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Gassian N, Paget-Bailly S, Djoumakh OEK, Mansi L, Dobi E, Bazan F, Curtit E, Chaigneau L, Meneveau N, Paillard MJ, Selmani Z, Viot J, Borg C, Meynard G. HERibuline: Eribulin mesylate and Trastuzumab in pretreated HER2-positive advanced breast cancer—A report of region’s practice. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13020 Background: Until 2020, in human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer (ABC), the two first lines of metastatic treatment were well defined but after, many options were possible, most often combining targeted therapy plus chemotherapy. Eribulin mesylate is indicated for the treatment of patients with ABC previously treated by anthracycline and taxane regimens in the advanced setting. Here, we present the results of eribuline and trastuzumab (E/T) combination in HER2-positive ABC previously treated. Methods: Patients with HER2-positive ABC treated with the E/T combination from our region cancer institute were included in this retrospective study. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), overall response rate (ORR), clinical benefit rate (CBR) and safety. Results: Between November 2013 and July 2019, a total of 34 consecutive patients with HER2-positive ABC were included. The median number of previous lines for advanced setting was 4 (range 2-7). Patients treated by taxanes and anthracyclines represented 91% and 47% respectively; 50%, 79% and 62% were previously treated with pertuzumab, trastuzumab emtansine and lapatinib respectively. After a median follow up of 24.8 months, median PFS was 6.2 months (95% CI [3.35-7.13]) and median OS was 12.6 months (95% CI [7.13-18.56]). The ORR and CBR were 38% and 53%, respectively. No unexpected adverse event was observed. The most frequent grade 3-4 toxicity was hematologic (44.1%). Conclusions: Recently, new therapies have revolutionized the management of HER2-positive ABC and patients benefit from a prolonged overall survival associated with a maintained performance status. However, in pretreated and advanced metastatic setting, there are few scientific evidence to guide the choice of treatments. A combination of E/T could be an effective option in patients with good performance status and willing to receive treatment.
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Affiliation(s)
| | - Sophie Paget-Bailly
- Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098), University Hospital, Besançon, France
| | | | - Laura Mansi
- Department of Medical Onclogy, Besançon, France
| | | | | | - Elsa Curtit
- Institut Regional du Cancer en Franche-Comté-University Hospital, Besançon, France
| | - Loic Chaigneau
- Institut Regional du Cancer en Franche-Comté-University Hospital, Besançon, France
| | - Nathalie Meneveau
- Institut Regional du Cancer en Franche-Comté-University Hospital, Besançon, France
| | | | | | - Julien Viot
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | | | - Guillaume Meynard
- Service d'Oncologie Médicale, CHU Jean Minjoz Besançon, Besançon, France
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2
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Eberst G, Claudé F, Laurent L, Meurisse A, Roux-Claudé P, Barnig C, Vernerey D, Paget-Bailly S, Bouiller K, Chirouze C, Behr J, Grillet F, Ritter O, Karaer S, Pili-Floury S, Winiszewski H, Samain E, Decavel P, Capellier G, Westeel V. Result of one-year, prospective follow-up of intensive care unit survivors after SARS-CoV-2 pneumonia. Ann Intensive Care 2022; 12:23. [PMID: 35262794 PMCID: PMC8905558 DOI: 10.1186/s13613-022-00997-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [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] [Received: 09/30/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Survivors of viral ARDS are at risk of long-term physical, functional and neuropsychological complications resulting from the lung injury itself, but also from potential multiorgan dysfunction, and the long stay in the intensive care unit (ICU). Recovery profiles after severe SARS-CoV-2 pneumonia in intensive care unit survivors have yet to be clearly defined. Material and methods The goal of this single-center, prospective, observational study was to systematically evaluate pulmonary and extrapulmonary function at 12 months after a stay in the ICU, in a prospectively identified cohort of patients who survived SARS-CoV-2 pneumonia. Eligible patients were assessed at 3, 6 and 12 months after onset of SARS-CoV-2. Patients underwent physical examination, pulmonary function testing, chest computed tomography (CT) scan, a standardized six-minute walk test with continuous oximetry, overnight home respiratory polygraphy and have completed quality of life questionnaire. The primary endpoint was alteration of the alveolar–capillary barrier compared to reference values as measured by DLCO, at 12 months after onset of SARS-CoV-2 symptoms. Results In total, 85 patients (median age 68.4 years, (interquartile range [IQR] = 60.1–72.9 years), 78.8% male) participated in the trial. The median length of hospital stay was 44 days (IQR: 20–60) including 17 days in ICU (IQR: 11–26). Pulmonary function tests were completed at 3 months (n = 85), 6 months (n = 80), and 12 months (n = 73) after onset of symptoms. Most patients showed an improvement in DLCO at each timepoint (3, 6, and 12 months). All patients who normalized their DLCO did not subsequently deteriorate, except one. Chest CT scans were abnormal in 77 patients (96.3%) at 3 months and although the proportion was the same at 12 months, but patterns have changed. Conclusion We report the results of a comprehensive evaluation of 85 patients admitted to the ICU for SARS-CoV-2, at one-year follow-up after symptom onset. We show that most patients had an improvement in DLCO at each timepoint. Trial registration: Clinical trial registration number: NCT04519320. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-022-00997-8. The most interesting findings were that most patients showed an improvement in their DLCO at 3, 6, and 12 months, and all patients but one who normalized their DLCO did not deteriorate afterwards. Only 11% of patients had persistent impairment of DLCO at 1 year.
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Affiliation(s)
- Guillaume Eberst
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France. .,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France. .,UMR 1098, University of Franche-Comté, Besançon, France.
| | - Fréderic Claudé
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Lucie Laurent
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Aurelia Meurisse
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Pauline Roux-Claudé
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Cindy Barnig
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Dewi Vernerey
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Kevin Bouiller
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Catherine Chirouze
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Julien Behr
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Franck Grillet
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Ophélie Ritter
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Sinan Karaer
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Sébastien Pili-Floury
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Hadrien Winiszewski
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Emmanuel Samain
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France
| | - Pierre Decavel
- Laboratory of Clinical Functional Exploration of Movement, Department of Physical Medicine and Rehabilitation, University Hospital of Besançon, Besançon, France
| | - Gilles Capellier
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France.,Australian and New Zealand Intensive Care Research Center, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Virginie Westeel
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
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3
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Traore I, Eberst G, Claudé F, Laurent L, Meurisse A, Paget-Bailly S, Roux-Claudé P, Jacoulet P, Barnig C, Martarello R, Poirson B, Bouiller K, Chirouze C, Behr J, Grillet F, Ritter O, Pili-Floury S, Winiszewski H, Samain E, Capellier G, Westeel V. Prevalence and Characteristics of Sleep Apnea in Intensive Care Unit Survivors After SARS-CoV-2 Pneumonia. Nat Sci Sleep 2022; 14:2213-2225. [PMID: 36578669 PMCID: PMC9791936 DOI: 10.2147/nss.s377946] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sleep apnea (SA) was reported as possibly exacerbating symptoms of COVID-19, a disease induced by SARS-CoV-2 virus. The same comorbidities are common with both pathologies. This study aimed to estimate the prevalence, characteristics of SA and variation in AHI three months after severe COVID-19 requiring intensive care unit (ICU) admission. METHODS A prospective cohort of patients admitted to ICU for severe COVID-19 underwent an overnight home polygraphy 3 months after onset of symptoms, as part of a comprehensive follow-up program (pulmonary function tests, 6-minute walk tests and chest CT-scan). Patients with an apnea hypopnea index (AHI) ≥5 were considered as having SA. We performed a comparative descriptive analysis of 2 subgroups according to the existence, severity of SA and indication for effective SA treatment: patients with absent or mild SA (AHI <15) vs patients with moderate to severe SA (AHI ≥15). RESULTS Among 68 patients included, 62 (91%) had known comorbidities (34 hypertension, 21 obesity, 20 dyslipidemia, 16 type 2 diabetes). It has been observed a preexisting SA for 13 patients (19.1%). At 3 months, 62 patients (91%) had SA with 85.5% of obstructive events. Twenty-four patients had no or a mild SA (AHI <15) and 44 had moderate to severe SA (AHI ≥15). Ischemic heart disease exclusively affected the moderate to severe SA group. Except for thoracic CT-scan which revealed less honeycomb lesions, COVID-19 symptoms were more severe in the group with moderate to severe SA, requiring a longer curarization, more prone position sessions and more frequent tracheotomy. CONCLUSION SA involved 91% of patients in our population at 3 months of severe COVID-19 and was mainly obstructive type. Although SA might be a risk factor as well as consequences of ICU care in severe COVID-19 infection, our results underline the importance of sleep explorations after an ICU stay for this disease.
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Affiliation(s)
- Ibrahim Traore
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Guillaume Eberst
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Fréderic Claudé
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Lucie Laurent
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Aurelia Meurisse
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Pauline Roux-Claudé
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Pascale Jacoulet
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Cindy Barnig
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Rachel Martarello
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Bastien Poirson
- Department of Geriatrics, University Hospital of Besançon, Besançon, France
| | - Kevin Bouiller
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Catherine Chirouze
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Julien Behr
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Franck Grillet
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Ophélie Ritter
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Sébastien Pili-Floury
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Hadrien Winiszewski
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Emmanuel Samain
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France
| | - Gilles Capellier
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France.,Australian and New Zealand Intensive Care Research Center, Department of Epidemiology and Preventive Medicine, Monash University, Monash, Australia
| | - Virginie Westeel
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
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4
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Baumann A, Henriques J, Selmani Z, Meurisse A, Lepiller Q, Vernerey D, Valmary-Degano S, Paget-Bailly S, Riethmuller D, Ramanah R, Mougin C, Prétet JL. HPV16 Load Is a Potential Biomarker to Predict Risk of High-Grade Cervical Lesions in High-Risk HPV-Infected Women: A Large Longitudinal French Hospital-Based Cohort Study. Cancers (Basel) 2021; 13:cancers13164149. [PMID: 34439304 PMCID: PMC8394477 DOI: 10.3390/cancers13164149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/27/2021] [Accepted: 08/04/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary This study aimed at assessing HPV16 and HPV18 viral loads to predict the development of cervical high-grade lesion. Among 885 women positive for hrHPV and presenting no or mild cytological abnormalities, HPV16 and HPV18 prevalence was 25.9% and 8.4%, respectively. Of those women, 135 developed a high-grade lesion during the follow-up. Considering an HPV16 viral load cut-off set at 3.2 log10 GE/103 cells a subgroup of women at high risk of developing high-grade cervical lesion (HR = 2.67; 95% CI 1.80–3.97 p ≤ 0.0001) has been identified. Moreover, a composite score based on HPV16 load, cytology and hrHPV detection allowed for CIN2+ risk stratification. To conclude, HPV16 load is a relevant biomarker to identify women at high risk for developing precancerous lesions of the cervix. Abstract High-risk HPV (hrHPV) testing has been implemented as a primary screening tool for cervical cancer in numerous countries. However, there is still a need for relevant triage strategies to manage hrHPV positive women to avoid excessive referral to colposcopy. The objective of this study was to assess, in women infected by hrHPV and presenting no or mild cytological abnormalities, HPV16 and HPV18 viral loads to predict the development of cervical high-grade lesion. Among 2102 women positive for hrHPV, 885 had no lesion or mild cytological abnormalities at baseline and had at least one follow-up (FU) visit. HPV16 and HPV18 prevalence was 25.9% and 8.4%, respectively. Of those women, 15% developed a high-grade lesion during the FU. An HPV16 viral load cut-off set at 3.2 log10GE/103 cells permitted to identify a subgroup of women at high risk of developing high-grade cervical lesion (HR = 2.67; 95% CI 1.80–3.97; p ≤ 0.0001). No specific HPV18 viral load threshold could have been defined in regard to the present study. In multivariate analysis, HPV16 load (absence/log10GE/103 cells < 3.2 vs. ≥3.2), RLU/PC 239 (1–100 pg/mL vs. >100 pg/mL) and cytology (normal vs abnormal) were independently associated with a significant increased risk of high-grade lesion development and were used to construct the prognostic score. In conclusion, HPV16 load is a relevant biomarker to identify women at high risk for developing cervical precancerous lesions.
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Affiliation(s)
- Antoine Baumann
- Papillomavirus National Reference Centre, CHU de Besançon, 25000 Besançon, France; (A.B.); (Z.S.); (Q.L.); (D.R.); (C.M.)
- Pathology Department, CHU de Besançon, 25000 Besançon, France;
| | - Julie Henriques
- Methodology and Quality of Life Unit in Oncology, CHU de Besançon, 25000 Besançon, France; (J.H.); (A.M.); (D.V.); (S.P.-B.)
- UMR1098, Host-Graft-Tumor Interactions and Cell and Tissue Engineering, University Bourgogne Franche-Comté, INSERM, 25000 Besançon, France
- La Fédération Hospitalo-Universitaire Integrated Center for Research in Inflammatory Diseases (FHU Increase), ANR-11-LABX-0021, LabEx LipSTIC, University Bourgogne Franche-Comté, 25000 Besançon, France
| | - Zohair Selmani
- Papillomavirus National Reference Centre, CHU de Besançon, 25000 Besançon, France; (A.B.); (Z.S.); (Q.L.); (D.R.); (C.M.)
- UMR1098, Host-Graft-Tumor Interactions and Cell and Tissue Engineering, University Bourgogne Franche-Comté, INSERM, 25000 Besançon, France
- La Fédération Hospitalo-Universitaire Integrated Center for Research in Inflammatory Diseases (FHU Increase), ANR-11-LABX-0021, LabEx LipSTIC, University Bourgogne Franche-Comté, 25000 Besançon, France
| | - Aurélia Meurisse
- Methodology and Quality of Life Unit in Oncology, CHU de Besançon, 25000 Besançon, France; (J.H.); (A.M.); (D.V.); (S.P.-B.)
- UMR1098, Host-Graft-Tumor Interactions and Cell and Tissue Engineering, University Bourgogne Franche-Comté, INSERM, 25000 Besançon, France
- La Fédération Hospitalo-Universitaire Integrated Center for Research in Inflammatory Diseases (FHU Increase), ANR-11-LABX-0021, LabEx LipSTIC, University Bourgogne Franche-Comté, 25000 Besançon, France
| | - Quentin Lepiller
- Papillomavirus National Reference Centre, CHU de Besançon, 25000 Besançon, France; (A.B.); (Z.S.); (Q.L.); (D.R.); (C.M.)
- EA3181, University Bourgogne Franche-Comté, 25000 Besançon, France
| | - Dewi Vernerey
- Methodology and Quality of Life Unit in Oncology, CHU de Besançon, 25000 Besançon, France; (J.H.); (A.M.); (D.V.); (S.P.-B.)
- UMR1098, Host-Graft-Tumor Interactions and Cell and Tissue Engineering, University Bourgogne Franche-Comté, INSERM, 25000 Besançon, France
- La Fédération Hospitalo-Universitaire Integrated Center for Research in Inflammatory Diseases (FHU Increase), ANR-11-LABX-0021, LabEx LipSTIC, University Bourgogne Franche-Comté, 25000 Besançon, France
| | - Séverine Valmary-Degano
- Pathology Department, CHU de Besançon, 25000 Besançon, France;
- EA3181, University Bourgogne Franche-Comté, 25000 Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life Unit in Oncology, CHU de Besançon, 25000 Besançon, France; (J.H.); (A.M.); (D.V.); (S.P.-B.)
- UMR1098, Host-Graft-Tumor Interactions and Cell and Tissue Engineering, University Bourgogne Franche-Comté, INSERM, 25000 Besançon, France
- La Fédération Hospitalo-Universitaire Integrated Center for Research in Inflammatory Diseases (FHU Increase), ANR-11-LABX-0021, LabEx LipSTIC, University Bourgogne Franche-Comté, 25000 Besançon, France
| | - Didier Riethmuller
- Papillomavirus National Reference Centre, CHU de Besançon, 25000 Besançon, France; (A.B.); (Z.S.); (Q.L.); (D.R.); (C.M.)
