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Remon J, Auclin E, Zubiri L, Schneider S, Rodriguez-Abreu D, Minatta N, Gautschi O, Aboubakar F, Muñoz-Couselo E, Pierret T, Rothschild SI, Cortiula F, Reynolds KL, Thibault C, Gavralidis A, Blais N, Barlesi F, Planchard D, Besse BMD. Immune checkpoint blockers in solid organ transplant recipients and cancer: the INNOVATED cohort. ESMO Open 2024; 9:103004. [PMID: 38653155 PMCID: PMC11053286 DOI: 10.1016/j.esmoop.2024.103004] [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: 01/27/2024] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Patients with solid organ transplant (SOT) and solid tumors are usually excluded from clinical trials testing immune checkpoint blockers (ICB). As transplant rates are increasing, we aimed to evaluate ICB outcomes in this population, with a special focus on lung cancer. METHODS We conducted a multicenter retrospective cohort study collecting real data of ICB use in patients with SOT and solid tumors. Clinical data and treatment outcomes were assessed by using retrospective medical chart reviews in every participating center. Study endpoints were: overall response rate (ORR), 6-month progression-free survival (PFS), and grade ≥3 immune-related adverse events. RESULTS From August 2016 to October 2022, 31 patients with SOT (98% kidney) and solid tumors were identified (36.0% lung cancer, 19.4% melanoma, 13.0% genitourinary cancer, 6.5% gastrointestinal cancer). Programmed death-ligand 1 expression was positive in 29% of tumors. Median age was 61 years, 69% were males, and 71% received ICB as first-line treatment. In the whole cohort the ORR was 45.2%, with a 6-month PFS of 56.8%. In the lung cancer cohort, the ORR was 45.5%, with a 6-month PFS of 32.7%, and median overall survival of 4.6 months. The grade 3 immune-related adverse events rate leading to ICB discontinuation was 12.9%. Allograft rejection rate was 25.8%, and risk of rejection was similar regardless of the type of ICB strategy (monotherapy or combination, 28% versus 33%, P = 1.0) or response to ICB treatment. CONCLUSIONS ICB could be considered a feasible option for SOT recipients with some advanced solid malignancies and no alternative therapeutic options. Due to the risk of allograft rejection, multidisciplinary teams should be involved before ICB therapy.
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Affiliation(s)
- J Remon
- Paris-Saclay University, Department of Cancer Medicine, Gustave Roussy, Villejuif.
| | - E Auclin
- Department of Cancer Medicine, Hôpital Européen Georges-Pompidou, Paris, France
| | - L Zubiri
- Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, USA
| | - S Schneider
- Department Pneumology, Hôpital de Bayonne, Bayonne, France
| | - D Rodriguez-Abreu
- Medical Oncology Department, Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - N Minatta
- Department of Oncology Hospital Italiano Buenos Aires, Buenos Aires, Argentina
| | - O Gautschi
- Department of Cancer Medicine, University of Berne and Cantonal Hospital of Lucerne, Lucerne, Switzerland
| | - F Aboubakar
- Department of Pneumology, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - E Muñoz-Couselo
- Department of Oncology, Hospital Vall d'Hebron de Barcelona, VHIO Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - T Pierret
- Department of Pneumology, CHU Grenoble Alpes, Grenoble, France
| | - S I Rothschild
- Medical Oncology Department, University Hospital Basel, Basel; Division Oncology/Hematology, Department of Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - F Cortiula
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | - K L Reynolds
- Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, USA
| | - C Thibault
- Department of Cancer Medicine, Hôpital Européen Georges-Pompidou, Paris, France
| | - A Gavralidis
- Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, USA; Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston; Salem Hospital, Salem, USA
| | - N Blais
- Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - F Barlesi
- Paris-Saclay University, Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - D Planchard
- Paris-Saclay University, Department of Cancer Medicine, Gustave Roussy, Villejuif
| | - B M D Besse
- Paris-Saclay University, Department of Cancer Medicine, Gustave Roussy, Villejuif
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Besse B, Felip E, Garcia Campelo R, Cobo M, Mascaux C, Madroszyk A, Cappuzzo F, Hilgers W, Romano G, Denis F, Viteri S, Debieuvre D, Galetta D, Baldini E, Razaq M, Robinet G, Maio M, Delmonte A, Roch B, Masson P, Schuette W, Zer A, Remon J, Costantini D, Vasseur B, Dziadziuszko R, Giaccone G. Randomized open-label controlled study of cancer vaccine OSE2101 versus chemotherapy in HLA-A2-positive patients with advanced non-small-cell lung cancer with resistance to immunotherapy: ATALANTE-1. Ann Oncol 2023; 34:920-933. [PMID: 37704166 DOI: 10.1016/j.annonc.2023.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 04/04/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Patients with advanced non-small-cell lung cancer (NSCLC) treated with immune checkpoint blockers (ICBs) ultimately progress either rapidly (primary resistance) or after durable benefit (secondary resistance). The cancer vaccine OSE2101 may invigorate antitumor-specific immune responses after ICB failure. The objective of ATALANTE-1 was to evaluate its efficacy and safety in these patients. PATIENTS AND METHODS ATALANTE-1 was a two-step open-label study to evaluate the efficacy and safety of OSE2101 compared to standard-of-care (SoC) chemotherapy (CT). Patients with human leukocyte antigen (HLA)-A2-positive advanced NSCLC without actionable alterations, failing sequential or concurrent CT and ICB were randomized (2 : 1) to OSE2101 or SoC (docetaxel or pemetrexed). Primary endpoint was overall survival (OS). Interim OS futility analysis was planned as per Fleming design. In April 2020 at the time of interim analysis, a decision was taken to prematurely stop the accrual due to coronavirus disease 2019 (COVID-19). Final analysis was carried out in all patients and in the subgroup of patients with ICB secondary resistance defined as failure after ICB monotherapy second line ≥12 weeks. RESULTS Two hundred and nineteen patients were randomized (139 OSE2101, 80 SoC); 118 had secondary resistance to sequential ICB. Overall, median OS non-significantly favored OSE2101 over SoC {hazard ratio (HR) [95% confidence interval (CI)] 0.86 [0.62-1.19], P = 0.36}. In the secondary resistance subgroup, OSE2101 significantly improved median OS versus SoC [11.1 versus 7.5 months; HR (95% CI) 0.59 (0.38-0.91), P = 0.017], and significantly improved post-progression survival (HR 0.46, P = 0.004), time to Eastern Cooperative Oncology Group (ECOG) performance status deterioration (HR 0.43, P = 0.006) and Quality of Life Questionnaire Core 30 (QLQ-C30) global health status compared to SoC (P = 0.045). Six-month disease control rates and progression-free survival were similar between groups. Grade ≥3 adverse effects occurred in 11.4% of patients with OSE2101 and 35.1% in SoC (P = 0.002). CONCLUSIONS In HLA-A2-positive patients with advanced NSCLC and secondary resistance to immunotherapy, OSE2101 increased survival with better safety compared to CT. Further evaluation in this population is warranted.
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Affiliation(s)
- B Besse
- Paris-Saclay University, Cancer Medicine Department, Institut Gustave Roussy, Villejuif, France.
