1
|
Brahmi M, Lesluyes T, Dufresne A, Toulmonde M, Italiano A, Mir O, Le Cesne A, Valentin T, Chevreau C, Bonvalot S, Penel N, Coindre JM, Le Guellec S, Le Loarer F, Karanian M, Blay JY, Chibon F. Expression and prognostic significance of PDGF ligands and receptors across soft tissue sarcomas. ESMO Open 2021; 6:100037. [PMID: 33524869 PMCID: PMC7848659 DOI: 10.1016/j.esmoop.2020.100037] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/06/2020] [Accepted: 12/13/2020] [Indexed: 11/28/2022] Open
Abstract
Background While the anti-PDGFRA antibody olaratumab failed to confirm an impact on survival in unselected advanced soft tissue sarcoma (STS) patients, the level of expression and the prognosis of platelet-derived growth factor (PDGF) receptors and ligands in STS remain unclear. Patients and methods We analyzed PDGF ligands and receptors' expression levels in a series of 255 patients with different histologies of STS [gastrointestinal stromal tumor (GIST), myxoid liposarcoma (MLPS), sarcoma with complex genomics, synovial sarcoma (SyS)] with Agilent single-color micro-arrays. We explored expression levels as prognostic values in univariate and multivariate analysis using R software (version 3.4.2). Results Complex patterns of correlation of expression between ligands and receptors were observed for each histotype. PDGFA levels were highest in SyS and lowest in MLPS (P < 4 × 10−9), PDGFB and C levels were lower in GIST (P < 2 × 10−15 and P < 3 × 10−9) while PDGFD expression was similar across histological subtypes. PDGF receptor (PDGFR) A expression was lowest in MLPS (P < 0.002), whereas PDGFRB and L expressions were lowest in GIST and SyS (P < 0.0004). Interestingly, high PDGFA expression levels were associated with higher risk of metastasis (P = 0.006), whereas PDGFD levels above average were associated with a reduced risk of metastasis (P = 0.01) in univariate and multivariate analysis. Conclusions The expression of PDGF ligands and receptors varies across sarcoma histological subtypes. PDGFA and D expression levels independently and inversely correlate with the risk of metastatic relapse. The expression of PDGF ligands and receptors substantially varies across sarcoma histological subtypes. PDGFA and D expression levels independently and inversely correlate with the risk of metastatic relapse. The differential expression of ligands might be used as biomarker of efficacy for PDGFRα antibodies in STS.
Collapse
Affiliation(s)
- M Brahmi
- Centre Léon Bérard, Lyon, France.
| | - T Lesluyes
- University of Bordeaux, Bordeaux, France; Inserm U1218, Institut Bergonié, Bordeaux, France; Inserm UMR1037, Cancer Research Center of Toulouse, Toulouse, France; Institut Claudius Regaud, Toulouse, France
| | | | - M Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - O Mir
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - A Le Cesne
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - T Valentin
- Institut Claudius Regaud, Toulouse, France
| | - C Chevreau
- Institut Claudius Regaud, Toulouse, France
| | - S Bonvalot
- Department of Medical Oncology, Institut Curie, Paris, France
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | | | | | - F Le Loarer
- Inserm U1218, Institut Bergonié, Bordeaux, France
| | | | - J-Y Blay
- Centre Léon Bérard, Lyon, France; Université Claude Bernard, Lyon, France
| | - F Chibon
- Inserm UMR1037, Cancer Research Center of Toulouse, Toulouse, France; Institut Claudius Regaud, Toulouse, France
| |
Collapse
|
2
|
Dufresne A, Lesluyes T, Ménétrier-Caux C, Brahmi M, Darbo E, Toulmonde M, Italiano A, Mir O, Le Cesne A, Le Guellec S, Valentin T, Chevreau C, Bonvalot S, Robin YM, Coindre JM, Caux C, Blay JY, Chibon F. Specific immune landscapes and immune checkpoint expressions in histotypes and molecular subtypes of sarcoma. Oncoimmunology 2020; 9:1792036. [PMID: 32923153 PMCID: PMC7458655 DOI: 10.1080/2162402x.2020.1792036] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Soft tissue sarcomas are a group of rare and aggressive connective tissue neoplasms for which curative therapeutic opportunities are limited in advanced phase. Clinical trials assessing immunotherapy in these tumors have so far reported limited efficacy. The objective of this study is to provide a description of the immunologic landscape of sarcomas to guide the next clinical trials of immunotherapy in these diseases. The gene expression profile of 93 immune checkpoint (ICP) and membrane markers (MM) of immune cells was analyzed in a series of 253 soft tissue sarcoma (synovial sarcoma, myxoid liposarcoma, sarcoma with complex genomic and GIST) using Agilent Whole Human Genome Microarrays. The unsupervised hierarchical clustering of gene expression level was found able to properly group patients according to the histological subgroup of sarcoma, indicating that each sarcoma subgroup is associated with a specific immune signature defined by its gene expression pattern. Using the prognostic impact of CIBERSORT signature on metastatic-free survival in each subgroup, specific target could be proposed for each of the four groups: Treg through ICOS and GITR in GIST, M0 macrophages in all four sarcoma subtypes, OX40 in SS, CD40 in GIST and SS. The immune landscape of sarcoma was found to be as heterogeneous as the histotypes and molecular subtypes, but strongly correlated to the histotype. Histotype adapted immunotherapeutic approaches in each sarcoma subtypes must be considered in view of these results, consistently with the already reported specific response of histotypes of ICPs.
