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Boige V, Blons H, François E, Ben Abdelghani M, Phelip JM, Le Brun-Ly V, Mineur L, Galais MP, Villing AL, Hautefeuille V, Miglianico L, De La Fouchardière C, Genet D, Levasseur N, Levaché CB, Penel N, Mitry E, Jacquot S, Aparicio T, Brument E, Gourgou S, Castan F, Bouché O. Maintenance Therapy With Cetuximab After FOLFIRI Plus Cetuximab for RAS Wild-Type Metastatic Colorectal Cancer: A Phase 2 Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2333533. [PMID: 37721754 PMCID: PMC10507485 DOI: 10.1001/jamanetworkopen.2023.33533] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/28/2023] [Indexed: 09/19/2023] Open
Abstract
Importance The optimal maintenance strategy after induction chemotherapy with anti-epidermal growth factor receptor antibody for patients with RAS wild-type metastatic colorectal cancer (mCRC) remains to be debated. Objective To evaluate the efficacy and safety of maintenance therapy with single-agent cetuximab after FOLFIRI (leucovorin [folinic acid], fluorouracil, and irinotecan) plus cetuximab induction therapy. Design, Setting, and Participants The TIME (Treatment After Irinotecan-Based Frontline Therapy: Maintenance With Erbitux]) (PRODIGE 28 [Partenariat de Recherche en Oncologie Digestive]-UCGI 27 [UniCancer GastroIntestinal Group]) phase 2 noncomparative, multicenter randomized clinical trial was conducted from January 15, 2014, to November 23, 2018, among 139 patients with unresectable RAS wild-type mCRC. The cutoff date for analysis was July 21, 2022. Interventions After first-line induction therapy with 8 cycles of FOLFIRI plus cetuximab, patients without disease progression were randomized (1:1) to biweekly maintenance with cetuximab or observation. On disease progression, the same induction regimen was recommended for 16 weeks followed by further maintenance with cetuximab or observation until disease progression under the full induction regimen. Main Outcomes and Measures The primary end point was the 6-month progression-free rate from randomization. Analysis was performed on an intention-to-treat basis. An exploratory biomolecular analysis, using next-generation sequencing, investigated the putative prognostic value of the tumor mutation profile. Results Of 214 patients enrolled (141 men [65.9%]; median age, 67 years [range, 23-85 years]), 139 were randomized to receive cetuximab (n = 67; 45 men [67.2%]; median age, 64 years [range, 34-85 years]) or to be observed (n = 72; 50 men [69.4%]; median age, 68 years [23-85 years]). The 6-month progression-free rate was 38.8% ([26 of 67] 95% CI, 27.1%-51.5%) in the cetuximab group and 5.6% ([4 of 72] 95% CI, 1.5%-13.6%) in the observation group. At a median follow-up of 40.5 months (95% CI, 33.6-47.5 months), median progression-free survival (PFS) from randomization was 5.3 months (95% CI, 3.7-7.4 months) in the cetuximab group and 2.0 months (95% CI, 1.8-2.7 months) in the observation group. Median overall survival (OS) was 24.8 months (95% CI, 18.7-30.4 months) in the cetuximab group and 19.7 months (95% CI, 13.3-24.4 months) in the observation group. In an exploratory multivariate analysis, any tumor-activating mutation in the mitogen-activated protein kinase (MAPK) pathway genes was associated with shorter PFS from randomization regardless of treatment group (hazard ratio, 1.63 [95% CI, 1.01-2.62]; P = .04). The most frequent grade 3 or 4 treatment-related toxic effect in the cetuximab group during maintenance therapy was rash (8 of 67 [11.9%]). Conclusion and Relevance The randomized clinical trial did not meet its primary end point but suggests clinically meaningful PFS and OS benefits associated with cetuximab maintenance therapy. However, maintenance cetuximab or treatment breaks after first-line combination FOLFIRI-cetuximab therapy seems inappropriate for patients with MAPK-mutated independently of the side of primary tumor. A more complete assessment of MAPK pathway mutations warrants further investigation to the refine treatment strategy for patients with RAS wild-type mCRC. Trial Registration ClinicalTrials.gov Identifier: NCT02404935.
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Affiliation(s)
- Valérie Boige
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
- INSERM UMR-S1138, Centre de Recherche des Cordeliers-Sorbonne Université- Université de Paris Cité, Paris, France
| | - Hélène Blons
- INSERM UMR-S1138, Centre de Recherche des Cordeliers-Sorbonne Université- Université de Paris Cité, Paris, France
- Department of Biochemistry, Molecular Oncology and Pharmacogenetics, European Georges Pompidou Hospital, APHP-Centre, Université Paris Cité, Paris Cancer Institute CARPEM, Paris, France
| | - Eric François
- Department of Medical Oncology, Antoine Lacassagne Centre, Nice, France
| | | | - Jean-Marc Phelip
- Departement of Hepato-gastroenterology, Saint Etienne Hospital, Saint Priest en Jarez, France
| | - Valerie Le Brun-Ly
- Departement of Medical Oncology and Radiotherapy, Dupuytren Hospital, Limoges, France
| | - Laurent Mineur
- Departement of Clinical Research, Sainte Catherine Institute, Avignon, France
| | | | | | | | - Laurent Miglianico
- Department of Radiotherapy, Saint Grégoire Hospital, Saint-Grégoire, France
| | | | - Dominique Genet
- Departement of Oncology and Radiotherapy, François Chénieux Clinic, Limoges, France
| | - Nadia Levasseur
- Department of Oncology, Jean Rougier Hospital, Cahors, France
| | - Charles-Briac Levaché
- Departement of Oncology and Radiotherapy, Francheville Polyclinic, Périgueux, France
| | - Nicolas Penel
- Pole of Oncology, Oscar Lambret Centre, Lille, France
| | - Emmanuel Mitry
- Department of Medical Oncology, Paoli Calmettes Institute, Marseille, France
| | - Stéphane Jacquot
- Department of Radiotherapy, Clementville Clinic, Montpellier, France
| | - Thomas Aparicio
- Department of Gastro-enterology, Saint Louis Hospital, APHP, Université Paris Cité, Paris, France
| | | | - Sophie Gourgou
- Biometry Unit, Montpellier Cancer Institute, Montpellier, France
| | - Florence Castan
- Biometry Unit, Montpellier Cancer Institute, Montpellier, France
| | - Olivier Bouché
- Department of Digestive Oncology, CHU Reims, Université Reims Champagne-Ardenne, Reims, France
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de Rauglaudre B, Sibertin-Blanc C, Fabre A, Le Malicot K, Bennouna J, Ghiringhelli F, Taïeb J, Boige V, Bouché O, Chatellier T, Faroux R, François E, Jacquot S, Genet D, Mulot C, Olschwang S, Seitz JF, Aparicio T, Dahan L. Predictive value of vascular endothelial growth factor polymorphisms for maintenance bevacizumab efficacy in metastatic colorectal cancer: an ancillary study of the PRODIGE 9 phase III trial. Ther Adv Med Oncol 2022; 14:17588359221141307. [PMID: 36601631 PMCID: PMC9806434 DOI: 10.1177/17588359221141307] [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: 06/17/2022] [Accepted: 11/07/2022] [Indexed: 12/28/2022] Open
Abstract
Background Several studies have reported the impact of single nucleotide polymorphisms (SNPs) in vascular endothelial growth factor (VEGF) pathway genes on the efficacy of bevacizumab in metastatic colorectal cancer (mCRC), but results are still inconsistent. The PRODIGE 9 phase III study compared bevacizumab maintenance versus observation alone after induction chemotherapy with FOLFIRI plus bevacizumab. Objective We evaluated the impact of SNPs of VEGF-A, VEGF receptors (VEGFR-1, VEGFR-2), and hypoxia inducible factor-1α (HIF-1α) on tumor control duration (TCD), overall survival (OS), progression-free survival (PFS), and duration of first chemotherapy free-intervals (CFI). Patients and methods We included 314/491 patients from PRODIGE 9 with a DNA blood sample available. Nine SNPs were genotyped on germline DNA using real-time Polymerase Chain Reaction TaqMan TM (Thermo Fisher Scientific, Waltham, MA , USA 02451). Results In the bevacizumab arm, patients with the VEGFR-1 rs9582036 CC genotype (n = 14) had significantly longer TCD [22.4 months (95% confidence interval (CI): 14.75-not reached)] than patients with the AA or CA genotype [14.4 months (95% CI: 11.7-17.1)] (p = 0.036), whereas there was no significant difference in the observation arm. In the bevacizumab arm, no significant difference was found between the CC, and AA or CA genotype for OS [28.2 (95% CI: 18.1-42.8) versus 22.5 (95% CI: 18.6-24.6) months, p = 0.5], PFS [9.4 (95% CI: 7.2-11.3) versus 9.2 (95% CI: 8.71-10.1)], and duration of the first CFI [4.6 (95% CI: 1.6-13.3) versus 4.14 (95% CI: 0.5-29.0) months, p = 0.3]. Conclusion Among mCRC patients treated with bevacizumab maintenance, those with the VEGFR-1 rs9582036 CC genotype experienced longer TCD. The presence of this genotype may thus predict a benefit of bevacizumab maintenance in mCRC.
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Affiliation(s)
| | - Camille Sibertin-Blanc
- UMR S-910 INSERM, Génétique Médicale et
Génomique Fonctionnelle, Aix-Marseille Université, Marseille, France,Hôpital Sainte Musse, Centre Hospitalier
Intercommunal Toulon 6 La Seyne-sur-Mer, Toulon, France
| | - Aurélie Fabre
- UMR S-910 INSERM, Génétique Médicale et
Génomique Fonctionnelle, Aix-Marseille Université, Marseille, France
| | - Karine Le Malicot
- Département de Statistique, Fédération
Française de Cancérologie Digestive (FFCD), Dijon, France
| | | | | | - Julien Taïeb
- Hôpital Européen Georges Pompidou – Université
Paris-Cité, SIRIC CARPEM, Paris, France
| | - Valérie Boige
- Department of Cancer Medicine, Gustave Roussy,
Villejuif, France
| | - Olivier Bouché
- Service de Gastroentérologie et Oncologie
Digestive, CHU Reims, Reims, France
| | | | - Roger Faroux
- Centre Hospitalier les Oudairies, La
Roche-sur-Yon, France
| | | | | | | | - Claire Mulot
- CRB EPIGENETEC, Centre de Recherche des
Cordeliers, INSERM U1138 – Université de Paris, La Sorbonne, Paris,
France
| | - Sylviane Olschwang
- Hôpital Privé Clairval, Ramsay Santé,
Marseille, France Medipath, Eguilles, France
| | - Jean-François Seitz
- Hôpital la Timone, Assistance Publique
Hôpitaux de Marseille – Aix-Marseille Université, Marseille, France,UMR S-910 INSERM, Génétique Médicale et
Génomique Fonctionnelle, Aix-Marseille Université, Marseille, France
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Boige V, Francois E, Blons H, Ben Abdelghani M, Phelip J, Ly Lebrun V, Mineur L, Galais M, Villing AL, Hautefeuille V, Miglianico L, de la Fouchardiere C, Genet D, Levasseur N, Lachaux N, Gourgou S, Castan F, Bouche O. 387P Maintenance treatment with cetuximab versus observation in RAS wild-type metastatic colorectal cancer: Final results of the randomized phase II TIME-PRODIGE 28 UNICANCER study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Guiu Lahaye S, Balmana Gelpi J, Gauthier L, Bigot F, Goncalves A, Frenel JS, Bachelot T, Dalenc F, Mailliez A, Chakiba C, Genet D, Dohollou N, Desmoulins I, Canon JLR, Guyonneau C, Buisson A, Chevalier LM, Delaloge S, Follana P. DOLAF: An international multicenter phase II trial of durvalumab (MEDI4736) plus olaparib plus fulvestrant in patients with metastatic or locally advanced ER-positive, HER2-negative breast cancer selected using criteria that predict sensitivity to olaparib. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps1116] [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
TPS1116 Background: PARP inhibitors have documented clinical activity in patients with HER2 negative breast cancer (BC) and a germline pathogenic variant (PV) in BRCA1 or BRCA2. Defects in other genes involved in homologous recombination DNA repair (HRR) or mismatch repair pathway (microsatellite instability MSI) have been associated with preclinical cellular sensitivity to PARP inhibitors. Several preclinical and clinical studies have suggested synergy between immune checkpoint blockade and PARP inhibitors. Indeed, tumors with deficiency in HRR have higher mutagenic potential and produce a larger number of neoantigens. Around 60% of BC with a germline PV in BRCA1/ 2 are ER+/HER2- tumors, and the ER-pathway remains a key target of their therapy. The combination of PARP inhibitors with endocrine therapy has shown to be superior to monotherapy. Methods: DOLAF is an open-label, international, multicentric, phase II trial assessing the combination of olaparib, fulvestrant, and durvalumab in ER+/HER2- metastatic or locally advanced BC with somatic or germline PV in BRCA1, BRCA2 or other genes implicated in the HRR pathway (ATM, BARD1, BRIP1, CDK12, CHEK1, CHEK2, FANCA, FAND2, FANCL, MRE11A, NBN, PALB2, PPP2R2A, RAD51B, RAD51C, RAD51D and RAD54L) or in MSI status or other actionable genes ( AKT1, ESR1, FGFR1, FGFR2, FGFR3, and PIK3CA) all based on central tumor NGS. Further an amendment in May 2021, patients with only alterations in these other actionable genes can no longer be included. Patients must have received 1 prior line of endocrine therapy for their metastatic BC, including CDK4/6 inhibitor and maximum of 1 line of chemotherapy in the metastatic setting. Patients receive olaparib (twice daily at 300 mg), fulvestrant (2 intramuscular injections of 250 mg every 28 days) and durvalumab (1500 mg intravenous every 4 weeks). The primary objective is to evaluate the progression-free survival rate at 24 weeks. Secondary endpoints include safety, overall survival, objective response rate, in the overall population and in the germline BRCA mutated population. With an optimum two-stage Simon design, α = 2.5%, β = 5%, p0 (probability of inefficiency maximum) = 50%, p1 (probability of minimum efficiency) = 65%, it is necessary to include 158 patients. The strategy could be considered sufficiently effective if there are at least 87 patients without progression at 24 weeks. Given the lack of safety data from this association, a safety run-in phase including 6 patients has been completed without DLT. As of December 31, 2021, 266 patients have been screened of whom 102 have been treated. The first interim analysis occured in November 2021 after the inclusion of 64 evaluable patients. IDMC suggested that the trial continue as planned. Clinical trial information: NCT04053322.
