). Organ toxicities and death were more frequent in patients with post conditioning renal failure. In a multivariate analysis, pretransplant chronic renal failure, bendamustine dose >160 mg/m2 and age were independent prognostic factors for ARF. Pretransplant chronic renal failure, hyperhydration volume, duration of hyperhydration, and etoposide dose were predictive factors of NRM. A simple, four-point scoring system can stratify patients by levels of risk for ARF and may allow for a reduction in the bendamustine dose to avoid toxicity. Drugs shortage may have dangerous consequences. Prospective, comparative studies are needed to confirm the toxicity/efficacy extents from this conditioning regimen compared to other types of high dose therapy.
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Affiliation(s)
| | | | | | | | | | - Momar Diouf
- Clinical Research DepartmentAmiens University hospitalAmiensEA4666 France
| | | | - Roch Houot
- Hematology, University hospitalRennes France
| | - Thomas Gastinne
- Department of HematologyNantes University HospitalNantes France
| | - Carole Soussain
- Department of HematologyCurie Institute, Hôpital René HugueninSaint‐Cloud France
| | - Sandra Malak
- Department of HematologyCurie Institute, Hôpital René HugueninSaint‐Cloud France
| | - Richard Lemal
- Service d'hématologie clinique adulte et de thérapie cellulaire, CHU ESTAING, EA 7453 CHELTER, Université Clermont Auvergne CIC‐501Clermont‐Ferrand France
| | | | | | | | | | - Jean‐Pierre Vilque
- Institut d'Hématologie de Basse‐Normandie, Centre François BaclesseCaen France
| | - Mohamed‐Amine Bekadja
- Hematology and Cell TherapyEtablissement Hospitalier Universitaire (EHU) 1st NovemberOran Algeria
| | | | | | - Stéphanie Guidez
- Oncologie hématologique et thérapie cellulaire, CHU PoitiersPoitiers France
| | - Diane Coso
- Department of HematologyInstitut Paoli CalmettesMarseille
| | - Charles Herbaux
- Hematology, Hôpital HURIEZ UAM allogreffe de CSH, CHRULille France
| | | | | | - Eric Durot
- Department of HematologyCentre Hospitalier UniversitaireReims Cedex FRA
| | - Gandhi Damaj
- Institut d'Hématologie de Basse‐Normandie, CHUCaen France
- Microenvironnement Cellulaire et Pathologies, Normandie Univ, UnicaenMILPAT Caen14000 France
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Tardy MP, Slama B, Doyen J, Stoppa AM, Gutnecht J, Re D, Richez V, Kaphan R, Kogay M, Etienne-Grimaldi MC, Boscagli A, Peyrade F. Large retrospective study of lenalidome-dexamethasone (Rd) in patients older than 80 with multiple myeloma (MM): Is less more? J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e20035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Jean Gutnecht
- Centre Hospitalier Intercommunal de Frejus, Frejus, France
| | - Daniel Re
- Centre Hospitalier Antibes Juan-les-Pins, Antibes, France
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Maurer MJ, Ghesquières H, Link BK, Jais JP, Habermann TM, Thompson CA, Haioun C, Allmer C, Johnston PB, Delarue R, Micallef IN, Peyrade F, Inwards DJ, Ketterer N, Farooq U, Fitoussi O, Macon WR, Molina TJ, Syrbu S, Feldman AL, Slager SL, Weiner GJ, Ansell SM, Cerhan JR, Salles GA, Witzig TE, Tilly H, Nowakowski GS. Diagnosis-to-Treatment Interval Is an Important Clinical Factor in Newly Diagnosed Diffuse Large B-Cell Lymphoma and Has Implication for Bias in Clinical Trials. J Clin Oncol 2018; 36:1603-1610. [PMID: 29672223 DOI: 10.1200/jco.2017.76.5198] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Purpose Selection bias in clinical trials has consequences for scientific validity and applicability of study results to the general population. There is concern that patients with clinically aggressive disease may not have enrolled in recent diffuse large B-cell lymphoma (DLBCL) trials due to the consent process and the inability to delay therapy for eligibility evaluation. We have examined the diagnosis-to-treatment interval (DTI) and its association with clinical factors and outcome in a clinic-based observational cohort of patients with DLBCL from the United States. Validation of results was performed in an independent, clinical trial-based cohort from Europe. Patients and Methods Patients were prospectively enrolled in the University of Iowa and Mayo Clinic Specialized Programs of Research Excellence Molecular Epidemiology Resource (MER; N = 986) or the Lymphoma Study Association (LYSA) LNH-2003 clinical trials program (N = 1,444). All patients received anthracycline-based immunochemotherapy at initial diagnosis. Associations of DTI with clinical factors and outcome were examined. Outcome was assessed using event-free survival at 24 months from diagnosis (EFS24). Results Median (range) DTI was 15 days (0 to 155 days in the MER and 23 days (0 to 215 days) in LYSA. Shorter DTI was strongly associated with adverse clinical factors, including elevated lactate dehydrogenase levels, poor performance status, B symptoms, and higher International Prognostic Index in both cohorts (all P < .001). Longer DTI was associated with improved EFS24 in both the MER (per-week odds ratio, 0.80; 95% CI, 0.74 to .0.87) and LYSA (per-week odds ratio, 0.90; 95% CI, 0.86 to 0.94); association with EFS24 remained significant after adjustment for International Prognostic Index. Conclusion DTI is strongly associated with prognostic clinical factors and outcome in newly diagnosed DLBCL. DTI should be reported in all clinical trials of newly diagnosed DLBCL and future trials should take steps to avoid selection bias due to treatment delay.
