1
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Lefèvre A, Tissot C. [Pembrolizumab in adjuvant therapy in non-small cell lung cancers]. Bull Cancer 2024; 111:334-336. [PMID: 38471995 DOI: 10.1016/j.bulcan.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 03/14/2024]
Affiliation(s)
- Antoine Lefèvre
- Département d'oncologie médicale, Gustave-Roussy, université Paris-Saclay, 94805 Villejuif, France.
| | - Claire Tissot
- Hôpital privé de la Loire, 42100 Saint-Étienne, France
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2
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Raynaud C, Rodrigues M. [Dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer]. Bull Cancer 2024:S0007-4551(24)00075-4. [PMID: 38493028 DOI: 10.1016/j.bulcan.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 03/18/2024]
Affiliation(s)
- Charles Raynaud
- Département d'oncologie médicale, Institut Curie - Saint-Cloud, 35, rue Dailly, 92210 Saint-Cloud, France.
| | - Manuel Rodrigues
- Département d'oncologie médicale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France; DRUM Team, Inserm U830, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
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3
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Duval M, Zaanan A. [Pembrolizumab+chemotherapy as first-line treatment in patients with HER negative advanced oesogastric adenocarcinoma]. Bull Cancer 2024:S0007-4551(24)00072-9. [PMID: 38458924 DOI: 10.1016/j.bulcan.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Martin Duval
- Service d'oncologie médicale, institut Curie, hôpital René-Huguenin-Saint-Cloud, 35, rue Dailly, 92210 Saint-Cloud, France.
| | - Aziz Zaanan
- Département d'oncologie digestive, hôpital européen Georges-Pompidou (HEGP), Assistance publique-Hôpitaux de Paris (AP-HP), université Paris Cité, institut du cancer parisien CARPEM, 20, rue Leblanc 75015 Paris, France
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4
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Dougé A, Caux C, Bay JO. [Cell therapy in all its forms]. Bull Cancer 2024; 111:213-221. [PMID: 38242769 DOI: 10.1016/j.bulcan.2024.01.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024]
Abstract
Immunotherapy strategies have revolutionized the management of a significant number of patients in recent years, whether they are undergoing treatment for hematologic malignancies or solid tumors. This therapeutic class is extensive, ranging from antibodies targeting immune checkpoint molecules to adoptive cell therapy strategies, including bispecific antibodies and anticancer vaccines. All these strategies are currently in active development. Adoptive cell therapy involves the infusion of normal or genetically modified immune cells into a patient with the aim of restoring strong antitumor immunity, primarily associated with the cytotoxicity of T lymphocytes. Currently, there are three major adoptive cell therapy strategies: allogeneic hematopoietic stem cell transplantation, CAR-T cell therapy, and TCR-T cell therapy. The objective of this article is to describe the mechanisms of action of these three strategies as well as their current advantages, limitations and constraints.
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Affiliation(s)
- Aurore Dougé
- Service d'oncologie médicale, centre hospitalier universitaire, Clermont-Ferrand, France; EA(UR)7453 CHELTER, université Clermont Auvergne, Clermont-Ferrand, France.
| | - Christophe Caux
- CNRS 5286, centre de recherche en cancérologie de Lyon, Inserm U1052, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - Jacques-Olivier Bay
- Service d'oncologie médicale, centre hospitalier universitaire, Clermont-Ferrand, France; EA(UR)7453 CHELTER, université Clermont Auvergne, Clermont-Ferrand, France
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5
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Bello Roufai D. [Place of innovative therapies in the management of cervical cancer]. Bull Cancer 2024; 111:51-61. [PMID: 38087730 DOI: 10.1016/j.bulcan.2023.10.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 01/22/2024]
Abstract
Despite optimized screening and prevention strategies, cervical cancer remains a major public health problem, even in developed countries. In France, the incidence is estimated at 3159 cases per year in 2023. While the management of early-stage cases is now highly standardized, few therapeutic advances were made in the treatment of metastatic stages before 2021, before the therapeutic arsenal that we know today took off. The aim of this review is to summarize these advances.
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Affiliation(s)
- Diana Bello Roufai
- Département d'oncologie médicale, Institut Curie, 35, rue Dailly, 92210 Saint-Cloud, France.
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6
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Gagé A, Pereira B, Belliere A, Janicot H, Jeannin G, Bourrachot C, Durand M, Rolland-Debord C, Merle P. [Interest of focal radiotherapy in case of oligoprogression under immunotherapy in the treatment of metastatic non-small cell lung cancer]. Bull Cancer 2023; 110:1234-1243. [PMID: 38445648 DOI: 10.1016/j.bulcan.2023.09.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 06/09/2023] [Accepted: 09/28/2023] [Indexed: 03/07/2024]
Abstract
INTRODUCTION The prognosis of metastatic non-small cell lung cancer (NSCLC) has been improved by the use of immune checkpoint inhibitors (ICI). Unfortunately, in some cases, cancer cells will develop resistance mechanisms. In case of progression in a limited number of lesions (oligoprogression), focal treatment with radiotherapy is proposed while continuing the ICI therapy. METHODS A cohort of 37 patients with metastatic NSCLC treated with nivolumab (anti-PD-1) in second or subsequent line and who received focal radiotherapy for oligoprogression with continuation of nivolumab was compared with a control cohort of 87 patients no oligoprogressor treated par immunotherapy. RESULTS After a median follow-up of 37 months [18; 62], the median progression free survival (PFS) in the radiotherapy-treated cohort was 15.04 versus 5.04 months in the control cohort, with a statistically significant difference (P=0.048). The median PFS following focal radiotherapy in the oligoprogressor group was 7.5 months. In univariate analysis, the presence of lung metastasis was associated with increased PFS, in contrast to the presence of brain metastases, which were associated with decreased PFS in the radiotherapy group. The median overall survival was not reached in both groups, with no significant difference between the two cohorts. CONCLUSION The combination of focal radiotherapy in case of oligoprogression and continued treatment with nivolumab in the treatment of metastatic NSCLC in the second or subsequent line of treatment seems to be with an increase in PFS.
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Affiliation(s)
- Anaïs Gagé
- Université Clermont-Auvergne, service de pneumologie, CHU de Gabriel-Montpied, rue Montalembert, BP 69, 63003 Clermont-Ferrand, France
| | - Bruno Pereira
- CHU fr Clermont-Ferrand, unité de Biostatistiques (DRCI), Clermont-Ferrand, France
| | - Aurélie Belliere
- Centre Jean Perrin, service de radiothérapie, Clermont-Ferrand, France
| | - Henri Janicot
- Université Clermont-Auvergne, service de pneumologie, CHU de Gabriel-Montpied, rue Montalembert, BP 69, 63003 Clermont-Ferrand, France
| | - Gaëlle Jeannin
- Université Clermont-Auvergne, service de pneumologie, CHU de Gabriel-Montpied, rue Montalembert, BP 69, 63003 Clermont-Ferrand, France
| | - Clara Bourrachot
- Université Clermont-Auvergne, service de pneumologie, CHU de Gabriel-Montpied, rue Montalembert, BP 69, 63003 Clermont-Ferrand, France
| | - Muriel Durand
- Université Clermont-Auvergne, service de pneumologie, CHU de Gabriel-Montpied, rue Montalembert, BP 69, 63003 Clermont-Ferrand, France
| | - Camille Rolland-Debord
- Université Clermont-Auvergne, service de pneumologie, CHU de Gabriel-Montpied, rue Montalembert, BP 69, 63003 Clermont-Ferrand, France
| | - Patrick Merle
- Université Clermont-Auvergne, service de pneumologie, CHU de Gabriel-Montpied, rue Montalembert, BP 69, 63003 Clermont-Ferrand, France; Université Clermont-Auvergne, Inserm-UMR 1240-IMOST, 63003 Clermont-Ferrand, France
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7
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Mailly-Giacchetti L, Lopez-Trabada D, Feldman J, André T, Cohen R. [Safety and efficacy of immune checkpoint inhibitors in elderly patients]. Bull Cancer 2023; 110:1204-1214. [PMID: 37679205 DOI: 10.1016/j.bulcan.2023.06.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/14/2023] [Accepted: 06/23/2023] [Indexed: 09/09/2023]
Abstract
Immune checkpoint inhibitors (ICI) are the standard of care for many solid tumors with specific physiopathology mechanisms and adverse events. While the percentage of elderly patients increase from years to years, these patients are underrepresented in clinical trials. Immunosenescence and inflammaging, two main components of the aging of our immune system, and their consequences on the safety and the efficacy are today major focus of clinical research. However, there are still no risk assessment score specific to ICI in elderly patients. In this review we showed the global reassuring data on safety from several retrospective and subgroup analysis, in elderly patients. In summary, impairment of the general state is an independent factor of occurrence of adverse events treatment related whatever the age. Here, we highlight the necessity to use of geriatric evaluation screening test in clinic, the need of specific risk score ICI use in the erdely population and mostly the inclusion of elderly patients in clinical trial to generate specific data.
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Affiliation(s)
| | | | - Judith Feldman
- Department of Geriatry, Saint-Antoine Hospital, AP-HP, Paris, France
| | - Thierry André
- Sorbonne University, Department of Medical Oncology, Saint-Antoine Hospital, AP-HP; SIRIC CURAMUS, INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe Labellisée par la Ligue Nationale Contre le Cancer, Paris, France
| | - Romain Cohen
- Sorbonne University, Department of Medical Oncology, Saint-Antoine Hospital, AP-HP; SIRIC CURAMUS, INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe Labellisée par la Ligue Nationale Contre le Cancer, Paris, France.
