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Cabrit N, Faron M, Tierney J, Cheugoua-Zanetsie M, Thirion P, Cunningham D, Winter K, Fu J, Mauer M, Shapiro J, Burmeister B, Walsh T, Piessen G, Klevebro F, Ychou M, Van Der Gaast A, Law S, Stahl M, Paoletti X, Ducreux M, Michiels S. SO-5 Disease-free survival as surrogate for overall survival in neoadjuvant chemo(radio)therapy treatment of esophageal or gastro-esophageal junction carcinoma: An analysis of 4518 individual patients and 22 trials. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Faron M, Cheugoua-Zanetsie M, Thirion P, Tierney J, Cunningham D, Winter K, Fu J, Mauer M, Shapiro J, Burmeister B, Walsh T, Piessen G, Klevebro F, Ychou M, Van Der Gaast A, Law S, Stahl M, van Sandick J, Pignon J, Ducreux M, Michiels S. SO-4 Individual participant data network meta-analysis (IPD-NMA) of neoadjuvant chemotherapy or chemoradiotherapy in esophageal or gastro-esophageal junction carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Assenat E, de la Fouchardière C, Portales F, Ychou M, Debourdeau A, Desseigne F, Iltache S, Fiess C, Mollevi C, Mazard T. Sequential first-line treatment with nab-paclitaxel/gemcitabine and FOLFIRINOX in metastatic pancreatic adenocarcinoma: GABRINOX phase Ib-II controlled clinical trial. ESMO Open 2021; 6:100318. [PMID: 34837745 PMCID: PMC8637474 DOI: 10.1016/j.esmoop.2021.100318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Nab-paclitaxel/gemcitabine (AG) and FOLFIRINOX (FFX) are promising drugs in metastatic pancreatic cancer (MPC). This study evaluated a new first-line sequential treatment (AG followed by FFX) in MPC that might overcome resistance to primary therapy and delay tumor progression. PATIENTS AND METHODS Patients with histologically/cytologically confirmed MPC were included in a multicentric trial receiving AG (day 1, 8 and 15) followed by FFX (day 29 and 43). In phase Ib, three dose-levels were tested for maximum tolerated dose (MTD) and recommended phase II dose. In phase II, the main outcome was the objective response rate (ORR) and secondarily safety, progression-free survival (PFS) and overall survival (OS). RESULTS In phase Ib, we included 33 patients (31 assessable) of median age 61.0 years (range 42-75 years) and represented by 54.8% males. Five dose-limiting toxicities were reported without any death. The main grade 3/4 toxicities were neutropenia with spontaneous resolution (35.5%/32.3%), venous thromboembolism (grade 3: 22.6%) and thrombopenia (grade 3: 29.0%), while the MTD was not reached. In phase II, we included 58 patients of median age 60 years (range 34-72 years), 50% males and with Eastern Cooperative Oncology Group stage score 0 and 1 of 37.9% and 62.1%, respectively. They received a median of 4 (1-9) cycles in 8.5 months (0.5-19.8 months). The ORR was 64.9% [95% confidence interval (CI) 51.1% to 77.1%], and neurotoxicity was remarkably low. The main grade 3-4 toxicities were venous thromboembolism, thrombopenia, neutropenia/febrile neutropenia, nausea, diarrhea, weight loss and asthenia without any death. Tumor response was complete in 3.5% and partial in 61.4%, while disease was stable in 19.3% and progressive in 15.8% of patients. The median PFS was 10.5 months (95% CI 6.0-12.5 months) and median OS was 15.1 months (95% CI 10.6-20.1 months). CONCLUSION Sequential AG and FFX showed acceptable toxicity as first-line treatment with no limiting neurotoxicity, while high response rate and survival justify randomized trials.
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Affiliation(s)
- E Assenat
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; CHU Montpellier, University of Montpellier, Montpellier, France.
| | | | - F Portales
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France
| | - M Ychou
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, University of Montpellier, Montpellier, France
| | - A Debourdeau
- CHU Montpellier, University of Montpellier, Montpellier, France
| | - F Desseigne
- Medical Oncology Department, Léon Bérard Centre, Lyon, France
| | - S Iltache
- CHU Montpellier, University of Montpellier, Montpellier, France
| | - C Fiess
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; Clinical Research and Innovation Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France
| | - C Mollevi
- Biometrics Unit, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP), INSERM UMR UA 11, University of Montpellier, Montpellier, France
| | - T Mazard
- Medical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France; Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, University of Montpellier, Montpellier, France
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Blay JY, Boucher S, Le Vu B, Cropet C, Chabaud S, Perol D, Barranger E, Campone M, Conroy T, Coutant C, De Crevoisier R, Debreuve-Theresette A, Delord JP, Fumoleau P, Gentil J, Gomez F, Guerin O, Jaffré A, Lartigau E, Lemoine C, Mahe MA, Mahon FX, Mathieu-Daude H, Merrouche Y, Penault-Llorca F, Pivot X, Soria JC, Thomas G, Vera P, Vermeulin T, Viens P, Ychou M, Beaupere S. Delayed care for patients with newly diagnosed cancer due to COVID-19 and estimated impact on cancer mortality in France. ESMO Open 2021; 6:100134. [PMID: 33984676 PMCID: PMC8134718 DOI: 10.1016/j.esmoop.2021.100134] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The impact of the first coronavirus disease 2019 (COVID-19) wave on cancer patient management was measured within the nationwide network of the Unicancer comprehensive cancer centers in France. PATIENTS AND METHODS The number of patients diagnosed and treated within 17 of the 18 Unicancer centers was collected in 2020 and compared with that during the same periods between 2016 and 2019. Unicancer centers treat close to 20% of cancer patients in France yearly. The reduction in the number of patients attending the Unicancer centers was analyzed per regions and cancer types. The impact of delayed care on cancer-related deaths was calculated based on different hypotheses. RESULTS A 6.8% decrease in patients managed within Unicancer in the first 7 months of 2020 versus 2019 was observed. This reduction reached 21% during April and May, and was not compensated in June and July, nor later until November 2020. This reduction was observed only for newly diagnosed patients, while the clinical activity for previously diagnosed patients increased by 4% similar to previous years. The reduction was more pronounced in women, in breast and prostate cancers, and for patients without metastasis. Using an estimated hazard ratio of 1.06 per month of delay in diagnosis and treatment of new patients, we calculated that the delays observed in the 5-month period from March to July 2020 may result in an excess mortality due to cancer of 1000-6000 patients in coming years. CONCLUSIONS In this study, the delays in cancer patient management were observed only for newly diagnosed patients, more frequently in women, for breast cancer, prostate cancer, and nonmetastatic cancers. These delays may result is an excess risk of cancer-related deaths in the coming years.
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Affiliation(s)
- J Y Blay
- Centre Leon Berard, Lyon, France.
| | | | | | - C Cropet
- Centre Leon Berard, Lyon, France
| | | | - D Perol
- Centre Leon Berard, Lyon, France
| | | | - M Campone
- Institut de Cancerologie de l'Ouest, Nantes et Angers, France
| | - T Conroy
- Institut de Cancerologie de Lorraine, Nancy, France
| | - C Coutant
- Centre George Francoise Leclerc, Dijon, France
| | | | | | - J P Delord
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | | | - J Gentil
- Centre George Francoise Leclerc, Dijon, France
| | - F Gomez
- Centre Leon Berard, Lyon, France
| | - O Guerin
- Institut de Cancerologie de l'Ouest, Nantes et Angers, France
| | | | | | - C Lemoine
- Institut Paoli-Calmettes, Marseille, France
| | - M A Mahe
- Centre François Baclesse, Caen, France
| | | | - H Mathieu-Daude
- Institut de Cancerologie de Montpellier, Montpellier, France
| | | | | | - X Pivot
- Centre Paul Strauss/ICANS, Strasbourg, France
| | | | - G Thomas
- Centre François Baclesse, Caen, France
| | - P Vera
- Centre Henri Becquerel, Rouen, France
| | | | - P Viens
- Institut Paoli-Calmettes, Marseille, France
| | - M Ychou
- Institut de Cancerologie de Montpellier, Montpellier, France
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Tanos R, Otandault A, Mollevi C, Bauer A, Tousch G, Picque Lasorsa L, El Messaoudi S, Colinge J, Colombo PE, Jacot W, Mazard T, Sayagués J, Gillet B, Pezet D, Ychou M, Thierry A. Towards a screening test for cancer by circulating DNA analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz257.020] [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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Taieb J, Taly V, Vernerey D, Bourreau C, Bennouna J, Faroux R, Desrame J, Bouche O, Borg C, Egreteau J, Mineur L, Lepere C, Deplanque G, Mulot C, Louvet C, Mabro M, Ychou M, de Gramont A, Andre T, Laurent-Puig P. Analysis of circulating tumour DNA (ctDNA) from patients enrolled in the IDEA-FRANCE phase III trial: Prognostic and predictive value for adjuvant treatment duration. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Abboud K, André T, Brunel M, Ducreux M, Eveno C, Glehen O, Goéré D, Gornet JM, Lefevre JH, Mariani P, Pinto A, Quenet F, Sgarbura O, Ychou M, Pocard M. Management of colorectal peritoneal metastases: Expert opinion. J Visc Surg 2019; 156:377-379. [PMID: 31466831 DOI: 10.1016/j.jviscsurg.2019.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
When peritoneal metastases are diagnosed (strong agreement of experts): (i) seek advice from a multidisciplinary coordination meeting (MCM) with large experience in peritoneal disease (e.g. BIG RENAPE network); (ii) transfer (or not) the patient to a referral center with experience in hyperthermic intraperitoneal chemotherapy (HIPEC), according to the advice of the MCM. With regard to systemic chemotherapy (strong agreement of experts): (i) it should be performed both before and after surgery, (ii) for no longer than 6 months; (iii) without postoperative anti-angiogenetic drugs. With regard to cytoreductive surgery (strong agreement of experts): (i) Radical surgery requires a xiphopubic midline incision; (ii) no cytoreductive surgery via laparoscopy. With regard to HIPEC: HIPEC can be proposed for trials outside an HIPEC referral center (weak agreement between experts): (i) if surgery is radical; (ii) if the expected morbidity is "reasonable"; (iii) if the indication for HIPEC was suggested by a MCM, and; (iv) mitomycin is preferred to oxaliplatin (which cannot be recommended) for this indication.
