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Saint-Herblain, France

Roussel M.,Toulouse University Hospital Center | Facon T.,Lille University Hospital Center | Moreau P.,Nantes University Hospital Center | Harousseau J.-L.,CLCC Rene Gauducheau | Attal M.,Toulouse University Hospital Center
Recent Results in Cancer Research | Year: 2011

High dose therapy (HDT) with autologous stem cell transplantation (ASCT) is the standard of care for eligible newly diagnosed MM patients. Several randomized studies demonstrated a survival advantage for patients undergoing transplantation, compared with conventional chemotherapy. Introduction of new drugs in this setting have markedly increased survival rates within the last 10 years. Efforts to further improve response rates and survival in those patients are still needed, mainly by increasing the depth of tumor reduction and the duration of response through more effective induction, consolidation and maintenance therapies. Nevertheless, this approach is currently challenged by the promising results of long-term treatment with novel agents. Recent data suggest that the upfront combination of a proteasome inhibitor plus one immunomodulatory drug (IMiD) is highly effective. The most promising 3-drug association might be Bortezomib, Lenalidomide and dexamethasone (VRD). Adjunction of a 4th drug is not proven to be more efficient. Consolidation and maintenance therapies are emerging in all trials with great results. For elderly patients, or not eligible for ASCT, the introduction of novel agents has also changed the management of the disease. Melphalan-prednisone-thalidomide and bortezomib-melphalan-prednisone are the two standards of care. Current trials are challenging the role of alkylators in the frontline setting. Maintenance therapy is also undergoing evaluation. © 2011 Springer-Verlag.

Fiteni F.,Besancon University Hospital Center | Fiteni F.,University of Franche Comte | Vernerey D.,Besancon University Hospital Center | Bonnetain F.,Besancon University Hospital Center | And 18 more authors.
European Journal of Cancer | Year: 2016

Background We investigated whether the health-related quality of life (HRQoL) score is a prognostic factor for overall survival (OS) in elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods We included 451 NSCLC patients aged 70-89 years enrolled in the Intergroupe Francophone de Cancérologie Thoracique 0501 trial, using scores of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at baseline to investigate the prognostic value of HRQoL for OS, in addition to conventional factors. Cox regression model was used for both univariate and multivariate analyses of OS. Results Global health status (GH) dimension score at baseline was associated with favourable OS when adjusted for clinical, functional, and histological factors (hazard ratio [HR]: 0.986; 95% confidence interval [CI]: 0.980-0.992). We distinguished three groups according to GH score: high (GH <46), intermediate (46 ≤GH ≤67), and low (GH >67) mortality risk. The median OS values were 14.5, 8.2, and 5.3 months in the low-, intermediate-, and high-risk categories, respectively (log-rank P <0.0001). In the high-risk group, doublet chemotherapy was not associated with favourable OS (HR: 0.70; 95% CI: 0.49-1.003; P=0.052), whereas in the intermediate- and low-risk groups, doublet chemotherapy was associated with favourable OS (HR: 0.72; 95% CI: 0.54-0.96; P=0.023 and HR: 0.50; 95% CI: 0.30-0.84; P=0.0089, respectively). Conclusion This study supports the additional prognostic value of HRQoL data at diagnosis to identify vulnerable subpopulations in elderly NSCLC patients. HRQoL could thus be valuable in selecting patients who will benefit from doublet chemotherapy. © 2015 Elsevier Ltd.

Clough K.B.,The Paris Breast Center Linstitut Du Sein | Acosta-Marin V.,The Paris Breast Center Linstitut Du Sein | Acosta-Marin V.,Centro Clinico Of Estereotaxia Ceclines | Nos C.,The Paris Breast Center Linstitut Du Sein | And 10 more authors.
Annals of Surgical Oncology | Year: 2015