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8
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Rodrigues M, Eberst L, Follana P, Gauthier L, Jacquemin V, Tessier C, El Mouaddin N, Boudier P, Fiteni F, Angeli E, Roche S, Delanoy N, Sabatier R, Flippot R, de la Motte Rouge T. Real-world dostarlimab use in advanced/recurrent endometrial cancer in France. Bull Cancer 2023; 110:1041-1050. [PMID: 37659907 DOI: 10.1016/j.bulcan.2023.06.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/12/2023] [Indexed: 09/04/2023]
Abstract
INTRODUCTION In October 2020, the French Health Authority granted early access outside of the clinical trial setting for dostarlimab, a programmed death-1 inhibitor. Dostarlimab was approved by the European Medicines Agency (in April 2021) as monotherapy for patients with post-platinum mismatch repair deficient/microsatellite instability-high advanced/recurrent endometrial cancer, based on the results of the GARNET trial (NCT02715284). METHODS This was a real-world descriptive analysis of patients granted cohort temporary authorization of use to receive dostarlimab between November 2020 and June 2021. Physicians could complete follow-up forms at each treatment cycle to provide clinical information, safety, and efficacy data. Safety and disease progression data were also captured through pharmacovigilance reports. RESULTS Of 95 temporary authorization of use requests made by 80 oncologists in 59 French hospitals, 87 patients were eligible, and 80 received≥1 dose of dostarlimab. Based on treatment response assessments received (n=43), the mean (standard deviation) time from treatment initiation to response evaluation was 11 (6) weeks. The disease control rate (complete plus partial responses plus stable disease rates) was 56% (n=24/43), and the overall response rate was 35% (n=15/43); both consistent with those reported in the GARNET trial. No new safety signals were reported. DISCUSSION The enrolment of 80 patients in an 8-month period highlights the need for access to novel treatment regimens in France for these patients post-platinum. Prospective randomized studies are ongoing to assess the efficacy and safety of dostarlimab and other checkpoint inhibitors as first-line treatment in patients with endometrial cancer.
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Affiliation(s)
- Manuel Rodrigues
- Institut Curie, département d'oncologie médicale et Inserm U830, Paris, France.
| | - Lauriane Eberst
- Institut de cancérologie de Strasbourg Europe, Strasbourg, France; Agence nationale de sécurité du médicament, Saint Denis, France
| | | | | | | | | | | | - Philippe Boudier
- Institut de cancérologie de Strasbourg Europe, Strasbourg, France; Agence nationale de sécurité du médicament, Saint Denis, France
| | - Frederic Fiteni
- Centre hospitalier universitaire de Nîmes, Nîmes/UMR Inserm IDESP, institut Desbret d'épidémiologie et de santé publique, université de Montpellier, service d'oncologie médicale, 34090 Montpellier, France
| | - Eurydice Angeli
- Hôpital Avicenne, service d'oncologie médicale, Bobigny, France
| | | | - Nicolas Delanoy
- AP-HP, institut du cancer Paris CARPEM, hôpital européen Georges-Pompidou, department of medical oncology, Paris, France
| | - Renaud Sabatier
- Aix-Marseille université, Inserm, institut Paoli-Calmettes, department of medical oncology, Marseille, France
| | - Ronan Flippot
- Gustave-Roussy, Paris Saclay university, department of cancer medicine, Villejuif, France
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9
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Prod'homme C, Macaire C, Chevalier L, Templier C, Mortier L. ["Hope for the best and prepare for the worst": A case of metastatic melanoma progressing under last line of immunotherapy]. Bull Cancer 2023; 110:978-981. [PMID: 37164772 DOI: 10.1016/j.bulcan.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Chloé Prod'homme
- Université Lille, ULR 2694-METRICS : évaluation des technologies de santé et des pratiques médicales, CHU de Lille, clinique de médecine palliative, 59000 Lille, France.
| | - Camille Macaire
- Université Lille, Inserm U1189, CHU de Lille, service de dermatologie, 59000 Lille, France
| | - Luc Chevalier
- Université Lille, ULR 2694-METRICS : évaluation des technologies de santé et des pratiques médicales, CHU de Lille, clinique de médecine palliative, 59000 Lille, France
| | - Carole Templier
- Université Lille, Inserm U1189, CHU de Lille, service de dermatologie, 59000 Lille, France
| | - Laurent Mortier
- Université Lille, Inserm U1189, CHU de Lille, service de dermatologie, 59000 Lille, France
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10
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Penninckx S, Martinive P, Mirjolet C. Radiation-activated nanoparticles: Which combination to optimize radiosensitization? Cancer Radiother 2023; 27:494-498. [PMID: 37544778 DOI: 10.1016/j.canrad.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023]
Abstract
Radiotherapy plays a crucial role in the treatment of various cancers. With the ongoing technological advancements in radiotherapy equipment, allowing for increasingly precise targeting of tumours, there are numerous strategies being explored to enhance its effectiveness by combining it with other therapies. Among these, metal nanoparticles seem to have a promising future driven by their ability to locally amplify the dose deposited by ionizing radiation, and to radiosensitize cells by modifying their oxidative status. Recent advancements in understanding the mechanisms of action of these nanoparticles have provided valuable insights for the development of new therapeutic combinations. Among these, the combination with immunotherapies would make it possible to benefit both from the amplified local effect of radiotherapy by nanoparticles and to induce a better antitumour immune response. In this article, we review shortly the existing literature on ongoing combinations and suggest potential novel therapies associated with the combination of radiotherapy and nanoparticles.
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Affiliation(s)
- S Penninckx
- Medical Physics Department, institut Jules-Bordet, Université libre de Bruxelles, 1070 Brussels, Belgium; Radiotherapy Department, institut Jules-Bordet, Université libre de Bruxelles, 1070 Brussels, Belgium.
| | - P Martinive
- Radiotherapy Department, institut Jules-Bordet, Université libre de Bruxelles, 1070 Brussels, Belgium
| | - C Mirjolet
- Radiation Oncology Department, Preclinical Radiation Therapy and Radiobiology Unit, centre Georges-François-Leclerc, Unicancer, Dijon, France; TiReCs team, Inserm UMR 1231, Dijon, France
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11
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Le Grand S, Karlin L. [Teclistamab as monotherapy in patients with relapsed or refractory multiple myeloma who received three or more lines of therapy]. Bull Cancer 2023; 110:871-872. [PMID: 37296008 DOI: 10.1016/j.bulcan.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Sophie Le Grand
- Institut universitaire du cancer Toulouse Oncopôle, service d'hématologie, Toulouse, France.
| | - Lionel Karlin
- Hôpital Lyon Sud, service d'hématologie clinique, Pierre-Benite, France
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12
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Camps Maléa A, Hennequin C, Rivera S. [Targeted systemic treatments and locoregional radiotherapy for breast cancer: Can we expect a benefit from the potentiation of local treatment?]. Cancer Radiother 2023; 27:535-541. [PMID: 37558607 DOI: 10.1016/j.canrad.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 08/11/2023]
Abstract
Breast cancer is the first most common cancer worldwide, and radiation therapy has a major role to play in locoregional adjuvant treatment. In recent years, we have seen the emergence of adjuvant targeted systemic therapies improving the prognosis of patients at high risk of recurrence. Practices concerning combinations of targeted therapies and locoregional radiation therapy for non-metastatic breast cancers often remain heterogeneous due to the low level of evidence and lack of validated recommendations. This literature review covers immunotherapy, CDK 4/6 inhibitors, PARP inhibitors and anti-Her2 therapies. Combining these targeted systemic therapies with radiation therapy could potentiate local treatment. The optimal therapeutic sequence and fractionation for maximum synergistic effect remain to be defined. However, while efficacy may be enhanced, radiosensitization of healthy tissue may also lead to increased toxicity. It appears possible to continue immunotherapy, trastuzumab, pertuzumab, TDM-1 or lapatinib during locoregional breast and lymph node irradiation. PARP inhibitors and CDK4/6 inhibitors are still to be suspended, due to the lack of data in the adjuvant setting and their short half-life, which does not necessitate prolonged discontinuation. As with the new antibody-drug conjugates, prospective data are needed in conjunction with adjuvant radiation therapy.