- EA3181, University Bourgogne Franche-Comté, 25000 Besançon, France
- Gynecology Department, CHU de Besançon, 25000 Besançon, France;
| | - Rajeev Ramanah
- Gynecology Department, CHU de Besançon, 25000 Besançon, France;
| | - Christiane Mougin
- Papillomavirus National Reference Centre, CHU de Besançon, 25000 Besançon, France; (A.B.); (Z.S.); (Q.L.); (D.R.); (C.M.)
- UMR1098, Host-Graft-Tumor Interactions and Cell and Tissue Engineering, University Bourgogne Franche-Comté, INSERM, 25000 Besançon, France
- La Fédération Hospitalo-Universitaire Integrated Center for Research in Inflammatory Diseases (FHU Increase), ANR-11-LABX-0021, LabEx LipSTIC, University Bourgogne Franche-Comté, 25000 Besançon, France
| | - Jean-Luc Prétet
- Papillomavirus National Reference Centre, CHU de Besançon, 25000 Besançon, France; (A.B.); (Z.S.); (Q.L.); (D.R.); (C.M.)
- EA3181, University Bourgogne Franche-Comté, 25000 Besançon, France
- Correspondence: ; Tel.: +33-(03)-70-63-20-49
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5
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Ferrara R, Imbimbo M, Malouf R, Paget-Bailly S, Calais F, Marchal C, Westeel V. Single or combined immune checkpoint inhibitors compared to first-line platinum-based chemotherapy with or without bevacizumab for people with advanced non-small cell lung cancer. Cochrane Database Syst Rev 2021; 4:CD013257. [PMID: 33930176 PMCID: PMC8092423 DOI: 10.1002/14651858.cd013257.pub3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis have changed the first-line treatment of people with advanced non-small cell lung cancer (NSCLC). Single-agent pembrolizumab (a PD-1 inhibitor) is currently the standard of care as monotherapy in patients with PD-L1 expression ≥ 50%, either alone or in combination with chemotherapy when PD-L1 expression is less than 50%. Atezolizumab (PD-L1 inhibitor) has also been approved in combination with chemotherapy and bevacizumab (an anti-angiogenic antibody) in first-line NSCLC regardless of PD-L1 expression. The combination of first-line PD-1/PD-L1 inhibitors with anti-CTLA-4 antibodies has also been shown to improve survival compared to platinum-based chemotherapy in advanced NSCLC, particularly in people with high tumour mutational burden (TMB). The association of ipilimumab (an anti CTLA4) and nivolumab (PD-1 inhibitor) has been approved by the US Food and Drug Administration (FDA) in all patients with PD-L1 expression ≥1%. Although these antibodies are currently used in clinical practice, some questions remain unanswered, such as the best-treatment strategy, the role of different biomarkers for treatment selection and the effectiveness of immunotherapy according to specific clinical characteristics. OBJECTIVES To determine the effectiveness and safety of first-line immune checkpoint inhibitors (ICIs), as monotherapy or in combination, compared to platinum-based chemotherapy, with or without bevacizumab for people with advanced NSCLC, according to the level of PD-L1 expression. SEARCH METHODS We performed an electronic search of the main databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase) from inception until 31 December 2020 and conferences meetings from 2015 onwards. SELECTION CRITERIA We included randomised controlled trials (RCTs) reporting on the efficacy or safety of first-line ICI treatment for adults with advanced NSCLC who had not previously received any anticancer treatment. We included trials comparing single- or double-ICI treatment to standard first-line therapy (platinum-based chemotherapy +/- bevacizumab). All data come from 'international multicentre studies involving adults, age 18 or over, with histologically-confirmed stage IV NSCLC. DATA COLLECTION AND ANALYSIS Three review authors independently assessed the search results and a fourth review author resolved any disagreements. Primary outcomes were overall survival (OS) and progression-free survival (PFS); secondary outcomes were overall objective response rate (ORR) by RECIST v 1.1, grade 3 to 5 treatment-related adverse events (AEs) (CTCAE v 5.0) and health-related quality of life (HRQoL). We performed meta-analyses where appropriate using the random-effects model for hazard ratios (HRs) or risk ratios (RRs), with 95% confidence intervals (95% CIs), and used the I² statistic to investigate heterogeneity. MAIN RESULTS Main results We identified 15 trials for inclusion, seven completed and eight ongoing trials. We obtained data for 5893 participants from seven trials comparing first-line single- (six trials) or double- (two trials) agent ICI with platinum-based chemotherapy, one trial comparing both first-line single- and double-agent ICsI with platinum-based chemotherapy. All trials were at low risk of selection and detection bias, some were classified at high risk of performance, attrition or other source of bias. The overall certainty of evidence according to GRADE ranged from moderate-to-low because of risk of bias, inconsistency, or imprecision. The majority of the included trials reported their outcomes by PD-L1 expressions, with PD-L1 ≥ 50 being considered the most clinically useful cut-off level for decision makers. Also, iIn order to avoid overlaps between various PDL-1 expressions we prioritised the review outcomes according to PD-L1 ≥ 50. Single-agent ICI In the PD-L1 expression ≥ 50% group single-agent ICI probably improved OS compared to platinum-based chemotherapy (hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.60 to 0.76, 6 RCTs, 2111 participants, moderate-certainty evidence). In this group, single-agent ICI also may improve PFS (HR: 0.68, 95% CI 0.52 to 0.88, 5 RCTs, 1886 participants, low-certainty evidence) and ORR (risk ratio (RR):1.40, 95% CI 1.12 to 1.75, 4 RCTs, 1672 participants, low-certainty evidence). HRQoL data were available for only one study including only people with PD-L1 expression ≥ 50%, which suggested that single-agent ICI may improve HRQoL at 15 weeks compared to platinum-based chemotherapy (RR: 1.51, 95% CI 1.08 to 2.10, 1 RCT, 297 participants, low-certainty evidence). In the included studies, treatment-related AEs were not reported according to PD-L1 expression levels. Grade 3-4 AEs may be less frequent with single-agent ICI compared to platinum-based chemotherapy (RR: 0.41, 95% CI 0.33 to 0.50, I² = 62%, 5 RCTs, 3346 participants, low-certainty evidence). More information about efficacy of single-agent ICI compared to platinum-based chemotherapy according to the level of PD-L1 expression and to TMB status or specific clinical characteristics is available in the full text. Double-agent ICI Double-ICI treatment probably prolonged OS compared to platinum-based chemotherapy in people with PD-L1 expression ≥50% (HR: 0.72, 95% CI 0.59 to 0.89 2 RCTs, 612 participants, moderate-certainty evidence). Trials did not report data on HRQoL, PFS and ORR according to PD-L1 groups. Treatment related AEs were not reported according to PD-L1 expression levels. The frequency of grade 3-4 AEs may not differ between double-ICI treatment and platinum-based chemotherapy (RR: 0.78, 95% CI 0.55 to 1.09, I² = 81%, 2 RCTs, 1869 participants, low-certainty evidence). More information about efficacy of double-agent ICI according to the level of PD-L1 expression and to TMB status is available in the full text. AUTHORS' CONCLUSIONS Authors' conclusions The evidence in this review suggests that single-agent ICI in people with NSCLC and PD-L1 ≥50% probably leads to a higher overall survival rate and may lead to a higher progression-free survival and overall response rate when compared to platinum-based chemotherapy and may also lead to a lower rate of adverse events and higher HRQoL. Combined ICI in people with NSCLC and PD-L1 ≥50% also probably leads to a higher overall survival rate when compared to platinum-based chemotherapy, but its effect on progression-free survival, overall response rate and HRQoL is unknown due to a lack of data. The rate of adverse events may not differ between groups. This review used to be a living review. It is transitioned out of living mode because current research is exploring ICI in association with chemotherapy or other immunotherapeutic drugs versus ICI as single agent rather than platinum based chemotherapy.
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Affiliation(s)
- Roberto Ferrara
- Thoracic Oncology Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milano, Italy
| | - Martina Imbimbo
- Department of Oncology, Lausanne University Hospital, and Ludwig Institute for Cancer Research, University of Lausanne, Lausanne, Switzerland
| | - Reem Malouf
- National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK
| | - Sophie Paget-Bailly
- Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France
- Université de Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France, Besançon, France
| | - François Calais
- Bibliothèque universitaire de Santé, Université de Franche-Comté, Besançon, France
| | | | - Virginie Westeel
- Department of Thoracic Oncology, University Hospital of Besançon, Besançon, France
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
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6
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Laurent A, Fournier A, Lheureux F, Martin Delgado MC, Bocci MG, Prestifilippo A, Aslanian P, Henriques J, Paget-Bailly S, Constantin JM, Besch G, Quenot JP, Anota A, Bouhemad B, Capellier G. An international tool to measure perceived stressors in intensive care units: the PS-ICU scale. Ann Intensive Care 2021; 11:57. [PMID: 33837861 PMCID: PMC8036172 DOI: 10.1186/s13613-021-00846-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background The intensive care unit is increasingly recognized as a stressful environment for healthcare professionals. This context has an impact on the health of these professionals but also on the quality of their personal and professional life. However, there is currently no validated scale to measure specific stressors perceived by healthcare professionals in intensive care. The aim of this study was to construct and validate in three languages a perceived stressors scale more specific to intensive care units (ICU). Results We conducted a three-phase study between 2016 and 2019: (1) identification of stressors based on the verbatim of 165 nurses and physicians from 4 countries (Canada, France, Italy, and Spain). We identified 99 stressors, including those common to most healthcare professions (called generic), as well as stressors more specific to ICU professionals (called specific); (2) item elaboration and selection by a panel of interdisciplinary experts to build a provisional 99-item version of the scale. This version was pre-tested with 70 professionals in the 4 countries and enabled us to select 50 relevant items; (3) test of the validity of the scale in 497 ICU healthcare professionals. Factor analyses identified six dimensions: lack of fit with families and organizational functioning; patient- and family-related emotional load; complex/at risk situations and skill-related issues; workload and human resource management issues; difficulties related to team working; and suboptimal care situations. Correlations of the PS-ICU scale with a generic stressors measure (i.e., the Job Content Questionnaire) tested its convergent validity, while its correlations with the Maslach Burnout Inventory-HSS examined its concurrent validity. We also assessed the test–retest reliability of PS-ICU with intraclass correlation coefficients. Conclusions The perceived stressors in intensive care units (PS-ICU) scale have good psychometric properties in all countries. It includes six broad dimensions covering generic or specific stressors to ICU, and thus, enables the identification of work situations that are likely to generate high levels of stress at the individual and unit levels. For future studies, this tool will enable the implementation of targeted corrective actions on which intervention research can be based. It also enables national and international comparisons of stressors’ impact. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-021-00846-0.
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Affiliation(s)
- Alexandra Laurent
- Psy-DREPI Laboratory EA 7458, University of Bourgogne Franche-Comté, Dijon, France. .,Department of Anaesthesiology and Critical Care Medicine, University Hospital of Dijon Bourgogne, Dijon, France.
| | - Alicia Fournier
- Psy-DREPI Laboratory EA 7458, University of Bourgogne Franche-Comté, Dijon, France.,MSHE Ledoux, University of Bourgogne Franche-Comté, Dijon, France
| | - Florent Lheureux
- Laboratory of Psychology EA3188, University of Bourgogne Franche-Comté,, Dijon, France
| | - Maria Cruz Martin Delgado
- Hospital Universitario de Torrejón, Intensive Care Unit, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Maria G Bocci
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Rome, Italy.,Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | | | - Pierre Aslanian
- Intensive Care Unit of Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Julie Henriques
- Methodology and Quality of Life in Oncology Unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
| | - Jean-Michel Constantin
- Department of Anaesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Sorbonne University, GRC 29, AP-HP, DMU DREAM, Paris, France
| | - Guillaume Besch
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Besançon, University of Franche-Comte EA3920, Besançon, France
| | - Jean-Pierre Quenot
- Service de Médecine Intensive-Réanimation, University Hospital of Dijon Bourgogne, Dijon, France
| | - Amelie Anota
- Methodology and Quality of Life in Oncology Unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
| | - Belaid Bouhemad
- Department of Anaesthesiology and Critical Care Medicine, University Hospital of Dijon Bourgogne, Dijon, France
| | - Gilles Capellier
- Medical Intensive Care Unit, University Hospital of Besançon, University of Franche-Comte EA 3920, Besançon, France
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7
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Roche M, Ravot C, Malapert A, Paget-Bailly S, Garandeau C, Pitiot V, Tomatis M, Riche B, Galamand B, Granger M, Barbavara C, Bourgeois C, Genest E, Stefani L, Haïne M, Castel-Kremer E, Morel-Soldner I, Collange V, Le Saux O, Dayde D, Falandry C. Feasibility of a prehabilitation programme dedicated to older patients with cancer before complex medical-surgical procedures: the PROADAPT pilot study protocol. BMJ Open 2021; 11:e042960. [PMID: 33811052 PMCID: PMC8023742 DOI: 10.1136/bmjopen-2020-042960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/20/2021] [Accepted: 02/26/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ageing is associated with an increased prevalence of comorbidities and sarcopenia as well as a decline of functional reserve of multiple organ systems, which may lead, in the context of the disease-related and/or treatment-related stress, to functional deconditioning. The multicomponent 'Prehabilitation & Rehabilitation in Oncogeriatrics: Adaptation to Deconditioning risk and Accompaniment of Patients' Trajectories (PROADAPT)' intervention was developed multiprofessionally to implement prehabilitation in older patients with cancer. METHODS The PROADAPT pilot study is an interventional, non-comparative, prospective, multicentre study. It will include 122 patients oriented to complex medical-surgical curative procedures (major surgery or radiation therapy with or without chemotherapy). After informed consent, patients will undergo a comprehensive geriatric assessment and will be offered a prehabilitation kit that includes an advice booklet with personalised objectives and respiratory rehabilitation devices. Patients will then be called weekly and monitored for physical and respiratory rehabilitation, preoperative renutrition, motivational counselling and iatrogenic prevention. Six outpatient visits will be planned: at inclusion, a few days before the procedure and at 1, 3, 6 and 12 months after the end of the procedure. The main outcome of the study is the feasibility of the intervention, defined as the ability to perform at least one of the components of the programme. Clinical data collected will include patient-specific and cancer-specific characteristics. ETHICS AND DISSEMINATION The study protocol was approved by the Ile de France 8 ethics committee on 5 June 2018. The results of the primary and secondary objectives will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03659123. Pre-results of the trial.