Collapse
Affiliation(s)
- A Dufresne
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - T Lesluyes
- University of Bordeaux, Bordeaux, France.,Inserm U1218, Institut Bergonié, Bordeaux, France.,Inserm UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | - C Ménétrier-Caux
- Inserm U1052, CNRS 5286, Cancer Research Center of Lyon, Université Claude Bernard Lyon 1, Bordeaux, France
| | - M Brahmi
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - E Darbo
- University of Bordeaux, Bordeaux, France.,Inserm U1218, Institut Bergonié, Bordeaux, France.,Bordeaux Bioinformatics Center (BCIB), Bordeaux, France
| | - M Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - O Mir
- Department of Ambulatory Care, Institut Gustave Roussy, Villejuif, France
| | - A Le Cesne
- Department of Cancer Medicine, Institut Gustave Roussy, Villejuif, France
| | - S Le Guellec
- Inserm UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Department of Pathology, Institut Claudius Regaud, Toulouse, France
| | - T Valentin
- Inserm UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | - C Chevreau
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | - S Bonvalot
- Department of Surgery, Institut Curie, Bordeaux, France
| | - Y M Robin
- Department of Pathology, Centre Oscar Lambret, Lille, France
| | - J-M Coindre
- University of Bordeaux, Bordeaux, France.,Department of Pathology, Institut Bergonié, Bordeaux, France
| | - C Caux
- Inserm U1052, CNRS 5286, Cancer Research Center of Lyon, Université Claude Bernard Lyon 1, Bordeaux, France
| | - J Y Blay
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France.,Inserm U1052, CNRS 5286, Cancer Research Center of Lyon, Université Claude Bernard Lyon 1, Bordeaux, France
| | - F Chibon
- Inserm UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| |
Collapse
|
3
|
Valentin T, Lesluyes T, Le Guellec S, Chibon F. Chemotherapy in localized soft tissue sarcoma: will we soon have to treat grade 1 tumors? Update on CINSARC performances. Ann Oncol 2019; 30:153-155. [PMID: 30335133 DOI: 10.1093/annonc/mdy465] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Valentin
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse; INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse.
| | - T Lesluyes
- INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse; INSERM U1218, Institut Bergonié, Bordeaux; University of Bordeaux, Bordeaux
| | - S Le Guellec
- INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse; Department of Pathology, Institut Claudius Regaud, Toulouse, France
| | - F Chibon
- INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse; Department of Pathology, Institut Claudius Regaud, Toulouse, France
| |
Collapse
|
4
|
Le Guellec S, Lesluyes T, Sarot E, Valle C, Filleron T, Rochaix P, Valentin T, Pérot G, Coindre JM, Chibon F. Validation of the Complexity INdex in SARComas prognostic signature on formalin-fixed, paraffin-embedded, soft-tissue sarcomas. Ann Oncol 2018; 29:1828-1835. [DOI: 10.1093/annonc/mdy194] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
|
5
|
Penel N, Coindre JM, Giraud A, Terrier P, Ranchere-Vince D, Collin F, Le Guellec S, Bazille C, Lae M, De Pinieux G, Ray-Coquard I, Bonvalot S, Le Cesne A, Robin YM, Stoeckle E, Ducimetiere F, Toulmonde M, Blay JY. Adult Translocation-related soft tissue sarcomas (TRS): Presentation, management and outcome of 2,143 cases confirmed by expert pathologists. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx387.005] [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
|
6
|
Roché HH, Lafouresse FF, Filleron T, Laffont R, Maisongrosse V, Pichery M, Le Guellec S, Penault-Llorca F, Lemonnier J, Lacroix-Triki M, Girard JP. Abstract P6-09-05: Prognostic and predictive values of high endothelial venules (HEV) and tumor infiltrating CD8+ lymphocytes (CD8) in tumors of patients included in the adjuvant PACS04 trial: HEV is predictive of outcome for HER2+ tumors exposed to trastuzumab. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-09-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: HEV are specialized blood vessels that function as portals of entry for lymphocytes into lymphoid organs and tumor tissues (Moussion and Girard, Nature 2011, 479:542-546; Girard et al, Nature Rev Immunol 2012, 12:762-773). We retrospectively considered HEV and CD8 as potential prognostic and/or predictive factors in a large randomized adjuvant trial of node positive breast cancer patients (PACS04). This trial included 3010 node positive patients randomized between anthracyclins alone or anthracyclins and docetaxel chemotherapy. Patients with HER2+ expressing tumors had a second randomization with or without trastuzumab given sequentially for one year. With 59.5 median follow-up, metastatic free interval (MFI), the first end-point, was 84.5% at 5 years for the whole population.
Methods: 1660 tumor samples (9.7% triple negative, 67.5% HR+/HER2- and 22.8% HER2+) were collected and analyzed by immunostaining on full sections for HEV (MECA-79 mAb, BD Biosciences) and CD8 (C8/144B mAb, Dako). HEV densities were determined as previously described (Martinet et al., Cancer Res 2011, 71:5678-5687). CD8+ cells and tumor-infiltrating lymphocytes (TIL) were scored according to recently published guidelines. Univariate analyses were performed using cox proportional hazard model for continuous variable. Independent analyses for the predictive evaluation of trastuzumab outcome were performed in the HER2+ subgroup.
Results: MFI and overall survival at 5 years for this series are respectively of 84.9% (TN: 77.4%, HR+/HER2-: 89%, HER2+:75.8%) and 91% not different with the total group. The table shows expression of the different markers according to the subgroup of tumors.
