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Chan S, Kudo M, Sangro B, Kelley R, Furuse J, Park JW, Sunpaweravong P, Fasolo A, Yau T, Kawaoka T, Cheng AL, Azevedo S, Reig Monzon M, Assenat E, Yarchoan M, He A, Makowsky M, Gupta C, Negro A, Abou-Alfa G. 67O Outcomes in the Asian subgroup of the phase III HIMALAYA study of tremelimumab (T) plus durvalumab (D) in unresectable hepatocellular carcinoma (uHCC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.103] [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: 12/07/2022] Open
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Chan L, Kudo M, Sangro B, Kelley R, Furuse J, Park JW, Sunpaweravong P, Fasolo A, Yau T, Kawaoka T, Cheng AL, Azevedo S, Reig Monzon M, Assenat E, Yarchoan M, He A, Makowsky M, Ran D, Negro A, Abou-Alfa G. 714P Impact of viral aetiology in the phase III HIMALAYA study of tremelimumab (T) plus durvalumab (D) in unresectable hepatocellular carcinoma (uHCC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Hountondji L, Palassin P, Faure S, Iltache S, Dupuy M, Pageaux G, Faillie J, Lesage C, Negre E, Assenat E, Rullier P, Rivet V, Quantin X, Meunier L, Maria A. Hépatites auto-immunes induites par inhibiteurs de checkpoints : étude observationnelle CHILI. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.256] [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: 10/18/2022]
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Assenat E, de la Fouchardière C, Portales F, Ychou M, Debourdeau A, Desseigne F, Iltache S, Fiess C, Mollevi C, Mazard T. Sequential first-line treatment with nab-paclitaxel/gemcitabine and FOLFIRINOX in metastatic pancreatic adenocarcinoma: GABRINOX phase Ib-II controlled clinical trial. ESMO Open 2021; 6:100318. [PMID: 34837745 PMCID: PMC8637474 DOI: 10.1016/j.esmoop.2021.100318] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Nab-paclitaxel/gemcitabine (AG) and FOLFIRINOX (FFX) are promising drugs in metastatic pancreatic cancer (MPC). This study evaluated a new first-line sequential treatment (AG followed by FFX) in MPC that might overcome resistance to primary therapy and delay tumor progression. PATIENTS AND METHODS Patients with histologically/cytologically confirmed MPC were included in a multicentric trial receiving AG (day 1, 8 and 15) followed by FFX (day 29 and 43). In phase Ib, three dose-levels were tested for maximum tolerated dose (MTD) and recommended phase II dose. In phase II, the main outcome was the objective response rate (ORR) and secondarily safety, progression-free survival (PFS) and overall survival (OS). RESULTS In phase Ib, we included 33 patients (31 assessable) of median age 61.0 years (range 42-75 years) and represented by 54.8% males. Five dose-limiting toxicities were reported without any death. The main grade 3/4 toxicities were neutropenia with spontaneous resolution (35.5%/32.3%), venous thromboembolism (grade 3: 22.6%) and thrombopenia (grade 3: 29.0%), while the MTD was not reached. In phase II, we included 58 patients of median age 60 years (range 34-72 years), 50% males and with Eastern Cooperative Oncology Group stage score 0 and 1 of 37.9% and 62.1%, respectively. They received a median of 4 (1-9) cycles in 8.5 months (0.5-19.8 months). The ORR was 64.9% [95% confidence interval (CI) 51.1% to 77.1%], and neurotoxicity was remarkably low. The main grade 3-4 toxicities were venous thromboembolism, thrombopenia, neutropenia/febrile neutropenia, nausea, diarrhea, weight loss and asthenia without any death. Tumor response was complete in 3.5% and partial in 61.4%, while disease was stable in 19.3% and progressive in 15.8% of patients. The median PFS was 10.5 months (95% CI 6.0-12.5 months) and median OS was 15.1 months (95% CI 10.6-20.1 months). CONCLUSION Sequential AG and FFX showed acceptable toxicity as first-line treatment with no limiting neurotoxicity, while high response rate and survival justify randomized trials.
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Affiliation(s)
- E Assenat
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; CHU Montpellier, University of Montpellier, Montpellier, France.
| | | | - F Portales
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France
| | - M Ychou
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, University of Montpellier, Montpellier, France
| | - A Debourdeau
- CHU Montpellier, University of Montpellier, Montpellier, France
| | - F Desseigne
- Medical Oncology Department, Léon Bérard Centre, Lyon, France
| | - S Iltache
- CHU Montpellier, University of Montpellier, Montpellier, France
| | - C Fiess
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; Clinical Research and Innovation Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France
| | - C Mollevi
- Biometrics Unit, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP), INSERM UMR UA 11, University of Montpellier, Montpellier, France
| | - T Mazard
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, University of Montpellier, Montpellier, France
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Ren Z, Assenat E, Rimassa L, Fang W, Tang B, Chica Duque S, Li V, Wu J, Wang Y, Barnes G. 936P Effects of tislelizumab (TIS) monotherapy on health-related quality of life in patients with previously treated unresectable hepatocellular carcinoma (HCC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.156] [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: 11/15/2022] Open
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Assenat E, Blanc J, Bouattour M, Gauthier L, Touchefeu Y, Portales F, Borg C, Fares N, Mineur L, Bleuse JP, Mazard T. 48P (BREGO) Regorafenib combined with modified m-GEMOX in patients with advanced biliary tract cancer (BTC): A phase II randomized trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Coustal C, Quantin X, Lesage C, Michot J, Laparra A, Ederhy S, Assenat E, Faure M, Issa N, Lambotte O, Puyade M, Dereure O, Rullier P, Serre I, Klouche K, Vernhet H, Faillie J, Roubille F, Guilpain P, Maria A. Facteurs pronostiques des myocardites induites par les inhibiteurs du checkpoint immunologique. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Coustal C, Du-Thanh A, Roubille F, Assenat E, Maria A. Une dermatomyosite inhabituelle sous inhibiteurs du checkpoint immunologique. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.097] [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: 11/24/2022]
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Rivet V, Quantin X, Faillie J, Lesage C, Meunier L, Faure S, Hillaire-Buys D, Lesouder C, Fabre S, Assenat E, Rullier P, Guilpain P, Maria A. Gestion des toxicités induites par les inhibiteurs de checkpoint immunologique : données de la RCP « ToxImmun » en Occitanie Est. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.241] [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: 10/21/2022]
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Rivet V, Quantin X, Faillie JL, Lesage C, Meunier L, Faure S, Hillaire-Buys D, Lesouder C, Fabre S, Assenat E, Rullier P, Guilpain P, Maria ATJ. [Management of immune-related toxicities associated with immune checkpoints inhibitors: Data from the multidisciplinary meeting « ToxImmun » in Eastern Occitania]. Rev Med Interne 2021; 42:310-319. [PMID: 33485701 DOI: 10.1016/j.revmed.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 12/06/2020] [Accepted: 01/01/2021] [Indexed: 10/22/2022]
Abstract
Immune checkpoint inhibitors (ICIs) can cause numerous and complex immune-related adverse events whose management need a multidisciplinary approach. Herein, we investigated 114 requests, mostly concerning patients suffering from lung cancer, that were submitted to the « ToxImmun » multidisciplinary meeting in Eastern Occitania between December the 17th 2018 and January the 20th 2020. The leading reasons for the request concerned the putative causal link between immunotherapy and immune-toxicity and its management, followed by possible retreatment after temporary withdrawn because of adverse event, and finally the possibility to initiate ICIs in patients with pre-existing autoimmunity. Colitis, hepatitis and myocarditis were the most frequent immune-related adverse events (IRAEs), both all grade and grade 3-4. Sicca syndrome (with or without Sjogren criteria) was also frequent (26% of cases) and seems to be associated with severe toxicity and multi-toxicity. The mean time to first IRAE was 3.8 months, a time shortened with the use of anti-PD-L1 agents or ICI combination. A majority of requests came from initial evaluation by the internist confirming the early and main role of this specialty in the management of immunotoxicity. Expansion of this regional multidisciplinary meeting, coordinated by internists and medical oncologists, could improve management of immune-related adverse events for the patients' benefits.
