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Rebucci-Peixoto M, Vienot A, Adotevi O, Jacquin M, Ghiringhelli F, de la Fouchardière C, You B, Maurina T, Kalbacher E, Bazan F, Meynard G, Clairet AL, Fagnoni-Legat C, Spehner L, Bouard A, Vernerey D, Meurisse A, Kim S, Borg C, Mansi L. A Phase II Study Evaluating the Interest to Combine UCPVax, a Telomerase CD4 TH1-Inducer Cancer Vaccine, and Atezolizumab for the Treatment of HPV Positive Cancers: VolATIL Study. Front Oncol 2022; 12:957580. [PMID: 35928870 PMCID: PMC9343837 DOI: 10.3389/fonc.2022.957580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background There is a strong rational of using anti–programmed cell death protein-1 and its ligand (anti–PD-1/L1) antibodies in human papillomavirus (HPV)–induced cancers. However, anti–PD-1/L1 as monotherapy induces a limited number of objective responses. The development of novel combinations in order to improve the clinical efficacy of an anti–PD-1/L1 is therefore of interest. Combining anti–PD-1/L1 therapy with an antitumor vaccine seems promising in HPV-positive (+) cancers. UCPVax is a therapeutic cancer vaccine composed of two separate peptides derived from telomerase (hTERT, human telomerase reverse transcriptase). UCPVax is being evaluated in a multicenter phase I/II study in NSCLC (non–small cell lung cancer) and has demonstrated to be safe and immunogenic. The aim of the VolATIL study is to evaluate the combination of atezolizumab (an anti-PD-L1) and UCPVax vaccine in a multicenter phase II study in patients with HPV+ cancers. Methods Patients with HPV+ cancer (anal canal, head and neck, and cervical or vulvar), at locally advanced or metastatic stage, and refractory to at least one line of systemic chemotherapy are eligible. The primary end point is the objective response rate (ORR) at 4 months. Patients will receive atezolizumab every 3 weeks at a fixed dose of 1,200 mg in combination with the UCPVax vaccine at 1 mg subcutaneously. Discussion Anti-cancer vaccines can restore cancer-immunity via the expansion and activation of tumor-specific T cells in patients lacking pre-existing anti-tumor responses. Moreover, preclinical data showed that specific TH1 CD4 T cells sustain the quality and homing of an antigen-specific CD8+ T-cell immunity. In previous clinical studies, the induction of anti-hTERT immunity was significantly correlated to survival in patients with advanced squamous anal cell carcinoma. Thus, there is a strong rational to combine an anti-cancer hTERT vaccine and an immune checkpoint inhibitor to activate and promote antitumor T-cell immunity. This pivotal proof of concept study will evaluate the efficacy and safety of the combination of a telomerase-based TH1 inducing vaccine (UCPVax) and an anti–PD-L1 (atezolizumab) immunotherapy in HPV+ cancers, as well as confirming their synergic mechanism, and settling the basis for a new combination for future clinical trials. Clinical Trial Registration https://www.clinicaltrials.gov/, identifier NCT03946358.
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Affiliation(s)
- Magali Rebucci-Peixoto
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
- Clinical Investigational Center, CIC-1431, Centre Hospitalier Universitaire, Besançon, France
- *Correspondence: Magali Rebucci-Peixoto,
| | - Angélique Vienot
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
- Clinical Investigational Center, CIC-1431, Centre Hospitalier Universitaire, Besançon, France
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, Besançon, France
| | - Olivier Adotevi
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
- Clinical Investigational Center, CIC-1431, Centre Hospitalier Universitaire, Besançon, France
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, Besançon, France
| | - Marion Jacquin
- Clinical Investigational Center, CIC-1431, Centre Hospitalier Universitaire, Besançon, France
- Cancéropôle Est, Strasbourg, France
| | | | | | - Benoit You
- Department of Oncology, Hospices Civils de Lyon, Lyon, France
| | - Tristan Maurina
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
| | - Elsa Kalbacher
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
| | - Fernando Bazan
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
| | - Guillaume Meynard
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
| | - Anne-Laure Clairet
- Department of Pharmacy, University Hospital of Besançon, Besançon, France
| | | | - Laurie Spehner
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, Besançon, France
| | - Adeline Bouard
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, Besançon, France
| | - Dewi Vernerey
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
- Methodology and Quality of Life in Oncology Unit, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Aurélia Meurisse
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
- Methodology and Quality of Life in Oncology Unit, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Stefano Kim
- Clinical Investigational Center, CIC-1431, Centre Hospitalier Universitaire, Besançon, France
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, Besançon, France
- Department of Oncology, Sanatorio Allende, Cordoba, Argentina
| | - Christophe Borg
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
- Clinical Investigational Center, CIC-1431, Centre Hospitalier Universitaire, Besançon, France
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, Besançon, France
| | - Laura Mansi
- Department of Oncology, Centre Hospitalier Universitaire, Besançon, France
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Gassian N, Clairet AL, Goujon M, Frontczak A, Calcagno F, Almotlak H, Mouillet G, Maurina T, Stein U, Nguyen T, Jeannin M, Thiery-Vuillemin A. Evaluation of drug-drug interactions among patients with metastatic prostate cancer in routine care. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.111] [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
111 Background: Prostate cancer often occurs in an elderly population, at higher risk of drug-drug interactions (DDIs). There is a medical need to increase the knowledge of DDI prevalence and their severity among patients coming from routine care. This study used a prospective approach with the aim to quantify and describe DDIs in medical prescription of prostate cancer treatments. Methods: DDIs were assessed from two perspectives: 1) “real DDI” between the patient’s comedications and the actual anti-cancer agent prescribed; 2) “modelized DDI” between the patient’s comedications and drugs that have proven activity in metastatic endocrine sensitive prostate cancer (MESPC) or castrate resistant prostate cancer (CRPC) settings with positive phase 3 trial and gained EMA approval. French national thesaurus, Micromedex software and complementary manual analysis by pharmacist were used to identified DDIs. Clinical relevance of DDIs was scored using the validated scale of Hatoum. Results: A total of 91 patients were included, 15% of whom were participating in a clinical trial. Some imbalances were observed between patients from clinical trial and routine care (age, ECOG, MESPC/MCRPC). The median number of comedications used per patient was 6 [1-16]. Among real DDI, Enzalutamide was the anticancer agent with the higher risk of interaction (18-54% of patients). In modelized DDI, Enzalutamide and Apalutamide were the two most risky drugs (35-76% and 22-73% depending on Micromedex or Thesaurus analyze). Not all DDIs discovered were clinically significant according to Hatoum scale. Conclusions: DDIs are frequents, according to Micromedex and National Thesaurus tools but pharmacist and physician advices are essentials to determine their potential impacts.
