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Hagège M, Bringuier M, Martinez-Tapia C, Chouaïd C, Helissey C, Brain E, Lempdes GR, Dubot C, Bello-Roufai D, Geiss R, Kempf E, Gourden A, Elgharbi H, Garrigou S, Gregoire L, Derbez B, Canouï-Poitrine F. Disentangling the reasons why older adults do not readily participate in cancer trials: a socio-epidemiological mixed methods approach. Age Ageing 2024; 53:afae007. [PMID: 38346934 PMCID: PMC10861365 DOI: 10.1093/ageing/afae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/13/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Few studies of the under-representation of older adults in cancer clinical trials (CTs) have encompassed the entire pathway from a trial being available in a cancer centre to the patient's invitation to participate and then agreement or refusal to participate. OBJECTIVES The study's primary objective was to evaluate CT non-invitation and refusal rates. The secondary objectives were to identify factors associated with non-invitation and refusal and to assess experiences of CT participation from the patients' and professionals' perspectives. METHODS Here, we used mixed methods and a socio-epidemiological approach to analyse reasons for the non-participation of eligible older patients with a solid cancer in cancer CTs in France. RESULTS We found that non-invitation and low CT participation are mainly related to the patients' sociodemographic characteristics and living conditions (such as social isolation, being single, divorced or widowed, not having children and the absence of close family members) and the healthcare professionals' perceptions of insufficient informal support or a high homecare requirement. CONCLUSION Our results suggest that efforts to increase fair inclusion and the participation of older adults in CTs should target the physician-patient relationship, the medical profession and hospital funding, rather than the patient alone.
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Affiliation(s)
- Meoïn Hagège
- Department of Health, French institute for health research, Institut Mondor de Recherche Biomédicale, InsermU955, Eq. CEpiA & University Paris Est Créteil, 8 rue du general Sarrail, F-94010 Créteil, France
| | | | - Claudia Martinez-Tapia
- Department of Health, French institute for health research, Institut Mondor de Recherche Biomédicale, InsermU955, Eq. CEpiA & University Paris Est Créteil, 8 rue du general Sarrail, F-94010 Créteil, France
| | - Christos Chouaïd
- Department of Health, French institute for health research, Institut Mondor de Recherche Biomédicale, InsermU955, Eq. CEpiA & University Paris Est Créteil, 8 rue du general Sarrail, F-94010 Créteil, France
- Department of Pneumology, Centre Hospitalier Intercommunal Créteil, 40 Av. de Verdun, F-94000 Créteil, France
| | - Carole Helissey
- Departement of Oncology, Hôpital d'Instruction des Armées Bégin, 69 Av. de Paris, F-94160 Saint-Mandé, France
| | - Etienne Brain
- Institut Curie, 35 Rue Dailly, F-92210 Saint-Cloud, France
| | | | - Coraline Dubot
- Institut Curie, 35 Rue Dailly, F-92210 Saint-Cloud, France
| | | | - Romain Geiss
- Institut Curie, 35 Rue Dailly, F-92210 Saint-Cloud, France
| | - Emmanuelle Kempf
- Department of Oncology, Hôpital Henri Mondor, 54 avenue du maréchal lattre de tassigny, F-94010 Créteil, France
| | - Audrey Gourden
- Departement of Oncology, Hôpital d'Instruction des Armées Bégin, 69 Av. de Paris, F-94160 Saint-Mandé, France
| | - Hanane Elgharbi
- Department of Pneumology, Centre Hospitalier Intercommunal Créteil, 40 Av. de Verdun, F-94000 Créteil, France
| | - Sonia Garrigou
- Department of Oncology, Hôpital Henri Mondor, 54 avenue du maréchal lattre de tassigny, F-94010 Créteil, France
| | - Laetitia Gregoire
- Department of Oncology, Hôpital Henri Mondor, 54 avenue du maréchal lattre de tassigny, F-94010 Créteil, France
| | - Benjamin Derbez
- Department of Sociology, Université Paris 8, Cresspa CSU, 2 Rue de la Liberté, F-93200 Saint-Denis, France
| | - Florence Canouï-Poitrine
- Department of Health, French institute for health research, Institut Mondor de Recherche Biomédicale, InsermU955, Eq. CEpiA & University Paris Est Créteil, 8 rue du general Sarrail, F-94010 Créteil, France
- Department of Oncology, Hôpital Henri Mondor, 54 avenue du maréchal lattre de tassigny, F-94010 Créteil, France
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Couderc AL, Liuu E, Boudou-Rouquette P, Poisson J, Frelaut M, Montégut C, Mebarki S, Geiss R, ap Thomas Z, Noret A, Pierro M, Baldini C, Paillaud E, Pamoukdjian F. Pre-Therapeutic Sarcopenia among Cancer Patients: An Up-to-Date Meta-Analysis of Prevalence and Predictive Value during Cancer Treatment. Nutrients 2023; 15:nu15051193. [PMID: 36904192 PMCID: PMC10005339 DOI: 10.3390/nu15051193] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
This study will address the prevalence of pre-therapeutic sarcopenia (PS) and its clinical impact during cancer treatment among adult cancer patients ≥ 18 years of age. A meta-analysis (MA) with random-effect models was performed via a MEDLINE systematic review, according to the PRISMA statement, focusing on articles published before February 2022 that reported observational studies and clinical trials on the prevalence of PS and the following outcomes: overall survival (OS), progression-free survival (PFS), post-operative complications (POC), toxicities (TOX), and nosocomial infections (NI). A total of 65,936 patients (mean age: 45.7-85 y) with various cancer sites and extensions and various treatment modes were included. Mainly defined by CT scan-based loss of muscle mass only, the pooled prevalence of PS was 38.0%. The pooled relative risks were 1.97, 1.76, 2.70, 1.47, and 1.76 for OS, PFS, POC, TOX, and NI, respectively (moderate-to-high heterogeneity, I2: 58-85%). Consensus-based algorithm definitions of sarcopenia, integrating low muscle mass and low levels of muscular strength and/or physical performance, lowered the prevalence (22%) and heterogeneity (I2 < 50%). They also increased the predictive values with RRs ranging from 2.31 (OS) to 3.52 (POC). PS among cancer patients is prevalent and strongly associated with poor outcomes during cancer treatment, especially when considering a consensus-based algorithm approach.