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Affiliation(s)
- V Rivet
- Service de médecine interne : maladies multi-organiques de l'adulte, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Faculté de médecine, université de Montpellier, Montpellier, France
| | - X Quantin
- Faculté de médecine, université de Montpellier, Montpellier, France; Service d'oncologie médicale-oncologie thoracique, institut du cancer de Montpellier, Val d'Aurelle, Montpellier, France
| | - J L Faillie
- Faculté de médecine, université de Montpellier, Montpellier, France; Département de pharmacologie médicale et toxicologie, centre régional de pharmacovigilance, hôpital Lapeyronie, CHRU de Montpellier, Montpellier, France
| | - C Lesage
- Service de dermatologie clinique, hôpital Saint-Éloi, CHRU de Montpellier, Montpellier, France
| | - L Meunier
- Faculté de médecine, université de Montpellier, Montpellier, France; Service d'hépato-gastro-entérologie, hôpital Saint-Éloi, CHRU de Montpellier, Montpellier, France
| | - S Faure
- Service d'hépato-gastro-entérologie, hôpital Saint-Éloi, CHRU de Montpellier, Montpellier, France
| | - D Hillaire-Buys
- Faculté de médecine, université de Montpellier, Montpellier, France; Département de pharmacologie médicale et toxicologie, centre régional de pharmacovigilance, hôpital Lapeyronie, CHRU de Montpellier, Montpellier, France
| | - C Lesouder
- Département de pharmacologie médicale et toxicologie, centre régional de pharmacovigilance, hôpital Lapeyronie, CHRU de Montpellier, Montpellier, France
| | - S Fabre
- Service de médecine interne, clinique Beau-Soleil, Montpellier, France
| | - E Assenat
- Faculté de médecine, université de Montpellier, Montpellier, France; Service d'oncologie médicale, hôpital Saint-Éloi, CHRU de Montpellier, Montpellier, France
| | - P Rullier
- Service de médecine interne : maladies multi-organiques de l'adulte, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - P Guilpain
- Service de médecine interne : maladies multi-organiques de l'adulte, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Faculté de médecine, université de Montpellier, Montpellier, France; IRMB Institute for regenerative medicine and biotherapy, Inserm U1183, hôpital Saint-Éloi, Montpellier, France
| | - A T J Maria
- Service de médecine interne : maladies multi-organiques de l'adulte, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Faculté de médecine, université de Montpellier, Montpellier, France; IRMB Institute for regenerative medicine and biotherapy, Inserm U1183, hôpital Saint-Éloi, Montpellier, France.
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Rafii H, Frère C, Benzidia I, Crichi B, Andre T, Assenat E, Bournet B, Carpentier A, Connault J, Doucet L, Durant C, Emmerich J, Gris JC, Hij A, Le Hello C, Madelaine I, Messas E, Ndour A, Villiers S, Marjanovic Z, Ait Abdallah N, Yannoutsos A, Farge D. Management of cancer-related thrombosis in the era of direct oral anticoagulants: A comprehensive review of the 2019 ITAC-CME clinical practice guidelines. On behalf of the Groupe Francophone Thrombose et Cancer (GFTC). J Med Vasc 2020; 45:28-40. [PMID: 32057323 DOI: 10.1016/j.jdmv.2019.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Venous thromboembolism (VTE) is a common disease complication in cancer patients and the second cause of death after cancer progression. VTE management and prophylaxis are critical in cancer patients, but effective therapy can be challenging because these patients are at higher risk of VTE recurrence and bleeding under anticoagulant treatment. Numerous published studies report inconsistent implementation of existing evidence-based clinical practice guidelines (CPG), including underutilization of thromboprophylaxis, and wide variability in clinical practice patterns across different countries and various practitioners. This review aims to summarize the 2019 ITAC-CME evidence-based CPGs for treatment and prophylaxis of cancer-related VTE, which include recommendations on the use of direct oral anticoagulants specifically in cancer patients. The guidelines underscore the gravity of developing VTE in cancer and recommend the best approaches for treating and preventing cancer-associated VTE, while minimizing unnecessary or over-treatment. Greater adherence to the 2019 ITAC guidelines could substantially decrease the burden of VTE and improve survival of cancer patients.
