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Gaillard T, Carton M, Mailliez A, Desmoulins I, Mouret-Reynier MA, Petit T, Leheurteur M, Dieras V, Ferrero JM, Uwer L, Guiu S, Gonçalves A, Levy C, Debled M, Dalenc F, Patsouris A, Bachelot T, Eymard JC, Chevrot M, Conversano A, Robain M, Hequet D. De novo metastatic breast cancer in patients with a small locoregional tumour (T1-T2/N0): Characteristics and prognosis. Eur J Cancer 2021; 158:181-188. [PMID: 34689042 DOI: 10.1016/j.ejca.2021.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The estimated rate of de novo metastatic breast cancer (dnMBC) at the time of diagnosis is between 5 to 12%. International guidelines recommend metastatic work-up (MWU) only in women with advanced breast cancer. The purpose of this study was to describe the characteristics and prognosis of patients with dnMBC diagnosed without an initial indication for MWU. METHODS We conducted a retrospective, comparative study in dnMBC patients selected from the ESME-MBC cohort. Patients were treated in France between 2008 and 2016. We compared two populations: patients in whom dnMBC was diagnosed by staging although not indicated by guidelines (non-guideline staging [NGS]) and those in whom dnMBC was diagnosed by guideline staging (GS). RESULTS During the study period, 22,463 patients with MBC were included in the ESME cohort. Among them, 6698 were dnMBC patients. In 247 of these patients (6% of dnMBC and 1% of the overall population), dnMBC was diagnosed by non-guideline staging. Women in this group were significantly younger (57 vs. 59 years, p = 0.02) and had fewer metastatic sites at diagnosis than dnMBC-GS patients. The two groups were not significantly different in terms of the other characteristics. Overall survival (OS) and progression-free survival (PFS) were better in the dnMBC-NGS group than in the dnMBC-GS group. The impact on survival was confirmed by univariate and multivariate analysis (HR 1.83 [1.31-2.57], p < 0.01). CONCLUSION This study provides the first description of a very specific population. These patients with dnMBC-NGS were younger and more likely to have oligometastatic disease with a better prognosis.
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Affiliation(s)
- T Gaillard
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud, France.
| | - M Carton
- Department of Biostatistics, Institut Curie, Paris & Saint-Cloud, France
| | - A Mailliez
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - I Desmoulins
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - M A Mouret-Reynier
- Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - T Petit
- Department of Medical Oncology, ICANS Centre Paul Strauss, Strasbourg, France
| | - M Leheurteur
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | - V Dieras
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - J M Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - L Uwer
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Nancy, France
| | - S Guiu
- Department of Medical Oncology, Institut de Cancérologie de Montpellier, Montpellier, France
| | - A Gonçalves
- Department of Medical Oncology, Institut Paoli Calmette, Marseille, France
| | - C Levy
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - M Debled
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - F Dalenc
- Department of Medical Oncology, IUCT-Oncopole Institut Claudius Regaud, Toulouse, France
| | - A Patsouris
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Angers & Nantes, France
| | - T Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - J C Eymard
- Department of Medical Oncology, Institut Jean Godinot, Reims, France
| | - M Chevrot
- Real World Data Department, Unicancer Data Office, Paris, France
| | - A Conversano
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - M Robain
- Real World Data Department, Unicancer Data Office, Paris, France
| | - D Hequet
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud, France
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Frasca M, Courtinard C, Bouleuc C, Levy C, Mouret-Reynier MA, Bachelot T, Goncalves A, Perotin V, Eymard JC, Mathoulin-Pelissier S. Palliative care delivery according to age among metastatic breast cancer patients. ESME-MBC cohort. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.193] [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: 11/14/2022] Open
Abstract
Abstract
Background
Metastatic breast cancer (MBC) may require inpatient palliative care (IPC) but literature suggests age-related disparities in palliative care delivery. This study, based on real-world data, aimed to assess the cumulative incidence function (CIF) of IPC delivery and if age is an independent factor, taking into account the competing risk of death.
Methods
The national multicenter ESME (Epidemio-Strategy-Medical-Economical)-MBC cohort includes consecutive MBC patients treated in the 18 French Comprehensive Cancer Centers. IPC identification used ICD-10 palliative care coding. Main analysis first estimated pseudo values of 2-year and 8-year CIF of IPC. Linear regression models estimated the mean changes of pseudo-values (2 models: 2-year and 8-year CIF of IPC).