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Affiliation(s)
- K Abboud
- Service de chirurgie générale et thoracique, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - T André
- Service d'oncologie médicale, Sorbonne université, hôpital Saint-Antoine, 184, rue du Faubourg Saint-Antoine, 75571 Paris, France
| | - M Brunel
- Service de chirurgie digestive, hôpital Mignot, 177, rue de Versailles, 78157 Le Chesnay, France
| | - M Ducreux
- Département d'oncologie médicale, Gustave-Roussy cancer campus, université Paris-Saclay, 94800 Villejuif, France
| | - C Eveno
- Équipe «Mucines, différenciation épithéliale, et cancérogenèse», unité mixte de recherche 1172-JPARC, Inserm, département de chirurgie digestive et oncologique, centre de recherche Jean-Pierre Aubert, centre hospitalier universitaire (CHU) de Lille, CHU Claude-Huriez, université de Lille, 59000 Lille, France
| | - O Glehen
- Département de chirurgie oncologique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France; EMR 3738, Lyon 1 université, 69000 Lyon, France
| | - D Goéré
- Service de chirurgie générale et oncologique, hôpital Saint-Louis, assistance publique, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - J-M Gornet
- Département de gastroentérologie, hôpital Saint-Louis, assistance publique, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - J H Lefevre
- Département de chirurgie digestive, Sorbonne université, hôpital Saint-Antoine, AP-HP, 75012 Paris, France
| | - P Mariani
- Département de chirurgie oncologique, institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - A Pinto
- Unité Inserm U1275 CAP Paris-Tech, carcinose péritoine Paris technologiques, université de Paris, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France
| | - F Quenet
- Département de chirurgie oncologique, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34298 Montpellier, France; Université de Montpellier, 34000 Montpellier, France
| | - O Sgarbura
- Département de chirurgie oncologique, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34298 Montpellier, France; Université de Montpellier, 34000 Montpellier, France
| | - M Ychou
- Université de Montpellier, 34000 Montpellier, France; Département d'oncologie digestive, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34298 Montpellier, France
| | - M Pocard
- Unité Inserm U1275 CAP Paris-Tech, carcinose péritoine Paris technologiques, université de Paris, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
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Samalin E, Mazard T, Assenat E, Rouyer M, De la Fouchardière C, Guimbaud R, Smith D, Portales F, Ychou M, Fiess C, de Forges H, Lopez-Crapez E, Thézenas S. Triplet chemotherapy plus cetuximab as first-line treatment in RAS wild-type metastatic colorectal carcinoma patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mazard T, Ghiringhelli F, Mollevi C, Assenat E, Gavoille C, Smith D, Pezzella V, Meddeb R, Pastor B, Ychou M, Thierry A. UCGI 28 Panirinox: A randomized phase II study assessing Panitumumab + FOLFIRINOX or mFOLFOX6 in RAS and BRAF wild type metastatic colorectal cancer patients (mCRC) selected from circulating DNA analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Prieur A, Kepenekian V, Mazard T, Payen L, Maucourt-Boulch D, Assenat E, Mariani O, Liaud P, Flacelière M, Soulé J, Dayde D, Calattini S, Ychou M, Glehen O, Joubert D, You B. Progastrin, a New Blood Biomarker for Multiple Cancers Allowing a New Strategy for Screening, Early Detection and Monitoring. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.85400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The majority of cancers evolve for years before becoming symptomatic. But once symptomatic, it is often too late for the patients to be cured. It is thus of paramount importance to improve early cancer screening in the general population as well as in genetically predisposed individuals. Moreover, although there is an undeniable progress in treatments, in particular in the immuno-oncology field, there is a growing need for circulating biomarkers to monitor treatment efficacy to better impact patient health and social economics. Aim: Progastrin (PG) is abnormally released in the blood of patients with colorectal cancer (CRC), as the gene coding for PG is a direct target of the WNT/β-catenin oncogenic pathway involved in tumorigenesis of many organs and activated from the very first steps of tumorigenesis, allowing the detection of PG in early stage cancers. The objective was to assess the diagnostic value of PG in a series of different types of cancers (early and advanced stages), as well as the role of PG as a circulating biomarker for treatment follow-up in patients with peritoneal carcinomatosis, a metastatic disease where imaging monitoring is impossible (due to the small size of lesions). Methods: Progastrin was measured in plasma EDTA samples using the ELISA cancerREAD technology. For the evaluation of PG in cancer patients, 673 samples were collected for comparison with 119 healthy volunteers. For the follow-up monitoring, patients were enrolled during management of peritoneal carcinomatosis (before or after neoadjuvant chemotherapy, or surgery). The diagnostic value of PG concentrations at inclusion in 190 GI cancer patients was assessed against 80 control samples. Results: Progastrin was detected in 77% of cancer patients, all cancers combined. The diagnosis area under the ROC curve of PG was 0.9114, P < 0.0001. Sensitivity ranged from 71% (breast cancer) to 87% (skin melanoma). All the 15 different types of cancers tested were positive. Early stage detection was assessed for colorectal and breast cancers with a sensitivity of 62.5% for adenomatous polyps, and 68.2% for stage 0 and I breast cancers. Sensitivity increased up to 82% for stage II colorectal cancer and to 78% for stage II-IV breast cancers. For the follow-up of peritoneal carcinomatosis patients, median PG levels decreased whatever the GI subtype with sequential treatments from 4.4 pM at inclusion time, to 1.3 after adjuvant chemotherapy. A trend for better PFS was observed in patients with PG decline after surgery. Conclusion: Progastrin assay is a simple and inexpensive blood test exhibiting high diagnostic accuracy for multiple gastro-intestinal, gynecologic, skin cancers. It may be used for cancer screening before tumor localization. It also exhibits promising therapeutic monitoring value during treatment in advanced CRC patients. Assessment of PG value as a multitumor screening biomarker, and as a monitoring test, is ongoing.
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Affiliation(s)
| | | | - T. Mazard
- Institut Régional du Cancer de Montpellier, Montpellier, France
| | - L. Payen
- Hospices Civils de Lyon, Pierre-Bénite, France
| | | | | | | | | | | | | | - D. Dayde
- Plateforme de Recherche Clinique Transversale, Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France
| | - S. Calattini
- Plateforme de Recherche Clinique Transversale, Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France
| | - M. Ychou
- Institut Régional du Cancer de Montpellier, Montpellier, France
| | - O. Glehen
- Centre Hospitalier Lyon Sud, Department of Surgical Oncology, Lyon, France
| | | | - B. You
- Les Hospices Civils de Lyon, Lyon, France
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Thierry AR, El Messaoudi S, Mollevi C, Raoul JL, Guimbaud R, Pezet D, Artru P, Assenat E, Borg C, Mathonnet M, De La Fouchardière C, Bouché O, Gavoille C, Fiess C, Auzemery B, Meddeb R, Lopez-Crapez E, Sanchez C, Pastor B, Ychou M. Clinical utility of circulating DNA analysis for rapid detection of actionable mutations to select metastatic colorectal patients for anti-EGFR treatment. Ann Oncol 2018; 28:2149-2159. [PMID: 28911069 DOI: 10.1093/annonc/mdx330] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background While tumor-tissue remains the 'gold standard' for genetic analysis in cancer patients, it is challenged with the advent of circulating cell-free tumor DNA (ctDNA) analysis from blood samples. Here, we broaden our previous study on the clinical validation of plasma DNA in metastatic colorectal cancer patients, by evaluating its clinical utility under standard management care. Patients and methods Concordance and data turnaround-time of ctDNA when compared with tumor-tissue analysis were studied in a real-time blinded prospective multicenter clinical study (n = 140 metastatic colorectal patients). Results are presented according to STARD criteria and were discussed in regard with clinical outcomes of patients. Results Much more mutations were found by ctDNA analysis: 59%, 11.8% and 14.4% of the patients were found KRAS, NRAS and BRAF mutant by ctDNA analysis instead of 44%, 8.8% and 7.2% by tumor-tissue analysis. Median tumor-tissue data turnaround-time was 16 days while 2 days for ctDNA analysis. Discordant samples analysis revealed that use of biopsy, long delay between tumor-tissue and blood collection and resection of the tumor at time of blood draw, tumor site, or type of tissue analyzed seem to affect concordance. Altogether, the clinical data with respect to the anti-epidermal growth factor receptor response (RAS status) and the prognosis (BRAF status) of those discordant patients do not appear contradictory to the mutational status as determined by plasma analysis. Lastly, we present the first distribution profile of the RAS and BRAF hotspot mutations as determined by ctDNA analysis (n = 119), revealing a high proportion of patients with multiple mutations (45% of the population and up to 5 mutations) and only 24% of WT scored patients for both genes. Mutation profile as determined from ctDNA analysis with using various detection thresholds highlights the importance of the test sensitivity. Conclusion Our study showed that ctDNA could replace tumor-tissue analysis, and also clinical utility of ctDNA analysis by considerably reducing data turnaround time.