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Affiliation(s)
- Matthew J Maurer
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Hervé Ghesquières
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Brian K Link
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Jean-Philippe Jais
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Thomas M Habermann
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Carrie A Thompson
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Corinne Haioun
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Cristine Allmer
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Patrick B Johnston
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Richard Delarue
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Ivana N Micallef
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Frederic Peyrade
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - David J Inwards
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Nicolas Ketterer
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Umar Farooq
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Olivier Fitoussi
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - William R Macon
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Thierry J Molina
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Sergei Syrbu
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Andrew L Feldman
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Susan L Slager
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - George J Weiner
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Stephen M Ansell
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - James R Cerhan
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Gilles A Salles
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Thomas E Witzig
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Hervé Tilly
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
| | - Grzegorz S Nowakowski
- Matthew J. Maurer, Thomas M. Habermann, Carrie A. Thompson, Cristine Allmer, Patrick B. Johnston, Ivana N. Micallef, David J. Inwards, William R. Macon, Andrew L. Feldman, Susan L. Slager, Stephen M. Ansell, James R. Cerhan, Thomas E. Witzig, and Grzegorz S. Nowakowski, Mayo Clinic, Rochester, MN; Hervé Ghesquières and Gilles A. Salles, Université Claude Bernard, Lyon; Jean-Philippe Jais, Richard Delarue, Thierry J. Molina, Hopital Necker, Paris; Corinne Haioun, Groupe Hospitalier Mondor, Créteil; Frederic Peyrade, Centre Antoine Lacassagne, Nice; Olivier Fitoussi, Polyclinique Bordeaux Nord-Aquitaine, Bordeaux; Hervé Tilly, Centre de lutte Contre le Cancer Henri Becquerel, Rouen, France; Brian K. Link, Umar Farooq, Sergei Syrbu, and George J. Weiner, University of Iowa, Iowa City, IA; and Nicolas Ketterer, Clinique Bois-Cerf, Lausanne, Switzerland
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Cabannes-Hamy A, Peyrade F, Jardin F, Emile JF, Delwail V, Mounier N, Haioun C, Perrot A, Fitoussi O, Lara D, Delarue R, André M, Offner F, Ghesquières H, Pascal L, Soussain C, Lazarovici J, Schiano JM, Gaulard P, Tilly H, Thieblemont C. Central nervous system relapse in patients over 80 years with diffuse large B-cell lymphoma: an analysis of two LYSA studies. Cancer Med 2018; 7:539-548. [PMID: 29473343 PMCID: PMC5852369 DOI: 10.1002/cam4.1139] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/24/2017] [Accepted: 06/09/2017] [Indexed: 11/28/2022] Open
Abstract
CNS relapse is reported in 2–5% of diffuse large B‐cell lymphoma (DLBCL) patients, dramatically decreasing overall survival (OS). Very few studies address incidence and risk factors of CNS relapse in very elderly patients, a challenging population to treat given their commonly associated comorbidities. A retrospective analysis was performed of 270 DLBCL patients >80 years treated between 2004 and 2013 in two multicentre phase II LYSA trials (LNH03‐7B, LNH09‐7B) evaluating the addition of rituximab or ofatumumab to mini‐CHOP as front‐line therapy. No patients received CNS prophylaxis. CNS relapse was evaluated according to cumulative incidence, patient characteristics, risk factors, and survival. Median age was 83 years (range: 79–95). After a median follow‐up of 28.7 months, eight patients had CNS relapse (3.0%). Median time between inclusion and CNS relapse was 19.2 months (range: 3.2–32.6). Patients survived a median of 1.5 months after CNS relapse (range: 0.4–4.1). Median OS from relapse was significantly lower in CNS relapse patients (1.5 months, 95% CI: 0.4–3.5) compared to patients with non‐CNS relapse (6.6 months; 95% CI: 4.6–11.9). No baseline characteristics were associated with CNS relapse. The proportion of patients with CNS disease did not differ significantly between patients with low‐intermediate risk according to CNS‐IPI and patients with high risk (3% vs. 2.8%, P = 1.00). CNS relapse cumulative incidence in very elderly treatment‐naive patients is 1.8% at 2 years and is associated with poor survival. This population had a long median time to CNS relapse. Absence of prophylaxis did not strongly impact CNS relapse incidence.
