1
|
Tricarico P, Chardin D, Martin N, Contu S, Hugonnet F, Otto J, Humbert O. Total metabolic tumor volume on 18F-FDG PET/CT is a game-changer for patients with metastatic lung cancer treated with immunotherapy. J Immunother Cancer 2024; 12:e007628. [PMID: 38649279 PMCID: PMC11043703 DOI: 10.1136/jitc-2023-007628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE Because of atypical response imaging patterns in patients with metastatic non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICPIs), new biomarkers are needed for a better monitoring of treatment efficacy. The aim of this prospective study was to evaluate the prognostic value of volume-derived positron-emission tomography (PET) parameters on baseline and follow-up 18F-fluoro-deoxy-glucose PET (18F-FDG-PET) scans and compare it with the conventional PET Response Criteria in Solid Tumors (PERCIST). METHODS Patients with metastatic NSCLC were included in two different single-center prospective trials. 18F-FDG-PET studies were performed before the start of immunotherapy (PETbaseline), after 6-8 weeks (PETinterim1) and after 12-16 weeks (PETinterim2) of treatment, using PERCIST criteria for tumor response assessment. Different metabolic parameters were evaluated: absolute values of maximum standardized uptake value (SUVmax) of the most intense lesion, total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), but also their percentage changes between PET studies (ΔSUVmax, ΔTMTV and ΔTLG). The median follow-up of patients was 31 (7.3-31.8) months. Prognostic values and optimal thresholds of PET parameters were estimated by ROC (Receiver Operating Characteristic) curve analysis of 12-month overall survival (12M-OS) and 6-month progression-free survival (6M-PFS). Tumor progression needed to be confirmed by a multidisciplinary tumor board, considering atypical response patterns on imaging. RESULTS 110 patients were prospectively included. On PETbaseline, TMTV was predictive of 12M-OS [AUC (Area Under Curve) =0.64; 95% CI: 0.61 to 0.66] whereas SUVmax and TLG were not. On PETinterim1 and PETinterim2, all metabolic parameters were predictive for 12M-OS and 6M-PFS, the residual TMTV on PETinterim1 (TMTV1) being the strongest prognostic biomarker (AUC=0.83 and 0.82; 95% CI: 0.74 to 0.91, for 12M-OS and 6M-PFS, respectively). Using the optimal threshold by ROC curve to classify patients into three TMTV1 subgroups (0 cm3; 0-57 cm3; >57 cm3), TMTV1 prognostic stratification was independent of PERCIST criteria on both PFS and OS, and significantly outperformed them. Subgroup analysis demonstrated that TMTV1 remained a strong prognostic biomarker of 12M-OS for non-responding patients (p=0.0003) according to PERCIST criteria. In the specific group of patients with PERCIST progression on PETinterim1, low residual tumor volume (<57 cm3) was still associated with a very favorable patients' outcome (6M-PFS=73%; 24M-OS=55%). CONCLUSION The absolute value of residual metabolic tumor volume, assessed 6-8 weeks after the start of ICPI, is an optimal and independent prognostic measure, exceeding and complementing conventional PERCIST criteria. Oncologists should consider it in patients with first tumor progression according to PERCIST criteria, as it helps identify patients who benefit from continued treatment. TRIAL REGISTRATION NUMBER 2018-A02116-49; NCT03584334.
Collapse
Affiliation(s)
- Pierre Tricarico
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Nice, France
| | - David Chardin
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Nice, France
- IBV, Université Côte d'Azur, CNRS, Inserm, Nice, France
| | - Nicolas Martin
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Sara Contu
- Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Florent Hugonnet
- Department of Nuclear Medicine, Centre Hospitalier Princesse Grâce, Monaco
| | - Josiane Otto
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Olivier Humbert
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Nice, France
- IBV, Université Côte d'Azur, CNRS, Inserm, Nice, France
| |
Collapse
|
2
|
Falchero L, Guisier F, Darrason M, Boyer A, Dayen C, Cousin S, Merle P, Lamy R, Madroszyk A, Otto J, Tomasini P, Assoun S, Canellas A, Gervais R, Hureaux J, Le Treut J, Leleu O, Naltet C, Tiercin M, Van Hulst S, Missy P, Morin F, Westeel V, Girard N. Long-term effectiveness and treatment sequences in patients with extensive stage small cell lung cancer receiving atezolizumab plus chemotherapy: Results of the IFCT-1905 CLINATEZO real-world study. Lung Cancer 2023; 185:107379. [PMID: 37757576 DOI: 10.1016/j.lungcan.2023.107379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Small cell lung cancer (SCLC) has a tendency towards recurrence and limited survival. Standard-of-care in 1st-line is platinum-etoposide chemotherapy plus atezolizumab or durvalumab,based on landmarkclinical trials. METHODS IFCT-1905 CLINATEZO is a nationwide, non-interventional, retrospectivestudy of patients with extensive-SCLC receivingatezolizumab plus chemotherapy as part of French Early Access Program. Objectives were to analyse effectiveness,safetyand subsequent treatments. RESULTS The population analyzed included 518 patients who received atezolizumabin 65 participating centers. There were 66.2% male,mean age was 65.7 years; 89.1% had a performance status (PS) 0/1 and 26.6% brain metastases. Almost all(95.9%) were smokers. Fifty-five (10.6%) received at least 1 previous treatment. Median number of atezolizumab injections was 7.0 (range [1.0-48.0]) for a median duration of 4.9 months (95% CI 4.5-5.1). Atezolizumab was continued beyond progression in 122 patients (23.6%) for a median duration of 1.9 months (95% CI: [1.4-2.3]). Best objective response was complete and partialin 19 (3.9%) and 378 (77.1%)patients. Stable diseasewas observed in 50 patients (10.2%). Median follow-up was30.8 months (95% CI: [29.9-31.5]). Median overall survival (OS), 12-, 24-month OS rates were 11.3 months (95% CI: [10.1-12.4]), 46.7% (95% CI [42.3-50.9]) and 21.2% (95% CI [17.7-24.8]). Median real-world progression-free survival, 6-, 12-month rates were 5.2 months (95% CI [5.0-5.4]), 37.5% (95% CI [33.3-41.7]) and 15.2% (95% CI [12.2-18.6]). For patients with PS 0/1, median OS was 12.2 months (95% CI [11.0-13.5]). For patients with previous treatment, median OS was 14.9 months (95% CI [10.1-21.5]). Three-hundred-and-twenty-six patients(66.4%) received subsequent treatment and27 (5.2%) were still underatezolizumabat date of last news. CONCLUSIONS IFCT-1905 CLINATEZO shows reproductibility, in real-life,ofIMpower-133survival outcomes, possibly attributed to selection of patients fit for this regimen, adoption of pragmatic approaches,including concurrent radiotherapy and treatment beyond progression.
Collapse
Affiliation(s)
- Lionel Falchero
- Service de Pneumologie et Cancérologie Thoracique, Hôpitaux Nord-Ouest, Villefranche Sur Saône, France
| | - Florian Guisier
- Univ Rouen Normandie, LITIS Lab QuantIF team EA4108, Rouen, France, CHU Rouen, Inserm CIC-CRB 1404, Department of Pneumology, Thoracic oncology and respiratory intensive care, Rouen, France
| | - Marie Darrason
- HCL, Centre Hospitalier Lyon Sud, URCC Secteur essais cliniques, Pierre-Bérard, France
| | - Arnaud Boyer
- Hôpital Saint Joseph, Service de Pneumologie, Marseille, Franc'
| | - Charles Dayen
- Clinique de l'Europe, Service de Pneumologie, Amiens, France
| | - Sophie Cousin
- Institut'Bergonié, Département d'Oncologie Médicale, Bordeaux, France
| | - Patrick Merle
- CHU, Hôpital Gabriel Montpied, Hôpital de jour, Service d'oncologie Thoracique, Clermont Ferrand, France
| | - Régine Lamy
- CHBS, Hôpital Du Scorff, Oncologie médicale, Lorient, France
| | - Anne Madroszyk
- Institut Paoli Calmettes, Département d'Oncologie Médicale, Marseille, France Centre Antoine Lacassagne, Oncologie, Nice, France
| | | | - Pascale Tomasini
- APHM, Service d'Oncologie Multidisciplinaire &Franceations Thérapeutiques, Hôpital Nord, Marseille, France
| | - Sandra Assoun
- APHP, Service de Pneumologie, Hôpital Bichat, Paris, France
| | | | - Radj Gervais
- Service de Pneumol'gie, Centre François Baclesse, Caen, France
| | - José Hureaux
- Service de Pneumologie, CHU Angers, Angers, France
| | | | - Olivier Leleu
- Service de Pneumologie, Centre Hospitalier, Abbeville, France
| | - Charles Naltet
- Service de Pneumologie Oncologie, Groupe Hospitalier ParisFrance Joseph, Paris, France
| | - Marie Tiercin
- Fédération de Pneumologie, Centre Hospitalier, Saint Malo, France
| | - Sylvie Van Hulst
- Service de Cancérologie, Centre Hospitalier Universitaire, Nîmes, France
| | | | - Franck Morin
- IFCT, Unité de Recherche Clinique, Paris, France
| | - Virginie Westeel
- CHU Besançon, Hôpita Minjoz, Service de Pneumologie, Besançon, France
| | - Nicolas Girard
- Institut du Thorax Curie Montsouris, Institut Curie, Paris, France, Paris Saclay University, University Versailles Saint Quentin, Versailles, France.
| |
Collapse
|
3
|
Boutros J, Martin N, Otto J, Marquette CH, Lhomel B, Naghavi AO, Schiappa R, Bondiau PY, Doyen J. Combining Stereotactic Radiotherapy and Conventional Radiotherapy for Peripheral Locally Advanced Lung Cancer. Clin Oncol (R Coll Radiol) 2023; 35:624-625. [PMID: 37330363 DOI: 10.1016/j.clon.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/19/2023]
Affiliation(s)
- J Boutros
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; Department of Pulmonary Medicine and Oncology, Centre Hospitalier Universitaire de Nice, Nice, France.
| | - N Martin
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - J Otto
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - C-H Marquette
- Department of Pulmonary Medicine and Oncology, Centre Hospitalier Universitaire de Nice, Nice, France; University of Côte D'Azur, Nice, France
| | - B Lhomel
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte D'Azur, Nice, France
| | - A O Naghavi
- Department of Radiation Oncology and Research Institute, Tampa, FL, USA
| | - R Schiappa
- Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - P-Y Bondiau
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte D'Azur, Nice, France
| | - J Doyen
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte D'Azur, Nice, France
| |
Collapse
|
4
|
Lach M, Otto J, Bondiau PY, Boulahssass R, Schiappa R, Jazmati D, von Krüchten R, Martin N, Doyen J. Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival. J Thorac Dis 2023; 15:3764-3775. [PMID: 37559621 PMCID: PMC10407508 DOI: 10.21037/jtd-23-108] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/26/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND The best platinum-based chemotherapy regimen remains to be determined in elderly patients treated with definitive chemoradiotherapy for advanced non-small cell lung cancer (NSCLC). Predictive indexes for toxicity and survival are also needed to give the safest and most effective treatment for this population. METHODS This is a retrospective cohort study. Patients with histologically confirmed stage IIIA, IIIB or IIIC NSCLC over 70 years of age, treated with radiotherapy and chemotherapy, were included. Patients from two cancer centers treated between 12/2006 and 08/2019 were included in the data analysis. RESULTS Fifty-eight patients were enrolled in the study. The median age was 76.6 years [interquartile range (IQR): 71.6-83.4]. Thirty-nine patients were treated with concomitant chemoradiotherapy and 19 with a sequential strategy. The chemotherapy regimen consisted in a combination of platinum and taxanes. At a median follow-up of 52 months (IQR: 7-69), the 2-year progression-free survival (PFS) and overall survival (OS) were 35.5% and 66.9%, respectively. Male sex and a high Charlson index were identified as independent prognostic factors for worse OS. Acute grade 3-5 toxicities occurred in 34.4% of patients, including 1 grade 5 toxicity, and grade 3-4 late toxicities occurred in 17.2% of patients. In the whole cohort a high Charlson index was the only predictive factor for a higher risk of grade 3-5 acute toxicities (statistical trend in the concurrent cohort, P=0.06). CONCLUSIONS The Charlson index correlated with toxicity and survival in elderly patients treated with chemoradiotherapy in locally advanced NSCLC. The addition of taxanes to platinum chemotherapy was safe in the present study and warrants further exploration.
Collapse
Affiliation(s)
- Maciej Lach
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d’Azur, Nice, France
| | - Josiane Otto
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d’Azur, Nice, France
| | - Pierre-Yves Bondiau
- Department of Radiation Oncology, Centre Antoine-Lacassagne, University of Côte d’Azur, Nice, France
| | - Rabia Boulahssass
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est, CHU of Nice, University of Côte d’Azur, Nice, France
| | - Renaud Schiappa
- Department of Biostatistics, Centre Antoine-Lacassagne, University of Côte d’Azur, Nice, France
| | - Danny Jazmati
- Department of Radiation Oncology, Heinrich Heine University, Duesseldorf, Germany
| | - Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Nicolas Martin
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d’Azur, Nice, France
| | - Jérôme Doyen
- Department of Radiation Oncology, Centre Antoine-Lacassagne, University of Côte d’Azur, Nice, France
| |
Collapse
|
5
|
Benzaquen J, Bondiau PY, Otto J, Marquette CH, Berthet JP, Naghavi AO, Schiappa R, Hannoun-Levi JM, Padovani B, Doyen J. Comparison of outcome after stereotactic ablative radiotherapy of patients with metachronous lung versus primary lung cancer. Radiat Oncol 2023; 18:97. [PMID: 37287020 DOI: 10.1186/s13014-023-02286-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 05/20/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Early-stage lung cancer, primarily treated with surgery, often occur in poor surgical candidates (impaired respiratory function, prior thoracic surgery, severe comorbidities). Stereotactic ablative radiotherapy (SABR) is a non-invasive alternative that provides comparable local control. This technique is particularly relevant for surgically resectable metachronous lung cancer, in patients unable to undergo surgery.. The objective of this study is to evaluate the clinical outcome of patients treated with SABR for stage I metachronous lung cancer (MLC) versus stage I primary lung cancer (PLC). PATIENTS AND METHODS 137 patients treated with SABR for stage I non-small cell lung cancer were retrospectively reviewed, of which 28 (20.4%) were MLC and 109 (79.6%) were PLC. Cohorts were evaluated for differences in overall survival (OS), progression-free survival (PFS), metastasis-free survival, local control (LC), and toxicity. RESULTS After SABR, patients treated for MLC have comparable median age (76.6 vs 78.6, p = 0.2), 3-year LC (83.6% vs. 72.6%, p = 0.2), PFS (68.7% vs. 50.9%, p = 0.9), and OS (78.6% vs. 52.1%, p = 0.9) as PLC, along with similar rates of total (54.1% vs. 42.9%, p = 0.6) and grade 3 + toxicity (3.7% vs. 3.6%, p = 0.9). Previous treatment of MLC patients was either surgery (21/28, 75%) or SABR (7/28, 25%). The median follow-up was 53 months. CONCLUSION SABR is a safe and effective approach for localized metachronous lung cancer.
