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Villagrán-García M, Farina A, Campetella L, Arzalluz-Luque J, Honnorat J. Autonomic nervous system involvement in autoimmune encephalitis and paraneoplastic neurological syndromes. Rev Neurol (Paris) 2024; 180:107-116. [PMID: 38142198 DOI: 10.1016/j.neurol.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/25/2023]
Abstract
In autoimmune neurological diseases, the autonomic nervous system can be the primary target of autoimmunity (e.g. autoimmune autonomic ganglionopathy), or, more frequently, be damaged together with other areas of the nervous system (e.g. Guillain-Barré syndrome). Patients with autoimmune encephalitis and paraneoplastic neurological syndromes (PNS) often develop dysautonomia; however, the frequency and spectrum of autonomic signs and symptoms remain ill defined except for those scenarios in which dysautonomia is a core feature of the disease. Such is the case of Lambert-Eaton myasthenic syndrome, Morvan syndrome or anti-NMDAR encephalitis; in the latter, patients with dysautonomia have been reported to carry a more severe disease and to retain higher disability than those without autonomic dysfunction. Likewise, the presence of autonomic involvement indicates a higher risk of death due to neurological cause in patients with anti-Hu PNS. However, in anti-Hu and other PNS, as well as in the context of immune checkpoint inhibitors' toxicities, the characterization of autonomic involvement is frequently overshadowed by the severity of other neurological symptoms and signs. When evaluated with tests specific for autonomic function, patients with autoimmune encephalitis or PNS usually show a more widespread autonomic involvement than clinically suggested, which may reflect a potential gap of care when it comes to diagnosing dysautonomia. This review aims to revise the autonomic involvement in patients with autoimmune encephalitis and PNS, using for that purpose an antibody-based approach. We also discuss and provide general recommendations for the evaluation and management of dysautonomia in these patients.
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Affiliation(s)
- M Villagrán-García
- French Reference Centre on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, hôpital neurologique, Bron, France; Inserm U1314, MeLiS-UCBL-CNRS UMR 5284, University Claude-Bernard Lyon 1, Lyon, France
| | - A Farina
- French Reference Centre on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, hôpital neurologique, Bron, France; Inserm U1314, MeLiS-UCBL-CNRS UMR 5284, University Claude-Bernard Lyon 1, Lyon, France; Department of Neuroscience, Psychology, Pharmacology and Child Health, University of Florence, Florence, Italy
| | - L Campetella
- French Reference Centre on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, hôpital neurologique, Bron, France; Inserm U1314, MeLiS-UCBL-CNRS UMR 5284, University Claude-Bernard Lyon 1, Lyon, France
| | - J Arzalluz-Luque
- French Reference Centre on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, hôpital neurologique, Bron, France; Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - J Honnorat
- French Reference Centre on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, hôpital neurologique, Bron, France; Inserm U1314, MeLiS-UCBL-CNRS UMR 5284, University Claude-Bernard Lyon 1, Lyon, France.
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2
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Bouvet P, de Gea P, Aimard M, Chounlamountri N, Honnorat J, Delcros JG, Salin PA, Meissirel C. A novel peptide derived from vascular endothelial growth factor prevents amyloid beta aggregation and toxicity. Aging Cell 2023; 22:e13907. [PMID: 37415305 PMCID: PMC10497828 DOI: 10.1111/acel.13907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/10/2023] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
Amyloid-β oligomers (Aβo) are the most pathologically relevant Aβ species in Alzheimer's disease (AD), because they induce early synaptic dysfunction that leads to learning and memory impairments. In contrast, increasing VEGF (Vascular Endothelial Growth Factor) brain levels have been shown to improve learning and memory processes, and to alleviate Aβ-mediated synapse dysfunction. Here, we designed a new peptide, the blocking peptide (BP), which is derived from an Aβo-targeted domain of the VEGF protein, and investigated its effect on Aβ-associated toxicity. Using a combination of biochemical, 3D and ultrastructural imaging, and electrophysiological approaches, we demonstrated that BP strongly interacts with Aβo and blocks Aβ fibrillar aggregation process, leading to the formation of Aβ amorphous aggregates. BP further impedes the formation of structured Aβo and prevents their pathogenic binding to synapses. Importantly, acute BP treatment successfully rescues long-term potentiation (LTP) in the APP/PS1 mouse model of AD, at an age when LTP is highly impaired in hippocampal slices. Moreover, BP is also able to block the interaction between Aβo and VEGF, which suggests a dual mechanism aimed at both trapping Aβo and releasing VEGF to alleviate Aβo-induced synaptic damage. Our findings provide evidence for a neutralizing effect of the BP on Aβ aggregation process and pathogenic action, highlighting a potential new therapeutic strategy.
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Affiliation(s)
- P. Bouvet
- MeLiS, Institut NeuroMyoGène (INMG), Synaptopathies and Autoantibodies, Institut National de la Santé et de la Recherche Médicale (INSERM), U1314Centre National de la Recherche Scientifique (CNRS), UMR5284LyonFrance
- Univ LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - P. de Gea
- MeLiS, Institut NeuroMyoGène (INMG), Synaptopathies and Autoantibodies, Institut National de la Santé et de la Recherche Médicale (INSERM), U1314Centre National de la Recherche Scientifique (CNRS), UMR5284LyonFrance
- Univ LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - M. Aimard
- MeLiS, Institut NeuroMyoGène (INMG), Synaptopathies and Autoantibodies, Institut National de la Santé et de la Recherche Médicale (INSERM), U1314Centre National de la Recherche Scientifique (CNRS), UMR5284LyonFrance
- Univ LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - N. Chounlamountri
- MeLiS, Institut NeuroMyoGène (INMG), Synaptopathies and Autoantibodies, Institut National de la Santé et de la Recherche Médicale (INSERM), U1314Centre National de la Recherche Scientifique (CNRS), UMR5284LyonFrance
- Univ LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - J. Honnorat
- MeLiS, Institut NeuroMyoGène (INMG), Synaptopathies and Autoantibodies, Institut National de la Santé et de la Recherche Médicale (INSERM), U1314Centre National de la Recherche Scientifique (CNRS), UMR5284LyonFrance
- Univ LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - J. G. Delcros
- Univ LyonUniversité Claude Bernard Lyon 1LyonFrance
- Centre de Recherche en Cancérologie de Lyon, Apoptosis, Cancer and Development, Institut PLAsCAN, INSERM U1052, CNRS UMR5286Centre Léon BérardLyonFrance
- Centre de Recherche en Cancérologie de Lyon, Small Molecules for Biological TargetsINSERM U1052 – CNRS UMR5286, ISPB RockefellerLyonFrance
| | - P. A. Salin
- Univ LyonUniversité Claude Bernard Lyon 1LyonFrance
- Centre de Recherche en Neurosciences de Lyon, Forgetting Processes and Cortical DynamicsINSERM U1028, CNRS UMR5292BronFrance
| | - C. Meissirel
- MeLiS, Institut NeuroMyoGène (INMG), Synaptopathies and Autoantibodies, Institut National de la Santé et de la Recherche Médicale (INSERM), U1314Centre National de la Recherche Scientifique (CNRS), UMR5284LyonFrance
- Univ LyonUniversité Claude Bernard Lyon 1LyonFrance
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Idbaih A, Ducray F, Honnorat J. Foreword. Rev Neurol (Paris) 2023; 179:377. [PMID: 37197890 DOI: 10.1016/j.neurol.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/19/2023]
Affiliation(s)
- A Idbaih
- Service de neurologie 2, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, AP-HP, Hôpital universitaire La Pitié Salpêtrière, DMU Neurosciences, 75013 Paris, France.
| | - F Ducray
- Department of Neuro-Oncology, East Group Hospital, Hospices civils de Lyon, Lyon, France; Inserm U1052, CNRS UMR 5286, Centre de recherche en cancérologie de Lyon, Cancer Cell Plasticity Department, Transcriptome Diversity in Stem Cells Laboratory, Lyon, France
| | - J Honnorat
- Department of Neuro-Oncology, East Group Hospital, Hospices civils de Lyon, Lyon, France; Inserm U1052, CNRS UMR 5286, Centre de recherche en cancérologie de Lyon, Cancer Cell Plasticity Department, Transcriptome Diversity in Stem Cells Laboratory, Lyon, France
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4
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Farina A, Villagrán-García M, Honnorat J. Neurological adverse events of immune checkpoint inhibitors: An update of clinical presentations, diagnosis, and management. Rev Neurol (Paris) 2023; 179:506-515. [PMID: 36934022 DOI: 10.1016/j.neurol.2023.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 02/14/2023] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023]
Abstract
The use of immune checkpoint inhibitors (ICIs) has represented a major advance in cancer treatment. By enhancing endogenous immune responses to destroy cancer cells, ICIs can cause immune-related adverse events (irAEs), with possible involvement of any organ system. IrAEs are frequent, particularly those involving the skin or the endocrine system, and usually completely reversible after temporary immunosuppression, while neurological irAEs (n-irAEs) are relatively rare, often severe, and they carry a considerable risk of mortality and long-term disability. They usually affect the peripheral nervous system, mainly manifesting as myositis, polyradiculoneuropathy, or cranial neuropathy, and, less frequently, involve the central nervous system, causing encephalitis, meningitis, or myelitis. Although somehow reminiscent of the disorders that neurologists are familiar to deal with in their daily practice, n-irAEs are characterized by distinctive features from their idiopathic counterparts; for instance, myositis may have a predominant oculo-bulbar involvement reminiscent of myasthenia gravis and frequently associates with myocarditis; peripheral neuropathy, although often resembling Guillain-Barré syndrome, usually responds to corticosteroids. Remarkably, several associations between the neurological phenotype and the type of ICIs or the type of cancer have emerged in the last few years, and the growing administration of ICIs in patients with neuroendocrine cancers has led to an increased number of reports of paraneoplastic neurological syndromes (triggered or worsened by ICIs). This review aims to update current knowledge regarding the clinical presentation of n-irAEs. We also discuss the essential parts of the diagnostic approach, and we provide general recommendations for the management of these disorders.
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Affiliation(s)
- A Farina
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; MeLiS, UCBL, CNRS UMR 5284, Inserm U1314, Université Claude-Bernard Lyon 1, Lyon, France; Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino, Università di Firenze, Firenze, Italy
| | - M Villagrán-García
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; MeLiS, UCBL, CNRS UMR 5284, Inserm U1314, Université Claude-Bernard Lyon 1, Lyon, France
| | - J Honnorat
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; MeLiS, UCBL, CNRS UMR 5284, Inserm U1314, Université Claude-Bernard Lyon 1, Lyon, France.
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Hristovska I, Robert M, Combet K, Honnorat J, Comte JC, Pascual O. Sleep decreases neuronal activity control of microglial dynamics in mice. Nat Commun 2022; 13:6273. [PMID: 36271013 PMCID: PMC9586953 DOI: 10.1038/s41467-022-34035-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/12/2022] [Indexed: 12/25/2022] Open
Abstract
Microglia, the brain-resident immune cells, are highly ramified with dynamic processes transiently contacting synapses. These contacts have been reported to be activity-dependent, but this has not been thoroughly studied yet, especially in physiological conditions. Here we investigate neuron-microglia contacts and microglia morphodynamics in mice in an activity-dependent context such as the vigilance states. We report that microglial morphodynamics and microglia-spine contacts are regulated by spontaneous and evoked neuronal activity. We also found that sleep modulates microglial morphodynamics through Cx3cr1 signaling. At the synaptic level, microglial processes are attracted towards active spines during wake, and this relationship is hindered during sleep. Finally, microglial contact increases spine activity, mainly during NREM sleep. Altogether, these results indicate that microglial function at synapses is dependent on neuronal activity and the vigilance states, providing evidence that microglia could be important for synaptic homeostasis and plasticity.
