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Peyle M, Massoud M, Patrier S, Gaillot-Durand L, Side G, Devouassoux-Shisheboran M, Massardier J, Descargues P, Msika A, Hajri T, Rousset P, Haesebaert J, Lotz JP, Jamelot M, You B, Golfier F, Eiriksson L, Allias F, Bolze PA. Impact of molecular genotyping on the diagnosis and treatment of human chorionic gonadotropin-producing tumors. J Gynecol Obstet Hum Reprod 2024; 53:102704. [PMID: 38040333 DOI: 10.1016/j.jogoh.2023.102704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVES To assess the use of molecular genotyping to accurately diagnose and treat human chorionic gonadotropin (hCG)-producing tumors and to evaluate the discriminating capacity of molecular testing on prognosis and overall survival. METHODS We conducted a retrospective descriptive study of patients registered with the French Reference Center for Trophoblastic Disease between 1999 and 2021. We included all patients with hCG-producing tumors for whom results of molecular genotyping were available. RESULTS Fifty-five patients with molecular genotyping were included: 81.2 % (n = 45) had tumors of gestational origin, 12.7 % (n = 7) of non-gestational origin and 5.5 % (n = 3) of undetermined origin. The results of molecular genotyping influenced the treatment decisions for 17 % of patients in this cohort. Overall survival was 93.3 % for patients with gestational tumors (after a median follow-up of 74 months) compared to 71.4 % for patients with non-gestational tumors (after a median follow-up of 23 months). CONCLUSION In atypical presentations of hCG-producing tumors, molecular genotyping is a valuable tool to guide diagnosis and tailor treatment recommendations.
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Affiliation(s)
- M Peyle
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France
| | - M Massoud
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France
| | - S Patrier
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service d'anatomie et cytologie pathologique, Centre Hospitalier Universitaire de Rouen, 76000, Rouen, France
| | - L Gaillot-Durand
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Pathologie - Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France
| | - G Side
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service d'anatomie et cytologie pathologique, Centre Hospitalier Universitaire de Rouen, 76000, Rouen, France
| | - M Devouassoux-Shisheboran
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Pathologie - Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France
| | - J Massardier
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Gynécologie Obstétrique, Unité de Diagnostic Anténatal, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 59 boulevard Pinel, 69500 Bron, France
| | - P Descargues
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France
| | - A Msika
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France
| | - T Hajri
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France
| | - P Rousset
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Radiologie, Hôpital Lyon Sud, Hospices Civils de Lyon, 165, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France; Université Lyon 1, Centre pour l'Innovation en Cancérologie de Lyon (CICLY), EA3738, Faculté de Médecine Lyon Sud Charles Mérieux, France
| | - J Haesebaert
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Pôle de Santé Publique, service de recherche et d'épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France; Université Claude Bernard Lyon 1, U1290 Reshape, Lyon, France
| | - J P Lotz
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Hôpital Tenon, Pôle Onco-Hématologie Hôpitaux Universitaires de l'Est Parisien, Assistance Publique-Hôpitaux de Paris, 4 Rue de la Chine, 75020 Paris, France; Sorbonne Université, Faculté de Médecine, 91-105 Bd de l'Hôpital, 75013 Paris, France
| | - M Jamelot
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Hôpital Tenon, Pôle Onco-Hématologie Hôpitaux Universitaires de l'Est Parisien, Assistance Publique-Hôpitaux de Paris, 4 Rue de la Chine, 75020 Paris, France; Sorbonne Université, Faculté de Médecine, 91-105 Bd de l'Hôpital, 75013 Paris, France
| | - B You
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Université Lyon 1, Centre pour l'Innovation en Cancérologie de Lyon (CICLY), EA3738, Faculté de Médecine Lyon Sud Charles Mérieux, France; Service d'oncologie médicale, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL EPSILYON, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - F Golfier
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Université Lyon 1, Centre pour l'Innovation en Cancérologie de Lyon (CICLY), EA3738, Faculté de Médecine Lyon Sud Charles Mérieux, France
| | - L Eiriksson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - F Allias
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Pathologie - Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France
| | - P A Bolze
- Centre Français de Référence des Maladies Trophoblastiques, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495 Pierre Bénite, France; Université Lyon 1, Centre pour l'Innovation en Cancérologie de Lyon (CICLY), EA3738, Faculté de Médecine Lyon Sud Charles Mérieux, France.
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Derquin F, Floquet A, Hardy-Bessard AC, Edeline J, Lotz JP, Alexandre J, Pautier P, Angeles MA, Delanoy N, Lefeuvre-Plesse C, Cancel M, Treilleux I, Augereau P, Lavoue V, Kalbacher E, Berton Rigaud D, Selle F, Nadeau C, Gantzer J, Joly F, Guillemet C, Pomel C, Favier L, Abdeddaim C, Venat-Bouvet L, Provansal M, Fabbro M, Kaminsky MC, Lortholary A, Lecuru F, Coquard IR, de La Motte Rouge T. Need for risk-adapted therapy for malignant ovarian germ cell tumors: A large multicenter analysis of germ cell tumors' patients from French TMRG network. Gynecol Oncol 2020; 158:666-672. [PMID: 32624235 DOI: 10.1016/j.ygyno.2020.06.491] [Citation(s) in RCA: 2] [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] [Received: 04/15/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Malignant ovarian germ cell tumors are rare tumors, affecting young women with a generally favorable prognosis. The French reference network for Rare Malignant Gynecological Tumors (TMRG) aims to improve their management. The purpose of this study is to report clinicopathological features and long-term outcomes, to explore prognostic parameters and to help in considering adjuvant strategy for stage I patients. PATIENTS AND METHODS Data from patients with MOGCT registered among 13 of the largest centers of the TMRG network were analyzed. We report clinicopathological features, estimated 5-year event-free survival (5y-EFS) and 5-year overall survival (5y-OS) of MOGCT patients. RESULTS We collected data from 147 patients including 101 (68.7%) FIGO stage I patients. Histology identifies 40 dysgerminomas, 52 immature teratomas, 32 yolk sac tumors, 2 choriocarcinomas and 21 mixed tumors. Surgery was performed in 140 (95.2%) patients and 106 (72.1%) received first line chemotherapy. Twenty-two stage I patients did not receive chemotherapy. Relapse occurred in 24 patients: 13 were exclusively treated with upfront surgery and 11 received surgery and chemotherapy. 5y-EFS was 82% and 5y-OS was 92.4%. Stage I patients who underwent surgery alone had an estimated 5y-EFS of 54.6% and patients receiving adjuvant chemotherapy 94.4% (P < .001). However, no impact on estimated 5y-OS was observed: 96.3% versus 97.8% respectively (P = .62). FIGO stage, complete primary surgery and post-operative alpha fetoprotein level significantly correlated with survival. CONCLUSION Adjuvant chemotherapy does not seem to improve survival in stage I patients. Active surveillance can be proposed for selected patients with a complete surgical staging.
