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Besse B, Felip E, Garcia Campelo R, Cobo M, Mascaux C, Madroszyk A, Cappuzzo F, Hilgers W, Romano G, Denis F, Viteri S, Debieuvre D, Galetta D, Baldini E, Razaq M, Robinet G, Maio M, Delmonte A, Roch B, Masson P, Schuette W, Zer A, Remon J, Costantini D, Vasseur B, Dziadziuszko R, Giaccone G. Randomized open-label controlled study of cancer vaccine OSE2101 versus chemotherapy in HLA-A2-positive patients with advanced non-small-cell lung cancer with resistance to immunotherapy: ATALANTE-1. Ann Oncol 2023; 34:920-933. [PMID: 37704166 DOI: 10.1016/j.annonc.2023.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 04/04/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Patients with advanced non-small-cell lung cancer (NSCLC) treated with immune checkpoint blockers (ICBs) ultimately progress either rapidly (primary resistance) or after durable benefit (secondary resistance). The cancer vaccine OSE2101 may invigorate antitumor-specific immune responses after ICB failure. The objective of ATALANTE-1 was to evaluate its efficacy and safety in these patients. PATIENTS AND METHODS ATALANTE-1 was a two-step open-label study to evaluate the efficacy and safety of OSE2101 compared to standard-of-care (SoC) chemotherapy (CT). Patients with human leukocyte antigen (HLA)-A2-positive advanced NSCLC without actionable alterations, failing sequential or concurrent CT and ICB were randomized (2 : 1) to OSE2101 or SoC (docetaxel or pemetrexed). Primary endpoint was overall survival (OS). Interim OS futility analysis was planned as per Fleming design. In April 2020 at the time of interim analysis, a decision was taken to prematurely stop the accrual due to coronavirus disease 2019 (COVID-19). Final analysis was carried out in all patients and in the subgroup of patients with ICB secondary resistance defined as failure after ICB monotherapy second line ≥12 weeks. RESULTS Two hundred and nineteen patients were randomized (139 OSE2101, 80 SoC); 118 had secondary resistance to sequential ICB. Overall, median OS non-significantly favored OSE2101 over SoC {hazard ratio (HR) [95% confidence interval (CI)] 0.86 [0.62-1.19], P = 0.36}. In the secondary resistance subgroup, OSE2101 significantly improved median OS versus SoC [11.1 versus 7.5 months; HR (95% CI) 0.59 (0.38-0.91), P = 0.017], and significantly improved post-progression survival (HR 0.46, P = 0.004), time to Eastern Cooperative Oncology Group (ECOG) performance status deterioration (HR 0.43, P = 0.006) and Quality of Life Questionnaire Core 30 (QLQ-C30) global health status compared to SoC (P = 0.045). Six-month disease control rates and progression-free survival were similar between groups. Grade ≥3 adverse effects occurred in 11.4% of patients with OSE2101 and 35.1% in SoC (P = 0.002). CONCLUSIONS In HLA-A2-positive patients with advanced NSCLC and secondary resistance to immunotherapy, OSE2101 increased survival with better safety compared to CT. Further evaluation in this population is warranted.
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Affiliation(s)
- B Besse
- Paris-Saclay University, Cancer Medicine Department, Institut Gustave Roussy, Villejuif, France.
| | - E Felip
- Oncology Department, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona
| | - R Garcia Campelo
- Medical Oncology Department, Complejo Hospitalario Universitario A Coruña, Biomedical Research Institute, INIBIC, A Coruña
| | - M Cobo
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain
| | - C Mascaux
- Pneumology Department, Hôpitaux Universitaires de Strasbourg-Nouvel Hôpital Civil, Strasbourg
| | - A Madroszyk
- Medical Oncology Department, IPC-Institut Paoli-Calmettes, Marseille, France
| | - F Cappuzzo
- Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - W Hilgers
- Medical Oncology Department, Sainte Catherine Cancer Center, Avignon, France
| | - G Romano
- Medical Oncology Department, Ospedale Vito Fazzi-ASL Lecce, Lecce, Italy
| | - F Denis
- Medical Oncology Department, Institut Inter-Régional de Cancérologie Jean Bernard-Elsan, Le Mans, France
| | - S Viteri
- Medical Oncology Department, Instituto Oncológico Dr. Rosell, Hospital Universitario Dexeus, Grupo Quironsalud, Barcelona, Spain
| | - D Debieuvre
- Pneumology Department, Groupe Hospitalier de la Région Mulhouse Sud Alsace, Mulhouse, France
| | - D Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari
| | - E Baldini
- Oncology Department, Ospedale San Luca, Lucca, Italy
| | - M Razaq
- Oncology Department, Stephenson Cancer Center, Oklahoma City, USA
| | - G Robinet
- Oncology Department, Centre Hospitalier Régional Universitaire Morvan, Brest, France
| | - M Maio
- Department of Oncology, University of Siena and Center for Immuno-Oncology, University Hospital, Siena
| | - A Delmonte
- Thoracic Department, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Meldola, Italy
| | - B Roch
- Thoracic Oncology Unit, Montpellier University, University Hospital of Montpellier, Montpellier
| | - P Masson
- Pneumology Department, Centre Hospitalier de Cholet, Cholet, France
| | - W Schuette
- Medical Oncology Department, Hospital Martha-Maria Halle-Doelau, Halle, Germany
| | - A Zer
- Thoracic Cancer Service, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - J Remon