| | - E Felip
- Oncology Department, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona
| | - R Garcia Campelo
- Medical Oncology Department, Complejo Hospitalario Universitario A Coruña, Biomedical Research Institute, INIBIC, A Coruña
| | - M Cobo
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain
| | - C Mascaux
- Pneumology Department, Hôpitaux Universitaires de Strasbourg-Nouvel Hôpital Civil, Strasbourg
| | - A Madroszyk
- Medical Oncology Department, IPC-Institut Paoli-Calmettes, Marseille, France
| | - F Cappuzzo
- Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - W Hilgers
- Medical Oncology Department, Sainte Catherine Cancer Center, Avignon, France
| | - G Romano
- Medical Oncology Department, Ospedale Vito Fazzi-ASL Lecce, Lecce, Italy
| | - F Denis
- Medical Oncology Department, Institut Inter-Régional de Cancérologie Jean Bernard-Elsan, Le Mans, France
| | - S Viteri
- Medical Oncology Department, Instituto Oncológico Dr. Rosell, Hospital Universitario Dexeus, Grupo Quironsalud, Barcelona, Spain
| | - D Debieuvre
- Pneumology Department, Groupe Hospitalier de la Région Mulhouse Sud Alsace, Mulhouse, France
| | - D Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari
| | - E Baldini
- Oncology Department, Ospedale San Luca, Lucca, Italy
| | - M Razaq
- Oncology Department, Stephenson Cancer Center, Oklahoma City, USA
| | - G Robinet
- Oncology Department, Centre Hospitalier Régional Universitaire Morvan, Brest, France
| | - M Maio
- Department of Oncology, University of Siena and Center for Immuno-Oncology, University Hospital, Siena
| | - A Delmonte
- Thoracic Department, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Meldola, Italy
| | - B Roch
- Thoracic Oncology Unit, Montpellier University, University Hospital of Montpellier, Montpellier
| | - P Masson
- Pneumology Department, Centre Hospitalier de Cholet, Cholet, France
| | - W Schuette
- Medical Oncology Department, Hospital Martha-Maria Halle-Doelau, Halle, Germany
| | - A Zer
- Thoracic Cancer Service, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - J Remon
- Paris-Saclay University, Cancer Medicine Department, Institut Gustave Roussy, Villejuif, France
| | - D Costantini
- Medical Development Department, OSE Immunotherapeutics, Paris, France
| | - B Vasseur
- Medical Development Department, OSE Immunotherapeutics, Paris, France
| | - R Dziadziuszko
- Oncology and Radiotherapy Department and Early Phase Clinical Trials Centre, Medical University of Gdansk, Gdansk, Poland
| | - G Giaccone
- Meyer Cancer Center, Weill Cornell Medicine, New York, USA
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Remon J, Besse B, Aix SP, Callejo A, Al-Rabi K, Bernabe R, Greillier L, Majem M, Reguart N, Monnet I, Cousin S, Garrido P, Robinet G, Campelo RG, Madroszyk A, Mazières J, Curcio H, Wasąg B, Pretzenbacher Y, Fournier B, Dingemans AMC, Dziadziuszko R. Osimertinib treatment based on plasma T790M monitoring in patients with EGFR-mutant non-small cell lung cancer (NSCLC): EORTC Lung Cancer Group 1613 APPLE phase II randomized clinical trial. Ann Oncol 2023; 34:468-476. [PMID: 36863484 DOI: 10.1016/j.annonc.2023.02.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [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: 08/21/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The APPLE trial aimed to evaluate the feasibility of longitudinal plasma EGFR T790M monitoring for the best sequencing strategy of gefitinib and osimertinib. METHODS APPLE is a randomized, non-comparative, phase II study in patients with common EGFR-mutant, treatment-naïve NSCLC including 3-arms: Arm A (osimertinib upfront until RECIST progression, PD), Arm B (gefitinib until emergence of circulating tumor DNA EGFR T790M mutation by cobas EGFR Test v2 or RECIST PD) and Arm C (gefitinib until RECIST PD), and then switch to osimertinib in both arms. The primary endpoint is the progression-free survival rate "on osimertinib" at 18 months (PFSR-OSI-18) after randomization in Arm B (H0: PFSR-OSI-18 of ≤40%). Secondary endpoints include response rate, overall survival (OS) and brain PFS (BPFS). We report the results of Arms B and C. RESULTS From November 2017 to February 2020, 52 and 51 patients were randomized into Arms B and C. Most patients were females (70%) and had EGFR Del19 (65%); one-third had baseline brain metastases. In Arm B, 17% of patients (8/47) switched to osimertinib based on the emergence of ct-DNA T790M mutation before RECIST PD, with a median time to molecular PD of 266 days. The study met its primary endpoint of PFSR-OSI-18 by 67.2% (84% CI: 56.4-75.9%) in Arm B vs. 53.5% (84% CI 42.3-63.5%) in Arm C, with a median PFS of 22.0 months vs. 20.2 months, respectively. The median OS was not reached in Arm B vs. 42.8 months in Arm C. Median BPFS in Arms B and C were 24.4 months and 21.4 months, respectively. CONCLUSIONS The serial monitoring of ct-DNA T790M-status in advanced EGFR-mutant NSCLC during treatment with first-generation EGFR inhibitors was feasible, and a molecular progression before RECIST PD led to an earlier switch to osimertinib in 17% of patients with satisfactory PFS and OS outcomes.
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Affiliation(s)
- J Remon
- Paris-Saclay University, Institut Gustave Roussy, Villejuif, France
| | - B Besse
- Paris-Saclay University, Institut Gustave Roussy, Villejuif, France
| | - S Ponce Aix
- Hospital Universitario 12 De Octubre, Madrid, Spain
| | - A Callejo
- Hospital Universitari Vall d'Hebron- Vall d'Hebron Institut Oncologia, Barcelona, Spain
| | - K Al-Rabi
- King Hussein Cancer Center, Amman, Jordan
| | - R Bernabe
- University Hospital Virgen del Rocio, Sevilla, Spain
| | - L Greillier
- Aix Marseille University, Assitance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - M Majem
- Hospital De La Santa Creu I Sant Pau, Barcelona, Spain
| | - N Reguart
- Hospital Clinic Universitari de Barcelona, IDIBAPS, Barcelona, Spain
| | - I Monnet
- Centre Hospitalier Intercommunal De Creteil, Creteil, France
| | - S Cousin
- Institut Bergonie, Bordeaux, France
| | - P Garrido
- Hospital Universitario Ramon y Cajal, Madrid, Spain
| | | | - R Garcia Campelo
- University Hospital A Coruna-Hospital Teresa Herrera, A Coruna, Spain
| | | | - J Mazières
- CHU de Toulouse - Hopital Larrey, Toulouse, France
| | - H Curcio
- Centre François Baclesse, CHU Côte de Nacre, Caen, France
| | - B Wasąg
- Medical University of Gdansk, Gdansk, Poland
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4
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Remon J, Lacas B, Herbst R, Reck M, Garon EB, Scagliotti GV, Ramlau R, Hanna N, Vansteenkiste J, Yoh K, Groen HJ, Heymach JV, Mandrekar SJ, Okamoto I, Neal JW, Heist RS, Planchard D, Pignon JP, Besse B, Besse B, Lacas B, Pignon J, Remon J, Berghmans T, Dahlberg S, Felip E, Berghmans T, Besse B, Dahlberg S, Felip E, Garon E, Groen HJ, Hanna N, Heist RS, Herbst R, Heymach JV, Lacas B, Adjei AA, Heist R, Mandrekar SJ, Neal JW, Okamoto I, Pignon JP, Ramlau R, Remon J, Reck M, Scagliotti GV, Vansteenkiste J, Yoh K. ANtiangiogenic Second-line Lung cancer Meta-Analysis on individual patient data in non-small cell lung cancer: ANSELMA. Eur J Cancer 2022; 166:112-125. [DOI: 10.1016/j.ejca.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/16/2022]
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Remon J, Bernabé R, Diz P, Felip E, González-Larriba JL, Lázaro M, Mielgo-Rubio X, Sánchez A, Sullivan I, Massutti B. SEOM-GECP-GETTHI Clinical Guidelines for the treatment of patients with thymic epithelial tumours (2021). Clin Transl Oncol 2022; 24:635-645. [PMID: 35122634 PMCID: PMC8817662 DOI: 10.1007/s12094-022-02788-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/27/2022]
Abstract
Thymic epithelial tumours (TET) represent a heterogeneous group of rare malignancies that include thymomas and thymic carcinoma. Treatment of TET is based on the resectability of the tumour. If this is considered achievable upfront, surgical resection is the cornerstone of treatment. Platinum-based chemotherapy is the standard regimen for advanced TET. Due to the rarity of this disease, treatment decisions should be discussed in specific multidisciplinary tumour boards, and there are few prospective clinical studies with new strategies. However, several pathways involved in TET have been explored as potential targets for new therapies in previously treated patients, such as multi-tyrosine kinase inhibitors with antiangiogenic properties and immune checkpoint inhibitors (ICI). One third of patient with thymoma present an autoimmune disorders, increasing the risk of immune-related adverse events and autoimmune flares under ICIs. In these guidelines, we summarize the current evidence for the therapeutic approach in patients with TET and define levels of evidence for these decisions.
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Affiliation(s)
- J Remon
- Department of Medical Oncology, Centro Integral Oncológico Clara Campal (HM-CIOCC), Hospital HM Nou Delfos, HM Hospitales, Avinguda de Vallcarca, 151, 08023, Barcelona, Spain.
| | - R Bernabé
- Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - P Diz
- Department of Medical Oncology, Hospital Universitario de León, León, Spain
| | - E Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J L González-Larriba
- Department of Medical Oncology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - M Lázaro
- Department of Medical Oncology, Hospital Alvaro Cunqueiro, Vigo, Spain
| | - X Mielgo-Rubio
- Department of Medical Oncology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - A Sánchez
- Department of Medical Oncology, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - I Sullivan
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - B Massutti
- Department of Medical Oncology, Hospital General Universitario de Alicante, Alicante, Spain
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Remon J, Hendriks LEL, Bironzo P. Malignant pleural mesothelioma: new guidelines make us stronger for defeating this disease. Ann Oncol 2021; 33:123-125. [PMID: 34883215 DOI: 10.1016/j.annonc.2021.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 11/29/2021] [Indexed: 12/22/2022] Open
Affiliation(s)
- J Remon
- Department of Medical Oncology, Centro Integral Oncológico Clara Campal (HM-CIOCC), Hospital HM Nou Delfos, HM Hospitales, Barcelona, Spain.