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Affiliation(s)
- Aurélie Cabannes-Hamy
- APHP, Hôpital Saint-Louis, Hemato-Oncologie, Paris, France.,Université Diderot, Sorbonne Paris-Cité, Paris, France.,EA7324, Université Descartes, Paris, France
| | | | - Fabrice Jardin
- Department of Hematology, Centre Henri Becquerel, UNIROUEN, INSERMU1245, Rouen, France
| | - Jean-François Emile
- APHP, Hôpital universitaire Ambroise Paré, Service d'anatomie pathologique, Boulogne, France
| | - Vincent Delwail
- Department of Oncology-Hematology and Cell Therapy, University Hospital, CIC INSERM 1402, Poitiers, France
| | | | - Corinne Haioun
- Lymphoid Malignancies Unit, AP-HP, Groupe Hospitalier Mondor, Créteil, France
| | - Aurore Perrot
- Hematology Department, University Hospital, Vandoeuvre Les Nancy, France
| | - Olivier Fitoussi
- Polyclinique Bordeaux-Nord, Service d'onco-hématologie, Bordeaux, France
| | - Diane Lara
- Service d'Hematologie Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | | | - Marc André
- Department of Hematology, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium
| | - Fritz Offner
- CHU, Department of internal medicine, Ghent, Belgium
| | - Hervé Ghesquières
- Hematologie, Centre hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre-Benite, France
| | - Laurent Pascal
- Groupement des Hôpitaux de l'Institut Catholique de Lille, Hematologie, Lille, France
| | - Carole Soussain
- Hematologie, CLCC Hôpital René Huguenin - Institut Curie, Saint-Cloud, France
| | - Julien Lazarovici
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif
| | | | - Philippe Gaulard
- Département de Pathologie, Hôpital Henri Mondor, AP-HP, Créteil, France.,INSERM U955, Créteil, France.,Université Paris-Est, Créteil, France
| | - Hervé Tilly
- Department of Hematology, Centre Henri Becquerel, UNIROUEN, INSERMU1245, Rouen, France
| | - Catherine Thieblemont
- APHP, Hôpital Saint-Louis, Hemato-Oncologie, Paris, France.,Université Diderot, Sorbonne Paris-Cité, Paris, France.,EA7324, Université Descartes, Paris, France
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Saâda-Bouzid E, Defaucheux C, Karabajakian A, Coloma VP, Servois V, Paoletti X, Even C, Fayette J, Guigay J, Loirat D, Peyrade F, Alt M, Gal J, Le Tourneau C. Hyperprogression during anti-PD-1/PD-L1 therapy in patients with recurrent and/or metastatic head and neck squamous cell carcinoma. Ann Oncol 2018; 28:1605-1611. [PMID: 28419181 DOI: 10.1093/annonc/mdx178] [Citation(s) in RCA: 412] [Impact Index Per Article: 68.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Indexed: 12/20/2022] Open
Abstract
Background Pembrolizumab and nivolumab are immune checkpoint inhibitors targeting PD-1 that have recently been approved in pretreated recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC) patients. In the clinic, some patients seem not only not to benefit from anti-PD-L1/PD-1 agents but rather to experience an acceleration of tumor growth kinetics (TGK). Patients and methods We retrospectively compared TGK on immunotherapy and TGK on last treatment in patients with R/M HNSCC treated with PD-1/PD-L1 inhibitors in four French centers. The TGK ratio (TGKR, ratio of the slope of tumor growth before treatment and the slope of tumor growth on treatment) was calculated. Hyperprogression was defined as a TGKR ≥ 2. Results From September 2012 to September 2015, 34 patients were identified. Patterns of recurrence included exclusive loco-regional recurrence in 14 patients, exclusive distant metastases in 11 patients, and both in 9 patients. No pseudo-progression was observed. Hyperprogression was observed in 10 patients (29%), including 9 patients with at least a locoregional recurrence, and only 1 patient with exclusively distant metastases. Hyperprogression significantly correlated with a regional recurrence (TGKR ≥ 2: 90% versus TGKR < 2: 37%, P = 0.008), but not with local or distant recurrence. Hyperprogression was associated with a shorter progression-free survival (PFS) according to RECIST (P = 0.003) and irRECIST (P = 0.02), but not with overall survival (P = 0.77). Conclusions Hyperprogression was observed in 29% of patients with R/M HNSCC treated with anti-PD-L1/PD-1 agents and correlated with a shorter PFS. It occurred in 39% of patients with at least a locoregional recurrence and 9% of patients with exclusively distant metastases. No pseudo-progressions were reported. Mechanisms and causality of hyperprogression should further be assessed through prospective controlled studies.