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Affiliation(s)
| | - Judith Balmana Gelpi
- Clinical Cancer Genetics and Breast Cancer Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Adrien Buisson
- Department of Biopathology, Centre Léon BERARD, Lyon, France
| | | | | | - Philippe Follana
- GINECO and Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
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De La Motte Rouge T, Frenel JS, Hardy-Bessard AC, Bachelot T, Pistilli B, Delaloge S, Deiana L, Del Piano F, Genet D, Gardner M, Legouffe E, Levache C, Orfeuvre H, Valmar C, Venat L, Zannetti A, Le Scodan R, Dalenc F, Berger D, Bidard F. 167MO Association between ER, PR and HER2 levels and outcome under palbociclib (Pal) + aromatase inhibitors (AIs) as first-line therapy for ER+ HER2- metastatic breast cancer (MBC): An exploratory analysis of the PADA-1 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bizot A, Karimi M, Rassy E, Heudel PE, Levy C, Vanlemmens L, Uzan C, Deluche E, Genet D, Saghatchian M, Giacchetti S, Grenier J, Patsouris A, Dieras V, Pierga JY, Petit T, Ladoire S, Jacot W, Benderra MA, De Jesus A, Delaloge S, Lambertini M, Pistilli B. Multicenter evaluation of breast cancer patients' satisfaction and experience with oncology telemedicine visits during the COVID-19 pandemic. Br J Cancer 2021; 125:1486-1493. [PMID: 34588616 PMCID: PMC8480754 DOI: 10.1038/s41416-021-01555-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 05/29/2021] [Revised: 08/31/2021] [Accepted: 09/17/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, teleconsultation was implemented in clinical practice to limit patient exposure to COVID-19 while monitoring their treatment and follow-up. We sought to examine the satisfaction of patients with breast cancer (BC) who underwent teleconsultations during this period. METHODS Eighteen centres in France and Italy invited patients with BC who had at least one teleconsultation during the first wave of the COVID-19 pandemic to participate in a web-based survey that evaluated their satisfaction (EORTC OUT-PATSAT 35 and Telemedicine Satisfaction Questionnaire [TSQ] scores) with teleconsultation. RESULTS Among the 1299 participants eligible for this analysis, 53% of participants were undergoing standard post-treatment follow-up while 22 and 17% were currently receiving active anticancer therapy for metastatic and localised cancers, respectively. The mean satisfaction scores were 77.4 and 73.3 for the EORTC OUT-PATSAT 35 and TSQ scores, respectively. In all, 52.6% of participants had low/no anxiety. Multivariable analysis showed that the EORTC OUT-PATSAT 35 score correlated to age, anxiety score and teleconsultation modality. The TSQ score correlated to disease status and anxiety score. CONCLUSION Patients with BC were satisfied with oncology teleconsultations during the COVID-19 pandemic. Teleconsultation may be an acceptable alternative follow-up modality in specific circumstances.
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Affiliation(s)
- Alexandra Bizot
- Medical Oncology Department, Gustave Roussy, Villejui, France
| | - Maryam Karimi
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - Elie Rassy
- Medical Oncology Department, Gustave Roussy, Villejui, France
| | | | - Christelle Levy
- Institut Normand du Sein, Centre Francois Baclesse, Caen, France
| | | | - Catherine Uzan
- Breast and Gynecologic Surgery, Assistance Publique - Hopitaux De Paris, Paris, France
| | - Elise Deluche
- Medical Oncology Department, CHU Limoges - Hopital Dupuytren, Limoges, France
| | - Dominique Genet
- Medical Oncology Department, Clinique Chenieux, Limoges, France
| | | | | | - Juline Grenier
- Medical Oncology Department, Institut Ste Catherine, Avignon, France
| | - Anne Patsouris
- Medical Oncology Department, ICO - Institut de Cancérologie de l'Ouest Nantes-Angers, Angers, France
| | - Véronique Dieras
- Medical Oncology Department, Centre Eugene - Marquis, Rennes, France
| | - Jean-Yves Pierga
- Medical Oncology Department, Institut Curie & St Cloud, Université de Paris, Paris, France
| | - Thierry Petit
- Medical Oncology Department, Centre Paul Strauss Centre de Lutte contre le Cancer, Strasbourg, France
| | - Sylvain Ladoire
- Medical Oncology Department, Centre Georges-François Leclerc (Dijon), Dijon, France
| | - William Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier University, INSERM, U1194, Montpellier, France
| | | | - Anne De Jesus
- Patient Relationship Coordination, Gustave Roussy, Villejuif, France
| | | | - Matteo Lambertini
- Medical Oncology Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
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Metges JP, Genet D, Tougeron D, Ligeza C, Ducreux M, Borg C, Guimbaud R, Phelip JM, Dourthe LM, Kim S. Real-world safety and effectiveness of regorafenib in metastatic colorectal cancer: the French CORRELATE cohort. Future Oncol 2021; 17:3343-3353. [PMID: 34011165 DOI: 10.2217/fon-2021-0266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim: We report real-world evidence with regorafenib in previously treated metastatic colorectal cancer from the French cohort of the international, prospective, observational CORRELATE study. Patients & methods: Patients receiving regorafenib according to French health authority approval were included. The primary end point was treatment-emergent adverse events. Overall survival and progression-free survival were secondary end points. Results: Two hundred and forty-two patients (61% male, median age: 66 years) were enrolled. The most common grade ≥3 drug-related treatment-emergent adverse events were hand-foot skin reaction (10.3%), asthenia/fatigue (9.9/1.2%) and hypertension (6.2%). Median overall survival and progression-free survival were 6.8 (95% CI: 6.3-7.6) and 2.8 months (95% CI: 2.6-3.0), respectively. Conclusion: The real-world safety and effectiveness data of regorafenib in metastatic colorectal cancer in France align with findings from Phase III clinical trials and the global CORRELATE population.
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Affiliation(s)
- Jean-Philippe Metges
- Institut de Cancérologie et d'Hématologie Réseau ARPEGO, CHRU de Brest - Hôpital Morvan, Brest, 29200, France
| | - Dominique Genet
- Service d'Oncologie, Clinique François Chenieux, Limoges, 87000, France
| | - David Tougeron
- Service d'Hépato-gastro-entérologie, CHU de Poitiers, Faculté de Médecine de Poitiers, Poitiers, 86021, France
| | - Catherine Ligeza
- Service d'Oncologie Médicale, Clinique Mutualiste de l'Estuaire, Saint-Nazaire, 44600, France
| | - Michel Ducreux
- Service de Gastro-entérologie, Institut Gustave Roussy, Villejuif, Université Paris-Saclay, 94805, France
| | - Christophe Borg
- Service d'Oncologie Médicale, Hôpital Nord Franche Comté, Site du Mittan, Montbéliard, 25200, France
| | - Rosine Guimbaud
- Oncologie Médicale Digestive, CHU de Toulouse, Toulouse, 31300, France
| | - Jean-Marc Phelip
- Service de Gastro-entérologie, CHU de Saint-Etienne Hôpital Nord, Saint Priest en Jarez, 42270, France
| | | | - Stefano Kim
- Service d'Oncologie Médicale, CHU de Besançon, Besançon, 25000, France
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Guiu S, Balmana J, Roca L, Goncalves A, Mailliez A, Bigot F, Bachelot T, Dalenc F, Dohollou N, Genet D, Desmoulins I, Chakiba C, Delaloge S, Martineau G, Haddad V, Follana P. Abstract OT-13-05: Dolaf- an international multicenter phase 2 trial of durvalumab (medi4736) plus olaparib plus fulvestrant in metastatic or locally advanced er-positive, her2-negative breast cancer patients selected using criteria that predict sensitivity to olaparib (UCBG308). Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ot-13-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Olaparib is a PARP inhibitor that has shown high response rates and clinical activity in patients with advanced HER2-negative breast cancer (BC) and a germline BRCA1 and BRCA2 mutation. There is also evidence of cellular sensitivity to PARP inhibitors associated to defects in other genes involved in homologous recombination DNA repair (HRR) or mismatch repair pathway (microsatellite instability MSI). Moreover, about 15% of patients with ER+/HER2- metastatic BC have at least 100 mutations in their tumor, leading to genomic instability and potential sensitivity to PARP inhibitors. Several preclinical and clinical studies have suggested the benefit of an association of immune checkpoint blockade, like durvalumab, with PARP inhibitor. Indeed, tumors with BRCA1/2 mutations or other deficiency in HRR have high mutagenic burden and produce a larger number of neoantigens. Most BRCA-associated BC are ER+/HER2-. Although loss of the BRCA gene function is a key driver of oncogenesis in these patients, ER-pathway appears to remain a key target for their therapy. Preclinical data indicate that olaparib may enhance endocrine therapy efficacy and circumvent resistance. Therefore, the combination of durvalumab, olaparib and endocrine therapy could be a therapeutic option for patients with BRCA1/2 mutation or for patients with selected ER+/HER2- advanced BC.
Trial design: DOLAF is an open-label, international, multicentric, phase II trial assessing the combination of olaparib, fulvestrant, and durvalumab. Olaparib will be administered orally twice daily at 300 mg. Fulvestrant will be administered as two intramuscular injections of 250 mg (Cycle 1 Days 1 and 15, and Day 1 of each subsequent 28-day cycle). Durvalumab will be started 4 weeks after the first dose of olaparib at 1500 mg intravenous every 4 weeks.
Eligibility criteria include: ER+/HER2- metastatic or locally advanced BC with documented germline alteration in BRCA1 or BRCA2 or deleterious germline or somatic alterations implicated in the HRR pathway (ATM, BARD1, BRCA1, BRCA2, BRIP1, CDK12, CHEK1, CHEK2, FANCA, FAND2, FANCL, MRE11A, NBN, PALB2, PPP2R2A, RAD51B, RAD51C, RAD51D and RAD54L) or in MSI status or other actionable genes (AKT1, ESR1, FGFR1, FGFR2, FGFR3, and PIK3CA) all based on central tumor next generation DNA sequencing. Patients could have received 1 line of endocrine therapy and/or 1 line of chemotherapy in the metastatic setting.Specific aims: To evaluate the efficacy of the combination in terms of progression-free survival rate at 24 weeks using RECIST v1.1. Secondary endpoints include: safety (according to the NCI-CTCAE v5.0), overall survival, progression-free survival, objective response rate, duration of response in the overall study population and in the germline BRCA mutated population.
Statistical methods: Given the lack of safety data from this association, a safety run-in of 6 patients was planned. With an optimum two-stage Simon design,α = 2.5%, β = 5%, p0 (the probability of inefficiency maximum) = 50%, p1 (the probability of minimum efficiency) = 65%, it would be necessary to include 149 evaluable patients. The strategy could be considered sufficiently effective if there are at least 87 successes. According to the established design (including a rate of 5% of patients lost to follow-up or non-evaluable), it will be necessary to include 158 patients. We hypothesized that about 20% of screened patients will have a molecular alteration to allow enrollment. Thus, we need to screen 790 patients.
The study is recruiting. The safety run-in is over. By July 1, 2020, 62 patients have been screened and 8 have been treated (NCT04053322). Contact information: DOLAF@unicancer.fr
Citation Format: Severine Guiu, Judith Balmana, Lise Roca, Anthony Goncalves, Audrey Mailliez, Frederic Bigot, Thomas Bachelot, Florence Dalenc, Nadine Dohollou, Dominique Genet, Isabelle Desmoulins, Camille Chakiba, Suzette Delaloge, Geraldine Martineau, Veronique Haddad, Philippe Follana. Dolaf- an international multicenter phase 2 trial of durvalumab (medi4736) plus olaparib plus fulvestrant in metastatic or locally advanced er-positive, her2-negative breast cancer patients selected using criteria that predict sensitivity to olaparib (UCBG308) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr OT-13-05.
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Affiliation(s)
- Severine Guiu
- 1Institut du Cancer de Montpellier, Montpellier, France
| | | | - Lise Roca
- 1Institut du Cancer de Montpellier, Montpellier, France
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Boige V, FRANCOIS E, BEN Abdelghani M, Phelip JM, Le Brun-Ly V, Mineur L, Galais MP, Villing AL, Hautefeuille V, Miglianico L, De La Fouchardiere C, Genet D, Levasseur N, Levache CB, Lachaux N, Gourgou S, Castan F, Bouché O. Maintenance treatment with cetuximab versus observation in RAS wild-type metastatic colorectal cancer: Results of the randomized phase II PRODIGE 28-time UNICANCER study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.3_suppl.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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
15 Background: Compared to observation, maintenance therapy with a fluoropyrimidine +/- bevacizumab showed significant improvement in progression-free survival (PFS) but not in overall survival (OS) in patients with unresectable metastatic colorectal cancer (mCRC) and disease control after first-line doublet chemotherapy (CT) +/- bevacizumab. Few studies are available on the role of maintenance therapy after induction anti-EGFR-based CT, and the benefit from anti-EGFR maintenance monotherapy during CT-free intervals (CFI) in patients with RAS wild-type (wt) mCRC. Methods: RAS wt unresectable mCRC patients with controlled disease after FOLFIRI + cetuximab (8 cycles) were randomized (1:1) to receive maintenance with bi-weekly cetuximab alone (arm A) or observation (arm B) until disease progression (PD)/unacceptable toxicity/death. Randomization was stratified according to tumor response, center, baseline Köhne Score, CEA and platelet count. In case of tumor progression during the CFI, FOLFIRI + cetuximab was to be reintroduced for 8 cycles, followed by a new CFI. Tumor response was assessed per RECIST1.1 every 8 weeks. The primary objective of this multicenter non-comparative randomized phase II trial was 6-month PFS rate after initiation of maintenance therapy. A total of 134 randomized and evaluable patients (67 per arm) were required (Fleming’s one-step design, one-sided α=5%, β=20%, H0: 40%; H1: 55%). Secondary endpoints were overall response rate (ORR), time to strategy failure, PFS, OS, safety, quality of life, circulating tumor cells and circulating tumor DNA detection and dynamic changes during treatment. Results: From January 2014 to April 2019, 214 patients were included and 139 randomized (67 arm A/72 arm B) in 35 centers. Baseline characteristics were: males, 67%/69%; median age, 64/68 years; ECOG PS 0, 54%/46%; previous adjuvant therapy, 25%/14%; single metastatic site, 58%/47%; right-sided primary, 24%/18%. The ORR in the overall and the randomized population was 55% and 72%, respectively. The median follow-up was 30 months. The 6-month PFS rate after initiation of maintenance therapy was 30% 95%CI[19; 42] in the maintenance arm, and 6% 95%CI[2;14] in the observation arm, with a median PFS of 5.3 95%CI[3.7;6.5] and 2.0 95%CI[1.8;2.8] months, respectively. Any grade treatment-related toxicity, including skin rash (40%/4%), diarrhea (33%/8%), and hypomagnesemia (46%/10%) was more frequent in arm A. Conclusions: Based on the study hypothesis, the cetuximab maintenance arm did not meet the primary objective. However, the clinically meaningful difference in PFS without any overlap in the confidence intervals between the two arms warrants further investigation. Clinical trial information: NCT02404935.