Collapse
Affiliation(s)
- Jonathan Benzaquen
- Department of Pulmonary Medicine and Thoracic Oncology, Nice University Hospital, Pasteur Hospital, FHU OncoAge, Côte d'Azur University, 30, Voie Romaine, 06000, Nice, France.
- CNRS, INSERM, Institute of Research On Cancer and Aging, Côte d'Azur University, Nice, France.
| | - Pierre-Yves Bondiau
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | - Josiane Otto
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | - Charles-Hugo Marquette
- Department of Pulmonary Medicine and Thoracic Oncology, Nice University Hospital, Pasteur Hospital, FHU OncoAge, Côte d'Azur University, 30, Voie Romaine, 06000, Nice, France
- CNRS, INSERM, Institute of Research On Cancer and Aging, Côte d'Azur University, Nice, France
| | - Jean-Philippe Berthet
- Department of Thoracic Surgery, Nice University Hospital, Pasteur Hospital, Nice, France
| | - Arash O Naghavi
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Renaud Schiappa
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | - Jean-Michel Hannoun-Levi
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | - Bernard Padovani
- Department of Radiology, Nice University Hospital, Côte d'Azur University, Nice, France
| | - Jérôme Doyen
- CNRS, INSERM, Institute of Research On Cancer and Aging, Côte d'Azur University, Nice, France
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| |
Collapse
|
6
|
Zalcman G, Madroszyk Flandin AC, Molinier O, Dayen C, Egenod T, Debieuvre D, Beaucaire-Danel S, Dixmier A, Pichon E, Galland Girodet S, Giroux-Leprieur E, Cloarec N, Cadranel J, Otto J, Romand P, Langlais A, Morin F, Antoine M, Westeel V, Toffart A. 972O Nivolumab (Nivo) plus ipilimumab (Ipi) 6-months treatment versus continuation in patients with advanced non-small cell lung cancer (aNSCLC): Results of the randomized IFCT-1701 phase III trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
7
|
Khatir W, Humbert O, Benzaquen J, Bontoux C, Neels J, Berland L, Rivera FAG, Allegra M, Salah M, Tanga V, Bordone O, Fayada J, Lespinet-Fabre V, Bohly D, Long-Mira E, Lassalle S, Vouret V, Brest P, Mograbi B, Maniel C, Otto J, Boutros J, Heeke S, Hofman V, Marquette CH, Hofman P, Ilié M. Identification of a circulating immunological signature predictive of response to immune checkpoint inhibitors in patients with advanced non-small cell lung cancer. Clin Transl Med 2022; 12:e1018. [PMID: 35994416 PMCID: PMC9394752 DOI: 10.1002/ctm2.1018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Wassila Khatir
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Olivier Humbert
- Department of Nuclear Medicine, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Jonathan Benzaquen
- Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France.,Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Christophe Bontoux
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Jaap Neels
- Team Metabolic Challenges of Immune Cells in Obesity, Diabetes, and Cardiovascular Disease, Centre Méditerranéen de Médecine Moléculaire (C3M), INSERM, Université Côte d'Azur, Nice, France
| | - Léa Berland
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Maryline Allegra
- Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Myriam Salah
- Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Virginie Tanga
- Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Olivier Bordone
- Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Julien Fayada
- Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Virginie Lespinet-Fabre
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Doriane Bohly
- Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Valérie Vouret
- Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Patrick Brest
- Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Baharia Mograbi
- Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Charlotte Maniel
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Josiane Otto
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Jacques Boutros
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Simon Heeke
- Department of Thoracic H&N Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France.,Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Charles-Hugo Marquette
- Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France.,Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France.,Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Team 4, Institute of Research on Cancer and Aging (IRCAN), CNRS INSERM, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France.,Biobank Côte d'Azur (BB-0033-00025), Centre Hospitalier Universitaire de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.,Department of Thoracic H&N Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
8
|
Barlesi F, Tomasini P, Karimi M, Michiels S, Raimbourg J, Daniel C, Janicot H, Madroszyk A, Audigier-Valette C, Quoix E, Mazieres J, Moro-Sibilot D, Dansin E, Molinier O, Morel H, Pichon E, Cortot A, Otto J, Chomy FO, Souquet PJ, Cloarec N, Giroux Leprieur E, Bieche I, Lacroix L, Boyault S, Attignon V, Soubeyran I, Morel A, Tran-Dien A, Jacquet A, Dall'Olio FG, Jimenez M, Soria JC, Besse B. Comprehensive genome profiling in patients with metastatic non-small cell lung cancer: the precision medicine phase 2 randomized SAFIR02-Lung trial. Clin Cancer Res 2022; 28:4018-4026. [PMID: 35802649 DOI: 10.1158/1078-0432.ccr-22-0371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/20/2022] [Accepted: 07/06/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Targeted therapies (TT) and immune checkpoint blockers (ICB) have revolutionized the approach to non-small cell lung cancer (NSCLC) treatment in the era of precision medicine. Their impact as switch maintenance therapy based on molecular characterization is unknown. EXPERIMENTAL DESIGN SAFIR02-Lung was an open-label, randomized, phase 2 trial, involving 33 centers in France. We investigated eight TT (substudy-1) and one ICB (substudy-2), compared to standard-of-care as a maintenance strategy in advanced EGFR, ALK wild-type (wt) NSCLC patients without progression after first line chemotherapy, based on high-throughput genome analysis. The primary outcome was progression-free survival (PFS). RESULTS Among the 175 patients randomized in substudy-1, 116 received TT (selumetinib, vistusertib, capivasertib, AZD4547, AZD8931, vandetanib, olaparib, savolitinib) and 59 standard-of-care. Median PFS was 2.7 months (95% CI 1.6-2.9) with TT vs. 2.7 months (1.6-4.1) with standard-of-care (HR 0.97, 0.7-1.36; p=0.87). There were no significant differences in PFS within any molecular subgroup. In substudy-2, 183 patients were randomized, 121 received durvalumab and 62 standard-of-care. Median PFS was 3.0 months (2.3-4.4) with durvalumab versus 3.0 months (2.0-5.1) with standard-of-care (HR=0.86; 0.62-1.20; p=0.38). Preplanned subgroup analysis showed an enhanced benefit with durvalumab in patients with PD-L1 Tumor Proportion Score (TPS) ≥ 1%, (n=29, HR=0.29; 0.11-0.75) as compared to PD-L1 <1% (n=31, HR=0.71, 0.31-1.60, interaction p= 0.036). CONCLUSIONS Molecular profiling can feasibly be implemented to guide treatment choice for the maintenance strategy in EGFR/ALK wt NSCLC; in the current study it did not lead to substantial treatment benefits beyond durvalumab for PD-L1 ≥ 1 patients.
Collapse
Affiliation(s)
- Fabrice Barlesi
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Pascale Tomasini
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | | | | | | | | | - Henri Janicot
- CHU - Hopital Gabriel Montpied, Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alain Morel
- Institut de Cancérologie de l'Ouest, Angers, France
| | | | | | | | | | | | | |
Collapse
|
9
|
Baldacci S, Besse B, Avrillon V, Mennecier B, Mazieres J, Dubray-Longeras P, Cortot AB, Descourt R, Doubre H, Quantin X, Duruisseaux M, Monnet I, Moro-Sibilot D, Cadranel J, Clément-Duchêne C, Cousin S, Ricordel C, Merle P, Otto J, Schneider S, Langlais A, Morin F, Westeel V, Girard N. Lorlatinib for advanced anaplastic lymphoma kinase–positive non–small cell lung cancer: Results of the IFCT-1803 LORLATU cohort. Eur J Cancer 2022; 166:51-59. [DOI: 10.1016/j.ejca.2022.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/03/2022] [Accepted: 01/09/2022] [Indexed: 12/14/2022]
|
10
|
Girard N, Galland-Girodet S, Avrillon V, Besse B, Duruisseaux M, Cadranel J, Otto J, Prevost A, Roch B, Bennouna J, Bouledrak K, Coudurier M, Egenod T, Lamy R, Ricordel C, Moro-Sibilot D, Odier L, Tillon-Strozyk J, Zalcman G, Missy P, Westeel V, Baldacci S. Lorlatinib for advanced ROS1+ non-small-cell lung cancer: results of the IFCT-1803 LORLATU study. ESMO Open 2022; 7:100418. [PMID: 35227966 PMCID: PMC9058895 DOI: 10.1016/j.esmoop.2022.100418] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/10/2022] [Accepted: 02/02/2022] [Indexed: 12/25/2022] Open
Abstract
Introduction ROS1-rearranged (ROS1+) non-small-cell lung cancer (NSCLC) is a rare lung cancer with limited treatment options. Phase I-II studies with ROS1-tyrosine kinase inhibitors (TKIs) included small numbers of patients and real-world data are lacking. We investigate the efficacy and safety of lorlatinib, a third-generation TKI targeting ALK and ROS1, in patients with ROS1+ NSCLC treated through an expanded access program. Methods Consecutive patients with advanced ROS1+ NSCLC treated with lorlatinib between October 2015 and June 2019 were included. Data were collected from medical records. The primary endpoint was progression-free survival. Results Out of the 80 patients included, 47(59%) were female, 49(62%) never smokers (less than 100 cigarettes over the lifetime), and 68(85%) had stage IV NSCLC at diagnosis. Most frequent histology was adenocarcinoma (95%) and median age was 58.2 years. At the time of lorlatinib initiation, 51(64%) patients had brain metastases and 55(81%) were PS 0-1. Lorlatinib was administered as second/third/fourth/fifth+ line in 29%/28%/18%/26% of patients. All patients previously received at least one ROS1 TKI, and 55(69%) previously received chemotherapy. Median follow-up from lorlatinib initiation was 22.2 months. Median progression-free survival and overall survival from lorlatinib initiation were 7.1 months [95% confidence interval (CI) 5.0-9.9 months] and 19.6 months (95% CI 12.3-27.5 months). Median duration of treatment with lorlatinib was 7.4 months (95% CI 6.5-13.1 months). Overall response and disease control rates were 45% and 82%, respectively. The central nervous system response rate was 72%. Treatment was stopped due to toxicity in 10 patients (13%). The safety profile was consistent with previously published data. Conclusions Lorlatinib is a major treatment option for advanced refractory ROS1+ NSCLC in treatment strategy. Data are lacking on lorlatinib efficacy in advanced refractory ROS1+ NSCLC. Lorlatinib median progression-free survival and objective response rate were 7.1 months and 45%, respectively. Lorlatinib represents a major treatment option for patients with a ROS1+ NSCLC.
Collapse
|
11
|
Mazieres J, Lafitte C, Ricordel C, Greillier L, Negre E, Zalcman G, Domblides C, Madelaine J, Bennouna J, Mascaux C, Moro-Sibilot D, Pinquie F, Cortot AB, Otto J, Cadranel J, Langlais A, Morin F, Westeel V, Besse B. Combination of Trastuzumab, Pertuzumab, and Docetaxel in Patients With Advanced Non-Small-Cell Lung Cancer Harboring HER2 Mutations: Results From the IFCT-1703 R2D2 Trial. J Clin Oncol 2022; 40:719-728. [PMID: 35073148 DOI: 10.1200/jco.21.01455] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE HER2 exon 20 insertions and point mutations are oncogenic drivers found in 1%-2% of patients with non-small-cell lung cancer (NSCLC). No targeted therapy is approved for this subset of patients. We prospectively evaluated the effectiveness of the combination of two antibodies against human epidermal growth factor 2 (HER2 [HER2] trastuzumab and pertuzumab with docetaxel; trastuzumab and pertuzumab) and docetaxel. METHODS The IFCT 1703-R2D2 trial is a multicenter, nonrandomized phase II study. Patients with HER2-mutated, advanced NSCLC who progressed after ≥ 1 platinum-based treatment were enrolled. Patients received pertuzumab at a loading dose of 840 mg and 420 mg thereafter; trastuzumab at an 8 mg/kg loading dose and 6 mg/kg thereafter; and docetaxel at a dose of 75 mg/m2 every 3 weeks. The primary outcome was the objective response rate (ORR). Other end points included the duration of response, progression-free survival, and safety (NCT03845270). RESULTS Forty-five patients were enrolled and treated. The median age was 64.5 years (range, 31-84 years), 35% were smokers, 72% were females, 15% had an Eastern Cooperative Oncology Group performance status of 2, and 30% had brain metastases. The objective response rate was 29% (n = 13), and 58% had stable disease (n = 26). The median progression-free survival was 6.8 months (95% CI, 4.0 to 8.5). The median duration of response in patients with a confirmed response (n = 13) was 11 months (95% CI, 2.9 to 14.9). Grade 3/4 treatment-related adverse events were observed in 64% of the patients. No patient discontinued treatment because of toxicity. The most frequent grade ≥ 3 treatment-related adverse events were neutropenia (33%), diarrhea (13%), and anemia (9%). CONCLUSION Triple therapy with trastuzumab, pertuzumab, and docetaxel is feasible and effective for HER2-mutated pretreated advanced NSCLC. These results highlight the effectiveness of the HER2 antibody-based strategy, which should be considered for these patients.