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Affiliation(s)
- A Camps Maléa
- Service de radiothérapie, centre Henry-S-Kaplan, CHRU Bretonneau, Tours, France
| | - C Hennequin
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris, France
| | - S Rivera
- Département d'oncologie-radiothérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
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13
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Blondet L, Sarabi M. [New drug approval: Durvalumab in combinaison with cisplatin and gemcitabine in first-line in patient with advanced biliary tract cancer]. Bull Cancer 2023:S0007-4551(23)00198-4. [PMID: 37208249 DOI: 10.1016/j.bulcan.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/21/2023] [Accepted: 04/13/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Laure Blondet
- Hôpital Saint-Antoine, service d'oncologie médicale, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
| | - Matthieu Sarabi
- UMR Inserm 1052/CNRS 5286, centre Léon-Bérard (Lyon), centre de recherche contre le cancer de Lyon, département de cancérologie médicale, groupe oncologie et endoscopie digestive, Cancer Immune Surveillance and Therapeutic Targeting (CISTAR), Lyon, France
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14
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Quesada S, Lebreton C, Caux C, Italiano A, Dubois B. [Tertiary lymphoid structures in cancer: From biology to therapeutic guides]. Bull Cancer 2023:S0007-4551(23)00205-9. [PMID: 37150731 DOI: 10.1016/j.bulcan.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 05/09/2023]
Abstract
Tertiary lymphoid structures (TLS) are inducible ectopic lymphoid aggregates, which form in response to various inflammatory situations, including cancer. TLS are notably composed of B lymphocytes, T lymphocytes, mature dendritic cells and other key players such as high endothelial venules. Furthermore, TLS can present different levels of organization and maturation, from simple T/B lymphocyte aggregates to authentic mature B cell follicles with germinal centers adjacent to T cell rich areas. While over the past decade, TLS may have been associated with a favorable prognosis in various cancers, the year 2022 was marked by the first prospective trial (PEMBROSARC) that reported the interest of TLS as predictive biomarkers of pembrolizumab efficacy for the treatment of soft-tissue sarcomas. All along this review, we will first address the molecular and cellular bases of TLS as well as the different strategies for identifying them in clinical practice, then discuss the prognostic/predictive impact of their presence and finally, we will elaborate on the current limitations and perspectives in translational research.
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Affiliation(s)
- Stanislas Quesada
- Institut régional du cancer de Montpellier - ICM (UNICANCER), département d'oncologie médicale, Montpellier, France.
| | - Coriolan Lebreton
- Institut Bergonié (UNICANCER), département d'oncologie médicale, Bordeaux, France; ARTiSt Lab, Inserm U1312, université de Bordeaux, Bordeaux, France
| | - Christophe Caux
- Centre Léon Bérard, CNRS 5286, Inserm 1052, université Claude Bernard Lyon 1, université de Lyon, centre de recherche en cancérologie de Lyon (CRCL), Équipe "Surveillance immunitaire des tumeurs et ciblage thérapeutique", Lyon, France; Laboratoire d'immunothérapie du cancer de Lyon (LICL), Lyon, France
| | - Antoine Italiano
- Institut Bergonié (UNICANCER), département d'oncologie médicale, Bordeaux, France; Université de Bordeaux, faculté de médecine, Bordeaux, France; DITEP, institut Gustave Roussy - IGR (UNICANCER), Villejuif, France
| | - Bertrand Dubois
- Centre Léon Bérard, CNRS 5286, Inserm 1052, université Claude Bernard Lyon 1, université de Lyon, centre de recherche en cancérologie de Lyon (CRCL), Équipe "Surveillance immunitaire des tumeurs et ciblage thérapeutique", Lyon, France; Laboratoire d'immunothérapie du cancer de Lyon (LICL), Lyon, France
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15
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Fenioux C, Troussier I, Amelot A, Borius PY, Canova CH, Blais E, Mazeron JJ, Maingon P, Valéry CA. Long duration of immunotherapy before radiosurgery might improve intracranial control of melanoma brain metastases. Cancer Radiother 2023; 27:206-213. [PMID: 37149466 DOI: 10.1016/j.canrad.2022.11.004] [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: 09/13/2022] [Revised: 11/12/2022] [Accepted: 11/19/2022] [Indexed: 05/08/2023]
Abstract
PURPOSE Despite significant advances that have been made in management of metastatic melanoma with immune checkpoint therapy, optimal timing of combination immune checkpoint therapy and stereotactic radiosurgery is unknown. We have reported toxicity and efficiency outcomes of patients treated with concurrent immune checkpoint therapy and stereotactic radiosurgery. PATIENTS AND METHODS From January 2014 to December 2016, we analyzed 62 consecutive patients presenting 296 melanoma brain metastases, treated with gamma-knife and receiving concurrent immune checkpoint therapy with anti-CTLA4 or anti-PD1 within the 12 weeks of SRS procedure. Median follow-up time was 18 months (mo) (13-22). Minimal median dose delivered was 18 gray (Gy), with a median volume per lesion of 0.219 cm3. RESULTS The 1-year control rate per irradiated lesion was 89% (CI 95%: 80.41-98.97). Twenty-seven patients (43.5%) developed distant brain metastases after a median time of 7.6 months (CI 95% 1.8-13.3) after gamma-knife. In multivariate analysis, positive predictive factors for intracranial tumor control were: delay since the initiation of immunotherapy exceeding 2 months before gamma-knife procedure (P=0.003) and use of anti-PD1 (P=0.006). Median overall survival (OS) was 14 months (CI 95%: 11-NR). Total irradiated tumor volume<2.1 cm3 was a positive predictive factor for overall survival (P=0.003). Ten patients (16.13%) had adverse events following irradiation, with four grade≥3. Predictive factors of all grade toxicity were: female gender (P=0.001) and previous treatment with MAPK (P=0.05). CONCLUSION A long duration of immune checkpoint therapy before stereotactic radiosurgery might improve intracranial tumor control, but this relationship and its ideal timing need to be assessed in prospective trials.
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Affiliation(s)
- C Fenioux
- Service de radiothérapie oncologique, hôpital de la Pitié-Salpêtrière, Paris, France
| | - I Troussier
- Service de radiothérapie oncologique, hôpital de la Pitié-Salpêtrière, Paris, France
| | - A Amelot
- Service de neurochirurgie, hôpital de la Pitié-Salpêtrière, Paris, France
| | - P Y Borius
- Service de neurochirurgie, hôpital de la Pitié-Salpêtrière, Paris, France; Unité de radiochirurgie gamma-knife, hôpital de la Pitié-Salpêtrière, Paris, France
| | - C H Canova
- Service de radiothérapie oncologique, hôpital de la Pitié-Salpêtrière, Paris, France
| | - E Blais
- Service de radiothérapie oncologique, hôpital de la Pitié-Salpêtrière, Paris, France
| | - J J Mazeron
- Service de radiothérapie oncologique, hôpital de la Pitié-Salpêtrière, Paris, France
| | - P Maingon
- Service de radiothérapie oncologique, hôpital de la Pitié-Salpêtrière, Paris, France
| | - C A Valéry
- Service de neurochirurgie, hôpital de la Pitié-Salpêtrière, Paris, France; Unité de radiochirurgie gamma-knife, hôpital de la Pitié-Salpêtrière, Paris, France.
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16
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Dussart C, Decaux-Tramoni B, Quesada S, Thomas QD, Benzerouale O, Nicolas E, Fiteni F. [Combination strategies for checkpoint inhibition: Current practices and perspectives]. Bull Cancer 2023:S0007-4551(23)00166-2. [PMID: 37055309 DOI: 10.1016/j.bulcan.2023.03.021] [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: 01/24/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 04/15/2023]
Abstract
T-cell checkpoint blockade therapies have revolutionized treatment protocols and prognosis in patients with cancer. Pointed out by the success of PD-1 (programmed cell death-1) plus CTLA-4 (cytotoxic-T-lymphocyte associated antigen 4) blockade in patients with melanoma, the perspective of new synergistic immunotherapy combinations seems to be an important opportunity to improve outcomes for patients. In this article, we first focus on immunotherapy combinations that have shown their efficiency and that are currently approved in solid tumors. Then, we present a summary of emerging targets with reported pre-clinical efficacy and currently evaluated through ongoing clinical trials and other immunomodulatory molecules in the tumor microenvironment.
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Affiliation(s)
- Chloé Dussart
- CHU de Nîmes, service d'oncologie médicale, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Baptiste Decaux-Tramoni
- CHU de Nîmes, service d'oncologie médicale, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Stanislas Quesada
- Institut régional du cancer de Montpellier, département d'oncologie médicale, 34298 Montpellier cedex 5, France
| | - Quentin Dominique Thomas
- Institut régional du cancer de Montpellier, département d'oncologie médicale, 34298 Montpellier cedex 5, France
| | - Ouail Benzerouale
- CHU de Nîmes, service d'oncologie médicale, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Emanuel Nicolas
- CHU de Nîmes, service d'oncologie médicale, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France; Université de Montpellier, Institut Desbrest d'épidémiologie et de santé publique, Inserm UMR 1302, 34090 Montpellier, France
| | - Frédéric Fiteni
- CHU de Nîmes, service d'oncologie médicale, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France; Université de Montpellier, Institut Desbrest d'épidémiologie et de santé publique, Inserm UMR 1302, 34090 Montpellier, France.
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17
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El-Ghazzi N, Bay JO. [Rare tumors: Angiosarcoma]. Bull Cancer 2023; 110:581-588. [PMID: 36973135 DOI: 10.1016/j.bulcan.2023.03.002] [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: 11/14/2022] [Revised: 02/21/2023] [Accepted: 03/02/2023] [Indexed: 03/29/2023]
Abstract
Angiosarcomas are a rare subtype representing 1-2% of soft tissue sarcomas. Risk factors are rarely elucidated but radiotherapy and lymphedema are the most common ones, usually following local treatment for local breast cancer. Despite the improvement of our knowledge, the prognosis remains poor with 35-40% of 5 year-overall survival. Local treatment when feasible should include a R0 surgery completed with adjuvant radiation. When metastatic, front lines chemotherapies include doxorubicine or weekly paclitaxel. If possible, in oligometastatic patients, metastasectomy should always be considered allowing the best responses. The knowledge of angiosarcoma's biology is rapidly increasing and new biomarkers are emerging. The use of immunotherapy in particular subtypes including head and neck angiosarcomas shows promising results. The model of the angiosarcoma project, a patient-participating study, seems to be an excellent way to study rare tumors. We should focus our efforts on understanding the underlying molecular biology to propose the best precision medicine for those patients.