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Affiliation(s)
- E Saâda-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice
| | - C Defaucheux
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud
| | - A Karabajakian
- Department of Medical Oncology, Centre Léon Bérard, Lyon
| | - V P Coloma
- Department of Oncology, Gustave Roussy, Villejuif
| | - V Servois
- Department of Radiology, Institut Curie, Paris
| | - X Paoletti
- Department of Biostatistics, Institut Gustave Roussy, Villejuif
| | - C Even
- Department of Oncology, Gustave Roussy, Villejuif
| | - J Fayette
- Department of Medical Oncology, Centre Léon Bérard, Lyon
| | - J Guigay
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice
| | - D Loirat
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud
| | - F Peyrade
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice
| | - M Alt
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud
| | - J Gal
- Department of Biostatistics, Centre Antoine Lacassagne, Nice
| | - C Le Tourneau
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud.,INSERM U900 Research Unit, Saint-Cloud, France
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Saâda-Bouzid E, Refae S, Ebran N, Gal J, Peyrade F, Guigay J, Milano G. Variations in PD1, PD-L1, IDO1 and VEGR2 genes and association with outcomes in advanced head and neck squamous cell carcinoma (HNSCC) patients treated with anti-PD1/PD-L1 based immunotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx509.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tardy M, Viotti J, Boscagli Melaine A, Thyss A, Peyrade F, Gastaud L. Autologous stem cell transplantation (ASCT) is safe and effective for the treatment of non-hodgkin lymphoma (NHL) in an elderly population of patients over 65 years old: A single center experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.022] [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: 11/12/2022] Open
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Mertens C, Le Caer H, Ortholan C, Blot E, Even C, Rousselot H, Peyrade F, Sire C, Cupissol D, Pointreau Y, Debourdeau P, Rolland F, Fayette J, Capitain O, Sun X, Debbah M, Schwob D, Boulahssass R, Aupérin A, Guigay J. The ELAN-ONCOVAL (ELderly heAd and Neck cancer-Oncology eValuation) study: Evaluation of the feasibility of a suited geriatric assessment for use by oncologists to classify patients as fit or unfit. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx374.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Verriere B, Gastaud L, Chamorey E, Peyrade F, Deletie E, Bouredji K, Quinsat D, Schiappa R, Thyss A, Re D. Description of late onset neutropenia in indolent lymphoma patients treated with bendamustine plus rituximab. Hematol Oncol 2017; 36:144-149. [PMID: 28685846 DOI: 10.1002/hon.2458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/26/2017] [Accepted: 06/05/2017] [Indexed: 11/11/2022]
Abstract
Bendamustine (B) associated with rituximab (R) is widely described in literature for the management of patients with chronic lymphoid leukaemia (CLL) and indolent non-Hodgkin lymphoma. Safety data regarding late hematotoxicity such as late onset neutropenia (LON) are scarce. The aim of our study was to assess the incidence and to identify risk factors for LON in patients with indolent non-Hodgkin lymphoma and CLL treated with B and R (B-R). One hundred forty five patients were treated with B-R as first or second line. Patients with neutropenia prior induction treatment, treated beyond second line and relapsing within 3 months after the end of induction treatment, were excluded. Patients receiving at least 1 cycle of B-R and having LON during follow-up period were included and considered as eligible for toxicity assessment. A complete blood count was performed 4 weeks after the last cycle of induction treatment and thereafter every 3 months for 1 year. Thirty six patients were identified in our cohort (incidence of 25%), mostly affected by CLL (n = 11) and follicular lymphoma (FL) (n = 15). During follow-up, 84 events of LON were recorded, 61% and 39% were of grades 1/2 and 3/4, respectively. No episode of febrile neutropenia was documented. Amongst 13 of the 15 patients with FL undergoing R maintenance, 8 had treatment discontinuation because of LON. Median time for LON (grade > 2) and time to recovery (grade < 3) were of 11.2 and 17.3 weeks, respectively. One year after B-R induction, LON persisted in 4 patients. The risk of LON was increased both in patients with FL or CLL and performance status >1. The LON in B-R treated patients is clinically relevant. Close clinical and biological follow-up and treatment prophylaxis (eg, valaciclovir and cotrimoxazole) especially for FL patients undergoing maintenance with R monotherapy seems relevant.
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Affiliation(s)
- B Verriere
- Pharmacy department, Antibes Hospital, Antibes, France
| | - L Gastaud
- Oncology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - E Chamorey
- Biostatistics and epidemiology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - F Peyrade
- Oncology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - E Deletie
- Pharmacy department, Antibes Hospital, Antibes, France
| | - K Bouredji
- Oncology and hemato oncology department, Antibes Hospital, Antibes, France
| | - D Quinsat
- Internal Medicine department, Antibes Hospital, Antibes, France
| | - R Schiappa
- Biostatistics and epidemiology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - A Thyss
- Oncology department, Anticancer Center Antoine Lacassagne, Nice, France
| | - D Re
- Oncology department, Anticancer Center Antoine Lacassagne, Nice, France.,Oncology and hemato oncology department, Antibes Hospital, Antibes, France
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Chamorey E, Francois E, Etienne-Grimaldi MC, Viotti J, Peyrade F, Bozec A, Ferrero JM, Schiappa R, Milano G. Abstract 3823: High intrinsic DPD activity matters too. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-3823] [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
Introduction: Fluoropyrimidines (FP) are of major use in treating cancer. Dihydropyrimidine dehydrogenase (DPD) is the main enzyme responsible for FP catabolism. Low DPD activity screening has proven its predictive clinical value in identifying patients at risk for toxicity. However, high DPD activity may translate to decreased FP activation and efficacy.
Patients and methods: One hundred and forty-three patients (monocentric retrospective study) underwent a pretreatment assessment of DPD activity in lymphocytes between 01/01/2004 and 20/04/2016. Included patients were male or female, >18 years, FP-treatment-based. Cut-off for DPD activity was assessed using smoothing spline curves.