Collapse
Affiliation(s)
- Julien Mazieres
- Pneumology, CHU Toulouse-Hôpital Larrey, Université Paul Sabatier, Toulouse, France
| | - Claire Lafitte
- Pneumology, Hôpital Cardio-Vasculaire & Pneumologique Louis Pradel, Bron, France
| | | | - Laurent Greillier
- Aix Marseille Univ, APHM, INSERM, CNRS, CRCM, Hôpital Nord, Multidisciplinary Oncology and Therapeutic Innovations, Marseille, France
| | - Elodie Negre
- Thoracic Oncology, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Gérard Zalcman
- Thoracic Oncology, CIC INSERM 1425, Université de Paris, Hôpital Bichat, Paris, France
| | | | | | - Jaafar Bennouna
- Medical Oncology-CHU de Nantes, CRCINA INSERM, Nantes, France
| | - Céline Mascaux
- Pneumology, Nouvel Hôpital Civil-Hôpitaux Universitaires de Strasbourg, Inserm UMR_S 1113, IRFAC, Strasbourg University, Strasbourg, France
| | | | | | - Alexis B Cortot
- Univ. Lille, CHU Lille, Thoracic Oncology Department, CNRS, Inserm, Institut Pasteur de Lille, UMR9020-UMR-S 1277-Canther, F-59000, Lille, France
| | - Josiane Otto
- Oncology, Centre Antoine Lacassagne, Nice, France
| | | | - Alexandra Langlais
- Biostatistics, Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Franck Morin
- Clinical Research Unit, Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | | | - Benjamin Besse
- Medicine and Thoracic Pathology Committee, Gustave Roussy, Villejuif, France; Paris-Saclay University, Orsay, France
| |
Collapse
|
12
|
Humbert O, Bauckneht M, Gal J, Paquet M, Chardin D, Rener D, Schiazza A, Genova C, Schiappa R, Zullo L, Rossi G, Martin N, Hugonnet F, Darcourt J, Morbelli S, Otto J. Prognostic value of immunotherapy-induced organ inflammation assessed on 18FDG PET in patients with metastatic non-small cell lung cancer. Eur J Nucl Med Mol Imaging 2022; 49:3878-3891. [PMID: 35562529 PMCID: PMC9399195 DOI: 10.1007/s00259-022-05788-8] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/30/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE We evaluated the prognostic value of immunotherapy-induced organ inflammation observed on 18FDG PET in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICPIs). METHODS Data from patients with IIIB/IV NSCLC included in two different prospective trials were analyzed. 18FDG PET/CT exams were performed at baseline (PETBaseline) and repeated after 7-8 weeks (PETInterim1) and 12-16 weeks (PETInterim2) of treatment, using iPERCIST for tumor response evaluation. The occurrence of abnormal organ 18FDG uptake, deemed to be due to ICPI-related organ inflammation, was collected. RESULTS Exploratory cohort (Nice, France): PETInterim1 and PETInterim2 revealed the occurrence of at least one ICPI-induced organ inflammation in 72.8% of patients, including midgut/hindgut inflammation (33.7%), gastritis (21.7%), thyroiditis (18.5%), pneumonitis (17.4%), and other organ inflammations (9.8%). iPERCIST tumor response was associated with improved progression-free survival (p < 0.001). iPERCIST tumor response and immuno-induced gastritis assessed on PET were both associated with improved overall survival (OS) (p < 0.001 and p = 0.032). Combining these two independent variables, we built a model predicting patients' 2-year OS with a sensitivity of 80.3% and a specificity of 69.2% (AUC = 72.7). Validation cohort (Genova, Italy): Immuno-induced gastritis (19.6% of patients) was associated with improved OS (p = 0.04). The model built previously predicted 2-year OS with a sensitivity and specificity of 72.0% and 63.6% (AUC = 70.7) and 3-year OS with a sensitivity and specificity of 69.2% and 80.0% (AUC = 78.2). CONCLUSION Immuno-induced gastritis revealed by early interim 18FDG PET in around 20% of patients with NSCLC treated with ICPI is a novel and reproducible imaging biomarker of improved OS.
Collapse
Affiliation(s)
- Olivier Humbert
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France.
- TIRO-UMR E 4320, UCA/CEA, Nice, France.
| | - Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Jocelyn Gal
- Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Marie Paquet
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - David Chardin
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
- TIRO-UMR E 4320, UCA/CEA, Nice, France
| | - David Rener
- Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Aurelie Schiazza
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - Carlo Genova
- UOC Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Dipartimento Di Medicina Interna E Specialità Mediche (DiMI), Facoltà Di Medicina E Chirurgia, Università Degli Studi Di Genova, Genoa, Italy
| | - Renaud Schiappa
- Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Lodovica Zullo
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Rossi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
- UO Oncologia Medica, Ospedale Padre Antero Micone, Genoa, Italy
| | - Nicolas Martin
- Department of Medical Oncology, Centre Antoine-Lacassagne, UCA, Nice, France
| | - Florent Hugonnet
- Department of Nuclear Medicine, Centre Hospitalier Princesse Grâce, Monaco, Monaco
| | - Jacques Darcourt
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
- TIRO-UMR E 4320, UCA/CEA, Nice, France
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Josiane Otto
- Department of Medical Oncology, Centre Antoine-Lacassagne, UCA, Nice, France
| |
Collapse
|
13
|
Thomas D, Lan N, Jones C, Raju V, Soon J, Otto J, Wood C, Spencer R, Rankin J, Dwivedi G, Ihdayhid A. Evaluation of a Chest Pain Evaluation Pathway in the Emergency Department Utilising Computed Tomography Coronary Angiography as a First-Line Outpatient Test. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.337] [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: 10/16/2022]
|
14
|
Huangfu G, Jaltotage B, Pang J, Lan N, Abraham A, Otto J, Ihdayhid A, Rankin J, Watts G, Ayonrinde O, Dwivedi G. CT Evaluation of Hepatic Fat: A Novel Marker for High-Risk Coronary Atherosclerosis in Familial Hypercholesterolaemia. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.240] [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: 11/26/2022]
|
15
|
Chouaid C, Filleron T, Debieuvre D, Pérol M, Girard N, Dansin E, Lena H, Gervais R, Cousin S, Otto J, Schott R, Planchard D, Madroszyk A, Kaderbhai C, Dubray-Longeras P, Hiret S, Pichon E, Clément-Duchêne C, Chenuc G, Simon G, Bosquet L, QUantin X. A Real-World Study of Patients with Advanced Non-squamous Non-small Cell Lung Cancer with EGFR Exon 20 Insertion: Clinical Characteristics and Outcomes. Target Oncol 2021; 16:801-811. [PMID: 34661827 DOI: 10.1007/s11523-021-00848-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND In Europe, few data regarding the characteristics of EGFR exon 20 insertion (20ins) mutations in non-small cell lung cancer (NSCLC) are available. OBJECTIVE Using a large real-world cohort, we assessed the incidence, characteristics, and outcomes of patients with non-squamous (nsq) NSCLC harboring EGFR exon 20ins. PATIENTS AND METHODS The Epidemio-Strategy and Medical Economics advanced and metastatic lung cancer data platform including advanced/metastatic nsqNSCLC patients from January 2015 was analyzed (cut-off date: June 30, 2020). Characteristics, epidermal growth factor receptor (EGFR) mutation and other mutations, treatment patterns, and clinical outcomes were assessed for patients harboring EGFR exon 20ins, common EGFR mutations, other EGFR mutations, and wild-type EGFR. Survival parameters were estimated by the Kaplan-Meier method in these four groups. RESULTS Out of 9435 nsqNSCLC patients tested for EGFR, 1549 (16.4%) had a mutation, including 61 with EGFR exon 20ins (3.9% of all mutated EGFR). These 61 patients had a mean age of 63.6 years, were mostly female (68.9%) and non-smokers (55.7%), with de novo stage IV disease (73.8%) and performance status 0-1 (76.9%). Almost all patients (95.1%) with exon 20ins received systemic therapy (median, three lines). First-line systemic treatments consisted mainly of combination chemotherapy (70.7%), single-agent EGFR tyrosine kinase inhibitors (10.3%), and single-agent immunotherapy (5.2%). After a median follow-up of 25.0 (95% confidence interval [CI] 22.3-32.4) months, the median real-world overall survival was 24.3 (19.1-32.6) months in patients with exon 20ins compared to 35.4 (95% CI 32.6-37.5) in patients with common EGFR mutation (n = 1049) (p = 0.049) and 19.6 (95% CI 18.6-20.5) in patients with wild-type EGFR (n = 7866) (p = 0.2). CONCLUSIONS This large national study in nsqNSCLC patients confirms that EGFR exon 20ins is a rare condition (0.6%). The prognosis associated with exon 20ins appears to be in line with that of wild-type EGFR, but worse than common EGFR mutations, highlighting the need for advancements for this rare population.
Collapse
Affiliation(s)
- Christos Chouaid
- Service de Pneumologie, Pneumology, Intercommunal Hospital, 40 avenue de Verdun, 94010, Créteil, France.
| | | | | | | | | | | | | | | | | | | | - Roland Schott
- Institut de Cancérologie Strasbourg Europe ICANS, Strasbourg, France
| | | | | | | | | | - Sandrine Hiret
- Institut de Cancérologie de l'Ouest, Angers, Nantes, France
| | | | - Christelle Clément-Duchêne
- Institut de Cancérologie de Lorraine, Nancy, France.,Centre de Recherche en Automatique de Nancy (CRAN), Université de Lorraine, Nancy, France
| | | | | | | | - Xavier QUantin
- Institut Régional du Cancer de Montpellier, Montpellier, France
| |
Collapse
|
16
|
Girard N, Mazieres J, Otto J, Lena H, Lepage C, Egenod T, Smith D, Madelaine J, Gérinière L, El Hajbi F, Ferru A, Clément-Duchêne C, Madroszyk A, Desrame J, Morin F, Langlais A, Michel P, Louvet C, Westeel V, Walter T. LBA41 Nivolumab (nivo) ± ipilimumab (ipi) in pre-treated patients with advanced, refractory pulmonary or gastroenteropancreatic poorly differentiated neuroendocrine tumors (NECs) (GCO-001 NIPINEC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2119] [Citation(s) in RCA: 2] [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: 11/24/2022] Open
|
17
|
Verrill L, Boyer M, Williams L, Otto J, Lando A, Dawood N, Liggans G. Hand Washing Observations in Fast-Food and Full-Service Restaurants: Results from the 2014 U.S. Food and Drug Administration Retail Food Risk Factors Study. J Food Prot 2021; 84:1016-1022. [PMID: 33465242 DOI: 10.4315/jfp-20-412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/11/2020] [Accepted: 01/06/2021] [Indexed: 11/11/2022]
Abstract
ABSTRACT Properly executed hand washing by food service employees can greatly minimize the risk of transmitting foodborne pathogens to food and food contact surfaces in restaurants. However, food service employee hand washing is often not done correctly or does not occur as often as it should. The purpose of this study was to assess the relative impact of (i) the convenience and accessibility of hand washing facilities; (ii) the maintenance of hand washing supplies, (iii) multiunit status, (iv) having a certified food protection manager, and (v) having a food safety management system for compliance with proper hand washing. Results revealed marked differences in hand washing behaviors between fast-food and full-service restaurants; 45% of 425 fast-food restaurants and 57% of 396 full-service restaurants were out of compliance for washing hands correctly, and 57% of fast-food restaurants and 78% of full-service restaurants were out of compliance for employee hands being washed when required. Logistic regression results indicated the benefits of accessibility and maintenance of the hand washing sink and of a food safety management system for increasing the likelihood of employees washing hands when they are supposed to and washing them correctly when they do. HIGHLIGHTS
Collapse
Affiliation(s)
- L Verrill
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - M Boyer
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - L Williams
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - J Otto
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - A Lando
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - N Dawood
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - G Liggans
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| |
Collapse
|
18
|
Cortot AB, Madroszyk A, Giroux-Leprieur E, Molinier O, Quoix E, Bérard H, Otto J, Rault I, Moro-Sibilot D, Raimbourg J, Amour E, Morin F, Hureaux J, Moreau L, Debieuvre D, Morel H, Renault A, Pichon E, Huret B, Charpentier S, Denis MG, Cadranel J. First-Line Afatinib plus Cetuximab for EGFR-Mutant Non-Small Cell Lung Cancer: Results from the Randomized Phase II IFCT-1503 ACE-Lung Study. Clin Cancer Res 2021; 27:4168-4176. [PMID: 34031056 DOI: 10.1158/1078-0432.ccr-20-4604] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/12/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Double inhibition of epidermal growth factor receptor (EGFR) using a tyrosine kinase inhibitor plus a monoclonal antibody may be a novel treatment strategy for non-small cell lung cancer (NSCLC). We assessed the efficacy and toxicity of afatinib + cetuximab versus afatinib alone in the first-line treatment of advanced EGFR-mutant NSCLC. PATIENTS AND METHODS In this phase II, randomized, open-label study, patients with stage III/IV EGFR-positive NSCLC were randomly assigned (1:1) to receive afatinib (group A) or afatinib + cetuximab (group A + C). Oral afatinib 40 mg was given once daily; cetuximab 250 mg/m² was administered intravenously on day 15 of cycle 1, then every 2 weeks at 500 mg/m² for 6 months. The primary endpoint was time to treatment failure (TTF) rate at 9 months. Exploratory analysis of EGFR circulating tumor DNA in plasma was performed. RESULTS Between June 2016 and November 2018, 59 patients were included in group A and 58 in group A + C. The study was ended early after a futility analysis was performed. The percentage of patients without treatment failure at 9 months was similar for both groups (59.3% for group A vs. 64.9% for group A + C), and median TTF was 11.1 (95% CI, 8.5-14.1) and 12.9 (9.2-14.5) months, respectively. Other endpoints, including progression-free survival and overall survival, also showed no improvement with the combination versus afatinib alone. There was a slight numerical increase in grade ≥3 adverse events in group A + C. Allele frequency of the EGFR gene mutation in circulating tumor DNA at baseline was associated with shorter PFS, regardless of the treatment received. CONCLUSIONS These results suggest that addition of cetuximab to afatinib does not warrant further investigation in treatment-naïve advanced EGFR-mutant NSCLC.