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Affiliation(s)
- I. Hristovska
- INSERM U1314, CNRS UMR5284, MeLiS, Lyon, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Lyon, France
| | - M. Robert
- INSERM U1314, CNRS UMR5284, MeLiS, Lyon, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Lyon, France ,grid.414243.40000 0004 0597 9318French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, 59 Boulevard Pinel, 69677 Bron, Cedex France
| | - K. Combet
- INSERM U1314, CNRS UMR5284, MeLiS, Lyon, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Lyon, France
| | - J. Honnorat
- INSERM U1314, CNRS UMR5284, MeLiS, Lyon, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Lyon, France ,grid.414243.40000 0004 0597 9318French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, 59 Boulevard Pinel, 69677 Bron, Cedex France
| | - J-C Comte
- grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Lyon, France ,grid.461862.f0000 0004 0614 7222INSERM U1028, CNRS UMR5292, Lyon, France ,Centre de Recherche en Neuroscience de Lyon, Lyon, France
| | - O. Pascual
- INSERM U1314, CNRS UMR5284, MeLiS, Lyon, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Lyon, France
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6
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Alberto T, Honnorat J, Joubert B. Sindromi neurologiche paraneoplastiche. Neurologia 2022. [DOI: 10.1016/s1634-7072(22)46429-4] [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: 11/30/2022] Open
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Ciano-Petersen NL, Muñiz-Castrillo S, Vogrig A, Joubert B, Honnorat J. Immunomodulation in the acute phase of autoimmune encephalitis. Rev Neurol (Paris) 2022; 178:34-47. [PMID: 35000790 DOI: 10.1016/j.neurol.2021.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022]
Abstract
Autoimmune encephalitides constitute an emerging group of diseases for which the diagnosis and management may be challenging, and are usually associated with antibodies against neuroglial antigens used as biomarkers. In this review, we aimed to clarify the diagnostic approach to patients with encephalitis of suspected autoimmune origin in order to initiate early immunotherapy, and to summarize the evidence of current immunotherapies and alternative options assessed for refractory cases. Currently, the general therapeutic approach consists of steroids, IVIG, and/or plasma exchange as first-line medications, which should be prescribed once a diagnosis of possible autoimmune encephalitis is established. For patients not responding to these treatments, rituximab and cyclophosphamide are used as second-line immunotherapy. Additionally, alternative therapies, chiefly tocilizumab and bortezomib, have been reported to be useful in particularly refractory cases. Although the aforementioned approach with first and second-line immunotherapy is widely accepted, the best therapeutic strategy is still unclear since most available evidence is gathered from retrospective non-controlled studies. Moreover, several predictors of good long-term prognosis have been proposed such as response to first-line therapies, modified Rankin score lesser than 4 at the worst neurologic status, no need for admission in intensive care unit, and early escalation to second-line immunotherapy. Thus, the lack of solid evidence underlines the necessity of future well-conducted trials addressing both the best therapeutic regimen and the outcome predictors, but since autoimmune encephalitides have a relatively low incidence, international collaborations seem imperative to reach a reasonable study population size.
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Affiliation(s)
- N L Ciano-Petersen
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Biomedical Research Institute of Málaga-IBIMA, Málaga, Spain; Neurology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - S Muñiz-Castrillo
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - A Vogrig
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - B Joubert
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - J Honnorat
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
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Ducray F, Sanson M, Chinot O, Fontanilles M, Rivoirard R, Thomas-Maisonneuve L, Cartalat S, Tabouret E, Bonneville-Levard A, Darlix A, Ameli R, Meyronet D, Gueyffier F, Remontet L, Maucort-Boulch D, Dehais C, Honnorat J. KS02.4.A Olaparib in Recurrent IDH-mutant High-Grade Glioma (OLAGLI). Neuro Oncol 2021; 23:ii4-ii4. [PMCID: PMC8427448 DOI: 10.1093/neuonc/noab180.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023] Open
Abstract
Abstract
BACKGROUND
There is a need to develop new treatments in IDH-mutant high-grade gliomas recurring after radiotherapy and chemotherapy. Based on preclinical studies showing that IDH-mutant tumors could be vulnerable to PARP inhibition we launched a phase II study to test the efficacy of olaparib (Lynparza) monotherapy in this population.
METHODS
Adults with recurrent high-grade IDH-mutant gliomas after radiotherapy and at least one line of alkylating chemotherapy (PCV or TMZ), KPS > 60, normal organ function were enrolled. The primary endpoint was 6 months PFS according to RANO criteria. Patients were treated with olaparib 300 mg twice daily. We used a single-stage Fleming design with p0 = 30%, p1 = 50%, a type I unilateral error rate of 5% and a power of 80%.
RESULTS
35 patients with recurrent IDH-mutant gliomas (IDH1R132H-mutant n = 32, other IDH mutation n = 3, 1p/19 codeleted n = 16, 1p/19q non-codeleted n = 14) were enrolled (malignantly transformed low-grade gliomas n = 21, anaplastic gliomas n = 8, glioblastomas n = 6). Median time since diagnosis was 7.4 years (1–22 years), median time since radiotherapy was 2.8 years (0.6–18 years), median number of previous chemotherapy lines was 2 (1–5). With a median follow-up of 11 months, 30 patients had stopped treatment due to tumor progression and 2 patients were still on treatment 16 to 18 months after treatment start. At 6 months, 11/35 patients were progression-free (31 %). According to RANO criteria, based on local investigator analysis, 2 patients (5%) had a partial response and 14 patients a stable disease (37%) with a median duration of response of 9 months (4–18+). Median PFS and OS were 2.3 and 15.9 months and were similar in 1p/19q codeleted and non-codeleted patients. A grade 3 olaparib-related adverse event was observed in 5 patients (14%, lymphopenia n = 3, fatigue n = 2, diarrhea n = 1) and a grade 2 in 15 patients (43%), most frequently consisting in fatigue (23%), gastrointestinal disorders (20%) and lymphopenia (20%). No patient definitively stopped olaparib due to side effects.
CONCLUSIONS
In this heavily pre-treated population of recurrent IDH-mutant gliomas, olaparib monotherapy was well tolerated and resulted in some activity supporting its evaluation in association with alkylating chemotherapy in recurrent IDH-mutant gliomas in future studies.
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Affiliation(s)
- F Ducray
- Hospices Civils de Lyon, Lyon, France
| | | | | | | | - R Rivoirard
- Institut de Cancerologie de la Loire, Saint Etienne, France
| | | | | | | | | | - A Darlix
- CHU Montpellier, Montpellier, France
| | - R Ameli
- Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | - C Dehais
- Hospices Civils de Lyon, Lyon, France
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Mesny E, Barritault M, Izquierdo C, Poncet D, d’Hombres A, Guyotat J, Jouanneau E, Ameli R, Honnorat J, Meyronet D, Ducray F. P14.12 Gyriform infiltration as imaging biomarker for adult diffuse astrocytic glioma, IDH wildtype, with molecular features of glioblastoma. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.137] [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
Diffuse astrocytic gliomas, IDH wildtype, with molecular features of glioblastoma (molecular glioblastomas) are associated with a poor prognosis. We previously found that these tumors frequently display gyriform infiltration, defined as areas of elective cortical hypersignal on MRI FLAIR sequence. The objective of the present study was to assess the diagnostic value of gyriform infiltration as an imaging marker for these tumors.
MATERIAL AND METHODS
MRI scans from 430 patients with newly diagnosed glioma (molecular glioblastoma n = 31, IDH wildtype glioblastoma n = 298, IDH-mutant astrocytoma n = 50, IDH-mutant and 1p19q codeleted oligodendroglioma n= 51) were evaluated for the presence of a gyriform infiltration by 2 independent reviewers. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the performance of the presence of a gyriform infiltration for identifying molecular glioblastoma.
RESULTS
A gyriform infiltration was observed in 16/31 (52%) patients with a molecular glioblastoma, 40/298 (13%) patients with an IDH-wildtype glioblastoma but in none of the patients with an IDH-mutant astrocytomas or an IDH-mutant and 1p19q codeleted oligodendroglioma. Among the 56 patients with a gyriform infiltration, 54 patients had an IDH wildtype pTERT mutant glioma and 2 an IDH wildtype pTERT wildtype glioma. Interrater agreement was good (κ= 0.68, P < 0.001). Specificity, sensitivity, PPV and NPV of the presence of a gyriform infiltration for the diagnosis of molecular glioblastoma were 90%, 29%, 52% and 96% and for the diagnosis of an IDHwt pTERT mutant glioma were 97%, 15%, 96% and 20%. The presence of a gyriform infiltration was associated with a worse prognosis in the entire cohort (13.6 months vs 29.3 months, P = .001).
CONCLUSION
Gyriform infiltration is a specific imaging marker of molecular glioblastomas and IDH wildtype pTERT mutant diffuse gliomas.
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Affiliation(s)
- E Mesny
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de neuro-oncologie, Lyon, France
| | - M Barritault
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service d’anatomopathologie, Lyon, France
| | - C Izquierdo
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de neuro-oncologie, Lyon, France
| | - D Poncet
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service d’anatomopathologie, Lyon, France
| | - A d’Hombres
- Hospices Civils de Lyon, CHU Lyon Sud, Service de radiothérapie, Lyon, France
| | - J Guyotat
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de neuro-chirurgie, Lyon, France
| | - E Jouanneau
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de neuro-chirurgie, Lyon, France
| | - R Ameli
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de radiologie, Lyon, France
| | - J Honnorat
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de neuro-oncologie, Lyon, France
| | - D Meyronet
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service d’anatomopathologie, Lyon, France
| | - F Ducray
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de neuro-oncologie, Lyon, France
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Laigle-Donadey F, Metellus P, Guyotat J, Menei P, Proust F, Dufour H, Chinot O, Honnorat J, Faillot T, Paquis P, Peruzzi P, Emery E, Guillamo JS, Carpentier A, Wager M, Lebbah S, Hajage D, Delattre JY, Cornu P. PL03.1.A Surgery for glioblastomas in the elderly: an ANOCEF trial (CSA). Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
The role of surgery for the treatment of malignant gliomas in patients 70 years of age or older is unsettled. We conducted a randomized trial that compared surgical resection of the tumor and biopsy only, both followed by standard therapy, in such patients.
MATERIAL AND METHODS
Patients aged 70 years and older, with a KPS of at least 50, presenting with a radiological suspicion of an operable glioblastoma (GBM) were randomly assigned between tumor resection and biopsy. Subsequently, they underwent standard radiotherapy during the first years of the trial (2008–2017), with the adjunction of concomitant and adjuvant temozolomide when this regimen became standard (2017–2019). The primary end point was survival; secondary endpoints were progression free survival (PFS), cognitive status (MMS), autonomy (KPS), quality of life (EORTC QLQ C30 and BN20), and perioperative morbidity/ mortality.
RESULTS
From 2008 to 2019, 107 patients from 9 centers were enrolled in the study, of whom 101 were evaluable for analysis because the diagnosis of GBM was histologically confirmed (50 patients in the “surgery” arm and 51 patients in the “biopsy” arm). There was no statistically significant difference of median survival between the “surgery” arm (9.37 mo) and the “biopsy” arms (8.96 mo, p=0.36). However, the surgery group had increased PFS (5.06 mo vs 4.02 mo; p=0.034; p=0.002 on multivariate analysis) and better QOL (e.g. physical and cognitive functioning, motor dysfunction, fatigue) and KPS score evolution as compared to the “biopsy” group. Surgery was not associated with increased mortality or morbidity.
CONCLUSION
This study suggests that optimal debulking surgery does not provide a significant survival benefit in elderly patients suffering from newly diagnosed malignant glioma, but resection improves QOL and autonomy with a significant though modest improvement of PFS.
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Affiliation(s)
| | - P Metellus
- Hôpital Privé Clairval, Marseille, France
| | | | - P Menei
- CHU d’Angers, Angers, France
| | - F Proust
- Hôpital Charles Nicolle, Rouen, France
| | - H Dufour
- Hôpital de la Timone, Marseille, France
| | - O Chinot
- Hôpital de la Timone, Marseille, France
| | | | | | | | | | | | | | | | - M Wager
- CHU de Poitiers, Poitiers, France
| | - S Lebbah
- Hôpital Pitié-Salpêtrière, Paris, France
| | - D Hajage
- Hôpital Pitié-Salpêtrière, Paris, France
| | | | - P Cornu
- Hôpital Pitié-Salpêtrière, Paris, France
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11
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Picart T, Poncet D, Barritault M, Pallud J, Metellus P, Zouaoui S, Bauchet L, Guyotat J, Gabut M, Honnorat J, Ducray F, Meyronet D. OS02.4.A Molecular characterization of adult cerebellar glioblastomas identifies distinct prognosis subgroups. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Adult cerebellar glioblastomas (cGBM) are very rare and recent studies have shown that they constitute a heterogeneous group of gliomas. The aim of the present study was to characterize the prevalence and prognostic significance of major driver molecular alterations in a large series of cGBM.
MATERIAL AND METHODS
Adults with histologically proven cGBM diagnosed between 2003 and 2017 were identified from the French brain tumor database and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie. Tumors were reviewed and reclassified according to WHO 2016. Targeted sequencing was performed, including determination of H3F3A, TERTp, IDH1/2, FGFR1, BRAF and EGFR status.
