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Brudon A, Legendre M, Mageau A, Bermudez J, Bonniaud P, Bouvry D, Cadranel J, Cazes A, Crestani B, Dégot T, Delestrain C, Diesler R, Epaud R, Philippot Q, Theou-Anton N, Kannengiesser C, Ba I, Debray MP, Fanen P, Manali E, Papiris S, Nathan N, Amselem S, Gondouin A, Guillaumot A, Andréjak C, Jouneau S, Beltramo G, Uzunhan Y, Galodé F, Westeel V, Mehdaoui A, Hirschi S, Leroy S, Marchand-Adam S, Nunes H, Picard C, Prevot G, Reynaud-Gaubert M, De Vuyst P, Wemeau L, Defossez G, Zalcman G, Cottin V, Borie R. High risk of lung cancer in surfactant-related gene variant carriers. Eur Respir J 2024:2301809. [PMID: 38575158 DOI: 10.1183/13993003.01809-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/19/2024] [Indexed: 04/06/2024]
Abstract
RATIONALE Several rare surfactant-related genes variants associated with interstitial lung disease are suspected to be associated with lung cancer, but data are missing. OBJECTIVES We aimed to study the epidemiology and phenotype of lung cancer in an international cohort of surfactant-related gene (SRG) variant carriers. METHODS We conducted a cross-sectional study of all adults with SRG variants in the OrphaLung network and compared lung cancer risk with telomerase-related gene (TRG) variant carriers. RESULTS We identified 99 SRG adult variant carriers (SFTPA1 [n=18], SFTPA2 [n=31], SFTPC [n=24], ABCA3 [n=14] and NKX2-1 [n=12]), including 20 (20.2%) with lung cancer (SFTPA1 [n=7]; SFTPA2 [n=8], SFTPC [n=3], NKX2-1 [n=2] and ABCA3 [n=0]). Among SRG variant carriers, the odds of lung cancer was associated with age (odds ratio [OR] 1.04 [95% CI 1.01-1.08]), smoking (OR 20.7 [6.60-76.2]) and SFTPA1/SFTPA2 variants (OR 3.97 [1.39-13.2]). Adenocarcinoma was the only histological type reported, with PDL1 expression≥1% of tumor cells in 3 cases. Cancer staging was localized (I/II) in 8 (40%) individuals, locally advanced (III) in 2 (10%) and metastatic (IV) in 10 (50%). We found no somatic variant eligible for targeted therapy. Seven cancers were surgically removed, 10 received systemic therapy, and 3 received the best supportive care according to their stage and performance status. The median overall survival was 24 months, with stage I/II cancers showing better survival. We identified 233 TRG variant carriers. The comparative risk (subdistribution hazard ratio) for lung cancer in SRG patients versus TRG patients was 18.1 [7.1-44.7]. CONCLUSION The high risk of lung cancer among SRG variant carriers suggests specific screening and diagnostic and therapeutic challenges. The benefit of regular CT scan follow-up should be evaluated.
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Affiliation(s)
- Alexandre Brudon
- Service d'oncologie thoracique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- These authors contributed equally to this work
| | - Marie Legendre
- U.F. de Génétique moléculaire, Hôpital Armand Trousseau, AP-HP, Paris, France
- Sorbonne Université, Inserm UMR-S 933, Maladies génétiques d'expression pédiatrique, Paris, France
- These authors contributed equally to this work
| | - Arthur Mageau
- Département de Médecine Interne, Hôpital Bichat, AP-HP, Paris, France
- Université Paris Cité, Inserm IAME UMR 1137 Team Descid, Paris, France
| | - Julien Bermudez
- Service de Pneumologie, Centre de compétences de Maladies Pulmonaires rares et de Transplantation pulmonaire, CHU Nord, APHM, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Philippe Bonniaud
- Department of Respiratory Diseases and Intensive Care, Reference Constitutive Center for Adulte Rare Pulmonary Diseases, Dijon-Bourgogne University Hospital; University of Burgundy, Inserm UMR1231, Dijon, France
| | - Diane Bouvry
- Département de pneumologie, Hôpital Avicenne, APHP, Bobigny, France
- Université Paris 13, Inserm UMR U1272, Bobigny, France
| | - Jacques Cadranel
- Service de pneumologie et oncologie thoracique, DMU APPROCHES, Hôpital Tenon, APHP, Paris, France
- Sorbonne Université, GRC04 Theranoscan, Paris, France
| | - Aurélie Cazes
- Département d'anatomie pathologique, Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, INSERM U1552, Paris, France
| | - Bruno Crestani
- Service de Pneumologie A Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, Inserm UMR-S 1152 PHERE, Paris, France
| | - Tristan Dégot
- Service de pneumologie, Groupe de transplantation pulmonaire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Céline Delestrain
- Centre de référence pour les maladies respiratoires rares RespiRare, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université de Paris Est Creteil, Inserm IMRB F-94010, Creteil, France
| | - Rémi Diesler
- Service de pneumologie, Centre national coordinateur de référence des pathologies pulmonaires rares, ERN-LUNG, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Ralph Epaud
- Centre de référence pour les maladies respiratoires rares RespiRare, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université de Paris Est Creteil, Inserm IMRB F-94010, Creteil, France
| | - Quentin Philippot
- Service de Pneumologie A Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, Inserm UMR-S 1152 PHERE, Paris, France
| | - Nathalie Theou-Anton
- Département de génétique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- Université Paris Cité, Paris, France
| | - Caroline Kannengiesser
- Département de génétique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- Université Paris Cité, Paris, France
| | - Ibrahima Ba
- Département de génétique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- Université Paris Cité, Paris, France
| | - Marie-Pierre Debray
- Service de Radiologie, Hopital Bichat, APHP, Paris, France
- Université Paris Cité, Paris, France
| | - Pascale Fanen
- Service de Radiologie, Hopital Bichat, APHP, Paris, France
- Université de Paris Est Creteil, Inserm IMRB F-94010, Creteil, France
| | - Efrosine Manali
- General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyros Papiris
- General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nadia Nathan
- Sorbonne Université, Inserm UMR-S 933, Maladies génétiques d'expression pédiatrique, Paris, France
- Département de pneumologie pédiatrique, Centre de référence des maladies respiratoires rares RespiRare, Paris, France
| | - Serge Amselem
- U.F. de Génétique moléculaire, Hôpital Armand Trousseau, AP-HP, Paris, France
- Sorbonne Université, Inserm UMR-S 933, Maladies génétiques d'expression pédiatrique, Paris, France
| | - Antoine Gondouin
- Service de pneumologie, Centre des maladies pulmonaires rares, Hôpital de Besançon, Besançon, France
| | - Anne Guillaumot
- Service de pneumologie, Hôpital de Brabois, Vandoeuvre-les-Nancy, France
| | - Claire Andréjak
- Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, France
- EA 4294, AGIR, Jules Verne Picardy University, Amiens, France
| | - Stephane Jouneau
- Service de Pneumologie, Centre de Référence Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Inserm UMR1085 IRSET, Université de Rennes 1, EHESP, Rennes, France
| | - Guillaume Beltramo
- Department of Respiratory Diseases and Intensive Care, Reference Constitutive Center for Adulte Rare Pulmonary Diseases, Dijon-Bourgogne University Hospital; University of Burgundy, Inserm UMR1231, Dijon, France
| | - Yurdagul Uzunhan
- Département de pneumologie, Hôpital Avicenne, APHP, Bobigny, France
| | - François Galodé
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Pediatrics Department, Pediatric Pulmonology, CEDEX, Bordeaux, France
| | - Virginie Westeel
- Service de pneumologie, Centre des maladies pulmonaires rares, Hôpital de Besançon, Besançon, France
| | - Anas Mehdaoui
- Pneumonology and Thoracic Oncology Department, Eure-Seine Hospital Center, Évreux, France
| | - Sandrine Hirschi
- Service de pneumologie, Groupe de transplantation pulmonaire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sylvie Leroy
- Service de pneumologie, FHU Oncoage, Hôpital Pasteur - Centre Hospitalier Universitaire de Nice, Nice, France
- Université Nice Côte d'Azur, Nice, France
| | - Sylvain Marchand-Adam
- Service de pneumologie, Hôpital de Tours, Tours, France
- Université de Tours, Inserm U1100, Tours, France
| | - Hilario Nunes
- Département de pneumologie, Hôpital Avicenne, APHP, Bobigny, France
- Université Paris 13, Inserm UMR U1272, Bobigny, France
| | - Clément Picard
- Service de pneumologie et de transplantation pulmonaire, Hôpital Foch, Suresnes, France
| | | | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre de compétences de Maladies Pulmonaires rares et de Transplantation pulmonaire, CHU Nord, APHM, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Paul De Vuyst
- Service de pneumologie, Hôpital Erasme, Bruxelles, Belgium
| | - Lidwine Wemeau
- Service de pneumologie et immuno-allergie, Institut coeur-poumon, Lille, France
| | | | - Gérard Zalcman
- Service d'oncologie thoracique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- Université Paris Cité, Inserm CIC-EC 1425, Paris, France
| | - Vincent Cottin
- Service de pneumologie, Centre national coordinateur de référence des pathologies pulmonaires rares, ERN-LUNG, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Raphael Borie
- Service de Pneumologie A Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, Inserm UMR-S 1152 PHERE, Paris, France
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Parrot A, Canellas A, Barral M, Gibelin A, Cadranel J. [Severe hemoptysis in the onco-hematology patient]. Rev Mal Respir 2024; 41:303-316. [PMID: 38155073 DOI: 10.1016/j.rmr.2023.11.004] [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: 05/12/2023] [Accepted: 11/04/2023] [Indexed: 12/30/2023]
Abstract
In France, even though it occurs only exceptionally in cases of hemopathy, severe hemoptysis in cancer is the leading cause of hemoptysis. Without adequate treatment, in-hospital mortality exceeds 60%, even reaching 100% at 6 months. The management of severe hemoptysis should be discussed with the oncologist. Aside from situations of threatening hemoptysis, in which bronchoscopy should be performed immediately, CT angiography is an essential means of localizing the bleeding and determining the causes and the vascular mechanisms involved. In more than 90% of cases, hemoptysis is linked to systemic bronchial or non-bronchial hypervascularization, whereas in fewer than 5%, it is associated with pulmonary arterial origin or, exceptionally, with damage to the alveolar-capillary barrier. The most severely ill patients must be treated in intensive care in centers equipped with interventional radiology, thoracic surgery and, ideally, with interventional bronchoscopy. Interventional radiology is the first-line symptomatic treatment. In over 80% of cases, bronchial arteriography with embolization allows immediate control. Emergency surgery should be avoided, as it is associated with significant mortality. Appropriate and adequate care reduces hospital mortality to 30%, enabling patients to benefit from the most recent, survival-prolonging treatments.
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Affiliation(s)
- A Parrot
- Service de pneumologie et oncologie thoracique, Assistance publique-Hôpitaux de Paris, hôpital Tenon, Sorbonne université, 75970 Paris, France.
| | - A Canellas
- Service de pneumologie et oncologie thoracique, Assistance publique-Hôpitaux de Paris, hôpital Tenon, Sorbonne université, 75970 Paris, France
| | - M Barral
- Service de radiologie, Assistance publique-Hôpitaux de Paris, hôpital Tenon, Sorbonne université, 75970 Paris, France; UFR médecine, Sorbonne université, 75006 Paris, France
| | - A Gibelin
- Service de médecine intensive et réanimation, Assistance publique-Hôpitaux de Paris, hôpital Tenon, Sorbonne université, 75970 Paris, France
| | - J Cadranel
- Service de pneumologie et oncologie thoracique, Assistance publique-Hôpitaux de Paris, hôpital Tenon, Sorbonne université, 75970 Paris, France; UFR médecine, Sorbonne université, 75006 Paris, France
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Gougis P, Hamy AS, Jochum F, Bihan K, Carbonnel M, Salem JE, Dumas E, Kabirian R, Grandal B, Barraud S, Coussy F, Hotton J, Savarino R, Marabelle A, Cadranel J, Spano JP, Laas E, Reyal F, Abbar B. Immune Checkpoint Inhibitor Use During Pregnancy and Outcomes in Pregnant Individuals and Newborns. JAMA Netw Open 2024; 7:e245625. [PMID: 38630478 PMCID: PMC11024778 DOI: 10.1001/jamanetworkopen.2024.5625] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/12/2024] [Indexed: 04/19/2024] Open
Abstract
Importance With the widespread use of immune checkpoint inhibitors (ICIs), concerns about their pregnancy outcomes through maternal exposure have emerged, and clinical comparative data are lacking. Objective To assess the risk of pregnancy-, fetal-, and/or newborn-related adverse outcomes associated with exposure to ICIs compared with exposure to other anticancer agents. Design, Setting, and Participants In this cohort study, all reports mentioning a pregnancy-related condition and an antineoplastic agent (Anatomical Therapeutic Chemical classification group L01) used for a cancer indication registered in the World Health Organization international pharmacovigilance database VigiBase up to June 26, 2022, were extracted. Exposure Anticancer agents, including ICIs, used during pregnancy for a cancer indication. Immune checkpoint inhibitors included blockers of programmed cell death 1 (PD1) or its ligand (PD-L1) or cytotoxic T-lymphocyte-associated protein 4 (CTLA4). Main Outcomes and Measures The main outcome was the reporting odds ratio (ROR) for maternal, fetal, or newborn complications in patients treated with ICIs vs any other anticancer drug. Adverse events, categorized into 45 individual maternofetal adverse outcomes, were directly mapped to Medical Dictionary for Regulatory Activities preferred terms in VigiBase. Results A total of 3558 reports (ICI: 91 [2.6%]; other anticancer drugs: 3467 [97.4%]) were included in the analysis. In the ICI group, most reports were from the US (60 [65.9%]), and the mean (SD) patient age was 28.9 (10.2) years; in 24 of 55 reports with data on cancer type (43.6%), patients were treated for melanoma. The molecules involved in the ICI group were anti-PD1 (58 reports [63.7%]), anti-PD1 plus anti-CTLA4 (15 [16.5%]), anti-CTLA4 (13 [14.3%]), anti-PD-L1 (4 [4.4%]), and anti-PD1 plus anti-lymphocyte activation gene 3 (1 [1.1%]). An ICI was used in combination with a non-ICI anticancer agent in 10 participants (11.0%). Compared with other anticancer drugs, none of the 45 adverse outcomes identified were overreported in the group exposed to ICIs. However, preterm birth was significantly overreported for the anti-PD1 plus anti-CTLA4 combination compared with other anticancer drugs (12 of 15 [80.0%] vs 793 of 3452 [23.0%]; ROR, 13.87; 95% CI, 3.90-49.28; P < .001) but not for anti-PD-L1 or anti-CTLA4 monotherapy. Three reports of possibly immune-related maternofetal events were identified: 1 case of maternal antiphospholipid syndrome leading to spontaneous abortion, 1 case of pneumonitis leading to neonatal respiratory distress syndrome and death, and 1 case of transient congenital hypothyroidism. Conclusions and Relevance In this cohort study of 91 individuals exposed to ICIs during pregnancy, ICI exposure was not associated with overreporting of specific adverse pregnancy, fetal, and/or newborn outcomes compared with other anticancer treatments. However, due to possible rare immune-related neonatal adverse events, ICI use in pregnant women should be avoided when possible, especially the anti-PD1 plus anti-CTLA4 combination.
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Affiliation(s)
- Paul Gougis
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
- INSERM, Assistance Publique–Hôpitaux de Paris (AP-HP), Clinical Investigation Center (CIC) 1901, Department of Pharmacology, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
- Department of Medical Oncology, AP-HP, Pitié-Salpêtrière Hospital, Institut Universitaire de Cancérologie, INSERM U1136, CLIP Galilée, Sorbonne Université, Paris, France
| | - Anne-Sophie Hamy
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
- Department of Medical Oncology, Institut Curie, Université Paris, Paris, France
| | - Floriane Jochum
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
| | - Kevin Bihan
- INSERM, Assistance Publique–Hôpitaux de Paris (AP-HP), Clinical Investigation Center (CIC) 1901, Department of Pharmacology, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
- Paris Pitié–St Antoine Regional Pharmacovigilance Center, Medical Pharmacology Department, AP-HP Sorbonne University Hospital Group, Paris, France
| | - Marie Carbonnel
- INSERM U1135, Centre d’Immunologie et des Maladies Infectieuses–Paris, Sorbonne Université, Paris, France
- Department of Obstetrics and Gynecology, Foch Hospital, University of Versailles-Saint-Quentin-en-Yvelines Paris Saclay, Montigny-Le-Bretonneux, Suresnes, France
| | - Joe-Elie Salem
- INSERM, Assistance Publique–Hôpitaux de Paris (AP-HP), Clinical Investigation Center (CIC) 1901, Department of Pharmacology, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Elise Dumas
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
| | - Rayan Kabirian
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
| | - Beatriz Grandal
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
- Department of Breast, Gynecological and Reconstructive Surgery, Institut Curie, Université Paris, Paris, France
| | - Solenn Barraud
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
| | - Florence Coussy
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
- Department of Medical Oncology, Institut Curie, Université Paris, Paris, France
| | - Judicael Hotton
- Department of Surgical Oncology, Institut Godinot, Reims, France
| | - Raphaelle Savarino
- Department of Medical Oncology, Institut Curie, Université Paris, Paris, France
| | - Aurélien Marabelle
- Département d’Innovation Thérapeutique et d’Essais Précoces, Gustave Roussy, Département de Médecine Interne et Immunologie clinique, AP-HP, Hôpital Universitaire Bicêtre, INSERM U1015 and CIC1428, Le Kremlin Bicêtre, Villejuif, France
| | - Jacques Cadranel
- Department of Pneumology, AP-HP, Tenon Hospital, Institut Universitaire de Cancérologie, Sorbonne Université, Paris, France
| | - Jean-Philippe Spano
- Department of Medical Oncology, AP-HP, Pitié-Salpêtrière Hospital, Institut Universitaire de Cancérologie, INSERM U1136, CLIP Galilée, Sorbonne Université, Paris, France
| | - Enora Laas
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
- Department of Breast, Gynecological and Reconstructive Surgery, Institut Curie, Université Paris, Paris, France
| | - Fabien Reyal
- Residual Tumor and Response to Treatment Laboratory, Institut National de la Santé et de la Recherche Médicale (INSERM), U932 Immunity and Cancer, Institut Curie, Université Paris, Paris, France
- Department of Breast, Gynecological and Reconstructive Surgery, Institut Curie, Université Paris, Paris, France
- Department of Surgical Oncology, Institut Godinot, Reims, France
| | - Baptiste Abbar
- Department of Medical Oncology, AP-HP, Pitié-Salpêtrière Hospital, Institut Universitaire de Cancérologie, INSERM U1136, CLIP Galilée, Sorbonne Université, Paris, France
- INSERM U1135, Centre d’Immunologie et des Maladies Infectieuses–Paris, Sorbonne Université, Paris, France
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4
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Deneuville L, Mageau A, Debray MP, Sacre K, Costedoat-Chalumeau N, Hachulla E, Uzunhan Y, Le Tallec E, Cadranel J, Marchand Adam S, Montani D, Rémi-Jardin M, Reynaud-Gaubert M, Prevot G, Beltramo G, Crestani B, Cottin V, Borie R. Chronic interstitial lung disease associated with systemic lupus erythematosus: A multicentric study of 89 cases. Respirology 2024. [PMID: 38494831 DOI: 10.1111/resp.14703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/03/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND AND OBJECTIVE Chronic interstitial lung disease (ILD) occurs rarely with systemic lupus erythematosus (SLE) as compared with other connective tissue diseases. This multicentric retrospective study of patients with SLE-ILD from the OrphaLung and French SLE networks during 2005-2020 aimed to describe the characteristics of patients with SLE-ILD and analyse factors associated with prognosis. METHODS We analysed data for 89 patients with SLE-ILD (82 women, 92.1%) (median age at SLE diagnosis: 35 years [interquartile range 27-47]). All patients met the 2019 EULAR/ACR criteria for the diagnosis of SLE. RESULTS Forty two (47.2%) patients were positive for anti-ribonuclear protein antibodies and 45 (50.6%) for anti SSA/Ro antibodies. A total of 58 (65.2%) patients had another connective tissue disease: Sjögren's syndrome (n = 33, 37.1%), systemic sclerosis (n = 14, 15.7%), inflammatory myopathy (n = 6, 6.7%), or rheumatoid arthritis (n = 6, 6.7%). ILD was diagnosed along with SLE in 25 (28.1%) patients and at a median of 6 (0-14) years after the SLE diagnosis. The most frequent CT pattern was suggestive of non-specific interstitial pneumonia (n = 41, 46.0%) with or without superimposed organizing pneumonia. After a median follow-up of 86.5 [39.5-161.2] months, 18 (20.2%) patients had died and 6 (6.7%) underwent lung transplantation. The median 5-year and 10-year transplantation-free survival were 96% (92-100) and 87% (78-97). In total, 44 (49.4%) patients showed ILD progression. Cutaneous manifestations and Raynaud's phenomenon were associated with better survival. Only forced vital capacity was significantly associated with survival and ILD progression. CONCLUSION ILD is a rare manifestation of SLE with good overall prognosis but with possible risk of ILD progression. Patients with SLE-ILD frequently have another connective tissue disease.