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Affiliation(s)
- F Derquin
- Medical Oncology Department, Centre Hospitaliser Yves Le Foll, Saint Brieuc, France
| | - A Floquet
- Medical Oncology Department, Institut Bergonié, Bordeaux, France
| | | | - J Edeline
- Medical Oncology Department, Centre Eugène Marquis, Rennes, France
| | - J P Lotz
- Medical Oncology Department, Sorbonne University, APHP, Paris, France
| | - J Alexandre
- Medical Oncology Department, Hôpital Cochin, APHP, Paris, France
| | - P Pautier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - M A Angeles
- Surgical Oncology Department, Institut Claudius Regaud, Toulouse, France
| | - N Delanoy
- Medical Oncology Department, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | | | - M Cancel
- Medical Oncology Department, Centre Hospitalier Universitaire Bretonneau, Tours, France
| | - I Treilleux
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
| | - P Augereau
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Angers, France
| | - V Lavoue
- Gynecology Department, Centre Hospitalier Universitaire, Rennes, France
| | - E Kalbacher
- Medical Oncology Department, Centre Hospitalier Régional Universitaire, Besançon, France
| | - D Berton Rigaud
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Nantes, France
| | - F Selle
- Diaconnesses Hospital Group, Paris, France
| | - C Nadeau
- Gynecology Department, CHU de Poitiers, Poitiers, France
| | - J Gantzer
- Medical Oncology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F Joly
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - C Guillemet
- Medical Oncology Department, Centre Henri-Becquerel, Rouen, France
| | - C Pomel
- Medical Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - L Favier
- Medical Oncology Department, Centre Georges François Leclerc, Dijon, France
| | - C Abdeddaim
- Medical Oncology Department, Centre Oscar Lambret, Lille, France
| | - L Venat-Bouvet
- Medical Oncology Department, CHU Dupuytren, Limoges, France
| | - M Provansal
- Medical Oncology Department, Institut Paoli Calmettes, Marseille, France
| | - M Fabbro
- Medical Oncology Department, Institut régional du Cancer Montpellier, Montpellier, France
| | - M C Kaminsky
- Medical Oncology Department, Institut de Cancérologie de Lorraine - Alexis Vautrin, Vandoeuvre-Les-Nancy, France
| | - A Lortholary
- Medical Oncology Department, Hôpital Privé du Confluent, Nantes, France
| | - F Lecuru
- Medical Oncology Department, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - I Ray Coquard
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
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Haviari S, Blanchet B, Colomban O, Venat-Bouvet L, Dohollou N, Floquet A, Louvet C, Lotz JP, Lacourtoisie SA, Favier L, Fabbro M, Bonichon-Lamichhane N, Kurtz J, Follana P, Leheurteur M, Del Piano F, Alliot C, Alexandre J, You B, Tod M. Post-hoc analysis of the nintedanib exposure-response relationships in the CHIVA trial in advanced ovarian cancer: A GINECO study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.045] [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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Cornelis FH, Korenbaum C, Ben Ammar M, Tavolaro S, Nouri-Neuville M, Lotz JP. Multimodal image-guided electrochemotherapy of unresectable liver metastasis from renal cell cancer. Diagn Interv Imaging 2019; 100:309-311. [PMID: 30691970 DOI: 10.1016/j.diii.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 01/10/2019] [Indexed: 12/20/2022]
Affiliation(s)
- F H Cornelis
- Department of Radiology, Tenon Hospital, Sorbonne University, 4, rue de la Chine, 75020 Paris, France.
| | - C Korenbaum
- Department of Medical Oncology and Cellular Therapy, Tenon Hospital, Sorbonne University, 4, rue de la Chine, 75020 Paris, France
| | - M Ben Ammar
- Department of Radiology, Tenon Hospital, Sorbonne University, 4, rue de la Chine, 75020 Paris, France
| | - S Tavolaro
- Department of Radiology, Tenon Hospital, Sorbonne University, 4, rue de la Chine, 75020 Paris, France
| | - M Nouri-Neuville
- Department of Radiology, Tenon Hospital, Sorbonne University, 4, rue de la Chine, 75020 Paris, France
| | - J P Lotz
- Department of Medical Oncology and Cellular Therapy, Tenon Hospital, Sorbonne University, 4, rue de la Chine, 75020 Paris, France
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Pudlarz T, Naoun N, Beinse G, Grazziotin-Soares D, Lotz JP. AACR 2019 — Congrès de l’association américaine de recherche contre le cancer. ONCOLOGIE 2019. [DOI: 10.3166/onco-2019-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dans ce numéro spécial de la revueOncologie, les principaux points discutés au congrès de l’Association américaine pour la recherche sur le cancer (AACR) sont rapportés. L’objectif ici est de présenter de manière concise des exposés qui méritent une attention toute particulière. Le programme de la réunion de l’AACR de cette année, qui a eu lieu à Atlanta, a couvert les dernières découvertes de tout le spectre de la recherche sur le cancer — des sciences de la population à la prévention ; biologie du cancer, études translationnelles et cliniques ; à la survie et à la défense des droits — et souligne le travail des meilleurs esprits en matière de recherche et de médecine d’institutions du monde entier. Le congrès qui a duré cinq jours a proposé un programme multidisciplinaire couvrant tous les aspects de la recherche sur le cancer depuis ses bases fondamentales jusqu’à ses applications translationnelles et cliniques. Grâce à notre compréhension accrue des bases moléculaires du cancer, de nombreuses thérapies ciblées nouvelles ont émergé. Ainsi, notre compréhension sur la façon dont les tumeurs échappent aux attaques du système immunitaire a conduit au développement de nouvelles thérapies. Compte tenu de l’importance accrue de l’immunothérapie dans le traitement du cancer, nous présentons ici les dernières avancées dans ce domaine. Enfin, d’autres approches telles que l’étude du microbiome, l’épigénétique et l’intelligence artificielle comme un outil dans la recherche sur le cancer ont aussi été discutées au congrès de l’AACR 2019.
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Grazziotin-Soares D, Lotz JP. Un sous-groupe de cancer gastrique positif au virus d’Epstein-Barr (EBV) identifié pour sa sensibilité à l’immunothérapie. ONCOLOGIE 2019. [DOI: 10.3166/onco-2019-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Plusieurs études ont montré une association entre l’infection par le virus d’Epstein-Barr (EBV) et la survenue de nombreux cancers chez l’homme, dont certains carcinomes gastriques. Le potentiel oncogénique de l’EBV a été largement exploré, mais les mécanismes précis de la carcinogenèse ne sont pas complètement compris. Les protéines virales codées par EBV sont connues pour notamment déréguler des voies de signalisation de la réponse aux dommages de l’ADN (DDR). Cette inactivation du DDR entraîne alors un accroissement de l’instabilité génomique qui favoriserait la transformation cellulaire pour générer des cellules malignes. Dans un article récemment publié dans la revueNature Medicine, une caractérisation moléculaire des tissus tumoraux et de l’ADN tumoral circulant (ADNtc) provenant de patients non sélectionnés atteints de cancer gastrique métastatique, traités par pembrolizumab, a été réalisée. Ces travaux ont montré que, dans la cohorte étudiée, une forte corrélation pouvait être établie entre la positivité de PD-L1, EBV(+) et MSI-H. Ces résultats suggèrent que le cancer gastrique EBV(+) pourrait être, à l’instar des tumeurs MSI-H, une cible à fort potentiel pour observer un bénéfice clinique de l’immunothérapie. Ainsi, le statut EBV pourrait servir, en clinique, de biomarqueur pour identifier les patients atteints de cancer gastrique, pouvant bénéficier ou non d’une immunothérapie. Au-delà de leur intérêt clinique, ces travaux ouvrent également la voie vers une meilleure caractérisation des mécanismes moléculaires sous-tendant ce phénomène.