- Paris-Saclay University, Cancer Medicine Department, Institut Gustave Roussy, Villejuif, France
| | - D Costantini
- Medical Development Department, OSE Immunotherapeutics, Paris, France
| | - B Vasseur
- Medical Development Department, OSE Immunotherapeutics, Paris, France
| | - R Dziadziuszko
- Oncology and Radiotherapy Department and Early Phase Clinical Trials Centre, Medical University of Gdansk, Gdansk, Poland
| | - G Giaccone
- Meyer Cancer Center, Weill Cornell Medicine, New York, USA
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Buyse M, Montestruc F, Chiem JC, Deltuvaite-Thomas V, Salvaggio S, Garcia Campelo M, Cobo Dols M, Quoix E, Madroszyk Flandin AC, Cappuzzo F, Romano G, Viteri Ramirez S, Schuette W, Zer A, Comis S, Vasseur B, Dziadziuszko R, Giaccone G, Besse B, Felip E. 1024P Net treatment benefit of OSE2101 in HLA-A2+ non-small cell lung cancer (NSCLC) patients after failure to immune checkpoint inhibitors (IO) in phase III Atalante-1 randomized trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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3
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Besse B, Campelo RG, Cobo-Dols M, Quoix EA, Madroszyk A, Felip E, Cappuzzo F, Denis F, Hilgers W, Romano G, Debieuvre D, Galetta D, Baldini E, Viteri Ramirez S, Phan MD, Schuette W, Zer A, Vasseur B, Dziadziuszko R, Giaccone G. Quality of life (QoL) of OSE2101 in patients with HLA-A2+ non–small cell lung cancer (NSCLC) after failure to immune checkpoint inhibitors (IO): Final data of phase 3 Atalante-1 randomized trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.9094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9094 Background: OSE2101 (Tedopi) is an anticancer vaccine increasing overall survival (OS) versus Standard of Care (SoC docetaxel or pemetrexed) in HLA-A2+ NSCLC patients with secondary resistance after sequential Chemo (CT)-IO (ESMO 2021 #47LBA). Here we present the QoL analysis. Methods: EGFR and ALK negative NSCLC patients who failed prior IO, ECOG PS 0-1 were randomized 2:1 to receive either OSE2101 or SoC (docetaxel or pemetrexed). Primary endpoint was OS; secondary endpoints included time to ECOG PS deterioration and QoL by EORTC QLQ-C30/LC13 questionnaires at baseline and before each treatment administration until the end of treatment (EOT). Changes in QLQ-C30/LC13 scores from baseline to EoT were assessed using mixed-effects model for repeated measures (MMRM). Overall treatment effect and associated p value were estimated using MMRM. Results: 95 out of 118 (81%) patients with secondary resistance to IO completed baseline and ≥ one follow-up questionnaire. Median OS was 11.1 mo for OSE2101 vs 7.5 mo for SoC [HR 0.59; p = 0.02]. Median time to ECOG PS deterioration was 9.0 mo for OSE2101 vs 3.3 mo for SoC [HR: 0.43; p = 0.004]. Global Health Status remained stable with OSE2101 whereas it deteriorated from the 1st cycle with SoC (p = 0.045). Most pronounced effects were observed in the physical (ability to perform activities that require physical effort; p = 0.07) and the role (ability to work and carry out daily activities; p = 0.03) functioning scores (refer table below). Patients had less mouth soreness (p = 0.01), dysphagia (p = 0.01), peripheral neuropathy (p = 0.03), alopecia (p < 0.001) and fatigue (p = 0.06) with OSE2101 than with SoC. The change from baseline of dyspnea, coughing, hemoptysis, and pain were not significantly different between the 2 groups. Conclusions: In advanced HLA-A2+ NSCLC patients with secondary resistance to IO after sequential CT-IO, OSE2101 improves OS and maintains QoL vs. SoC, especially global health status, physical and role functioning scores. Patients presented fewer symptoms typically related to adverse effects of chemotherapy as compared to SoC. Clinical trial information: NCT02654587. [Table: see text]
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Affiliation(s)
| | | | - Manuel Cobo-Dols
- Hospital Universitario Regional Málaga, Medical Oncology Department, Instituto de Investigaciones Biomédicas Málaga (IBIMA), Málaga, Spain
| | | | - Anne Madroszyk
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Enriqueta Felip
- Vall d’Hebron University Hospital and Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
| | | | - Fabrice Denis
- Institut Inter-Regional de Cancérologie Jean Bernard-Elsan, Le Mans, France
| | | | | | - Didier Debieuvre
- Groupe Hospitalier de la région Mulhouse Sud Alsace, Mulhouse, France
| | - Domenico Galetta
- Medical Oncology Department, Clinical Cancer Center Giovanni Paolo II, Bari, Italy
| | | | | | - Minh Duc Phan
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | | | - Alona Zer
- Thoracic Cancer Service, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | | | - Rafal Dziadziuszko
- Department of Oncology and Radiotherapy and Early Clinical Trials Unit, Medical University of Gdansk, Gdańsk, Poland
| | - Giuseppe Giaccone
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY
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Kotecki N, Champiat S, Delord JP, Vinceneux A, Jungels C, Marabelle A, Korakis I, Wojciekowski S, Block E, Clarke N, Fromond C, Poirier N, Costantini D, Vasseur B, Cassier P. 983P Phase I dose escalation study in patients (pts) with advanced solid tumours receiving first-in-class BI 765063, a selective signal-regulatory protein α (SIRPα) inhibitor, in combination with ezabenlimab (BI 754091), a programmed cell death protein 1 (PD-1) inhibitor. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Champiat S, Cassier PA, Kotecki N, Korakis I, Vinceneux A, Jungels C, Blatchford J, Elgadi MM, Clarke N, Fromond C, Poirier N, Vasseur B, Marabelle A, Delord JP. Safety, pharmacokinetics, efficacy, and preliminary biomarker data of first-in-class BI 765063, a selective SIRPα inhibitor: Results of monotherapy dose escalation in phase 1 study in patients with advanced solid tumors. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.2623] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2623 Background: BI 765063 is a humanized IgG4 monoclonal antibody antagonist of SIRPα (Signal Regulatory Protein α), which blocks the “don't eat me” signal of the SIRPα/CD47 axis, a critical innate immune checkpoint. SIRPα is expressed on myeloid cells. BI 765063 binds to the V1 SIRPα allele with high affinity and to the V2 SIRPα allele with low affinity. BI 765063 lacks SIRPγ binding to preserve T-cell activation. We report results of the completed BI 765063 monotherapy dose escalation in patients with advanced solid tumors. Methods: This study involves a step 1 dose escalation to determine the dose-limiting toxicities (DLT) and maximum tolerated dose (MTD), then a step 2 dose-confirmation expansion at recommended phase 2 dose. In Step 1, BI 765063 ascending doses, given IV every 3 weeks, were tested using a Bayesian Logistic Regression Model (BLRM) approach with overdose control. The endpoints were safety, pharmacokinetics, receptor occupancy (RO) in peripheral CD14+ monocytes and efficacy (RECIST 1.1). Results: Fifty patients (26 V1/V1, 24 V1/V2) received at least one dose of BI 765063. The most frequent tumors were ovarian (9), colorectal (8), lung (5), breast (4), melanoma (3), and kidney (3). No DLTs were reported up to the highest dose tested. MTD was not reached. The most frequent related adverse events were infusion related reaction (IRR) (46%), fatigue (12%), headache (10%), arthralgia and diarrhea (8% each). All related adverse events were mild to moderate, except one case of IRR Grade 3. No related anemia nor thrombocytopenia were observed. BI 765063 showed dose proportional exposure and full RO saturation in Cycle 1 after the fourth dose level. Clinical benefit was observed in 21/47 (45%) patients evaluable per RECIST 1.1. One patient with hepatocellular carcinoma (HCC) with liver and lung metastases and 7 prior lines of therapy showed a durable partial response maintained for 27 weeks treatment (ongoing). The baseline tumor biopsy of this patient showed high CD8 T-cell and macrophage infiltration. There was an increase in CD8 T-cell infiltration and activation on treatment. An increase in PD-L1 expression on tumor cells 2 weeks after first dosing was also observed. Analysis of paired tumor biopsies in other patients is ongoing. Conclusions: The first-in-class SIRPα inhibitor BI 765063 was well-tolerated, showed monotherapy activity, and sustained RO saturation. A durable partial response was observed in an advanced HCC patient. The on-treatment biopsy of the responder showed an increase in CD8 T-cell infiltration and activation. PD-L1 expression on tumor cells also increased. BI 765063 dose escalation in combination with ezabenlimab (anti-PD1 antibody) is ongoing. Clinical trial information: NCT03990233.
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Affiliation(s)
- Stéphane Champiat
- Gustave Roussy Cancer Campus, Department of Drug Development (DITEP), Villejuif, France
| | | | | | - Iphigenie Korakis
- Department of Oncology, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | | | | | - Jon Blatchford
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach/Riss, Germany
| | | | - Nicole Clarke
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim Am Rhein, Germany
| | | | | | | | - Aurelien Marabelle
- Gustave Roussy Cancer Campus, Department of Drug Development (DITEP), Villejuif, France
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Marabelle A, Cassier P, Delord JP, Jungles C, Champiat S, Vinceneux A, Korakis I, Huhn R, Poirier N, Vasseur B, Kotecki N. 162TiP A phase I study evaluating BI 765063, a first in class selective myeloid SIRPa inhibitor, as standalone and in combination with BI 754091, a programmed death-1 (PD-1) inhibitor, in patients with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz452.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Felip E, Giaccone G, Dziadziuszko R, Denis F, Moran T, Debieuvre D, Cobo M, Galetta D, Vanel FR, Romano G, Madroszyk A, Chouaid C, Ferrand FR, Hilgers W, Cappuzzo F, Masson P, Peled N, Vasseur B, Remon J, Besse B. ATALANTE-1 randomized phase III trial, OSE 2101 versus standard treatment as second- or third-line in HLA-A2 positive advanced non-small cell lung cancer (NSCLC) patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps9121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS9121 Background: New treatment strategies are needed for advanced NSCLC patients who progress on treatment with immune checkpoint inhibitors (ICI). Tedopi (OSE2101) is a neoepitope vaccine restricted to HLA-A2 positive patients (45%) targeting five