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Affiliation(s)
- Lou Deneuville
- Université Paris Cité, Inserm, PHERE, F-75018 Paris, et Hôpital Bichat, APHP, Service de Pneumologie A, Centre constitutif du centre de référence des Maladies Pulmonaires Rares, FHU APOLLO, Paris, France
| | - Arthur Mageau
- Département de Médecine Interne, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Karim Sacre
- Département de Médecine Interne, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for Rare Systemic Autoimmune Diseases North and North-West of France (CeRAINO), CHU Lille, Univ. Lille, Inserm, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Yurdagul Uzunhan
- Service de Pneumologie, Centre constitutif du centre de référence des maladies pulmonaires rares, Hôpital Avicenne, INSERM U1272, Université Sorbonne Paris Nord, Bobigny, France
| | - Erwan Le Tallec
- Service de Médecine Interne et Immunologie Clinique, CHU de Rennes, Rennes, France
| | - Jacques Cadranel
- Service de Pneumologie, Centre de référence des maladies pulmonaires rares (site constitutif), Assistance Publique Hôpitaux de Paris-Hôpital Tenon et Sorbonne Université, Paris, France
| | - Sylvain Marchand Adam
- Service de Pneumologie et explorations fonctionnelles respiratoires, CHRU de Tours et université de Tours, Inserm 1100, Tours, France
| | - David Montani
- Université Paris-Saclay, AP-HP, INSERM UMR_S 999, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Martine Rémi-Jardin
- Department of Thoracic Imaging, Heart & Lung Institute, University Hospital Center of Lille, Lille, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre de compétences des maladies pulmonaires rares, CHU Nord, AP-HM, Marseille; Aix- Marseille Université, IHU Méditerranée Infection, MEPHI, Marseille, France
| | | | - Guillaume Beltramo
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre constitutif de référence des maladies pulmonaires rares, CHU Dijon-Bourgogne, Université de Bourgogne, UMR 1231-LNC-HSP-pathies, Dijon, France
| | - Bruno Crestani
- Université Paris Cité, Inserm, PHERE, F-75018 Paris, et Hôpital Bichat, APHP, Service de Pneumologie A, Centre constitutif du centre de référence des Maladies Pulmonaires Rares, FHU APOLLO, Paris, France
| | - Vincent Cottin
- Service de Pneumologie, Centre coordonnateur national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Université de Lyon; INRAE; ERN-LUNG, Lyon, France
| | - Raphael Borie
- Université Paris Cité, Inserm, PHERE, F-75018 Paris, et Hôpital Bichat, APHP, Service de Pneumologie A, Centre constitutif du centre de référence des Maladies Pulmonaires Rares, FHU APOLLO, Paris, France
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5
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Ederhy S, Cadranel J, Granger C, Hammoudi N. Investigation of endocarditis finds advanced lung adenocarcinoma: both resolve after tyrosine kinase inhibitor treatment. Lancet 2024; 403:860-861. [PMID: 38431352 DOI: 10.1016/s0140-6736(24)00042-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/29/2023] [Accepted: 01/05/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Stéphane Ederhy
- Department of Cardiology, Saint-Antoine Hospital, AP-HP, Paris, France; Groupe de Recherche Clinique, Sorbonne Université, Paris, France; UNICO-GRECO Cardio-Oncology Program, Sorbonne Université, Paris, France.
| | - Jacques Cadranel
- Department of Pulmonology and Thoracic Oncology, Assistance Publique Hopitaux de Paris, Hopital Tenon, Paris, France; Groupe de Recherche Clinique 4 (GRC 4), Theranoscan, Paris, France
| | - Camille Granger
- Sorbonne Université, ACTION Study Group, INSERM, UMR_S 1166, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France; Hôpital Pitié-Salpêtrière endocarditis team (AP-HP), Paris, France
| | - Nadjib Hammoudi
- Sorbonne Université, ACTION Study Group, INSERM, UMR_S 1166, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France; Hôpital Pitié-Salpêtrière endocarditis team (AP-HP), Paris, France
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6
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Fenioux C, Abbar B, Boussouar S, Bretagne M, Power JR, Moslehi JJ, Gougis P, Amelin D, Dechartres A, Lehmann LH, Courand PY, Cautela J, Alexandre J, Procureur A, Rozes A, Leonard-Louis S, Qin J, Cheynier R, Charmeteau-De Muylder B, Redheuil A, Tubach F, Cadranel J, Milon A, Ederhy S, Similowski T, Johnson DB, Pizzo I, Catalan T, Benveniste O, Hayek SS, Allenbach Y, Rosenzwajg M, Dolladille C, Salem JE. Publisher Correction: Thymus alterations and susceptibility to immune checkpoint inhibitor myocarditis. Nat Med 2024; 30:910. [PMID: 38172633 DOI: 10.1038/s41591-023-02771-0] [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: 01/05/2024]
Affiliation(s)
- Charlotte Fenioux
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
- Hôpitaux de Paris, Henri Mondor Hospital, Department of Oncology, Créteil, France
| | - Baptiste Abbar
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Oncology, Paris, France
| | - Samia Boussouar
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Radiology, Paris, France
| | - Marie Bretagne
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - John R Power
- Department of Medecine, University of California, San Diego, San Diego, CA, USA
| | - Javid J Moslehi
- Department of Medecine, University of California, San Francisco, San Francisco, CA, USA
| | - Paul Gougis
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Damien Amelin
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Lorenz H Lehmann
- Department of Cardiology, University Hospital Heidelberg; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pierre-Yves Courand
- Fédération de Cardiologie, IMMUCARE, Hôpital de La Croix-Rousse Et Hôpital Lyon Sud, Hospices Civils de Lyon; Université de Lyon, CREATIS UMR INSERM U1044, INSA, Lyon, France
| | - Jennifer Cautela
- Aix-Marseille University, University Mediterranean Center of Cardio-Oncology, Unit of Heart Failure and Valvular Heart Diseases, Center for Cardiovascular and Nutrition Research, INSERM 1263, INRAE 1260, Nord Hospital, Assistance Publique-Hôpitaux de Marseille, Paris, France
| | - Joachim Alexandre
- CHU de Caen Normandie, Department of Pharmacology, Pharmacoepidemiology Unit; Normandie Université, UNICAEN, INSERM U1086 ANTICIPE Centre François Baclesse, Caen, France
| | - Adrien Procureur
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Antoine Rozes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Sarah Leonard-Louis
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Laboratoire de Neuropathologie, Paris, France
| | - Juan Qin
- Department of Medecine, University of California, San Francisco, San Francisco, CA, USA
| | - Rémi Cheynier
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | | | - Alban Redheuil
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Radiology, Paris, France
| | - Florence Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Jacques Cadranel
- Hôpitaux de Paris, Tenon Hospital, Department of Pulmonology and Thoracic Oncology and GRC Theranoscan Sorbonne University, Paris, France
| | - Audrey Milon
- Hôpitaux de Paris, Tenon Hospital, Department of Radiology, Paris, France
| | - Stéphane Ederhy
- Hôpitaux de Paris, Saint-Antoine Hospital, Department of Cardiology, Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS 1158 Neurophysiologie respiratoire expérimentale et clinique'; Assistance Publique -Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 'Département R3S', Paris, France
| | - Douglas B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ian Pizzo
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Toniemarie Catalan
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Olivier Benveniste
- Department of Internal Medicine, Sorbonne University, AP-HP, INSERM UMRS 974, Pitié-Salpêtrière Hospital, Paris, France
| | - Salim S Hayek
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Yves Allenbach
- Department of Internal Medicine, Sorbonne University, AP-HP, INSERM UMRS 974, Pitié-Salpêtrière Hospital, Paris, France
| | - Michelle Rosenzwajg
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Immunology, Paris, France
| | - Charles Dolladille
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Joe-Elie Salem
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France.
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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7
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Sesé L, Borie R, Kannengiesser C, Cottin V, Israel-Biet D, Crestani B, Cadranel J, Chenivesse C, Boubaya M, Valeyre D, Annesi-Maesano I, Nunes H. Impact of Air Pollution and MUC5B Genotype on Survival in Idiopathic Pulmonary Fibrosis. Ann Am Thorac Soc 2024; 21:519-523. [PMID: 38096447 DOI: 10.1513/annalsats.202305-495rl] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
- Lucile Sesé
- Hôpital Avicenne Bobigny, France
- Université Sorbonne Paris Nord Bobigny, France
| | - Raphaël Borie
- Hôpital Bichat Paris, France
- Université Paris Cité Paris, France
| | | | - Vincent Cottin
- Hôpital Louis Pradel Lyon, France
- Université Claude Bernard Lyon 1 Lyon, France
- Institut National de Recherche pour l'Agriculture et l'Environnement Paris, France
- OrphaLung, member of Respifil, ERN-LUNG Lyon, France
| | | | | | | | | | | | - Dominique Valeyre
- Hôpital Avicenne Bobigny, France
- Université Sorbonne Paris Nord Bobigny, France
| | | | - Hilario Nunes
- Université Sorbonne Paris Nord Bobigny, France
- Hôpital Avicenne Paris, France
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8
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Godet C, Brun AL, Couturaud F, Laurent F, Frat JP, Marchand-Adam S, Gagnadoux F, Blanchard E, Taillé C, Philippe B, Hirschi S, Andréjak C, Bourdin A, Chenivesse C, Dominique S, Mangiapan G, Murris-Espin M, Rivière F, Garcia G, Blanc FX, Goupil F, Bergeron A, Flament T, Priou P, Mal H, de Keizer J, Ragot S, Cadranel J. CT Imaging Assessment of Response to Treatment in Allergic Bronchopulmonary Aspergillosis in Adults With Bronchial Asthma. Chest 2024:S0012-3692(24)00261-7. [PMID: 38387646 DOI: 10.1016/j.chest.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/10/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND One of the major challenges in managing allergic bronchopulmonary aspergillosis remains consistent and reproducible assessment of response to treatment. RESEARCH QUESTION What are the most relevant changes in CT scan parameters over time for assessing response to treatment? STUDY DESIGN AND METHODS In this ancillary study of a randomized clinical trial (NEBULAMB), patients with asthma with available CT scan and without exacerbation during a 4-month allergic bronchopulmonary aspergillosis exacerbation treatment period (corticosteroids and itraconazole) were included. Changed CT scan parameters were assessed by systematic analyses of CT scan findings at initiation and end of treatment. CT scans were assessed by two radiologists blinded to the clinical data. Radiologic parameters were determined by selecting those showing significant changes over time. Improvement of at least one, without worsening of the others, defined the radiologic response. Agreement between radiologic changes and clinical and immunologic responses was likewise investigated. RESULTS Among the 139 originally randomized patients, 132 were included. We identified five CT scan parameters showing significant changes at end of treatment: mucoid impaction extent, mucoid impaction density, centrilobular micronodules, consolidation/ground-glass opacities, and bronchial wall thickening (P < .05). These changes were only weakly associated with one another, except for mucoid impaction extent and density. No agreement was observed between clinical, immunologic, and radiologic responses, assessed as an overall response, or considering each of the parameters (Cohen κ, -0.01 to 0.24). INTERPRETATION Changes in extent and density of mucoid impaction, centrilobular micronodules, consolidation/ground-glass opacities, and thickening of the bronchial walls were found to be the most relevant CT scan parameters to assess radiologic response to treatment. A clinical, immunologic, and radiologic multidimensional approach should be adopted to assess outcomes, probably with a composite definition of response to treatment. TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT02273661; URL: www. CLINICALTRIALS gov).
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Affiliation(s)
- Cendrine Godet
- Université Paris Cité, Assistance Publique - Hôpitaux de Paris, Hôpital Bichat, Service de Pneumologie B et Transplantation pulmonaire, Paris, France.
| | | | - Francis Couturaud
- Université Brest, INSERM U1304-GETBO, CHU Brest, Département de Médecine Interne et Pneumologie, CIC INSERM 1412, CHU Brest, FCRIN INNOVTE, France
| | - François Laurent
- Université Bordeaux, INSERM, CRCTB, U 1045, F-33000 Bordeaux, France
| | - Jean-Pierre Frat
- Université Poitiers, INSERM, CIC 1402, IS-ALIVE, CHU Poitiers, Médecine Intensive Réanimation, Poitiers, France
| | - Sylvain Marchand-Adam
- Université François Rabelais, Tours, INSERM 1100, Tours, France; Service de pneumologie et explorations fonctionnelles respiratoires, CHRU de Tours, Tours, France
| | - Frédéric Gagnadoux
- Service de Pneumologie et Allergologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Elodie Blanchard
- Service de Pneumologie, CHU Bordeaux site Haut Lévêque Pessac, France
| | - Camille Taillé
- AP-HP Nord-Université Paris Cité, Hôpital Bichat, Service de Pneumologie et Centre de Référence constitutif des Maladies Pulmonaires Rares, INSERM, UMR 1152, Paris, France
| | | | - Sandrine Hirschi
- Service de Pneumologie, Centre de Compétence des Maladies Pulmonaires Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Claire Andréjak
- Université Picardie Jules Verne, UR 4294, CHU Amiens Picardie, Service de Pneumologie, Amiens, France
| | - Arnaud Bourdin
- Université Montpellier, INSERM, CNRS, CHU Montpellier, PhyMed Exp, Montpellier, France
| | - Cécile Chenivesse
- Université Lille, CNRS, INSERM, CHU Lille, U1019 - UMR9017 - CIIL - Center for Infection and Immunity of Lille, F-5900 Lille, France; CRISALIS, F-CRIN Network, INSERM US015, Toulouse, France
| | | | | | - Marlène Murris-Espin
- CHU de Toulouse, Service de Pneumologie, CRCM adulte et Transplantation pulmonaire, Clinique des Voies Respiratoires, Hôpital Larrey, Toulouse, France
| | - Frédéric Rivière
- Service de Pneumologie, Centre Hospitalier Universitaire Côte de Nacre, Caen, France
| | - Gilles Garcia
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; INSERM UMR-S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis-Robinson, France; Department of Respiratory and Intensive Care Medicine, Assistance Publique - Hôpitaux de Paris, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - François-Xavier Blanc
- Nantes Université, CHU Nantes, INSERM, Service de Pneumologie, CIC 1413, l'institut du thorax, Nantes, France
| | | | - Anne Bergeron
- Division of Pulmonology, Geneva University Hospitals, Geneva, Switzerland
| | - Thomas Flament
- Service de pneumologie et explorations fonctionnelles respiratoires, CHRU de Tours, Tours, France
| | - Pascaline Priou
- Service de Pneumologie et Allergologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Hervé Mal
- Université Paris Cité, Assistance Publique - Hôpitaux de Paris, Hôpital Bichat, Service de Pneumologie B et Transplantation pulmonaire, Paris, France
| | - Joe de Keizer
- Université Poitiers, INSERM, CIC-1402, Biostatistics, Poitiers, France, Faculté de Médecine et de Pharmacie de Poitiers, Poitiers, France
| | - Stéphanie Ragot
- Université Poitiers, INSERM, CIC-1402, Biostatistics, Poitiers, France, Faculté de Médecine et de Pharmacie de Poitiers, Poitiers, France
| | - Jacques Cadranel
- Université Paris Sorbonne, Assistance Publique - Hôpitaux de Paris, Hôpital Tenon, Service de Pneumologie et Oncologie Thoracique, Centre constitutif Maladies pulmonaires rares, Paris, France
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9
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Mabo A, Borie R, Wemeau-Stervinou L, Uzunhan Y, Gomez E, Prevot G, Reynaud-Gaubert M, Traclet J, Bergot E, Cadranel J, Marchand-Adam S, Bergeron A, Blanchard E, Bondue B, Bonniaud P, Bourdin A, Burgel PR, Hirschi S, Marquette CH, Quétant S, Nunes H, Chenivesse C, Crestani B, Guirriec Y, Monnier D, Ménard C, Tattevin P, Cottin V, Luque Paz D, Jouneau S. Infections in autoimmune pulmonary alveolar proteinosis: a large retrospective cohort. Thorax 2023; 79:68-74. [PMID: 37758458 DOI: 10.1136/thorax-2023-220040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/19/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease, predisposing to an increased risk of infection. A complete picture of these infections is lacking. RESEARCH QUESTION Describe the characteristics and clinical outcomes of patients diagnosed with aPAP, and to identify risk factors associated with opportunistic infections. METHODS We conducted a retrospective cohort including all patients diagnosed with aPAP between 2008 and 2018 in France and Belgium. Data were collected using a standardised questionnaire including demographics, comorbidities, imaging features, outcomes and microbiological data. RESULTS We included 104 patients, 2/3 were men and median age at diagnosis was 45 years. With a median follow-up of 3.4 years (IQR 1.7-6.6 years), 60 patients (58%), developed at least one infection, including 23 (22%) with opportunistic infections. Nocardia spp was the main pathogen identified (n=10). Thirty-five (34%) patients were hospitalised due to infection. In univariate analysis, male gender was associated with opportunistic infections (p=0.04, OR=3.88; 95% CI (1.02 to 22.06)). Anti-granulocyte macrophage colony-stimulating factor antibody titre at diagnosis was significantly higher among patients who developed nocardiosis (1058 (316-1591) vs 580 (200-1190), p=0.01). Nine patients had died (9%), but only one death was related to infection. INTERPRETATION Patients with aPAP often presented with opportunistic infections, especially nocardiosis, which highlights the importance of systematic search for slow-growing bacteria in bronchoalveolar lavage or whole lung lavage.
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Affiliation(s)
- Axelle Mabo
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Raphael Borie
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Service de Pneumologie A, Hopital Bichat, APHP, Paris, France
| | - Lidwine Wemeau-Stervinou
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Institut Cœur-Poumon, Service de Pneumologie et Immuno-Allergologie, CHRU Lille, Lille, France
| | - Yurdagül Uzunhan
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Service de Pneumologie, Hôpital Avicenne, APHP, Bobigny, France
| | - Emmanuel Gomez
- Centre de Compétence pour les Maladies Pulmonaires Rares, Département de Pneumologie, Hôpitaux de Brabois, CHRU de Nancy, Vandoeuvre-les Nancy, France
| | - Gregoire Prevot
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Larry, CHU Toulouse, Toulouse, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie et Transplantation Pulmonaire, Centre de Compétences des Maladies Rares Pulmonaires et de l'Hypertension Pulmonaire, CHU Nord de Marseille, AP-HM, Aix Marseille Université, Marseille, France
| | - Julie Traclet
- Service de Pneumologie, Centre National Coordonnateur de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), UMR754, INRAE, Université Lyon 1, ERN-LUNG, Lyon, France
| | - Emmanuel Bergot
- Centre de Compétence pour les Maladies Pulmonaires Rares de l'Adulte, Service de Pneumologie et Oncologie Thoracique, Hôpital Côte de Nacre, CHU de Caen, Caen, France
| | - Jacques Cadranel
- Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares, Hôpital Tenon, APHP, Sorbonne Université, Paris, France
| | - Sylvain Marchand-Adam
- Service de Pneumologie, CHRU de Tours, Université François Rabelais de Tours, INSERM U1100, Tours, France
| | - Anne Bergeron
- Service de Pneumologie, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - Elodie Blanchard
- Service de Pneumologie, centre de compétence pour les maladies pulmonaires rares, CHU de Bordeaux, Pessac, France
| | - Benjamin Bondue
- Service de Pneumologie, CUB Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Philippe Bonniaud
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adulte, CHU Dijon-Bourgogne, Inserm U123, Université de Bourgogne, Dijon, France
| | - Arnaud Bourdin
- Service de Pneumologie, CHU Montpellier, Université de Montpellier, Inserm U1046, Montpellier, France
| | - Pierre Regis Burgel
- Service de Pneumologie, Hopital Cochin Pneumologie, AP-HP, Université Paris Cité Paris, Paris, France
| | - Sandrine Hirschi
- Service de Pneumologie et Transplantation Pulmonaire, Hopitaux universitaires de Strasbourg, Strasbourg, France
| | - Charles Hugo Marquette
- Service de Pneumologie, CHU Nice, Fédération Hospitalo-Universitaire OncoAge, Nice, France
| | - Sébastien Quétant
- Service Hospitalo-Universitaire de Pneumologie et Physiologie, Pôle Thorax et Vaisseaux, CHU de Grenoble-Alpes, La Tronche, Grenoble, France
| | - Hilario Nunes
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Service de Pneumologie, Hôpital Avicenne, APHP, Bobigny, France
| | - Cécile Chenivesse
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Institut Cœur-Poumon, Service de Pneumologie et Immuno-Allergologie, CHRU Lille, Lille, France
| | - Bruno Crestani
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Service de Pneumologie A, Hopital Bichat, APHP, Paris, France
| | - Yoann Guirriec
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Delphine Monnier
- Service d'Immunologie, Laboratoire de Biologie Médicale de Référence Lipoprotéinose Alvéolaire, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Cédric Ménard
- Service d'Immunologie, Laboratoire de Biologie Médicale de Référence Lipoprotéinose Alvéolaire, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Pierre Tattevin
- Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Inserm U1230, Université de Rennes, Rennes, France
| | - Vincent Cottin
- Service de Pneumologie, Centre National Coordonnateur de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), UMR754, INRAE, Université Lyon 1, ERN-LUNG, Lyon, France
| | - David Luque Paz
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Rennes, France
- Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Inserm U1230, Université de Rennes, Rennes, France
| | - Stéphane Jouneau
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Rennes, France
- Inserm UMR1085 IRSET, Université de Rennes, EHESP, Rennes, France
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10
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Benusiglio PR, Dardenne A, Fallet V, Cadranel J. Emerging cancer risks in BRCA2 pathogenic germline variant carriers. Eur J Hum Genet 2023; 31:1355-1356. [PMID: 37758835 PMCID: PMC10689811 DOI: 10.1038/s41431-023-01465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Affiliation(s)
- Patrick R Benusiglio
- Sorbonne Université, UF d'Oncogénétique Clinique, Département de Génétique Médicale, Hôpital Pitié-Salpêtrière, AP-HP, 47-83 Boulevard de l'Hôpital, F-75013, Paris, France.
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine (CRSA), Equipe Instabilité des Microsatellites et Cancer, F-75012, Paris, France.
| | - Antoine Dardenne
- Sorbonne Université, Service de Chirurgie Digestive, Hôpital Saint-Antoine, APHP, F-75012, Paris, France
| | - Vincent Fallet
- Sorbonne Université, GRC-04 Theranoscan et Service de Pneumologie et Oncologie Thoracique, Hôpital Tenon, APHP, F-75020, Paris, France
| | - Jacques Cadranel
- Sorbonne Université, GRC-04 Theranoscan et Service de Pneumologie et Oncologie Thoracique, Hôpital Tenon, APHP, F-75020, Paris, France
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11
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Dehem A, Mazieres J, Chour A, Guisier F, Ferreira M, Boussageon M, Girard N, Moro-Sibilot D, Cadranel J, Zalcman G, Ricordel C, Wislez M, Munck C, Poulet C, Gauvain C, Descarpentries C, Wasielewski E, Cortot AB, Baldacci S. Characterization of 164 patients with NRAS mutated non-small cell lung cancer (NSCLC). Lung Cancer 2023; 186:107393. [PMID: 37839252 DOI: 10.1016/j.lungcan.2023.107393] [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: 07/16/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND NRAS mutations are observed in less than 1% of non-small cell lung cancer (NSCLC). Clinical data regarding this rare subset of lung cancer are scarce and response to systemic treatment such as chemotherapy or immune checkpoint inhibitors (ICI) has never been reported. METHODS All consecutive patients with an NRAS mutated NSCLC, diagnosed between August 2014 and November 2020 in 14 French centers, were included. Clinical and molecular data were collected and reviewed from medical records. RESULTS Out of the 164 included patients, 106 (64.6%) were men, 150 (91.5%) were current or former smokers, and 104 (63.4%) had stage IV NSCLC at diagnosis. The median age was 62 years, and the most frequent histology was adenocarcinoma (81.7%). NRAS activating mutations were mostly found in codon 61 (70%), while codon 12 and 13 alterations were observed in 16.5% and 4.9% of patients, respectively. Programmed death ligand-1 expression level <1%/1-49%/≥50% were respectively found in 30.8%/27.1%/42.1% of tumors. With a median follow-up of 12.5 months, median overall survival (OS) of stage IV patients was 15.3 months (95% CI 9.9-27.6). No significant difference in OS was found according to the type of mutation (codon 61 vs. other), HR = 1.12 (95% CI 0.65-1.95). Among stage IV patients treated with platinum-based doublet (n = 66), ICI (n = 48), or combination of both (n = 10), objective response rate, and median progression free survival were respectively 45% and 5.8 months, 35% and 6.9 months, 70% and 8.6 months. CONCLUSION NRAS mutated NSCLC are characterized by a high frequency of smoking history and codon 61 mutations. Further studies are needed to confirm the encouraging outcome of immunotherapy in combination with chemotherapy.