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Affiliation(s)
| | - Eric FRANCOIS
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | | | - Jean Marc Phelip
- Saint Etienne University Hospital, Saint Priest En Jarez, France
| | - Valerie Le Brun-Ly
- Department of Medical Oncology, CHU Limoges-Hôpital Dupuytren, Limoges, France
| | | | | | | | | | | | | | | | | | | | | | - Sophie Gourgou
- Biostatistics Unit, CTD INCa, ICM-Montpellier Cancer Institute, Montpellier, France
| | - Florence Castan
- Biometrics Department, Institut du Cancer de Montpellier, Montpellier, France
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Dohan A, Gallix B, Guiu B, Le Malicot K, Reinhold C, Soyer P, Bennouna J, Ghiringhelli F, Barbier E, Boige V, Taieb J, Bouché O, François E, Phelip JM, Borel C, Faroux R, Seitz JF, Jacquot S, Ben Abdelghani M, Khemissa-Akouz F, Genet D, Jouve JL, Rinaldi Y, Desseigne F, Texereau P, Suc E, Lepage C, Aparicio T, Hoeffel C. Early evaluation using a radiomic signature of unresectable hepatic metastases to predict outcome in patients with colorectal cancer treated with FOLFIRI and bevacizumab. Gut 2020; 69:531-539. [PMID: 31101691 DOI: 10.1136/gutjnl-2018-316407] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/28/2019] [Accepted: 04/30/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE The objective of this study was to build and validate a radiomic signature to predict early a poor outcome using baseline and 2-month evaluation CT and to compare it to the RECIST1·1 and morphological criteria defined by changes in homogeneity and borders. METHODS This study is an ancillary study from the PRODIGE-9 multicentre prospective study for which 491 patients with metastatic colorectal cancer (mCRC) treated by 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) and bevacizumab had been analysed. In 230 patients, computed texture analysis was performed on the dominant liver lesion (DLL) at baseline and 2 months after chemotherapy. RECIST1·1 evaluation was performed at 6 months. A radiomic signature (Survival PrEdiction in patients treated by FOLFIRI and bevacizumab for mCRC using contrast-enhanced CT TextuRe Analysis (SPECTRA) Score) combining the significant predictive features was built using multivariable Cox analysis in 120 patients, then locked, and validated in 110 patients. Overall survival (OS) was estimated with the Kaplan-Meier method and compared between groups with the logrank test. An external validation was performed in another cohort of 40 patients from the PRODIGE 20 Trial. RESULTS In the training cohort, the significant predictive features for OS were: decrease in sum of the target liver lesions (STL), (adjusted hasard-ratio(aHR)=13·7, p=1·93×10-7), decrease in kurtosis (ssf=4) (aHR=1·08, p=0·001) and high baseline density of DLL, (aHR=0·98, p<0·001). Patients with a SPECTRA Score >0·02 had a lower OS in the training cohort (p<0·0001), in the validation cohort (p<0·0008) and in the external validation cohort (p=0·0027). SPECTRA Score at 2 months had the same prognostic value as RECIST at 6 months, while non-response according to RECIST1·1 at 2 months was not associated with a lower OS in the validation cohort (p=0·238). Morphological response was not associated with OS (p=0·41). CONCLUSION A radiomic signature (combining decrease in STL, density and computed texture analysis of the DLL) at baseline and 2-month CT was able to predict OS, and identify good responders better than RECIST1.1 criteria in patients with mCRC treated by FOLFIRI and bevacizumab as a first-line treatment. This tool should now be validated by further prospective studies. TRIAL REGISTRATION Clinicaltrial.gov identifier of the PRODIGE 9 study: NCT00952029.Clinicaltrial.gov identifier of the PRODIGE 20 study: NCT01900717.
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Affiliation(s)
- Anthony Dohan
- Radiologie A, Assistance Publique - Hôpitaux de Paris, Cochin Hospital, Paris, France.,Medical School, Université de Paris, Paris, France.,Radiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Benoit Gallix
- Radiology, McGill University Health Centre, Montreal, Quebec, Canada.,IRCAD, Institut Hospitalo-Universitaire, Strasbourg, France.,Medical School, Université de Strasbourg, Strasbourg, France
| | - Boris Guiu
- Radiology, Hopital Saint-Eloi, Montpellier, Languedoc-Roussillon, France.,Medical School, Université de Montpellier, Montpellier, France
| | - Karine Le Malicot
- Biostatistics, FFCD, Dijon, France.,EPICAD, INSERM LNC-UMR 1231, University of Burgundy and Franche-Comté, Dijon, France
| | - Caroline Reinhold
- Radiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Philippe Soyer
- Radiologie A, Assistance Publique - Hôpitaux de Paris, Cochin Hospital, Paris, France.,Medical School, Université de Paris, Paris, France
| | - Jaafar Bennouna
- Gastroenterology and Digestive Oncology, Centre Hospitalier Universitaire de Nantes, Nantes, Pays de la Loire, France
| | | | - Emilie Barbier
- Biostatistics, FFCD, Dijon, France.,EPICAD, INSERM LNC-UMR 1231, University of Burgundy and Franche-Comté, Dijon, France
| | - Valérie Boige
- Oncologic Medicine, Institut Gustave Roussy, Villejuif, France
| | - Julien Taieb
- Medical School, Université de Paris, Paris, France.,Hepatogastroenterology and GI Oncology, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Olivier Bouché
- Gastrointestinal Oncology Unit, CHU Reims, Reims, France
| | - Eric François
- Pôle de Médecine, Centre Antoine-Lacassagne, Nice, France
| | - Jean-Marc Phelip
- Hepatogastroenterology, Saint Etienne University Hospital, Hôpital Nord, Saint Priest en Jarez, France
| | | | - Roger Faroux
- Gastroenterology, Hospital of La Roche sur Yon, La Roche sur Yon, France
| | - Jean-Francois Seitz
- Hepatogastroenterology and Oncology, Hopital de la Timone, Marseille, Provence-Alpes-Côte d'Azu, France
| | - Stéphane Jacquot
- Oncology, Centre de Cancérologie du Grand Montpellier, Montpellier, France
| | | | | | - Dominique Genet
- Medical Oncology, Clinique Francois Chenieux, Limoges, France
| | - Jean Louis Jouve
- Hepatogastroenterology, University Hospital Le Bocage, Dijon, France
| | - Yves Rinaldi
- Digestive Oncology, Hopital Européen, Marseilles, France
| | | | - Patrick Texereau
- Gastroenterology, Centre Hospitalier de Mont-de-Marsan, Mont-de-Marsan, Aquitaine, France
| | - Etienne Suc
- Medical oncology, Clinique Saint Jean de Languedoc, Toulouse, Midi-Pyrénées, France
| | - Come Lepage
- EPICAD, INSERM LNC-UMR 1231, University of Burgundy and Franche-Comté, Dijon, France.,Hepatogastroenterology, University Hospital Le Bocage, Dijon, France
| | - Thomas Aparicio
- Medical School, Université de Paris, Paris, France.,Gastroenterology and Digestive Oncology Department, Assistance Publique - Hôpitaux de Paris, Saint-Louis Hospital, Paris, France
| | - Christine Hoeffel
- Radiology, Hopital Maison Blanche, Reims, Champagne-Ardenne, France.,CRESTIC, Université de Reims, Reims, URCA, France
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Aparicio T, Bouché O, Taieb J, Maillard E, Kirscher S, Etienne PL, Faroux R, Khemissa Akouz F, El Hajbi F, Locher C, Rinaldi Y, Lecomte T, Lavau-Denes S, Baconnier M, Oden-Gangloff A, Genet D, Paillaud E, Retornaz F, François E, Bedenne L. Bevacizumab+chemotherapy versus chemotherapy alone in elderly patients with untreated metastatic colorectal cancer: a randomized phase II trial-PRODIGE 20 study results. Ann Oncol 2019; 29:133-138. [PMID: 29045659 PMCID: PMC5834151 DOI: 10.1093/annonc/mdx529] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [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] [Indexed: 02/07/2023] Open
Abstract
Background Metastatic colorectal cancer frequently occurs in elderly patients. Bevacizumab in combination with front line chemotherapy (CT) is a standard treatment but some concern raised about tolerance of bevacizumab for these patients. The purpose of PRODIGE 20 was to evaluate tolerance and efficacy of bevacizumab according to specific end points in this population. Patients and methods Patients aged 75 years and over were randomly assigned to bevacizumab + CT (BEV) versus CT. LV5FU2, FOLFOX and FOLFIRI regimen were prescribed according to investigator’s choice. The composite co-primary end point, assessed 4 months after randomization, was based on efficacy (tumor control and absence of decrease of the Spitzer QoL index) and safety (absence of severe cardiovascular toxicities and unexpected hospitalization). For each arm, the treatment will be consider as inefficient if 20% or less of the patients met the efficacy criteria and not safe if 40% or less met the safety criteria. Results About 102 patients were randomized (51 BEV and 51 CT), median age was 80 years (range 75–91). Primary end point was met for efficacy in 50% and 58% and for safety in 61% and 71% of patients in BEV and CT, respectively. Median progression-free survival was 9.7 months in BEV and 7.8 months in CT. Median overall survival was 21.7 months in BEV and 19.8 months in CT. The 36-month overall survival rate was 27% in BEV and 10.1% in CT. Severe toxicities grade 3/4 were mainly non-hematologic toxicities (80.4% in BEV, 63.3% in CT). Conclusion Bevacizumab combined with CT was safe and efficient. Both arms met the primary safety and efficacy criteria.
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Affiliation(s)
- T Aparicio
- Gastroenterology Department, CHU Saint Louis, APHP, Paris, France.,Université Paris 7, Sorbonne Paris Cité, Paris, France
| | - O Bouché
- Digestive Oncology Department, CHU Robert Debré, Reims, France
| | - J Taieb
- Digestive Oncology Department, CHU Georges Pompidou, APHP, Paris, France
| | - E Maillard
- Statistics Department, Fédération Francophone de Cancérologie Digestive, Dijon, France
| | - S Kirscher
- Oncology Department, Institut Sainte Catherine, Avignon, France
| | - P-L Etienne
- Oncology Department, CARIO, HPCA, Plérin, France
| | - R Faroux
- Gastroenterology Department, CHG Vendée, La Roche sur Yon, France
| | | | - F El Hajbi
- Oncology Department, Centre Oscar Lambret, Lille, France
| | - C Locher
- Gastroenterology Department, CH Meaux, Meaux, France
| | - Y Rinaldi
- Gastroenterology Departement, Hôpital Européen, Marseille, France
| | - T Lecomte
- Gastroenterology Department, CHU Trousseau, Tours, France
| | | | - M Baconnier
- Gastroenterology Department, CH Annecy Genevois, Pringy, France
| | - A Oden-Gangloff
- Gastroenterology Department, CHU Charles Nicolle, Rouen, France
| | - D Genet
- Oncology Department, Clinique Chenieux, Limoges, France
| | - E Paillaud
- Geriatric Department, CHU Henri Mondor, APHP, Créteil, France
| | - F Retornaz
- Geriatric Department, Hôpital Européen, Marseille, France
| | - E François
- Gastroenterology Department, Centre Antoine Lacassagne, Nice, France
| | - L Bedenne
- Gastroenterology Department, CHU Le Bocage, INSERM U 866, Dijon, France
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Curtit E, Vannetzel JM, Darmon JC, Roche S, Bourgeois H, Dewas S, Catala S, Mereb E, Fanget CF, Genet D, Forest AM, Bernier C, Pivot X. Results of PONDx, a prospective multicenter study of the Oncotype DX ® breast cancer assay: Real-life utilization and decision impact in French clinical practice. Breast 2019; 44:39-45. [PMID: 30634106 DOI: 10.1016/j.breast.2018.12.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 12/28/2018] [Accepted: 12/31/2018] [Indexed: 12/11/2022] Open
Abstract
Adjuvant chemotherapy shows clear benefits in HER2-positive and triple-negative breast cancer (BC). Its benefits are less universal in BCs expressing hormone receptors. The 21-gene Oncotype DX® Breast Recurrence Score test was designed for HR+, HER2- early-stage BC before decision on adjuvant chemotherapy. Its validity and utility was demonstrated prospectively across multiple studies. The observational study PONDx characterized the use of Oncotype DX® Breast in routine practice in France and evaluated its decision impact. Of 882 ER-positive BC patients (67% postmenopausal), most (79%) had N0/Nmic node involvement, grade 2 tumors (68%), tumor size 1-5 cm (88%), and ductal histology (78%). BCs with histopathologically elevated recurrence risk included grade 3: 18%; N1: 21%; Ki67 > 20%: 31%. Recurrence Score results by prognostic category were: <18: 54%, 18-30: 36%; >30: 10%. Compared to recommendations before individual availability of the score, results prompted net absolute reductions in chemotherapy recommendations of 36% (total population), and 29% (grade 3 and/or Ki67 > 20% histologies). Decisions reflected prognostic implications: in the Recurrence Score <18 category, 95% of patients received recommendations of hormonal therapy only, in the >30 category, 97.5% were recommended additional chemotherapy; 95% followed the final recommendations of their physicians. The Recurrence Score provides independent predictive and prognostic information in ER + N0/N1 early BC, including high-risk subgroups. PONDx further characterizes the population where the test is beneficial in real-life use and fits current clinical needs. Oncotype DX® Breast enables relevant net reductions in chemotherapy use, sparing patients from serious toxicities. Its therapeutic implications are highly accepted by physicians and patients.