Results: Median patient follow-up was 30 months [CI95%: 27.3-36.2], mean age 63+/-3 years, females accounted for 53%, 90% of patients had a good performance status (0 or 1). Fifty-eight percent of FP indications (65% 5-FU and 35% capecitabine) were adjuvant or neoadjuvant and 42% were prescribed for local or metastatic recurrences. Tolerance was poor for 43% of patients and 49% needed dose reduction. Objective response (complete and partial) was observed in 50% of patients, stable disease in 38% and progression in 12%. No significant correlation was observed between DPD activity and response to treatment. Mean DPD activity (pmol min−1 mg−1 protein) was 0.21+/-0.1 (quartile: [0.001-0.14-0.20-0.28-0.48]). DPD activity analyzed as a continuous variable was significantly linked to overall survival (OS) (p=0.042) but not with progression-free survival (PFS). The higher the DPD activity, the lower the OS. DPD activity analyzed as a binary variable (cut-off at 0.30) was significantly linked to overall survival (p=0.012) but also with PFS (p=0.016). A Cox regression model for OS and PFS adjusted for age, sex, type of cancer, type of administered FP, and associated surgical or radiotherapy treatment was performed. After adjustment, DPD activity remained significantly linked to OS (p=0.03) and PFS (p=0.021).
Conclusions: DPD activity screening could lead to a two-pronged approach: FP dose reduction in the event of low DPD and dose increase for high DPD. Such a strategy needs to be prospectively validated under personalized DPD-based treatment.
Note: This abstract was not presented at the meeting.
Citation Format: Emmanuel Chamorey, Eric Francois, Marie-Christine Etienne-Grimaldi, Julien Viotti, Frederic Peyrade, Alexandre Bozec, Jean-Marc Ferrero, Renaud Schiappa, Gerard Milano. High intrinsic DPD activity matters too [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3823. doi:10.1158/1538-7445.AM2017-3823
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Tardy MP, Lescure C, Doyen J, Daste A, Lange M, Saint-Ghislain M, Lefebvre G, Sarradin V, Bozec A, Saada-Bouzid E, Peyrade F. Characteristics of very long responder to maintenance cetuximab after a platinum-cetuximab based chemotherapy for recurrent and/or metastatic head and neck squamous cell carcinomas (RM HNSCC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e17524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17524 Background: Standard treatment for first line RM HNSCC is the association of platinum-5FU and cetuximab. For non-progressive patients (pts), cetuximab is given weekly as maintenance until progression or unacceptable toxicity. In the EXTREME protocol (Vermorken et al, NEJM 2008), this strategy showed an OS of 10.1 months with a mean duration of maintenance of 3 months. This study aimed at describing pts who have benefited from a cetuximab maintenance for a longer period (i.e. > 6 months). Methods: We did a retrospective study in 7 centers in France. Inclusion criteria were: pts > 18 years with a RM HNSCC treated between November 2009 and January 2017, with platinum based chemotherapy and cetuximab followed by weekly cetuximab maintenance of more than 6 months. Results: 53 pts (45 male), with a median age of 57 [38-76] were recorded. Median follow-up was 63.7 months [14.8-237.6]. 72% [37/53] had an oral cavity or oropharynx tumor location with a well or moderately differentiated carcinoma (74%). 45/53 (85%) were smokers and 4/21 (19%) p16 positive. 46/53 (87%) had a Performans Status of 0-1. Mean BMI and albumin level were respectively 22.5 [SD: 4.19] and 40g/l [SD: 4.9]. EXTREME regimen was used for 44 pts, 2 pts had platinum and cetuximab and 7 received platinum, docetaxel and cetuximab. Mean number of chemotherapy cycles was 5 [3-7]. After chemotherapy, the number of pts with complete response (CR), partial response (PR) or stabilization was respectively 5 (9%), 23 (43%) and 25 (47%). 2 pts in PR finally achieved CR during maintenance. One of them stopped cetuximab and was still in CR 5 months later. Mean duration time of maintenance by cetuximab was 11 months [6-24]. Toxicities were mainly cutaneous: 47/53 pts had toxicities, of which 6 had grade 3. Presence of cutaneous toxicities seemed to be correlated with a longer response (p = 0.01). PFS and OS were respectively 15.5 and 27.4 months. Conclusions: Our study allowed us to identify a cohort of long responder pts to maintenance cetuximab including 2 pts who obtained a complete response. More analysis should be done to identify biomarkers able to predict long responder.