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Affiliation(s)
- Anne-Laure Couderc
- Internal Medicine Geriatrics and Therapeutic Unit, APHM, 13009 Marseille, France
- CNRS, EFS, ADES, Aix-Marseille University, 13015 Marseille, France
| | - Evelyne Liuu
- Department of Geriatrics, CHU Poitiers, 86000 Poitiers, France
- CIC1402 INSERM Unit, Poitiers University Hospital, 86000 Poitiers, France
| | - Pascaline Boudou-Rouquette
- Ariane Program, Department of Medical Oncology, Cochin Hospital, Paris Cancer Institute CARPEM, APHP, 75014 Paris, France
- INSERM U1016-CNRS UMR8104, Cochin Institute, Paris Cancer Institute CARPEM, Paris Cité University, 75015 Paris, France
| | - Johanne Poisson
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
- Faculty of Health, Paris Cité University, 75006 Paris, France
| | - Maxime Frelaut
- Department of Medical Oncology, Gustave Roussy Institute, 94805 Villejuif, France
| | - Coline Montégut
- Internal Medicine Geriatrics and Therapeutic Unit, APHM, 13009 Marseille, France
- Coordination Unit for Geriatric Oncology (UCOG), PACA West, 13009 Marseille, France
| | - Soraya Mebarki
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
| | - Romain Geiss
- Department of Medical Oncology, Curie Institute, 92210 Saint-Cloud, France
| | - Zoé ap Thomas
- Department of Cancer Medicine, Gustave Roussy Institute, 94805 Villejuif, France
| | - Aurélien Noret
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
| | - Monica Pierro
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
| | - Capucine Baldini
- Drug Development Department, Gustave Roussy Institute, 94805 Villejuif, France
| | - Elena Paillaud
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
- INSERM, IMRB, Clinical, Epidemiology and Ageing, Université Paris-Est Creteil, 94010 Creteil, France
| | - Frédéric Pamoukdjian
- Department of Geriatrics, Avicenne Hospital, APHP, 93000 Bobigny, France
- INSERM UMR_S942 Cardiovascular Markers in Stressed Conditions MASCOT, Sorbonne Paris Nord University, 93000 Bobigny, France
- Correspondence:
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Alati A, Fabiano E, Geiss R, Mareau A, Charles-Nelson A, Bibault JE, Giraud P, Kreps S, Méjean A, Housset M, Durdux C. Bladder preservation in older adults with muscle-invasive bladder cancer: A retrospective study with concurrent chemotherapy and twice-daily hypofractionated radiotherapy schedule. J Geriatr Oncol 2022; 13:978-986. [PMID: 35717533 DOI: 10.1016/j.jgo.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Bladder cancer occurs mainly in older adults and surgery is not always possible when there are geriatric conditions and comorbidities. Trimodal treatment (TMT) combining trans-urethral resection of bladder tumour (TURBT) followed by concurrent chemoradiation (CRT) would be a curative alternative in such patients. METHODS All consecutive patients 75 years of age and older with non-metastatic muscle-invasive bladder cancer (MIBC) treated with TMT by Georges Pompidou European Hospital team were retrospectively analysed. Induction CRT combined hypofractionated twice-daily radiotherapy targeting bladder and pelvis to a total dose of 24 Gy (Gy) with concurrent platinum salt and 5-fluorouracil. Consolidation CRT to a total dose of 44 Gy was proposed to patients with biopsy-proven complete response after induction phase and those with persistent tumour underwent salvage cystectomy. We assessed using Kaplan-Meier method overall survival (OS), cancer specific survival (CSS), invasive recurrence-free survival (IRFS), metastasis-free survival (MFS), survival with bladder preserved (SBP), and toxicities. With a Cox model for OS and the Fine Gray method of competing risk for secondary endpoints, we analysed in univariate (u) and multivariate (m) analysis the impact of tumour characteristics and patient profiles: gender, age, age-adjusted Charlson comorbidity index, polypharmacy, and malnutrition. RESULTS From 1988 to 2017, 85 patients were included. After induction, complete response rate was 83.5%. With a median follow-up of 63 months, 5 year-OS, CSS, IRFS, MFS and SBP were 61.0%, 77.6%, 71%, 82.9%, and 70.2% respectively. A persistent tumour after induction impacted SBP (SHRm 3.61; p = 0.004), CSS (SHRm 3.27; p = 0.023), and MFS (SHRm 3.68; p = 0.018). Late grade 3 urinary and gastrointestinal toxicities were 3.5% and 1.2%. CONCLUSION We report here the largest series of bladder preservation over 75 years in a curative intent. Outcomes and tolerance in selected older adults compared favourably with surgical series and with CRT studies using classical fractionation.
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Affiliation(s)
- Aurélia Alati
- Department of Radiation Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France.
| | - Emmanuelle Fabiano
- Department of Radiation Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Romain Geiss
- Geriatric Department, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Alexis Mareau
- Clinical Research Unit, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Anais Charles-Nelson
- Clinical Research Unit, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Jean-Emmanuel Bibault
- Department of Radiation Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Philippe Giraud
- Department of Radiation Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Sarah Kreps
- Department of Radiation Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Arnaud Méjean
- Department of Urology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Martin Housset
- Department of Radiation Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
| | - Catherine Durdux
- Department of Radiation Oncology, Georges Pompidou European Hospital, University of Paris Descartes, Paris, France
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Poisson J, Martinez-Tapia C, Heitz D, Geiss R, Albrand G, Falandry C, Gisselbrecht M, Couderc AL, Boulahssass R, Liuu E, Boudou-Rouquette P, Chah Wakilian A, Gaxatte C, Pamoukdjian F, de Decker L, Antoine V, Cattenoz C, Solem-Laviec H, Guillem O, Medjenah H, Natella PA, Canouï-Poitrine F, Laurent M, Paillaud E. Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross-sectional survey (NutriAgeCancer). J Cachexia Sarcopenia Muscle 2021; 12:1477-1488. [PMID: 34519440 PMCID: PMC8718093 DOI: 10.1002/jcsm.12776] [Citation(s) in RCA: 39] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 06/28/2021] [Accepted: 07/13/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Nutritional impairment is common in cancer patients and is associated with poor outcomes. Only few studies focused on cachexia. We assessed the prevalence of cachexia in older cancer patients, identified associated risk factors, and evaluated its impact on 6 month overall mortality. METHODS A French nationwide cross-sectional survey (performed in 55 geriatric oncology clinics) of older cancer patients aged ≥70 referred for geriatric assessment prior to treatment choice and initiation. Demographic, clinical, and nutritional data were collected. The first outcome was cachexia, defined as loss of more than 5% of bodyweight over the previous 6 months, or a body mass index below 20 kg/m2 with weight loss of more than 2%, or sarcopenia (an impaired Strength, Assistance with walking, Rise from chair, Climb stairs and Falls score) with weight loss of more than 2%. The second outcome was 6 month overall mortality. RESULTS Of the 1030 patients included in the analysis [median age (interquartile range): 83 (79-87); males: 48%; metastatic cancer: 42%; main cancer sites: digestive tract (29%) and breast (16%)], 534 [52% (95% confidence interval: 49-55%)] had cachexia. In the multivariate analysis, patients with breast (P < 0.001), gynaecologic (P < 0.001), urinary (P < 0.001), skin (P < 0.001), and haematological cancers (P = 0.006) were less likely to have cachexia than patients with colorectal cancer. Patients with upper gastrointestinal tract cancers (including liver and pancreatic cancers; P = 0.052), with previous surgery for cancer (P = 0.001), with metastases (P = 0.047), poor performance status (≥2; P < 0.001), low food intake (P < 0.001), unfeasible timed up-and-go test (P = 0.002), cognitive disorders (P = 0.03) or risk of depression (P = 0.005), were more likely to have cachexia. At 6 months, 194 (20.5%) deaths were observed. Cachexia was associated with 6 month mortality risk (adjusted hazard ratio = 1.49; 95% confidence interval: 1.05-2.11) independently of age, in/outpatient status, cancer site, metastatic status, cancer treatment, dependency, cognition, and number of daily medications. CONCLUSIONS More than half of older patients with cancer managed in geriatric oncology clinics had cachexia. The factors associated with cachexia were upper gastrointestinal tract cancer, metastases, poor performance status, poor mobility, previous surgery for cancer, cognitive disorders, a risk of depression, and low food intake. Cachexia was independently associated with 6 month mortality.