Marker values according to sub molecular classification TNRH+/HER2-HER2+/RH-Number1601119378Metastatic events3411990HEV/mm2(median,range)0.51 (0, 7.73)0.13 (0, 10.23)0.38 (0, 13.63)CD8score (median, range)2 (0, 3)1 (0, 3)2 (0, 3)Table 1
No difference in univariate analysis was observed in TN and HR+/HER2- subgroups in terms of relationship between marker expression and outcomes. For the HER2+ group, HEV and CD8 were correlated to better outcome (HEV: HR=0.73, p =0.011; CD8: HR=0.64; p=0.006). For HER2+ patients not receiving trastuzumab (222 pts, 55 events), CD8 was predictive of metastasis risk (HR: 0.65, p=0.032), but not HEV (HR:0.82, p=0.09). Conversely, in the trastuzumab treated group (156 pts, 35 events), HEV was significantly correlated with a lower risk of relapse (HR: 0.45, p=0.02), but CD8 was not (HR:0.63, p=0.07). TIL counts are still ongoing and will be reported at time of presentation.
Conclusions: HEV and CD8 are associated with better prognosis in the HER2+ tumor group. Interestingly, HEV presence in the tumor seems to be a significant predictive factor of trastuzumab efficacy.
Citation Format: Roché HH, Lafouresse FF, Filleron T, Laffont R, Maisongrosse V, Pichery M, Le Guellec S, Penault-Llorca F, Lemonnier J, Lacroix-Triki M, Girard J-P. Prognostic and predictive values of high endothelial venules (HEV) and tumor infiltrating CD8+ lymphocytes (CD8) in tumors of patients included in the adjuvant PACS04 trial: HEV is predictive of outcome for HER2+ tumors exposed to trastuzumab [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-05.
Collapse
Affiliation(s)
- HH Roché
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - FF Lafouresse
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - T Filleron
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - R Laffont
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - V Maisongrosse
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - M Pichery
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - S Le Guellec
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - F Penault-Llorca
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - J Lemonnier
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - M Lacroix-Triki
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| | - J-P Girard
- Institut Claudius Regaud - IUCT-O, Toulouse, France; IPBS-CNRS Université, Toulouse, France; Centre Jean Perrin, Clermont-Ferrand, France; R&D Unicancer, Paris, France
| |
Collapse
|
7
|
Ducassou A, Valentin T, Filleron T, Delannes M, Ferron G, Le Guellec S, Rochaix P, Boulet B, Chevreau C. EP-1408: Adjuvant concurrent chemoradiotherapy in soft tissue sarcomas of the limbs: an effective strategy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32658-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
8
|
Le Guellec S. Biologie moléculaire dans le diagnostic des tumeurs des tissus mous et de l’os et apport au pronostic des sarcomes. ONCOLOGIE 2016. [DOI: 10.1007/s10269-016-2608-6] [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: 11/25/2022]
|
9
|
Valentin T, Le Cesne A, Ray-Coquard I, Italiano A, Decanter G, Bompas E, Isambert N, Thariat J, Linassier C, Bertucci F, Bay JO, Bellesoeur A, Penel N, Le Guellec S, Filleron T, Chevreau C. Management and prognosis of malignant peripheral nerve sheath tumors: The experience of the French Sarcoma Group (GSF-GETO). Eur J Cancer 2016; 56:77-84. [PMID: 26824706 DOI: 10.1016/j.ejca.2015.12.015] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 12/12/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Malignant peripheral nerve sheath tumors (MPNST) are a rare subtype of soft tissue sarcoma. They can arise in irradiated fields, in patients with type 1 neurofibromatosis (NF1), or sporadically. MPNST exhibit an aggressive behaviour, and their optimal management remains controversial. An unsolved issue is whether NF1-related and sporadic forms of MPNST have a different prognosis, and should be managed differently. MATERIAL AND METHODS Adult and paediatric patients with histologically confirmed MPNST treated between 1990 and 2013 in French cancer centres of the GSF/GETO network, were included in this retrospective study. RESULTS A total of 353 patients (37% with NF1 and 59% with sporadic tumours) were analysed. Median age at diagnosis was 42 years (range 1-94). The majority of tumours developed in the limbs, were deep-seated and of high grade. Two hundreds and ninety four patients underwent a curative intent surgery. Among them, 60 patients (21%) had neoadjuvant treatment (mainly chemotherapy), and 173 (59%) had adjuvant treatment (mainly radiotherapy). For operated patients, median progression free and overall survival (OS) were 26.3 months and 95.8 months, respectively. In multivariate analysis, poor-prognosis factors for OS were high grade, deep location, locally advanced stage at diagnosis, and macroscopically incomplete resection (R2). NF1 status was not negatively prognostic, except in the recurrence or metastatic setting, where NF1-related MPNST patients treated with palliative chemotherapy showed worse survival than patients with sporadic forms. CONCLUSION To our knowledge, our series is the largest study of patients with MPNST reported to date. For operated patients, we showed a worse prognosis for NF1-related MPNST, due to different clinical features at diagnosis, more than NF1 status itself. The French sarcoma group is now conducting correlative analyses on these patients, using the latest molecular tools.
Collapse
Affiliation(s)
- T Valentin
- Department of Medical Oncology, IUCT-Oncopole, Toulouse, France.