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Affiliation(s)
| | | | - Morgan Goujon
- Department of Medical Oncology, University Hospital, Besançon, France
| | | | - Fabien Calcagno
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Guillaume Mouillet
- Department of Medical Oncology, University Hospital, Besancon Cedex, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital, Besancon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Thierry Nguyen
- Department of Medical Oncology, University Hospital, Besançon, France
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Thiery-Vuillemin A, Gravis G, Schlürmann F, Bompas E, Rolland F, Gross-Goupil M, Vano YA, Guillot A, Barthélémy P, Joly C, Laramas M, Dourthe LM, Maurina T, Gauthier H, Taillandy K, Meurisse A, Vernerey D, Albiges L. Randomized phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen in anti-angiogenic naïve patients with metastatic renal cell carcinoma (mRCC): Final analysis of SURF study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.344] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
344 Background: SUN is approved in mRCC setting at the dose of 50mg daily for 4 weeks followed by 2 weeks rest (4/2 schedule). The 4/2 schedule often requires dose modifications for toxicity. Current recommendation is to reduce the dose to 37.5mg per day. Alternative schedules (2 weeks of treatment followed by one-week rest (2/1 schedule) have shown promising results. SURF trial evaluated prospectively schedule 2/1 when toxicity occurs. Methods: SURF [NCT02689167] is a prospective, non-comparative randomized study. Patients (pts) with mRCC (clear cell) were included at SUN initiation. When a dose adjustment of SUN was required, patients were randomized between 4/2 schedule at 37.5mg daily and experimental 2/1 schedule at 50mg daily. Primary objective was to assess duration of SUN treatment among the 73 first evaluable pts. Overall 226 pts were enrolled with 133 randomized. All other analyses are shown for the 133 randomized patients. Results: Pts were 75.2% males, with a median age 63.7 years for 94% with a Karnofsky ≥ 80%. Of them, 54.9% had partial/total nephrectomy. IMDC risk score was favourable (45.1%), intermediate (46.6%) or poor (8.3%). Pts characteristics were well balanced between 2 arms. Metastatic sites were lungs (60.5%), bones (16.3%), lymph nodes (15.5%). At 6 months, 48 patients (65.8%) of the 2/1 schedule were still on treatment (above predefined threshold for positivity). Other data are listed on the table. No new safety signal was identified. Permanent SUN discontinuation due to toxicity was 22.2% in control arm vs 12.3% in experimental arm. Conclusions: SURF is the largest prospective randomised trial evaluating two different SUN schedules modifications in mRCC in case of toxicity. This positive trial confirms the role of adapting SUN to a 2/1 schedule rather than reducing SUN dose to the classical 4/2 schedule. Clinical trial information: NCT02689167. [Table: see text]
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Affiliation(s)
| | | | | | | | - Frederic Rolland
- Institut de Cancérologie de l'Ouest, Department of Medical Oncology, Saint-Herblain, France
| | - Marine Gross-Goupil
- Centre Hospitalier Universitaire de Bordeaux-Hôpital Saint-André, Bordeaux, France
| | - Yann-Alexandre Vano
- Department of Medical Oncology, Georges Pompidou Hospital, University Paris Descartes, Paris, France
| | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | | | - Charlotte Joly
- Oncology Department, Hôpital Henri Mondor, APHP, Créteil, France
| | | | | | | | | | | | - Aurelia Meurisse
- Methodology and Quality of Life Unit, Department of Oncology University Hospital, Besancon, France
| | - Dewi Vernerey
- Methodology and Quality of Life Unit in Oncology, Department of Oncology, University Hospital of Besancon, Besançon, France
| | - Laurence Albiges
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
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Goujon M, Anota A, Frontczak A, Charton E, Maurina T, Almotlak H, Nguyen T, Fabien C, Stein U, Mouillet G, Thiery-Vuillemin A. Association of health-related quality of life (HRQOL) variations with biological biomarkers for patients with metastatic castrate-resistant prostate cancer (MCRPC) treated by abiraterone/prednisone combination or prednisone. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.54] [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
54 Background: A potential link between Health-Related Quality of life (HRQoL) and oncologic outcomes such as overall survival or progression-free survival has been underlined for endocrine therapies in patients with metastatic castrate resistant prostate cancer (mCRPC). Other surrogates such as circulating tumor cells (CTCs) or PSA can be used to evaluate disease control. This study explored the associations between HRQoL and biological biomarkers for patients with mCRPC treated by abiraterone / prednisone or prednisone within registration phase III trial COU-AA-301. Methods: Baseline differences of HRQoL evaluated with FACT-P total score (FACT-P TS) according to biological parameters (including CTCs and PSA) and links between HRQoL's change and variations of these parameters were assessed. The primary objective was to estimate the association between improvement or deterioration in FACT-P TS and the variations of CTCs and PSA. All analyses were conducted using clinically meaningful improvement and deterioration in FACT-P TS and subscales. Results: Among 1130 patients enrolled, 1111 (98.3%) had a baseline FACT-P TS available. At baseline, a favorable CTCs count was associated with higher FACT-P TS compared to unfavorable CTCs (difference in means 8 points, [95% CI, 4 to 12] p < 0.001). At 3 months, there were differences in mean change from baseline FACT-P TS favoring patients with biomarkers response, with clinically meaningful difference for CTCs (12.7 points, [95% CI, 6 to 19.5%] p < 0.001) and PSA (11.64 points, [95% CI, 9.3 to 14] p < 0.0001). Biological progression was associated with higher risk of FACT-P TS worsening for PSA (Odds Ratio (OR) 2.8 [95% CI, 1.9 to 4.2]) with more frequent FACT-P TS improvement in case of response for CTCs (OR 3.14 [95% CI, 1.3 to 7.7]) and PSA (OR 2.9 [95% CI 2.1 to 4]). Significantly longer time until definitive deterioration was observed for patients with CTCs or PSA response (p < 0.001) and shorter time in case of progression (p < 0.001). Conclusions: QUA-lify is the first study to show an association between HRQoL and biomarkers outcomes in patients with mCRPC treated with endocrine therapy in a post-taxane setting. This concept is reinforced by the consistency of the association for all analyses carried out.
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Affiliation(s)
- Morgan Goujon
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Amelie Anota
- Quality of Life in Oncology Clinical Research Platform; Methodological and Quality of Life in Oncology, INSERM UMR 1098, University Hospital of Besancon, Besancon, France
| | | | - Emilie Charton
- Methodology and Quality of Life Unit, Department of Oncology, INSERM UMR 1098, University Hospital of Besancon; French National Platform Quality of Life and Cancer, Besançon, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Thierry Nguyen
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Calcagno Fabien
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Guillaume Mouillet
- Department of Medical Oncology, Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098), University Hospital, Besançon, France
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Couchoud C, Fagnoni P, Aubin F, Westeel V, Maurina T, Thiery-Vuillemin A, Gerard C, Kroemer M, Borg C, Limat S, Nerich V. Economic evaluations of cancer immunotherapy: a systematic review and quality evaluation. Cancer Immunol Immunother 2020; 69:1947-1958. [PMID: 32676716 DOI: 10.1007/s00262-020-02646-0] [Citation(s) in RCA: 7] [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: 11/08/2019] [Accepted: 06/17/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Scientific advances in the last decade have highlighted the use of immunotherapy, especially immune checkpoint inhibitors, to be an effective strategy in cancer therapy. However, these immunotherapeutic agents are expensive, and their use must take into account economic criteria. Thus, the objective of the present study was to systematically identify and review published EE related to the use of ipilimumab, nivolumab or pembrolizumab in melanoma, lung cancer, head and neck cancer or renal cell carcinoma, and to assess their quality. METHODS The systematic literature research was conducted on Medline via PubMed and the Cochrane Central Register of Controlled Trials to identify economic evaluations published before July 2018. The quality of each selected economic evaluation was assessed by two independent reviewers using the Drummond checklist. RESULTS Our systematic review was based on 32 economic evaluations using different methodological approaches, different perspectives and different time horizons. Three-quarters of the economic evaluations are full (n = 24) with a Drummond score ≥ 7, synonymous of "high quality". Among them, 66% reported a strategy that was cost-effective. The most assessed immunotherapeutic agent was nivolumab. In patients with renal cell carcinoma or head and neck cancer, it was less likely to be cost-effective than in patients with melanoma or lung cancer. CONCLUSIONS Whether or not these findings will be confirmed remains to be seen when market approval to cover more indications is extended and new effective immunotherapeutic agents become available.
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Affiliation(s)
- Charlotte Couchoud
- Department of Pharmacy, University Hospital of Besançon, 3 Boulevard Alexandre Fleming, 25030, Besancon Cedex, France
| | - Philippe Fagnoni
- Department of Pharmacy, University Hospital, Dijon, France
- INSERM UMR 866, University of Bourgogne-Franche-Comté, Dijon, France
- EPICAD LNC UMR 1231, University of Bourgogne-Franche-Comté, Dijon, France
| | - François Aubin
- Department of Dermatology, University Hospital, Besançon, France
- INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, Besançon, France
| | - Virginie Westeel
- INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, Besançon, France
- Pulmonary Medicine Department, University Hospital Jean Minjoz, Besançon, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Antoine Thiery-Vuillemin
- INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, Besançon, France
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Claire Gerard
- Department of Pharmacy, University Hospital of Besançon, 3 Boulevard Alexandre Fleming, 25030, Besancon Cedex, France
- INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, Besançon, France
| | - Marie Kroemer
- Department of Pharmacy, University Hospital of Besançon, 3 Boulevard Alexandre Fleming, 25030, Besancon Cedex, France
- INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, Besançon, France
| | - Christophe Borg
- INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, Besançon, France
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Samuel Limat
- Department of Pharmacy, University Hospital of Besançon, 3 Boulevard Alexandre Fleming, 25030, Besancon Cedex, France
- INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, Besançon, France
| | - Virginie Nerich
- Department of Pharmacy, University Hospital of Besançon, 3 Boulevard Alexandre Fleming, 25030, Besancon Cedex, France.
- INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, Besançon, France.
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Thiery-Vuillemin A, Gravis G, Constans Schlurmann F, Bompas E, Rolland F, Gross-Goupil M, Vano Y, Guillot A, Barthélémy P, Joly C, Laramas M, Dourthe L, Maurina T, Gauthier Petithuguenin H, Taillandy K, Meurisse A, Vernerey D, Albiges L. 720P Randomised phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen in anti-angiogenic naïve patients with metastatic renal cell carcinoma (mRCC): Interim analysis (IA) of SURF study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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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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Wespiser M, Goujon M, Nguyen Tan Hon T, Maurina T, Kleinclauss F, Créhange G, Thiery-Vuillemin A. [Radiotherapy of oligometastases: Sequences and interactions with systemic therapies, example of kidney cancer]. Cancer Radiother 2019; 23:896-903. [PMID: 31591034 DOI: 10.1016/j.canrad.2019.08.007] [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: 07/28/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 10/25/2022]
Abstract
This article is a review of the literature that aims to clarify the place of systemic and locoregional treatments, with a focus on radiotherapy and surgery in the management of patients with oligometastatic kidney cancer. We have selected articles of interest published in Medline indexed journals. We have also analysed the related guidelines: National Comprehensive Cancer Network (NCCN) 2019, European Association of Urology (EAU) 2019, European Society of Medical Oncology (ESMO) 2019, Association française d'urologie (Afu) 2018 as well as some abstracts of international congresses. The main treatments evaluated were surgery and radiotherapy. We defined the different scenarios conventionally encountered in clinical practice. The evolution of systemic therapies (increased overall survival and response rate) is likely to increase the number of patients potentially accessible to locoregional treatments. The complete analysis of the literature underlines the place of locoregional treatments whatever the scenarios mentioned. Data on stereotactic radiotherapy found a local control rate consistently above 70% in all studies with a maintained response and positive impact on overall survival and progression-free survival. The improvement of overall survival by sequential use of the various therapeutic classes confirms the need for optimization of locoregional treatments in the model of oligometastatic kidney cancer. The dogma of radioresistance must definitely be set aside with current irradiation techniques.
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Affiliation(s)
- M Wespiser
- Service d'oncologie médicale, centre hospitalier régional universitaire Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
| | - M Goujon
- Service d'oncologie médicale, centre hospitalier régional universitaire Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - T Nguyen Tan Hon
- Service d'oncologie médicale, centre hospitalier régional universitaire Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - T Maurina
- Service d'oncologie médicale, centre hospitalier régional universitaire Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - F Kleinclauss
- Université de Franche-Comté, 25000 Besançon, France; Inserm UMR 1098, 25000 Besançon, France; Service d'urologie-andrologie et transplantation rénale, centre hospitalier régional universitaire Jean-Minjoz, 25030 Besançon cedex, France
| | - G Créhange
- Département de radiothérapie oncologique, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - A Thiery-Vuillemin
- Service d'oncologie médicale, centre hospitalier régional universitaire Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France; Université de Franche-Comté, 25000 Besançon, France; Inserm UMR 1098, 25000 Besançon, France
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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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Mouillet G, Paillard MJ, Maurina T, Vernerey D, Nguyen Tan Hon T, Almotlak H, Stein U, Calcagno F, Berthod D, Robert E, Meurisse A, Thiery-Vuillemin A. Open-label, randomized multicentre phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen (dose modification or dose interruptions) in patients with advanced or metastatic renal cell carcinoma: study protocol of the SURF trial. Trials 2018; 19:221. [PMID: 29650037 PMCID: PMC5898055 DOI: 10.1186/s13063-018-2613-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/17/2018] [Accepted: 03/27/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sunitinib is a tyrosine kinase inhibitor approved in the first-line metastatic renal cell carcinoma (MRCC) setting at the dose of 50 mg daily for 4 weeks followed by a pause of 2 weeks. Due to toxicity, this standard schedule (50 mg daily 4/2) can induce up to 50% of sunitinib dose modification (reduction and/or interruption). The current recommendation in such case is to reduce the dose to 37.5 mg per day (standard schedule 4/2). Recent data highlight an alternative schedule: 2 weeks of treatment followed by 1 week of pause (experimental schedule 2/1). The SURF trial is set up to evaluate prospectively experimental schedule 2/1 when toxicity occurs. This article displays the key elements of the study protocol. METHODS/DESIGN SURF [NCT02689167] is a prospective, randomized, open-label phase IIb study. Patients are included at sunitinib initiation while receiving standard schedule 4/2 (50 mg daily) according to the marketing authorization indication. When a dose adjustment of sunitinib is required, patients are randomized between standard schedule 4/2 (37.5 mg daily) and experimental schedule 2/1 (50 mg daily). Key eligibility criteria are the following: patients with locally advanced inoperable or MRCC who are starting first-line treatment with sunitinib, with histologically or cytologically confirmed renal cancer clear cell variant or with a clear cell component, and with Karnofsky performance status ≥70%. The primary objective is to assess the median duration of sunitinib treatment (DOT) in each group. The key secondary objectives are progression-free survival, overall survival, time to randomization, objective response rate, safety, sunitinib dose intensity, health-related quality of life, and the description of main drivers triggering randomization. We hypothesized that experimental schedule 2/1 would result in an improvement in median DOT from 6 to 8.5 months. It was estimated that 112 patients would be needed in each arm during 24 months. In order to take into account the possibility of treatment discontinuation before randomization, 248 patients are necessary. DISCUSSION The SURF trial is asking a pragmatic question adapted to the current practice on what is the best way to adapt sunitinib when treatment-related adverse events occur. The results of the SURF trial will bring high-value data to support the use of an alternative schedule in sunitinib treatment. TRIAL REGISTRATION ClinicalTrials.gov, NCT02689167 . Registered on 26 February 2016.
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Affiliation(s)
- Guillaume Mouillet
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France. .,Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besancon, France. .,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France.
| | - Marie-Justine Paillard
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France.,Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Dewi Vernerey
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besancon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
| | - Thierry Nguyen Tan Hon
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Fabien Calcagno
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
| | - Diane Berthod
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Elise Robert
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
| | - Aurelia Meurisse
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besancon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
| | - Antoine Thiery-Vuillemin
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
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11
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Thiery-Vuillemin A, Cholley T, Calcagno F, Hugues M, Maurina T, Limat S, Nguyen Tan Hon T, Almotlak H, Mouillet G, Nerich V. Factors Influencing Overall Survival for Patients With Metastatic Clear-Cell Renal-Cell Carcinoma in Daily Practice. Clin Genitourin Cancer 2018; 16:e297-e305. [DOI: 10.1016/j.clgc.2017.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/11/2017] [Accepted: 09/17/2017] [Indexed: 01/08/2023]
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12
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Bednarek C, Nguyen T, Puyraveau M, Bonnet É, Lescut N, Azélie C, Miny J, Mauvais O, Maurina T, Tochet F, Bosset JF, Thariat J, Sun X. Implementation of intensity-modulated radiotherapy for head and neck cancers in routine practice. Cancer Radiother 2017; 21:21-27. [DOI: 10.1016/j.canrad.2016.07.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 07/05/2016] [Indexed: 11/30/2022]
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13
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Dénommé F, Kroemer M, Montcuquet P, Nallet G, Thiery-Vuillemin A, Bazan F, Mouillet G, Villanueva C, Demarchi M, Stein U, Almotlak H, Chaigneau L, Curtit E, Meneveau N, Maurina T, Dobi E, Hon TNT, Cals L, Mansi L, Verlut C, Pana-Katatali H, Caubet M, Paillard MJ, Limat S, Pivot X, Nerich V. [Prevalence and management of pain in patients with metastatic cancer in Franche-Comté]. Bull Cancer 2016; 103:849-860. [PMID: 27692731 DOI: 10.1016/j.bulcan.2016.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/15/2016] [Accepted: 08/29/2016] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Pain management is a major public health problem, especially in oncology. In order to assess professional practice, the IRFC-FC conducted a survey amongst patients with metastatic osteophilic solid tumor in Franche-Comté. The aims were to assess the pain prevalence, and its characteristics, its management and its impact on patients' quality of life in patients in pain. METHODS An observational, prospective and multicenter survey was conducted using a self-report questionnaire. Patients with metastatic breast or prostate cancer managed in 5 day-hospitals of the IRFC-FC over a period of three months were included. RESULTS Two hundred thirty-three questionnaires were analyzed. Pain prevalence rate was 48.5%. Three quarters of patients in pain had chronic background pain, moderate to severe, with or without breakthrough pain. Considering their pain intensity and their analgesic therapy, 42.0% of patients seem to have an inadequate treatment. Eighty-five percent of treated patients reported to be compliant and felt that their pain was well managed despite a strong impact on their quality of life. CONCLUSION The setting of a specific clinical pathway is essential to secure the standardized, optimal and efficient management of patients in pain. The assessment of patient satisfaction and quality of life must be integrated in clinical practice to identify patients in pain for which the treatment is inappropriate.
