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Tao Y, Biau J, Sun XS, Sire C, Martin L, Alfonsi M, Prevost JB, Modesto A, Lafond C, Tourani JM, Miroir J, Kaminsky MC, Coutte A, Liem X, Chautard E, Vauleon E, Drouet F, Ruffier A, Ramee JF, Waksi G, Péchery A, Wanneveich M, Guigay J, Aupérin A, Bourhis J. Pembrolizumab versus cetuximab concurrent with radiotherapy in patients with locally advanced squamous cell carcinoma of head and neck unfit for cisplatin (GORTEC 2015-01 PembroRad): a multicenter, randomized, phase II trial. Ann Oncol 2023; 34:101-110. [PMID: 36522816 DOI: 10.1016/j.annonc.2022.10.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [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: 06/28/2022] [Revised: 10/01/2022] [Accepted: 10/13/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND To evaluate potential synergistic effect of pembrolizumab with radiotherapy (RT) compared with a standard-of-care (SOC) cetuximab-RT in patients with locally advanced-squamous cell carcinoma of head and neck (LA-SCCHN). PATIENTS AND METHODS Patients with nonoperated stage III-IV SCC of oral cavity, oropharynx, hypopharynx, and larynx and unfit for receiving high-dose cisplatin were enrolled. Patients received once-daily RT up to 69.96 Gy in 33 fractions with weekly cetuximab (cetuximab-RT arm) or 200 mg Q3W pembrolizumab during RT (pembrolizumab-RT arm). The primary endpoint was locoregional control (LRC) rate 15 months after RT. To detect a difference between arms of 60%-80% in 15-month LRC, inclusion of 66 patients per arm was required to achieve a power of at least 0.85 at two-sided significance level of 0.20. RESULTS Between May 2016 and October 2017, 133 patients were randomized to cetuximab-RT (n = 66) and pembrolizumab-RT (n = 67). Two patients (one in each arm) were not included in the analysis (a consent withdrawal and a progression before treatment start). The median age was 65 years (interquartile range 60-70 years), 92% were smokers, 60% were oropharynx (46% of oropharynx with p16+) and 75% were stage IV. Median follow-up was 25 months in both arms. The 15-month LRC rate was 59% with cetuximab-RT and 60% with pembrolizumab-RT ]odds ratio 1.05, 95% confidence interval (CI) 0.43-2.59; P = 0.91]. There was no significant difference between arms for progression-free survival (hazard ratio 0.85, 95% CI 0.55-1.32; P = 0.47) and for overall survival (hazard ratio 0.83, 95% CI 0.49-1.40; P = 0.49). Toxicity was lower in the pembrolizumab-RT arm than in the cetuximab-RT arm: 74% versus 92% patients with at least one grade ≥3 adverse events (P = 0.006), mainly due to mucositis, radiodermatitis, and rash. CONCLUSION Compared with the SOC cetuximab-RT, pembrolizumab concomitant with RT did not improve the tumor control and survival but appeared less toxic in unfit patients with LA-SCCHN.
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Affiliation(s)
- Y Tao
- Gustave-Roussy Institute, Villejuif, France
| | - J Biau
- Centre Jean Perrin, Clermont Ferrand, France
| | - X S Sun
- Hôpital Nord Franche-Comté, Montbéliard and CHU Besançon, Montbéliard, France
| | - C Sire
- Centre Hospitalier de Bretagne Sud, Lorient, France
| | - L Martin
- Clinique des Ormeaux, Le Havre, France
| | - M Alfonsi
- Clinique Sainte Catherine, Avignon, France
| | | | - A Modesto
- Institut Claudius Regaud, Toulouse, France
| | - C Lafond
- Clinique Victor Hugo-Centre Jean Bernard, Le Mans, France
| | - J M Tourani
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - J Miroir
- Centre Jean Perrin, Clermont Ferrand, France
| | - M C Kaminsky
- Institut de Cancérologie de Lorraine, Nancy, France
| | - A Coutte
- Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - X Liem
- Centre Oscar Lambret, Lille, France
| | - E Chautard
- Centre Jean Perrin, Clermont Ferrand, France
| | - E Vauleon
- Centre Eugène Marquis, Rennes, France
| | - F Drouet
- Clinique Mutualiste de l'estuaire, Saint-Nazaire, France
| | - A Ruffier
- Gustave-Roussy Institute, Villejuif, France; Clinique Victor Hugo-Centre Jean Bernard, Le Mans, France
| | - J F Ramee
- Centre Hospitalier Départemental de Vendée, La Roche sur Yon, France
| | | | | | | | - J Guigay
- Centre Antoine Lacassagne, FHU OncoAge, University Côte d'Azur, Nice, France
| | - A Aupérin
- Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France
| | - J Bourhis
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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Le Tourneau C, Salas S, Pointreau Y, Ceruse P, Babin E, Rondeau V, Guigay J, Rotarski M, Chehimi M, Toullec C, Marie G, Sire C, Darut Jouve A, Theron A, Calderon B, Houessinon A, Cotté FE, Lavignon M, Even C, Fayette J. 695P Effectiveness and quality-of-life (QoL) data from real-world study (ProNiHN) in patients (pts) with recurrent and/or metastatic squamous cell carcinoma of head and neck (R/M SCCHN) treated with nivolumab (nivo) in France. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.819] [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: 11/01/2022] Open
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Muratori L, Texier M, Mayache-Badis L, Bidault F, Iacob M, Daste A, Fayette J, Lefebvre G, Saada-Bouzid E, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminsky-Forrett MC, Johnson A, Ferrand F, Aupérin A, Guigay J, Raynard B, Even C. 916P Impact of sarcopenia (S) on efficacy and toxicity of nivolumab (N) in patients (pts) with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) in TOPNIVO (T) study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1326] [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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Bourhis J, Tao Y, Sun X, Sire C, Martin L, Liem X, Coutte A, Pointreau Y, Thariat J, Miroir J, Rolland F, Kaminsky MC, Borel C, Maillard A, Sinigaglia L, Guigay J, Saada-Bouzid E, Even C, Aupérin A. LBA35 Avelumab-cetuximab-radiotherapy versus standards of care in patients with locally advanced squamous cell carcinoma of head and neck (LA-SCCHN): Randomized phase III GORTEC-REACH trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2112] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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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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Guigay J, Lee KW, Patel M, Daste A, Wong D, Goel S, Gordon M, Gutierrez M, Balmanoukian A, Le Tourneau C, Mita A, Vansteene D, Keilholz U, Schöffski P, Grote H, Zhou D, Bajars M, Penel N. 920P Avelumab (anti-PD-L1) in patients with platinum-refractory/ineligible recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Results from a phase Ib cohort. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1035] [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: 11/27/2022] Open
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Even C, Daste A, Fayette J, Lefebvre G, Saada-Bouzid E, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminski M, Johnson A, Vauleon E, Le Tourneau C, Sire C, Prevost A, Jallut I, Bourhis J, Guigay J, Aupérin A, Texier M. 917MO TOPNIVO - A safety study of nivolumab in patients with recurrent and/or metastatic platinum-refractory squamous cell carcinoma of head and neck (R/M SCCHN): Final analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1032] [Citation(s) in RCA: 1] [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: 10/23/2022] Open