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Affiliation(s)
- H Rafii
- Eurocord, Équipe 3 EA3518, hôpital Saint-Louis, Université de Paris, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - C Frère
- Inserm UMRS_1166, Department of Haematology, hôpital Pitié-Salpêtrière, Université de Paris, Sorbonne Paris-Cité, AP-HP, Paris, France
| | - I Benzidia
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - B Crichi
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - T Andre
- Hôpital Saint-Antoine, AP-HP, Paris, France
| | - E Assenat
- Montpellier school of Medicine, Saint-Eloi University Hospital, Montpellier, France
| | - B Bournet
- Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | | | | | - L Doucet
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | | | | | - A Hij
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - C Le Hello
- CHU Saint-Étienne, Saint-Étienne, France
| | | | - E Messas
- Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
| | - A Ndour
- Hôpital Saint-Louis, AP-HP, Paris, France
| | - S Villiers
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | - N Ait Abdallah
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | | | - D Farge
- Internal Medicine (UF04), Équipe 3 EA 3518, Autoimmune and Vascular Disease Unit, Saint-Louis Hospital, Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, AP-HP, Sorbonne Paris-Cité, Paris, France; Department of Medicine, McGill University, Montreal, QC, Canada
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Zhu A, Galle P, Llovet J, Finn R, Kang YK, Yen C, Assenat E, Brandi G, Motomura K, Ohno I, Daniele B, Vogel A, Yamashita T, Hsu CH, Meyer T, Widau R, Schelman W, Wang C, Hsu Y, Kudo M. Prognostic and predictive value of baseline alpha-fetoprotein (AFP) in patients with advanced hepatocellular carcinoma (HCC) treated with ramucirumab from two phase III studies (REACH, REACH-2). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Llovet J, Kudo M, Kang YK, Yen CJ, Finn R, Galle P, Assenat E, Motomura K, Okusaka T, Berg T, Hsu CH, Ikeda M, Hsu Y, Liang K, Widau R, Schelman W, O’Brien L, Gao L, Zhu A. Ramucirumab in patients with advanced hepatocellular carcinoma (HCC) and elevated alpha fetoprotein (AFP): An exposure-response analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Kudo M, Galle P, Motomura K, Assenat E, Merle P, Brandi G, Daniele B, Okusaka T, Tomasek J, Borg C, Zagonel V, Morimoto M, Pracht M, Finn R, Llovet J, Homma G, Jen MH, Shinozaki K, Yoshikawa R, Zhu A. Efficacy and safety of ramucirumab (RAM) for advanced hepatocellular carcinoma (HCC) with elevated alpha-fetoprotein (AFP) following first-line sorafenib across age subgroups in two global phase III trials (REACH and REACH-2). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Meyer T, Finn R, Kudo M, Kang Y, Yen C, Galle P, Llovet J, Assenat E, Brandi G, Motomura K, Okusaka T, Hubner R, Karwal M, Baron A, Ikeda M, Liang K, Wang C, Widau R, Schelman W, Zhu A. Ramucirumab in advanced hepatocellular carcinoma and elevated alpha-fetoprotein following sorafenib: outcomes by prior transarterial chemoembolisation from two randomised, double-blind, placebo-controlled phase 3 studies (REACH-2 and REACH). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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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Samalin E, Mazard T, Assenat E, Rouyer M, De la Fouchardière C, Guimbaud R, Smith D, Portales F, Ychou M, Fiess C, de Forges H, Lopez-Crapez E, Thézenas S. Triplet chemotherapy plus cetuximab as first-line treatment in RAS wild-type metastatic colorectal carcinoma patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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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Exposito MJ, Akce M, Alvarez J, Assenat E, Balart L, Baron A, Decaens T, Heurgue-Berlot A, Martin A, Paik S, Poulart V, Sehbai A, Shimada M, Takemura N, Yoon J. Abstract No. 526 CheckMate-9DX: phase 3, randomized, double-blind study of adjuvant nivolumab vs placebo for patients with hepatocellular carcinoma (HCC) at high risk of recurrence after curative resection or ablation. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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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Jimenez Exposito M, Akce M, Alvarez J, Assenat E, Balart L, Baron A, Decaens T, Heurgue-Berlot A, Martin A, Paik S, Poulart V, Sehbai A, Shimada M, Takemura N, Yoon JH. CA209-9DX: Phase III, randomized, double-blind study of adjuvant nivolumab vs placebo for patients with hepatocellular carcinoma (HCC) at high risk of recurrence after curative resection or ablation. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy432.059] [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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Decaens T, Barone C, Assenat E, Wermke M, Fasolo A, Merle P, Blanc JF, Grando V, Bruns R, Straub J, Zhao C, Faivre S. Efficacy and safety of the Met inhibitor tepotinib in patients (pts) with advanced Met+ hepatocellular carcinoma (HCC) previously treated with sorafenib. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy432.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mazard T, Ghiringhelli F, Mollevi C, Assenat E, Gavoille C, Smith D, Pezzella V, Meddeb R, Pastor B, Ychou M, Thierry A. UCGI 28 Panirinox: A randomized phase II study assessing Panitumumab + FOLFIRINOX or mFOLFOX6 in RAS and BRAF wild type metastatic colorectal cancer patients (mCRC) selected from circulating DNA analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jimenez Exposito M, Akce M, Montero Alvarez J, Assenat E, Balart L, Baron A, Decaens T, Heurgue-Berlot A, Martin A, Paik S, Poulart V, Sehbai A, Takemura N, Yoon JH. CA209-9DX: phase III, randomized, double-blind study of adjuvant nivolumab vs placebo for patients with hepatocellular carcinoma (HCC) at high risk of recurrence after curative resection or ablation. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Aparicio T, Darut Jouve A, Khemissa F, Montérymard C, Artru P, Cany L, Romano O, Valenza B, Le Foll C, Delbaldo C, Falandry C, Duluc M, Rinaldi Y, Legoux J, Ben Abdelghani M, Assenat E, Dhooge M, Smith D, Des Guetz G, Lepage C. Phase II trial to evaluate efficacy and tolerance of regorafenib monotherapy in patients (pts) over 70 with previously treated metastatic colorectal adenocarcinoma (mCRC) FFCD 1404 - REGOLD. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Prieur A, Kepenekian V, Mazard T, Payen L, Maucourt-Boulch D, Assenat E, Mariani O, Liaud P, Flacelière M, Soulé J, Dayde D, Calattini S, Ychou M, Glehen O, Joubert D, You B. Progastrin, a New Blood Biomarker for Multiple Cancers Allowing a New Strategy for Screening, Early Detection and Monitoring. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.85400] [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
Background: The majority of cancers evolve for years before becoming symptomatic. But once symptomatic, it is often too late for the patients to be cured. It is thus of paramount importance to improve early cancer screening in the general population as well as in genetically predisposed individuals. Moreover, although there is an undeniable progress in treatments, in particular in the immuno-oncology field, there is a growing need for circulating biomarkers to monitor treatment efficacy to better impact patient health and social economics. Aim: Progastrin (PG) is abnormally released in the blood of patients with colorectal cancer (CRC), as the gene coding for PG is a direct target of the WNT/β-catenin oncogenic pathway involved in tumorigenesis of many organs and activated from the very first steps of tumorigenesis, allowing the detection of PG in early stage cancers. The objective was to assess the diagnostic value of PG in a series of different types of cancers (early and advanced stages), as well as the role of PG as a circulating biomarker for treatment follow-up in patients with peritoneal carcinomatosis, a metastatic disease where imaging monitoring is impossible (due to the small size of lesions). Methods: Progastrin was measured in plasma EDTA samples using the ELISA cancerREAD technology. For the evaluation of PG in cancer patients, 673 samples were collected for comparison with 119 healthy volunteers. For the follow-up monitoring, patients were enrolled during management of peritoneal carcinomatosis (before or after neoadjuvant chemotherapy, or surgery). The diagnostic value of PG concentrations at inclusion in 190 GI cancer patients was assessed against 80 control samples. Results: Progastrin was detected in 77% of cancer patients, all cancers combined. The diagnosis area under the ROC curve of PG was 0.9114, P < 0.0001. Sensitivity ranged from 71% (breast cancer) to 87% (skin melanoma). All the 15 different types of cancers tested were positive. Early stage detection was assessed for colorectal and breast cancers with a sensitivity of 62.5% for adenomatous polyps, and 68.2% for stage 0 and I breast cancers. Sensitivity increased up to 82% for stage II colorectal cancer and to 78% for stage II-IV breast cancers. For the follow-up of peritoneal carcinomatosis patients, median PG levels decreased whatever the GI subtype with sequential treatments from 4.4 pM at inclusion time, to 1.3 after adjuvant chemotherapy. A trend for better PFS was observed in patients with PG decline after surgery. Conclusion: Progastrin assay is a simple and inexpensive blood test exhibiting high diagnostic accuracy for multiple gastro-intestinal, gynecologic, skin cancers. It may be used for cancer screening before tumor localization. It also exhibits promising therapeutic monitoring value during treatment in advanced CRC patients. Assessment of PG value as a multitumor screening biomarker, and as a monitoring test, is ongoing.