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Grazziotin-Soares D, Lotz JP. Atlanta & Chicago 2019. La recherche sur les cancers rares : tumeurs germinales du testicule. ONCOLOGIE 2019. [DOI: 10.3166/onco-2019-0037] [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: 11/20/2022]
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de la Motte Rouge T, Derquin F, Floquet A, Edeline J, Lotz JP, Alexandre J, Pautier P, Ferron G, Boissier E, Lefeuvre-Plesse C, Vegas H, Patsouris A, Kalbacher E, Berton-Rigaud D, Hardy Bessard AC, Lavoué V, Ray-Coquard I. Need for a stratified analysis in stage I malignant ovarian germ cell tumors (MOGCT): Prospective survival analysis of cases collection from the French rare malignant ovarian tumors (TMRO) network & GINECO group. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.147] [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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You B, Bolze P, Lotz JP, Massardier J, Gladieff L, Hajri T, Maucort-Boulch D, Bin S, Roux A, Rousset P, Freyer G, Golfier F. TROPHIMMUN, a 2 cohort phase II trial of the anti-PD-L1 monoclonal antibody avelumab in chemo-resistant gestational trophoblastic neoplasia (GTN) patients: Preliminary outcomes in cohort A. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.042] [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: 11/13/2022] Open
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Assoun S, Benderra MA, Géraud A, Bayle A, Boilève A, Grazziotin-Soares D, Lotz JP. Congrès de l’association américaine de recherche contre le cancer — AACR 2018. ONCOLOGIE 2018. [DOI: 10.3166/onco-2018-0011] [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: 11/20/2022]
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Grazziotin-Soares D, Lotz JP. Un lien entre normalisation de l’angiogenèse et stimulation de l’immunité antitumorale. ONCOLOGIE 2017. [DOI: 10.1007/s10269-017-2732-y] [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: 10/18/2022]
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Pautier P, Brard C, Floquet A, Gladieff L, Rios M, Piperno-Neumann S, Berton-Rigaud D, Blay JY, Fabbro M, Lotz JP, Vinceneux A, Bertucci F, De La Motte Rouge T, Guillemet C, Genestie C, Duffaud F. A randomized clinical trial of adjuvant chemotherapy with doxorubicin, ifosfamide and cisplatin (API), followed by radiotherapy versus radiotherapy alone in patients with localized uterine sarcomas (SARCGYN study). Update at 10 years. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx387.002] [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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Clou E, Gaudas J, Ahmed K, Avenin D, Esteso A, Galula G, Fillon J, Lotz J, Debrix I. Impact of a pharmaceutical consultation: Review of a pilot study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx087.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Benderra MA, Richard S, Antoine M, Buob D, Zilberman S, Esteso A, Lotz J, Kerrou K, Gligorov J. Breast cancer prognosis after neoadjuvant chemotherapy for breast cancers: molecular downstaging, proliferation, and endocrine sensitivity importance. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.45] [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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Selle F, Soares DG, Lotz JP. A rational approach for salvage of testicular cancer patients. Ann Oncol 2015; 27:202. [PMID: 26483046 DOI: 10.1093/annonc/mdv492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- F Selle
- Department of Medical Oncology and Cellular Therapy, Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), APREC (Alliance Pour la Recherche En Cancérologie), Paris Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris, France
| | - D G Soares
- Department of Medical Oncology and Cellular Therapy, Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), APREC (Alliance Pour la Recherche En Cancérologie), Paris
| | - J P Lotz
- Department of Medical Oncology and Cellular Therapy, Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), APREC (Alliance Pour la Recherche En Cancérologie), Paris Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris, France
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Soares DG, Lotz JP. AACR 2015 : les avancées et les défis de la médecine personnalisée. ONCOLOGIE 2015. [DOI: 10.1007/s10269-015-2531-2] [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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Talbot JN, Gligorov J, Nataf V, Montravers F, Huchet V, Michaud L, Ohnona J, Balogova S, Cussenot O, Daraï E, Lotz JP, Kerrou K. Current applications of PET imaging of sex hormone receptors with a fluorinated analogue of estradiol or of testosterone. Q J Nucl Med Mol Imaging 2015; 59:4-17. [PMID: 25693420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Currently, the most frequent approach in the oncologic applications of positron emission tomography (PET) is detecting the hypermetabolic activity of the cancer tissue. A more specific approach, which may be complementary, is detecting the overexpression of receptors. In this review article, we aim to evaluate the results that are currently available for PET imaging of the sex hormone receptors in clinical oncology. The indication of PET and now PET/CT has been more disputed in breast carcinoma than in many other primary cancers (e.g., lung, head and neck, colorectal, lymphoma). 18F-fluorodeoxyglucose (FDG), the glucose analogue for PET imaging, has a limited sensitivity to detect the primary breast tumors in case of lobular or in situ forms or small sized tumors localised on systematic mammography, and to identify minimal node invasion in the axilla. Using 16α-[¹⁸F]fluoro-17β-estradiol (FES), a fluorinated estradiol analogue, PET is able to detect the over-expression of the oestrogen receptor (ER) in lesions, at a whole-body level. FES and FDG appear complementary for a better diagnostic performance in staging locally advanced breast cancer or restaging recurrent or metastatic breast cancer. Another potential indication is predicting the response to starting or resuming hormone therapy in patients with metastatic breast cancer, in relation with the ER status of all lesions revealed by FES PET. In two retrospective studies, FDG PET was also able to predict the response to hormone therapy, on basis of a metabolic flare, observed either after 7-10 days of treatment or during an estradiol challenge. A prospective comparison of those approaches is warranted. One study reported predicting response to neoadjuvant chemotherapy thanks to a low value of FES SUV(max) or FES/FDG SUV(max) ratio. The presence of ER in uterine tumors, including the benign ones, in ovarian cancers or even in meningiomas, may have therapeutic consequences and FES PET could have a clinical utility in those settings; only initial results are available. The indication of PET and PET/CT has been even more disputed in prostate carcinoma, due to the lack of significant FDG uptake in most cases, at least before the castration-resistant stage. Using FDHT, a fluorinated testosterone analogue, PET is able to detect the over-expression of the androgen receptor (AR) in lesions, at a whole-body level. At least partly due to the rather large number of alternative tracers that are in development or even routinely available in some countries, few FDHT studies have been published until now. From absorbed dose values previously published for FES by the team of University of Washington School of Medicine at Seattle, and for FDHT by the teams of Memorial Sloan-Kettering Cancer Center at New York and of Washington University at St. Louis, we applied the coefficients of ICRP publication 103 and calculated an effective dose per unit of injected activity of 0.023 mSv/MBq for FES and 0.018 mSv/MBq for FDHT. The radiation exposure is of the same order of magnitude as with FDG.
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Affiliation(s)
- J N Talbot
- Department of Nuclear Medicine, Hôpital Tenon AP‑HP et Université Pierre et Marie Curie, Paris, France -
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Selle F, Gligorov J, Richard S, Khalil A, Alexandre I, Avenin D, Provent S, Soares DG, Lotz JP. Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer. ACTA ACUST UNITED AC 2014; 48:13-24. [PMID: 25493378 PMCID: PMC4288488 DOI: 10.1590/1414-431x20144214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/15/2014] [Indexed: 02/15/2023]
Abstract
Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis.