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Affiliation(s)
- A R Thierry
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - S El Messaoudi
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - C Mollevi
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier.,Biometry Unit, Regional Institute of Cancer of Montpellier, Montpellier
| | - J L Raoul
- Department of Medical Oncology, Paoli Calmettes Institute, Marseille
| | - R Guimbaud
- Department of Oncology, University Hospital Center of Toulouse - Hospital Rangueil-Purpan, Toulouse
| | - D Pezet
- Digestive Oncology Unit, Department of Digestive Surgery, University Hospital Center of Clermont-Ferrand, UMR Inserm/Auvergne University U1071, Clermont-Ferrand
| | - P Artru
- Jean-Mermoz Private Hospital, Lyon
| | - E Assenat
- CHRU Montpellier, St. Eloi Hospital, Montpellier
| | - C Borg
- CHRU Jean MINJOZ, Besançon
| | - M Mathonnet
- Digestive Surgery Department, Clinical Investigation Centre, University Hospital Center of Limoges, INSERM 0801, Limoges
| | | | | | - C Gavoille
- Alexis Vautrin Oncology Institute of Lorraine, Nancy
| | - C Fiess
- Digestive Oncology Department, Regional Institute of Cancer of Montpellier, Montpellier, France
| | - B Auzemery
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - R Meddeb
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - E Lopez-Crapez
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - C Sanchez
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - B Pastor
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier
| | - M Ychou
- IRCM, Institute of Research in Oncology of Montpellier, Montpellier.,INSERM, U1194, Montpellier.,Department of Oncology, Montpellier University, Montpellier.,Regional Institute of Cancer of Montpellier, Montpellier.,Digestive Oncology Department, Regional Institute of Cancer of Montpellier, Montpellier, France
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Créoff M, Castan F, Lauche O, Llacer C, Prunaretty J, Aillères N, Fenoglietto P, Raphaël T, Ychou M, Azria D, Riou O. Évaluation de l’efficacité et de la toxicité de la radiothérapie en conditions stéréotaxiques des carcinomes hépatocellulaires. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.08.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Taieb J, Bonnetain F, Mineur L, Bennouna J, Desrame J, Faroux R, Fratte S, Dauba J, Vernerey D, Louvet C, Lepere C, Dupuis O, Becouarn Y, Mabro M, Egreteau J, Bouche O, Deplanque G, Ychou M, de Gramont A, André T. Three versus six months’ adjuvant oxaliplatin-based chemotherapy for patients with stage III colon cancer: Per-protocol, subgroups and long-lasting neuropathy results. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Samalin E, Senellart H, Thezenas S, Jacquot S, Ellis S, Khemissa F, Ramdani M, Portales F, Assenat E, Mazard T, Mineur L, Ychou M. Multicenter randomized phase II trial (BEVATOMOX) assessing the raltitrexed, oxaliplatin and bevacizumab combination versus FOLFOX6 bevacizumab as 2nd line treatment in metastatic colorectal cancer (mCRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bousquet J, Bourret R, Camuzat T, Augé P, Bringer J, Noguès M, Jonquet O, de la Coussaye JE, Ankri J, Cesari M, Guérin O, Vellas B, Blain H, Arnavielhe S, Avignon A, Combe B, Canovas G, Daien C, Dray G, Dupeyron A, Jeandel C, Laffont I, Laune D, Marion C, Pastor E, Pélissier JY, Galan B, Reynes J, Reuzeau JC, Bedbrook A, Granier S, Adnet PA, Amouyal M, Alomène B, Bernard PL, Berr C, Caimmi D, Claret PG, Costa DJ, Cristol JP, Fesler P, Hève D, Millot-Keurinck J, Morquin D, Ninot G, Picot MC, Raffort N, Roubille F, Sultan A, Touchon J, Attalin V, Azevedo C, Badin M, Bakhti K, Bardy B, Battesti MP, Bobia X, Boegner C, Boichot S, Bonnin HY, Bouly S, Boubakri C, Bourrain JL, Bourrel G, Bouix V, Bruguière V, Cade S, Camu W, Carre V, Cavalli G, Cayla G, Chiron R, Coignard P, Coroian F, Costa P, Cottalorda J, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cros V, Cuisinier F, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dujols P, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fouletier M, Fraisse P, Gabrion P, Gellerat-Rogier M, Gelis A, Genis C, Giraudeau N, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Kouyoudjian P, Lamoureux R, Landreau L, Lapierre M, Larrey D, Laurent C, Léglise MS, Lemaitre JM, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert CM, Makinson A, Mandrick K, Mares P, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Mottet D, Nérin P, Nicolas P, Nouvel F, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Portejoie F, Pujol JLE, Quantin X, Quéré I, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Robine JM, Rolland C, Royère E, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Stephan Y, Strubel D, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Tribout V, Uziel A, Van de Perre P, Venail F, Vergne-Richard C, Vergotte G, Vian L, Vialla F, Viart F, Villain M, Viollet E, Ychou M, Mercier J. MACVIA-LR (Fighting Chronic Diseases for Active and Healthy Ageing in Languedoc-Roussillon): A Success Story of the European Innovation Partnership on Active and Healthy Ageing. J Frailty Aging 2017; 5:233-241. [PMID: 27883170 DOI: 10.14283/jfa.2016.105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of elderly people. All sub-activities (poly-pharmacy, falls prevention initiative, prevention of frailty, chronic respiratory diseases, chronic diseases with multimorbidities, chronic infectious diseases, active and independent living and disability) have been included in MACVIA-LR which has a strong political commitment and involves all stakeholders (public, private, patients, policy makers) including CARSAT-LR and the Eurobiomed cluster. It is a Reference Site of the EIP on AHA. The framework of MACVIA-LR has the vision that the prevention and management of chronic diseases is essential for the promotion of AHA and for the reduction of handicap. The main objectives of MACVIA-LR are: (i) to develop innovative solutions for a network of Living labs in order to reduce avoidable hospitalisations and loss of autonomy while improving quality of life, (ii) to disseminate the innovation. The three years of MACVIA-LR activities are reported in this paper.
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Affiliation(s)
- J Bousquet
- Professor Jean Bousquet, CHRU, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France, Tel +33 611 42 88 47,
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Cherradi S, Ayrolles-Torro A, Vezzo-Vié N, Gueguinou N, Denis V, Combes E, Boissière F, Busson M, Canterel-Thouennon L, Mollevi C, Pugnière M, Bibeau F, Ychou M, Martineau P, Gongora C, Del Rio M. Antibody targeting of claudin-1 as a potential colorectal cancer therapy. J Exp Clin Cancer Res 2017; 36:89. [PMID: 28659146 PMCID: PMC5490170 DOI: 10.1186/s13046-017-0558-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/19/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Metastatic colorectal cancer (mCRC) is one of the major causes of cancer-related death. Despite the substantial progress in mCRC management, it remains important to identify new therapeutic options and biological markers for personalized medicine. Here, we investigated the expression of claudin-1 (CLDN1), a major tight junction transmembrane protein, in the different colorectal cancer (CRC) molecular subtypes and then assessed the anti-tumor effect of a new anti-CLDN1 monoclonal antibody (mAb). METHODS Gene expression profiling and immunochemistry analysis of normal and tumor tissue samples from patients with stage IV CRC were used to determine CLDN1 gene expression. Then, the 6F6 mAb against CLDN1 extracellular part was generated. Its effect on CRC cell cycle, proliferation, survival and migration was assessed in vitro, using a 3D cell culture system, flow cytometry, clonogenic and migration assays. In vivo, 6 F6 mAb efficacy was evaluated in nude mice after subcutaneous xenografts or intrasplenic injection of CRC cells. RESULTS Compared with normal mucosa where it was almost exclusively cytoplasmic, in CRC samples CLDN1 was overexpressed (p < 0.001) and mainly localized at the membrane. Moreover, it was differentially expressed in the various CRC molecular subtypes. The strongest expressions were found in the consensus molecular subtype CMS2 (p < 0.001), the transit-ampliflying (p < 0.001) and the C5 subtypes (p < 0.001). Lower CLDN1 expression predicted a better outcome in the molecular subtypes C3 and C5 (p = 0.012 and p = 0.004, respectively). CLDN1 targeting with the 6 F6 mAb led to reduction of survival, growth and migration of CLDN1-positive cells. In preclinical mouse models, the 6F6 mAb decreased tumor growth and liver metastasis formation. CONCLUSION Our data indicate that CLDN1 targeting with an anti-CLDN1 mAb results in decreased growth and survival of CRC cells. This suggests that CLDN1 could be a new potential therapeutic target.