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Affiliation(s)
- Agathe Dehem
- Univ. Lille, CHU Lille, Thoracic Oncology Department, F-59000 Lille, France
| | - Julien Mazieres
- Thoracic Oncology, Respiratory Department, Centre Hospitalier Universitaire de Toulouse - Hôpital Larrey, Toulouse, France
| | - Ali Chour
- Respiratory Department, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, Lyon, France; Oncopharmacology Laboratory, Cancer Research Center of Lyon, UMR INSERM 1052 CNRS 5286, Lyon, France; Université Claude Bernard, Université de Lyon, Lyon, France
| | - Florian Guisier
- Department of Pneumology, Hôpital Charles-Nicolle - CHU de Rouen, Rouen, France
| | - Marion Ferreira
- Department of Pneumology and Respiratory Functional Exploration, University Hospital of Tours, Tours, France
| | | | - Nicolas Girard
- Thorax Institute, Institut Curie, Paris, France and Paris Saclay, UVSQ, UFR Simone Veil, Versailles, France
| | | | - Jacques Cadranel
- Pneumology and Thoracic Oncology department, APHP Paris - Hôpital Tenon and Sorbonne University, Paris, France
| | - Gérard Zalcman
- Université Paris Cité, Institut du Cancer AP-HP.Nord, Thoracic Oncology Department, CIC INSERM 1425, Hôpital Bichat Claude Bernard, Paris, France
| | | | - Marie Wislez
- Oncology Thoracic Unit Pulmonology Department, Hôpital Cochin, APHP, Paris, France
| | - Camille Munck
- Pneumologie, Hôpital Saint Vincent de Paul, Lille, France
| | - Claire Poulet
- Pneumology department, CHU Amiens-Picardie - Site Sud, Amiens, France
| | - Clément Gauvain
- Univ. Lille, CHU Lille, Thoracic Oncology Department, F-59000 Lille, France
| | - Clotilde Descarpentries
- Department of Biochemistry and Molecular Biology « Hormonology Metabolism Nutrition Oncology », CHU lille, F-59000 Lille, France
| | - Eric Wasielewski
- Univ. Lille, CHU Lille, Thoracic Oncology Department, F-59000 Lille, France
| | - Alexis B Cortot
- Univ. Lille, CHU Lille, Thoracic Oncology Department, CNRS, Inserm, Institut Pasteur de Lille, UMR9020 - UMR-S 1277 - Canther, F-59000 Lille, France
| | - Simon Baldacci
- Univ. Lille, CHU Lille, Thoracic Oncology Department, CNRS, Inserm, Institut Pasteur de Lille, UMR9020 - UMR-S 1277 - Canther, F-59000 Lille, France.
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12
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Mawet M, Basse C, Barrois M, Gligorov J, Cadranel J, Chabbert-Buffet N, Selleret L. Second-trimester medical abortion after exposure to lorlatinib during early pregnancy, a case report. J Gynecol Obstet Hum Reprod 2023; 52:102673. [PMID: 37777070 DOI: 10.1016/j.jogoh.2023.102673] [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: 04/28/2023] [Revised: 09/08/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023]
Abstract
Use of Lorlatinib, a third-generation tyrosine kinase inhibitor currently indicated in the treatment of non-small-cell lung cancer (NSCLC) with ALK or ROS1 gene fusion, is formally contra-indicated during pregnancy due to teratogenic effects observed during pre-clinical studies. We report the case of a 38-year-old woman with a ROS1-positive NSCLC, successfully treated with lorlatinib as second line therapy, who became pregnant while on treatment. Due to significant disease progression 12 weeks after lorlatinib stop and the great uncertainty on the pregnancy outcome, she finally decided to interrupt the pregnancy at 22 weeks of gestation. Echography and gross infant examination did not reveal any malformation. Pregnancies occurring under this kind of new oncologic treatment is expected to happen more frequently in the future. It seems therefore important to us to report any information on the topic to increase our level of knowledge and improve decision-making.
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Affiliation(s)
- Marie Mawet
- Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France; Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Liège, 4000, Liège, Belgique.
| | - Clémence Basse
- Institut du Thorax Curie Montsouris, 75005, Paris, France
| | - Mathilde Barrois
- Department of Gynecology and Obstetrics, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014, Paris, France
| | - Joseph Gligorov
- Department of Oncology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France
| | - Jacques Cadranel
- Department of Oncology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France
| | - Nathalie Chabbert-Buffet
- Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France
| | - Lise Selleret
- Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France
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13
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Fenioux C, Abbar B, Boussouar S, Bretagne M, Power JR, Moslehi JJ, Gougis P, Amelin D, Dechartres A, Lehmann LH, Courand PY, Cautela J, Alexandre J, Procureur A, Rozes A, Leonard-Louis S, Qin J, Cheynier R, Charmeteau-De Muylder B, Redheuil A, Tubach F, Cadranel J, Milon A, Ederhy S, Similowski T, Johnson DB, Pizzo I, Catalan T, Benveniste O, Hayek SS, Allenbach Y, Rosenzwajg M, Dolladille C, Salem JE. Thymus alterations and susceptibility to immune checkpoint inhibitor myocarditis. Nat Med 2023; 29:3100-3110. [PMID: 37884625 DOI: 10.1038/s41591-023-02591-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023]
Abstract
Immune checkpoint inhibitors (ICI) have transformed the therapeutic landscape in oncology. However, ICI can induce uncommon life-threatening autoimmune T-cell-mediated myotoxicities, including myocarditis and myositis. The thymus plays a critical role in T cell maturation. Here we demonstrate that thymic alterations are associated with increased incidence and severity of ICI myotoxicities. First, using the international pharmacovigilance database VigiBase, the Assistance Publique Hôpitaux de Paris-Sorbonne University data warehouse (Paris, France) and a meta-analysis of clinical trials, we show that ICI treatment of thymic epithelial tumors (TET, and particularly thymoma) was more frequently associated with ICI myotoxicities than other ICI-treated cancers. Second, in an international ICI myocarditis registry, we established that myocarditis occurred earlier after ICI initiation in patients with TET (including active or prior history of TET) compared to other cancers and was more severe in terms of life-threatening arrythmias and concurrent myositis, leading to respiratory muscle failure and death. Lastly, we show that presence of anti-acetylcholine-receptor antibodies (a biological proxy of thymic-associated autoimmunity) was more prevalent in patients with ICI myocarditis than in ICI-treated control patients. Altogether, our results highlight that thymic alterations are associated with incidence and seriousness of ICI myotoxicities. Clinico-radio-biological workup evaluating the thymus may help in predicting ICI myotoxicities.
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Affiliation(s)
- Charlotte Fenioux
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
- Hôpitaux de Paris, Henri Mondor Hospital, Department of Oncology, Créteil, France
| | - Baptiste Abbar
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Oncology, Paris, France
| | - Samia Boussouar
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Radiology, Paris, France
| | - Marie Bretagne
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - John R Power
- Department of Medecine, University of California, San Diego, San Diego, CA, USA
| | - Javid J Moslehi
- Department of Medecine, University of California, San Francisco, San Francisco, CA, USA
| | - Paul Gougis
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Damien Amelin
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Lorenz H Lehmann
- Department of Cardiology, University Hospital Heidelberg; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pierre-Yves Courand
- Fédération de Cardiologie, IMMUCARE, Hôpital de La Croix-Rousse Et Hôpital Lyon Sud, Hospices Civils de Lyon; Université de Lyon, CREATIS UMR INSERM U1044, INSA, Lyon, France
| | - Jennifer Cautela
- Aix-Marseille University, University Mediterranean Center of Cardio-Oncology, Unit of Heart Failure and Valvular Heart Diseases, Center for Cardiovascular and Nutrition Research, INSERM 1263, INRAE 1260, Nord Hospital, Assistance Publique-Hôpitaux de Marseille, Paris, France
| | - Joachim Alexandre
- CHU de Caen Normandie, Department of Pharmacology, Pharmacoepidemiology Unit; Normandie Université, UNICAEN, INSERM U1086 ANTICIPE Centre François Baclesse, Caen, France
| | - Adrien Procureur
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Antoine Rozes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Sarah Leonard-Louis
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Laboratoire de Neuropathologie, Paris, France
| | - Juan Qin
- Department of Medecine, University of California, San Francisco, San Francisco, CA, USA
| | - Rémi Cheynier
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | | | - Alban Redheuil
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Radiology, Paris, France
| | - Florence Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Jacques Cadranel
- Hôpitaux de Paris, Tenon Hospital, Department of Pulmonology and Thoracic Oncology and GRC Theranoscan Sorbonne University, Paris, France
| | - Audrey Milon
- Hôpitaux de Paris, Tenon Hospital, Department of Radiology, Paris, France
| | - Stéphane Ederhy
- Hôpitaux de Paris, Saint-Antoine Hospital, Department of Cardiology, Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS 1158 Neurophysiologie respiratoire expérimentale et clinique'; Assistance Publique -Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 'Département R3S', Paris, France
| | - Douglas B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ian Pizzo
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Toniemarie Catalan
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Olivier Benveniste
- Department of Internal Medicine, Sorbonne University, AP-HP, INSERM UMRS 974, Pitié-Salpêtrière Hospital, Paris, France
| | - Salim S Hayek
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Yves Allenbach
- Department of Internal Medicine, Sorbonne University, AP-HP, INSERM UMRS 974, Pitié-Salpêtrière Hospital, Paris, France
| | - Michelle Rosenzwajg
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Immunology, Paris, France
| | - Charles Dolladille
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Joe-Elie Salem
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France.
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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14
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Fenioux C, Abbar B, Boussouar S, Bretagne M, Power JR, Moslehi JJ, Gougis P, Amelin D, Dechartres A, Lehmann LH, Courand PY, Cautela J, Alexandre J, Procureur A, Rozes A, Leonard-Louis S, Qin J, Cheynier R, Charmeteau-De Muylder B, Redheuil A, Tubach F, Cadranel J, Milon A, Ederhy S, Similowski T, Johnson DB, Pizzo I, Catalan T, Benveniste O, Hayek SS, Allenbach Y, Rosenzwajg M, Dolladille C, Salem JE. Author Correction: Thymus alterations and susceptibility to immune checkpoint inhibitor myocarditis. Nat Med 2023:10.1038/s41591-023-02690-0. [PMID: 38012317 DOI: 10.1038/s41591-023-02690-0] [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: 11/29/2023]
Affiliation(s)
- Charlotte Fenioux
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
- Hôpitaux de Paris, Henri Mondor Hospital, Department of Oncology, Créteil, France
| | - Baptiste Abbar
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Oncology, Paris, France
| | - Samia Boussouar
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Radiology, Paris, France
| | - Marie Bretagne
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - John R Power
- Department of Medecine, University of California, San Diego, San Diego, CA, USA
| | - Javid J Moslehi
- Department of Medecine, University of California, San Francisco, San Francisco, CA, USA
| | - Paul Gougis
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Damien Amelin
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Lorenz H Lehmann
- Department of Cardiology, University Hospital Heidelberg; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pierre-Yves Courand
- Fédération de Cardiologie, IMMUCARE, Hôpital de La Croix-Rousse Et Hôpital Lyon Sud, Hospices Civils de Lyon; Université de Lyon, CREATIS UMR INSERM U1044, INSA, Lyon, France
| | - Jennifer Cautela
- Aix-Marseille University, University Mediterranean Center of Cardio-Oncology, Unit of Heart Failure and Valvular Heart Diseases, Center for Cardiovascular and Nutrition Research, INSERM 1263, INRAE 1260, Nord Hospital, Assistance Publique-Hôpitaux de Marseille, Paris, France
| | - Joachim Alexandre
- CHU de Caen Normandie, Department of Pharmacology, Pharmacoepidemiology Unit; Normandie Université, UNICAEN, INSERM U1086 ANTICIPE Centre François Baclesse, Caen, France
| | - Adrien Procureur
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Antoine Rozes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Sarah Leonard-Louis
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Laboratoire de Neuropathologie, Paris, France
| | - Juan Qin
- Department of Medecine, University of California, San Francisco, San Francisco, CA, USA
| | - Rémi Cheynier
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | | | - Alban Redheuil
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Radiology, Paris, France
| | - Florence Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Jacques Cadranel
- Hôpitaux de Paris, Tenon Hospital, Department of Pulmonology and Thoracic Oncology and GRC Theranoscan Sorbonne University, Paris, France
| | - Audrey Milon
- Hôpitaux de Paris, Tenon Hospital, Department of Radiology, Paris, France
| | - Stéphane Ederhy
- Hôpitaux de Paris, Saint-Antoine Hospital, Department of Cardiology, Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS 1158 Neurophysiologie respiratoire expérimentale et clinique'; Assistance Publique -Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 'Département R3S', Paris, France
| | - Douglas B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ian Pizzo
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Toniemarie Catalan
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Olivier Benveniste
- Department of Internal Medicine, Sorbonne University, AP-HP, INSERM UMRS 974, Pitié-Salpêtrière Hospital, Paris, France
| | - Salim S Hayek
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Yves Allenbach
- Department of Internal Medicine, Sorbonne University, AP-HP, INSERM UMRS 974, Pitié-Salpêtrière Hospital, Paris, France
| | - Michelle Rosenzwajg
- Hôpitaux de Paris, Pitié Salpêtrière Hospital, Department of Immunology, Paris, France
| | - Charles Dolladille
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France
| | - Joe-Elie Salem
- Sorbonne Université, INSERM, CIC-1901 Paris-Est, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, Paris, France.
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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15
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Sidali S, Borie R, Sicre de Fontbrune F, El Husseini K, Rautou PE, Lainey E, Goria O, Crestani B, Cadranel J, Cottin V, Bunel V, Dumortier J, Jacquemin E, Reboux N, Hirschi S, Bourdin A, Meszaros M, Dharancy S, Hilaire S, Mallet V, Reynaud-Gaubert M, Terriou L, Gottrand F, Abou Chahla W, Khan JE, Carrier P, Saliba F, Rubbia-Brandt L, Aubert JD, Elkrief L, de Lédinghen V, Abergel A, Olivier T, Houssel P, Jouneau S, Wemeau L, Bergeron A, Leblanc T, Ollivier-Hourmand I, Nguyen Khac E, Morisse-Pradier H, Ba I, Boileau C, Roudot-Thoraval F, Vilgrain V, Bureau C, Nunes H, Naccache JM, Durand F, Francoz C, Roulot D, Valla D, Paradis V, Kannengiesser C, Plessier A. Liver disease in germline mutations of telomere-related genes: Prevalence, clinical, radiological, pathological features, outcome, and risk factors. Hepatology 2023:01515467-990000000-00633. [PMID: 37934624 DOI: 10.1097/hep.0000000000000667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND AND AIM Germline mutations of telomere-related genes (TRG) induce multiorgan dysfunction, and liver-specific manifestations have not been clearly outlined. We aimed to describe TRG mutations-associated liver diseases. APPROACH AND RESULTS Retrospective multicenter analysis of liver disease (transaminases > 30 IU/L and/or abnormal liver imaging) in patients with TRG mutations. Main measurements were characteristics, outcomes, and risk factors of liver disease in a TRG mutations cohort. The prevalence of liver disease was compared to a community-based control group (n = 1190) stratified for age and matched 1:3 for known risk factors of liver disease. Among 132 patients with TRG mutations, 95 (72%) had liver disease, with associated lung, blood, skin, rheumatological, and ophthalmological TRG diseases in 82%, 77%, 55%, 39%, and 30% of cases, respectively. Liver biopsy was performed in 52/95 patients, identifying porto-sinusoidal vascular disease in 48% and advanced fibrosis/cirrhosis in 15%. After a follow-up of 21 months (12-54), ascites, hepato-pulmonary syndrome, variceal bleeding, and HCC occurred in 14%, 13%, 13%, and 2% of cases, respectively. Five-year liver transplantation-free survival was 69%. A FIB-4 score ≥ 3·25 and ≥1 risk factor for cirrhosis were associated with poor liver transplantation-free survival. Liver disease was more frequent in patients with TRG mutations than in the paired control group [80/396, (20%)], OR 12.9 (CI 95%: 7.8-21.3, p < 0.001). CONCLUSIONS TRG mutations significantly increase the risk of developing liver disease. Although symptoms may be mild, they may be associated with severe disease. Porto-sinusoidal vascular disease and cirrhosis were the most frequent lesions, suggesting that the mechanism of action is multifactorial.
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Affiliation(s)
- Sabrina Sidali
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Hépato-Gastroentérologie, Rouen, France
| | - Raphaël Borie
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | - Flore Sicre de Fontbrune
- Hematology Transplant Unit, Hôpital Saint louis, APHP, Paris, France, and French National Referral Center for Aplastic Anemia, CRMR
| | - Kinan El Husseini
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Pneumologie, Rouen, France
| | - Pierre-Emmanuel Rautou
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | - Odile Goria
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Hépato-Gastroentérologie, Rouen, France
| | - Bruno Crestani
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | | | - Vincent Cottin
- Centre Hospitalier Universitaire Lyon Sud, Pneumologie, Pierre-Bénite, France
| | - Vincent Bunel
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | | | - Emmanuel Jacquemin
- Hôpital Kremlin-Bicêtre AP-HP, Hépatologie Pédiatrique, Le Kremlin-Bicêtre, France
| | - Noémi Reboux
- Centre Hospitalier Régional Universitaire Morvan, Hépatologie, Brest, France
| | - Sandrine Hirschi
- Centre Hospitalier Universitaire de Strasbourg, Pneumologie, Strasbourg, France
| | - Arnaud Bourdin
- Centre Hospitalier Universitaire de Montpellier, Pneumologie, Montpellier, France
| | - Magdalena Meszaros
- Centre Hospitalier Universitaire de Montpellier, Hépatologie, Montpellier, France
| | - Sebastien Dharancy
- Centre Hospitalier Régional Universitaire de Lille, Hépatologie, Lille, France
| | | | | | | | - Louis Terriou
- Centre Hospitalier Régional Universitaire de Lille, Médecine interne- Hématologie, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, CHU Lille, Department of pediatric gastroenterology hepatology and nutrition, Inserm, Lille, France
| | - Wadih Abou Chahla
- Centre Hospitalier Régional Universitaire de Lille, Hémato-Pédiatrie, Lille, France
| | | | - Paul Carrier
- Hôpital Universitaire Dupuytren, Hépatologie, Limoges, France
| | - Faouzi Saliba
- Hôpital Paul-Brousse, AP-HP, Hépatologie, Villejuif, France
| | | | - John-David Aubert
- Centre Hospitalier Universitaire Vaudois, Pneumologie, Lausanne, Suisse
| | - Laure Elkrief
- Centre Hospitalier Régional Universitaire de Tours, Hépatologie, Tours, France
| | - Victor de Lédinghen
- Centre Hospitalier Universitaire - Haut-Lévêque, Hépatologie, Pessac, France
| | - Armand Abergel
- Centre Hospitalier Universitaire, Hépatologie, Clermont-Ferrand, France
| | | | - Pauline Houssel
- Centre Hospitalier Universitaire, Hépatologie, Rennes, France
| | | | - Lidwine Wemeau
- Centre Hospitalier Régional Universitaire de Lille, Pneumologie, Lille, France
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève (HUG), Pneumologie, Genève, Suisse
| | - Thierry Leblanc
- Hematology Transplant Unit, Hôpital Saint louis, APHP, Paris, France, and French National Referral Center for Aplastic Anemia, CRMR
| | | | - Eric Nguyen Khac
- Centre Hospitalier Universitaire Amiens-Picardie Site Sud, Hépatologie, Amiens, France
| | | | - Ibrahima Ba
- Hôpital Bichat-Claude Bernard AP-HP, Génétique, Paris, France
| | | | | | | | | | - Hilario Nunes
- Hôpital Avicenne AP-HP, Pneumologie, Bobigny, France
| | | | - François Durand
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | - Claire Francoz
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | - Dominique Valla
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | | | - Aurélie Plessier
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
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Guerra X, Rennotte S, Fetita C, Boubaya M, Debray MP, Israël-Biet D, Bernaudin JF, Valeyre D, Cadranel J, Naccache JM, Nunes H, Brillet PY. U-net convolutional neural network applied to progressive fibrotic interstitial lung disease: Is progression at CT scan associated with a clinical outcome? Respir Med Res 2023; 85:101058. [PMID: 38141579 DOI: 10.1016/j.resmer.2023.101058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/18/2023] [Accepted: 10/17/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Computational advances in artificial intelligence have led to the recent emergence of U-Net convolutional neural networks (CNNs) applied to medical imaging. Our objectives were to assess the progression of fibrotic interstitial lung disease (ILD) using routine CT scans processed by a U-Net CNN developed by our research team, and to identify a progression threshold indicative of poor prognosis. METHODS CT scans and clinical history of 32 patients with idiopathic fibrotic ILDs were retrospectively reviewed. Successive CT scans were processed by the U-Net CNN and ILD quantification was obtained. Correlation between ILD and FVC changes was assessed. ROC curve was used to define a threshold of ILD progression rate (PR) to predict poor prognostic (mortality or lung transplantation). The PR threshold was used to compare the cohort survival with Kaplan Mayer curves and log-rank test. RESULTS The follow-up was 3.8 ± 1.5 years encompassing 105 CT scans, with 3.3 ± 1.1 CT scans per patient. A significant correlation between ILD and FVC changes was obtained (p = 0.004, ρ = -0.30 [95% CI: -0.16 to -0.45]). Sixteen patients (50%) experienced unfavorable outcome including 13 deaths and 3 lung transplantations. ROC curve analysis showed an aera under curve of 0.83 (p < 0.001), with an optimal cut-off PR value of 4%/year. Patients exhibiting a PR ≥ 4%/year during the first two years had a poorer prognosis (p = 0.001). CONCLUSIONS Applying a U-Net CNN to routine CT scan allowed identifying patients with a rapid progression and unfavorable outcome.