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Affiliation(s)
- Nathan El-Ghazzi
- CHU Gabriel-Montpied, service d'oncologie médicale, Clermont-Ferrand, France; Université Clermont Auvergne, Clermont-Ferrand, France.
| | - Jacques-Olivier Bay
- CHU Gabriel-Montpied, service d'oncologie médicale, Clermont-Ferrand, France; Université Clermont Auvergne, Clermont-Ferrand, France
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18
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Guillaume Z, Allory Y, Auclin E, Gervais C, Auvray M, Rochand A, Mejean A, Audenet F, Vano YA, Oudard S, Thibault C. [Collecting duct carcinoma and renal medullary carcinoma in the age of new therapies]. Bull Cancer 2023; 110:450-462. [PMID: 36906403 DOI: 10.1016/j.bulcan.2023.02.015] [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: 11/01/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/12/2023]
Abstract
Collecting duct carcinoma (also known as Bellini tumour) and renal medullary carcinoma are two extremely rare and aggressive renal cancers. They are both less responsive to conventional treatments used in clear cell renal carcinoma. There are very few studies evaluating their optimal management and currently, at the metastatic stage, polychemotherapy based on platinum salts remains the most widely used. The emergence of new treatments such as anti-angiogenic TKIs, immunotherapy or treatments targeting specific genetic abnormalities, opens up a new field of possibilities in the management of these cancers. The evaluation of the response to these treatments is therefore essential. In this article, we will review the status of their management and the various studies that have evaluated recent treatments in these two cancers.
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Affiliation(s)
- Zoé Guillaume
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | | | - Edouard Auclin
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Claire Gervais
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Marie Auvray
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Adrien Rochand
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Arnaud Mejean
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - François Audenet
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Yann-Alexandre Vano
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Stéphane Oudard
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France
| | - Constance Thibault
- Université de Paris, Européen Georges-Pompidou hospital, 75020 Paris, France.
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19
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Gabriel PE, Pinar U, Parra J, Vaessen C, Mozer P, Chartier-Kastler E, Rouprêt M, Seisen T. [Pathological pelvic lymph node involvement in muscle-invasive bladder cancer patients treated with radical cystectomy: A narrative review]. Prog Urol 2023; 33:145-154. [PMID: 36604248 DOI: 10.1016/j.purol.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 12/06/2022] [Accepted: 12/19/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To perform a narrative review of the contemporary literature on the diagnosis, prognosis and adjuvant management of muscle-invasive bladder cancer (MIBC) patients with pathological pelvic lymph node involvement (pN+) at radical cystectomy. METHOD A narrative review of the contemporary literature available on Medline was conducted to report studies evaluating the diagnosis, prognosis and/or adjuvant treatments for MIBC patients with pN+ disease at radical cystectomy. RESULTS Open or robotic extended pelvic lymph node dissection up to the crossing of the ureter with common iliac vessels can enhance the diagnosis of pN+ MIBC, especially using separate packages for the submission of a maximum number of lymph nodes. The main prognosis factors for pN+ patients are the number of positive and retrieved lymph nodes, lymph node density, extranodal extension as well as lymph node metastasis diameter. Adjuvant chemotherapy is likely to prolong overall survival in pN+ patients treated with radical cystectomy alone while adjuvant immunotherapy using nivolumab has been shown to decrease the risk of recurrence in all pN+ patients, especially those with ypN+ disease after neoadjuvant chemotherapy followed by radical cystectomy. However, few data are currently available on the role of adjuvant radiation therapy, which remains currently experimental for these patients. CONCLUSION Multiple parameters have been reported to impact the diagnosis and prognosis of patients with pN+ MIBC at radical cystectomy. Adjuvant management is currently based on chemotherapy and immunotherapy with preliminary data on radiation therapy.
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Affiliation(s)
- P-E Gabriel
- Sorbonne université, GRC n(o) 5, onco-urologie prédictive, AP-HP, hôpital de la Pitié-Salpêtrière, service d'urologie, 75013 Paris, France.
| | - U Pinar
- Sorbonne université, GRC n(o) 5, onco-urologie prédictive, AP-HP, hôpital de la Pitié-Salpêtrière, service d'urologie, 75013 Paris, France
| | - J Parra
- Sorbonne université, GRC n(o) 5, onco-urologie prédictive, AP-HP, hôpital de la Pitié-Salpêtrière, service d'urologie, 75013 Paris, France
| | - C Vaessen
- Sorbonne université, GRC n(o) 5, onco-urologie prédictive, AP-HP, hôpital de la Pitié-Salpêtrière, service d'urologie, 75013 Paris, France
| | - P Mozer
- Sorbonne université, GRC n(o) 5, onco-urologie prédictive, AP-HP, hôpital de la Pitié-Salpêtrière, service d'urologie, 75013 Paris, France
| | - E Chartier-Kastler
- Sorbonne université, GRC n(o) 5, onco-urologie prédictive, AP-HP, hôpital de la Pitié-Salpêtrière, service d'urologie, 75013 Paris, France
| | - M Rouprêt
- Sorbonne université, GRC n(o) 5, onco-urologie prédictive, AP-HP, hôpital de la Pitié-Salpêtrière, service d'urologie, 75013 Paris, France
| | - T Seisen
- Sorbonne université, GRC n(o) 5, onco-urologie prédictive, AP-HP, hôpital de la Pitié-Salpêtrière, service d'urologie, 75013 Paris, France
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20
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Boudier B, Aldea M. [Drug approval: ATEZOLIZUMAB as monotherapy in NSCLC PD-L1 ≥ 50%, without EGFR mutation or ALK rearrangement, for adjuvant treatment after complete surgery and platinum-based chemotherapy]. Bull Cancer 2023; 110:337-338. [PMID: 36803981 DOI: 10.1016/j.bulcan.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/08/2023] [Indexed: 02/17/2023]
Affiliation(s)
| | - Mihaela Aldea
- Gustave-Roussy, 14 Rue Edouard Vaillant, 94805 Villejuif, France
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21
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Nay P, Morice P, Blanc-Durand F. [Immunotherapy in oncogynaecology]. Bull Cancer 2023; 110:395-401. [PMID: 36759214 DOI: 10.1016/j.bulcan.2023.01.004] [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: 10/27/2022] [Revised: 12/20/2022] [Accepted: 01/15/2023] [Indexed: 02/10/2023]
Abstract
Immune checkpoint inhibitors have deeply changed treatment paradigm of many tumor types, notably by providing long-term remissions, even in the metastatic setting. These immunotherapies aim to restore T-cells activity against tumour cells, in particular via the inhibition of PD1/PD-L1 interaction. As for lung or renal carcinomas, and melanomas, the management of endometrial and uterine cervical cancers has been disrupted by PD1/PD-L1 inhibitors efficacy. In locally advanced or metastatic cervical carcinomas, the combination of platinum-based chemotherapy with pembrolizumab demonstrated improved overall and progression-free survival in all subgroups of patients, and became the new standard of care. Regarding endometrial cancers, while single-agent immunotherapies have shown very limited activity in an unselected population, dostarlimab and pembrolizumab have been associated with remarkable antitumor activity in case of microsatellite instability (dMMR/MSI), detected in around 30% of patients. Finally, in endometrial cancer that has progressed after first-line chemotherapy, the association of pembrolizumab with an oral antiangiogenic kinase inhibitor (lenvatinib) has demonstrated its superiority over second-line chemotherapy regimens, regardless molecular subgroups, and has become the new standard of care in this indication.
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Affiliation(s)
- Paula Nay
- Institut Gustave Roussy, service d'oncologie-gynécologie, Villejuif, France; Sorbonne université, Paris, France
| | - Philippe Morice
- Institut Gustave Roussy, service d'oncologie-gynécologie, Villejuif, France
| | - Felix Blanc-Durand
- Institut Gustave Roussy, service d'oncologie-gynécologie, Villejuif, France.
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22
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Gaillard A, Matet A, Rodrigues M. [New drug approval: Tebentafusp for treatment of metastatic uveal melanoma HLA A*02:01-positive patients]. Bull Cancer 2023; 110:9-10. [PMID: 36357199 DOI: 10.1016/j.bulcan.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Antoine Gaillard
- CHRU Morvan-UBO (Université de Bretagne Occidentale), Service d'oncologie-radiothérapie, 2, avenue Foch, 29200 Brest, France.
| | - Alexandre Matet
- Inserm UMR1138 & Université Paris Cité, Institut Curie, Service d'ophtalmologie, 26 rue d'Ulm, 75248 Paris cedex 05, France.
| | - Manuel Rodrigues
- Institut Curie, Service d'oncologie médicale & INSERM U830, 26, rue d'Ulm, 75005 Paris, France.