| | - L E L Hendriks
- Department of Respiratory Medicine, Maastricht University Medical Centre, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
| | - P Bironzo
- Department of Oncology, University of Torino, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
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Conde E, Hernandez S, Caminoa A, Benito A, Martinez R, Alonso M, Jimenez B, Boni V, Remon J, Pijuan L, Clave S, Arriola E, Esteban I, De Castro J, Sansano I, Felip E, Abdulkader I, Garcia J, Rojo F, Domine M, Teixido C, Reguart N, Compañ D, Insa A, Mancheño N, Palanca S, Juan O, Baixeras N, Nadal E, Cebollero M, Calles A, Martin P, Salas C, Provencio M, Aranda I, Massuti B, Lopez-Vilaro L, Majem M, Enguita A, Paz-Ares L, Garrido P, Lopez-Rios F. MA14.02 RET Fusion Testing in Advanced Non-Small Cell Lung Carcinoma Patients: the RETING Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Remon J, Soria JC, Peters S. Early and locally advanced non-small-cell lung cancer: an update of the ESMO Clinical Practice Guidelines focusing on diagnosis, staging, systemic and local therapy. Ann Oncol 2021; 32:1637-1642. [PMID: 34481037 DOI: 10.1016/j.annonc.2021.08.1994] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 12/25/2022] Open
Affiliation(s)
- J Remon
- Department of Medical Oncology, Centro Integral Oncológico Clara Campal (HM-CIOCC), Hospital HM Nou Delfos, HM Hospitales, Barcelona, Spain
| | - J-C Soria
- University Paris-Saclay and Gustave Roussy Cancer Campus, Villejuif, France
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne University, Lausanne, Switzerland
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Jiménez-Labaig P, Pacheco-Barcia V, Cebrià A, Gálvez F, Obispo B, Páez D, Quílez A, Quintanar T, Ramchandani A, Remon J, Rogado J, Sánchez DA, Sánchez-Cánovas M, Sanz-García E, Sesma A, Tarazona N, Cotés A, González E, Bosch-Barrera J, Fernández A, Felip E, Vera R, Rodríguez-Lescure Á, Élez E. Identifying and preventing burnout in young oncologists, an overwhelming challenge in the COVID-19 era: a study of the Spanish Society of Medical Oncology (SEOM). ESMO Open 2021; 6:100215. [PMID: 34325108 PMCID: PMC8332651 DOI: 10.1016/j.esmoop.2021.100215] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/07/2021] [Accepted: 06/25/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Young oncologists are at particular risk of professional burnout, and this could have a significant impact on their health and care of their patients. The coronavirus disease 2019 (COVID-19) pandemic has forced rapid changes in professionals' jobs and training, with the consequent physical and psychological effects. We aimed to characterize burnout levels and determinants in young oncologists, and the effects of the pandemic on their training and health. METHODS Two online surveys were conducted among oncology residents and young oncology specialists in Spain. The first addressed professional burnout and its determinants before the COVID-19 pandemic, while the second analyzed the impact of the pandemic on health care organization, training, and physical and psychological health in the same population. RESULTS In total, 243 respondents completed the first survey, and 263 the second; 25.1% reported significant levels of professional burnout. Burnout was more common among medical oncology residents (28.2%), mainly in their second year of training. It was significantly associated with a poor work-life balance, inadequate vacation time, and the burnout score. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care and 84.3% of residents missed part of their training rotations. Overall, 17.2% of this population reported that they had contracted COVID-19, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. Almost a quarter of young oncologists (23.3%) had doubts about their medical vocation. CONCLUSIONS Burnout affects a considerable number of young oncologists. The COVID-19 pandemic has had a profound impact on causes of burnout, making it even more necessary to periodically monitor it to define appropriate detection and prevention strategies.
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Affiliation(s)
- P Jiménez-Labaig
- Department of Medical Oncology, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - V Pacheco-Barcia
- Department of Medical Oncology, Gómez Ulla Military Hospital, Madrid, Spain
| | - A Cebrià
- Department of Mental Health, Parc Taulí University Hospital, Sabadell, Catalunya, Spain
| | - F Gálvez
- Department of Medical Oncology, Jaén University Hospital, Jaén, Andalucía, Spain
| | - B Obispo
- Department of Medical Oncology, Infanta Leonor University Hospital, Madrid, Spain
| | - D Páez
- Department of Medical Oncology, Santa Creu i Sant Pau University Hospital, Barcelona, Catalunya, Spain
| | - A Quílez
- Department of Medical Oncology, Can Misses Hospital, Área de salud de Ibiza y Formentera (ASEF), Ibiza, Illes Balears, Spain
| | - T Quintanar
- Department of Medical Oncology, Elche University General Hospital, Elche, Comunitat Valenciana, Spain
| | - A Ramchandani
- Department of Medical Oncology, University Hospital Complex, Insular-Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Islas Canarias, Spain
| | - J Remon
- Department of Medical Oncology, HM Delfos Hospital, Barcelona, Catalunya, Spain
| | - J Rogado
- Department of Medical Oncology, Infanta Leonor University Hospital, Madrid, Spain
| | - D A Sánchez
- Department of Medical Oncology, Virgen de La Arrixaca University Hospital, Murcia, Región de Murcia, Spain
| | - M Sánchez-Cánovas
- Department of Hematology and Medical Oncology, Morales Meseguer University General Hospital, Murcia, Región de Murcia, Spain
| | - E Sanz-García
- Department of Medical Oncology, HM Sanchinarro Hospital-Centro Integral Oncológico Clara Campal (CIOOC), Madrid, Spain
| | - A Sesma
- Department of Medical Oncology, Lozano Blesa University Clinical Hospital, Zaragoza, Aragón, Spain
| | - N Tarazona
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, Comunitat Valenciana, Spain; Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
| | - A Cotés
- Department of Medical Oncology, Elda General Hospital, Elda, Comunitat Valenciana, Spain
| | - E González
- Department of Medical Oncology, Virgen de las Nieves University Hospital, Granada, Andalucía, Spain
| | - J Bosch-Barrera
- Department of Medical Oncology, Dr. Josep Trueta University Hospital, Institut Català d'Oncologia (ICO), Girona, Catalunya, Spain
| | - A Fernández
- Department of Medical Oncology, University Hospital Complex of Ourense (CHUO), Ourense, Galicia, Spain
| | - E Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital & Institute of Oncology (VHIO), Vall d'Hebron Hospital Campus, Barcelona, Catalunya, Spain
| | - R Vera
- Department of Medical Oncology, University Hospital Complex of Navarra, Pamplona, Navarra, Spain
| | - Á Rodríguez-Lescure
- Department of Medical Oncology, Elche University General Hospital, Elche, Comunitat Valenciana, Spain
| | - E Élez
- Department of Medical Oncology, Vall d'Hebron University Hospital & Institute of Oncology (VHIO), Vall d'Hebron Hospital Campus, Barcelona, Catalunya, Spain.
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10
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Basse C, Swalduz A, Mc Leer A, Moro-Sibilot D, Remon J, Girard N. [NSCLC and new oncogenic mutations: Diagnosis and perspectives]. Rev Mal Respir 2021; 38:477-488. [PMID: 34020835 DOI: 10.1016/j.rmr.2021.02.069] [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: 11/17/2020] [Accepted: 02/09/2021] [Indexed: 11/25/2022]
Abstract
The development of new targeted therapies in non-small cell lung carcinoma (NSCLC) depends on a better understanding of the molecular basis of carcinogenesis, a knowledge of the role of molecular aberrations in disease progression and the development of molecular biology platforms with the capacity to identify new biomarkers. In the current article, we review the techniques routinely used in cancer molecular biology platforms as well as new techniques under development. These new NSCLC biomarkers have been made available to clinicians and biologists in parallel with the development of targeted drugs. New molecular abnormalities of EGFR exon 20, HER2, MET, RET, BRAF, ROS1 and NTRK have been identified and there have been clinical trials of the most innovative targeted drugs.
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Affiliation(s)
- C Basse
- Institut du thorax curie Montsouris, institut Curie, Paris, France
| | | | - A Mc Leer
- Département d'anatomie et cytologie pathologiques, UF pathologie moléculaire, CHU Grenoble-Alpes, CS10217 cedex, 38043 Grenoble, France; Service physiologie et pneumologie, UF oncologie thoracique, CHU Grenoble-Alpes, CS10217 cedex, 38043 Grenoble, France; Inserm U1209 CNRS UMR5309, université Grenoble Alpes, Institute for advanced biosciences, Grenoble, France
| | - D Moro-Sibilot
- Service physiologie et pneumologie, UF oncologie thoracique, CHU Grenoble-Alpes, CS10217 cedex, 38043 Grenoble, France; Inserm U1209 CNRS UMR5309, université Grenoble Alpes, Institute for advanced biosciences, Grenoble, France.