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Affiliation(s)
- F Selle
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - J Gligorov
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - S Richard
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - A Khalil
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - I Alexandre
- Medical Oncology Department, Hospital Centre of Bligny, Briis-sous-Forges, France
| | - D Avenin
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - S Provent
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - D G Soares
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
| | - J P Lotz
- Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris, France
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Selle F, Wittnebel S, Biron P, Gravis G, Roubaud G, Bui BN, Delva R, Bay JO, Fléchon A, Geoffrois L, Caty A, Soares DG, de Revel T, Fizazi K, Gligorov J, Micléa JM, Dubot C, Provent S, Temby I, Gaulet M, Horn E, Brindel I, Lotz JP. A phase II trial of high-dose chemotherapy (HDCT) supported by hematopoietic stem-cell transplantation (HSCT) in germ-cell tumors (GCTs) patients failing cisplatin-based chemotherapy: the Multicentric TAXIF II study. Ann Oncol 2014; 25:1775-1782. [PMID: 24894084 DOI: 10.1093/annonc/mdu198] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND High-dose chemotherapy (HDCT) is an effective salvage treatment of germ-cell tumors (GCTs) patients. In the first salvage setting, 30%-70% of patients may achieve durable remissions. Even when HDCT is administered as subsequent salvage treatment, up to 20% of patients may still be definitively cured. However, patients with refractory/relapsed disease still have a very poor long-term prognosis, requiring earlier intervention of HDCT. PATIENTS AND METHODS This phase II trial was addressed to nonrefractory patients failing Cisplatin-based chemotherapy. Inclusion criteria included seminomatous GCT in relapse after two lines of chemotherapy, nonseminomatous GCT in relapse after first or second lines, partial remission after first line, primary mediastinal GCT in first relapse. Patients received two cycles combining Epirubicin and Paclitaxel (Epi-Tax), followed by three consecutive HDCT, one using a Paclitaxel/Thiotepa (Thio-Tax) association and two using the 5-day Ifosfamide-Carboplatin-Etoposide regimen. The main objective was to determine the complete response rate. RESULTS Forty-five patients were included between September 2004 and December 2007: 44 received the first HDCT cycle, 39 two HDCT cycles, 29 could receive the whole protocol. Sixteen patients did not receive the entire protocol, including eight (17.7%) for toxic side-effects. Two patients (4.4%) died of toxicities, and 17 (37.7%) of disease progression. With a median follow-up time of 26 months (range, 4-51), the final overall response rate was 48.8% (including a complete response rate of 15.5% and a partial response/negative serum markers rate of 26.6%) in an intent-to-treat analysis. The median progression-free survival (PFS) and overall survival (OS) times were 22 months [95% confidence interval (CI) 2-not reached] and 32 months (95% CI 4-49), respectively. The 2-year PFS was a plateau setup at 50% (95% CI 32-67) and the 2-year OS was 66% (95% CI 44-81). CONCLUSION The TAXIF II protocol was effective in nonrefractory GCT patients failing Cisplatin-based chemotherapy. The toxic death rate remained acceptable in the field of HDCT regimens. TRIAL REGISTRATION NUMBER NCT00231582.
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Affiliation(s)
- F Selle
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris; Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris.
| | - S Wittnebel
- Department of Medicine, Institut Gustave Roussy, Villejuif
| | - P Biron
- Department of Medical Oncology, Centre Léon Bérard, Lyon
| | - G Gravis
- Department of Medical Oncology, Institut Paoli Calmette, Marseille
| | - G Roubaud
- Department of Medicine, Institut Bergonié, Bordeaux
| | - B N Bui
- Department of Medicine, Institut Bergonié, Bordeaux
| | - R Delva
- Department of Chemotherapy, Centre Paul Papin, Angers
| | - J O Bay
- Department of Medicine, Centre Hospitalier Universitaire, Clermont-Ferrand
| | - A Fléchon
- Department of Medical Oncology, Centre Léon Bérard, Lyon
| | - L Geoffrois
- Department of Medicine, Centre Alexis Vautrin, Nancy
| | - A Caty
- Department of Medicine, Centre Oscar Lambret, Lille
| | - D G Soares
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris
| | - T de Revel
- Department of Hematology, Hôpital D'Instruction des Armées Percy, Clamart
| | - K Fizazi
- Department of Medicine, Institut Gustave Roussy, Villejuif
| | - J Gligorov
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris; Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris
| | - J M Micléa
- Cytapheresis and Cell Therapy Unit, Hôpital St Louis (AP-HP), Paris
| | - C Dubot
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris
| | - S Provent
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris
| | - I Temby
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris
| | - M Gaulet
- Statistic, 3ES-Cegedim Strategic Data, Boulogne, France
| | - E Horn
- Department of Internal Medicine, Brown University, Rhode Island Hospital, Providence, Rhode Island, USA
| | - I Brindel
- Department of Clinical Research, Hôpital St Louis (AP-HP), Paris, France
| | - J P Lotz
- Department of Medical Oncology and Cellular Therapy, APREC (Alliance Pour la Recherche En Cancérologie), Hôpital Tenon (Hôpitaux Universitaires de l'Est-Parisien, AP-HP), Paris; Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), Paris
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Thariat J, Schouman T, Brouchet A, Sarini J, Miller R, Reychler H, Ray-Coquard I, Italiano A, Verite C, Sohawon S, Bompas E, Dassonville O, Salas S, Aldabbagh K, Maingon P, de La MotteRouge T, Kurtz J, Usseglio J, Kerbrat P, Raoul G, Lotz J, Bar-Sela G, Brugières L, Chaigneau L, Saada E, Odin G, Marcy P, Thyss A, Julieron M. Osteosarcomas of the mandible: multidisciplinary management of a rare tumor of the young adult a cooperative study of the GSF-GETO, Rare Cancer Network, GETTEC/REFCOR and SFCE. Ann Oncol 2013; 24:824-31. [DOI: 10.1093/annonc/mds507] [Citation(s) in RCA: 33] [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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Popovic L, Jovanovic D, Donat D, Petrovic D, Roganovic T, Lotz JP. High dose chemotherapy with autologous stem cell transplantation for patients with germ-cell cancer. J BUON 2013; 18:290-291. [PMID: 23613419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Beyer J, Albers P, Altena R, Aparicio J, Bokemeyer C, Busch J, Cathomas R, Cavallin-Stahl E, Clarke NW, Claßen J, Cohn-Cedermark G, Dahl AA, Daugaard G, De Giorgi U, De Santis M, De Wit M, De Wit R, Dieckmann KP, Fenner M, Fizazi K, Flechon A, Fossa SD, Germá Lluch JR, Gietema JA, Gillessen S, Giwercman A, Hartmann JT, Heidenreich A, Hentrich M, Honecker F, Horwich A, Huddart RA, Kliesch S, Kollmannsberger C, Krege S, Laguna MP, Looijenga LHJ, Lorch A, Lotz JP, Mayer F, Necchi A, Nicolai N, Nuver J, Oechsle K, Oldenburg J, Oosterhuis JW, Powles T, Rajpert-De Meyts E, Rick O, Rosti G, Salvioni R, Schrader M, Schweyer S, Sedlmayer F, Sohaib A, Souchon R, Tandstad T, Winter C, Wittekind C. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. Ann Oncol 2012; 24:878-88. [PMID: 23152360 PMCID: PMC3603440 DOI: 10.1093/annonc/mds579] [Citation(s) in RCA: 252] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of germ-cell cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, ∼50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.
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Affiliation(s)
- J Beyer
- Department of Hematology and Oncology, Vivantes Klinikum Am Urban, Berlin.