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Affiliation(s)
- Xavier Guerra
- Department of Radiology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France.
| | - Simon Rennotte
- Samovar Laboratory, Télécom SudParis, Institut Polytechnique de Paris, Evry, France
| | - Catalin Fetita
- Samovar Laboratory, Télécom SudParis, Institut Polytechnique de Paris, Evry, France
| | - Marouane Boubaya
- Clinical Research Unit, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Sorbonne Paris-Nord, Bobigny, France
| | - Marie-Pierre Debray
- Department of Radiology, Bichat-Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Dominique Israël-Biet
- Department of Pulmonology, Georges Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Université Paris - Cité, Paris, France
| | - Jean-François Bernaudin
- INSERM UMR 1272 Hypoxie & Poumon SMBH, Université Sorbonne Paris - Nord, Bobigny, France; Medicine Sorbonne Université, Paris, France
| | - Dominique Valeyre
- INSERM UMR 1272 Hypoxie & Poumon SMBH, Université Sorbonne Paris - Nord, Bobigny, France; Department of Pulmonology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Jacques Cadranel
- Medicine Sorbonne Université, Paris, France; Department of Pulmonology, Tenon Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-Marc Naccache
- Department of Pulmonology, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Hilario Nunes
- INSERM UMR 1272 Hypoxie & Poumon SMBH, Université Sorbonne Paris - Nord, Bobigny, France; Department of Pulmonology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Pierre-Yves Brillet
- Department of Radiology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France; INSERM UMR 1272 Hypoxie & Poumon SMBH, Université Sorbonne Paris - Nord, Bobigny, France
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17
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Letellier A, Rolland-Debord C, Luque-Paz D, Milon A, Choinier P, Blin E, Halitim P, Bravais J, Lefèvre G, Parrot A, Piéroni L, Cadranel J. Prognostic value of serum Krebs von den Lungen-6 (KL-6) levels in COVID-19 pneumonia. Respir Med Res 2023; 84:101054. [PMID: 37897878 DOI: 10.1016/j.resmer.2023.101054] [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: 12/26/2022] [Revised: 07/23/2023] [Accepted: 09/30/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND AND OBJECTIVES Krebs von den Lungen-6 (KL-6), expressed by damaged type II pneumocytes, is useful in the diagnosis and severity assessment of many diffuse interstitial lung diseases. The objective of our study was to determine the prognostic value of the initial KL-6 plasma level in COVID-19 pneumonia. METHODS All patients hospitalized for a suspected COVID-19 pneumonia between March and May 2020 in our Chest department of a French university hospital were included. KL-6 serum concentrations were measured within 72 h of diagnostic suspicion by chemiluminescence enzyme immunoassay Survival analysis was performed using a Cox regression and modeled by a Kaplan-Meier curve. RESULTS Sixty-six COVID-19 patients (average age = 64 ± 14 years, 71.2 % males) with KL-6 serum measurement were included. Median KL-6 serum concentration was 409 ± 312 U/mL. KL-6 was significantly higher in men (p = 0.003), elders (p = 0.0001) and in patients with greater Charlson's score (p = 0.002). Higher KL-6 concentration was significantly associated with in-hospital mortality (HR: 8.66; 95 % CI:1.1-69.2, p = 0.014), radiological extension of lesions on chest CT scan (p = 0.004) and higher WHO severity score (p = 0.042), but not with admission in intensive care unit. In 9 (14 %) non-surviving COVID-19 patients, KL-6 serum concentration increased whereas it remained stable or decreased in survivors. At 3 months follow-up (n = 48), DLCO was negatively correlated with the initial KL-6 value (r = 0.47, p = 0.001), while FVC, FEV1 and MRC score were not. CONCLUSION Initial KL-6 serum concentration is significantly associated with in-hospital mortality, unfavorable outcome, and persistent impairment of DLCO at 3 months. Initial KL-6 plasma determination appears as a prognostic biomarker in COVID-19 pneumonia.
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Affiliation(s)
- Alice Letellier
- Department of Pulmonology and Thoracic Oncology, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - Camille Rolland-Debord
- Department of Pulmonology and Thoracic Oncology, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - David Luque-Paz
- Department of Infectious Diseases and Intensive Care Unit, Pontchaillou Hospital, CHU Rennes, 2 rue Henri Guilloux, 35000 Rennes, France
| | - Audrey Milon
- Radiology Department, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine,75920 Paris, France
| | - Pascaline Choinier
- Department of Pulmonology and Thoracic Oncology, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - Emmanuelle Blin
- Department of Pulmonology and Thoracic Oncology, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - Pierre Halitim
- Department of Pulmonology and Thoracic Oncology, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - Juliette Bravais
- Department of Pulmonology and Thoracic Oncology, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - Guillaume Lefèvre
- Biochemistry Department, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - Antoine Parrot
- Department of Pulmonology and Thoracic Oncology, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - Laurence Piéroni
- Biochemistry Department, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France
| | - Jacques Cadranel
- Department of Pulmonology and Thoracic Oncology, AP-HP Tenon Hospital, Sorbonne University, 4 rue de la Chine, 75920 Paris, France.
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18
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Lasvergnas J, Fallet V, Duchemann B, Jouveshomme S, Cadranel J, Chouaïd C. PDL1-status predicts primary resistance of metastatic, EGFR-mutated non small cell lung cancers to EGFR tyrosine-kinase inhibitors. Respir Med Res 2023; 84:101018. [PMID: 37302160 DOI: 10.1016/j.resmer.2023.101018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/06/2023] [Revised: 04/03/2023] [Accepted: 04/16/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND EGFR tyrosine-kinase inhibitors (TKIs) are the reference treatment for metastatic, EGFR-mutated, non-small-cell lung cancers (EGFRm NSCLCs). However, 16-20% of those tumors progress early (3-6 months) and factors predicting that resistance are unknown. This study was undertaken to examine PDL1 status as such a factor. METHODS This retrospective analysis included metastatic, EGFRm-NSCLC patients who received first-line 1st-, 2nd- or 3rd-generation EGFR TKIs with PDL1 expression determined in pretreatment biopsies. Kaplan-Meier estimations of probabilities of progression-free survival (PFS) and overall survival (OS) were compared with log-rank test, and logistic-regression analyses. RESULTS PDL1 status of the 145 included patients was ≥1% (47%), 1-49% (33%) or ≥50% (14%). For PDL1-positive vs PDL1-negative patients, respectively, median PFS lasted 8 (95% CI: 6-12) vs 12 (95% CI: 11-17) months (p = 0.008), with 18% vs. 8% (NS) of NSCLCs progressing at 3 months, and 47% vs. 18% (HR 0.25 [95% CI 0.10-0.566], p<0.001) at 6 months. Multivariate analysis retained 1st- or 2nd-generation EGFR TKI, brain metastases and albuminemia <35 g/L at diagnosis as significantly associated with shorter PFS, but not PDL1 status, which was independently associated with progression at 6 months (HR 3.76 [1.23-12.63], p = 0.02). PDL1-negative and PDL1-positive patients' OS lasted 27 (95% CI 24-39) and 22 (95% CI 19-41) months, respectively (NS). Multivariate analysis retained only brain metastases or albuminemia <35 g/L at diagnosis as being independently associated with OS. CONCLUSION PDL1 expression ≥1% seems to be associated with early progression during the first 6 months of first-line EGFR-TKI treatment of metastatic EGFRm NSCLCs, without impacting OS.
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Affiliation(s)
- Julie Lasvergnas
- Service de Pneumologie, Groupe Hospitalier Paris Saint-Joseph, 195 rue Raymond Losserand, 75014 Paris, France.
| | - Vincent Fallet
- Service de Pneumologie et Oncologie Thoracique, DMU APPROCHES, Hôpital Tenon, APHP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
| | - Boris Duchemann
- Service d'Oncologie Médicale et Thoracique, Université Paris Sorbonne Nord, APHP, Hôpital Avicenne, 125 rue de Stalingrad, 93000 Bobigny, France
| | - Stephane Jouveshomme
- Service de Pneumologie, Groupe Hospitalier Paris Saint-Joseph, 195 rue Raymond Losserand, 75014 Paris, France
| | - Jacques Cadranel
- Service de Pneumologie et Oncologie Thoracique, DMU APPROCHES, Hôpital Tenon, APHP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
| | - Christos Chouaïd
- Service de Pneumologie, CHI Créteil, 40 av. de Verdun, 94000 Créteil, France; Inserm U955, UPEC, IMRB, Créteil, France
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Rusu T, Delion M, Pirot C, Blin A, Rodenas A, Talbot JN, Veran N, Portal C, Montravers F, Cadranel J, Prignon A. Fully automated radiolabeling of [ 68Ga]Ga-EMP100 targeting c-MET for PET-CT clinical imaging. EJNMMI Radiopharm Chem 2023; 8:30. [PMID: 37843660 PMCID: PMC10579204 DOI: 10.1186/s41181-023-00213-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND c-MET is a transmembrane receptor involved in many biological processes and contributes to cell proliferation and migration during cancer invasion process. Its expression is measured by immunehistochemistry on tissue biopsy in clinic, although this technique has its limitations. PET-CT could allow in vivo mapping of lesions expressing c-MET, providing whole-body detection. A number of radiopharmaceuticals are under development for this purpose but are not yet in routine clinical use. EMP100 is a cyclic oligopeptide bound to a DOTA chelator, with nanomolar affinity for c-MET. The aim of this project was to develop an automated method for radiolabelling the radiopharmaceutical [68Ga]Ga-EMP100. RESULTS The main results showed an optimal pH range between 3.25 and 3.75 for the complexation reaction and a stabilisation of the temperature at 90 °C, resulting in an almost complete incorporation of gallium-68 after 10 min of heating. In these experiments, 90 µg of EMP-100 peptide were initially used and then lower amounts (30, 50, 75 µg) were explored to determine the minimum required for sufficient synthesis yield. Radiolysis impurities were identified by radio-HPLC and ascorbic acid and ethanol were used to improve the purity of the compound. Three batches of [68Ga]Ga-EMP100 were then prepared according to the optimised parameters and all met the established specifications. Finally, the stability of [68Ga]Ga-EMP100 was assessed at room temperature over 3 h with satisfactory results in terms of appearance, pH, radiochemical purity and sterility. CONCLUSIONS For the automated synthesis of [68Ga]Ga-EMP100, the parameters of pH, temperature, precursor peptide content and the use of adjuvants for impurity management were efficiently optimised, resulting in the production of three compliant and stable batches according to the principles of good manufacturing practice. [68Ga]Ga-EMP100 was successfully synthesised and is now available for clinical development in PET-CT imaging.
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Affiliation(s)
- Timofei Rusu
- THERANOSCAN Clinical Research Group Sorbonne University, Tenon Hospital AP-HP, Paris, France.
- Positron Molecular Imaging Laboratory (LIMP) UMS28 Small Animal Phenotyping, Sorbonne University, Paris, France.
- Nuclear Medicine Imaging Department and Radiopharmacy, Tenon Hospital AP-HP, Paris, France.
- Radiopharmacist - Hôpital Tenon Assistance Publique - Hôpitaux de Paris, Paris, France.
| | - Matthieu Delion
- Nuclear Medicine Imaging Department and Radiopharmacy, Tenon Hospital AP-HP, Paris, France
| | - Charlotte Pirot
- Nuclear Medicine Imaging Department and Radiopharmacy, Tenon Hospital AP-HP, Paris, France
| | - Amaury Blin
- Nuclear Medicine Imaging Department and Radiopharmacy, Tenon Hospital AP-HP, Paris, France
| | - Anita Rodenas
- THERANOSCAN Clinical Research Group Sorbonne University, Tenon Hospital AP-HP, Paris, France
| | - Jean-Noël Talbot
- Institut National des Sciences et Techniques Nucléaires (INSTN), Saclay, France
| | - Nicolas Veran
- CHRU de Nancy Pôle Pharmacie : Centre Hospitalier Régional Universitaire de Nancy Pôle Pharmacie, Nancy, France
| | | | - Françoise Montravers
- Nuclear Medicine Imaging Department and Radiopharmacy, Tenon Hospital AP-HP, Paris, France
| | - Jacques Cadranel
- THERANOSCAN Clinical Research Group Sorbonne University, Tenon Hospital AP-HP, Paris, France
- Service de Pneumologie et Oncologie Thoracique, APHP - Hôpital Tenon and Sorbonne Université, Paris, France
| | - Aurélie Prignon
- THERANOSCAN Clinical Research Group Sorbonne University, Tenon Hospital AP-HP, Paris, France
- Positron Molecular Imaging Laboratory (LIMP) UMS28 Small Animal Phenotyping, Sorbonne University, Paris, France
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20
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Chour A, Denis J, Mascaux C, Zysman M, Bigay-Game L, Swalduz A, Gounant V, Cortot A, Darrason M, Fallet V, Auclin E, Basse C, Tissot C, Decroisette C, Bombaron P, Giroux-Leprieur E, Odier L, Brosseau S, Creusot Q, Gueçamburu M, Meersseman C, Rochand A, Costantini A, Gaillard CM, Wasielewski E, Girard N, Cadranel J, Lafitte C, Lebossé F, Duruisseaux M. Brief Report: Severe Sotorasib-Related Hepatotoxicity and Non-Liver Adverse Events Associated With Sequential Anti-Programmed Cell Death (Ligand)1 and Sotorasib Therapy in KRAS G12C-Mutant Lung Cancer. J Thorac Oncol 2023; 18:1408-1415. [PMID: 37217096 DOI: 10.1016/j.jtho.2023.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 02/12/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Sequential anti-programmed cell death protein 1 (PD-1) or anti-programmed death-ligand 1 (PD-L1) followed by small targeted therapy use is associated with increased prevalence of adverse events (AEs) in NSCLC. KRASG12C inhibitor sotorasib may trigger severe immune-mediated hepatotoxicity when used in sequence or in combination with anti-PD-(L)1. This study was designed to address whether sequential anti-PD-(L)1 and sotorasib therapy increases the risk of hepatotoxicity and other AEs. METHODS This is a multicenter, retrospective study of consecutive advanced KRASG12C-mutant NSCLC treated with sotorasib outside clinical trials in 16 French medical centers. Patient records were reviewed to identify sotorasib-related AEs (National Cancer Institute Common Classification Criteria for Adverse Events-Version 5.0). Grade 3 and higher AE was considered as severe. Sequence group was defined as patients who received an anti-PD-(L)1 as last line of treatment before sotorasib initiation and control group as patients who did not receive an anti-PD-(L)1 as last line of treatment before sotorasib initiation. RESULTS We identified 102 patients who received sotorasib, including 48 (47%) in the sequence group and 54 (53%) in the control group. Patients in the control group received an anti-PD-(L)1 followed by at least one treatment regimen before sotorasib in 87% of the cases or did not receive an anti-PD-(L)1 at any time before sotorasib in 13% of the cases. Severe sotorasib-related AEs were significantly more frequent in the sequence group compared with those in the control group (50% versus 13%, p < 0.001). Severe sotorasib-related AEs occurred in 24 patients (24 of 48, 50%) in the sequence group, and among them 16 (67%) experienced a severe sotorasib-related hepatotoxicity. Severe sotorasib-related hepatotoxicity was threefold more frequent in the sequence group compared with that in the control group (33% versus 11%, p = 0.006). No fatal sotorasib-related hepatotoxicity was reported. Non-liver severe sotorasib-related AEs were significantly more frequent in the sequence group (27% versus 4%, p < 0.001). Severe sotorasib-related AEs typically occurred in patients who received last anti-PD-(L)1 infusion within 30 days before sotorasib initiation. CONCLUSIONS Sequential anti-PD-(L)1 and sotorasib therapy are associated with a significantly increased risk of severe sotorasib-related hepatotoxicity and severe non-liver AEs. We suggest avoiding starting sotorasib within 30 days from the last anti-PD-(L)1 infusion.
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Affiliation(s)
- Ali Chour
- Respiratory Department and Early Phase, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, Lyon, France; Oncopharmacology Laboratory, Cancer Research Center of Lyon, Unité mixte de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1052 Centre national de la recherche scientifique (CNRS) 5286, Lyon, France; Université Claude Bernard, Université de Lyon, Lyon, France
| | - Julie Denis
- Respiratory Department and Early Phase, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, Lyon, France; Université Claude Bernard, Université de Lyon, Lyon, France
| | - Céline Mascaux
- Pulmonology Department, University Hospital of Strasbourg, Strasbourg, France; Université de Strasbourg, Institut national de la santé et de la recherche médicale (INSERM) Unité mixte de recherche (UMR)_S 1113, IRFAC, Laboratory Streinth (Stress REsponse and INnovative THerapy against cancer), ITI InnoVec, Strasbourg, France
| | - Maeva Zysman
- Service des Maladies Respiratoires et des épreuves fonctionnelles respiratoires CHU Bordeaux, Pessac, France; Univ-Bordeaux, Centre de Recherche cardio-thoracique de Bordeaux, U1045, CIC 1401.-F, Pessac, France
| | | | | | - Valérie Gounant
- Thoracic Oncology Department-Early Phases Unit CIC-1425 Institut national de la santé et de la recherche médicale (INSERM), Institut du cancer Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Cité, Paris, France
| | - Alexis Cortot
- Thoracic Oncology Department, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Marie Darrason
- Service de Pneumologie, Lyon Sud Hospital Center, Pierre-Benite, France
| | - Vincent Fallet
- Hopital Tenon Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; GRC 4, Theranoscan, Sorbonne Université, Paris, France
| | - Edouard Auclin
- Oncology Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) centre, Université Paris Cité, Paris, France
| | - Clémence Basse
- Thorax Institute Curie Montsouris, Institut Curie, Paris, France; UVSQ, Paris Saclay University, Versailles, France
| | - Claire Tissot
- Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France
| | | | | | - Etienne Giroux-Leprieur
- Respiratory Diseases and Thoracic Oncology Department, Hôpital Ambroise Pare Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
| | - Luc Odier
- Department of Pneumology, Hopital Nord-Ouest Villefranche, Villefranche Sur Saone, France
| | - Solenn Brosseau
- Thoracic Oncology Department-Early Phases Unit CIC-1425 Institut national de la santé et de la recherche médicale (INSERM), Institut du cancer Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Cité, Paris, France
| | - Quentin Creusot
- Pulmonology Department, University Hospital of Strasbourg, Strasbourg, France; Université de Strasbourg, Institut national de la santé et de la recherche médicale (INSERM) Unité mixte de recherche (UMR)_S 1113, IRFAC, Laboratory Streinth (Stress REsponse and INnovative THerapy against cancer), ITI InnoVec, Strasbourg, France
| | - Marina Gueçamburu
- Service des Maladies Respiratoires et des épreuves fonctionnelles respiratoires CHU Bordeaux, Pessac, France; Univ-Bordeaux, Centre de Recherche cardio-thoracique de Bordeaux, U1045, CIC 1401.-F, Pessac, France
| | | | - Adrien Rochand
- Oncology Department, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) centre, Université Paris Cité, Paris, France
| | - Adrien Costantini
- Respiratory Diseases and Thoracic Oncology Department, Hôpital Ambroise Pare Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
| | - Claire Marine Gaillard
- Department of Pneumology, Hopital Nord-Ouest Villefranche, Villefranche Sur Saone, France
| | - Eric Wasielewski
- Thoracic Oncology Department, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Nicolas Girard
- Thorax Institute Curie Montsouris, Institut Curie, Paris, France; UVSQ, Paris Saclay University, Versailles, France
| | - Jacques Cadranel
- Hopital Tenon Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Claire Lafitte
- Respiratory Department and Early Phase, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, Lyon, France
| | - Fanny Lebossé
- Hepatology unit, Croix Rousse hospital, Lyon Liver Institute, Hospices Civils of Lyon, Lyon, France; Cancer Research Center of Lyon, Unité mixte de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1052 Centre national de la recherche scientifique (CNRS) 5286, Lyon, France
| | - Michaël Duruisseaux
- Respiratory Department and Early Phase, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, Lyon, France; Oncopharmacology Laboratory, Cancer Research Center of Lyon, Unité mixte de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1052 Centre national de la recherche scientifique (CNRS) 5286, Lyon, France; Université Claude Bernard, Université de Lyon, Lyon, France.
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Cadranel JFD, Ollivier-Hourmand I, Cadranel J, Thevenot T, Zougmore H, Nguyen-Khac E, Bureau C, Allaire M, Nousbaum JB, Loustaud-Ratti V, Causse X, Sogni P, Hanslik B, Bourliere M, Peron JM, Ganne-Carrie N, Dao T, Thabut D, Maitre B, Debzi N, Smadhi R, Sombie R, Kpossou R, Nouel O, Bissonnette J, Ruiz I, Medmoun M, Dastis SN, Deltenre P, Artru F, Raherison C, Elkrief L, Lemagoarou T. International survey among hepatologists and pulmonologists on the hepatic hydrothorax: plea for recommendations. BMC Gastroenterol 2023; 23:305. [PMID: 37697230 PMCID: PMC10496231 DOI: 10.1186/s12876-023-02931-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND The Hepatic hydrothorax is a pleural effusion related to portal hypertension; its diagnosis and therapeutic management may be difficult. The aims of this article are which follows: To gather the practices of hepatogastroenterologists or pulmonologists practitioners regarding the diagnosis and management of the hepatic hydrothorax. METHODS Practitioners from 13 French- speaking countries were invited to answer an online questionnaire on the hepatic hydrothorax diagnosis and its management. RESULTS Five hundred twenty-eight practitioners (80% from France) responded to this survey. 75% were hepatogastroenterologists, 20% pulmonologists and the remaining 5% belonged to other specialities. The Hepatic hydrothorax can be located on the left lung for 64% of the responders (66% hepatogastroenterologists vs 57% pulmonologists; p = 0.25); The Hepatic hydrothorax can exist in the absence of clinical ascites for 91% of the responders (93% hepatogastroenterologists vs 88% pulmonologists; p = 0.27). An Ultrasound pleural scanning was systematically performed before a puncture for 43% of the responders (36% hepatogastroenterologists vs 70% pulmonologists; p < 0.001). A chest X-ray was performed before a puncture for 73% of the respondeurs (79% hepatogastroenterologists vs 54% pulmonologists; p < 0.001). In case of a spontaneous bacterial empyema, an albumin infusion was used by 73% hepatogastroenterologists and 20% pulmonologists (p < 0.001). A drain was used by 37% of the responders (37% hepatogastroenterologists vs 31% pulmonologists; p = 0.26).An Indwelling pleural catheter was used by 50% pulmonologists and 22% hepatogastroenterologists (p < 0.01). TIPS was recommended by 78% of the responders (85% hepatogastroenterologists vs 52% pulmonologists; p < 0.001) and a liver transplantation, by 76% of the responders (86% hepatogastroenterologists vs 44% pulmonologists; p < 0.001). CONCLUSIONS The results of this large study provide important data on practices of French speaking hepatogastroenterologists and pulmonologists; it appears that recommendations are warranted.