tumor-associated antigens frequently expressed in lung cancer cells, ACE, HER2, MAGE2, MAGE3 and P53. Previously, in a phase II trial (Barve et al. JCO 2008), Tedopi showed a median overall survival (OS) of 17.3 months with a manageable safety profile in advanced NSCLC patients. ATALANTE-1 (NCT02654587) is a randomized, open-label, phase 3 study comparing the efficacy and safety of TEDOPI with standard of care (SoC) treatment in HLA-A2 positive patients with advanced NSCLC, as second- or third-line therapy. Methods: Patients with advanced NSCLC without EGFR-sensitizing mutations or ALK rearrangements; progressive disease to platinum-based chemotherapy (ChT) with sequential or concurrent ICI; HLA-A2 positivity (blood test); ECOG PS 0-1; with treated and asymptomatic brain metastases,, are randomized 2:1 to receive 5mg Tedopi subcutaneously Q3W for 6 cycles, then Q8W for the reminder of the year and finally Q12W, or SoC treatment with: docetaxel 75 mg/m2 Q3W or pemetrexed 500 mg/m2 Q3W (in non-squamous and pemetrexed-naïve patients). Treatment continues until progression, intolerable toxicity or consent withdrawal, in both arms. Patients are stratified by histology, best response to first line, and line rank of ICI. Tumor assessment is performed every 6 weeks (RECIST 1.1). Primary endpoint is OS. Secondary end points are PFS, ORR, DCR, and duration of response, quality of life and safety. This is a superiority study with a hazard ratio of 0.7, two-sided alpha 5% and power 80%, after 278 events are observed. An independent analysis (1year OS rate) is planned in the first 84 patients treated with Tedopi. Last trial review by the DMC in June 18 suggested that the trial continues as planned. Translational research will be performed evaluating pharmacodynamic markers of efficacy such as immunogenicity response against Tedopi vaccine neoantigens, as well as parameters in liquid and tissue biopsies. End January 19, 87 patients (51 Tedopi, 36 Soc) have been enrolled. Clinical trial information: NCT02654587.
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Affiliation(s)
| | | | - Rafal Dziadziuszko
- Medical University of Gdańsk, Department of Oncology and Radiotherapy, Gdańsk, Poland
| | - Fabrice Denis
- Institut Inter-Regional de Cancérologie Jean Bernard, Le Mans, France
| | - Teresa Moran
- Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Manuel Cobo
- Hospital Regional Universitario de Malaga, Málaga, Spain
| | - Domenico Galetta
- Medical Oncology Department, Clinical Cancer Center Giovanni Paolo II, Bari, Italy
| | | | | | | | | | | | | | | | | | - Nir Peled
- Clalit Health Services, Soroka Medical Center, Beer-Sheeva, Israel
| | | | - Jordi Remon
- Centro Integral Oncología Clara Campal Barcelona, HM-Delfos, Barcelona, Spain
| | - Benjamin Besse
- Paris-Sud University, Orsay and Gustave Roussy, Villejuif, France
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Petre-Lazar B, Sharma G, Hutchings S, Goodwin H, Emul NY, Dixon G, Vasseur B. Comparison of the systemic and local pharmacokinetics, safety and tolerability of clonidine mucoadhesive buccal tablets with reference clonidine oral tablets in healthy volunteers. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tao Y, Giralt J, Bensadoun J, Lalla R, Ozsahin E, Pajkos G, Kortmann R, Contreras-Martinez J, Céruse P, Zasadny X, Arias de la Vega F, Vasseur B, Houdas L, Henke M. PO-0636: Safety profile support efficacy of gingival clonidine tablet to prevent severe oral mucositis in HNC. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31886-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Giralt J, Tao Y, Bensadoun RJ, Lalla RV, Ozsahin EM, Pajkos G, Kortmann RD, Contreras-Martinez J, Ceruse P, Zasadny X, Arias de la Vega F, Attali P, Vasseur B, Henke M. Mucoadhesive clonidine (Clonidine Lauriad) in the prevention of severe radiomucositis in head and neck cancer patients: A phase II randomized trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.6058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jordi Giralt
- Hopital General Val D Hebron Barcelone, Barcelone, Spain
| | - Yungan Tao
- Institut Gustave Roussy, Villejuif, France
| | | | | | | | | | | | | | | | - Xavier Zasadny
- Clinique François Chénieux, Service de Radiothérapie, Limoges, France
| | | | | | | | - Michael Henke
- Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
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Spanggaard I, Snoj M, Cavalcanti A, Bouquet C, Sersa G, Robert C, Vasseur B, Attali P, Mir L, Gehl J. Proof of Concept of Gene Therapy Using Plasmid Amep in Disseminated Melanoma: Safety and Efficacy Results of A Phase I First-In-Man Study. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34337-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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12