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Affiliation(s)
- Johanne Poisson
- Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit, Georges Pompidou European Hospital, Paris, France.,Faculty of Health, University of Paris, Paris, France
| | - Claudia Martinez-Tapia
- INSERM-IMRB CEpiA (Clinical Epidemiology and Ageing Unit), Paris-Est University, UPEC, Créteil, France
| | - Damien Heitz
- Oncology and Hematology Unit, Strasbourg University Hospital Center - Hautepierre Hospital, Strasbourg, France
| | - Romain Geiss
- Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit, Georges Pompidou European Hospital, Paris, France
| | - Gilles Albrand
- Geriatric Oncology Unit, Antoine Charial hospital, Hospices Civils de Lyon, Lyon, France
| | - Claire Falandry
- Geriatrics Unit, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Mathilde Gisselbrecht
- Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit, Georges Pompidou European Hospital, Paris, France
| | - Anne-Laure Couderc
- AP-HM, Division of Internal Medicine, Geriatric Medicine and Therapeutic, Sainte Marguerite Hospital, Marseille, France
| | | | - Evelyne Liuu
- Geriatric Department, CHU La Milétrie, Poitiers, France
| | | | - Anne Chah Wakilian
- Geriatric Department, Broca Hospital, Paris Centre Hospitals, Paris Descartes University, Paris, France
| | - Cedric Gaxatte
- Geriatric Oncology Unit, Lille University Hospital, Lille, France
| | - Fréderic Pamoukdjian
- AP-HP, Geriatric Oncology Unit, Avicenne Hospital and Paris 13 University, Sorbonne Paris Cité, Bobigny, France
| | - Laure de Decker
- Clinical Gerontology Department, Nantes University Hospital Center, Nantes, France
| | - Valery Antoine
- Department of Geriatric Medicine, Nimes University Hospital, Nimes, France
| | | | - Heidi Solem-Laviec
- Geriatric Oncology Unit, Oncology Supportive Care Department, François Baclesse Regional Cancer Center, Caen, France
| | - Olivier Guillem
- Geriatric Medicine Unit, Inter-communal Hospital Center from Southern Alps, Gap, France
| | - Hayat Medjenah
- Public Health Department and Clinical Research Unit, APHP, Henri-Mondor Hospital, Creteil, France
| | - Pierre André Natella
- Public Health Department and Clinical Research Unit, APHP, Henri-Mondor Hospital, Creteil, France
| | - Florence Canouï-Poitrine
- INSERM-IMRB CEpiA (Clinical Epidemiology and Ageing Unit), Paris-Est University, UPEC, Créteil, France.,Public Health Department and Clinical Research Unit, APHP, Henri-Mondor Hospital, Creteil, France
| | - Marie Laurent
- Internal Medicine and Geriatric Department, Paris- Sud-Val-de-Marne Geriatric Oncology Clinic, AP-HP, Henri-Mondor Hospital, Créteil, France
| | - Elena Paillaud
- Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit, Georges Pompidou European Hospital, Paris, France.,Faculty of Health, University of Paris, Paris, France.,INSERM-IMRB CEpiA (Clinical Epidemiology and Ageing Unit), Paris-Est University, UPEC, Créteil, France
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Helissey C, Geiss R, Baldini C, Noret A, Frelaut M, Rodrigues M, Bringuier M. [Why and how to assess older people with cancer?]. Bull Cancer 2021; 108:513-520. [PMID: 33836861 DOI: 10.1016/j.bulcan.2021.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/22/2020] [Accepted: 01/03/2021] [Indexed: 11/15/2022]
Abstract
The older population accounts for almost 60% of new cancers. Their management is a public health problem and is complex. It raises different questions: Is the patient's prognosis linked to cancer or another pathology? The heterogeneity of this population emphasises the importance of the overall condition assessment, in particular to avoid over-treatment (or under-treatment), and to be able to identify frail or vulnerable elderly patients who are at risk of having more treatment toxicities. Through this article, we will recall the importance of geriatric in-depth evaluation (EGA) by detailing the different factors that impact the therapeutic decision, tolerance to treatments… This EGA is however time-consuming and not all patients can be evaluated. In order to identify the subjects covered by this EGA, screening scales have been developed. Finally, we will develop the place of research in oncogeriatric management.
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Affiliation(s)
- Carole Helissey
- Hôpital militaire Begin, unité de recherche clinique, Saint-69 avenue de Paris, 94160 Saint-Mandé, France.
