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Salaün H, Djerroudi L, Haik L, Schnitzler A, Bataillon G, Deniziaut G, Bièche I, Vincent‐Salomon A, Debled M, Cottu P. The prognosis of patients treated with everolimus for advanced ER-positive, HER2-negative breast cancer is driven by molecular features. J Pathol Clin Res 2024; 10:e12372. [PMID: 38563252 PMCID: PMC10985771 DOI: 10.1002/2056-4538.12372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
Everolimus is widely used in patients with advanced ER-positive, HER2-negative breast cancer. We looked at alterations in the PIK3CA/AKT/mTOR pathway in a multicenter cohort as potential biomarkers of efficacy. Patients with advanced ER-positive, HER2-negative breast cancer treated with everolimus and endocrine therapy between 2012 and 2014 in two cancer centers were included. Targeted sequencing examined mutations in PIK3CA, ESR1, and AKT1 genes. An immunochemical analysis was conducted to evaluate expression of PTEN, INPP4B, STK11, p4EBP1, and pS6. We analyzed 71 patients (44 primary tumors; 27 metastatic tissues). Median age was 63 years [58-69]. All patients had heavily pretreated advanced disease. A mutation in the PIK3CA pathway was observed in 32 samples (PIK3CA exons 10 and 21 and AKT1 exon 4 in 15.5%, 24.0%, and 5.6% of samples), and in ESR1 in 5 samples (7.0%), respectively. Most samples showed cytoplasmic expression of the PIK3CA pathway proteins. Progression-free survival was longer in patients with a pS6 or p4EBP1 histoscore ≥ median value (6.6 versus 3.7 months, p = 0.037), and in patients with a PTEN histoscore ≤ median value (7.1 versus 5.3 months, p = 0.02). Overall survival was longer in patients with pS6 ≥ 3rd quartile (27.6 versus 19.3 months, p = 0.038) and in patients with any mutation in the PIK3CA/AKT/mTOR pathway (27.6 versus 19.3 months, p = 0.011). The prognosis of patients treated with everolimus for advanced ER-positive, HER2-negative breast cancer appears primarily driven by molecular features associated with the activation of the PIK3CA/AKT/mTOR pathway.
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Affiliation(s)
- Hélène Salaün
- Department of Medical OncologyInstitut CurieParisFrance
| | - Lounes Djerroudi
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
| | - Laura Haik
- Department of Medical OncologyInstitut BergoniéBordeauxFrance
| | - Anne Schnitzler
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
| | - Guillaume Bataillon
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
- Present address:
Department of PathologyIUCT OncopoleToulouseFrance
| | - Gabrielle Deniziaut
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
- Present address:
Department of PathologyCHU Pitié‐SalpêtrièreParisFrance
| | - Ivan Bièche
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
- Paris‐Cité UniversityParisFrance
| | - Anne Vincent‐Salomon
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
- PSL Research UniversityParisFrance
| | - Marc Debled
- Department of Medical OncologyInstitut BergoniéBordeauxFrance
| | - Paul Cottu
- Department of Medical OncologyInstitut CurieParisFrance
- Paris‐Cité UniversityParisFrance
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Najid S, Seban RD, Champion L, De Moura A, Sebbag C, Salaün H, Cabel L, Bonneau C. Clinical Utility of Pre-Therapeutic [18F]FDG PET/CT Imaging for Predicting Outcomes in Breast Cancer. J Clin Med 2023; 12:5487. [PMID: 37685551 PMCID: PMC10488013 DOI: 10.3390/jcm12175487] [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: 06/26/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND [18F]FDG PET/CT is used for staging and could also provide information associated with clinical outcomes. The objective of this study was to determine the clinical utility of biomarkers measured using [18F]FDG PET/CT to predict the absence of pathological complete response (no-pCR) and recurrence. METHODS In this retrospective study, we included patients with non-special-type breast carcinoma who underwent [18F]FDG PET/CT before neoadjuvant chemotherapy between 2011 and 2019. Clinicopathological data were collected. Tumor SUVmax and total metabolic tumor volume (TMTV) were measured from PET images. The association between biomarkers and no-pCR was studied using logistic regression. The cut-off value was determined using the area under the ROC Curve. To predict 3-year recurrence-free survival (RFS), we used a multivariable Cox model, and the cut-off value was determined using time-dependent ROC and predictiveness curves. RESULTS Two hundred and eighty-six patients were included in the analysis. One hundred and twelve patients had a pCR (39.2%). The pCR rate was significantly higher in patients with a high nuclear grade (p < 0.01), HER2+ and TNBC subtypes (p < 0.01), high Ki67 (p < 0.01), and low TMTV (p < 0.01). A high TMTV value (>9.0 cm3) was significantly associated with no-pCR in the whole cohort (OR = 2.4, 95% CI: 1.3-4.2, p < 0.01). After a median follow-up of 4.5 years, 65 patients experienced recurrence and 39 patients died. High TMTV (>13.5 cm3) was associated with shorter RFS (HR = 4.0, 95% CI: 1.9-8.4, p < 0.01). CONCLUSION High TMTV in pre-therapeutic imaging is associated with no-pCR and recurrence. It can help in identifying high-risk patients and be considered as an intensified or alternative adjuvant therapy for closely monitoring patients.