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23
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Borgeaud M, Courtes MG, Tsantoulis P, Bodmer A, Labidi-Galy I, Koessler T. Immunotherapy in Urological, Gynecological and Gastrointestinal Cancers - Current Landscape. Praxis (Bern 1994) 2023; 112:149-155. [PMID: 36855887 DOI: 10.1024/1661-8157/a003974] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Immunotherapy is becoming increasingly important in the management of urological, gynecological, and gastrointestinal cancers. Immune checkpoint inhibitor-based combinations have become a standard of care for patients with metastatic renal and liver cancers, as well as for many patients with bladder, cervical, gastric, and esophageal cancers, based on various biomarkers. Some tumor types are less responsive to immunotherapy, such as prostate and colon cancer. In these tumors, however, a subgroup of patients with a microsatellite-instability-high/DNA-mismatch repair deficient molecular phenotype significantly benefits from immunotherapy. Molecular characterization is therefore essential to identify patients who may benefit from these treatments. One of the major challenges is the search for new predictive biomarkers and novel combinations or strategies to further improve patient outcome.
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Affiliation(s)
- Maxime Borgeaud
- Service d'oncologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
- Co-first authors
| | | | - Petros Tsantoulis
- Service d'oncologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Alexandre Bodmer
- Service d'oncologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | | | - Thibaud Koessler
- Service d'oncologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
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24
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Abstract
This article describes three emerging, novel cancer immunotherapies: BITE, TIL and cancer vaccines are therapies that recognize specific targets on cancer cells and trigger a specific immune response. So far, not all tumor types can benefit from these approaches the best results have been observed in hematological malignancies, melanoma, and lung cancer. These novel biological products are currently being tested in several cancer centers in Switzerland, and physicians must be familiar with these procedures, as some of their patients might be treated with such therapies in the near future.
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Affiliation(s)
- Nicolas Mach
- Clinical Research Unit, Oncology Dpt, Hôpitaux Universitaires de Genève, Geneva, Switzerland
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25
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El Ghazzi N, Italiano A, Bay JO, Dougé A. [CAR-T cells development in solid tumors]. Bull Cancer 2023; 110:32-41. [PMID: 36543680 DOI: 10.1016/j.bulcan.2022.12.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022]
Abstract
CAR-T cells have produced very promising results in the field of onco-hematology and have been rapidly approved for marketing in France for several years now. In solid tumors, current results are more disappointing. Indeed, many hurdles come in the way. Tumor vascularization, the strongly immunosuppressive microenvironment, the loss of the target antigen as well as T cell exhaustion are part of the explanation of those results. Hence many researchers are working to develop strategies to counteract these resistance mechanisms. Arming CAR-T cells with BiTEs, with immune checkpoint inhibitors or with interleukins seem to be effective ways to improve antitumor efficacy. Other strategies including vaccines association or local delivery of the CAR-T cells look very promising. Many Phase I studies are investigating these new strategies and are expected to improve the previous results obtained to date in this area.
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Affiliation(s)
- Nathan El Ghazzi
- CHU Gabriel Montpied, service d'oncologie médicale, Clermont-Ferrand, France; Université Clermont Auvergne, Clermont-Ferrand, France
| | - Antoine Italiano
- Institut Bergonié, unité de phases précoces, Bordeaux, France; Université de Bordeaux, Bordeaux, France
| | - Jacques-Olivier Bay
- CHU Gabriel Montpied, service d'oncologie médicale, Clermont-Ferrand, France; Université Clermont Auvergne, Clermont-Ferrand, France
| | - Aurore Dougé
- CHU Gabriel Montpied, service d'oncologie médicale, Clermont-Ferrand, France; Université Clermont Auvergne, Clermont-Ferrand, France.
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26
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El-Ghazzi N, Rousseau B, Rodrigues M. [New drug arrival : Pembrolizumab as second-line treatment in MSI-H/dMMR endometrial, colorectal, gastric, intestinal and biliary cancers]. Bull Cancer 2023; 110:11-13. [PMID: 36357200 DOI: 10.1016/j.bulcan.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/23/2022] [Accepted: 10/02/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Nathan El-Ghazzi
- Service d'oncologie médicale, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - Benoit Rousseau
- Memorial Sloan Kettering Cancer Center, New York, NY, États-Unis
| | - Manuel Rodrigues
- Inserm U830, DNA Repair and Uveal Melanoma (D.R.U.M.), équipe labellisée par la ligue nationale contre le cancer, Paris, France; Institut curie, département d'oncologie médicale, PSL research university, 26, rue d'Ulm, 75005 Paris, France
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27
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Delaye M, Neuzillet C. [Biliary tract cancers: new medical therapeutic approaches guided by molecular data]. Ann Pathol 2022; 42:6S8-6S10. [PMID: 36577542 DOI: 10.1016/s0242-6498(22)00213-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- M Delaye
- Institut Curie, département d'oncologie médicale. Université Versailles-Saint-Quentin (UVSQ). Saint-Cloud, France; Association pour l'étude des Cancers et Affections des voies Biliaires (ACABi), Paris, France.
| | - C Neuzillet
- Institut Curie, département d'oncologie médicale. Université Versailles-Saint-Quentin (UVSQ). Saint-Cloud, France; Association pour l'étude des Cancers et Affections des voies Biliaires (ACABi), Paris, France
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28
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El Houat Y, Bouvier L, Baty M, Palard-Novello X, Pointreau Y, de Crevoisier R, Castelli J. Head and neck cancers volume reduction: should we reduce our prophylactic node radiation to spare the antitumor immune response? Cancer Radiother 2022; 26:916-920. [PMID: 36075834 DOI: 10.1016/j.canrad.2022.06.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/15/2022]
Abstract
Radiotherapy for locally advanced head and neck cancer classically include large prophylactic node volume. However, the use of these large volumes can be responsible for significant toxicity. Furthermore, the disappointing results of radioimmunotherapy combinations in head and neck tumors raise concerns about radiotherapy's potential negative impact on the immune response when large lymph node volumes are treated. Besides, in other tumor locations, such as lung cancers, the volumes of elective irradiation have been considerably reduced, with the same local control as before. This opinion piece reviews the current state of radiation volumes in head and neck cancers, the rationale for these volumes, the potential impact of radiotherapy on immune response, and the volume changes that would improve the efficacy of radioimmunotherapy combinations.
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Affiliation(s)
- Y El Houat
- Département de radiothérapie, centre Eugène-Marquis, 35000 Rennes, France
| | - L Bouvier
- Département de radiothérapie, centre Eugène-Marquis, 35000 Rennes, France
| | - M Baty
- Département de radiothérapie, centre Eugène-Marquis, 35000 Rennes, France
| | - X Palard-Novello
- Département de médecine nucléaire, centre Eugène-Marquis, 35000 Rennes, France
| | - Y Pointreau
- Institut inter-régional de cancérologie (ILC), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
| | - R de Crevoisier
- Département de radiothérapie, centre Eugène-Marquis, 35000 Rennes, France
| | - J Castelli
- Département de radiothérapie, centre Eugène-Marquis, 35000 Rennes, France.
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Modesto A, Graff Cailleaud P, Blanchard P, Boisselier P, Pointreau Y. [Challenges and limits of therapeutic de-escalation for papillomavirus-related oropharyngeal cancer]. Cancer Radiother 2022; 26:921-924. [PMID: 36030192 DOI: 10.1016/j.canrad.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 10/15/2022]
Abstract
The incidence of HPV-related oropharyngeal cancers has been increasing in Western countries for several decades. If they are individualized within the latest TNM classification, the current standards of management do not authorize the management of these patients to be singled out. However, their distinct oncogenesis and their excellent prognosis compared to other patients has allowed the development of several clinical trials based on the question of therapeutic de-escalation. This review of the literature aims to take stock of the elements provided by clinical research in recent years.
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Affiliation(s)
- A Modesto
- Département de radiothérapie, Institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; Centre de recherche du cancer de Toulouse, UMR 1037, Inserm, université Toulouse III Paul-Sabatier, 2, avenue Hubert-Curien, 31100 Toulouse, France.
| | - P Graff Cailleaud
- Radiation oncology department, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - P Blanchard
- Radiation oncology department, Gustave-Roussy cancer center, oncostat U1018, Inserm, Paris-Saclay university, Villejuif, France
| | - P Boisselier
- Département d'oncologie radiothérapie, Institut du cancer de Montpellier (ICM) - Val d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34090 Montpellier, France
| | - Y Pointreau
- Institut interrégionaL de cancérologie (ILC), centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France
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Serre R, Deutsch E, Huguet F, Pointreau Y. [Immuno-radiotherapy: A review of the rationale, recent clinical developments and future prospects]. Cancer Radiother 2022; 26:955-961. [PMID: 36030189 DOI: 10.1016/j.canrad.2022.06.027] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022]
Abstract
Thanks to the success of checkpoint inhibitors, immunotherapy now plays a major role in the management of a large number of solid tumors, while the number of indications continues to grow and new combinations could, in the near future, further modify treatment standards. However, the response rates of immunotherapies as monotherapy are modest and their use is increasingly considered in combination with other cancer treatments (chemotherapy, surgery, radiotherapy or certain targeted therapies). Combinations with radiotherapy seem particularly attractive because there is a strong experimental rationale linking part of the efficacy of ionizing radiation to an induced stimulation of both of the innate and adaptive response. Many early phases and a number of large randomized combination trials have published efficacy and safety results, while important trials are still ongoing and will provide answers in the near future. This short review recalls the experimental biological rationale for immuno-radiotherapy and highlights some of the fundamental directions being explored, then presents the clinical efficacy and safety results available to date, those expected in the near future, and finally outlines the outlook in this rapidly evolving field.