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Affiliation(s)
| | | | | | | | - Honoré Zougmore
- Hepatogastroenterology and Nutrition Department GHPSO Boulevard Laennec, 60100, Creil, France
| | | | | | - Manon Allaire
- Hepatogastroenterology Department, La Pitié Salpétrière, Paris, France
| | | | | | | | | | | | - Marc Bourliere
- Hepatogastroenterology department, Saint-Joseph, Marseille, France
| | | | | | - Thong Dao
- Hepatogastroenterology department, CHU Caen, Caen, France
| | - Dominique Thabut
- Hepatogastroenterology Department, La Pitié Salpétrière, Paris, France
| | | | - Nabil Debzi
- Hepatology Department CHU Mustapha, Alger, Algérie, Algeria
| | - Ryad Smadhi
- Hepatogastroenterology and Nutrition Department GHPSO Boulevard Laennec, 60100, Creil, France
- Hepatology Department CHU Mustapha, Alger, Algérie, Algeria
| | - Roger Sombie
- Gastroenterology Department, CHU Yalgado Ouedraogo Ouagadougou, Ouagadougou, Burkina Faso
| | - Raimi Kpossou
- Hepatogastroenterology Deparment, National Hospital and University Center Hubert Koutoukou Maga, Cotonou, Benin
| | - Olivier Nouel
- Hepatogastroenterology Department, St Brieuc, France
| | - Julien Bissonnette
- Department of Hepatology and Liver Transplantation, University of Montreal Hospital, Montreal, Canada
| | - Isaac Ruiz
- Department of Hepatology and Liver Transplantation, University of Montreal Hospital, Montreal, Canada
| | - Mourad Medmoun
- Hepatogastroenterology and Nutrition Department GHPSO Boulevard Laennec, 60100, Creil, France
| | | | | | - Florent Artru
- Hepatogastroenterology Department, Lausanne, Suisse, Switzerland
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Rolland-Debord C, Piéroni L, Bejar F, Milon A, Choinier P, Blin E, Bravais J, Halitim P, Letellier A, Camuset J, Parrot A, Fajac A, Cadranel J. Cell and cytokine analyses from bronchoalveolar lavage in non-critical COVID-19 pneumonia. Intern Emerg Med 2023; 18:1723-1732. [PMID: 37353659 DOI: 10.1007/s11739-023-03341-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/05/2023] [Indexed: 06/25/2023]
Abstract
Cell and cytokine analyses from bronchoalveolar lavage (BAL) in non-critically ill patients with COVID-19 pneumonia are poorly described. This study focused on patients hospitalized in the non-intensive care unit for either suspected COVID-19 pneumonia or persistent respiratory symptoms following proven COVID-19 pneumonia. Overall, 54 patients who underwent BAL between April 2020 and February 2021 for suspected or follow-up of proven COVID-19 pneumonia were included. Based on SARS-CoV-2 polymerase chain reaction test results and clinical follow-up, three pulmonary disease groups were defined: non-COVID-19 (n = 20), acute COVID-19 (n = 13), and post-COVID-19 (n = 24) pneumonia patients. Cytological and cytokine analyses were performed on BAL fluid (IL-1β, IL-6, IL-8, IL-10, TNF-α, IFN-γ, HGF, and TGF-β), with investigators blinded to the patient groups. Lymphocytic alveolitis with plasmocytes was observed in acute COVID-19 pneumonia, returning to normal post-COVID-19. The highest cytokine levels were observed in COVID-19 patients, with significantly increased IFN-γ, IL-10, and HGF levels compared to non-COVID-19 patients, while significantly decreased IL-6, IL-8, IL-10, IFN-γ, TNF-α, and HGF levels were noted in post-COVID-19 patients. In COVID-19 patients, correlations between IL-10, TNF-α and IFN-γ concentrations were found. Lymphocytic alveolitis with plasmacytosis was found in non-critical COVID-19 pneumonia This alveolitis is associated with the presence of IL-6, IL-8, IL-10, TNF-α, IFN-γ and HGF. Alveolitis and cytokines levels decreased in post-COVID-19 pneumonia.
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Affiliation(s)
- Camille Rolland-Debord
- Department of Pneumology and Thoracic Oncology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France.
- Department of Pneumology, Service de Pneumologie, CHU Gabriel Montpied, Université Clermont Auvergne, 53 rue Montalembert, 63000, Clermont-Ferrand, France.
| | - Laurence Piéroni
- Department of Biochemistry, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Farah Bejar
- Department of Biochemistry, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Audrey Milon
- Department of Radiology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Pascaline Choinier
- Department of Pneumology and Thoracic Oncology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Emmanuelle Blin
- Department of Pneumology and Thoracic Oncology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Juliette Bravais
- Department of Pneumology and Thoracic Oncology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Pierre Halitim
- Department of Pneumology and Thoracic Oncology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Alice Letellier
- Department of Pneumology and Thoracic Oncology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Juliette Camuset
- Department of Thoracic and Vascular Surgery, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Antoine Parrot
- Department of Pneumology and Thoracic Oncology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Anne Fajac
- Department of Pathology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Jacques Cadranel
- Department of Pneumology and Thoracic Oncology, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
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23
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Teixeira L, Diéras V, Crestani B, Lederlin M, Villanueva C, Duchemann B, Pierga JY, Cadranel J. [Diagnosis and management of interstitial lung disease induced by antibody-drug conjugates in breast cancer: A French expert opinion paper]. Bull Cancer 2023; 110:937-949. [PMID: 37331827 DOI: 10.1016/j.bulcan.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 06/20/2023]
Abstract
Interstitial lung disease (ILD) has been reported with many cancer drugs including some recent antibody-drug conjugates (ADCs). The mechanisms of ILD induced by many chemotherapy drugs, other drug classes and ADCs used in cancer, including breast cancer, are not clearly elucidated. In the absence of specific clinical or radiological signs, the diagnosis of drug-induced ILD is often a diagnosis of exclusion. When present, the most frequent symptoms are respiratory signs (cough, dyspnea, chest pain) and general signs (fatigue, fever). Any suspicion of ILD should be evaluated by imaging and, if in doubt, the CT scan should be evaluated by a pulmonologist and a radiologist. A network of multidisciplinary experts for proactive early management of ILD is important, including oncologist, radiologist, pulmonologist, infectious disease specialist and nurses. Patient education is essential to report new or exacerbated lung symptoms and prevent high-grade ILD. Study drug is discontinued temporarily or permanently according to ILD severity and type of ADC. For asymptomatic cases (Grade 1), the efficacy of corticosteroids is not clearly established; for higher grades, the benefit/risk balance of long-term corticosteroid therapy should be considered for the dose and treatment duration. Hospitalization and oxygen supplementation are required for severe cases (Grades 3-4). For patient follow-up, the expertise of a pulmonologist is necessary with repeated chest scans, spirometry and DLCO. Preventing ADC-induced ILDs and evolution to high grade rests on a network of multidisciplinary experts for assessment of individual risk factors, early management, close follow-up and patient education.
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Affiliation(s)
- Luis Teixeira
- AP-HP, hôpital Saint-Louis, service de sénologie, Inserm U976, HIPI, Paris, France; Université Paris Cité, Paris, France.
| | - Véronique Diéras
- Centre Eugène-Marquis, département d'oncologie médicale, Rennes, France
| | - Bruno Crestani
- Université Paris Cité, Inserm U1152, Paris, France; Assistance publique-Hôpitaux de Paris, hôpital Bichat, département de pneumologie, Paris, France
| | - Mathieu Lederlin
- CHU de Rennes, université de Rennes, département de radiologie, Rennes, France
| | - Cristian Villanueva
- Centre de cancérologie de Montpellier, département d'oncologie médicale, Montpellier, France
| | - Boris Duchemann
- Hôpital Avicenne, département d'oncologie médicale, Bobigny, France
| | - Jean-Yves Pierga
- Institut Curie, département d'oncologie médicale, Paris et Saint-Cloud, France; Université Paris Cité, Paris, France
| | - Jacques Cadranel
- AP-HP Tenon, Sorbonne université, centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et oncologie thoracique, Paris, France
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Roboubi A, Audousset C, Fréalle É, Brun AL, Laurent F, Vitte J, Mortuaire G, Lefevre G, Cadranel J, Chenivesse C. Allergic bronchopulmonary aspergillosis: A multidisciplinary review. J Mycol Med 2023; 33:101392. [PMID: 37172543 DOI: 10.1016/j.mycmed.2023.101392] [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: 12/27/2022] [Revised: 04/20/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is a rare disease characterized by a complex allergic inflammatory reaction of airways against Aspergillus affecting patients with chronic respiratory diseases (asthma, cystic fibrosis). Exacerbation is often the way to diagnose ABPA and marks its evolution by its recurrent character leading to cortico-requirement or long-term antifungal treatment. Early diagnosis allows treatment of ABPA at an initial stage, preventing recurrence of exacerbations and long-term complications, mainly represented by bronchiectasis. This review of the literature aims to present the current state of the art in terms of diagnosis and treatment of ABPA from a multidisciplinary perspective. As there is no clinical, biological nor radiological specific sign, diagnostic criteria are regularly revised. They are mainly based on the elevation of total and specific IgE against Aspergillus fumigatus and the presence of suggestive CT abnormalities such as mucoid impaction and consolidations. ABPA management includes eviction of mold and pharmacological therapy. Exacerbations are treated in first line with a moderate dose of oral corticosteroids. Azole antifungal agents represent an alternative for the treatment of exacerbations and are the preferential strategy to reduce the future risk of exacerbations and for corticosteroids sparing. Asthma biologics may be of interest; however, their place remains to be determined. Avoiding complications of ABPA while limiting the side effects of systemic drugs remains a major challenge of ABPA management. Several drugs, including new antifungals and asthma biologics, are currently being tested and may be useful in the future.
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Affiliation(s)
| | - Camille Audousset
- CHU Lille, Univ. Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Lille, France
| | - Émilie Fréalle
- CHU Lille, Laboratoire de Parasitologie-Mycologie, Univ. Lille, ULR 4515-LGCgE, Laboratoire de Génie Civil et Géo-Environnement, Lille F-59000, France
| | - Anne-Laure Brun
- Hôpital Foch, Service de radiologie diagnostique et interventionnelle, Suresnes, France
| | - François Laurent
- Université de Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC1401, CHU de Bordeaux, Pessac, France
| | - Joana Vitte
- Aix-Marseille Univ, MEPHI, Marseille, France; IHU Méditerranée Infection, Marseille, France; Desbrest Institute of Epidemiology and Public Health IDESP, Univ Montpellier, INSERM UA 11, Montpellier, France
| | - Geoffrey Mortuaire
- CHU de Lille, Service d'ORL et de chirurgie cervico-faciale, Lille 59000, France; Université de Lille, Inserm, CHU de Lille, U1286, INFINITE-Institute for translational research in inflammation, Lille 59000, France
| | - Guillaume Lefevre
- Univ Lille, U1286 INFINITE - Lille Inflammation Research International Center, CHU Lille, Lille, France
| | - Jacques Cadranel
- Sorbonne Université, APHP-Hopital Tenon, GRC04 Theranoscan Sorbonne Université, Paris, France
| | - Cécile Chenivesse
- Univ. Lille, CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Lille, France; CRISALIS (Clinical Research Initiative in Severe Asthma: a Lever for Innovation & Science), F-CRIN Network, INSERM US015, Toulouse, France.
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Michaux L, Perrier A, Mehlman C, Alshehhi H, Dubois A, Lacave R, Coulet F, Cadranel J, Fallet V. Therapeutic strategies to overcome EGFR mutations as acquired resistance mechanism in ALK-rearranged non-small-cell lung cancer: Case Reports. Front Oncol 2023; 13:1182558. [PMID: 37448514 PMCID: PMC10338053 DOI: 10.3389/fonc.2023.1182558] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/30/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction ALK tyrosine kinase inhibitors (ALK TKIs) have improved prognosis in ALK-rearranged (ALK +) non-small-cell lung cancer (NSCLC). However, drug resistance mechanisms occur inevitably during the course of treatment leading to disease progression. Activation of epidermal growth factor receptor (EGFR) bypass signaling pathway is an uncommon cause of acquired resistance to ALK TKIs. Method We present two patients with EML4-ALK rearranged NSCLC, developing an acquired EGFR resistance mutation after receiving multiple lines of ALK TKIs. Results While preclinical models have showed encouraging data, there is a critical need for clinical studies on treatment strategies to overcome this drug resistance. Three real-life therapeutic approaches were used in this report: i) using brigatinib, an inhibitor targeting both ALK and EGFR tyrosine kinases; ii) combining two ALK TKIs together; and iii) delivering doublet platinum chemotherapy. In case 1, time to treatment failure (TTF) was 9.5 months with brigatinib; in case 2, TTF was 10 months with combined TKIs (osimertinib and brigatinib), whereas TTF with chemotherapy was only 2 months. Tolerability profile TKIs combotherapy was acceptable. Conclusion These case reports underline the therapeutic complexity of EGFR-acquired resistance mutation in ALK+ NSCLC and offers some leads to solve this real-life clinical challenge.
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Affiliation(s)
- Lionel Michaux
- Department of Pulmonology and Thoracic Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Tenon and Groupe de Recherche Clinique 4 (GRC 4), Theranoscan, Sorbonne Université, Paris, France
| | - Alexandre Perrier
- Genetics Department, Assistance Publique Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière and Sorbonne Université, Paris, France
| | - Camille Mehlman
- Department of Pulmonology and Thoracic Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Tenon and Groupe de Recherche Clinique 4 (GRC 4), Theranoscan, Sorbonne Université, Paris, France
| | - Hussa Alshehhi
- Pathology Department, Assistance Publique Hôpitaux de Paris, Hôpital Tenon and Sorbonne Université, Paris, France
| | - Antonin Dubois
- Department of Pharmacy, Assistance Publique Hôpitaux de Paris, Hôpital Tenon and Sorbonne Université, Paris, France
| | - Roger Lacave
- Genetics Department, Assistance Publique Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière and Sorbonne Université, Paris, France
| | - Florence Coulet
- Genetics Department, Assistance Publique Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière and Sorbonne Université, Paris, France
| | - Jacques Cadranel
- Department of Pulmonology and Thoracic Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Tenon and Groupe de Recherche Clinique 4 (GRC 4), Theranoscan, Sorbonne Université, Paris, France
| | - Vincent Fallet
- Department of Pulmonology and Thoracic Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Tenon and Groupe de Recherche Clinique 4 (GRC 4), Theranoscan, Sorbonne Université, Paris, France
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26
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Mankikian J, Caille A, Reynaud-Gaubert M, Agier MS, Bermudez J, Bonniaud P, Borie R, Brillet PY, Cadranel J, Court-Fortune I, Crestani B, Debray MP, Gomez E, Gondouin A, Hirschi-Santelmo S, Israel-Biet D, Jouneau S, Juvin K, Leger J, Kerjouan M, Marquette CH, Naccache JM, Nunes H, Plantier L, Prevot G, Quetant S, Traclet J, Valentin V, Uzunhan Y, Wémeau-Stervinou L, Bejan-Angoulvant T, Cottin V, Marchand-Adam S. Rituximab and mycophenolate mofetil combination in patients with interstitial lung disease (EVER-ILD): a double-blind, randomised, placebo-controlled trial. Eur Respir J 2023; 61:2202071. [PMID: 37230499 DOI: 10.1183/13993003.02071-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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: 10/27/2022] [Accepted: 03/21/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Standard of care for interstitial lung disease (ILD) with a nonspecific interstitial pneumonia (NSIP) pattern proposes mycophenolate mofetil (MMF) as one of the first-step therapies while rituximab is used as rescue therapy. METHODS In a randomised, double-blind, two-parallel group, placebo-controlled trial (NCT02990286), patients with connective tissue disease-associated ILD or idiopathic interstitial pneumonia (with or without autoimmune features) and a NSIP pattern (defined on NSIP pathological pattern or on integration of clinicobiological data and a NSIP-like high-resolution computed tomography pattern) were randomly assigned in a 1:1 ratio to receive rituximab (1000 mg) or placebo on day 1 and day 15 in addition to MMF (2 g daily) for 6 months. The primary end-point was the change in percent predicted forced vital capacity (FVC) from baseline to 6 months analysed by a linear mixed model for repeated measures analysis. Secondary end-points included progression-free survival (PFS) up to 6 months and safety. FINDINGS Between January 2017 and January 2019, 122 randomised patients received at least one dose of rituximab (n=63) or placebo (n=59). The least-squares mean change from baseline to 6 months in FVC (% predicted) was +1.60 (se 1.13) in the rituximab+MMF group and -2.01 (se 1.17) in the placebo+MMF group (between-group difference 3.60, 95% CI 0.41-6.80; p=0.0273). PFS was better in the rituximab+MMF group (crude hazard ratio 0.47, 95% CI 0.23-0.96; p=0.03). Serious adverse events occurred in 26 (41%) patients of the rituximab+MMF group and in 23 (39%) of the placebo+MMF group. Nine infections were reported in the rituximab+MMF group (five bacterial infections, three viral infections, one other) and four bacterial infections in the placebo+MMF group. INTERPRETATION Combination of rituximab and MMF was superior to MMF alone in patients with ILD and a NSIP pattern. The use of this combination must take into consideration the risk of viral infection.
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Affiliation(s)
- Julie Mankikian
- CHRU Tours, Service de Pneumologie et d'Explorations Fonctionnelles Respiratoires, Tours, France
| | - Agnès Caille
- CIC, INSERM 1415, CHRU Tours, Tours, France
- Methods in Patients-Centered Outcomes and Health Research, INSERM UMR 1246, Nantes, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre de Compétences des Maladies Pulmonaires Rares, APHM, CHU Nord, 13015 Marseille, France
- Aix Marseille Université, Marseille, France
| | - Marie-Sara Agier
- CHRU Tours, Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance, Tours, France
| | - Julien Bermudez
- Service de Pneumologie, Centre de Compétences des Maladies Pulmonaires Rares, APHM, CHU Nord, 13015 Marseille, France
- Aix Marseille Université, Marseille, France
| | - Philippe Bonniaud
- Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adulte, Service de Pneumologie et Soins Intensifs Respiratoires, Centre Hospitalo-Universitaire de Dijon-Bourgogne, Dijon, France
- UFR des Sciences de Santé, Université de Bourgogne-Franche Comté et INSERM UMR 1231, Dijon, France
| | - Raphael Borie
- Université de Paris, Inserm, U1152, laboratoire d'excellence INFLAMEX, F-75018 Paris, France
- Hôpital Bichat, APHP, Service de Pneumologie A, Centre Constitutif du Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, F-75018 Paris, France
| | - Pierre-Yves Brillet
- APHP, Service de Radiologie, Hôpital Avicenne, Université Paris Sorbonne Nord, Bobigny, France
| | - Jacques Cadranel
- APHP, Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'adulte et Sorbonne Université, Hôpital Tenon, Paris, France
| | - Isabelle Court-Fortune
- Sainbiose DVH U1059 Inserm, Faculté de Médecine J Lisfranc, Université Jean Monnet, Saint Etienne, France
| | - Bruno Crestani
- Université de Paris, Inserm, U1152, laboratoire d'excellence INFLAMEX, F-75018 Paris, France
- Hôpital Bichat, APHP, Service de Pneumologie A, Centre Constitutif du Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, F-75018 Paris, France
| | - Marie-Pierre Debray
- Université de Paris, Inserm, U1152, laboratoire d'excellence INFLAMEX, F-75018 Paris, France
- APHP, Service de Radiologie, Hôpital Bichat, Paris, France
| | - Emmanuel Gomez
- Service de Pneumologie et Transplantation, Hopitaux Universitaires de Strasbourg - Nouvel Hôpital Civil, Strasbourg, France
| | - Anne Gondouin
- Université de Paris, APHP, Service de Pneumologie, Centre de Compétences Maladies Pulmonaires Rares, Hôpital Européen Georges Pompidou, Paris, France
| | - Sandrine Hirschi-Santelmo
- Hôpital de Pontchaillou, Service de Pneumologie, Centre de Compétences pour les Maladies Pulmonaires Rares, Rennes, France
| | | | - Stéphane Jouneau
- Université Côte d'Azur, Département de Pneumologie, CHU de Nice, Nice, France
- Groupe Hospitalier Paris Saint Joseph, Service de Pneumologie-Allergologie-Oncologie Thoracique, Paris, France
| | - Karine Juvin
- Université de Paris, APHP, Service de Pneumologie, Centre de Compétences Maladies Pulmonaires Rares, Hôpital Européen Georges Pompidou, Paris, France
| | | | - Mallorie Kerjouan
- Hôpital de Pontchaillou, Service de Pneumologie, Centre de Compétences pour les Maladies Pulmonaires Rares, Rennes, France
| | - Charles-Hugo Marquette
- APHP, Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'Adulte, Hôpital Avicenne, Bobigny, France
| | - Jean-Marc Naccache
- APHP, Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'adulte et Sorbonne Université, Hôpital Tenon, Paris, France
- Université de Tours, Centre d'Etude des Pathologies Respiratoires (CEPR) INSERM U1100 Faculté de Médecine, Tours, France
| | - Hilario Nunes
- Service de Pneumologie, Hôpital Larrey, Toulouse, France
| | - Laurent Plantier
- CHRU Tours, Service de Pneumologie et d'Explorations Fonctionnelles Respiratoires, Tours, France
- CHU de Grenoble-Alpes Service de Pneumologie et Physiologie, Pôle Thorax et Vaisseaux, La Tronche, France
| | - Grégoire Prevot
- Centre National de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service de Pneumologie, Lyon, France
| | - Sébastien Quetant
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence des Maladies Pulmonaires Rares (site constitutif), Lille, France
| | | | - Victor Valentin
- CHRU de Tours, Service de Pharmacologie Clinique, Tours, France
| | - Yurdagul Uzunhan
- APHP, Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'Adulte, Hôpital Avicenne, Bobigny, France
| | - Lidwine Wémeau-Stervinou
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence des Maladies Pulmonaires Rares (site constitutif), Lille, France
| | - Theodora Bejan-Angoulvant
- Université de Tours, EA 4245, Tours, France
- CHRU de Tours, Service de Pharmacologie Clinique, Tours, France
| | - Vincent Cottin
- Centre National de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service de Pneumologie, Lyon, France
| | - Sylvain Marchand-Adam
- CHRU Tours, Service de Pneumologie et d'Explorations Fonctionnelles Respiratoires, Tours, France
- Université de Tours, Centre d'Etude des Pathologies Respiratoires (CEPR) INSERM U1100 Faculté de Médecine, Tours, France
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Parrot A, Barral M, Amiot X, Bachmeyer C, Wagner I, Eyries M, Alamowitch S, Ederhy S, Epaud R, Dupuis-Girod S, Cadranel J. [Hereditary hemorrhagic telangiectasia]. Rev Mal Respir 2023; 40:391-405. [PMID: 37062633 DOI: 10.1016/j.rmr.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/26/2023] [Indexed: 04/18/2023]
Abstract
Hereditary hemorrhagic telangiectasia, also known as Rendu-Osler - Weber disease, is a rare, autosomal dominant vascular disease, with prevalence of 1/5,000. The condition is characterized by muco-cutaneous telangiectasias, which are responsible for a hemorrhagic syndrome of variable severity, as well as arteriovenous malformations (AVMs) appearing in the lungs, the liver, and the nervous system. They can be the source of shunts, which may be associated with high morbidity (neurological ischemic stroke, brain abscess, high-output heart failure, biliary ischemia…). It is therefore crucial to establish a clinical diagnosis using the Curaçao criteria or molecular diagnosis based on genetic analysis of the ENG, ACVRL1, SMAD4 and GDF2 genes. In most cases, multidisciplinary management allows patients to have normal life expectancy. Advances in interventional radiology and better understanding of the pathophysiology of angiogenesis have resulted in improved therapeutic management. Anti-angiogenic treatments, such as bevacizumab (BVZ, an anti-VEGF antibody), have proven to be effective in cases involving bleeding complications and severe liver damage with cardiac repercussions. Other anti-angiogenic agents are currently being investigated, including tyrosine kinase inhibitors.
