1
|
Fraser G, Cramer P, Demirkan F, Silva RS, Grosicki S, Pristupa A, Janssens A, Mayer J, Bartlett NL, Dilhuydy MS, Pylypenko H, Loscertales J, Avigdor A, Rule S, Villa D, Samoilova O, Panagiotidis P, Goy A, Pavlovsky MA, Karlsson C, Hallek M, Mahler M, Salman M, Sun S, Phelps C, Balasubramanian S, Howes A, Chanan-Khan A. Updated results from the phase 3 HELIOS study of ibrutinib, bendamustine, and rituximab in relapsed chronic lymphocytic leukemia/small lymphocytic lymphoma. Leukemia 2019; 33:969-980. [PMID: 30315239 PMCID: PMC6484712 DOI: 10.1038/s41375-018-0276-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [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: 02/12/2018] [Revised: 05/09/2018] [Accepted: 08/28/2018] [Indexed: 12/21/2022]
Abstract
We report follow-up results from the randomized, placebo-controlled, phase 3 HELIOS trial of ibrutinib+bendamustine and rituximab (BR) for previously treated chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) without deletion 17p. Overall, 578 patients were randomized 1:1 to either ibrutinib (420 mg daily) or placebo, in combination with 6 cycles of BR, followed by ibrutinib or placebo alone. Median follow-up was 34.8 months (range: 0.1-45.8). Investigator-assessed median progression-free survival (PFS) was not reached for ibrutinib+BR, versus 14.3 months for placebo+BR (hazard ratio [HR] [95% CI], 0.206 [0.159-0.265]; P < 0.0001); 36-month PFS rates were 68.0% versus 13.9%, respectively. The results are consistent with the primary analysis findings (HR = 0.203, as assessed by independent review committee, with 17-month median follow-up). Median overall survival was not reached in either arm; HR (95% CI) for ibrutinib+BR versus placebo: 0.652 (0.454-0.935; P = 0.019). Minimal residual disease (MRD)-negative response rates were 26.3% for ibrutinib+BR and 6.2% for placebo+BR (P < 0.0001). Incidence of treatment-emergent adverse events (including grades 3-4) were generally consistent with the initial HELIOS report. These long-term data support improved survival outcomes and deepening responses with ibrutinib+BR compared with BR in relapsed CLL/SLL.
Collapse
Affiliation(s)
- G Fraser
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada.
| | - P Cramer
- Department of Internal Medicine, Center of Integrated Oncology and German CLL Study Group, University of Cologne, Cologne, Germany
| | - F Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | - R Santucci Silva
- IEP São Lucas/Hemomed Oncologia e Hematologia, São Paulo, Brazil
| | - S Grosicki
- Department of Cancer Prevention, Faculty of Public Health, Silesian Medical University, Katowice, Poland
| | - A Pristupa
- Regional Clinical Hospital, Ryazan, Russia
| | - A Janssens
- Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - J Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University Hospital Brno, Jihlavska, Brno, Czech Republic
| | - N L Bartlett
- Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA
| | | | - H Pylypenko
- Department of Hematology, Cherkassy Regional Oncological Center, Cherkassy, Ukraine
| | - J Loscertales
- Hematology Department, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain
| | - A Avigdor
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, University of Tel-Aviv, Tel-Aviv, Israel
| | - S Rule
- Department of Haematology, Plymouth University Medical School, Plymouth, UK
| | - D Villa
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - O Samoilova
- Nizhny Novogorod Regional Clinical Hospital, Nizhny Novogorod, Russia
| | - P Panagiotidis
- 1st Department of Propedeutic Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Goy
- John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, USA
| | - M A Pavlovsky
- Department of Hematology, Fundaleu, Buenos Aires, Argentina
| | - C Karlsson
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - M Hallek
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - M Mahler
- Janssen Research & Development, Raritan, NJ, USA
| | - M Salman
- Janssen Research & Development, Raritan, NJ, USA
| | - S Sun
- Janssen Research & Development, Raritan, NJ, USA
| | - C Phelps
- Janssen Research & Development, Raritan, NJ, USA
| | | | - A Howes