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Golfier F, You B, Lotz JP, Massardier J, Bolze PA, Hajri T, Foulmann K, Schott AM, Raudrant D. I132 HOW TO CHOOSE THE BEST REGIMEN TO TREAT LOW RISK GESTATIONAL TROPHOBLASTIC NEOPLASIA? Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60162-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Selle F, Fizazi K, Biron P, Gravis-Mescam G, Bui B, Bay J, Flechon A, Dubot C, Caty A, Burcoveanu D, Delva R, de Revel T, Miclea J, Gaulet M, Horn E, Provent S, Temby I, Brindel I, Khalil J, Gligorov J, Lotz JP. The TAXIF II Protocol Final Results: A Phase II Trial of High-Dose Chemotherapy Supported by Haematopoietic Stem Cell Transplantation in Patients with Disseminated Germ-Cell Tumors Failing Chemotherapy and with Adverse Prognostic Factors. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33414-1] [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: 10/25/2022] Open
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Bui-Nguyen B, Ray-Coquard I, Chevreau C, Penel N, Bay JO, Coindre JM, Cupissol D, Italiano A, Bonichon F, Lotz JP, Thyss A, Jimenez M, Mathoulin-Pélissier S, Blay JY. High-dose chemotherapy consolidation for chemosensitive advanced soft tissue sarcoma patients: an open-label, randomized controlled trial. Ann Oncol 2012; 23:777-784. [PMID: 21652583 DOI: 10.1093/annonc/mdr282] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Metastatic soft tissue sarcoma (STS) prognosis remains poor and few cytotoxic agents offer proven efficacy. This randomized open phase III study examines whether high-dose (HD) chemotherapy with peripheral blood stem cells (PBSCs) could improve overall survival (OS) of chemosensitive patients. PATIENTS AND METHODS Advanced STS patients aged 18-65 years received four courses of standard mesna, adryamycin, ifosfamide and dacarbazine (MAID) treatment. Chemotherapy-responding patients and patients with at least stable disease amenable to complete surgical resection were randomized to receive standard dose (SD) with two successive MAID cycles or HD treatments of one MAID then MICE intensification: mesna (3.6 g/m(2), day 1-5), ifosfamide (2.5 g/m(2), day 1-4), carboplatin [area under the curve (AUC) 5/day 2-4] and etoposide (300 mg/m(2), day 1-4) with PBSC reinjection at day 7. RESULTS From 2000 to 2008, 207 patients received four cycles of MAID and 87 assessable patients were randomly assigned to receive the following: 46 SD, 41 HD, with 45 and 38 maintained for analyses after secondary centralized histological review. Futility analyses led to study closure in November 2008. Three-year OS was 49.4% for the SD group versus 32.7% for HD arm, hazard ratio= 1.26, 95% confidence interval 0.70-2.29; progression-free survival was 32.4% and 14.0%, respectively. HD treatment led to higher grades 3-4 toxicity. CONCLUSION This study failed to show an OS advantage for advanced STS patients treated with dose-intensified chemotherapy with PBSC.
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Affiliation(s)
- B Bui-Nguyen
- Department of Medical Oncology, Institut Bergonié, Bordeaux.
| | | | | | | | - J O Bay
- Center Jean Perrin, Center Hospitalier Universitaire Estaing, Clermont-Ferrand
| | - J M Coindre
- Department of Pathology and INSERM U916, Institut Bergonié, Bordeaux
| | - D Cupissol
- Center Val d'Aurelle-Paul Lamarque, Montpellier
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux
| | - F Bonichon
- Clinical and Epidemiological Research Unit, Institut Bergonié and Inserm CIC-EC 7, Bordeaux
| | | | - A Thyss
- Center Antoine-Lacassagne, Nice
| | - M Jimenez
- French National Federation for Comprehensive Cancer Centers, Paris, France
| | - S Mathoulin-Pélissier
- Clinical and Epidemiological Research Unit, Institut Bergonié and Inserm CIC-EC 7, Bordeaux
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Bouaud J, Seroussi B, Gligorov J, Darai E, Lotz JP, Rouzier R, Touboul E, Uzan S. 098 Limitations in clinical practice guideline implementation in cancer care: feedback from routine use of a computerized decision support system (OncoDoc2) in breast cancer management. BMJ Qual Saf 2010. [DOI: 10.1136/qshc.2010.041624.11] [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: 11/03/2022]
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Machover D, Gastiaburu J, Delgado M, Goldschmidt E, Hulhoven R, Benavides M, Lotz JP, Misset JL, de Vassal F, Tapiero H. Phase I-II study of aclarubicin for treatment of acute myeloid leukaemia. Eur J Haematol Suppl 2009; 47:33-42. [PMID: 3471523 DOI: 10.1111/j.1600-0609.1987.tb00020.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Pivot X, Koralewski P, Hidalgo J, Chan A, Gonçalves A, Schwartsmann G, Assadourian S, Lotz J. A multicenter phase II study of XRP6258 administered as a 1-h i.v. infusion every 3 weeks in taxane-resistant metastatic breast cancer patients. Ann Oncol 2008; 19:1547-52. [DOI: 10.1093/annonc/mdn171] [Citation(s) in RCA: 152] [Impact Index Per Article: 9.5] [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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Theodore C, Chevreau C, Yataqhene Y, Fizazi K, Delord JP, Lotz JP, Geoffrois L, Kerbrat P, Bui V, Flechon A. A phase II multicenter study of oxaliplatin in combination with paclitaxel in poor prognosis patients who failed cisplatin-based chemotherapy for germ-cell tumors. Ann Oncol 2008; 19:1465-1469. [DOI: 10.1093/annonc/mdn122] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Moureau-Zabotto L, Ricci S, Lefranc JP, Coulet F, Genestie C, Antoine M, Uzan S, Lotz JP, Touboul E, Lacave R. Prognostic impact of multidrug resistance gene expression on the management of breast cancer in the context of adjuvant therapy based on a series of 171 patients. Br J Cancer 2006; 94:473-80. [PMID: 16434992 PMCID: PMC2361174 DOI: 10.1038/sj.bjc.6602958] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Study of the prognostic impact of multidrug resistance gene expression in the management of breast cancer in the context of adjuvant therapy. This study involved 171 patients treated by surgery, adjuvant chemotherapy±radiotherapy±hormonal therapy (mean follow-up: 55 months). We studied the expression of multidrug resistance gene 1 (MDR1), multidrug resistance-associated protein (MRP1), and glutathione-S-transferase P1 (GSTP1) using a standardised, semiquantitative rt–PCR method performed on frozen samples of breast cancer tissue. Patients were classified as presenting low or high levels of expression of these three genes. rt-PCR values were correlated with T stage, N stage, Scarff–Bloom–Richardson (SBR) grade, age and hormonal status. The impact of gene expression levels on 5-year disease-free survival (DFS) and overall survival (OS) was studied by univariate and multivariate Cox analysis. No statistically significant correlation was demonstrated between MDR1, MRP1 and GSTP1 expressions. On univariate analysis, DFS was significantly decreased in a context of low GSTP1 expression (P=0.0005) and high SBR grade (P=0.003), size ⩾5 cm (P=0.038), high T stage (P=0.013), presence of intravascular embolus (P=0.034), and >3 N+ (P=0.05). On multivariate analysis, GSTP1 expression and the presence of ER remained independent prognostic factors for DFS. GSTP1 expression did not affect OS. The levels of MDR1 and MRP1 expression had no significant influence on DFS or OS. GSTP1 expression can be considered to be an independent prognostic factor for DFS in patients receiving adjuvant chemotherapy for breast cancer.
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Affiliation(s)
- L Moureau-Zabotto
- Service d'Oncologie Radiothérapie, Hôpital Tenon, AP-HP, Cancerest, GHU EST, Université Paris VI, 4 rue de la Chine, Paris 75020, France.