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Affiliation(s)
- A Parrot
- Service de pneumologie, centre de compétence de la maladie de Rendu-Osler, hôpital Tenon, AP-HP, 75020 Paris, France.
| | - M Barral
- Service de radiologie, hôpital Tenon, AP-HP, 75020 Paris, France; UFR médecine, Sorbonne université, 75006 Paris, France
| | - X Amiot
- Service de gastroentérologie, hôpital Tenon, AP-HP, 75020 Paris, France
| | - C Bachmeyer
- Service de médecine interne, hôpital Tenon, AP-HP, 75020 Paris, France
| | - I Wagner
- Service d'ORL, hôpital Tenon, AP-HP, 75020 Paris, France
| | - M Eyries
- Service de génétique, hôpital de la Pitié-Salpetrière, AP-HP, 75020 Paris, France
| | - S Alamowitch
- Service des urgences cérébrovasculaires, hôpital de la Pitié-Salpetrière, AP-HP, 75020 Paris, France
| | - S Ederhy
- Service de cardiologie et GRC no 27, hôpital Saint-Antoine, AP-HP, 75020 Paris, France
| | - R Epaud
- Service de pédiatrie, centre intercommunaux de Créteil, Créteil, France
| | - S Dupuis-Girod
- Service de génétique, centre de référence pour la maladie de Rendu-Osler, hospices civils de Lyon, hôpital Mère-Enfant, 69500 Bron, France
| | - J Cadranel
- Service de pneumologie, centre de compétence de la maladie de Rendu-Osler, hôpital Tenon, AP-HP, 75020 Paris, France; UFR médecine, Sorbonne université, 75006 Paris, France
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28
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Schlemmer F, Valentin S, Boyer L, Guillaumot A, Chabot F, Dupin C, Le Guen P, Lorillon G, Bergeron A, Basille D, Delomez J, Andrejak C, Bonnefoy V, Goussault H, Assié JB, Choinier P, Ruppert AM, Cadranel J, Mennitti MC, Roumila M, Colin C, Günther S, Sanchez O, Gille T, Sésé L, Uzunhan Y, Faure M, Patout M, Morelot-Panzini C, Laveneziana P, Zysman M, Blanchard E, Raherison-Semjen C, Giraud V, Giroux-Leprieur E, Habib S, Roche N, Dinh-Xuan AT, Sifaoui I, Brillet PY, Jung C, Boutin E, Layese R, Canoui-Poitrine F, Maitre B. Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study. Eur Respir J 2023; 61:13993003.01532-2022. [PMID: 36669777 PMCID: PMC10066566 DOI: 10.1183/13993003.01532-2022] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/20/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Survivors of severe-to-critical COVID-19 may have functional impairment, radiological sequelae and persistent symptoms requiring prolonged follow-up. This pragmatic study aimed to describe their clinical follow-up and determine their respiratory recovery trajectories, and factors that could influence them and their health-related quality of life. METHODS Adults hospitalised for severe-to-critical COVID-19 were evaluated at 3 months and up to 12 months post-hospital discharge in this prospective, multicentre, cohort study. RESULTS Among 485 enrolled participants, 293 (60%) were reassessed at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 ones initially managed with standard oxygen were reassessed at 6 and 12 months, respectively. At 3 months, 34%, 70% and 56% of the participants had a restrictive lung defect, impaired DLCO and significant radiological sequelae, respectively. During extended follow-up, DLCO and FVC (% of predicted value) increased by means of +4 points at 6 months, and +6 points at 12 months. Sex, body mass index, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19 and prolonged invasive mechanical ventilation (IMV) were associated with DLCO at month 3, but not its trajectory thereafter. Among 475 (98%) patients with at least one chest computed-tomography scan during follow-up, 196 (41%) had significant sequelae on their last images. CONCLUSION Although pulmonary function and radiological abnormalities improved up to 1 year post-acute-COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.
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Affiliation(s)
- Frédéric Schlemmer
- Unité de Pneumologie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Créteil, France .,Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France
| | - Simon Valentin
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, INSERM UMR_S 1116, Vandœuvre-lès-Nancy, France
| | - Laurent Boyer
- Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France.,APHP, Hôpitaux Universitaires Henri-Mondor, Service des Explorations Fonctionnelles, Créteil, France
| | - Anne Guillaumot
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France
| | - François Chabot
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, INSERM UMR_S 1116, Vandœuvre-lès-Nancy, France
| | - Clairelyne Dupin
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Pierre Le Guen
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Gwenael Lorillon
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève, Service de Pneumologie, Genève, Switzerland
| | - Damien Basille
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Julia Delomez
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Claire Andrejak
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Valentine Bonnefoy
- Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France
| | - Hélène Goussault
- Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France
| | - Jean-Baptiste Assié
- Unité de Pneumologie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Pascaline Choinier
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Anne-Marie Ruppert
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Jacques Cadranel
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | | | - Mehdi Roumila
- Département de Pneumologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Charlotte Colin
- Département de Pneumologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Sven Günther
- APHP, Hôpital Européen Georges-Pompidou, Service de Physiologie, Université de Paris, Paris, France
| | - Olivier Sanchez
- APHP, Hôpital Européen Georges-Pompidou, Service de Pneumologie, Université de Paris, Paris, France
| | - Thomas Gille
- APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Physiologie et Explorations Fonctionnelles, Bobigny, France.,Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France
| | - Lucile Sésé
- APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Physiologie et Explorations Fonctionnelles, Bobigny, France.,Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France
| | - Yurdagul Uzunhan
- Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France.,APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Pneumologie, Centre de Reference Maladies Pulmonaires Rares de l'Adulte (site constitutif), Bobigny, France
| | - Morgane Faure
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Maxime Patout
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Capucine Morelot-Panzini
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Pierantonio Laveneziana
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, hôpitaux Pitié-Salpêtrière, Saint-Antoine et Tenon, Paris, France
| | - Maeva Zysman
- Département de Pneumologie, CHU Haut-Lévèque, Bordeaux, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM U1045, Pessac, France
| | - Elodie Blanchard
- Département de Pneumologie, CHU Haut-Lévèque, Bordeaux, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM U1045, Pessac, France
| | - Chantal Raherison-Semjen
- Département de Pneumologie, CHU Guadeloupe, Guadeloupe, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM 1219 Epicene Team, Pessac, France
| | - Violaine Giraud
- APHP, Hôpital Ambroise-Paré, Service de Pneumologie et Oncologie thoracique, Boulogne, France
| | - Etienne Giroux-Leprieur
- APHP, Hôpital Ambroise-Paré, Service de Pneumologie et Oncologie thoracique, Boulogne, France.,Univ Paris-Saclay, Université de Versailles-Saint-Quentin (UVSQ), Boulogne, France
| | - Stéfanie Habib
- APHP, Hôpital Cochin, Service de Pneumologie, Université Paris Cité, Institut Cochin (UMR1016), Paris, France
| | - Nicolas Roche
- APHP, Hôpital Cochin, Service de Pneumologie, Université Paris Cité, Institut Cochin (UMR1016), Paris, France
| | - Anh Tuan Dinh-Xuan
- APHP, Hôpital Cochin, Service de Physiologie et Explorations Fonctionnelles, Université de Paris, Paris, France
| | - Islem Sifaoui
- Département d'Imagerie Médicale, APHP, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | | | - Camille Jung
- Centre Hospitalier Intercommunal, CRC, Créteil, France
| | - Emmanuelle Boutin
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France
| | - Richard Layese
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France
| | - Florence Canoui-Poitrine
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France.,APHP, Hôpitaux Universitaires Henri-Mondor, Unité de Recherche Clinique (URC Mondor), Créteil, France.,These two authors contributed equally to this work
| | - Bernard Maitre
- Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France.,Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France.,These two authors contributed equally to this work
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29
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Gazzano M, Parizot C, Psimaras D, Vozy A, Baron M, Abbar B, Fallet V, Litvinova E, Canellas A, Birzu C, Pourcher V, Touat M, Weiss N, Demeret S, Roos-Weil D, Spano JP, Lebbe C, Salem JE, Cadranel J, Hervier B, Gorochov G, Guihot A. Anti-PD-1 immune-related adverse events are associated with high therapeutic antibody fixation on T cells. Front Immunol 2022; 13:1082084. [PMID: 36605194 PMCID: PMC9808779 DOI: 10.3389/fimmu.2022.1082084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Immune checkpoint inhibitors (ICI) widely improved the treatment of solid and hematologic malignancies. Yet, a remarkable proportion of patients receiving ICI develop immune related adverse events (irAEs) which are difficult to define as treatment-related. This underlines the need to develop a biomarker to guide irAE diagnosis. We developed a novel flow cytometry assay combining measurement of anti-PD-1 (programmed cell death protein-1) occupancy and evaluation of remaining PD-1 receptor availability with anti-IgG4 PE and anti-PD-1 BV421. We prospectively collected blood and biological fluids samples from patients treated by IgG4 anti-PD-1 therapy (nivolumab or pembrolizumab), with (n=18) or without (n=12) current irAE. We analyzed PD-1+ and IgG4+ staining pattern and MFI values of these parameters on CD4 and CD8 T cells, and IgG4+/PD-1+ MFI ratios are calculated. A higher mean fluorescence intensity IgG4+/PD-1+ ratio was measured on peripheral CD4+ T cells of irAE cases, when compared to controls (p=0.003). ICI-related toxicity is therefore associated with increased therapeutic antibody occupancy of PD-1 receptors on CD4+ T cells. Furthermore, in one case of ICI-related pneumonitis, binding of therapeutic antibody was stronger on lung CD4+ T cell than in blood. In another case of ICI-related encephalitis, the PD-1 receptor occupancy was total on CSF CD4 T cells, but only partial on peripherical CD4 T cells. Our results suggest that flow cytometry monitoring of ICI occupancy can be used in patients treated with monoclonal ICI to guide irAE diagnosis.
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Affiliation(s)
- Marianne Gazzano
- Department of Immunology, Pitié Salpêtrière Hospital, Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France,*Correspondence: Marianne Gazzano,
| | - Christophe Parizot
- Department of Immunology, Pitié Salpêtrière Hospital, Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Dimitri Psimaras
- Department of Neuro-Oncology, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Aurore Vozy
- Department Medical Oncology, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Marine Baron
- Department of Immunology, Pitié Salpêtrière Hospital, Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Baptiste Abbar
- Department Medical Oncology, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Vincent Fallet
- Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Elena Litvinova
- Department of Immunology, Pitié Salpêtrière Hospital, Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Anthony Canellas
- Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Cristina Birzu
- Department of Neurology 2-Mazarin, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France,Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, INSERM, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Valérie Pourcher
- Service des maladies infectieuses et tropicales, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France,INSERM UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Université, Paris, France
| | - Mehdi Touat
- Department of Neurology 2-Mazarin, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France,Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, INSERM, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Nicolas Weiss
- Department of Neurology, Médecine intensive – réanimation à orientation neurologique, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Sophie Demeret
- Department of Neurology, Médecine intensive – réanimation à orientation neurologique, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Damien Roos-Weil
- Clinical Hematology Unit, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Jean-Philippe Spano
- Department Medical Oncology, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Celeste Lebbe
- Department of Dermatology, Saint Louis Hospital, APHP, Paris, France
| | - Joe-Elie Salem
- Department of Pharmacology, Cardio-oncology Program, CIC-1901, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Jacques Cadranel
- Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Baptiste Hervier
- Department of Internal Medicine, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Guy Gorochov
- Department of Immunology, Pitié Salpêtrière Hospital, Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France
| | - Amélie Guihot
- Department of Immunology, Pitié Salpêtrière Hospital, Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Sorbonne Université, Paris, France,Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), INSERM U1135, CNRS ERL8285, Sorbonne Université, Pitié-Salpêtrière Hospital, Paris, France
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30
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Funke-Chambour M, Kewalramani N, Machahua C, Poletti V, Wells AU, Cadranel J. Reply to: Pharmacotherapy for lung cancer with comorbid interstitial pneumonia: limited evidence requires appropriate evaluation. ERJ Open Res 2022; 8:00469-2022. [PMID: 36655227 PMCID: PMC9835994 DOI: 10.1183/23120541.00469-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 01/21/2023] Open
Abstract
The divergent views on lung cancer treatments in fibrosing lung patients reflect differences due to variable side-effect incidences in different countries and among ethnicities. International efforts are needed to better define treatment approaches. https://bit.ly/3DX40fq.
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Affiliation(s)
- Manuela Funke-Chambour
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,Manuela Funke-Chambour ()
| | - Namrata Kewalramani
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carlos Machahua
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Venerino Poletti
- Department of Thoracic Diseases, “G.B. Morgagni” Hospita, Forlì, Dipartimento di Medicina Specialistica Diagnostica e Sperimentale (DIMES) University of Bologna, Bologna, Italy
| | - Athol U. Wells
- Royal Brompton and Harefield NHS Foundation Trust, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Jacques Cadranel
- Department of Pulmonary Medicine and Thoracic Oncology, Constitutive Reference Center of Rare Pulmonary Diseases, AP-HP, Hôpital Tenon and GRC04 Theranoscan, Sorbonne Université, Paris, France
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Mageau A, Deneuville L, Debray M, Sacre K, Cottin V, Costedoat-Chalumeau N, Hachulla E, Uzunhan Y, Le Tallec E, Cadranel J, Marchand-Adam S, Montani D, Reynaud-Gobert M, Prevot G, Beltramo G, Crestani B, Borie R. Atteintes interstitielles pulmonaires au cours du lupus érythémateux systémique. Étude rétrospective multicentrique de 89 cas. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.064] [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: 12/12/2022]
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Cottin V, Guéguen S, Nunes H, Jouneau S, Crestani B, Bonniaud P, Wemeau L, Israël-Biet D, Reynaud-Gaubert M, Gondouin A, Cadranel J, Marchand-Adam S, Bramki M, Dufaure-Garé I, Amselem S, Clément A, RaDiCo team. Exemples de partenariats réussis d'une cohorte de maladie rare. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.09.027] [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: 11/06/2022] Open
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Godet C, Cadranel J, Frat JP, Ragot S, Couturaud F. Nebulised liposomal amphotericin-B: A promising strategy for preventing ABPA relapse. Eur Respir J 2022; 60:13993003.01678-2022. [PMID: 36137593 DOI: 10.1183/13993003.01678-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Cendrine Godet
- Assistance Publique - Hôpitaux de Paris, Hôpital Bichat, Service de Pneumologie, Paris, France
| | - Jacques Cadranel
- Assistance Publique - Hôpitaux de Paris, Hôpital Tenon, Service de Pneumologie et Oncologie thoracique, Centre constitutif Maladies pulmonaires rares and Sorbonne Université, Paris, France
| | - Jean-Pierre Frat
- CHU Poitiers, Médecine Intensive Réanimation, Poitiers, France; Inserm, CIC 1402, IS-ALIVE, Université de Poitiers, France
| | - Stéphanie Ragot
- INSERM, CIC-1402, Biostatistics, Poitiers, France; Université de Poitiers, Faculté de Médecine et de Pharmacie de Poitiers, Poitiers, France
| | - Francis Couturaud
- Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Département de Médecine Interne et Pneumologie, INSERM U1304, CIC INSERM 1412, Brest, FCRIN INNOVTE, France
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Cottin V, Bonniaud P, Cadranel J, Crestani B, Jouneau S, Marchand-Adam S, Nunes H, Wémeau-Stervinou L, Bergot E, Blanchard E, Borie R, Bourdin A, Chenivesse C, Clément A, Gomez E, Gondouin A, Hirschi S, Lebargy F, Marquette CH, Montani D, Prévot G, Quetant S, Reynaud-Gaubert M, Salaun M, Sanchez O, Trumbic B, Berkani K, Brillet PY, Campana M, Chalabreysse L, Chatté G, Debieuvre D, Ferretti G, Fourrier JM, Just N, Kambouchner M, Legrand B, Le Guillou F, Lhuillier JP, Mehdaoui A, Naccache JM, Paganon C, Rémy-Jardin M, Si-Mohamed S, Terrioux P. [French practical guidelines for the diagnosis and management of IPF - 2021 update, full version]. Rev Mal Respir 2022; 39:e35-e106. [PMID: 35752506 DOI: 10.1016/j.rmr.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients' association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.
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Affiliation(s)
- V Cottin
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France; UMR 754, IVPC, INRAE, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; Membre d'OrphaLung, RespiFil, Radico-ILD2, et ERN-LUNG, Lyon, France.
| | - P Bonniaud
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et soins intensifs respiratoires, centre hospitalo-universitaire de Bourgogne et faculté de médecine et pharmacie, université de Bourgogne-Franche Comté, Dijon ; Inserm U123-1, Dijon, France
| | - J Cadranel
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et oncologie thoracique, Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Tenon, Paris ; Sorbonne université GRC 04 Theranoscan, Paris, France
| | - B Crestani
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - S Jouneau
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Pontchaillou, Rennes ; IRSET UMR1085, université de Rennes 1, Rennes, France
| | - S Marchand-Adam
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, hôpital Bretonneau, service de pneumologie, CHRU, Tours, France
| | - H Nunes
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie, AP-HP, hôpital Avicenne, Bobigny ; université Sorbonne Paris Nord, Bobigny, France
| | - L Wémeau-Stervinou
- Centre de référence constitutif des maladies pulmonaires rares, Institut Cœur-Poumon, service de pneumologie et immuno-allergologie, CHRU de Lille, Lille, France
| | - E Bergot
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie et oncologie thoracique, hôpital Côte de Nacre, CHU de Caen, Caen, France
| | - E Blanchard
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Haut Levêque, CHU de Bordeaux, Pessac, France
| | - R Borie
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - A Bourdin
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, département de pneumologie et addictologie, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, Montpellier ; Inserm U1046, CNRS UMR 921, Montpellier, France
| | - C Chenivesse
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et d'immuno-allergologie, hôpital Albert Calmette ; CHRU de Lille, Lille ; centre d'infection et d'immunité de Lille U1019 - UMR 9017, Université de Lille, CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, Lille, France
| | - A Clément
- Centre de ressources et de compétence de la mucoviscidose pédiatrique, centre de référence des maladies respiratoires rares (RespiRare), service de pneumologie pédiatrique, hôpital d'enfants Armand-Trousseau, CHU Paris Est, Paris ; Sorbonne université, Paris, France
| | - E Gomez
- Centre de compétence pour les maladies pulmonaires rares, département de pneumologie, hôpitaux de Brabois, CHRU de Nancy, Vandoeuvre-les Nancy, France
| | - A Gondouin
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Jean-Minjoz, Besançon, France
| | - S Hirschi
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, Nouvel Hôpital civil, Strasbourg, France
| | - F Lebargy
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Maison Blanche, Reims, France
| | - C-H Marquette
- Centre de compétence pour les maladies pulmonaires rares, FHU OncoAge, département de pneumologie et oncologie thoracique, hôpital Pasteur, CHU de Nice, Nice cedex 1 ; Université Côte d'Azur, CNRS, Inserm, Institute of Research on Cancer and Aging (IRCAN), Nice, France
| | - D Montani
- Centre de compétence pour les maladies pulmonaires rares, centre national coordonnateur de référence de l'hypertension pulmonaire, service de pneumologie et soins intensifs pneumologiques, AP-HP, DMU 5 Thorinno, Inserm UMR S999, CHU Paris-Sud, hôpital de Bicêtre, Le Kremlin-Bicêtre ; Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
| | - G Prévot
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Larrey, Toulouse, France
| | - S Quetant
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et physiologie, CHU Grenoble Alpes, Grenoble, France
| | - M Reynaud-Gaubert
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, AP-HM, CHU Nord, Marseille ; Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - M Salaun
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, oncologie thoracique et soins intensifs respiratoires & CIC 1404, hôpital Charles Nicole, CHU de Rouen, Rouen ; IRIB, laboratoire QuantiIF-LITIS, EA 4108, université de Rouen, Rouen, France
| | - O Sanchez
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et soins intensifs, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | | | - K Berkani
- Clinique Pierre de Soleil, Vetraz Monthoux, France
| | - P-Y Brillet
- Université Paris 13, UPRES EA 2363, Bobigny ; service de radiologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - M Campana
- Service de pneumologie et oncologie thoracique, CHR Orléans, Orléans, France
| | - L Chalabreysse
- Service d'anatomie-pathologique, groupement hospitalier est, HCL, Bron, France
| | - G Chatté
- Cabinet de pneumologie et infirmerie protestante, Caluire, France
| | - D Debieuvre
- Service de pneumologie, GHRMSA, hôpital Emile-Muller, Mulhouse, France
| | - G Ferretti
- Université Grenoble Alpes, Grenoble ; service de radiologie diagnostique et interventionnelle, CHU Grenoble Alpes, Grenoble, France
| | - J-M Fourrier
- Association Pierre-Enjalran Fibrose Pulmonaire Idiopathique (APEFPI), Meyzieu, France
| | - N Just
- Service de pneumologie, CH Victor-Provo, Roubaix, France
| | - M Kambouchner
- Service de pathologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - B Legrand
- Cabinet médical de la Bourgogne, Tourcoing ; Université de Lille, CHU Lille, ULR 2694 METRICS, CERIM, Lille, France
| | - F Le Guillou
- Cabinet de pneumologie, pôle santé de l'Esquirol, Le Pradet, France
| | - J-P Lhuillier
- Cabinet de pneumologie, La Varenne Saint-Hilaire, France
| | - A Mehdaoui
- Service de pneumologie et oncologie thoracique, CH Eure-Seine, Évreux, France
| | - J-M Naccache
- Service de pneumologie, allergologie et oncologie thoracique, GH Paris Saint-Joseph, Paris, France
| | - C Paganon
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France
| | - M Rémy-Jardin
- Institut Cœur-Poumon, service de radiologie et d'imagerie thoracique, CHRU de Lille, Lille, France
| | - S Si-Mohamed
- Département d'imagerie cardiovasculaire et thoracique, hôpital Louis-Pradel, HCL, Bron ; Université de Lyon, INSA-Lyon, Université Claude-Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Villeurbanne, France
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Mehlman C, Swalduz A, Monnet I, Morin C, Guisier F, Curcio H, Du Rusquec P, Cortot A, Gounant V, Abbar B, Duchemann B, Giroux-Leprieur E, Pierret T, Quilot F, Cadranel J, Fallet V. 995P Effectiveness of combination of osimertinib with another targeted therapy in advanced EGFR mutated non-small cell lung cancer harbouring other oncogenic drivers: The real-world COMPOSIT study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1121] [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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Zalcman G, Madroszyk Flandin AC, Molinier O, Dayen C, Egenod T, Debieuvre D, Beaucaire-Danel S, Dixmier A, Pichon E, Galland Girodet S, Giroux-Leprieur E, Cloarec N, Cadranel J, Otto J, Romand P, Langlais A, Morin F, Antoine M, Westeel V, Toffart A. 972O Nivolumab (Nivo) plus ipilimumab (Ipi) 6-months treatment versus continuation in patients with advanced non-small cell lung cancer (aNSCLC): Results of the randomized IFCT-1701 phase III trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1100] [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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Peters S, Gadgeel SM, Mok TSK, Nadal E, Kilickap S, Perol M, Cadranel J, Sugawara S, Chiu CH, Moskovitz M, Yu CJ, Tanaka T, Nersesian R, Shagan SM, Maclennan M, Mathisen M, Bhagawati Prasad VNS, Archer VR, Dziadziuszko R. Efficacy/safety of entrectinib in patients (pts) with ROS1-positive (ROS1+) advanced/metastatic NSCLC from the Blood First Assay Screening Trial (BFAST). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.17_suppl.lba9023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA9023 Background: Tissue-based biomarker testing remains challenging as tumor biopsies are often inadequate for comprehensive biomarker testing and repeat biopsies can be risky in pts with advanced/metastatic NSCLC. These challenges could be overcome by using blood-based testing to identify the most appropriate targeted therapy. BFAST (NCT03178552) is a global open-label, multicohort trial evaluating the efficacy and safety of selected therapies in pts with advanced/metastatic NSCLC harboring actionable genetic alterations, as identified by next-generation sequencing (NGS) in cell-free DNA (liquid biopsies). We present data from the ROS1+ cohort: this is the first evaluation of entrectinib efficacy in pts identified by prospective blood-based NGS. Methods: In this single-arm analysis, adults (≥18 years) with treatment-naïve measurable stage IIIB/IV NSCLC, identified as ROS1+ by the FoundationOne®Liquid CDx CTA blood-based NGS test, received oral entrectinib 600 mg/day until disease progression (PD), unacceptable toxicity, consent withdrawal or death. Pts with asymptomatic brain metastases at screening were eligible. Tumor scans were performed at baseline and every 8 weeks thereafter for all disease involvement areas (brain imaging not mandated in pts without baseline CNS disease). Primary endpoint: investigator (INV)-assessed objective response rate (ORR; RECIST 1.1). Secondary endpoints: INV-assessed duration of response (DoR) and progression-free survival (PFS); independent review facility (IRF)-assessed ORR, DoR, PFS; overall survival (OS); time to CNS PD; safety. Results: 55 pts with ROS1+ NSCLC identified by blood-based NGS were enrolled and treated with entrectinib. Median age was 56 yrs; 58% of pts were female and 75% had no history of tobacco use. Non-squamous adenocarcinoma was the most common histology (n = 48/55; 87%); 4 pts (7.3%) had baseline CNS disease. Median follow-up: 18.3 months. At data cut-off (26 Nov 2021, n = 54 pts with measurable disease), confirmed ORR was 81.5% (n = 44/54; 95% CI 68.6–90.8) by INV (2 complete responses [CR], 42 partial responses [PR]) and IRF (3 CR, 41 PR). Median DoR was 13.0 months (95% CI 6.3–18.4) by INV and 16.7 months (95% CI 5.6–24.0) by IRF. Median PFS was 12.9 months (95% CI 8.7–18.5) by INV, and 14.8 months (95% CI 7.2–24.0) by IRF. OS data were immature with 20 events (36.4%) recorded. Median time to CNS PD was not reached (INV: 9 events; IRF: 6 events). Most treatment-related adverse events were non-serious with no treatment-related deaths. Conclusion: These data support the clinical value of blood-based NGS as another method to inform clinical decision-making in ROS1+ NSCLC. Pts with ROS1+ NSCLC (by blood-based NGS) treated with entrectinib showed deep and durable responses, consistent with results from entrectinib trials that used tissue-based testing. No new safety signals were observed. Clinical trial information: NCT03178552.