Collapse
Affiliation(s)
- Alexis B Cortot
- Univ. Lille, CHU Lille, Thoracic Oncology Department, CNRS, Inserm, Institut Pasteur de Lille, UMR9020, UMR-S 1277, Canther, Lille, France. .,Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - Anne Madroszyk
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Institut Paoli-Calmettes, Marseille, France
| | - Etienne Giroux-Leprieur
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Respiratory Diseases and Thoracic Oncology, APHP-AmbroiseParé Hospital and EA 4340 University Versailles-Saint Quentin en Yvelines, Boulogne, France
| | - Olivier Molinier
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service des Maladies Respiratoires, Centre Hospitalier, Le Mans, France
| | - Elisabeth Quoix
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, University Hospital, Strasbourg, France
| | - Henri Bérard
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie, hôpital d'instruction des armées Sainte-Anne, Toulon, France
| | - Josiane Otto
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Medicine, Centre Antoine Lacassagne, Nice, France
| | - Isabelle Rault
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, Amiens, France
| | - Denis Moro-Sibilot
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Thoracic Oncology Unit Teaching Hospital A Michallon, INSERM U823, Grenoble, France
| | - Judith Raimbourg
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,ICO René Gauducheau, Saint-Herblain, France
| | - Elodie Amour
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - José Hureaux
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie, pôle Hippocrate, CHU, Angers, France; MINT, UNIV Angers, Inserm 1066, CNRS 6021, université Bretagne Loire, Angers, France
| | - Lionel Moreau
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie, Hôpital Louis Pasteur, Hôpitaux Civils de Colmar, Colmar, France
| | - Didier Debieuvre
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,GHRMSA, Mulhouse, France
| | - Hugues Morel
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, CHR Orléans, Orléans, France
| | - Aldo Renault
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, Hospital, Pau, France
| | - Eric Pichon
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie, CHRU Bretonneau, Tours, France
| | - Benjamin Huret
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, Private Hospital, Ramsay Generale de Sante, Villeneuve d'Ascq, France
| | - Sandrine Charpentier
- Department of Biochemistry, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Marc G Denis
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Biochemistry, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Jacques Cadranel
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie et d'Oncologie Thoracique, hôpital Tenon, Assistance Publique Hôpitaux de Paris and GRC 04 Theranoscan Sorbonne Université, Paris, France
| |
Collapse
|
19
|
Mazieres J, Lafitte C, Ricordel C, Greillier L, Pujol JL, Zalcman G, Domblides C, Madelaine J, Bennouna J, Mascaux C, Moro-Sibilot D, Pinquié F, Cortot A, Otto J, Cadranel J, Langlais A, Morin F, Westeel V, Besse B. Combination of trastuzumab, pertuzumab and docetaxel in patients with advanced non-small cell lung cancer (NSCLC) harboring HER2 mutation: Final results from the IFCT-1703 R2D2 trial. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.9015] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9015 Background: Human epidermal growth factor receptor 2 ( HER2) exon 20 insertions and mutations are oncogenic drivers found in 1-2% of NSCLC. However, there are no approved therapies for these patients. Many studies suggest that the use of HER2 inhibitors developed for breast cancer patients might be of interest in this setting. The aim of this trial was to prospectively evaluate the interest of a combination of two antibodies against HER2 (trastuzumab and pertuzumab) with docetaxel. Methods: IFCT-1703 R2D2 trial is a multicenter, non-randomized phase 2 study with a two-stage design, a power of 90% and an alpha risk at 5% (one-sided). HER2 mutational status was assessed locally in certified molecular genetic centers. Main other inclusion criteria were advanced NSCLC, progression after ≥ 1 platinum-based chemotherapy, asymptomatic brain metastases, left ventricular ejection fraction (LVEF) ≥ 50%, and PS 0-2. Patients were treated every 3 weeks with pertuzumab at a loading dose of 840 mg, and 420 mg thereafter; plus trastuzumab at a loading dose of 8 mg/kg and 6 mg/kg thereafter; and docetaxel at 75 mg/m². Treatment was given until toxicity or disease progression. The primary outcome was overall response rate (ORR). Other endpoints included duration of response, progression-free survival and safety. NCT number: NCT03845270. Results: From May 2019 to October 2020, 45 patients were enrolled in 17 centers and received study treatment. Median age was 64.5 years (range 31–84), 72% females, 35% smokers, 100% non-squamous histology and 15% with ECOG PS 2. 31.1% patients had brain metastases. PD-L1 was expressed ≥ 1% and ≥ 50% in 36% and 7% of the patients, respectively. No other oncogene driver was found associated with HER2 exon 20 mutation. With a median follow-up of 12 months, 44 (98%) patients were evaluable for the primary endpoint. Overall response rate was 29% (n = 13), stable disease 56% (n = 26). Median PFS was 6.8 months (95% CI[4.0-8.5]). Median duration of treatment in patients with confirmed response (n = 13) was 10 months (95% CI[2.7-14.9]). At the time of data cut-off, 15 patients (33%) were still under treatment. Grade 3/4 treatment-related adverse events (AEs) were observed in 64% of patients. No patient experienced treatment discontinuation because of toxicity. One sudden death was possibly related to treatment. Most frequent grade ≥ 3 AEs were neutropenia (33%), diarrhea (13%) and anaemia (9%). Grade 1/2 dyspnea was observed in 3 (6.7%) patients. No ILD were reported. Variation LVEF was -1.72% on average (min: -18 %; max: 10 %). Conclusions: The triplet trastuzumab, pertuzumab and docetaxel is feasible and active in HER2 pretreated advanced NSCLC. These results confirm the activity of HER2 antibodies-based strategy which should be considered in these patients. Clinical trial information: NCT03845270.
Collapse
Affiliation(s)
- Julien Mazieres
- Thoracic Oncology Department, CHU Toulouse–Hôpital Larrey, Toulouse, France
| | - Claire Lafitte
- Pneumology, Hôpital Cardio-Vasculaire & Pneumologique Louis Pradel, Bron, France
| | | | - Laurent Greillier
- Multidisciplinary Oncology and Therapeutic Innovations, Hôpital Nord, Marseille, France
| | - Jean-Louis Pujol
- Thoracic oncology, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Gerard Zalcman
- Department of Thoracic Oncology, CIC INSERM 1425, Université de Paris, Hôpital Bichat, Paris, France
| | | | | | | | - Celine Mascaux
- Pneumology, Nouvel Hôpital Civil - Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | | | | | - Josiane Otto
- Oncology, Centre Antoine Lacassagne, Nice, France
| | | | - Alexandra Langlais
- Biostatistics, Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Franck Morin
- Clinical Research Unit, Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | | | - Benjamin Besse
- Department of Medicine and Thoracic Pathology Committee, Gustave Roussy, Villejuif, France
| |
Collapse
|
20
|
Chouaid C, Filleron T, Debieuvre D, Perol M, Girard N, Dansin E, Gervais R, Cousin S, Otto J, Schott R, Planchard D, Madroszyk A, Kaderbhai C, Dubray-Longeras P, Hiret S, Pichon E, Clement-Duchene CA, Martin AL, Simon G, Quantin X. EGFR Exon 20 insertion: Prognostic and predictive values in advanced non-small cell lung cancer, a real-world study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.9062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9062 Background: In Europe, 10-15% of non-squamous non-small cell lung cancer (nsqNSCLC) have EGFR mutations of which 5-12% are an Exon 20 insertion (20ins). Methods: Analysis of Epidemio-Strategy and Medical Economics (ESME) Advanced and Metastatic Lung cancer (AMLC) Data Platform (NCT03848052), a multicenter real-life database using a supervised, retrospective data collection process. The database includes 13737 advanced nsqNSCLC treated from January 2015 at participating centres. The cut-off date for patient follow-up for this analysis was June 30, 2020. The aim of the study was to assess real-world patient characteristics, treatment patterns and clinical outcomes of advanced nsqNSCLC EGFR 20ins. Overall survival (OS) of EGFR cohorts (20ins, 19del/L858R without 20ins, other EGFR mutations) and EGFR wild-type/not tested cohort were assessed. Results: 1549 (11.3%) nsqNSCLC had an EGFR mutation, 61 (3.9%) of whom being an EGFR 20ins. These 61 patients (pts) are mainly female (68.9%), non-smoker (55.7%), with de novo stage IIIB/IV disease (78.6%), PS 0-1 (76.9%). Median age was 68.0 years (q1-q3: 54-74). PD-L1 status was assessed in 34 (55.7%) pts, mainly (n = 20) before first line and 22 (64.7%) had negative result. Most (63.9%) pts had EGFR 20ins positive result available before first line. Almost all pts (95.1%, n = 58) received a systemic therapy with a median number of 3 (q1-q3: 1-4) lines. In first line setting, 74% of the pts received chemotherapy (mainly chemotherapy combination), 13.7% received EGFR TKI (mainly as monotherapy) and 8.6% received immunotherapy only. Median treatment duration for pts treated with CarboPem (n = 19), CisplatinPem (n = 16) and CarboTaxol (n = 6) were 4.7 (q1-q3: 2.6-6.6), 7.4 (q1-q3: 5.0-12.8) and 3.3 (q1-q3: 2.8-3.8) months, respectively. For afatinib (n = 3), erlotinib (n = 2) and gefitinib (n = 1), median treatment durations were 1.6 (q1-q3: 0.5-2.8); 1.8 (q1-q3: 1.4-2.1) and 2.3 months, respectively. After a median follow up of 36.3 (95%CI: 34.1-39.8) months, median OS was 24.3 (95%CI: 19.1-32.6) months; 1 and 2-years OS rates were 82.5% (95%CI: 69.7-90.2) and 52.6% (95%CI: 37.3-65.9), respectively. For pts with 19del/L858R without 20ins (n = 1049) and those with other EGFR mutations (n = 439) median OS were 35.4 (95%CI: 32.6-37.5) and 41.7 (95%CI: 31.9-53.5), respectively compared to 20.7 (95%CI: 20.0-21.8] months for pts EGFR wild type/not tested (n = 12188). Conclusions: This large, national real-world analysis based on medical chart data’s confirm that EGFR 20ins is a rare disease (0.4% of advanced nsqNSCLC). Currently available EGFR TKIs appear to have low efficacy and response to chemotherapy seems identical to that of EGFR wild-type/not tested pts. Prognosis for NSCLC pts with EGFR 20ins mutations was in line with that of EGFR wild type/not tested but worse than common EGFR mutations highlighting the need for advancements for this rare population.
Collapse
Affiliation(s)
- Christos Chouaid
- Pneumology, Centre Hospitalier Intercommunal (CHI) Creteil, Créteil, France
| | - Thomas Filleron
- Department of Biostatistics, Institut Claudius Regaud-IUCT, Toulouse, France
| | - Didier Debieuvre
- Groupe Hospitalier de la région Mulhouse Sud Alsace, Mulhouse, France
| | - Maurice Perol
- Centre Léon Bérard, Department of Medical Oncology, Lyon, France
| | - Nicolas Girard
- Institut Curie, Institut du Thorax Curie-Montsouris, Paris, France
| | - Eric Dansin
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | | | - Sophie Cousin
- Medical Oncology, Institute Bergonié, Bordeaux, France
| | - Josiane Otto
- Oncology, Centre Antoine Lacassagne, Nice, France
| | - Roland Schott
- Institut de Cancérologie Strasbourg Europe ICANS, Strasbourg, France
| | - David Planchard
- Gustave Roussy, Department of Medical Oncology, Villejuif, France
| | - Anne Madroszyk
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | | | | | - Sandrine Hiret
- Institut de Cancérologie de l’Ouest, Saint-Herblain, France
| | - Eric Pichon
- Centre Hospitalier Universitaire, Tours, France
| | | | | | | | | |
Collapse
|
21
|
Heeke S, Hofman V, Benzaquen J, Otto J, Tanga V, Zahaf K, Allegra M, Long-Mira E, Lassalle S, Marquette CH, Ilie M, Hofman P. Detection of EGFR Mutations From Plasma of NSCLC Patients Using an Automatic Cartridge-Based PCR System. Front Pharmacol 2021; 12:657743. [PMID: 33935776 PMCID: PMC8079969 DOI: 10.3389/fphar.2021.657743] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/12/2021] [Indexed: 11/17/2022] Open
Abstract
The introduction of liquid biopsies for the detection of EGFR mutations in non-small cell lung cancer patients (NSCLC) has revolutionized the clinical care. However, liquid biopsies are technically challenging and require specifically trained personnel. To facilitate the implementation of liquid biopsies for the detection of EGFR mutations from plasma, we have assessed a fully automated cartridge-based qPCR test that allows the automatic detection of EGFR mutations directly from plasma. We have analyzed 54 NSCLC patients and compared the results of the cartridge-base device to an FDA-approved assay. Detection of EGFR mutations was comparable but slightly lower in the cartridge-based device for L858R mutations (14/15 detected, 93%) and exon 19 deletions (18/20 detected, 90%). Unfortunately, 8/54 (15%) tests failed but increasing the proteinase K volume helped to recover 3/4 (75%) unsuccessful samples. In summary, the fully automated cartridge-based device allowed the detection of EGFR mutations directly from plasma in NSCLC patients with promising accuracy. However, protocol adjustments are necessary to reduce a high test failure rate.
Collapse
Affiliation(s)
- Simon Heeke
- Department of Thoracic H&N Medical Oncology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Centre Hospitalier Universitaire Nice, Nice, France.,Team 4 IRCAN, Inserm U1081/CNRS 7284, IRCAN, Nice, France.,FHU Oncoage, Nice, France
| | - Jonathan Benzaquen
- FHU Oncoage, Nice, France.,Pulmonary Department, Pasteur Hospital, Nice, France
| | - Josiane Otto
- FHU Oncoage, Nice, France.,Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Virginie Tanga
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Centre Hospitalier Universitaire Nice, Nice, France
| | - Katia Zahaf
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Centre Hospitalier Universitaire Nice, Nice, France
| | - Maryline Allegra
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Centre Hospitalier Universitaire Nice, Nice, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Centre Hospitalier Universitaire Nice, Nice, France.,Team 4 IRCAN, Inserm U1081/CNRS 7284, IRCAN, Nice, France.,FHU Oncoage, Nice, France
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Centre Hospitalier Universitaire Nice, Nice, France.,Team 4 IRCAN, Inserm U1081/CNRS 7284, IRCAN, Nice, France.,FHU Oncoage, Nice, France
| | - Charles-Hugo Marquette
- Team 4 IRCAN, Inserm U1081/CNRS 7284, IRCAN, Nice, France.,FHU Oncoage, Nice, France.,Pulmonary Department, Pasteur Hospital, Nice, France
| | - Marius Ilie
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Centre Hospitalier Universitaire Nice, Nice, France.,Team 4 IRCAN, Inserm U1081/CNRS 7284, IRCAN, Nice, France.,FHU Oncoage, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Centre Hospitalier Universitaire Nice, Nice, France.,Team 4 IRCAN, Inserm U1081/CNRS 7284, IRCAN, Nice, France.,FHU Oncoage, Nice, France
| |
Collapse
|
22
|
Herbreteau G, Langlais A, Greillier L, Audigier-Valette C, Uwer L, Hureaux J, Moro-Sibilot D, Guisier F, Carmier D, Madelaine J, Otto J, Souquet PJ, Gounant V, Merle P, Molinier O, Renault A, Rabeau A, Morin F, Denis MG, Pujol JL. Circulating Tumor DNA as a Prognostic Determinant in Small Cell Lung Cancer Patients Receiving Atezolizumab. J Clin Med 2020; 9:E3861. [PMID: 33261056 PMCID: PMC7760916 DOI: 10.3390/jcm9123861] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The IFCT-1603 trial evaluated atezolizumab in small cell lung cancer (SCLC). The purpose of the present study was to determine whether circulating tumor DNA (ctDNA), prospectively collected at treatment initiation, was associated with the prognosis of SCLC, and whether it identified patients who benefited from atezolizumab. METHODS 68 patients were included in this study: 46 patients were treated with atezolizumab and 22 with conventional chemotherapy. Circulating DNA was extracted from plasma and NGS (Next Generation Sequencing) looked for mutations in the TP53, RB1, NOTCH1, NOTCH2, and NOTCH3 genes. ctDNA was detectable when at least one somatic mutation was identified, and its relative abundance was quantified by the variant allele fraction (VAF) of the most represented mutation. RESULTS We found that 49/68 patients (70.6%) had detectable baseline ctDNA. The most frequently identified mutations were TP53 (32/49; 65.3%) and RB1 (25/49; 51.0%). Patients with detectable ctDNA had a significantly lower disease control rate at week 6 compared with patients with no detectable ctDNA, regardless of the nature of the treatment. Detection of ctDNA was associated with a poor OS prognosis. The detection of ctDNA at a relative abundance greater than the median value was significantly associated with poor overall survival (OS) and progression free survival (PFS). Interestingly, the benefit in overall survival (OS) associated with low ctDNA was more pronounced in patients treated with atezolizumab than in patients receiving chemotherapy. Among patients whose relative ctDNA abundance was below the median, those treated with atezolizumab tended to have higher OS than those in the chemotherapy arm. CONCLUSION ctDNA is strongly associated with the prognosis of SCLC patients treated with second-line immunotherapy. Its analysis seems justified for future SCLC clinical trials.