RESULTS
A total of 83 adult patients (median age 57 years) with cGBM (hemispheric n= 47, vermian n=14 or both n=22) were identified. Median overall survival was 10 months. Main molecular alterations observed were TERT promoter, H3F3A K27M, hotspot FGFR1 (N546 and K656), BRAF mutations, EGFR amplification and ATRX loss of expression in 19.2%, 18.8%, 10.9%, 2.6%, 19.5% and 22.7% of patients, respectively. cGBM could be classified into 6 mutually exclusive subgroups associated with age at diagnosis and prognosis: pTERT and/or EGFR amplified tumors (n=22, 26.5%, median age = 62 years, median OS = 4 months), H3K27M-mutant tumors (n=15, 18.1%, median age = 48 years, median OS =8 months), tumors with MAPK pathway activating mutations (FGFR1, BRAF) or occurring in NF1 patients (n=15, 18.1%, median age = 41 years, median OS = 57 months), radiation-induced tumors (n=5, 6%, median age = 47 years, median OS = 5 months), IDH-mutant tumors (n=1) and unclassified tumors (n=25, 30.1%, median age = 63 years, median OS = 17 months). In multivariate analysis, MAPK activating mutations and ATRX loss of expression were independently associated with a better outcome and pTERT/EGFR alterations with a worse outcome.
CONCLUSION
About 18% of tumors diagnosed as cGBM harbor actionable MAPK activating genetic alterations. Targeted sequencing enables to classify these tumors into clinically relevant subgroups.
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Affiliation(s)
- T Picart
- Hospices Civils de Lyon, Department of Neurosurgery, Lyon, France
| | - D Poncet
- Hospices Civils de Lyon, Department of Neuropathology and Molecular Biology, Lyon, France
| | - M Barritault
- Hospices Civils de Lyon, Department of Neuropathology and Molecular Biology, Lyon, France
| | - J Pallud
- Hôpital Sainte Anne, Department of Neurosurgery, Paris, France
| | - P Metellus
- Hôpital Privé Clairval, Department of Neurosurgery, Marseille, France
| | - S Zouaoui
- CHU de Montpellier, French Brain Tumor Database, Montpellier, France
| | - L Bauchet
- CHU de Montpellier, Department of Neurosurgery, Montpellier, France
| | - J Guyotat
- Hospices Civils de Lyon, Department of Neurosurgery, Lyon, France
| | - M Gabut
- CRCL, Department of Cancer Cell Plasticity, Lyon, France
| | - J Honnorat
- Hospices Civils de Lyon, Department of Neurooncology, Lyon, France
| | - F Ducray
- Hospices Civils de Lyon, Department of Neurooncology, Lyon, France
| | - D Meyronet
- Hospices Civils de Lyon, Department of Neuropathology and Molecular Biology, Lyon, France
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12
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Flabeau O, Laurent C, Schneider S, Honnorat J, Ellie E. Spinal cord tractopathy in paraneoplastic anti-CV2/CRMP5 myelitis responsive to plasma exchange. Rev Neurol (Paris) 2021; 178:280-282. [PMID: 34247849 DOI: 10.1016/j.neurol.2021.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/16/2021] [Indexed: 10/20/2022]
Affiliation(s)
- O Flabeau
- Department of Neurology, Centre Hospitalier de la Côte Basque, 64100 Bayonne, France
| | - C Laurent
- Department of Neuroradiology, Centre Hospitalier de la Côte Basque, 64100 Bayonne, France
| | - S Schneider
- Department of Pneumology, Centre Hospitalier de la Côte Basque, 64100 Bayonne, France
| | - J Honnorat
- French Reference Center on autoimmune encephalitis, Hospices Civils de Lyon, Institut NeuroMyoGene, Inserm U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - E Ellie
- Department of Neurology, Centre Hospitalier de la Côte Basque, 64100 Bayonne, France.
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13
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Ducray F, Sanson M, Chinot OL, Fontanilles M, Rivoirard R, Thomas-Maisonneuve L, Cartalat S, Tabouret E, Bonneville-Levard A, Darlix A, Ameli R, Meyronet D, Gueyffier F, Remontet L, Maucort-Boulch D, Dehais C, Honnorat J. Olaparib in recurrent IDH-mutant high-grade glioma (OLAGLI). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.2007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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
2007 Background: There is a need to develop new treatments in IDH-mutant high-grade gliomas recurring after radiotherapy and chemotherapy. Based on preclinical studies showing that IDH-mutant tumors could be vulnerable to PARP inhibition we launched a phase II study to test the efficacy of olaparib (Lynparza) monotherapy in this population. Methods: Adults with recurrent high-grade IDH-mutant gliomas after radiotherapy and at least one line of alkylating chemotherapy (PCV or TMZ), KPS > 60, normal organ function were enrolled. The primary endpoint was 6 months PFS according to RANO criteria. Patients were treated with olaparib 300 mg twice daily. We used a single-stage Fleming design with p0 = 30%, p1 = 50%, a type I unilateral error rate of 5% and a power of 80%. Results: 35 patients with recurrent IDH-mutant gliomas (IDH1R132H-mutant n = 32, other IDH mutation n = 3, 1p/19 codeleted n = 16, 1p/19q non-codeleted n = 14) were enrolled (malignantly transformed low-grade gliomas n = 21, anaplastic gliomas n = 8, glioblastomas n = 6). Median time since diagnosis was 7.4 years (1-22 years), median time since radiotherapy was 2.8 years (0.6-18 years), median number of previous chemotherapy lines was 2 (1-5). With a median follow-up of 11 months, 30 patients had stopped treatment due to tumor progression and 2 patients were still on treatment 16 to 18 months after treatment start. At 6 months, 11/35 patients were progression-free (31 %). According to RANO criteria, based on local investigator analysis, 2 patients (5%) had a partial response and 14 patients a stable disease (37%) with a median duration of response of 9 months (4-18 months+). Median PFS and OS were 2.3 and 15.9 months and were similar in 1p/19q codeleted and non-codeleted patients. A grade 3 olaparib-related adverse event was observed in 5 patients (14%, lymphopenia n = 3, fatigue n = 2, diarrhea n = 1) and a grade 2 in 15 patients (43%), most frequently consisting in fatigue (23%), gastrointestinal disorders (20%) and lymphopenia (20%). No patient definitively stopped olaparib due to side effects. Conclusions: In this heavily pre-treated population of recurrent IDH-mutant gliomas, olaparib monotherapy was well tolerated and resulted in some activity supporting its evaluation in association with alkylating chemotherapy in recurrent IDH-mutant gliomas in future studies. Clinical trial information: NCT03561870.
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Affiliation(s)
- Francois Ducray
- Service de Neuro-oncologie, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France
| | - Marc Sanson
- FranceHopitaux Universitaires La Pitie Salpetriere- Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Olivier L. Chinot
- Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neurooncologie, Marseille, France, Marseille, France
| | - Maxime Fontanilles
- Department of Medical Oncology Department, Centre Henri Becquerel, Rouen, France
| | - Romain Rivoirard
- Institut de Cancerologie de la Loire, ST Priest EN Jarez, France
| | | | | | - Emeline Tabouret
- Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service de Neurooncologie, Marseille, France, Marseille, France
| | | | - Amelie Darlix
- Department of Medical Oncology, Institut du Cancer de Montpellier, Institut de Génomique fonctionnelle, CNRS, University of MontpellierOncology, Montpellier, France
| | | | | | | | | | - Delphine Maucort-Boulch
- Université de Lyon, F-69000, Lyon, France, Université Lyon 1, F-69100, Villeurbanne, France, Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, F-69003, Lyon, France, CNRS, UMR 5558, Lyon, France
| | - Caroline Dehais
- Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires La Pitié-Salpêtrière, Department of Neuro-oncology, Paris, France
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14
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Hebert J, Riche B, Rabilloud M, Honnorat J. Epidemiology of paraneoplastic neurologic disorders and autoimmune encephalitides in France. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Tailland M, Le Verger L, Honnorat J, Biquard F, Codron P, Cassereau J. Post-herpetic anti-N-methyl-d-aspartate receptor encephalitis in a pregnant woman. Rev Neurol (Paris) 2019; 176:129-131. [PMID: 31542179 DOI: 10.1016/j.neurol.2019.01.402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 11/16/2022]
Affiliation(s)
- M Tailland
- Department of Neurology, University Hospital of Angers, 49033 Angers, France.
| | - L Le Verger
- Department of Neurology, University Hospital of Angers, 49033 Angers, France
| | - J Honnorat
- Department of Neuro-oncology, Hospices Civils de Lyon, Lyon, France
| | - F Biquard
- Department of Gynecology, University Hospital of Angers, Angers, France
| | - P Codron
- Department of Neurology, University Hospital of Angers, 49033 Angers, France
| | - J Cassereau
- Department of Neurology, University Hospital of Angers, 49033 Angers, France; Neuromuscular diseases reference centre, University Hospital of Angers, Angers, France
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16
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Desestret V, Pissaloux D, Treilleux I, Small M, Robert M, Rogemond V, Picard G, Psimaras D, Alentorn A, Honnorat J. JS1.1 Specific genetic alterations of breast tumors lead to Yo paraneoplastic cerebellar syndromes. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Paraneoplastic cerebellar degenerations with anti-Yo antibodies (Yo-PCD) are rare syndromes associated with ovarian or breast cancers and caused by an auto-immune response against neuronal antigens expressed by tumor cells. We previously demonstrated in Yo-PCD ovarian cancers an association between massive infiltration of ovarian tumors by activated immune effector cells and recurrent gains and/or mutations of onconeural Yo genes (CDR2L and CDR2), suggesting that such genetic alterations in ovarian tumor cells may trigger immune tolerance breakdown and initiation of the auto-immune reaction against Purkinje cells.
MATERIAL AND METHODS
We pursued the characterization of Yo-PCD tumors and specifically studied breast cancer by IHC, FISH, CGH array and RNA sequencing analysis of 17 breast Yo-PCD tumors and by comparing their genetic characteristics with 10 sporadic breast tumors and public databases.
RESULTS
We confirmed that specific genetic alterations were also present in breast cancers associated with Yo-PCD. Moreover, this study provides additional evidence for a role of tumor cell specificities in PCD immunopathology by revealing peculiarities in Yo-PCD breast tumors compared to Yo-PCD ovarian cancer. Indeed, not only the CDR2L Yo gene was amplified in 8/9 breast Yo-PCD cancers but also the Erb2/Her2 gene in 15/16 (both genes are on chromosome 17q). In addition to this original Her2 and Yo antigen amplification confirmed by FISH, we observed an overexpression of these proteins by IHC analysis. These Yo-PCD breast cancers are also all negative for hormone receptors (HR). Thus, Yo-PCD breast tumors seem to belong to the molecularly and clinically distinct class of HR-negative and Her2-enriched breast cancers, which represents less than 10 % of breast cancers in the general population. Transcriptomic analysis confirmed that breast Yo-PCD tumors differ by their expression programs from classical breast cancers molecular subtypes.
CONCLUSION
Understanding the tumor genetic features leading to the immune breakdown and anti-tumor immune response as well as nervous tissue attack remains challenging and seems to be specific according to the tumor subtypes. Herein, our results suggest that, despite sharing common genetic alterations (copy number variations and mutations affecting Yo genes), the Yo-PCD immunopathogenesis of breast and ovarian cancers differ by involving different tumor-specific molecular pathways.
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Affiliation(s)
- V Desestret
- Institut NeuroMyogène, INSERM U1217/UMR CRS 5310, Lyon, France, Lyon, France
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices civils de Lyon, Lyon, France
| | - D Pissaloux
- Department of Biopathology, Centre Leon Berard, Lyon, France
- Cancer Genomics platform, Department of Translational Research, Centre Leon Berard, Lyon, France
| | - I Treilleux
- Department of Biopathology, Centre Leon Berard, Lyon, France
| | - M Small
- Institut NeuroMyogène, INSERM U1217/UMR CRS 5310, Lyon, France, Lyon, France
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices civils de Lyon, Lyon, France
| | - M Robert
- Institut NeuroMyogène, INSERM U1217/UMR CRS 5310, Lyon, France, Lyon, France
- University of Lyon, Claude Bernard Lyon1, Lyon, France
| | - V Rogemond
- Institut NeuroMyogène, INSERM U1217/UMR CRS 5310, Lyon, France, Lyon, France
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices civils de Lyon, Lyon, France
| | - G Picard
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices civils de Lyon, Lyon, France
| | - D Psimaras
- French Reference Center on Paraneoplastic Neurological Syndrome, Assistante Publique-Hôpitaux de Paris, Paris, France
| | - A Alentorn
- French Reference Center on Paraneoplastic Neurological Syndrome, Assistante Publique-Hôpitaux de Paris, Paris, France
| | - J Honnorat
- Institut NeuroMyogène, INSERM U1217/UMR CRS 5310, Lyon, France, Lyon, France
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices civils de Lyon, Lyon, France
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17
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Hodroj K, Meyronet D, Barritault M, Bourg V, Cohen-Moyal E, Cartalat S, Ameli R, Berhouma M, Honnorat J, Ducray F. OS5.4 Characteristics of adult diffuse H3K27M-mutant gliomas at recurrence. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.037] [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
Adult diffuse H3K27M-mutant gliomas are rare and associated with a poor prognosis but could benefit in the next future from specific therapeutic strategies. In this context, the aim of the present study was to describe the characteristics of these tumors at recurrence.