| | - J Remon
- Department of Medical Oncology, Centro Integral Oncológico Clara Campal (HM-CIOCC), Hospital HM Delfos, HM Hospitales, Barcelona, Espagne
| | - N Girard
- Institut du thorax curie Montsouris, institut Curie, Paris, France
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11
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Riudavets M, Lamberts V, Auclin E, Aldea M, Vasseur D, Jovelet C, Naltet C, Lavaud P, Gazzah A, Aboubakar F, Remon J, Rouleau E, Lacroix L, Ngocamus M, Nicotra C, Besse B, Planchard D, Mezquita L. 22P Clinical utility of ddPCR for detection of sensitizing and resistance EGFRm in pts with advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Mosele F, Remon J, Mateo J, Westphalen CB, Barlesi F, Lolkema MP, Normanno N, Scarpa A, Robson M, Meric-Bernstam F, Wagle N, Stenzinger A, Bonastre J, Bayle A, Michiels S, Bièche I, Rouleau E, Jezdic S, Douillard JY, Reis-Filho JS, Dienstmann R, André F. Recommendations for the use of next-generation sequencing (NGS) for patients with metastatic cancers: a report from the ESMO Precision Medicine Working Group. Ann Oncol 2020; 31:1491-1505. [PMID: 32853681 DOI: 10.1016/j.annonc.2020.07.014] [Citation(s) in RCA: 563] [Impact Index Per Article: 140.8] [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: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 02/06/2023] Open
Abstract
Next-generation sequencing (NGS) allows sequencing of a high number of nucleotides in a short time frame at an affordable cost. While this technology has been widely implemented, there are no recommendations from scientific societies about its use in oncology practice. The European Society for Medical Oncology (ESMO) is proposing three levels of recommendations for the use of NGS. Based on the current evidence, ESMO recommends routine use of NGS on tumour samples in advanced non-squamous non-small-cell lung cancer (NSCLC), prostate cancers, ovarian cancers and cholangiocarcinoma. In these tumours, large multigene panels could be used if they add acceptable extra cost compared with small panels. In colon cancers, NGS could be an alternative to PCR. In addition, based on the KN158 trial and considering that patients with endometrial and small-cell lung cancers should have broad access to anti-programmed cell death 1 (anti-PD1) antibodies, it is recommended to test tumour mutational burden (TMB) in cervical cancers, well- and moderately-differentiated neuroendocrine tumours, salivary cancers, thyroid cancers and vulvar cancers, as TMB-high predicted response to pembrolizumab in these cancers. Outside the indications of multigene panels, and considering that the use of large panels of genes could lead to few clinically meaningful responders, ESMO acknowledges that a patient and a doctor could decide together to order a large panel of genes, pending no extra cost for the public health care system and if the patient is informed about the low likelihood of benefit. ESMO recommends that the use of off-label drugs matched to genomics is done only if an access programme and a procedure of decision has been developed at the national or regional level. Finally, ESMO recommends that clinical research centres develop multigene sequencing as a tool to screen patients eligible for clinical trials and to accelerate drug development, and prospectively capture the data that could further inform how to optimise the use of this technology.
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Affiliation(s)
- F Mosele
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - J Remon
- Department of Medical Oncology, Centro Integral Oncológico Clara Campal (HM-CIOCC), Hospital HM Delfos, HM Hospitales, Barcelona, Spain
| | - J Mateo
- Clinical Research Program, Vall Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
| | - C B Westphalen
- Comprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - F Barlesi
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - M P Lolkema
- Department of Medical Oncology, Erasmus MC Cancer Center, Rotterdam, the Netherlands
| | - N Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori, 'Fondazione G. Pascale' - IRCCS, Naples, Italy
| | - A Scarpa
- ARC-Net Research Centre and Department of Diagnostics and Public Health - Section of Pathology, University of Verona, Verona, Italy
| | - M Robson
- Breast Medicine and Clinical Genetics Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - F Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - N Wagle
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - J Bonastre
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - A Bayle
- Department of Medical Oncology, Gustave Roussy, Villejuif, France; Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - S Michiels
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - I Bièche
- Department of Genetics, Institut Curie, Paris Descartes University, Paris, France
| | - E Rouleau
- Cancer Genetic Laboratories, Department of Medical Biology and Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - S Jezdic
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - J-Y Douillard
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - J S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - R Dienstmann
- Oncology Data Science Group, Molecular Prescreening Program, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - F André
- Department of Medical Oncology, Gustave Roussy, Villejuif, France; Inserm, Gustave Roussy Cancer Campus, UMR981, Villejuif, France; Paris Saclay University, Orsay, France.
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13
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Remon J, García-Campelo R, de Álava E, Vera R, Rodríguez-Peralto JL, Rodríguez-Lescure Á, Bellosillo B, Garrido P, Rojo F, Álvarez-Alegret R. Correction to: Liquid biopsy in oncology: a consensus statement of the Spanish Society of Pathology and the Spanish Society of Medical Oncology. Clin Transl Oncol 2020; 22:961-962. [PMID: 32030654 PMCID: PMC7919771 DOI: 10.1007/s12094-020-02313-x] [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] [Indexed: 11/28/2022]
Abstract
The article Liquid biopsy in oncology.
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Affiliation(s)
- J Remon
- Department of Medical Oncology, Centro Integral Oncológico Clara Campal Barcelona (CIOCCB), HM Delfos, Barcelona, Spain.
| | - R García-Campelo
- Department of Medical Oncology, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - E de Álava
- Institute of Biomedicine of Sevilla (IBiS), Department of Normal and Pathological Cytology and Histology, Virgen del Rocio University Hospital /CSIC/University of Sevilla, Sevilla, Spain.,CIBERONC, Madrid, Spain
| | - R Vera
- Department of Medical Oncology, Complejo Hospitalario de Navarra and Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - J L Rodríguez-Peralto
- CIBERONC, Madrid, Spain.,Department of Pathology, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - Á Rodríguez-Lescure
- Department of Medical Oncology, Hospital General Universitario de Elche y Vega Baja, Elche, Spain.,Group for Breast Cancer Research (GEICAM), Madrid, Spain
| | - B Bellosillo
- CIBERONC, Madrid, Spain.,Department of Pathology, Hospital del Mar, Barcelona, Spain
| | - P Garrido
- CIBERONC, Madrid, Spain.,School of Medicine, Universidad de Alcalá, Madrid, Spain.,Medical Oncology Department, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - F Rojo
- CIBERONC, Madrid, Spain.,Department of Pathology, Fundación Universitaria Jiménez Díaz, Madrid, Spain
| | - R Álvarez-Alegret
- Department of Pathology, Hospital Universitario Miguel Servet, Zaragoza, Spain
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14
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Remon J, Tabbò F, Jimenez B, Collazo A, de Castro J, Novello S. Sequential blinded treatment decisions in ALK-positive non-small cell lung cancers in the era of precision medicine. Clin Transl Oncol 2020; 22:1425-1429. [PMID: 31955355 DOI: 10.1007/s12094-020-02290-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/16/2019] [Accepted: 01/03/2020] [Indexed: 11/25/2022]
Abstract
Next-generation ALK TKIs have become the new standard of care in first-line setting in advanced ALK-positive NSCLC patients. However, sequential strategies at progression are relevant, as may have an impact on patients' outcome. In this commentary we discuss whether genomic-tailored strategies at progression would be more suitable for improving outcome of ALK-positive NSCLC patients.
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Affiliation(s)
- J Remon
- Department of Medical Oncology, Centro Integral Oncológico Clara Campal (HM-CIOCC), Hospital HM Delfos, HM Hospitales, Avinguda de Vallcarca, 151, 08023, Barcelona, Spain.
| | - F Tabbò
- Thoracic Oncology Unit, Department of Oncology, University of Torino, Regione Gonzole, 10, 10043, Orbassano (TO), Turin, Italy
| | - B Jimenez
- Medical Oncology Department, Centro Integral Oncológico Clara Campal Madrid, HM Sanchinarro, Calle Oña, 10, 28050, Madrid, Spain
| | - A Collazo
- Medical Oncology Department, Centro Integral Oncológico Clara Campal Madrid, HM Sanchinarro, Calle Oña, 10, 28050, Madrid, Spain
| | - J de Castro
- Medical Oncology Department, Centro Integral Oncológico Clara Campal Madrid, HM Sanchinarro, Calle Oña, 10, 28050, Madrid, Spain
| | - S Novello
- Thoracic Oncology Unit, Department of Oncology, University of Torino, Regione Gonzole, 10, 10043, Orbassano (TO), Turin, Italy
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15
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Mas L, Patane A, Arrieta O, Soria T, Cardona A, Martín C, Ruiz-Patiño A, Ruiz R, Rioja P, Lozano S, Barron LZ, Barrón F, Corassa M, Freitas H, De Lima VC, Corrales-Rodriguez L, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. P1.12 Real World Characterization and Treatment Patterns of Patients with Thymic Carcinoma: Lessons from a Latin American Collaborative Study (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Mezquita L, Planchard D, Dorta M, Aldea M, Naltet C, Lamberts V, Grecea AM, Martin-Romano P, De Kievit F, Jovelet C, Rouleau E, Lacroix L, Remon J, Lavaud P, Gazzah A, Morris C, Howarth K, Green E, Massard C, Besse B. OA03.08 Clinical Utility of CTDNA Driver Genomic Alterations (GA) Directing Targeted Therapy in Untreated Advanced NSCLC Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.038] [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: 11/17/2022]
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17
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Mountzios G, Remon J, Novello S, Blais N, Califano R, Cufer T, Dingemans AM, Liu SV, Peled N, Pennell NA, Reck M, Rolfo C, Tan D, Vansteenkiste J, West H, Besse B. Position of an international panel of lung cancer experts on the decision for expansion of approval for pembrolizumab in advanced non-small-cell lung cancer with a PD-L1 expression level of ≥1% by the USA Food and Drug Administration. Ann Oncol 2019; 30:1686-1688. [PMID: 31504132 DOI: 10.1093/annonc/mdz295] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G Mountzios
- Department of Medical Oncology, Henry Dunant Hospital Center, Athens, Greece.
