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Wils J, Sahmoud T, Sobrero A, Bleiberg H, Ahmedzai S, Blazeby J, Blijham G, Conroy T, Cunningham D, Curran D, Díaz-Rubio E, Ducreux M, Evans J, Glimelius B, Hutchinson G, Kerr D, Kiebert G, Köhne H, Labianca R, Langendijk R, Nitti D, Nordlinger B, Rougier P, Scheithauer W, Therasse P. Evaluation of Clinical Efficacy of New Medical Treatments in Advanced Colorectal Cancer. Results of a Workshop Organized by the Eortc Gitccg. Tumori 2018; 84:335-47. [PMID: 9678614 DOI: 10.1177/030089169808400306] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 11/16/2022]
Abstract
During the last few years several factors have contributed to an increasing change in the medical treatment of advanced colorectal cancer. Among them are the more general acceptance of the impact of chemotherapy on quality of life and survival in first as well as in second-line treatment, the introduction of new drugs and the definition of novel endpoints which can roughly be defined as “patient benefit”. For this reason the European Organization for Research and Treatment of Cancer (EORTC) Gastrointestinal Tract Cancer Cooperative Group (GITCCG) felt it was appropriate to organize a workshop with experts from different countries and national groups to discuss in depth several aspects concerning the treatment of patients with advanced colorectal cancer.
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Affiliation(s)
- J Wils
- St Laurentius Ziekenhuis, Roermond, The Netherlands.
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Droz JP, Schlumberger M, Rougier P, Ghosn M, Gardet P, Parmentier C. Chemotherapy in Metastatic Nonanaplastic Thyroid Cancer: Experience at the Institut Gustave-Roussy. Tumori 2018; 76:480-3. [PMID: 2256195 DOI: 10.1177/030089169007600513] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [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: 11/15/2022]
Abstract
Forty-nine patients with metastatic nonanaplastic thyroid carcinoma were treated over a 10-year period. Five successive chemotherapeutic protocols were used: a combination of doxorubicin, etoposide, 5-fluorouracil and cyclophosphamide; elliptinium acetate; doxorubicin; cispiatin; and the combination of doxorubicin and cispiatin. Results obtained with the different protocols were very disappointing, with only two objective responses (3%). Phase II trials with new chemotherapeutic agents are warranted in selected cases of nonanaplastic metastatic thyroid carcinoma.
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Affiliation(s)
- J P Droz
- Department of Medicine, Institut Gustave-Roussy, Villejuif, France
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Zaanan A, Samalin E, Louvet C, Montérymard C, Khemissa F, Bouche O, Louafi S, Ghiringhelli F, Bernard P, Chibaudel B, Artru P, Molin Y, Baba-Hamed N, Romano O, Aparicio T, Michel P, Rougier P, Tougeron D, Manfredi S, Taieb J. PRODIGE 51 - GASTFOX: Phase III randomised trial evaluating FOLFOX with or without DOCETAXEL (TFOX) as 1st line chemotherapy for locally advanced or metastatic oesophago-gastric adenocarcinoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bleiberg H, Decoster G, de Gramont A, Rougier P, Sobrero A, Benson A, Chibaudel B, Douillard JY, Eng C, Fuchs C, Fujii M, Labianca R, Larsen AK, Mitchell E, Schmoll HJ, Sprumont D, Zalcberg J. A need to simplify informed consent documents in cancer clinical trials. A position paper of the ARCAD Group. Ann Oncol 2017; 28:922-930. [PMID: 28453700 PMCID: PMC5406755 DOI: 10.1093/annonc/mdx050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background In respect of the principle of autonomy and the right of self-determination, obtaining an informed consent of potential participants before their inclusion in a study is a fundamental ethical obligation. The variations in national laws, regulations, and cultures contribute to complex informed consent documents for patients participating in clinical trials. Currently, only few ethics committees seem willing to address the complexity and the length of these documents and to request investigators and sponsors to revise them in a way to make them understandable for potential participants. The purpose of this work is to focus on the written information in the informed consent documentation for drug development clinical trials and suggests (i) to distinguish between necessary and not essential information, (ii) to define the optimal format allowing the best legibility of those documents. Methods The Aide et Recherche en Cancérologie Digestive (ARCAD) Group, an international scientific committee involving oncologists from all over the world, addressed these issues and developed and uniformly accepted a simplified informed consent documentation for future clinical research. Results A simplified form of informed consent with the leading part of 1200-1800 words containing all of the key information necessary to meet ethical and regulatory requirements and 'relevant supportive information appendix' of 2000-3000 words is provided. Conclusions This position paper, on the basis of the ARCAD Group experts discussions, proposes our informed consent model and the rationale for its content.