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Ray-Coquard I, Guastalla JP, Treilleux I, Biron P, Blay JY, Curé H, Flechon A, Lotz JP, Méeus P, Mignot L, Raudrant D, Tournigand C, Pujade Lauraine E. Tumeurs rares malignes de l’ovaire. ONCOLOGIE 2005. [DOI: 10.1007/s10269-005-0286-x] [Citation(s) in RCA: 2] [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: 11/24/2022]
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André T, Tournigand C, Rosmorduc O, Provent S, Maindrault-Goebel F, Avenin D, Selle F, Paye F, Hannoun L, Houry S, Gayet B, Lotz JP, de Gramont A, Louvet C. Gemcitabine combined with oxaliplatin (GEMOX) in advanced biliary tract adenocarcinoma: a GERCOR study. Ann Oncol 2005. [PMID: 15319238 DOI: 10.1093/annonc/mdh351.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Since gemcitabine-oxaliplatin (GEMOX) has been used in pancreatic adenocarcinoma, we studied its activity and tolerability in advanced biliary tract adenocarcinoma (ABTA). PATIENTS AND METHODS Consecutive adult patients with confirmed ABTA were recruited from four centers. Those in group A had performance status (PS) 0-2, bilirubin <2.5x normal and received GEMOX as first-line chemotherapy. Those in group B had PS >2 and/or bilirubin >2.5x normal and/or prior chemotherapy. All received gemcitabine 1000 mg/m2 as a 10 mg/m2/min infusion on day 1, followed by oxaliplatin 100 mg/m2 as a 2-h infusion on day 2, every 2 weeks. RESULTS Tumor sites were gallbladder (19), extrahepatic bile ducts (5), ampulla of vater (3) and intrahepatic bile ducts (29). Results for group A (n = 3) were: objective response 36% [95% confidence interval (CI) 18.7% to 52.3%], stable disease 26%, progressive disease 39%, median progression-free survival (PFS) 5.7 months and overall survival (OS) 15.4 months. Results for group B (n = 23) were: objective response 22% (95% CI 6.5% to 37.4%), stable disease 30%, progressive disease 48%, PFS 3.9 months and OS 7.6 months. National Cancer Institute Common Toxicity Criteria grade 3-4 toxicities were neutropenia 14% of patients, thrombocytopenia 9%, nausea/vomiting 5% and peripheral neuropathy 7%. CONCLUSION The GEMOX combination is active and well tolerated in ABTA.
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Affiliation(s)
- T André
- Oncology Department, Tenon Hospital, Paris, France.
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Maindrault-Gœbel F, de Gramont A, Louvet C, André T, Carola E, Mabro M, Artru P, Gilles V, Lotz J, Izrael V, Krulik M. Erratum to “High-dose intensity oxaliplatin added to the simplified bimonthly leucovorin and 5-fluorouracil regimen as a second-line therapy for metastatic colorectal cancer (FOLFOX 7)” [European Journal of Cancer 37 (2001) 1000–1005]. Eur J Cancer 2004. [DOI: 10.1016/j.ejca.2004.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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André T, Tournigand C, Rosmorduc O, Provent S, Maindrault-Goebel F, Avenin D, Selle F, Paye F, Hannoun L, Houry S, Gayet B, Lotz JP, de Gramont A, Louvet C. Gemcitabine combined with oxaliplatin (GEMOX) in advanced biliary tract adenocarcinoma: a GERCOR study. Ann Oncol 2004; 15:1339-43. [PMID: 15319238 DOI: 10.1093/annonc/mdh351] [Citation(s) in RCA: 270] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Since gemcitabine-oxaliplatin (GEMOX) has been used in pancreatic adenocarcinoma, we studied its activity and tolerability in advanced biliary tract adenocarcinoma (ABTA). PATIENTS AND METHODS Consecutive adult patients with confirmed ABTA were recruited from four centers. Those in group A had performance status (PS) 0-2, bilirubin <2.5x normal and received GEMOX as first-line chemotherapy. Those in group B had PS >2 and/or bilirubin >2.5x normal and/or prior chemotherapy. All received gemcitabine 1000 mg/m2 as a 10 mg/m2/min infusion on day 1, followed by oxaliplatin 100 mg/m2 as a 2-h infusion on day 2, every 2 weeks. RESULTS Tumor sites were gallbladder (19), extrahepatic bile ducts (5), ampulla of vater (3) and intrahepatic bile ducts (29). Results for group A (n = 3) were: objective response 36% [95% confidence interval (CI) 18.7% to 52.3%], stable disease 26%, progressive disease 39%, median progression-free survival (PFS) 5.7 months and overall survival (OS) 15.4 months. Results for group B (n = 23) were: objective response 22% (95% CI 6.5% to 37.4%), stable disease 30%, progressive disease 48%, PFS 3.9 months and OS 7.6 months. National Cancer Institute Common Toxicity Criteria grade 3-4 toxicities were neutropenia 14% of patients, thrombocytopenia 9%, nausea/vomiting 5% and peripheral neuropathy 7%. CONCLUSION The GEMOX combination is active and well tolerated in ABTA.
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Affiliation(s)
- T André
- Oncology Department, Tenon Hospital, Paris, France.
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36
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Saintigny P, Lotz JP, Selle F, Gligorov J, Provent S, Saavedra A, Nakry T, Bertheloot L, Izrael V. Survival of 410 patients (pts) with solid tumors following high-dose chemotherapy (HDCT): A single center experience on 650 autologous haematopoietic stem-cell transplantation. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. Saintigny
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
| | - J.-P. Lotz
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
| | - F. Selle
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
| | - J. Gligorov
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
| | - S. Provent
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
| | - A. Saavedra
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
| | - T. Nakry
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
| | - L. Bertheloot
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
| | - V. Izrael
- Hopital Avicenne-APHP, Bobigny, France; Hopital Tenon-APHP, Paris, France
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Ray-Coquard I, Cassier P, Treilleux I, Lotz JP, Tournigand C, Merad Z, Jprovencal H, Mayeur D, Bougnoux P, Guastalla JP. Rare ovarian tumors (ROT). Impact of an interactive website on medical practice and inclusions in a clinical trial. Results after 1 year. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- I. Ray-Coquard
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - P. Cassier
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - I. Treilleux
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - J.-P. Lotz
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - C. Tournigand
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - Z. Merad
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - H. Jprovencal
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - D. Mayeur
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - P. Bougnoux
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
| | - J. P. Guastalla
- Centre Léon Bérard, Lyon, France; Hopital Thenon, Paris, France; Hopital Saint Antoine, Paris, France; CHU Boulogne sur Mer, Boulogne sur mer, France; Center Hospitalier Annecy, Annecy, France; Centre Mignot, Versaille, France; CHU Tours, Tours, France
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Lotz J, Brault D, Le Lay K, Campione M, Kerbrat P, Hocini H, Maindrault-Goebel F, Tsé C, Provent S, Launois R. 991 Serial monitoring of serum HER-2 extracellular domain (H-ECD) during herceptin-taxol chemotherapy (CT) for metastatic breast cancer (MBC) pts: preliminary results from the French experience (HER.ME.S protocol). EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)91018-4] [Citation(s) in RCA: 2] [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: 11/25/2022] Open
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Dal Cortivo L, Cottu PH, Lotz JP, Robert I, Extra JM, Miclea JM, Marty M, Marolleau JP. Residual tumor cell contamination in peripheral blood stem cells collections of 117 breast cancer patients evaluated by immunocytochemical technique. J Hematother Stem Cell Res 2001; 10:855-62. [PMID: 11798511 DOI: 10.1089/152581601317210944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
During the last years, high-dose chemotherapy and hematopoietic stem cell support have been thought to improve the treatment of poor-prognosis breast cancer. Nevertheless, the question remained as to whether the reinfusion of contaminating residual malignant cells could contribute to relapse. By using an immunocytochemical method, we have analyzed the tumor cell contamination of peripheral blood stem cells (PBSC) collected from advanced breast cancer patients. We studied 153 PBSC samples from 117 stage III and IV breast cancer patients and compared two screening methods-the usual microscopic observation and the automated cellular image analysis system (ACIS-assisted) screening. With manual observation, we found that 7 of 117 patients (5.9%) presented circulating epithelial tumor cells in 9 of 153 (5.8%) PBSC analyzed, whereas automated screening allowed positive detection in 15 of the same 117 patients (12.8%) and in 18 of the 153 PBSC (11.7%). No difference was found between presence or absence of circulating tumor cells and previous chemotherapy treatment (p = 0.5) or stage TNM (p = 0.13) in this group of poor-prognosis breast cancer. We did not find incidence of infusion of contaminated PBSC on overall survival or time to progression.