Results
Our analysis included 12375 patients, 5093 (41.2%) of whom were aged 65 or over. The median follow-up was 41.5 months (95% CI, 40.5-42.5). The CIF of IPC was 10.3% (95% CI, 10.2-10.4) and 24.8% (95% CI, 24.7-24.8) at two and eight years, respectively. At two years, among triple-negative patients, young patients (<65 yo) had a higher CIF of IPC than older patients after adjusting for cancer characteristics, centre, and period (65+/<65: β=-0.05; 95% CI, -0.08 to -0.01). Among other tumour subtypes, older patients received short-term IPC more frequently than young patients (65+/<65: β = 0.02; 95% CI, 0.01 to 0.03). At eight years, outside large centres, IPC was delivered less frequently to older patients adjusted to cancer characteristics and period (65+/<65: β=-0.03; 95% CI, -0.06 to -0.01).
Conclusions
We found a relatively low CIF of IPC and that age influenced IPC delivery. Young triple negative and older non-triple negative patients needed more short-term IPC. Older patients diagnosed outside large centres received less long-term IPC. These findings highlight the need for a wider implementation of IPC facilities and for more age-specific interventions.
Key messages
Our study highlighted particular challenge for older MBC patients diagnosed outside large French Comprehensive Cancer Centers. By identifying age at MBC diagnosis as a factor of IPC delivery, this report supports a wider implementation of IPC facilities and more age-specific interventions.
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Affiliation(s)
- M Frasca
- INSERM U1219 Epicene team, University of Bordeaux, Bordeaux, France
- Department of palliative Medicine, CHU of Bordeaux, Bordeaux, France
| | - C Courtinard
- Department of Research and Development, R&D Unicancer, Paris, France
| | - C Bouleuc
- Department of Medical Oncology, Institut Curie, Paris, France
| | - C Levy
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - M A Mouret-Reynier
- Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - T Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - A Goncalves
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - V Perotin
- Department of Palliative Medicine, Institut du Cancer de Montpellier, Montpellier, France
| | - J C Eymard
- Department of Medical Oncology, Institut de Cancérologie Jean-Godinot, Reims, France
| | - S Mathoulin-Pelissier
- INSERM U1219 Epicene team, University of Bordeaux, Bordeaux, France
- INSERM CIC1401, Institut Bergonie, Bordeaux, France
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3
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Gougis P, Carton M, Tchokothe C, Campone M, Dalenc F, Mailliez A, Levy C, Jacot W, Debled M, Leheurteur M, Bachelot T, Hennequin A, Perrin C, Gonçalves A, Uwer L, Eymard JC, Petit T, Mouret-Reynier MA, Chamorey E, Simon G, Saghatchian M, Cailliot C, Le Tourneau C. CinéBreast-factors influencing the time to first metastatic recurrence in breast cancer: Analysis of real-life data from the French ESME MBC database. Breast 2019; 49:17-24. [PMID: 31675683 PMCID: PMC7375625 DOI: 10.1016/j.breast.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/09/2019] [Accepted: 10/11/2019] [Indexed: 12/25/2022] Open
Abstract
Purpose The Time to First Metastatic Recurrence (TFMR) could be considered as an indirect reflection of the tumour growth kinetics which plays an important role in cancer. Molecular subtypes such as expression of estrogen receptor are known predictive factors of TFMR. The CinéBreast study aimed to identify predictive factors of the time to TFMR. Methods The French Epidemiological Strategy and Medical Economics (ESME) Metastatic Breast Cancer (MBC) Database (NCT03275311) was used, which contains data from a cohort of metastatic breast cancer patients from 2008 to 2016 using retrospective data collection. It is a national multi-centre database. The impact of TFMR on overall survival (OS) since first metastasis was also evaluated. Results Among 16 702 patients recorded in the ESME MBC database, 10 595 had an initially localised breast cancer with hormone receptor (HR) and HER2 status available, with a metastatic recurrence. Median follow up was 56 months. Median TFMR was 59 months (<24: 20%, 24–60: 31%, 60–120: 25%, >120: 24%). HER2+ and TNBC were respectively 4 times and 12 times (p < 0.0001) more likely to have a recurrence within 2 years when compared to the luminal subgroup. Short TFMR and HR-/HER2-subtype significantly correlated with a poor OS in multivariate analysis. Some patients with MBC (20% in HER2+, 10% in ER+/HER2-and <5% in the ER-/HER2-) were long-term survivors in all 3 subgroups. Conclusions In this large-scale real-life data study, patients with a TNBC metastatic recurrence had a shorter TFMR. Short TFMR significantly correlated with worse overall survival. ESME is a large-scale real-life database of 16 702 metastatic breast cancer patients. A short time to first metastatic recurrence is associated with poor overall survival. Triple-negative tumours were more likely to recur early than HR+ and HER2+ tumours.