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Affiliation(s)
- Fanny Dénommé
- CHRU de Besançon, pôle pharmacie, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Marie Kroemer
- CHRU de Besançon, pôle pharmacie, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France
| | - Philippe Montcuquet
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Gilles Nallet
- Oncolie, réseau de cancérologie de Franche-Comté, pôle cancérologie, 2, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Antoine Thiery-Vuillemin
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France; CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Fernando Bazan
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Guillaume Mouillet
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Cristian Villanueva
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Martin Demarchi
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Ulrich Stein
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Hamadi Almotlak
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Loïc Chaigneau
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Elsa Curtit
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France; CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Nathalie Meneveau
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Tristan Maurina
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Erion Dobi
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Thierry Nguyen Tan Hon
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Laurent Cals
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Laura Mansi
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France; CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Clotilde Verlut
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Héloïse Pana-Katatali
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Mathieu Caubet
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Marie-Justine Paillard
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Samuel Limat
- CHRU de Besançon, pôle pharmacie, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France
| | - Xavier Pivot
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France; CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Virginie Nerich
- CHRU de Besançon, pôle pharmacie, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France.
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Chamberland F, Maurina T, Degano-Valmary S, Spicarolen T, Chaigneau L. Angiosarcoma: A Case Report of Gingival Disease with Both Palatine Tonsils Localization. Rare Tumors 2016; 8:5907. [PMID: 27746875 PMCID: PMC5064291 DOI: 10.4081/rt.2016.5907] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 04/28/2016] [Accepted: 05/13/2016] [Indexed: 11/23/2022] Open
Abstract
Angiosarcomas are one of the rarest subtypes of sarcomas; those are malignant vascular tumors arising from vascular endothelial cells. Occurrence of intra-oral angiosarcoma is extremely rare (0.0077% of all cancers in Europe). We present here, to our knowledge, the first case of a 83-year-old man with gingival and both palatine tonsils localization of a grade-two angiosarcoma discovered after a two months history of a painful lesion followed by hematoma and spontaneous bleeding. Chemotherapy with paclitaxel and hemostatic radiotherapy were inefficient and he died seven months after the first symptoms. It is essential to use the vascular markers, such as CD34, CD31, ERG and FLI1, for a correct histological diagnosis, which remains difficult because it displays a wide range of morphological appearances and multiple patterns may be present in the same tumor. The main prognostic factors are chronic pre-existing lymphedema and tumor size greater than five centimeters. Malignancy grade and stage classification should be provided in all cases in which this is feasible because of predictive meaning. When possible, wide surgical resection with negative margins remains the cornerstone for the treatment of localized angiosarcomas, but despite the improvement of surgical techniques the prognosis is poor with more than half of patients died within the first year. Adjuvant radiotherapy is the standard treatment of high–grade (two and three), deep lesions, regardless of size, because it improved the local recurrence-free survival. For advanced disease, if possible, metastasectomy should be considered. The first-line chemotherapy with doxorubicin or paclitaxel should be discussed compared to best supportive care according to patient comorbidities and preference.
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Affiliation(s)
- Frédéric Chamberland
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Nord Franche-Comté , Belfort
| | - Tristan Maurina
- Department of Oncology, University Hospital Center Jean Minjoz , Besançon, France
| | | | - Thierry Spicarolen
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Nord Franche-Comté , Belfort
| | - Loïc Chaigneau
- Department of Oncology, University Hospital Center Jean Minjoz , Besançon, France
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Adotévi O, Mansi L, Beziaud L, Ravel P, Marie-Joseph EL, Laheurte C, Rangan L, Maurina T, Mouillet G, Hon TNT, Curtit E, Pivot X, Godet Y, Borg C, Thiery-Vuillemin A. The efficacy of everolimus relies on a modulation of adaptative anti tumor T cell immunity. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.35] [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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16
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Mouillet G, Maurina T, Paillard MJ, Montcuquet P, Hon TNT, Almotlak H, Stein U, Berthod D, Robert E, Meurisse A, Bonnetain F, Thiery-Vuillemin A. Surf: Open label, randomized multi-centre phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen (dose modification or dose interruptions) in patients with advanced or metastatic renal cell carcinoma (mRCC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.70] [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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17
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Beziaud L, Mansi L, Ravel P, Marie-Joseph EL, Laheurte C, Rangan L, Bonnefoy F, Pallandre JR, Boullerot L, Gamonet C, Vrecko S, Queiroz L, Maurina T, Mouillet G, Hon TNT, Curtit E, Royer B, Gaugler B, Bayry J, Tartour E, Thiery-Vuillemin A, Pivot X, Borg C, Godet Y, Adotévi O. Rapalogs Efficacy Relies on the Modulation of Antitumor T-cell Immunity. Cancer Res 2016; 76:4100-12. [DOI: 10.1158/0008-5472.can-15-2452] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 04/27/2016] [Indexed: 11/16/2022]
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18
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Caubet M, Dobi E, Pozet A, Almotlak H, Montcuquet P, Maurina T, Mouillet G, N'guyen T, Stein U, Thiery-Vuillemin A, Fiteni F. Carboplatin-etoposide combination chemotherapy in metastatic castration-resistant prostate cancer: A retrospective study. Mol Clin Oncol 2015; 3:1208-1212. [PMID: 26807222 PMCID: PMC4665308 DOI: 10.3892/mco.2015.628] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 06/22/2015] [Indexed: 11/26/2022] Open
Abstract
The combination of cisplatin or carboplatin and etoposide is the standard treatment for certain poorly differentiated neuroendocrine cancers, such as small-cell lung cancer. The aim of this study was to assess the efficacy and tolerability of the carboplatin-etoposide regimen in metastatic castration-resistant prostate cancer (mCRPC). A total of 27 patients treated by carboplatin [area under the curve (AUC)=5] and etoposide (100 mg/m2 intravenous infusion on days 1–3 or 75 mg orally/day for 10 days) for mCRPC were included for analysis. The median progression-free survival was 3.3 months [95% confidence interval (CI): 1.9–4.2] and the median overall survival (OS) was 8.1 months (95% CI: 4.06–12.36). The main grade 3–4 toxicities were haematological, namely anemia (33.3%), neutropenia (25.9%) and thrombocytopenia (22.2%), whereas the most common non-hematological toxicity was asthenia (22.2%). The efficacy, compliance and safety profile were generally similar between the oral and intravenous etoposide groups. Pretreated patients with mCRPC may benefit from the carboplatin-etoposide regimen in terms of OS. The toxicities were acceptable, without reported treatment-related mortality. Therefore, the oral etoposide regimen may be an viable alternative for improving the quality of life of the patients. However, this regimen requires further prospective investigation to confirm its efficacy.