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Affiliation(s)
| | | | | | - Amaury Daste
- Hôpital Saint André, CHU de Bordeaux, Bordeaux, France
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Fayette J, Guigay J, Le Tourneau C, Degardin M, Peyrade F, Neidhardt EM, Sablin MP, Even C, Orlandini F, Juzyna B, Bellera C. Cabazitaxel in recurrent/metastatic squamous cell carcinoma of the head and neck: phase II UNICANCER trial ORL03. Oncotarget 2017; 8:51830-51839. [PMID: 28881692 PMCID: PMC5584293 DOI: 10.18632/oncotarget.15901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 01/23/2017] [Indexed: 12/26/2022] Open
Abstract
Treatments are limited after platinum Cetuximab or anti-PD1 failure for patients with recurrent/metastatic head and neck squamous cell carcinoma. Cabazitaxel has increased overall survival in hormone-refractory metastatic prostate cancer after failure of Docetaxel. Our aim was to detect a signal of activity with Cabazitaxel in patients with head and neck cancer who had failed platinum-, Cetuximab- and taxanes-based chemotherapy. This multicenter phase II trial included progressive patients with an ECOG ≤2. Cabazitaxel was given at 25 mg/m2/3 weeks (maximum of 10 cycles), with growth factors support. Efficacy was centralized and assessed every 6 weeks. The primary endpoint was control rate at six-weeks. A Simon’s two-stage optimal design (P0=0.10; P1=0.30) required 29 evaluable patients. At the end of trial, at least 6 non-progressions were required to consider the drug worthy of further study. Out of the 31 enrolled patients, 29 were eligible; 42% had received at least three previous lines of chemotherapy. For the primary end point, 8 patients (27.6%; 95%CI 12.7%-47.2%) had a stable disease at six weeks. Median progression-free survival was 1.05 months (95%CI 0.69-2.07). All patients were analyzed for toxicity: 6 patients had febrile neutropenia. During the 81 cycles administered, 49 grade 3-5 events were observed concerning 81% of the patients, including 35 severe adverse events of which 15 were related to Cabazitaxel. Although Cabazitaxel met its primary endpoint to deserve further investigations, its toxicity makes it difficult to use in frail patients and new schemes are needed (20 mg/m2 for example) if further investigations are launched.
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Affiliation(s)
| | - Joel Guigay
- Gustave Roussy Institute, Villejuif, France.,Antoine Lacassagne Center, Nice, France
| | - Christophe Le Tourneau
- Institut Curie, Saint-Cloud & Paris, France.,EA7285, Versailles-Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
| | | | | | | | | | | | | | | | - Carine Bellera
- Bergonié Institute, Clinical and Epidemiological Research Unit & INSERM U897 & Data Center for Cancer Clinical Trials, Bordeaux, France
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Peyrade F. A clinician's perspective on a long time to publish. Lancet Haematol 2016; 4:e11. [PMID: 27916631 DOI: 10.1016/s2352-3026(16)30182-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 11/18/2016] [Indexed: 11/19/2022]
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Guigay J, Chamorey E, Céruse P, Mornex F, Degardin M, Alfonsi M, Digue L, Berrier A, Artignan X, Cals L, Faivre S, Vuillemin E, Rolland F, Timochenko A, Babin E, Seronde-Delmas A, Prevost A, Romano O, Peyrade F, Le Tourneau C. Observational study of the cetuximab relative dose intensity (RDI) in the first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Data on the maintenance and every two weeks use (DIRECT study). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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37
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Guigay J, Bidault F, Fayette J, Even C, Cupissol D, Rolland F, Peyrade F, Laguerre B, Le Tourneau C, Zanetta S, Bozec Le Moal L, Borel C, Digue L, Delaye J, Diffetocq S, Costes V, Auperin A, Faivre L. Pazopanib in patients with progressive recurrent or metastatic (R/M) salivary gland carcinoma (SGC): Further evaluation of efficacy including tumor growth rates (GR) analysis. H&N Unicancer Group PACSA trial with the REFCOR. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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38
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Tardy MP, Gastaud L, Boscagli A, Peyrade F, Gallamini A, Thyss A. Autoimmune hemolytic anemia after nivolumab treatment in Hodgkin lymphoma responsive to immunosuppressive treatment. A case report. Hematol Oncol 2016; 35:875-877. [PMID: 27539158 DOI: 10.1002/hon.2338] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 06/23/2016] [Accepted: 07/04/2016] [Indexed: 11/07/2022]
Abstract
The patients with refractory Hodgkin lymphoma have a poor prognosis. The nivolumab, an IgG4 monoclonal antibody inhibiting the program death 1 pathway has recently demonstrated its efficacy and its safety in patients with heavily pretreated refractory Hodgkin lymphoma. The side effects of this immunotherapy include autoimmune-like syndromes. A 75-year-old woman with no significant comorbidities was treated by nivolumab (3 mg/kg every 2 wk) as a third-line treatment for refractory Hodgkin lymphoma. A clinical response was observed with the first injection of nivolumab, with a reduction in superficial lymph nodes. After the second injection, the patient presented an authentic autoimmune hemolytic anemia with a profound anemia at 64 g/L and biologic characteristics of hemolysis (elevated unconjugated bilirubin, lactate dehydrogenase, and reticulocytes). The direct antiglobulin test was strongly positive for IgG antibodies, and the indirect antiglobulin test became positive with a very high level of autoantibodies. After 2 injections of nivolumab, the patient underwent a fluodeoxyglucose F 18 positron emission tomography-computed tomography, showing a partial response according to modified Cheson criteria. A treatment with prednisone (2 mg/kg), initiated after transfusion of 2 units of red blood cells, permitted the complete resolution of this autoimmune reaction after 3 months of corticotherapy. The fluodeoxyglucose F 18 positron emission tomography-computed tomography performed at the end of the corticotherapy showed a clear disease progression. Considering the very good response achieved after only 2 injections of nivolumab, the limited therapeutic resources for this old woman, and the complete resolution of the autoimmune hemolytic anemia, nivolumab was reintroduced at the same dose, with close clinical and biological monitoring. She received 6 more injections of nivolumab without recurrence of hemolysis.