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Galot R, Le Tourneau C, Guigay J, Licitra L, Tinhofer I, Kong A, Caballero C, Fortpied C, Bogaerts J, Govaerts AS, Staelens D, Raveloarivahy T, Rodegher L, Laes JF, Saada-Bouzid E, Machiels JP. Personalized biomarker-based treatment strategy for patients with squamous cell carcinoma of the head and neck: EORTC position and approach. Ann Oncol 2019; 29:2313-2327. [PMID: 30307465 DOI: 10.1093/annonc/mdy452] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The molecular landscape of squamous cell carcinoma of the head and the neck (SCCHN) has been characterized and actionable or targetable genomic alterations have been identified. However, targeted therapies have very limited activity in unselected SCCHN, and the current treatment strategy is still based on tumor location and disease stage and not on tumor biology. Trying to select upfront the patients who will benefit from a specific treatment might be a way to improve patients' outcome. With the objective of optimizing the activity of targeted therapies and immunotherapy, we have designed an umbrella biomarker-driven study dedicated to recurrent and/or metastatic SCCHN patients (EORTC-1559-HNCG, NCT03088059). In this article, we review not only the different trial designs for biomarker-driven studies with their respective advantages and opportunities but also the potential pitfalls that led to the design of the EORTC-1559-HNCG protocol. We also discuss the scientific and logistic challenges of biomarker-driven trials.
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Affiliation(s)
- R Galot
- Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Belgium; Institute for Clinical and Experimental Research (POLE MIRO), Université Catholique de Louvain, Brussels, Belgium
| | - C Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris & Saint-Cloud, Paris, France; INSERM U900 Research Unit, Saint-Cloud, France; Versailles-Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
| | - J Guigay
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - L Licitra
- Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS "Istituto Nazionale dei Tumori", Milan; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - I Tinhofer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin; Department of Radiooncology and Radiotherapy, Berlin Institute of Health, Berlin, Germany
| | - A Kong
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - C Caballero
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - C Fortpied
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - J Bogaerts
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - A-S Govaerts
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - D Staelens
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - T Raveloarivahy
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - L Rodegher
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | | | - E Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - J-P Machiels
- Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Belgium; Institute for Clinical and Experimental Research (POLE MIRO), Université Catholique de Louvain, Brussels, Belgium.
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Even C, Torossian N, Ibrahim T, Martin N, Mayache Badis L, Ferrand F, Iacob M, Guigay J, Tourneau CL, Daste A, Saada-Bouzid E, Saleh K. First-line versus second-line immunotherapy in recurrent/metastatic squamous cell carcinoma of the head and neck. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.030] [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: 11/12/2022] Open
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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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11
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Frikha M, Auperin A, Tao Y, Elloumi F, Toumi N, Blanchard P, Lang P, Sun S, Racadot S, Thariat J, Alfonsi M, Tuchais C, Cornely A, Moussa A, Guigay J, Daoud J, Bourhis J. A randomized trial of induction docetaxel-cisplatin-5FU followed by concomitant cisplatin-RT versus concomitant cisplatin-RT in nasopharyngeal carcinoma (GORTEC 2006-02). Ann Oncol 2019; 29:731-736. [PMID: 29236943 DOI: 10.1093/annonc/mdx770] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Concomitant chemotherapy (CT)-radiotherapy (RT) is a standard of care in locally advanced nasopharyngeal carcinoma (NPC) and a role for induction CT is not established. Methods Patients with locally advanced NPC, WHO type 2 or 3, were randomized to induction TPF plus concomitant cisplatin-RT or concomitant cisplatin-RT alone. The TPF regimen consisted of three cycles of Docetaxel 75 mg/m2 day 1; cisplatin 75 mg/m2 day 1; 5FU 750 mg/m2/day days 1-5. RT consisted of 70 Gy in 7 weeks plus concomitant cisplatin 40 mg/m2 weekly. Results A total of 83 patients were included in the study. Demographics and tumour characteristics were well balanced between both arms. Most of the patients (95%) in the TPF arm received three cycles of induction CT. The rate of grade 3-4 toxicity and the compliance (NCI-CTCAE v3) during cisplatin-RT were not different between both arms. With a median follow-up of 43.1 months, the 3-year PFS rate was 73.9% in the TPF arm versus 57.2% in the reference arm [hazard ratio (HR) = 0.44; 95% confidence interval (CI): 0.20-0.97, P = 0.042]. Similarly the 3 years overall survival rate was 86.3% in the TPF arm versus 68.9% in the reference arm (HR = 0.40; 95% CI: 0.15-1.04, P = 0.05). Conclusion In conclusion, several important aspects can be emphasized: the compliance to induction TPF was good and TPF did not compromise the tolerance of the concomitant RT-cisplatin phase. The improved PFS and overall survival rates needs to be confirmed by further trials.
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Affiliation(s)
- M Frikha
- Medical Oncology Department, Sfax University Hospital, Sfax, Tunisia
| | - A Auperin
- Department of Statistics, Gustave-Roussy, Villejuif, France
| | - Y Tao
- Department of Radiation Oncology, Gustave-Roussy, Villejuif, France
| | - F Elloumi
- Radiation Oncology Department, Sfax University Hospital, Sfax, Tunisia
| | - N Toumi
- Radiation Oncology Department, Sfax University Hospital, Sfax, Tunisia
| | - P Blanchard
- Department of Radiation Oncology, Gustave-Roussy, Villejuif, France
| | - P Lang
- Radiation Oncology Department, Pitié Salpetrière, Paris, France
| | - S Sun
- Radiation Oncology Department, Centre Hospitalier Montbeliard, Montbeliard, France
| | - S Racadot
- Radiation Oncology Department, Centre L. Bérard, Lyon, France
| | - J Thariat
- Department of Oncology, Centre A. Lacassagne, Nice, France
| | - M Alfonsi
- Radiation Oncology Department, Clinique St Catherine, Avignon, France
| | - C Tuchais
- Radiation Oncology Department, Centre C. Papin, Angers, France
| | - A Cornely
- Department of Statistics, Gustave-Roussy, Villejuif, France
| | - A Moussa
- Department of Statistics, Gustave-Roussy, Villejuif, France
| | - J Guigay
- Department of Oncology, Centre A. Lacassagne, Nice, France
| | - J Daoud
- Radiation Oncology Department, Sfax University Hospital, Sfax, Tunisia.
| | - J Bourhis
- Department of Radiation Oncology, Gustave-Roussy, Villejuif, France; Radiation Oncology Department, CHUV, Lausanne, Switzerland.