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Affiliation(s)
- L Dal Cortivo
- Laboratorie de Thérapie cellulaire, Hôpital Saint-Louis, 75010 Paris, France.
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40
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Pujade-Lauraine E, Curé H, Battista C, Guastalla JP, Chiurazzi B, Fabbro M, Tubiana-Mathieu N, Bourgeois H, Lioure B, Paraiso D, Lotz JP. High dose chemotherapy in ovarian cancer. Int J Gynecol Cancer 2001; 11 Suppl 1:64-7. [PMID: 11489006 DOI: 10.1046/j.1525-1438.2001.11(suppl.1)sup1064.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E Pujade-Lauraine
- GINECO trials, Departement of Hematology and Medical Oncology, Hôtel-Dieu, Paris, France
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41
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Trillet-Lenoir V, Lotz JP, Le Cesne A, Roy P, Avallet L, Edouard A. Reflexions from the experience of the French CLEOPATRE program and concerns about the status of clinical research on small cell lung cancer. Lung Cancer 2001; 33:303-7. [PMID: 11551426 DOI: 10.1016/s0169-5002(01)00180-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- V Trillet-Lenoir
- Medical Oncology Unit, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite Cédex, France.
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42
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Ledermann JA, Herd R, Maraninchi D, Viens P, Buclon M, Philip T, Cure H, Lotz JP, Chauvin F, Ferrante P, Rosti G. High-dose chemotherapy for ovarian carcinoma: long-term results from the Solid Tumour Registry of the European Group for Blood and Marrow Transplantation (EBMT). Ann Oncol 2001; 12:693-9. [PMID: 11432630 DOI: 10.1023/a:1011136807190] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE to determine the outcome of epithelial ovarian cancer in patients registered with the European Group for Blood and Marrow Transplantation (EBMT). PATIENTS AND METHODS A retrospective analysis was performed on 254 patients with advanced or recurrent disease, median age 46 years (14-63) from 39 centres treated between 1982 and 1996. Only 25% of patients were known to have no or microscopic disease after initial surgery; in approximately 20% the disease status was unknown, the remainder had macroscopic disease. RESULTS One hundred five patients received high-dose chemotherapy in complete or very good partial remission, twenty-seven in second remission and the remainder in the presence of residual disease. Most received melphalan or carboplatin, or a combination (86%) supported by autologous bone marrow or peripheral blood stem cells. The survival of patients treated in remission was significantly better than in other groups (median 33 vs. 14 months; P = 0.0001). The durability of remission was longer after transplantation in first remission than in second remission (median disease-free survival 18 vs. 9 months; P = 0.005). With a median follow-up of 76 months from diagnosis the median disease-free and overall survival in stage III disease transplanted in remission is 42 and 59 months and for stage IV disease 26 and 40 months. CONCLUSIONS High-dose chemotherapy has a potential benefit for patients in remission. The results support the conduct of randomised studies to determine whether there is a real value from this treatment.
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Affiliation(s)
- J A Ledermann
- Department of Oncology, Royal Free & University College Medical School, UCL, London, UK.
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43
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Maindrault-Goebel F, de Gramont A, Louvet C, André T, Carola E, Mabro M, Artru P, Gilles V, Lotz JP, Izrael V, Krulik M. High-dose intensity oxaliplatin added to the simplified bimonthly leucovorin and 5-fluorouracil regimen as second-line therapy for metastatic colorectal cancer (FOLFOX 7). Eur J Cancer 2001; 37:1000-5. [PMID: 11334725 DOI: 10.1016/s0959-8049(01)00068-5] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This phase II study examined a regimen (FOLFOX7) of leucovorin (LV), high-dose intensity oxaliplatin, and 5-fluorouracil (5-FU), as second-line therapy for metastatic colorectal cancer. 48 patients were enrolled - 36 refractory and 12 resistant to prior therapy with LV-5-FU. Oxaliplatin (130 mg/m2) was infused with LV (400 mg/m2) over 2 h on day 1, followed by bolus 400 mg/m2 and a 46-h infusion (2400 g/m2) of 5-FU, every 2 weeks. Patients who responded or were stable received eight cycles. Patients were evaluated every 2 months. 20 patients (42%) had partial responses (95% confidence interval (CI): 28-56%), 19 (40%) had stable disease and 9 (19%) progressed. Median progression-free survival (PFS) was 6 months and median survival 16.1 months. Toxic effects of National Cancer Institute-Common Toxicity Criteria (NCI-CTC) grade 3/4 were: peripheral neuropathy 15%, nausea 8%, diarrhoea 11%, neutropenia 9%, thrombocytopenia 11%. Overall, 38% of patients experienced grade 3/4 toxicities, and 64% received 90% or more of the scheduled oxaliplatin dose intensity during the first four cycles. FOLFOX7 was highly active, with good tolerability, in pretreated patients resistant to LV-5-FU [corrected].
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Affiliation(s)
- F Maindrault-Goebel
- Service de Médecine Interne-Oncologie, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
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44
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Dosquet C, Chen Y, Makke J, Miclea JM, Coudert MC, Marolleau JP, Fermand JP, Cottu P, Lotz JP, Benbunan M. Cytokines and vascular cell adhesion molecule-1 in the blood of patients undergoing HPC mobilization. Transfusion 2001; 41:206-12. [PMID: 11239224 DOI: 10.1046/j.1537-2995.2001.41020206.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The mechanism of HPC mobilization in humans is unclear. In this study, the relationship between PBPC mobilization and blood levels of G-CSF, endogenous cytokines (IL-8, SCF, thrombopoietin [TPO]), and the vascular cell adhesion molecule-1 (VCAM-1) was analyzed in patients with malignancy who were undergoing a PBPC mobilization regimen. STUDY DESIGN AND METHODS Fifty-four patients with multiple myeloma (MM) and 29 with breast cancer (BC) underwent a mobilization regimen combining conventional chemotherapy and G-CSF up to the last day of PBPC collection. The CD34+ cell count was determined on each day when leukapheresis was scheduled. Venous blood samples (n = 117) were drawn before apheresis for CD34+ cell count (flow cytometry) and cytokine (G-CSF, IL-8, SCF, TPO) and VCAM-1 measurements (ELISA). RESULTS In multiple regression analysis, SCF was a significant determinant of CD34+ cell levels in BC patients (R = 0.50, p = 0.03) and of VCAM-1 levels in MM patients (R = 0.32, p = 0.02). SCF was negatively correlated with CD34+ cell count in patients with BC. SCF and VCAM-1 blood levels were correlated in MM and BC patients. CONCLUSION SCF and VCAM-1 could play a role in PBPC mobilization in patients and could be useful measures by which to study patients undergoing a mobilization regimen.
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Affiliation(s)
- C Dosquet
- Cell Therapy Unit and the Departments of Hematology and Oncology, Saint-Louis Hospital, Paris. France.