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Affiliation(s)
- Elsa Curtit
- Institut Régional Fédératif du Cancer pour la Région Franche-Comté, Université de Bourgogne Franche-Comté, Pôle Cancero-Biologie, 2 Bd Fleming, 25000, Besançon, France.
| | | | - Jean-Claude Darmon
- ICA-Polyclinique Urbain V, 95 Chemin du Pont des Deux Eaux, 84000, Avignon, France.
| | - Sophie Roche
- Centre Jean Bernard, 9 Rue Beauverger, 72000, Le Mans, France.
| | | | - Sylvain Dewas
- Centre Bourgogne - Polyclinique du Bois, 44 Avenue Marx Dormoy, 59000, Lille, France.
| | - Stéphanie Catala
- Centre Catalan d'Oncologie, 80 Rue Pascal Marie Agasse, 66000, Perpignan, France.
| | - Emile Mereb
- Hôpital Manchester - Centre Hospitalier de Charleville-Mézières, 45 Avenue de Manchester, Charleville-Mézières, France.
| | - Charlotte Furtos Fanget
- Institut de Cancérologie Lucien Neuwirth, 108bis Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France.
| | - Dominique Genet
- Clinique François Chenieux, 18 Rue du Général Catroux, 87000, Limoges, France.
| | - Anne-Marie Forest
- Centre Hospitalier de Montluçon 18, Avenue du 8 Mai 1945, 03113, Montluçon, France.
| | - Céline Bernier
- 3C Sud Ile de France, Centre de Coordination en Cancérologie Inter-établissements, Centre Hospitalier de Bligny, 91640, Briis-sous-Forges, France.
| | - Xavier Pivot
- Institut Régional du Cancer, 3 Rue de la Porte de l'hôpital, 67065, Strasbourg, France.
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Aparicio T, Bouché O, Taieb J, Maillard E, Kirscher S, Etienne PL, Faroux R, Khemissa Akouz F, El Hajbi F, Locher C, Rinaldi Y, Lecomte T, Lavau-Denes S, Baconnier M, Oden-Gangloff A, Genet D, Paillaud E, Retornaz F, François E, Bedenne L. Bevacizumab+chemotherapy versus chemotherapy alone in elderly patients with untreated metastatic colorectal cancer: a randomized phase II trial-PRODIGE 20 study results. Ann Oncol 2018; 29:2270. [PMID: 29718089 DOI: 10.1093/annonc/mdx808] [Citation(s) in RCA: 4] [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: 11/14/2022] Open
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Aparicio T, Ducreux M, Faroux R, Barbier E, Manfredi S, Lecomte T, Etienne PL, Bedenne L, Bennouna J, Phelip JM, François E, Michel P, Legoux JL, Gasmi M, Breysacher G, Rougier P, De Gramont A, Lepage C, Bouché O, Seitz JF, Adenis A, Alessio A, Aouakli A, Azzedine A, Bedjaoui A, Bidault A, Blanchi A, Botton A, Cadier-Lagnes A, Fatisse A, Gagnaire A, Gilbert A, Gueye A, Hollebecque A, Lemaire A, Mahamat A, Marre A, Patenotte A, Rotenberg A, Roussel A, Thirot-Bidault A, Votte A, Weber A, Zaanan A, Dupont-Gossart A, Villing A, Queuniet A, Coudert B, Denis B, Garcia B, Lafforgue B, Landi B, Leduc B, Linot B, Paillot B, Rhein B, Winkfield B, Barberis C, Becht C, Belletier C, Berger C, Bineau C, Borel C, Brezault C, Buffet C, Cornila C, Couffon C, De La Fouchardière C, Giraud C, Lecaille C, Lepere C, Lobry C, Locher C, Lombard-Bohas C, Paoletti C, Platini C, Rebischung C, Sarda C, Vilain C, Briac-Levaché C, Auby D, Baudet-Klepping D, Bechade D, Besson D, Cleau D, Festin D, Gargot D, Genet D, Goldfain D, Luet D, Malka D, Peré-Vergé D, Pillon D, Sevin-Robiche D, Smith D, Soubrane D, Tougeron D, Zylberait D, Carola E, Cuillerier E, Dorval Danquechin E, Echinard E, Janssen E, Maillard E, Mitry E, Norguet-Monnereau E, Suc E, Terrebonne E, Zrihen E, Pariente E, Almaric F, Audemar F, Bonnetain F, Desseigne F, Dewaele F, Di Fiore F, Ghiringhelli F, Husseini F, Khemissa F, Kikolski F, Morvan F, Petit-Laurent F, Riot F, Subtil F, Zerouala-Boussaha F, Caroli-Bosc F, Boilleau-Jolimoy G, Bordes G, Cavaglione G, Coulanjon G, Deplanque G, Gatineau-Saillant G, Goujon G, Medinger G, Roquin G, Brixi-Benmansour H, Castanie H, Lacroix H, Maechel H, Perrier H, Salloum H, Senellart H, Baumgaertner I, Cumin I, Graber I, Trouilloud I, Boutin J, Butel J, Charneau J, Cretin J, Dauba J, Deguiral J, Egreteau J, Ezenfis J, Forestier J, Goineau J, Lacourt J, Lafon J, Martin J, Meunier J, Moreau J, Provencal J, Taieb J, Thaury J, Tuaillon J, Vergniol J, Villand J, Vincent J, Volet J, Bachet J, Barbare J, Souquet J, Grangé J, Dor J, Paitel J, Jouve J, Raoul J, Cheula J, Gornet J, Sabate J, Vantelon J, Vaillant J, Aucouturier J, Barbieux J, Herr J, Lafargue J, Lagasse J, Latrive J, Plachot J, Ramain J, Robin J, Spano J, Douillard J, Beerblock K, Bouhier-Leporrier K, Slimane Fawzi K, Cany L, Chone L, Dahan L, Gasnault L, Rob L, Stefani L, Wander L, Baconnier M, Ben Abdelghani M, Benchalal M, Blasquez M, Carreiro M, Charbit M, Combe M, Duluc M, Fayolle M, Gignoux M, Giovannini M, Glikmanas M, Mabro M, Mignot M, Mornet M, Mousseau M, Mozer M, Pauwels M, Pelletier M, Porneuf M, Ramdani M, Schnee M, Tissot M, Zawadi M, Clavero-Fabri M, Gouttebel M, Kaminsky M, Galais M, Abdelli N, Barrière N, Bouaria N, Bouarioua N, Delas N, Gérardin N, Hess-Laurens N, Stremsdoerfer N, Berthelet O, Boulat O, Capitain O, Favre O, Amoyal P, Bergerault P, Burtin P, Cassan P, Chatrenet P, Chiappa P, Claudé P, Couzigou P, Feydy P, Follana P, Geoffroy P, Godeau P, Hammel P, Laplaige P, Lehair P, Martin P, Novello P, Pantioni P, Pienkowski P, Pouderoux P, Prost P, Ruszniewski P, Souillac P, Texereau P, Thévenet P, Haineaux P, Benoit R, Coriat R, Lamy R, Mackiewicz R, Beorchia S, Chaussade S, Hiret S, Jacquot S, Lavau Denes S, Montembault S, Nahon S, Nasca S, Nguyen S, Oddou-Lagraniere S, Pesque-Penaud S, Fratte S, Chatellier T, Mansourbakht T, Morin T, Walter T, Boige V, Bourgeois V, Derias V, Guérin-Meyer V, Hautefeuille V, Jestin Le Tallec V, Lorgis V, Quentin V, Sebbagh V, Veuillez V, Adhoute X, Coulaud X, Becouarn Y, Coscas Y, Courouble Y, Le Bricquir Y, Molin Y, Rinaldi Y, Lam Y, Ladhib Z. Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials. Eur J Cancer 2018; 98:1-9. [DOI: 10.1016/j.ejca.2018.03.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 02/07/2023]
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Aparicio T, Bouché O, Francois E, Retornaz F, Barbier E, Taieb J, Kirscher S, Etienne PL, Faroux R, Khemissa Akouz F, El Hajbi F, Locher C, Rinaldi Y, Lecomte T, Lavau-Denes S, Baconnier M, Oden-Gangloff A, Genet D, Bedenne L, Paillaud E, Zawadi MA, Volet J, Cavaglione G, Lepere C, Rougier P, Zaanan A, Besson D, Fawzi KS, Adenis A, Gatineau-Sailliant G, Brezault C, Coriat R, Tougeron D, Hautefeuille V, Chone L, Molin Y, Seitz JF, Le Tallec VJ, Ben Abdelghani M, Villing AL, Aouakli A, Sebbagh V, Bedjaoui A, Mitry E, Carola E, Boulat O, Queuniet AM, Capitain O, Jouve JL, Baumgaertner I, Almaric F, Bonnetain F, Subtil F. Geriatric analysis from PRODIGE 20 randomized phase II trial evaluating bevacizumab + chemotherapy versus chemotherapy alone in older patients with untreated metastatic colorectal cancer. Eur J Cancer 2018; 97:16-24. [DOI: 10.1016/j.ejca.2018.03.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 03/19/2018] [Accepted: 03/27/2018] [Indexed: 12/27/2022]
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Aparicio T, Ghiringhelli F, Boige V, Le Malicot K, Taieb J, Bouché O, Phelip JM, François E, Borel C, Faroux R, Dahan L, Jacquot S, Genet D, Khemissa F, Suc E, Desseigne F, Texereau P, Lepage C, Bennouna J. Bevacizumab Maintenance Versus No Maintenance During Chemotherapy-Free Intervals in Metastatic Colorectal Cancer: A Randomized Phase III Trial (PRODIGE 9). J Clin Oncol 2018; 36:674-681. [DOI: 10.1200/jco.2017.75.2931] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose Conflicting results are reported for maintenance treatment with bevacizumab during chemotherapy-free intervals (CFI) in metastatic colorectal cancer after induction chemotherapy. Patients and Methods In this open-label, phase III, randomized controlled trial, we compared the tumor control duration (TCD) observed with bevacizumab maintenance and with no treatment (observation) during CFI subsequent to induction chemotherapy with 12 cycles of fluorouracil, leucovorin, and irinotecan plus bevacizumab. After disease progression, the induction regimen was repeated for eight cycles, followed by a new CFI. Results From March 2010 to July 2013, 491 patients were randomly assigned. Disease progression or death occurred during induction chemotherapy in 85 patients (17%); 261 patients (53%) had at least one reinduction, 107 (22%) had two reinductions, and 56 (11%) had three or more reinductions. The median TCD was 15 months in both groups; the median progression-free survival (PFS) from randomization was 9.2 and 8.9 months in the maintenance group and observation groups, respectively. The TCD observed in both groups was higher compared with the TCD hypotheses of the trial. The median overall survival (OS) was 21.7 and 22.0 months in the maintenance and observation groups, respectively. In the per-protocol population, defined as patients with at least one reinduction after the first progression, the median duration of the first CFI was 4.3 months in both arms; the median TCD was 17.8 and 23.3 months ( P = .339), the median PFS was 9.9 and 9.5 months, and the median OS was 27.6 and 28.5 months in the maintenance and observation groups, respectively. Multivariable analysis revealed that female gender, WHO performance status ≥ 2, and unresected primary tumors were associated with a shorter TCD. Conclusion Bevacizumab maintenance monotherapy did not improve TCD, CFI duration, PFS, or OS.