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Affiliation(s)
- Mélanie Roche
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Christine Ravot
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Amélie Malapert
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life Unit in Oncology, University Hospital Centre Besancon, Besancon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, Université Bourgogne Franche-Comté, Besancon, France
| | - Charlène Garandeau
- Direction à la Recherche Clinique et à l'Innovation, Hospices Civils de Lyon, Lyon, France
| | - Virginie Pitiot
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Mélanie Tomatis
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Riche
- Service de Biostatistique - Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive CNRS UMR 5558, Équipe Biostatistiques Santé, Université de Lyon, Lyon, France
| | - Béatrice Galamand
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Marion Granger
- Geriatrics Unit, Hospices Civils de Lyon, Lyon, France
- Centre Hospitalier de Chambery, Chambery, France
| | | | - Chrystelle Bourgeois
- Department of Medical Oncology, Centre Hospitalier Annecy Genevois, Pringy, France
| | | | - Laetitia Stefani
- Department of Medical Oncology, Centre Hospitalier Annecy Genevois, Pringy, France
| | - Max Haïne
- Pôle de gérontologie et Médecine de Réadaptation, Hôpital Nord-Ouest, Villefranche-sur-Saone, France
| | | | - Isabelle Morel-Soldner
- Geriatrics Unit, Centre Hospitalier de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Vincent Collange
- Département anesthésie réanimation, Medipole Lyon-Villeurbanne, Villeurbanne, France
| | - Olivia Le Saux
- Therapeutic targeting of the tumor cell and its immune microenvironment, Centre de Recherche en Cancerologie de Lyon, Lyon, France
| | - David Dayde
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Claire Falandry
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
- CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France
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8
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Mouillet G, Falcoz A, Fritzsch J, Almotlak H, Jacoulet P, Pivot X, Villanueva C, Mansi L, Kim S, Curtit E, Meneveau N, Adotevi O, Jary M, Eberst G, Vienot A, Calcagno F, Pozet A, Djoumakh O, Borg C, Westeel V, Anota A, Paget-Bailly S. Feasibility of health-related quality of life (HRQoL) assessment for cancer patients using electronic patient-reported outcome (ePRO) in daily clinical practice. Qual Life Res 2021; 30:3255-3266. [PMID: 33387291 DOI: 10.1007/s11136-020-02721-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Routine Electronic Monitoring of Health-Related Quality of Life (HRQoL) (REMOQOL) in clinical care with real-time feedback to physicians could help to enhance patient-centered care. We evaluated the feasibility of REMOQOL in the French context in the QOLIBRY study. The primary objective was to assess the patients' compliance with REMOQOL. METHODS The QOLIBRY study was a single-center, prospective study conducted in the University Hospital of Besançon (France). Eligible patients were those treated with systemic therapies for breast, lung or colorectal cancer at any stage. Patients were invited to complete the EORTC QLQ-C30 questionnaire and cancer-site-specific modules before each visit on tablets and/or computers in the hospital or at home. During the consultation, physicians had real-time access to visual summaries of HRQoL scores. Compliance was assessed as adequate if at least 66% of HRQoL assessments were completed during the 4 months of follow-up. RESULTS Between March 2016 and October 2018, 177 patients were included in the QOLIBRY study. Median age was 64 years (IQR 54-71). The proportion of patients with an adequate compliance rate was 95.5% (n = 63) in the breast cancer cohort, 98.2% (n = 55) in the colorectal cancer cohort, and 90.9% (n = 50) in the lung cancer cohort. The physicians checked the HRQoL results in 73.1% of visits and prescribed supportive care and adapted patient management in 8.3% and 5.2% of visits, respectively. CONCLUSION & PERSPECTIVES The results of QOLIBRY study suggest that REMOQOL is feasible in the French context. However, information about HRQoL monitoring, training of the physicians in the use of the software, and recommendations for using HRQoL results to guide care are essential and must be improved.
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Affiliation(s)
- Guillaume Mouillet
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besançon, France.
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France.
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France.
| | - Antoine Falcoz
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Joëlle Fritzsch
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
| | - Pascale Jacoulet
- Respiratory Medicine Department, University Hospital of Besançon, 25000, Besançon, France
| | - Xavier Pivot
- Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | | | - Laura Mansi
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Stefano Kim
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Elsa Curtit
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Nathalie Meneveau
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
| | - Olivier Adotevi
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Marine Jary
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Guillaume Eberst
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
- Respiratory Medicine Department, University Hospital of Besançon, 25000, Besançon, France
| | - Angelique Vienot
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Fabien Calcagno
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
| | - Astrid Pozet
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Oumelkheir Djoumakh
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Christophe Borg
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
| | - Virginie Westeel
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
- Respiratory Medicine Department, University Hospital of Besançon, 25000, Besançon, France
| | - Amélie Anota
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
- French National Platform Quality of Life and Cancer, Besançon, France
| | - Sophie Paget-Bailly
- Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, University Bourgogne Franche-Comté, 25000, Besançon, France
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Ferrara R, Imbimbo M, Malouf R, Paget-Bailly S, Calais F, Marchal C, Westeel V. Single or combined immune checkpoint inhibitors compared to first-line platinum-based chemotherapy with or without bevacizumab for people with advanced non-small cell lung cancer. Cochrane Database Syst Rev 2020; 12:CD013257. [PMID: 33316104 PMCID: PMC8094159 DOI: 10.1002/14651858.cd013257.pub2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis have changed the first-line treatment of people with advanced non-small cell lung cancer (NSCLC). Single-agent pembrolizumab (a PD-1 inhibitor) is currently the standard of care as monotherapy in patients with PD-L1 expression ≥ 50%, either alone or in combination with chemotherapy when PD-L1 expression is less than 50%. Atezolizumab (PD-L1 inhibitor) has also been approved in combination with chemotherapy and bevacizumab (an anti-angiogenic antibody) in first-line NSCLC regardless of PD-L1 expression. The combination of first-line PD-1/PD-L1 inhibitors with anti-CTLA-4 antibodies has also been shown to improve survival compared to platinum-based chemotherapy in advanced NSCLC, particularly in people with high tumour mutational burden (TMB). The association of ipilimumab (an anti CTLA4) and nivolumab (PD-1 inhibitor) has been approved by the US Food and Drug Administration (FDA) in all patients with PD-L1 expression ≥1%. Although these antibodies are currently used in clinical practice, some questions remain unanswered, such as the best-treatment strategy, the role of different biomarkers for treatment selection and the effectiveness of immunotherapy according to specific clinical characteristics. OBJECTIVES Primary objective: to determine the effectiveness and safety of first-line immune checkpoint inhibitors (ICIs), as monotherapy or in combination, compared to platinum-based chemotherapy, with or without bevacizumab for people with advanced NSCLC, according to the level of PD-L1 expression. SECONDARY OBJECTIVE to maintain the currency of evidence using a living systematic review approach. SEARCH METHODS We performed an electronic search of the main databases (Cochrane Lung Cancer Group Trial Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase) from inception until 21 October 2020 and conferences meetings from 2015 onwards. SELECTION CRITERIA We included randomised controlled trials (RCTs) reporting on the efficacy or safety of first-line ICI treatment for adults with advanced NSCLC who had not previously received any anticancer treatment. We included trials comparing single- or double-ICI treatment to standard first-line therapy (platinum-based chemotherapy +/- bevacizumab). All data come from 'international multicentre studies involving adults, age 18 or over, with histologically-confirmed stage IV NSCLC who had not received any previous systemic anti-cancer treatment for advanced disease. DATA COLLECTION AND ANALYSIS Three review authors independently assessed the search results and a fourth review author resolved any disagreements. Primary outcomes were overall survival (OS) and progression-free survival (PFS); secondary outcomes were overall objective response rate (ORR) by RECIST v 1.1, grade 3 to 5 treatment-related adverse events (AEs) (CTCAE v 5.0) and health-related quality of life (HRQoL). We performed meta-analyses where appropriate using the random-effects model for hazard ratios (HRs) or risk ratios (RRs), with 95% confidence intervals (95% CIs), and used the I² statistic to investigate heterogeneity. MAIN RESULTS Main results We identified 15 trials for inclusion, seven completed and eight ongoing trials. We obtained data for 5893 participants from seven trials comparing first-line single- (six trials) or double- (two trials) agent ICI with platinum-based chemotherapy, one trial comparing both first-line single- and double-agent ICsI with platinum-based chemotherapy. All trials were at low risk of selection and detection bias, some were classified at high risk of performance, attrition or other source of bias. The overall certainty of evidence according to GRADE ranged from moderate-to-low because of risk of bias, inconsistency, or imprecision. The majority of the included trials reported their outcomes by PD-L1 expressions, with PD-L1 ≥ 50 being considered the most clinically useful cut-off level for decision makers. Also, iIn order to avoid overlaps between various PDL-1 expressions we prioritised the review outcomes according to PD-L1 ≥ 50. Single-agent ICI In the PD-L1 expression ≥ 50% group single-agent ICI probably improved OS compared to platinum-based chemotherapy (hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.60 to 0.76, 6 RCTs, 2111 participants, moderate-certainty evidence). In this group, single-agent ICI also may improve PFS (HR: 0.68, 95% CI 0.52 to 0.88, 5 RCTs, 1886 participants, low-certainty evidence) and ORR (risk ratio (RR):1.40, 95% CI 1.12 to 1.75, 4 RCTs, 1672 participants, low-certainty evidence). HRQoL data were available for only one study including only people with PD-L1 expression ≥ 50%, which suggested that single-agent ICI may improve HRQoL at 15 weeks compared to platinum-based chemotherapy (RR: 1.51, 95% CI 1.08 to 2.10, 1 RCT, 297 participants, low-certainty evidence). In the included studies, treatment-related AEs were not reported according to PD-L1 expression levels. Grade 3-4 AEs may be less frequent with single-agent ICI compared to platinum-based chemotherapy (RR: 0.41, 95% CI 0.33 to 0.50, I² = 62%, 5 RCTs, 3346 participants, low-certainty evidence). More information about efficacy of single-agent ICI compared to platinum-based chemotherapy according to the level of PD-L1 expression and to TMB status or specific clinical characteristics is available in the full text. Double-agent ICI Double-ICI treatment probably prolonged OS compared to platinum-based chemotherapy in people with PD-L1 expression ≥50% (HR: 0.72, 95% CI 0.59 to 0.89 2 RCTs, 612 participants, moderate-certainty evidence). Trials did not report data on HRQoL, PFS and ORR according to PD-L1 groups. Treatment related AEs were not reported according to PD-L1 expression levels. The frequency of grade 3-4 AEs may not differ between double-ICI treatment and platinum-based chemotherapy (RR: 0.78, 95% CI 0.55 to 1.09, I² = 81%, 2 RCTs, 1869 participants, low-certainty evidence). More information about efficacy of double-agent ICI according to the level of PD-L1 expression and to TMB status is available in the full text. AUTHORS' CONCLUSIONS Authors' conclusions The evidence in this review suggests that single-agent ICI in people with NSCLC and PD-L1 ≥50% probably leads to a higher overall survival rate and may lead to a higher progression-free survival and overall response rate when compared to platinum-based chemotherapy and may also lead to a lower rate of adverse events and higher HRQoL. Combined ICI in people with NSCLC and PD-L1 ≥50% also probably leads to a higher overall survival rate when compared to platinum-based chemotherapy, but its effect on progression-free survival, overall response rate and HRQoL is unknown due to a lack of data. The rate of adverse events may not differ between groups.
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Affiliation(s)
- Roberto Ferrara
- Thoracic Oncology Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milano, Italy
| | - Martina Imbimbo
- Department of Oncology, Lausanne University Hospital, and Ludwig Institute for Cancer Research, University of Lausanne, Lausanne, Switzerland
| | - Reem Malouf
- National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK
| | - Sophie Paget-Bailly
- Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France
- Université de Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France, Besançon, France
| | - François Calais
- Bibliothèque universitaire de Santé, Université de Franche-Comté, Besançon, France
| | | | - Virginie Westeel
- Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France
- Department of Thoracic Oncology, University Hospital of Besançon, Besançon, France
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
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10
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Garnier L, Charton E, Falcoz A, Paget-Bailly S, Vernerey D, Jary M, Ducray F, Curtit E. Quality of patient-reported outcome reporting according to the CONSORT statement in randomized controlled trials with glioblastoma patients. Neurooncol Pract 2020; 8:148-159. [PMID: 33898048 DOI: 10.1093/nop/npaa074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Randomized controlled trials (RCTs) represent the best evidence in oncology research. Glioblastoma is the most frequent and deadly primary brain tumor, affecting health-related quality of life. An important end point is patient-reported outcomes (PROs). There are no data regarding how well publications of glioblastoma RCTs report PROs. A specific PRO extension of the Consolidated Standards of Reporting Trials (CONSORT) statement was created to improve the quality of reporting. The aim of this study was to evaluate adherence to the CONSORT-PRO statement in reporting RCTs addressing the treatment of patients with glioblastoma. PRO analysis methodology was explored and criteria associated with higher quality of reporting were investigated. Methods From PubMed/MEDLINE and the Cochrane Library databases, all phase 2 and 3 RCTs related to glioblastoma published between 1995 and 2018 were reviewed according to the CONSORT-PRO statements. An overall quality score on a 0 to 100 scale was defined based on these criteria and factors associated with this score were identified. Results Forty-four RCTs were identified as relevant according to predefined criteria. The median overall quality score was 26. No difference was observed regarding reporting quality over the years. CONSORT-PRO items concerning data collection and analysis were poorly reported. Thirty-four trials (77%) used longitudinal data. The most frequent statistical method for PROs analysis was the mean change from baseline (63%). Factors associated with improved overall quality score were the presence of a secondary publication dedicated to PROs results, the statement of any targeted dimensions, and when trials reported results using multiple methods. Conclusion Despite the importance of measuring PROs in patients with glioblastoma, employment of the CONSORT-PRO statement is poor in RCTs.
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Affiliation(s)
- Louis Garnier
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Host-Graft Tumor Interaction, Besançon, France.,Department of Neuro-Oncology, Hospices Civils de Lyon, Lyon, France
| | - Emilie Charton
- University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Host-Graft Tumor Interaction, Besançon, France.,Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France.,French National Platform Quality of Life and Cancer, Besançon, France
| | - Antoine Falcoz
- University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Host-Graft Tumor Interaction, Besançon, France.,Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France
| | - Sophie Paget-Bailly
- University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Host-Graft Tumor Interaction, Besançon, France.,Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France
| | - Dewi Vernerey
- University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Host-Graft Tumor Interaction, Besançon, France.,Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France
| | - Marine Jary
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Host-Graft Tumor Interaction, Besançon, France
| | - François Ducray
- Department of Neuro-Oncology, Hospices Civils de Lyon, Lyon, France
| | - Elsa Curtit
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Host-Graft Tumor Interaction, Besançon, France
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11
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Malouf R, Marchal C, Paget-Bailly S, Westeel V, Bernard A. Limited resections versus lobectomy for stage I non-small cell lung cancer. Hippokratia 2020. [DOI: 10.1002/14651858.cd013728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Reem Malouf
- National Perinatal Epidemiology Unit (NPEU); University of Oxford; Oxford UK
| | | | - Sophie Paget-Bailly
- Methodological and Quality of Life in Oncology Unit; University Hospital of Besançon; Besançon France
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique; Besançon France
| | - Virginie Westeel
- Methodological and Quality of Life in Oncology Unit; University Hospital of Besançon; Besançon France
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique; Besançon France
- Department of Thoracic Oncology; University Hospital of Besançon; Besançon France
| | - Alain Bernard
- Chirurgie Cardio-Vasculaire et Thoracique; CHU Dijon; Dijon Cedex France
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12
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Mouillet G, Falcoz A, Fritzsch J, Djoumakh O, Borg C, Westeel V, Anota A, Paget-Bailly S. E-Monitoring de la qualité de vie des patients atteints de cancer - Résultats de l’étude de faisabilité QOLIBRY. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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Mouillet G, Falcoz A, Barthélémy P, Geoffrois L, Ladoire S, Eymard JC, Plaza J, Viel E, Maurina T, Calcagno F, Stein U, Fritzsch J, Djoumakh O, Paget-Bailly S, Thiery-Vuillemin A. 1878P Health-related quality of life (HRQoL) assessment for patients with advanced renal cell carcinoma (aRCC) treated with a tyrosine kinase inhibitor (TKI) using electronic patient reported outcomes in daily clinical practice: QUANARIE trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1525] [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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14
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Mouillet G, Fritzsch J, Anota A, Djoumakh O, Falcoz A, Borg C, Westeel V, Paget-Bailly S. e-Monitoring de la qualité de vie relative à la santé des patients atteints de cancer : satisfaction des investigateurs des études QOLIBRY et QUANARIE. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.03.058] [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: 11/16/2022] Open
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15
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Mamguem Kamga A, Di Martino C, Anota A, Paget-Bailly S, Coutant C, Arveux P, Desmoulins I, Dabakuyo-Yonli TS. Impact of routine assessment of health-related quality of life coupled with therapeutic information on compliance with endocrine therapy in patients with non-metastatic breast cancer: protocol for a randomized controlled trial. Trials 2020; 21:527. [PMID: 32546198 PMCID: PMC7296931 DOI: 10.1186/s13063-020-04397-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/08/2020] [Indexed: 01/02/2023] Open
Abstract
Background Despite its proven efficacy in reducing recurrence and improving survival, adherence to endocrine therapy (ET) is suboptimal in women with breast cancer (BC). Health-related quality of life (HRQoL) in BC has been widely studied and many positive effects have been highlighted. Recently, a link between HRQoL and compliance with ET has been suggested, which would suggest a potential role for HRQoL assessment in improving compliance with ET. With the advent of digital technologies, electronic collection of HRQoL on a tablet is now possible. Thus, we hypothesize that systematic HRQoL assessment (using a tablet, prior to each consultation, with presentation of scores to clinicians) coupled with therapeutic information could have an impact on 12-month compliance with ET in patients with non-metastatic BC. Methods In this study, we will include 342 women with non-metastatic hormone receptor–positive BC with an indication for treatment with ET. Patients will be randomly assigned 1:1 by minimization and stratified by age, stage, type of ET prescribed, and presence of comorbidities (or not) in two arms. The intervention will consist of numerical HRQoL assessment using the CHES (Computer-based Health Evaluation System) software before each consultation (with delivery of scores to clinicians) coupled with therapeutic information. Therapeutic information will consist of three workshops related to understanding the prescription, nutrition, and fatigue. A reminder letter will be sent to patients every month. Patients in the control group will follow standard care. HRQoL will be assessed using a classic “paper-pencil” collection at baseline in both arms to ensure comparability between arms and at 12 months. The primary endpoint is 12-month compliance with ET. Patient satisfaction with care and the clinicians’ perception of the usefulness of routine HRQoL assessment will also be assessed. Discussion This study will allow clinicians to identify and better understand the areas in which patients who receive ET have difficulties and thus it will assist clinicians with patient management. Systematic evaluation of HRQoL could provide an additional endpoint for measuring patients’ health status and treatment-related symptoms, including ET. If the results of this study are positive, this intervention could be proposed as an integral part of daily clinical practice in patients who receive ET. Trial registration ClinicalTrials.govNCT04176809. Registered Nov. 25, 2019.