| | - J Remon
- Department of Medical Oncology, CIOCC HM Delfos Hospital, Barcelona, Spain
| | - S Novello
- Department of Oncology, University of Turin, AOU San Luigi, Orbassano, Italy
| | - N Blais
- Centre Hospitalier Universitaire de Montréal, University of Montreal, Montreal, Canada
| | - R Califano
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester; Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - T Cufer
- University Clinic Golnik, Medical Faculty Ljubljana, Slovenia
| | - A M Dingemans
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht and Erasmus Medical Center, Rotterdam, The Netherlands
| | - S V Liu
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, USA
| | - N Peled
- Soroka Medical Center and Ben-Gurion University, Beer-Sheva, Israel
| | - N A Pennell
- Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, USA
| | - M Reck
- Lung Clinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany
| | - C Rolfo
- Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, USA
| | - D Tan
- Division of Medical Oncology, National Cancer Centre, Singapore
| | - J Vansteenkiste
- Respiratory Oncology Unit, University Hospital KU Leuven, Leuven, Belgium
| | - H West
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, USA
| | - B Besse
- Cancer Medicine Department, Institut Gustave Roussy, Villejuif; Université Paris-Saclay, Orsay, France
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18
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Abstract
Osimertinib was the first third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) to receive FDA and EMA approval for metastatic EGFR-mutant non-small-cell lung cancer (NSCLC) patients that have acquired the EGFR T790M resistance mutation. Clinical trials have demonstrated the efficacy of osimertinib in this patient population and clinical trials of other third-generation EGFR TKI are currently under way. Additional challenges in this patient population, such as the upfront efficacy of osimertinib, validation of T790M in liquid biopsies as a dynamic predictive marker of efficacy, along with combination with immune checkpoint inhibitors are being explored, representing an extraordinary time of development for EGFR-mutant NSCLC.
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Affiliation(s)
- J Remon
- Medical Oncologist Department, Thoracic Tumor Unit, Vall d'Hebron University Hospital, Barcelona.,Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - C E Steuer
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | - S S Ramalingam
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | - E Felip
- Medical Oncologist Department, Thoracic Tumor Unit, Vall d'Hebron University Hospital, Barcelona.,Vall d'Hebron Institute of Oncology, Barcelona, Spain
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19
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Garrido P, Campelo RG, Majem M, Carcereny E, Isla D, Larriba JG, Coves J, De Castro Carpeno J, Domine M, Lianes P, Juan O, Terrassa J, Provencio M, Blasco A, Garcia J, De Las Peñas RG, Artal A, Remon J, Catot S, Felip E, Viñolas N. MA22.05 Assessment of Gender Differences in the Psychosocial and Economic Impact on Patients with Stage IV Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Geraud A, Mezquita L, Auclin E, Combarel D, Delahousse J, Naltet C, Jovelet C, Lavaud P, Gazzah A, Lacroix L, Remon J, Caramella C, Planchard D, Mir O, Paci A, Besse B. MA21.09 Tyrosine Kinase Inhibitors' Plasma Concentration and Oncogene-Addicted Advanced Non-Small Lung Cancer (aNSCLC) Resistance. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Mas L, Patané A, Arrieta O, Soria T, Cardona A, Martin C, Ruiz-Patiño A, Rojas L, Ruiz R, Rioja P, Lozano S, Barrón ZZ, Corassa M, Freitas H, De Lima VC, Corrales L, Sotelo C, Rodriguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. EP1.15-28 Survival of Thymoma Is Extensive in Latin-American Patients: Results from Over 10 Years of Experience (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Ferrara R, Naigeon M, Auclin E, Duchemann B, Cassard L, Medhi J, Boselli L, Grivel J, Desnoyer A, Texier M, Mezquita L, Aboubakar F, Hendriks L, Planchard D, Caramella C, Remon J, Ngocamus M, Nicotra C, Proto C, Sangaletti S, Chaput N, Besse B. P1.04-31 Immunosenescence Correlates with Poor Outcome from PD-(L)1 Blockade but Not Chemotherapy in Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Cedrés S, Felip E, Cruz C, Martinez de Castro A, Pardo N, Navarro A, Martinez-Marti A, Remon J, Zeron-Medina J, Balmaña J, Llop-Guevara A, Miquel JM, Sansano I, Nuciforo P, Mancuso F, Serra V, Vivancos A. Activity of HSP90 Inhibiton in a Metastatic Lung Cancer Patient With a Germline BRCA1 Mutation. J Natl Cancer Inst 2019. [PMID: 29529211 PMCID: PMC6093313 DOI: 10.1093/jnci/djy012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Heat shock proteins (HSPs) are molecular chaperones that maintain proteins in their correct conformation to ensure stability and protect carcinoma cells from apoptosis. HSP90 inhibitors (HSP90i) block multiple targets simultaneously, and despite responses in a selected population, no HSP90i have yet been approved. We present a patient with a lung tumor with an exceptional response to cisplatin/gemcitabine in combination with HSP90i, which nowadays continues with HSP90i maintenance after three years. Whole-exome sequencing of the lung tumor unveiled a BRCA1/2 deficiency mutational signature, and mutation analysis confirmed a germline BRCA1 mutation. The striking efficacy of HSP90i plus chemotherapy vs chemotherapy alone was reproduced in a patient-derived xenograft (PDX) model from a breast cancer patient with a BRCA1 mutation (mean tumor volume [SD], No. of tumors: vehicle 8.38 [7.07] mm3, n = 3; HSP90i 4.18 [1.93] mm3, n = 5; cisplatin plus gemcitabine 3.31 [1.95] mm3, n = 5; cisplatin plus gemcitabine plus HSP90i 0.065 [0.076] mm3, n = 6). This case and the PDX demonstrate the efficacy for therapeutic inhibition of HSP90 in a BRCA-mutated patient, opening a new potential avenue for better identifying patients who might benefit most from HSP90i.
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Affiliation(s)
- Susana Cedrés
- Thoracic Tumors Group, Vall d'hebron Institute of Oncology, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital
| | - Enriqueta Felip
- Thoracic Tumors Group, Vall d'hebron Institute of Oncology, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital.,Universidad Autonoma de Barcelona, Barcelona, Spain
| | - Cristina Cruz
- Experimental Therapeutic Group, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital
| | - Ana Martinez de Castro
- Thoracic Tumors Group, Vall d'hebron Institute of Oncology, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital
| | - Nuria Pardo
- Thoracic Tumors Group, Vall d'hebron Institute of Oncology, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital.,Universidad Autonoma de Barcelona, Barcelona, Spain
| | - Alejandro Navarro
- Thoracic Tumors Group, Vall d'hebron Institute of Oncology, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital.,Universidad Autonoma de Barcelona, Barcelona, Spain
| | - Alex Martinez-Marti
- Thoracic Tumors Group, Vall d'hebron Institute of Oncology, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital.,Universidad Autonoma de Barcelona, Barcelona, Spain
| | - Jordin Remon
- Thoracic Tumors Group, Vall d'hebron Institute of Oncology, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital
| | | | - Judith Balmaña
- Thoracic Tumors Group, Vall d'hebron Institute of Oncology, Barcelona, Spain.,Oncology Department, Vall d'hebron University Hsopital.,Universidad Autonoma de Barcelona, Barcelona, Spain
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24
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Charrier M, Mezquita L, Lueza B, Dupraz L, Planchard D, Remon J, Caramella C, Cassard L, Boselli L, Reiners KS, Pogge von Strandmann E, Rusakiewicz S, Ferrara R, Duchemann B, Naigeon M, Pignon JP, Besse B, Chaput N. Circulating innate immune markers and outcomes in treatment-naïve advanced non-small cell lung cancer patients. Eur J Cancer 2019; 108:88-96. [PMID: 30648633 DOI: 10.1016/j.ejca.2018.12.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Innate immunity represents the first step of activation of the immune system and dictates the quality of adaptive immune responses. Studies have reported links between systemic inflammatory or innate immune markers and prognosis in patients with lung cancer. To our knowledge, the prospective and concomitant study of these systemic markers has never been performed. METHODS Advanced treatment-naive non-small cell lung cancer (NSCLC) patients eligible for first-line platinum-based chemotherapy were prospectively included from December 2012 to July 2015 (N = 148). Blood samples of patients were collected before the first cycle for fresh NK cell phenotyping. Peripheral blood mononuclear cells were cryopreserved for natural cytotoxicity receptor (NCR) genotyping as well as sera for NCR's ligand quantification. Data on leukocytes, neutrophils and monocyte counts and lactate dehydrogenase (LDH) levels were extracted from electronic medical records. RESULTS Among all studied markers, monocytosis, neutrophilia, leucocytosis, high LDH and sBAG6 levels and reduced levels of NCR3 transcripts were associated with poor overall survival (OS) in univariate analysis. The levels of NCR3 transcripts was linked to age, number of metastatic sites, monocyte counts, LDH and sBAG6 levels. Neutrophilia was associated to high sBAG6 levels. NCR3 was the unique innate immune parameter that remained as an independent factor associated with both OS (P = 0.003) and progression-free survival (P = 0.009) in the multivariate analysis. CONCLUSION This study brought evidence that these biomarkers are entangled; parameters associated with an inflammatory process were related to reduced levels of NCR3 transcripts. Finally, the level of NCR3 transcripts was independently associated with outcomes in treatment-naive patients with advanced NSCLC.