MATERIAL AND METHODS
We retrospectively analyzed the characteristics of a series of 27 adult diffuse H3K27M-mutant gliomas at recurrence
RESULTS
Median age at diagnosis was 37 years. Initial treatment consisted of temozolomide radiochemotherapy (n=17, 62%), radiotherapy alone (n=1, 4%), chemotherapy alone (n=4, 15%), wait and see (n=1, 4%) and palliative care (n=4, 15%). Median PFS and median OS were 11 and 22 months in the whole series and 15 and 29 months in the patients who were treated with temozolomide radiochemotherapy. The pattern of recurrence could be analyzed in 19 patients. Ten patients (50%) demonstrated a local recurrence, five patients a local and distant recurrence (25%), two patients only a distant recurrence (10%) and two patients a leptomeningeal progression (10%). At recurrence, 15 patients received an oncological treatment that consisted of an alkylating chemotherapy (n=5), a bevacizumab based chemotherapy regimen (n=9) and of radiotherapy (n=1). Median PFS and OS after first recurrence in these patients were 6 and 14 months, respectively. An activating FGFR1 mutation was identified in 4 out of the 9 patients in whom it was assessed.
CONCLUSION
At recurrence, adult diffuse H3K27M-mutant gliomas are associated with a high rate of distant locations. A subset of patients harbor targetable FGFR1 activating mutations.
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Affiliation(s)
- K Hodroj
- interne d’oncologie HCL, Lyon, France
| | | | | | - V Bourg
- neurologie CHU de Nice, Nice, France
| | | | | | - R Ameli
- Neuro-radiologie HCL, Lyon, France
| | | | | | - F Ducray
- Neuro-oncologie HCL, Lyon, France
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18
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Poncet D, Picart T, Guyotat J, Jouanneau E, Joubert B, Vasiljevic A, Honnorat J, Meyronet D, Ducray F, Barritault M. P14.88 Comparison of SNaPshot PCR and digital droplet PCR for the identification of TERT promoter in non-diagnostic biopsies from glioma patients. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.323] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
We previously showed that TERT promotor (pTERT) mutations can be detected in a high proportion of non-diagnostic biopsies from glioma patients using SNaPshot PCR. The aim of the present study was to assess the diagnostic value of digital droplet PCR (ddPCR) in this setting.
MATERIAL AND METHODS
pTERT mutations were retrospectively assessed using SNaPshot PCR and ddPCR in the non-diagnostic biopsies of 14 adult patients who underwent an initial non-diagnostic needle biopsy that led to perform another biopsy that finally demonstrated a pTERT-mutant glioma.
RESULTS
Median age at diagnosis was 69 years and the median interval between the initial and final biopsy was 22 days. The initial biopsy consisted of unspecific infiltrating glial cells (n=10), hemorrhage, necrosis and/or fibrosis (n=4). Using SNaPshot PCR, the final biopsy found an IDH-WT pTERT-mutant glioma in 12 cases (glioblastoma n=12), an IDH-mutant pTERT-mutant oligodendroglioma in one case and an IDH-WT pTERT-WT glioblastoma in one case. Retrospectively, a pTERT mutation was identified by both ddPCR and SNaPshot in the non-diagnostic biopsies in 85% (11 /13) of pTERT mutant-gliomas. No mutation was detected in the non-diagnostic biopsies of IDH-WT pTERT-WT gliomas using either technique. Overall, a pTERT mutation were detected in 79% (11/14) of non-diagnostic biopsies.
CONCLUSION
Digital Droplet PCR, as SNaPshot PCR, enables the identification of pTERT mutations in a high rate of non-diagnostic biopsies from glioma patients. The sensitivity of both techniques seems similar in this setting.
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Affiliation(s)
- D Poncet
- Hospices Civils de Lyon, Lyon, France
| | - T Picart
- Hospices Civils de Lyon, Lyon, France
| | - J Guyotat
- Hospices Civils de Lyon, Lyon, France
| | | | - B Joubert
- Hospices Civils de Lyon, Lyon, France
| | | | | | | | - F Ducray
- Hospices Civils de Lyon, Lyon, France
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19
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Birzu C, Jaume L, Rostomashvilli S, Honnorat J, Berzero G, Psimaras D. P10.06 Stiff limb syndrome associated to anti NMDA-R antibodies. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.146] [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
Stiff person spectrum disorder is a group of rare conditions clinically characterized by the core symptoms of fluctuating muscular stiffness with superimposed spasms and an exaggerated startle response (hyperkplexia). It includes multiple variants amongst which are focal forms like stiff limb syndrome. Up to date, it was described in association with a spectrum of antibodies interfering with gabaergic transmission, most frequently antibodies targeting GAD, glycine receptor, amphiphysin and more rare dipeptidylpeptidase like protein 6, gephyrin, GABAAR and Glycine transporter 2.
MATERIAL AND METHODS
We report the case of a stiff limb syndrome associated to anti-NMDAR antibodies. The patient, a French 44-year male, with no antecedents presents with a 2-month history of painful spasms in his both legs resulting in a difficulty of walking and multiple falls. The diagnosis was supported by a stiff limb syndrome clinical pattern, a clinical response to treatment with benzodiazepines and baclofen and by the absence of other neurological finding that could have suggested an alternative diagnosis.
RESULTS
Anti NMDA-R antibodies were identified in blood and CSF samples using both immunofluorescence and cell-based assay. Any other intracellular and surface antibodies were negatives, GAD-ab included. Oncological evaluation was negative. The patient didn’t present encephalopathy signs and neuropsychological evaluation was normal. The patient received immunotherapy with one cure of intravenous immunoglobulins after an only partial improvement with symptomatic treatment.
CONCLUSION
This is the first case report of an association between the anti NMDA-R and stiff limb syndrome. Further investigations are needed to provide a better understanding of the pathophysiology of stiff person spectrum disorders.
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Affiliation(s)
- C Birzu
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2-Mazarin et Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l’Institut du Cerveau et de la Moelle Epinière (CRICM), UMRS 975, Paris 75013, France; Inserm U 975, CNRS, UMR, Paris, France
| | - L Jaume
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2-Mazarin et Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l’Institut du Cerveau et de la Moelle Epinière (CRICM), UMRS 975, Paris 75013, France; Inserm U 975, CNRS, UMR, Paris, France
| | - S Rostomashvilli
- Centre Hospitalier Interregional Robert Ballanger Aulnay Sous Bois, Aulnay sous Bois, France
| | - J Honnorat
- Centre de Référence National pour les Syndromes Neurologiques Paranéoplasique, Hôpital Neurologique, Lyon, France; SynatAc Team, NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Lyon, France, Lyon, France
| | - G Berzero
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2-Mazarin et Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l’Institut du Cerveau et de la Moelle Epinière (CRICM), UMRS 975, Paris 75013, France; Inserm U 975, CNRS, UMR, Paris, France
- IRCCS Mondino Foundation, Pavia, Italy, Pavia, Italy
| | - D Psimaras
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2-Mazarin et Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l’Institut du Cerveau et de la Moelle Epinière (CRICM), UMRS 975, Paris 75013, France; Inserm U 975, CNRS, UMR, Paris, France
- Centre de Compétence des Syndromes Neurologiques Paraneoplasiques et Encéphalites Autoimmunes, Groupe Hospitalier Pitié-Salpêtrière, Paris, France, Paris, France
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20
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SEYVE A, Cartalat S, Meyronet D, D’hombres A, Barritault M, Jouanneau E, Berhouma M, Guyotat J, Honnorat J, Ducray F. P14.13 Incidence of pseudoprogression in high-grade IDH-mutant gliomas. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Pseudoprogression (PsP) is a well-known concern in IDH-wildtype glioblastomas. The aim of the present study was to describe its incidence in high-grade IDH-mutant gliomas.
MATERIAL AND METHODS
We retrospectively analyzed the characteristics of a consecutive series of high-grade IDH-mutant gliomas treated with radiotherapy (RT) with or without chemotherapy between March 2009 and September 2017. PsP was defined as a new enhanced lesion that occurred after RT and subsequently disappeared or remained stable during follow-up for a least 6 months.
RESULTS
The study population consisted of 38 anaplastic IDH-mutant and 1p/19q codeleted oligodendrogliomas, 34 IDH-mutant anaplastic astrocytomas and 18 IDH-mutant glioblastomas. Treatment consisted of radiotherapy alone (n=8, 9%), radiotherapy and PCV chemotherapy (n=63, 70%) and temozolomide radiochemotherapy (n=19, 21%). After a median follow-up of 3.5 years (range 1–8 years), 24 patients (28%) presented a PsP that occurred after a median delay of 10 months after radiotherapy (2 to 32 months). PsP was more frequent in patients treated with RT+PCV than in those treated with RT+TMZ (34% vs 10%, p=0.05). During the first two years after RT completion, 19 patients (21%) presented a PsP and 15 patients (17%) a true progression. At last follow-up, 1 patient (4%) in the PsP group had died compared to 10 patients (16%) in the group of patients without PsP.
CONCLUSION
PsP is a frequent issue in IDH-mutant high-grade gliomas. Its timing of onset is delayed compared to the timing of PsP onset reported in IDH-wildtype glioblastomas. The association between the use of PCV chemotherapy and PsP requires validation in an independent series.
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Affiliation(s)
- A SEYVE
- Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | | | | | - J Guyotat
- Hospices Civils de Lyon, Lyon, France
| | | | - F Ducray
- Hospices Civils de Lyon, Lyon, France
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21
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Picart T, Barritault M, Tabouret E, Idbaih A, Izquierdo Gracia C, Poncet D, Honnorat J, Meyronet D, Guyotat J, Ducray F. OS5.5 Characteristics of high-grade gliomas with H3 G34 mutation in adults. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
H3 G34-mutant high-grade gliomas occur primarily in children but can also be encountered in adults. The aim of the present study was to describe the characteristics of H3 G34-mutant high-grade gliomas in adults.
MATERIAL AND METHODS
We analysed the characteristics of 17 adult H3 G34-mutant high-grade gliomas and compared them with those of adult grade IV gliomas with H3 K27M mutation (n=21), IDH mutation (n=42) and TERT promoter (pTERT) mutation (n=88).
RESULTS
Median age at diagnosis in H3 G34-mutant gliomas was 25 years (range: 19–33 y). All tumors had a hemispheric location. The radiological presentation was suggestive of a high-grade glioma in 6 patients but in 10 patients it initially suggested another diagnosis due to absent or faint contrast enhancement (n=9) or the presence of an initial intratumoral haemorrhage (n=1). In non- or faint contrast-enhancing cases, diffusion-weighted imaging (DWI) was more helpful to suspect an aggressive tumor than MR spectroscopy and perfusion MRI. All H3 G34-mutant gliomas were classified as IDH wildtype glioblastomas. PNET-like foci were observed in 8 cases and most cases were immunonegative for ATRX (92%) and Olig2 (81%) and demonstrated MGMT promoter methylation (82%). The clinical, radiological and histological presentation of H3 G34-mutant gliomas was different from that of midline H3 K27M-mutant diffuse gliomas and from that of IDH-mutant and IDH-wildtype pTERT-mutant glioblastomas. Median overall survival of G34-mutant gliomas was 23.9 months compared to 19.6 months (p=0.16), 13.7 months (p=0.45) and 58 months (p=2.3x10-10) in H3 K27M-mutant diffuse gliomas, IDHwt pTERT-mutant and IDH-mutant glioblastomas, respectively.
CONCLUSION
Adults H3 G34-mutant high-grade gliomas are associated with distinct characteristics and a poor prognosis. DWI seems helpful to identify cases that present as non-contrast enhancing lesions and can wrongly suggest another diagnosis in these young patients.