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Maindrault-Goebel F, de Gramont A, Louvet C, André T, Carola E, Gilles V, Lotz JP, Tournigand C, Mabro M, Molitor JL, Artru P, Izrael V, Krulik M. Evaluation of oxaliplatin dose intensity in bimonthly leucovorin and 48-hour 5-fluorouracil continuous infusion regimens (FOLFOX) in pretreated metastatic colorectal cancer. Oncology Multidisciplinary Research Group (GERCOR). Ann Oncol 2000; 11:1477-83. [PMID: 11142489 DOI: 10.1023/a:1026520812351] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Studies of bimonthly 48-hour regimens of high-dose leucovorin (LV) (FOLinic acid), 5-fluorouracil (5-FU) by continuous infusion combined with OXaliplatin (FOLFOX) in pretreated patients with metastatic colorectal cancer suggest that oxaliplatin dose intensity is an important prognostic factor for response rate and progression-free survival (PFS). To help define the optimal dose schedule for oxaliplatin in pretreated metastatic colorectal cancer, we retrospectively analyzed data from three phase II studies using different FOLFOX regimens (FOLFOX2, 3 and 6). PATIENTS AND METHODS Data on 126/161 patients were analyzed. FOLFOX2 included oxaliplatin 100 mg/m2; FOLFOX3, 85 mg/m2; and FOLFOX6, 100 mg/m2 (added to a simplified LV-5-FU regimen), all as two-hour infusions. A total of 47 patients received low dose intensity oxaliplatin (LDI: < or = 85 mg/m2/2 weeks) and 79 patients high dose intensity oxaliplatin (HDI: > 85 mg/m2/2 weeks). RESULTS Objective responses occurred in 31 (39%) HDI patients and 9 (19%) LDI patients (P = 0.03). Median PFS was 28 weeks, with 52% of HDI patients progression free at 6 months, and 26 weeks with 36% of LDI patients progression free at six months (P = 0.02). Increased oxaliplatin dose intensity was not associated with increased neurotoxicity or other toxicities. FOLFOX are among the most effective regimens for treating LV-5-FU-resistant metastatic colorectal cancer. CONCLUSIONS This study shows that oxaliplatin dose intensification significantly improves response rate and PFS in pretreated metastatic disease without increasing severe toxicity.
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Lotz JP, Gligorov J, Selle F, Lefevre G, Pautier P, Lhommé C. [High dose chemotherapy in ovarian and breast adenocarcinoma with poor prognosis]. Gynecol Obstet Fertil 2000; 28:620-31. [PMID: 11075500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- J P Lotz
- Service d'oncologie médicale, hôpital Tenon, Paris, France
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47
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Yanovich S, Mitsky P, Cornetta K, Maziarz RT, Rosenfeld C, Krause DS, Lotz JP, Bitran JD, Williams S, Preti R, Somlo G, Burtness B, Mills B. Transplantation of CD34+ peripheral blood cells selected using a fully automated immunomagnetic system in patients with high-risk breast cancer: results of a prospective randomized multicenter clinical trial. Bone Marrow Transplant 2000; 25:1165-74. [PMID: 10849529 DOI: 10.1038/sj.bmt.1702415] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tumor contamination of autologous peripheral blood stem/progenitor cell grafts occurs in a substantial proportion of high-risk breast cancer patients, and the possibility that such contamination may contribute to relapse has focused attention on methods for removal of the contaminating cells prior to transplantation. One such approach is positive selection of CD34+ cells. A fully automated immunomagnetic cell selection system has recently been introduced to facilitate the positive selection process. A multicenter randomized clinical trial was designed to evaluate the capacity of CD34+ cells isolated using the fully automated system to support prompt hematopoietic reconstitution following high-dose chemotherapy in high-risk breast cancer patients, as well as to assess the safety and tolerability of the CD34+ cell transplants. In recipients of isolated CD34+ cells, the median time to an absolute neutrophil count > or =500/microl was 10 days, a value identical to that observed in patients receiving unfractionated apheresis collections. In the isolated CD34+ cell recipients median time to a platelet count > or =20 000/microl was 12 days, compared with 10 days in the unfractionated cell group. There were no statistically significant differences between the groups in median time to neutrophil or platelet engraftment. Infusion of autologous cells was well tolerated by the study groups. There were no inter-group differences in the incidence of infections, need for platelet transfusions, or duration of hospitalization. Isolated CD34+ cells were high in purity and sufficient in number for use in autologous transplantation. The fully automated immunomagnetic cell selection system affords an efficient and time-saving option for isolation of CD34+cells to be used as autologous grafts in high-risk breast cancer patients, and the isolated CD34+ cells support undelayed hematopoietic reconstitution.
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Affiliation(s)
- S Yanovich
- Medical College of Virginia, Richmond 23298, USA
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48
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André T, Balosso J, Louvet C, Hannoun L, Houry S, Huguier M, Colonna M, Lotz JP, De Gramont A, Bellaïche A, Parc R, Touboul E, Izrael V. Combined radiotherapy and chemotherapy (cisplatin and 5-fluorouracil) as palliative treatment for localized unresectable or adjuvant treatment for resected pancreatic adenocarcinoma: results of a feasibility study. Int J Radiat Oncol Biol Phys 2000; 46:903-11. [PMID: 10705012 DOI: 10.1016/s0360-3016(99)00478-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To evaluate a cisplatin-containing chemoradiotherapy (CRT) regimen followed by chemotherapy for unresectable (locally advanced group, n = 32) and resected (adjuvant group, n = 10) pancreatic adenocarcinoma. The quality of palliation and percentage of secondary resections were also studied for unresectable disease. METHODS AND MATERIALS The protocol comprised CRT (45 Gy over 5 weeks), combined with 5-fluorouracil and cisplatin during the first and fifth weeks, followed, 3 weeks later, by 4 cycles of the same chemotherapy plus leucovorin. RESULTS All patients completed CRT but only 50% of each group finished the entire protocol. Gastrointestinal toxicity and weight loss were the major side effects during CRT. Enhanced hematological toxicity limited the post-CRT chemotherapy. For the locally advanced group, median survival was 9 months; 1- and 2-year survival rates were 31 and 12. 5%, respectively. The overall response rate was 16% and 50% had stable disease. A lasting palliative effect defined as improved performance status and decreased analgesic consumption, was recorded for 43% of the patients. Only three secondary resections have been performed. For the adjuvant group, median survival was 17 months. CONCLUSIONS Although toxic in advanced disease, this regimen significantly lowered pain and analgesic consumption, but had poor impact on secondary resectability. In an adjuvant setting, although equally toxic, this series was too small to allow conclusions to be drawn.
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Affiliation(s)
- T André
- Department of Medical Oncology, University Hospital, Grenoble, France.
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Lotz JP, Lhommé C, Pautier P, Couteau C, Gligorov J, Alexandre J, Selle F, Izrael V, Maraninchi D, Viens P. [High-dose chemotherapy in ovarian adenocarcinoma]. Bull Cancer 2000; 87:63-9. [PMID: 10673633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- J P Lotz
- Service d'oncologie médicale, hôpital Tenon, 4, rue de la Chine, 75020 Paris
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Ghazli M, Sananes S, Chopier J, Touboul E, Lotz JP, Antoine M, Antoine JM, Uzan S. [Inflammatory and/or locally advanced breast cancers. Difficulty evaluating the response to initial chemotherapy]. Contracept Fertil Sex 1999; 27:872-6. [PMID: 10676046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
At the Tenon Hospital (Paris), 48 inflammatory or locally advanced breast cancers were treated by neoadjuvant chemotherapy (three different protocols), followed by surgery (mastectomy or tumorectomy and axillary dissection). The histological data of the specimens are analyzed with regard to the clinical and radiologic evolution. Twenty complete clinical responses (41%), 22 partial clinical responses (45%), and no response in six cases (14%) were observed. Histology demonstrated residual tumors in 42 cases (87.5%), even in the case of complete clinical response (14 cases), without notable change of the grade (SBR). Lymph node clearance demonstrated positive nodes in 38 cases (79%). Despite its great agreement with clinical examination, mammography does not predict the existence of histological residual tumors after initial chemotherapy. Chemotherapy allowed local treatment, but can rarely sterilize the tumor completely.
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Affiliation(s)
- M Ghazli
- Département de diagnostic et traitement des cancers du sein, Hôpital Tenon, Paris, France
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