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Affiliation(s)
- R Serre
- Department of Radiation Oncology, Centre Hospitalier Universitaire Dupuytren, Limoges, France, Inria-Inserm team COMPO, Marseille, France.
| | - E Deutsch
- Gustave Roussy Cancer Campus, Villejuif, France, Université Paris-Saclay, Ile-de-France, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France; Inserm U1030, Radiothérapie Moléculaire et Innovation Thérapeutique, Villejuif, France
| | - F Huguet
- Department of Radiation Oncology, Hôpital Tenon, AP-HP, Paris, France, Sorbonne Université, Paris, France; Inserm U938 Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, Paris, France
| | - Y Pointreau
- Department of Radiation Oncology, ILC-Centre Jean Bernard, Le Mans, France
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Bendavid J, Modesto A. Radiation therapy and antiangiogenic therapy: Opportunities and challenges. Cancer Radiother 2022; 26:962-967. [PMID: 35989153 DOI: 10.1016/j.canrad.2022.06.012] [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: 05/30/2022] [Accepted: 06/21/2022] [Indexed: 10/15/2022]
Abstract
The importance of tumoral vascularization as a therapeutic target was first described in 1971 by Folkman. Anarchic vascularization in response to tumour hypoxia, especially mediated by vascular endothelial growth factor, represents a major target in the management of many cancers. The contribution of systemic anti-angiogenic treatments including humanized anti-VEGF monoclonal antibodies (bevacizumab) and tyrosine kinase inhibitors, whose effect on vascular normalization and correction of tumour hypoxia has been shown in preclinical studies to be enhancing the effect of radiotherapy. Early trials combining radiotherapy and antiangiogenics with a small number of patients have contradictory results and tend to put into perspective the opportunity that this synergistic association represents. The efficiency found must be tempered by some toxicity described, especially in association with high doses per fraction. The aim of this article is to present the main studies reporting the efficiency and safety of the combination of antiangiogenic drugs and radiotherapy, as well as the expected opportunities.
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Affiliation(s)
- J Bendavid
- Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
| | - A Modesto
- Département de radiothérapie, IUCT Oncopole, 1, avenue Irène-Jolio-Curie, 31100 Toulouse, France
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Storme S, Debieuvre D, Souquet PJ, Toffart AC, Couraud S. [Management of immunotherapy in patients with non-small cell lung cancer presenting durable oncological response]. Rev Mal Respir 2022; 39:578-586. [PMID: 35909007 DOI: 10.1016/j.rmr.2022.06.006] [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: 04/08/2022] [Accepted: 06/20/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Concerns about the proper schedule for discontinuing immunotherapy have been raised by many clinicians, as well as the minimal check-up required to assess residual disease before stopping immunotherapy. In fact, there currently exist no recommendations concerning immunotherapy prescription and optimal assessment in the event of persistent oncological response in cases of metastatic non-small cell lung cancer (NSCLC). METHODS We conducted an online survey among board-certified French Thoracic Oncologists belonging to two professional associations. The survey included multiple-choice questions that either stood alone or were included in case reports. RESULTS The survey was sent to 490 physicians, of whom 88 responded. For minimal residual disease assessment after 2 years of immunotherapy, PET-scan is prescribed by 92% of respondents and cerebral MRI by 59%. In the event of complete response after 2 years of treatment, 83% of physicians stop prescribing pembrolizumab and 70% discontinue nivolumab. In the event of partial response, 88% of respondents continue immunotherapy. In this case, only 33% use a complementary locoregional treatment such as radiotherapy. CONCLUSION Our survey highlights a pronounced tendency to stop immunotherapy in the event of complete oncological response. In the event of partial morphologic response, on the other hand, there is a tendency to continue immunotherapy. However, the use of locoregional treatments remains more heterogeneous.
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Affiliation(s)
- S Storme
- Faculté de médecine Lyon-Est, Claude-Bernard, université Claude-Bernard, Lyon 1, France.
| | - D Debieuvre
- Service de pneumologie, hôpital Émile-Muller, Mulhouse, France
| | - P-J Souquet
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hospices civils de Lyon, hôpital Lyon Sud, Lyon, France
| | - A-C Toffart
- Service hospitalo-universitaire de pneumologie et physiologie, CHU de Grenoble-Alpes, Grenoble, France
| | - S Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hospices civils de Lyon, hôpital Lyon Sud, Lyon, France
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Nigen B, Chéné AL, Liberge R, Sagan C, Blanc FX. [Immune-related pneumonitis: A differential diagnosis of SARS-CoV-2 pneumonia]. Rev Mal Respir 2022:S0761-8425(22)00258-3. [PMID: 35906150 DOI: 10.1016/j.rmr.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/04/2022] [Indexed: 12/17/2022]
Abstract
Introduction Les inhibiteurs de points de contrôle immunitaire ont révolutionné la prise en charge de nombreux cancers et ont permis d’obtenir une efficacité et une réponse durable pour certains patients. L’immunothérapie est associée à des effets secondaires en lien avec l’infiltration de cellules immunitaires dans les tissus normaux pouvant entraîner des réactions dysimmunitaires disproportionnées. Ces effets secondaires peuvent toucher n’importe quel organe, dont le poumon, pouvant parfois engager le pronostic vital. Ils peuvent ressembler à des événements de nature infectieuse, dont la COVID-19. Observations Nous rapportons le cas de 3 patients ayant présenté des toxicités pulmonaires sévères secondaires à l’immunothérapie entre mars et mai 2020 avec hypothèse initiale d’une pneumopathie à SARS-CoV-2. Après investigations approfondies, le diagnostic de toxicité pulmonaire à l’immunothérapie fut retenu, avec une évolution clinique et radiologique favorable suite à l’instauration d’une corticothérapie. Conclusion La toxicité pulmonaire secondaire à l’immunothérapie reste un effet indésirable rare, mais pouvant engager le pronostic vital. La démarche diagnostique impose d’éliminer plusieurs diagnostics différentiels. Le tableau clinique est réversible et l’évolution habituellement favorable après instauration d’une corticothérapie.
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Demoly P, Leroyer C, Serrano E, Le Maux A, Magnier G, Chartier A. The SQ HDM SLIT-Tablet is safe and well tolerated in patients with House Dust Mite allergic rhinitis with or without asthma: A "real-life" French study. Clin Transl Allergy 2022; 12:e12129. [PMID: 35344293 PMCID: PMC8967264 DOI: 10.1002/clt2.12129] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/02/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background The SQ House Dust Mite (HDM) SubLingual ImmunoTherapy (SLIT)‐Tablet (Acarizax) is the only allergen immunotherapy authorized by European regulatory authorities to treat HDM‐induced allergic asthma (AA) that is not well‐controlled by inhaled corticosteroids and associated with mild‐to‐severe HDM allergic rhinitis (AR). The aim of this study was to add evidence on the safety of the SQ HDM SLIT‐Tablet in patients with AR, alone or with AA, under real‐life conditions. Methods This was a French “real‐life”, multicenter, non‐comparative, longitudinal, prospective study. It included patients initiating the SQ HDM SLIT‐Tablet for either persistent moderate‐to‐severe HDM AR or AA not well‐controlled by inhaled corticosteroids and associated with mild‐to‐severe HDM AR. Adverse Events (AEs) were collected at the first intake and throughout the study. Logistic regression was used to compare safety according to asthma control before treatment initiation. Results Between May 09, 2018 and May 29, 2019, 1526 patients were enrolled at 185 sites and 1483 were included in the safety population (SAF). Of them, 33.6% had suspected clinical manifestations of AA. Asthma was uncontrolled for 18.2% of the patients, partially controlled for 27.9% and well‐controlled for 53.8%. Overall, 31.9% of the SAF patients experienced at least one AE. The percentage of patients with AEs was 29.9% among patients with AR alone and 35.9% among those with AA (p = 0.0193). No significant difference was observed in the rate of AE or SAE depending on asthma control at inclusion (2.2% of SAEs reported for patients with uncontrolled asthma, 1.4% for partly controlled and 1.1% for well‐controlled). Conclusions The overall results indicate a good SQ HDM SLIT‐Tablet safety profile consistent with that reported in previous studies, regardless of asthma control.
