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Maury JM, Benitez JC, Boucher ME, Dansin E, Kerjouan M, Bigay-Game L, Pichon E, Thillays F, Falcoz PE, Svetlana L, Oulkhouir Y, Fabien C, Thiberville L, Clément Duchene C, Westeel V, Missy P, Thomas PA, Molina T, Girard N, Besse B. Outcomes of thymic epithelial tumors (TETs) with pleural metastases: Real-world insight from RYTHMIC. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.8578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8578 Background: TETs are rare and potentially aggressive malignancies with high associated prevalence of autoimmune disorders (AIDs). The pleura is the main metastatic site at relapse, referred as Masaoka-Koga stage (MK) IVa. The benefit of surgical management is unknown, so we have collected outcomes of patients with MK IVa TETs in a large prospective database. Methods: RYTHMIC (Réseau tumeurs THYMiques et Cancer) is a French nationwide network mandated to systematically discuss every case of TETs. The database, hosted by IFCT (Intergroupe Francophone de Cancérologie Thoracique), prospectively includes all consecutive pts with a diagnosis of TET discussed in RYTHMIC national or regional tumor boards. We analyzed epidemiologic, clinical and pathological characteristics of patients (pts) with MK IVa TETs. Results: From January 2012 to December 2019, 2909 pts were included in the database, including 182 MK IVa (6.2%). The median age at diagnosis was 63.5 (range 9 to 91). 58/182 (32%) pts reported AIDs, 76% myasthenia gravis. 129/182 pts had synchronous pleural metastasis. 118/182 (65%) tumors were resected, of them 10 (8.4%) had only pericardial metastases. Thymoma (T) B2 rate was 35.6%, B3 17.8% and thymic carcinoma (TC) 13.5%. Induction chemotherapy (CT) was given in 46 (39%) T and 10 (8%) TC with response rate of 50% and 70% respectively. Thymectomy was performed in addition to pleurectomy in 44 pts (37.2%), pericardiectomy in 68 (57.6%), lung resection in 80 (67.8%) or pneumonectomy in 15 (12.7%). Node resection was performed in 57.6% (n = 67), 12 (18%) were positive. The complete resection rate assessed by surgeons was 57% with a median of 15 (0 to 28) resected pleural metastasis. Intrapleural chemotherapy was added for 19 (16%) pts. No mortality was reported 90 days after surgery procedure. Median follow-up was 36 months. Pleural recurrence was seen in 47 (72%) pts. Median disease-free survival (DFS) was 39 vs 16 months in resected vs not resected tumors (p < 0.0001), 5-years overall survival (OS) was 88 vs 66% (p = 0.28), respectively. Risk of relapse decreased by 60% with surgery (HR = 0.4, 95CI (0.25-0.62); p < 0.0001). Conclusions: The prevalence of MK IVa in our cohort was 6.2%. Surgery appears to be a safe and valid option for pts with MK IVa TET at diagnosis.