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Affiliation(s)
| | | | - A. de Gramont
- Department of Medical Oncology, Institut Hospitalier Franco-Britannique, Levallois Perret
| | - P. Rougier
- Gastroenterology and Digestive Oncology Department, European Hospital, Georges Pompidou, Paris, France
| | - A. Sobrero
- Medical Oncology Unit, Ospedale San Martino, Genova, Italy
| | - A. Benson
- Division of Hematology/Oncology, Robert H. Comprehensive Cancer Center Northwestern University, Chicago, USA
| | - B. Chibaudel
- Department of Medical Oncology, Institut Hospitalier Franco-Britannique, Levallois Perret
| | - J. Y. Douillard
- Department of Medical Oncology, Centre R. Gauducheau Université de Nantes, Saint Herblain, France
| | - C. Eng
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - C. Fuchs
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M. Fujii
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - R. Labianca
- Cancer Center, Ospedale Giovanni XXIII, Bergamo, Italy
| | - A. K. Larsen
- Laboratory of Cancer Biology and Therapeutics, INSERM and Université Pierre et Marie Curie, Saint-Antoine Hospital, Paris, France
| | - E. Mitchell
- Kimmel Cancer Center at Jefferson, Jefferson University Hospitals, Philadelphia, USA
| | - H. J. Schmoll
- Department of Internal Medicine IV, University Clinic Halle, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - D. Sprumont
- Institute of Health Law, University of Neuchâtel, Neuchâtel, Switzerland
| | - J. Zalcberg
- Faculty of Medicine, Nursing and Health Sciences, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Pointet AL, Pernot S, Pellerin O, Amouyal G, Berger A, Rougier P, Sapoval M, Taieb J. DC-beads loaded with irinotecan combined with systemic chemotherapy for pretreated liver dominant metastatic colorectal cancer: Procedure and outcomes of 49 patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Al-Batran SE, Van Cutsem E, Oh SC, Bodoky G, Shimada Y, Hironaka S, Sugimoto N, Lipatov ON, Kim TY, Cunningham D, Rougier P, Muro K, Liepa AM, Chandrawansa K, Emig M, Ohtsu A, Wilke H. Quality-of-life and performance status results from the phase III RAINBOW study of ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated gastric or gastroesophageal junction adenocarcinoma. Ann Oncol 2016; 27:673-9. [PMID: 26747859 PMCID: PMC4803452 DOI: 10.1093/annonc/mdv625] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/17/2015] [Accepted: 12/18/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The phase III RAINBOW trial demonstrated that the addition of ramucirumab to paclitaxel improved overall survival, progression-free survival, and tumor response rate in fluoropyrimidine-platinum previously treated patients with advanced gastric/gastroesophageal junction (GEJ) adenocarcinoma. Here, we present results from quality-of-life (QoL) and performance status (PS) analyses. PATIENTS AND METHODS Patients with Eastern Cooperative Oncology Group PS of 0/1 were randomized to receive ramucirumab (8 mg/kg i.v.) or placebo on days 1 and 15 of a 4-week cycle, with both arms receiving paclitaxel (80 mg/m(2)) on days 1, 8, and 15. Patient-reported outcomes were assessed with the QoL/health status questionnaires EORTC QLQ-C30 and EQ-5D at baseline and 6-week intervals. PS was assessed at baseline and day 1 of every cycle. Time to deterioration (TtD) in each QLQ-C30 scale was defined as randomization to first worsening of ≥10 points (on 100-point scale) and TtD in PS was defined as first worsening to ≥2. Hazard ratios (HRs) for treatment effect were estimated using stratified Cox proportional hazards models. RESULTS Of the 665 patients randomized, 650 (98%) provided baseline QLQ-C30 and EQ-5D data, and 560 (84%) also provided data from ≥1 postbaseline time point. Baseline scores for both instruments were similar between arms. Of the 15 QLQ-C30 scales, 14 had HR < 1, indicating similar or longer TtD in QoL for ramucirumab + paclitaxel. Treatment with ramucirumab + paclitaxel was also associated with a delay in TtD in PS to ≥2 (HR = 0.798, P = 0.0941). Alternate definitions of PS deterioration yielded similar results: PS ≥ 3 (HR = 0.656, P = 0.0508), deterioration by ≥1 PS level (HR = 0.802, P = 0.0444), and deterioration by ≥2 PS levels (HR = 0.608, P = 0.0063). EQ-5D scores were comparable between treatment arms, stable during treatment, and worsened at discontinuation. CONCLUSION In patients with previously treated advanced gastric/GEJ adenocarcinoma, addition of ramucirumab to paclitaxel prolonged overall survival while maintaining patient QoL with delayed symptom worsening and functional status deterioration. CLINICALTRIALSGOV NCT01170663.
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Affiliation(s)
- S-E Al-Batran
- Institute of Clinical Cancer Research (IKF), UCT-University Cancer Center, Frankfurt, Germany
| | - E Van Cutsem
- University Hospitals Gasthuisberg, Leuven, Belgium
| | - S C Oh
- Korea University Guro Hospital, Seoul, South Korea
| | - G Bodoky
- Szent László Hospital, Budapest, Hungary
| | - Y Shimada
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - S Hironaka
- Department of Clinical Trial Promotion, Chiba Cancer Center, Chiba, Japan
| | - N Sugimoto
- Department of Clinical Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - O N Lipatov
- Bashkortostan Clinical Oncology Center, Ufa, Russia
| | - T-Y Kim
- Department of Internal Medicine and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | | | - P Rougier
- Hôpital Européen Georges Pompidou, Université Paris V, Paris, France
| | - K Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - A M Liepa
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | - M Emig
- Eli Lilly and Company, Bad Homburg, Germany
| | - A Ohtsu
- Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan
| | - H Wilke
- Department of Oncology, Kliniken Essen Mitte Center of Pallative Care, Muenster University Clinic, Essen, Germany
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Yelnik A, Tasseel Ponche S, Andriantsifanetra C, Provost C, Calvalido A, Rougier P. Walking with eyes closed is easier than walking with eyes open without visual cues: The Romberg task versus the goggle task. Ann Phys Rehabil Med 2015; 58:332-5. [DOI: 10.1016/j.rehab.2015.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/24/2015] [Accepted: 08/29/2015] [Indexed: 11/16/2022]
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Lévi FA, Boige V, Hebbar M, Smith D, Lepère C, Focan C, Karaboué A, Guimbaud R, Carvalho C, Tumolo S, Innominato P, Ajavon Y, Truant S, Castaing D, De Baere T, Kunstlinger F, Bouchahda M, Afshar M, Rougier P, Adam R, Ducreux M. Conversion to resection of liver metastases from colorectal cancer with hepatic artery infusion of combined chemotherapy and systemic cetuximab in multicenter trial OPTILIV. Ann Oncol 2015; 27:267-74. [PMID: 26578731 DOI: 10.1093/annonc/mdv548] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [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] [Received: 08/11/2015] [Accepted: 10/28/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Systemic chemotherapy typically converts previously unresectable liver metastases (LM) from colorectal cancer to curative intent resection in ∼15% of patients. This European multicenter phase II trial tested whether hepatic artery infusion (HAI) with triplet chemotherapy and systemic cetuximab could increase this rate to 30% in previously treated patients. PATIENTS AND METHODS Participants had unresectable LM from wt KRAS colorectal cancer. Main non-inclusion criteria were advanced extra hepatic disease, prior HAI and grade 3 neuropathy. Irinotecan (180 mg/m(2)), oxaliplatin (85 mg/m(2)) and 5-fluorouracil (2800 mg/m(2)) were delivered via an implanted HAI access port and combined with i.v. cetuximab (500 mg/m(2)) every 14 days. Multidisciplinary decisions to resect LM were taken after every three courses. The rate of macroscopic complete resections (R0 + R1) of LM, progression-free survival (PFS) and overall survival (OS) were computed according to intent to treat. RESULTS The patient population consisted of 42 men and 22 women, aged 33-76 years, with a median of 10 LM involving a median of six segments. Up to 3 extrahepatic lesions of <1 cm were found in 41% of the patients. A median of six courses was delivered. The primary end point was met, with R0-R1 hepatectomy for 19 of the 64 previously treated patients, 29.7% (95% confidence interval 18.5-40.9). Grade 3-4 neutropenia (42.6%), abdominal pain (26.2%), fatigue (18%) and diarrhea (16.4%) were frequent. Objective response rate was 40.6% (28.6-52.3). Median PFS and OS reached 9.3 (7.8-10.9) and 25.5 months (18.8-32.1) respectively. Those with R0-R1 hepatectomy had a median OS of 35.2 months (32.6-37.8), with 37.4% (23.6-51.2) alive at 4 years. CONCLUSION The coordination of liver-specific intensive chemotherapy and surgery had a high curative intent potential that deserves upfront randomized testing. PROTOCOL NUMBERS EUDRACT 2007-004632-24, NCT00852228.