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Affiliation(s)
- Ariane Mamguem Kamga
- Epidemiology and Quality of Life Research Unit, INSERM U1231, Georges Francois Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon Cedex, 21000, France
| | - Cyril Di Martino
- Georges François Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Amelie Anota
- Methodological and Quality of Life Unit in Oncology, University Hospital Of Besançon, 3 Boulevard Alexandre Fleming, Besançon, 25000, France.,INSERM, EFS BFC, UMR1098, Interaction Hôte-Greffon-Tumeur/Ingénierie Cellulaire ET Génique, University Bourgogne Franche-Comté, 32 Avenue de l'Observatoire, Besançon, 25000, France.,National Quality of Life and Cancer Platform, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Sophie Paget-Bailly
- Methodological and Quality of Life Unit in Oncology, University Hospital Of Besançon, 3 Boulevard Alexandre Fleming, Besançon, 25000, France.,INSERM, EFS BFC, UMR1098, Interaction Hôte-Greffon-Tumeur/Ingénierie Cellulaire ET Génique, University Bourgogne Franche-Comté, 32 Avenue de l'Observatoire, Besançon, 25000, France
| | - Charles Coutant
- Surgery Department, Georges François Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon, 21000, France.,Burgundy Franche-Comté University, 7 Boulevard Jeanne d'Arc, Dijon, 21000, France
| | - Patrick Arveux
- Epidemiology and Quality of Life Research Unit, INSERM U1231, Georges Francois Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon Cedex, 21000, France.,Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, University Paris-Sud, UVSQ Gustave Roussy, 12 Avenue Paul Vaillant Couturier, Villejuif, 94800, France
| | - Isabelle Desmoulins
- Medical Oncology Unit, Centre Georges-François Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Tienhan Sandrine Dabakuyo-Yonli
- Epidemiology and Quality of Life Research Unit, INSERM U1231, Georges Francois Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon Cedex, 21000, France. .,National Quality of Life and Cancer Platform, 1 rue du Professeur Marion, Dijon, 21000, France.
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16
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Vardanega J, Henriques J, Pourcelot C, Dirand C, Nallet G, Brédart A, Anota A, Chaigneau L, Curtit E, Limat S, Paget-Bailly S, Nerich V. [Adjuvant hormonal therapy for early breast cancer: Assessment of patients' satisfaction]. Bull Cancer 2019; 106:1104-1114. [PMID: 31615646 DOI: 10.1016/j.bulcan.2019.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/02/2019] [Accepted: 08/18/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Since the cancer plan, evaluation of professional practices is essential to ensure the implementation of high-quality health care. Assess patient satisfaction is one of the pillars of high-quality health care. The main objective of the study was to assess the satisfaction of patients with early breast cancer taking a hormonal therapy, the secondary objective was to identify factors associated with their satisfaction. METHODS The modified EORTC OUT-PATSAT-35 questionnaire was sent to a sample of patients in Franche-Comté in order to evaluate nine dimensions of satisfaction among which interpersonal skills, provided information, and overall satisfaction. For each dimension, a satisfaction score between 0 (no satisfaction) and 100 (highest satisfaction) was measured. Logistic regression analyses were used to study the factors associated with satisfaction. RESULTS The mean overall satisfaction score for the 280 patients who answered was 73 [0-100]. Practicing an extra-professional activity was associated with higher satisfaction for several dimensions (odds ratio between 2.80 and 4.12, P<0.05) whereas it was decreased in the case of a modified appetite (odds ratio between 0.27 and 0.52, P<0.05). No link has been shown between satisfaction and adherence. DISCUSSION The patients were satisfied and several factors impacting their satisfaction were identified, based on a questionnaire that must evolve to take into account the ambulatory aspect of their care. During the consultations, particular attention will be paid to these factors.
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Affiliation(s)
- Julie Vardanega
- CHU de Besançon, pôle pharmaceutique, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - Julie Henriques
- CHU de Besançon, unité de méthodologie et de qualité de vie en oncologie, 3, boulevard Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, fédération Hospitalo-Universitaire INCREASE, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, EFS BFC, UMR1098, Inserm, 8, rue du Dr Jean-François-Xavier-Girod, 25000 Besançon, France
| | - Charlotte Pourcelot
- CHU de Besançon, pôle pharmaceutique, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - Camille Dirand
- CHU de Besançon, pôle pharmaceutique, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - Gilles Nallet
- Réseau régional de cancérologie, oncolie, pôle cancérologie, 2, boulevard Fleming, 25030 Besançon cedex, France
| | - Anne Brédart
- Institut Curie, département des soins de soutien, unité de psycho-oncologie, 26, rue d'Ulm, 75005 Paris cedex 05, France; Université Paris Descartes, laboratoire de psychopathologie et processus de santé, 71, avenue Edouard-Vaillant, 92774 Boulogne-Billancourt, France
| | - Amélie Anota
- CHU de Besançon, unité de méthodologie et de qualité de vie en oncologie, 3, boulevard Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, fédération Hospitalo-Universitaire INCREASE, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, EFS BFC, UMR1098, Inserm, 8, rue du Dr Jean-François-Xavier-Girod, 25000 Besançon, France; Plateforme nationale qualité de vie et cancer, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - Loïc Chaigneau
- CHU de Besançon, oncologie médicale, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - Elsa Curtit
- CHU de Besançon, oncologie médicale, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - Samuel Limat
- CHU de Besançon, pôle pharmaceutique, 3, boulevard Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, fédération Hospitalo-Universitaire INCREASE, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, EFS BFC, UMR1098, Inserm, 8, rue du Dr Jean-François-Xavier-Girod, 25000 Besançon, France
| | - Sophie Paget-Bailly
- CHU de Besançon, unité de méthodologie et de qualité de vie en oncologie, 3, boulevard Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, fédération Hospitalo-Universitaire INCREASE, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, EFS BFC, UMR1098, Inserm, 8, rue du Dr Jean-François-Xavier-Girod, 25000 Besançon, France
| | - Virginie Nerich
- CHU de Besançon, pôle pharmaceutique, 3, boulevard Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, fédération Hospitalo-Universitaire INCREASE, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, EFS BFC, UMR1098, Inserm, 8, rue du Dr Jean-François-Xavier-Girod, 25000 Besançon, France.
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17
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Mouillet G, Fritzsch J, Thiery-Vuillemin A, Meneveau N, Almotlak H, Mansi L, Curtit E, Kim S, Jary M, Maurina T, Eberst G, Barthelemy P, Eymard JC, Geoffrois L, Djoumakh O, Anota A, Adotevi O, Westeel V, Paget-Bailly S. Physicians’ satisfaction with health-related quality of life (HRQoL) assessment in daily clinical practice using electronic patient-reported outcome (ePRO) for cancer patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Paulus V, Pana-Katatali H, Perol M, Paget-Bailly S, Trinquart L, Perol D, Calais F, Bonnetain F, Westeel V. Maintenance therapy for advanced non-small cell lung cancer (NSCLC). Hippokratia 2019. [DOI: 10.1002/14651858.cd011631.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Valérie Paulus
- University Hospital of Besançon; Thoracic Oncology; 3, Boulevard Alexandre Fleming Besançon France 25030
| | - Héloïse Pana-Katatali
- University Hospital of Besançon; Thoracic Oncology; 3, Boulevard Alexandre Fleming Besançon France 25030
| | - Maurice Perol
- Centre Leon Berard; Medical Oncology; 28 Rue Laennec Lyon France 69008
| | - Sophie Paget-Bailly
- University Hospital of Besançon; Methodological and Quality of Life in Oncology Unit; 2 Place Saint Jacques Besançon France 25030
| | | | - David Perol
- Centre Leon Berard; Clinical Research Department; 28 rue Laennec Lyon France 69373
| | - François Calais
- University of Franche-Comté; University Library; Besançon France
| | - Franck Bonnetain
- University Hospital of Besançon; Methodological and Quality of Life Unit in Oncology; 2 Place Saint Jacques Besançon France 25030
| | - Virginie Westeel
- University Hospital of Besançon; Methodological and Quality of Life in Oncology Unit; 2 Place Saint Jacques Besançon France 25030
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Pivot X, Romieu G, Debled M, Pierga JY, Kerbrat P, Bachelot T, Lortholary A, Espié M, Fumoleau P, Serin D, Jacquin JP, Jouannaud C, Rios M, Abadie-Lacourtoisie S, Venat-Bouvet L, Cany L, Catala S, Khayat D, Gambotti L, Pauporté I, Faure-Mercier C, Paget-Bailly S, Henriques J, Grouin JM. 6 months versus 12 months of adjuvant trastuzumab in early breast cancer (PHARE): final analysis of a multicentre, open-label, phase 3 randomised trial. Lancet 2019; 393:2591-2598. [PMID: 31178155 DOI: 10.1016/s0140-6736(19)30653-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 02/16/2019] [Accepted: 03/05/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND In 2013, the interim analysis of the Protocol for Herceptin as Adjuvant therapy with Reduced Exposure (PHARE) trial could not show that 6 months of adjuvant trastuzumab was non-inferior to 12 months. Here, we report the planned final analysis based on the prespecified number of occurring events. METHODS PHARE is an open-label, phase 3, non-inferiority randomised trial of patients with HER2-positive early breast cancer comparing 6 months versus 12 months of trastuzumab treatment concomitant with or following standard neoadjuvant or adjuvant chemotherapy. The study was undertaken in 156 centres in France. Eligible patients were women aged 18 years or older with non-metastatic, operable, histologically confirmed adenocarcinoma of the breast and either positive axillary nodes or negative axillary nodes but a tumour of at least 10 mm. Participants must have received at least four cycles of a chemotherapy for this breast cancer and have started receiving adjuvant trastuzumab-treatment. Eligible patients were randomly assigned to either 6 months or 12 months of trastuzumab therapy duration between the third and sixth months of adjuvant trastuzumab. The randomisation was stratified by concomitant or sequential treatment with chemotherapy, oestrogen receptor status, and centre. The primary objective was non-inferiority in the intention-to-treat population in the 6-month group in terms of disease-free survival with a prespecified hazard margin of 1·15. This trial is registered with ClinicalTrials.gov, number NCT00381901. FINDINGS 3384 patients were enrolled and randomly assigned to either 12 months (n=1691) or 6 months (n=1693) of adjuvant trastuzumab. One patient in the 12-month group and three patients in the 6-month group were excluded, so 1690 patients in each group were included in the intention-to-treat analysis. At a median follow-up of 7·5 years (IQR 5·3-8·8), 704 events relevant to disease-free survival were observed (345 [20·4%] in the 12-month group and 359 [21·2%] in the 6-month group). The adjusted hazard ratio for disease-free survival in the 12-month group versus the 6-month group was 1·08 (95% CI 0·93-1·25; p=0·39). The non-inferiority margin was included in the 95% CI. No differences in effects pertaining to trastuzumab duration were found in any of the subgroups. After the completion of trastuzumab treatment, rare adverse events occurred over time and the safety analysis remained similar to the previously published report. In particular, we found no change in the cardiac safety comparison, and only three additional cases in which the left ventricular ejection fraction decreased to less than 50% have been reported in the 12-month group. INTERPRETATION The PHARE study did not show the non-inferiority of 6 months versus 12 months of adjuvant trastuzumab. Hence, adjuvant trastuzumab standard duration should remain 12 months. FUNDING The French National Cancer Institute.