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Affiliation(s)
| | | | - T. Mazard
- Institut Régional du Cancer de Montpellier, Montpellier, France
| | - L. Payen
- Hospices Civils de Lyon, Pierre-Bénite, France
| | | | | | | | | | | | | | - D. Dayde
- Plateforme de Recherche Clinique Transversale, Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France
| | - S. Calattini
- Plateforme de Recherche Clinique Transversale, Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France
| | - M. Ychou
- Institut Régional du Cancer de Montpellier, Montpellier, France
| | - O. Glehen
- Centre Hospitalier Lyon Sud, Department of Surgical Oncology, Lyon, France
| | | | - B. You
- Les Hospices Civils de Lyon, Lyon, France
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Decaens T, Barone C, Assenat E, Wermke M, Fasolo A, Merle P, Blanc J, Grando V, Bruns R, Straub J, Zhao C, Faivre S. Phase II efficacy and safety data for the MET inhibitor tepotinib in patients (pts) with sorafenib-treated advanced hepatocellular carcinoma (HCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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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25
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Hébuterne X, Besnard I, François E, Bachmann P, Mahamat AA, Assenat E, Akouz FK, Mineur L, Seitz JF, Senesse P, Schneider S. Impact of an early active dietary counselling on grade ≥3 toxicity in patients receiving first-line chemotherapy for metastatic colorectal cancer. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1116] [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: 11/24/2022]
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26
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Cheng A, Abou-Alfa G, Ren Z, Assenat E, Cubillo A, Pluntke S, Rimassa L, Ross P, Wyrwicz L, Hou J, Li C, Wu J, Ducreux M. Efficacy, safety, and pharmacokinetics of the anti-programmed cell death receptor-1 (PD-1) monoclonal antibody, tislelizumab (BGB-A317) in a phase 2, open-label, multicenter study to investigate in patients with unresectable hepatocellular carcinoma - Trial in progress. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.099] [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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27
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Thierry AR, El Messaoudi S, Mollevi C, Raoul JL, Guimbaud R, Pezet D, Artru P, Assenat E, Borg C, Mathonnet M, De La Fouchardière C, Bouché O, Gavoille C, Fiess C, Auzemery B, Meddeb R, Lopez-Crapez E, Sanchez C, Pastor B, Ychou M. Clinical utility of circulating DNA analysis for rapid detection of actionable mutations to select metastatic colorectal patients for anti-EGFR treatment. Ann Oncol 2018; 28:2149-2159. [PMID: 28911069 DOI: 10.1093/annonc/mdx330] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background While tumor-tissue remains the 'gold standard' for genetic analysis in cancer patients, it is challenged with the advent of circulating cell-free tumor DNA (ctDNA) analysis from blood samples. Here, we broaden our previous study on the clinical validation of plasma DNA in metastatic colorectal cancer patients, by evaluating its clinical utility under standard management care. Patients and methods Concordance and data turnaround-time of ctDNA when compared with tumor-tissue analysis were studied in a real-time blinded prospective multicenter clinical study (n = 140 metastatic colorectal patients). Results are presented according to STARD criteria and were discussed in regard with clinical outcomes of patients. Results Much more mutations were found by ctDNA analysis: 59%, 11.8% and 14.4% of the patients were found KRAS, NRAS and BRAF mutant by ctDNA analysis instead of 44%, 8.8% and 7.2% by tumor-tissue analysis. Median tumor-tissue data turnaround-time was 16 days while 2 days for ctDNA analysis. Discordant samples analysis revealed that use of biopsy, long delay between tumor-tissue and blood collection and resection of the tumor at time of blood draw, tumor site, or type of tissue analyzed seem to affect concordance. Altogether, the clinical data with respect to the anti-epidermal growth factor receptor response (RAS status) and the prognosis (BRAF status) of those discordant patients do not appear contradictory to the mutational status as determined by plasma analysis. Lastly, we present the first distribution profile of the RAS and BRAF hotspot mutations as determined by ctDNA analysis (n = 119), revealing a high proportion of patients with multiple mutations (45% of the population and up to 5 mutations) and only 24% of WT scored patients for both genes. Mutation profile as determined from ctDNA analysis with using various detection thresholds highlights the importance of the test sensitivity. Conclusion Our study showed that ctDNA could replace tumor-tissue analysis, and also clinical utility of ctDNA analysis by considerably reducing data turnaround time.