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Affiliation(s)
- S Cherradi
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - A Ayrolles-Torro
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - N Vezzo-Vié
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
- Institut régional du Cancer de Montpellier (ICM), Montpellier, F-34298, France
| | - N Gueguinou
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - V Denis
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - E Combes
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - F Boissière
- Institut régional du Cancer de Montpellier (ICM), Montpellier, F-34298, France
| | - M Busson
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - L Canterel-Thouennon
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
- Institut régional du Cancer de Montpellier (ICM), Montpellier, F-34298, France
| | - C Mollevi
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
- Institut régional du Cancer de Montpellier (ICM), Montpellier, F-34298, France
| | - M Pugnière
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - F Bibeau
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
- Institut régional du Cancer de Montpellier (ICM), Montpellier, F-34298, France
| | - M Ychou
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
- Institut régional du Cancer de Montpellier (ICM), Montpellier, F-34298, France
| | - P Martineau
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - C Gongora
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France
| | - M Del Rio
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothicaires, F-34298, Montpellier Cedex 5, France.
- Institut régional du Cancer de Montpellier (ICM), Montpellier, F-34298, France.
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Ronellenfitsch U, Schwarzbach M, Hofheinz R, Kienle P, Nowak K, Kieser M, Slanger TE, Burmeister B, Kelsen D, Niedzwiecki D, Schuhmacher C, Urba S, van de Velde C, Walsh TN, Ychou M, Jensen K. Predictors of overall and recurrence-free survival after neoadjuvant chemotherapy for gastroesophageal adenocarcinoma: Pooled analysis of individual patient data (IPD) from randomized controlled trials (RCTs). Eur J Surg Oncol 2017; 43:1550-1558. [PMID: 28551325 DOI: 10.1016/j.ejso.2017.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 03/07/2017] [Accepted: 05/02/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Neoadjuvant chemotherapy improves prognosis of patients with locally advanced gastroesophageal adenocarcinoma. The aim of this study was to identify predictors for postoperative survival following neoadjuvant therapy. These could be useful in deciding about postoperative continuation of chemotherapy. METHODS This meta-analysis used IPD from RCTs comparing neoadjuvant chemotherapy with surgery alone for gastroesophageal adenocarcinoma. Trials providing IPD on age, sex, performance status, pT/N stage, resection status, overall and recurrence-free survival were included. Survival was calculated in the entire study population and subgroups stratified by supposed predictors and compared using the log-rank test. Multivariable Cox models were used to identify independent survival predictors. RESULTS Four RCTs providing IPD from 553 patients fulfilled the inclusion criteria. (y)pT and (y)pN stage and resection status strongly predicted postoperative survival both after neoadjuvant therapy and surgery alone. Patients with R1 resection after neoadjuvant therapy survived longer than those with R1 resection after surgery alone. Patients with stage pN0 after surgery alone had better prognosis than those with ypN0 after neoadjuvant therapy. Patients with stage ypT3/4 after neoadjuvant therapy survived longer than those with stage pT3/4 after surgery alone. Multivariable regression identified resection status and (y)pN stage as predictors of survival in both groups. (y)pT stage predicted survival only after surgery alone. CONCLUSION After neoadjuvant therapy for gastroesophageal adenocarcinoma, survival is determined by the same factors as after surgery alone. However, ypT stage is not an independent predictor. These results can facilitate the decision about postoperative continuation of chemotherapy in pretreated patients.
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Affiliation(s)
- U Ronellenfitsch
- Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - M Schwarzbach
- Department of General, Visceral, Vascular, and Thoracic Surgery, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
| | - R Hofheinz
- Day Treatment Center (TTZ), Interdisciplinary Tumor Center Mannheim (ITM) & 3rd Department of Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - P Kienle
- Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - K Nowak
- Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - M Kieser
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130, 69120 Heidelberg, Germany.
| | - T E Slanger
- Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - B Burmeister
- University of Queensland, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
| | - D Kelsen
- Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY 10021, USA.
| | - D Niedzwiecki
- The Alliance for Clinical Trials in Oncology (Alliance) Statistics and Data Center, Duke University Medical Center, Hock Plaza, 2424 Erwin Rd, Room 8040, Durham, NC 27705, USA.
| | - C Schuhmacher
- Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675 Munich, Germany.
| | - S Urba
- Division of Hematology/Oncology, University of Michigan Medical Center, 1500 E Medical Center Drive, C347, SPC 5848, Ann Arbor, MI 48109, USA.
| | - C van de Velde
- Department of Surgery, Leiden University Medical Center, K6-R, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
| | - T N Walsh
- Department of Surgery, Connolly Hospital, Blanchardstown, Dublin 15, Ireland.
| | - M Ychou
- Centre Régional de Lutte Contre le Cancer, Val d'Aurelle, Montpellier Cedex 05, France.
| | - K Jensen
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130, 69120 Heidelberg, Germany.
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Del Rio M, Mollevi C, Bibeau F, Vie N, Selves J, Emile JF, Roger P, Gongora C, Robert J, Tubiana-Mathieu N, Ychou M, Martineau P. Molecular subtypes of metastatic colorectal cancer are associated with patient response to irinotecan-based therapies. Eur J Cancer 2017; 76:68-75. [PMID: 28284171 DOI: 10.1016/j.ejca.2017.02.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 11/16/2016] [Revised: 01/21/2017] [Accepted: 02/01/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Currently, metastatic colorectal cancer is treated as a homogeneous disease and only RAS mutational status has been approved as a negative predictive factor in patients treated with cetuximab. The aim of this study was to evaluate if recently identified molecular subtypes of colon cancer are associated with response of metastatic patients to first-line therapy. PATIENTS AND METHODS We collected and analysed 143 samples of human colorectal tumours with complete clinical annotations, including the response to treatment. Gene expression profiling was used to classify patients in three to six classes using four different molecular classifications. Correlations between molecular subtypes, response to treatment, progression-free and overall survival were analysed. RESULTS We first demonstrated that the four previously described molecular classifications of colorectal cancer defined in non-metastatic patients also correctly classify stage IV patients. One of the classifications is strongly associated with response to FOLFIRI (P=0.003), but not to FOLFOX (P=0.911) and FOLFIRI + Bevacizumab (P=0.190). In particular, we identify a molecular subtype representing 28% of the patients that shows an exceptionally high response rate to FOLFIRI (87.5%). These patients have a two-fold longer overall survival (40.1 months) when treated with FOLFIRI, as first-line regimen, instead of FOLFOX (18.6 months). CONCLUSIONS Our results demonstrate the interest of molecular classifications to develop tailored therapies for patients with metastatic colorectal cancer and a strong impact of the first-line regimen on the overall survival of some patients. This however remains to be confirmed in a large prospective clinical trial.
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Affiliation(s)
- M Del Rio
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier, F-34298, France; INSERM, U1194, Montpellier, F-34298, France; Université de Montpellier, Montpellier, F-34090, France; Institut régional du Cancer de Montpellier, Montpellier, F-34298, France
| | - C Mollevi
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier, F-34298, France; INSERM, U1194, Montpellier, F-34298, France; Université de Montpellier, Montpellier, F-34090, France; Institut régional du Cancer de Montpellier, Montpellier, F-34298, France
| | - F Bibeau
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier, F-34298, France; INSERM, U1194, Montpellier, F-34298, France; Université de Montpellier, Montpellier, F-34090, France; Institut régional du Cancer de Montpellier, Montpellier, F-34298, France
| | - N Vie
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier, F-34298, France; INSERM, U1194, Montpellier, F-34298, France; Université de Montpellier, Montpellier, F-34090, France; Institut régional du Cancer de Montpellier, Montpellier, F-34298, France
| | - J Selves
- Centre Hospitalier Universitaire de Toulouse, F-31300, France; Centre de Recherche en Cancérologie de Toulouse, Unité Mixte de Recherche 1037 INSERM - Université Toulouse III, France
| | - J-F Emile
- Université de Versailles, Boulogne, France; Hôpital Ambroise Paré, Boulogne, France
| | - P Roger
- Université de Montpellier, Montpellier, F-34090, France; Service d'Anatomie et Cytologie Pathologiques, CHU Nîmes, Place du Professeur Debré, 30029, Nîmes, France
| | - C Gongora
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier, F-34298, France; INSERM, U1194, Montpellier, F-34298, France; Université de Montpellier, Montpellier, F-34090, France; Institut régional du Cancer de Montpellier, Montpellier, F-34298, France
| | - J Robert
- INSERM U916, Institut Bergonié, Université de Bordeaux, France
| | - N Tubiana-Mathieu
- Service d'oncologie médicale, CHU Dupuytren, avenue Luther-King, 87000, Limoges, France
| | - M Ychou
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier, F-34298, France; INSERM, U1194, Montpellier, F-34298, France; Université de Montpellier, Montpellier, F-34090, France; Institut régional du Cancer de Montpellier, Montpellier, F-34298, France
| | - P Martineau
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier, F-34298, France; INSERM, U1194, Montpellier, F-34298, France; Université de Montpellier, Montpellier, F-34090, France; Institut régional du Cancer de Montpellier, Montpellier, F-34298, France.