Background: The current retrospective study was intended to obtain up-to-date and comprehensive data on surgical practice for breast cancer throughout France, including neoadjuvant chemotherapy (NAC) and the more recent surgical techniques of oncoplastic surgery (OPS). Methods: In June 2011, e-mail surveys were sent to 33 nationally renowned breast cancer surgeons from French public or private hospitals. The questionnaire focused on all the new cases of breast cancer treated in 2010. It included questions regarding surgical practices, with special emphases on NAC and OPS and other surgical characteristics. Results: The overall response rate for the survey was 72.7 %. The total number of breast cancer cases from the survey was 13,762, which constitutes 26.2 % of the total incidence in 2010. Breast-conserving surgery (BCS) was performed for 71.0 % of the patients, and the results were similar throughout the types of practices. Of these patients, 13.9 % received OPS, either upfront or after NAC. Mastectomy was performed for 29.0 % of the patients, which is consistent with French official numbers. Among all patients, 16.3 % underwent surgery after NAC. Conclusion: To the authors’ knowledge, there are no publications of national figures on NAC or OPS rates to date. They are convinced that this study offers real-life surgical care information on a large population and covers France’s breast cancer surgical landscape. Mastectomy rates in France remain stable and consistent with those in other European countries. However, additional large-scale retrospective studies are required to confirm these figures and further explore NAC and OPS rates as well as surgical practice characteristics. © 2015, Society of Surgical Oncology.

Hamai A.,French Institute of Health and Medical Research | Duperrier-Amouriaux K.,French Institute of Health and Medical Research | Pignon P.,French Institute of Health and Medical Research | Raimbaud I.,French Institute of Health and Medical Research | And 12 more authors.
PLoS ONE | Year: 2011

The highly immunogenic human tumor antigen NY-ESO-1 (ESO) is a target of choice for anti-cancer immune therapy. In this study, we assessed spontaneous antibody (Ab) responses to ESO in a large cohort of patients with primary breast cancer (BC) and addressed the correlation between the presence of anti-ESO Ab, the expression of ESO in the tumors and their characteristics. We found detectable Ab responses to ESO in 1% of the patients. Tumors from patients with circulating Ab to ESO exhibited common characteristics, being mainly hormone receptor (HR)- invasive ductal carcinomas of high grade, including both HER2- and HER2+ tumors. In line with these results, we detected ESO expression in 20% of primary HR- BC, including both ESO Ab+ and Ab- patients, but not in HR+ BC. Interestingly, whereas expression levels in ESO+ BC were not significantly different between ESO Ab+ and Ab- patients, the former had, in average, significantly higher numbers of tumor-infiltrated lymph nodes, indicating that lymph node invasion may be required for the development of spontaneous anti-tumor immune responses. Thus, the presence of ESO Ab identifies a tumor subtype of HR- (HER2- or HER2+) primary BC with frequent ESO expression and, together with the assessment of antigen expression in the tumor, may be instrumental for the selection of patients for whom ESO-based immunotherapy may complement standard therapy. © 2011 Hamaï et al.

Redjimi N.,French Institute of Health and Medical Research | Duperrier-Amouriaux K.,French Institute of Health and Medical Research | Raimbaud I.,French Institute of Health and Medical Research | Luescher I.,University of Lausanne | And 8 more authors.
PLoS ONE | Year: 2011

Spontaneous CD4 + T-cell responses to the tumor-specific antigen NY-ESO-1 (ESO) are frequently found in patients with epithelial ovarian cancer (EOC). If these responses are of effector or/and Treg type, however, has remained unclear. Here, we have used functional approaches together with recently developed MHC class II/ESO tetramers to assess the frequency, phenotype and function of ESO-specific cells in circulating lymphocytes from EOC patients. We found that circulating ESO-specific CD4 + T cells in EOC patients with spontaneous immune responses to the antigen are prevalently T H1 type cells secreting IFN-γ but no IL-17 or IL-10 and are not suppressive. We detected tetramer + cells ex vivo, at an average frequency of 1:25000 memory cells, that is, significantly lower than in patients immunized with an ESO vaccine. ESO tetramer + cells were mostly effector memory cells at advanced stages of differentiation and were not detected in circulating CD25 +FOXP3 +Treg. Thus, spontaneous CD4 + T-cell responses to ESO in cancer patients are prevalently of T H1 type and not Treg. Their relatively low frequency and advanced differentiation stage, however, may limit their efficacy, that may be boosted by immunogenic ESO vaccines. © 2011 Redjimi et al.

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