Collapse
Affiliation(s)
- Guillaume Herbreteau
- Department of Biochemistry, Nantes University Hospital, 9 quai Moncousu, 44093 Nantes, France;
| | - Alexandra Langlais
- IFCT Intergroupe Francophone de Cancérologie Thoracique, 10 Rue de la Grange Batelière, 75009 Paris, France; (A.L.); (F.M.)
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique—Hôpitaux de Marseille, Aix Marseille University, 13015 Marseille, France;
| | - Clarisse Audigier-Valette
- Department of Thoracic Oncology, 54 Rue Henri Sainte Claire Deville, CHITS CH Sainte Musse, 83000 Toulon, France;
| | - Lionel Uwer
- Institut de Cancérologie de Lorraine Alexis Vautrin, 6 Avenue de Bourgogne, 54519 Vandoeuvre-les-Nancy, France;
| | - José Hureaux
- Pôle Hippocrate, Angers University Hospital, 49933 Angers, France;
| | | | - Florian Guisier
- Department of Pneumology, Thoracic Oncology and Respiratory Intensive Care, Rouen University Hospital, 76000 Rouen, France;
| | - Delphine Carmier
- Service de Pneumologie CHRU Hôpitaux de Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37000 Tours, France;
| | - Jeannick Madelaine
- Service de Pneumologie, CHU Caen Normandie, Av de La Côte de Nacre, 14000 Caen, France;
| | - Josiane Otto
- Pôle Médecine, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06100 Nice, France;
| | - Pierre-Jean Souquet
- Service de Pneumologie Aiguë Spécialisée et Cancérologie Thoracique, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69310 Pierre-Benite, France;
| | - Valérie Gounant
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, 75018 Paris, France;
| | - Patrick Merle
- Service de Pneumologie, 58 Rue Montalembert, CHU G Montpied, 63000 Clermont Ferrand, France;
| | - Olivier Molinier
- Service de Pneumologie, Centre Hospitalier, 194 Avenue Rubillard, 72037 Le Mans, France;
| | - Aldo Renault
- Service de Pneumologie, Centre Hospitalier, 4 Boulevard Hauterive, 64000 Pau, France;
| | - Audrey Rabeau
- Service de Pneumologie, Centre Hospitalier, Université Paul Sabatier, 31300 Toulouse, France;
| | - Franck Morin
- IFCT Intergroupe Francophone de Cancérologie Thoracique, 10 Rue de la Grange Batelière, 75009 Paris, France; (A.L.); (F.M.)
| | - Marc G Denis
- Department of Biochemistry, Nantes University Hospital, 9 Quai Moncousu, 44093 Nantes, France;
| | - Jean-Louis Pujol
- Department of Thoracic Oncology, Montpellier Regional University Hospital, 34090 Montpellier, France
| |
Collapse
|
23
|
Nadal E, Heeke S, Benzaquen J, Vilariño N, Navarro A, Azuara D, Varela M, Otto J, Baixeras N, Shahbazian D, Puchois P, Church SE, Smith TH, Lanteri E, Ilié M, Hofman P. Two Patients With Advanced-Stage Lung Adenocarcinoma With Radiologic Complete Response to Nivolumab Treatment Harboring an STK11/LKB1 Mutation. JCO Precis Oncol 2020; 4:1239-1245. [DOI: 10.1200/po.20.00174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ernest Nadal
- Department of Medical Oncology, Catalan Institute of Oncology, Oncobell Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Spain
| | - Simon Heeke
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire (CHU) of Nice, Nice, France
- Université Côte D’Azur, Nice, France
| | - Jonathan Benzaquen
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire (CHU) of Nice, Nice, France
- Université Côte D’Azur, Nice, France
| | - Noelia Vilariño
- Department of Medical Oncology, Catalan Institute of Oncology, Oncobell Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Spain
| | - Arturo Navarro
- Department of Radiation Oncology, Catalan Institute of Oncology, Oncobell Program, IDIBELL, L’Hospitalet de Llobregat, Spain
| | - Daniel Azuara
- Translational Research Laboratory, Catalan Institute of Oncology, Oncobell Program, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Mar Varela
- Department of Pathology, Hospital Universitari de Bellvitge, L’Hospitalet, Barcelona, Spain
| | - Josiane Otto
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Nuria Baixeras
- Department of Pathology, Hospital Universitari de Bellvitge, L’Hospitalet, Barcelona, Spain
| | | | | | | | | | - Elisabeth Lanteri
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire (CHU) of Nice, Nice, France
- Université Côte D’Azur, Nice, France
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire (CHU) of Nice, Nice, France
- Université Côte D’Azur, Nice, France
- FHU OncoAge, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire (CHU) of Nice, Nice, France
- Université Côte D’Azur, Nice, France
- FHU OncoAge, Nice, France
| |
Collapse
|
24
|
Quoix E, Audigier-Valette C, Lavolé A, Molinier O, Westeel V, Barlesi F, Le Treut J, Pichon E, Dauba J, Otto J, Moreau L, Madelaine J, Dumont P, Margery J, Debieuvre D, Renault PA, Pujol JL, Langlais A, Morin F, Moro-Sibilot D, Souquet PJ. Switch maintenance chemotherapy versus observation after carboplatin and weekly paclitaxel doublet chemotherapy in elderly patients with advanced non-small cell lung cancer: IFCT-1201 MODEL trial. Eur J Cancer 2020; 138:193-201. [PMID: 32898792 DOI: 10.1016/j.ejca.2020.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE Maintenance chemotherapy is a reasonable choice for patients with metastatic non-small cell lung carcinoma (NSCLC) not progressing after induction therapy with a platinum-based doublet. Nevertheless, there have been no studies dedicated to elderly patients. PATIENTS AND METHODS We conducted a randomised trial in patients aged 70-89 years, with advanced NSCLC (with neither EGFR mutation nor ALK rearrangement), who had not progressed after four cycles of monthly carboplatin and weekly paclitaxel in order to compare maintenance with either pemetrexed (500 mg/m2 d1, 22) in patients with non-squamous cell carcinoma or gemcitabine (1,150 mg/m2 d1, 8, 22) in squamous cell carcinoma to simple observation. The patients were required to have a performance status (PS) 0-2, mini-mental score >23, and creatinine clearance ≥45 mL/min. The primary end-point was overall survival (OS). RESULTS 632 patients were enrolled from May 2013 to October 2016. Of the 328 (52.3%) patients randomised after induction therapy, 166 patients were assigned to the observation arm, versus 162 to the switch maintenance arm, 119 of whom received pemetrexed and 43 gemcitabine. The median OS from randomisation was 14.1 months (95% confidence interval [CI]: 12.0-17.0) in the observation arm and 14 months (95% CI: 10.9-16.9) in the maintenance arm (p = 0.72). The median progression-free survival (PFS) from randomisation was 2.7 months (95% CI: 2.6-3.1) in the observation arm versus 5.7 months (95% CI: 4.8-7.1) in the maintenance arm (p < 0.001). CONCLUSION Switch maintenance therapy significantly prolonged PFS but not OS and, thus, should not be proposed to elderly patients with advanced NSCLC.
Collapse
Affiliation(s)
- Elisabeth Quoix
- Department of Pneumology, University Hospital of Strasbourg, Strasbourg, France.
| | | | | | | | - Virginie Westeel
- Department of Pneumology, University Hospital of Besançon, Besançon, France
| | - Fabrice Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Jacques Le Treut
- Department of Pneumology, Pays D'Aix Hospital, Aix-en-Provence, France
| | - Eric Pichon
- Department of Pneumology, University Hospital of Tours, Tours, France
| | - Jérôme Dauba
- Department of Medical Oncology, Hospital Layné, Mont-de-Marsan, France
| | | | - Lionel Moreau
- Department of Pneumology, Louis Pasteur Hospital, Colmar, France
| | - Jeannick Madelaine
- Department of Pneumology, University Hospital of Caen Normandie, Caen, France
| | - Patrick Dumont
- Department of Pneumology, Hospital of Chauny, Chauny, France
| | - Jacques Margery
- Department of Pneumology, Hôpital D'Instruction des Armées Percy, Clamart, France
| | - Didier Debieuvre
- Department of Pneumology, GHRMSA, Emile Miller Hospital, Mulhouse, France
| | | | - Jean-Louis Pujol
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Denis Moro-Sibilot
- Thoracic Oncology Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | - Pierre-Jean Souquet
- Department of Pneumology and Thoracic Oncology, Hospital of Lyon Sud, Lyon, France
| |
Collapse
|
25
|
Baldacci S, Besse B, Avrillon V, Mennecier B, Dubray-Longeras P, Mazieres J, Descourt R, Duruisseaux M, Quantin X, Doubre H, Monnet I, Moro-Sibilot D, Schneider S, Cousin S, Merle P, Otto J, Langlais A, Morin F, Westeel V, Girard N. 1303P Lorlatinib for advanced ALK+ non-small cell lung cancer (NSCLC): Efficacy and safety data from IFCT-1803 LORLATU expanded access program (EAP) cohort. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
26
|
Chardin D, Paquet M, Schiappa R, Darcourt J, Bailleux C, Poudenx M, Sciazza A, Ilie M, Benzaquen J, Martin N, Otto J, Humbert O. Baseline metabolic tumor volume as a strong predictive and prognostic biomarker in patients with non-small cell lung cancer treated with PD1 inhibitors: a prospective study. J Immunother Cancer 2020; 8:jitc-2020-000645. [PMID: 32709713 PMCID: PMC7380842 DOI: 10.1136/jitc-2020-000645] [Citation(s) in RCA: 33] [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] [Accepted: 06/21/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Reliable predictive and prognostic markers are still lacking for patients treated with programmed death receptor 1 (PD1) inhibitors for non-small cell lung cancer (NSCLC). The purpose of this study was to investigate the prognostic and predictive values of different baseline metabolic parameters, including metabolic tumor volume (MTV), from 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) scans in patients with NSCLC treated with PD1 inhibitors. METHODS Maximum and peak standardized uptake values, MTV and total lesion glycolysis (TLG), as well as clinical and biological parameters, were recorded in 75 prospectively included patients with NSCLC treated with PD1 inhibitors. Associations between these parameters and overall survival (OS) were evaluated as well as their accuracy to predict early treatment discontinuation (ETD). RESULTS A high MTV and a high TLG were significantly associated with a lower OS (p<0.001). The median OS in patients with MTV above the median (36.5 cm3) was 10.5 months (95% CI: 6.2 to upper limit: unreached), while the median OS in patients with MTV below the median was not reached. Patients with no prior chemotherapy had a poorer OS than patients who had received prior systemic treatment (p=0.04). MTV and TLG could reliably predict ETD (area under the receiver operating characteristic curve=0.76, 95% CI: 0.65 to 0.87 and 0.72, 95% CI: 0.62 to 0.84, respectively). CONCLUSION MTV is a strong prognostic and predictive factor in patients with NSCLC treated with PD1 inhibitors and can be easily determined from routine 18F-FDG PET/CT scans. MTV, could help to personalize immunotherapy and be used to stratify patients in future clinical studies.
Collapse
Affiliation(s)
- David Chardin
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France .,Laboratoire TIRO (UMR E 4320), Université Côté d'Azur (UCA), Nice, France
| | - Marie Paquet
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France
| | - Renaud Schiappa
- Department of Epidemiology, Biostatistics and Health Data, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, Provence-Alpes-Côte d'Azur, France
| | - Jacques Darcourt
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France.,Laboratoire TIRO (UMR E 4320), Université Côté d'Azur (UCA), Nice, France
| | - Caroline Bailleux
- Laboratoire TIRO (UMR E 4320), Université Côté d'Azur (UCA), Nice, France.,Department of Medical Oncology, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France
| | - Michel Poudenx
- Department of Medical Oncology, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France
| | - Aurélie Sciazza
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France
| | - Marius Ilie
- Laboratory of Clinical and Experimental Pathology, Hospital-Integrated Biobank (BB-0033-00025), Centre Hospitalier Universitaire de Nice, Université Côte d'Azur (UCA), Nice, France
| | - Jonathan Benzaquen
- Department of Pulmonology and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur (UCA), Nice, France
| | - Nicolas Martin
- Department of Medical Oncology, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France
| | - Josiane Otto
- Department of Medical Oncology, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France
| | - Olivier Humbert
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), Nice, France.,Laboratoire TIRO (UMR E 4320), Université Côté d'Azur (UCA), Nice, France
| |
Collapse
|
27
|
Refae S, Gal J, Ebran N, Otto J, Borchiellini D, Peyrade F, Chamorey E, Brest P, Milano G, Saada-Bouzid E. Correction to: Germinal Immunogenetics predict treatment outcome for PD-1/PD-L1 checkpoint inhibitors. Invest New Drugs 2020; 39:287-292. [PMID: 32500464 DOI: 10.1007/s10637-020-00954-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Sadal Refae
- Centre Antoine Lacassagne, Oncopharmacology Unit, University Côte d'Azur, F-06189, Nice, France
| | - Jocelyn Gal
- Centre Antoine Lacassagne, Epidemiology and Biostatistics Department, University Côte d'Azur, F-06189, Nice, France
| | - Nathalie Ebran
- Centre Antoine Lacassagne, Oncopharmacology Unit, University Côte d'Azur, F-06189, Nice, France
| | - Josiane Otto
- Centre Antoine Lacassagne, Medical Oncology Department, University Côte d'Azur, F-06189, Nice, France
| | - Delphine Borchiellini
- Centre Antoine Lacassagne, Medical Oncology Department, University Côte d'Azur, F-06189, Nice, France
| | - Frederic Peyrade
- Centre Antoine Lacassagne, Medical Oncology Department, University Côte d'Azur, F-06189, Nice, France
| | - Emmanuel Chamorey
- Centre Antoine Lacassagne, Epidemiology and Biostatistics Department, University Côte d'Azur, F-06189, Nice, France
| | - Patrick Brest
- Centre Antoine Lacassagne, CNRS, Inserm, Ircan, FHU-Oncoage, University Côte d'Azur, F-06189, Nice, France
| | - Gérard Milano
- Centre Antoine Lacassagne, Oncopharmacology Unit, University Côte d'Azur, F-06189, Nice, France.
| | - Esma Saada-Bouzid
- Centre Antoine Lacassagne, Medical Oncology Department, University Côte d'Azur, F-06189, Nice, France.