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Affiliation(s)
- A R Thierry
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - S El Messaoudi
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - C Mollevi
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier.,Biometry Unit, Regional Institute of Cancer of Montpellier, Montpellier
| | - J L Raoul
- Department of Medical Oncology, Paoli Calmettes Institute, Marseille
| | - R Guimbaud
- Department of Oncology, University Hospital Center of Toulouse - Hospital Rangueil-Purpan, Toulouse
| | - D Pezet
- Digestive Oncology Unit, Department of Digestive Surgery, University Hospital Center of Clermont-Ferrand, UMR Inserm/Auvergne University U1071, Clermont-Ferrand
| | - P Artru
- Jean-Mermoz Private Hospital, Lyon
| | - E Assenat
- CHRU Montpellier, St. Eloi Hospital, Montpellier
| | - C Borg
- CHRU Jean MINJOZ, Besançon
| | - M Mathonnet
- Digestive Surgery Department, Clinical Investigation Centre, University Hospital Center of Limoges, INSERM 0801, Limoges
| | | | | | - C Gavoille
- Alexis Vautrin Oncology Institute of Lorraine, Nancy
| | - C Fiess
- Digestive Oncology Department, Regional Institute of Cancer of Montpellier, Montpellier, France
| | - B Auzemery
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - R Meddeb
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - E Lopez-Crapez
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - C Sanchez
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - B Pastor
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - M Ychou
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier.,Digestive Oncology Department, Regional Institute of Cancer of Montpellier, Montpellier, France
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Edeline J, Bonnetain F, Phelip JM, Watelet J, Hammel P, Joly JP, Benabdelghani M, Fartoux L, Bouhier-Leporrier K, Jouve JL, Faroux R, Guerin-Meyer V, Assenat E, Seitz JF, Malka D, Louvet C, Bertaut A, Juzyna B, Stanbury T, Boucher E. Adjuvant GEMOX for biliary tract cancer: Updated relapse-free survival and first overall survival results of the randomized PRODIGE 12-ACCORD 18 (UNICANCER GI) phase III trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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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29
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Samalin E, Senellart H, Thezenas S, Jacquot S, Ellis S, Khemissa F, Ramdani M, Portales F, Assenat E, Mazard T, Mineur L, Ychou M. Multicenter randomized phase II trial (BEVATOMOX) assessing the raltitrexed, oxaliplatin and bevacizumab combination versus FOLFOX6 bevacizumab as 2nd line treatment in metastatic colorectal cancer (mCRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.055] [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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30
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Assenat E, Fouchardiere C, Mollevi C, Samalin E, Portales F, Desseigne F, Carenco C, Dupuy M, Lopez-Martinez E, Fiess C, Mazard T, Ychou M. Gabrinox: A phase I-II of nab-paclitaxel plus gemcitabine followed by folfirinox in metastatic pancreatic adenocarcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.71] [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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31
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Samalin E, Thezenas S, Delord JP, Italiano A, Smith D, Portales F, Mazard T, Assenat E, Poujol S, Solassol I, Khier S, Chalbos P, Ychou M. P-161 A phase I-trial assessing several schedules of Oral S-1 combined with fixed doses of Oxaliplatin and Irinotecan in patients with advanced or metastatic digestive adenocarcinoma as first- or second-line treatment. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.161] [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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32
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Assenat E, Delord JP, Thézenas S, Samalin E, Portales F, Sari C, Thirion A, Guimboaud R, Ychou M. P-158 (BREGO) Regorafenib combined with modified (m) GEMOX (Gemcitabine- Oxaliplatin) in patients with advanced biliary tract cancer (BTC): a phase Ib/II randomized trial. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.158] [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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33
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Carenco C, Assenat E, Faure S, Duny Y, Danan G, Bismuth M, Herrero A, Jung B, Ursic-Bedoya J, Jaber S, Larrey D, Navarro F, Pageaux GP. Tacrolimus and the risk of solid cancers after liver transplant: a dose effect relationship. Am J Transplant 2015; 15:678-86. [PMID: 25648361 DOI: 10.1111/ajt.13018] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 09/11/2014] [Accepted: 09/12/2014] [Indexed: 01/25/2023]
Abstract
Although increased rates of solid organ cancers have been reported following liver transplantation (LT), the impact of quantitative exposure to calcineurin inhibitors (CNI) remains unclear. We have therefore probed the relationship between the development of solid organ cancers following LT and the level of CNI exposure. This prospective single-center study was conducted between 1995 and 2008 and is based on 247 tacrolimus-treated liver transplant recipients who survived at least 1 year following surgery. The incidence of cancer was recorded, and the mean blood concentration of tacrolimus (TC) was determined at 1 and 3 years following LT. The study results indicate that 43 (17.4%) patients developed de novo solid cancers. Mean TC during the first year after LT was significantly higher in patients who developed solid organ tumors (10.3 ± 2.1 vs. 7.9 ± 1.9 ng/mL, p < 0.0001). Independent risks factors in multivariate analysis were tobacco consumption before LT (OR = 5.42; 95% CI [1.93-15.2], p = 0.0014) and mean annual TC during the first year after LT (p < 0.0001; OR = 2.01; 95% CI [1.57-2.59], p < 0.0001). Similar effects were observed in 216 patients who received tacrolimus continuously for ≥3 years. It appears therefore that CNI should be used with caution after LT, and that new immunosuppressive therapies could deliver significant clinical benefits in this regard.
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Affiliation(s)
- C Carenco
- Liver Transplantation Unit, Digestive Department, Saint Eloi University Hospital, University of Montpellier I, Montpellier, France
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Mazard T, Ychou M, Thezenas S, Poujol S, Pinguet F, Thirion A, Bleuse JP, Portales F, Samalin E, Assenat E. Feasibility of biweekly combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in patients with metastatic solid tumors: results of a two-step phase I trial: XELIRI and XELIRINOX. Cancer Chemother Pharmacol 2011; 69:807-14. [PMID: 22037922 DOI: 10.1007/s00280-011-1764-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 10/12/2011] [Indexed: 12/27/2022]
Abstract
BACKGROUND Biweekly schedule of capecitabine combined with irinotecan (XELIRI), consecutively with irinotecan and oxaliplatin (XELIRINOX), was evaluated in patients with metastatic cancer from any solid tumors. PATIENTS AND METHODS In this two-step phase I trial, seventeen and eleven patients were enrolled in the XELIRI and XELIRINOX stages, respectively. RESULTS In XELIRI, a total of 136 chemotherapy cycles were administered with a median number of 8 cycles per patient (2-16). Main dose-limiting toxicities (DLT) were grade 3-4 neutropenia, with one toxicity-related death. Maximum tolerated dose (MTD) for capecitabine combined with 180 mg/m(2) of irinotecan was 3,500 mg/m(2)/day. In XELIRINOX, capecitabine starting dose was 2,500 mg/m(2)/day. Fifty-eight chemotherapy cycles were administered with a median of 4 cycles per patient (1-16). DLT included 3 grade 4 neutropenia, associated with 1 grade 3 diarrhea, and 1 grade 4 pneumopathy leading to patient death. MTD for capecitabine with 180 mg/m(2) of irinotecan and 85 mg/m(2) of oxaliplatin was 3,000 mg/m(2)/day. The recommended doses for capecitabine were 3,000 and 2,500 mg/m(2)/day D1-D7 in combination with 180 mg/m(2) of irinotecan in XELIRI, plus 85 mg/m(2) of oxaliplatin in XELIRINOX (D1 = D14), respectively. CONCLUSION XELIRI and XELIRINOX regimens are feasible and warrant further investigation in combination with targeted therapy in metastatic colorectal cancer patients.