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Affiliation(s)
| | | | | | | | | | | | | | - Marc Espié
- University Hospital Saint-Louis, Paris, France
| | | | | | | | | | - Maria Rios
- Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France
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Curtit E, Henriques J, Paget-Bailly S, Ladoire S, Darut-Jouve A, Debled M, Romieu G, Garnier-Tixidre C, Jacquin JP, Soulie P, Jouannaud C, Rios M, Petit T, Bachelot TD, Faure-Mercier C, Gambotti L, Blanché H, Deleuze JF, Cox D, Pivot X. Prognosis value of a genetic score based on germline genetic variants in a prospective cohort of early triple-negative breast cancer patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1529 Background: Triple-negative breast cancers (TNBC) are a heterogeneous group of tumors with poor outcome. In this study, the association between germline genetic variants and invasive disease-free survival (iDFS) was analyzed in TNBC patients. Methods: A genome wide-association study (GWAS) aimed to identify variants (single nucleotide polymorphisms – SNPs) associated with prognosis in 1121 patients with TNBC in the SIGNAL prospective cohort. Associations between gene variants and iDFS were assessed in univariate Cox regression models. Variants were combined in a score to identify risk categories. A prognostic model based on breast cancer stage and genetic variants was estimated using a multivariate Cox regression. Interaction between stage and genetic score was tested. Discrimination of the model was assessed by the Harrell’s C statistic and internal validity by bootstrap method. Results: The characteristics of the 1121 patients were representative of a population with early TNBC. Four SNPs on chromosomes 9 and 2 were found significantly associated to iDFS in univariate Cox models. Homozygous status for the most frequent allele was associated with poorer iDFS for two SNPs and this status was present in 50% and 57% of the population. For the two other SNPs, the most frequent allele was associated with more favorable iDFS. Three prognostic categories were derived from the genetic score. The following table presents the results from the multivariate Cox model including genetic score and disease stage. Clinical trial information: RECF1098. Conclusions: In a prospective cohort of 1121 patients with early TNBC, 4 genetic variants (SNPs) were associated with iDFS. A score involving SNPs provided similar prognostic indications as breast cancer stages. A search assessing the function and the role of the involved genes is ongoing.[Table: see text]
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Affiliation(s)
- Elsa Curtit
- University Hospital - Medical Oncology Department, Besançon, France
| | - Julie Henriques
- Methodology and Quality of Life Unit, Department of Oncology University Hospital, Besançon, France
| | - Sophie Paget-Bailly
- Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098), University Hospital, Besançon, France
| | - Sylvain Ladoire
- Dpt of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | | | | | | | - Jean-Philippe Jacquin
- GINECO-Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest-En-Jarez, France
| | | | | | | | - Thierry Petit
- Paul Strauss Cancer Center and University of Strasbourg, Strasbourg, France
| | | | | | | | | | | | | | - Xavier Pivot
- Administrateur de l’Institut Régional du Cancer, Strasbourg Cedex, France
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Ferrara R, Imbimbo M, Paget-Bailly S, Malouf R, Calais F, Agazzi GM, Marchal C, Westeel V. Single or combined immune checkpoint inhibitors compared to first-line chemotherapy with or without bevacizumab for people with advanced non-small cell lung cancer. Hippokratia 2019. [DOI: 10.1002/14651858.cd013257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Roberto Ferrara
- Fondazione IRCSS Istituto Nazionale dei Tumori; Thoracic Oncology Unit; Milano Milano Italy 20133
| | - Martina Imbimbo
- Fondazione IRCSS Istituto Nazionale dei Tumori; Thoracic Oncology Unit; Milano Milano Italy 20133
| | - Sophie Paget-Bailly
- University Hospital of Besançon; Methodological and Quality of Life in Oncology Unit; 2 Place Saint Jacques Besançon France 25030
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique; Besançon France 25000
| | - Reem Malouf
- University of Oxford; National Perinatal Epidemiology Unit (NPEU); Old Road Campus Oxford UK OX3 7LF
| | - François Calais
- University of Franche-Comté; University Library; Besançon France
| | - Giorgio Maria Agazzi
- University of Brescia; Department of Radiology; P.le Spedali Civili 1 Brescia Italy
| | - Corynne Marchal
- University Hospital of Besançon; Department of Thoracic Oncology; 2, Boulevard Alexandre Fleming Besançon France 25030
| | - Virginie Westeel
- University Hospital of Besançon; Methodological and Quality of Life in Oncology Unit; 2 Place Saint Jacques Besançon France 25030
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique; Besançon France 25000
- University Hospital of Besançon; Department of Thoracic Oncology; 2, Boulevard Alexandre Fleming Besançon France 25030
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Mouillet G, Fritzsch J, Paget-Bailly S, Pozet A, Es-Saad I, Meurisse A, Vernerey D, Mouyabi K, Berthod D, Bonnetain F, Anota A, Thiery-Vuillemin A. Health-related quality of life assessment for patients with advanced or metastatic renal cell carcinoma treated with a tyrosine kinase inhibitor using electronic patient-reported outcomes in daily clinical practice (QUANARIE trial): study protocol. Health Qual Life Outcomes 2019; 17:25. [PMID: 30717745 PMCID: PMC6360763 DOI: 10.1186/s12955-019-1085-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/07/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Two main therapies, pazopanib and sunitinib, are used in the first-line setting for metastatic renal cell carcinoma (mRCC). These two tyrosine kinase inhibitors (TKI) are equally effective in terms of survival; however, they frequently induce adverse events. In this setting, Health-Related Quality of life (HRQoL) is a key element in the choice between these two treatments and the evaluation of treatment effectiveness. It could be of interest to evaluate HRQoL in daily clinical practice to aid adequate therapy choice and management. Currently, the development of information and communication technology may allow HRQoL monitoring in routine practice. The objective of the QUANARIE study is to evaluate the use of HRQoL assessment in daily clinical practice for patients with mRCC treated with TKI using electronic patient-reported outcomes (e-PRO). The present article describes the key elements of the study protocol. METHODS The QUANARIE study is an interventional, prospective, multicentre trial. Patients diagnosed with mRCC initiating sunitinib or pazopanib treatment will be invited to complete the EORTC QLQ-C30 questionnaire, nine additional questions from the EORTC items library, and the EuroQoL EQ-5D, prior to each visit with the physician. Questionnaires will be completed by patients using tablets and/or computer terminals via the e-PRO software. The physician will have real-time access to a visual summary of the HRQoL evaluation. The primary objective is to assess the proportion of patients having good compliance with Routine Electronic Monitoring of HRQoL (REMOQOL) during the first 12 months. Physicians' satisfaction with REMOQOL will be assessed as a secondary objective. We hypothesise that 80% of patients having good compliance with REMOQOL would be meaningful. A sample size of 56 patients would be needed. DISCUSSION The results of this study will show whether REMOQOL is feasible on a large scale and whether patients are receptive to this new practice. This study will also determine how real-time multidimensional evaluation of patient perception can help physicians in their daily practice and how they used it in conjunction with other clinical information to manage patient care. TRIAL REGISTRATION ClinicalTrials.gov; Identifier: NCT03062410 ; First Posted: February 23, 2017; Last Update Posted: August 9, 2017.
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Affiliation(s)
- Guillaume Mouillet
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, F-25000 Besançon, France
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Joëlle Fritzsch
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Sophie Paget-Bailly
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Astrid Pozet
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Ikram Es-Saad
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Aurelia Meurisse
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Dewi Vernerey
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Kristina Mouyabi
- Clinical Research and Innovation Office, University Hospital of Besançon, F-25000 Besançon, France
| | - Diane Berthod
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, F-25000 Besançon, France
| | - Franck Bonnetain
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Amélie Anota
- Methodological and Quality of Life Unit, University Hospital of Besançon, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
- French National Platform Quality of Life and Cancer, Besançon, France
| | - Antoine Thiery-Vuillemin
- Department of Medical Oncology, University Hospital of Besançon, Boulevard Fleming, F-25000 Besançon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, F-25000 Besançon, France
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Klajer E, Paget-Bailly S, Meynard G, Meurisse A, Bazan F, Chaigneau L, Dobi E, Meneveau N, Montcuquet P, Villanueva C, Thiery-Vuillemin A, Kalbacher E, Populaire C, Collonge-Rame MA, Gligorov J, Curtit E, Pivot X, Mansi L. Impact of BRCA status on outcomes and survival in high-risk early breast cancers. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.207] [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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Jacquinot Q, Paget-Bailly S, Fumoleau P, Romieu G, Pierga JY, Espié M, Lortholary A, Nabholtz JM, Mercier CF, Pauporté I, Henriques J, Pivot X. Fluctuation of the left ventricular ejection fraction in patients with HER2-positive early breast cancer treated by 12 months of adjuvant trastuzumab. Breast 2018; 41:1-7. [PMID: 29913374 DOI: 10.1016/j.breast.2018.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 03/03/2018] [Revised: 06/02/2018] [Accepted: 06/02/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Cardiac toxicity with a decrease of the left ventricular ejection fraction (LVEF) is the main side effect induced by trastuzumab. This study reports the fluctuation of LVEF over the 12 months of adjuvant trastuzumab in PHARE trial (NCT00381901). METHODS LVEF assessment was performed every 3 months while patients received trastuzumab and after completion of treatment over the first 2 years and then every 6 months afterwards. The fluctuations of LVEF over time were described and a logistic regression model was performed investigating associated factors to LVEF perfect recovery at baseline value. RESULTS A total of 1631 patients who received 12 months of trastuzumab from PHARE trial, were considered in the analysis. A total of 13 881 LVEF measurements were assessed. Baseline mean LVEF was 66.08% (standard error (SE): 0.15) and the mean relative LVEF decrease observed at 12-month was 3.61% (SE: 0.31). No clinical characteristic was significantly associated to LVEF fluctuation. After completion of trastuzumab, the relative difference progressively disappeared with beyond 30 months a relative difference value of 0.08% (SE: 0.42). Nevertheless, at 30 months, 48.53% of patients with available measures (379/781) did not fully recover their baseline LVEF value. CONCLUSION The LVEF decreased during treatment with trastuzumab and rose up after the completion of treatment without coming back to the initial values for a substantial subset. These results would suggest investigating some strategies aimed to improve the ability to achieve a full recovery.
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Affiliation(s)
- Quentin Jacquinot
- UPFR des Sports, Université de Bourgogne Franche-Comté, Besançon, France; EA 3920: Marqueurs pronostiques et facteurs de régulation des pathologies cardiaques et vasculaires, CHU Jean-Minjoz, Besançon, France.
| | - Sophie Paget-Bailly
- INSERM UMR 1098: Unité de méthodologie et de qualité de vie en cancérologie, CHU Jean-Minjoz, Besançon, France.
| | | | | | | | - Marc Espié
- Hôpital Universitaire Saint-Louis, Paris, France.
| | | | | | | | | | - Julie Henriques
- INSERM UMR 1098: Unité de méthodologie et de qualité de vie en cancérologie, CHU Jean-Minjoz, Besançon, France.
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André T, Vernerey D, Mineur L, Bennouna J, Desrame J, Faroux R, Fratte S, Hug de Larauze M, Paget-Bailly S, Chibaudel B, Bez J, Dauba J, Louvet C, Lepere C, Dupuis O, Becouarn Y, Mabro M, Egreteau J, Bouche O, Deplanque G, Ychou M, Galais MP, Ghiringhelli F, Dourthe LM, Bachet JB, Khalil A, Bonnetain F, de Gramont A, Taieb J. Three Versus 6 Months of Oxaliplatin-Based Adjuvant Chemotherapy for Patients With Stage III Colon Cancer: Disease-Free Survival Results From a Randomized, Open-Label, International Duration Evaluation of Adjuvant (IDEA) France, Phase III Trial. J Clin Oncol 2018; 36:1469-1477. [DOI: 10.1200/jco.2017.76.0355] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Purpose Reduction of adjuvant treatment duration may decrease toxicities without loss of efficacy in stage III colon cancer. This could offer clear advantages to patients and health care providers. Methods In International Duration Evaluation of Adjuvant Chemotherapy (IDEA) France, as part of the IDEA international collaboration, patient with colon cancer patients were randomly assigned to 3 and 6 months of modified FOLFOX6 (mFOLFOX6: infusional fluorouracil, leucovorin, and oxaliplatin) or capecitabine plus oxaliplatin (CAPOX) by physician choice. The primary end point was disease-free survival (DFS), and analyses were descriptive. Results A total of 2,010 eligible patients received either 3 or 6 months of chemotherapy (modified intention-to-treat population); 2,000 (99%) had stage III colon cancer (N1: 75%, N2: 25%); 1,809 (90%) received mFOLFOX6, and 201 (10%) received CAPOX. The median age was 64 years, and the median follow-up time was 4.3 years. Overall, 94% (3 months) and 78% (6 months) of patients completed treatment (fluoropyrimidines ± oxaliplatin). Maximal grade 2 and 3 neuropathy rates were 28% and 8% in the 3-month arm and 41% and 25% in the 6-month arm ( P < .001). Final rates of residual neuropathy greater than grade 1 were 3% in the 3-month arm and 7% in the 6-month arm ( P < .001). There were 578 DFS events: 314 and 264 in the 3- and 6-month arms, respectively. The 3-year DFS rates were 72% and 76% in the 3- and 6-month arms, respectively (hazard ratio [HR], 1.24; 95% CI, 1.05 to 1.46; P = .0112). In the 3 and 6-month arms, respectively, for patients who received mFOLFOX6, the 3-year DFS rates were 72% and 76% (HR, 1.27; 95% CI, 1.07 to 1.51); for the T4 and/or N2 population, they were 58% and 66% (HR, 1.44; 95% CI, 1.14 to 1.82); and for the T1-3N1 population, they were 81% and 83% (HR, 1.15; 95% CI, 0.89 to 1.49). Conclusion IDEA France, in which 90% of patients received mFOLFOX6, shows superiority of 6 months of adjuvant chemotherapy compared with 3 months, especially in the T4 and/or N2 subgroups. These results should be considered alongside the international IDEA collaboration data.
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Affiliation(s)
- Thierry André
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Dewi Vernerey
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Laurent Mineur
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Jaafar Bennouna
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Jérôme Desrame
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Roger Faroux
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Serge Fratte
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Marine Hug de Larauze
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Sophie Paget-Bailly
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Benoist Chibaudel
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Jeremie Bez
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Jérôme Dauba
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Christophe Louvet
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Céline Lepere
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Olivier Dupuis
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Yves Becouarn
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - May Mabro
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Joëlle Egreteau
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Olivier Bouche
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Gaël Deplanque
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Marc Ychou
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Marie Pierre Galais
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - François Ghiringhelli
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Louis Marie Dourthe
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Jean-Baptiste Bachet
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Ahmed Khalil
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Franck Bonnetain
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Aimery de Gramont
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
| | - Julien Taieb
- Thierry André and Benoist Chibaudel, Hôpital Saint-Antoine, Assistance Publique—Hôpitaux de Paris; Thierry André, Sorbonne Universités, UMPC Paris 06; Marine Hug de Larauze and Benoist Chibaudel and Thierry André, Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR); Christophe Louvet, Institut Mutualiste Montsouris; Céline Lepère, Hôpital Européen Georges Pompidou (HEGP); Gaël Deplanque, Groupe Hospitalier Saint-Joseph; Jean-Baptiste Bachet, Groupe Hospitalier Pitié Salpêtrière and Sorbonne
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Turpin A, Paget-Bailly S, Ploquin A, Hollebecque A, Peugniez C, El-Hajbi F, Bonnetain F, Hebbar M. Clinical Relevance of Alternative Endpoints in Colorectal Cancer First-Line Therapy With Bevacizumab: A Retrospective Study. Clin Colorectal Cancer 2017; 17:e99-e107. [PMID: 29128267 DOI: 10.1016/j.clcc.2017.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 09/25/2017] [Accepted: 10/10/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND We studied the relationship between intermediate criteria and overall survival (OS) in metastatic colorectal cancer (mCRC) patients who received first-line chemotherapy with bevacizumab. PATIENTS AND METHODS We assessed OS, progression-free survival (PFS), duration of disease control (DDC), the sum of the periods in which the disease did not progress, and the time to failure of strategy (TFS), which was defined as the entire period before the introduction of a second-line treatment. Linear correlation and regression models were used, and Prentice criteria were investigated. RESULTS With a median follow-up of 57.6 months for 216 patients, the median OS was 24.5 months (95% confidence interval [CI], 21.3-29.7). The median PFS, DDC, and TFS were 8.9 (95% CI, 8.4-9.7), 11.0 (95% CI, 9.8-12.4), and 11.1 (95% CI, 10.0-13.0) months, respectively. The correlations between OS and DDC (Pearson coefficient, 0.79 [95% CI, 0.73-0.83], determination coefficient, 0.62) and OS and TFS (Pearson coefficient, 0.79 [95% CI, 0.73-0.84], determination coefficient, 0.63) were satisfactory. Linear regression analysis showed a significant association between OS and DDC, and between OS and TFS. Prentice criteria were verified for TFS as well as DDC. CONCLUSION DDC and TFS correlated with OS and are relevant as intermediate criteria in the setting of patients with mCRC treated with a first-line bevacizumab-based regimen.