| |
Collapse
|
28
|
Baldacci S, Avrillon V, Besse B, Mennecier B, Duruisseaux M, Mazieres J, Descourt R, Doubre H, Dubray-Longeras P, Cadranel J, Moro-Sibilot D, Ricordel C, Galland-Girodet S, Monnet I, Otto J, Schneider S, Missy P, Morin F, Westeel V, Girard N. Lorlatinib for advanced ALK and ROS1+ non-small cell lung cancer (NSCLC): Efficacy and treatment sequences in the IFCT-1803 LORLATU expanded access program (EAP) cohort. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9615 Background: Lorlatinib, a third-generation tyrosine kinase inhibitor targeting ALK and ROS1, has been made available in France starting October 2015 through an EAP for advanced, refractory, ALK+ NSCLC after the failure of chemotherapy and TKIs. Besides the landmark, multi-cohort phase II trial that assessed lorlatinib in ALK+ NSCLC, real-life evidence regarding the efficacy and safety, as well as treatment sequences including lorlatinib, is lacking. Methods: We report the cohort of consecutive patients with advanced, refractory, ALK or ROS1+ NSCLC enrolled in the French EAP of lorlatinib from October 2015 to October 2019. Data were collected from medical records by French Cooperative Thoracic Intergroup (IFCT) research study assistants on site. Primary endpoint was progression-free survival. Results: 200 patients were included: 143 (71.5%) ALK+, 57 (28.5%) ROS1+, 87 (44%) men, 127 (66%) never-smokers, and 167 (85%) stage IV disease. Mean age was 59 years. At the time of initiation of lorlatinib, 146 (74%) patients had Central Nervous System (CNS) disease (78 % for ALK+, 63% for ROS1+), 131 (76%) were PS 0/1. Lorlatinib was delivered as 2nd/3rd/4th/5th+ line in 3%/17%/27%/53%of ALK+ patients and in 30%/30%/16%/24%of ROS1+ patients, respectively. 150 (75%), 185 (93%), 138 (69%), and 80 (40%) patients had received prior chemotherapy, crizotinib, 2nd generation TKIs, and brain radiotherapy, respectively. Median PFS and OS from the initiation of lorlatinib were 11.8 (95% CI 7.3-14.6) months and NR (95% CI 18.6-NR) months, respectively for ALK+ patients and 7.6 (95% CI 6.2-10.2) months and 20.9 (95% CI 10.0-NR) months, respectively for ROS1+ patients. ORR and DCR were 46.2% (95% CI 37.6-54.7) and 86.2% (95% CI 80.2-92.1), respectively for ALK+ patients and 47.1% (95% CI 33.4-60.8) and 88.2% (95% CI 79.4-97.1), respectively for ROS1+ patients. CNS ORR was 41.7% (95% CI 33.3-50.1) and 37.7% (95% CI 24.7-50.8), respectively. With a median follow-up of 15.6 (95% CI 14.0-17.6) months, progression under lorlatinib treatment was observed in 71 (50%) ALK+ patients and 35 (61%) ROS1+ patients, and CNS progression in 24 (34%) and 8 (23%) patients, respectively. The safety profile of lorlatinib was consistent with published data. Conclusions: These real-life results confirmed lorlatinib as a major treatment option for patients with advanced refractory ALK or ROS1+ NSCLC.
Collapse
Affiliation(s)
- Simon Baldacci
- Thoracic Oncology Department, Lille University Hospital, Lille, France
| | | | | | | | | | - Julien Mazieres
- Toulouse University Hospital, and Paul Sabatier University, Toulouse, France
| | | | | | - Pascale Dubray-Longeras
- Centre Jean Perrin, département d'oncologie médicale et CIC 501 Inserm, Clermont Ferrand, France
| | - Jacques Cadranel
- AP-HP, Hôpital Tenon, service de Pneumogie; GRC 04 Theranoscan, Sorbonne Université, Paris, France
| | - Denis Moro-Sibilot
- Unité d’Oncologie Thoracique, Service Hospitalier Universitaire Pneumologie Physiologie Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Grenoble, France
| | - Charles Ricordel
- Unité COSS INSERM U1242-CEM-Université de Rennes 1, Service de Pneumologie-CHU Rennes, Rennes, France
| | | | - Isabelle Monnet
- Service de pneumologie, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Josiane Otto
- Centre Antoine Lacassagne, Service d'Oncologie Médicale, Nice, France
| | | | - Pascale Missy
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | | | | |
Collapse
|
29
|
Mazieres J, Cropet C, Montané L, Barlesi F, Souquet P, Quantin X, Dubos-Arvis C, Otto J, Favier L, Avrillon V, Cadranel J, Moro-Sibilot D, Monnet I, Westeel V, Le Treut J, Brain E, Trédaniel J, Jaffro M, Collot S, Ferretti G, Tiffon C, Mahier-Ait Oukhatar C, Blay J. Vemurafenib in non-small-cell lung cancer patients with BRAFV600 and BRAFnonV600 mutations. Ann Oncol 2020; 31:289-294. [DOI: 10.1016/j.annonc.2019.10.022] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/08/2019] [Accepted: 10/20/2019] [Indexed: 12/21/2022] Open
|
30
|
Moro-Sibilot D, Cozic N, Pérol M, Mazières J, Otto J, Souquet PJ, Bahleda R, Wislez M, Zalcman G, Guibert SD, Barlési F, Mennecier B, Monnet I, Sabatier R, Bota S, Dubos C, Verriele V, Haddad V, Ferretti G, Cortot A, De Fraipont F, Jimenez M, Hoog-Labouret N, Vassal G. Crizotinib in c-MET- or ROS1-positive NSCLC: results of the AcSé phase II trial. Ann Oncol 2019; 30:1985-1991. [PMID: 31584608 DOI: 10.1093/annonc/mdz407] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In 2013, the French National Cancer Institute initiated the AcSé program to provide patients with secure access to targeted therapies outside of their marketed approvals. Efficacy and safety was then assessed using a two-stage Simon phase II trial design. When the study design was designed, crizotinib was approved only as monotherapy for adults with anaplastic lymphoma kinase plus non-small-cell lung cancers (NSCLC). PATIENTS AND METHODS Advanced NSCLC patients with c-MET ≥6 copies, c-MET-mutated, or ROS-1-translocated tumours were enrolled in one of the three cohorts. Patients were treated with crizotinib 250 mg twice daily. Efficacy was assessed using the objective response rate (ORR) after two cycles of crizotinib as primary outcome. Secondary outcomes included disease control rate at four cycles, best ORR, progression-free survival, overall survival, and drug tolerance. RESULTS From August 2013 to March 2018, 5606 patients had their tumour tested for crizotinib targeted molecular alterations: 252 patients had c-MET ≥6 copies, 74 c-MET-mutation, and 78 ROS-1-translocated tumour. Finally, 25 patients in the c-MET ≥6 copies cohort, 28 in the c-MET-mutation cohort, and 37 in the ROS-1-translocation cohort were treated in the phase II trial. The ORR was 16% in the c-MET ≥6 copies cohort, 10.7% in the mutated, and 47.2% in the ROS-1 cohort. The best ORR during treatment was 32% in the c-MET-≥6 copies cohort, 36% in the c-MET-mutated, and 69.4% in the ROS-1-translocation cohort. Safety data were consistent with that previously reported. CONCLUSIONS Crizotinib activity in patients with ROS1-translocated tumours was confirmed. In the c-MET-mutation and c-MET ≥6 copies cohorts, despite insufficient ORR after two cycles of crizotinib, there are signs of late response not sufficient to justify the development of crizotinib in this indication. The continued targeting of c-MET with innovative therapies appears justified. CLINICAL TRIAL NUMBER NCT02034981.
Collapse
Affiliation(s)
- D Moro-Sibilot
- Thoracic Oncology Unit, Grenoble-Alpes University Hospital, Grenoble; Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris.
| | - N Cozic
- Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, INSERM U1018, ESP, Paris-Saclay and Paris-Sud Universities, Villejuif
| | - M Pérol
- Department of Medical Oncology, Léon Bérard Cancer Centre, Lyon
| | - J Mazières
- Pneumology Department, Toulouse University Hospital and Paul Sabatier University, Toulouse
| | - J Otto
- Department of Medicine, Antoine Lacassagne Cancer Centre, Nice
| | - P J Souquet
- Department of Pneumology and Thoracic Oncology, Lyon Sud Hospital Center, Hospices Civils de Lyon, Pierre Bénite
| | - R Bahleda
- Drug Development Department (DITEP), Gustave Roussy Cancer Campus, Villejuif
| | - M Wislez
- Pneumology Department, Tenon Hospital, AP-HP and "Pierre and Marie Curie" University, Paris
| | - G Zalcman
- Thoracic Oncology Department-CIC INSERM 1425, Bichat University Hospital, AP-HP, Paris; Paris-Diderot University, Paris
| | | | - F Barlési
- Multidisciplinary Oncology & Therapeutic Innovations Department, APHM and Aix Marseille University, INSERM, CNRS, CRCM, Marseille
| | - B Mennecier
- Pneumology Department, Strasbourg University Hospital, Strasbourg
| | - I Monnet
- Pneumology Department, CHIC Creteil, Créteil
| | - R Sabatier
- Department of Medical Oncology, Inserm 1068, CNRS UMR7258, CRCM, Paoli-Calmettes Institute and Aix-Marseille University, Marseille
| | - S Bota
- Pneumology Department, Charles Nicolle Hospital, Rouen University Hospital, Rouen
| | - C Dubos
- Pneumology Department, François Baclesse Cancer Centre, Caen
| | - V Verriele
- Anatomy and Pathological Cytologies Department, Paul Papin Cancer Centre, ICO, Angers
| | - V Haddad
- Department of Tumour Biology, Léon Bérard Cancer Centre, Lyon
| | - G Ferretti
- Radiology and Medical Imaging Department, Grenoble-Alpes University Hospital, Grenoble
| | - A Cortot
- Department of Thoracic Oncology, Lille University Hospital and University of Lille, Lille
| | - F De Fraipont
- Molecular Genetic Unit: Hereditary Diseases and Oncology, Grenoble-Alpes University Hospital, Grenoble
| | - M Jimenez
- Research and Development UNICANCER, Paris
| | | | - G Vassal
- Clinical Research Division, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
31
|
Humbert O, Cadour N, Paquet M, Schiappa R, Poudenx M, Chardin D, Borchiellini D, Benisvy D, Ouvrier MJ, Zwarthoed C, Schiazza A, Ilie M, Ghalloussi H, Koulibaly PM, Darcourt J, Otto J. 18FDG PET/CT in the early assessment of non-small cell lung cancer response to immunotherapy: frequency and clinical significance of atypical evolutive patterns. Eur J Nucl Med Mol Imaging 2019; 47:1158-1167. [PMID: 31760467 DOI: 10.1007/s00259-019-04573-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [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: 05/02/2019] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE This prospective study aimed (1) to assess the non-small cell lung cancer (NSCLC) evolutive patterns to immunotherapy using FDG-PET and (2) to describe their association with clinical outcome. DESIGN Fifty patients with metastatic NSCLC were included before pembrolizumab or nivolumab initiation. FDG-PET scan was performed at baseline and after 7 weeks of treatment (PETinterim1) and different criteria/parameters of tumor response were assessed, including PET response criteria in solid tumors (PERCIST). If a first PERCIST progressive disease (PD) without clinical worsening was observed, treatment was continued and a subsequent FDG-PET (PETinterim2) was performed at 3 months of treatment. Pseudo-progression (PsPD) was defined as a PERCIST response/stability on PETinterim2 after an initial PD. If a second PERCIST PD was assessed on PETinterim2, a homogeneous progression of lesions (termed immune homogeneous progressive-disease: iPDhomogeneous) was distinguished from a heterogeneous evolution (termed immune dissociated-response: iDR). A durable clinical benefit (DCB) of immunotherapy was defined as treatment continuation over a 6-month period. The association between PET evolutive profiles and DCB was assessed. RESULTS Using PERCIST on PETinterim1, 42% (21/50) of patients showed a response or stable disease, most of them (18/21) reached a DCB. In contrast, 58% (29/50) showed a PD, but more than one-third (11/29) were misclassified as they finally reached a DCB. No standard PETinterim1 criteria could accurately distinguished responding from non-responding patients. Treatment was continued in 19/29 of patients with a first PERCIST PD; the subsequent PETinterim2 demonstrated iPDhomogeneous, iDR and PsPD in 42% (8/19), 26% (5/19), and 32% (6/19), respectively. Whereas no patients with iPDhomogeneous experienced a DCB, all patients with iDR and PsPD reached a clinical benefit to immunotherapy. CONCLUSION In patients with a first PD on PERCIST and treatment continuation, a subsequent PET identifies more than half of them with iDR and PsPD, both patterns being strongly associated with a clinical benefit of immunotherapy.
Collapse
Affiliation(s)
- O Humbert
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France. .,Laboratory Transporter in Imaging and Radiotherapy in Oncology (TIRO), UMR E 4320, CEA, UCA, Nice, France.
| | - N Cadour
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - M Paquet
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - R Schiappa
- Department of Biostatistics, Centre Antoine-Lacassagne, UCA, Nice, France
| | - M Poudenx
- Department of Medical Oncology, Centre Antoine-Lacassagne, UCA, Nice, France
| | - D Chardin
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France.,Laboratory Transporter in Imaging and Radiotherapy in Oncology (TIRO), UMR E 4320, CEA, UCA, Nice, France
| | - D Borchiellini
- Department of Medical Oncology, Centre Antoine-Lacassagne, UCA, Nice, France.,Clinical Research and Innovation Office, Centre Antoine-Lacassagne, UCA, Nice, France
| | - D Benisvy
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - M J Ouvrier
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - C Zwarthoed
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - A Schiazza
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - M Ilie
- Laboratory of Clinical and Experimental Pathology, Hospital-Integrated Biobank (BB-0033-00025), Nice Hospital University, FHU OncoAge, UCA, Nice, France
| | - H Ghalloussi
- Department of Medical Oncology, Centre Antoine-Lacassagne, UCA, Nice, France
| | - P M Koulibaly
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France
| | - J Darcourt
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur (UCA), 33 Avenue de Valombrose, 06189, Nice, France.,Laboratory Transporter in Imaging and Radiotherapy in Oncology (TIRO), UMR E 4320, CEA, UCA, Nice, France
| | - J Otto
- Department of Medical Oncology, Centre Antoine-Lacassagne, UCA, Nice, France
| |
Collapse
|
32
|
Cohen C, Al Orainy S, Pop D, Poudenx M, Otto J, Berthet JP, Venissac N, Mouroux J. Anatomical pulmonary resections for primary lung cancer in octogenarians within a dedicated care protocol. J Thorac Dis 2019; 11:3732-3737. [PMID: 31656645 DOI: 10.21037/jtd.2019.09.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background The aim of this study was to assess the feasibility of major pulmonary resection for a limited non-small cell lung cancer (NSCLC) in octogenarians within a dedicated care protocol. Methods We retrospectively analyzed data of 55 octogenarians operated on in a single institution between January 2005 and December 2016. They were all included in a specific care protocol with systematic geriatric assessment and adaptation of the peri-operative care. We describe the results of post-operative morbidity, mortality, and survival after anatomical resection and radical lymphadenectomy. Results Mean age at the time of surgery was 82.1 years (80-86 years). Median Charlson's comorbidity score was 0 (0-3). All patients were classified Balducci 1 or 2. We performed 2 pneumonectomies (3%), 3 bilobectomies (5%), 47 lobectomies (85%) and 3 segmentectomies (5%). The median hospital stay was 11.5 days (7-31 days). The 30-day mortality rate was 3%. The total of relevant clinical complications (Clavien 3 to 5) was 16% (n=9). The Overall Survival at one, three and five years were, respectively: 83% (95% CI: 75-95%); 70% (95% CI: 56-87%); 58% (95% CI: 43-79%). Conclusions Major pulmonary resection for primary lung cancer in octogenarians seems to be safe, with an acceptable morbidity, mortality and long-term survival rate, when processing to rigorous selection of the patients, within a dedicated care protocol.