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Affiliation(s)
- Pascal Demoly
- IDESP, UMR UA11 INSERM-University of Montpellier, Montpellier, France.,Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, University Montpellier, Montpellier, France
| | - Christophe Leroyer
- Clinical Investigation Center, CIC Inserm 1412, Hôpital Cavale Blanche, University Hospital of Brest, Brest, France
| | - Elie Serrano
- Department of ENT and Head and Neck Surgery, Hôpital Larrey, University Hospital of Toulouse, Toulouse, France
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Ederhy S, Devos P, Pinna B, Funck-Brentano E, Abbar B, Fenioux C, Cohen AA, Moslehi J, Bretagne M, Allenbach Y, Kharroubi D, Salem JE. 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging for the diagnosis of immune checkpoint inhibitor-associated myocarditis. Arch Cardiovasc Dis 2022:S1875-2136(22)00011-0. [PMID: 35120869 DOI: 10.1016/j.acvd.2021.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/24/2022]
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Quesada S, Vaflard P. [New drug approval: Pembrolizumab in association with chemotherapy as first line treatment for advanced/metastatic oesophageal carcinomas or HERnegative gastroesophageal adenocarcinoma, expressing PD-L1 with a CPS≥10]. Bull Cancer 2022; 109:111-113. [PMID: 34998526 DOI: 10.1016/j.bulcan.2021.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Stanislas Quesada
- Institut du cancer de Montpellier (ICM), 208, avenue des Apothicaires - Parc Euromédecine, 34298 Montpellier cedex 5, France.
| | - Pauline Vaflard
- Institut Curie, département d'oncologie médicale, 26, rue d'Ulm, 75005 Paris, France
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Quesada S, Vaflard P. [New EMA drug approval: Nivolumab in association with chemotherapy as first line treatment for HER2-negative esophageal adenocarcinoma with PD-L1 expression (CPS≥5)]. Bull Cancer 2022; 109:109-110. [PMID: 34996599 DOI: 10.1016/j.bulcan.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/19/2021] [Accepted: 11/06/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Stanislas Quesada
- Institut régional du cancer de Montpellier (ICM), 208, avenue des Apothicaires, parc euromédecine, 34298 Montpellier cedex 5, France.
| | - Pauline Vaflard
- Institut Curie, département d'oncologie médicale, 26, rue d'Ulm, 75005 Paris, France
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Alcazer V, Depil S. [Development of allogeneic CAR T-cells]. Bull Cancer 2021; 108:S73-80. [PMID: 34920810 DOI: 10.1016/j.bulcan.2021.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/11/2021] [Accepted: 01/20/2021] [Indexed: 11/23/2022]
Abstract
Chimeric antigen receptor (CAR) T-cell therapy represents a major breakthrough in the field of hematology. "Off-the-shelf" allogeneic CAR T-cells from donors have many potential advantages over autologous approaches, such as the immediate availability of cryopreserved batches, possible standardization of the cell product, time for multiple cell modifications, redosing and decreased cost. However, allogeneic T-cells possess foreign immunological identities that can lead to graft-versus-host disease (GvHD) and their rejection by the host immune system. In this review, we describe the different approaches to produce allogeneic CAR T-cells with limited potential for GvHD and that can persist in the recipient. The preliminary clinical results obtained with the first generation of allogeneic CAR T-cells are presented as well as the perspectives in hematological malignancies and solid tumors.
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Vanacker H, Vinceneux A, Nicolas-Virelizier E, Brahmi M, Cassier PA. [Bispecific antibodies targeting CD3 in oncology and hematology]. Bull Cancer 2021; 108:S181-S194. [PMID: 34920802 DOI: 10.1016/j.bulcan.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 11/15/2022]
Abstract
Bispecific therapies targeting CD3, so-called T-cell engagers (TCE), belong to the new spectrum of anti-tumor immunotherapies stimulating T-lymphocytes. TCE are unique constructs targeting the MHC-independent CD3 epsilon subunit (CD3e) and a tumor antigen. To date, only blinatumomab have reached market agreements in lymphoid malignancies with constructs targeting CD3exCD19. Other TCE are in advances development, with promising results targeting CD20 and BSMA in lymphoma and myeloma. These successes have relaunched the development of TCE in solid tumors, bringing mixed results so far (notably in terms of tolerance). Still, TCE pave the way to new immunotherapy in tumors considered to be refractory to inhibitors of immune checkpoints such as prostate cancer or colorectal cancer.
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Affiliation(s)
- Hélène Vanacker
- Centre Léon-Bérard, unité de phase précoces, oncologie médicale, 28, rue Laennec, 69008 Lyon, France; Université Claude Bernard Lyon 1, 43, boulevard du 11 novembre 1918, 69100 Villeurbanne, France
| | - Armelle Vinceneux
- Centre Léon-Bérard, unité de phase précoces, oncologie médicale, 28, rue Laennec, 69008 Lyon, France
| | | | - Mehdi Brahmi
- Centre Léon-Bérard, unité de phase précoces, oncologie médicale, 28, rue Laennec, 69008 Lyon, France
| | - Philippe A Cassier
- Centre Léon-Bérard, unité de phase précoces, oncologie médicale, 28, rue Laennec, 69008 Lyon, France.
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40
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Escure G, Manier S. [Bispecific antibodies in multiple myeloma]. Bull Cancer 2021; 108:S205-S212. [PMID: 34920804 DOI: 10.1016/j.bulcan.2021.10.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022]
Abstract
Immunotherapies have recently emerged as potential game changers in the treatment of multiple myeloma (MM). Those include monoclonal antibodies (targeting CD38 or CS1), bispecific antibodies (BsAb, mainly targeting BCMA, GPRC5D or FcRH5), antibody-drug conjugate (mainly targeting BCMA) and CAR-T cells (mainly targeting BCMA). BsAb have the capacity to bind two different antigens, one at the tumor cell surface and one on T cells (CD3), recreating the immune synapse. In this article, we discuss the main clinical data on BsAb in MM, as well as their different constructs and the potential mechanism of resistance.
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Affiliation(s)
- Guillaume Escure
- CHU Lille, hôpital Huriez, service d'hématologie, 59000 Lille, France; Université de Lille, Unité CANTHER, Inserm UMR-S1277 & CNRS UMR9020, 59000 Lille, France
| | - Salomon Manier
- CHU Lille, hôpital Huriez, service d'hématologie, 59000 Lille, France; Université de Lille, Unité CANTHER, Inserm UMR-S1277 & CNRS UMR9020, 59000 Lille, France.
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Abstract
Three CD19 CAR-T cells (Yescarta®, Kymriah® and Breyanzi®), have been approved in relapsed or refractory diffuse large B cell lymphomas (DLBCL) after at least two previous lines of therapy. These immunotherapies have transformed the prognosis of these lymphomas, which can't be cured by conventional treatments. Long-term updates of registration studies as well as the first real-life data allow a better knowledge of the efficacy of these emerging therapies, their toxicity and their resistance mechanisms. These advances have also led to consider the earlier use of CAR-T cells in the therapeutic strategy and to extend it to other B lymphomas such as mantle cell and indolent lymphomas. Indeed, Yescarta® and Tecartus® have been recently approved in those malignancies, Furthermore, other strategies are being investigated to develop new CAR-T cells to target Hodgkin's lymphomas and T-cell lymphomas, although data in these settings still have to be completed. In this article, we review the latest data on the use of CAR-T cells in lymphomas.
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Affiliation(s)
- Ondine Messéant
- CHU de Rennes, University of Rennes, Department of Hematology, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - Roch Houot
- CHU de Rennes, University of Rennes, Department of Hematology, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
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Chabannon C, Lemaitre J, Peffault de Latour R, Neven B, Bay JO, Robin M, Kuball J, Terwel S, Mohty M, Yakoub-Agha I. [CAR-T CELLS: How does the EBMT registry monitor European activities, identify hurdles and prepare for changes in regulations]. Bull Cancer 2021; 108:S155-61. [PMID: 34920798 DOI: 10.1016/j.bulcan.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/06/2021] [Accepted: 08/23/2021] [Indexed: 11/23/2022]
Abstract
CAR-T Cells are gene therapy medicinal products, a subcategory of Advanced Therapy Medicinal Products as defined in the EC Regulation 1394/2007. They may represent the first example of such medicinal products that are industry-manufactured and commercialized on a large scale. Their very nature, their manufacturing processes, pricing and conditions upon which they were approved by regulatory agencies, all lead the latter to require long-term follow-up after marketing approval with a view for a better definition of CAR-T Cells safety profile and efficacy profile in real world conditions. Collection and analysis of data over a 15-year period of time represents a technical and political challenge. So does the a priori definition of data to be collected for a wealth of forthcoming analyses that focus on the interests of a variety of stakeholders. EBMT has been collecting and analyzing data on hematopoietic cell transplants for decades. EBMT currently works with many interested parties to collect data on patients treated with CAR-T Cells.
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Bories P, Ysebaert L. [Chimeric antigen receptor T cells]. Bull Cancer 2021; 108:S55-S64. [PMID: 34920808 DOI: 10.1016/j.bulcan.2021.08.003] [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: 04/30/2021] [Revised: 07/22/2021] [Accepted: 08/09/2021] [Indexed: 10/19/2022]
Abstract
Chimeric antigen receptor T-cell (CAR T-cells) therapies which are genetically modified T lymphocyte targeting tumor antigens have modified therapeutic landscape in hematology. Aggressive B cells lymphoma are currently treated in daily practice with anti-CD19 CAR T. In indolent B cell lymphomas, their efficacy has been established by recent clinical trials. Longer follow-up evaluation is needed to determine their added value in a field where approved strategies already provide high long-term survival rates. They will also be challenged by another immunotherapy with bispecific antibodies. In chronic lymphoid leukemia, early phase trials have identified several limitations related to the immune context of this disease, but associations with targeted therapy like ibrutinib are very promising. In this moving therapeutic landscape, molecular and cellular engineering progress will increase the capacities of these new cellular-based therapies.
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Affiliation(s)
- Pierre Bories
- Institut Universitaire du Cancer-Toulouse Oncopole, Réseau régional de cancérologie Onco-Occitanie, Toulouse, France; Institut Universitaire du Cancer-Toulouse Oncopole, service d'hématologie, Toulouse, France
| | - Loïc Ysebaert
- Institut Universitaire du Cancer-Toulouse Oncopole, service d'hématologie, Toulouse, France; Université Paul Sabatier, faculté de médecine, Toulouse, France; Centre de recherches en cancérologie de Toulouse, Inserm UMR1037, Toulouse, France.