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Affiliation(s)
- T Picart
- Hospices Civils de Lyon, Bron, France
| | | | - E Tabouret
- AP-HM - Hôpital de la Timone, Marseille, France
| | - A Idbaih
- AP-HP Hôpitaux La Pitié-Salpêtrière-Charles-Foix, Paris, France
| | | | - D Poncet
- Hospices Civils de Lyon, Bron, France
| | | | | | - J Guyotat
- Hospices Civils de Lyon, Bron, France
| | - F Ducray
- Hospices Civils de Lyon, Bron, France
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22
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Vialatte de Pémille C, Psimaras D, Adanyegu I, Graus F, Dürr A, Honnorat J, Delattre J, Alentorn A. P14.102 Cerebellar atrophy patterns in paraneoplastic cerebellar degeneraiton and spinocerebellar ataxia 1 (SCA1). Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.337] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Brain and more specifically cerebellar atrophy is a major radiological finding in both Paraneoplastic Cerebellar Degeneration (PCD) with anti-Yo antibodies and Spinocerebellar Ataxia type 1 (SCA1).We sought to analyze the different brain volumetric patterns of cerebellar atrophy in these diseases.
MATERIAL AND METHODS
We performed a retrospective multicentric study (Paris, Lyon, Barcelona reference centres) with either anti-Yo PCD (n=16) or SCA1 (n=17) and 30 healthy subjects paired by age. We used VolBrain and CERES algorithms to obtain the brain and cerebellum segmentation, respectively as well as the cortical thickness. We used a Sparse Canonical Correlation Analysis (SCCAN) and Voxel Brain Morphometry (VBM) with family wise error correction to analyze volumetric differences between the different conditions.
RESULTS
SCA patients were younger than PCD patients (p<0.05, ANOVA). In univariate analysis, most of the atrophic regions (p<0.05) were common between PCD and SCA1 compared to controls. Isolated cortical thickness and grey matter analysis showed predominant atrophy in PCD patients. Multivariate analysis using SCCAN and VBM confirmed these results. We identified a particular atrophy pattern in PCD patients involving lobules III to VII. We observed a more diffuse atrophy distribution in SCA1 patients and a lower cortical atrophy in PCD patients.
CONCLUSION
We described the specific pattern of topographic cerebellar atrophy in PCD and SCA1 patients. The cerebellar atrophy in PCD is mainly localized in the neocerebellum.
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Affiliation(s)
- C Vialatte de Pémille
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2,Sorbonne Université, UPMC Univ, Paris, France
| | - D Psimaras
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2,Sorbonne Université, UPMC Univ, Paris, France
| | - I Adanyegu
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Genetics,Sorbonne Université, Paris, France
| | - F Graus
- AP-HP, GDepartment of Neurology, Hospital Clinic, University of Barcelona and Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.roupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2, Sorbonne Université, UPMC Univ, Barcelona, Spain
| | - A Dürr
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Genetics,Sorbonne Université, Paris, France
| | - J Honnorat
- AP-HP,French Reference Center on Paraneoplastic Neurological Syndromes, Hospices Civils de Lyon, and Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310, Université de Lyon - Université Claude Bernard Lyon 1, Lyon, France, Lyon, France
| | - J Delattre
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2,Sorbonne Université, UPMC Univ, Paris, France
| | - A Alentorn
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2,Sorbonne Université, UPMC Univ, Paris, France
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Bani Sadr A, Eker OF, Berner L, Ameli R, Hermier M, Barritault M, Meyronet D, Guyotat J, Jouanneau E, Honnorat J, Ducray F, Berthezène Y. P13.02 Conventional MRI radiomics in the diagnosis of early- and pseudo-progression. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.223] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
After radiochemotherapy, 20% to 30% of patients with early worsening MRI experience pseudoprogression (Psp) which is not distinguishable from early progression (EP). We aimed to assess the diagnostic performance and survival predictive ability of radiomics in patients with suspected EP or Psp.
MATERIAL AND METHODS
Radiomics features (RF) of 76 patients (53 EP and 23 Psp) retrospectively identified were extracted from conventional MRI based on four volumes-of-interest. Subjects were randomly assigned into training and validation groups. Classification model (EP versus Psp) consisted of a random forest algorithm after univariate filtering. Overall (OS) and progression-free survivals (PFS) were predicted using a semi-supervised principal component analysis and, forecasts were evaluated using C index and integrated Brier scores (IBS).
RESULTS
Using 11 RFs, radiomics classified patients with 75.0% and 76.0% accuracy, 81.6% and 94.1% sensitivity, 50.0% and 37.5% specificity, respectively in training and validation phases. Addition of MGMT promoter status improved accuracy to 83% and 79.2% and, specificity to 63.6% and 75%.
OS model included 14 RFs and stratified low- and high-risk patients both in the training (hazard ratio (HR), 3.63, p=0.002) and the validation (HR, 3.76, p=0.001) phases. Similarly, PFS model stratified patients during training (HR, 2.58, p=0.005) and validation (HR, 3.58, p=0.004) phases using 5 RF. OS and PFS forecasts had C index of 0.65 and 0.69 and IBS of 0.122 and 0.147, respectively.
CONCLUSION
Conventional MRI radiomics has promising diagnostic value, especially when combined with MGMT promoter status, but specificity remains moderate. In addition, our results suggest a potential for predicting OS and PFS.
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Affiliation(s)
| | - O F Eker
- Hospices Civils de Lyon, Bron, France
| | - L Berner
- Hospices Civils de Lyon, Bron, France
| | - R Ameli
- Hospices Civils de Lyon, Bron, France
| | - M Hermier
- Hospices Civils de Lyon, Bron, France
| | | | | | - J Guyotat
- Hospices Civils de Lyon, Bron, France
| | | | | | - F Ducray
- Hospices Civils de Lyon, Bron, France
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Picart T, Pardey Bracho G, Ameli R, Berner L, Thomas L, Cartalat S, Honnorat J, Ducray F, Guyotat J. P04.18 Management of diffuse gliomas using hypnosis-aided awake surgery: oncological and functional preliminary results in a series of 16 cases. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.113] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Awake resection of diffuse gliomas aims to find a tailored onco-functional balance for each patient. Hypnosis represents an innovative technique able to optimize the comfort and well-being of the patient during such procedures. The aim of the present study is to analyse the oncological and functional outcome in a cohort of patients operated on with hypnosis-aided awake surgery.
MATERIAL AND METHODS
All consecutive adult patients that underwent hypnosis-aided resection for a diffuse glioma between January 2018 and January 2019 were recorded. Neurological and cognitive status were assessed preoperatively and at 3 months postoperatively. Extent of tumor resection was quantified by a radiologist on magnetic resonance imaging.
RESULTS
Sixteen patients (6 males and 10 females), with a mean age of 39 years, were included. Gliomas were revealed by epileptic seizures (62.5%), motor deficit (6.25%) or incidentally discovered (31.25%) and were either located in the right hemisphere (50%) or in the left hemisphere (50%), with a mean initial volume of 42 mL. Histologically, there were six grade II-astrocytomas, three grade III-astrocytomas, five grade II-oligodendroglioma, one grade III-oligodendroglioma and one ganglioglioma. Under HAS, the awake-time after the anaesthesia drugs stop was short, because low doses of drugs were required thanks to the hypnotic state. All patients were able to reliably performed the different tests until functional subcortical limits were reached. Postoperative magnetic resonance imaging showed complete resection in 8 cases (50%), subtotal resection in 2 cases (12.5%) and partial resection in 6 cases (37.5%), with a mean resection rate of 84.6%. At 3 months after surgery, there was only a new motor deficit (6.25%). The language and neuropsychological assessments were improved in 7 patients (43.75%), stable in 7 patients (43.75%) and deteriorated in some tests in 2 patients (12.5%). After surgery, no patient reported negative emotion concerning the awake glioma resection and all patient declared being ready for a second awake resection in the future, if indicated.
CONCLUSION
According to these preliminary results, hypnosis-aided awake resection of diffuse gliomas appears to be safe and effective from an onco-functional viewpoint and parallelly contributes to decrease intra-operative pain, anxiety and major discomfort.
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Affiliation(s)
- T Picart
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - G Pardey Bracho
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - R Ameli
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - L Berner
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - L Thomas
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - S Cartalat
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - J Honnorat
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - F Ducray
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - J Guyotat
- Hospices Civils de Lyon - Hôpital Neurologique Pierre Wertheimer, Bron, France
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25
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Vogrig A, Fouret M, Joubert B, Picard G, Rogemond V, Pinto A, Muñiz Castrillo S, Roger M, Raimbourg J, Dayen C, Grignou L, Pallix-Guyot M, Lannoy J, Ducray F, Desestret V, Psimaras D, Honnorat J. JS1.2 Increased frequency of paraneoplastic encephalitis with anti-Ma2 antibodies in the cancer immunotherapy era. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Given the mechanism of action of immune checkpoint inhibitors (ICIs), a possible association with the development of paraneoplastic neurological syndromes (PNS) has been hypothesized. We sought to determine if ICI treatment might trigger anti-Ma2 antibody-associated paraneoplastic neurological syndromes (Ma2-PNS).
MATERIAL AND METHODS
We performed a retrospective nationwide study of all patients with Ma2-PNS developed during ICI treatment between 2017–2018. The frequency of neuronal-antibody detection before and after ICI implementation was also analyzed.
RESULTS
Our series of patients included 5 men and 1 woman (median age, 63 years). The patients were receiving either nivolumab (n = 3), pembrolizumab (n = 2) or a combination of nivolumab and ipilimumab (n=1), for treatment of neoplasms that included lung (n=4) and kidney (n=1) cancers, and pleural mesothelioma (n=1). Median delay between ICI introduction and onset of the neurological syndrome was 4 months. Clinical syndromes included a combination of limbic encephalitis and diencephalitis (n=3), isolated limbic encephalitis (n=2) and a syndrome characterized by opthalmoplegia and head-drop (n=1). Patients with diencephalitis manifested hyperphagia, weight gain and somnolence. Post-ICI Ma2-PNS accounted for 35% of the total 17 Ma2-PNS diagnosed in our center over the 2017–2018 biennium. Eight cases had been detected in the preceding biennium 2015–2016, corresponding to a 112% increase of Ma2-PNS frequency since the implementation of ICIs in France. No other neuronal-antibody demonstrated a similar increment.
CONCLUSION
We show a clear association between ICI use and increased frequency of Ma2-PNS. Physicians need to be aware that ICIs can trigger Ma2-PNS since clinical presentation can be challenging.
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Affiliation(s)
- A Vogrig
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - M Fouret
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - B Joubert
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - G Picard
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - V Rogemond
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - A Pinto
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - S Muñiz Castrillo
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - M Roger
- Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - J Raimbourg
- Institut de Cancérologie de l’Ouest René Gauducheau, St. Herblain, France
| | - C Dayen
- Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
| | - L Grignou
- Hôpital de La Cavale Blanche, Brest, France
| | | | - J Lannoy
- Centre Hospitalier Universitarie de Lille, Lille, France
| | - F Ducray
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - V Desestret
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
| | - D Psimaras
- Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - J Honnorat
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Lyon, France
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26
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Gravier Dumonceau A, Jeannin-Mayer S, Roche P, Honnorat J, Joubert B, Thobois S, Laurencin C. Unilateral clinical manifestations in LGI1-antibody encephalitis. Rev Neurol (Paris) 2019; 175:481-483. [PMID: 31182313 DOI: 10.1016/j.neurol.2018.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/17/2018] [Accepted: 09/20/2018] [Indexed: 10/26/2022]
Affiliation(s)
- A Gravier Dumonceau
- Service de neurologie C, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69003 Lyon, France
| | - S Jeannin-Mayer
- Service d'exploration fonctionnelle et épileptologie, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69003 Lyon, France
| | - P Roche
- Service d'exploration fonctionnelle et épileptologie, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69003 Lyon, France
| | - J Honnorat
- Service de neuro-oncologie, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69003 Lyon, France; Inserm U1217, CNRS UMR 5310, centre de référence des syndromes neurologiques paranéoplasiques, université Claude Bernard Lyon 1, hospices civils de Lyon, institut neuromyogène, Lyon, France
| | - B Joubert
- Service de neuro-oncologie, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69003 Lyon, France; Inserm U1217, CNRS UMR 5310, centre de référence des syndromes neurologiques paranéoplasiques, université Claude Bernard Lyon 1, hospices civils de Lyon, institut neuromyogène, Lyon, France
| | - S Thobois
- Service de neurologie C, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69003 Lyon, France; UMR 5229, CNRS, institut des sciences cognitives Marc-Jeannerod, 69500 Bron, France; Faculté de médecine et de Maïeutique Lyon Sud Charles-Mérieux, université de Lyon 1, Lyon, France
| | - C Laurencin
- Service de neurologie C, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69003 Lyon, France; UMR 5229, CNRS, institut des sciences cognitives Marc-Jeannerod, 69500 Bron, France.