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Affiliation(s)
- P Gougis
- Department of Drug Development and Innovation, Institut Curie, Paris, Saint-Cloud, France; Department of Clinical Pharmacology, Centre D'Investigation Clinique Paris-Est, AP-HP, Pitié-Salpêtrière Hospital, PSL University, CLIP² Galilée, Paris, France
| | - M Carton
- Department of Biostatistics, Institut Curie, Saint-Cloud, France
| | - C Tchokothe
- Department of Biostatistics, Institut Curie, Saint-Cloud, France
| | - M Campone
- Department of Medical Oncology, Institut de Cancérologie de L'Ouest, Nantes and Angers, France
| | - F Dalenc
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | - A Mailliez
- Department of Breast Cancer, Centre Oscar Lambret, Lille, France
| | - C Levy
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - W Jacot
- Department of Medical Oncology, Institut Du Cancer de Montpellier, Montpellier, France
| | - M Debled
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - M Leheurteur
- Department of Medical Oncology, Henri Becquerel Centre, Rouen, France
| | - T Bachelot
- Department of Biostatistics, Centre Léon Bérard, Lyon, France
| | - A Hennequin
- Department of Medical Oncology, Center Georges François Leclerc, Dijon, France
| | - C Perrin
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - A Gonçalves
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - L Uwer
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - J C Eymard
- Department of Medical Oncology, Centre Jean Godinot, Reims, France
| | - T Petit
- Department of Medical Oncology, Centre Paul Strauss, Strasbourg, France
| | - M A Mouret-Reynier
- Department of Medical Oncology, Centre Jean Perrin, Clermont Ferrand, France
| | - E Chamorey
- Department of Biostatistics, Centre Antoine Lacassagne, Nice, France
| | - G Simon
- Department of Research and Development, R&D Unicancer, Paris, France
| | - M Saghatchian
- Department of Biostatistics, Institut Curie, Saint-Cloud, France
| | - C Cailliot
- Department of Research and Development, R&D Unicancer, Paris, France
| | - C Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris, Saint-Cloud, France; U900 INSERM Research Unit, Saint-Cloud, France.
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Marchand Crety C, Garbar C, Madelis G, Guillemin F, Soibinet Oudot P, Eymard JC, Servagi Vernat S. Adjuvant radiation therapy for malignant Abrikossoff's tumor: a case report about a femoral triangle localisation. Radiat Oncol 2018; 13:115. [PMID: 29925410 PMCID: PMC6011335 DOI: 10.1186/s13014-018-1064-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/14/2018] [Indexed: 12/28/2022] Open
Abstract
Background Granular cell or Abrikossoff’s tumors are usually benign however rare malignant forms concern 1 to 3% of cases reported. Pelvic locations are exceptional. Case presentation We report a case of a 43-years-old patient who had a benign Abrikossoff’s tumor localized in the right femoral triangle diagnosed at the biopsy. The patient underwent a surgical tumorectomy and inguinal lymph nodes resection. Histologically, the tumor showed enough criteria to give diagnosis of malignancy: nuclear pleomorphism, tumor cell spindling, vesicular nuclei with large nucleoli. Moreover, five lymph nodes were metastatic. Immunohistochemistry findings confirmed the diagnosis of granular cell tumor which is positive for S100 protein and CD68 antibodies. The mitotic index was nevertheless low with a Ki67 labeling index of 1–2%. A large surgical revision with an inguinal curage following radiotherapy were decided on oncology committee. Adjuvant radiotherapy on the tumor bed and right inguinal area of 50 Gy in conventional fractionation was delivered with the aim of reducing local recurrence risk. There was no recurrence on longer follow-up (10 months post radiotherapy). Conclusions Adjuvant radiotherapy seems an appropriate therapeutic approach, even if controversial, given that some authors report effectiveness on local disease progression.