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Affiliation(s)
- Anthony Turpin
- Service d'oncologie médicale, Hôpital Claude Huriez, University Hospital, Lille, France; Université Lille Nord de France, Lille, France; CNRS-UMR8161, Institut de Biologie de Lille, Lille, France.
| | - Sophie Paget-Bailly
- Unité de Méthodologie et Qualité de vie en cancérologie (INSERM U1098), University Hospital, Besançon, France
| | - Anne Ploquin
- Service d'oncologie médicale, Hôpital Claude Huriez, University Hospital, Lille, France; Université Lille Nord de France, Lille, France
| | | | - Charlotte Peugniez
- Service d'onco-hématologie, Hôpital Saint Vincent de Paul, Lille, France
| | - Farid El-Hajbi
- Service de cancérologie digestive, Centre Oscar Lambret, Lille, France
| | - Franck Bonnetain
- Unité de Méthodologie et Qualité de vie en cancérologie (INSERM U1098), University Hospital, Besançon, France
| | - Mohamed Hebbar
- Service d'oncologie médicale, Hôpital Claude Huriez, University Hospital, Lille, France; Université Lille Nord de France, Lille, France
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Mouillet G, Pozet A, Fritzsch J, Es-Saad I, Paget-Bailly S, Foubert A, Berthod D, Anota A, Bonnetain F, Thiery-Vuillemin A. Heath related quality of life (HRQOL) assessment for patients with advanced renal cell carcinoma (mRCC) treated with tyrosine kinase inhibitor (TKI) using electronic patient reported outcome (PRO) in daily clinical practice. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.065] [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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Curtit E, Pivot X, Henriques J, Paget-Bailly S, Fumoleau P, Rios M, Bonnefoi H, Bachelot T, Soulié P, Jouannaud C, Bourgeois H, Petit T, Tennevet I, Assouline D, Mathieu MC, Jacquin JP, Lavau-Denes S, Darut-Jouve A, Ferrero JM, Tarpin C, Lévy C, Delecroix V, Trillet-Lenoir V, Cojocarasu O, Meunier J, Pierga JY, Kerbrat P, Faure-Mercier C, Blanché H, Sahbatou M, Boland A, Bacq D, Besse C, Thomas G, Deleuze JF, Pauporté I, Romieu G, Cox DG. Assessment of the prognostic role of a 94-single nucleotide polymorphisms risk score in early breast cancer in the SIGNAL/PHARE prospective cohort: no correlation with clinico-pathological characteristics and outcomes. Breast Cancer Res 2017; 19:98. [PMID: 28830573 PMCID: PMC5568360 DOI: 10.1186/s13058-017-0888-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 05/24/2016] [Accepted: 08/04/2017] [Indexed: 12/17/2022] Open
Abstract
Background Genome-wide association studies (GWAS) have to date identified 94 genetic variants (single nucleotide polymorphisms (SNPs)) associated with risk of developing breast cancer. A score based on the combined effect of the 94 risk alleles can be calculated to measure the global risk of breast cancer. We aimed to test the hypothesis that the 94-SNP-based risk score is associated with clinico-pathological characteristics, breast cancer subtypes and outcomes in early breast cancer. Methods A 94-SNP risk score was calculated in 8703 patients in the PHARE and SIGNAL prospective case cohorts. This score is the total number of inherited risk alleles based on 94 selected SNPs. Clinical data and outcomes were prospectively registered. Genotyping was obtained from a GWAS. Results The median 94-SNP risk score in 8703 patients with early breast cancer was 77.5 (range: 58.1–97.6). The risk score was not associated with usual prognostic and predictive factors (age; tumor, node, metastasis (TNM) status; Scarff-Bloom-Richardson grade; inflammatory features; estrogen receptor status; progesterone receptor status; human epidermal growth factor receptor 2 (HER2) status) and did not correlate with breast cancer subtypes. The 94-SNP risk score did not predict outcomes represented by overall survival or disease-free survival. Conclusions In a prospective case cohort of 8703 patients, a risk score based on 94 SNPs was not associated with breast cancer characteristics, cancer subtypes, or patients’ outcomes. If we hypothesize that prognosis and subtypes of breast cancer are determined by constitutional genetic factors, our results suggest that a score based on breast cancer risk-associated SNPs is not associated with prognosis. Trial registration PHARE cohort: NCT00381901, Sept. 26, 2006 – SIGNAL cohort: INCa RECF1098, Jan. 28, 2009 Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0888-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elsa Curtit
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire, UMR 1098 INSERM-EFS-Université de Bourgogne Franche-Comté, Boulevard Fleming, 25000, Besançon, France. .,Department of Medical Oncology, University Hospital Jean Minjoz, 3, boulevard Alexandre Fleming, 25030, Besancon Cedex, France.
| | - Xavier Pivot
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire, UMR 1098 INSERM-EFS-Université de Bourgogne Franche-Comté, Boulevard Fleming, 25000, Besançon, France
| | - Julie Henriques
- Centre Hospitalier Universitaire, Unité de Méthodologie et de Qualité de Vie en Cancérologie, 2 place St Jacques, 25000, Besançon, France
| | - Sophie Paget-Bailly
- Centre Hospitalier Universitaire, Unité de Méthodologie et de Qualité de Vie en Cancérologie, 2 place St Jacques, 25000, Besançon, France
| | - Pierre Fumoleau
- Georges-François Leclerc, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Maria Rios
- Institut de Cancérologie de Lorraine - Alexis Vautrin, département d'Oncologie Médicale, 6, avenue de Bourgogne, 54511, Vandoeuvre Les Nancy Cedex, France
| | - Hervé Bonnefoi
- Institut Bergonié, Département d'Oncologie Médicale, 229 Cours de l'Argonne, 33000, Bordeaux, France
| | - Thomas Bachelot
- Centre Léon Bérard, Département de Cancérologie Médicale, 28 rue Laënnec, Lyon Cedex 08, France
| | - Patrick Soulié
- Institut de Cancérologie de l'Ouest, Service Oncologie Médicale, 2 rue Moll, 49993, Angers Cedex 09, France
| | - Christelle Jouannaud
- Institut Jean Godinot, Service Oncologie Médicale, 1 rue du Général Koenig, 51056, Reims cedex, France
| | - Hugues Bourgeois
- Clinique Victor Hugo-Centre Jean Bernard, 18 rue Victor Hugo, 72015, Le Mans Cedex 2, France
| | - Thierry Petit
- Centre Paul Strauss, Service d'Oncologie Médicale, 3 rue de la Porte de l'Hôpital, 67065, Strasbourg Cedex, France
| | | | - David Assouline
- Institut Daniel Hollard, Service Oncologie Médicale, 8 rue du Docteur Calmette, 38028, Grenoble Cedex 01, France
| | - Marie-Christine Mathieu
- Institut Gustave Roussy, Comité de Pathologie mammaire, 39 rue Camille Desmoulins, 94805, Villejuif Cedex, France
| | - Jean-Philippe Jacquin
- Institut de Cancérologie Lucien Neuwirth, Service Oncologie Médicale, 108 bis avenue Albert Raimond, 42270, Saint Priest en Jarez, France
| | - Sandrine Lavau-Denes
- Centre Hospitalier de Limoges, Service d'Oncologie Médicale, 2 avenue Martin Luther King, 87042, Limoges Cedex, France
| | - Ariane Darut-Jouve
- Clinique Drévon, Centre d'oncologie et de radiothérapie du Parc, 18 cours du général de Gaulle, 21000, Dijon, France
| | - Jean-Marc Ferrero
- Centre Antoine Lacassagne, Département Oncologie Médicale, 33 avenue de Valombrose, 06189, Nice Cedex 02, France
| | - Carole Tarpin
- Institut Paoli-Calmettes, Département d'Oncologie Médicale, 232 Boulevard de Sainte-Marguerite, 13009, Marseille, France
| | - Christelle Lévy
- Centre François Baclesse, 3 avenue du Général Harris, 14076, Caen Cedex 5, France
| | - Valérie Delecroix
- Centre Etienne Dolet, Pôle Mutualiste, Service Oncologie Médicale, 11 boulevard Georges Charpak, 44606, Saint Nazaire, France
| | - Véronique Trillet-Lenoir
- Centre Hospitalier Lyon Sud, Service d'Oncologie Médicale, 165 chemin du Grand Revoyet, 69495, Pierre-Benite Cedex, France
| | - Oana Cojocarasu
- Centre Hospitalier Le Mans, Service d'Onco-Hématologie et Médecine interne, 194 avenue Rubillard, 72037, Le Mans Cedex, France
| | - Jérôme Meunier
- Centre Hospitalier Régional d'Orléans, Service d'Oncologie médicale, 1 rue Porte Madeleine, 45032, Orleans Cedex 1, France
| | - Jean-Yves Pierga
- Institut Curie, Department of Medical Oncology, 26 rue d'Ulm, 75248, Paris Cedex 05, France
| | - Pierre Kerbrat
- Centre Eugène Marquis, Service Oncologie médicale, Rue de la Bataille Flandres-Dunkerque, CS 44229, 35042, Rennes Cedex, France
| | - Céline Faure-Mercier
- Institut National du Cancer, Direction de la Recherche, 52 avenue Morizet, 92513, Boulogne-Billancourt, France
| | - Hélène Blanché
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, 75010, Paris, France
| | - Mourad Sahbatou
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, 75010, Paris, France
| | - Anne Boland
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, 91057, Evry Cedex, France
| | - Delphine Bacq
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, 91057, Evry Cedex, France
| | - Céline Besse
- Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, 91057, Evry Cedex, France
| | - Gilles Thomas
- Synergie Lyon Cancer, Centre Léon Bérard, 28 rue Laënnec, Lyon Cedex 08, France
| | - Jean-François Deleuze
- Centre d'Etudes du Polymorphisme Humain, 27 rue Juliette Dodu, 75010, Paris, France.,Centre National du Génotypage, 2 rue Gaston Crémieux, CP 5721, 91057, Evry Cedex, France
| | - Iris Pauporté
- Institut National du Cancer, Direction de la Recherche, 52 avenue Morizet, 92513, Boulogne-Billancourt, France
| | - Gilles Romieu
- Oncologie Sénologie, ICM Institut Régional du Cancer, 34298, Montpellier Cedex, France
| | - David G Cox
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052 - Centre Léon Bérard, 28 rue Laennec, 69373, Lyon, France
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Pivot X, Fumoleau P, Pierga JY, Delaloge S, Bonnefoi H, Bachelot T, Jouannaud C, Bourgeois H, Rios M, Soulié P, Jacquin JP, Lavau-Denes S, Kerbrat P, Cox D, Faure-Mercier C, Pauporte I, Gligorov J, Curtit E, Henriques J, Paget-Bailly S, Romieu G. Superimposable outcomes for sequential and concomitant administration of adjuvant trastuzumab in HER2-positive breast cancer: Results from the SIGNAL/PHARE prospective cohort. Eur J Cancer 2017. [PMID: 28624696 DOI: 10.1016/j.ejca.2017.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AIM Adjuvant clinical trials in early human epidermal growth factor receptor 2 (HER2)-positive breast cancer have assessed either sequential or concomitant incorporation of trastuzumab with chemotherapy; only the North Central Cancer Treatment Group (NCCTG)-N9831 trial prospectively compared both modalities. In routine trastuzumab has been incorporated into a concurrent regimen with taxane chemotherapy instead of sequential modality on the basis of a positive risk-benefit ratio. This present study assessed sequential versus concomitant administration of adjuvant trastuzumab. METHODS A population combining patients from Protocol for Herceptin® as Adjuvant therapy with Reduced Exposure (PHARE) a randomised phase III clinical trial (NCT00381901) and SIGNAL (RECF1098) a prospective study specifically designed for Genome-wide Association Studies (GWAS) analyses was studied. In this cohort with 58 months of median follow-up, the comparison in the HER2-positive group of adjuvant trastuzumab and chemotherapy modalities was based on a propensity score methodology. Treatment modalities were based on physician's choice and comparisons adjustment were made by a propensity score methodology. Overall Survival (OS) and Disease-Free Survival (DFS) were estimated using the Kaplan-Meier method, and comparisons between groups were based on the log rank test. RESULTS The SIGNAL/PHARE cohort included 11,728 breast cancer cases treated in adjuvant setting; some 5502 of them with HER2-positive tumour: 34.5% (1897/5502) were treated by sequential and 65.5% (3605/5502) by concomitant modality of administration for taxane-chemotherapy and trastuzumab. The adjusted comparison found similar OS (HR = 1.01; 95% CI: 0.86-1.19) and similar DFS (HR = 1.08; 95% CI: 0.96-1.21). CONCLUSION These results suggest that the sequential administration of trastuzumab given after the completion of adjuvant chemotherapy might be as valid as the concomitant administration of trastuzumab and taxane chemotherapy in the adjuvant setting.
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Affiliation(s)
- Xavier Pivot
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire INSERM 1098, Boulevard Fleming, 25030 Besançon, France.
| | - Pierre Fumoleau
- Georges-François Leclerc, 1 Rue du Professeur Marion, 21000 Dijon, France
| | - Jean-Yves Pierga
- Institut Curie, Department of Medical Oncology, 26 rue d'Ulm, 75248 Paris Cedex 05, France
| | - Suzette Delaloge
- Institut Gustave Roussy, Comité de Pathologie mammaire, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France
| | - Hervé Bonnefoi
- Institut Bergonié, Département d'Oncologie Médicale, 229 Cours de l'Argonne, 33000 Bordeaux, France
| | - Thomas Bachelot
- Centre Léon Bérard, Département de Cancérologie Médicale, 28 rue Laënnec, Lyon Cedex 08, France
| | - Christelle Jouannaud
- Institut Jean Godinot, Service Oncologie Médicale, 1 rue du Général Koenig, 51056 Reims Cedex, France
| | - Hugues Bourgeois
- Clinique Victor Hugo-Centre Jean Bernard, 18 rue Victor Hugo, 72015 Le Mans Cedex 2, France
| | - Maria Rios
- Institut de Cancérologie de Lorraine - Alexis Vautrin, département d'Oncologie Médicale, 6, avenue de Bourgogne, 54511 Vandoeuvre Les Nancy Cedex, France
| | - Patrick Soulié
- Institut de Cancérologie de l'Ouest, Service Oncologie Médicale, 2 rue Moll, 49993 Angers Cedex 09, France
| | - Jean-Philippe Jacquin
- Institut de Cancérologie Lucien Neuwirth, Service Oncologie Médicale, 108 bis avenue Albert Raimond, 42270 Saint Priest en Jarez, France
| | - Sandrine Lavau-Denes
- Centre Hospitalier de Limoges, Service d'Oncologie Médicale, 2 avenue Martin Luther King, 87042 Limoges Cedex, France
| | - Pierre Kerbrat
- Centre Eugène Marquis, Service Oncologie médicale, Rue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes Cedex, France
| | - David Cox
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052 - Centre Léon Bérard, 28 rue Laennec, 69373 Lyon, France
| | - Céline Faure-Mercier
- Institut National du Cancer, Direction de la Recherche, 52 avenue Morizet, 92513 Boulogne-Billancourt, France
| | - Iris Pauporte
- Institut National du Cancer, Direction de la Recherche, 52 avenue Morizet, 92513 Boulogne-Billancourt, France
| | - Joseph Gligorov
- Hôpital Tenon, Service Oncologie médicale, 4 rue de la Chine, 75970 Paris Cedex 20, France
| | - Elsa Curtit
- Hôpital Jean-Minjoz, Centre Hospitalier Universitaire INSERM 1098, Boulevard Fleming, 25030 Besançon, France
| | - Julie Henriques
- Centre Hospitalier Universitaire, Unité de Méthodologie et de Qualité de Vie en Cancérologie, 2 place St Jacques, 25000 Besançon, France
| | - Sophie Paget-Bailly
- Centre Hospitalier Universitaire, Unité de Méthodologie et de Qualité de Vie en Cancérologie, 2 place St Jacques, 25000 Besançon, France
| | - Gilles Romieu
- Oncologie Sénologie, ICM Institut Régional du Cancer, 34298 Montpellier Cedex, France
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Es-Saad I, Paget-Bailly S, Fritzsch J, Mouillet G, Bonnetain F. [Assessment of the quality of life with regard to health following a cancer diagnosis]. Rev Infirm 2017; 66:36-37. [PMID: 28048994 DOI: 10.1016/j.revinf.2016.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The measurement of the quality of life in terms of health of people undergoing treatment for cancer is developing. This new indicator focusing on patients' personal experience is combined with standard criteria relating to their tumours. The data are also a factor in the prognosis of overall survival. A team of researchers at Besançon university hospital shares its experience.