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Assenat E, Fouchardiere C, Mollevi C, Samalin E, Portales F, Desseigne F, Carenco C, Dupuy M, Lopez-Martinez E, Fiess C, Mazard T, Ychou M. Gabrinox: A phase I-II of nab-paclitaxel plus gemcitabine followed by folfirinox in metastatic pancreatic adenocarcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bidard FC, Ychou M, Madic J, Saliou A, Bouché O, Rivoire M, Ghiringhelli F, Francois E, Guimbaud R, Mineur L, Khemissa-Akouz F, Mazard T, Moussata D, Cacheux W, Proudhon C, Stern MH, Pierga JY, Stanbury T, Thezenas S, Mariani P. Circulating tumor DNA and circulating tumor cells as predictor of outcome in the PRODIGE14-ACCORD21-METHEP2 phase II trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.05] [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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Samalin E, Fouchardiere C, Thezenas S, Boige V, Senellart H, Guimbaud R, Taieb J, Francois E, Galais MP, Adenis A, Lievre A, Dahan L, Di Fiore F, Boissiere F, Crapez E, Bibeau F, Ho-Pun-Cheung A, Poujol S, Mazard T, Ychou M. Sorafenib (Soraf) and irinotecan (Iri) combination for pretreated RAS-mutated metastatic colorectal cancer (mCRC) patients: a multicentre randomized phase II trial (NEXIRI 2-PRODIGE 27). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.15] [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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Van Cutsem E, Ciardiello F, Ychou M, Seitz JF, Hofheinz R, Arriaga Y, Garcia-Carbonero R, Grothey A, Miriyala A, Kalmus J, Kappeler C, Falcone A, Zaniboni A. PD-012 Analysis of patients ≥75 years in the open-label phase 3b CONSIGN trial of regorafenib in previously treated metastatic colorectal cancer (mCRC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rouanet P, Rullier E, Lelong B, Maingon P, Tuech Jean J, Pezet D, Rivoire M, Meunier B, Nougaret S, Castan F, Lemanski C, Gourgou S, Ychou M. O-021 Tailored strategy for locally-advanced rectal carcinoma: preliminary results of a phase II multicenter trial (GRECCAR 4). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw198.21] [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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Mollevi C, Del Rio M, Bibeau F, Vie N, Selves J, Emile JF, Roger P, Gongora C, Robert J, Tubiana N, Ychou M, Martineau P. Association entre les sous-types moléculaires et la réponse aux chimiothérapies dans le cancer colorectal métastatique. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.03.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Bousquet J, Bourret R, Camuzat T, Augé P, Domy P, Bringer J, Best N, Jonquet O, de la Coussaye JE, Noguès M, Robine JM, Avignon A, Blain H, Combe B, Dray G, Dufour V, Fouletier M, Giraudeau N, Hève D, Jeandel C, Laffont I, Larrey D, Laune D, Laurent C, Mares P, Marion C, Pastor E, Pélissier JY, Radier-Pontal F, Reynes J, Royère E, Ychou M, Bedbrook A, Granier S, Abecassis F, Albert S, Adnet PA, Alomène B, Amouyal M, Arnavielhe S, Asteriou T, Attalin V, Aubas P, Azevedo C, Badin M, Bakhti, Baptista G, Bardy B, Battesti MP, Bénézet O, Bernard PL, Berr C, Berthe J, Bobia X, Bockaert J, Boegner C, Boichot S, Bonnin HY, Boulet P, Bouly S, Boubakri C, Bourdin A, Bourrain JL, Bourrel G, Bouix V, Breuker C, Bruguière V, Burille J, Cade S, Caimmi D, Calmels MV, Camu W, Canovas G, Carre V, Cavalli G, Cayla G, Chiron R, Claret PG, Coignard P, Coroian F, Costa DJ, Costa P, Cottalorda, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cristol JP, Cros V, Cuisinier F, Daien C, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dhivert-Donnadieu H, Dujols P, Dupeyron A, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fesler P, Fraisse P, Froger J, Gabrion P, Galano E, Gellerat-Rogier M, Gellis A, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hantkié H, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Journot L, Kaczorek M, Kouyoudjian P, Labauge P, Landreau L, Lapierre M, Leblond C, Léglise MS, Lemaitre JM, Le Moing V, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert JM, Makinson A, Mandrick K, Marmelat V, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Morquin D, Mottet D, Nérin P, Nicolas P, Ninot G, Nouvel F, Ortiz JP, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Picot MC, Pin JP, Pinto N, Porte E, Portejoie F, Pujol JL, Quantin X, Quéré I, Raffort N, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Rolland C, Roubille F, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Soua B, Stephan Y, Strubel D, Sultan A, Taddei-Ologeanu, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Touchon J, Tribout V, Uziel A, Van de Perre P, Vasquez X, Verdier JM, Vergne-Richard C, Vergotte G, Vian L, Viarouge-Reunier C, Vialla F, Viart F, Villain M, Villiet M, Viollet E, Wojtusciszyn A, Aoustin M, Bourquin C, Mercier J. Introduction. Presse Med 2015; 44 Suppl 1:S1-5. [DOI: 10.1016/j.lpm.2015.07.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Ricotta R, Ghezzi S, Verrioli A, Porcu L, Cremolini C, Argiles G, Adenis A, Ychou M, Barone C, Bouche O, Humblet Y, Mineur L, Sobrero A, Pietrogiovanna L, Maiolani M, Galbiati D, Tosi F, Redaelli D, Grothey A. Cavitation of lung metastases induced by regorafenib is associated with radiological response in metastatic colorectal cancer: data from the phase III correct study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sobrero A, Grothey A, Siena S, Falcone A, Ychou M, Humblet Y, Bouche O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz H, Goldberg R, Xu L, Wagner A, Van Cutsem E. Subgroup analysis of patients with metastatic colorectal cancer (mCRC) treated with regorafenib (REG) in the CORRECT trial who had progression-free survival (PFS) longer than 4 months. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.13] [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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Shinozaki E, Laurent S, Gravalos C, Benavides M, Munoz FL, Mizuguchi H, Wahba M, Ychou M, Ciardiello F, Siena S, Yamaguchi K, Muro K, Denda T, Tsuji Y, Loehrer P, Lenz H, Tebbutt N, Mayer R, Van Cutsem E, Ohtsu A. 2151 Timing of adverse events (AEs) in the Phase 3 RECOURSE trial of TAS-102 versus placebo in patients (pts) with metastatic colorectal cancer (mCRC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31072-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ricotta R, Verrioli A, Ghezzi S, Grothey A, Cremolini C, Argiles G, Adenis A, Ychou M, Barone C, Bouchet O, Humblet Y, Mineur L, Sobrero A, Peeters M, Van Cutsem E, Porcu L, Amatu A, Sartore-Bianchi A, Vanzulli A, Siena S. 2015 Cavitation of lung metastases induced by regorafenib in patients with colorectal carcinoma: Data from the phase III CORRECT study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30939-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Samalin E, Thezenas S, Delord JP, Italiano A, Smith D, Portales F, Mazard T, Assenat E, Poujol S, Solassol I, Khier S, Chalbos P, Ychou M. P-161 A phase I-trial assessing several schedules of Oral S-1 combined with fixed doses of Oxaliplatin and Irinotecan in patients with advanced or metastatic digestive adenocarcinoma as first- or second-line treatment. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Delbaldo C, Ychou M, Zawadi A, Douillard JY, André T, Guerin-Meyer V, Rougier P, Dupuis O, Faroux R, Jouhaud A, Quinaux E, Buyse M, Piedbois P. Postoperative irinotecan in resected stage II-III rectal cancer: final analysis of the French R98 Intergroup trial†. Ann Oncol 2015; 26:1208-1215. [PMID: 25739671 DOI: 10.1093/annonc/mdv135] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 12/09/2014] [Accepted: 02/20/2015] [Indexed: 08/08/2023] Open
Abstract
BACKGROUD The R98 trial explores the addition of irinotecan to a 5-fluorouracil (5-FU) plus leucovorin (5-FU/LV) adjuvant regimen in optimally resected stages II-III rectal cancers. We report the updated long-term results. Disease-free survival (DFS) was the primary end point. PATIENST AND METHODS Between March 1999 and December 2005, 357 patients were randomized: 178 in 5-FU/LV and 179 in LV5-FU2 + irinotecan arm. The trial was stratified by control arm: Mayo Clinic regimen or LV5-FU2 regimen. RESULTS Three hundred and fifty-seven randomized patients were evaluable for efficacy. With a follow-up of 156 months, the DFS was in favour of experimental arm but did not reach statistical significance [hazard ratio (HR) = 0.80, P = 0.154]. The same was observed for overall survival (OS) (HR = 0.87, P = 0.433). The 5-year DFS was 58% in the control arm and 63% in the experimental arm. The 5-year OS was 74% in the control arm and 75% in the experimental arm. Patients allocated to the experimental arm had more grade 3-4 neutropenia when compared with the LV5-FU2 arm (33% versus 6%, P = 0.03), but not when compared with the Mayo Clinic arm (33% versus 36%, P = 0.84). Grade 3-4 diarrhoea tended to be higher in the experimental arm, but analyses stratified by control arm or by radiotherapy failed to show significant differences across strata (test for interaction P = 0.44). CONCLUSION Even though a benefit of irinotecan in subgroups of patients cannot be excluded, due to early termination and lack of power, the study does not support the addition of irinotecan to 5-FU/LV in routine in patients with resected stage II-III rectal cancer.