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Affiliation(s)
- Matthieu Caubet
- Department of Radiotherapy, University Hospital of Besançon, 25030 Besançon, France
| | - Erion Dobi
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Hospital of Montbéliard, 25200 Montbéliard, France
| | - Astrid Pozet
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, 25030 Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Hospital of Lons-le-Saunier, 39000 Lons-le-Saunier, France
| | - Philippe Montcuquet
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Vesoul Hospital, 70000 Vesoul, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Hospital of Montbéliard, 25200 Montbéliard, France
| | - Guillaume Mouillet
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Hospital of Montbéliard, 25200 Montbéliard, France
| | - Thierry N'guyen
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Vesoul Hospital, 70000 Vesoul, France
| | | | - Frederic Fiteni
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, 25030 Besançon, France
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Adotevi O, Beziaud L, Mansi L, Laheurte C, Nguyen T, Maurina T, Mouillet G, Queiroz L, Jacquemard C, Godet Y, Royer B, Thiery-Vuillemin A, Borg C. Modulation of antitumor T cell responses induced by everolimus in metastatic Renal Cell Carcinoma patients. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e22113] [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: 11/20/2022] Open
Affiliation(s)
| | | | - Laura Mansi
- Medical Oncology CHRU Jean Minjoz, Besançon, France
| | | | | | | | | | | | | | - Yann Godet
- UMR1098 INSERM/EFS/UFC, Besançon, France
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Adotevi O, Calcagno F, Maurina T, Kim S, Thiery-Vuillemin A, Borg C, Godet Y, Laheurte C. Abstract 2588: Antiangiogenic and immunomodulatory effects of metronomic cyclophosphamide (CPM) treatment in prostate cancer patients with PSA failure. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-2588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: After curative local therapy, patients (pts) will experience rising PSA as an early indicator of recurrent prostate cancer and no standard of care exists. Previous studies demonstrated the clinical interest of cyclophosphamide metronomic chemotherapy (CMC) in several cancers. Multifactorial modes of action including immunological and anti-angiogenic effects have been well described by Kerbel et al and Ghiringhelli et al (Cancer Research 2006 and European Journal of immunology 2004, respectively). In the current study, we investigated the safety and immuno-modulatory effects of CMC in prostate cancer patients with PSA failure (biochemical relapse).
Methods: We conducted a prospective phase II study to characterize the clinical and immunological interest of CMC in histologically proven prostate cancer patients previously treated by prostatectomy and with biochemical relapse (defined as PSA > 1 and < 20ng/mL and progressive PSA level on 3 different measures). CMC was administered per os, at daily dose of 50 mg during 6 months. PSA level, serum VEGF and immune parameters were monitored every month in blood samples.
Results: Thirty-four consecutive pts were enrolled in this study and all received CMC. The median age was 68,3 (range, 56,9-82,1) and all pts had good performance status (ECOG-PS = 0). Gleason Score was 7 in 58%, ≤6 in 13%, and ≥ 8 in 13%. No serious adverse events (grade 3-5) were observed. The most common drug-related adverse event was grade 1 lymphopenia. Baseline PSA was 2,92 ng/mL (range, 1,1-9,35). Twenty-two pts presented stable PSA (64.7%), one patient had partial response defined by >50% decline in the serum PSA (3%), and 11 pts (32%) had PSA progression before 6 months. The immuno-monitoring performed in all pts who completed 6 months CMC. A decrease of immunosuppressive regulatory T cells (Treg) was observed in 56% (10/18). In addition, high rate of activated HLA-DR+ cytotoxic CD8 T cells was also detected in these pts. Furthermore, serum VEGF level decreased at month 1 but it returned to baseline level at the end of treatment in 9/17 pts evaluated (52%). In some patients the correlation was observed between the control of PSA level, the decrease of Treg and VEGF parameters.
Conclusions: This study demonstrated the clinical benefit and the ability of CMC to promote the blockage of angiogenesis and immuno-modulatory effect in prostate cancer patients treated for a biochemical relapse. It will be of interest to combine CMC to vaccination in these patients.
Citation Format: Olivier Adotevi, Fabien Calcagno, Tristan Maurina, Stefano Kim, Antoine Thiery-Vuillemin, Christophe Borg, Yann Godet, Caroline Laheurte. Antiangiogenic and immunomodulatory effects of metronomic cyclophosphamide (CPM) treatment in prostate cancer patients with PSA failure. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2588. doi:10.1158/1538-7445.AM2014-2588
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Affiliation(s)
| | | | | | - Stefano Kim
- 2University Hospital of Besancon, Besancon, France
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21
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Medioni J, Deplanque G, Ferrero JM, Maurina T, Rodier JMP, Raymond E, Allyon J, Maruani G, Houillier P, Mackenzie S, Renaux S, Dufour-Lamartinie JF, Elaidi R, Lerest C, Oudard S. Phase I safety and pharmacodynamic of inecalcitol, a novel VDR agonist with docetaxel in metastatic castration-resistant prostate cancer patients. Clin Cancer Res 2014; 20:4471-7. [PMID: 25013124 DOI: 10.1158/1078-0432.ccr-13-3247] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE We conducted a phase I multicenter trial in naïve metastatic castrate-resistant prostate cancer patients with escalating inecalcitol dosages, combined with docetaxel-based chemotherapy. Inecalcitol is a novel vitamin D receptor agonist with higher antiproliferative effects and a 100-fold lower hypercalcemic activity than calcitriol. EXPERIMENTAL DESIGN Safety and efficacy were evaluated in groups of three to six patients receiving inecalcitol during a 21-day cycle in combination with docetaxel (75 mg/m2 every 3 weeks) and oral prednisone (5 mg twice a day) up to six cycles. Primary endpoint was dose-limiting toxicity (DLT) defined as grade 3 hypercalcemia within the first cycle. Efficacy endpoint was ≥30% PSA decline within 3 months. RESULTS Eight dose levels (40-8,000 μg) were evaluated in 54 patients. DLT occurred in two of four patients receiving 8,000 μg/day after one and two weeks of inecalcitol. Calcemia normalized a few days after interruption of inecalcitol. Two other patients reached grade 2, and the dose level was reduced to 4,000 μg. After dose reduction, calcemia remained within normal range and grade 1 hypercalcemia. The maximum tolerated dose was 4,000 μg daily. Respectively, 85% and 76% of the patients had ≥30% PSA decline within 3 months and ≥50% PSA decline at any time during the study. Median time to PSA progression was 169 days. CONCLUSION High antiproliferative daily inecalcitol dose has been safely used in combination with docetaxel and shows encouraging PSA response (≥30% PSA response: 85%; ≥50% PSA response: 76%). A randomized phase II study is planned.
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Affiliation(s)
- Jacques Medioni
- Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France. Paris Descartes University, Paris, France.