Collapse
Affiliation(s)
- Charlotte Cohen
- Department of Thoracic Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, 06001 Nice Cedex 1, France
| | - Saleh Al Orainy
- Department of Thoracic Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, 06001 Nice Cedex 1, France
| | - Daniel Pop
- Department of Thoracic Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, 06001 Nice Cedex 1, France
| | - Michel Poudenx
- Department of Thoracic Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, 06001 Nice Cedex 1, France.,Department of Thoracic Oncology, Centre Antoine Lacassagne, 06300 Nice, France
| | - Josiane Otto
- Department of Thoracic Oncology, Centre Antoine Lacassagne, 06300 Nice, France
| | - Jean-Philippe Berthet
- Department of Thoracic Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, 06001 Nice Cedex 1, France
| | - Nicolas Venissac
- Department of Thoracic Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, 06001 Nice Cedex 1, France
| | - Jérome Mouroux
- Department of Thoracic Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, 06001 Nice Cedex 1, France
| |
Collapse
|
33
|
Guo L, Montaudié H, Bouhlel L, Picard A, Otto J, Falk A, Poudenx M, Bondiau PY, Gal J, Lacour JP, Passeron T, Sumodhee S, Doyen J. Impact du schéma d’irradiation sur la survie des patients atteints de carcinomes bronchiques non à petites cellules et de mélanomes évolués traités par l’association d’irradiation et d’inhibiteurs de checkpoint de l’immunité. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
34
|
Abstract
Chronic neuropathic pain has a prevalence of 6.9-10% in the general population. The current recommendations for treatment are presented based on a literature search. Neuropathic pain requires the use of co-analgesic, antidepressant, anticonvulsant drugs and topical agents because non-opioid analgesic drugs are usually ineffective. The use of meta-analyses tricyclic antidepressants, selective serotonin-norephinephrine reuptake inhibitors, and calcium channel anticonvulsants are recommended as the drugs of first choice. Under certain conditions chronic neuropathic pain can be treated with opioids. Topical therapeutics are only used to treat peripheral neuropathic pain. At present the use of drugs is independent of the etiology of the pain. Comorbidities, concomitant medication, potential side effects and patients' age have to be considered in treatment planning.
Collapse
Affiliation(s)
- J Otto
- Sektion für Neurologische Schmerzforschung und -therapie, Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| | - J Forstenpointner
- Sektion für Neurologische Schmerzforschung und -therapie, Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| | - A Binder
- Klinik für Neurologie, Klinikum Saarbrücken gGmbH, Saarbrücken, Deutschland
| | - R Baron
- Sektion für Neurologische Schmerzforschung und -therapie, Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland.
| |
Collapse
|
35
|
Pujol JL, Greillier L, Audigier-Valette C, Moro-Sibilot D, Uwer L, Hureaux J, Guisier F, Carmier D, Madelaine J, Otto J, Gounant V, Merle P, Mourlanette P, Molinier O, Renault A, Rabeau A, Antoine M, Denis MG, Bommart S, Langlais A, Morin F, Souquet PJ. A Randomized Non-Comparative Phase II Study of Anti-Programmed Cell Death-Ligand 1 Atezolizumab or Chemotherapy as Second-Line Therapy in Patients With Small Cell Lung Cancer: Results From the IFCT-1603 Trial. J Thorac Oncol 2019; 14:903-913. [PMID: 30664989 DOI: 10.1016/j.jtho.2019.01.008] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [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: 12/05/2018] [Revised: 01/02/2019] [Accepted: 01/09/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This randomized phase II trial aimed at evaluating the engineered programmed cell death ligand 1 (PD-L1) antibody atezolizumab in SCLC progressing after first-line platinum-etoposide chemotherapy. METHODS Patients were randomized 2:1 to atezolizumab (1200 mg intravenously every 3 weeks) until progression or unacceptable toxicity, or conventional chemotherapy (up to 6 cycles of topotecan or re-induction of initial chemotherapy). Patients were not selected based on PD-L1 tissue expression. The primary endpoint was objective response rate at 6 weeks. A two-stage design with 2:1 randomization and O'Brien-Fleming stopping rules was used. The null hypothesis was rejected if more than 12 of 45 patients were responders. RESULTS Overall, 73 patients were randomized (atezolizumab n = 49; chemotherapy n = 24). At 6 weeks, 1 of 43 eligible atezolizumab patients achieved an objective response (2.3%, 95% confidence interval [CI]: 0.0-6.8), whereas 8 others had stable disease (20.9% disease control rate; 95% CI: 8.8-33.1). Among eligible chemotherapy patients (n = 20), 10% achieved an objective response (65% disease control rate). Median progression-free survival was 1.4 months (95% CI: 1.2-1.5) with atezolizumab and 4.3 months (95% CI: 1.5-5.9) with chemotherapy. Overall survival did not significantly differ between groups. Median overall survival was 9.5 months versus 8.7 months for the atezolizumab and the chemotherapy group, respectively (adjusted hazard ratioatezolizumab : 0.84, 95% CI: 0.45-1.58; p = 0.60). Two atezolizumab patients (4.2%) experienced grade 3 fatigue, and two others grade 1 dysthyroidism. Among 53 evaluable specimens, only 1 (2%) had positive immunohistochemical PD-L1 staining (SP142 clone). CONCLUSIONS Atezolizumab monotherapy in relapsed SCLC failed to show significant efficacy. No unexpected safety concerns were observed.
Collapse
Affiliation(s)
- Jean-Louis Pujol
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France.
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique - Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | | | | | - Lionel Uwer
- Institut de Cancerologie de Lorraine Alexis Vautrin. 6 Avenue de Bourgogne, Vandoeuvre-les-Nancy, France
| | - José Hureaux
- Pôle Hippocrate, Angers University Hospital, Angers, France
| | - Florian Guisier
- Service de Pneumologie, Oncologie Thoracique et soins Intensifs Respiratoires, CHU de Rouen, Rouen, France
| | - Delphine Carmier
- Service de Pneumologie CHRU Hôpitaux de Tours, Hôpital Bretonneau, Tours, France
| | | | - Josiane Otto
- Pôle Médecine, Centre Antoine Lacassagne, Nice, France
| | - Valérie Gounant
- Department of Thoracic Oncology, Bichat Claude Bernard Hospital, Paris, France
| | - Patrick Merle
- Service de Pneumologie, Chu Gabriel-Montpied, Clermont-Ferrand, France
| | | | - Olivier Molinier
- Service de Pneumologie, Centre Hospitalier du Mans, Le Mans, France
| | - Aldo Renault
- Service de Pneumologie, Centre Hospitalier de Pau, Pau, France
| | - Audrey Rabeau
- Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - Martine Antoine
- Service d'Anatomo-pathologie, Hôpitaux Universitaires Est Parisien Site Tenon, Paris, France
| | - Marc G Denis
- Department of Biochemistry, Nantes University Hospital, Nantes, France
| | - Sebastien Bommart
- Department of radiology, Montpellier Regional University Hospital, Montpellier, France
| | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Pierre-Jean Souquet
- Service de Pneumologie Aiguë Spécialisée et Cancérologie Thoracique, Centre Hospitalier Lyon, Lyon, France
| |
Collapse
|
36
|
Pujol J, Greillier L, Audigier-Valette C, Moro-Sibilot D, Uwer L, Hureaux J, Thiberville L, Carmier D, Madelaine J, Otto J, Gounant V, Merle P, Mourlanette P, Molinier O, Renault P, Mazieres J, Antoine M, Langlais A, Morin F, Souquet P. Étude de phase II randomisée non comparative de l’anti-PD-L1 atézolizumab versus chimiothérapie comme traitement de deuxième ligne chez les patients atteints d’un cancer du poumon à petites cellules (CBPC) : résultats de l’essai IFCT-1603. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.066] [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]
|
37
|
Milano G, Refae S, Gal J, Ebran N, Otto J, Shell S, Everts R, Chamorey E, Saada-Bouzid E. A SNP germinal signature for predicting checkpoint inhibitor treatment outcome. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy493.010] [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
|
38
|
Mazieres J, Montané L, Barlesi F, Coudert B, Souquet P, Otto J, Gervais R, Moro-Sibilot D, Monnet I, Brain E, Huillard O, Quéré G, Debieuvre D, Fabre E, Jaffro M, Collot S, Ferretti G, Tiffon C, Mahier - Ait Oukhatar C, Blay J. OA12.05 Vemurafenib in Patients Harboring V600 and Non V600 BRAF Mutations: Final Results of the NSCLC Cohort from the AcSé Trial. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
39
|
Quoix E, Audigier Valette C, Lavolé A, Molinier O, Westeel V, Barlesi F, Le Treut J, Pichon E, Dauba J, Otto J, Dumont P, Moreau L, Madelaine J, Margery J, Debieuvre D, Renault P, Langlais A, Morin F, Moro-Sibilot D, Souquet PJ. Maintenance chemotherapy versus follow-up after carboplatin and weekly paclitaxel doublet chemotherapy in elderly patients with advanced non-small cell lung cancer (NSCLC): IFCT-1201 MODEL randomised phase III trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
40
|
Pujol JL, Greillier L, Audigier Valette C, Moro-Sibilot D, Uwer L, Hureaux J, Thiberville L, Carmier D, Madelaine J, Otto J, Gounant V, Merle P, Mourlanette P, Molinier O, Renault P, Mazieres J, Antoine M, Langlais A, Morin F, Souquet PJ. A randomized non-comparative phase II study of anti–PD-L1 ATEZOLIZUMAB or chemotherapy as second-line therapy in patients with small cell lung cancer: Results from the IFCT-1603 trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy298] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
41
|
Refae S, Ebran N, Gal J, Otto J, Giacchero D, Borchiellini D, Guigay J, Peyrade F, Milano G, Saada E. Abstract 4548: Host immunogenetics and hyperprogression under PD1/PD-L1 checkpoint inhibitors. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-4548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Hyperprogressive disease (HPD) has been described in advanced solid tumors patients treated with anti PD1 anti PDL1 monotherapy (Champiat, Clin Can Res 2016; Saada-Bouzid, Ann Oncol, 2017). Our aim was to explore whether host constitutional variations in the nucleotide sequence of genes involved in immune response might be associated with the occurrence of HPD in patients treated with anti PD-(L)1.
Methods : From April to August 2017, 98 patients were treated in the Centre Antoine Lacassagne (Nice, France) with anti PD-(L)1. Potential SNPs for four candidate genes with a minor allele frequency≥ 5% in caucasians were selected according to genome browser data-base: PD1 (rs10204525, rs11568821, rs2227981), PD-L1 (rs2282055, rs2297136, rs2297137, rs4143815, rs10815225), IDO1 (rs3739319, rs3808606, rs373931, rs9657182) and VEGR2 (rs2305948, rs1870377, rs2071559). High through-output genotyping was done by MassARRAY (AGENA). HPD was defined as a TGKR (ratio of the slope of tumor growth before treatment and the slope of tumor growth on treatment) ≥ 2.
Results: Patients were treated for head and neck squamous cell carcinoma (16/98), non-small cell lung cancer (48/98), melanoma (13/98), renal cell carcinoma (14/98) and 7 others. Median age was 66 years old, 33 were male. All tested SNPs were in Hardy-Weinberg equilibrium. Responses were associated with G3-G4 toxicities (10% vs 42%, p=0.001). TGKR was assessable in 80 patients. HPD was observed in 11/80 (14 %) patients. HPD was significantly associated with age≥70y (6% vs 25%, p=0.02) and genotype for PD1 rs 2227981 (8/32=35% G/G vs 2/43=5% A/G or A/A, p=0.02), PDL1 rs 2282055 (1/37=3% T/T vs 10/43=23% T/G or G/G,p=0.02) and VEGFR2 rs1870377 (2/48=5% T/T vs 9/32=28% T/A or A/A, p=0.005). Multivariate analysis confirmed the association between HPD and VEGFR2 rs1870377 T/A or A/A (OR=15.3, p=0.007), PDL1 rs 2282055 T/G or G/G (OR=18.7, p=0.01) and age≥70y (OR=14.4, p=0.006).). Combining the three alleles at risk for HPD gave an OR =12.4 (p=0.001).
Conclusion: In patients treated with anti PD-(L)1, HPD was independently associated with older age and host related gene variations. Host related immunogenetics could become an integrative part of predictive factor for immunotherapy outcome.
Citation Format: Sadal Refae, Nathalie Ebran, Jocelyn Gal, Josiane Otto, Damien Giacchero, Delphine Borchiellini, Joel Guigay, Frederique Peyrade, Gerard Milano, Esma Saada. Host immunogenetics and hyperprogression under PD1/PD-L1 checkpoint inhibitors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4548.