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Affiliation(s)
- Ikram Es-Saad
- Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098) CHRU Besançon, Jean-Minjoz, 3 boulevard Fleming, 25 030 Besançon, France.
| | - Sophie Paget-Bailly
- Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098) CHRU Besançon, Jean-Minjoz, 3 boulevard Fleming, 25 030 Besançon, France
| | - Joëlle Fritzsch
- Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098) CHRU Besançon, Jean-Minjoz, 3 boulevard Fleming, 25 030 Besançon, France
| | - Guillaume Mouillet
- Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098) CHRU Besançon, Jean-Minjoz, 3 boulevard Fleming, 25 030 Besançon, France
| | - Franck Bonnetain
- Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098) CHRU Besançon, Jean-Minjoz, 3 boulevard Fleming, 25 030 Besançon, France
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Kim S, Paget-Bailly S, Messager M, Nguyen T, Mathieu P, Lamfichekh N, Fein F, Fratté S, Cléau D, Lakkis Z, Jary M, Sakek N, Jacquin M, Foubert A, Bonnetain F, Mariette C, Fiteni F, Borg C. Perioperative docetaxel, cisplatin, and 5-fluorouracil compared to standard chemotherapy for resectable gastroesophageal adenocarcinoma. Eur J Surg Oncol 2017; 43:218-225. [DOI: 10.1016/j.ejso.2016.06.395] [Citation(s) in RCA: 7] [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] [Received: 01/15/2016] [Revised: 04/20/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022] Open
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Vernerey D, Anota A, Vandel P, Paget-Bailly S, Dion M, Bailly V, Bonin M, Pozet A, Foubert A, Benetkiewicz M, Manckoundia P, Bonnetain F. Erratum to: Development and validation of the FRAGIRE tool for assessment an older person's risk for frailty. BMC Geriatr 2016; 16:212. [PMID: 27938329 PMCID: PMC5146844 DOI: 10.1186/s12877-016-0385-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Dewi Vernerey
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | - Amelie Anota
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France.,National clinical research Platform for Quality of life in Oncology, Besançon, France
| | - Pierre Vandel
- Department of psychiatry, EA 481, University Hospital of Besançon, Besançon, France
| | - Sophie Paget-Bailly
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | - Michele Dion
- Centre Georges Chevrier «Knowledge: norms and sensitivities», UMR CNRS 7366, University of Burgundy, Dijon, France
| | - Vanessa Bailly
- Interregional Gerontology Pole from Burgundy and Franche-Comté, Dijon, France
| | - Marie Bonin
- Interregional Gerontology Pole from Burgundy and Franche-Comté, Dijon, France
| | - Astrid Pozet
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | - Audrey Foubert
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | | | - Patrick Manckoundia
- Department of Geriatrics and Internal Medicine, Hospital of Champmaillot, University Hospital, Dijon, France.,Inserm/U1093 Cognition, Action and Sensorimotor Plasticity, University of Burgundy Franche-Comté, Dijon, France
| | - Franck Bonnetain
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France. .,National clinical research Platform for Quality of life in Oncology, Besançon, France.
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Es-saad I, Mouillet G, Paillard MJ, Paget-Bailly S, Anota A, Pozet A, Foubert A, Bonnetain F. Recueil en routine de la qualité de vie des patients atteints d’un cancer, étude de faisabilité. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.10.057] [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: 11/17/2022] Open
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Paget-Bailly S, Kalbacher E, Ramanah R, Meurisse A, Es Saad I, Bonnetain F. Qualité de vie des patientes atteintes de cancers gynécologiques pelviens – étude de faisabilité d’une cohorte où la qualité de vie est recueillie électroniquement. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.10.053] [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] Open
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35
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Vernerey D, Anota A, Vandel P, Paget-Bailly S, Dion M, Bailly V, Bonin M, Pozet A, Foubert A, Benetkiewicz M, Manckoundia P, Bonnetain F. Development and validation of the FRAGIRE tool for assessment an older person's risk for frailty. BMC Geriatr 2016; 16:187. [PMID: 27855641 PMCID: PMC5114762 DOI: 10.1186/s12877-016-0360-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 04/12/2016] [Accepted: 11/09/2016] [Indexed: 11/14/2022] Open
Abstract
Background Frailty is highly prevalent in elderly people. While significant progress has been made to understand its pathogenesis process, few validated questionnaire exist to assess the multidimensional concept of frailty and to detect people frail or at risk to become frail. The objectives of this study were to construct and validate a new frailty-screening instrument named Frailty Groupe Iso-Ressource Evaluation (FRAGIRE) that accurately predicts the risk for frailty in older adults. Methods A prospective multicenter recruitment of the elderly patients was undertaken in France. The subjects were classified into financially-helped group (FH, with financial assistance) and non-financially helped group (NFH, without any financial assistance), considering FH subjects are more frail than the NFH group and thus representing an acceptable surrogate population for frailty. Psychometric properties of the FRAGIRE grid were assessed including discrimination between the FH and NFH groups. Items reduction was made according to statistical analyses and experts’ point of view. The association between items response and tests with “help requested status” was assessed in univariate and multivariate unconditional logistic regression analyses and a prognostic score to become frail was finally proposed for each subject. Results Between May 2013 and July 2013, 385 subjects were included: 338 (88%) in the FH group and 47 (12%) in the NFH group. The initial FRAGIRE grid included 65 items. After conducting the item selection, the final grid of the FRAGIRE was reduced to 19 items. The final grid showed fair discrimination ability to predict frailty (area under the curve (AUC) = 0.85) and good calibration (Hosmer-Lemeshow P-value = 0.580), reflecting a good agreement between the prediction by the final model and actual observation. The Cronbach's alpha for the developed tool scored as high as 0.69 (95% Confidence Interval: 0.64 to 0.74). The final prognostic score was excellent, with an AUC of 0.756. Moreover, it facilitated significant separation of patients into individuals requesting for help from others (P-value < 0.0001), with sensitivity of 81%, specificity of 61%, positive predictive value of 93%, negative predictive value of 34%, and a global predictive value of 78%. Conclusions The FRAGIRE seems to have considerable potential as a reliable and effective tool for identifying frail elderly individuals by a public health social worker without medical training. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0360-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dewi Vernerey
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | - Amelie Anota
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France.,National clinical research Platform for Quality of life in Oncology, Besançon, France
| | - Pierre Vandel
- Department of psychiatry, EA 481, University Hospital of Besançon, Besançon, France
| | - Sophie Paget-Bailly
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | - Michele Dion
- Centre Georges Chevrier «Knowledge: norms and sensitivities», UMR CNRS 7366, University of Burgundy, Dijon, France
| | - Vanessa Bailly
- Interregional Gerontology Pole from Burgundy and Franche-Comté, Dijon, France
| | - Marie Bonin
- Interregional Gerontology Pole from Burgundy and Franche-Comté, Dijon, France
| | - Astrid Pozet
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | - Audrey Foubert
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | | | - Patrick Manckoundia
- Department of Geriatrics and Internal Medicine, Hospital of Champmaillot, University Hospital, Dijon, France.,Inserm/U1093 Cognition, Action and Sensorimotor Plasticity, University of Burgundy Franche-Comté, Dijon, France
| | - Franck Bonnetain
- Methodological and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France. .,National clinical research Platform for Quality of life in Oncology, Besançon, France.
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Fiteni F, Paget-Bailly S, Messager M, N'Guyen T, Lakkis Z, Mathieu P, Lamfichekh N, Picard A, Benzidane B, Cléau D, Bonnetain F, Borg C, Mariette C, Kim S. Docetaxel, Cisplatin, and 5-Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma. Cancer Med 2016; 5:3085-3093. [PMID: 27726290 PMCID: PMC5119963 DOI: 10.1002/cam4.885] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/26/2016] [Accepted: 07/31/2016] [Indexed: 12/25/2022] Open
Abstract
Docetaxel, cisplatin, and 5‐fluorouracil (DCF) significantly improved overall survival in metastatic gastroesophageal adenocarcinoma (GEA). The aim of this study was to assess efficacy of DCF regimen as perioperative chemotherapy compared with surgery alone in patients with resectable GEA. We identified 789 patients who underwent surgery alone and 62 patients who received at least one cycle of DCF regimen consisting of docetaxel (75 mg/m2 on day 1), cisplatin (75 mg/m2 on day 1), and 5‐fluorouracil (750 mg/m2/day on continuous perfusion on days 1 to 5), every 3 weeks. Overall survival was compared using Cox proportional hazards regression model with adjustments for confounding factors provided by two propensity score methods: inverse probability of treatment weighting (IPTW) and matched‐pair analysis. In Cox multivariate analysis weighted by IPTW, DCF group was associated with favorable overall survival (OS) compared with the surgery group (HR = 0.59; 95% CI, 0.45–0.78; P = 0.0003). For the matched‐pair analysis (comparing 41 patients for each group with the same baseline characteristics), median OS was 22 months and 57 months for the surgery group and DCF group, respectively (log‐rank P = 0.0011). In Cox multivariate analysis, DCF group was associated with favorable OS compared with the surgery group (HR = 0.29; 95% IC, 0.14–0.64; P = 0.0019). In the matched‐pair population, major complications (Dindo‐Clavien grade 3–5) arose in six patients (14.63%) in the DCF group and seven patients (17.07%) in the surgery group (P = 1). Perioperative DCF chemotherapy is superior to surgery alone in terms of OS. A randomized phase III trial should compare DCF to standard perioperative regimens.
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Affiliation(s)
- Frédéric Fiteni
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France
| | - Mathieu Messager
- Lille University Hospital, Department of Digestive Surgery, Lille, France.,FREGAT (French Esophageal and Gastric Tumour) working group, Paris, France
| | - Thierry N'Guyen
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Zaher Lakkis
- Department of Digestive Surgery and Liver Transplantation, University Hospital of Besançon, Besançon, France
| | - Pierre Mathieu
- Department of Digestive Surgery and Liver Transplantation, University Hospital of Besançon, Besançon, France
| | - Najib Lamfichekh
- Department of Surgery, Nord Franche Comté Hospital, Montbeliard, France
| | - Alain Picard
- Department of Surgery, Nord Franche Comté Hospital, Belfort, France
| | - Bilell Benzidane
- Department of Oncology and Radiotherapy, Nord Franche Comté Hospital, Montbeliard, France
| | - Denis Cléau
- Department of Gastroenterology, Hospital of Vesoul, Vesoul, France
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.,University of Franche-Comté, Besançon, EA 3181, France
| | - Christophe Borg
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,Unit 1098, INSERM, University of Franche-Comté, Besançon, France.,Clinical Investigational Center, University Hospital of Besançon, CIC-1431, France
| | - Christophe Mariette
- Lille University Hospital, Department of Digestive Surgery, Lille, France.,FREGAT (French Esophageal and Gastric Tumour) working group, Paris, France
| | - Stefano Kim
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,Unit 1098, INSERM, University of Franche-Comté, Besançon, France.,Clinical Investigational Center, University Hospital of Besançon, CIC-1431, France
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Pivot X, Pierga JY, Delaloge S, Fumoleau P, Bonnefoi H, Bachelot T, Jouannaud C, Bourgeois H, Rios M, Soulie P, Jacquin J, Lavau-Denes S, Kerbrat P, Faure Mercier C, Pauporte I, Gligorov J, Curtit E, Henriques J, Paget-Bailly S, Romieu G. Superimposable outcomes for sequential and concomitant administration of adjuvant trastuzumab in HER2-positive breast cancer: Results from the SIGNAL/PHARE prospective cohort. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.01] [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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Turpin A, Paget-Bailly S, Ploquin A, Hollebecque A, Dominguez S, Bonnetain F, El Hajbi F, Hebbar M. Correlation between alternative endpoints and overall survival in metastatic colorectal cancer patients eligible to a maintenance strategy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.143] [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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Curtit E, Pivot X, Henriques J, Paget-Bailly S, Fumoleau P, Rios M, Bonnefoi H, Soulie P, Jouannaud C, Bourgeois H, Pierga JY, Tennevet I, Trillet-Lenoir V, Kerbrat P, Petit T, Bachelot T, Deleuze JF, Pauporte I, Romieu G, Cox D. Assessment of the prognostic role of a 94-single nucleotide polymorphisms risk score in early breast cancer in the SIGNAL/PHARE prospective cohort: no correlation with clinico-pathological characteristics and outcomes. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.34] [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: 11/12/2022] Open
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Curtit E, Vincent-Salomon A, Paget-Bailly S, Romieu G, Fumoleau P, Bonnefoi H, Jouannaud C, Petit T, Darut-Jouve A, Trillet-Lenoir V, Tarpin C, Pierga JY, Rios M, Jacquin J, Bachelot T, Cox D, Deleuze JF, Pauporte I, Henriques J, Pivot X. Effects of HER2 immuno-histochemistry expression levels on survival in patients treated by trastuzumab at the adjuvant setting in the SIGNAL/PHARE prospective cohort. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.40] [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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Fiteni F, Pam A, Anota A, Vernerey D, Paget-Bailly S, Westeel V, Bonnetain F. Health-related quality-of-life as co-primary endpoint in randomized clinical trials in oncology. Expert Rev Anticancer Ther 2015; 15:885-91. [DOI: 10.1586/14737140.2015.1047768] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Anota A, Mouillet G, Trouilloud I, Dupont-Gossart AC, Artru P, Lecomte T, Zaanan A, Gauthier M, Fein F, Dubreuil O, Paget-Bailly S, Taieb J, Bonnetain F. Sequential FOLFIRI.3 + Gemcitabine Improves Health-Related Quality of Life Deterioration-Free Survival of Patients with Metastatic Pancreatic Adenocarcinoma: A Randomized Phase II Trial. PLoS One 2015; 10:e0125350. [PMID: 26010884 PMCID: PMC4444351 DOI: 10.1371/journal.pone.0125350] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 03/19/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND A randomized multicenter phase II trial was conducted to assess the sequential treatment strategy using FOLFIRI.3 and gemcitabine alternately (Arm 2) compared to gemcitabine alone (Arm 1) in patients with metastatic non pre-treated pancreatic adenocarcinoma. The primary endpoint was the progression-free survival (PFS) rate at 6 months. It concludes that the sequential treatment strategy appears to be feasible and effective with a PFS rate of 43.5% in Arm 2 at 6 months (26.1% in Arm 1). This paper reports the results of the longitudinal analysis of the health-related quality of life (HRQoL) as a secondary endpoint of this study. METHODS HRQoL was evaluated using the EORTC QLQ-C30 at baseline and every two months until the end of the study or death. HRQoL deterioration-free survival (QFS) was defined as the time from randomization to a first significant deterioration as compared to the baseline score with no further significant improvement, or death. A propensity score was estimated comparing characteristics of partial and complete responders. Analyses were repeated with inverse probability weighting method using the propensity score. Multivariate Cox regression analyses were performed to identify independent factors influencing QFS. RESULTS 98 patients were included between 2007 and 2011. Adjusting on the propensity score, patients of Arm 2 presented a longer QFS of Global Health Status (Hazard Ratio: 0.52 [0.31-0.85]), emotional functioning (0.35 [0.21-0.59]) and pain (0.50 [0.31-0.81]) than those of Arm 1. CONCLUSION Patients of Arm 2 presented a better HRQoL with a longer QFS than those of Arm 1. Moreover, the propensity score method allows to take into account the missing data depending on patients' characteristics. TRIAL REGISTRATION INFORMATION Eudract N° 2006-005703-34. (Name of the Trial: FIRGEM).
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Affiliation(s)
- Amélie Anota
- National Quality of Life in Oncology Platform, Besançon, France
- Methodological and Quality of Life in Oncology Unit (EA 3181), University Hospital of Besançon, Besançon, France
| | - Guillaume Mouillet
- Methodological and Quality of Life in Oncology Unit (EA 3181), University Hospital of Besançon, Besançon, France
| | - Isabelle Trouilloud
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | | | - Pascal Artru
- Hepato-Gastro-Enterology and Digestive Oncology Department, Hospital Jean Mermoz, Lyon, France
| | - Thierry Lecomte
- Department of Gastroenterology and Digestive Oncology, University Hospital of Tours- Trousseau Hospital, Chambray-Les-Tours, France
| | - Aziz Zaanan
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Mélanie Gauthier
- Biostatistics and Quality of Life Unit, Centre Georges François Leclerc, Dijon, France
| | - Francine Fein
- Department of Gastroenterology, University Hospital of Besançon, Besançon, France
| | - Olivier Dubreuil
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Sophie Paget-Bailly
- Methodological and Quality of Life in Oncology Unit (EA 3181), University Hospital of Besançon, Besançon, France
| | - Julien Taieb
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Franck Bonnetain
- National Quality of Life in Oncology Platform, Besançon, France
- Methodological and Quality of Life in Oncology Unit (EA 3181), University Hospital of Besançon, Besançon, France
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Laurent-Puig P, Paget-Bailly S, Vernerey D, Vazart C, Decaulne V, Fontaine K, Rousseau F, Elliott F, Quirke P, Richman S, Seligman J, Seymour MT, Bonnetain F, Liebaert F, Thiébaut R. Evaluation of miR 31 3p as a biomarker of prognosis and panitumumab benefit in RAS-wt advanced colorectal cancer (aCRC): Analysis of patients (pts) from the PICCOLO trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.3547] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Franck Bonnetain
- Methodology and Quality of Life Unit, Department of Oncology, EA 3181, University Hospital of Besançon; French National Platform Quality of Life and Cancer, Besançon, France
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Kim S, Fiteni F, Paget-Bailly S, Ghiringhelli F, Lakkis Z, Jary M, Fein F, Bonnetain F, Mariette C, Borg C. The impact of taxane-based preoperative chemotherapy in gastroesophageal signet ring cell adenocarcinomas. J Hematol Oncol 2015; 8:52. [PMID: 25976888 PMCID: PMC4440289 DOI: 10.1186/s13045-015-0148-y] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 05/06/2015] [Indexed: 12/13/2022] Open
Abstract
The benefit of preoperative chemotherapy in resectable gastroesophageal adenocarcinomas was not observed in signet ring cell subtype. However, the potential interest of taxane-based preoperative chemotherapy on this subtype is still an unresolved issue. Nineteen patients with localized signet ring cell adenocarcinomas received taxane-based regimens, and 17 patients underwent surgery. Complete resection was achieved in 80 %, and median overall survival was 40.8 months (95 % confidence interval (CI), 20.2—not reached). Even though one patient achieved a complete pathological response, seven patients had an upstaging of their tumors at surgery. The potential benefits of taxane-based chemotherapy seem to be limited to a reduced number of patients.