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Affiliation(s)
- Thomas Aparicio
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Francois Ghiringhelli
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Valérie Boige
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Karine Le Malicot
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Julien Taieb
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Olivier Bouché
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Jean-Marc Phelip
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Eric François
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Christian Borel
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Roger Faroux
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Laetitia Dahan
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Stéphane Jacquot
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Dominique Genet
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Faiza Khemissa
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Etienne Suc
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Françoise Desseigne
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Patrick Texereau
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Come Lepage
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
| | - Jaafar Bennouna
- Thomas Aparicio, Centre Hospitalier Universitaire (CHU) Saint Louis, Assistance Public Hôpitaux de Paris (APHP), and Université Paris 7, Sorbonne Paris Cité; Julien Taieb, Hôpital Européen Georges Pompidou, Paris; Francois Ghiringhelli, Centre Georges-François Leclerc; Karine Le Malicot, Fédération Francophone de Cancérologie Digestive; Come Lepage, CHU Le Bocage, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche (UMR) 1231, Dijon; Valérie Boige, Institut Gustave Roussy,
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Emile JF, Julié C, Le Malicot K, Lepage C, Tabernero J, Mini E, Folprecht G, Van Laethem JL, Dimet S, Boulagnon-Rombi C, Allard MA, Penault-Llorca F, Bennouna J, Laurent-Puig P, Taieb J, Thaler J, Greil R, Gaenzer J, Eisterer W, Tschmelitsch J, Keil F, Samonigg H, Zabernigg A, Schmid F, Steger G, Steinacher R, Andel J, Jagdt B, Lang A, Fridrik M, Függer R, Hofbauer F, Woell E, Geissler D, Lenauer A, Prager M, D'Haens G, Demolin G, Kerger J, Deboever G, Ghillebert G, Polus M, Van Cutsem E, Kalantari HR, Delaunoit T, Goeminne JC, Peeters M, Vergauwe P, Houbiers G, Humblet Y, Janssens J, Schrijvers D, Vanderstraeten E, Van Laethem JL, Vermorken J, Van Daele D, Ferrante M, Forget F, Hendlisz A, Yilmaz M, Nielsen SE, Vestermark L, Larsen J, Zawadi MA, Bouche O, Mineur L, Bennouna-Louridi J, Dourthe LM, Ychou M, Boucher E, Taieb J, Pezet D, Desseigne F, Ducreux M, Texereau P, Miglianico L, Rougier P, Fratte S, Levache CB, Merrouche Y, Ellis S, Locher C, Ramee JF, Garnier C, Viret F, Chauffert B, Cojean-Zelek I, Michel P, Lecaille C, Borel C, Seitz JF, Smith D, Lombard-Bohas C, Andre T, Gornet JM, Fein F, Coulon-Sfairi MA, Kaminsky MC, Lagasse JP, Luet D, Etienne PL, Gasmi M, Vanoli A, Nguyen S, Aparicio T, Perrier H, Stremsdoerfer N, Laplaige P, Arsene D, Auby D, Bedenne L, Coriat R, Denis B, Geoffroy P, Piot G, Becouarn Y, Bordes G, Deplanque G, Dupuis O, Fruge F, Guimbaud R, Lecomte T, Lledo G, Sobhani I, Asnacios A, Azzedine A, Desauw C, Galais MP, Gargot D, Lam YH, Abakar-Mahamat A, Berdah JF, Catteau S, Clavero-Fabri MC, Codoul JF, Legoux JL, Goldfain D, Guichard P, Verge DP, Provencal J, Vedrenne B, Brezault-Bonnet C, Cleau D, Desir JP, Fallik D, Garcia B, Gaspard MH, Genet D, Hartwig J, Krummel Y, Budnik TM, Palascak-Juif V, Randrianarivelo H, Rinaldi Y, Aleba A, Darut-Jouve A, de Gramont A, Hamon H, Wendehenne F, Matzdorff A, Stahl MK, Schepp W, Burk M, Mueller L, Folprecht G, Geissler M, Mantovani-Loeffler L, Hoehler T, Asperger W, Kroening H, von Weikersthal LF, Fuxius S, Groschek M, Meiler J, Trarbach T, Rauh J, Ziegenhagen N, Kretzschmar A, Graeven U, Nusch A, von Wichert G, Hofheinz RD, Kleber G, Schmidt KH, Vehling-Kaiser U, Baum C, Schuette J, Haag GM, Holtkamp W, Potenberg J, Reiber T, Schliesser G, Schmoll HJ, Schneider-Kappus W, Abenhardt W, Denzlinger C, Henning J, Marxsen B, Derigs HG, Lambertz H, Becker-Boost I, Caca K, Constantin C, Decker T, Eschenburg H, Gabius S, Hebart H, Hoffmeister A, Horst HA, Kremers S, Leithaeuser M, Mueller S, Wagner S, Daum S, Schlegel F, Stauch M, Heinemann V, Maiello E, Latini L, Zaniboni A, Amadori D, Aprile G, Barni S, Mattioli R, Martoni A, Passalacqua R, Nicolini M, Pasquini E, Rabbi C, Aitini E, Ravaioli A, Barone C, Biasco G, Tamberi S, Gambi A, Verusio C, Marzola M, Lelli G, Boni C, Cascinu S, Bidoli P, Vaghi M, Cruciani G, Di Costanzo F, Sobrero A, Mini E, Petrioli R, Aglietta M, Alabiso O, Capuzzo F, Falcone A, Corsi DC, Labianca R, Salvagni S, Chiara S, Ciuffreda L, Ferraù F, Giuliani F, Lonardi S, Gebbia N, Mantovani G, Sanches E, Mellidez JC, Santos P, Freire J, Sarmento C, Costa L, Pinto AM, Barroso S, Santo JE, Guedes F, Monteiro A, Sa A, Furtado I, Salazar R, Aguilar EA, Herrero FR, Tabernero J, Valera JS, Ayerbes MV, Batlle JF, Gil S, Esteve AA, Garcia-Giron C, Vivanco GL, Salvia AS, Orduña VA, Garcia RV, Gallego J, Sureda BM, Remon J, Safont Aguilera MJ, Nogueras LC, Merino BQ, Castro CG, de Prado PM, Pericay CP, Figueiras MC, Jordan IG, Gome Reina MJ, Garcia ALL, Garcia-Ramos AA, Cervantes A, Martos CF, Gaspar EM, Montero IC, Emperador PE, Carbonero AL, Castillo MG, Garcia TG, Lopez JG, Flores EG, Morales MG, Muñoz ML, Martín AL, Maurel J, Camara JC, Garcia RD, Salgado M, Busquier IH, Ruiz TC, Muñoa AL, Aliguer MN, de Taranco AVO, Ureña MM, Gaspa FL, Ponce JJ, Roig CB, Jimenez PV, Brotons AG, Rodriguez SA, Martinez JA, Ruiz LC, Ruiz MC, Bridgewater J, Glynne-Jones R, Tahir S, Hickish T, Cassidy J, Samuel L. Prospective validation of a lymphocyte infiltration prognostic test in stage III colon cancer patients treated with adjuvant FOLFOX. Eur J Cancer 2017. [DOI: 10.1016/j.ejca.2017.04.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Aparicio T, Bouché O, Francois E, Maillard E, Kirscher S, Taieb J, Etienne PL, Faroux R, Khemissa Akouz F, El Hajbi F, Locher C, Rinaldi Y, Lecomte T, Lavau-Denes S, Baconnier M, Oden-Gangloff A, Genet D, Paillaud E, Retornaz F, Bedenne L. Prognostic factor analysis for elderly patients treated for metastatic colorectal cancer in the randomized phase II trial PRODIGE 20. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.131] [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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Sibertin-Blanc C, Fabre A, Aparicio T, Le Malicot K, Bennouna J, Ghiringhelli F, Taïeb J, Boige V, Bouche O, Faroux R, Francois E, Jacquot S, Genet D, Khemissa F, Cany L, Bachet JB, Mulot C, Seitz JF, Olschwang S, Dahan L. Impact of genetic polymorphisms of VEGF pathway on the response to bevacizumab in metastatic colorectal cancer (mCRC): Ancillary study of PRODIGE 9 trial. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.3534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
- Camille Sibertin-Blanc
- Department of Digestive Oncology. Aix-Marseille University - Assistance Publique Hôpitaux de Marseille ; (2)UMR S-910 INSERM, Marseille, France
| | - Aurelie Fabre
- UMR S-910 INSERM ; (3) Department of Medical Genetics. Aix-Marseille University - Assistance Publique Hopitaux de Marseille, Marseille, France
| | | | | | - Jaafar Bennouna
- Institut de Cancérologie de l'Ouest – site René Gauducheau, Saint Herblain, France
| | | | - Julien Taïeb
- APHP and Paris Descartes University, Paris, France
| | - Valerie Boige
- Service d'Oncologie Digestive, Gustave Roussy, Villejuif, France
| | | | - Roger Faroux
- Centre Hospitalier Départemental Les Oudairies, La Roche Sur Yon, France
| | - Eric Francois
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Stephane Jacquot
- Department of radiotherapy and oncology, CLINIQUE PRIVÉE CLÉMENTVILLE, Montpellier, France
| | | | | | | | | | | | | | - Sylviane Olschwang
- UMR S-910 INSERM. Medical genetics and functional genomics ; (3) Department of Medical Genetics. Aix-Marseille University - Assistance Publique Hopitaux de Marseille, Marseille, France
| | - Laetitia Dahan
- La Timone, Marseille University Hospital, Marseille, France
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Aparicio T, Bennouna J, Le Malicot K, Ghiringhelli F, Boige V, Taieb J, Bouche O, Phelip JM, Francois E, Borel C, Faroux R, Seitz JF, Jacquot S, Genet D, Khemissa F, Suc E, Desseigne F, Texereau P, Jouve JL. Final results of PRODIGE 9, a randomized phase III comparing no treatment to bevacizumab maintenance during chemotherapy-free intervals in metastatic colorectal cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.3531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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)
| | - Jaafar Bennouna
- Institut de Cancérologie de l'Ouest – site René Gauducheau, Saint Herblain, France
| | | | | | - Valerie Boige
- Service d'Oncologie Digestive, Gustave Roussy, Villejuif, France
| | - Julien Taieb
- Hôpital Européen Georges-Pompidou, Paris, France
| | | | | | - Eric Francois
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Christian Borel
- Department of Oncology, Paul Strauss Center, Strasbourg, France
| | - Roger Faroux
- Centre Hospitalier Départemental Les Oudairies, La Roche Sur Yon, France
| | | | - Stephane Jacquot
- Department of radiotherapy and oncology, CLINIQUE PRIVÉE CLÉMENTVILLE, Montpellier, France
| | | | | | - Etienne Suc
- Department of Oncology, Clinique Saint Jean du Languedoc, Toulouse, France
| | | | - Patrick Texereau
- Department of Hepato-Gastroenterology, Hôpital Layne, Mont-De-Marsan, France
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Aparicio T, Bouche O, Francois E, Maillard E, Kirscher S, Taïeb J, Etienne PL, Faroux R, Khemissa F, El Hajbi F, Locher C, Rinaldi Y, Lecomte T, Lavau-Denes S, Baconnier M, Oden-Gangloff A, Genet D, Paillaud E, Retornaz F, Bedenne L. PRODIGE 20: Bevacizumab + chemotherapy (BEV-CT) versus chemotherapy alone (CT) in elderly patients (pts) with untreated metastatic colorectal cancer (mCRC)—A randomized phase II trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.3541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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)
- Thomas Aparicio
- Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Bobigny, France
| | - Olivier Bouche
- Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Eric Francois
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Emilie Maillard
- Biostatistic Unit, Fédération Francophone de Cancérologie Digestive, Dijon, France
| | | | - Julien Taïeb
- APHP and Paris Descartes University, Paris, France
| | | | - Roger Faroux
- Centre Hospitalier Départemental Les Oudairies, La Roche sur Yon, France
| | | | | | - Christophe Locher
- Department of Hepato-Gastroenterology, Meaux Hospital, Meaux, France
| | | | | | | | | | - Alice Oden-Gangloff
- Digestive Oncology Unit, Department of Hepato-Gastroenterology, Rouen University, Rouen, France
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Quoix E, Nemunaitis J, Papai Z, Lena H, Genet D, Louis C, Cobo M, Al Farhat Y, Marie-Bastien B, Limacher J. TG4010 Immunotherapy Combined with First-Line Chemotherapy in Advanced Non-Small Cell Lung Cancer (NSCLC). Phase 2B Results of the Time Study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv050.09] [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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Thaler J, Greil R, Gaenzer J, Eisterer W, Tschmelitsch J, Samonigg H, Zabernigg A, Schmid F, Steger G, Steinacher R, Andel J, Lang A, Függer R, Hofbauer F, Woell E, Geissler D, Lenauer A, Prager M, Van Laethem JL, Van Cutsem E, D'Haens G, Demolin G, Kerger J, Deboever G, Ghillebert G, Polus M, Van Cutsem E, RezaieKalantari H, Delaunoit T, Goeminne JC, Peeters M, Vergauwe P, Houbiers G, Humblet Y, Janssens J, Schrijvers D, Vanderstraeten E, Van Laethem JL, Vermorken J, Van Daele D, Ferrante M, Forget F, Hendlisz A, Yilmaz M, Nielsen SE, Vestermark L, Larsen J, Ychou M, Zawadi A, Zawadi MA, Bouche O, Mineur L, Bennouna-Louridi J, Dourthe LM, Ychou M, Boucher E, Taieb J, Pezet D, Desseigne F, Ducreux M, Texereau P, Miglianico L, Rougier P, Fratte S, Levache CB, Merrouche, Y, Ellis S, Locher C, Ramee JF, Garnier C, Viret F, Chauffert B, Cojean-Zelek I, Michel P, Lecaille C, Borel C, Seitz JF, Smith D, Lombard-Bohas C, Andre T, Gornet JM, Fein F, Coulon-Sfairi MA, Kaminsky MC, Lagasse JP, Luet D, Etienne PL, Gasmi M, Vanoli A, Nguyen S, Aparicio T, Perrier H, Stremsdoerfer N, Laplaige P, Arsene D, Auby D, Bedenne L, Coriat R, Denis B, Geoffroy P, Piot G, Becouarn Y, Bordes G, Deplanque G, Dupuis O, Fruge F, Guimbaud R, Lecomte T, Lledo G, Sobhani I, Asnacios A, Azzedine A, Desauw C, Galais MP, Gargot D, Lam YH, Abakar-Mahamat A, Berdah JF, Catteau S, Clavero-Fabri MC, Codoul JF, Legoux JL, Goldfain D, Guichard P, Verge DP, Provencal J, Vedrenne B, Brezault-Bonnet C, Cleau D, Desir JP, Fallik D, Garcia B, Gaspard MH, Genet D, Hartwig J, Krummel Y, MatysiakBudnik T, Palascak-Juif V, Randrianarivelo H, Rinaldi Y, Aleba A, Darut-Jouve A, de Gramont A, Hamon H, Wendehenne F, Matzdorff A, Stahl MK, Schepp W, Burk M, Mueller L, Folprecht G, Geissler M, Mantovani-Loeffler L, Hoehler T, Asperger W, Kroening H, von Weikersthal LF, Fuxius S, Groschek M, Meiler J, Trarbach T, Rauh J, Ziegenhagen N, Kretzschmar A, Graeven U, Nusch A, von Wichert G, Hofheinz RD, Kleber G, Schmidt KH, Vehling-Kaiser U, Baum C, Schuette J, Haag GM, Holtkamp W, Potenberg J, Reiber T, Schliesser G, Schmoll HJ, Schneider-Kappus W, Abenhardt W, Denzlinger C, Henning J, Marxsen B, GuenterDerigs H, Lambertz H, Becker-Boost I, Caca K, Constantin C, Decker T, Eschenburg H, Gabius S, Hebart H, Hoffmeister A, Horst HA, Kremers S, Leithaeuser M, Mueller S, Wagner S, Daum S, Schlegel F, Stauch M, Heinemann V, Labianca R, Colucci G, Amadori D, Mini E, Falcone A, Boni C, Maiello E, Latini L, Zaniboni A, Amadori D, Aprile G, Barni S, Mattioli R, Martoni A, Passalacqua R, Nicolini M, Pasquini E, Rabbi C, Aitini E, Ravaioli A, Barone C, Biasco G, Tamberi S, Gambi A, Verusio C, Marzola M, Lelli G, Boni C, Cascinu S, Bidoli P, Vaghi M, Cruciani G, Di Costanzo F, Sobrero A, Mini E, Petrioli R, Aglietta M, Alabiso O, Capuzzo F, Falcone A, Corsi DC, Labianca R, Salvagni S, Chiara S, Ferraù F, Giuliani F, Lonardi S, Gebbia N, Mantovani G, Sanches E, Sanches E, Mellidez JC, Santos P, Freire J, Sarmento C, Costa L, Pinto AM, Barroso S, Santo JE, Guedes F, Monteiro A, Sa A, Furtado I, Tabernero J, Salazar R, Aguilar EA, Herrero FR, Tabernero J, Valera JS, ValladaresAyerbes M, FeliuBatlle J, Gil S, Garcia-Giron C, Vivanco GL, Salvia AS, Orduña VA, Garcia RV, Gallego J, Sureda BM, Remon J, Safont Aguilera MJ, CireraNogueras L, Merino B, Castro CG, de Prado PM, PijaumePericay C, ConstenlaFigueiras M, Jordan I, GomeReina MJ, Garcia ALL, Garcia-Ramos AA, Cervantes A, Martos CF, MarcuelloGaspar E, Montero IC, Emperador PE, Carbonero AL, Castillo MG, Garcia TG, Lopez JG, Flores EG, GuillotMorales M, LlanosMuñoz M, Martín AL, Maurel J, Camara JC, Garcia RD, Salgado M, HernandezBusquier I, Ruiz TC, LacastaMuñoa A, Aliguer M, Ortiz de Taranco AV, Ureña MM, Gaspa FL, Ponce JJ, Roig CB, Jimenez PV, GalanBrotons A, AlbiolRodriguez S, Martinez JA, Ruiz LC, CentellesRuiz M, Bridgewater J, Glynne-Jones R, Tahir S, Hickish T, Cassidy J, Samuel L. Prognostic value of KRAS mutations in stage III colon cancer: post hoc analysis of the PETACC8 phase III trial dataset. Ann Oncol 2015; 26:822-825. [DOI: 10.1093/annonc/mdv070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Aparicio T, Bennouna J, Le Malicot K, Ghiringhelli F, Boige V, Taieb J, Bouché O, Francois E, Phelip J, Borel F, Faroux R, Seitz J, Jacquot S, Genet D, Lepage C. Interim Analysis of Prodige 9, a Randomized Phase III Trial Comparing No Treatment to Bevacizumab Maintenance During Chemotherapy-Free Intervals in Metastatic Colorectal Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Barlesi F, Gervais R, Chouaid C, Souquet P, Milleron B, Monnet I, Étienne-Mastroiani B, Berard H, Deplanque G, Zalcman G, Domas J, Pichon E, Janicot H, Perol M, Shott R, Vaylet F, Genet D, Moro-Sibilot D, Fournel P, Falchero L, Morando C, Loundou A, Scherpereel A. Chimiothérapie (CT) de maintenance par bevacizumab/pemetrexed chez des patients (pts) avec un cancer bronchique non à petites cellules non épidermoïdes (CBNPCne) avancé : survie globale actualisée de l’essai randomisé de phase III AVAPERL. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lavau-Denes S, Lacroix P, Maubon A, Preux PM, Genet D, Vénat-Bouvet L, Labourey JL, Martin J, Slaouti P, Tubiana-Mathieu N. Prophylaxis of catheter-related deep vein thrombosis in cancer patients with low-dose warfarin, low molecular weight heparin, or control: a randomized, controlled, phase III study. Cancer Chemother Pharmacol 2013; 72:65-73. [PMID: 23636449 DOI: 10.1007/s00280-013-2169-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 04/16/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE Whether an anticoagulant prophylaxis is needed for patients with cancer with a central venous catheter is a highly controversial subject. We designed a study to compare different prophylactic strategies over 3 months of treatment. METHODS We performed a phase III prospective, open-label randomized trial. After the insertion of a central venous access device, consecutive patients with planned chemotherapy for cancer were randomized to no anticoagulant prophylaxis, low molecular weight heparin [low molecular weight heparin (LMWH); with isocoagulation doses], or warfarin 1 mg/day. Treatments were given over the first 3 months. Doppler ultrasound and venographies were performed on days 1 and 90, respectively, or sooner in case of clinical presumption of thrombosis. RESULTS A total of 420 patients were randomized, and 407 were evaluable. Forty-two catheter-related deep vein thrombosis (DVT) occurred (10.3 %), 20 in those with no anticoagulation, 8 in those receiving warfarin, and 14 in those receiving LMWH. Nine additional non-related catheter deep vein thrombosis (CDVT) occurred. Anticoagulation significantly reduced the incidence of catheter-related DVT (p = 0.035) and catheter non-related DVT (p = 0.007), with no difference between warfarin and LMWH. Safety was good (3.4 % of attributable events) but compliance with randomized prophylaxis was lower than expected. CONCLUSIONS Prophylaxis showed a benefit regarding catheter-related and non-catheter-related DVT with no increase in serious side effects.