| | | | | | | | | | | | - Jorge Allyon
- Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France
| | - Gerard Maruani
- Physiology Department, Georges Pompidou European Hospital, Paris, France. Inserm UMRS 845, Centre de Recherche, Université Paris-Descartes, Paris, France
| | - Pascal Houillier
- Paris Descartes University, Paris, France. Physiology Department, Georges Pompidou European Hospital, Paris, France
| | - Sarah Mackenzie
- Inserm UMRS 845, Centre de Recherche, Université Paris-Descartes, Paris, France
| | | | | | - Reza Elaidi
- ARTIC, Georges Pompidou European Hospital, Paris, France
| | - Celine Lerest
- ARTIC, Georges Pompidou European Hospital, Paris, France
| | - Stephane Oudard
- Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France. Paris Descartes University, Paris, France
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22
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Richard V, Paillard MJ, Mouillet G, Lescut N, Maurina T, Guichard G, Montcuquet P, Martin L, Kleinclauss F, Thiery-Vuillemin A. [Neoadjuvant before surgery treatments: state of the art in prostate cancer]. Prog Urol 2014; 24:595-607. [PMID: 24975795 DOI: 10.1016/j.purol.2014.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 11/28/2013] [Accepted: 02/18/2014] [Indexed: 11/25/2022]
Abstract
GOAL To study the impact of systemic treatment in neoadjuvant strategy before surgery in prostate cancer. MATERIALS Literature reviews with data analysis from PubMed search using the keywords "neoadjuvant", "chemotherapy", "hormonal therapy", "prostate surgery", "radical prostatectomy", but also reports from ASCO and ESMO conferences. The articles on neoadjuvant treatment before radiotherapy were excluded. RESULTS First studies with former therapy are more than 15-years-old and with questionable methodology: lack of power to have a clear idea of the impact on survival criteria such as overall survival or relapse-free survival. However, the impact of neoadjuvant hormone therapy on the classic risk factors for relapse (positive margins, intraprostatic disease, positive lymph nodes) was demonstrated by these studies and a Cochrane meta-analysis. The association with hormone therapy seems mandatory in comparison to treatment based solely on chemotherapy and/or targeted therapy. Promising data on the use of new drugs and their combinations arise: abiraterone acetate combined with LHRH analogue showed a fast PSA decrease and higher rates of pathologic complete response. Other results are promising with hormonal blockages at various key points. CONCLUSION Studies with 2nd generation anti-androgene agents or enzyme inhibitors seem to show very promising results. To provide answers about the effectiveness of current neoadjuvant strategy in terms of survival, other studies are needed: randomized phase III or phase II exploring predictive biomarkers. The design of such trials requires a multidisciplinary approach with urologists, oncologists, radiologists and methodologists.
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Affiliation(s)
- V Richard
- Service d'urologie, CHU de Besançon, 25030 Besançon cedex, France
| | - M-J Paillard
- Service d'oncologie médicale, CHU de Besançon, boulevard Flemming, 25030 Besançon cedex, France
| | - G Mouillet
- Service d'oncologie médicale, CHU de Besançon, boulevard Flemming, 25030 Besançon cedex, France
| | - N Lescut
- Service de radiothérapie, CHU de Besançon, 25030 Besançon cedex, France; UMR1098, SFR IBCT, université de Franche-Comté, 25020 Besançon, France
| | - T Maurina
- Service d'oncologie médicale, CHU de Besançon, boulevard Flemming, 25030 Besançon cedex, France
| | - G Guichard
- Service d'urologie, CHU de Besançon, 25030 Besançon cedex, France
| | - P Montcuquet
- Service d'oncologie médicale, CHU de Besançon, boulevard Flemming, 25030 Besançon cedex, France
| | - L Martin
- Service d'urologie, CHU de Besançon, 25030 Besançon cedex, France
| | - F Kleinclauss
- Service d'urologie, CHU de Besançon, 25030 Besançon cedex, France; Inserm, UMR1098, 25020 Besançon cedex, France; UMR1098, SFR IBCT, université de Franche-Comté, 25020 Besançon, France
| | - A Thiery-Vuillemin
- Service d'oncologie médicale, CHU de Besançon, boulevard Flemming, 25030 Besançon cedex, France; Inserm, UMR1098, 25020 Besançon cedex, France; UMR1098, SFR IBCT, université de Franche-Comté, 25020 Besançon, France.
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23
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Nerich V, Hugues M, Paillard MJ, Borowski L, Nai T, Stein U, Nguyen Tan Hon T, Montcuquet P, Maurina T, Mouillet G, Kleinclauss F, Pivot X, Limat S, Thiery-Vuillemin A. Clinical impact of targeted therapies in patients with metastatic clear-cell renal cell carcinoma. Onco Targets Ther 2014; 7:365-74. [PMID: 24600236 PMCID: PMC3942215 DOI: 10.2147/ott.s56370] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [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] [Indexed: 01/15/2023] Open
Abstract
Introduction The aim of this retrospective clinical study was to assess, in the context of the recent evolution of systemic therapies, the potential effect of targeted therapies on overall survival (OS) of patients with metastatic clear-cell renal cell carcinoma (mccRCC) in daily practice. Patients and methods All consecutive patients with histologically confirmed mccRCC who received systemic therapy between January 2000 and December 2010 in two oncology treatment centers in our Franche-Comté region in eastern France were included in the analysis. The primary end point was OS. The analysis of prognostic factors was performed using a two-step approach: univariate then multivariate analysis with a stepwise Cox proportional hazards regression model. Results For the entire cohort of 111 patients, the median OS was 17 months (95% confidence interval [CI]; 13–22 months) and the two-year OS was 39%. Three prognostic factors were independent predictors of long survival: prior nephrectomy (hazard ratio =0.38 [0.22–0.64], P<0.0001); systemic therapy by targeted therapy (hazard ratio =0.50 [0.31–0.80], P=0.005); and lack of liver metastasis (hazard ratio =0.43 [0.22–0.82], P=0.002). Median OS was 21 months [14–29 months] for patients who received at least one targeted therapy compared with 12 months [7–15 months] for patients who were treated only by immunotherapy agents (P=0.003). Conclusion Our results suggest that targeted therapies are associated with improved OS in comparison with cytokines, which is in line with other publications.
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Affiliation(s)
- Virginie Nerich
- Department of Pharmacy, University Hospital, Besançon, France ; Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France
| | - Marion Hugues
- Department of Pharmacy, University Hospital, Besançon, France
| | | | | | - Thierry Nai
- Department of Pharmacy, University Hospital, Besançon, France
| | - Ulrich Stein
- Department of Medical Oncology, Besançon, France
| | | | | | | | | | - François Kleinclauss
- Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Urology, University Hospital, Besançon, France
| | - Xavier Pivot
- Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Medical Oncology, Besançon, France
| | - Samuel Limat
- Department of Pharmacy, University Hospital, Besançon, France ; Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France
| | - Antoine Thiery-Vuillemin
- Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Medical Oncology, Besançon, France
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24
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Michaelson MD, Oudard S, Ou YC, Sengeløv L, Saad F, Houede N, Ostler P, Stenzl A, Daugaard G, Jones R, Laestadius F, Ullèn A, Bahl A, Castellano D, Gschwend J, Maurina T, Chow Maneval E, Wang SL, Lechuga MJ, Paolini J, Chen I. Randomized, Placebo-Controlled, Phase III Trial of Sunitinib Plus Prednisone Versus Prednisone Alone in Progressive, Metastatic, Castration-Resistant Prostate Cancer. J Clin Oncol 2014; 32:76-82. [DOI: 10.1200/jco.2012.48.5268] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [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
Purpose We evaluated angiogenesis-targeted sunitinib therapy in a randomized, double-blind trial of metastatic castration-resistant prostate cancer (mCRPC). Patients and Methods Men with progressive mCRPC after docetaxel-based chemotherapy were randomly assigned 2:1 to receive sunitinib 37.5 mg/d continuously or placebo. Patients also received oral prednisone 5 mg twice daily. The primary end point was overall survival (OS); secondary end points included progression-free survival (PFS). Two interim analyses were planned. Results Overall, 873 patients were randomly assigned to receive sunitinib (n = 584) or placebo (n = 289). The independent data monitoring committee stopped the study for futility after the second interim analysis. After a median overall follow-up of 8.7 months, median OS was 13.1 months and 11.8 months for sunitinib and placebo, respectively (hazard ratio [HR], 0.914; 95% CI, 0.762 to 1.097; stratified log-rank test, P = .168). PFS was significantly improved in the sunitinib arm (median 5.6 v 4.1 months; HR, 0.725; 95% CI, 0.591 to 0.890; stratified log-rank test, P < .001). Toxicity and rates of discontinuations because of adverse events (AEs; 27% v 7%) were greater with sunitinib than placebo. The most common treatment-related grade 3/4 AEs were fatigue (9% v 1%), asthenia (8% v 2%), and hand–foot syndrome (7% v 0%). Frequent treatment-emergent grade 3/4 hematologic abnormalities were lymphopenia (20% v 11%), anemia (9% v 8%), and neutropenia (6% v < 1%). Conclusion The addition of sunitinib to prednisone did not improve OS compared with placebo in docetaxel-refractory mCRPC. The role of antiangiogenic therapy in mCRPC remains investigational.