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Affiliation(s)
- F A Lévi
- UMRS 776 'Biological Rhythms and Cancers', INSERM, Villejuif Université Paris Sud 11, Orsay Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France Cancer Chronotherapy Unit, Warwick Medical School, Coventry, UK
| | - V Boige
- Service d'Oncologie Digestive, Institut Gustave Roussy, Villejuif
| | - M Hebbar
- Department of Medical Oncology, Hôpital Huriez, Lille
| | - D Smith
- Hôpital Saint-André, Department of Medical Oncology, Centre Hospitalo-Universitaire, Bordeaux
| | - C Lepère
- Service d'Hépato-Gastro-Entérologie, Hôpital Européen Georges Pompidou, Paris, France
| | - C Focan
- Department of Oncology, Centre Hospitalier Chrétien, Clinique Saint-Joseph, Liège, Belgium
| | - A Karaboué
- UMRS 776 'Biological Rhythms and Cancers', INSERM, Villejuif Université Paris Sud 11, Orsay Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France
| | - R Guimbaud
- Department of Oncology, University Hospital of Purpan, Toulouse, France
| | - C Carvalho
- Medical Oncology Unit, Hospital Fernando Foncesca, Amadora, Portugal
| | - S Tumolo
- Department of Oncology, Santa Maria Degli Angeli General Hospital, Pordenone, Italy
| | - P Innominato
- UMRS 776 'Biological Rhythms and Cancers', INSERM, Villejuif Université Paris Sud 11, Orsay Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France Cancer Chronotherapy Unit, Warwick Medical School, Coventry, UK
| | - Y Ajavon
- Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France
| | - S Truant
- Department of Medical Oncology, Hôpital Huriez, Lille
| | - D Castaing
- Université Paris Sud 11, Orsay Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France
| | - T De Baere
- Service d'Oncologie Digestive, Institut Gustave Roussy, Villejuif
| | - F Kunstlinger
- Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France
| | - M Bouchahda
- UMRS 776 'Biological Rhythms and Cancers', INSERM, Villejuif Université Paris Sud 11, Orsay Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France
| | - M Afshar
- Cancer Chronotherapy Unit, Warwick Medical School, Coventry, UK
| | - P Rougier
- Service d'Hépato-Gastro-Entérologie, Hôpital Européen Georges Pompidou, Paris, France Université René Descartes, Paris V, France
| | - R Adam
- UMRS 776 'Biological Rhythms and Cancers', INSERM, Villejuif Université Paris Sud 11, Orsay Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France
| | - M Ducreux
- Université Paris Sud 11, Orsay Assistance Publique-Hopitaux de Paris, Department of Medical Oncology, Department of Hepatobiliary Center and Radiology, Paul Brousse Hospital, Villejuif, France Service d'Oncologie Digestive, Institut Gustave Roussy, Villejuif
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Gamache G, Rougier P, Honeine JL, Martinet C, Bouchereau A. La transition assis-debout : effets de la durée d’assise. Neurophysiol Clin 2015. [DOI: 10.1016/j.neucli.2015.10.075] [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] Open
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Martinet C, Bouchereau A, Gamache G, Honeine JL, Rougier P. Influence du port de semelles de compression sur la stabilité posturale et cardiaque. Neurophysiol Clin 2015. [DOI: 10.1016/j.neucli.2015.10.078] [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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Bouchereau A, Martinet C, Gamache G, Honeine JL, Rougier P. Effet des bas de compression sur la stabilisation hémodynamique et posturale. Neurophysiol Clin 2015. [DOI: 10.1016/j.neucli.2015.10.076] [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] Open
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Hirsch L, Lepere C, Vaillant JN, Louafi S, Pernot S, Landi B, Zaanan A, Taieb J, Rougier P. P-206 Efficacy and tolerance of a simplified combination of Streptozotocin and epi-adriamycin in metastatic foregut neuroendocrine tumor (NET). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Garcia-Carbonero R, Obermannova R, Bodoky G, Prausova J, Ciuleanu TE, Garcia Alfonso P, Portnoy D, Cohn A, Van Cutsem E, Yamazaki K, Al-Batran SE, Rougier P, Liepa A, Yang L, Zhang Y, Nasroulah F, Chang SC, Tabernero J. O-020 Quality-of-life results from RAISE: randomized, double-blind phase III study of FOLFIRI plus ramucirumab or placebo in patients with metastatic colorectal carcinoma after first-line therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv235.19] [Citation(s) in RCA: 4] [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: 11/14/2022] Open
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Delbaldo C, Ychou M, Zawadi A, Douillard JY, André T, Guerin-Meyer V, Rougier P, Dupuis O, Faroux R, Jouhaud A, Quinaux E, Buyse M, Piedbois P. Postoperative irinotecan in resected stage II-III rectal cancer: final analysis of the French R98 Intergroup trial†. Ann Oncol 2015; 26:1208-1215. [PMID: 25739671 DOI: 10.1093/annonc/mdv135] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/20/2015] [Indexed: 08/08/2023] Open
Abstract
BACKGROUD The R98 trial explores the addition of irinotecan to a 5-fluorouracil (5-FU) plus leucovorin (5-FU/LV) adjuvant regimen in optimally resected stages II-III rectal cancers. We report the updated long-term results. Disease-free survival (DFS) was the primary end point. PATIENST AND METHODS Between March 1999 and December 2005, 357 patients were randomized: 178 in 5-FU/LV and 179 in LV5-FU2 + irinotecan arm. The trial was stratified by control arm: Mayo Clinic regimen or LV5-FU2 regimen. RESULTS Three hundred and fifty-seven randomized patients were evaluable for efficacy. With a follow-up of 156 months, the DFS was in favour of experimental arm but did not reach statistical significance [hazard ratio (HR) = 0.80, P = 0.154]. The same was observed for overall survival (OS) (HR = 0.87, P = 0.433). The 5-year DFS was 58% in the control arm and 63% in the experimental arm. The 5-year OS was 74% in the control arm and 75% in the experimental arm. Patients allocated to the experimental arm had more grade 3-4 neutropenia when compared with the LV5-FU2 arm (33% versus 6%, P = 0.03), but not when compared with the Mayo Clinic arm (33% versus 36%, P = 0.84). Grade 3-4 diarrhoea tended to be higher in the experimental arm, but analyses stratified by control arm or by radiotherapy failed to show significant differences across strata (test for interaction P = 0.44). CONCLUSION Even though a benefit of irinotecan in subgroups of patients cannot be excluded, due to early termination and lack of power, the study does not support the addition of irinotecan to 5-FU/LV in routine in patients with resected stage II-III rectal cancer.