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Affiliation(s)
- Sophia Najid
- Institut Curie, Inserm U900, 92210 Saint-Cloud, France
| | - Romain-David Seban
- Department of Nuclear Medicine, Institut Curie, 92210 Saint-Cloud, France;
| | - Laurence Champion
- Department of Nuclear Medicine, Institut Curie, 92210 Saint-Cloud, France;
| | - Alexandre De Moura
- Department of Medical Oncology, Institut Curie, PSL Research University, 75005 Paris, France; (A.D.M.); (C.S.); (H.S.); (L.C.)
- UVSQ, Paris Saclay University, 92210 Saint-Cloud, France
| | - Clara Sebbag
- Department of Medical Oncology, Institut Curie, PSL Research University, 75005 Paris, France; (A.D.M.); (C.S.); (H.S.); (L.C.)
- UVSQ, Paris Saclay University, 92210 Saint-Cloud, France
| | - Hélène Salaün
- Department of Medical Oncology, Institut Curie, PSL Research University, 75005 Paris, France; (A.D.M.); (C.S.); (H.S.); (L.C.)
- UVSQ, Paris Saclay University, 92210 Saint-Cloud, France
| | - Luc Cabel
- Department of Medical Oncology, Institut Curie, PSL Research University, 75005 Paris, France; (A.D.M.); (C.S.); (H.S.); (L.C.)
- UVSQ, Paris Saclay University, 92210 Saint-Cloud, France
| | - Claire Bonneau
- Department of Surgery, Institut Curie, 92210 Saint-Cloud, France
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Champiat S, Salaün H, Lucibello F, Scoazec JY, Besse B, Lalanne AI, Rouleau E, Metzger N, Saint-Ghislain M, Ryckewaert T, Gardrat S, Barnhill R, Cassoux N, Stern MH, Lantz O, de Koning L, Marabelle A, Rodrigues M. Exceptional Response to Dual Colony-Stimulating Factor 1 Receptor/PD-L1 Targeting After Primary Resistance to PD-1 Inhibition in a Patient With a Metastatic Uveal Melanoma. JCO Precis Oncol 2023; 7:e2200363. [PMID: 37224427 DOI: 10.1200/po.22.00363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/03/2023] [Accepted: 04/05/2023] [Indexed: 05/26/2023] Open
Affiliation(s)
- Stéphane Champiat
- Drug Development Department, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
- Department of Translational Research, University Paris-Saclay, Inserm U1015, Villejuif, France
- University Paris-Saclay, Inserm, Clinical Investigation Center (CIC-BT1428) Biotheris, Villejuif, France
| | - Hélène Salaün
- Medical Oncology Department, PSL Research University, Institut Curie, Paris, France
| | - Francesca Lucibello
- Center for Cancer Immunotherapy, INSERM U932, Institut Curie, PSL Research University, Paris, France
| | - Jean-Yves Scoazec
- Department of Biopathology, University Paris-Saclay, Gustave Roussy Cancer Center, Villejuif, France
| | - Benjamin Besse
- Paris Saclay University, Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - Ana Ines Lalanne
- Clinical Immunology Laboratory, Institut Curie, Paris, France
- Clinical Investigation Center (CIC-BT1428), Institut Curie, Paris, France
| | - Etienne Rouleau
- Department of Biopathology, University Paris-Saclay, Gustave Roussy Cancer Center, Villejuif, France
| | - Nolwenn Metzger
- Department of Somatic Genetics, Institut Curie, PSL Research University, Paris, France
| | | | | | - Sophie Gardrat
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
- Unit 830 (Cancer, Heterogeneity, Instability and Plasticity) INSERM, Institut Curie, PSL Research University, Paris, France
| | - Raymond Barnhill
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Nathalie Cassoux
- Department of Ophthalmology, Institut Curie, PSL Research University, Paris, France
| | - Marc-Henri Stern
- Unit 830 (Cancer, Heterogeneity, Instability and Plasticity) INSERM, Institut Curie, PSL Research University, Paris, France
| | - Olivier Lantz
- Center for Cancer Immunotherapy, INSERM U932, Institut Curie, PSL Research University, Paris, France
- Clinical Immunology Laboratory, Institut Curie, Paris, France
- Clinical Investigation Center (CIC-BT1428), Institut Curie, Paris, France
| | - Leanne de Koning
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Aurélien Marabelle
- Drug Development Department, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Manuel Rodrigues