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Affiliation(s)
- M Charrier
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Medicine, F-94270, Le Kremlin-Bicêtre, France
| | - L Mezquita
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Department of Cancer Medicine, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - B Lueza
- Biostatistics and Epidemiology Department, University Paris Saclay, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Oncostat CESP, INSERM, University Paris-Saclay, France; UVSQ, University Paris-Sud, F-94085, Villejuif, France
| | - L Dupraz
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - D Planchard
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Department of Cancer Medicine, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - J Remon
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Department of Cancer Medicine, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - C Caramella
- Radiology Department, Gustave Roussy, Cancer Campus, F-94085, Villejuif, France
| | - L Cassard
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - L Boselli
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - K S Reiners
- Institute for Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
| | - E Pogge von Strandmann
- Experimental Tumor Research, Center for Tumor Biology and Immunology, Clinic for Hematology, Oncology and Immunology, Philipps University, 35043 Marburg, Germany
| | - S Rusakiewicz
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Center of Clinical Investigations in Biotherapies of Cancer (CICBT) 1428, Villejuif, France
| | - R Ferrara
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - B Duchemann
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Medicine, F-94270, Le Kremlin-Bicêtre, France
| | - M Naigeon
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Medicine, F-94270, Le Kremlin-Bicêtre, France
| | - J P Pignon
- Biostatistics and Epidemiology Department, University Paris Saclay, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Oncostat CESP, INSERM, University Paris-Saclay, France; UVSQ, University Paris-Sud, F-94085, Villejuif, France
| | - B Besse
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Medicine, F-94270, Le Kremlin-Bicêtre, France; Department of Cancer Medicine, Gustave Roussy Cancer Campus, F-94805, Villejuif, France
| | - N Chaput
- Gustave Roussy Cancer Campus, F-94805, Villejuif, France; Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS/US 23 INSERM, Gustave Roussy Cancer Campus, F-94805, Villejuif, France; University Paris-Saclay, Faculty of Pharmacy, Chatenay-Malabry, F-92296, France.
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Remon J, Hendriks LE, Cabrera C, Reguart N, Besse B. Immunotherapy for oncogenic-driven advanced non-small cell lung cancers: Is the time ripe for a change? Cancer Treat Rev 2018; 71:47-58. [PMID: 30359792 DOI: 10.1016/j.ctrv.2018.10.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/03/2018] [Accepted: 10/10/2018] [Indexed: 12/12/2022]
Abstract
Immune checkpoint inhibitors (ICIs) have been incorporated in the treatment strategy of advanced non-small cell lung cancer (NSCLC) in first- and second-line setting improving the prognosis of these patients. However, the treatment landscape has been also drastically overturned with the advent of targeted therapies in oncogenic-addicted advanced NSCLC patients. Despite ICIs represent an active and new treatment option for a wide range of advanced NSCLC patients, the efficacy and the optimal place of ICI in the treatment strategy algorithm of oncogenic-addicted tumors remains still controversial, as only a minority of trials with ICI enrol oncogenic-addicted NSCLC patients previously treated with standard therapy. Therefore, there are still several open questions about ICI in oncogenic-driven NSCLC, such as the efficacy and toxicities, which need to be addressed before considering treatment with ICI as a standard approach in this population. It is in this framework, we provide a thorough overview on this currently controversial topic.
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Affiliation(s)
- J Remon
- Centro Integral Oncología Clara Campal Bacelona, HM-Delfos, Medical Oncology Department, Barcelona, Spain.
| | - L E Hendriks
- Gustave Roussy, Cancer Medicine Department, Villejuif, France; Maastricht University Medical Center+, Pulmonary Diseases Department, GROW - School for Oncology and Developmental Biology, Maastricht, the Netherlands.
| | - C Cabrera
- Hospital Clínic i Provincial de Barcelona, Medical Oncology Department, Barcelona, Spain.
| | - N Reguart
- Hospital Clínic i Provincial de Barcelona, Medical Oncology Department, Barcelona, Spain.
| | - B Besse
- Gustave Roussy, Cancer Medicine Department, Villejuif, France; University Paris-Sud, Orsay, France.
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Ferrara R, Naigeon M, Auclin E, Duchemann B, Cassard L, Medhi J, Boselli L, Grivel J, Desnoyer A, Mezquita L, Aboubakar F, Hendriks L, Planchard D, Caramella C, Remon J, Ngocamus M, Nicotra C, Besse B, Chaput N. Immunosenescence (iSenescence) correlates with disease progression in advanced non-small cell lung cancer (aNSCLC) patients treated with PD-(L)1 inhibitors (IO). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Remon J, Rouleau E, Barlesi F, Leary A, Bièche I, Job B, Lacroix L, Auguste A, Mauduit M, Audigier-Valette C, Raimbourg J, Madroszyk A, Michiels S, Bayar M, Jimenez M, Soria J, Besse B. P3.03-27 Somatic BRCA1/2 Mutations in Advanced NSCLC Patients: Description of a Sub-Population from the Ongoing Unicancer SAFIR02-Lung / IFCT-1301 Trial. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cedres Perez S, Sanso M, Hernando-Calvo A, Callejo A, Pardo Aranda N, Navarro Mendivil A, Martinez A, Remon J, Miquel J, Rodriguez G, Monton V, Villacampa G, Dienstmann R, Vivancos A, Felip Font E. Multiple primary cancers (MPC) in a series of lung cancer (LC) patient: Incidence and outcome. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy301] [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: 11/13/2022] Open
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Remon J, Jovelet C, Lacroix L, Planchard D, Mezquita L, Howarth K, Green E, Plagnol V, Morris C, Rosenfeld N, Caramella C, Lepéchoux C, Aboubakar Nana F, Botticella A, Adam J, Ferrara R, Gazzah A, Ngocamus M, Soria J, Besse B. P2.13-24 Prospective Efficacy of Osimertinib in Circulating Tumour DNA (ctDNA) T790M-Mutant NSCLC Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Remon J, Mezquita L, Planchard D, Jovelet C, Lacroix L, Rouleau E, Howarth K, Plagnol V, Morris C, Green E, Le Pechoux C, Caramella C, Adam J, Besse B. Clinical validation and utility of InVision ctDNA in advanced non-small cell lung cancer (NSCLC) patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy318.012] [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: 11/13/2022] Open
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31
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Remon J, Mezquita L, Ortiz-Cuaran S, Jovelet C, Lacroix L, Morris C, Green E, Saintigny P, Besse B, Swalduz A, Howarth K, Rouleau E, De Kievit F, Baker-Neblett K, Roitt S, Plagnol V, Perol M, Planchard D. Clinical outcomes in patients with advanced NSCLC treated with targeted therapies, with actionable mutations identified by InVisionFirst ctDNA assay. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy318.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Martinez-Marti A, Felip E, Matito J, Mereu E, Navarro A, Cedrés S, Pardo N, Martinez de Castro A, Remon J, Miquel JM, Guillaumet-Adkins A, Nadal E, Rodriguez-Esteban G, Arqués O, Fasani R, Nuciforo P, Heyn H, Villanueva A, Palmer HG, Vivancos A. Dual MET and ERBB inhibition overcomes intratumor plasticity in osimertinib-resistant-advanced non-small-cell lung cancer (NSCLC). Ann Oncol 2018; 28:2451-2457. [PMID: 28961841 PMCID: PMC5834054 DOI: 10.1093/annonc/mdx396] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Third-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) such as osimertinib are the last line of targeted treatment of metastatic non-small-cell lung cancer (NSCLC) EGFR-mutant harboring T790M. Different mechanisms of acquired resistance to third-generation EGFR-TKIs have been proposed. It is therefore crucial to identify new and effective strategies to overcome successive acquired mechanisms of resistance. Methods For Amplicon-seq analysis, samples from the index patient (primary and metastasis lesions at different timepoints) as well as the patient-derived orthotopic xenograft tumors corresponding to the different treatment arms were used. All samples were formalin-fixed paraffin-embedded, selected and evaluated by a pathologist. For droplet digital PCR, 20 patients diagnosed with NSCLC at baseline or progression to different lines of TKI therapies were selected. Formalin-fixed paraffin-embedded blocks corresponding to either primary tumor or metastasis specimens were used for analysis. For single-cell analysis, orthotopically grown metastases were dissected from the brain of an athymic nu/nu mouse and cryopreserved at -80°C. Results In a brain metastasis lesion from a NSCLC patient presenting an EGFR T790M mutation, we detected MET gene amplification after prolonged treatment with osimertinib. Importantly, the combination of capmatinib (c-MET inhibitor) and afatinib (ErbB-1/2/4 inhibitor) completely suppressed tumor growth in mice orthotopically injected with cells derived from this brain metastasis. In those mice treated with capmatinib or afatinib as monotherapy, we observed the emergence of KRAS G12C clones. Single-cell gene expression analyses also revealed intratumor heterogeneity, indicating the presence of a KRAS-driven subclone. We also detected low-frequent KRAS G12C alleles in patients treated with various EGFR-TKIs. Conclusion Acquired resistance to subsequent EGFR-TKI treatment lines in EGFR-mutant lung cancer patients may induce genetic plasticity. We assess the biological insights of tumor heterogeneity in an osimertinib-resistant tumor with acquired MET-amplification and propose new treatment strategies in this situation.