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Lavau-Denes S, Lacroix P, Maubon A, Preux P, Genet D, Venat-Bouvet L, Labourey J, Martin J, Slaouti P, Tubiana-Mathieu N. Prophylaxis of Catheter-Related Deep Vein Thrombosis in Cancer Patients with Low-Dose Warfarin, Low Molecular Weight Heparin, or Control: A Randomized, Controlled, Phase III Study. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34352-0] [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: 10/25/2022] Open
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Lemaître C, Fischer B, Kalousi A, Hoffbeck AS, Guirouilh-Barbat J, Shahar OD, Genet D, Goldberg M, Betrand P, Lopez B, Brino L, Soutoglou E. The nucleoporin 153, a novel factor in double-strand break repair and DNA damage response. Oncogene 2012; 31:4803-9. [PMID: 22249246 DOI: 10.1038/onc.2011.638] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
DNA repair is essential in maintaining genome integrity and defects in different steps of the process have been linked to cancer and aging. It is a long lasting question how DNA repair is spatially and temporarily organized in the highly compartmentalized nucleus and whether the diverse nuclear compartments regulate differently the efficiency of repair. Increasing evidence suggest the involvement of nuclear pore complexes in repair of double-strand breaks (DSBs) in yeast. Here, we show that the human nucleoporin 153 (NUP153) has a role in repair of DSBs and in the activation of DNA damage checkpoints. We explore the mechanism of action of NUP153 and we propose its potential as a novel therapeutic target in cancers.
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Affiliation(s)
- C Lemaître
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, UMR 7104 CNRS, CU de Strasbourg, France
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Barlesi F, Gervais R, Chouaid C, Souquet P, Lavolé A, Monnet I, Étienne-Mastroiani B, Bérard H, Zalcman G, Domas J, Pichon E, Janicot H, Pérol M, Schott R, Vaylet F, Genet D, Moro-Sibilot D, Fournel P, Falchero L, Amador ML, Scherpereel A. AVAPERL : essai randomisé comparant bevacizumab (BEV)+pemetrexed (PEM) versus BEV en traitement (TRT) de maintenance (MTC) après une chimiothérapie (CT) par CDDP/PEM/BEV chez les patients (pts) avec cancer bronchique non à petites cellules non épide. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.048] [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]
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Monteil J, Maubon A, Leobon S, Roux S, Marin B, Renaudie J, Genet D, Fermeaux V, Aubard Y, Tubiana-Mathieu N. Lymph node assessment with (18)F-FDG-PET and MRI in uterine cervical cancer. Anticancer Res 2011; 31:3865-3871. [PMID: 22110211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND To assess pelvic (P) and/or paraaortic (PA) lymph node (LN) involvement in patients with primary stage IA-IVA cervical cancer, (18)F-fluorodeoxyglucose (FDG)-PET, and MRI were compared with histological results. MATERIALS AND METHODS Forty patients were prospectively evaluated. Twenty-eight patients underwent radio-chemotherapy (RT-CT) after initial staging and lymph node dissection (LND). RESULTS PLN metastases were present in 6/31 patients. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) and accuracy in detecting PLN metastases were 67%, 84%, 50%, 91% and 81%, with MRI, and 33%, 92%, 50%, 85% and 81%, with FDG-PET. PALN metastases were present in 5/27 patients. Sensitivity, specificity, PPV, NPV and accuracy were 60%, 73%, 33%, 89% and 70% with MRI and 100%, 77%, 50%, 100% and 81% with FDG-PET in detecting PALN metastasis. CONCLUSION FDG-PET is less accurate than MRI for PLN, but more accurate for PALN; FDG-PET cannot replace PA surgical procedures, but could guide them.
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Affiliation(s)
- Jacques Monteil
- Department of Nuclear Medicine, University Hospital, Limoges, France
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Innominato PF, Focan C, Gorlia T, Moreau T, Garufi C, Waterhouse J, Giacchetti S, Coudert B, Iacobelli S, Genet D, Tampellini M, Chollet P, Lentz MA, Mormont MC, Lévi F, Bjarnason GA. Circadian rhythm in rest and activity: a biological correlate of quality of life and a predictor of survival in patients with metastatic colorectal cancer. Cancer Res 2009; 69:4700-7. [PMID: 19470769 DOI: 10.1158/0008-5472.can-08-4747] [Citation(s) in RCA: 158] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The rest-activity circadian rhythm (CircAct) reflects the function of the circadian timing system. In a prior single-institution study, the extent of CircAct perturbation independently predicted for survival and tumor response in 192 patients receiving chemotherapy for metastatic colorectal cancer. Moreover, the main CircAct parameters correlated with several health-related quality of life (HRQoL) scales. In this prospective study, we attempted to extend these results to an independent cohort of chemotherapy-naive metastatic colorectal cancer patients participating in an international randomized phase III trial (European Organisation for Research and Treatment of Cancer 05963). Patients were randomized to receive chronomodulated or conventional infusion of 5-fluorouracil, leucovorin, and oxaliplatin as first-line treatment for metastatic colorectal cancer. Patients from nine institutions completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and wore a wrist accelerometer (actigraph) for 3 days before chemotherapy delivery. Two validated parameters (I<O and r24) were used to estimate CircAct. Of 130 patients with baseline CircAct assessments, 96 had baseline HRQoL data. I<O was confirmed to correlate with global quality of life, physical functioning, social functioning, fatigue, and appetite loss (r > |0.25|; P < 0.01). I<O further independently predicted for overall survival with a hazard ratio of 0.94 (P < 0.0001). The associations between CircAct parameters, HRQoL, and survival, which were shown in this international study involving previously untreated metastatic colorectal cancer patients, confirm prior single-institution findings in mostly pretreated metastatic colorectal cancer patients. The circadian timing system constitutes a novel therapeutic target. Interventions that normalize circadian timing system dysfunction may affect quality of life and survival in cancer patients.
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Le Brun-Ly V, Martin J, Venat-Bouvet L, Darodes N, Labourey JL, Genet D, Tubiana-Mathieu N. Cardiac Toxicity with Capecitabine, Vinorelbine and Trastuzumab Therapy: Case Report and Review of Fluoropyrimidine-Related Cardiotoxicity. Oncology 2009; 76:322-5. [DOI: 10.1159/000209336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2008] [Accepted: 09/13/2008] [Indexed: 11/19/2022]
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Coudert B, Focan C, Genet D, Giacchetti S, Cvickovic F, Zambelli A, Fillet G, Chollet P, Amoroso D, Van Der Auwera J, Lentz MA, Marreaud S, Baron B, Gorlia T, Biville F, Lévi F. A randomized multicenter study of optimal circadian time of vinorelbine combined with chronomodulated 5-fluorouracil in pretreated metastatic breast cancer patients: EORTC trial 05971. Chronobiol Int 2009; 25:680-96. [PMID: 18780198 DOI: 10.1080/07420520802384036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Studies in animals synchronized with an alternation of 12 h of light and 12 h of darkness have showed that hematological and systemic toxicities could be reduced if vinorelbine were administered 19 or 23 hours after light onset (HALO), corresponding to 17:00 and 21:00 h in diurnally active humans. This trial aimed to define the least toxic time of vinorelbine administration in metastatic breast cancer patients. Initially, the study treatment consisted of three courses of vinorelbine of 30 mg/m(2)/d on D1 and D6 and chronomodulated 5-fluorouracil of 850 mg/m(2) from D2 to D5 every 21 days. Ninety metastatic breast cancer patients were randomized to receive vinorelbine at one of the eight possible dosing times. Further to the recommendations of the Independent Data Monitoring Committee, the vinorelbine dose was reduced to 25 mg/m(2)/d midway through the study. The primary objective of the study was detection of the least toxic time based on the incidence of grade 3-4 (G3-4) neutropenia. To show a significant result, the 90% confidence interval width of the least toxic time had to be<6 h. The least toxic time detection based on the incidence of other toxicities was also analyzed. The time of least drug toxic was estimated using a logistic regression model assuming that the logit transformation of the toxicity rate follows a sinusoidal distribution over 24 h. The bootstrap technique was used to obtain the 90% confidence interval. The least toxic time of G3-4 neutropenia was observed at 21:00 h with a non-significant 90% CI. Secondary endpoint analyses indicated the least toxic time could differ when based on other toxicity parameters (e.g., a significant least toxic time of 17:00 h was observed for G3-4 leucopenia), in agreement with animal data. The least toxic time of 10:30 h was estimated for any G3-4 gastrointestinal toxicity. This results of this study do not allow us to recommend an optimal time for vinorelbine administration. It has highlighted, however, the inherent methodological difficulties in the conduct of such a trial in the human setting. It indicates that future optimal time-finding trials should have tolerability and/or activity as the primary endpoint in place of a particular toxicity. The randomized optimal time-finding design may be used to identify the best time of chemotherapy administration.
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Affiliation(s)
- Bruno Coudert
- Centre Georges Francois Leclerc and IFR100, Dijon, France
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Kapella M, Genet D, Pech de Laclause B, Durand-Fontanier S, Lachachi M, Fabre A, Valleix D, Descottes B. Métastase surranélienne : survie après chirurgie d’exérèse. ACTA ACUST UNITED AC 2008; 145:346-9. [DOI: 10.1016/s0021-7697(08)74314-x] [Citation(s) in RCA: 5] [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]
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Efficace F, Innominato PF, Bjarnason G, Coens C, Humblet Y, Tumolo S, Genet D, Tampellini M, Bottomley A, Garufi C, Focan C, Giacchetti S, Lévi F. Validation of Patient's Self-Reported Social Functioning As an Independent Prognostic Factor for Survival in Metastatic Colorectal Cancer Patients: Results of an International Study by the Chronotherapy Group of the European Organisation for Research and Treatment of Cancer. J Clin Oncol 2008; 26:2020-6. [DOI: 10.1200/jco.2007.12.3117] [Citation(s) in RCA: 74] [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: 01/23/2023] Open
Abstract
Purpose A recent study identified a prognostic model for survival in metastatic colorectal cancer patients which included WBC count, alkaline phosphatase (AP), number of metastatic sites, and patients’ self-reported social functioning. The aim of this research is to validate this model on data from an independent sample. Patients and Methods This validation study is based on a prospective randomized controlled trial in patients with metastatic colorectal cancer conducted by the European Organisation for Research and Treatment of Cancer (EORTC) Chronotherapy Group. Overall, 564 patients in 10 countries were enrolled. For the purpose of this independent validation, patients with health-related quality of life (HRQOL) baseline data were analyzed. HRQOL was assessed using the EORTC Quality of Life Questionnaire C30 (QLQ-C30). The Cox proportional hazards regression model was used for both univariate and multivariate analyses of survival. Results The previous model with an additional adjustment, by stratification for sex, was replicated and its parameters were confirmed to independently predict survival: WBC count with an hazard ratio (HR) of 1.31 (95% CI, 1.021 to 1.698; P = .034); AP with an HR of 1.53 (95% CI, 1.188 to 1.979; P = .001); number of sites involved with an HR of 1.90 (95% CI, 1.531 to 2.364; P < .0001); and patients’ self-reported social functioning with an HR of 0.94 (95% CI, 0.905 to 0.976; P = .001). The latter translates into a 6% increase in the likelihood of an earlier death for every 10-point decrease in the social functioning scale of the EORTC QLQ-C30. Conclusion This study provides confirmatory evidence of the independent prognostic value of patients’ self-reported social functioning in patients with advanced colorectal cancer.