| | - A Le Cesne
- Department of Medical Oncology, Gustave Roussy Institute, Villejuif, France
| | - I Ray-Coquard
- Department of Medical Oncology, Léon Bérard Center, Lyon, France
| | - A Italiano
- Department of Medical Oncology, Bergonié Institute, Bordeaux, France
| | - G Decanter
- Department of Surgery, Oscar Lambret Center, Lille, France
| | - E Bompas
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | - N Isambert
- Department of Medical Oncology, Georges-François Leclerc Center, Dijon, France
| | - J Thariat
- Department of Radiotherapy, Antoine Lacassagne Center, Nice, France
| | - C Linassier
- Department of Medical Oncology, University Hospital, Tours, France
| | - F Bertucci
- Department of Medical Oncology, Paoli-Calmettes Institute, Marseille, France
| | - J O Bay
- Department of Medical Oncology, University Hospital, Clermont-Ferrand, France
| | - A Bellesoeur
- Department of Medical Oncology, Gustave Roussy Institute, Villejuif, France
| | - N Penel
- Department of Surgery, Oscar Lambret Center, Lille, France
| | - S Le Guellec
- Department of Pathology, IUCT-Oncopole, Toulouse, France
| | - T Filleron
- Department of Statistics, IUCT-Oncopole, Toulouse, France
| | - C Chevreau
- Department of Medical Oncology, IUCT-Oncopole, Toulouse, France
| |
Collapse
|
10
|
Khalifa J, Ouali M, Chaltiel L, Le Guellec S, Le Cesne A, Blay JY, Cousin P, Chaigneau L, Bompas E, Piperno-Neumann S, Bui-Nguyen B, Rios M, Delord JP, Penel N, Chevreau C. Efficacy of trabectedin in malignant solitary fibrous tumors: a retrospective analysis from the French Sarcoma Group. BMC Cancer 2015; 15:700. [PMID: 26472661 PMCID: PMC4608145 DOI: 10.1186/s12885-015-1697-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 10/07/2015] [Indexed: 12/25/2022] Open
Abstract
Background Advanced malignant solitary fibrous tumors (SFTs) are rare soft-tissue sarcomas with a poor prognosis. Several treatment options have been reported, but with uncertain rates of efficacy. Our aim is to describe the activity of trabectedin in a retrospective, multi-center French series of patients with SFTs. Methods Patients were mainly identified through the French RetrospectYon database and were treated between January 2008 and May 2013. Trabectedin was administered at an initial dose of 1.5 mg/m2, q3 weeks. The best tumor response was assessed according to the Response Evaluation Criteria In Solid Tumors 1.1. The Kaplan–Meier method was used to estimate median progression-free survival (PFS) and overall survival (OS). The growth-modulation index (GMI) was defined as the ratio between the time to progression with trabectedin (TTPn) and the TTP with the immediately prior line of treatment (TTPn-1). Results Eleven patients treated with trabectedin for advanced SFT were identified. Trabectedin had been used as second-line treatment in 8 patients (72.7 %) and as at least third-line therapy in a further 3 (27.3 %). The best RECIST response was a partial response (PR) in one patient (9.1 %) and stable disease (SD) in eight patients (72.7 %). Disease-control rate (DCR = PR + SD) was 81.8 %. After a median follow-up of 29.2 months, the median PFS was 11.6 months (95 % CI = 2.0; 15.2 months) and the median OS was 22.3 months (95 % CI = 9.1 months; not reached). The median GMI was 1.49 (range: 0.11–4.12). Conclusion Trabectedin is a very promising treatment for advanced SFTs. Further investigations are needed.
Collapse
Affiliation(s)
- J Khalifa
- Department of Medical Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1, avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France.
| | - M Ouali
- Department of Statistics, Institut Claudius Regaud / Institut Universitaire du Cancer de Toulouse - Oncopôle, 1, avenue Irène Joliot-Curie, 31059, Toulouse, France.
| | - L Chaltiel
- Department of Statistics, Institut Claudius Regaud / Institut Universitaire du Cancer de Toulouse - Oncopôle, 1, avenue Irène Joliot-Curie, 31059, Toulouse, France.
| | - S Le Guellec
- Department of Pathology, Institut Claudius Regaud / Institut Universitaire du Cancer de Toulouse - Oncopôle, 1, avenue Irène Joliot-Curie, 31059, Toulouse, France.
| | - A Le Cesne
- Department of Medical Oncology, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France.
| | - J-Y Blay
- Department of Medical Oncology, Centre Léon Bérard, 28 Promenade Léa et Napoléon Bullukian, 69008, Lyon, France.
| | - P Cousin
- Department of Medical Oncology, Centre Léon Bérard, 28 Promenade Léa et Napoléon Bullukian, 69008, Lyon, France.
| | - L Chaigneau
- Department of Medical Oncology, Jean Minjoz University Hospital, 3 Boulevard Alexandre Fleming, 25030, Besançon, France.
| | - E Bompas
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Site Hospitalier Nord Boulevard Jacques Monod, 44805, Saint-Herblain, France.
| | - S Piperno-Neumann
- Department of Medical Oncology, Institut Curie, 26 rue d'Ulm, 75248, Paris, France.
| | - B Bui-Nguyen
- Department of Medical Oncology, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France.
| | - M Rios
- Department of Medical Oncology, Centre Alexis Vautrin, 6 Avenue de Bourgogne, 54519, Vandœuvre-lès-Nancy, France.
| | - J-P Delord
- Department of Medical Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1, avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France.
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, 3 Rue Frédéric Combemale, 59000, Lille, France.
| | - C Chevreau
- Department of Medical Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1, avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France.