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Affiliation(s)
- C Delbaldo
- Oncology Unit, Diaconesses Croix Saint Simon Hospital, Paris.
| | - M Ychou
- Digestive Oncology Unit, ICM Val D'Aurelle, Montpellier
| | - A Zawadi
- Radiotherapy Unit, Departemental Hospital Center, La Roche Sur Yon
| | | | - T André
- Oncology Unit, Saint-Antoine Hospital, GERCOR, and UMPC University Paris VI, Paris
| | | | - P Rougier
- Hepatogastroenterology and Digestive Oncology Unit, Université Paris V, Europeen Georges Pompidou Hospital, Paris
| | - O Dupuis
- Radiotherapy Unit, Jean-Bernard Center, Le Mans
| | - R Faroux
- Digestive Unit, Departemental Hospital Center, La Roche sur Yon
| | - A Jouhaud
- Radiotherapy Unit, Henri Mondor Hospital, Créteil, France
| | - E Quinaux
- International Development Drug Institute (IDDI), Louvain-la-Neuve, Belgium
| | - M Buyse
- International Development Drug Institute (IDDI), Louvain-la-Neuve, Belgium
| | - P Piedbois
- Oncology Unit, Paul Strauss Center, Strasbourg, France
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Assenat E, Delord JP, Thézenas S, Samalin E, Portales F, Sari C, Thirion A, Guimboaud R, Ychou M. P-158 (BREGO) Regorafenib combined with modified (m) GEMOX (Gemcitabine- Oxaliplatin) in patients with advanced biliary tract cancer (BTC): a phase Ib/II randomized trial. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Falcone A, Laurent S, Grávalos C, Benavides M, Longo Muñoz F, Ychou M, Ciardiello F, Siena S, Yamaguchi K, Muro K, Denda T, Tsuji Y, Tebbutt N, Loehrer P, Lenz HJ, Mayer R, Ohtsu A, Van Cutsem E. P-284 Phase 3 RECOURSE trial of TAS-102 versus placebo with best supportive care in patients with metastatic colorectal cancer: European subgroup. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hebbar M, Chibaudel B, André T, Mineur L, Smith D, Louvet C, Dutel J, Ychou M, Legoux J, Mabro M, Faroux R, Auby D, Brusquant D, Khalil A, Truant S, Hadengue A, Dalban C, Gayet B, Paye F, Pruvot F, Bonnetain F, de Gramont A. FOLFOX4 versus sequential dose-dense FOLFOX7 followed by FOLFIRI in patients with resectable metastatic colorectal cancer (MIROX): a pragmatic approach to chemotherapy timing with perioperative or postoperative chemotherapy from an open-label, randomized phase III trial. Ann Oncol 2015; 26:1040. [DOI: 10.1093/annonc/mdv141] [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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Hebbar M, Chibaudel B, André T, Mineur L, Smith D, Louvet C, Dutel JL, Ychou M, Legoux JL, Mabro M, Faroux R, Auby D, Brusquant D, Khalil A, Truant S, Hadengue A, Dalban C, Gayet B, Paye F, Pruvot FR, Bonnetain F, Taieb J, Brucker P, Landi B, Flesch M, Carola E, Martin P, Vaillant E, de Gramont A. FOLFOX4 versus sequential dose-dense FOLFOX7 followed by FOLFIRI in patients with resectable metastatic colorectal cancer (MIROX): a pragmatic approach to chemotherapy timing with perioperative or postoperative chemotherapy from an open-label, randomized phase III trial. Ann Oncol 2014; 26:340-7. [PMID: 25403578 DOI: 10.1093/annonc/mdu539] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Perioperative FOLFOX4 (oxaliplatin plus 5-fluorouracil/leucovorin) chemotherapy is the current standard in patients with resectable metastases from colorectal cancer (CRC). We aimed to determine whether a sequential chemotherapy with dose-dense oxaliplatin (FOLFOX7) and irinotecan (FOLFIRI; irinotecan plus 5-fluorouracil/leucovorin) is superior to FOLFOX4. The chemotherapy timing was not imposed, and was perioperative or postoperative. PATIENTS AND METHODS In this open-label, phase III trial, patients with resectable or resected metastases were randomly assigned either to 12 cycles of FOLFOX4 (oxaliplatin 85 mg/m(2)) or 6 cycles of FOLFOX7 (oxaliplatin 130 mg/m(2)) followed by 6 cycles of FOLFIRI (irinotecan 180 mg/m(2)). Randomization was done centrally, with stratification by chemotherapy timing, type of local treatment (surgery versus radiofrequency ablation with/without surgery), and Fong's prognostic score. The primary end point was 2-year disease-free survival (DFS). RESULTS A total of 284 patients were randomized, 142 in each treatment group. Chemotherapy was perioperative in 168 (59.2%) patients and postoperative in 116 (40.8%) patients. Perioperative chemotherapy was preferentially proposed for synchronous metastases, whereas postoperative chemotherapy was more frequently used for metachronous metastases. Two-year DFS was 48.5% in the FOLFOX4 group and 50.0% in the FOLFOX7-FOLFIRI group. In the multivariable analysis, more than one metastasis [hazard ratio (HR) = 2.15] and synchronous metastases (HR = 1.63) were independent prognostic factors for shorter DFS. Five-year overall survival (OS) rate was 69.5% with FOLFOX4 versus 66.6% with FOLFOX7-FOLFIRI. CONCLUSIONS FOLFOX7-FOLFIRI is not superior to FOLFOX4 in patients with resectable metastatic CRC. Five-year OS rates observed in both groups are the highest ever reported in this setting, possibly reflecting the pragmatic approach to chemotherapy timing. CLINICAL TRIALS NUMBER NCT00268398.
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Affiliation(s)
- M Hebbar
- Department of Medical Oncology, University Hospital, Lille
| | - B Chibaudel
- Department of Medical Oncology, Hospital Saint-Antoine, Paris
| | - T André
- Department of Medical Oncology, Hospital Saint-Antoine, Paris
| | - L Mineur
- Department of Radiotherapy, Institute Sainte-Catherine, Avignon
| | - D Smith
- Department of Medical Oncology and Radiotherapy, Hospital Saint-André, Bordeaux
| | - C Louvet
- Department of Oncology, Institute Mutualiste Montsouris, Paris
| | - J L Dutel
- Department of Medical Oncology, Radiotherapy Service, Hospital Centre Beauvais, Beauvais
| | - M Ychou
- Regional Centre against Cancer, Val d'Aurelle-Paul Lamarque, Montpellier
| | - J L Legoux
- Department of Hepatology and Gastroenterology, Hospital de Haut-Lévêque, Pessac
| | - M Mabro
- Department of Medical Oncology, Hospital Foch, Suresnes
| | - R Faroux
- Department of Gastroenterology, Hospital La Roche-sur-Yon, La Roche-sur-Yon
| | - D Auby
- Department of Medicine, Hospital Libourne, Libourne
| | | | - A Khalil
- Department of Medical Oncology, Hospital Tenon, Paris
| | - S Truant
- Department of Digestive Surgery and Transplantation, University Hospital, Lille
| | | | - C Dalban
- Methodology and Quality of Life in Oncology Department EA 3181, Hospital Besançon, Besançon
| | - B Gayet
- Department of Surgery, Institute Mutualiste Montsouris, Paris
| | - F Paye
- Department of Digestive Surgery, Hospital Saint-Antoine, Paris
| | - F R Pruvot
- Department of Digestive Surgery and Transplantation, University Hospital, Lille
| | - F Bonnetain
- Methodology and Quality of Life in Oncology Department EA 3181, Hospital Besançon, Besançon
| | - J Taieb
- Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris
| | - P Brucker
- Department of Gastroenterology, Centre hospitalier François Maillot, Briey
| | - B Landi