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Affiliation(s)
- A Martinez-Marti
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona;; Autonomous University of Barcelona (UAB), Barcelona
| | - E Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona;; Autonomous University of Barcelona (UAB), Barcelona;.
| | - J Matito
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - E Mereu
- Single Cell Genomics Group, Centro Nacional de Análisis Genómico (CNAG) - Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona;; Pompeu Fabra University (UPF), Barcelona
| | - A Navarro
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - S Cedrés
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - N Pardo
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona;; Autonomous University of Barcelona (UAB), Barcelona
| | - A Martinez de Castro
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - J Remon
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - J M Miquel
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - A Guillaumet-Adkins
- Single Cell Genomics Group, Centro Nacional de Análisis Genómico (CNAG) - Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona;; Pompeu Fabra University (UPF), Barcelona
| | - E Nadal
- Chemoresistance and Predictive Factors Group, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO) Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Barcelona;; Department of Medical Oncology, ICO, IDIBELL, L'Hospitalet, Barcelona
| | - G Rodriguez-Esteban
- Single Cell Genomics Group, Centro Nacional de Análisis Genómico (CNAG) - Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona;; Pompeu Fabra University (UPF), Barcelona
| | | | - R Fasani
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - P Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - H Heyn
- Single Cell Genomics Group, Centro Nacional de Análisis Genómico (CNAG) - Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona;; Pompeu Fabra University (UPF), Barcelona
| | - A Villanueva
- Chemoresistance and Predictive Factors Group, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO) Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Barcelona;; Xenopat S.L., Business Bioincubator, Bellvitge Health Science Campus, Barcelona, Spain
| | | | - A Vivancos
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona;.
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Remon J, Besse B. Brain Metastases in Oncogene-Addicted Non-Small Cell Lung Cancer Patients: Incidence and Treatment. Front Oncol 2018; 8:88. [PMID: 29696132 PMCID: PMC5904204 DOI: 10.3389/fonc.2018.00088] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 03/14/2018] [Indexed: 12/11/2022] Open
Abstract
Brain metastases (BM) are common in non-small cell lung cancer patients including in molecularly selected populations, such as EGFR-mutant and ALK-rearranged tumors. They are associated with a reduced quality of life, and are commonly the first site of progression for patients receiving tyrosine kinase inhibitors (TKIs). In this review, we summarize incidence of BM and intracranial efficacy with TKI agents according to oncogene driver mutations, focusing on important clinical issues, notably optimal first-line treatment in oncogene-addicted lung tumors with upfront BM (local therapies followed by TKI vs. TKI monotherapy). We also discuss the potential role of newly emerging late-generation TKIs as new standard treatment in oncogene-addicted lung cancer tumors compared with sequential strategies.
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Affiliation(s)
- J. Remon
- Medical Oncology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Benjamin Besse
- Cancer Medicine Department, Institut Gustave Roussy, Villejuif, France
- University Paris-Sud, Orsay, France
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Remon J, Vilariño N, Reguart N. Immune checkpoint inhibitors in non-small cell lung cancer (NSCLC): Approaches on special subgroups and unresolved burning questions. Cancer Treat Rev 2018; 64:21-29. [PMID: 29454155 DOI: 10.1016/j.ctrv.2018.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 12/18/2017] [Revised: 01/29/2018] [Accepted: 02/04/2018] [Indexed: 01/08/2023]
Abstract
Immune checkpoint inhibitors (ICIs) have been incorporated in the treatment strategy of advanced non-small cell lung cancer (NSCLC). Beyond the already approved indications in first- and second-line setting of advanced NSCLC, new data has recently emerged demonstrating its efficacy in locally advanced disease as maintenance after chemo-radiotherapy and currently several trials are also exploring its efficacy in earlier stages of the disease to evaluate whether these results could be extrapolated to the adjuvant setting. With the advent of all these new therapies, their potential in other thoracic malignancies such as mesothelioma and small-cell lung cancer are also being evaluated with encouraging preliminary data that endorses their short-term incorporation as new therapeutic options in these thoracic malignancies. However, despite all these new evidence, there are still several open questions that remain to be solved like the use of immune agents in special subpopulations such as elderly or fragile patients or the case of patients with brain metastases or autoimmune disorders. In addition some other open questions remain with regards ICIs activity in patients receiving corticosteroid or antibiotics, the potential use in oncogenic addicted tumours, as well as the safety of retreatment after the onset of immune-related adverse events (ir-AE) or the optimal dose schedule or time on treatment for ICIs administration. Herein, we propose to address all these questions, reviewing most recent evidence available in order to give readers some practical advises and guidance on how to deal with these challenges when treating NSCLC patients with immunotherapy.
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Affiliation(s)
- J Remon
- Hospital Vall d'Hebron, Medical Oncology Department, Barcelona, Spain.
| | - N Vilariño
- Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
| | - N Reguart
- Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
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Remon J, Pardo N, Martinez-Martí A, Cedrés S, Navarro A, Martinez de Castro AM, Felip E. Corrigendum to "Immune-checkpoint inhibition in first-line treatment of advanced non-small cell lung cancer patients: Current status and future approaches" [Lung Cancer 106 (2017) 70-75]. Lung Cancer 2018; 117:80. [PMID: 29398170 DOI: 10.1016/j.lungcan.2017.11.007] [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: 11/16/2022]
Affiliation(s)
- J Remon
- Hospital Vall d'Hebron, Medical Oncology Department, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - N Pardo
- Hospital Vall d'Hebron, Medical Oncology Department, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - A Martinez-Martí
- Hospital Vall d'Hebron, Medical Oncology Department, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - S Cedrés
- Hospital Vall d'Hebron, Medical Oncology Department, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - A Navarro
- Hospital Vall d'Hebron, Medical Oncology Department, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - A M Martinez de Castro
- Hospital Vall d'Hebron, Medical Oncology Department, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - E Felip
- Hospital Vall d'Hebron, Medical Oncology Department, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
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Abstract
Molecular profiling has changed the treatment landscape in advanced non-small-cell lung cancer. Accurately identifying the tumours that harbour sensitizing EGFR mutations, the most common targetable molecular alteration, as well as those with acquired resistance mutations (e.g. T790M) on treatment is a high clinical priority. The current clinical gold standard is genotyping of tumour specimens. However, the practical utility of this approach is limited by the lack of available tissue and the potential complications associated with biopsies. With the advent of newer sequencing assays, it has become feasible to assess tumour genomics via a blood sample, termed a 'liquid biopsy'. In this review, we summarize the available techniques for liquid biopsies and their applicability for detecting sensitizing and resistance EGFR mutations and how these results may be used for making treatment decisions.