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Affiliation(s)
- M. Dror Michaelson
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Stephane Oudard
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Yen-Chuan Ou
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Lisa Sengeløv
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Fred Saad
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Nadine Houede
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Peter Ostler
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Arnulf Stenzl
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Gedske Daugaard
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Robert Jones
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Fredrik Laestadius
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Anders Ullèn
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Amit Bahl
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Daniel Castellano
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Juergen Gschwend
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Tristan Maurina
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Edna Chow Maneval
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Shaw-Ling Wang
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Maria Jose Lechuga
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Jolanda Paolini
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
| | - Isan Chen
- M. Dror Michaelson, Massachusetts General Hospital Cancer Center, Boston, MA; Stephane Oudard, George Pompidou European Hospital, Rene Descartes University, Paris; Nadine Houede, Institut Bergonie, Bordeaux; Tristan Maurina, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; Yen-Chuan Ou, Taichung Veterans General Hospital, Taichung, Taiwan; Lisa Sengeløv, Herlev Hospital, Herlev; Gedske Daugaard, Rigshospitalet, Copenhagen, Denmark; Fred Saad, University of Montreal, Montreal, Canada; Peter Ostler,
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Thiery-Vuillemin A, Curtit E, Maurina T, Montange D, Succi C, NGuyen T, Kim S, Montcuquet P, Pivot X, Royer B. Hemodialysis does not affect everolimus pharmacokinetics: two cases of patients with metastatic renal cell cancer. Ann Oncol 2012; 23:2992-2993. [PMID: 23071263 DOI: 10.1093/annonc/mds477] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Thiery-Vuillemin
- INSERM, UMR1098, Besançon; UMR1098, SFR IBCT, University of Franche-Comté, Besançon, France; Medical Oncology Unit, CHU Minjoz, Besançon.
| | - E Curtit
- Medical Oncology Unit, CHU Minjoz, Besançon
| | - T Maurina
- Medical Oncology Unit, CHU Minjoz, Besançon
| | | | - C Succi
- Osmose Franche Comté, Besançon, France
| | - T NGuyen
- Medical Oncology Unit, CHU Minjoz, Besançon
| | - S Kim
- Medical Oncology Unit, CHU Minjoz, Besançon
| | | | - X Pivot
- INSERM, UMR1098, Besançon; UMR1098, SFR IBCT, University of Franche-Comté, Besançon, France; Medical Oncology Unit, CHU Minjoz, Besançon
| | - B Royer
- INSERM, UMR1098, Besançon; Pharmacology Unit, CHU Minjoz, Besançon
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Kim C, Curti E, Nguyen T, Maurina T, Lakkis Z, Heyd B, Dobi E, Fratte S, Winkfield B, Borg C. Bifractionated CPT-11 with LV5FU2 Infusion (FOLFIRI-3) In Combination with Bevacizumab Followed by a Capecitabine and Bevacizumab Maintenance Therapy: A Phase II Study in First-Line Metastatic Colorectal Cancers. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33214-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Thiery-Vuillemin A, Montange D, Kalbacher E, Maurina T, Nguyen T, Royer B, Bouchet S, Bazan F, Curtit E, Pivot X. Impact of sunitinib pharmacokinetic monitoring in a patient with metastatic renal cell carcinoma undergoing hemodialysis. Ann Oncol 2011; 22:2152-2154. [DOI: 10.1093/annonc/mdr343] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Medioni J, Ferrero J, Deplanque G, Maurina T, Rodier JP, Raymond E, Allyon J, Renaux S, Dufour-Lamartinie J, Oudard S. Dose-finding and efficacy phase II study of inecalcitol, a new VDR agonist, in combination with docetaxel-prednisone regimen for patients (pts) with castration-resistant prostate cancer (CRPC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ou Y, Michaelson MD, Sengeløv L, Saad F, Houede N, Ostler PJ, Stenzl A, Daugaard G, Jones RJ, Laestadius F, Bahl A, Castellano DE, Gschwend J, Maurina T, Ye D, Chen I, Wang S, Maneval EC, Oudard S. Randomized, placebo-controlled, phase III trial of sunitinib in combination with prednisone (SU+P) versus prednisone (P) alone in men with progressive metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4515] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Medioni J, Deplanque G, Maurina T, Ferrero JM, Rodier JM, Raymond E, Ayllon J, Renaux S, Dufour-Lamartinie JF, Oudard S. 710 DOSE FINDING AND EFFICACY PHASE 2 STUDY OF INECALCITOL, A NEW VDR AGONIST, IN COMBINATION WITH DOCETAXEL-PREDNISONE REGIMEN FOR CASTRATION-RESISTANT PROSTATE CANCER (CRPC) PATIENTS (PTS). J Urol 2011. [DOI: 10.1016/j.juro.2011.02.1678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Medioni J, Deplanque G, Ferrero J, Maurina T, Rodier JP, Raymond E, Allyon J, Renaux S, Dufour-Lamartinie J, Oudard S. Dose-finding and efficacy phase II study of inecalcitol, a new VDR agonist, in combination with docetaxel-prednisone regimen for castration-resistant prostate cancer (CRPC) patients (pts). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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
142 Background: Inecalcitol is a novel vitamin D receptor (VDR) agonist which shows high antiproliferative effects in human cancer cell lines and a 100-fold lower hypercalcemic activity than calcitriol the natural ligand of VDR. Methods: Escalating dosages of inecalcitol were combined to chemotherapy in naive metastatic CRPC patients. Safety and efficacy were evaluated in groups of 3-6 pts receiving inecalcitol every other day, daily or twice a day on a 21-day cycle in combination with docetaxel (75mg/m2 q3w) and oral prednisone (5mg bid). Pts received up to six cycles unless unacceptable toxicity or disease progression. Primary endpoint was dose limiting toxicity (DLT) defined as G3 hypercalcemia within the first cycle. Efficacy endpoint was PSA response defined as ≥30% decline within 3 months. Results: Eight dose levels from 40 to 8,000 μg have been evaluated in 54 pts; 83 % had bone metastases, 13% had visceral disease only. Median age was 71 years (range, 49-87), median Gleason score (Gs) 7 and median PSA 28.5 ng/mL (range, 0.8-962.4). DLT occurred in 2/4 patients receiving 8,000 μg/day after 1 and 2 weeks of treatment. Calcemia normalized in few days after interruption of treatment. The 2 other experienced only G2 and were stepped down to 4,000 μg. After dose reduction, calcemia remained within normal ranges and G1.The maximum tolerated dose is defined at 4,000 μg qd. Most of adverse events reported were grade 2. G3-4 were mainly hematological toxicity. Frequency of AEs related to docetaxel did not seem to be modified.82% of the patients had ≥30% PSA decline within 3 months of treatment whereas in historical data around 65% are responder with docetaxel as a single agent. PSA response was observed after 1 cycle of treatment in 43% of the patients. Time to biochemical relapse defined as an increase of 25% over nadir was 169 days. Conclusions: High antiproliferative daily dose of inecalcitol, a new VDR, agonist has been safely used in combination with docetaxel in CRPC patients. This combination treatment shows encouraging PSA response (> 30% PSA response: 82%). A multicenter randomized double blind phase III study is forecasted to confirm these results. [Table: see text]
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Affiliation(s)
- J. Medioni
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - G. Deplanque
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - J. Ferrero
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - T. Maurina
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - J. P. Rodier
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - E. Raymond
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - J. Allyon
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - S. Renaux
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - J. Dufour-Lamartinie
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
| | - S. Oudard
- Medical Oncology Department, Georges Pompidou European Hospital, Paris, France; Groupe Hospital St. Joseph, Paris, France; Anticancer Center, Centre Antoine-Lacassagne, Nice, France; Jean Minjoz Hospital, Besancon, France; Bichat Hospital, Paris, France; Beaujon Hospital, Clichy, France; Georges Pompidou European Hospital, Paris, France; Hybrigenics, Paris, France