- Janssen Research & Development, High Wycombe, UK
| | | |
Collapse
|
2
|
Goede V, Fischer K, Busch R, Jaeger U, Dilhuydy MS, Wickham N, De Guibert S, Ritgen M, Langerak AW, Bieska G, Engelke A, Humphrey K, Wenger M, Hallek M. Chemoimmunotherapy with GA101 plus chlorambucil in patients with chronic lymphocytic leukemia and comorbidity: results of the CLL11 (BO21004) safety run-in. Leukemia 2012; 27:1172-4. [PMID: 22936013 DOI: 10.1038/leu.2012.252] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
3
|
Roubaud G, Gross-Goupil M, Wallerand H, de Clermont H, Dilhuydy MS, Ravaud A. Combination of gemcitabine and doxorubicin in rapidly progressive metastatic renal cell carcinoma and/or sarcomatoid renal cell carcinoma. Oncology 2011; 80:214-8. [PMID: 21720184 DOI: 10.1159/000329078] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 04/29/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Metastatic renal cell carcinoma (mRCC) can be rapidly progressive when tumors exhibit sarcomatoid or Fuhrman grade 4 features. Efficacy of gemcitabine (Gem) with doxorubicin (Dox) in sarcomatoid or rapidly progressive mRCC has been reported. We retrospectively evaluated Gem + Dox in a consecutive cohort of this particular patient population. PATIENTS AND METHODS Patients had an Eastern Cooperative Oncology Group performance status of 2 or more and rapidly progressive mRCC or mRCC with sarcomatoid features. Gem (1,500 mg/m(2)) and Dox (50 mg/m(2)) were given every 2 weeks with granulocyte colony-stimulating factor. RESULTS Twenty-nine patients were treated. Sarcomatoid features were predominant in 6 patients, while 14 tumors were Fuhrman grade 4. All patients had progressive mRCC within 4 months. No grade 4 toxicity or drug-related death was reported. One partial response (7 months), 1 mixed response, and 14 stable diseases (≥4 months for 9 patients) were observed and no response was seen in sarcomatoid tumors. The median disease-free survival was 3.7 months (≥6 months for 8 patients) and the median overall survival was 4.8 months (>12 months for 5 patients). CONCLUSION This study showed a lower response rate than previously reported. Nevertheless, some patients had prolonged survival outcomes. This combination could be an option in sarcomatoid histology (NCCN guidelines) or rapidly progressive disease, but this population represents an unmet medical need.
Collapse
Affiliation(s)
- G Roubaud
- Department of Medical Oncology, Hôpital Saint André, Bordeaux, France
| | | | | | | | | | | |
Collapse
|
4
|
Dilhuydy MS, Durieux A, Pariente A, de Clermont H, Pasticier G, Monteil J, Ravaud A. PET Scans for Decision-Making in Metastatic Renal Cell Carcinoma: A Single-Institution Evaluation. Oncology 2007; 70:339-44. [PMID: 17164590 DOI: 10.1159/000097946] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2006] [Accepted: 08/06/2006] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Therapeutic decision-making in metastatic renal cell carcinoma (MRCC) is based on conventional radiological evaluation. Fluorodeoxyglucose positron emission tomography (FDG-PET) scans may modify this strategy. METHODS Patients with MRCC for whom a therapeutic decision had been made underwent an FDG-PET scan in order to complete the standard radiological evaluation. RESULTS Twenty-four patients and 26 FDG-PET scans were eligible. In 18 patients, metastatic disease was evaluable on the computed tomography (CT) scan; the FDG-PET scan was positive in 16 patients and negative in 10. In 2 patients, the FDG-PET scan was positive while they were considered disease free on radiological evaluation. In 5 patients (20.8%), the previous therapeutic decision was changed. Thirteen patients had a pathological evaluation for 19 sites. One patient out of 13 had a false-positive FDG-PET scan, while 4 sites out of 6 were false-negative. The sensitivity was 75% (95% CI: 47.6-92.7) and the predictive positive value was 92.3% (95% CI: 64-99.8). With a median follow-up of 24 months, 3 patients developed new metastatic sites. CONCLUSION Our data suggest that, when positive, an FDG-PET scan may modify the decision made; when negative, it should not modify decision-making especially for surgery, owing to its sensitivity.