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Affiliation(s)
- Magalie P Tardy
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Lauris Gastaud
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Annick Boscagli
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Frederic Peyrade
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Andrea Gallamini
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
| | - Antoine Thyss
- Department of Oncology, Antoine-Lacassagne Center, Cancer Research Center, Nice, France
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39
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Guigay J, Fayette J, Even C, Cupissol D, Rolland F, Peyrade F, Laguerre B, Le Tourneau C, Zanetta S, Bozec Le Moal L, Borel C, Do P, Digue L, Delaye J, Auperin A, Bidault F, Costes V, Faivre L. PACSA: Phase II study of pazopanib in patients with progressive recurrent or metastatic (R/M) salivary gland carcinoma (SGC). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.6086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Didier Cupissol
- Institut Régional du Cancer Montpellier, Montpellier, France
| | | | | | | | | | | | | | | | - Pascal Do
- Centre Francois Baclesse, Caen, France
| | | | | | | | | | - Valerie Costes
- CHU Hôpital Gui de Chauliac, Montpellier; REFCOR, Paris, France
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40
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Gastaud L, Rossignol B, Peyrade F, Ré D, Thariat J, Thyss A, Doyen J. Place de la radiothérapie dans la prise en charge des lymphomes malins non hodgkiniens. Cancer Radiother 2016; 20:236-47. [DOI: 10.1016/j.canrad.2016.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 12/27/2015] [Accepted: 01/29/2016] [Indexed: 12/11/2022]
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41
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Gastaud L, Rossignol B, Peyrade F, Ré D, Thariat J, Thyss A, Doyen J. Place de la radiothérapie dans la prise en charge des lymphomes malins non hodgkiniens. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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42
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Pilorge S, Harel S, Ribrag V, Larousserie F, Willems L, Franchi P, Legoff M, Biau D, Anract P, Roux C, Blanc-Autran E, Delarue R, Gisselbrecht C, Ketterer N, Recher C, Bonnet C, Peyrade F, Haioun C, Tilly H, Salles G, Brice P, Bouscary D, Deau B, Tamburini J. Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies. Leuk Lymphoma 2016; 57:2820-2826. [PMID: 27118302 DOI: 10.1080/10428194.2016.1177180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is a rare DLBCL location variant. We treated 76 PB-DLBCL patients by immuno-chemotherapy, resulting in an 84% sustained complete remission rate and a 78.9% survival over a 4.7-year median follow-up period. Ann Arbor stage IV and high age-adjusted international prognostic index were predictive of adverse outcome in univariate analysis. In multivariate analysis using a Cox model, only aa-IPI predicted long-term survival. While based on a limited number of cases, we suggested that radiotherapy may be useful as a consolidation modality in PB-DLBCL. We also suggested that positron emission tomography/CT scan should be interpreted with caution due to a persistent [18F]fluorodeoxyglucose [18FDG] uptake of bone lesions even after remission in some in PB-DLBCL patients. Our study based on a homogeneous cohort of PB-DLBCL patients confirmed the favorable outcome of this DLBCL variant and support the implementation of prospective clinical trials in this disease.
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Affiliation(s)
- Sylvain Pilorge
- a Hematology Department , Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris, France.,b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France
| | - Stephanie Harel
- c Lymphoid Malignancies Unit , Saint Louis Hospital , Paris , France
| | | | - Frédérique Larousserie
- b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France.,e Pathology Department , Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris, France
| | - Lise Willems
- a Hematology Department , Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris, France.,b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France
| | - Patricia Franchi
- a Hematology Department , Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris, France.,b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France
| | - Marielle Legoff
- a Hematology Department , Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris, France.,b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France
| | - David Biau
- b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France.,f Orthopedic Surgery Department , Cochin Hospital, AP-HP , Paris, France
| | - Philippe Anract
- b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France.,f Orthopedic Surgery Department , Cochin Hospital, AP-HP , Paris, France
| | - Christian Roux
- b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France.,g Rhumatology Department , Cochin Hospital, AP-HP , Paris, France
| | - Estelle Blanc-Autran
- h Nuclear Medicine Department , Centre Medico-Chirurgical Marie-Lannelongue , Le Plessis-Robinson , France
| | | | | | | | - Christian Recher
- l Service d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole , Toulouse , France
| | - Christophe Bonnet
- m Département de Médecine, Service d'Hématologie Clinique , CHU Liège, Campus Universitaire du Sart-Tilman , Belgique
| | - Frederic Peyrade
- n Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | - Corinne Haioun
- o Department of Hematology , Henri Mondor University Hospital , Créteil , France
| | - Hervé Tilly
- p Centre Henri-Becquerel , Université de Rouen , Rouen , France
| | - Gilles Salles
- q Centre Hospitalier Lyon Sud , Service d'Hématologie, Hospices Civils de Lyon , Lyon , France
| | - Pauline Brice
- c Lymphoid Malignancies Unit , Saint Louis Hospital , Paris , France
| | - Didier Bouscary
- a Hematology Department , Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris, France.,b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France
| | - Bénédicte Deau
- a Hematology Department , Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris, France.,b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France