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Favier L, Liegard M, Guiu S, van Praagh I, Largillier R, Weber B, Coeffic D, Vasseur B, Coudert B. Long-term follow-up and factors of survival of HER-2 positive breast cancer patients treated either by neoadjuvant trastuzumab docetaxel (TAXHER-S01 study) or by neoadjuvant trastuzumab docetaxel carboplatin (GETN[A]1 study). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e11507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e11507 Background: Almost 20% of breast cancers over express Her2, which is associated with a more aggressive phenotype and with a decreased survival. Nevertheless, trastuzumab (T) has been a revolutionary step in the adjuvant and in the metastatic treatments of Her2 positive breast cancers. Here, we focus on neoadjuvant T and try to determine the factors correlating with disease free survival and with overall survival in Her2 positive breast cancer treated with T based neoadjuvant chemotherapy. Methods: Data from two published T based neoadjuvant phases II were used: the TAX-HER trial which studied the use of 6 courses of 3 weekly docetaxel with weekly neoadjuvant T (scheme TH) (Coudert et. al. Annals of Oncology 2006) and the GET(N)A-1 trial which studied the use of 6 courses of 3 weekly docetaxel and carboplatin along with weekly neoadjuvant T (scheme TCH) followed by 3 weekly adjuvant T (Coudert et. al. JCO 2007). Moreover, additional patients from our institution and treated by neoadjuvant TH and adjuvant T were included. Survival curves were estimated using Kaplan-Meier methods and compared by log-rank test. Results: Data was available for 128 patients. 62 patients (48.4%) received neoadjuvant TH from whom 39 did not receive adjuvant T. 66 (51.6%) received neoadjuvant TCH and adjuvant T. Tumors characteristics were as followed: 65 (50.7%) SBR 1–2, 54 (42.19%) SBR 3, 49 (38.28%) hormonal receptors (RH) negative and 72 (56.25%) RH positive. The rate of pathological complete response (pCR) (Chevalier 1/2) was 39.6%. Overall survival (OS) for the entire cohort was 74,8 months. Relapse was defined as local, regional, metastatic relapse or death. Survival without relapse (SR) was 74.8 months. No difference was noted in OS and in SR according to the type of chemotherapy, TH or TCH. pCR did significantly influence SR (p = 0. 03) and survival without local recurrence (SLR) (p = 0.04) but neither OS nor survival without metastatic relapse (SMR). Multivariate analysis demonstrated that OS was correlated with node response (as defined by sataloff grade NA or NB) (p=0.0275) and the use of hormonal therapy in RH positive tumors (p=0.0724). [Table: see text]
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Affiliation(s)
- L. Favier
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
| | - M. Liegard
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
| | - S. Guiu
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
| | - I. van Praagh
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
| | - R. Largillier
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
| | - B. Weber
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
| | - D. Coeffic
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
| | - B. Vasseur
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
| | - B. Coudert
- Centre George-François Leclerc, Dijon, France; Centre Jean Perrin and INSERM U 71, Clermont Ferrand, France; Centre Antoine Lacassagne, Nice, France; Centre Alexis Vautrin, Nancy, France; Clinique du Mail, Grenoble, France; Laboratoires ROCHE, Neuilly, France; TAXHER-S01 & GETN(A) Groups
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Arnould L, Arveux P, Couturier J, Gelly-Marty M, Loustalot C, Ettore F, Sagan C, Antoine M, Penault-Llorca F, Vasseur B, Fumoleau P, Coudert BP. Pathologic complete response to trastuzumab-based neoadjuvant therapy is related to the level of HER-2 amplification. Clin Cancer Res 2007; 13:6404-9. [PMID: 17975153 DOI: 10.1158/1078-0432.ccr-06-3022] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) are used to determine human epidermal growth factor receptor-2 (HER-2) status and patient eligibility for trastuzumab therapy. Using FISH and IHC, we analyzed the relationship between pathologic complete response to trastuzumab-based neoadjuvant therapy and level of HER-2 amplification in locally advanced breast cancer. EXPERIMENTAL DESIGN Breast biopsies from 93 HER-2-positive patients treated with trastuzumab-based neoadjuvant therapy were centrally collected and analyzed retrospectively for HER-2 amplification using FISH and HER-2 overexpression using IHC. Tumors were classified by FISH as no, low, or high amplification. Biopsies were reassessed centrally by IHC and graded 0, 1+, 2+, or 3+. RESULTS HER-2 status of tumor samples as assessed by FISH and IHC correlated: 16 no amplification (11 IHC 1+ and 5 IHC 2+), 27 low amplification (26 IHC 3+ and 1 IHC 2+), and 50 high amplification (all IHC 3+). Trastuzumab-based neoadjuvant therapy achieved pathologic complete response in 35 of 93 (37.6%) tumors. Pathologic complete response rate in low- and high-amplification tumors was significantly higher than in no-amplification tumors (44% versus 6%; P < 0.004). Pathologic complete response rate in high-amplification tumors was significantly higher compared with low-amplification tumors (56% versus 22%; P < 0.005). In the subgroup of low- plus high-amplification tumors, no correlation was found between pathologic complete response rate and IHC score, treatment regimen, T or N stage, tumor grade, or hormonal receptors. CONCLUSIONS This is the first study to show positive correlation between level of HER-2 amplification assessed by FISH and rate of pathologic complete response to trastuzumab-based neoadjuvant treatment.