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Affiliation(s)
- Jean-Michel Maury
- Department of Thoracic Surgery Lung and Heart Lung Transplantation, Lyon, France
| | | | | | - Eric Dansin
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | | | | | - Eric Pichon
- Centre Hospitalier Universitaire, Tours, France
| | | | | | | | | | - Calcagno Fabien
- Department of Medical Oncology, University Hospital, Besançon, France
| | | | | | | | - Pascale Missy
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | | | | | | | - Benjamin Besse
- Department of Medicine and Thoracic Pathology Committee, Gustave Roussy, Villejuif, France
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Ferrara R, Mezquita L, Texier M, Lahmar J, Audigier-Valette C, Tessonnier L, Mazieres J, Zalcman G, Brosseau S, Le Moulec S, Leroy L, Duchemann B, Lefebvre C, Veillon R, Westeel V, Koscielny S, Champiat S, Ferté C, Planchard D, Remon J, Boucher ME, Gazzah A, Adam J, Lo Russo G, Signorelli D, Garassino MC, Soria JC, Caramella C, Besse B. Comparison of Fast-Progression, Hyperprogressive Disease, and Early Deaths in Advanced Non–Small-Cell Lung Cancer Treated With PD-1/PD-L1 Inhibitors or Chemotherapy. JCO Precis Oncol 2020; 4:829-840. [DOI: 10.1200/po.20.00021] [Citation(s) in RCA: 9] [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] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Hyperprogressive disease (HPD), fast progression (FP), and early death (ED) have been described in 13.8%, 4.7%, and 5.6% and in 5.1%, 2.8%, and 6.8%, respectively, of patients with non–small-cell lung cancer (NSCLC) treated with single-agent programmed cell death ligand 1 inhibitors (ICI) or chemotherapy, respectively. Whether FP/ED and HPD represent overlapping patterns is unknown. PATIENTS AND METHODS FP, ED, and HPD were retrospectively assessed in patients with NSCLC treated with single-agent ICI or chemotherapy. Eligibility required 2 computed tomography (CT) scans before and 1 CT scan during treatment. (1) HPD, (2) FP, (3) ED were defined as (1) RECIST version 1.1 progression at first CT scan and tumor growth rate variation per month > 50%, (2) ≥ 50% increase in the sum of the longest diameters of target lesions within 6 weeks from baseline, and (3) death as a result of radiologic progression within 12 weeks from baseline CT scan, respectively. RESULTS Of 406 ICI-treated NSCLC, 56 patients (13.8%), 9 patients (2.2%), and 36 patients (8.8%) were HPD, FP, and ED, respectively. Eight (14.2%) and 20 (35.7%) of 56 patients with HPD were also FP and ED. ED significantly correlated with baseline Eastern Cooperative Oncology Group performance status ≥ 2 compared with HPD (33% v 13%, P = .02). Overall survival was significantly longer for HPD (3.4 months [95% CI, 2.7 to 4.0 months]) compared with FP (0.7 months [95% CI, 0.6 to 0.8 months]); HR, 0.18 [95% CI, 0.08 to 0.42]; P < .0001) and ED (1.4 months [95% CI, 1.3 to 1.6 months]); HR, 0.19 [95% CI, 0.11 to 0.34]); P < .0001), whereas it did not differ between FP and ED (HR, 1.3 [95% CI, 0.56 to 3.0]; P = .55). Of 59 patients with NSCLC treated with single-agent chemotherapy, the HPD, FP, and ED rates were 5.1%, 1.7%, and 6.7%, respectively. CONCLUSION FP, ED, and HPD represent distinct progression patterns with limited overlap and different survival outcomes.
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Affiliation(s)
- Roberto Ferrara
- Medical Oncology Department, Gustave Roussy, Villejuif, France
- Medical Oncology Department, Thoracic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Mezquita
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Matthieu Texier
- Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif, France
| | - Jihene Lahmar
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Laurent Tessonnier
- Nuclear Medicine Department, Centre Hospitalier Toulon Sainte-Musse, Toulon, France
| | - Julien Mazieres
- Pneumology Department, Centre Hospitalier Universitaire de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Gerard Zalcman
- Thoracic Oncology Department, Hôpital Bichat-Claude Bernard, Université Paris-Diderot, Paris, France