| |
Collapse
|
11
|
Laval S, Laklai H, Fanjul M, Pucelle M, Laurell H, Billon-Galés A, Le Guellec S, Delisle MB, Sonnenberg A, Susini C, Pyronnet S, Bousquet C. Dual roles of hemidesmosomal proteins in the pancreatic epithelium: the phosphoinositide 3-kinase decides. Oncogene 2014; 33:1934-44. [PMID: 23624916 DOI: 10.1038/onc.2013.146] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 07/27/2012] [Revised: 02/14/2013] [Accepted: 03/11/2013] [Indexed: 02/06/2023]
Abstract
Given the failure of chemo- and biotherapies to fight advanced pancreatic cancer, one major challenge is to identify critical events that initiate invasion. One priming step in epithelia carcinogenesis is the disruption of epithelial cell anchorage to the basement membrane which can be provided by hemidesmosomes (HDs). However, the existence of HDs in pancreatic ductal epithelium and their role in carcinogenesis remain unexplored. HDs have been explored in normal and cancer pancreatic cells, and patient samples. Unique cancer cell models where HD assembly can be pharmacologically manipulated by somatostatin/sst2 signaling have been then used to investigate the role and molecular mechanisms of dynamic HD during pancreatic carcinogenesis. We surprisingly report the presence of mature type-1 HDs comprising the integrin α6β4 and bullous pemphigoid antigen BP180 in the human pancreatic ductal epithelium. Importantly, HDs are shown to disassemble during pancreatic carcinogenesis. HD breakdown requires phosphoinositide 3-kinase (PI3K)-dependent induction of the matrix-metalloprotease MMP-9, which cleaves BP180. Consequently, integrin α6β4 delocalizes to the cell-leading edges where it paradoxically promotes cell migration and invasion through S100A4 activation. As S100A4 in turn stimulates MMP-9 expression, a vicious cycle maintains BP180 cleavage. Inactivation of this PI3K-MMP-9-S100A4 signaling loop conversely blocks BP180 cleavage, induces HD reassembly and inhibits cell invasion. We conclude that mature type-1 HDs are critical anchoring structures for the pancreatic ductal epithelium whose disruption, upon PI3K activation during carcinogenesis, provokes pancreatic cancer cell migration and invasion.
Collapse
Affiliation(s)
- S Laval
- 1] INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France [2] Université Toulouse III Paul Sabatier, Toulouse, France
| | - H Laklai
- 1] INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France [2] Université Toulouse III Paul Sabatier, Toulouse, France
| | - M Fanjul
- 1] INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France [2] Université Toulouse III Paul Sabatier, Toulouse, France
| | - M Pucelle
- INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France
| | - H Laurell
- 1] INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France [2] Université Toulouse III Paul Sabatier, Toulouse, France
| | - A Billon-Galés
- 1] INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France [2] Université Toulouse III Paul Sabatier, Toulouse, France
| | - S Le Guellec
- Services d'Anatomie et Cytologie Pathologique of Hôpital Rangueil, Toulouse, France
| | - M-B Delisle
- Services d'Anatomie et Cytologie Pathologique of Hôpital Rangueil, Toulouse, France
| | - A Sonnenberg
- Department of Cell Biology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Susini
- 1] INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France [2] Université Toulouse III Paul Sabatier, Toulouse, France
| | - S Pyronnet
- 1] INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France [2] Université Toulouse III Paul Sabatier, Toulouse, France
| | - C Bousquet
- 1] INSERM UMR 1037, Laboratoire d'excellence Toulouse Cancer (labex TOUCAN), Equipe labellisée Ligue Nationale Contre le Cancer (LNCC), Centre de Recherche en Cancérologie de Toulouse (CRCT), Toulouse, France [2] Université Toulouse III Paul Sabatier, Toulouse, France
| |
Collapse
|
12
|
Dalenc F, Le Guellec S, Arnould L, Coudert B, Vagner S, Bachelot T, Treilleux I, Debled M, MacGrogan G, Jacot W, Bibeau F, Vanlemmens L, André F, Mathieu MC, Augereau P, Verriele V, Penault-Llorca F, Lacroix-Triki M, Filleron T. Abstract P3-14-13: eIF4E/4EBP1 axis and response to neoadjuvant trastuzumab-based treatment in HER2+ breast cancer – Results of a multicentre French retrospective cohort. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-14-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Despite a growing number of studies exploring the underlying mechanisms, resistance to trastuzumab (TTZ) in HER2+ breast cancer (BC) remains elusive and an important issue in clinical practice. Among the proposed mechanisms, involvement of the PI3K/Akt/mTOR pathway is one of the best characterized. In a previous preclinical and clinical study (n = 54) (Bergé Y et al, SABCS 2009 and [1]), we have shown a significant correlation between eIF4E (a downstream effector of the PI3K/Akt/mTOR pathway) expression level as determined by immunohistochemistry (IHC) on initial tumor biopsy and pathological complete response (pCR) in patients with HER2+ BC treated with a neoadjuvant TTZ-containing regimen. The aim of this study was to validate these findings on an independent and larger cohort of HER2+ BC treated in neoadjuvant setting.
Method
In this multicenter (n = 9) study, 274 patients (pts) with HER2+ BC treated were included. All pts received neoadjuvant chemotherapy regimen containing TTZ, consisting mostly of 3-4 cycles of FEC (5FU, Epirubicin, Cyclophosphamid) followed by 3-4 cycles of TTZ–Docetaxel (n = 116). 74 pts received 6 cycles of TTZ–Docetaxel, 18 received 6 cycles of TTZ–Docetaxel-Cyclophosphamid, 12 received 6 cycles of TTZ–Docetaxel-carbolpatine, and the remaining 54 pts received other regimens. Pathological response was assessed according to Sataloff and Chevallier criteria. Unstained slides from the initial tumor biopsy were centrally collected for biomarkers analysis. Expression levels of eIF4E, p-4EBP1 and pS6 were determined by IHC. An immunoreactive score (IRS) combining the percentage of stained tumor cells and staining intensity was assessed by two pathologists.