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Kiesel B, M Thomé C, Weiss T, Jakola A, Darlix A, Pellerino A, Furtner J, Kerschbaumer J, Weller M, Pilkington G, Moyal ECJ, Henriksson R, Watts C, Rudà R, Reifenberger G, Oberg I, Honnorat J, Wick W, Preusser M, Widhalm G, Berghoff A. CMET-26. PERIOPERATIVE IMAGING OF BRAIN METASTASES: A EUROPEAN ASSOCIATION OF NEURO-ONCOLOGY (EANO) YOUNGSTERS SURVEY. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Carina M Thomé
- Clinical Cooperation Unit Neurooncology, German Cancer Research Center, Heidelberg, Germany
| | - Tobias Weiss
- Department of Neurology, University Hospital Zurich, Zurich, Switzerl
| | - Asgeir Jakola
- Department of Neurosurgery, St. Olav’s University Hospital, Trondheim, Norway; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Amelie Darlix
- Department of Medical Oncology, Institut régional du Cancer Montpellier, University of Montpellier, Montpellier, France
| | - Alessia Pellerino
- Dept Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | | | | | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerl
| | | | | | | | - Colin Watts
- Cambridge University Hospitals, Cambridge, England, United Kingdom
| | - Roberta Rudà
- Dept Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | - Guido Reifenberger
- Department of Neuropathology, Heinrich Heine University Hospital, Düsseldorf, Germany
| | - Ingela Oberg
- Cambridge University Hospitals, Cambridge, England, United Kingdom
| | - Jerôme Honnorat
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon, France
| | - Wolfgang Wick
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
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28
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Izquierdo C, Barritault M, Poncet D, Cartalat S, Joubert B, Bruna J, Jouanneau E, Guyotat J, Vasiljevic A, Fenouil T, Berthezène Y, Honnorat J, Meyronet D, Ducray F. NIMG-43. RADIOLOGICAL CHARACTERISTICS AND NATURAL HISTORY OF ADULT IDH WILD-TYPE ASTROCYTOMAS WITH TERT PROMOTER MUTATIONS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Cristina Izquierdo
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon, France
| | - Marc Barritault
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service danatomopathologie, Lyon, France
| | - Delphine Poncet
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service danatomopathologie, Lyon, France
| | - Stéphanie Cartalat
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon, France
| | - Bastien Joubert
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon, France
| | - Jordi Bruna
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-ICO LHospitalet-IDIBELL, lHospitalet de Llobregat, Barcelona, Spain
| | - Emmanuel Jouanneau
- Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Neurochirurgie B, Lyon
| | - Jacques Guyotat
- Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Neurochirurgie D, Bron, Lyon, France
| | - Alexandre Vasiljevic
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service danatomopathologie, Bron, Lyon, France
| | - Tanguy Fenouil
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service danatomopathologie, Bron, Lyon, France
| | - Yves Berthezène
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuroradiology, Bron, Lyon, France
| | - Jerôme Honnorat
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Bron, Lyon, France
| | - David Meyronet
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service danatomopathologie, Bron, Lyon, France
| | - François Ducray
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon, France
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Barritault M, Picart T, Poncet D, Fenouil T, Guyotat J, Jouanneau E, Joubert B, Vasiljevic A, Honnorat J, Meyronet D, Ducray F. PATH-36. IDH AND TERT PROMOTER MUTATIONS IN NON-DIAGNOSTIC BIOPSIES FROM GLIOMA PATIENTS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marc Barritault
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service Danatomopathologie, Lyon, Cedex, France
| | | | - Delphine Poncet
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service Danatomopathologie, Lyon, Cedex, France
| | - Tanguy Fenouil
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service Danatomopathologie, Lyon, Cedex, France
| | - Jacques Guyotat
- Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Neurochirurgie D, Lyon, Cedex, France, France
| | | | - Bastien Joubert
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon, Cedex, France
| | | | - Jerôme Honnorat
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon, Cedex, France
| | - David Meyronet
- Hospices Civils de Lyon, Groupe Hospitalier Est, Service Danatomopathologie, Lyon, Cedex, France
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Honnorat J, Joubert B. Movement disorders in autoimmune encephalitis and paraneoplastic neurological syndromes. Rev Neurol (Paris) 2018; 174:597-607. [DOI: 10.1016/j.neurol.2018.07.006] [Citation(s) in RCA: 8] [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] [Received: 07/23/2018] [Revised: 07/27/2018] [Accepted: 07/27/2018] [Indexed: 12/14/2022]
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Izquierdo C, Barritault M, Poncet D, Cartalat S, Joubert B, Bruna J, Jouanneau E, Guyotat J, Vasiljevic A, Fenouil T, Berthezène Y, Honnorat J, Meyronet D, Ducray F. OS3.3 Radiological characteristics and natural history of adult IDH wild type astrocytomas with TERT promoter mutations. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - D Poncet
- Hôpital Pierre Wertheimer, Lyon, France
| | | | - B Joubert
- Hôpital Pierre Wertheimer, Lyon, France
| | - J Bruna
- Hospital Universitari de Bellvitge-ICO L’Hospitalet-IDIBELL, Hospitalet Llobregat, Spain
| | | | - J Guyotat
- Hôpital Pierre Wertheimer, Lyon, France
| | | | - T Fenouil
- Hôpital Pierre Wertheimer, Lyon, France
| | | | | | | | - F Ducray
- Hôpital Pierre Wertheimer, Lyon, France
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Barritault M, Picart T, Poncet D, Fenouil T, Guyotat J, Jouanneau E, Joubert B, Vasiljevic A, Honnorat J, Meyronet D, Ducray F. P01.120 Importance of systematic TERT promoter and IDH mutations screening in non-diagnostic biopsies from patients with a suspected glioma. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Barritault
- Hospices Civiles de Lyon, Lyon, France
- Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France
| | - T Picart
- Hospices Civiles de Lyon, Lyon, France
| | - D Poncet
- Hospices Civiles de Lyon, Lyon, France
| | - T Fenouil
- Hospices Civiles de Lyon, Lyon, France
| | - J Guyotat
- Hospices Civiles de Lyon, Lyon, France
| | | | - B Joubert
- Hospices Civiles de Lyon, Lyon, France
| | | | | | | | - F Ducray
- Hospices Civiles de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
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Stupp R, Taphoorn M, Driven L, Taillibert S, Honnorat J, Chen T, Sroubek J, Paek S, Escuder J, Easaw J, David C, Kim C, Desai R, Olivi A, Kew Y, Hottinger A, Hegi M, Kirson E, Lavy-Shahaf G, Ram Z. Tumor Treating Fields (TTFields)—A Novel Cancer Treatment Modality: Translating Preclinical Evidence and Engineering Into a Survival Benefit with Delayed Decline in Quality of Life. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.09.013] [Citation(s) in RCA: 5] [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: 11/26/2022]
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Izquierdo C, Alentorn A, Idbaih A, Simó M, Kaloshi G, Ricard D, Barritault M, Meyronet D, Bruna J, Honnorat J, Delattre JY, Ducray F. Long-term impact of temozolomide on 1p/19q-codeleted low-grade glioma growth kinetics. J Neurooncol 2017; 136:533-539. [PMID: 29143276 DOI: 10.1007/s11060-017-2677-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 08/03/2017] [Accepted: 11/11/2017] [Indexed: 10/18/2022]
Abstract
Although upfront temozolomide (TMZ) has been widely-used to treat 1p/19q-codeleted diffuse low-grade gliomas (LGG), its long-term impact on the growth kinetics of these tumors has not been determined. Based on serial magnetic resonance images we retrospectively evaluated the evolution of the mean tumor diameter (MTD) in 36 progressive 1p/19q-codeleted LGG treated with upfront TMZ. After TMZ onset, all but two patients (94.4%) presented a progressive MTD decrease that lasted for a median duration of 23 months (range 3-114). In 10 patients (27%) MTD regrowth occurred during TMZ treatment and in 22 patients (66%) after TMZ discontinuation. In these patients, median time to MTD regrowth after TMZ discontinuation was 12 months (range 1-88). The rate of MTD regrowth at 3 and 5 years after TMZ onset was 77 and 94%, respectively. Time to tumor progression (TTP) based on volumetric analysis was shorter than TTP based on Response Assessment in Neuro-Oncology (RANO) bidimensional criteria (23 vs. 35 months, p = 0.05) and shorter than time to next oncological treatment (23 vs. 46 months, p = 0.001). In 10 patients (27%), absence of volumetric analysis led to continue TMZ for a median of 10 cycles after MTD had started to regrow. Volumetric analysis is important to precisely assess chemotherapy efficacy in 1p/19q-codeleted LGG, identify early tumor progression and avoid futile chemotherapy continuation. In the present series, although some long-lasting volumetric responses were observed, most tumors resumed their growth within 3 years after TMZ onset.
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Affiliation(s)
- C Izquierdo
- Service de Neuro-Oncologie, Groupe Hospitalier Est, Hospices Civils de Lyon, 59 Bvd Pinel, 69394, Lyon Cedex, France.,Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-ICO L'Hospitalet-IDIBELL, Av. Gran vía de l'Hospitalet, 199-203, 08907, l'Hospitalet de Llobregat, Barcelona, Spain
| | - A Alentorn
- Service de Neurologie 2-Mazarin, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.,Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, 75013, Paris, France
| | - A Idbaih
- Service de Neurologie 2-Mazarin, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.,Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, 75013, Paris, France
| | - M Simó
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-ICO L'Hospitalet-IDIBELL, Av. Gran vía de l'Hospitalet, 199-203, 08907, l'Hospitalet de Llobregat, Barcelona, Spain
| | - G Kaloshi
- Service de Neurologie 2-Mazarin, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.,Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, 75013, Paris, France
| | - D Ricard
- Service de Neurologie 2-Mazarin, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.,Service de Neurologie, HIA du Val-de-Grâce, 74 Bvd de Port-Royal, 75005, Paris, France.,École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005, Paris, France.,Cognac-G UMR-MD4 8257, Service de Santé des Armées, Université Paris Descartes, 74, Bvd de Port-Royal, 75005, Paris, France
| | - M Barritault
- Service d'anatomopathologie, Groupe Hospitalier Est, Hospices Civils de Lyon, 59 Bvd Pinel, 69394, Lyon Cedex, France.,Université Claude Bernard Lyon 1, Lyon, France.,Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France
| | - D Meyronet
- Service d'anatomopathologie, Groupe Hospitalier Est, Hospices Civils de Lyon, 59 Bvd Pinel, 69394, Lyon Cedex, France.,Université Claude Bernard Lyon 1, Lyon, France.,Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France
| | - J Bruna
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-ICO L'Hospitalet-IDIBELL, Av. Gran vía de l'Hospitalet, 199-203, 08907, l'Hospitalet de Llobregat, Barcelona, Spain
| | - J Honnorat
- Service de Neuro-Oncologie, Groupe Hospitalier Est, Hospices Civils de Lyon, 59 Bvd Pinel, 69394, Lyon Cedex, France.,Université Claude Bernard Lyon 1, Lyon, France.,Institut NeuroMyoGene, INSERM 1217/CNRS 5310, Université de Lyon, Lyon, France
| | - J Y Delattre
- Service de Neurologie 2-Mazarin, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 75013, Paris, France.,Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, 75013, Paris, France
| | - F Ducray
- Service de Neuro-Oncologie, Groupe Hospitalier Est, Hospices Civils de Lyon, 59 Bvd Pinel, 69394, Lyon Cedex, France. .,Université Claude Bernard Lyon 1, Lyon, France. .,Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France.