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Even C, Daste A, Saada-Bouzid E, Fayette J, Kaminsky-Forrett MC, Zanetta S, Prevost A, Lefebvre G, Borel C, Cupissol D, Huguet F, Delord JP, Baste Rotllan N, Delaye J, Jallut I, Vintonenko N, Bourhis J, Guigay J, Texier M, Auperin A. TOPNIVO: A safety study of nivolumab in patients with recurrent and/or metastatic platinum-refractory squamous cell carcinoma of the head and neck (R/M SCCHN): First results on behalf of the UNICANCER Head&Neck Group and the GORTEC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.021] [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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Ortholan C, Auperin A, Mertens C, Le Caer H, Guigay J. Radiothérapie hypofractionnée des cancers ORL chez le sujet âgé. Cancer Radiother 2018; 22:640-643. [DOI: 10.1016/j.canrad.2018.06.008] [Citation(s) in RCA: 6] [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] [Received: 06/19/2018] [Accepted: 06/27/2018] [Indexed: 01/01/2023]
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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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Cohen EEW, Licitra LF, Burtness B, Fayette J, Gauler T, Clement PM, Grau JJ, Del Campo JM, Mailliez A, Haddad RI, Vermorken JB, Tahara M, Guigay J, Geoffrois L, Merlano MC, Dupuis N, Krämer N, Cong XJ, Gibson N, Solca F, Ehrnrooth E, Machiels JPH. Biomarkers predict enhanced clinical outcomes with afatinib versus methotrexate in patients with second-line recurrent and/or metastatic head and neck cancer. Ann Oncol 2018; 28:2526-2532. [PMID: 28961833 PMCID: PMC5834024 DOI: 10.1093/annonc/mdx344] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [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] [Indexed: 12/15/2022] Open
Abstract
Background In the phase III LUX-Head & Neck 1 (LUX-H&N1) trial, second-line afatinib significantly improved progression-free survival (PFS) versus methotrexate in patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). Here, we evaluated association of prespecified biomarkers with efficacy outcomes in LUX-H&N1. Patients and methods Randomized patients with R/M HNSCC and progression following ≥2 cycles of platinum therapy received afatinib (40 mg/day) or methotrexate (40 mg/m2/week). Tumor/serum samples were collected at study entry for patients who volunteered for inclusion in biomarker analyses. Tumor biomarkers, including p16 (prespecified subgroup; all tumor subsites), EGFR, HER2, HER3, c-MET and PTEN, were assessed using tissue microarray cores and slides; serum protein was evaluated using the VeriStrat® test. Biomarkers were correlated with efficacy outcomes. Results Of 483 randomized patients, 326 (67%) were included in the biomarker analyses; baseline characteristics were consistent with the overall study population. Median PFS favored afatinib over methotrexate in patients with p16-negative [2.7 versus 1.6 months; HR 0.70 (95% CI 0.50-0.97)], EGFR-amplified [2.8 versus 1.5 months; HR 0.53 (0.33-0.85)], HER3-low [2.8 versus 1.8 months; HR 0.57 (0.37-0.88)], and PTEN-high [1.6 versus 1.4 months; HR 0.55 (0.29-1.05)] tumors. Afatinib also improved PFS in combined subsets of patients with p16-negative and EGFR-amplified tumors [2.7 versus 1.5 months; HR 0.47 (0.28-0.80)], and patients with p16-negative tumors who were EGFR therapy-naïve [4.0 versus 2.4 months; HR 0.55 (0.31-0.98)]. PFS was improved in afatinib-treated patients who were VeriStrat 'Good' versus 'Poor' [2.7 versus 1.5 months; HR 0.71 (0.49-0.94)], but no treatment interaction was observed. Afatinib improved tumor response versus methotrexate in all subsets analyzed except for those with p16-positive disease (n = 35). Conclusions Subgroups of HNSCC patients who may achieve increased benefit from afatinib were identified based on prespecified tumor biomarkers (p16-negative, EGFR-amplified, HER3-low, PTEN-high). Future studies are warranted to validate these findings. Clinical trial registration NCT01345682.
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Affiliation(s)
- E E W Cohen
- Moores Cancer Center, University of California San Diego, La Jolla, USA;.