Results
Median age at diagnosis was 50 years [range 22–84]. Most pts presented with T2 (52.6%), N1 (53.9%) stage, with a median tumor size of 40mm [range 0-150mm] as determined on clinical examination. Tumors were mainly invasive ductal of no special type (93.8%), of histological grade III (50%) and II (45%), ER+ (54.4%). Breast conserving surgery with free margins was achieved in 50.9% of pts. pCR (breast Sataloff TA) was observed in 53% of pts, and in 47.6% when considering both breast and lymph node response. Out of the 274 pts, 257 had sufficient tumor on the initial biopsy for biomarker analysis. Preliminary results showed a median eIF4E IRS of 6 [range 1-12], with 52.1% of cases displaying a low eIF4E expression level (IRS£6). The agreement for inter-observer assessment of eIF4E status was good (k = 0.618, 95% CI [0.523-0.713]). Scoring of p-4EBP1 and pS6 are ongoing and correlations of pCR with eIF4E/4EBP1 axis will be presented.
Conclusion
In this large multicentre retrospective study, the rate of pCR obtained in neoadjuvant setting of HER2+ BC is similar to those described in the literature. Thorough tumor collection allows biomarkers analysis, which has been specifically focused on downstream effectors of the PI3K/Akt/mTOR pathway.
Reference[1] Zindy P, Bergé Y, Allal B et al. Formation of the eIF4F translation-initiation complex determines sensitivity to anticancer drugs targeting the EGFR and HER2 receptors. Cancer Res. 2011;71(12):4068-73.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-14-13.
Collapse
Affiliation(s)
- F Dalenc
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - S Le Guellec
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - L Arnould
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - B Coudert
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - S Vagner
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - T Bachelot
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - I Treilleux
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - M Debled
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - G MacGrogan
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - W Jacot
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - F Bibeau
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - L Vanlemmens
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - F André
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - M-C Mathieu
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - P Augereau
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - V Verriele
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - F Penault-Llorca
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - M Lacroix-Triki
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| | - T Filleron
- Institut Claudius Regaud, Toulouse, France; Centre GF Leclerc, Dijon, France; Institut Curie, Orsay, France; Centre Léon Bérard, Lyon, France; Institut Bergonié, Bordeaux, France; Centre Val d'Aurelle-ICM, Montpellier, France; Centre Oscar Lambret, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Paul Papin, Angers, France; Centre Jean Perrin, Clermont-Ferrand, France
| |
Collapse
|
13
|
Mathoulin-Pélissier S, Chevreau C, Bellera C, Bauvin E, Savès M, Grosclaude P, Albert S, Goddard J, Le Guellec S, Delannes M, Bui BN, Mendiboure J, Stoeckle E, Coindre JM, Kantor G, Kind M, Cowppli-Bony A, Hoppe S, Italiano A. Adherence to consensus-based diagnosis and treatment guidelines in adult soft-tissue sarcoma patients: a French prospective population-based study. Ann Oncol 2013; 25:225-31. [PMID: 24285018 DOI: 10.1093/annonc/mdt407] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Soft-tissue sarcomas (STSs) are rare tumors with varied histological presentations. Management and treatment are thus complex, but crucial for patient outcomes. We assess adherence to adult STS management guidelines across two French regions (10% of the French population). We also report standardized incidence. PATIENTS AND METHODS STS patients diagnosed from 1 November 2006 to 31 December 2007 were identified from pathology reports, medical hospital records, and cancer registries. Guideline adherence was assessed by 23 criteria (validated by Delphi consensus method), and age and sex-standardized incidence rates estimated. Associations between patient, treatment, and institutional factors and adherence with three major composite criteria relating to diagnostic imaging and biopsy as well as multidisciplinary team (MDT) case-review are reported. RESULTS Two hundred and seventy-four patients were included (57.7% male, mean age 60.8 years). Practices were relatively compliant overall, with over 70% adherence for 10 criteria. Three criteria with perfect Delphi consensus had low adherence: receiving histological diagnosis before surgery, adequacy of histological diagnosis (adherence around 50% for both), and MDT discussion before surgery (adherence <30%). Treatment outside of specialized centers was associated with lower adherence for all three composite criteria, and specific tumor sites and/or features were associated with lower adherence for diagnostic imaging, methods, and MDT meetings. STS standardized incidence rates were 4.09 (European population) and 3.33 (World) /100 000 inhabitants. CONCLUSIONS Initial STS diagnosis and treatment across all stages (imaging, biopsy, and MDT meetings) need improving, particularly outside specialized centers. Educational interventions to increase surgeon's sarcoma awareness and knowledge and to raise patients' awareness of the importance of seeking expert care are necessary.
Collapse
Affiliation(s)
- S Mathoulin-Pélissier
- Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Modesto A, Filleron T, Chevreau C, Le Pechoux C, Rochaix P, Le Guellec S, Ducassou A, Gangloff D, Ferron G, Delannes M. Role of radiation therapy in the conservative management of sarcoma within an irradiated field. Eur J Surg Oncol 2013; 40:187-92. [PMID: 24074728 DOI: 10.1016/j.ejso.2013.07.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 07/16/2013] [Accepted: 07/22/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To report on clinical outcome and toxicity profile after combined treatment that included radiation therapy (RT) in patients with localized sarcoma within an irradiated field. PATIENTS AND METHODS Individual clinical data from all consecutive patients diagnosed and treated for a localized SIF between January 2000 and October 2011 at the Institut Claudius Regaud, Toulouse, France, were retrospectively reviewed. Outcomes of patients with SIF who underwent adjuvant or definitive radiotherapy were compared with patients who did not receive further RT. RESULTS Of the 27 patients eligible for this study: surgery alone (S), surgery followed by RT (S + RT) or definitive RT (RT) was performed in 16, 8 and 2 cases respectively. The rate of unresectable, gross or microscopically positive margin disease among the 10 re-irradiated patients was significantly higher than the non re-irradiated group (90% vs. 12% p < 0.001). After a median follow-up of 3.8 years, there was a trend toward longer survival and better local control in the subgroup of patients who received adjuvant or definitive RT compared to the rest of the cohort with an acceptable toxicity profile. The 4-year relapse free survival rates of patients treated with and without RT were 53% and 27% respectively (p = 0.09). CONCLUSION SIF complete surgical resection is often difficult to achieve, enhancing the risk of relapse. RT should be discussed in case of unresectable tumor or after suboptimal surgery as part of intensified local management that has a curative intent.