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Taphoorn MJB, Dirven L, Taillibert S, Honnorat J, Chen T, Sroubek J, Paek SH, Escuder JB, Easaw JC, David CA, Kim CY, Desai RD, Kew Y, Olivi A, Nicholas GA, Lavy-Shahaf G, Kirson ED, Ram Z, Stupp R. QLIF-25. EFFECT OF TUMOR TREATING FIELDS (TTFIELDS) ON HEALTH-RELATED QUALITY OF LIFE (HRQoL) IN NEWLY DIAGNOSED GLIOBLASTOMA. RESULTS OF THE EF-14 RANDOMIZED PHASE III TRIAL. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Campello C, Parker F, Slimani S, Le Floch A, Herbrecht A, Aghakhani N, Lacroix C, Loiseau H, Lejeune J, Perrin G, Honnorat J, Dufour H, Chinot O, Figarella D, Bauchet L, Duffau H, Lonjon M, Labauge P, Messerer M, Daures J, Fabbro P, Ducot B. Tumeurs gliales intramédullaires de l’adulte : la série du rapport. Neurochirurgie 2017; 63:381-390. [DOI: 10.1016/j.neuchi.2016.10.003] [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] [Received: 03/20/2016] [Revised: 09/18/2016] [Accepted: 10/23/2016] [Indexed: 10/19/2022]
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37
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Stupp R, Taphoorn M, Dirven L, Taillibert S, Honnorat J, Chen T, Sroubek J, Paek S, Bruna Escuder J, Easaw J, David C, Kim C, Desai R, Kew Y, Olivi A, Hottinger A, Kirson E, Lavy-Shahaf G, Hegi M, Ram Z. Tumor Treating Fields (TTFields) – A novel cancer treatment modality: Translating preclinical evidence and engineering into a survival benefit with delayed decline in quality of life. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx366.009] [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: 11/12/2022] Open
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38
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Stahl JP, Azouvi P, Bruneel F, De Broucker T, Duval X, Fantin B, Girard N, Herrmann JL, Honnorat J, Lecuit M, Mailles A, Martinez-Almoyna L, Morand P, Piroth L, Tattevin P. Guidelines on the management of infectious encephalitis in adults. Med Mal Infect 2017; 47:179-194. [PMID: 28412044 DOI: 10.1016/j.medmal.2017.01.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 02/06/2023]
Affiliation(s)
- J P Stahl
- Infectiologie, université et CHU Grenoble Alpes, 38700 La Tronche, France.
| | - P Azouvi
- Réhabilitation neurologique, centre hospitalier de Garches, 92380 Garches, France
| | - F Bruneel
- Service de réanimation, centre hospitalier de Versailles, 78150 Le Chesnay, France
| | - T De Broucker
- Neurologie, centre hospitalier de Saint-Denis, 93200 Saint-Denis, France
| | - X Duval
- Thérapeutique, CHU Bichat, 75018 Paris, France
| | - B Fantin
- IAME, UMR 1137, Inserm, médecine interne, hôpital Beaujon, université Paris Diderot, Sorbonne Paris Cité, AP-HP, 75013 Paris, France
| | - N Girard
- Neuroradiologie, hôpital La Timone, 13385 Marseille, France
| | - J L Herrmann
- Microbiologie, hôpital Raymond-Poincaré, 92380 Garches, France
| | - J Honnorat
- Neurologie, hôpital neurologique, CHU de Lyon, 69002 Lyon, France
| | - M Lecuit
- Unité de biologie des infections, institut Pasteur, CNR et CCOMS Listeria, Inserm U1117, 75015 Paris, France; Department of infectious diseases and tropical medicine, institut imagine, Paris Descartes university, Sorbonne Paris Cité, Necker-Enfants-Malades university hospital, Assistance publique-Hôpitaux de Paris, 75015 Paris, France
| | - A Mailles
- Direction des maladies infectieuses, santé publique, 94415 Saint-Maurice, France
| | | | - P Morand
- Virologie, université et CHU Grenoble Alpes, 38700 La Tronche, France
| | - L Piroth
- Infectiologie, CHU de Dijon, 21000 Dijon, France
| | - P Tattevin
- Infectiologie, CHU de Rennes, 35000 Rennes, France
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Izquierdo C, Alentorn A, Simó M, Idbaih A, Ricard D, Kaloshi G, Bruna J, Honnorat J, Delattre J, Ducray F. P10.14 Long-term impact of Temozolomide on 1p19q codeleted oligodendrogliomas growth kinetics. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.332] [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: 11/14/2022] Open
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40
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Fillatre P, Crabol Y, Morand P, Piroth L, Honnorat J, Stahl JP, Lecuit M. Infectious encephalitis: Management without etiological diagnosis 48hours after onset. Med Mal Infect 2017; 47:236-251. [PMID: 28314470 PMCID: PMC7131623 DOI: 10.1016/j.medmal.2017.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 02/22/2017] [Indexed: 12/18/2022]
Abstract
Introduction The etiological diagnosis of infectious encephalitis is often not established 48 hours after onset. We aimed to review existing literature data before providing management guidelines. Method We performed a literature search on PubMed using filters such as “since 01/01/2000”, “human”, “adults”, “English or French”, and “clinical trial/review/guidelines”. We also used the Mesh search terms “encephalitis/therapy” and “encephalitis/diagnosis”. Results With Mesh search terms “encephalitis/therapy” and “encephalitis/diagnosis”, we retrieved 223 and 258 articles, respectively. With search terms “encephalitis and corticosteroid”, we identified 38 articles, and with “encephalitis and doxycycline” without the above-mentioned filters we identified 85 articles. A total of 210 articles were included in the analysis. Discussion Etiological investigations must focus on recent travels, animal exposures, age, immunodeficiency, neurological damage characteristics, and potential extra-neurological signs. The interest of a diagnosis of encephalitis for which there is no specific treatment is also to discontinue any empirical treatments initially prescribed. Physicians must consider and search for autoimmune encephalitis.
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Affiliation(s)
- P Fillatre
- Service de maladies infectieuses et réanimation médicale, CHU Pontchaillou, 35000 Rennes, France
| | - Y Crabol
- Médecine interne, CHBUA site de Vannes, 56017 Vannes, France
| | - P Morand
- Virologie, CHU Grenoble Alpes, 38043 Grenoble cedex 9, France
| | - L Piroth
- Infectiologie, CHU de Dijon, 21000 Dijon, France
| | - J Honnorat
- Inserm U1028, CNRS UMR5292, équipe neuro-oncologie et neuro-inflammation (Oncoflam), centre de recherche en neurosciences (CRNL), université Lyon 1, 69500 Bron, France
| | - J P Stahl
- Service d'infectiologie, CHU de Grenoble, 38043 Grenoble cedex 9, France.
| | - M Lecuit
- Institut Pasteur, Biology of Infection Unit, CNR CCOMS Listeria, Inserm U1117, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Department of Infectious Diseases and Tropical Medicine, Necker-Enfants-Malades University Hospital, Institut Imagine, Assistance Publique-Hôpitaux de Paris, Paris, France
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De Rossi P, Harde E, Dupuis JP, Martin L, Chounlamountri N, Bardin M, Watrin C, Benetollo C, Pernet-Gallay K, Luhmann HJ, Honnorat J, Malleret G, Groc L, Acker-Palmer A, Salin PA, Meissirel C. A critical role for VEGF and VEGFR2 in NMDA receptor synaptic function and fear-related behavior. Mol Psychiatry 2016; 21:1768-1780. [PMID: 26728568 PMCID: PMC5116482 DOI: 10.1038/mp.2015.195] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 10/07/2015] [Accepted: 10/22/2015] [Indexed: 01/17/2023]
Abstract
Vascular endothelial growth factor (VEGF) is known to be required for the action of antidepressant therapies but its impact on brain synaptic function is poorly characterized. Using a combination of electrophysiological, single-molecule imaging and conditional transgenic approaches, we identified the molecular basis of the VEGF effect on synaptic transmission and plasticity. VEGF increases the postsynaptic responses mediated by the N-methyl-D-aspartate type of glutamate receptors (GluNRs) in hippocampal neurons. This is concurrent with the formation of new synapses and with the synaptic recruitment of GluNR expressing the GluN2B subunit (GluNR-2B). VEGF induces a rapid redistribution of GluNR-2B at synaptic sites by increasing the surface dynamics of these receptors within the membrane. Consistently, silencing the expression of the VEGF receptor 2 (VEGFR2) in neural cells impairs hippocampal-dependent synaptic plasticity and consolidation of emotional memory. These findings demonstrated the direct implication of VEGF signaling in neurons via VEGFR2 in proper synaptic function. They highlight the potential of VEGF as a key regulator of GluNR synaptic function and suggest a role for VEGF in new therapeutic approaches targeting GluNR in depression.
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Affiliation(s)
- P De Rossi
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Neurooncology and Neuroinflammation, Lyon Neuroscience Research Center, Lyon, France
| | - E Harde
- Institute of Cell Biology and Neuroscience and BMLS, Goethe University Frankfurt, Frankfurt, Germany,Max Planck Institute for Brain Research, Frankfurt, Germany,Focus Program Translational Neurosciences, University of Mainz, Mainz, Germany
| | - J P Dupuis
- Interdisciplinary Institute for Neuroscience, Unité Mixte de Recherche 5297, Université de Bordeaux, Bordeaux, France,Interdisciplinary Institute for Neuroscience, UMR 5297, Centre National de la Recherche Scientifique, Bordeaux, France
| | - L Martin
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Neurooncology and Neuroinflammation, Lyon Neuroscience Research Center, Lyon, France
| | - N Chounlamountri
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Neurooncology and Neuroinflammation, Lyon Neuroscience Research Center, Lyon, France
| | - M Bardin
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Neurooncology and Neuroinflammation, Lyon Neuroscience Research Center, Lyon, France
| | - C Watrin
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Neurooncology and Neuroinflammation, Lyon Neuroscience Research Center, Lyon, France
| | - C Benetollo
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Functional Neurogenomics and Optogenetics, Lyon Neuroscience Research Center, Lyon, France
| | - K Pernet-Gallay
- Grenoble Institute of Neurosciences, Grenoble, France,INSERM U836, Microscopy and Electron Microscopy Platform, Grenoble, France
| | - H J Luhmann
- Institute of Physiology, University Medical Center, University of Mainz, Mainz, Germany
| | - J Honnorat
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Neuro-Oncology Department, Hospices Civils de Lyon, Hôpital Neurologique, Lyon, France
| | - G Malleret
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Forgetting and Cortical Dynamics, Lyon Neuroscience Research Center, Lyon, France
| | - L Groc
- Interdisciplinary Institute for Neuroscience, Unité Mixte de Recherche 5297, Université de Bordeaux, Bordeaux, France,Interdisciplinary Institute for Neuroscience, UMR 5297, Centre National de la Recherche Scientifique, Bordeaux, France
| | - A Acker-Palmer
- Institute of Cell Biology and Neuroscience and BMLS, Goethe University Frankfurt, Frankfurt, Germany,Max Planck Institute for Brain Research, Frankfurt, Germany,Focus Program Translational Neurosciences, University of Mainz, Mainz, Germany
| | - P A Salin
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Forgetting and Cortical Dynamics, Lyon Neuroscience Research Center, Lyon, France
| | - C Meissirel
- Institut National de la Santé et de la Recherche Médicale, Unité 1028, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5292, Lyon, France,Claude Bernard University Lyon 1, Lyon, France,Neurooncology and Neuroinflammation, Lyon Neuroscience Research Center, Lyon, France,Equipe Neurooncologie et Neuroinflammation, Centre de Recherche en Neurosciences de Lyon, Institut National de la Santé et de la Recherche Médicale, Unité 1028, Faculté de Médecine Laennec, Lyon cedex O8, 69372 Lyon, France. E-mail:
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Belbezier A, Joubert B, Haesebaert J, Desestret V, Fabien N, Ducray F, Picard G, Rogemond V, Psimaras D, Delattre J, Antoine J, Honnorat J. Description des encéphalites associées aux anticorps anti-GAD. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.068] [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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Esteban Mader M, Bonnet C, Meyronet D, Joly M, Uro-Coste E, Forest F, Guyotat J, Jouvet A, Honnorat J, Ducray F. P08.39 Characteristics of adults’ gliomas with H3-K27M mutations. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Berzero G, Karantoni E, Dehais C, Ducray F, De Seze J, Picard G, Rogemond V, Honnorat J, Delattre J, Psimaras D. OS6.7 Early intravenous immunoglobulin treatment in paraneoplastic neurological syndromes with onconeural antibodies: results from the IasON trial. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.049] [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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Bonnet C, Cartalat-Carel S, Thomas L, Joubert B, Meyronet D, D’Hombres A, Jouanneau E, Guyotat J, Honnorat J, Ducray F. P08.43 Bevacizumab discontinuation and bevacizumab re-challenge in glioblastoma patients. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.176] [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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Bernard-Arnoux F, Lamure M, Ducray F, Aulagner G, Honnorat J, Armoiry X. The cost-effectiveness of tumor-treating fields therapy in patients with newly diagnosed glioblastoma. Neuro Oncol 2016; 18:1129-36. [PMID: 27177573 PMCID: PMC4933490 DOI: 10.1093/neuonc/now102] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/13/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is strong concern about the costs associated with adding tumor-treating fields (TTF) therapy to standard first-line treatment for glioblastoma (GBM). Hence, we aimed to determine the cost-effectiveness of TTF therapy for the treatment of newly diagnosed patients with GBM. METHODS We developed a 3-health-state Markov model. The perspective was that of the French Health Insurance, and the horizon was lifetime. We calculated the transition probabilities from the survival parameters reported in the EF-14 trial. The main outcome measure was incremental effectiveness expressed as life-years gained (LYG). Input costs were derived from the literature. We calculated the incremental cost-effectiveness ratio (ICER) expressed as cost/LYG. We used 1-way deterministic and probabilistic sensitivity analysis to evaluate the model uncertainty. RESULTS In the base-case analysis, adding TTF therapy to standard of care resulted in increases of life expectancy of 4.08 months (0.34 LYG) and €185 476 per patient. The ICER was €549 909/LYG. The discounted ICER was €596 411/LYG. Parameters with the most influence on ICER were the cost of TTF therapy, followed equally by overall survival and progression-free survival in both arms. The probabilistic sensitivity analysis showed a 95% confidence interval of the ICER of €447 017/LYG to €745 805/LYG with 0% chance to be cost-effective at a threshold of €100 000/LYG. CONCLUSION The ICER of TTF therapy at first-line treatment is far beyond conventional thresholds due to the prohibitive announced cost of the device. Strong price regulation by health authorities could make this technology more affordable and consequently accessible to patients.