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Maillard C, Vasseur B, Campana F, Bergougnoux L. Efficacité du trastuzumab (Herceptin®) en première ligne de traitement après progression chez des patientes atteintes de cancer du sein métastatique: étude de cohorte Hermine. Rev Epidemiol Sante Publique 2007. [DOI: 10.1016/j.respe.2007.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Favier L, Guiu S, Dunach E, Assous D, Bonnetain F, Gligorov J, Stockmeier V, Vasseur B, Fumoleau P, Coudert B. 2058 POSTER Factors influencing survival of 107 HER2 positive breast cancer patients treated with trastuzumab based neoadjuvant chemotherapy. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70820-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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16
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Remblier C, Bergougnoux L, Pau D, Barbaza M, Campana F, Vasseur B. P1-11 - Évaluation pharmaco-épidémiologique d’une cohorte de 623 patientes atteintes d’un cancer du sein métastatique et traitées par Herceptin® : étude HERMINE. Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76885-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Abstract
Cet article est une revue des essais in vitro et in vivo utilisés pour évaluer le caractère génotoxique des micropolluants des milieux environnementaux relatifs aux eaux continentales et marines, rejets liquides d'origine domestique, industrielle ou agricole, sédiments de rivières et boues de stations de traitement d'épuration.
Les essais in vitro réalisés sur cellules eucaryotes ou procaryotes sont fondés sur la détection des mutations géniques et chromosomiques, ou la mesure des adduits à l'ADN. Ils constituent des systèmes d'épreuve miniaturisés qui requièrent des volumes d'échantillons faibles; ils se prêtent ainsi au dépistage à grande échelle de la génotoxicité et à l'étude des concentrats et des extraits préparés à partir des milieux contaminés. Ils sont cependant moins bien adaptés à la prédiction de l'impact des micropolluants sur l'environnement.
La recherche de conditions d'essai plus proches de la réalité environnementale a conduit au développement des essais in vivo réalisés sur organismes supérieurs, mollusques, poissons ou amphibiens, qui évaluent un potentiel génotoxique à partir d'études cytogénétiques ou d'études du caryotype des organismes exposés.
Les critères de génotoxicité étudiés in vitro peuvent être utilisés dans le cadre d'études écoépidémiologiques, sur le terrain, afin d'évaluer l'impact réel des micropolluants présents dans les milieux environnementaux sujets à des contaminations d'origines diverses.
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Milpied N, Vasseur B, Parquet N, Garnier JL, Antoine C, Quartier P, Carret AS, Bouscary D, Faye A, Bourbigot B, Reguerre Y, Stoppa AM, Bourquard P, Hurault de Ligny B, Dubief F, Mathieu-Boue A, Leblond V. Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: a retrospective analysis on 32 patients. Ann Oncol 2000; 11 Suppl 1:113-6. [PMID: 10707791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND B-lymphoproliferative post-transplant disorder (BLPD) is a severe complication of organ and bone marrow transplantation. The reduction of immuno-suppressive therapy or surgery for localized disease may cure some BLPDs. Other therapeutic approaches such as chemotherapy and antiviral drugs are toxic and of limited efficacy. Adoptive immunotherapy with donor T-cell infusions has yielded promising results but is, at the present time, easily applicable only in bone marrow-transplanted patients. Anti-B-cell Murine monoclonal antibodies (MoAbs) have proven effective but are no longer available for human use. We report the activity of a humanized anti CD 20 Mo Ab (Rituximab-MABTHERA Roche) in 32 episodes of BLPD treated in 14 French centers. PATIENTS AND METHODS Between November 1997 and September 1998, 32 patients were diagnosed with BLPD. Twenty-six patients had undergone solid organ transplants (liver 8, kidney 8, heart 4, lung 3, heart lung 1, kidney-pancreas 1, liver-kidney 1) and six patients had received bone marrow transplantations. The median age of the patients was 34 years (3-67 years) and the median delay between graft and tumor 5 months (1-156 months). In organ recipients, tumors were classified as polymorphic and monomorphic in 10 and 15 cases, respectively; 4 of 6 bone marrow transplant recipients were treated without pathology documentation because of a rise in EBV load, fever and lymph node enlargement. Tumors were associated with EBV in 22 of 26 tested cases. Rituximab was used as first-line therapy in 30 patients (after reduction of immunosuppressive treatment in 27 patients) and as salvage therapy in 2 patients (after failure of chemotherapy). The median time from diagnosis of BLPD to treatment with Rituximab was 14 days (1-110 days). Two patients received eight infusions, twenty-six patients four infusions, one patient three infusions and three patients two infusions of 375 mg/m2. RESULTS The tolerance of rituximab was good. The overall response rate was 69%, with 20 complete responses and 2 partial responses. In solid organ transplant the response rate was 65% (15 CR and 2 PR) while it was 83% in bone marrow-transplanted patients (5 CR). With a median follow-up of 8 months (1-16 months) 24 patients are still alive. The one-year projected survival is 73%. Of the 22 patients who achieved response, 15 patients (11 solid organ transplant and 4 bone marrow transplant) are alive with no evidence of disease, 4 patients relapsed a median of 7 months (3-10 months) after treatment and 3 died while in CR of concurrent diseases. Of the 10 patients who did not respond to Rituximab 5 are alive with no evidence of disease after salvage therapy. CONCLUSIONS The use of rituximab appears to be a safe and relatively efficient therapy in BLPDs. The results need to be confirmed in a prospective multicentric trial.