| | - Solenn Brosseau
- Thoracic Oncology Department, Hôpital Bichat-Claude Bernard, Université Paris-Diderot, Paris, France
| | | | - Laura Leroy
- Medical Oncology Department, Institute Bergonié, Bordeaux, France
| | - Boris Duchemann
- Medical Oncology Department, Hôpital Avicenne, Bobigny, France
| | - Corentin Lefebvre
- Service des Maladies Respiratoires, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Remi Veillon
- Service des Maladies Respiratoires, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Virginie Westeel
- Pneumology Department, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Serge Koscielny
- Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif, France
| | - Stephane Champiat
- Drug Development Department, Gustave Roussy, Villejuif, France
- Radiology Department, Gustave Roussy, Villejuif, France
| | - Charles Ferté
- Drug Development Department, Gustave Roussy, Villejuif, France
- Radiology Department, Gustave Roussy, Villejuif, France
| | - David Planchard
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Jordi Remon
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Anas Gazzah
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Julien Adam
- Pathology Department, Gustave Roussy, Villejuif, France
| | - Giuseppe Lo Russo
- Medical Oncology Department, Thoracic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Diego Signorelli
- Medical Oncology Department, Thoracic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marina Chiara Garassino
- Medical Oncology Department, Thoracic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Benjamin Besse
- Medical Oncology Department, Gustave Roussy, Villejuif, France
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Benitez JC, Boucher ME, Dansin E, Kerjouan M, Mazieres J, Pichon E, Thillays F, Falcoz PE, Roch B, Oulkhouir Y, Fabien C, Thiberville L, Clément Duchene C, Morin F, Missy P, Thomas PA, Maury JM, Molina T, Girard N, Besse B. Prevalence of autoimmune diseases in thymic epithelial tumors (TET) insights from RYTHMIC. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9073 Background: TET are associated with autoimmune disorders (AID) in up to 30% of patients (pts). However, there have been wide variations in the reported prevalence of AID in TET pts in small single-center series. RYTHMIC (Réseau tumeurs THYMiques et Cancer) is a French network mandated to systematically discuss every case of TET. We aimed to describe the prevalence of AID in a large French population. Methods: RYTHMIC database, hosted by IFCT (Intergroupe Francophone de Cancérologie Thoracique), prospectively includes all consecutive pts with a diagnosis of TET discussed in French national or regional tumor boards. We analyzed epidemiologic, clinical and pathological characteristics of pts with TET’s related AID. Results: From January 2012 to December 2019, 2909 pts were included in the database. The mean age at diagnosis of TET was 54 and 52% were male. In the overall population, Masaoka Koga stages were well balanced with 12.6% (n = 187) stage I, 8.8% (n = 131) stage IIa, 8.4% (n = 124) stage IIb, 11.1% (n = 164) stage III and 8.5% (n = 125) stage IV. There were 364 (12.5%) events of AID in 302 pts. 62 pts (17%) had more than 1 AID. Among the events, 236 were myasthenia gravis (MG) (64.8%), 19 Hypo-gammaglobulinemia syndrome (5.2%), 15 pure red cell aplasia (4.1%), 18 thyroiditis (4.9%) and 16 systemic erythematous lupus (4.4%). Diagnosis of AID was mostly done at tumor diagnosis (n = 239, 65.7%) but some patient had AID diagnosed before diagnosis (n = 67, 18.4%) or during follow up (n = 32, 8.8%). Among pts presenting AID, B2 was the most common subtype (n = 133, 36.5%). The incidence of AID per subtype was as follow: A (n = 10/81, 12.3%), AB (n = 48/225, 21.3%), B1 (n = 35/130, 26.9%), B2 (n = 133/295, 45.0%), B3 (n = 46/113, 40.7%), thymic carcinoma (n = 16/275, 5.8%). Conclusions: The prevalence of AID in pts with TET was 12.5%, > 40% in B2 and B3 subtypes. Diagnosis of AID can be delayed compared to the diagnosis of TET. Immunotherapy indication should be carefully assessed in pts with TET other than thymic carcinoma.