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Barrière S, El-Ghazzi N, Garcia M, Guièze R. [Bispecific antibodies in onco-hematology: Applications and perspectives]. Bull Cancer 2021; 108:S195-S204. [PMID: 34920803 DOI: 10.1016/j.bulcan.2021.10.002] [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: 07/11/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 10/19/2022]
Abstract
Bispecific antibodies are novel approaches of immunotherapy engaging immune cells to destroy tumor cells. Their structure is variable and underlies their pharmacocinetic properties. These coumpounds are now being evaluated across multiple hematological malignancies. The anti-CD3/CD19 antibody blinatumomab is the first in class and have been approved for the treatment of patients with Ph-negative B-cell acute lymphoblastic leukemia. Other emerging applications are lymphoma, multiple myeloma and acute myeloid leukemia. The safety profile of bispecific antibodies is acceptable while limited by neurotoxicity and cytokine-release syndrome. The present review aims to depict the landscape of emerging bispecific antibodies currently in development for hematological malignancies.
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Affiliation(s)
- Sabrina Barrière
- CHU de Clermont-Ferrand, service d'hématologie clinique et de thérapie cellulaire, 1, rue Lucie- et Raymond-Aubrac, 63100 Clermont-Ferrand, France.
| | - Nathan El-Ghazzi
- CHU de Clermont-Ferrand, service d'hématologie clinique et de thérapie cellulaire, 1, rue Lucie- et Raymond-Aubrac, 63100 Clermont-Ferrand, France
| | - Manon Garcia
- Université Clermont-Auvergne, EA 7453, CHELTER, Clermont-Ferrand, France; Institut GReD, 28, place Henri-Dunant, 63100 Clermont-Ferrand, France
| | - Romain Guièze
- CHU de Clermont-Ferrand, service d'hématologie clinique et de thérapie cellulaire, 1, rue Lucie- et Raymond-Aubrac, 63100 Clermont-Ferrand, France; Université Clermont-Auvergne, EA 7453, CHELTER, Clermont-Ferrand, France
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Nguyen S, Lacan C, Roos-Weil D. [Allogeneic CAR-NK cells: A promising alternative to autologous CAR-T cells - State of the art, sources of NK cells, limits and perspectives]. Bull Cancer 2021; 108:S81-91. [PMID: 34920811 DOI: 10.1016/j.bulcan.2021.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/11/2021] [Accepted: 06/18/2021] [Indexed: 12/27/2022]
Abstract
Immunotherapy with chimeric antigen receptor engineered-T cells (CAR-T) has revolutionized the landscape of treatment of relapsed or refractory B-cell. However, the use of autologous T cells has limitations: variable quality of collected effector T cells, duration of the process sometimes incompatible with uncontrolled hemopathy, limited number of available CAR cells, sometimes fatal toxicities, extremely high cost. Natural Killer (NK) cells are an interesting alternative to T cells. NK cells are very powerful cytotoxic effectors that have demonstrated an anti-tumor effect after haploidentical hematopoietic stem cells transplantation or in adoptive cell therapy against a number of solid or hematological tumors. Mainly, they can be used in allogeneic situations without causing major toxic side effects. The sources of NK cells are multiple: cell line, cord blood, peripheral blood, induced pluripotent stem cells. Recent advances in manufacturing engineered CAR-NK cells make it possible to promote antibody-dependent cell-mediated cytotoxicity (ADCC), as well as the activation and persistence of these cells, notably via the cytokine Il-15. The majority of the reports on CAR-NK cells concern pre-clinical or early clinical trials. However, the many advantages of "off-the-shelf" allogeneic CAR-NK cells provide great potential in cancer treatments.
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Abstract
Herein are presented the recommendations from the Société française de radiothérapie oncologique regarding indications and modalities of lung cancer radiotherapy. The recommendations for delineation of the target volumes and organs at risk are detailed.
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Affiliation(s)
- J Khalifa
- Département de radiothérapie, Institut universitaire du cancer de Toulouse - Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - D Lerouge
- Département de radiothérapie, centre François-Baclesse, 3, avenue du General-Harris, 14076 Caen, France
| | - C Le Péchoux
- Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - N Pourel
- Département de radiothérapie, institut Sainte-Catherine, 250, chemin de Baigne-Pieds, CS80005, 84918 Avignon cedex 9, France
| | - J Darréon
- Service de physique médicale, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - F Mornex
- Service de radiothérapie, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - P Giraud
- Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France
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Laune Q, Brosseau S. [New MAA: First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma]. Bull Cancer 2021:S0007-4551(21)00437-9. [PMID: 34848048 DOI: 10.1016/j.bulcan.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/12/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Quentin Laune
- Centre Hospitalier Universitaire de Brest, Service Oncologie, Hôpital Morvan, 2, avenue Maréchal Foch Brest, 29200 Finistère, Bretagne
| | - Solenn Brosseau
- Université de Paris, Service d'Oncologie Thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP), 46, rue Henri Huchard, 75018 Paris; U830 INSERM Cancer Hétérogénéité et Plasticité, Centre de recherche, Institut Curie, 75231 Paris cedex 05.
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Travert C, Cannone P, Greillier L, Tomasini P. [Immunotherapy adaptation in lung cancer during the COVID-19 pandemic]. Rev Mal Respir 2021; 38:865-872. [PMID: 34246519 PMCID: PMC8241593 DOI: 10.1016/j.rmr.2021.06.005] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/14/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION COVID-19 pandemics required changes in medical practices. In thoracic oncology, pembrolizumab was doubled to 400mg every 6weeks, nivolumab to 480mg every 4weeks. The objective of our study was to assess the impact on quality of life, and on psychological state, as well as the tolerance, of this new schedule. METHODS Thoracic oncologic patients who underwent these therapeutic changes in our center during the first COVID-19 epidemic wave were included. Their quality of life was assessed using the Quality of Life Questionnaire-30, their psychological state by the Hospital Anxiety Depression (HAD) scale. We also reported the preferred administration schedule, as well as adverse events. RESULTS Thirty patients were included. The overall quality of life was preserved. Rates on HAD scale were low. Tolerance was acceptable. In majority, patients preferred the new procedure. They had a significantly better quality of life compared to those who preferred the old one. CONCLUSIONS This new immunotherapy schedule in thoracic oncology is well tolerated and allows a preservation of quality of life. This therapeutic option may be favored in the context of COVID-19 pandemics.
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Affiliation(s)
- C Travert
- Aix-Marseille université, AP-HM, INSERM, CNRS, CRCM, hôpital Nord, service d'oncologie multidisciplinaire et innovations thérapeutiques, Marseille, France; Institut du cancer de Montpellier, Montpellier, France
| | - P Cannone
- Aix-Marseille université, AP-HM, INSERM, CNRS, CRCM, hôpital Nord, service d'oncologie multidisciplinaire et innovations thérapeutiques, Marseille, France
| | - L Greillier
- Aix-Marseille université, AP-HM, INSERM, CNRS, CRCM, hôpital Nord, service d'oncologie multidisciplinaire et innovations thérapeutiques, Marseille, France
| | - P Tomasini
- Aix-Marseille université, AP-HM, INSERM, CNRS, CRCM, hôpital Nord, service d'oncologie multidisciplinaire et innovations thérapeutiques, Marseille, France.
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Huguet F, Durand B, Atallah S, Prébet C, Richard S, Baujat B. Combination of radiation therapy-immunotherapy for head and neck cancers: Promises kept? Cancer Radiother 2021; 25:811-815. [PMID: 34711485 DOI: 10.1016/j.canrad.2021.08.018] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/24/2022]
Abstract
Chemoradiotherapy with concurrent cisplatin has been the standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC) for over 20 years. Recently, immunotherapy, a new therapeutic class, has emerged for patients with recurrent or metastatic HNSCC and has significantly extended their survival. Will it bring the same benefit to patients with localized tumors? There is a strong rationale for combining radiation therapy and checkpoint inhibitors for HNSCC. Indeed, radiation therapy can have both immunostimulatory and immunomodulatory effects. This is what explains the famous abscopal effect. The aim of this review is to present the data available on the combination of radiation therapy and immunotherapy for HNSCC.
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Affiliation(s)
- F Huguet
- Service d'Oncologie Radiothérapie, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
| | - B Durand
- Service d'Oncologie Radiothérapie, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - S Atallah
- Service d'Oto-Rhino-Laryngologie Chirurgie cervico-faciale, France
| | - C Prébet
- Service d'Oncologie Médicale, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | - S Richard
- Service d'Oncologie Médicale, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | - B Baujat
- Service d'Oto-Rhino-Laryngologie Chirurgie cervico-faciale, France
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Laune Q, Brosseau S. [New MAA: First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma]. Bull Cancer 2021; 109:4-6. [PMID: 34654542 DOI: 10.1016/j.bulcan.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Quentin Laune
- Centre hospitalier universitaire de Brest, hôpital Morvan, service oncologie, 2, avenue Maréchal-Foch-Brest, 29200 Finistère, France.
| | - Solenn Brosseau
- Assistance publique-Hôpitaux de Paris (AP-HP), université de Paris, institut universitaire du Cancer Paris-Nord, hôpital Bichat-Claude Bernard, service d'oncologie thoracique-CIC, Inserm 1425, 46, rue Henri-Huchard, 75018 Paris, France; Institut Curie, centre de recherche, U830 Inserm cancer hétérogénéité et plasticité, 75231 Paris cedex 05, France
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