| | - L F Licitra
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan;; Department of Medical Oncology, University of Milan, Milan, Italy
| | - B Burtness
- Department of Medical Oncology, Yale University School of Medicine, New Haven, USA
| | - J Fayette
- Department of Medicine, Léon Bérard Center, Lyon;; Department of Medicine, Hospices Civils de Lyon, University of Lyon, Lyon, France
| | - T Gauler
- Department of Medicine, West German Cancer Center, University Hospital Essen of the University Duisburg-Essen, Essen, Germany
| | - P M Clement
- Department of Oncology, Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - J J Grau
- Department of Medical Oncology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona
| | - J M Del Campo
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Mailliez
- Oncology Department Mastology, Centre Oscar Lambret, Lille, France
| | - R I Haddad
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston;; Department of Medicine, Brigham and Women's Hospital, Boston, USA
| | - J B Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
| | - M Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - J Guigay
- Department of Medical Oncology, Centre Antoine Lacassagne, FHU OncoAge, Nice
| | - L Geoffrois
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - M C Merlano
- Department of Medical Oncology, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy
| | | | - N Krämer
- Staburo GmbH, Munich, Germany on behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | - X J Cong
- Biometrics and Data Management, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, USA
| | - N Gibson
- Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | - F Solca
- Pharmacology and Translational Research, Boehringer Ingelheim RCV GmbH & Co. KG, Vienna, Austria
| | - E Ehrnrooth
- TA Oncology, Boehringer Ingelheim, Danmark A/S, Denmark
| | - J-P H Machiels
- Institut Roi Albert II, Service d'Oncologie Médicale, Cliniques Universitaires Saint-Luc, Brussels;; Institut de Recherche Clinique et Expérimentale (Pole MIRO), Université Catholique de Louvain, Brussels, Belgium
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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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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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Haddad R, Blumenschein G, Fayette J, Guigay J, Colevas A, Licitra L, Kasper S, Vokes E, Worden F, Saba N, Tahara M, Concha-Benavente F, Monga M, Lynch M, Li L, Shaw J, Gillison M, Harrington K, Ferris R. Treatment beyond progression with nivolumab in patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) in the phase 3 checkmate 141 study: A biomarker analysis and updated clinical outcomes. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx374.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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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Licitra L, Ferris R, Blumenschein G, Harrington K, Guigay J, Kasper S, Saba N, Haddad R, Kiyota N, Monga M, Lynch M, Li L, Gillison M, Fayette J. Nivolumab vs investigator’s choice (IC) in patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN): treatment effect on clinical outcomes by best overall response in checkmate 141. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx374.012] [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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Lecomte P, Binquet C, Le Bras M, Tabarin A, Cardot-Bauters C, Borson-Chazot F, Lombard-Bohas C, Baudin E, Delemer B, Klein M, Vergès B, Aparicio T, Cosson E, Beckers A, Caron P, Chabre O, Chanson P, Du Boullay H, Guilhem I, Niccoli P, Rohmer V, Guigay J, Vulpoi C, Scoazec JY, Goudet P. Histologically Proven Bronchial Neuroendocrine Tumors in MEN1: A GTE 51-Case Cohort Study. World J Surg 2017; 42:143-152. [DOI: 10.1007/s00268-017-4135-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Guigay J, Even C, Mayache-Badis L, Debbah M, Saada-Bouzid E, Tao Y, Deschamps F, Janot F, Lezghed N, Michel C. Long-term response in patient with recurrent oropharyngeal carcinoma treated with cetuximab, docetaxel and cisplatin (TPEx) as first-line treatment followed by cetuximab maintenance. Oral Oncol 2017; 68:114-118. [PMID: 28347701 DOI: 10.1016/j.oraloncology.2017.03.009] [Citation(s) in RCA: 14] [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: 07/29/2016] [Revised: 03/14/2017] [Accepted: 03/16/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Cetuximab, an anti-EGFR monoclonal antibody in combination with platinum and 5FU is the standard of care in first-line treatment of patients with recurrent head and neck squamous cell carcinoma (HNSCC), with an expected median outcome of 10months. For this population, development of efficacious and safer therapies is still needed. CASE REPORT A 62-year-old male with a first recurrence of human papillomavirus positive stage IVA (T3N2bM0) adenocarcinoma of the glossotonsillar sulcus not amenable to locoregional curative treatment was offered chemotherapy as part of the TPEx clinical trial. He was treated by cetuximab (loading dose 400mg/m2 on day 1 cycle 1, then 250mg/m2 weekly), and chemotherapy (cisplatin 75mg/m2 and docetaxel 75mg/m2, on day 1). Cycles were repeated every 21days for 4 cycles (TPEx regimen) with systematic granulocyte colony-stimulating factor support at each cycle. Bi-monthly maintenance cetuximab 500mg/m2 was then administered. The patient showed a clinical complete response according to RECIST 1.1 criteria after 5months maintenance, with progression-free survival of 25months. Relapses that followed were treated with stereotactic irradiation, radiofrequency ablation, cetuximab and paclitaxel. The patient is alive eleven years after cancer diagnosis and remains controlled for his disease, with a cumulative period of 59months of cetuximab administration (equivalence of 121 injections). CONCLUSION This case report demonstrated that TPEx regimen, by synergistic interaction between taxanes and cetuximab, followed by bimonthly cetuximab maintenance may lead to patient complete remission within the first year of treatment. Furthermore, prolonged intermittent treatment with cetuximab seems to participate in the improved survival associated with preserved quality of life. Key favorable prognostic factors may be moderate tumor differentiation, oropharyngeal location, HPV p16 positive tumor status.
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Affiliation(s)
- J Guigay
- Department of Medical Oncology, Antoine Lacassagne Cancer Research Center, Nice, France.
| | - C Even
- Department of Head and Neck Cancer, Gustave Roussy, Villejuif, France
| | - L Mayache-Badis
- Department of Head and Neck Cancer, Gustave Roussy, Villejuif, France
| | - M Debbah
- Department of Head and Neck Cancer, Gustave Roussy, Villejuif, France
| | - E Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Cancer Research Center, Nice, France
| | - Y Tao
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - F Deschamps
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France
| | - F Janot
- Department of Head and Neck Cancer, Gustave Roussy, Villejuif, France
| | - N Lezghed
- Department of Head and Neck Cancer, Gustave Roussy, Villejuif, France
| | - C Michel
- GORTEC, Oncology Cooperative Group in Head and Neck Cancer, Tours, France
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Kiyota N, Harrington K, Ferris R, Shaw J, Taylor F, Derosa M, Turner-Bowker D, Morrissey L, Cocks K, Gillison M, Guigay J. 361O Patient-reported outcomes (PROs) in recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) treated with nivolumab (Nivo) or Investigator's Choice (IC): CheckMate 141. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00519-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kiyota N, Harrington K, Ferris R, Shaw J, Taylor F, Derosa M, Turner-Bowker D, Morrissey L, Cocks K, Gillison M, Guigay J. 361O Patient-reported outcomes (PROs) in recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) treated with nivolumab (Nivo) or Investigator’s Choice (IC): CheckMate 141. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw587.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Harrington K, Ferris R, Shaw J, Taylor F, Derosa M, Turner-Bowker D, Morrissey L, Cocks K, Kiyota N, Gillison M, Guigay J. head and neck cancer Patient-reported outcomes (PROs) in recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) treated with nivolumab (nivo) or investigator’s choice (IC): CheckMate 141. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.30] [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] Open