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Affiliation(s)
- Solange Peters
- Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | | | - Tony S. K. Mok
- State Laboratory of Translational Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Ernest Nadal
- Thoracic Oncology Unit, Department of Medical Oncology, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Saadettin Kilickap
- Istinye University Faculty of Medicine, Department of Medical Oncology, Istanbul, Turkey
| | - Maurice Perol
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Jacques Cadranel
- Department of Pneumology and Thoracic Oncology, APHP, Hôpital Tenon and GRC04 Theranoscan Sorbonne Université, Paris, France
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Chao-Hua Chiu
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mor Moskovitz
- Thoracic Cancer Service, Rambam Health Care Campus, Haifa, Israel
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | | | | | | | | | - Rafal Dziadziuszko
- Department of Oncology and Radiotherapy and Early Clinical Trials Unit, Medical University of Gdansk, Gdańsk, Poland
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Cadranel J, Sebane L, Ferrer L, Canellas A, Etchepare G, Meteye C, Gallinato O, Fallet V, Lacave R, Menu P, Colin T. Multimodal machine learning model prediction of “individual” response to immunotherapy in 1L stage IV NSCLC. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e21151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21151 Background: Immunotherapy (IO) is the standard of care in 1L stage IV non-small cell lung cancer (NSCLC) cases that are not eligible for targeted therapies. Today, a level of PD-L1 expression of 50% or above is the only standard predictive biomarker for IO efficacy as monotherapy. However, a majority of patients fail to respond to the treatment and are exposed to potentially severe immune-related adverse events. There is thus an urgent need to discover new predictive signatures of response to IO in such setting. Methods: A retrospective 1-year cohort of 63 patients with advanced NSCLC, PD-L1 expression > 50%, and treated with 1L pembrolizumab monotherapy was analyzed to develop a machine learning-based algorithm predictive of response to immunotherapy. Multimodal baseline data were collected including clinical, biological, pathology, molecular, baseline CT scan data and clinical outcomes status (objective response at first evaluation, PFS, OS). For each patient, thoracic tumors were segmented in 3D by both an experimented pneumologist and a radiologist using the SOPHiA DDM for Radiomics platform. Radiomics features were then extracted following the IBSI standards and combined with the other data modalities. A filter-based variable selection method was applied before testing several machine learning algorithms to obtain an individual prediction of the response at first evaluation. The optimization criterion was the Area Under the ROC Curve (AUC). Due to the small size of the cohort, a nested leave-pair-out cross-validation was used to properly estimate the model performance. Results: A logistic regression algorithm reached an AUC of 0.85, a precision of 83%, a sensitivity of 77% and a specificity of 74% for predicting response at first evaluation. The algorithm was able to correctly predict 21 progressions among 28 observed and 27 disease controls among 35 observed. Features with highest weight were representative of the full scope of data modalities included in the model, highlighting the importance of a truly multimodal analysis. Indeed, withdrawing any specific data modality (e.g., radiomics features), led to a decrease of at least ̃10% of the AUC. Patients were then stratified into two groups, progression versus disease control, based upon their predicted response status at first evaluation. These two groups displayed a statistically significant difference in PFS (p < 0.001), suggesting that baseline multimodal data analysis could help predict long-term outcomes. Conclusions: This proof-of-concept study suggests that machine learning applied to baseline multi-modal data can help predict response to IO at the individual patient level, as well as stratify patients to inform long-term outcomes. This algorithm is being improved and validated through a large real-world multicentric international observational study including more than 4000 patients (DEEP-Lung-IV study, NCT04994795).
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Priou S, Lamé G, Zalcman G, Wislez M, Bey R, Chatellier G, Cadranel J, Tannier X, Zelek L, Daniel C, Tournigand C, Kempf E. Influence of the SARS-CoV-2 outbreak on management and prognosis of new lung cancer cases, a retrospective multicenter real-life cohort study. Eur J Cancer 2022; 173:33-40. [PMID: 35843177 PMCID: PMC9234022 DOI: 10.1016/j.ejca.2022.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/04/2022]
Abstract
Introduction The SARS-CoV-2 pandemic has impacted the care of cancer patients. This study sought to assess the pandemic’s impact on the clinical presentations and outcomes of newly referred patients with lung cancer from the Greater Paris area. Methods We retrospectively retrieved the electronic health records and administrative data of 11.4 million patients pertaining to Greater Paris University Hospital (AP-HP). We compared indicators for the 2018–2019 period to those of 2020 in regard to newly referred lung cancer cases. We assessed the initial tumour stage, the delay between the first multidisciplinary tumour board (MTB) and anticancer treatment initiation, and 6-month overall survival (OS) rates depending on the anticancer treatment, including surgery, palliative systemic treatment, and best supportive care (BSC). Result Among 6240 patients with lung cancer, 2179 (35%) underwent tumour resection, 2069 (33%) systemic anticancer therapy, 775 (12%) BSC, whereas 1217 (20%) did not receive any treatment. During the first lockdown, the rate of new diagnoses decreased by 32% compared with that recorded in 2018–2019. Initial tumour stage, repartition of patients among treatment categories, and MTB-related delays remained unchanged. The 6-month OS rates of patients diagnosed in 2018–2019 who underwent tumour resection were 98% versus 97% (HR = 1.2; 95% CI: 0.7–2.0) for those diagnosed in 2020; the respective rates for patients who underwent systemic anticancer therapy were 78% versus 79% (HR = 1.0; 95% CI: 0.8–1.2); these rates were 20% versus 13% (HR = 1.3; 95% CI: 1.1–1.6) for those who received BSC. COVID-19 was associated with poorer OS rates (HR = 2.1; 95% CI: 1.6–3.0) for patients who received systemic anticancer therapy. Conclusions The SARS-CoV-2 pandemic has not exerted any deleterious impact on 6-month OS of new lung cancer patients that underwent active anticancer therapy in Greater Paris University hospitals.
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Sebbag E, Cloarec N, Barthelemy P, Sedmak N, Hamamouche N, Servy H, Desjeux G, Monnet I, Najem A, Porneuf M, Rajpar LS, Meunier J, San T, Chauvenet L, Darut Jouve A, Falkowski S, Rizzo C, Litrowski N, Canellas A, Paitel JF, Pracht M, Cadranel J, Weiss L, Chouaid C, Aparicio T, Nancey S, Arnold C, Sauleau E, Gottenberg JE. POS1412 FIRSTS RESULTS OF THE PRAISE STUDY (PATIENT-REPORTED AUTOIMMUNITY SECONDARY TO CANCER IMMUNOTHERAPY): MULTICENTRIC PROSPECTIVE COHORT STUDY ON AUTOIMMUNE DISEASES SECONDARY TO CANCER IMMUNOTHÉRAPY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1093] [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: 11/04/2022]
Abstract
BackgroundIn cancer immunotherapy, T-lymphocyte activation can lead to secondary autoimmune diseases named OASI for Opportunistic Autoimmunity Secondary to cancer Immunotherapy [1]. The epidemiology of OASI deserves to be further studied due to the unadapted reporting of clinical trials and the lack of prospective studies. Moreover, literature focuses on the most severe OASI and/or on specific OASI (myocarditis, colitis, arthritis).ObjectivesOur goal was to determine incidence, severity of all grade OASI using a multicentric prospective patient cohort starting treatment with cancer immunotherapy.MethodsWe present a multicentric, prospective, observational, longitudinal, real life, French e-cohort. 900 patients treated with ipilimumumab and/or nivolumab will be included. Data is collected from the patient and the oncologist at inclusion, then patients report directly any symptom that could be suggestive of OASI with the help of monthly digital questionaries. In case an OASI is suspected, further confirmation is made with the practician in charge and by a paired analysis with the Système National De Santé (SNDS), the French health insurance registry.ResultsOn the 19/01/2022, 439 patients were included, 310 males (70.6%) and 129 females (29.4%). Mean age is 66 years old with a median follow up of 192 days. 354 patients (80.6%) are treated with Nivolumab alone, 7 (1.6%) with Ipilimumab alone and 76 (17.8 %) with combined Nivolumab + Ipilimumab. 136 patients (31.6%) are treated for a non-small cell lung carcinoma, 107 patients (24.9%) for a clear cell renal carcinoma, 91 patients (21.2%) for a skin melanoma, 49 patients (11.4%) for a head or neck epidermoid carcinoma, 24 patients (5.6%) for another lung cancer sub-type, and 32 patients (5.3%) for another histological cancer type. The mean follow-up is 294 days (+/- 192). 83 patients (18.9%) died since the beginning of the follow up.47 patients (10.7%) developed 63 OASI. The mean delay between the beginning of cancer immunotherapy and the OASI is 134.7 days (+/- 103.4).Approximately, one third of the OASI were musculoskeletal diseases. The OASI included polymyalgia rheumatica (3 patients), psoriatic arthritis (1 patient), polyarthritis (1 patient) systemic lupus (1 patient), arthralgias and myalgias (8 patients), colitis (11 patients), dysthyroïditis (6 patients), hepatitis (4 patients), nephritis (3 patients), pneumonitis (2 patients), hypophysitis (2 patients), adrenal insufficiency (4 patients), myocarditis (1 patient), hemophagocytic lympho-histiocytosis (1 patient), and other types of OASI (15 patients).26 patients (55% of patients with OASI, 5,9% of all patients) had to stop cancer immunotherapy due to an OASI, one because of a rheumatic disease (systemic lupus). 52 patients were treated with corticosteroids, 1 patient with methotrexate (psoriatic arthritis), 3 patients with infliximab (colitis) and 1 patient with abatacept (myocarditis). 1 patient died after an OASI (colitis).ConclusionThe first results of this prospective study, using an original patient-centered methodology, confirm the expected incidence of autoimmune events secondary to cancer immunotherapy and the role of rheumatologists in their therapeutic management.References[1]Kostine M, Chiche L, Lazaro E, et al. Opportunistic autoimmunity secondary to cancer immunotherapy (OASI): An emerging challenge. Rev Med Interne. 2017;38(8):513-525. doi:10.1016/j.revmed.2017.01.004AcknowledgementsBMS funded the study (unrestricted grant) but had no role in study design, data collection, analysis or decision to publish.Disclosure of InterestsEden Sebbag: None declared, Nicolas Cloarec: None declared, Philippe Barthelemy: None declared, Nathanaël Sedmak: None declared, Naima Hamamouche Consultant of: Work for Sanoia Digital CRO, Hervé Servy Consultant of: Work for Sanoia Digital CRO, Guillaume Desjeux Consultant of: Work for Sanoia Digital CRO, Isabelle Monnet: None declared, Abeer Najem: None declared, Marc Porneuf: None declared, Laetitia-Shanna Rajpar: None declared, Jérôme Meunier: None declared, Tévy San: None declared, Laure Chauvenet: None declared, Ariane DARUT JOUVE: None declared, Sabrina FALKOWSKI: None declared, Claudia Rizzo: None declared, Noémie Litrowski: None declared, Anthony Canellas: None declared, Jean-François Paitel: None declared, Marc Pracht: None declared, Jacques Cadranel: None declared, Laurence Weiss: None declared, Christos Chouaid: None declared, Thomas Aparicio: None declared, Stephane Nancey: None declared, Cécile Arnold: None declared, Erik Sauleau: None declared, Jaqcues-Eric Gottenberg: None declared
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Fallet V, Sanchis-Borja M, Benusiglio PR, Cadranel J. Do Female BRCA2 Pathogenic Variant Carriers Have an Increased Risk of Lung Cancer? J Clin Oncol 2022; 40:2508. [PMID: 35549390 DOI: 10.1200/jco.22.00488] [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)
- Vincent Fallet
- Vincent Fallet, MD, Mateo Sanchis-Borja, MD, Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique Hôpitaux de Paris and GRC 4, Theranoscan, Sorbonne Université, Paris, France; Patrick R. Benusiglio, MD, Department of Genetics, Oncogenetics Consulting, Oncogenetics Functional Unit, Groupe Hospitalier Pitié-Salpêtrière APHP, Paris, France, Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France; and Jacques Cadranel, PhD, Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique Hôpitaux de Paris and GRC 4, Theranoscan, Sorbonne Université, Paris, France
| | - Mateo Sanchis-Borja
- Vincent Fallet, MD, Mateo Sanchis-Borja, MD, Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique Hôpitaux de Paris and GRC 4, Theranoscan, Sorbonne Université, Paris, France; Patrick R. Benusiglio, MD, Department of Genetics, Oncogenetics Consulting, Oncogenetics Functional Unit, Groupe Hospitalier Pitié-Salpêtrière APHP, Paris, France, Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France; and Jacques Cadranel, PhD, Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique Hôpitaux de Paris and GRC 4, Theranoscan, Sorbonne Université, Paris, France
| | - Patrick R Benusiglio
- Vincent Fallet, MD, Mateo Sanchis-Borja, MD, Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique Hôpitaux de Paris and GRC 4, Theranoscan, Sorbonne Université, Paris, France; Patrick R. Benusiglio, MD, Department of Genetics, Oncogenetics Consulting, Oncogenetics Functional Unit, Groupe Hospitalier Pitié-Salpêtrière APHP, Paris, France, Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France; and Jacques Cadranel, PhD, Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique Hôpitaux de Paris and GRC 4, Theranoscan, Sorbonne Université, Paris, France
| | - Jacques Cadranel
- Vincent Fallet, MD, Mateo Sanchis-Borja, MD, Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique Hôpitaux de Paris and GRC 4, Theranoscan, Sorbonne Université, Paris, France; Patrick R. Benusiglio, MD, Department of Genetics, Oncogenetics Consulting, Oncogenetics Functional Unit, Groupe Hospitalier Pitié-Salpêtrière APHP, Paris, France, Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France; and Jacques Cadranel, PhD, Department of Pneumology and Thoracic Oncology, Tenon Hospital, Assistance Publique Hôpitaux de Paris and GRC 4, Theranoscan, Sorbonne Université, Paris, France
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Kewalramani N, Machahua C, Poletti V, Cadranel J, Wells AU, Funke-Chambour M. Lung cancer in patients with fibrosing interstitial lung diseases – An overview of current knowledge and challenges. ERJ Open Res 2022; 8:00115-2022. [PMID: 35747227 PMCID: PMC9209850 DOI: 10.1183/23120541.00115-2022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/18/2022] [Indexed: 11/30/2022] Open
Abstract
Patients with progressive fibrosing interstitial lung diseases (fILD) have increased morbidity and mortality. Lung fibrosis can be associated with lung cancer. The pathogenesis of both diseases shows similarities, although not all mechanisms are understood. The combination of the diseases is challenging, due to the amplified risk of mortality, and also because lung cancer treatment carries additional risks in patients with underlying lung fibrosis. Acute exacerbations in fILD patients are linked to increased mortality, and the risk of acute exacerbations is increased after lung cancer treatment with surgery, chemotherapy or radiotherapy. Careful selection of treatment modalities is crucial to improve survival while maintaining acceptable quality of life in patients with combined lung cancer and fILD. This overview of epidemiology, pathogenesis, treatment and a possible role for antifibrotic drugs in patients with lung cancer and fILD is the summary of a session presented during the virtual European Respiratory Society Congress in 2021. The review summarises current knowledge and identifies areas of uncertainty. Most current data relate to patients with combined idiopathic pulmonary fibrosis and lung cancer. There is a pressing need for additional prospective studies, required for the formulation of a consensus statement or guideline on the optimal care of patients with lung cancer and fILD. Lung fibrosis can be associated with lung cancer. More and better-designed studies are needed to determine the true incidence/prevalence of lung cancer in fILD. Optimal treatment strategies urgently need to be defined and evaluated.https://bit.ly/37CzTMu
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Baldacci S, Besse B, Avrillon V, Mennecier B, Mazieres J, Dubray-Longeras P, Cortot AB, Descourt R, Doubre H, Quantin X, Duruisseaux M, Monnet I, Moro-Sibilot D, Cadranel J, Clément-Duchêne C, Cousin S, Ricordel C, Merle P, Otto J, Schneider S, Langlais A, Morin F, Westeel V, Girard N. Lorlatinib for advanced anaplastic lymphoma kinase–positive non–small cell lung cancer: Results of the IFCT-1803 LORLATU cohort. Eur J Cancer 2022; 166:51-59. [DOI: 10.1016/j.ejca.2022.01.018] [Citation(s) in RCA: 5] [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: 10/31/2021] [Revised: 01/03/2022] [Accepted: 01/09/2022] [Indexed: 12/14/2022]
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Benusiglio PR, Fallet V, Cadranel J. Invited editorial: Q and A on hereditary lung cancer. Respir Med Res 2022; 81:100881. [DOI: 10.1016/j.resmer.2021.100881] [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] [Received: 11/29/2021] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
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Mc Leer A, Foll M, Brevet M, Antoine M, Novello S, Mondet J, Cadranel J, Girard N, Giaj Levra M, Demontrond P, Audigier-Valette C, Letouzé E, Lantuéjoul S, Fernandez-Cuesta L, Moro-Sibilot D. Detection of acquired TERT amplification in addition to predisposing p53 and Rb pathways alterations in EGFR-mutant lung adenocarcinomas transformed into small-cell lung cancers. Lung Cancer 2022; 167:98-106. [PMID: 35183375 DOI: 10.1016/j.lungcan.2022.01.008] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/04/2022] [Accepted: 01/13/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Among the different mechanisms of acquired resistance to EGFR tyrosine kinase inhibitors (TKIs) reported in EGFR-mutated lung adenocarcinoma (EGFR-LUAD) patients, histological transformation into small cell carcinoma (SCLC) occurs in 3-14% of resistant cases, regardless of the generation of EGFR-TKI. In recent studies, bi-allelic inactivation of TP53 and RB1 has been identified in a vast majority of transformed SCLCs. However, the molecular mechanisms driving this histologic transformation remain largely unknown, mainly due to the rarity of samples. PATIENTS AND METHODS Out of an initial cohort of 64 patients, tumor tissues of adequate quality and quantity for whole exome sequencing (WES) analysis were available for nine tumors for six patients: paired pre- and post-SCLC transformation samples for three Patients and post-SCLC transformation samples for three other patients. RESULTS Mutational analyses showed concurrent TP53 mutations and Rb pathway alterations in five of the six patients analyzed, confirming their suggested role as predisposing genetic alterations to SCLC transformation. In addition, TERT amplification was detected in four of the six patients and found to be an event acquired during SCLC transformation. Clonal history evolution analyses from the paired LUAD/SCLC samples showed different evolution patterns. In two patients, a large proportion of mutations were present in the most recent common ancestor cell of the initial LUAD and the transformed SCLC clones, whereas in the third patient, few clonal mutations were common between the LUAD and SCLC samples and the ancestor clone that lead to SCLC was present at low frequency in the initial LUAD. CONCLUSION Despite varied clinical presentations and clonal history evolution patterns, in addition to p53 and Rb pathways alterations, TERT amplification emerged as another common genetic mechanism of EGFR-LUAD to SCLC transformation in our cohort, and could represent a candidate therapeutic target in this subset of SCLC tumors.