| | - Romain Geiss
- Hôpital européen Georges-Pompidou, unité d'oncogériatrie, service de gériatrie, 20, rue Leblanc, Paris, France
| | - Capucine Baldini
- Saclay University of Paris, Drug Development Department (DITEP), Gustave Roussy, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Aurélien Noret
- Institut Curie, université PSL, département d'Oncologie médicale, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - Maxime Frelaut
- Saclay University of Paris, Drug Development Department (DITEP), Gustave Roussy, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Manuel Rodrigues
- Institut Curie, université PSL, département d'Oncologie médicale, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - Michael Bringuier
- Institut Curie, université PSL, département interdisciplinaire de soins de support pour le patient en oncologie (DISSPO) et département d'oncologie médicale, 35, rue Dailly, 92210 Saint-Cloud, France
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Darrigues L, Pierga JY, Bernard-Tessier A, Bièche I, Silveira AB, Michel M, Loirat D, Cottu P, Cabel L, Dubot C, Geiss R, Ricci F, Vincent-Salomon A, Proudhon C, Bidard FC. Circulating tumor DNA as a dynamic biomarker of response to palbociclib and fulvestrant in metastatic breast cancer patients. Breast Cancer Res 2021; 23:31. [PMID: 33676547 PMCID: PMC7937332 DOI: 10.1186/s13058-021-01411-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/22/2021] [Indexed: 12/21/2022] Open
Abstract
Background Following the PALOMA-3 study results, the combination of palbociclib, a CDK4/6 inhibitor, with fulvestrant, a selective estrogen receptor degrader, has become a standard therapy in women with estrogen receptor-positive (ER+) HER2-negative (HER2−) metastatic breast cancer (MBC). Palbociclib has been shown to increase the progression-free survival (PFS) overall but no predictive biomarker of palbociclib efficacy has been validated so far. We thus evaluated whether early changes of circulating tumor DNA (ctDNA) levels are associated with palbociclib plus fulvestrant efficiency. Methods ER+ HER2− MBC patients were included in a prospective observational cohort before treatment initiation. Tumor response was assessed by radiological evaluation (RECIST v1.1) every 3 months. Plasma samples were collected before treatment (baseline), at day 15 (D15), at day 30 (D30), and at disease progression. We searched for somatic mutations from archived tumor tissues by targeted deep sequencing. For patients with somatic mutations identified, circulating tumor DNA (ctDNA) was tracked using digital droplet PCR. Ratios of ctDNA levels ([D15/baseline] and [D30/baseline]) were then correlated with prospectively registered patient characteristics and outcomes. Results Twenty-five of the 61 patients enrolled had a somatic mutation testable in plasma (NPIK3CA = 21, NTP53 = 2, NAKT1 = 2). At baseline, 84% of patients had detectable ctDNA levels but ctDNA levels had no prognostic impact on PFS (p = 0.10). Among those patients, ctDNA was still detected in 82% at D15 and 68% at D30. ctDNA clearance observed at day 30 was associated with longer PFS (HR = 7.2, 95% CI = 1.5–32.6, p = 0.004). On the contrary, a [D30/baseline] ctDNA ratio > 1 was associated with a shorter PFS (HR = 5.1, 95% CI = 1.4–18.3, p = 0.02) and all 5 patients with increased ctDNA levels at D30 showed disease progression after 3 months under palbociclib-fulvestrant. Finally, at the time of radiological tumor progression, ctDNA was detected in all patients tested. Conclusion Our study demonstrates that the efficiency of palbociclib and fulvestrant can be monitored by serial analyses of ctDNA before radiological evaluation and that early ctDNA variation is a prognostic factor of PFS. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-021-01411-0.
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Affiliation(s)
- Lauren Darrigues
- Circulating Tumor Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France.,Department of Surgical Oncology, Institut Curie, Paris, France.,Université de Paris, Paris, France
| | - Jean-Yves Pierga
- Circulating Tumor Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France.,Université de Paris, Paris, France.,Department of Medical Oncology, Institut Curie, 35 rue Dailly, 92210, Saint Cloud, France
| | - Alice Bernard-Tessier
- Circulating Tumor Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France
| | - Ivan Bièche
- Université de Paris, Paris, France.,Department of Biopathology, Institut Curie, Paris, France
| | - Amanda Bartolini Silveira
- Circulating Tumor Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France
| | - Marc Michel
- Circulating Tumor Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France
| | - Delphine Loirat
- Department of Medical Oncology, Institut Curie, 35 rue Dailly, 92210, Saint Cloud, France
| | - Paul Cottu
- Department of Medical Oncology, Institut Curie, 35 rue Dailly, 92210, Saint Cloud, France
| | - Luc Cabel
- Department of Medical Oncology, Institut Curie, 35 rue Dailly, 92210, Saint Cloud, France.,INSERM U934 CNRS UMR3215, Paris, France
| | - Coraline Dubot
- Department of Medical Oncology, Institut Curie, 35 rue Dailly, 92210, Saint Cloud, France
| | - Romain Geiss
- Department of Medical Oncology, Institut Curie, 35 rue Dailly, 92210, Saint Cloud, France
| | - Francesco Ricci
- Department of Medical Oncology, Institut Curie, 35 rue Dailly, 92210, Saint Cloud, France
| | | | - Charlotte Proudhon
- Circulating Tumor Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France. .,INSERM U934 CNRS UMR3215, Paris, France.
| | - François-Clément Bidard
- Circulating Tumor Biomarkers Laboratory, Inserm CIC-BT 1428, Institut Curie, PSL Research University, 26 rue d'Ulm, 75005, Paris, France. .,Department of Medical Oncology, Institut Curie, 35 rue Dailly, 92210, Saint Cloud, France. .,UVSQ Paris-Saclay University, Saint Cloud, France.
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Hauchecorne M, Pierro M, Brain E, Bringuier M, Soubeyran P, Chakiba C, Mathoulin-Pelissier S, Paillaud E, Geiss R, Besse B, Mourey L, Vincent H, Baldini C. Perspectives on cancer care in older patients in France. Ecancermedicalscience 2020; 14:1103. [PMID: 33082853 PMCID: PMC7532034 DOI: 10.3332/ecancer.2020.1103] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Indexed: 11/06/2022] Open
Abstract
In France, cancer is the leading cause of death. Its incidence is increasing due to the growing population and longer life expectancy. Although older adults represent most new cases, they remain underrepresented in clinical trials. Their prognosis is often worse due to delayed diagnosis and multimorbidities. Geriatric oncology has made great strides worldwide, highlighted by important studies implementing geriatric assessment in clinical research and supported by the successive national cancer plans. This paper reviews the most important actions taken in France during the last decade to improve the management of older patients with cancer.