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Affiliation(s)
- T Mazard
- Département d'Oncologie Médicale, CHU Saint Eloi, Montpellier, France.
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Colombo PE, Patani N, Bibeau F, Assenat E, Bertrand MM, Senesse P, Rouanet P. Clinical impact of lymph node status in rectal cancer. Surg Oncol 2011; 20:e227-33. [PMID: 21911287 DOI: 10.1016/j.suronc.2011.08.004] [Citation(s) in RCA: 17] [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] [Received: 04/19/2011] [Revised: 07/30/2011] [Accepted: 08/22/2011] [Indexed: 01/14/2023]
Abstract
Lymph node status at the time of diagnosis remains one of the principal indicators of prognosis in patients with rectal cancer. Involvement of loco-regional lymph nodes is relevant to surgical and clinical oncologists and continues to impact significantly upon local and systemic management strategies, in both neo-adjuvant and adjuvant settings. In this review, the clinical impact of lymph node status in the surgical management of rectal cancer is considered, with particular reference to the significance of lymphadenectomy and the potential implications for rectal tumours amenable to trans-anal excision. Current standards of care are reviewed and the extent to which the determination of lymph node status influences oncological decisions regarding neo-adjuvant and adjuvant therapies are discussed with areas of controversy highlighted.
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Affiliation(s)
- P E Colombo
- Department of Surgical Oncology, Val d'Aurelle Anticancer Centre, 34298 Montpellier Cedex 5, France.
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Mazard T, Assenat E, Ychou M, Ducreux M, Rene A, Mollevi C, Nougaret S, Gallix B. 1402 POSTER DISCUSSION CT Evaluation of the Response of Colorectal Liver Metastasis After Bevacizumab Treatment – a Density Quantitative Analysis Correlated With Patient Outcome. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70895-4] [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: 10/17/2022]
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Assenat E, Gallix B, Ducreux M, Rene A, Mollevi C, Adenis A, Chauffert B, Boucher E, Francois E, Pierga J, Nougaret S, Mazard T, Ychou M. Quantitative density evaluation of liver metastases on CT scan: A new tool to evaluate early the benefit of bevacizumab plus chemothrapy regimen. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14015] [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: 11/20/2022] Open
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Portales F, Thézenas S, Samalin E, Assenat E, Senesse P, Ychou M. Incidence and management of bone metastases digestive cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14110] [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: 11/20/2022] Open
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39
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Ho-Pun-Cheung A, Assenat E, Bascoul-Mollevi C, Bibeau F, Boissière-Michot F, Thezenas S, Cellier D, Azria D, Rouanet P, Senesse P, Ychou M, Lopez-Crapez E. A large-scale candidate gene approach identifies SNPs in SOD2 and IL13 as predictive markers of response to preoperative chemoradiation in rectal cancer. Pharmacogenomics J 2010; 11:437-43. [PMID: 20644561 DOI: 10.1038/tpj.2010.62] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Neoadjuvant radiochemotherapy followed by total mesorectal excision is now the standard treatment for locally advanced rectal cancer. However, tumor response to chemoradiation varies widely among individuals and cannot be determined before the final pathologic evaluation. The aim of this study was to identify germline genetic markers that could predict sensitivity or resistance to preoperative radiochemotherapy (RT-CT) in rectal cancer. We evaluated the predictive value of 128 single-nucleotide polymorphisms (SNPs) in 71 patients preoperatively treated by RT-CT. The selected SNPs were distributed over 76 genes that are involved in various cellular processes such as DNA repair, apoptosis, proliferation or immune response. The SNPs superoxide dismutase 2 (SOD2) rs4880 (P=0.005) and interleukin-13 (IL13) rs1800925 (P=0.0008) were significantly associated with tumor response to chemoradiation. These results reinforce the idea of using germline polymorphisms for personalized treatment.
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Affiliation(s)
- A Ho-Pun-Cheung
- Department of Biology, Val d'Aurelle Cancer Institute, Montpellier, France
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Ychou M, François E, Thézenas S, Laurent-Puig P, Bouche O, Adenis A, Bennouna J, Assenat E, Portales F, Samalin E. Sorafenib (S) in combination with irinotecan (I) as a treatment in metastatic colorectal cancer (mCRC) patients (pts) with KRAS mutation (mt) as second line or later: Interim analysis results of multicenter phase II part trial (NEXIRI). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bournet B, Souque A, Senesse P, Assenat E, Barthet M, Lesavre N, Aubert A, O'Toole D, Hammel P, Levy P, Ruszniewski P, Bouisson M, Escourrou J, Cordelier P, Buscail L. Endoscopic ultrasound-guided fine-needle aspiration biopsy coupled with KRAS mutation assay to distinguish pancreatic cancer from pseudotumoral chronic pancreatitis. Endoscopy 2009; 41:552-7. [PMID: 19533561 DOI: 10.1055/s-0029-1214717] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Differential diagnosis between pancreatic adenocarcinoma (PADC) and pseudotumoral forms of chronic pancreatitis remains difficult. Mutation of KRAS oncogene is present in 75% to 95% of PADC. This study aimed to evaluate whether the combined analysis of KRAS mutation with cytopathological findings from endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) might improve discrimination between PADC and chronic pancreatitis. PATIENTS AND METHODS This prospective multicenter study included 178 patients with solid pancreatic masses (men 104, women 74; mean age 64.5 years). Cytopathological examination and KRAS mutation analysis (codon-12 and codon-13, restriction fragment length polymorphism [RFLP] and direct sequencing) were performed on EUS-FNAB material. Final diagnoses were obtained on EUS-FNAB analysis and/or a second biopsy and/or clinical follow-up and/or surgery: PADC, n = 129; chronic pancreatitis, n = 27; other pancreatic neoplasms, n = 16; and benign lesions, n = 6. RESULTS KRAS status analysis was successful in all EUS-FNAB samples. Codon-12 KRAS point mutation was found in 66% of PADC samples. No case of chronic pancreatitis displayed KRAS mutation. Sensitivity, specificity, positive and negative predictive values, and overall accuracy of cytopathology alone for diagnosis of PADC versus chronic pancreatitis were 83%, 100%, 100%, 56% and 86%, respectively. When KRAS mutation analysis was combined with cytopathology, these values reached 88%, 100%, 100%, 63% and 90% respectively. CONCLUSION Although the value of KRAS analysis in addition to EUS-FNAB is limited for distinguishing pancreatic mass lesions, when chronic pancreatitis presented as a pseudotumor a negative finding (wild-type KRAS), was useful in strongly suggesting a benign lesion.