- Department of Hepatogastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou Service Hépato-gastroentérologie; Paris
| | - M Flesch
- Department of Medical Oncology, Clinique Clément Drevon, Dijon
| | - E Carola
- Department of Medical Oncology, Centre Hospitalier, Senlis
| | - P Martin
- Department of Cancerology, Centre Bourgogne, Lille
| | - E Vaillant
- Department of Gastroenterology, Clinique Ambroise Paré, Lille, France
| | - A de Gramont
- Department of Medical Oncology, Hospital Saint-Antoine, Paris
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Ychou M. Intensive Chemotherapy for Metastatic Colorectal Cancer (MCRC). Ann Oncol 2013. [DOI: 10.1093/annonc/mdt443.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Duffour J, Roca L, Bressolle F, Abderrahim A, Poujol S, Pinguet F, Ychou M. Clinical Impact of Intensified 5-Fluorouracil-Based Chemotherapy Using a Prospective Pharmacokinetically-Guided Dosing Approach: Comparative Study in Elderly and Non-Elderly Patients with Metastatic Colorectal Cancer. J Chemother 2013; 22:179-85. [DOI: 10.1179/joc.2010.22.3.179] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Verslype C, Van Cutsem E, Dicato M, Arber N, Berlin J, Büchler M, Cervantes A, Ciardiello F, Ducreux M, Douillard J, Grothey A, Haller D, Haustermans K, Heinemann V, Hidalgo M, Labianca R, Li J, Marshall J, Nordlinger B, O'Reilly E, Roth A, Rougier P, Ryan D, Schmiegel W, Seufferlein T, Schmoll H, Sobrero A, Tabernero J, Tempero M, Van Laethem J, Ychou M, Zalcberg J. The management of metastatic pancreatic cancer: expert discussion and recommendations from the 14th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2012. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Chen DS, Feltquate DM, Smothers F, Hoos A, Langermann S, Marshall S, May R, Fleming M, Hodi FS, Senderowicz A, Wiman KG, de Dosso S, Fiedler W, Gianni L, Cresta S, Schulze-Bergkamen HB, Gurrieri L, Salzberg M, Dietrich B, Danielczyk A, Baumeister H, Goletz S, Sessa C, Strumberg D, Schultheis B, Santel A, Gebhardt F, Meyer-Sabellek W, Keil O, Giese K, Kaufmann J, Maio M, Choy G, Covre A, Parisi G, Nicolay H, Fratta E, Fonsatti E, Sigalotti L, Coral S, Taverna P, Azab M, Deutsch E, Lepechoux C, Pignon JP, Tao YT, Rivera S, Bourgier BC, Angokai M, Bahleda R, Slimane K, Angevin E, Besse BB, Soria JC, Dragnev K, Beumer JH, Anyang B, Ma T, Galimberti F, Erkmen CP, Nugent W, Rigas J, Abraham K, Johnstone D, Memoli V, Dmitrovsky E, Voest EE, Siu L, Janku F, Soria JC, Tsimberidou A, Kurzrock R, Tabernero J, Rodon J, Berger R, Onn A, Batist G, Bresson C, Lazar V, Molenaar JJ, Koster J, Ebus M, Zwijnenburg DA, van Sluis P, Lamers F, Schild L, van der Ploeg I, Caron HN, Versteeg R, Pouyssegur J, Marchiq I, Chiche J, Roux D, Le Floch R, Critchlow SE, Wooster RF, Agresta S, Yen KE, Janne PA, Plummer ER, Trinchieri G, Ellis L, Chan SL, Yeo W, Chan AT, Mouliere F, El Messaoudi S, Gongora C, Lamy PJ, del Rio M, Lopez-Crapez E, Gillet B, Mathonnet M, Pezet D, Ychou M, Thierry AR, Ribrag V, Vainchenker W, Constantinescu S, Keilhack H, Umelo IA, Noeparast A, Chen G, Renard M, Geers C, Vansteenkiste J, Teugels E, de Greve J, Rixe O, Qi X, Chu Z, Celerier J, Leconte L, Minet N, Pakradouni J, Kaur B, Cuttitta F, Wagner AJ, Zhang YX, Sicinska E, Czaplinski JT, Remillard SP, Demetri GD, Weng S, Debussche L, Agoni L, Reddy EP, Guha C, Silence K, Thibault A, de Haard H, Dreier T, Ulrichts P, Moshir M, Gabriels S, Luo J, Carter C, Rajan A, Khozin S, Thomas A, Lopez-Chavez A, Brzezniak C, Doyle L, Keen C, Manu M, Raffeld M, Giaccone G, Lutzker S, Melief JM, Eckhardt SG, Trusolino L, Migliardi G, Zanella ER, Cottino F, Galimi F, Sassi F, Marsoni S, Comoglio PM, Bertotti A, Hidalgo M, Weroha SJ, Haluska P, Becker MA, Harrington SC, Goodman KM, Gonzalez SE, al Hilli M, Butler KA, Kalli KR, Oberg AL, Huijbers IJ, Bin Ali R, Pritchard C, Cozijnsen M, Proost N, Song JY, Krimpenfort P, Michalak E, Jonkers J, Berns A, Banerji U, Stewart A, Thavasu P, Banerjee S, Kaye SB. Lectures. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mouliere F, El Messaoudi S, Gongora C, Lamy P, del Rio M, Lopez-Crapez E, Gillet B, Mathonnet M, Pezet D, Ychou M, Thierry A. Personalized Medicine by Analyzing Circulating DNA: Application to the Management Care of Colorectal Cancer Patients. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt042.29] [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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Ducreux M, Adenis A, Pignon JP, François E, Chauffert B, Ichanté JL, Boucher E, Ychou M, Pierga JY, Montoto-Grillot C, Conroy T. Efficacy and safety of bevacizumab-based combination regimens in patients with previously untreated metastatic colorectal cancer: final results from a randomised phase II study of bevacizumab plus 5-fluorouracil, leucovorin plus irinotecan versus bevacizumab plus capecitabine plus irinotecan (FNCLCC ACCORD 13/0503 study). Eur J Cancer 2013; 49:1236-45. [PMID: 23352604 DOI: 10.1016/j.ejca.2012.12.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 12/10/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND The combination of bevacizumab and bolus 5-fluorouracil, leucovorin and irinotecan is highly effective in patients with metastatic colorectal cancer (mCRC). This randomised, multicenter, non-comparative phase II trial assessed the efficacy and safety of bevacizumab plus oral capecitabine plus irinotecan (XELIRI) or infusional 5-fluorouracil, leucovorin plus irinotecan (FOLFIRI) as first-line therapy for patients with mCRC. PATIENTS AND METHODS Patients received bevacizumab 7.5mg/kg on day 1 plus XELIRI (irinotecan 200mg/m(2) on day 1 and oral capecitabine 1,000 mg/m(2) bid on days 1-14) every 3 weeks or bevacizumab 5mg/kg on day 1 plus FOLFIRI (5-fluorouracil 400mg/m(2) on day 1 plus 2,400 mg/m(2) as a 46-h infusion, leucovorin 400mg/m(2) on day 1, and irinotecan 180 mg/m(2) on day 1) every 2 weeks. Patients aged ≥ 65 years received a lower dose of capecitabine (800 mg/m(2) twice daily). The primary endpoint was 6-month progression-free survival (PFS) rate. RESULTS A total of 145 patients were enrolled (bevacizumab-XELIRI, n=72; bevacizumab-FOLFIRI, n=73). The 6-month PFS rate was 82% (95% confidence intervals (CI) 71-90%) in the bevacizumab-XELIRI arm and 85% (95% CI 75-92%) in the bevacizumab-FOLFIRI arm. In both the bevacizumab-XELIRI and bevacizumab-FOLFIRI arms, median PFS and overall survival (OS) were 9 and 23 months, respectively. The most frequent toxicities were grade 3/4 neutropenia (bevacizumab-XELIRI 18%; bevacizumab-FOLFIRI 26%) and grade 3 diarrhoea (12% and 5%, respectively). CONCLUSIONS This randomised non-comparative study demonstrates that bevacizumab-XELIRI and bevacizumab-FOLFIRI are effective regimens for the first-line treatment of patients with mCRC with manageable toxicity profiles.
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Affiliation(s)
- M Ducreux
- Department of Medicine, Institut Gustave Roussy, Villejuif, Université Paris-Sud, Le Kremlin Bicêtre, France.