- Medical Oncology Department, PSL Research University, Institut Curie, Paris, France
- Unit 830 (Cancer, Heterogeneity, Instability and Plasticity) INSERM, Institut Curie, PSL Research University, Paris, France
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Salaün H, de Koning L, Saint-Ghislain M, Servois V, Ramtohul T, Garcia A, Matet A, Cassoux N, Mariani P, Piperno-Neumann S, Rodrigues M. Nivolumab plus ipilimumab in metastatic uveal melanoma: a real-life, retrospective cohort of 47 patients. Oncoimmunology 2022; 11:2116845. [PMID: 36092639 PMCID: PMC9450894 DOI: 10.1080/2162402x.2022.2116845] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Hélène Salaün
- Medical Oncology Department, PSL Research University, Institut Curie, 26, rue d’Ulm, Paris, France
| | - Leanne de Koning
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Mathilde Saint-Ghislain
- Medical Oncology Department, PSL Research University, Institut Curie, 26, rue d’Ulm, Paris, France
| | - Vincent Servois
- Department of Radiology, Institut Curie, PSL Research University, Paris, France
| | - Toulsie Ramtohul
- Department of Radiology, Institut Curie, PSL Research University, Paris, France
| | - Agathe Garcia
- INSERM Unit 830, DNA Repair and Uveal Melanoma (D.R.U.M.), Equipe Labellisée Par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
| | - Alexandre Matet
- Department of Ophthalmology, Institut Curie, University Paris Cité, PSL Research University, Paris, France
| | - Nathalie Cassoux
- Department of Ophthalmology, Institut Curie, University Paris Cité, PSL Research University, Paris, France
| | - Pascale Mariani
- Department of Surgical Oncology, University of Paris, Institut Curie, PSL Research University, Paris, France
| | - Sophie Piperno-Neumann
- Medical Oncology Department, PSL Research University, Institut Curie, 26, rue d’Ulm, Paris, France
| | - Manuel Rodrigues
- Medical Oncology Department, PSL Research University, Institut Curie, 26, rue d’Ulm, Paris, France
- INSERM Unit 830, DNA Repair and Uveal Melanoma (D.R.U.M.), Equipe Labellisée Par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
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Salaün H, Le Nail LR, Simon C, Narciso B, De Pinieux G, Vegas H, Vinceneux A. Unexpected severe hepatic and skin toxicities during high dose methotrexate course for osteosarcoma. J Oncol Pharm Pract 2022; 28:1458-1464. [PMID: 35138194 DOI: 10.1177/10781552221076456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION high dose methotrexate (HD-MTX) regimen is used in osteosarcoma, leukemia and lymphoma treatment. Osteosarcoma is mostly diagnosed in children and adolescents. Most frequent methotrexate toxicities are mucositis, myelosuppression, renal failure, hepatitis and necrotizing encephalopathy. Toxicities increase with renal impairment, denutrition, in older patients, with some pharmacogenetics factors or with drug interactions. CASE REPORT We report a 16th years old woman diagnosed with osteosarcoma and experienced an unexpected severe hepatic and skin toxicities as toxic epidermal necrolys, Steven Johnson syndrome. MANAGEMENT AND OUTCOME This toxicity occurred despite acid folinic rescue performed as good practice recommendation. Fourteen hours after methotrexate administration, renal failure was observed and after 72 h an erythematous rash and epidermal detachment with toxic epidermal necrolys. Seven days after methotrexate administration, hepatic failure began until grade IV cytolysis. High dose of folinic acid were administered during all severe toxicities. Methotrexate were not longer administered to this young patient and chemotherapy with ifosfamide (IFO), doxorubicine and cisplatin were performed in this patient and complete histologic response were observed in the surgical bone resection. DISCUSSION No classical toxicities risk factors were identified in this patient but a homozygote mutation of MTHFR gene and homozygote SLCO1B1 gene mutation were found. MTHFR and SLCO1B1 are both implicated in methotrexate metabolism.