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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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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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Clement PM, Gauler T, Machiels JP, Haddad RI, Fayette J, Licitra LF, Tahara M, Cohen EEW, Cupissol D, Grau JJ, Guigay J, Caponigro F, de Castro G, de Souza Viana L, Keilholz U, Del Campo JM, Cong XJ, Ehrnrooth E, Vermorken JB. Afatinib versus methotrexate in older patients with second-line recurrent and/or metastatic head and neck squamous cell carcinoma: subgroup analysis of the LUX-Head & Neck 1 trial. Ann Oncol 2016; 27:1585-93. [PMID: 27084954 PMCID: PMC4959921 DOI: 10.1093/annonc/mdw151] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/15/2016] [Accepted: 03/21/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In the phase III LUX-Head & Neck 1 (LHN1) trial, afatinib significantly improved progression-free survival (PFS) versus methotrexate in recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients progressing on/after platinum-based therapy. This report evaluates afatinib efficacy and safety in prespecified subgroups of patients aged ≥65 and <65 years. PATIENTS AND METHODS Patients were randomized (2:1) to 40 mg/day oral afatinib or 40 mg/m(2)/week intravenous methotrexate. PFS was the primary end point; overall survival (OS) was the key secondary end point. Other end points included: objective response rate (ORR), patient-reported outcomes, tumor shrinkage, and safety. Disease control rate (DCR) was also assessed. RESULTS Of 483 randomized patients, 27% (83 afatinib; 45 methotrexate) were aged ≥65 years (older) and 73% (239 afatinib; 116 methotrexate) <65 years (younger) at study entry. Similar PFS benefit with afatinib versus methotrexate was observed in older {median 2.8 versus 2.3 months, hazard ratio (HR) = 0.68 [95% confidence interval (CI) 0.45-1.03], P = 0.061} and younger patients [2.6 versus 1.6 months, HR = 0.79 (0.62-1.01), P = 0.052]. In older and younger patients, the median OS with afatinib versus methotrexate was 7.3 versus 6.4 months [HR = 0.84 (0.54-1.31)] and 6.7 versus 6.2 months [HR = 0.98 (0.76-1.28)]. ORRs with afatinib versus methotrexate were 10.8% versus 6.7% and 10.0% versus 5.2%; DCRs were 53.0% versus 37.8% and 47.7% versus 38.8% in older and younger patients, respectively. In both subgroups, the most frequent treatment-related adverse events were rash/acne (73%-77%) and diarrhea (70%-80%) with afatinib, and stomatitis (43%) and fatigue (31%-34%) with methotrexate. Fewer treatment-related discontinuations were observed with afatinib (each subgroup 7% versus 16%). A trend toward improved time to deterioration of global health status, pain, and swallowing with afatinib was observed in both subgroups. CONCLUSIONS Advancing age (≥65 years) did not adversely affect clinical outcomes or safety with afatinib versus methotrexate in second-line R/M HNSCC patients. CLINICAL TRIAL REGISTRATION NCT01345682 (ClinicalTrials.gov).
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Affiliation(s)
- P M Clement
- Department of Oncology, KU Leuven, Leuven Department of General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - T Gauler
- Department of Medicine (Cancer Research), West German Cancer Center, University Hospital Essen, Essen, Germany
| | - J P Machiels
- Institut Roi Albert II, Service d'Oncologie Médicale, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (Pole MIRO), Université Catholique de Louvain, Brussels, Belgium
| | - R I Haddad
- Departmant of Medical Oncology, Dana-Farber Cancer Institute/Harvard Medical School, Boston, USA
| | - J Fayette
- Departmant of Medical Oncology, Léon Bérard Center, University of Lyon, Lyon, France
| | - L F Licitra
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - M Tahara
- Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - E E W Cohen
- Department of Medicine, University of California San Diego Moores Cancer Center, La Jolla, USA
| | - D Cupissol
- Service d'Oncologie Médicale, Institut du Cancer de Montpellier Val d'Aurelle, Montpellier, France
| | - J J Grau
- Department of Medical Oncology, Hospital Clínic and University of Barcelona, Barcelona, Spain
| | - J Guigay
- Department of Medical Oncology, Gustave Roussy, Villejuif Centre Antoine Lacassagne, Nice, France
| | - F Caponigro
- Department of Melanoma, Soft Tissues, Muscolo Scheletal, Head and Neck, Head and Neck Medical Oncology, National Tumor Institute of Naples, Naples, Italy
| | - G de Castro
- Oncologia Clinica, Instituto do Câncer do Estado de São Paulo, São Paulo
| | - L de Souza Viana
- Department of Medical Oncology, Hospital de Câncer de Barretos, São Paulo, Brazil
| | - U Keilholz
- Charité Comprehensive Cancer Center, Berlin, Germany
| | - J M Del Campo
- Department of Medical Oncology, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - X J Cong
- Biometrics and Data Management, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, USA
| | - E Ehrnrooth
- Division of Oncology, Boehringer Ingelheim Danmark A/S, Copenhagen, Denmark
| | - J B Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
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Walter T, Planchard D, Bouledrak K, Scoazec J, Souquet P, Dussol A, Guigay J, Hervieu V, Berdelou A, Ducreux M, Arpin D, Lombard-Bohas C, Baudin E. Evaluation of the combination of oxaliplatin and 5-fluorouracil or gemcitabine in patients with sporadic metastatic pulmonary carcinoid tumors. Lung Cancer 2016; 96:68-73. [DOI: 10.1016/j.lungcan.2016.03.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 11/15/2022]
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Guigay J. SP-0409: Immunotherapy for HNSCC: an emerging paradigm? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31658-9] [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: 11/29/2022]
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Tahara M, Cohen E, Haddad R, Fayette J, Licitra L, Clement P, Vermorken J, Gauler T, Cupissol D, Grau J, Guigay J, del Campo J, Okami K, Takahashi S, Burtness B, Cong X, Gibson N, Solca F, Ehrnrooth E, Machiels JP. 314O_PR Second-line afatinib vs methotrexate (MTX) in patients (pts) with recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC): subgroup/biomarker analysis of LUX-head and neck 1 (LUX-H&N1). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv527.01] [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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Guigay J, Fayette J, Dillies A, Sire C, Kerger J, Tennevet I, Machiels J, Zanetta S, Pointreau Y, Bozec Le Moal L, Henry S, Schilf A, Bourhis J. Cetuximab, docetaxel, and cisplatin as first-line treatment in patients with recurrent or metastatic head and neck squamous cell carcinoma: a multicenter, phase II GORTEC study. Ann Oncol 2015; 26:1941-1947. [DOI: 10.1093/annonc/mdv268] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/02/2015] [Indexed: 02/06/2023] Open
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Sullivan I, Baudin E, Guigay J, Scoazec J, Leboulleux S, Berdelou A, Ducreux M, Malka D, Caramella C, Besse B, Planchard D. 3076 Tumor control of advanced pulmonary carcinoid tumors with somatostatin analogs: Experience at Gustave Roussy. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31717-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cuny F, Babin E, Lacau-Saint-Guily J, Baujat B, Bensadoun R, Bozec A, Chevalier D, Choussy O, Deneuve S, Fakhry N, Guigay J, Makeieff M, Merol JC, Mouawad F, Pavillet J, Rebiere C, Righini C, Sostras MC, Tournaille M, Vergez S. French Society of ENT (SFORL) guidelines for care pathway organization in head and neck oncology (short version). Early management of head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:205-8. [PMID: 26183548 DOI: 10.1016/j.anorl.2015.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Early management in oncology is based on coordination and high-quality exchange between the various health-care partners. The present guidelines are based on a literature search with levels of evidence. Treatment waiting time can be optimized by performing assessment as early as possible (Expert opinion), to limit the interval (ideally, less than 4 weeks) between first consultation and data collection. In the first specialist consultation, diagnostic work-up should be scheduled and the data required for management should be determined (Grade B). Work-up may be conducted on a day-care basis or with conventional admission (Expert opinion). The patient's medico-social context should be taken into account from the outset, with social work involvement whenever necessary (Expert opinion). Pain and nutritional management should be planned for (Grade A) and realistic therapeutic education be provided (Expert opinion). Community-hospital teamwork for supportive care should be optimized (Expert opinion). Management should be early and multidisciplinary, to shorten delay between diagnosis and treatment initiation.