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Affiliation(s)
- Mathilde Hauchecorne
- Senior Oncology Unit, Medical Oncology Department, Gustave Roussy Cancer Campus, Chevilly-Larue 94550, France
| | - Monica Pierro
- Medical Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Etienne Brain
- Department of Medical Oncology, Institut Curie, Saint-Cloud 92210, France
| | - Michael Bringuier
- Department of Medical Oncology, Institut Curie, Saint-Cloud 92210, France
| | - Pierre Soubeyran
- Department of Medical Oncology, Institut Bergonié, Université de Bordeaux, Inserm U1218, 33076 Bordeaux Cedex, France
| | - Camille Chakiba
- Department of Medical Oncology, Institut Bergonié, Université de Bordeaux, Inserm U1218, 33076 Bordeaux Cedex, France
| | | | - Elena Paillaud
- APHP, Paris Cancer Institute CARPEM, Department of Geriatrics, European Georges Pompidou Hospital, Paris 75015, France.,Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
| | - Romain Geiss
- APHP, Paris Cancer Institute CARPEM, Department of Geriatrics, European Georges Pompidou Hospital, Paris 75015, France
| | - Benjamin Besse
- Medical Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Loïc Mourey
- Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse 31059, France
| | - Hélène Vincent
- Senior Oncology Unit, Medical Oncology Department, Gustave Roussy Cancer Campus, Chevilly-Larue 94550, France
| | - Capucine Baldini
- Senior Oncology Unit, Medical Oncology Department, Gustave Roussy Cancer Campus, Chevilly-Larue 94550, France.,Drug Development Department, Gustave Roussy, Villejuif 94800, France
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8
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Quéroué M, Pulido M, Geiss R, Tassy L, Terret C, Mertens C, Paillaud E, de Decker L, Rainfray M, Lalet C, Mathoulin-Pélissier S. Littératie en santé et en santé numérique des personnes âgées avec un cancer, à partir d’un questionnaire. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.03.085] [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: 10/23/2022] Open
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9
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Biganzoli L, Cardoso F, Beishon M, Cameron D, Cataliotti L, Coles CE, Delgado Bolton RC, Trill MD, Erdem S, Fjell M, Geiss R, Goossens M, Kuhl C, Marotti L, Naredi P, Oberst S, Palussière J, Ponti A, Rosselli Del Turco M, Rubio IT, Sapino A, Senkus-Konefka E, Skelin M, Sousa B, Saarto T, Costa A, Poortmans P. The requirements of a specialist breast centre. Breast 2020; 51:65-84. [PMID: 32217457 PMCID: PMC7375681 DOI: 10.1016/j.breast.2020.02.003] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 12/15/2022] Open
Abstract
This article is an update of the requirements of a specialist breast centre, produced by EUSOMA and endorsed by ECCO as part of Essential Requirements for Quality Cancer Care (ERQCC) programme, and ESMO. To meet aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this article, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.
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Affiliation(s)
- Laura Biganzoli
- European Society of Breast Cancer Specialists (EUSOMA); Breast Centre, AUSL Toscana Centro, Prato, Italy.
| | - Fatima Cardoso
- European Society of Medical Oncology (ESMO); Breast Unit, Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal
| | | | - David Cameron
- European Cancer Concord (ECC); University of Edinburgh Cancer Centre, IGMM, Western General Hospital, Edinburgh, UK
| | - Luigi Cataliotti
- European Society of Breast Cancer Specialists (EUSOMA), Senonetwork Italia and Breast Centres Certification, Florence, Italy
| | - Charlotte E Coles
- European Society for Radiotherapy and Oncology (ESTRO); University of Cambridge, Cambridge, UK
| | - Roberto C Delgado Bolton
- European Association of Nuclear Medicine (EANM); Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), University of La Rioja, Logroño, La Rioja, Spain
| | - Maria Die Trill
- International Psycho-Oncology Society (IPOS); ATRIUM: Psycho-Oncology & Clinical Psychology, Madrid, Spain
| | - Sema Erdem
- European Cancer Organisation Patient Advisory Committee (ECCO PAC); Europa Donna, Milan, Italy
| | - Maria Fjell
- European Oncology Nursing Society (EONS); Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Romain Geiss
- International Society of Geriatric Oncology (SIOG); Medical Oncology, Hôpital René Huguenin - Institut Curie, St. Cloud, France
| | - Mathijs Goossens
- European Cancer League (ECL); Centre for Cancer Detection (CvKO), Brussels, Belgium
| | - Christiane Kuhl
- European Society of Radiology (ESR); Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany
| | - Lorenza Marotti
- European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy
| | - Peter Naredi
- European Cancer Organisation (ECCO); Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Simon Oberst
- Organisation of European Cancer Institutes (OECI); Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Jean Palussière
- Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Department of Imaging, Institut Bergonié, Bordeaux, France
| | - Antonio Ponti
- European Society of Breast Cancer Specialists (EUSOMA), Centre for Epidemiology and Prevention in Oncology (CPO) Piemonte, AOU Citta' Della Salute e Della Scienza, Turin, Italy
| | | | - Isabel T Rubio
- European Society of Surgical Oncology (ESSO); Breast Surgical Oncology, Clinica Universidad de Navarra Madrid, Spain
| | - Anna Sapino
- European Society of Pathology (ESP); Department of Medical Sciences, University of Turin, Turin, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Elzbieta Senkus-Konefka
- European Organisation for Research and Treatment of Cancer (EORTC); Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Marko Skelin
- European Society of Oncology Pharmacy (ESOP); Pharmacy Department, General Hospital Sibenik, Sibenik, Croatia
| | - Berta Sousa
- European Society of Oncology Pharmacy (ESOP); Pharmacy Department, General Hospital Sibenik, Sibenik, Croatia
| | - Tiina Saarto
- Flims Alumni Club (FAC); Breast Unit, Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal
| | | | - Philip Poortmans
- Iridium Kankernetwerk, University of Antwerp, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Wilrijk-Antwerp, Belgium
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10
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Vasseur A, Cabel L, Geiss R, Schleiermacher G, Pierron G, Kamal M, Jehanno N, Bataillon G, Guinebretiere JM, Bozec L. Efficacy of Lorlatinib in Primary Crizotinib-Resistant Adult Neuroblastoma Harboring ALK Y1278S Mutation. JCO Precis Oncol 2019; 3:1-5. [DOI: 10.1200/po.18.00396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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11
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Neuzillet Y, Geiss R, Caillet P, Paillaud E, Mongiat-Artus P. [Epidemiological, pathological and prognostic characteristics of bladder cancer in elderly patients]. Prog Urol 2019; 29:840-848. [PMID: 31471266 DOI: 10.1016/j.purol.2019.08.268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/08/2019] [Indexed: 02/01/2023]
Abstract
AIM To define and present explanations for the epidemiological, pathological and prognostic differences in bladder cancer in elderly patients. METHOD Bibliographical search was performed from the Medline bibliographic database (NLM Pubmed tool) and Embase focused on: bladder cancer, carcinogenesis, elderly, epidemiology, prognosis. RESULTS Bladder cancer is a growing concern for the elderly first and foremost and with an impact, mainly those who are consumers or former users of tobacco, whose therefore frequently have comorbidities associated with this consumption. The initiated carcinogenesis extends with the life length of patients, increasing the prevalence of bladder cancer. Aging promotes carcinogenesis by both potentiating its genetic abnormalities and reducing the immune system performance of the aged host to destroy cancer cells. The delay in the diagnosis of bladder cancer in elderly patients is explained and make up for the time could improve the prognosis. CONCLUSION Regardless of variations in therapeutic effect and morbidity and mortality of treatments, aging promotes the occurrence and aggressiveness of bladder cancer. The incentive to stop exposure to carcinogens and the search for bladder cancer in patients with hematuria should not reduce with advanced age but instead be promoted in order to improve the prognosis.