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Affiliation(s)
- B Bournet
- Department of Gastroenterology and INSERM U858, University of Toulouse, CHU Rangueil, Toulouse, France
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Malka D, Trarbach T, Fartoux L, Mendiboure J, de la Fouchardière C, Viret F, Assenat E, Boucher E, Rosmorduc O, Greten T. A multicenter, randomized phase II trial of gemcitabine and oxaliplatin (GEMOX) alone or in combination with biweekly cetuximab in the first-line treatment of advanced biliary cancer: Interim analysis of the BINGO trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4520] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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
4520 Background: There is no standard regimen for palliative chemotherapy of advanced biliary cancers. The GEMOX regimen is an option (BJC 2008). EGFR over-expression has been observed in advanced biliary cancers suggesting that the combination with anti-EGFR monoclonal antibodies may be appropriate. Methods: Patients with advanced biliary cancer, WHO performance status 0–1, and without prior palliative chemotherapy were eligible for this international, open-label, two-stage, randomized phase II trial. Patients received GEMOX (gemcitabine, 1000 mg/m2 [10 mg/m2/min] at day [D]1; oxaliplatin, 100 mg/m2 at D2) alone (arm A) or with cetuximab (500 mg/m2 at D1 or 2, arm B), every 2 weeks. Randomization was stratified according to tumor stage and location, center, and prior treatments. The primary endpoint was 4-month crude progression-free survival (PFS) rate (H0 hypothesis, < 40%; H1, ≥ 60%; planned sample size, 50 patients per arm). Secondary endpoints were response rate, PFS, overall survival, toxicity, early response assessment by PET, and blood/tumor EGFR signalling pathway member analyses. A data safety monitoring board-approved interim analysis was performed at the end of the first stage (18 patients per arm, minimal follow- up 4 months). Results: From October 2007 to October 2008, we enrolled 101 patients (median age, 62 yrs; male, 60%; metastatic, 86%; non-gallbladder, 76%). Among the 36 patients at the time of the interim analysis, the median number of treatment cycles was 6 and 8 in arms A and B, respectively. 76% (arm A) and 67% (arm B) had NCI-CTC grade 3–4 toxicity, mainly cytopenia (41%/39%), peripheral neuropathy (modified Levi's scale grade 2–3: 29%/33%), fatigue (6%/22%), gastrointestinal toxicity (12%/17%), and rash/hypersensitivity (0%/17%). The 4-month PFS rate was 44% (95% CI, 20–70) and 61% (95% CI, 36–83) in arms A and B, respectively. Conclusions: The GEMOX-cetuximab regimen seems well tolerated in patients with advanced biliary cancer. Adding cetuximab to GEMOX showed promising activity and therefore the trial was continued. Updated results on the whole population for primary and secondary endpoints will be available at the meeting. [Table: see text]
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Affiliation(s)
- D. Malka
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - T. Trarbach
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - L. Fartoux
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - J. Mendiboure
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - C. de la Fouchardière
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - F. Viret
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - E. Assenat
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - E. Boucher
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - O. Rosmorduc
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
| | - T. Greten
- Institut Gustave Roussy, Villejuif, France; West German Cancer Center, University of Essen, Essen, Germany; Hôpital Saint-Antoine AP-HP, Paris, France; Centre Léon Berard, Lyon, France; Institut Paoli Calmettes, Marseille, France; CRLC Val d’Aurelle –CHU, Montpellier, France; Centre Eugène Marquis, Rennes, France; Medizinische Hochschule, Hannover, Germany
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Assenat E, Kramar A, Poujol S, Gestin-Boyer C, Senesse P, Samalin E, Portales F, Thezenas S, Bleuse J, Ychou M. A phase I trial of a bi-weekly combination of capecitabine/irinotecan (XELIRI) then capecitabine/irinotecan/oxaliplatin (XELIRINOX) in solid tumors. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15075] [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
e15075 Background: Oral fluoropyrimidines, notably capecitabine, are increasingly replacing IV 5-FU/LV as the backbone of therapy for metastatic colorectal cancer. The bi-weekly combination of capecitabine/irinotecan warrants further examination. Methods: We conducted a phase I trial, in metastatic cancer patients treated for solid tumors, to determine the recommended dose of capecitabine administered orally bid from day 1 to 8 in combination with a bi-weekly fixed-dose of IV irinotecan 180 mg/m2 delivered on day 1 and 14 (FIRST STAGE: XELIRI); and + a bi-weekly fixed-dose of IV oxaliplatin (L-OHP) 85 mg/m2 delivered on day 1 and 14 (Second STAGE: XELIRINOX). Five increasing dose levels (DL1–5) of capecitabine were planned: 1000, 1250, 1500, 1750, and 2000 mg/m2 bid. A pharmacokinetic study of this association was performed. Results: In the first stage, a total of 17 patients were enrolled, with a median age of 60 (range 52–73) years. All patients had an ECOG PS of either 0 (59%), 1 (35%), or 2 (6%). Four patients experienced dose-limiting toxicity: 2 developed grade 4 neutropenia (at DL 1 and 4) and 2 others grade 4 febrile neutropenia (at DL3 and 4). One toxicity-related death occurred following febrile neutropenia (DL4). Maximal tolerated dose (MTD) was DL4, and the recommended dose regimen was bi-weekly irinotecan 180 mg/m2 combined with capecitabine 1500 mg/m2 bid (administered from days 1 to 8). In the second stage, the starting dose level of capecitabine in the bi- weekly association with irinotecan and L-OHP was defined as two dose levels below the MTD level reached in the first stage of the study (DL4 - 2 = DL2). Height patients were enrolled with a median age of 56 (35–75) and ECOG 0 for 62%, ECOG 1 for 38%. Chemotherapy is ongoing for three of them. Three patients experienced dose-limiting toxicity: 1 grade 4 neutropenia ( DL2), 1 grade 4 febrile neutropenia ( DL3) and 1 grade 4 pneumopathy ( DL3). The MTD of XELIRINOX was DL3, and the recommended dose regimen will be presented at the meeting. Conclusions: Bi-weekly combination of capecitabine/irinotecan/oxaliplatin (XELIRI / XELIRINOX) is feasible and could be tested in patients with metastatic colorectal cancer in combination with a targeted therapy. [Table: see text]
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Affiliation(s)
- E. Assenat
- Val D’Aurelle Cancer Institute, Montpellier, France
| | - A. Kramar
- Val D’Aurelle Cancer Institute, Montpellier, France
| | - S. Poujol
- Val D’Aurelle Cancer Institute, Montpellier, France
| | | | - P. Senesse
- Val D’Aurelle Cancer Institute, Montpellier, France
| | - E. Samalin