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Affiliation(s)
- J W Goldman
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, USA
| | - Z S Noor
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, USA
| | - J Remon
- Department of Oncology Medicine, Gustave Roussy, Villejuif
| | - B Besse
- Department of Oncology Medicine, Gustave Roussy, Villejuif
- University Paris-Sud, Orsay, France
| | - N Rosenfeld
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge
- Cancer Research UK Major Centre - Cambridge, Cambridge, UK
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Mezquita L, Auclin E, Charrier M, Ferrara R, Caramella C, Planchard D, Ponce S, Paz-Ares L, Audigier-Valette C, Tessonnier L, Martinez G, Zalcman G, Lahmar J, Remon J, Adam J, Chaput N, Soria J, Besse B. MA 05.03 The Early Monitoring of Derived Neutrophil-To Lymphocyte Ratio (dNLR) Could Be a Surrogate Marker of Benefit of Immunotherapy in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mezquita L, Auclin E, Ferrara R, Caramella C, Charrier M, Remon J, Planchard D, Ponce S, Paz-Ares L, Lahmar J, Leroy L, Audigier-Valette C, Zeron-Medina J, Garrido P, Zalcman G, Mazieres J, Adam J, Chaput N, Soria J, Besse B. P2.07-060 Response Assessment and Subgroups Analysis According to the Lung Immune Prognostic Index (LIPI) for Immunotherapy in Advanced NSCLC Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mezquita L, Jovelet C, Ngocamus M, Auclin E, Remon J, Green E, Plagnol V, Morris C, Gazzah A, Caramella C, Adam J, Lacroix L, Friboulet L, Soria J, Besse B, Planchard D. MA 11.01 Liquid Biopsies for Monitoring BRAF Mutation (V600E) in Advanced BRAF (V600E) Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Remon J, Martinez-Marti A, Carcereny Costa E, Zeron-Medina Cuairan J, Sansano I, Mate J, Pardo N, Cedres S, Navarro A, Martinez de castro A, Moran T, Felip Font E. Major pathological response after preoperative chemotherapy as a surrogate marker of survival in early-stage non-small cell lung cancer: cohort of NATCH phase III trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx381.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cedres S, Martinez Marti A, Navarro A, Pardo N, Remon J, Matos I, Ochoa de Olza M, Hierro C, Martin Liberal J, Miquel J, Viaplana C, Villacampa Javierre G, Dienstmann R, Felip Font E. Outcomes of malignant pleural mesothelioma (MPM) patients (p) treated with immune-oncology drugs (IO) in clinical trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx389.005] [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: 11/13/2022] Open
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Lindsay C, Faugeroux V, Michiels S, Pailler E, Facchinetti F, Ou D, Bluthgen M, Pannet C, Ngo-Camus M, Bescher G, Caramella C, Billiot F, Remon J, Planchard D, Soria JC, Besse B, Farace F. A prospective examination of circulating tumor cell profiles in non-small-cell lung cancer molecular subgroups. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx156] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Remon J, Ferté C. A step towards the harmonization of clinical trials inform consent forms. Ann Oncol 2017; 28:910-912. [DOI: 10.1093/annonc/mdx082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Remon J, Caramella C, Jovelet C, Lacroix L, Lawson A, Smalley S, Howarth K, Gale D, Green E, Plagnol V, Rosenfeld N, Planchard D, Bluthgen MV, Gazzah A, Pannet C, Nicotra C, Auclin E, Soria JC, Besse B. Osimertinib benefit in EGFR-mutant NSCLC patients with T790M-mutation detected by circulating tumour DNA. Ann Oncol 2017; 28:784-790. [PMID: 28104619 DOI: 10.1093/annonc/mdx017] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [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: 10/17/2016] [Indexed: 02/01/2023] Open
Abstract
Background Approximately 50% of epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC) patients treated with EGFR tyrosine kinase inhibitors (TKIs) will acquire resistance by the T790M mutation. Osimertinib is the standard of care in this situation. The present study assesses the efficacy of osimertinib when T790M status is determined in circulating cell-free tumour DNA (ctDNA) from blood samples in progressing advanced EGFR-mutant NSCLC patients. Material and methods ctDNA T790M mutational status was assessed by Inivata InVision™ (eTAm-Seq™) assay in 48 EGFR-mutant advanced NSCLC patients with acquired resistance to EGFR TKIs without a tissue biopsy between April 2015 and April 2016. Progressing T790M-positive NSCLC patients received osimertinib (80 mg daily). The objectives were to assess the response rate to osimertinib according to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1, the progression-free survival (PFS) on osimertinib, and the percentage of T790M positive in ctDNA. Results The ctDNA T790M mutation was detected in 50% of NSCLC patients. Among assessable patients, osimertinib gave a partial response rate of 62.5% and a stable disease rate of 37.5%. All responses were confirmed responses. After median follow up of 8 months, median PFS by RECIST criteria was not achieved (95% CI: 4-NA), with 6- and 12-months PFS of 66.7% and 52%, respectively. Conclusion(s) ctDNA from liquid biopsy can be used as a surrogate marker for T790M in tumour tissue.
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Affiliation(s)
- J Remon
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - C Caramella
- Radiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - C Jovelet
- Translational Research Laboratory, AMMICA, INSERM US23/CNRS UNS3655, Gustave Roussy, Villejuif, France
| | - L Lacroix
- Translational Research Laboratory, AMMICA, INSERM US23/CNRS UNS3655, Gustave Roussy, Villejuif, France
| | | | | | | | - D Gale
- Inivata Ltd, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | | | - N Rosenfeld
- Inivata Ltd, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cambridge Cancer Centre, Cambridge, UK
| | - D Planchard
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - M V Bluthgen
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - A Gazzah
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - C Pannet
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - C Nicotra
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - E Auclin
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - J C Soria
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- University Paris-Sud and Gustave Roussy Cancer Campus, Villejuif, France
| | - B Besse
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- University Paris-Sud and Gustave Roussy Cancer Campus, Villejuif, France
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Cedres S, Pardo N, Navarro-Mendivil A, Martinez A, Martinez de Castro A, Remon J, Amair F, Zeron J, Vilaro M, Felip E. Brain metastases (BM) development in molecular selected non-small cell lung cancer (NSCLC) patients included in clinical trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Remon J, Abedallaa N, Taranchon-Clermont E, Bluthgen V, Lindsay CR, Besse B, Thomas de Montpréville V. CD52, CD22, CD26, EG5 and IGF-1R expression in thymic malignancies. Lung Cancer 2017. [PMID: 28625631 DOI: 10.1016/j.lungcan.2017.03.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Thymic epithelial tumours are rare cancers for which new treatment options are required. Identification of putative predictive markers is important for developing clinical trials. We studied the expression of five putative predictive biomarkers, potentially actionable by approved experimental drugs. METHODS CD52, CD22, CD26, EG5, and IGF-1R expression were investigated by immunohistochemistry in formalin-fixed surgical samples of thymic epithelial tumour patients. All samples containing 10% positive epithelial tumour cells, independent of tumour cell intensity, were considered as positive. Correlation with histological subtype was performed. RESULTS 106 surgical samples (89 thymomas, 12 thymic carcinoma, and 5 thymic neuroendocrine tumours) were evaluated. Overall, CD52, CD22, CD26, EG5 and IGF-1R expression was observed in 7%, 42%, 25%, 42% and 77% of samples, respectively. CD52 expression was more frequent in B2 and B3 thymoma. All TET subtypes stained for CD22, mainly AB thymoma (68%). CD26 expression also correlated with AB thymoma (68%), and A thymoma (50%) subtype, while IGFR1 was the most common marker expressed by thymic carcinoma samples (92%), followed by EG5 (60%). Only EG5 expression was significantly higher in thymic carcinomas than in thymomas (75% vs. 38%, p=0.026). CONCLUSIONS Our data were consistent with a previous study of IGF-1R expression. Based on their expression, activity of agents targeting CD52, CD 22, CD26 and EG5 could be further explored in TET patients.
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Affiliation(s)
- J Remon
- Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - N Abedallaa
- Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - E Taranchon-Clermont
- Departement d'Anatomie Pathologiques Recherche, Institut Universitaire du Cancer Toulouse - Oncopole, 1 Avenue Irène Joint-Curie, 31509 Toulouse Cedex 9, France.
| | - V Bluthgen
- Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
| | - C R Lindsay
- Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
| | - B Besse
- Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805 Villejuif, France; University Paris-Sud, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
| | - V Thomas de Montpréville
- Pathology Department, Hôpital Marie Lannelongue, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France.
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Remon J, Soria J. Improving brain penetration of kinase inhibitors in lung cancer patients with oncogene dependency. Ann Oncol 2017; 28:196-198. [DOI: 10.1093/annonc/mdw553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Remon J, Le Rhun E, Besse B. Leptomeningeal carcinomatosis in non-small cell lung cancer patients: A continuing challenge in the personalized treatment era. Cancer Treat Rev 2016; 53:128-137. [PMID: 28110254 DOI: 10.1016/j.ctrv.2016.12.006] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/11/2016] [Accepted: 12/20/2016] [Indexed: 01/15/2023]
Abstract
Leptomeningeal metastasis is a fatal manifestation seen in advanced cancer patients. Its incidence is increasing, reaching 3.8% in molecularly unselected non-small cell lung cancer patients and up to 5% and 9% in ALK-rearranged and EGFR-mutant lung cancer patients, respectively. The prognosis remains poor despite systemic treatment, intrathecal chemotherapy, radiation therapy and personalized treatments in molecularly selected patients. However, new therapies with improved cerebral-spinal fluid penetration have been developed for subgroups of molecular selected patients indicating they could be promising therapeutic options for managing leptomeningeal disease. Systemic chemotherapy, which may be combined with intrathecal chemotherapy, remains standard treatment for lung cancer patients with leptomeningeal disease and a good-risk profile. We summarize evidence reported in the literature for managing this complication in lung cancer patients. Based on this, we have selected potential therapeutic strategies that could be used in daily clinical practice.
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Affiliation(s)
- J Remon
- Gustave Roussy, Medical Oncology Department, Villejuif, France.
| | - E Le Rhun
- Neurology, Oscar Lambert Center Lille, Neuro-Oncology Department, Lille University Hospital and Lille University, INSERM U-1192, France.
| | - B Besse
- Gustave Roussy, Medical Oncology Department, Villejuif, France; Paris Sud University, France.
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Besse B, Garrido P, Bennouna J, Mezquita L, Gazzah A, Remon J, Planchard D, Garcia MEO, Raimbourg J, Chao G, Gil M. Safety of necitumumab and pembrolizumab combination therapy in patients with stage IV non-small cell lung cancer (NSCLC): a phase 1b expansion cohort study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mezquita L, Charrier M, Lahmar J, Remon J, Bluthgen M, Facchinetti F, Planchard D, Gazzah A, Dupraz L, Adam J, Chaput N, Besse B. HLA-A2 and immune checkpoints inhibitors in advanced non-small cell lung cancer (NSCLC) patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.23] [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: 11/13/2022] Open
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