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Affiliation(s)
- C Delbaldo
- Oncology Unit, Diaconesses Croix Saint Simon Hospital, Paris.
| | - M Ychou
- Digestive Oncology Unit, ICM Val D'Aurelle, Montpellier
| | - A Zawadi
- Radiotherapy Unit, Departemental Hospital Center, La Roche Sur Yon
| | | | - T André
- Oncology Unit, Saint-Antoine Hospital, GERCOR, and UMPC University Paris VI, Paris
| | | | - P Rougier
- Hepatogastroenterology and Digestive Oncology Unit, Université Paris V, Europeen Georges Pompidou Hospital, Paris
| | - O Dupuis
- Radiotherapy Unit, Jean-Bernard Center, Le Mans
| | - R Faroux
- Digestive Unit, Departemental Hospital Center, La Roche sur Yon
| | - A Jouhaud
- Radiotherapy Unit, Henri Mondor Hospital, Créteil, France
| | - E Quinaux
- International Development Drug Institute (IDDI), Louvain-la-Neuve, Belgium
| | - M Buyse
- International Development Drug Institute (IDDI), Louvain-la-Neuve, Belgium
| | - P Piedbois
- Oncology Unit, Paul Strauss Center, Strasbourg, France
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Van Cutsem E, Boni C, Tabernero J, Massuti B, Middleton G, Dane F, Reichardt P, Pimentel FL, Cohn A, Follana P, Clemens M, Zaniboni A, Moiseyenko V, Harrison M, Richards DA, Prenen H, Pernot S, Ecstein-Fraisse E, Hitier S, Rougier P. Docetaxel plus oxaliplatin with or without fluorouracil or capecitabine in metastatic or locally recurrent gastric cancer: a randomized phase II study. Ann Oncol 2015; 26:149-156. [PMID: 25416687 DOI: 10.1093/annonc/mdu496] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [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: 12/13/2022] Open
Abstract
BACKGROUND Docetaxel/cisplatin/infusional 5-fluorouracil (5-FU; DCF) is a standard chemotherapy regimen for patients with advanced gastric cancer (GC). This phase II study evaluated docetaxel/oxaliplatin (TE), docetaxel/oxaliplatin/5-FU (TEF), and docetaxel/oxaliplatin/capecitabine (TEX) in patients with advanced GC. PATIENTS AND METHODS Patients with metastatic or locally recurrent gastric adenocarcinoma (including carcinoma of the gastro-oesophageal junction) were randomly assigned (1 : 1 : 1) to TE, TEF, or TEX. Each regimen was tested at two doses before full evaluation at optimized dose levels. The primary end point was progression-free survival (PFS). Overall survival (OS), tumour response, and safety were also assessed. A therapeutic index (median PFS relative to the incidence of febrile neutropenia) was calculated for each regimen and compared with DCF (historical data). RESULTS Overall, 248 patients were randomly assigned to receive optimized dose treatment. Median PFS was longer with TEF (7.66 [95% confidence interval (CI): 6.97-9.40] months) versus TE (4.50 [3.68-5.32] months) and TEX (5.55 [4.30-6.37] months). Median OS was 14.59 (95% CI: 11.70-21.78) months for TEF versus 8.97 (7.79-10.87) months for TE and 11.30 (8.08-14.03) months for TEX. The rate of tumour response (complete or partial) was 46.6% (95% CI 35.9-57.5) for TEF versus 23.1% (14.3-34.0) for TE and 25.6% (16.6-36.4) for TEX. The frequency and type of adverse events (AEs) were similar across the three arms. Common grade 3/4 AEs were fatigue (21%), sensory neuropathy (14%), and diarrhoea (13%). Febrile neutropenia was reported in 2% (TEF), 14% (TE), and 9% (TEX) of patients. The therapeutic index was improved with TEF versus TEX, TE, or DCF. CONCLUSION These results suggest that TEF is worthy of evaluation as an arm in a phase III trial or as a backbone regimen for new targeted agents in advanced GC. CLINICALTRIALS.GOV: Identifier Trial registration number: NCT00382720.