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Affiliation(s)
- C Marchand Crety
- Department of Radiation Therapy, Institut de Cancérologie Jean Godinot, Reims, France
| | - C Garbar
- Department of Pathology, Institut de Cancérologie Jean Godinot, Reims, France
| | - G Madelis
- Department of Medical Physic, Institut de Cancérologie Jean Godinot, Reims, France
| | - F Guillemin
- Department of Surgery, Institut de Cancérologie Jean Godinot, Reims, France
| | - P Soibinet Oudot
- Department of Medical Oncology, Institut de Cancérologie Jean Godinot, Reims, France
| | - J C Eymard
- Department of Medical Oncology, Institut de Cancérologie Jean Godinot, Reims, France
| | - S Servagi Vernat
- Department of Radiation Therapy, Institut de Cancérologie Jean Godinot, Reims, France.
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Sabatier R, Eymard JC, Walz J, Deville JL, Narbonne H, Boher JM, Salem N, Marcy M, Brunelle S, Viens P, Bladou F, Gravis G. Could thyroid dysfunction influence outcome in sunitinib-treated metastatic renal cell carcinoma? Ann Oncol 2012; 23:714-721. [PMID: 21653681 DOI: 10.1093/annonc/mdr275] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [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: 01/20/2023] Open
Abstract
BACKGROUND Sunitinib is a standard of care for metastatic renal cell carcinoma (mRCC). Hypothyroidism is frequently observed under sunitinib therapy. This study was conducted to prospectively determine the correlation between thyroid function and progression-free survival (PFS) in this population. PATIENTS AND METHODS One hundred and eleven mRCC patients treated with sunitinib were evaluated for serum thyroid-stimulating hormone (TSH) and T4 levels before treatment and every 6 weeks during treatment. Survival was analysed according to a landmark method with a cut-off of 6 months, excluding early progressive or early-censored patients. RESULTS Out of the 102 patients with normal baseline thyroid function, 53% developed thyroid dysfunction, including 95% hypothyroidisms out of which 90.9% received L-thyroxine replacement. Median time to TSH alteration was 5.4 months. Median PFS was 11.7 months for the entire population. Median PFS was not different between the groups with abnormal or normal thyroid function after 6 months of treatment (18.9 and 15.9 months, respectively, log-rank P = 0.94, hazard ratio = 1.02, 95% confidence interval = 0.54-1.93). There was no difference even after adjustment for Memorial Sloan-Kettering Cancer Centre classification and therapy line. CONCLUSIONS Abnormal thyroid function with hormonal substitution did not increase survival in our population, independent of initial prognosis and previous treatments. Larger comparative studies are deserved to validate these conclusions.
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Affiliation(s)
- R Sabatier
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Centre de Recherche contre le Cancer, INSERM UMR 891, Marseille.
| | - J C Eymard
- Department of Surgery, Institut Paoli-Calmettes, Marseille
| | - J Walz
- Department of Medical Oncology, Institut Jean Godinot, Reims
| | - J L Deville
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - H Narbonne
- Department of Endocrinology, CHU Marseille, Hôpital de la Timone, Marseille
| | | | - N Salem
- Departments of Radiotherapy Oncology
| | - M Marcy
- Departments of Anatomo-Pathology
| | - S Brunelle
- Departments of Radiology, Institut Paoli-Calmettes, Marseille
| | - P Viens
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Centre de Recherche contre le Cancer, INSERM UMR 891, Marseille; Université de la Méditerranée, UFR Médecine, Marseille
| | - F Bladou
- Université de la Méditerranée, UFR Médecine, Marseille; Department of Urology, CHU Marseille, Hôpital Sainte Marguerite, Marseille, France
| | - G Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille; Centre de Recherche contre le Cancer, INSERM UMR 891, Marseille
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Sartor AO, Petrylak DP, Witjes JA, Berry WR, Chatta GS, Vaughn DJ, Ferrero J, Demkow T, Eymard JC, Sternberg CN. Satraplatin in patients with advanced hormone-refractory prostate cancer (HRPC): Overall survival (OS) results from the phase III satraplatin and prednisone against refractory cancer (SPARC) trial. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Fizazi K, Hudes GR, Berry WR, Kelly WK, Eymard JC, Logothetis C, Le Maitre A, Pignon JP, Michiels S. A meta-analysis of individual patient data from randomized trials assessing chemotherapy with and without estramustine in patients with castration-refractory prostate cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4561 Background: Estramustine phosphate is a mustard-estradiol conjugate, with evidence of both hormonal and non-hormonal effects. In phase II trials, the response rates of microtubule inhibitors are increased when combined with estramustine. Morbidity includes notably thrombosis in about 7% of cases. Whether combining estramustine with chemotherapy increases survival in castration-refractory prostate cancer (CRPC) is still controversial. Methods: Data from all published and unpublished prospective randomized trials assessing chemotherapy + estramustine versus chemotherapy