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Affiliation(s)
- Hélène Salaün
- Department of Medical Oncology, 55216Institut Curie, PSL Research University, Paris, France
| | - Louis Romée Le Nail
- Centre Hospitalier Régional Universitaire de Tours, Service de Chirurgie Orthopédique 2, Faculté de Médecine de Tours, Université de Tours, Tours, France.,Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, Nantes, France
| | - Corinne Simon
- Regional Pharmacovigilance Center, Department of Pharmacosurveillance, CHRU de Tours, Tours, France
| | - Berengere Narciso
- 26928Centre hospitalier Régional universitaire de Tours, Service d'oncologie médicale, Faculté de Médecine de Tours, Université de Tours, Tours, France
| | - Gonzague De Pinieux
- Laboratoire d'étude des sarcomes osseux et remodelage des tissus calcifiés, INSERM UMR 1238, Université de Nantes, PhyOS, Nantes, France.,26928Centre hospitalier Régional universitaire de Tours, Service d'anatomie et cytologie pathologique, Faculté de Médecine de Tours, Université de Tours, Tours, France
| | - Hélène Vegas
- 26928Centre hospitalier Régional universitaire de Tours, Service d'oncologie médicale, Faculté de Médecine de Tours, Université de Tours, Tours, France
| | - Armelle Vinceneux
- 56126Centre Leon Bérard, Oncology Department, 28 promenade Léa et Napoléon Bullukian, 69008 Lyon, France
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Salaün H, Saint-Ghislain M, Bellesoeur A, Beuzeboc P, Neuzillet C, Diéras V, Stern MH, Rodrigues M. [Homologous recombination deficiency and PARP inhibitors in therapeutics]. Bull Cancer 2021; 109:76-82. [PMID: 34799081 DOI: 10.1016/j.bulcan.2021.09.015] [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: 08/26/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 10/19/2022]
Abstract
PARP inhibitors are effective in different types of tumors such as ovarian, breast, prostate and pancreatic cancer. Many studies are in progress and may lead to prescription evolution. PARP inhibitors prescription is almost reserved to patients with a constitutional BRCA mutation or a somatic BRCA alteration or a tumor with a deficiency in homologous recombination. Nowadays, the diagnosis of homologous recombination deficit, HRD, is possible with the prescription of a myChoice CDx (Myriad) test. PARP inhibitors are studied in association with chemotherapy and targeted therapies but also with radiotherapy and with immune checkpoint inhibitors. Access to PARP inhibitors is challenged with the emergence of resistance mechanism. Various trials are now studying the possibility of reversing these resistance mechanisms.
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Affiliation(s)
- Hélène Salaün
- PSL research university, institut Curie, medical oncology department, 35, rue Dailly, 92210 Saint-Cloud, France
| | - Mathilde Saint-Ghislain
- PSL research university, institut Curie, medical oncology department, 26, rue d'Ulm, 75005 Paris, France
| | - Audrey Bellesoeur
- PSL research university, institut Curie, medical oncology department, 26, rue d'Ulm, 75005 Paris, France; PSL research university, institut Curie, radiopharmacology department, 35, rue Dailly, 92210 Saint-Cloud, France
| | - Philippe Beuzeboc
- Hôpital Foch, oncology and supportive care department, Suresnes, France
| | - Cindy Neuzillet
- PSL research university, institut Curie, medical oncology department, 35, rue Dailly, 92210 Saint-Cloud, France
| | - Véronique Diéras
- Centre Eugène-Marquis, medical oncology departement, Rennes, France
| | - Marc Henri Stern
- Institut Curie, INSERM U830 « cancer, heterogeneity, instability and plasticity », 26, rue d'Ulm, 75005 Paris, France
| | - Manuel Rodrigues
- PSL research university, institut Curie, medical oncology department, 26, rue d'Ulm, 75005 Paris, France; Institut Curie, INSERM U830 « cancer, heterogeneity, instability and plasticity », 26, rue d'Ulm, 75005 Paris, France.
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Salaün H, Thariat J, Vignot M, Merrouche Y, Vignot S. Obésité et cancer. Bull Cancer 2017; 104:30-41. [PMID: 28007295 DOI: 10.1016/j.bulcan.2016.11.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 11/14/2016] [Accepted: 11/14/2016] [Indexed: 12/15/2022]
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