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Affiliation(s)
- F Cuny
- Inserm U1086 cancers et prévention, service d'ORL et chirurgie cervico-faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France.
| | - E Babin
- Inserm U1086 cancers et prévention, service d'ORL et chirurgie cervico-faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | | | - B Baujat
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - R Bensadoun
- Service de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - A Bozec
- Service d'ORL et chirurgie cervico-faciale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - D Chevalier
- Service d'ORL et chirurgie cervico-faciale, hôpital Claude-Huriez, CHRU, rue Michel Polonovski, 59037 Lille cedex, France
| | - O Choussy
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
| | - S Deneuve
- Service d'ORL et chirurgie cervico-faciale, CRLCC centre Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - N Fakhry
- Service d'ORL et de chirurgie cervico-faciale, hôpital de la Conception, CHU, 147, boulevard Baille, 13005 Marseille, France
| | - J Guigay
- Unité de cancérologie médicale en cancérologie cervico-faciale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - M Makeieff
- Service d'ORL et chirurgie cervico-faciale, hopital Robert-Debré, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - J-C Merol
- Service d'ORL et chirurgie cervico-faciale, hopital Robert-Debré, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - F Mouawad
- Service d'ORL et chirurgie cervico-faciale, hôpital Claude-Huriez, CHRU, rue Michel Polonovski, 59037 Lille cedex, France
| | - J Pavillet
- Service d'oncologie médicale, CHU de Grenoble, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France
| | - C Rebiere
- Service social, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - C Righini
- Clinique universitaire d'ORL, pôle TCCR, CHU de Grenoble Site Nord, Pavillon Dauphiné, 38043 Grenoble cedex, France
| | - M-C Sostras
- Service social, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - M Tournaille
- Service social, CLCC François-Baclesse, avenue du Général-Harris, 14000 Caen, France
| | - S Vergez
- Service d'ORL et chirurgie cervico-faciale, pôle voies respiratoires, hôpital Larrey, 24, chemin de Pouvourville, 31400 Toulouse, France
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Pavillet J, Guigay J, Lacau Saint-Guily J, Righini CA. Organization of primary care pathway in head and neck oncology (short version): Organization of chemotherapy in head and neck oncology. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:209-12. [PMID: 26183547 DOI: 10.1016/j.anorl.2015.06.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Chemotherapy may be indicated in head and neck cancer: as induction, associated with radiation therapy, or as a palliative solution, in case of local or locoregional progression if surgery and radiation therapy are contraindicated, and/or in case of metastatic progression. The most frequently used anticancer agents are platins, antimetabolites (5-fluorouracil, methotrexate) and taxanes. For several years now, in some indications, chemotherapy may be associated with targeted anti-EGFR antibody therapy. Prescription of chemotherapy and follow-up in head and neck cancer requires particular attention due to comorbidities related to alcohol abuse and smoking and frequent denutrition. Management thus requires close cooperation between the ENT physician, medical oncologists and radiation oncologists.
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Affiliation(s)
- J Pavillet
- Pôle de cancérologie, clinique universitaire d'oncologie médicale, hôpital Michallon, CHU de Grenoble, 38043 Grenoble cedex 09, France.
| | - J Guigay
- Oncologie médicale, CLCC Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - J Lacau Saint-Guily
- Service d'ORL et de chirurgie cervico-faciale, CHU Paris Est, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - C-A Righini
- Clinique universitaire d'ORL, hôpital Michallon, CHU de Grenoble, 38043 Grenoble cedex 09, France
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Deneuve S, Babin E, Lacau-St-Guily J, Baujat B, Bensadoun RJ, Bozec A, Chevalier D, Choussy O, Cuny F, Fakhry N, Guigay J, Makeieff M, Merol JC, Mouawad F, Pavillet J, Rebiere C, Righini CA, Sostras MC, Tournaille M, Vergez S. Guidelines (short version) of the French Otorhinolaryngology - Head and Neck Surgery Society (SFORL) on patient pathway organization in ENT: The therapeutic decision-making process. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:213-5. [PMID: 26139415 DOI: 10.1016/j.anorl.2015.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 10/23/2022]
Abstract
OBJECTIVES The authors present the guidelines of the French Otorhinolaryngology - Head and Neck Surgery Society (SFORL) for patient pathway organization in head and neck cancer, and in particular for multidisciplinary team meetings. The present article concerns the therapeutic decision-making process. METHODS A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. RESULTS It is recommended that: an organ specialist should contribute to all multidisciplinary meetings on head and neck cancer; all members of the multidisciplinary meeting should have specific knowledge in head and neck cancer; any referring physician who does not follow the multidisciplinary meeting's advice should justify that decision; there should be sufficient time to prepare, discuss and sum up the cases dealt with in the multidisciplinary team meeting.