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Affiliation(s)
- E Van Cutsem
- Digestive Oncology, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
| | - C Boni
- Department of Oncology, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona
| | - B Massuti
- Medical Oncology Service, Alicante University Hospital, Alicante, Spain
| | - G Middleton
- Department of Medical Oncology, University of Birmingham, Birmingham, UK
| | - F Dane
- Department of Medical Oncology, Marmara University Medical Faculty, Istanbul, Turkey
| | - P Reichardt
- Interdisciplinary Oncology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - F L Pimentel
- Oncology, Hospital de São Sebastião, Santa Maria da Feira, Portugal
| | - A Cohn
- US Oncology Research, Rocky Mountain Cancer Centers, Denver, USA
| | - P Follana
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - M Clemens
- Department of Internal Medicine I, Klinikum Mutterhaus der Borromaeerinnen, Trier, Germany
| | - A Zaniboni
- Medical Oncology, Fondazione Poliambulanza - Istituto Ospedaliero, Brescia, Italy
| | - V Moiseyenko
- Medical Oncology, N.N. Petrov Oncology SRI, St Petersburg, Russia
| | - M Harrison
- Department of Clinical Oncology, Mount Vernon Cancer Centre, Northwood, UK
| | - D A Richards
- US Oncology Research, Texas Oncology-Tyler, Tyler, USA
| | - H Prenen
- Digestive Oncology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - S Pernot
- Digestive Oncology, Universite Paris-V European Hospital Georges Pompidou, APHP, Paris, France
| | | | - S Hitier
- Statistics, Sanofi, Chilly-Mazarin, France
| | - P Rougier
- Digestive Oncology, Universite Paris-V European Hospital Georges Pompidou, APHP, Paris, France
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Al-Batran S, Van Cutsem E, Oh Sang C, Bodoky G, Shimada Y, Hironaka S, Sugimoto N, Lipatov O, Kim T, Cunningham D, Rougier P, Muro K, Liepa A, Ballal S, Emig M, Ohtsu A, Wilke H. Rainbow: Global, Phase 3, Randomized, Double-Blind Study of Ramucirumab Plus Paclitaxel vs Placebo Plus Paclitaxel Patients with Previously Treated Gastric or Gastroesophageal Junction Adenocarcinoma – Patient-Reported Outcomes and Performance Status. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu193.16] [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: 11/13/2022] Open
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Seufferlein T, Van Laethem J, Van Cutsem E, Berlin J, Büchler M, Cervantes A, Haustermans K, Hidalgo M, O'Reilly E, Verslype C, Schmiegel W, Rougier P. The management of locally advanced pancreatic cancer: European Society of Digestive Oncology (ESDO) expert discussion and recommendations from the 14th ESMO/World Congress on Gastrointestinal Cancer, Barcelona. Ann Oncol 2014; 25:ii1-ii4. [DOI: 10.1093/annonc/mdu163] [Citation(s) in RCA: 3] [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: 08/30/2023] Open
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Munoz F, Salmochi J, Rougier P. Effects of lumbar orthosis on postural control strategies in subacute low back pain. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Andriantsifanetra C, Tasseel-Ponche S, Provost C, Rougier P, Yelnik A. Influence de deux modalités de privation visuelle sur la marche chez le sujet sain. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.638] [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: 11/30/2022]
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Pellerin O, Pernot S, Rougier P, Taieb J, Sapoval M. Irinotecan drug eluted beads as a closure treatment for controlled liver colorectal cancer metastases after more than 2 systemic chemotherapy regiments. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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21
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Sorbye H, Mauer M, Gruenberger T, Glimelius B, Poston G, Rougier P, Schlag P, Bechstein W, Primrose J, Walpole E, Nordlinger B. PG 8.3 Recurrence patterns after resection of liver metastases. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70030-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cusin E, Rougier P, Do MC. Rôle de la mobilité du complexe pelvo-lombaire dans l’initiation de la marche. Neurophysiol Clin 2014. [DOI: 10.1016/j.neucli.2013.10.091] [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: 11/27/2022] Open
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Andriantsifanetra C, Calvalido A, Szmatula E, Tasseel-Ponche S, Rougier P, Yelnik A. Influence of two modes of visual deprivation on postural stability and gait in healthy subjects. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.359] [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: 10/26/2022]
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Andriantsifanetra C, Calvalido A, Szmatula E, Tasseel-Ponche S, Rougier P, Yelnik A. Influence de deux modalités de privation visuelle sur l’équilibre et la marche chez le sujet sain. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Verslype C, Van Cutsem E, Dicato M, Arber N, Berlin J, Büchler M, Cervantes A, Ciardiello F, Ducreux M, Douillard J, Grothey A, Haller D, Haustermans K, Heinemann V, Hidalgo M, Labianca R, Li J, Marshall J, Nordlinger B, O'Reilly E, Roth A, Rougier P, Ryan D, Schmiegel W, Seufferlein T, Schmoll H, Sobrero A, Tabernero J, Tempero M, Van Laethem J, Ychou M, Zalcberg J. The management of metastatic pancreatic cancer: expert discussion and recommendations from the 14th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2012. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Mansencal N, Mitry E, Rougier P, Dubourg O. Is echocardiographic follow-up of importance in patients presenting with carcinoid tumor and carcinoid syndrome? Arch Cardiovasc Dis 2013. [DOI: 10.1016/j.acvd.2013.03.039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pénichoux J, Michiels S, Bouché O, Etienne PL, Texereau P, Auby D, Rougier P, Ducreux M, Pignon JP. Taking into account successive treatment lines in the analysis of a colorectal cancer randomised trial. Eur J Cancer 2013; 49:1882-8. [PMID: 23490654 DOI: 10.1016/j.ejca.2013.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 02/13/2012] [Revised: 12/13/2012] [Accepted: 02/05/2013] [Indexed: 11/19/2022]
Abstract
The FFCD 2000-05 randomised trial included 410 patients with advanced colorectal cancer and compared a sequential arm S treated with 5-fluorouracil and leucovorin (LV5FU2) followed by FOLFOX (LV5FU2+oxaliplatin) and then FOLFIRI (LV5FU2+irinotecan) and a combination arm C that begins directly with FOLFOX followed by FOLFIRI. The first aim of this study was to analyse the prognostic effects on overall survival of disease progression, and of toxicities under first-line therapy. We also studied the benefit of introducing irinotecan in each arm. Finally, we compared the effect of treatment on repeated progression and toxicities. For this purpose, we used Cox regression models with time-dependent variables and shared gamma frailty regression models. We found that early on during follow-up, the prognostic effect on survival of progression under first-line therapy was greater in C (hazard ratio [HR]=18.0 [7.9-41.2]) than in S (HR=7.7 [3.9-17.4]). This difference was significant, but it decreased over time. The prognostic effect of severe toxicities was greater in S (HR=2.0 [1.4-2.9]) than in C (HR=1.3 [0.9-1.9]). Introducing irinotecan was significantly more beneficial in S (HR=0.2 [0.1-0.4]) than in C (HR=0.3 [0.2-1.5]). The risk of repeated progression was not significantly different between the two groups (HR=0.9 [0.8-1.1]) whereas the risk of toxicities was greater in C (HR=1.7 [1.4-2.1]). Overall, this study suggests that starting with less toxic first-line treatment is a valid option since it does not exert a deleterious effect on the risk of overall progression or death.