Collapse
Affiliation(s)
- A Modesto
- Institut Claudius Regaud, Department of Radiation Oncology, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France.
| | - T Filleron
- Institut Claudius Regaud, Department of Biostatistics, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France
| | - C Chevreau
- Institut Claudius Regaud, Department of Medical Oncology, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France
| | - C Le Pechoux
- Institut Gustave Roussy, Department of Radiation Oncology, 114 rue Édouard-Vaillant, 94805 Villejuif, France
| | - P Rochaix
- Institut Claudius Regaud, Department of Pathology, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France
| | - S Le Guellec
- Institut Claudius Regaud, Department of Pathology, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France
| | - A Ducassou
- Institut Claudius Regaud, Department of Radiation Oncology, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France
| | - D Gangloff
- Institut Claudius Regaud, Department of Surgery, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France
| | - G Ferron
- Institut Claudius Regaud, Department of Surgery, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France
| | - M Delannes
- Institut Claudius Regaud, Department of Radiation Oncology, 20-24, rue du Pont Saint-Pierre, 31000 Toulouse, France
| |
Collapse
|
15
|
Durand M, Le Guellec S, Pourchez J, Dubois F, Aubert G, Chantrel G, Vecellio L, Hupin C, De Gersem R, Reychler G, Pitance L, Diot P, Jamar F. Sonic aerosol therapy to target maxillary sinuses. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:244-50. [PMID: 22921302 DOI: 10.1016/j.anorl.2011.09.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/30/2011] [Accepted: 09/06/2011] [Indexed: 10/28/2022]
Abstract
AIM Intranasal aerosol administration of drugs is widely used by ENT specialists. Although clinical evidence is still lacking, intranasal nebulization appears to be an interesting therapeutic option for local drug delivery, targeting anatomic sites beyond the nasal valve. The sonic nebulizer NL11SN associates a 100Hertz (Hz) sound to the aerosolization to improve deposition in the nasal/paranasal sinuses. The aim of the present study was: to evaluate in vivo the influence of associating a 100Hz sound on sinus ventilation and nasal and pulmonary aerosol deposition in normal volunteers, and; to quantify in vitro aerosol deposition in the maxillary sinuses in a plastinated head model. MATERIAL AND METHODS Scintigraphic analysis of (81m)Kr gas ventilation and of sonic aerosol ((99m)Tc-DTPA) deposition using the NL11SN was performed in vivo in seven healthy volunteers. In parallel, NL11SN gentamicin nebulization was performed, with or without associated 100Hz sound, in a plastinated human head model; the gross amount of gentamicin delivered to the paranasal sinuses was determined by fluorescence polarization immunoassay. RESULTS Associating the 100Hz sound to (81m)Kr gas ensured paranasal sinus ventilation in healthy volunteers. (99m)Tc-DTPA particles nebulized with the NL11SN were deposited predominantly in the nasal cavities (2/3, vs 1/3 in the lungs). In vitro, the use of NL11SN in sonic mode increased gentamicin deposition threefold in the plastinated model sinuses (P<0.002); the resulting antibiotic deposit would be sufficient to induce a local therapeutic effect. CONCLUSION The NL11SN nebulizer ensured preferential nasal cavity aerosol deposition and successfully targeted the maxillary sinuses.
Collapse
Affiliation(s)
- M Durand
- Service d'ORL et chirurgie cervico-faciale, centre hospitalier Émile-Roux, Le Puy-en-Velay, France.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Le Guellec S, Durand M, Pourchez J, Dubois F, Aubert G, Chantrel G, Vecellio L, Hupin C, De Gersem R, Reychler G, Pitance L, Le Pennec D, Diot P, Jamar F. WS24.3 Evaluation of the performance of sonic nebuliser to target maxillary sinuses. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60166-0] [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: 11/30/2022]
|
17
|
Chaput B, Le Guellec S, Courtade-Saïdi M, Gangloff D, Meresse T, Chavoin JP, Grolleau JL, Garrido I. L’apport des techniques anatomopathologiques en oncodermatologie. ANN CHIR PLAST ESTH 2012; 57:132-9. [DOI: 10.1016/j.anplas.2012.02.009] [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] [Received: 01/08/2012] [Accepted: 02/16/2012] [Indexed: 12/15/2022]
|
18
|
Wagner T, Brechemier D, Dugert E, Le Guellec S, Julian A, Hitzel A, Beyne-Rauzy O. Diffuse pulmonary uptake on FDG-PET with normal CT diagnosed as intravascular large B-cell lymphoma: a case report and a discussion of the causes of diffuse FDG uptake in the lungs. Cancer Imaging 2012; 12:7-12. [PMID: 22275725 PMCID: PMC3266578 DOI: 10.1102/1470-7330.2012.0002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 71-year-old woman was admitted to our hospital with asthenia, weight loss, fever, cognitive impairment and shortness of breath. Physical examination showed hemiparesis and cerebellar ataxia. There was no superficial lymphadenopathy. Blood tests showed raised levels of C-reactive protein and lactate dehydrogenase. Bone marrow aspiration and biopsy were negative. [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) showed intense uptake within a right apical nodule and intense and diffuse uptake of FDG in the lungs without corresponding structural CT abnormality. Lung biopsy showed intravascular large B-cell lymphoma (IVLBCL). FDG-PET findings in IVLBCL and causes of diffuse FDG lung uptake with and without CT abnormalities are discussed.