Collapse
Affiliation(s)
- M S Dilhuydy
- Department of Medical Oncology and Radiotherapy, Hôpital Saint-André, University Hospital, CHU Bordeaux, France
| | | | | | | | | | | | | |
Collapse
|
5
|
Ravaud A, Dilhuydy MS. [Renal cell carcinoma: the end of a tunnel?]. ACTA ACUST UNITED AC 2006; 54:206-8. [PMID: 16530346 DOI: 10.1016/j.patbio.2006.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 01/27/2006] [Indexed: 11/27/2022]
|
6
|
Dilhuydy MS, Vatan R, Etienne G, Longy-Boursier M, Mercié P. Prolonged efficacy of infliximab for refractory adult-onset Still's disease. Clin Exp Rheumatol 2005; 23:121-2. [PMID: 15789901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
|
7
|
Dilhuydy MS, Delclaux C, Pariente A, De Precigout V, Aparicio M. [Hemolytic-uremic syndrome complicating a long-term treatment with gemcitabine. Report of a case and review of the literature]. Rev Med Interne 2002; 23:189-92. [PMID: 11876063 DOI: 10.1016/s0248-8663(01)00535-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Gemcitabine is a nucleoside analog used in solid tumors since 1987. The main side effect is myelosuppression. Acute renal failure with thrombotic microangiopathy has also been reported. We report a new case and suggest to screen for this complication. EXEGESIS A 71-year-old man with metastatic adenocarcinoma of the pancreas was treated with gemcitabine. He developed episodes of recurred haemolysis followed by haemolytic uremic syndrome. One single haemodialysis session was performed. No other known causes for haemolytic and uremic syndrome were found. Gemcitabine appears to be a new cause of thrombotic microangiopathy. It results from cumulative effects, arises preferentially when there is a renal dysfunction and diagnosis is often delayed. Treatment must be stopped. CONCLUSION We suggest that reticulocyte count, haptoglobin level and urinalysis could help the clinician to maintain high vigilance and to have a rapid diagnosis for this rare disorder.
Collapse
Affiliation(s)
- M S Dilhuydy
- Service de néphrologie et d'hémodialyse, hôpital Pellegrin, CHU, place Amélie-Raba-Léon, 33076 Bordeaux, France
| | | | | | | | | |
Collapse
|
8
|
Dilhuydy JM, Dilhuydy MS, Ouhtatou F, Laporte C, Nguyen TV, Vendrely V. [Fatigue and radiotherapy. Literature review]. Cancer Radiother 2001; 5 Suppl 1:131s-138s. [PMID: 11797272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Fatigue is a common complaint for the cancer patient during and after radiotherapy, according to the published studies. Fatigue is a subjective symptom mostly underestimated by oncologists and other care givers. Etiology is complex, poorly understood in spite of obvious causes like insomnia, nausea, pain, depression, psychological distress, anemia, hypothyroidism, menopause disturbances, treatment adverse effects. Fatigue presents multifactorial and multidimensional aspects. To evaluate it, many tools can be used as single-item, unidimensional and multidimensional instruments. Practically, the open discussion with the patient throughout radiotherapy is essential to define it. Taking charge fatigue requires its acknowledgment by radiotherapist, treatment of associated symptoms with a multidisciplinary approach.
Collapse
Affiliation(s)
- J M Dilhuydy
- Service de radiothérapie, Institut Bergonié, centre régional de lutte contre le cancer, 229, cours de l'Argonne, 33076 Bordeaux, France.
| | | | | | | | | | | |
Collapse
|
9
|
Dilhuydy MS, Mercié P, Viallard JF, Dumont T, Soubeyran I, Faure I, Leng B, Pellegrin JL. [Natural killer cell nasal lymphoma mimicking localized Wegener's disease]. Rev Med Interne 2001; 22:571-5. [PMID: 11433567 DOI: 10.1016/s0248-8663(01)00389-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Primary non-Hodgkin's lymphoma of the nasal cavity is particular. Pathological characteristics mainly associate a prevalent NK lymphocyte phenotype, a frequent exposure to the Epstein-Barr virus and a poor sensitivity to radiotherapy compared to other lymph node localizations. EXEGESIS The authors report the case of a 38-year-old man. The patient had previously presented a chronic maxillary sinusitis. After a diagnosis of Wegener's disease, the poor course under therapy resulted in a nasal lymphoma. Natural killer cell nasal lymphoma was confirmed with a leading biopsy at the same time as a serious clinical outcome. The patient died of septic shock with multivisceral failure. CONCLUSION The two differential diagnoses of ulcerative lymphoma of the midface are ulcerative infectious diseases and Wegener's disease. We must not miss this severe disease, with its poor prognosis and variable, though sometimes rapid speed of evolution.