Collapse
|
42
|
Milano GA, Refae S, Ebran N, Gal J, Otto J, Drubay D, Chamorey E, Ciccolini J, Saada E. Germinal immunogenetics as a predictor of anti-PD1/PD-L1 treatment outcome. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.3034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Sadal Refae
- Centre Antoine Lacassagne, Oncopharmacology Department – EA3836, Nice, France
| | - Nathalie Ebran
- Centre Antoine Lacassagne, Oncopharmacology Department – EA3836, Nice, France
| | - Jocelyn Gal
- Biostatistics’ Unite, Antoine Lacassagne Cancer Center, University of Cote d’Azur, Nice, France
| | | | | | | | | | | |
Collapse
|
43
|
Nudehi S, Larson C, Prusinski W, Kotfer D, Otto J, Beyers E, Schoer J, Palumbo R. Solar thermal decoupled water electrolysis process II: An extended investigation of the anodic electrochemical reaction. Chem Eng Sci 2018. [DOI: 10.1016/j.ces.2017.12.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
44
|
Doyen J, Poudenx M, Gal J, Otto J, Guerder C, Naghavi AO, Gérard A, Leysalle A, Cohen C, Padovani B, Ianessi A, Schiappa R, Chamorey E, Bondiau PY. Stereotactic ablative radiotherapy after concomitant chemoradiotherapy in non-small cell lung cancer: A TITE-CRM phase 1 trial. Radiother Oncol 2018; 127:239-245. [PMID: 29650404 DOI: 10.1016/j.radonc.2018.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/12/2017] [Revised: 03/14/2018] [Accepted: 03/26/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Platinum based chemoradiotherapy is the standard of care for inoperable non-small cell lung cancer (NSCLC). With evidence that NSCLC can have a dose dependent response with stereotactic ablative radiotherapy (SABR), we hypothesize that a SABR boost on residual tumor treated with chemoradiotherapy could increase treatment efficacy. The purpose of this study was to determine feasibility of such an approach. MATERIAL AND METHODS A prospective phase I trial was performed including 26 patients. Time-to-event continual reassessment method (TITE-CRM) was used for dose escalation which ranged from 3 × 7 to 3 × 12 Gy for the stereotactic boost, after 46 Gy (2 Gy per day) of chemoradiotherapy. RESULTS Median follow-up was of 37.1 months (1.7-60.7), and 3, 4, 3, 3, 9 and 4 patients were included at the dose levels 1, 2, 3, 4, 5 and 6, respectively. During chemoradiotherapy, 9 patients experienced grade 3 toxicity. After stereotactic radiotherapy, 1 patient experienced an esophageal fistula (with local relapse) at the 3 × 11 Gy level, and 1 patient died from hemoptysis at the 3 × 12 Gy level. The 2-year rate of local control, locoregional free survival, metastasis-free survival, and overall survival was 70.3%, 55.5%, 44.5% and 50.8%, respectively. CONCLUSION In the treatment of NSCLC with chemoradiotherapy followed by a stereotactic boost, the safe recommended dose in our protocol was a boost dose of 3 × 11 Gy.
Collapse
Affiliation(s)
- Jérôme Doyen
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte d'Azur, Nice, France.
| | - Michel Poudenx
- University of Côte d'Azur, Nice, France; Departement of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Jocelyn Gal
- University of Côte d'Azur, Nice, France; Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Josiane Otto
- University of Côte d'Azur, Nice, France; Departement of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Caroline Guerder
- Department of Radiation Oncology, Hôpital de la croix-rouge française, Toulon, France
| | - Arash O Naghavi
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, United States
| | - Anais Gérard
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte d'Azur, Nice, France
| | - Axel Leysalle
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte d'Azur, Nice, France
| | - Charlotte Cohen
- University of Côte d'Azur, Nice, France; Department of Thoracic Surgery, Centre Hospitalo-Universitaire de Nice, France
| | - Bernard Padovani
- University of Côte d'Azur, Nice, France; Department of Radiology, Centre Hospitalo-Universitaire de Nice, France
| | - Antoine Ianessi
- University of Côte d'Azur, Nice, France; Department of Radiology, Centre Antoine-Lacassagne, Nice, France
| | - Renaud Schiappa
- University of Côte d'Azur, Nice, France; Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Emmanuel Chamorey
- University of Côte d'Azur, Nice, France; Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Pierre-Yves Bondiau
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte d'Azur, Nice, France
| |
Collapse
|
45
|
Brüggemann P, Otto J, Lorenz N, Schorsch S, Szczepek AJ, Böcking B, Mazurek B. Erratum to: Long-term changes in multimodal intensive tinnitus therapy. A 5-year follow-up. HNO 2018; 66:211. [PMID: 29426995 DOI: 10.1007/s00106-018-0484-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Erratum to:HNO 2018 66 (Suppl):S34-S38 https://doi.org/10.1007/s00106-017-0463-4 Figure 1 was published incorrectly in the online version of this paper. The correct Figure is reproduced below.
Collapse
Affiliation(s)
- P Brüggemann
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - J Otto
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - N Lorenz
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - S Schorsch
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - A J Szczepek
- Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - B Böcking
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - B Mazurek
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
| |
Collapse
|
46
|
Cohen C, Pop D, Venissac N, Poudenx M, Otto J, Castelnau O, Mouroux J. Chemoradiation Therapy Followed by Surgery in the Treatment of Locoregionally Advanced Non-Small Cell Lung Cancer. Thorac Cardiovasc Surg 2017; 66:129-134. [PMID: 28992652 DOI: 10.1055/s-0037-1606832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of this study was to explore the feasibility of surgery after two induction cycles of cisplatin-docetaxel followed by concomitant 40 Gy chemoradiation in the treatment of initially unresectable stage III non-small cell lung cancer (NSCLC; TAXCIS protocol), and to evaluate overall survival (OS) and recurrence-free survival (RFS) and recurrence risk factors over a larger cohort of patients with a subgroup analysis of patients treated by pneumonectomy. METHODS Between 2004 and 2014, a total of 37 patients were treated. Only patients responding to induction treatment were included. RESULTS We operated on 32 stage IIIA and 5 stage IIIB patients. We performed 12 pneumonectomies, 1 bilobectomy, and 23 lobectomies. Status ypT0N0 was obtained for 35% of the patients. Surgery was considered R0 in 86% of the cases. Postoperative morbidity was 21.6% with a mortality of 10.8% (25% after pneumonectomy). OS was 50% at 5 years. The median RFS was 50 months. RFS was 47% at 5 years. Local or locoregional recurrence was diagnosed in 10.8% of the patients, and distant metastasis in 35.1%. Recurrence risk factors were pneumonectomy (p = 0.001) and a histologically incomplete response (p = 0.04). CONCLUSION The TAXCIS protocol followed by surgery is feasible for initially unresectable NSCLC stage IIIA and B patients. Benefit was noted in responding lesions with better OS and PFS, except after pneumonectomy.
Collapse
Affiliation(s)
- Charlotte Cohen
- Service de Chirurgie Thoracique, CHU de Nice, Hopital Pasteur I, Nice, France
| | - Daniel Pop
- Service de Chirurgie Thoracique, CHU de Nice, Hopital Pasteur I, Nice, France
| | - Nicolas Venissac
- Service de Chirurgie Thoracique, CHU de Nice, Hopital Pasteur I, Nice, France
| | - Michel Poudenx
- Centre Antoine-Lacassagne, Nice, Provence-Alpes-Côte d'Azure, France
| | - Josiane Otto
- Centre Antoine-Lacassagne, Nice, Provence-Alpes-Côte d'Azure, France
| | - Olivier Castelnau
- Groupe Arnault Tzanck, Saint-Laurent du Var, Provence-Alpes-Côte d'Azure, France
| | - Jérome Mouroux
- Service de Chirurgie Thoracique, CHU de Nice, Hopital Pasteur I, Nice, France
| |
Collapse
|
47
|
Falk AT, Heeke S, Hofman V, Lespinet V, Ribeyre C, Bordone O, Poudenx M, Otto J, Garnier G, Castelnau O, Guigay J, Leroy S, Marquette CH, Hofman P, Ilié M. NGS analysis on tumor tissue and cfDNA for genotype-directed therapy in metastatic NSCLC patients. Between hope and hype? Expert Rev Anticancer Ther 2017; 17:681-685. [PMID: 28511612 DOI: 10.1080/14737140.2017.1331736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/18/2022]
Abstract
INTRODUCTION The advent of genomic based precision medicine led to the implementation of biomarker testing in metastatic non-small cell lung cancer (NSCLC) patients. Next generation sequencing (NGS) has been recently implemented to routine diagnostic requirements in lung oncology. Areas covered: Two cases of patients with metastatic NSCLC for whom NGS analysis performed on both tumor and liquid biopsy has not improved the clinical course of their disease are reported. These cases illustrate the difficulty of the so-called 'personalized or precision' medicine in clinical routine practice for metastatic NSCLC. Expert commentary: Discovery and detection of critical cancer-gene alterations better indicates targeted therapies that must be administered to improve the care of NSCLC patients in the personalized medicine era. There has been much interest in the literature and the scientific community for NGS tailored therapies approach for patients. However, there may be a gap between this theoretical stratified medicine and clinical practice. The advantages and drawbacks of NGS on tumor tissue and cell-free DNA for metastatic NSCLC are discussed.
Collapse
Affiliation(s)
- Alexander T Falk
- a Team 3, Institute for Research on Cancer and Ageing , Nice (IRCAN), INSERM U1081/UMR CNRS 7284, FHU OncoAge , Nice , France.,b Radiation Oncology Department , Antoine Lacassagne Comprehensive Cancer Center , Nice , France
| | - Simon Heeke
- a Team 3, Institute for Research on Cancer and Ageing , Nice (IRCAN), INSERM U1081/UMR CNRS 7284, FHU OncoAge , Nice , France
| | - Véronique Hofman
- a Team 3, Institute for Research on Cancer and Ageing , Nice (IRCAN), INSERM U1081/UMR CNRS 7284, FHU OncoAge , Nice , France.,c Laboratory of Clinical and Experimental Pathology, Liquid Biopsy Laboratory , CHU de Nice, FHU OncoAge , Nice , France.,d Hospital-Integrated Biobank (BB-0033-00025) , CHU de Nice, FHU OncoAge , Nice , France
| | - Virginie Lespinet
- c Laboratory of Clinical and Experimental Pathology, Liquid Biopsy Laboratory , CHU de Nice, FHU OncoAge , Nice , France
| | - Camille Ribeyre
- c Laboratory of Clinical and Experimental Pathology, Liquid Biopsy Laboratory , CHU de Nice, FHU OncoAge , Nice , France
| | - Olivier Bordone
- c Laboratory of Clinical and Experimental Pathology, Liquid Biopsy Laboratory , CHU de Nice, FHU OncoAge , Nice , France
| | - Michel Poudenx
- e Department of Pulmonary Medicine and Oncology , CHU de Nice, FHU OncoAge , Nice , France
| | - Josiane Otto
- f Department of Oncology , Antoine Lacassagne Comprehensive Cancer Centre, FHU OncoAge , Nice , France
| | - Georges Garnier
- g Department of Oncology , Centre Hospitalier Princesse Grace, Monaco , Principauté de Monaco
| | - Olivier Castelnau
- h Service de pneumologie , Institut Arnault-Tzanck , Saint-Laurent-du-Var , France
| | - Joël Guigay
- f Department of Oncology , Antoine Lacassagne Comprehensive Cancer Centre, FHU OncoAge , Nice , France
| | - Sylvie Leroy
- e Department of Pulmonary Medicine and Oncology , CHU de Nice, FHU OncoAge , Nice , France
| | - Charles-Hugo Marquette
- a Team 3, Institute for Research on Cancer and Ageing , Nice (IRCAN), INSERM U1081/UMR CNRS 7284, FHU OncoAge , Nice , France.,e Department of Pulmonary Medicine and Oncology , CHU de Nice, FHU OncoAge , Nice , France
| | - Paul Hofman
- a Team 3, Institute for Research on Cancer and Ageing , Nice (IRCAN), INSERM U1081/UMR CNRS 7284, FHU OncoAge , Nice , France.,c Laboratory of Clinical and Experimental Pathology, Liquid Biopsy Laboratory , CHU de Nice, FHU OncoAge , Nice , France.,d Hospital-Integrated Biobank (BB-0033-00025) , CHU de Nice, FHU OncoAge , Nice , France
| | - Marius Ilié
- a Team 3, Institute for Research on Cancer and Ageing , Nice (IRCAN), INSERM U1081/UMR CNRS 7284, FHU OncoAge , Nice , France.,c Laboratory of Clinical and Experimental Pathology, Liquid Biopsy Laboratory , CHU de Nice, FHU OncoAge , Nice , France.,d Hospital-Integrated Biobank (BB-0033-00025) , CHU de Nice, FHU OncoAge , Nice , France
| |
Collapse
|
48
|
Koehler U, Hildebrandt O, Krönig J, Grimm W, Otto J, Hildebrandt W, Kinscherf R. [Chronic hypoxia and cardiovascular risk : Clinical significance of different forms of hypoxia]. Herz 2017; 43:291-297. [PMID: 28474128 DOI: 10.1007/s00059-017-4570-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 11/08/2016] [Revised: 03/13/2017] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
Abstract
It is of fundamental importance to differentiate whether chronic hypoxia occurs intermittently or persistently. While chronic intermittent hypoxia (CIH) is found typically in patients with obstructive sleep apnea (OAS), chronic persistent hypoxia (CPH) is typically diagnosed in patients with chronic lung disease. Cardiovascular risk is markedly increased in patients with CIH compared to patients with CPH. The frequent change between oxygen desaturation and reoxygenation in patients with CIH is associated with increased hypoxic stress, increased systemic inflammation, and enhanced adrenergic activation followed by endothelial dysfunction and increased arteriosclerosis. The pathophysiologic consequences of CPH are less well understood. The relationship between CPH and the development of pulmonary hypertension, pulmonary heart disease as well as polycythemia has been established.
Collapse
Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Baldingerstraße 1, 35043, Marburg, Deutschland.
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Baldingerstraße 1, 35043, Marburg, Deutschland
| | - J Krönig
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Baldingerstraße 1, 35043, Marburg, Deutschland
| | - W Grimm
- Klinik für Innere Medizin, SP Kardiologie, Intensivmedizin und Angiologie, Philipps-Universität, Marburg, Deutschland
| | - J Otto
- Medizinische Zellbiologie, Institut für Anatomie und Zellbiologie, Philipps-Universität, Marburg, Deutschland
| | - W Hildebrandt
- Medizinische Zellbiologie, Institut für Anatomie und Zellbiologie, Philipps-Universität, Marburg, Deutschland
| | - R Kinscherf
- Medizinische Zellbiologie, Institut für Anatomie und Zellbiologie, Philipps-Universität, Marburg, Deutschland
| |
Collapse
|
49
|
Duruisseaux M, Besse B, Cadranel J, Pérol M, Mennecier B, Bigay-Game L, Descourt R, Dansin E, Audigier-Valette C, Moreau L, Hureaux J, Veillon R, Otto J, Madroszyk-Flandin A, Cortot A, Guichard F, Boudou-Rouquette P, Langlais A, Missy P, Morin F, Moro-Sibilot D. Efficacité du bévacizumab associé à un doublet de chimiothérapie à base de sels de platine en première ligne de traitement des cancers du poumon ALK-réarrangés : analyse des données de l’étude IFCT-1302 CLINALK. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
50
|
Doyen J, Leysalle A, Gal J, Poudenx M, Otto J, Guerder C, Padovani B, Venissac N, Bondiau P. Chimioradiothérapie concomitante suivie d’une irradiation stéréotaxique des cancers bronchiques non à petite cellules : résultats finaux de l’essai de phase 1 Cybertaxcis. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.07.054] [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: 11/27/2022]
|