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Affiliation(s)
- Anne Mc Leer
- Université Grenoble Alpes, Grenoble, France; Service d'Anatomie et Cytologie Pathologiques, Pôle de Biologie et Pathologie, CHU Grenoble Alpes, Grenoble, France; UGA/INSERM U1209/CNRS 5309-Institute for Advanced Biosciences - Université Grenoble Alpes, Grenoble, France.
| | - Matthieu Foll
- International Agency for Research on Cancer (IARC-WHO), Section of Genetics, Lyon, France
| | - Marie Brevet
- Hospices Civils de Lyon, Institut de pathologie Multisite, Site Est, Bron and Université Claude Bernard Lyon 1, Lyon, France
| | - Martine Antoine
- Service d'Anatomie et Cytologie Pathologique, APHP, Hôpital Tenon, 75020 Paris, France and Theranoscan CRC#4 and Curamus Sorbonne Université, Paris, France
| | - Silvia Novello
- Department of Oncology, AOU San Luigi-Orbassano, University of Turin, Italy
| | - Julie Mondet
- Université Grenoble Alpes, Grenoble, France; Service d'Anatomie et Cytologie Pathologiques, Pôle de Biologie et Pathologie, CHU Grenoble Alpes, Grenoble, France; UGA/INSERM U1209/CNRS 5309-Institute for Advanced Biosciences - Université Grenoble Alpes, Grenoble, France
| | - Jacques Cadranel
- Service de Pneumologie et Oncologie thoracique, APHP, Hôpital Tenon and GRC#4 Theranoscan and Curamus Sorbonne Université, Paris, France
| | | | - Matteo Giaj Levra
- Clinique Hospitalo-Universitaire de Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Grenoble, France
| | | | | | - Eric Letouzé
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Université Paris Nord, Functional Genomics of Solid Tumors Laboratory, Equipe Labellisée Ligue Contre le Cancer, F-75006 Paris, France
| | - Sylvie Lantuéjoul
- Université Grenoble Alpes, Grenoble, France; Cancer Research Center Lyon, Centre Léon Bérard, Lyon, France
| | | | - Denis Moro-Sibilot
- Université Grenoble Alpes, Grenoble, France; UGA/INSERM U1209/CNRS 5309-Institute for Advanced Biosciences - Université Grenoble Alpes, Grenoble, France; Clinique Hospitalo-Universitaire de Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Grenoble, France
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Hermine O, Mariette X, Porcher R, Djossou F, Nguyen Y, Arlet JB, Savale L, Diehl JL, Georgin-Lavialle S, Cadranel J, Pialoux G, Lacombe K, Mekinian A, Gros H, Lescure X, Ghosn J, Coupez E, Grapin K, Rapp C, Michel M, Lecapitaine AL, Michot JM, Costedoat-Chalumeau N, Nguyen LBL, Semerano L, Raffi F, Aguillar C, Rouzaud C, Gottenberg JE, Hansmann Y, Bienvenu B, London J, Fantchou FS, Ackermann F, Gros A, Morel A, Gambier N, Sène D, Mégarbane B, Azoulay E, Bureau S, Dougados M, Emmerich J, Fartoukh M, Guidet B, Humbert M, Mahevas M, Pène F, Schlemmer F, Pourcher-Martinez V, Tibi A, Baron G, Perrodeau E, Baron S, Steg G, Yazdapanah Y, Simon T, Resche-Rigon M, Tharaux PL, Ravaud P. Tocilizumab plus dexamethasone versus dexamethasone in patients with moderate-to-severe COVID-19 pneumonia: A randomised clinical trial from the CORIMUNO-19 study group. EClinicalMedicine 2022; 46:101362. [PMID: 35350097 PMCID: PMC8949640 DOI: 10.1016/j.eclinm.2022.101362] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 02/07/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In moderate-to-severe COVID-19 pneumonia, dexamethasone (DEX) and tocilizumab (TCZ) reduce the occurrence of death and ventilatory support. We investigated the efficacy and safety of DEX+TCZ in an open randomized clinical trial. METHODS From July 24, 2020, through May 18, 2021, patients with moderate-to-severe COVID-19 pneumonia requiring oxygen (>3 L/min) were randomly assigned to receive DEX (10 mg/d 5 days tapering up to 10 days) alone or combined with TCZ (8 mg/kg IV) at day 1, possibly repeated with a fixed dose of 400 mg i.v. at day 3. The primary outcome was time from randomization to mechanical ventilation support or death up to day 14, analysed on an intent-to-treat basis using a Bayesian approach. ClinicalTrials.gov number, NCT04476979. FINDINGS A total of 453 patients were randomized, 3 withdrew consent, 450 were analysed, of whom 226 and 224 patients were assigned to receive DEX or TCZ+DEX, respectively. At day 14, mechanical ventilation or death occurred in 32/226 (14%) and 27/224 (12%) in the DEX and TCZ+DEX arms, respectively (hazard ratio [HR] 0·85, 90% credible interval [CrI] 0·55 to 1·31). At day 14, the World health Organization (WHO) clinical progression scale (CPS) was significantly improved in the TCZ+DEX arm (OR 0·69, 95% CrI, 0·49 to 0.97). At day 28, the cumulative incidence of oxygen supply independency was 82% in the TCZ+DEX arms and 72% in the DEX arm (HR 1·36, 95% CI 1·11 to 1·67). On day 90, 24 deaths (11%) were observed in the DEX arm and 18 (8%) in the TCZ+DEX arm (HR 0·77, 95% CI 0·42-1·41). Serious adverse events were observed in 25% and 21% in DEX and TCZ+DEX arms, respectively. INTERPRETATION Mechanical ventilation need and mortality were not improved with TCZ+DEX compared with DEX alone. The safety of both treatments was similar. However, given the wide confidence intervals for the estimate of effect, definitive interpretation cannot be drawn. FUNDING Programme Hospitalier de Recherche Clinique [PHRC COVID-19-20-0151, PHRC COVID-19-20-0029], Fondation de l'Assistance Publique - Hôpitaux de Paris (Alliance Tous Unis Contre le Virus) and from Fédération pour la Recherche Médicale" (FRM). Tocilizumab was provided by Roche.
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Affiliation(s)
- Olivier Hermine
- Département d'hématologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, 149 rue de Sèvres, Paris 75015, France
- Laboratory of physiopathology and treatment of Hematological malignancies, Institut imagine, INSERM U1153, Université de Paris, Paris, France
- Corresponding author at: Département d'hématologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, 149 rue de Sèvres, Paris 75015, France.
| | - Xavier Mariette
- Département de Rhumatologie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Raphael Porcher
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Felix Djossou
- Service de maladies infectieuses et tropicales (UMIT), TBIP, Univ. de Guyane, Cayenne 97300, French Guiana
- Univ. de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille 59000, France
| | - Yann Nguyen
- Département de Médecine interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Jean-Benoît Arlet
- Département de Médecine interne, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Laurent Savale
- Université Paris–Saclay, INSERM UMR_S999, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Jean Luc Diehl
- Département de Réanimation, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Sophie Georgin-Lavialle
- Département de Médecine Interne, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Jacques Cadranel
- Département de Pneumologie, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Gilles Pialoux
- Département de Maladies Infectieuses, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Karine Lacombe
- Département de Maladies Infectieuses, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Arsène Mekinian
- Département de Médecine Interne, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Hélène Gros
- Service de Médecine Interne et Maladies Infectieuses, CHI Robert Ballanger, Aulnay sous Bois 93600, France
| | - Xavier Lescure
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Jade Ghosn
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, and INSERM UMRS 1137 IAME, Université de Paris, Paris France
| | - Elisabeth Coupez
- Département de Réanimation, Hôpital Gabriel Montpied, CHU de Clermont Ferrand Université de Clermont Ferrand, France
| | - Kevin Grapin
- Département de Pneumologie, Hôpital Gabriel Montpied, CHU de Clermont Ferrand, Université de Clermont Ferrand, France
| | - Christophe Rapp
- Service de Médecine Interne, Hôpital Américain, Neuilly, France
| | - Marc Michel
- Département de Médecine interne, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université de Paris Est Créteil, Créteil France
| | | | - Jean Marie Michot
- Service d'hématologie, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Nathalie Costedoat-Chalumeau
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Luca Semerano
- Service de Rhumatologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Université de Paris Nord Sorbonne, Bobigny, France
| | - François Raffi
- Department of Infectious Diseases, Hotel-Dieu Hospital and INSERM CIC 1413, Nantes University Hospital, Nantes, France
| | - Claire Aguillar
- Département de maladies Infectieuses, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Claire Rouzaud
- Département de maladies Infectieuses, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
- Département de maladies Infectieuses, Hôpital Saint Joseph, University of Paris, Paris France
| | - Jacques Eric Gottenberg
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Service de maladies infectieuses, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Boris Bienvenu
- Département de médecine Interne, Hôpital Saint Joseph, Marseille, France
| | - Jonathan London
- Service de Médecine interne, Hôpital des Diaconesse-Croix saint Simon, Paris, France
| | - Franklin Samou Fantchou
- Service de Maladies Infectieuses, Centre hospitalier du centre Hospitalier de l'ouest Guyanais, Saint Laurent du Maroni, France
| | | | - Antoine Gros
- Service de Réanimation Médico-chirurgicale, Hôpital André Mignot, Versailles, France
| | - Alexandre Morel
- Service d'Hématologie, Hôpital Privé d'Antony, Antony, France
| | - Nicolas Gambier
- Service de Maladies Infectieuses, Centre Hospitalier Saint Denis, Hôpital Delafontaine, Saint Denis, France
| | - Damien Sène
- Service de Médecine Interne, Hôpital de Lariboisière, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Bruno Mégarbane
- Réanimation Médicale et Toxicologique, Hôpital de Lariboisière, Assistance Publique Hôpitaux de Paris, Université de Paris, INSERM UMRS-1144, Paris France
| | - Elie Azoulay
- Département de Réanimation, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Serge Bureau
- Direction de la recherche clinique, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Maxime Dougados
- Département de Rhumatologie, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Joseph Emmerich
- Département de médecine vasculaire, Hôpital Saint Joseph, Université de Paris, Paris France
| | - Muriel Fartoukh
- Département de Réanimation, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Bertrand Guidet
- Département de Réanimation, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Marc Humbert
- Université Paris–Saclay, INSERM UMR_S999, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Mathieu Mahevas
- Département de Médecine interne, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université de Paris Est Créteil, Créteil France
| | - Frédéric Pène
- Service de Médecine Intensive et Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris. Centre, Université de Paris, Paris France
| | - Frédéric Schlemmer
- Université de Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Unité de Pneumologie - Service de Médecine Intensive et Réanimation, Hôpitaux Universitaires Henri Mondor, Créteil France
| | - Valérie Pourcher-Martinez
- Département de Maladies Infectieuses, Hôpital de la Pitié Salpétrière, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Annick Tibi
- Agence Générale des Equipements et Produits de Santé, Assistance Publique des hôpitaux de Paris, Paris, France
| | - Gabriel Baron
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Elodie Perrodeau
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Stéphanie Baron
- Département de physiologie et explorations fonctionelles, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Gabriel Steg
- Département de cardiologie, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Yazdan Yazdapanah
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Tabassome Simon
- Service de pharmacologie clinique, centre de recherche clinique de Paris Est, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Matthieu Resche-Rigon
- Service de biostatistique et information médicale, INSERM U153, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Pierre-Louis Tharaux
- INSERM U970 Paris Cardiovascular Centre (PARCC), Université de Paris, Paris, France
| | - Philippe Ravaud
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
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Chour A, Denis J, Lafitte C, Mascaux C, Zysman M, Lemaitre A, Swalduz A, Gounant V, Cortot A, Darrason M, Cadranel J, Auclin E, Basse C, Tissot C, Decroisette C, Bombaron P, Giroux-Leprieur E, Falchero L, Lebossé F, Duruisseaux M. 37P Sotorasib-induced liver and non-liver toxicity associated with sequential sotorasib following anti-PD(L)1 in KRASG12C mutant lung cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.046] [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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Girard N, Galland-Girodet S, Avrillon V, Besse B, Duruisseaux M, Cadranel J, Otto J, Prevost A, Roch B, Bennouna J, Bouledrak K, Coudurier M, Egenod T, Lamy R, Ricordel C, Moro-Sibilot D, Odier L, Tillon-Strozyk J, Zalcman G, Missy P, Westeel V, Baldacci S. Lorlatinib for advanced ROS1+ non-small-cell lung cancer: results of the IFCT-1803 LORLATU study. ESMO Open 2022; 7:100418. [PMID: 35227966 PMCID: PMC9058895 DOI: 10.1016/j.esmoop.2022.100418] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/10/2022] [Accepted: 02/02/2022] [Indexed: 12/25/2022] Open
Abstract
Introduction ROS1-rearranged (ROS1+) non-small-cell lung cancer (NSCLC) is a rare lung cancer with limited treatment options. Phase I-II studies with ROS1-tyrosine kinase inhibitors (TKIs) included small numbers of patients and real-world data are lacking. We investigate the efficacy and safety of lorlatinib, a third-generation TKI targeting ALK and ROS1, in patients with ROS1+ NSCLC treated through an expanded access program. Methods Consecutive patients with advanced ROS1+ NSCLC treated with lorlatinib between October 2015 and June 2019 were included. Data were collected from medical records. The primary endpoint was progression-free survival. Results Out of the 80 patients included, 47(59%) were female, 49(62%) never smokers (less than 100 cigarettes over the lifetime), and 68(85%) had stage IV NSCLC at diagnosis. Most frequent histology was adenocarcinoma (95%) and median age was 58.2 years. At the time of lorlatinib initiation, 51(64%) patients had brain metastases and 55(81%) were PS 0-1. Lorlatinib was administered as second/third/fourth/fifth+ line in 29%/28%/18%/26% of patients. All patients previously received at least one ROS1 TKI, and 55(69%) previously received chemotherapy. Median follow-up from lorlatinib initiation was 22.2 months. Median progression-free survival and overall survival from lorlatinib initiation were 7.1 months [95% confidence interval (CI) 5.0-9.9 months] and 19.6 months (95% CI 12.3-27.5 months). Median duration of treatment with lorlatinib was 7.4 months (95% CI 6.5-13.1 months). Overall response and disease control rates were 45% and 82%, respectively. The central nervous system response rate was 72%. Treatment was stopped due to toxicity in 10 patients (13%). The safety profile was consistent with previously published data. Conclusions Lorlatinib is a major treatment option for advanced refractory ROS1+ NSCLC in treatment strategy. Data are lacking on lorlatinib efficacy in advanced refractory ROS1+ NSCLC. Lorlatinib median progression-free survival and objective response rate were 7.1 months and 45%, respectively. Lorlatinib represents a major treatment option for patients with a ROS1+ NSCLC.
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Cottin V, Bonniaud P, Cadranel J, Jouneau S, Marchand-Adam S, Nunes H, Wémeau-Stervinou L, Crestani B. [Idiopathic pulmonary fibrosis: Update of French practical guidelines]. Rev Mal Respir 2022; 39:193-198. [PMID: 35337709 DOI: 10.1016/j.rmr.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 10/18/2022]
Affiliation(s)
- V Cottin
- Service de pneumologie, centre national coordonnateur de référence des maladies pulmonaires rares (OrphaLung), UMR 754, INRAE, hospices civils de Lyon (HCL), université Claude-Bernard Lyon 1, hôpital Louis-Pradel, Lyon, France.
| | - P Bonniaud
- Inserm U123-1, faculté de médecine et pharmacie, centre de référence constitutif des maladies pulmonaires rares, centre hospitalo-universitaire de Bourgogne, université de Bourgogne-Franche Comté, Dijon, France
| | - J Cadranel
- Centre de référence constitutif des maladies pulmonaires rares, Sorbonne université GRC 04 Theranoscan, hôpital Tenon, AP-HP, Paris, France
| | - S Jouneau
- Service de pneumologie, centre de compétence pour les maladies pulmonaires rares de l'adulte, IRSET UMR1085, université de Rennes 1, hôpital Pontchaillou, Rennes, France
| | - S Marchand-Adam
- Service de pneumologie, centre de compétence pour les maladies pulmonaires rares de l'adulte, CHRU, hôpital Bretonneau, Tours, France
| | - H Nunes
- Service de pneumologie, centre de référence constitutif des maladies pulmonaires rares, université Sorbonne Paris Nord, hôpital Avicenne, AP-HP, Bobigny, France
| | - L Wémeau-Stervinou
- Service de pneumologie et immuno-allergologie, centre de référence constitutif des maladies pulmonaires rares, institut Cœur-Poumon, CHU de Lille, Lille, France
| | - B Crestani
- Service de pneumologie A, centre de référence constitutif des maladies pulmonaires rares, université Paris Cité, hôpital Bichat, AP-HP, Paris, France
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50
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Baron M, Soulié C, Lavolé A, Assoumou L, Abbar B, Fouquet B, Rousseau A, Veyri M, Samri A, Makinson A, Choquet S, Mazières J, Brosseau S, Autran B, Costagliola D, Katlama C, Cadranel J, Marcelin AG, Lambotte O, Spano JP, Guihot A. Impact of Anti PD-1 Immunotherapy on HIV Reservoir and Anti-Viral Immune Responses in People Living with HIV and Cancer. Cells 2022; 11:cells11061015. [PMID: 35326466 PMCID: PMC8946896 DOI: 10.3390/cells11061015] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Received: 02/01/2022] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023] Open
Abstract
The role of immune checkpoints (ICPs) in both anti-HIV T cell exhaustion and HIV reservoir persistence, has suggested that an HIV cure therapeutic strategy could involve ICP blockade. We studied the impact of anti-PD-1 therapy on HIV reservoirs and anti-viral immune responses in people living with HIV and treated for cancer. At several timepoints, we monitored CD4 cell counts, plasma HIV-RNA, cell associated (CA) HIV-DNA, EBV, CMV, HBV, HCV, and HHV-8 viral loads, activation markers, ICP expression and virus-specific T cells. Thirty-two patients were included, with median follow-up of 5 months. The CA HIV-DNA tended to decrease before cycle 2 (p = 0.049). Six patients exhibited a ≥0.5 log10 HIV-DNA decrease at least once. Among those, HIV-DNA became undetectable for 10 months in one patient. Overall, no significant increase in HIV-specific immunity was observed. In contrast, we detected an early increase in CTLA-4 + CD4+ T cells in all patients (p = 0.004) and a greater increase in CTLA-4+ and TIM-3 + CD8+ T cells in patients without HIV-DNA reduction compared to the others (p ≤ 0.03). Our results suggest that ICP replacement compensatory mechanisms might limit the impact of anti-PD-1 monotherapy on HIV reservoirs, and pave the way for combination ICP blockade in HIV cure strategies.
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Affiliation(s)
- Marine Baron
- INSERM U1135, CIMI, Département d’Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (B.A.); (B.F.); (A.R.); (A.S.); (B.A.); (A.G.)
- Correspondence:
| | - Cathia Soulié
- INSERM UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Département de Virologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (C.S.); (A.-G.M.)
| | - Armelle Lavolé
- GRC #04 Theranoscan, Département de Pneumologie et Oncologie Thoracique, AP-HP, Hôpital Tenon, Sorbonne Université, F-75020 Paris, France; (A.L.); (J.C.)
| | - Lambert Assoumou
- INSERM UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, F-75013 Paris, France; (L.A.); (D.C.)
| | - Baptiste Abbar
- INSERM U1135, CIMI, Département d’Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (B.A.); (B.F.); (A.R.); (A.S.); (B.A.); (A.G.)
| | - Baptiste Fouquet
- INSERM U1135, CIMI, Département d’Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (B.A.); (B.F.); (A.R.); (A.S.); (B.A.); (A.G.)
| | - Alice Rousseau
- INSERM U1135, CIMI, Département d’Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (B.A.); (B.F.); (A.R.); (A.S.); (B.A.); (A.G.)
| | - Marianne Veyri
- Département d’Oncologie Médicale, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (M.V.); (J.-P.S.)
| | - Assia Samri
- INSERM U1135, CIMI, Département d’Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (B.A.); (B.F.); (A.R.); (A.S.); (B.A.); (A.G.)
| | - Alain Makinson
- INSERM U1175, Département de Maladies Infectieuses, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, F-34090 Montpellier, France;
| | - Sylvain Choquet
- Département d’Hématologie Clinique, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France;
| | - Julien Mazières
- Département de Pneumologie, Centre Hospitalier Universitaire de Toulouse, F-31000 Toulouse, France;
| | - Solenn Brosseau
- Département de Pneumologie, AP-HP, Hôpital Bichat-Claude Bernard, F-75018 Paris, France;
| | - Brigitte Autran
- INSERM U1135, CIMI, Département d’Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (B.A.); (B.F.); (A.R.); (A.S.); (B.A.); (A.G.)
| | - Dominique Costagliola
- INSERM UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, F-75013 Paris, France; (L.A.); (D.C.)
| | - Christine Katlama
- Département de Maladies Infectieuses, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France;
| | - Jacques Cadranel
- GRC #04 Theranoscan, Département de Pneumologie et Oncologie Thoracique, AP-HP, Hôpital Tenon, Sorbonne Université, F-75020 Paris, France; (A.L.); (J.C.)
| | - Anne-Geneviève Marcelin
- INSERM UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Département de Virologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (C.S.); (A.-G.M.)
| | - Olivier Lambotte
- Département d’Immunologie Clinique, AP-HP, Hôpital Bicêtre, Université Paris-Saclay, F-94270 Le Kremlin Bicêtre, France;
- INSERM, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IDMIT/IMVA-HB), UMR1184, Université Paris-Saclay, F-94270 Le Kremlin Bicêtre, France
| | - Jean-Philippe Spano
- Département d’Oncologie Médicale, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (M.V.); (J.-P.S.)
| | - Amélie Guihot
- INSERM U1135, CIMI, Département d’Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, F-75013 Paris, France; (B.A.); (B.F.); (A.R.); (A.S.); (B.A.); (A.G.)
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