Collapse
Affiliation(s)
- M S Dilhuydy
- Service de médecine interne et maladies infectieuses, centre François-Magendie, hôpital Haut-Lévêque, 33604 Pessac, France
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Abstract
INTRODUCTION Pancreatic cancer is responsible for 6,000 deaths per year in France. During the course of the disease, venous thrombosis is common. Conversely, arterial thrombosis is rarely described. EXEGESIS We report the case of a 59-year-old patient with pancreatic adenocarcinoma. Treatment by gemcitabine allowed rapid and persistent improvement of the body weight and a prolonged survival (18 months). Sudden complication, i.e. splenic arterial thrombosis, reversed the favorable outcome. CONCLUSION Splenic venous thrombosis is a frequent complication occurring in the course of pancreatic cancer. It is easily diagnosed using abdominal computerized tomography. Arterial thrombosis is rarely observed. It might be due to either sporadic, unexpected, occurrence of cases related to the evolution of underlying pathological mechanisms, or to omitted treatment of vascular complications, as until the introduction of new anticancer drugs this disease was considered to be of very poor prognosis.
Collapse
Affiliation(s)
- P Mercié
- Clinique de médecine interne et maladies infectieuses, hôpital du Haut-Lévêque, Pessac, France
| | | | | | | | | | | | | |
Collapse
|
11
|
Dilhuydy MS, Delclaux C, De Precigout V, Haramburu F, Roger I, Deminière C, Mercié P, Pellegrin JL, Aparicio M. [Acute renal failure after polyvalent immunoglobulin therapy]. Presse Med 2000; 29:942-3. [PMID: 10855243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Acute renal failure can be induced by intravenous administration of immunoglobulins, especially in patients with a predisposition for nephrotoxicity. The onset and resolution of acute renal failure is typically rapid, but in some cases hemodialysis may be needed. CASE REPORT We present 2 cases of acute renal failure associated with intravenous immunoglobulin therapy: a 76-year-old man with a history of non-insulin-dependent diabetes mellitus and hypertension and a 77-year-old woman using nonsteroidal antiinflammatory drugs. DISCUSSION Intravenous immunoglobulins must be used with precaution in patients with risk factors for acute renal failure. In such patients, renal failure may be avoided by using preparations without sucrose.
Collapse
Affiliation(s)
- M S Dilhuydy
- Service de Néphrologie et d'Hémodialyse, CHU Pellegrin, Bordeaux
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Dilhuydy MS, Mercié P, Doutre MS, Viallard JF, Faure I, Ellie E, Beylot C, Leng B, Pellegrin JL. [Acrodystrophic neuropathy of Bureau and Barrière]. Rev Med Interne 1999; 20:1126-31. [PMID: 10635075 DOI: 10.1016/s0248-8663(00)87527-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The acrodystrophic neuropathy described by Bureau and Barrière in the 1950s is a rare trophic complication of chronic, analgesic neuropathy due to alcohol abuse, which is at the origin of perforating ulcers of the foot, vasomotor disorders with dysautonomia, and leads to mutilating arthropathy of the lower limb. This neuroacropathy, also termed vagabonds' or vagrants' disease, usually occurs in subjects with a debilitated condition, chronic alcoholism, and unfavourable socioeconomic conditions. EXEGESIS We report four cases of Bureau-Barrière disease which occurred in male subjects who were on average 55 years of age. The clinical presentation was close to that reported in the literature. Indeed, all four patients were alcoholic, nondiabetic and lived under conditions of precarious hygiene. Therapeutic management of the patients was difficult due to bad compliance with the treatment and persistence of alcohol abuse. Immobilization of the foot is considered to be the primary treatment. Local care including baths and bandages with hydrocolloids must be continued during several months, and associated with antibiotic therapy, administered by infusion when necessary. The outcome is often chronic, with poor prognosis. Given the limited therapeutic possibilities, acrodystrophic neuropathy is an invalidating disease with high morbidity. CONCLUSION Bureau-Barrière disease is a rare, serious invalidating disease. The clinical symptomatology is usually based on the diagnostic triad: analgesia of the foot, perforating ulcers of the foot, and deforming and mutilating arthropathy of the lower limb. Treatment is often hampered due to poor compliance with local care and persistence of alcohol abuse.
Collapse
Affiliation(s)
- M S Dilhuydy
- Clinique de médecine interne et maladies infectieuses, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Dilhuydy MS, Mercié P, Doutre MS, Viallard JF, Faure I, Ellie E, Pellegrin JL, Leng B. Acropathie ulcéromutilante sporadique de Bureau et Barrière. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80316-0] [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]
|
14
|
Dilhuydy MS, Lacoste D, Morlat P, Nouts C, Bernard N, Djossou F, Beylot J. Syndrome de réversion chez les patients infectés par le VIH et traités par antiprotéases : à propos de quatre cas de mycobactériose. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90164-3] [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: 10/18/2022]
|