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Affiliation(s)
- Y Neuzillet
- Service d'urologie et de transplantation rénale, hôpital Foch, université de Versailles - Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.
| | - R Geiss
- Unité d'oncogériatrie, service de gériatrie, hôpital européen Georges-Pompidou, université de Paris Descartes, 20, rue Leblanc, 75908 Paris cedex 15, France
| | - P Caillet
- Unité d'oncogériatrie, service de gériatrie, hôpital européen Georges-Pompidou, université de Paris Descartes, 20, rue Leblanc, 75908 Paris cedex 15, France
| | - E Paillaud
- Unité d'oncogériatrie, service de gériatrie, hôpital européen Georges-Pompidou, université de Paris Descartes, 20, rue Leblanc, 75908 Paris cedex 15, France
| | - P Mongiat-Artus
- Unité de chirurgie et d'anesthésie ambulatoires, service d'urologie, Inserm UMR, S1165, hôpital Saint-Louis, université de Paris-7-Denis-Diderot, 1, avenue Claude-Vellefaux, 75010 Paris, France
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12
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Bringuier M, Tazaro-Martinez C, Bonhomme S, Geiss R. [Epidemiology of cancer in the elderly in France]. Soins Gerontol 2019; 24:12-14. [PMID: 30765079 DOI: 10.1016/j.sger.2018.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the population aged 65 and over, there were 233 943 new cases of cancer in 2015 in France. For those aged 85 and over, the incidence was 41 947 new cases of cancer (10.6% of all cancer cases). In 2015, there were 112 596 deaths specifically related to cancer of people aged over 65 (55.6% of whom were men), representing 75.3% of all deaths from cancer.
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Affiliation(s)
- Michaël Bringuier
- Département interdisciplinaire de soins de support pour le patient en oncologie, Institut Curie, Hôpital René-Huguenin, 35 rue Dailly, 92210 Saint-Cloud, France.
| | - Catherine Tazaro-Martinez
- Département interdisciplinaire de soins de support pour le patient en oncologie, Institut Curie, Hôpital René-Huguenin, 35 rue Dailly, 92210 Saint-Cloud, France
| | - Sadia Bonhomme
- Département interdisciplinaire de soins de support pour le patient en oncologie, Institut Curie, 26 rue d'Ulm, 75005 Paris, France
| | - Romain Geiss
- Département d'oncologie médicale, Institut Curie, Hôpital René-Huguenin, 35 rue Dailly, 92210 Saint-Cloud, France
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13
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Basse C, Morel C, Alt M, Sablin MP, Franck C, Pierron G, Callens C, Melaabi S, Masliah-Planchon J, Bataillon G, Gardrat S, Lavigne M, Bonsang B, Vaflard P, Pons Tostivint E, Dubot C, Loirat D, Marous M, Geiss R, Clément N, Schleiermacher G, Kamoun C, Girard E, Ardin M, Benoist C, Bernard V, Mariani O, Rouzier R, Tresca P, Servois V, Vincent-Salomon A, Bieche I, Le Tourneau C, Kamal M. Relevance of a molecular tumour board (MTB) for patients' enrolment in clinical trials: experience of the Institut Curie. ESMO Open 2018; 3:e000339. [PMID: 29636991 PMCID: PMC5890857 DOI: 10.1136/esmoopen-2018-000339] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 11/27/2022] Open
Abstract
Background High throughput molecular screening techniques allow the identification of multiple molecular alterations, some of which are actionable and can be targeted by molecularly targeted agents (MTA). We aimed at evaluating the relevance of using this approach in the frame of Institut Curie Molecular Tumor Board (MTB) to guide patients with cancer to clinical trials with MTAs. Patients and methods We included all patients presented at Institut Curie MTB from 4 October 2014 to 31 October 2017. The following information was extracted from the chart: decision to perform tumour profiling, types of molecular analyses, samples used, molecular alterations identified and those which are actionable, and inclusion in a clinical trial with matched MTA. Results 736 patients were presented at the MTB. Molecular analyses were performed in 442 patients (60%). Techniques used included next-generation sequencing, comparative genomic hybridisation array and/or other techniques including immunohistochemistry in 78%, 51% and 58% of patients, respectively. Analyses were performed on a fresh frozen biopsy in 91 patients (21%), on archival tissue (fixed or frozen) in 326 patients (74%) and on both archival and fresh frozen biopsy in 25 patients (6%). At least one molecular alteration was identified in 280 analysed patients (63%). An actionable molecular alteration was identified in 207 analysed patients (47%). Forty-five analysed patients (10%) were enrolled in a clinical trial with matched MTA and 29 additional patients were oriented and included in a clinical trial based on a molecular alteration identified prior to the MTB analysis. Median time between date of specimen reception and molecular results was 28 days (range: 5–168). Conclusions The implementation of an MTB at Institut Curie enabled the inclusion of 10% of patients into a clinical trial with matched therapy.
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Affiliation(s)
- Clémence Basse
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Claire Morel
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Marie Alt
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Marie Paule Sablin
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Coralie Franck
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Gaëlle Pierron
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Céline Callens
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Samia Melaabi
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | | | - Guillaume Bataillon
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Sophie Gardrat
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Marion Lavigne
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Benjamin Bonsang
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Pauline Vaflard
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | | | - Coraline Dubot
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Delphine Loirat
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Miguelle Marous
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Romain Geiss
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Nathalie Clément
- Department of Pediatric Oncology, Institut Curie, PSL Research University, Paris, France
| | - Gudrun Schleiermacher
- Department of Pediatric Oncology, Institut Curie, PSL Research University, Paris, France
| | | | - Elodie Girard
- INSERM U900 Research Unit, Institut Curie, Paris, France
| | - Maude Ardin
- INSERM U900 Research Unit, Institut Curie, Paris, France
| | - Camille Benoist
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Virginie Bernard
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Odette Mariani
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Roman Rouzier
- INSERM U900 Research Unit, Institut Curie, Paris, France.,Department of Surgery, Institut Curie, PSL Research University, Paris, France
| | - Patricia Tresca
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | - Vincent Servois
- Department of Radiology and Nuclear Medicine, Institut Curie, PSL Research University, Paris, France
| | - Anne Vincent-Salomon
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France
| | - Ivan Bieche
- Department of Biopathology, Institut Curie, PSL Research University, Paris, France.,EA7331, University of Paris-Descartes, Paris, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris, France.,INSERM U900 Research Unit, Institut Curie, Paris, France.,Versailles-Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
| | - Maud Kamal
- Department of Drug Development and Innovation, Institut Curie, Paris, France
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Gennari A, Brain E, Nanni O, Muñoz Couselo E, Harbeck N, Geiss R, Rocca A, Cortés J, Degenhardt T, Piccardo A, Albérini JL, Matteucci F, Decensi A, Corradengo D, Andreis D, Marra D, Gebhart G, Brambati C, Amadori D, Bruzzi P. Molecular imaging with 18F-fluoroestradiol (18F-FES) to assess intra-patient heterogeneity in metastatic breast cancer (MBC): A European TRANSCAN program. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.030] [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: 11/14/2022] Open
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15
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Geiss R, Pierga JY, Auclin E, De Lempdes G, Rollot Trad F, cottu P, Giard C, Stevens D, Brain E. A decade of HER2-targeted therapy in older patients with invasive breast cancer at Institut Curie. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx364.011] [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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16
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Chang WK, Chung HP, Chou YY, Geiss R, Yang SD, Pertsch T, Chen YH. Electro-optically spectrum narrowed, multiline intracavity optical parametric oscillators. Opt Express 2016; 24:28905-28914. [PMID: 27958555 DOI: 10.1364/oe.24.028905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report on the first building of an active spectral narrowing mechanism in a pulsed, multiline optical parametric oscillator (OPO) based on a novel aperiodically poled lithium niobate (APPLN) device constructed using the aperiodic optical superlattice technique. The APPLN device functions simultaneously in the system as a multi-channel optical parametric down converter (OPDC) and an electro-optic (EO) gain spectral filter working on the corresponding (multiple) signal bands. When the APPLN OPO was installed in a diode pumped Nd:YVO4 laser system, highly narrowed dual-wavelength signal lines (at 1540 and 1550 nm) were observed at the output of the system through EO control of the APPLN. Correspondingly, an enhancement of the power spectral density of the source by a factor of ~7.8 with respect to the system operated in passive mode was found.