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Affiliation(s)
- S Deneuve
- Département de chirurgie oncologique, centre de lutte contre le cancer Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
| | - E Babin
- Service d'ORL, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - J Lacau-St-Guily
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - B Baujat
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - R-J Bensadoun
- Service d'oncologie et de radiothérapie, centre de Haute Énergie, 10, boulevard Pasteur, 06000 Nice, France
| | - A Bozec
- Service d'ORL, institut universitaire de la face et du cou, 31, avenue Valombrose, 06100 Nice, France
| | - D Chevalier
- Service d'ORL, hôpital Claude-Huriez, rue Michel Polonovski, 59037 Lille cedex, France
| | - O Choussy
- Service d'ORL, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
| | - F Cuny
- Service d'ORL, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - N Fakhry
- Service d'ORL et de chirurgie cervico-faciale, hôpital de la Conception, CHU, 147, boulevard Baille, 13005 Marseille, France
| | - J Guigay
- Service d'oncologie médicale, institut universitaire de la face et du cou, 31, avenue Valombrose, 06100 Nice, France
| | - M Makeieff
- Service d'ORL, hopital Robert-Debré, avenue du Général-Koenig, 51100 Reims, France
| | - J-C Merol
- Service d'ORL, hopital Robert-Debré, avenue du Général-Koenig, 51100 Reims, France
| | - F Mouawad
- Service d'ORL, hôpital Claude-Huriez, rue Michel Polonovski, 59037 Lille cedex, France
| | - J Pavillet
- Service d'oncologue médicale, CHU, 38043 Grenoble, France
| | - C Rebiere
- Service social, CHU, 14000 Caen, France
| | - C-A Righini
- Service d'ORL, hôpital Nord Michalon, BP 217, 38043 Grenoble cedex, France
| | - M-C Sostras
- Service social, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - M Tournaille
- Service social, CLCC François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - S Vergez
- Service d'ORL, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France
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Hadoux J, Malka D, Planchard D, Scoazec JY, Caramella C, Guigay J, Boige V, Leboulleux S, Burtin P, Berdelou A, Loriot Y, Duvillard P, Chougnet CN, Déandréis D, Schlumberger M, Borget I, Ducreux M, Baudin E. Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma. Endocr Relat Cancer 2015; 22:289-98. [PMID: 25770151 DOI: 10.1530/erc-15-0075] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 12/13/2022]
Abstract
There is no standard for second-line chemotherapy in poorly differentiated grade 3 neuroendocrine carcinoma (G3-NEC) patients. We analyzed the antitumor efficacy of 5-fluorouracil and oxaliplatin (FOLFOX) chemotherapy in this population. A single-center retrospective analysis of consecutive G3-NEC patients treated with FOLFOX chemotherapy after failure of a cisplatinum-based regimen between December 2003 and June 2012 was performed. Progression-free survival (PFS), overall survival (OS), response rate, and safety were assessed according to RECIST 1.1 and NCI.CTC v4 criteria. Twenty consecutive patients were included (seven males and 13 females; median age 55; range 23-87 years) with a performance status of 0-1 in 75% of them. Primary location was gastroenteropancreatic in 12, thoracic in four, other in two, and unknown in two patients. There were 12 (65%) large-cell and 7 (30%) small-cell G3-NEC tumors, and 1 (5%) unknown. All patients had distant metastases. Twelve (60%) patients received FOLFOX as second-line treatment and 8 (40%) as third-line treatment or later and the median number of administered cycles was 6 (range 3-14). The median follow-up was 19 months. Median PFS was 4.5 months. Among the 17 evaluable patients, five partial responses (29%), six stable diseases (35%), and six progressive diseases (35%) were observed. Median OS was 9.9 months. Main Grade 3-4 toxicities were neutropenia (35%), thrombopenia (20%), nausea/vomiting (10%), anemia (10%), and elevated liver transaminases (10%). Our results indicate that the FOLFOX regimen could be considered as a second-line option in poorly differentiated G3-NEC patients after cisplatinum-based first-line treatment but warrant further confirmation in future larger prospective studies.
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Affiliation(s)
- J Hadoux
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - D Malka
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - D Planchard
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - J Y Scoazec
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - C Caramella
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - J Guigay
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - V Boige
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - S Leboulleux
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - P Burtin
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - A Berdelou
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - Y Loriot
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - P Duvillard
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - C N Chougnet
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - D Déandréis
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - M Schlumberger
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - I Borget
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - M Ducreux
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
| | - E Baudin
- Departments of Nuclear Medicine and Endocrine TumorsDigestive OncologyMedical Oncology (Thoracic Group)PathologyRadiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceCentre Antoine LacassagneCLCC, 33, Avenue de Valombrose, F-06189 Nice, FranceDepartment of Urologic OncologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceDepartment of EndocrinologyHôpital Saint Louis - APHP, 1, Avenue Claude-Vellefaux, F-75010 Paris, FranceDepartment of Biostatistics and EpidemiologyGustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, FranceFaculté de MédecineParis-Sud University, F-94270 Le Kremlin Bicêtre, France
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Even C, Breuskin I, Ileana E, Massard C, Lacroix L, Lezghed N, Guigay J, Janot F, Soria J, Ferté C. OC-014: Molecular screening for cancer treatment optimization in head and neck cancer (MOSCATO 01). Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34774-5] [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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Guigay J, Keilholz U, Mesia R, Vintonenko N, Bourhis J, Auperin A. PO-091: TPExtreme randomized trial: Docetaxel-Platinum(P)-Cetuximab(C) versus 5FU-P-C in recurrent/metastatic HNSCC. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34851-9] [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: 10/23/2022]
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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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Clement P, Gauler T, Machiels J, Haddad R, Fayette J, Licitra L, Tahara M, Vermorken J, Cupissol D, Grau J, Guigay J, Caponigro F, de Castro G, de Souza Viana L, Keilholz U, del Campo J, Cong X, Svensson L, hrnrooth E, Cohen E. OC-005: Afatinib versus methotrexate in recurrent/metastatic HNSCC after platinum therapy: LUX-head and neck. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34765-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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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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Even C, Bobillot B, Mayache-Badis L, Ferrand F, Lezghed N, Bidault F, Auperin A, Temam S, Janot F, Schilf A, Guigay J. Results of Tpex (Docetaxel, Cisplatin, Cetuximab) Regimen Use in First Line Patients with Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck (R/M Scchn) in a Single Institution. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu340.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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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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Machiels JP, Haddad R, Fayette J, Licitra L, Tahara M, Vermorken J, Clement P, Gauler T, Cupissol D, Grau J, Guigay J, Caponigro F, De Castro G, De Souza Viana L, Keilholz U, Del Campo J, Cong X, Svensson L, Ehrnrooth E, Cohen E. Afatinib Versus Methotrexate (Mtx) As Second-Line Treatment for Patients with Recurrent and/or Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (Hnscc) Who Progressed After Platinum-Based Therapy: Primary Efficacy Results of Lux-Head & Neck 1, a Phase III Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.30] [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: 11/13/2022] Open
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Mirghani H, Amen F, Blanchard P, Moreau F, Guigay J, Hartl DM, Lacau St Guily J. Treatment de-escalation in HPV-positive oropharyngeal carcinoma: ongoing trials, critical issues and perspectives. Int J Cancer 2014; 136:1494-503. [PMID: 24622970 DOI: 10.1002/ijc.28847] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 03/05/2014] [Indexed: 01/22/2023]
Abstract
Due to the generally poor prognosis of head and neck squamous cell carcinoma (HNSCC), treatment has been intensified, these last decades, leading to an increase of serious side effects. High-risk human papillomavirus (HR-HPV) infection has been recently etiologically linked to a subset of oropharyngeal squamous cell carcinoma (OPSCC), which is on the increase. These tumors are different, at the clinical and molecular level, when compared to tumors caused by traditional risk factors. Additionally, their prognosis is much more favorable which has led the medical community to consider new treatment strategies. Indeed, it is possible that less intensive treatment regimens could achieve similar efficacy with less toxicity and improved quality of life. Several clinical trials, investigating different ways to de-escalate treatment, are currently ongoing. In this article, we review these main approaches, discuss the rationale behind them and the issues raised by treatment de-escalation in HPV-positive OPSCC.