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Milpied N, Vasseur B, Parquet N, Garnier JL, Antoine C, Quartier P, Carret AS, Bouscary D, Faye A, Bourbigot B, Reguerre Y, Stoppa AM, Bourquard P, Hurault de Ligny B, Dubief F, Mathieu-boue A, Leblond V. Ann Oncol 2000; 11:113-116. [DOI: 10.1023/a:1008372814223] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Milpied N, Vasseur B, Parquet N, Garnier J, Antoine C, Quartier P, Carret A, Bouscary D, Faye A, Bourbigot B, Reguerre Y, Stoppa A, Bourquard P, Hurault de Ligny B, Dubief F, Mathieu-Boue A, Leblond V. Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: A retrospective analysis on 32 patients. Ann Oncol 2000. [DOI: 10.1093/annonc/11.suppl_1.s113] [Citation(s) in RCA: 166] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Azoulay D, Savier E, Castaing D, Saliba F, Vasseur B, Emile JF, Vahédi K, Samuel D, Matuchansky C, Messing B, Bismuth H. [Combined transplantation of liver and small intestine in an adult. First case in France. Surgical aspects]. Presse Med 1999; 28:2211-3. [PMID: 10636007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND We report hare the first adult case of combined liver-small bowel transplantation performed in France. CASE REPORT A double liver + small bowel graft was transplanted in a 21-year-old patient hospitalized for 4 years for a short bowel syndrome requiring total parenteral nutrition. The patient also had severe hepatic fibrosis. The immediate post-operative period was uneventful. Two and one-half years after the double graft, the patient is on strictly oral nutrition, no longer has a stomy and lives a normal life in his home. DISCUSSION The advent of tacrolimus has led to long-term success of bowel grafts, developed earlier in children and now possible in adults. Combined liver-small bowel transplantation is formally indicated in patients with cirrhogenic liver disease associated with ineversible small bowel failure.
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Affiliation(s)
- D Azoulay
- Centre Hépato-Biliaire, Hôpital Paul Brousse, Villejuif, Université Paris-Sud.
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22
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Vasseur B, Samuel D. [Follow-up of liver transplantation]. Gastroenterol Clin Biol 1999; 23:B66-75. [PMID: 10897776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- B Vasseur
- Centre Hépato-biliaire, Hôpital Paul Brousse, Université Paris-Sud, Villejuif
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Meddeb M, Danglot G, Chudoba I, Vénuat AM, Bénard J, Avet-Loiseau H, Vasseur B, Le Paslier D, Terrier-Lacombe MJ, Hartmann O, Bernheim A. Additional copies of a 25 Mb chromosomal region originating from 17q23.1-17qter are present in 90% of high-grade neuroblastomas. Genes Chromosomes Cancer 1996; 17:156-65. [PMID: 8946194 DOI: 10.1002/(sici)1098-2264(199611)17:3<156::aid-gcc3>3.0.co;2-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Neuroblastoma shows remarkable heterogeneity, ranging from spontaneous regression to progression toward highly malignant tumors. In search of genetic abnormalities that could explain this variability, we have characterized neuroblastoma tumors by using multiple fluorescent hybridizations. Our results indicate that chromosome 17 is rearranged very frequently in the form of unbalanced translocations with numerous chromosomal partners, all leading to the presence of supernumerary copies of a 25 Mb chromosomal region originating from 17q23.1-qter. Additional 17q material was detected in more than 90% of untreated high-grade neuroblastomas and, along with 1p36 deletion, should represent the most frequent genetic abnormality of neuroblastoma observed until now.
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Affiliation(s)
- M Meddeb
- Laboratoire de Cytogénétique et de Génétique Oncologiques, CNRS URA 1967, Villejuif, France
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24
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Vasseur B, Cadiot G, Zins M, Fléjou JF, Belghiti J, Marmuse JP, Vilgrain V, Bernades P, Mignon M, Ruszniewski P. Peritoneal carcinomatosis in patients with digestive endocrine tumors. Cancer 1996; 78:1686-92. [PMID: 8859181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Peritoneal carcinomatosis (PC) in patients with digestive endocrine tumors (DET) is considered rare but its prevalence is unknown. The objectives of this study were to assess the prevalence and prognostic implications of PC in patients with various types of DET. METHODS One hundred and sixteen consecutive patients with DET seen over a 3-year period were studied. Fifty-nine had gastrinomas, 30 had carcinoid tumors, and 27 had other types of endocrine tumors, mainly nonfunctioning ones. Diagnosis of PC was based on clinical symptoms (ascites and König's syndrome), findings of computed tomography scans that were performed at least yearly, and pathologic confirmation of tumor nodules or positive cytology in the peritoneal fluid. Factors associated with PC were investigated and the influence of PC on patients' survival was assessed. RESULTS PC was found in 11 patients (overall PC prevalence: 10%; with 27% in patients with carcinoid tumors, 11% in those with nongastrinoma pancreatic endocrine tumors, and 0% in patients with gastrinomas). Nine of 11 patients with PC also had liver metastases. PC was metachronous to detection of the primary tumor in 7 of 11 patients, occurring 54 months (range, 23-273 months) after the diagnosis. In addition to the nature of the primary tumor, a greatest dimension of more than 5 cm was associated with the presence of PC in two of three patients with pancreatic endocrine tumors. In patients with carcinoid tumors, an ileal primary tumor occurred more frequently in patients with PC (87.5%) than in those without PC (50%). Prevalence of liver and other metastases was not significantly increased in patients with PC. Although five patients died of their disease, no deaths were related to PC. Actuarial survival rates at 5 years were 64% and 84% in patients with and without PC, respectively (P = not significant), whereas they were 73% and 93% in patients with and without liver metastases, respectively (P < 0.02). CONCLUSIONS PC is not a rare event in the course of DET, especially in patients with carcinoid tumors. It did not occur in the patient population with gastrinomas, which are less often malignant but may also differ from the other types of DET by several cell characteristics. In contrast to liver metastases, PC is not associated with a significant decrease in life expectancy.