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Affiliation(s)
- Fabio Efficace
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Pasquale F. Innominato
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Georg Bjarnason
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Corneel Coens
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Yves Humblet
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Salvatore Tumolo
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Dominique Genet
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Marco Tampellini
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Andrew Bottomley
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Carlo Garufi
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Christian Focan
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Sylvie Giacchetti
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
| | - Francis Lévi
- From the European Organisation for Research and Treatment of Cancer Data Center, Quality of Life Unit; Hôpital Universitaire St-Luc, Université Catholique de Louvain, Brussels; Centre Hospitalier Chrétien-Clinique Saint-Joseph, Departement d'Oncologie Medicale, Liege, Belgium; Institut National de la Santé et de la Recherche Médicale, U776, Rythmes Biologiques et Cancers; Assistance Publique-Hôpitaux de Paris, Unité de Chronothérapie, Département de Cancérologie, Hôpital Paul Brousse, Villejuif
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Genet D, Lejeune C, Bonnier P, Aubard Y, Venat-Bouvet L, Adjadj DJ, Martin J, Labourey JL, Benyoub A, Clavère P, Lebrun-Ly V, Juin P, Piana L, Tubiana-Mathieu N. Concomitant intensive chemoradiotherapy induction in non-metastatic inflammatory breast cancer: long-term follow-up. Br J Cancer 2007; 97:883-7. [PMID: 17876327 PMCID: PMC2360400 DOI: 10.1038/sj.bjc.6603987] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to evaluate with a long follow-up the efficacy of concomitant chemoradiotherapy in non-metastatic inflammatory breast cancer (IBC) and to evaluate the breast conservation rate. Between 1990 and 2000, 66 non-metastatic patients with IBC were treated with chemotherapy and concomitant irradiation. The induction chemotherapy consisted of epirubicine, cyclophosphamide and vindesine, in association with split-course bi-fractionated irradiation to a total dose of 65 Gy with concomitant cisplatin and 5-fluorouracil. Maintenance chemotherapy consisted of high-dose methotrexate and six cycles of epirubicine, cyclophosphamide and fluorouracil. Hormonal treatment was given if indicated. Mastectomy was not systemic. Among 65 evaluable patients, 57 (87.6%) achieved a complete clinical response and had a breast conservation. Only six loco regional relapses were noted in six patients with a delay of 20 months and with concomitant metastatic dissemination in four cases. Median disease-free survival (DFS) was 28 months. Median overall survival (OS) was 63 months and median follow-up was 55.5 months. Induction chemotherapy and concomitant irradiation is feasible in patients with IBC, permitting a breast conservation with a high rate of local control with an OS comparable to that of the best recent series.
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MESH Headings
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/radiotherapy
- Cisplatin/administration & dosage
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Disease-Free Survival
- Dose Fractionation, Radiation
- Epirubicin/administration & dosage
- Female
- Fluorouracil/administration & dosage
- Follow-Up Studies
- Humans
- Menopause
- Middle Aged
- Remission Induction
- Survival Rate
- Time Factors
- Treatment Outcome
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Affiliation(s)
- D Genet
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - C Lejeune
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - P Bonnier
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - Y Aubard
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - L Venat-Bouvet
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - D J Adjadj
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - J Martin
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - J L Labourey
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - A Benyoub
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - P Clavère
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - V Lebrun-Ly
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - P Juin
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - L Piana
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - N Tubiana-Mathieu
- Department of medical oncology, CHU Dupuytren, Limoges, France
- E-mail:
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Eymard JC, Priou F, Zannetti A, Ravaud A, Lepillé D, Kerbrat P, Gomez P, Paule B, Genet D, Hérait P, Ecstein-Fraïssé E, Joly F. Randomized phase II study of docetaxel plus estramustine and single-agent docetaxel in patients with metastatic hormone-refractory prostate cancer. Ann Oncol 2007; 18:1064-70. [PMID: 17434899 DOI: 10.1093/annonc/mdm083] [Citation(s) in RCA: 47] [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: 11/14/2022] Open
Abstract
BACKGROUND Docetaxel (Taxotere)-based regimens are the new standard therapy in advanced hormone-refractory prostate cancer (HRPC). A synergistic activity has been shown with docetaxel in combination with estramustine in vitro; however, the benefit of this combination remains controversial in clinical practice. We assessed the activity and safety of docetaxel alone and docetaxel-estramustine in HRPC. PATIENTS AND METHODS Patients (n = 92) with metastatic HRPC and rising prostate-specific antigen (PSA) while receiving androgen suppression were randomized to 3-weekly treatment with either docetaxel 75 mg/m(2), day 1 (D), or docetaxel 70 mg/m(2), day 2, plus oral estramustine 280 mg twice daily, days 1-5 (DE). RESULTS Ninety-one patients were treated (DE 47, D 44). A PSA response occurred in 68% (primary endpoint met) and 30% of patients, respectively. Median PSA response duration was 6.0 months in both groups. Median time to progression was 5.7 and 2.9 months, and median survival was 19.3 and 17.8 months in the DE and D arms, respectively. Hematologic and non-hematologic toxic effects were mild and similar in both arms. One patient in each group withdrew due to toxicity. Quality of life was similar in both groups. CONCLUSION Combining estramustine with docetaxel in this schedule is an active and well-tolerated treatment option in HRPC.
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Martin J, Labrousse A, Lebrun-Ly V, Labourey J, Genet D, Tubiana-Mathieu N. 24 Implications of oncogeriatric assessment in treatment decision of cancer in elderly. Crit Rev Oncol Hematol 2006. [DOI: 10.1016/s1040-8428(13)70095-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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39
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Rabinovitch-Chable H, Durand K, Genet D, Marin B, Dzugan H, Léobon S, Tubiana-Mathieu N, Preux PM, Paraf F, Cook-Moreau J, Sturtz FG. Logistic regression model of the clinical response to 5-fluorouracil based chemotherapy for metastatic colorectal cancer patients. Anticancer Res 2006; 26:3885-92. [PMID: 17094418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Several genes have been involved in drug resistance but none are currently used in the drug decision process. To address this problem, mRNA levels were measured for the 5-fluorouracil metabolism-related genes, thymidylate synthase, thymidine phosphorylase and dihydropyrimidine dehydrogenase in tumor samples of 40 patients with synchronous metastatic colon cancer by quantitative RT-PCR. Drug response and overall survival were also obtained for each patient. A logistic regression model was defined to calculate a response predicting score (RPS) with gene expression levels. This RPS split responders from nonresponders as, at the best statistical threshold (0.35), the area of receiver operating characteristic (ROC) curve established with this method was 0.82 and sensitivity and specificity were respectively 100% and 65.4%. Furthermore patients with scores above 0.35 tended to have better overall survival than those with a score less than 0.35 (p = 0.09).
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Giacchetti S, Bjarnason G, Garufi C, Genet D, Iacobelli S, Tampellini M, Smaaland R, Focan C, Coudert B, Humblet Y, Canon JL, Adenis A, Lo Re G, Carvalho C, Schueller J, Anciaux N, Lentz MA, Baron B, Gorlia T, Lévi F. Phase III trial comparing 4-day chronomodulated therapy versus 2-day conventional delivery of fluorouracil, leucovorin, and oxaliplatin as first-line chemotherapy of metastatic colorectal cancer: the European Organisation for Research and Treatment of Cancer Chronotherapy Group. J Clin Oncol 2006; 24:3562-9. [PMID: 16877722 DOI: 10.1200/jco.2006.06.1440] [Citation(s) in RCA: 161] [Impact Index Per Article: 8.9] [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: 01/08/2023] Open
Abstract
PURPOSE In two previous randomized trials, the adjustment of chemotherapy delivery to circadian rhythms improved tolerability and anticancer activity compared with constant-rate infusion during 5 days in patients with metastatic colorectal cancer. PATIENTS AND METHODS For this multicenter randomized trial, it was hypothesized that a chronomodulated infusion of fluorouracil, leucovorin, and oxaliplatin for 4 days (chronoFLO4) would improve survival by 10% compared with conventional 2-day delivery of the same drugs (FOLFOX2). Patients were treated every 2 weeks with intrapatient dose escalation. RESULTS Baseline characteristics were similar in both arms for the 564 patients (36 institutions, 10 countries). Median survival was 19.6 months (95% confidence limit [CL] = 18.2, 21.2) with chronoFLO4 and 18.7 months with FOLFOX2 (95% CL = 17.7, 21.0; P = .55). The main dose-limiting toxicities were diarrhea for chronoFLO4 and neutropenia for FOLFOX2. The analysis of survival predictors showed that sex was the single most important factor (P = .001). In women, the risk of an earlier death with chronoFLO4 was increased by 38% compared with FOLFOX2, with median survival times of 16.3 and 19.1 months (P = .03), respectively. In men, the risk of death was decreased by 25% with chronoFLO4 compared with FOLFOX2, with median survival times of 21.4 and 18.3 months (P = .02), respectively. CONCLUSION Both regimens achieved similar median survival times more than 18 months with an acceptable toxicity. The chronomodulated schedule produced a survival advantage over FOLFOX in men. The strong sex dependency of optimal scheduling of fluorouracil, leucovorin, and oxaliplatin calls for translational investigations of determinants related to the patient's molecular clock.
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Planchard D, Bourgeois H, Adoun M, Paitel JF, Blanc P, Genet D, Ferru A, Meurice JC, Deletage C, Tourani JM. Gemcitabine, ifosfamide, and cisplatin combination (GIP) in treatment of patients with locally advanced or metastatic nonsmall cell lung cancer: results of a phase II study. Am J Clin Oncol 2006; 29:345-51. [PMID: 16891860 DOI: 10.1097/01.coc.0000221320.81753.a9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We have carried out a phase II study to evaluate the efficacy and the toxicity associated with the combination of gemcitabine, ifosfamide, and cisplatin (GIP) in chemotherapy-naive patients with advanced nonsmall cell lung cancer (NSCLC). METHODS Each cycle consisted of treatment with ifosfamide (3000 mg/m2) and gemcitabine (1500 mg/m2) on day 1, followed by cisplatin (100 mg/m2) and gemcitabine (1500 mg/m2) on day 15. Each treatment cycle was repeated every 28 days. A maximum of 6 cycles were administered. RESULTS Sixty NSCLC patients (23 stage III and 37 stage IV) were entered in this study. The median survival for all patients is 9 months (stage III: 12.3 months; stage IV: 7.5 months). The overall survival at 1 and 2 years is 38% and 17%, respectively (52% and 30% for stage III; 30% and 8% for stage IV). The median time to progression is 6.3 months (stage III: 8.8 months; stage IV: 3.6 months). Progression free survival at 1 and 2 years for all patients is 22% and 8%. The response rate is 56% for patients with stage III disease and 27% for patients with stage IV disease. Among the grade 3/4 toxicities, hematological toxicity was the most frequent (59% of patients) followed by gastrointestinal toxicity (nausea/vomiting) in 21% of patients. CONCLUSION The GIP combination yields an efficacy, in terms of response and survival, comparable to that reported with other triplet combination treatments for local advanced or metastatic NSCLC, with an acceptable toxicity profile.
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Affiliation(s)
- David Planchard
- Pneumology Unit, University Hospital of Poitiers, Poitiers, France.
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Coudert B, Focan C, Genet D, Giacchetti S, Lentz M, Marreaud S, Baron B, Gorlia T, Lévi F. Optimal circadian time of vinorelbine (V) combined with chronomodulated 5-FU in pretreated metastatic breast cancer patients. EORTC 05971 randomized multicenter study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.2066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2066 Background: Chronotherapy is an aim to increase efficacy/toxicity ratio. Objectives: to define the dosing least toxic time (DLTT) of V (30 mg/m2/d at D1 and D6), combined with chrono 5-FU (10 pm-10 am) (850 mg/m2 D2-D5) over 3 courses q3w. Methods: A logistic regression model (LRM) estimated the DLTT assuming a sinusoidal distribution over time (i.e. over the 8 different arms) of the toxicity rate observed in each arm. The associated 90% confidence limits (CL) has been obtained by bootstrap method. Results: 90 patients were recruited. Toxicity in 46 pts led to the V dosage reduction to 25 mg/m2/d. 40 and 43 pts were assigned the V30 and the V25 regimen. 12% pts went off for toxicity, 5% for PD, 1% for refusal, 1% for unrelated death. 224 cycles were analyzed . V and 5FU relative dose intensities were 79.4% and 78.2% in the V30 while 88.1% and 87.4% in the V25 pts. Over the 3 cycles, toxicity by cycle was: Grade (G) 3 and G4 leucopenia in 47% and 29%, G3 and G4 neutropenia in 12% and 77%. G3 febrile neutropenia in 34%. G2 thrombopenia and anemia in 4% each. Other G3 and G 4 toxicity were stomatitis (12%), alopecia (7%), and less than 5%: cardiovascular, lethargy, diarrhea, constipation, other gastrointestinal, infection, sensory, pulmonary. LRM could not demonstrate a DLTT for the neutropenia G3–4 incidence, the primary endpoint. However, based on the stratified by dose analysis, a 90% CI of less than 6 hours width was observed: - around 17H17 [14H04–20H03] for the incidence of leucopenia G3–4. - around 8H16 [06H04–10H39] for tolerability (dose reduction, dose delay or treatment interruption for toxicity reason). This suggests that treatment tolerability was influenced by other factors beside leucopenia nadir. No other 90% CI of less than 6 hours width could be observed for other toxicity endpoints. Conclusions: Using a novel time finding study design with ad hoc statistics, this first randomized multicenter study has determined a DLTT for Vinorelbine in 90 women with MBC. Additional studies are ongoing to further assess the relevance of this trial design method that could prove useful for improving the safety of anticancer drugs during their clinical development. Support Pierre Fabre Oncology, Ligue Bourguignonne contre le Cancer No significant financial relationships to disclose.
