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Emile G, Penager S, Levy C, Johnson A, Allouache D, Lequesne J, Hrab I, Segura C, Morel A, Gunzer K, Faveyrial A, Cherifi F, Da Silva A. Baseline lymphopenia as prognostic factor in patients with metastatic breast cancer treated with palbociclib. Oncol Lett 2021; 23:25. [PMID: 34868362 DOI: 10.3892/ol.2021.13143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/13/2021] [Indexed: 01/08/2023] Open
Abstract
Cyclin-dependent-kinase 4-6 inhibitors (CDK4/6i) have improved the management of hormone receptor (HR)+/human epidermal growth factor receptor (HER)2- metastatic breast cancer (mBC). Currently, there are no valid prognostic factors for response to CDK4/6i. Baseline lymphopenia is reported as a prognostic factor in several types of cancer. The present retrospective study aimed to evaluate the effect of baseline absolute lymphocyte count (ALC) on response to palbociclib. Progression-free survival (PFS) was the primary endpoint. Secondary endpoints were overall survival (OS), best response and safety. A total of 114 patients treated for mBC between 2016 and 2019 were included. Median baseline ALC was 1.4 g/l (range, 0.2-4.3 g/l). A total of 65 (57%) and 49 (43%) patients had baseline ALC values of <1.5 and ≥1.5 g/l, respectively. Patients with baseline lymphopenia exhibited significantly shorter PFS (6 vs. 10 months; P=0.004) and OS (20 vs. 33 months; P=0.02). ALC <1.5 g/l independently predicted worse survival, as indicated by multivariate analysis (P=0.04; hazard ratio, 1.76; 95% confidence interval, 1.02-3.02). Patients with baseline ALC <1.5 g/l had significantly less partial response (14 vs. 22%; P=0.016) and more disease progression (46 vs. 20%; P=0.016) than those with ALC ≥1.5 g/l. ALC is a strong and easy-to-use dosage with prognostic factor for patients with HR+/HER2- mBC treated with palbociclib and endocrine therapy. Lymphopenia may also be a predictive factor of early progression. These data need to be verified in a larger prospective study.
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Affiliation(s)
- George Emile
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Sarah Penager
- Clinical Research Department, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Christelle Levy
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Alison Johnson
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Djelila Allouache
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Justine Lequesne
- Clinical Research Department, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Ioana Hrab
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Carine Segura
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Adeline Morel
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Katarina Gunzer
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Audrey Faveyrial
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Francois Cherifi
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
| | - Angelique Da Silva
- Breast Cancer Unit, François Baclesse Comprehensive Cancer Center, Caen, Calvados, Normandy 14000, France
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Bonnet C, Lamy T, Fruchart C, Legouill S, Gunzer K, Gastinne T, Jardin F, Karlin L, Houot R, Dupuis J, Tilly H, Salles G. IBRUTINIB IN ASSOCIATION WITH R-DHAP/OX FOR PATIENTS WITH RELAPSED/REFRACTORY B-CELL LYMPHOMA: PRELIMINARY RESULTS OF THE BIBLOS PHASE IB LYSA STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_188] [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: 11/10/2022]
Affiliation(s)
- C.M. Bonnet
- Clinical Hematology, Chu Liege; Angleur Belgium
| | - T. Lamy
- Hematology, Chu Rennes; Rennes France
| | - C. Fruchart
- Hematology; Centre François Baclesse Caen; Caen France
| | - S. Legouill
- Hematology, C.H.U. - Hotel Dieu; Nantes France
| | - K. Gunzer
- Hematology; Centre François Baclesse Caen; Caen France
| | - T. Gastinne
- Hematology, C.H.U. - Hotel Dieu; Nantes France
| | - F. Jardin
- Hematology; Centre Henri Becquerel; Rouen France
| | - L. Karlin
- Hematology; Centre Hospitalier Lyon-Sud, Pierre Benite; France
| | - R. Houot
- Hematology, Chu Rennes; Rennes France
| | - J. Dupuis
- Hematology; HU Henri Mondor Aphp, Creteil, Val-De-Marne; France
| | - H. Tilly
- Hematology; Centre Henri Becquerel; Rouen France
| | - G. Salles
- Hematology; Centre Hospitalier Lyon-Sud, Pierre Benite; France