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Affiliation(s)
- J Pénichoux
- Biostatistics and Epidemiology Unit, Institut de Cancérologie Gustave Roussy, Villejuif, France
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Seufferlein T, Bachet JB, Van Cutsem E, Rougier P. Pancreatic adenocarcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 23 Suppl 7:vii33-40. [PMID: 22997452 DOI: 10.1093/annonc/mds224] [Citation(s) in RCA: 246] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- T Seufferlein
- Department of Internal Medicine I, University of Ulm, Ulm, Germany
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Verslype C, Rosmorduc O, Rougier P. Hepatocellular carcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 23 Suppl 7:vii41-8. [PMID: 22997453 DOI: 10.1093/annonc/mds225] [Citation(s) in RCA: 273] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- C Verslype
- Department of Hepatology, University Hospitals Leuven, Leuven, Belgium
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Rougier P, Boudrahem S. Interaction entre l’asymétrie posturale et les effets induits par la technique de feedback visuel chez des sujets sains. Neurophysiol Clin 2012. [DOI: 10.1016/j.neucli.2012.09.089] [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: 10/27/2022] Open
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Munoz F, Fayolle-Minon I, Calmels P, Rougier P. Effet d’une orthèse lombaire semi-rigide sur les mouvements du tronc au cours de la marche du patient lombalgique. Neurophysiol Clin 2012. [DOI: 10.1016/j.neucli.2012.09.087] [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: 11/26/2022] Open
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Pérennou D, Rougier P. Les patients hémiparétiques utilisent davantage que les sujets normaux leurs muscles proximaux pour contrôler leur équilibre debout. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.261] [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: 10/27/2022]
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Köhne CH, Bokemeyer C, Folprecht G, Sartorius U, Schlichting M, Rougier P, Van Cutsem E. Chemotherapy Plus Cetuximab in Patients with Colorectal Metastases Grouped by Site: A Pooled Analysis of the Crystal and OPUS Studies. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32037-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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34
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Munoz MF, Salmochi JF, Rougier P, Calmels P, Badel P, Molimard J, Avril S. New non-invasive and patient-specific method allowing intradiscal pressure change measurement induced by lumbar conservative or surgical treatments. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.707] [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: 11/16/2022]
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35
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Pérennou D, Rougier P. Hemiparetics use more their proximal muscles for controlling the upright stance than healthy subjects do. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.268] [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: 10/27/2022]
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Munoz MF, Salmochi JF, Badel P, Rougier P, Calmels P, Molimard J, Avril S. Modification de la pression intradiscale induite par une orthèse lombaire. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.697] [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: 10/27/2022]
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Munoz MF, Salmochi JF, Rougier P, Calmels P, Badel P, Molimard J, Avril S. Nouvelle méthode non invasive et personnalisée de mesure des changements de pression intradiscale induits par un traitement conservateur ou chirurgical lombaire. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.698] [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: 10/27/2022]
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Yamazaki K, Ohtsu A, Yoshino T, Yoshida M, Grothey A, T.abernero J, Rougier P, Ballal S, Crane H, Yoshizuka N, Nasroulah F, Rutstein M. A Randomized, Double-Blind, Phase (PH) III Study of Folfiri Plus Ramucirumab (RAM) or Placebo (PL) in Patients (Patients) with Metastatic Colorectal Carcinoma (MCRC) Progressed During or Following 1st-Line Therapy with Bevacizumab (BEV), Oxaliplatin (OXALI), and a Fluoropyrimidine (FP) (RAISE) (NCT01183780). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)31973-6] [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: 10/25/2022] Open
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Bachet JB, Maréchal R, Demetter P, Bonnetain F, Couvelard A, Svrcek M, Bardier-Dupas A, Hammel P, Sauvanet A, Louvet C, Paye F, Rougier P, Penna C, Vaillant JC, André T, Closset J, Salmon I, Emile JF, Van Laethem JL. Contribution of CXCR4 and SMAD4 in predicting disease progression pattern and benefit from adjuvant chemotherapy in resected pancreatic adenocarcinoma. Ann Oncol 2012; 23:2327-2335. [PMID: 22377565 DOI: 10.1093/annonc/mdr617] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [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: 12/14/2022] Open
Abstract
BACKGROUND Prognosis of patients with pancreatic adenocarcinoma is poor. Many prognostic biomarkers have been tested, but most studies included heterogeneous patients. We aimed to investigate the prognostic and/or predictive values of four relevant biomarkers in a multicentric cohort of patients. PATIENTS AND METHODS A total of 471 patients who had resected pancreatic adenocarcinoma were included. Using tissue microarray, we assessed the relationship of biomarker expressions with the overall survival: Smad4, type II TGF-β receptor, CXCR4, and LKB1. RESULTS High CXCR4 expression was found to be the only independent negative prognostic biomarker [hazard ratio (HR) = 1.74; P < 0.0001]. In addition, it was significantly associated with a distant relapse pattern (HR = 2.19; P < 0.0001) and was the strongest prognostic factor compared with clinicopathological factors. In patients who did not received adjuvant treatment, there was a trend toward decrease in the overall survival for negative Smad4 expression. Loss of Smad4 expression was not correlated with recurrence pattern but was shown to be predictive for adjuvant chemotherapy (CT) benefit (HR = 0.59; P = 0.002). CONCLUSIONS CXCR4 is a strong independent prognostic biomarker associated with distant metastatic recurrence and appears as an attractive target to be evaluated in pancreatic adenocarcinoma. Negative SMAD4 expression should be considered as a potential predictor of adjuvant CT benefit.