| | - Jerome Tamburini
- a Hematology Department , Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris, France.,b Faculté de Médecine Sorbonne Paris Cité , Université Paris Descartes , Paris, France
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Falk A, Hébert C, Paquet M, Tran A, Peyrade F, Saada E, Reure J, Dassonville O, Poissonnet G, Bozec A, Thariat J, Leysalle A, Chand M, Benezery K. EP-1084: Elderly patients concomitant radiotherapy + cetuximab in locally advanced head and neck cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32334-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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44
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Picard A, Duranton-Tanneur V, Peyrade F, Chamorey E, Saudes L, Cardot-Leccia N, Sudaka A, Kubiniek V, Poissonnet G, Michiels JF, Lacour JP, Passeron T, Pedeutour F, Montaudié H. Évaluation du statut mutationnel des gènes KRAS, NRAS, HRAS, BRAF et EGFR comme facteur prédictif de la réponse au traitement par cétuximab chez les patients atteints de carcinomes épidermoïdes cutanés inopérables. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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45
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Martin N, Borchiellini D, Coso D, Gastaud L, Boscagli A, Saudes L, Re D, Gutnecht J, Garnier G, Petit E, Barriere J, Naman H, Rossignol B, Thyss A, Peyrade F. High-dose chemotherapy with carmustine, etoposide, cytarabine and melphalan followed by autologous stem cell transplant is an effective treatment for elderly patients with poor-prognosis lymphoma. Leuk Lymphoma 2015; 56:2379-87. [PMID: 25563428 DOI: 10.3109/10428194.2014.1001987] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Autologous stem cell transplant (ASCT) after high-dose chemotherapy (HDT) increases overall survival when used in relapsed non-Hodgkin lymphoma (NHL) in patients under 65 years old. Limited experience is available for older patients. We present a retrospective analysis of 73 consecutive patients aged over 65 years treated for aggressive or relapsed lymphoma by HDT with carmustine, etoposide, cytarabine and melphalan (BEAM) at full dosage followed by ASCT. Patient data were obtained from medical charts from two institutions. Median age was 67 years (65-74). Significant comorbidities were present in 24.7% of patients. The median number of days for grade 4 neutropenia was 9 (5-18). The early treatment-related mortality rate (<100 days) was 2.7%. The estimated 2-year progression-free survival and overall survival rates were 67.2% and 78.5%, respectively. In conclusion, the full-dose HDT-ASCT regimen is feasible, safe and efficient in selected patients over 65 years old.
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Affiliation(s)
- Nicolas Martin
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | | | - Diane Coso
- b Department of Hematology , Paoli-Calmettes Institute , Marseille , France
| | - Lauris Gastaud
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | - Annick Boscagli
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | | | - Daniel Re
- d Department of Oncology , Antibes-Juan-les-Pins Hospital , France
| | - Jean Gutnecht
- e Department of Oncology , Frejus-Saint Raphael Hospital , France
| | - Georges Garnier
- f Department of Oncology , Princesse Grace Hospital Center , Monaco
| | - Emmanuel Petit
- g Department of Oncology , Oxford Clinic , Cannes , France
| | - Jèrôme Barriere
- h Department of Oncology , St-Jean Polyclinic , Cagnes-sur-Mer , France
| | - Hervé Naman
- i Azurean Center of Oncology , Mougins , France
| | | | - Antoine Thyss
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
| | - Frederic Peyrade
- a Department of Oncology , Antoine-Lacassagne Center , Nice , France
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46
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Culié D, Benezery K, Vandersteen C, Chamorey E, Ettaiche M, Dassonville O, Poissonnet G, Peyrade F, Saada E, Bozec A. PO-075: Induction chemotherapy in locally advanced hypopharynx cancer: treatment outcomes and role of nutritional status. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34835-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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47
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Guigay J, Peyrade F, Saada E. SP-052: The role of PD-L1/PD1 pathway in SCCHN. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34812-x] [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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48
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Le Caer H, Guigay J, Mertens C, Ortholan C, Blot E, Tao Y, Peyrade F, Pointreau Y, Auperin A. Elderly head and neck cancer (elan) study: Personalized treatment according to geriatric assessment in patients age 70 or older: First (SCCHN) unsuitable for surgery. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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49
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Guigay J, Peyrade F, Petre-Lazar B, Mornex F, Ceruse P, Digue L, Berrier A, Degardin M, Alfonsi M, Artignan X, Cals L, Faivre S, Vuillemin E, Rolland F, Timochenko A, Babin E, Prevost A, Romano O, Chamorey E, Le Tourneau C. Cetuximab Relative Dose Intensity (Rdi) in Recurrent/Metastatic (R/M) Squamous Cell Carcinoma of the Head and Neck (Scchn): First Observational Prospective Study in Unselected Patients (Direct Trial). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu340.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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50
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Peyrade F, Righini C, Gal J, Benezery K, Lallemant B, Le Caer H, Bozec A, Follana P. Adjuvant radiotherapy (RDT) plus cisplatinum (Cis) and cetuximab (Cet) in resected head and neck squamous cell carcinoma. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.6042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Philippe Follana
- Département d'Oncologie Médicale, Centre Antoine Lacassagne, Nice, France
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