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Affiliation(s)
- H Mirghani
- Department of Head and Neck surgery, Institut de Cancérologie Gustave Roussy, Villejuif, France
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Levy A, Blanchard P, Temam S, Maison MM, Janot F, Mirghani H, Bidault F, Guigay J, Lusinchi A, Bourhis J, Daly-Schveitzer N, Tao Y. Squamous cell carcinoma of the larynx with subglottic extension: is larynx preservation possible? Strahlenther Onkol 2014; 190:654-60. [PMID: 24589921 DOI: 10.1007/s00066-014-0647-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 11/28/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE Squamous cell carcinoma of larynx with subglottic extension (sSCC) is a rare location described to carry a poor prognosis. The aim of this study was to analyze outcomes and feasibility of larynx preservation in sSCC patients. PATIENTS AND METHODS Between 1996 and 2012, 197 patients with sSCC were treated at our institution and included in the analysis. Stage III-IV tumors accounted for 76%. Patients received surgery (62%), radiotherapy (RT) (18%), or induction chemotherapy (CT) (20%) as front-line therapy. RESULTS The 5-year actuarial overall survival (OS), locoregional control (LRC), and distant control rate were 59% (95% CI 51-68), 83% (95% CI 77-89), and 88% (95% CI 83-93), respectively, with a median follow-up of 54.4 months. There was no difference in OS and LRC according to front-line treatments or between primary subglottic cancer and glottosupraglottic cancers with subglottic extension. In the multivariate analysis, age > 60 years and positive N stage were the only predictors for OS (HR 2, 95% CI 1.2-3.6; HR1.9, 95% CI 1-3.5, respectively). A lower LRC was observed for T3 patients receiving a larynx preservation protocol as compared with those receiving a front-line surgery (HR 14.1, 95% CI 2.5-136.7; p = 0.02); however, no difference of ultimate LRC was observed according to the first therapy when including T3 patients who underwent salvage laryngectomy (p = 0.6). In patients receiving a larynx preservation protocol, the 5-year larynx-preservation rate was 55% (95% CI 43-68), with 36% in T3 patients. The 5-year larynx preservation rate was 81% (95% CI 65-96) and 35% (95% CI 20-51) for patients who received RT or induction CT as a front-line treatment, respectively. CONCLUSION Outcomes of sSCC are comparable with other laryngeal cancers when managed with modern therapeutic options. Larynx-preservation protocols could be a suitable option in T1-T2 (RT or chemo-RT) and selected T3 sSCC patients (induction CT).
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Affiliation(s)
- A Levy
- Department of Radiotherapy, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
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Mirghani H, Amen F, Moreau F, Guigay J, Hartl DM, Lacau St Guily J. Oropharyngeal cancers: relationship between epidermal growth factor receptor alterations and human papillomavirus status. Eur J Cancer 2014; 50:1100-11. [PMID: 24424107 DOI: 10.1016/j.ejca.2013.12.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [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: 11/15/2013] [Revised: 12/11/2013] [Accepted: 12/13/2013] [Indexed: 01/01/2023]
Abstract
High-risk human papillomavirus (HR-HPV), particularly type 16, is now recognised as a causative agent in a subset of oropharyngeal squamous cell carcinomas (OPSCCs). These tumours are on the increase and generally have a better prognosis than their HPV negative counterparts. This raises the question of de escalation therapy to reduce long term consequences in a younger cohort of patients with a long life expectancy. Several clinical trials with anti-epidermal growth factor receptor (EGFR) therapies, particularly cetuximab, are ongoing. Few data exist on the relationship between EGFR and HPV induced oropharyngeal cancers. We summarise the main studies in relation to EGFR alterations (gene copy number, protein expression and mutations) and the impact on prognosis of HPV positive tumours that express high levels of EGFR. We also discuss the opportunity of targeting this pathway in light of recent studies.
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Affiliation(s)
- H Mirghani
- Department of Head and Neck Surgery, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - F Amen
- Department of Head and Neck Surgery, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - F Moreau
- Department of Virology, Faculty of Medicine University Pierre et Marie Curie Paris VI and Hospital Tenon Assistance Publique Hôpitaux de Paris, France.
| | - J Guigay
- Department of Medical Oncology, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - D M Hartl
- Department of Head and Neck Surgery, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - J Lacau St Guily
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine University Pierre et Marie Curie Paris VI and Hospital Tenon Assistance Publique Hôpitaux de Paris, France.
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Modesto A, Blanchard P, Tao Y, Rives M, Janot F, Serrano E, Guigay J, Delord J, Bourhis J, Daly-Schveitzer N. Esthesioneuroblastomas: Bicentric Review of Clinical Features, Multimodal Treatment, and Long-term Outcome. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1326] [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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Ferrand F, Gourzones C, Verillaud B, Saada E, Lang P, Schneider V, Amiel C, Guigay J, Busson P. Plasmatic Epstein-Barr Virus MICRO-RNA -BART-17 in Nasopharyngeal Carcinomas Patients: High Potential as a Tumor Biomarker Associated to EBV DNA Concentration. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33623-1] [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: 11/24/2022] Open
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