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Chung HP, Chang WK, Tseng CH, Geiss R, Pertsch T, Chen YH. Electro-optically spectrum tailorable intracavity optical parametric oscillator. Opt Lett 2015; 40:5132-5135. [PMID: 26565817 DOI: 10.1364/ol.40.005132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report a unique, pulsed intracavity optical parametric oscillator (IOPO) whose output spectrum is electro-optically (EO) tailorable based on an aperiodically poled lithium niobate (APPLN) working simultaneously as an optical parametric gain medium and an active gain spectrum filter in the system. We have successfully obtained from the IOPO the emission of single to multiple narrow-line signal spectral peaks in a near-infrared (1531 nm) band simply by electro-optic control. The power spectral density of the EO tailored signal can be enhanced by up to 10 times over the original (nontailored) signal.
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18
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Huguet F, Cabel L, Geiss R, Touboul E, Lefranc J, Daraï E, Lauratet B, Monnier L, Haberer-Guillerm S, Deluen F, Schlienger M. Carcinomes canalaires in situ du sein traités par irradiation postopératoire avec complément de dose au niveau du lit opératoire. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.07.091] [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]
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Abstract
Brillouin-light-scattering measurements and finite-element modeling of vibrational spectra in the range of 5-40 GHz are presented for an array of monocrystalline GaN nanowires with hexagonal cross sections. Analysis of the spectra is substantially complicated by the presence of a distribution of nanowire diameters. The measurements and calculations reveal a variety of modes with simple flexural, higher-order flexural, approximately 'plane-strain', approximately longitudinal and torsional displacement patterns that are similar to the corresponding modes of isotropic cylinders. The largest peaks in the spectra with acoustic angular wavenumbers in the range of 4 to ~15 μm(-1) were determined to arise from modes with relatively large transverse displacements, consistent with inelastic light scattering arising predominantly from surface ripple. These dominant modes have finite frequencies in the limit of zero wavenumber, corresponding to transverse standing waves. At higher wavenumbers, the spectra provide evidence for increased scattering through elasto-optic coupling, especially with respect to the emergence of a peak from a mode analogous to the longitudinal guided modes of thin films.
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Affiliation(s)
- W L Johnson
- Applied Chemicals and Materials Division, National Institute of Standards and Technology, Boulder, CO 80305, USA.
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20
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De La Motte Rouge T, Chaïbi P, Vignot S, Boussion H, Cabel L, Geiss R, Delgado FM, Khayat D, Chebib A, Spano JP. Frequency of cognitive impairment (CI) in elderly patients (pts) suffering from malignancies and impact on therapeutic decision. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.6110] [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
6110 Background: Therapeutic decision remains complex when a cancer is diagnosed in elderly pts. Our aim was to evaluate the frequency of CI in this population and its impact on therapeutic decision. Methods: An oncogeriatric evaluation including Comprehensive Geriatric Assessment (CGA) is systematically performed for all elderly cancer pts referred in our unit. We reviewed data of all pts assessed by geriatric oncologist at our institution from January 2009 to June 2011. Results: 378 pts were identified, among them a CI was noted in 87. Median age was 84 years (range 71 –94), 70 % ≥ 80 years. Most of the pts (78/87) were referred at the time of diagnosis. Metastatic disease was diagnosed in 32 pts (52%) and Diffuse Large B Cell Lymphoma stage III or IV in 21 pts (81 %). In 41 pts, CI was already diagnosed: Alzheimer disease (AD) (n=38) and Vascular Dementia (n=3). CGA help to identify CI in 46 additional pts: AD (n=36); Vascular Dementia (n=2) and Mild Cognitive Impairment (n=8). 45/87 pts (52 %) were dependant for at least one activity of daily living (ADL). As a result of CGA and benefit/risk oncologic assessment, best supportive care was recommended in 12 pts. Among them, only 4 pts presented with advanced metastatic disease (main reason for palliative care). Pts in whom “best supportive care” decision (n=12) was recommended were more dependants than those who received specific anticancer therapy (n=75): dependence for at least 2 ADL: 10/12 pts (83%) versus 16/75 (21%); and presented more AD already diagnosed (11/12 versus 30/75). In the remaining 75 pts, specific cancer therapy was proposed, including chemotherapy (n=67), surgery (n=5), radiotherapy (n=3) and hormonotherapy (n=9). Treatment was initiated as recommended in all but 4 pts (best supportive care decision taken following discussion with pts and relatives). During the follow-up, only 11/75 pts needed to be placed in nursing home because of loss of autonomy. A survival ≥ 1 year was observed in 27/75 (36%) pts. An update of cognitive performance will be presented. Conclusions: Our data support that even if CI is frequent in elderly pts with malignancies, specific anticancer therapy remains feasible and should be considered in most elderly pts with CI.