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Affiliation(s)
- J B Bachet
- Medical University Pierre et Marie Curie, UFR Paris VI, Paris; EA4340 "Epidémiologie et oncogènes des tumeurs digestives", Versailles Saint-Quentin-en-Yvelines University, Versailles; Department of Hepato-Gastroenterology, Pitié-Salpêtrière Hospital, APHP, Paris, France; Department of Gastroenterology, Gastrointestinal cancer Unit, Erasme Hospital, Université Libre de Bruxelles, Brussels.
| | - R Maréchal
- Department of Gastroenterology, Gastrointestinal cancer Unit, Erasme Hospital, Université Libre de Bruxelles, Brussels
| | - P Demetter
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles, and DiaPath, Brussels, Belgium
| | - F Bonnetain
- Department of Biostatistic and Epidemiology (EA 4184), Georges François Leclerc Center, Dijon
| | - A Couvelard
- Department of Pathology, Beaujon Hospital, APHP, Clichy
| | - M Svrcek
- Medical University Pierre et Marie Curie, UFR Paris VI, Paris; Department of Pathology, Saint Antoine Hospital, APHP, Paris
| | - A Bardier-Dupas
- Medical University Pierre et Marie Curie, UFR Paris VI, Paris; Department of Pathology, Pitié-Salpêtrière Hospital, APHP, Paris
| | - P Hammel
- Department of Gastroenterology, Beaujon Hospital, APHP, Clichy
| | - A Sauvanet
- Department of Surgery, Beaujon Hospital, APHP, Clichy
| | - C Louvet
- Medical University Pierre et Marie Curie, UFR Paris VI, Paris; Department of Oncology, Saint Antoine Hospital, APHP, Paris; Department of Oncology, Institut Mutualiste Montsouris, Paris
| | - F Paye
- Medical University Pierre et Marie Curie, UFR Paris VI, Paris; Department of Surgery, Saint Antoine Hospital, APHP, Paris
| | - P Rougier
- EA4340 "Epidémiologie et oncogènes des tumeurs digestives", Versailles Saint-Quentin-en-Yvelines University, Versailles; Department of Digestive Oncology, European Georges Pompidou Hospital, APHP, Paris
| | - C Penna
- EA4340 "Epidémiologie et oncogènes des tumeurs digestives", Versailles Saint-Quentin-en-Yvelines University, Versailles; Department of Surgery, Ambroise Paré Hospital, APHP, Boulogne-Billancourt
| | - J C Vaillant
- Medical University Pierre et Marie Curie, UFR Paris VI, Paris; Department of Surgery, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - T André
- Medical University Pierre et Marie Curie, UFR Paris VI, Paris; Department of Hepato-Gastroenterology, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - J Closset
- Department of Surgery, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - I Salmon
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles, and DiaPath, Brussels, Belgium
| | - J F Emile
- EA4340 "Epidémiologie et oncogènes des tumeurs digestives", Versailles Saint-Quentin-en-Yvelines University, Versailles; Department of Pathology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt, France
| | - J L Van Laethem
- Department of Gastroenterology, Gastrointestinal cancer Unit, Erasme Hospital, Université Libre de Bruxelles, Brussels
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Levi F, Boige V, Rougier P, Hebbar M, Smith D, Focan C, Guimbaud R, Carvalho C, Bouchahda M, Ducreux M. Safety and Efficacy of Intravenous Cetuximab (CET) and Hepatic Artery Infusion of Irinotecan, 5-Fluorouracil and Oxaliplatin in Patients with Unresectable Liver Metastases from Wt Kras Colorectal Cancer (CRC): Results from Optiliv European Phase II Trial. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33179-3] [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: 11/27/2022] Open
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Taieb J, Tabernero J, Mini E, Subtil F, Folprecht G, Van Laethem J, Thaler J, Bridgewater J, Van Cutsem E, Rougier P, Collette L, Praet M, Schneider M, Bouché O, Lepage C, Girault C, Emile J, Laurent-Puig P, Bedenne L. Adjuvant Folfox4 with or without Cetuximab (CTX) in Patients (PTS) with Resected Stage III Colon Cancer (CC): Dfs and OS Results and Subgroup Analyses of the PETACC8 Intergroup Phase III Trial. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34317-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Rougier P. PG 10.03 Lessons from the GASTRIC metaanalysis of adjuvant treatment. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70033-3] [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: 10/28/2022]
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Salmochi JF, de-Mauroy JC, Rougier P, Munoz F. Traitement de la lombalgie chronique par orthèse de correction posturale sagittale (LORDACTIV). Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.254] [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: 10/17/2022]
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Van Cutsem E, Dicato M, Geva R, Arber N, Bang Y, Benson A, Cervantes A, Diaz-Rubio E, Ducreux M, Glynne-Jones R, Grothey A, Haller D, Haustermans K, Kerr D, Nordlinger B, Marshall J, Minsky BD, Kang YK, Labianca R, Lordick F, Ohtsu A, Pavlidis N, Roth A, Rougier P, Schmoll HJ, Sobrero A, Tabernero J, Van de Velde C, Zalcberg J. The diagnosis and management of gastric cancer: expert discussion and recommendations from the 12th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2010. Ann Oncol 2011; 22 Suppl 5:v1-9. [PMID: 21633049 DOI: 10.1093/annonc/mdr284] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Well-recognized experts in the field of gastric cancer discussed during the 12th European Society Medical Oncology (ESMO)/World Congress Gastrointestinal Cancer (WCGIC) in Barcelona many important and controversial topics on the diagnosis and management of patients with gastric cancer. This article summarizes the recommendations and expert opinion on gastric cancer. It discusses and reflects on the regional differences in the incidence and care of gastric cancer, the definition of gastro-esophageal junction and its implication for treatment strategies and presents the latest recommendations in the staging and treatment of primary and metastatic gastric cancer. Recognition is given to the need for larger and well-designed clinical trials to answer many open questions.