- Val D’Aurelle Cancer Institute, Montpellier, France
| | - F. Portales
- Val D’Aurelle Cancer Institute, Montpellier, France
| | - S. Thezenas
- Val D’Aurelle Cancer Institute, Montpellier, France
| | - J. Bleuse
- Val D’Aurelle Cancer Institute, Montpellier, France
| | - M. Ychou
- Val D’Aurelle Cancer Institute, Montpellier, France
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Bécouarn Y, Guillo S, Artru P, Assenat E, Bosset JF, Conroy T, François E, Taïeb J, Touboul E. [Systematic review: value of perioperative chemotherapy in the management of resectable rectal adenocarcinoma (brief report)]. Bull Cancer 2008; 95:717-734. [PMID: 18763385] [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: 05/26/2023]
Abstract
UNLABELLED At the request of the National Thesaurus of Gastrointestinal Cancer (TNCD), the SOR program undertaken by the French federation of cancer centers and now led by the French National Cancer Institute, completed a systematic review to evaluate the value of perioperative chemotherapy in the management of resectable rectal adenocarcinoma in collaboration with clinician experts. METHODS Results of a systematic literature search using Medline and Embase (from January 1996 to October 2007) were completed by a survey of Evidence- Based Medicine websites. All phase III randomized trials and systematic reviews comparing surgery (alone or associated with adjuvant therapy) to the same treatment plus chemotherapy, or comparing different perioperative chemotherapy modalities in patients with resectable rectal adenocarcinoma, were included in the study. The quality and clinical relevance of the trials were evaluated using validated checklists, allowing to associate each result with its level of evidence. Data synthesis was performed taking into account both efficacy and toxicity outcomes for each intervention. Finally, research recommendations were formulated. RESULTS Of 29 studies meeting the selection criteria, 19 were included after critical methodological and clinical appraisal. As compared with preoperative radiotherapy, preoperative chemoradiotherapy with 5-fluorouracil and folinic acid does not improve overall or relapse-free survivals but decreases local recurrence rates. Postoperative chemotherapy with 5-fluorouracil and folinic acid does not improve overall or relapse-free survivals, whether the patients received preoperative radiotherapy or preoperative chemoradiotherapy, whereas it seems to decrease local recurrence rates after preoperative radiotherapy but not after preoperative chemoradiotherapy. As compared with postoperative chemoradiotherapy, preoperative chemoradiotherapy with continuous infusion of 5-fluorouracil does not improve overall or relapse-free survivals, but decreases local recurrence rates as well as acute and long-term toxicities. In the absence of preoperative radiotherapy, fluoropyrimidine-based postoperative chemotherapy improves both overall and relapse-free survivals and decreases local recurrence rates. CONCLUSIONS Preoperative chemoradiotherapy reduces the risk of local recurrence as compared with preoperative radiotherapy or postoperative chemoradiotherapy.
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Affiliation(s)
- Y Bécouarn
- oncologue médical, institut Bergonié, Bordeaux, France
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Aufort S, Molina E, Assenat E, Rigole H, Bauret P, Calvet C, Navarro F, Fabre JM, Blanc P, Taourel P, Larrey D, Bruel JM, Pageaux GP, Gallix BP. [Value of MRCP for diagnosis of biliary complications after liver transplantation]. ACTA ACUST UNITED AC 2008; 89:221-7. [PMID: 18354352 DOI: 10.1016/s0221-0363(08)70397-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To assess the value of MRCP in the detection of biliary complications after orthotopic liver transplantation. MATERIALS AND METHODS 27 transplanted patients with suspected biliary complication underwent a total of 34 MR and direct cholangiography procedures. MRCP were reviewed by 2 independent reviewers blinded to clinical and laboratory findings. The biliary tract was divided into 7 segments, and all lesions were evaluated using this segmental anatomy. Each segment was evaluated for the presence of dilatation, stenosis and intra-ductal debris. MRCP results were compared to results frpm direct cholangiography. RESULTS 216 (98%) of 221 biliary segments could be evaluated on MRCP, with good to excellent visualization in 179 (80%) cases. Segmental analysis showed sensitivity, specificity and accuracy values of 85%, 81% and 83% for the detection of biliary stenosis, 82%, 81% and 81% for the detection of biliary dilatation, and 60%, 88% and 80% for the detection of inyraductal debris. CONCLUSION MRCP is accurate for the detection of biliary stenosis and dilatation in patients after liver transplantation and provides an alternative to direct cholangiography.
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Affiliation(s)
- S Aufort
- Service d'Imagerie Médicale, CHU Montpellier, Hôpital Saint-Eloi, 80, rue Augustin Fliche, 34295 Montpellier Cedex 5
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Bécouarn Y, Guillo S, Artru P, Assenat E, Bosset JF, Conroy T, Françis E, Taïeb J, Touboul E. Synthèse méthodique: intérêt de la chimiothérapie périopératoire dans la prise en charge des patients atteints d’un adénocarcinome du rectum résécable d’emblée (rapport abrégé). ONCOLOGIE 2008. [DOI: 10.1007/s10269-008-0840-4] [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: 11/25/2022]
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Portales F, Assenat E, Latournerie M, Thezenas S, Serre A, Garrel R, Vercambre L, Altweg R, Azria D, Senesse P. Phase II clinical trial assessing the impact of an oral immunonutrition during concomitant chemoradiotherapy in advanced local-regional squamous cell carcinomas of the head and neck. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Assenat E, Kramar A, Senesse P, Samalin E, Portales F, Ychou M. A phase I trial of a bi-weekly combination of capecitabine/irinotecan (XELIRI) in solid tumors. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.13556] [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: 11/20/2022] Open
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Latournerie M, Assenat E, Thézénas S, Janiszewski C, Vercambre L, Serre A, Senesse P. P050 Essai de phase II, non randomisé, prospectif, évaluant l’impact d’une solution orale riche en acides gras n-3, L-arginine et anti-oxydants pendant la radio-chimiothérapie concomitante dans les cancers de la tête et du cou. NUTR CLIN METAB 2007. [DOI: 10.1016/s0985-0562(07)78852-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Senesse P, Augeix N, Mathieu-Daudé H, Janiszewski C, Latournerie M, Vercambre L, Assenat E, Sicard R, Dubois J. P026 Dénutrition, évaluation Compaqh, accréditation et T2A : un cocktail détonant ! NUTR CLIN METAB 2007. [DOI: 10.1016/s0985-0562(07)78828-3] [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: 10/22/2022]
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