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Lévy C, Allouache D, Lacroix J, Dugué AE, Supiot S, Campone M, Mahe M, Kichou S, Leheurteur M, Hanzen C, Dieras V, Kirova Y, Campana F, Le Rhun E, Gras L, Bachelot T, Sunyach MP, Hrab I, Geffrelot J, Gunzer K, Constans JM, Grellard JM, Clarisse B, Paoletti X. REBECA: a phase I study of bevacizumab and whole-brain radiation therapy for the treatment of brain metastasis from solid tumours. Ann Oncol 2015; 26:2359. [PMID: 26504187 DOI: 10.1093/annonc/mdv386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - J Lacroix
- Department of Radiology, Centre François Baclesse, Caen Department of GIP Cyceron, Caen
| | - A E Dugué
- Department of Clinical Research, Centre François Baclesse, Caen
| | | | | | - M Mahe
- Department of Radiotherapy, Institut de Cancérologie de l'Ouest René Gauducheau, Nantes-Saint Herblain, Caen
| | - S Kichou
- Department of Radiology, Centre François Baclesse, Caen
| | | | - C Hanzen
- Department of Radiotherapy, Centre Henri Becquerel, Rouen
| | | | - Y Kirova
- Department of Radiotherapy, Institut Curie, Paris
| | - F Campana
- Department of Radiotherapy, Institut Curie, Paris
| | | | - L Gras
- Department of Radiotherapy, Centre Oscar Lambret, Lille
| | | | - M-P Sunyach
- Department of Radiotherapy, Centre Léon Bérard, Lyon
| | | | - J Geffrelot
- Department of Radiotherapy, Centre François Baclesse, Caen
| | - K Gunzer
- Department of Oncology Department of Clinical Research, Centre François Baclesse, Caen
| | - J-M Constans
- Department of GIP Cyceron, Caen Department of Radiology, Centre Hospitalier Universitaire, Caen
| | - J-M Grellard
- Department of Clinical Research, Centre François Baclesse, Caen
| | - B Clarisse
- Department of Clinical Research, Centre François Baclesse, Caen
| | - X Paoletti
- Department of Biostatistics, Institut Curie/Inserm U900, Paris, France
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Campone M, Ferrero J, Gunzer K, Priou F, Dubreuil P, Mansfield C, Moussy A, Hermine O. 1874 Phase 1b/2 study results for masitinib plus gemcitabine and carboplatin in advanced triple negative breast cancer. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30824-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lévy C, Allouache D, Lacroix J, Dugué AE, Supiot S, Campone M, Mahe M, Kichou S, Leheurteur M, Hanzen C, Dieras V, Kirova Y, Campana F, Le Rhun E, Gras L, Bachelot T, Sunyach MP, Hrab I, Geffrelot J, Gunzer K, Constans JM, Grellard JM, Clarisse B, Paoletti X. REBECA: a phase I study of bevacizumab and whole-brain radiation therapy for the treatment of brain metastasis from solid tumours. Ann Oncol 2014; 25:2351-2356. [PMID: 25274615 DOI: 10.1093/annonc/mdu465] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [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: 12/27/2022] Open
Abstract
BACKGROUND Brain metastases (BMs) are associated with a poor prognosis. Standard treatment comprises whole-brain radiation therapy (WBRT). As neo-angiogenesis is crucial in BM growth, combining angiogenesis inhibitors such as bevacizumab with radiotherapy is of interest. We aimed to identify the optimal regimen of bevacizumab combined with WBRT for BM for phase II evaluation and provide preliminary efficacy data. PATIENTS AND METHODS In this multicentre single-arm phase I study with a 3 + 3 dose-escalation design, patients with unresectable BM from solid tumours received three cycles of bevacizumab at escalating doses [5, 10 and 15 mg/kg every 2 weeks at dose levels (DL) 0, 1 and 2, respectively] and WBRT (30 Gy/15 fractions/3 weeks) administered from day 15. DL3 consisted of bevacizumab 15 mg/kg with WBRT from day 15 in 30 Gy/10 fractions/2 weeks. Safety was evaluated using NCI-CTCAE version 3. BM response (RECIST 1.1) was assessed by magnetic resonance imaging at 6 weeks and 3 months after WBRT. RESULTS Nineteen patients were treated, of whom 13 had breast cancer. There were no DLTs. Grade 1-2 in-field and out-field toxicities occurred for five and nine patients across all DLs, respectively, including three and six patients (including one patient with both, so eight patients overall) of nine patients in DL3. One patient experienced BM progression during treatment (DL0). At the 3-month post-treatment assessment, 10 patients showed a BM response: one of three treated at DL0, one of three at DL1, two of three at DL2 and six of seven at DL3, including one complete response. BM progression occurred in five patients, resulting in two deaths. The remaining patient died from extracranial disease progression. CONCLUSION Bevacizumab combined with WBRT appears to be a tolerable treatment of BM. DL3 warrants further efficacy evaluation based on the favourable safety/efficacy balance. ClinicalTrials.gov Identifier: NCT01332929.