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Mansi L, Thiery-Vuillemin A, Nguyen T, Bazan F, Calcagno F, Rocquain J, Demarchi M, Villanueva C, Maurina T, Pivot X. Safety profile of new anticancer drugs. Expert Opin Drug Saf 2010; 9:301-17. [DOI: 10.1517/14740330903530663] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Laura Mansi
- CHU Jean Minjoz, Medical Oncology Unit, Boulevard Flemming, 25 000 Besancon, France
| | - Antoine Thiery-Vuillemin
- CHU Jean Minjoz, Medical Oncology Unit, Boulevard Flemming, 25 000 Besancon, France
- INSERM U645 Besancon, France
| | - Thierry Nguyen
- CHU Jean Minjoz, Medical Oncology Unit, Boulevard Flemming, 25 000 Besancon, France
| | - Fernando Bazan
- CHU Jean Minjoz, Medical Oncology Unit, Boulevard Flemming, 25 000 Besancon, France
| | | | | | - Martin Demarchi
- CHU Jean Minjoz, Medical Oncology Unit, Boulevard Flemming, 25 000 Besancon, France
| | - Cristian Villanueva
- CHU Jean Minjoz, Medical Oncology Unit, Boulevard Flemming, 25 000 Besancon, France
| | - Tristan Maurina
- CHU Jean Minjoz, Medical Oncology Unit, Boulevard Flemming, 25 000 Besancon, France
| | - Xavier Pivot
- CHU Jean Minjoz, Medical Oncology Unit, Boulevard Flemming, 25 000 Besancon, France
- INSERM U645 Besancon, France
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Medioni J, Deplanque G, Maurina T, Ferrero J, Rodier J, Raymond E, Allyon J, Kalla S, Dufour-Lamartinie J, Oudard S. 7030 Dose finding and safety analysis of inecalcitol in combination with docetaxel-prednisone regimen in hormone-refractory prostate cancer (HRPC) patients (pts). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71408-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Medioni J, Deplanque G, Maurina T, Ferrero JM, Rodier JM, Raymond E, Allyon J, Kalla S, Dufour-Lamartinie JF, Oudard S. Dose finding and safety analysis of inecalcitol in combination with a docetaxel-prednisone regimen in hormone-refractory prostate cancer (HRPC) patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5151 Background: Inecalcitol is a novel synthetic vitamin D3 analogue with potent antiproliferative effects in human cancer cell lines and a 100-fold lower hypercalcemic activity than calcitriol in animal models. Methods: Escalating dosages of inecalcitol were combined to chemotherapy in naive HRPC patients (pts). Safety and efficacy were evaluated in groups of 3–6 patients receiving oral inecalcitol daily or every other day on a 21-day cycle in combination with docetaxel (75mg/m2 q3w) and oral prednisone (5mg bid). Biphosphonates were prohibited during the first cycle. Patients received up to six cycles unless unacceptable toxicity or disease progression. Primary endpoint was dose limiting toxicity (DLT) defined as grade 3 hypercalcemia within the first cycle. Calcemia, creatininemia and CBC were assessed weekly; biochemistry, ECG and PSA every 3 weeks. Efficacy endpoint was PSA response defined as ≥30% decline within 3 months. Results: Five dose levels: 40, 80, 160, 300, 600 μg have been evaluated in 34 pts; 9 pts are still being treated at 600 μg; 25 pts have completed 6 cycles (13 bone metastases; 3 extrasqueletic metastasis, 8 bone and extrasqueletic metastases; 1 PSA-only disease). Median age was 72 years (range, 53–87), median Gleason score (Gs) 7 (36% Gs 10–8, 64% Gs 7–6) and median PSA 41.5 ng/mL (range, 0.9–962.4). No increased calcemia was reported. Most adverse events (AE) were G1–2, asthenia (19pts), constipation (14pts), diarrhea (13pts). G3–4 AEs were neutropenia (11pts) lymphopenia (9pts), asthenia (3pts), arrhythmia (2 pts), general health deterioration (2pts) and diarrhea (1pt). None of these AEs was considered related to inecalcitol. Of the 23 evaluable pts for PSA response, 20 (87%) had ≥30% PSA decline. Conclusions: Results from this ongoing study show the safe profile of inecalcitol when given daily in in HRPC pts. PSA responses with this combination are encouraging. As DLT was not reached, a higher dose of inecalcitol (1000 μg/day) will be further tested. [Table: see text]
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Affiliation(s)
- J. Medioni
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - G. Deplanque
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - T. Maurina
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - J. M. Ferrero
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - J. M. Rodier
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - E. Raymond
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - J. Allyon
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - S. Kalla
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - J. F. Dufour-Lamartinie
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
| | - S. Oudard
- Centre Hospitalier St Joseph, Paris, France; Centre Hospitalier Universitaire Jean Minjoz, Besançon, France; Centre Antoine Lacassagne, Nice, France; Hopital Beaujon, Clichy, France; Hopital Européen Georges Pompidou, Paris, France; Hybrigenics, Paris, France
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Chaigneau L, Royer B, Montange D, Nguyen T, Maurina T, Villanueva C, Demarchi M, Borg C, Fagnoni-Legat C, Kantelip JP, Pivot X. Influence of capecitabine absorption on its metabolites pharmacokinetics: a bioequivalence study. Ann Oncol 2008; 19:1980-1. [PMID: 18952760 DOI: 10.1093/annonc/mdn662] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pivot X, Villanueva C, Chaigneau L, Nguyen T, Demarchi M, Maurina T, Stein U, Borg C. Ixabepilone, a novel epothilone analog in the treatment of breast cancer. Expert Opin Investig Drugs 2008; 17:593-9. [PMID: 18363523 DOI: 10.1517/13543784.17.4.593] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Natural epothilones and their analogs promote tumor cell death by binding to tubulin and stabilizing microtubules, causing cell death. Ixabepilone (BMS-247550, Ixempra) is an epothilone analog that optimizes the properties naturally observed with epothilone B. OBJECTIVE To provide an overview of the results achieved by ixabepilone in metastatic breast cancer. METHODS A PubMed search was performed to provide an extensive review of all published data on ixabepilone, in addition to all data reported from international congresses, from 2003 to 2007. RESULTS/CONCLUSION There is a clear need for new agents active against resistant metastatic breast cancer and ixabepilone might be a welcome new compound in this situation.
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Affiliation(s)
- Xavier Pivot
- Oncologie Médicale, CHU J Minjoz, 25000 Besançon, France.
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Thiery-Vuillemin A, Chaigneau L, Meaux-Ruault N, Villanueva C, N'guyen T, Maurina T, Stein U, Lorgis V, Demarchi M, Pivot X. Anticancer therapy in patients with porphyrias: evidence today. Expert Opin Drug Saf 2008; 7:159-65. [DOI: 10.1517/14740338.7.2.159] [Citation(s) in RCA: 2] [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: 11/05/2022]
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Chaigneau L, Villanueva C, Thierry-Vuillemin A, Legat-Fagnoni C, N'Guyen T, Maurina T, Lorgis V, Pivot X. [Pemetrexed development in oncology]. Bull Cancer 2007; 94 Spec No Actualites:S142-8. [PMID: 17845985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The pemetrexed disodium (Alimta), LY231514) is the first antifolate able to inhibit at the same time the synthesis of purins and pyrimidins. Many therapeutic tests were carried out in clinical situations where the methotrexate and the fluorouracil had been the proof of their effectiveness. It then showed an interesting activity in a great number of tumours but with very different profiles of tolerance according to the studies and pathologies. The explanation will come in 2001 by the description from the relation between the vitamin deficiencies among treated patients and occurred from toxicities. The two randomized studies carried out in the malignant pleural mesothelioma and the non small cell lung cancer made it possible to establish its utility and to record the pemetrexed in these clinical situations. Others axes of development remain possible, but the results are stanby or to confirm as in squamous-cell cancer in the head and neck and breast, digestive or urinary tracts cancer. In all the cases, the optimization of the pemetrexed in terms of amount/methods of administration and associations possible because of its profile of tolerance makes of it a molecule of chemotherapy with a future.
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Affiliation(s)
- Loïc Chaigneau
- Service d'oncologie médicale, centre hospitalier universitaire Jean-Minjoz, 25000 Besançon.
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