alone in CRPC were sought using electronic database searching, hand searching, and by contacting experts in the field. The primary endpoint was overall survival (OS). The analysis was performed on an intention-to-treat basis. The stratified logrank test was used and an overall hazard ratio (HR) was computed using a fixed effect model. χ2 heterogeneity tests were used to test for statistical heterogeneity. All p-values were two-sided. Multivariate analysis was performed using a Cox model stratified by trial. Results: Individual data were obtained from all 5 randomized trials conducted in the PSA era that had been identified (n = 610). The control arms consisted of docetaxel (1), paclitaxel (1), ixabepilone (1), and vinblastine (2). With a median follow-up of 2.8 years, 510 deaths had occurred. OS was significantly better in the estramustine arm (HR = 0.82 [95% CI: 0.69–0.97]; p = 0.02). Overall, the risk reduction (RR) of death related to estramustine was 18% (± 8). There was no significant interaction (p = 0.66) between the RR of trials using vinblastine (RR = 15% [± 12]) and in those using taxanes or ixabepilone (RR = 21% [± 11]). The estimated 1-year OS rate was 57% and 50% in the estramustine arm and in the control arm, respectively. The 18-months OS rate was 43% and 35%, respectively. There was no interaction between the effect of estramustine and age, performance status, or serum PSA in the Cox model. Conclusions: Combining estramustine with chemotherapy increases OS over chemotherapy alone in patients with castration-refractory prostate cancer. [Table: see text]
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Affiliation(s)
- K. Fizazi
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
| | - G. R. Hudes
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
| | - W. R. Berry
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
| | - W. K. Kelly
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
| | - J. C. Eymard
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
| | - C. Logothetis
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
| | - A. Le Maitre
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
| | - J. P. Pignon
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
| | - S. Michiels
- Institut Gustave Roussy, Villejuif, France; Fox Chase Cancer Center, Philadelphia, PA; Cancer Centers of North Carolina, Cary, NC; Yale School of Medicine, New Haven, CT; Centre Jean Godinot, Reims, France; UT M. D. Anderson Cancer Center, Houston, TX
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8
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Brain EGC, Bachelot T, Serin D, Graïc Y, Eymard JC, Extra JM, Combe M, Nogues C, Rouëssé J. Phase III trial comparing doxorubicin docetaxel (AT) with doxorubicin cyclophosphamide (AC) in the adjuvant treatment of high-risk node negative (pN0) and limited node positive (pN+≤3) breast cancer (BC) patients (pts): First analysis of toxicity. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.617] [Citation(s) in RCA: 2] [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)
- E. G. C. Brain
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
| | - T. Bachelot
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
| | - D. Serin
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
| | - Y. Graïc
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
| | - J. C. Eymard
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
| | - J. M. Extra
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
| | - M. Combe
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
| | - C. Nogues
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
| | - J. Rouëssé
- René Huguenin Cancer Centre, Saint-Cloud, France; Léon Bérard Cancer Centre, Lyon, France; Institut Sainte Catherine, Avignon, France; Henri Becquerel Cancer Centre, Rouen, France; Institut Jean Godinot, Reims, France; Institut Curie, Paris, France; Le Mans Hospital, Le Mans, France
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9
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Escudier B, Droz JP, Rolland F, Terrier-Lacombe MJ, Gravis G, Beuzeboc P, Chauvet B, Chevreau C, Eymard JC, Lesimple T, Merrouche Y, Oudard S, Priou F, Guillemare C, Gourgou S, Culine S. Doxorubicin and ifosfamide in patients with metastatic sarcomatoid renal cell carcinoma: a phase II study of the Genitourinary Group of the French Federation of Cancer Centers. J Urol 2002; 168:959-61. [PMID: 12187199 DOI: 10.1097/01.ju.0000026902.77397.fd] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We assessed the efficacy and toxicity of a chemotherapy regimen combining doxorubicin and ifosfamide in patients with metastatic sarcomatoid renal cell carcinoma. MATERIALS AND METHODS Of the 25 patients included in a prospective multicenter phase II trial 23 were evaluable for efficacy and toxicity studies after pathological review. RESULTS A median of 3 cycles per patient (range 1 to 8) was administered. No objective response was observed. Median time to progression was 2.2 months and median overall survival was 3.9 months. A single patient died of toxicity. CONCLUSIONS The results do not support the standard use of doxorubicin/ifosfamide chemotherapy in patients with metastatic sarcomatoid renal cell carcinoma.