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Affiliation(s)
| | | | - J Lacroix
- Department of Radiology, Centre François Baclesse, Caen; Department of GIP Cyceron, Caen
| | - A E Dugué
- Department of Clinical Research, Centre François Baclesse, Caen
| | | | | | - M Mahe
- Department of Radiotherapy, Institut de Cancérologie de l'Ouest René Gauducheau, Nantes-Saint Herblain, Caen
| | - S Kichou
- Department of Radiology, Centre François Baclesse, Caen
| | | | - C Hanzen
- Department of Radiotherapy, Centre Henri Becquerel, Rouen
| | | | - Y Kirova
- Department of Radiotherapy, Institut Curie, Paris
| | - F Campana
- Department of Radiotherapy, Institut Curie, Paris
| | | | - L Gras
- Department of Radiotherapy, Centre Oscar Lambret, Lille
| | | | - M-P Sunyach
- Department of Radiotherapy, Centre Léon Bérard, Lyon
| | | | - J Geffrelot
- Department of Radiotherapy, Centre François Baclesse, Caen
| | - K Gunzer
- Department of Oncology; Department of Clinical Research, Centre François Baclesse, Caen
| | - J-M Constans
- Department of GIP Cyceron, Caen; Department of Radiology, Centre Hospitalier Universitaire, Caen
| | - J-M Grellard
- Department of Clinical Research, Centre François Baclesse, Caen
| | - B Clarisse
- Department of Clinical Research, Centre François Baclesse, Caen
| | - X Paoletti
- Department of Biostatistics, Institut Curie/Inserm U900, Paris, France
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Szyldergemajn SA, Gonçalves A, Metges JP, Gunzer K, Montagut C, Salazar R, Alsina M, Evans TRJ, Swinson D, Petty RD, Singer H, Kahatt CM. IMAGE, a randomized phase Ib/II study of elisidepsin in pretreated advanced gastroesophageal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lheureux S, Launay-Vacher V, Gunzer K, Delcambre C, Bouhier K, Kaluzinski L, Ngo M, Maron D, Zalcman G, Joly F. Is it possible to predict nonplatinum chemotherapy-related toxicity? J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gunzer K, de Mont-Serrat H, Uttenreuther-Fischer MM, Misset J. Addition of BIBW 2992, an irreversible inhibitor of EGFR/HER1 and HER2, to letrozole in estrogen receptor (ER)-positive metastatic breast cancer (mBC) progressing on letrozole monotherapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lheureux S, Launay-Vacher V, Allouache D, Gunzer K, Delcambre C, Rivière A, Bouhier K, Dupont M, Grossi S, Joly F. 3006 Predictive factors for toxicity of non platinum chemotherapy. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70605-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Lévy C, Switsers O, Ollivier J, Allouache D, Delcambre C, Génot J, Gunzer K, Toudic-Emily F, Segura C, Delozier T. Prognostic factors for survival of metastatic breast cancer (MBC): A retrospective study from 4,233 women treated in a single institution. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1102] [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: 11/20/2022] Open
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Oudard S, Chevreau C, Fléchon A, Gunzer K, Houédé N, Krakowski I, de Mont-Serrat H, Rouyrre N, Kaiser R, Droz J. 4005 ORAL An open label randomized Phase II study of oral triple angiokinase inhibitor BIBF 1120 in Hormone Refractory Prostate Cancer (HRPC) patients who progressed after docetaxel. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71073-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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