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Affiliation(s)
- B. Coudert
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
| | - C. Focan
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
| | - D. Genet
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
| | - S. Giacchetti
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
| | - M. Lentz
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
| | - S. Marreaud
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
| | - B. Baron
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
| | - T. Gorlia
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
| | - F. Lévi
- Centre François Leclerc, Dijon, France; Centre Hospitalier St. Joseph, Liege, Belgium; CHU de Limoges, Limoges, France; CHU de St Louis, Paris, France; EORTC Data Center, Brussels, Belgium; CHU Paul Brousse, Paris, France
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Durand-Faucher K, Rabinovitch-Chable H, Dzugan H, Charret S, Aubry K, Genet D, Léobon S, Tubiana-Mathieu N, Cook-Moreau J, Rigaud M, Sturtz FG. A quantitative RT-PCR method to determine topoisomerase I mRNA levels in human tissue samples. Clin Chem Lab Med 2005; 43:707-14. [PMID: 16207129 DOI: 10.1515/cclm.2005.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/15/2022]
Abstract
DNA topoisomerase I (Topo I) is involved in DNA replication, transcription, recombination and repair. Clinical interest has focused on Topo I as it is the molecular target of camptothecin (CPT), used in first and second lines of treatment for different cancer types. Furthermore, it is well demonstrated that the patients who best responded to CPT-based chemotherapy were generally those with the greatest tumoral Topo I expression and/or activity. We developed a sensitive, simple and reproducible method to measure Topo I mRNA expression in human cancer samples. Experiments were performed in two steps. First, we checked the accuracy of the reverse transcription-polymerase chain reaction (RT-PCR) method by testing intra- and interassay reproducibility of Topo I and G6PDH gene amplification in different cell types. We observed that crossing-points (Cps) were different, depending on the cell type, dilution or cDNA concentration, but that the intra- and interassay Cp standard deviation (SD) never exceeded 0.77% and 1.39% for Topo I amplification, or 1.63% and 2.9% for G6PDH amplification, respectively. Secondly, we used our method to measure Topo I mRNA levels in primary tumor samples obtained from 27 patients with advanced colorectal cancer and 10 patients with pharyngeal/laryngeal cancer. The accuracy of G6PDH as a housekeeping gene was tested by analyzing its correlation with the mRNA level of a second housekeeping gene, porphobilinogen deaminase (PBG-D) in the tumoral samples. We found that the normalized Topo I/G6PDH mRNA ratios were significantly correlated with that of Topo I/PBGD in colorectal tumors (r(2)=0.47, p=0.02) but not in pharyngeal/laryngeal tumors (r(2)=0.35, p=0.3). Neither ratio showed any significant association with clinicopathological parameters, such as gender, age, tumor size, or grade and lymph node status. We believe that RT-PCR is a reliable and highly reproducible technique. However, the choice of the reference gene is an important point and must be defined based on the samples studied.
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Genet D, Cupissol D, Calais G, Bontemps P, Bourgeois H, Dutin JP, Philippi MH, Bendahmane B, Mallard-Carre M, Tubiana-Mathieu N. Docetaxel Plus 5-Fluorouracil in Locally Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck. Am J Clin Oncol 2004; 27:472-6. [PMID: 15596913 DOI: 10.1097/01.coc.0000136017.13633.b0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [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: 11/26/2022]
Abstract
This phase II study evaluated docetaxel-5-fluorouracil (5-FU) in locally recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN). Patients were divided into 2 cohorts--those previously treated with chemotherapy and those nonpretreated--that received docetaxel 75 mg/m2 (day 1) plus 5-FU 1,000 mg/m2/day (days 1-5 every 3 weeks). Of 63 patients entered, 20 (31.7%) were pretreated and 43 (68.3%) were nonpretreated. Fifty-nine patients (93.7%) had received prior radiotherapy. After inclusion of 20 patients, the 5-FU dose was reduced to 750 mg/m2/day due to unacceptable toxicity. The overall response rate (ORR) was 20.6% on radiologic review (22.2%, investigator assessment). Pretreated patients achieved an ORR of 25.0% versus 18.6% for nonpretreated patients. This unexpected finding was partly attributed to differences in patient characteristics between the groups. Overall major grade 3 to 4 toxicities comprised neutropenia (66.6%), febrile neutropenia (31.7%), and mucositis (31.7%). Grade 3 to 4 toxicities were lower at the reduced 5-FU dose (750 mg/m2/day): Febrile neutropenia declined from 40.0% to 27.9%; mucositis declined from 55.0% to 20.9%. Three treatment-related deaths occurred (2 with 5-FU 750 mg/m2/day, 1 with 5-FU 1,000 mg/m2/day). Docetaxel-5-FU appears active in locally recurrent and/or metastatic SCCHN with acceptable toxicity at the dose of 5-FU 750 mg/m2.
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Affiliation(s)
- Dominique Genet
- Department of Medical Oncology, CHU Dupuytren, Limoges, France.
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Vénat-Bouvet L, Desfougères M, Aubard Y, Mollard J, Fermeaux V, Genet D, Labourey JL, Martin J, Lebrun-Ly V, Maubon A, Tubiana-Mathieu N. [MRI evaluation of primary chemotherapy response in breast cancer]. Bull Cancer 2004; 91:721-8. [PMID: 15544998] [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] [Received: 03/16/2004] [Accepted: 08/09/2004] [Indexed: 05/01/2023]
Abstract
The aim of this work was to evaluate the value of contrast enhanced MRI for determination of response to neoadjuvant chemotherapy (type FEC) in breast cancer according to two parameters: size of the enhancing tumor and the maximum relative enhancement curve (MRC) in the same tumor area. Twenty women with breast cancer (15 invasive ductal carcinomas and 5 invasive lobular carcinomas) T2 (n = 8) or T3 (n = 12) were evaluated by physical examination and MRI after a minimal of three courses of FEC and prior to surgery. Data from physical examination and imaging studies were compared to histopathological findings. Physical examination estimated correctly the residual tumor size in 45% of cases and MRI in 60% with 3 false negative cases. Among evaluated patients with MRI measurable residual tumor, tumor size was underestimated in 69% of the cases and overestimated in 31% of the cases. A MRC flattening was observed in 5 cases among the patients with a partial response or clinical stable disease correlated with a poor cellular density in the microscopic findings. MRI monitoring of chemotherapy response can be useful for guiding surgery. Therefore, underestimation of the residual tumor size and false negative rate are remaining problems.
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Levi FA, Tubiana-Mathieu N, Focan C, Brézault-Bonnet C, Coudert B, Carvalho C, Genet D, Giacchetti S, Lentz MA, Baron B. Chronomodulated ( Chrono) vs constant ( Cst) rate infusional 5-fluorouracil (FU) with or without cisplatin (CDDP) in patients with advanced or metastatic pancreatic cancer. A multicenter randomized trial of the Chronotherapy Group of the European Organisation for Research and Treatment of Cancer (EORTC 05962). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- F. A. Levi
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - N. Tubiana-Mathieu
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - C. Focan
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - C. Brézault-Bonnet
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - B. Coudert
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - C. Carvalho
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - D. Genet
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - S. Giacchetti
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - M.-A. Lentz
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
| | - B. Baron
- Hôpital Paul Brousse & INSERM, Villejuif, France; Centre Hospitalier Universitaire Dupuytren, Limoges, France; Les Cliniques St Joseph, Liège, Belgium; Hôpital Cochin, Paris, France; Centre Georges-François Leclerc, Dijon, France; Hospital Fernando Fonseca, Amadora (Lisboa), Portugal; EORTC, Brussels, Belgium
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Labourey JL, Lacroix P, Genet D, Gobeaux F, Martin J, Venat-Bouvet L, Lavau-Denes S, Maubon A, Tubiana-Mathieu N. Thrombotic complications of implanted central venous access devices: prospective evaluation. Bull Cancer 2004; 91:431-6. [PMID: 15281282] [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: 04/30/2023]
Abstract
Implanted venous access devices (IVAD) are routinely used in oncologic patients. Thrombotic complication is a source of morbidity. During one year 246 patients with different solid neoplastic diseases received IVAD for chemotherapy administration. Two hundred forty-nine IVAD were placed percutaneously or by surgical cutdown. IVAD were flushed immediately after implantation with 3-5 mL of heparinized saline (100 U/mL). No monthly flush was required. A prospective evaluation of thrombotic complications was realised. in event of catheter dysfunction and/or clinical symptoms of phlebitis, a catheter opacification and/or a Doppler ultrasonography were performed. Twenty-three catheter dysfunctions were noted, corresponding to 13 catheter occlusions. Twelve patients presented clinical symptoms of phlebitis. Eleven venous thrombosis were diagnosed in this group; 10 by echo-Doppler and one by scanography. A unvaried statistic analysis using Fisher's test was performed to detect risk factors. Two factors were identified: the position of catheter tip above T4 (p < 0.001) and mediastinal or cervical lymph nodes larger than 6 cm (p < 0.001). The first increased the risk of catheter occlusion and the second increased the risk of phlebitis.
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Mathieu NT, Genet D, Labrousse F, Bouillet P, Denes SL, Martin J, Labourey JL, Venat L, Clavere P, Moreau JJ. Pre-irradiation chemotherapy for newly diagnosed high grade astrocytoma. Anticancer Res 2004; 24:1249-53. [PMID: 15154655] [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: 04/29/2023]
Abstract
The purpose of this work was to determine the response rate and toxicity of a combination of Carmustine and Cisplatin administered before radiation in patients with newly diagnosed high grade astrocytoma. A good response rate has been published with this association in primary cerebral high grade tumor. This protocol was administered in a homogeneous population of 37 adult patients with measurable tumor on magnetic resonance imaging (MRI) or CT scan. After biopsy or subtotal resection, the patients received BCNU 40 mg/m2/d and CODP 40 mg/m2/d, for 3 days every 28 days for 3 cycles. Evaluation was performed before each cycle. Radiation therapy began 4 weeks after completing the chemotherapy or immediately if there was evidence of tumor progression on chemotherapy. Seven out of 37 (19%) demonstrated tumor regression with a median duration to progression of 11 months. Median survival was 6 months. Myelosuppression was the predominant but manageable toxicity. This work indicated that the first chemotherapy protocol gave poor results in a homogeneous group of patients, with bad prognosis.
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Affiliation(s)
- N Tubiana Mathieu
- Department of Medical Oncology and Radiotherapy, CHU Dupuytren, 2 avenue Martin Luther King, 87042 Limoges Cedex, France.
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Bessède JP, Vinh D, Genet D, Khalifa N, Aubry K, Rhein B, Orsel S, Tubiana-Mathieu N, Clavère P. [Induction chemotherapy and laryngeal preservation in pharyngolaryngeal carcinomas. Study of a 124 serie's patients and patient's follow up with laryngeal preservation]. Rev Laryngol Otol Rhinol (Bord) 2004; 125:81-8. [PMID: 15462166] [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] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To try and determine the value of chemotherapy and its subsequent effect on laryngeal preservation in patients presenting with laryngeal and pharyngeal carcinomas. One group was initially treated with surgery and radiotherapy. The second group was treated with chemotherapy and subsequent salvage surgery and/or radiotherapy. Their survival rates and laryngeal preservation rates were compared. PATIENTS AND METHODS From 251 patients the authors have retrospectively studied 124 patients with induction chemotherapy. The survival rate has been compared with a control group of 127 patients who was treated by initial surgery and radiotherapy. RESULTS The survival rate at 5 years for the patients initially treated by surgery and radiotherapy was 64.1%. The survival for patients with a total clinical response following chemotherapy was 49.8% at 5 years. Survival with no total clinical response following chemotherapy treated by secondary radiotherapy was 25.7% at 3 years. The initial rate of laryngeal preservation is 32.2% but this rate fell to 22% after local recurrencies. CONCLUSION The group with total clinical response after induction chemotherapy with laryngeal preservation have a non significantly difference in their survival compared with the group initially treated by surgery and radiotherapy. In contrary patients with non complete clinical response have a survival of 25.7% at 3 years. The rate of local recurrency of patients with laryngeal preservation is 32.5% and gives a finally rate of laryngeal preservation of 21%. These recurrencies decrease the survival rate.
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Affiliation(s)
- J P Bessède
- CHU Limoges, Service ORL, 2 Avenue Martin Luther King, 87042 Limoges, France.
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Vénat-Bouvet L, Ly K, Szelag JC, Martin J, Labourey JL, Genet D, Tubiana-Mathieu N. Thrombotic microangiopathy and digital necrosis: two unrecognized toxicities of gemcitabine. Anticancer Drugs 2003; 14:829-32. [PMID: 14597878 DOI: 10.1097/00001813-200311000-00009] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [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: 11/25/2022]
Abstract
We report one new case of hemolytic-uremic syndrome (HUS) and one case of digital necrosis after treatment with gemcitabine (Gemzar). Case 1, a 34-year-old man, was given first-line metastatic treatment with gemcitabine for a adenocarcinoma of the pancreas. After a cumulative dose of 10 000 mg/m2 gemcitabine, the onset of subacute renal failure associated with hemolytic anemia of mechanical origin was observed. A diagnosis of probable gemcitabine-induced thrombotic microangiopathy was arrived at. Symptoms resolved after stopping the chemotherapy, in spite of the progression of the disease. Case 2, a 61-year-old man, was administered a combination of gemcitabine and a platinum salt as first-line metastatic treatment for carcinoma of the bladder urothelium. Following a cumulative dose of 10 000 mg/m2 of gemcitabine, the patient suffered from bilateral peripheral vascular disease of somewhat acute onset with hemorrhagic lesions of the finger pads that became necrotic. The work-up was negative and a causal relationship was attributed to gemcitabine. The patient made good progress when given an i.v. infusion of Ilomedine (iloprost trometamol) and chemotherapy was withdrawn. We conclude that gemcitabine must be added to the list of drugs that cause HUS and necrotizing vasculitis.
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Affiliation(s)
- L Vénat-Bouvet
- Service Oncologie Médicale CHU Dupuytren, Limoges, France.
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