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Affiliation(s)
- B Escudier
- Institut Gustave Roussy, Villejuif, Centre Léon Bérard, Lyon, France
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10
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Spielmann M, Tubiana-Hulin M, Namer M, Mansouri H, Bougnoux PH, Tubiana-Mathieu N, Lotz V, Eymard JC. Sequential or alternating administration of docetaxel (Taxotere) combined with FEC in metastatic breast cancer: a randomised phase II trial. Br J Cancer 2002; 86:692-7. [PMID: 11875727 PMCID: PMC2375306 DOI: 10.1038/sj.bjc.6600165] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [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: 10/24/2001] [Accepted: 12/28/2001] [Indexed: 11/09/2022] Open
Abstract
The aim of this study, using a Fleming single-stage design, was to explore the efficacy and safety of Taxotere 100 x mg x m(-2) docetaxel and FEC 75 cyclophosphamide 500 mg x m(-2), fluorouracil 500 x mg x m(-2) and epirubicin 75 mg x m(-2), in alternating and sequential schedules for the first-line treatment of metastatic breast cancer. One hundred and thirty-six women were randomly allocated, to one of three treatment regimens: DTX 100 plus FEC 75, alternated for eight courses (ALT); four courses of DTX 100 followed by four courses of FEC 75 (SEQ T); or four courses of FEC 75 followed by four courses of DTX 100 (SEQ F). One hundred and thirty-one women were evaluable for tumour response. Although the treatment outcome was equivalent in the two sequential arms and the alternating regimen (P=0.110, not significant), the response rate was less encouraging in the SEQ F arm (52.3%) than in the other two arms (71.1% for ALT and 70.5% for SEQ T), in which docetaxel was administered first. Time to progression was similar in the ALT, SEQ T and SEQ F arms (9.5, 9.3 and 10.4 months respectively). Grade 3-4 neutropenia was observed in nearly all patients; febrile neutropenia occurred in 9% (ALT), 16% (SEQ T) and 2% (SEQ F) of patients. Few patients (< or =9%) developed grade 3-4 non-haematological toxicities. Relative dose intensity was 97-99% for all regimens. All treatment regimens were active and well tolerated.
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Affiliation(s)
- M Spielmann
- Institut Gustave Roussy, 39-53 rue Camille Desmoulins, 94805 Villejuif, France.