Collapse
Affiliation(s)
- T Wagner
- Nuclear Medicine Department, Toulouse Purpan University Hospital, Toulouse, France.
| | | | | | | | | | | | | |
Collapse
|
19
|
Vecellio L, Le Guellec S, De Gersem R, Reychler G, Pitance L, Le Pennec D, Diot P, Chantrel G, Jamar F. 73 Deposition of aerosol in healthy volunteer with a nasal sonic jet nebulizer. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60091-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: 10/18/2022]
|
20
|
Barbier L, Muscari F, Le Guellec S, Pariente A, Otal P, Suc B. Liver resection after downstaging hepatocellular carcinoma with sorafenib. Int J Hepatol 2011; 2011:791013. [PMID: 22135750 PMCID: PMC3226249 DOI: 10.4061/2011/791013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 01/24/2011] [Indexed: 12/14/2022] Open
Abstract
Background. Sorafenib is a molecular-targeted therapy used in palliative treatment of advanced hepatocellular carcinoma in Child A patients. Aims. To address the question of sorafenib as neoadjuvant treatment. Methods. We describe the cases of 2 patients who had surgery after sorafenib. Results. The patients had a large hepatocellular carcinoma in the right liver with venous neoplastic thrombi (1 in the right portal branch, 1 in the right hepatic vein). After 9 months of sorafenib, reassessment showed that tumours had decreased in size with a necrotic component. A right hepatectomy with thrombectomy was performed, and histopathology showed 35% to 60% necrosis. One patient had a recurrence after 6 months and had another liver resection; they are both recurrence-free since then. Conclusion. Sorafenib can downstage hepatocellular carcinoma and thus could represent a bridge to surgery. It may be possible to select patients in good general condition with partial regression of the tumour with sorafenib for a treatment in a curative intent.
Collapse
Affiliation(s)
- L. Barbier
- Department of Digestive Surgery and Liver Transplantation, Rangueil Hospital, 1 avenue du Professor Jean Poulhès, 31059 Toulouse Cedex 9, France,*L. Barbier:
| | - F. Muscari
- Department of Digestive Surgery and Liver Transplantation, Rangueil Hospital, 1 avenue du Professor Jean Poulhès, 31059 Toulouse Cedex 9, France
| | - S. Le Guellec
- Department of Pathology, Rangueil Hospital, 31059 Toulouse, France
| | - A. Pariente
- Department of Hepato-Gastro-Enterology, Pau Hospital, 4 Boulevard Hauterive, 64046 Pau, France
| | - P. Otal
- Department of Radiology, Rangueil Hospital, 31059 Toulouse, France
| | - B. Suc
- Department of Digestive Surgery and Liver Transplantation, Rangueil Hospital, 1 avenue du Professor Jean Poulhès, 31059 Toulouse Cedex 9, France
| |
Collapse
|
21
|
Le Guellec S, Mercier E, Chantrel G, Diot P, Vecellio L. 095 Influence of jet nebulization on ventilatory parameters during mechanical ventilation. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)74386-3] [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: 11/28/2022]
|
22
|
Vecellio L, Diot P, Le Guellec S, Chantrel G. 097 In vitro performances of an innovative device for mesh nebulizer. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)74388-7] [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]
|
23
|
Montharu J, Le Guellec S, De Monte M. 064 Anatomies comparées des animaux de laboratoire pour l’étude du dépôt pulmonaire de médicament. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71892-7] [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]
|
24
|
Le Guellec S, Montharu J, Renoux V, Vecellio L, Gaitan J, Bousarghin L, Touze A, Coates A, Diot P, Coursaget P. 086 Vaccination par voie inhalée contre le papillomavirus humain de type 16 chez la rate Sprague Dawley. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71914-3] [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]
|
25
|
Le Guellec S, Montharu J, El Moujahed A, Diot P, Gauthier F, De Monte M. 063 Évaluation de la toxicité pulmonaire de molécules aérosolisées chez le rat femelle Sprague Dawley. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71891-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
26
|
Le Guellec S, Malavaud B, Quintyn M, Escourrou G, Delisle M, Plante P, Rischmann P, Soulié M, Mazerolles C. Les micro-foyers d’adénocarcinome prostatique sur biopsies : corrélations entre la taille du foyer et les caractéristiques tumorales après prostatectomie radicale. Ann Pathol 2006. [DOI: 10.1016/s0242-6498(06)78402-4] [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]
|
27
|
Le Guellec S, Bousquet M, Brousset P. Détection de la mutation V617F de la tyrosine kinase JAK2 à partir d’ADN extrait de biopsies ostéomédullaires de patients porteurs de syndromes myéloprolifératifs chroniques par technique de PCR Taqman. Ann Pathol 2006. [DOI: 10.1016/s0242-6498(06)78407-3] [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: 11/28/2022]
|
28
|
Lacour S, Veron N, De Monte M, Brocca J, Le Guellec S, Deprez P, Diot P, Leblond V. 025 Impact d’une stratégie de prévention basée sur la pollution par l’ozone sur la santé de patients atteints d’insuffisance respiratoire. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71853-8] [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: 10/22/2022]
|
29
|
Lacour S, Veron N, Le Guellec S, Brocca J, De Monte M, Deprez P, Diot P, Leblond V. PAPRICA, Pollution Aérienne et Pathologie Respiratoire : Impact de la Communication sur l’Air. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72331-2] [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]
|
30
|
Lacour S, Veron N, Le Guellec S, Brocca J, De Monte M, Deprez P, Dior P, Leblond V. 074 PAPRICA Pollution Aérienne et Pathologie Respiratoire : Impact de la Communication sur l’Air. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)92486-8] [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: 10/18/2022]
|