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Affiliation(s)
- E Van Cutsem
- University Hospital Gasthuisberg, Leuven, Belgium.
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Barhoumi M, Mornex F, Bonnetain F, Rougier P, Mariette C, Bouché O, Bosset JF, Aparicio T, Mineur L, Azzedine A, Hammel P, Butel J, Stremsdoerfer N, Maingon P, Bedenne L, Chauffert B. Cancer du pancréas localement évolué non resécable : chimioradiothérapie d’induction suivie de chimiothérapie par gemcitabine contre chimiothérapie exclusive par gemcitabine : résultats définitifs de l’étude de phase III 2000–2001de la FFCD et de la SFRO. Cancer Radiother 2011; 15:182-91. [DOI: 10.1016/j.canrad.2010.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 08/22/2010] [Accepted: 10/01/2010] [Indexed: 01/12/2023]
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Maréchal R, Bachet J, Mackey JR, Demetter P, Graham K, Couvelard A, Svrcek M, Bardier A, Hammel P, Sauvanet A, Louvet C, Paye F, Rougier P, Hannoun L, Andre T, Dumontet CM, Cass CE, Salmon I, Emile J, Van Laethem J. Prediction of gemcitabine benefit after curative-intent resection of pancreatic adenocarcinoma using HENT1 and dCK protein expression. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4024] [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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Kohne C, Bokemeyer C, Heeger S, Sartorius U, Rougier P, Van Cutsem E. Efficacy of chemotherapy plus cetuximab according to metastatic site in KRAS wild-type metastatic colorectal cancer (mCRC): Analysis of CRYSTAL and OPUS studies. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3576] [Citation(s) in RCA: 13] [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: 11/20/2022] Open
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Van Cutsem E, Boni C, Tabernero J, Massuti B, Richards DA, Prenen H, Steinberg I, Rougier P. Randomized phase II study (GATE study) of docetaxel plus oxaliplatin with or without fluorouracil or capecitabine in metastatic or locally recurrent gastric cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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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Ducreux M, Rougier P, Smith D, Focan CNJ, Innominato PF, Bouchahda M, Ajavon Y, Castaing D, De Baere T, Karaboué A, Lepere C, Boige V, Adam R, Levi F. Safety and efficacy of neoadjuvant combination of hepatic artery infusion (HAI) of irinotecan, 5-fluorouracil, and oxaliplatin with intravenous (iv) cetuximab in patients with unresectable liver metastases from colorectal cancer (CRC): Interim report from OPTILIV—A European multicenter phase II trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14102] [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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Van Cutsem E, Bokemeyer C, Heeger S, Sartorius U, Rougier P, Kohne C. Outcome according to metastatic site in patients with KRAS wild-type tumors: Analysis from the CRYSTAL and OPUS studies. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.472] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
472 Background: The randomized CRYSTAL and OPUS studies showed that adding cetuximab (cet) to first-line chemotherapy (CT) significantly improved clinical benefit in patients (pts) with KRAS wild-type (wt) metastatic colorectal cancer (mCRC). R0 resection of colorectal liver metastases is a potentially curative option in this setting. In this descriptive analysis of these trials the benefit of adding cet to CT according to metastatic site was investigated. Methods: KRAS wt pts were grouped according to liver-limited disease (LLD) and those with other metastatic sites (non-LLD). Treatment arms were compared for response rates (RR), R0 resection rates (R0R), progression-free (PFS) and overall survival (OS). Results: The proportion of patients with LLD was comparable in each study and treatment arm (21%-30%). For most efficacy endpoints, pts with LLD derived greater benefit from CT alone or cet + CT compared with pts with non-LLD (Table). The highest R0R were seen in pts with LLD receiving cet + CT; increasing 2.3 and 3.7 fold from CT alone in the CRYSTAL and OPUS studies respectively. In pts with non-LLD adding cet to CT increased median OS by 5.1 and 3.4 months in the CRYSTAL and OPUS studies respectively (Table). Conclusions: The addition of cet to standard CT increases the R0R, RR, PFS and prolongs OS in first-line mCRC in KRAS wt pts, regardless of LLD. In pts with non- LLD treated with cet and FOLFIRI median OS was prolonged by more than 5 months. [Table: see text] [Table: see text]
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Affiliation(s)
- E. Van Cutsem
- University Hospital Gasthuisberg, Leuven, Belgium; Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; Global Clinical Development Unit, Oncology, Merck KGaA, Darmstadt, Germany; European Hospital George Pompidou, Paris, France; Onkologie Klinikum Oldenburg, Oldenburg, Germany
| | - C. Bokemeyer
- University Hospital Gasthuisberg, Leuven, Belgium; Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; Global Clinical Development Unit, Oncology, Merck KGaA, Darmstadt, Germany; European Hospital George Pompidou, Paris, France; Onkologie Klinikum Oldenburg, Oldenburg, Germany
| | - S. Heeger
- University Hospital Gasthuisberg, Leuven, Belgium; Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; Global Clinical Development Unit, Oncology, Merck KGaA, Darmstadt, Germany; European Hospital George Pompidou, Paris, France; Onkologie Klinikum Oldenburg, Oldenburg, Germany
| | - U. Sartorius
- University Hospital Gasthuisberg, Leuven, Belgium; Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; Global Clinical Development Unit, Oncology, Merck KGaA, Darmstadt, Germany; European Hospital George Pompidou, Paris, France; Onkologie Klinikum Oldenburg, Oldenburg, Germany
| | - P. Rougier
- University Hospital Gasthuisberg, Leuven, Belgium; Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; Global Clinical Development Unit, Oncology, Merck KGaA, Darmstadt, Germany; European Hospital George Pompidou, Paris, France; Onkologie Klinikum Oldenburg, Oldenburg, Germany
| | - C. Kohne
- University Hospital Gasthuisberg, Leuven, Belgium; Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; Global Clinical Development Unit, Oncology, Merck KGaA, Darmstadt, Germany; European Hospital George Pompidou, Paris, France; Onkologie Klinikum Oldenburg, Oldenburg, Germany
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