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Affiliation(s)
- B Vasseur
- Department of Gastroenterology, Hôpital Beaujon, Clichy, France
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25
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Abstract
Dacron graft replacement of the ascending aorta for thoracic dissections often results in major intraoperative or postoperative hemorrhage due to tissue tearing at the suture lines. We report a promising solution to this problem: strengthening the aortic wall with glutaraldehyde solution. Using this technique, we obtained a tough, resistant tissue that could be sutured without disintegration. We have used the method successfully in 5 consecutive patients.
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Affiliation(s)
- B Vasseur
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06510
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26
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Pourriat JL, Lamberto C, Fosse JP, Vasseur B, Cupa M. Steady-state breathing pattern responses to small inspiratory resistive loads in COPD patients. Application to weaning from mechanical ventilation. Chest 1989; 95:364-9. [PMID: 2492464 DOI: 10.1378/chest.95.2.364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We investigated the effect of small inspiratory resistive loads on the breathing patterns of patients with COPD admitted to the ICU for acute respiratory failure. Patients were in stable clinical condition three days after weaning from the acute-phase ventilation. Healthy nonsmokers served as controls. Breathing patterns were recorded for 20-min periods during unloaded breathing (R0), then with small inspiratory resistive loads (R1 = 2.5 cmH2O L/s and R2 = 5.2 cmH2O L/s) applied in random order. Respiratory parameters were memorized in real time and blood gases measured continuously with a transcutaneous PO2/PCO2 monitor and compared periodically with arterial blood gases. Minute volume (VE) and respiratory rate decreased with no modification in blood gas values. In the COPD patients, R1 was too small to be perceived; when R2 was applied, no increase in TI was observed, and VT and VT/TI decreased. The VE could not be maintained despite a shortening of expiratory time. The COPD patients did not have significant increase of occlusion pressure (P0.1). Mean blood gas values did not change during the testing, but the coefficient of variation of tcPCO2 increased. During the critical period following weaning from artificial ventilation, COPD patients did not respond in the same manner as normal subjects to inspiratory resistive loads, but did not have modified gas exchange during the 20-min period.
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Affiliation(s)
- J L Pourriat
- Département d'Anesthésie-Réanimation, Hôpital Avicenne, Paris, France
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27
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Pourriat JL, Lamberto C, Hoang PH, Fournier JL, Vasseur B. Diaphragmatic fatigue and breathing pattern during weaning from mechanical ventilation in COPD patients. Chest 1986; 90:703-7. [PMID: 3769572 DOI: 10.1378/chest.90.5.703] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The medium-term outcome of weaning from mechanical ventilation in COPD patients is not easy to anticipate because a respiratory fatigue may eventually develop. We evaluated the diaphragmatic function and the breathing pattern during 40 weaning trials on 15 patients ventilated after acute respiratory failure. We formed two groups according to the success (group B, n = 18) or failure (group A, n = 19) of the medium-term attempt (group A/less than 10 hours; group B/more than 12 hours). Provided the patients showed the classic weaning criteria (tidal volume greater than 5 ml/kg, respiratory frequency less than 30 breaths per minute, PaO2 greater than 50 mm Hg), the study of the breathing pattern did not allow differentiation between the groups. However, the transdiaphragmatic pressure (Pdi) and the Pdimax, which gave an indication of the power of diaphragm contraction, dropped early in the group that could not stand weaning, with an increase in the Pdi/Pdimax ratio. In addition, this same group showed a diaphragmatic dysfunction attested for by a frequent negative gastric pressure associated with or shortly preceded by an abdominal paradoxic motion.
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Abstract
The difficulty in taking sweat during heavy physical exercise has drawn the authors into testing a technique of sampling generally used in paediatrics. The fact that the results, which have been dealt with statistically, should coincide with the physiological facts already published allows us to consider a use of the technique in order to investigate the physiological mechanisms in action during sweating under different metabolic conditions.
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Debray C, Vaille C, Vasseur B, De la Tour J, Rozé C, Souchard M. [Action of pig gastrin and of gastrinic pentapeptide on pancreatic and biliary secretions in the anesthetised rat]. Sem Hop 1971; 47:2016-22. [PMID: 4327286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Mordelet-Dambrine M, Nicot G, Vasseur B, Parrot JL. [Histamine fixation by heparin. Critical study as a function of concentration and pH]. J Physiol (Paris) 1970; 62:157-68. [PMID: 5488484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Debray C, Hardouin JP, Vasseur B, Cerf M, Martin E, Mignon M, Gouin B. [Demonstration of gastro-secretogogue activity of pancreatic origin. Apropos of a case of insinoma and 3 cases of Zollinger-Ellison syndrome]. Ann Med Interne (Paris) 1969; 120:37-47. [PMID: 4304119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Vasseur B, Nicot G, Parrot JL. [Elimination of histamine antagonists in human urine]. Therapie 1968; 23:627-33. [PMID: 4391914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Vasseur B, Rançon F, Saindelle A, Ruff F, Parrot JL. [Histaminuria in normal and gastrectomized rats]. J Physiol (Paris) 1967; 59:409-21. [PMID: 4968306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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