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Affiliation(s)
- Stefano Kim
- Department of Medical Oncology, University Hospital of Besancon, 3 Boulevard Alexander Fleming, Besancon, F-25030, France. .,Clinical Investigational Centre, CIC-1431, University Hospital of Besançon, Besançon, France. .,INSERM, Unit 1098, University of Franche-Comté, Besançon, France.
| | - Frederic Fiteni
- Department of Medical Oncology, University Hospital of Besancon, 3 Boulevard Alexander Fleming, Besancon, F-25030, France. .,Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.
| | | | - Zaher Lakkis
- Department of Digestive Surgery and Liver Transplantation, University Hospital of Besançon, Besançon, France.
| | - Marine Jary
- Department of Medical Oncology, University Hospital of Besancon, 3 Boulevard Alexander Fleming, Besancon, F-25030, France. .,INSERM, Unit 1098, University of Franche-Comté, Besançon, France.
| | - Francine Fein
- Department of Gastroenterology, University Hospital of Besançon, Besançon, France.
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France. .,EA 3181 University of Franche-Comté, Besançon, Besançon, France.
| | | | - Christophe Borg
- Department of Medical Oncology, University Hospital of Besancon, 3 Boulevard Alexander Fleming, Besancon, F-25030, France. .,Clinical Investigational Centre, CIC-1431, University Hospital of Besançon, Besançon, France. .,INSERM, Unit 1098, University of Franche-Comté, Besançon, France.
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45
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Paget-Bailly S, Paulus V, Pana-Katatali H, Agazzi GM, Trinquart L, Calais F, Westeel V. Maintenance therapy for advanced non-small cell lung cancer (NSCLC). Hippokratia 2015. [DOI: 10.1002/14651858.cd011631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Sophie Paget-Bailly
- University Hospital of Besançon; Methodological and Quality of Life in Oncology Unit; 2 Place Saint Jacques Besançon France 25030
| | - Valérie Paulus
- University Hospital of Besançon; Thoracic Oncology; 3, Boulevard Alexandre Fleming Besançon France 25030
| | - Héloïse Pana-Katatali
- University Hospital of Besançon; Thoracic Oncology; 3, Boulevard Alexandre Fleming Besançon France 25030
| | | | | | - François Calais
- University of Franche-Comté; University Library; Besançon France
| | - Virginie Westeel
- University Hospital of Besançon; Thoracic Oncology; 3, Boulevard Alexandre Fleming Besançon France 25030
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Pivot X, Mansi L, Chaigneau L, Montcuquet P, Thiery-Vuillemin A, Bazan F, Dobi E, Sautiere JL, Rigenbach F, Algros MP, Butler S, Jamshidian F, Febbo P, Svedman C, Paget-Bailly S, Bonnetain F, Villanueva C. In the era of genomics, should tumor size be reconsidered as a criterion for neoadjuvant chemotherapy? Oncologist 2015; 20:344-50. [PMID: 25795632 PMCID: PMC4391758 DOI: 10.1634/theoncologist.2014-0198] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 12/18/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The Oncotype DX recurrence score (RS) assay has been validated for prediction of 10-year risk of distant recurrence and likelihood of benefit from chemotherapy in patients with estrogen receptor (ER)-positive, HER2-negative early breast cancer. Patients with high RS tumors have substantial benefit, and patients with low RS tumors have minimal if any benefit from chemotherapy. Tumor size is used as a key parameter when selecting patients for neoadjuvant chemotherapy. The aim of this study was to assess the distribution of RS in patients selected for neoadjuvant chemotherapy primarily according to tumor size. PATIENTS AND METHODS Patients with ER-positive and HER2-negative tumors that were node-negative or had no more than 1 positive node from three trials were included in this study. Oncotype DX was performed at Genomic Health, Inc., blinded to the clinical data. Descriptive statistics were calculated for distribution of RS for all cases. RESULTS Of 277 patients, 96 met eligibility criteria, and 81 had sufficient material for analysis. Median tumor size was 40 mm (interquartile range [IQR], 30-50 mm). Grade I, II, and III were observed in 13, 49, and 17 cases, respectively. There was a wide distribution of RS with a median of 21.4 (IQR, 16.05-26.75). In total, 23 (28.3%) had high, 28 (34.6%) intermediate, and 30 (37%) low RS results. CONCLUSION The RS may provide relevant information for neoadjuvant treatment decisions in select patients both in clinical practice and in studies. Inclusion of low RS disease patients in neoadjuvant trials will likely only dilute the ability to look at treatment effects.
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Affiliation(s)
- Xavier Pivot
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Laura Mansi
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Loic Chaigneau
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Philippe Montcuquet
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Antoine Thiery-Vuillemin
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Fernando Bazan
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Erion Dobi
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Jean L Sautiere
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Frederic Rigenbach
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Marie P Algros
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Steve Butler
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Farid Jamshidian
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Phillip Febbo
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Christer Svedman
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Sophie Paget-Bailly
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Franck Bonnetain
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
| | - Christian Villanueva
- Departments of Medical Oncology, Gynecology, Pathology, and Statistics, University Hospital Jean Minjoz, Besançon, France; University of Franche-Comté, UMR1098, SFR IBCT, Besançon, France; INSERM, UMR1098, Besançon, France; EFS Bourgogne Franche-Comté, UMR1098, Besançon, France; Genomic Health, Inc., Redwood City, California, USA
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Vernerey D, Hammel P, Paget-Bailly S, Huguet F, Van Laethem JL, Goldstein D, Glimelius B, Artru P, Moore MJ, André T, Mineur L, Chibaudel B, Louvet C, Bonnetain F. Prognosis model for overall survival in locally advanced unresecable pancreatic carcinoma: An ancillary study of the LAP 07 trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
235 Background: The management of locally advanced pancreatic cancer (LAPC) patients remains controversial and complex. Better discrimination for Overall Survival (OS) is needed to improve therapeutic decisions. We address this issue, with the largest Phase III cohort of LAPC, by establishing the first prognosis model for OS with the full spectrum of parameters currently available at diagnosis. Methods: We enrolled 442 LAPC patients recruited in LAP07, an international multicenter randomized phase III trial (NCT00634725). 30 baseline variables among demographic, cancer history, clinical, biological and radiological parameters were evaluated in univariate and multivariate analyses as prognostic factors for OS. The predictive value of the final model was evaluated with Harrell’s C index. This analysis was repeated 1,000 times with the use of bootstrap sample to derive 95%CI for the C. A prognostic score and nomogramm were then developed based on the identified prognostic factors in the final model. Results: Independent prognostic factors identified in multivariate analysis (n=370) for OS were: Age (HR= 1.01; 95%CI 1.00 - 1.03; p=0.0418), Pain (HR= 1.36 ; 95%CI 1.08 - 1.71; p=0.0094), Albumin (HR= 0.96; 95%CI 0.94 - 0.98; p=0.0001), and RECIST size (HR= 1.01; 95%CI 1.00 - 1.02; p=0.0033), Harrell’s C-statistic for the final model was 0.60 (95% bootstrap CI 0.56 0.63). A prognostic score between 0 and 4 was then calculated for each patient, based on the previous model. Three risk-groups for death could be identified: lower risk (n=17; median OS time = 18.8 months; group of reference); intermediate risk (n=166 ;median OS time = 13.4 months; HR=1.7); higher risk (n=187 ; median OS time = 11.8 months; HR=2.1); p = 0.0101 by the global log rank test. A score and nomogramm were also developped with the addition of CA19.9 information. Conclusions: Our results highlighted 4 OS’s independent pronostic factors among a broad spectrum of parameters at time of diagnosis. We identified 3 groups with different OS’s prognosis profile. The determination of this simple prognostic score allows risk stratification that may help guiding clinical management of patients and the design for future clinical trials.
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Affiliation(s)
- Dewi Vernerey
- Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France
| | | | | | | | | | | | | | | | | | | | - Laurent Mineur
- Radiotherapy and Oncology GI and Liver Unit, Institut Sainte-Catherine, Avignon, France
| | | | - Christophe Louvet
- Department of Oncology, Institut Mutualiste Montsouris, Paris, France
| | - Franck Bonnetain
- Centre Hospitalier Régional et Universitaire de Besançon, Besançon, France
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48
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Bryand A, Hamidou Z, Paget-Bailly S, Bonnetain F, Mathelin C, Baldauf JJ, Akladios C. [Health-related quality of life in patients treated for ovarian cancer: tools and issues]. ACTA ACUST UNITED AC 2015; 43:151-7. [PMID: 25596884 DOI: 10.1016/j.gyobfe.2014.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 12/15/2014] [Indexed: 11/30/2022]
Abstract
Health-related quality of life (QoL) in patients treated for ovarian cancer is directly and heavily impacted by the natural history of cancer, its evolution and its therapeutic modalities. The evaluation and consideration of various parameters of QoL seems to be a major issue. Indeed, on the one hand, it is essential to take into account the opinion of patients in the choice of therapeutic strategies for this cancer with a poor prognosis and, on the other hand, more and more studies show that QoL is an independent prognostic factor in ovarian cancer. Improvement in this case, in addition to being an endpoint by itself, would potentially improve the overall survival of patients. To date there are several tools to assess QOL of patients with ovarian cancer. The 2 questionnaires most commonly used are: FACT-O and the EORTC QLQ-OV28. The aim of our study was to evaluate from a review of the literature, the reciprocal effects of ovarian cancer on QoL and QoL on ovarian cancer survival, as well as specificities of each of the 2 questionnaires most commonly used in assessing the QoL.
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Affiliation(s)
- A Bryand
- CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - Z Hamidou
- Service de santé publique, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex, France
| | - S Paget-Bailly
- CHRU de Besançon, 2, place Saint-Jacques, 25000 Besançon, France
| | - F Bonnetain
- CHRU de Besançon, 2, place Saint-Jacques, 25000 Besançon, France
| | - C Mathelin
- CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - J-J Baldauf
- CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - C Akladios
- CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
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Carton M, Guida F, Paget-Bailly S, Cyr D, Radoi L, Sanchez M, Schmaus A, Cénée S, Papadopoulos A, Menvielle G, Févotte J, Pilorget C, Molinié F, Bara S, Stücke I, Luce D. Occupation and head and neck cancer in women-Results of the ICARE study. Am J Ind Med 2014; 57:1386-97. [PMID: 25351857 DOI: 10.1002/ajim.22394] [Citation(s) in RCA: 5] [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] [Accepted: 09/04/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND Few occupational studies have addressed head and neck cancer, and these studies have been predominantly conducted in men. Accordingly, our objective was to investigate the association between head and neck cancer and occupation in women. METHODS ICARE, a French population-based case-control study, included 296 squamous cell carcinomas of the head and neck in women and 775 controls. Lifelong occupational history was collected. Odds ratios (ORs) and 95% confidence intervals (CI), adjusted for smoking, alcohol drinking and education level, were estimated for occupations and industries. RESULTS An elevated OR was observed for working proprietors working for 10 years or more (OR = 3.83, 95% CI: 1.12-13.0) with a significant trend with duration of employment (P = 0.047). Elevated but non-significant ORs were observed for street vendors (OR = 3.76, 95% CI: 0.99-14.3, P for trend = 0.13), bakers (OR = 4.19, 95% CI: 0.63-27.9, P for trend = 0.06), and welders and flame cutters (OR = 2.18, 95% CI: 0.33-14.4, P for trend = 0.05). CONCLUSIONS This exploratory study suggests a role of occupational exposures in the development of HN cancer in women. Further investigations of exposures to specific agents are needed.
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Affiliation(s)
- Matthieu Carton
- Epidemiology of Occupational and Social Determinants of Health Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University of Versailles St-Quentin; Villejuif France
| | - Florence Guida
- Environmental Epidemiology of Cancer Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University Paris-Sud; Villejuif France
| | - Sophie Paget-Bailly
- Epidemiology of Occupational and Social Determinants of Health Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University of Versailles St-Quentin; Villejuif France
| | - Diane Cyr
- Epidemiology of Occupational and Social Determinants of Health Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University of Versailles St-Quentin; Villejuif France
| | - Loredana Radoi
- Epidemiology of Occupational and Social Determinants of Health Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University of Versailles St-Quentin; Villejuif France
| | - Marie Sanchez
- Environmental Epidemiology of Cancer Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University Paris-Sud; Villejuif France
| | - Annie Schmaus
- Epidemiology of Occupational and Social Determinants of Health Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University of Versailles St-Quentin; Villejuif France
| | - Sylvie Cénée
- Environmental Epidemiology of Cancer Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University Paris-Sud; Villejuif France
| | - Alexandra Papadopoulos
- Environmental Epidemiology of Cancer Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University Paris-Sud; Villejuif France
| | - Gwenn Menvielle
- Epidemiology of Occupational and Social Determinants of Health Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University of Versailles St-Quentin; Villejuif France
| | - Joëlle Févotte
- UMRESTTE (Epidemiological Research and Surveillance Unit in Transport; Occupation and Environment); University Claude Bernard; Lyon France
| | - Corinne Pilorget
- UMRESTTE (Epidemiological Research and Surveillance Unit in Transport; Occupation and Environment); University Claude Bernard; Lyon France
- Department of Occupational Health; French Institute for Public Health Surveillance; Saint Maurice France
| | | | | | - Isabelle Stücke
- Environmental Epidemiology of Cancer Team; Inserm, CESP Centre for research in Epidemiology and Population Health, UMRS 1018; Villejuif France
- UMRS 1018; University Paris-Sud; Villejuif France
| | - Danièle Luce
- Faculté de Médecine, Institut de Recherche Santé Environnement & Travail (IRSET); Inserm U 1085; Pointe-à-Pitre France
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50
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Kim SC, Paget-Bailly S, Trinquart L, Calais F, Bonnetain F, Westeel V. Third-line systemic treatment for non-small cell lung cancer. Hippokratia 2014. [DOI: 10.1002/14651858.cd011291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Stefano C Kim
- University Hospital of Besançon; Medical Oncology; 3, Boulevard Alexandre Fleming Besançon France 25030
| | - Sophie Paget-Bailly
- University Hospital of Besançon; Methodological and Quality of Life in Oncology Unit; 2 Place Saint Jacques Besançon France 25030
| | | | - François Calais
- University of Franche-Comté; University Library; Besançon France
| | - Franck Bonnetain
- University Hospital of Besançon; Methodological and Quality of Life Unit in Oncology; 2 Place Saint Jacques Besançon France 25030
| | - Virginie Westeel
- University Hospital of Besançon; Thoracic Oncology; 3, Boulevard Alexandre Fleming Besançon France 25030
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