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Affiliation(s)
| | | | | | | | | | - Eric Pichon
- Centre Hospitalier Universitaire Tours, Tours, France
| | | | | | - Benoit Roch
- Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | | | | | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | - Pascale Missy
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
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Mezquita L, Auclin E, Ferrara R, Audigier-Valette C, Tessonnier L, Charrier M, Boucher ME, Lahmar J, Caramella C, Remon J, Planchard D, Adam J, Gazzah A, Chaput N, Soria JC, Besse B. Baseline-derived neutrophil-to-lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) to predict the benefit of immune checkpoint inhibitors (ICI) in advanced non-small cell lung cancer (NSCLC) patients. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.9089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9089 Background: dNRL (Neutrophils/Leucocytes-Neutrophils) and LDH were recently correlated to ICI benefit in melanoma. We tested if dNLR and LDH could have the same role in NSCLC patients. Methods: Baseline dNLR and LDH were collected in 234 patients treated with PD1/PDL1 inhibitors from Nov. 2013 to Dec. 2016, in a discovery (D) cohort (N = 161) from Gustave Roussy and an independent validation (V) cohort (N = 73) from 2 centers. ICI benefit was analyzed according to overall survival (OS), progression free survival (PFS) and response rate (RR) by RECIST 1.1. Kaplan-Meier and Cox regression were performed. Results: In the D cohort, 100 patients (62%) were males, 136 (85%) smokers and PS ≤1, with median age 61.5; 133 patients (81%) stage IV; 100 (62%) had adenocarcinoma and 46 (29%) squamous cells carcinoma; 35 (22%) were KRASmut, 13 (8%) EGFRmut and 3 (2%) ALKpositive. PDL1 expression was positive in 43 (75%), negative in 14 (25%) and unknown in 78. 132 (82%) patients received PD1 inhibitors; the median of prior lines was 1 (1-11). dNLR > 3 and LDH > upper normal limit (UNL) were independent factors for poor OS (HR 4,67, p = 0.011 and HR 2,65, p = 0.002, respectively) and poor PFS (HR 4,71, p = 0.001 and HR 1,68, p = 0.042 respectively). The median follow-up (FU) was 12 months (m) [95% CI 11-14], the median PFS 3m [2-4] and the median OS 10m [8-13]. In the V cohort, with a median FU of 11m [8-14], dNLR > 3 and LDH > UNL were significantly associated with poor OS (both p = 0.001), with a trend toward association with PFS (p = 0.06, p = 0.08, respectively). A Lung Immune Predictive Index (LIPI) was tested considering dNLR > 3 and LDH > UNL, with three groups. In D cohort, the median OS for good (no factor), intermediate (one factor) and poor (two factors) was 34m [17-NR], 10m [8-NR], 3m [1-NR], respectively (p = 0.0001), and PFS was similarly correlated (p = 0.001). Same results were demonstrated in the V cohort. Conclusions: Baseline dNLR > 3 and LDH > UNL can predict the benefit of ICI in advanced NSCLC patients. The LIPI at baseline is an easy tool to identify the candidates to immunotherapy. Confirmation cohorts are ongoing to validate the predictive role of the LIPI.
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Affiliation(s)
- Laura Mezquita
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Paris-Sud University, Villejuif, France
| | - Edouard Auclin
- Medical and Gastrointestinal Oncology Department, Georges Pompidou Hospital; Methodology and Quality of Life Unit in Oncology (INSERM UMR 1098), University Hospital of Besançon, Paris, France
| | - Roberto Ferrara
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Laurent Tessonnier
- Nuclear Medicine Department, Centre Hospitalier Toulon Sainte-Musse, Toulon, France
| | - Melinda Charrier
- Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS / US 23 INSERM, Gustave Roussy, Villejuif, France
| | | | - Jihene Lahmar
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Jordi Remon
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | | | - Julien Adam
- Gustave Roussy, Drug Development Department (DITEP); Inserm U981, Villejuif, France
| | - Anas Gazzah
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - Nathalie Chaput
- Laboratory of Immunomonitoring in Oncology, UMS 3655 CNRS / US 23 INSERM, Gustave Roussy, Villejuif, France
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Bromer WW, Boucher ME, Patterson JM, Pekar AH, Frank BH. Glucagon structure and function. I. Purification and properties of bovine glucagon and monodesmidoglucagon. J Biol Chem 1972; 247:2581-5. [PMID: 5019963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Bromer WW, Boucher ME, Kofenberger JE. Amino acid sequence of bovine glucagon. J Biol Chem 1971; 246:2822-7. [PMID: 5102927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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