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Mornex F, Andre T, Louvet C, Seitz J, Ychou M, Lledo G, Tanguy R, Balosso J. Revisiting the Multimodal Adjuvant Treatment of Pancreatic Carcinoma Through Optimized Regimen Combining Gemcitabine Plus Oxaliplatin Chemotherapy Followed by Concurrent Gemcitabine and Modern Radiation Therapy -- Long-term Survival Favorable Results. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.236] [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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Van Cutsem E, Grothey A, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouche O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg R, Sargent D, Cihon F, Cupit L, Wagner A, Laurent D. Phase 3 Correct Trial of Regorafenib in Metastatic Colorectal Cancer (MCRC): Overall Survival Update. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34319-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Farace F, Lombard-Bohas C, Mitry E, Ychou M, Bengrine-Lefevre L, Lecomte T, Joly K, Ducreux M, Baudin E. Predictive Value of Circulating Endothelial Cell (CEC) Levels in Metastatic or Locally Advanced Neuroendocrine Digestive Tumor Patients Treated With Chemotherapy and Bevacizumab. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32775-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Pefani E, Panoskaltsis N, Mantalaris A, Georgiadis MC, Pistikopoulos EN, Aguilar-Mahecha A, Lafleur J, Seguin C, Rosenbloom M, Przybytkowski E, Pelmus M, Diaz Z, Batist G, Basik M, Tavernier J, Brunet L, Bazot J, Chemelle M, Dalban C, Guiu S, di Martino C, Lehtio J, Branca M, Johansson H, Orre M, Granholm V, Forshed J, Perez-Bercoff M, Kall L, Nielsen KV, Andresen L, Muller S, Matthiesen S, Schonau A, Oktriani R, Wahyono A, Haryono S, Utomo A, Aryandono T, Diaz Z, Gagnon-Kugler T, Rousseau C, Aguilar-Mahecha A, Alcindor T, Aloyz R, Assouline S, Basik M, Bachvarov D, Belanger L, Camlioglu E, Cartillone M, Chabot B, Christodoulopoulos R, Courtemanche C, Constantin A, Benlimame N, Dao I, Dalfen R, Gosselin L, Habbab F, Hains M, Haliotis T, Nielsen TH, Joncas M, Kavan P, Klink R, Langlaben A, Lebel M, Lesperance B, Mann K, Masson J, Metrakos P, McNamara S, Miller WH, Orain M, Panasci L, Paquet E, Phillie M, Qureshi S, Rodrigue D, Salman A, Spatz A, Tetu B, Tosikyan A, Tsatoumas M, Vuong T, Batist G, Ruijtenbeek R, Houtman R, de Wijn R, Boender P, Hilhorst R, Cohen Y, Onn A, Lax A, Yosepovich A, Litz S, Kalish S, Felemovicius R, Hout-Silony G, Gutman M, Shabtai M, Rosin D, Valeanu A, Winkler E, Sklair-Levy M, Kaufman B, Barshack I, Canu V, Sacconi A, Biagioni F, Mori F, di Benedetto A, Lorenzon L, di Agostino S, Cambria A, Germoni S, Grasso G, Blandino R, Panebianco V, Ziparo V, Federici O, Muti P, Strano S, Carboni F, Mottolese M, Diodoro MG, Pescarmona E, Garofalo A, Blandino G, Ho T, Feng L, Lintula S, Orpana KA, Stenman J, El Messaoudi S, Mouliere F, del Rio M, Guedj AS, Gongora C, Molina FM, Lamy PJ, Lopez-Crapez E, Rolet F, Mathonnet M, Ychou M, Pezet D, Thierry AR, Manuarii M, Tredan O, Bachelot T, Clapisson G, Courtier A, Parmentier G, Rabeony T, Grives A, Perez S, Mouret JF, Perol D, Chabaud S, Ray-Coquard I, Labidi-Galy I, Heudel P, Pierga JY, Caux C, Blay JY, Pasqual N, Menetrier-Caux C. Technology & tools development. Ann Oncol 2012. [DOI: 10.1093/annonc/mds163] [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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El Messaoudi S, Mouliere F, del Rio M, Guedj A, Gongora C, Molina F, Lamy P, Lopez-Crapez E, Rolet F, Mathonnet M, Ychou M, Pezet D, Thierry A. P3.12 Circulating Dna Analysis in The Era of Personalized Cancer Medicine: Application to Kras/Braf Point Mutations Detection in Colorectal Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)31365-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Reguiai Z, Bachet JB, Bachmeyer C, Peuvrel L, Beylot-Barry M, Bezier M, Boucher E, Chevelle C, Colin P, Guimbaud R, Mineur L, Richard MA, Artru P, Dufour P, Gornet JM, Samalin E, Bensadoun RJ, Ychou M, André T, Dreno B, Bouché O. Management of cutaneous adverse events induced by anti-EGFR (epidermal growth factor receptor): a French interdisciplinary therapeutic algorithm. Support Care Cancer 2012; 20:1395-404. [PMID: 22539049 DOI: 10.1007/s00520-012-1451-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 03/26/2012] [Indexed: 12/01/2022]
Abstract
PURPOSE Cutaneous adverse events induced by epidermal growth factor receptor (EGFR) inhibitors can hamper the patients' quality of life. The aim of our work was to draft an algorithm for the optimised management of this skin toxicity. METHODS This algorithm was built in three steps under the responsibility of a steering committee. Step I: a systematic literature analysis (SLA) has been performed. Step II: the collection of information about practices was performed through a questionnaire.These questions were asked during regional meetings to which oncologists, gastro-enterologists, radiotherapists, and dermatologists were invited. Step III: a final meeting was organised involving the bibliography group and the steering committee and regional scientific committees for proposing a final algorithm. RESULTS Step I: 14 publications were selected to evaluate the use of cyclines as curative or prophylactic treatment of the folliculitis induced by EGFR inhibitors. Nineteen publications were retained for the topical treatment of the folliculitis. Forty-six articles were selected for the management of the cutaneous lesions in link with appendages and 12 for xerosis and pruritus. Step II: 96 delegates attended the seven regional meetings and 67 questionnaires were analysed. Step III: a final algorithm was proposed on the basis of the conclusions of the first two steps and expert opinions present at this final meeting. The different propositions were unanimously approved by the 14 experts who voted. CONCLUSIONS This multidisciplinary study summarising published data and current practices produced a therapeutic algorithm, which should facilitate the standardised, optimised management of skin toxicity associated with EGFR inhibitors in France.
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Affiliation(s)
- Z Reguiai
- Department of Dermatology, CHU Reims, Hôpital Robert Debré, avenue du Général Koenig, 51092 Reims, France.
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Peuvrel L, Bachmeyer C, Reguiai Z, Bachet JB, André T, Bensadoun RJ, Bouché O, Ychou M, Dréno B. Semiology of skin toxicity associated with epidermal growth factor receptor (EGFR) inhibitors. Support Care Cancer 2012; 20:909-21. [DOI: 10.1007/s00520-012-1404-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 02/03/2012] [Indexed: 10/28/2022]
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Peuvrel L, Bachmeyer C, Reguiai Z, Bachet JB, André T, Bensadoun RJ, Bouché O, Ychou M, Dréno B. Survey on the management of skin toxicity associated with EGFR inhibitors amongst French physicians. J Eur Acad Dermatol Venereol 2012; 27:419-29. [PMID: 22211860 DOI: 10.1111/j.1468-3083.2011.04421.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) inhibitors are part of the therapeutic arsenal available for advanced cancer. However, they are frequently associated with cutaneous side-effects, which can hamper compliance, lead to treatment refusal and impair quality of life. OBJECTIVE To know the attitudes of French oncologists who deal with this skin toxicity. This work is one of the steps to build a therapeutic algorithm of side-effects induced by EGFR inhibitors taking both evidence-based medicine and standard practices into account. METHODS Physicians completed a questionnaire as part of regional meetings, before any discussion. Questions concerned the management of 11 clinical situations in the context of EGFR inhibitor prescription. RESULTS Sixty-seven questionnaires were analysed. The collaboration with dermatologists was especially planned for persisting or worsening lesions beyond 2 weeks, but never considered at the time of the introduction of targeted therapy. The results demonstrated the difficulties encountered in diagnosing and grading skin lesions. Attitudes of oncologists were uniform for preventive care and management of mild lesions for which moisturizing and cyclines were widely prescribed. Significant differences appeared in the treatment of less typical cases such as the involvement of skin appendages, secondary infections of folliculitis or cases associated with radiodermatitis. Discrepancies existed also for what to do in relation with maintenance or interruption of EGFR inhibitor mainly if they were responsible for severe lesions. CONCLUSION This original survey emphasizes the interest of greater multidisciplinary collaboration and the necessity to harmonize practice.
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Affiliation(s)
- L Peuvrel
- Department of Dermato- Cancerology CHU de Nantes, Nantes, France
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Mazard T, Ychou M, Thezenas S, Poujol S, Pinguet F, Thirion A, Bleuse JP, Portales F, Samalin E, Assenat E. Feasibility of biweekly combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in patients with metastatic solid tumors: results of a two-step phase I trial: XELIRI and XELIRINOX. Cancer Chemother Pharmacol 2011; 69:807-14. [PMID: 22037922 DOI: 10.1007/s00280-011-1764-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 10/12/2011] [Indexed: 12/27/2022]
Abstract
BACKGROUND Biweekly schedule of capecitabine combined with irinotecan (XELIRI), consecutively with irinotecan and oxaliplatin (XELIRINOX), was evaluated in patients with metastatic cancer from any solid tumors. PATIENTS AND METHODS In this two-step phase I trial, seventeen and eleven patients were enrolled in the XELIRI and XELIRINOX stages, respectively. RESULTS In XELIRI, a total of 136 chemotherapy cycles were administered with a median number of 8 cycles per patient (2-16). Main dose-limiting toxicities (DLT) were grade 3-4 neutropenia, with one toxicity-related death. Maximum tolerated dose (MTD) for capecitabine combined with 180 mg/m(2) of irinotecan was 3,500 mg/m(2)/day. In XELIRINOX, capecitabine starting dose was 2,500 mg/m(2)/day. Fifty-eight chemotherapy cycles were administered with a median of 4 cycles per patient (1-16). DLT included 3 grade 4 neutropenia, associated with 1 grade 3 diarrhea, and 1 grade 4 pneumopathy leading to patient death. MTD for capecitabine with 180 mg/m(2) of irinotecan and 85 mg/m(2) of oxaliplatin was 3,000 mg/m(2)/day. The recommended doses for capecitabine were 3,000 and 2,500 mg/m(2)/day D1-D7 in combination with 180 mg/m(2) of irinotecan in XELIRI, plus 85 mg/m(2) of oxaliplatin in XELIRINOX (D1 = D14), respectively. CONCLUSION XELIRI and XELIRINOX regimens are feasible and warrant further investigation in combination with targeted therapy in metastatic colorectal cancer patients.
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Affiliation(s)
- T Mazard
- Département d'Oncologie Médicale, CHU Saint Eloi, Montpellier, France.
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