Time to definitive health-related quality of life score deterioration in patients with resectable metastatic colorectal cancer treated with folfox4 versus sequential dose-dense folfox7 followed by folfiri: The mirox randomized phase III trial
Hamidou Z.,National Clinical Research Platform for Quality of Life in Oncology |
Hamidou Z.,College de France |
Chibaudel B.,Saint Antoine Hospital |
Hebbar M.,Lille University Hospital Center |
And 8 more authors.
PLoS ONE | Year: 2016
Purpose We previously showed that a sequential chemotherapy with dose-dense oxaliplatin (FOL-FOX7) and irinotecan (FOLFIRI; irinotecan plus 5-fluorouracil/leucovorin) is not superior to FOLFOX4 in patients at advanced stage of colorectal cancer with liver metastases. Here we aimed to determine whether time to health-related quality of life (HRQoL) score definitive deterioration (TUDD) differs by study arm. Methods HRQoL was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 at baseline and every 4 cycles until the end of the study or death. Functional scale, symptom scale, global health status, and financial difficulties were analyzed. The TUDD was defined as the time interval between randomization and the first decrease in HRQoL score ≥ 5-point with no further improvement in HRQoL score ≥ 5 points or any further HRQoL data. TUDD was estimated using the Kaplan-Meier method and the long-rank test. Cox regression analyses were used to identify HRQoL items influencing TUDD. Sensitivity analyses were done using a multiple imputation method and different definitions of TUDD. Results Of the 284 patients, 171 (60.2%) completed HRQoL questionnaires. Cox multivariate analysis showed no statistically significant difference in TUDD for most of the QLQ-C30 scales between treatments. Patients with dyspnea and those without symptoms at baseline had a significantly longer TUDD when there was a delay >12 months between diagnosis of the primary tumor and metastases (HR 0.48 [0.26-0.89]) and when there was diarrhea (HR 0.59 [0.36-0.96]), respectively. Conclusion This study shows that TUDD does not differ significantly according to type of treatment. The TUDD method produces meaningful longitudinal HRQoL results that may facilitate effective clinical decision making in patients with mCRC. © 2016 Hamidou et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Lledo G.,Private Hospital Jean Mermoz |
Huguet F.,Groupe Cooperateur Multidisciplinaire en Oncologie GERCOR |
Huguet F.,University Pierre and Marie Curie |
Chibaudel B.,Groupe Cooperateur Multidisciplinaire en Oncologie GERCOR |
And 14 more authors.
European Journal of Cancer | Year: 2016
Background To determine efficacy and toxicity of radiation therapy combined with oxaliplatin, 5-fluorouracil, and folinic acid (FOLFOX) and cetuximab in patients with locally advanced oesophageal cancer. Patients and methods Patients with stage III oesophageal or gastro-oesophageal junction cancer were enrolled in a Simon's two-stage phase II study. Patients received FOLFOX and weekly cetuximab on week 1-10 with concurrent radiotherapy (50.4 Gy in 30 fractions) on week 5-10. Primary end-point was clinical overall response rate (ORR). An ORR rate of more than 50% was expected. Results Among the 79 included patients, clinical ORR was 77% with 40% complete responses. Median overall survival and progression-free survival were 21.6 and 11.3 months, respectively. The most common grade III-IV toxicities observed during experimental chemoimmunotherapy followed by chemoradiation included neutropenia (28%), oesophagitis (12%), rash (11%), and allergy (9%). There was one treatment-related death due to oesophagitis with gastrointestinal bleeding. Conclusions Cetuximab-FOLFOX regimen combined with radiotherapy demonstrated its efficacy and was well tolerated. Unfortunately, these results were not confirmed in two recent phase III studies. © 2015 Elsevier Ltd. All rights reserved.
DNA mismatch repair and BRAF status in colorectal cancer: Interest for the therapeutic management? [Statuts MMR et BRAF dans les cancers colorectaux : Intérêts pour la prise en charge thérapeutique ?]
Cohen R.,University Paris Est Creteil |
Cervera P.,University Paris Est Creteil |
Svrcek M.,University Paris Est Creteil |
Svrcek M.,French Institute of Health and Medical Research |
And 12 more authors.
Bulletin du Cancer | Year: 2015
Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in France. Recently, colorectal cancer subtyping consortium (CRCSC) identified 4 consensus molecular subtypes (CMS). CMS1 is enriched for CRC with deficient DNA mismatch repair system (dMMR) and tumors with mutated BRAF. Intriguingly, CMS1 is characterized by better relapse-free survival but worse survival after relapse, compared with the other subtypes. In this review, we provide a comprehensive overview of prognostic and predictive impacts of MMR and BRAF status. We highlight immune checkpoints inhibitors as potentially future therapeutics for CRC with deficient MMR. We also focus on the management of BRAF mutant metastatic CRC, with a particular interest on targeted therapies. © 2015 Société Française du Cancer. Publié par Elsevier Masson SAS.