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11
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Namer M, Soler-Michel P, Turpin F, Chinet-Charrot P, de Gislain C, Pouillart P, Delozier T, Luporsi E, Etienne PL, Schraub S, Eymard JC, Serin D, Ganem G, Calais G, Maillart P, Colin P, Trillet-Lenoir V, Prevost G, Tigaud D, Clavère P, Marti P, Romieu G, Wendling JL. Results of a phase III prospective, randomised trial, comparing mitoxantrone and vinorelbine (MV) in combination with standard FAC/FEC in front-line therapy of metastatic breast cancer. Eur J Cancer 2001; 37:1132-40. [PMID: 11378344 DOI: 10.1016/s0959-8049(01)00093-4] [Citation(s) in RCA: 24] [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 comparative phase III trial of mitoxantrone+vinorelbine (MV) versus 5-fluorouracil+cyclophosphamide+either doxorubicin or epirubicin (FAC/FEC) in the treatment of metastatic breast cancer was conducted to determine whether MV would produce equivalent efficacy, while resulting in an improved tolerance in relation to alopecia and nausea/vomiting. This multicentre study recruited and randomised 281 patients with metastatic breast cancer; 280 were evaluable for response survival and toxicity (138 received FAC/FEC, 142 received MV). Patient characteristics were matched in each arm and stratification for prior exposure to adjuvant therapy was made prospectively. The overall response rate (ORR) was equivalent in the two arms (33.3% for FAC/FEC versus 34.5% for MV), but MV was more effective in patients who had received prior adjuvant therapy (13% (95% confidence interval (CI) 3-23) for FAC/FEC versus 33% (95% CI 20-47) for MV P=0.025) with a better progression-free survival (PFS) (5 months (range 1-18 months) versus 8 months (range 1-27 months); P=0.0007 for FAC/FEC versus MV, respectively) while FAC/FEC was more effective in previously untreated patients (ORR 43% (95% CI 33-53) versus 35% (95% CI 25-45), P=0.26; PFS 9 months (range 0-29 months) versus 6 months (range 0-26 months) P=0.014). Toxicity was monitored through the initial six cycles of therapy; febrile neutropenia and delayed haematological recovery was more frequent for MV (P=0.001), while nausea/vomiting of grades 3-4 was greater for FAC/FEC (P=0.031), as was alopecia (P=0.0001), cardiotoxicity was the same for the two regimens. MV represents a chemotherapy combination with equivalent efficacy to standard FAC/FEC and improved results for patients who have previously received adjuvant chemotherapy. Toxicity must be balanced to allow for increased haematological suppression and risk of febrile neutropenia with MV compared with a higher risk of subjectively unpleasant side-effects such as nausea/vomiting and alopecia with FAC/FEC.
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Affiliation(s)
- M Namer
- Centre Antoine Lacassagne, 36 Voie Romaine, 06002 Cedex, Nice, France.
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12
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Nguyen TD, Theobald S, Rougier P, Ducreux M, Lusinchi A, Bardet E, Eymard JC, Conroy T, Francois E, Seitz JF, Bugat R, Ychou M. Simultaneous high-dose external irradiation and daily cisplatin in unresectable, non-metastatic adenocarcinoma of the pancreas: a phase I-II study. Radiother Oncol 1997; 45:129-32. [PMID: 9424002 DOI: 10.1016/s0167-8140(97)00116-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Clinical trials have demonstrated that high dose radiation therapy and daily cisplatin (CDDP) could increase local control and survival in carcinoma from various sites. The present phase I-II study has combined high dose radiation therapy and daily CDDP at escalating dosages. METHODS From August 1994 to December 1995, 23 patients with non-resectable carcinoma of the pancreas were enrolled in a phase I-II multicentric, pilot study to test the toxicity and the effectiveness of high dose radiotherapy and daily cisplatin (CDDP) at escalating dosages. A dose of 6 mg/sqm/day of CDDP was selected for the phase II step since no grade IV toxicity occurred in any patient in the phase I step. RESULTS Toxicity was considered fairly acceptable. At the time of analysis, the 23 patients who entered the study had clear evidence of evolutive disease either locally or distantly in the liver. It is suggested that high dose radiotherapy (60 Gy continuously) and daily CDDP have little effect on local control of the tumor and survival, and only a moderate effect on pain. CONCLUSIONS In unresectable, apparently non-metastatic cancers of the pancreas, there is an urgent need for new agents or new combinations of agents to be tested.
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Abstract
Autologous activated macrophage (AAM) therapy is an adoptive cellular therapy based on ex vivo differentiation and activation of autologous peripheral blood monocytes. This study was undertaken to evaluate the tolerance, efficiency and biological effects of AAMs in chemoresistant progressive colorectal cancers. From January 1993 to May 1995, 15 patients were treated. Mononuclear cells were collected six times by weekly apheresis, cultured for 7 days, and activated with interferon-gamma. AAMs were then separated by elutriation and re-infused intravenously, with a mean total of 7.95 x 10(9) macrophages per patient. Clinical tolerance was good: toxicity consisted only of a World Health Organisation grade 2 fever after 28% of the infusions. Responses were not seen in the 14 evaluable patients, as expected with very bulky tumours: in 11, the tumours continued to progress, but disease was stabilised in 3 patients who experienced progression-free survival for 14, 12 and 12 weeks, respectively.
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