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Affiliation(s)
- F Bernard-Arnoux
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France (F.B.-A., M.L.); Neuro-oncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310, University of Lyon, University Claude Bernard Lyon 1, Lyon, France (F.D., J.H.); Hospices Civils de Lyon, Groupement Hospitalier Est, Pharmacy Department/UMR CNRS 5510 MATEIS, University of Lyon, University Claude Bernard Lyon 1, Bron, France (G.A.); Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation/UMR CNRS 5510 MATEIS, Bron, France (X.A.)
| | - M Lamure
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France (F.B.-A., M.L.); Neuro-oncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310, University of Lyon, University Claude Bernard Lyon 1, Lyon, France (F.D., J.H.); Hospices Civils de Lyon, Groupement Hospitalier Est, Pharmacy Department/UMR CNRS 5510 MATEIS, University of Lyon, University Claude Bernard Lyon 1, Bron, France (G.A.); Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation/UMR CNRS 5510 MATEIS, Bron, France (X.A.)
| | - F Ducray
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France (F.B.-A., M.L.); Neuro-oncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310, University of Lyon, University Claude Bernard Lyon 1, Lyon, France (F.D., J.H.); Hospices Civils de Lyon, Groupement Hospitalier Est, Pharmacy Department/UMR CNRS 5510 MATEIS, University of Lyon, University Claude Bernard Lyon 1, Bron, France (G.A.); Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation/UMR CNRS 5510 MATEIS, Bron, France (X.A.)
| | - G Aulagner
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France (F.B.-A., M.L.); Neuro-oncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310, University of Lyon, University Claude Bernard Lyon 1, Lyon, France (F.D., J.H.); Hospices Civils de Lyon, Groupement Hospitalier Est, Pharmacy Department/UMR CNRS 5510 MATEIS, University of Lyon, University Claude Bernard Lyon 1, Bron, France (G.A.); Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation/UMR CNRS 5510 MATEIS, Bron, France (X.A.)
| | - J Honnorat
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France (F.B.-A., M.L.); Neuro-oncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310, University of Lyon, University Claude Bernard Lyon 1, Lyon, France (F.D., J.H.); Hospices Civils de Lyon, Groupement Hospitalier Est, Pharmacy Department/UMR CNRS 5510 MATEIS, University of Lyon, University Claude Bernard Lyon 1, Bron, France (G.A.); Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation/UMR CNRS 5510 MATEIS, Bron, France (X.A.)
| | - X Armoiry
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France (F.B.-A., M.L.); Neuro-oncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310, University of Lyon, University Claude Bernard Lyon 1, Lyon, France (F.D., J.H.); Hospices Civils de Lyon, Groupement Hospitalier Est, Pharmacy Department/UMR CNRS 5510 MATEIS, University of Lyon, University Claude Bernard Lyon 1, Bron, France (G.A.); Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation/UMR CNRS 5510 MATEIS, Bron, France (X.A.)
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Henaine AM, Paubel N, Ducray F, Diebold G, Frappaz D, Guyotat J, Cartalat-Carel S, Aulagner G, Hartmann D, Honnorat J, Armoiry X. Current trends in the management of glioblastoma in a French University Hospital and associated direct costs. J Clin Pharm Ther 2016; 41:47-53. [PMID: 26748577 DOI: 10.1111/jcpt.12346] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 12/03/2015] [Indexed: 11/29/2022]
Abstract
WHAT IS NEW AND OBJECTIVES Trends in the care of glioblastoma in actual practice settings are poorly described. In a previous pharmacoepidemiologic study, we highlighted changes in the management of patients with glioblastoma (GBM) newly diagnosed between 2004 and 2008. Our aim was to complete and to extend the previous report with a study of a cohort of patients diagnosed in 2011 to emphasize the trends in the pharmacotherapy of GBM over the last decade. METHODS A single-centre study was undertaken of three historic cohorts of GBM patients newly diagnosed during years 2004, 2008 and 2011 (corresponding to groups 1, 2 and 3, respectively) but limited to patients eligible for radiotherapy after initial diagnosis. The type of medical management was described and compared, as well as overall survival and total cost from diagnosis to death or the last follow-up date. Cost analysis was performed from the French sickness fund perspective using tariffs from 2014. RESULTS Two hundred and seventeen patients (49 in Group 1, 73 in Group 2, 95 in Group 3) were selected with similar baseline characteristics. Fluorescence-guided surgery using 5-ALA was increasingly used over the three periods. There was a strong trend towards broader use of temozolomide radiochemotherapy (39%, 73% and 83% of patients, respectively) as first-line treatment as well as bevacizumab regimen at recurrence (6%, 48% and 58% of patients, respectively). The increase in overall survival between Group 2 and Group 1 was confirmed for patients in Group 3 (17·5 months vs. 10 months in Group 1). The mean total cost per patient was 53368 € in Group 1, 70 201 € in Group 2 and 78355 € in Group 3. Hospital care represented the largest expenditure (75%, 59% and 60% in groups 1, 2 and 3, respectively) followed by chemotherapy drug costs (11%, 30% and 29%, respectively). WHAT IS NEW AND CONCLUSION This is the first study to report on changes in the management of GBM in real-life practice. The ten-year study indicates an improvement in overall survival but also an increase in total cost of care. The data should be useful for informing the care of GBM patients in settings similar to ours.
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Affiliation(s)
- A M Henaine
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,UMR CNRS 5510 MATEIS, Lyon, France
| | - N Paubel
- Pharmacy Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - F Ducray
- NeuroOncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Neuroscience Research Center INSERM U1028/CNRS UMR 5292, University Claude Bernard Lyon 1, Lyon, France
| | - G Diebold
- Pharmacy Department, Centre Hospitalier de Roanne, Roanne, France
| | - D Frappaz
- Department of Pediatric and Adult Neuro-Oncology, Centre Léon Bérard, Lyon, France
| | - J Guyotat
- Neurosurgery Department, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Lyon, France
| | - S Cartalat-Carel
- NeuroOncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Neuroscience Research Center INSERM U1028/CNRS UMR 5292, University Claude Bernard Lyon 1, Lyon, France
| | - G Aulagner
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,UMR CNRS 5510 MATEIS, Lyon, France.,Pharmacy Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - D Hartmann
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,UMR CNRS 5510 MATEIS, Lyon, France
| | - J Honnorat
- NeuroOncology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - X Armoiry
- Université de Lyon, Claude Bernard Lyon 1, Lyon, France.,UMR CNRS 5510 MATEIS, Lyon, France.,Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation, Lyon, France
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Mazzocco P, Barthélémy C, Kaloshi G, Lavielle M, Ricard D, Idbaih A, Psimaras D, Renard MA, Alentorn A, Honnorat J, Delattre JY, Ducray F, Ribba B. Prediction of Response to Temozolomide in Low-Grade Glioma Patients Based on Tumor Size Dynamics and Genetic Characteristics. CPT Pharmacometrics Syst Pharmacol 2015; 4:728-37. [PMID: 26904387 PMCID: PMC4759703 DOI: 10.1002/psp4.54] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 04/23/2015] [Accepted: 05/04/2015] [Indexed: 01/27/2023]
Abstract
Both molecular profiling of tumors and longitudinal tumor size data modeling are relevant strategies to predict cancer patients' response to treatment. Herein we propose a model of tumor growth inhibition integrating a tumor's genetic characteristics (p53 mutation and 1p/19q codeletion) that successfully describes the time course of tumor size in patients with low‐grade gliomas treated with first‐line temozolomide chemotherapy. The model captures potential tumor progression under chemotherapy by accounting for the emergence of tissue resistance to treatment following prolonged exposure to temozolomide. Using information on individual tumors' genetic characteristics, in addition to early tumor size measurements, the model was able to predict the duration and magnitude of response, especially in those patients in whom repeated assessment of tumor response was obtained during the first 3 months of treatment. Combining longitudinal tumor size quantitative modeling with a tumor''s genetic characterization appears as a promising strategy to personalize treatments in patients with low‐grade gliomas.
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Affiliation(s)
- P Mazzocco
- Inria, project-team Numed, Ecole Normale Supérieure de Lyon Lyon France
| | - C Barthélémy
- Inria, project-team Popix, Université Paris-Sud Orsay France
| | - G Kaloshi
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - M Lavielle
- Inria, project-team Popix, Université Paris-Sud Orsay France
| | - D Ricard
- Hôpital d'instruction des Armées du Val-de-Grâce Paris France
| | - A Idbaih
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - D Psimaras
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - M-A Renard
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - A Alentorn
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - J Honnorat
- Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncologie; Université de Lyon, Claude Bernard Lyon 1, Lyon Neuroscience Research Center INSERM U1028/CNRS UMR Lyon France
| | - J-Y Delattre
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - F Ducray
- Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncologie; Université de Lyon, Claude Bernard Lyon 1, Lyon Neuroscience Research Center INSERM U1028/CNRS UMR Lyon France
| | - B Ribba
- Inria, project-team Numed, Ecole Normale Supérieure de Lyon Lyon France
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Quach TT, Honnorat J, Kolattukudy PE, Khanna R, Duchemin AM. Collapsin response mediator protein 3 increases the dendritic arborization of hippocampal neurons. Mol Psychiatry 2015; 20:1027. [PMID: 26293908 DOI: 10.1038/mp.2015.123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- T T Quach
- Lyon Neuroscience Research Center, INSERM U1028/CNRS UMR 5292, Lyon, France.,Department of Neuroscience, The Ohio State University, Columbus, OH, USA
| | - J Honnorat
- Lyon Neuroscience Research Center, INSERM U1028/CNRS UMR 5292, Lyon, France.,French Reference Center on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Neurologie B, Bron, France.,Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - P E Kolattukudy
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - R Khanna
- Department of Pharmacology and Neuroscience, Graduate Interdisciplinary Program, College of Medicine, The University of Arizona, Tucson, AZ, USA
| | - A M Duchemin
- Department of Psychiatry, College of Medicine, The Ohio State University, Columbus, OH, USA
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Stupp R, Taillibert S, Kanner A, Kesari S, Toms SA, Barnett GH, Fink KL, Silvani A, Lieberman FS, Zhu JJ, Taylor LP, Honnorat J, Hottinger A, Chen T, Tran DD, Kim CY, Hirte HW, Hegi ME, Palti Y, Ram Z. Tumor treating fields (TTFields): A novel treatment modality added to standard chemo- and radiotherapy in newly diagnosed glioblastoma—First report of the full dataset of the EF14 randomized phase III trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.2000] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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)
- Roger Stupp
- University Hospital Zurich & University of Zurich, Zurich, Switzerland
| | | | | | | | | | | | | | - Antonio Silvani
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Jay-Jiguang Zhu
- The University of Texas Medical School at Houston, Houston, TX
| | | | | | | | - Thomas Chen
- University of Southern California, Los Angeles, CA
| | | | - Chae-yong Kim
- Seoul Natl Univ Bundang Hosp, Seongnam-si, Korea South
| | | | | | | | - Zvi Ram
- Tel Aviv University, Tel Aviv, Israel
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