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Affiliation(s)
| | - Pascal Chaïbi
- Geriatric Department, Charles Foix Hospital, UCOG Paris Est, Ivry sur Seine, France
| | - Stéphane Vignot
- Medical Oncology Department, AP-HP, Salpetriere Hospital, University Paris VI, Paris, France
| | - Helene Boussion
- Medical Oncology Department, AP-HP, Salpetriere Hospital, University Paris VI, Paris, France
| | - Luc Cabel
- Medical Oncology Department, AP-HP, Salpetriere Hospital, University Paris VI, Paris, France
| | - Romain Geiss
- Medical Oncology Department, AP-HP, Salpetriere Hospital, University Paris VI, Paris, France
| | - Francois-Michel Delgado
- Medical Oncology Department, AP-HP, Salpetriere Hospital, University Paris VI, Paris, France
| | - David Khayat
- Salpetriere Hospital, University Paris VI, Paris, France
| | - Amale Chebib
- Geriatric Department, Charles Foix Hospital, UCOG Paris Est, Ivry sur Seine, France
| | - Jean-Philippe Spano
- Medical Oncology Department, AP-HP, Salpetriere Hospital, University Paris VI, Paris, France
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Johnson WL, Kim SA, Geiss R, Flannery CM, Soles CL, Wang C, Stafford CM, Wu WL, Torres JM, Vogt BD, Heyliger PR. Elastic constants and dimensions of imprinted polymeric nanolines determined from Brillouin light scattering. Nanotechnology 2010; 21:75703. [PMID: 20081293 DOI: 10.1088/0957-4484/21/7/075703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Elastic constants and cross-sectional dimensions of imprinted nanolines of poly(methyl methacrylate) (PMMA) on silicon substrates are determined nondestructively from finite-element inversion analysis of dispersion curves of hypersonic acoustic modes of these nanolines measured with Brillouin light scattering. The results for the cross-sectional dimensions, under the simplifying assumption of vertical sides and a semicircular top, are found to be consistent with dimensions determined from critical-dimension small-angle x-ray scattering measurements. The elastic constants C(11) and C(44) are found to be, respectively, 11.6% and 3.1% lower than their corresponding values for bulk PMMA. This result is consistent with the dimensional dependence of the quasi-static Young's modulus determined from buckling measurements on PMMA films with lower molecular weights. This study provides the first evidence of size-dependent effects on hypersonic elastic properties of polymers.
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Affiliation(s)
- W L Johnson
- Materials Reliability Division, National Institute of Standards and Technology, Boulder, CO 80305, USA
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Abstract
The temperature dependence of the strength of a thin copper electrodeposit has been measured, by microtensile testing, from room temperature to 150 °C. The ultimate tensile strength decreased from around 240 MPa at room temperature to just above 200 MPa at 150 °C. The yield strength followed a similar trend. Elongation to failure increased slightly with temperature. The Young’s modulus, as measured by the unload-load slope, was well below the values expected based on averaging single-crystal elastic constants at all test temperatures. The effect of strain rate on strength at room temperature, using a range of over a decade, was low, with a weak trend upward.
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Affiliation(s)
- D. T. Read
- National Institute of Standards and Technology
| | - Y.-W. Cheng
- National Institute of Standards and Technology
| | - R. Geiss
- National Institute of Standards and Technology
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Mannino D, Geiss R, Hodous T, Lapp NL. Suspected hypersensitivity pneumonitis after exposure to a biologic forage inoculant. South Med J 1996; 89:898-901. [PMID: 8790315 DOI: 10.1097/00007611-199609000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 44-year-old farmer had respiratory symptoms and bibasilar pulmonary infiltrates after three exposures to a new biologic forage inoculant. Open lung biopsy revealed chronic interstitial pneumonitis and bronchiolitis obliterans with organizing pneumonia. The patient responded to oral corticosteroids but acutely worsened after an inadvertent reexposure to the forage inoculant. He later recovered, with return of lung function and chest radiograph toward normal. This case suggests that biologic forage inoculants may be associated with hypersensitivity pneumonitis.
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Affiliation(s)
- D Mannino
- Critical Care Medicine, West Virginia University School of Medicine, Morgantown, USA
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25
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Stromberg B, Thorne S, Dimino-Emme L, Geiss R. Atypical chondroid syringoma. Nebr Med J 1991; 76:141-7. [PMID: 1652102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In summary, chondroid syringoma is a rare sweat gland neoplasm characterized by its slow growth and unpredictable growth phase. When malignant, it has a significant potential for recurrence, metastases, and even death. Due to the rarity of this tumor, an accurate preoperative diagnosis is difficult. Therefore, it is important for the clinician to have a high degree of suspicion for chondroid syringoma when considering the differential diagnosis of solid cutaneous nodules. A patient has been presented with a chondroid syringoma with atypical features, but no unequivocal evidence of malignancy. This poses a therapeutic dilemma. At the present time, the best therapeutic option appears to be accurate diagnosis, wide local excision, and close follow-up. Further research will elucidate the role of adjunctive treatment modalities.
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Affiliation(s)
- B Stromberg
- Department of Surgery (Division of Plastic and Reconstruction Surgery), Creighton University, Omaha, Nebraska
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26
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Corey JP, Nelson E, Crawford M, Riester JW, Geiss R. Metastatic vaginal carcinoma to the temporal bone. Am J Otol 1991; 12:128-31. [PMID: 2053604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Metastatic carcinoma of the temporal bone is being reported with increasing frequency. A literature review reveals 16 new cases reported in the past 2 years. In this article we present the first case of vaginal squamous cell carcinoma metastatic to the temporal bone reported in the literature. The pathophysiology, clinical presentation, and diagnostic difficulties of metastatic carcinoma to the temporal bone are discussed.
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Affiliation(s)
- J P Corey
- Section of Otolaryngology-Head and Neck Surgery, University of Chicago, IL 60637
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27
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Sievert H, Geiss R, Maul FD, Kaltenbach M, Bussmann WD. [Regional ventricular function before and after sublingual administration of nitroglycerin in patients with recent myocardial infarction in the subacute and chronic stage]. Z Kardiol 1986; 75:363-6. [PMID: 3092487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Seven patients with a recent myocardial infarction and mostly normal left ventricular end-diastolic pressure were investigated by radionuclide ventriculography after 3-4 days and three weeks before and after 1.6 mg nitroglycerin. Between day 3-4 and the third week global ejection fraction (EF) rose insignificantly (p greater than 0.05) from 31 +/- 4 to 37 +/- 6 percent. The regional EF in the non infarcted area remained nearly stable (74 +/- 5 to 85 +/- 13 relative percent, p greater than 0.05). However, the EF in the infarcted area rose from 22 +/- 9 to 38 +/- 11 relative percent (p less than 0.05 percent). On day 3-4 nitroglycerin induced a clear increase of the EF in the infarcted area from 22 +/- 9 to 35 +/- 11 relative percent (p less than 0.05). The global EF and the EF in the non infarcted area remained nearly constant (global EF from 31 +/- 4 to 34 +/- 5 percent, EF in the non infarcted area from 74 +/- 5 to 77 +/- 7 relative percent; p greater than 0.05). Three weeks after myocardial infarction 1.6 mg nitroglycerin did not produce a significant alteration of the ejection fraction (slight increase of the global EF from 37 +/- 6 to 40 +/- 6, the regional EF in the infarcted area from 38 +/- 11 to 48 +/- 11 relative percent and from 85 +/- 13 to 90 +/- 11 relative percent in the non infarcted area; p greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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